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  • 1
    Electronic Resource
    Electronic Resource
    Interleukin 10 Release During Endotoxaemia in Chimpanzees: Role of Platelet-Activating Factor and Interleukin 6 (1996)
    Oxford, U.K. and Cambridge, USA : Blackwell Science Ltd
    Scandinavian journal of immunology 43 (1996), S. 0 
    Details
    ISSN: 1365-3083
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Interleukin (IL-)10 has been demonstrated to inhibit endotoxin-induced production of a number of pro-inflammatory cytokines. The present study sought to compare the appearances in the circulation of IL-10, IL-6 and IL-8, and to assess the roles ofendogenously produced platelet-activating factor (PAF) and IL-6 in IL-10 release during endotoxaemia in chimpanzees. Intravenous injection of endotoxin (lot EC-5, 4 ng/kg, n = 8) induced a transient rise in serum IL-10concentrations, peaking after 2 h (213 ± 70 pg/ml; P 〈 0.05). No correlations existed between peak IL-10 levels, and peak IL-6 and IL-8 levels. Neither infusion of the specific PAF antagonist TCV-309(n = 4), nor infusion of a neutralizing anti-IL-6 monoclonal antibody (n = 4) influenced endotoxin-induced IL-10 release. IL-10 release elicited by injection of endotoxin is not mediated by PAF or IL6. Tom van der Poll MD, Academic Medical Center, Department of Internal Medicine, F4222, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-3083.1996.d01-12.x
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  • 2
    Electronic Resource
    Electronic Resource
    Effects of anti-tumour necrosis factor-α therapy on the quality of life in Crohn's disease (2002)
    Oxford, UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 16 (2002), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background : Infusion of anti-tumour necrosis factor-α appears to be highly effective in patients with Crohn's disease.Aim : To assess the effect of infliximab on the quality of life in patients with active or fistulizing disease, as measured by the inflammatory bowel disease questionnaire, and to examine the impact on its four dimensions.Methods : An observational study was conducted in 65 patients. An infusion of 5 mg/kg infliximab was given at week 0 in patients with active disease and at week 0, 2 and 6 in fistulizing disease. Changes from baseline in the total and dimensional inflammatory bowel disease questionnaire scores were calculated and compared between the patient groups. Potential predictors of change in the quality of life were identified.Results : In the active disease group, at week 4, the mean total and dimensional inflammatory bowel disease questionnaire scores improved compared to baseline (P 〈 0.001). In the fistulizing group, at week 6, all scores changed from baseline (P 〈 0.05). Improvement in the total inflammatory bowel disease questionnaire score correlated well with the improvement of the Crohn's disease activity index. Systemic and social scores improved more than bowel and emotional scores. Inflammatory Crohn's disease and a young age at diagnosis were predictors for a better response to infliximab therapy.Conclusions : Infliximab therapy improves all dimensions of the quality of life in patients with Crohn's disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2002.01268.x
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  • 3
    Electronic Resource
    Electronic Resource
    Meningococcal disease: a comparison of eight severity scores in 125 children (1996)
    Springer
    Intensive care medicine 22 (1996), S. 1433-1441 
    Details
    ISSN: 1432-1238
    Keywords: Key words Meningococcal disease ; Meningococcal meningitis ; Meningococcal septic shock ; Sepsis ; Severity of illness index ; Mortality rate ; Prognostication
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: To investigate the accuracy of eight different prognostic scores (Stiehm, Niklasson, Leclerc, Garlund, the MOC score, Tesero, the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) and Tüyzüs) in the prediction of fatal outcome in meningococcal disease. Design: Combined prospective and retrospective study. Setting: A 175-bed pediatric department of a university hospital providing secondary care to ±180,000 inhabitants and serving as a referral center. The Pediatric Intensive Care (14 beds) is one of the six PICUs in the Netherlands and provides tertiary care for children under 18 years. Patients: During an 8-year period (1986–1994) 125 children (mean age 4 years, 10 months) with culture- proven meningococcal disease were studied: 34 patients presenting with meningitis, 33 patients with septic shock and 58 patients with meningitis and septic shock. Main results: All eight scores discriminated above average between survivors and non-survivors, as expressed by the corresponding Receiver Operator Characteristic (ROC) curves. The area under the ROC curve (AUC) ranged from 0.74 for the Garlund score to 0.93 for the GMSPS. The GMSPS performed significantly better than its competitors, even after exclusion of the base deficit as one of the score components (AUC=0.92). It showed above average calibration when logistically transformed into a probability of mortality, and accurately identified a subgroup of patients with no mortality. None of the scores correctly identified non-survivors. Conclusion: The GMSPS is a simple score that can be reliably used for risk classification and the identification of low-risk patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01709565
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  • 4
    Electronic Resource
    Electronic Resource
    Neutrophil adhesion molecules and MOF (1997)
    Springer
    Intensive care medicine 23 (1997), S. 487-488 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050362
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  • 5
    Electronic Resource
    Electronic Resource
    Increased oxygen consumption after cardiac surgery is associated with the inflammatory response to endotoxemia (1996)
    Springer
    Intensive care medicine 22 (1996), S. 294-300 
    Details
    ISSN: 1432-1238
    Keywords: Key words Oxygen consumption ; Endotoxemia ; Tumor necrosis factor ; Interleukin-6 ; Hypermetabolism ; Post-perfusion syndrome ; Cardiac surgery
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: The aim of this study was to determine whether the increase in post-operative oxygen consumption (ΔVO2) in cardiac surgery patients is related to endotoxemia and subsequent cytokine release and whether ΔVO2 can be used as a parameter of post-perfusion syndrome. Design: Prospective study. Setting: Operating room and intensive care unit of a university hospital. Patients: Twenty-one consecutive male patients undergoing elective coronary artery bypass surgery without major organ dysfunction and not receiving corticosteroids. Measurements and results: Plasma levels of endotoxin, tumor necrosis factor (TNF) and interleukin-6 (IL-6) were measured before, during and for 18 h after cardiac surgery. Oxygen consumption, haemodynamics, the use of IV fluids and dopamine, body temperature and the time of extubation were also measured. Measurements from patients with high ΔVO2 (≥median value of the entire group) were compared with measurements from patients with low ΔVO2 (〈median). Patients with high ΔVO2 had higher levels of circulating endotoxin (P=0.004), TNF (P=0.04) and IL-6 (P=0.009) received more IV fluids and dopamine while in the ICU, and were extubated later than patients with low ΔVO2. Several hours after ΔVO2 the patient‘s body temperature rose. Forward stepwise regression analysis showed that circulating endotoxin and TNF explained 50% of the variability of ΔVO2. Conclusions: This study demonstrates that patients with high post operative oxygen consumption after elective cardiac surgery have higher circulating levels of endotoxin, TNF and IL-6 and also have more symptoms of post-perfusion syndrome. Early detection of high VO2 might be used as a clinical signal to improve circulation in order to meet the high oxygen demand of inflammation. In addition, continuous measurement of VO2 provides us with a clinical parameter of inflammation in interventional studies aiming at a reduction of endotoxemia or circulating cytokines.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01700449
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  • 6
    Electronic Resource
    Electronic Resource
    Is G-CSF safe and useful in the treatment of infectious diseases in the non-neutropenic host? (1997)
    Springer
    Intensive care medicine 23 (1997), S. 1-2 
    Details
    ISSN: 1432-1238
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340050282
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  • 7
    Electronic Resource
    Electronic Resource
    Cytokine and cytokine receptor polymorphisms in infectious disease (2000)
    Springer
    Intensive care medicine 26 (2000), S. S098 
    Details
    ISSN: 1432-1238
    Keywords: Key words Crohn's disease ; Intestinal mucosa ; Interleukin-10 ; Tumor necrosis factor ; ¶T-lymphocytes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Host immune responses strongly control the outcome of infectious disease, and the resistance to bacterial infections in humans is in part genetically determined. Responses to Gram-negative bacterial endotoxin are affected by the concentration of plasma lipoproteins and lipid transport proteins that are genetically controlled. Alterations of plasma lipid profiles by genetic manipulation in mice indeed strongly modify resistance to bacterial infections. Recently, the TLR-4 receptor has been identified as the endotoxin receptor, and TLR-4 mutations are the cause of endotoxin resistance in mice. It is probable that such defects also exist in humans, although they must be rare. The capacity of monocytes to produce TNFα varies more than tenfold, and several polymorphisms within the TNFα gene have been associated with increased TNFα production and increased mortality of sepsis. However, these associations most likely result from linkage disequilibrium with other immune response genes on chromosome 6. Polymorphisms within the IL-1β and the IL-1RA genes (located on chromosome 2) are associated with altered protein production rates, and certain haplotypes have been linked to inflammatory disease (no studies in bacterial infectious disease have been published). Mutations in the receptors for IL-12 and IFNγ, both critical for clearance of intracellular infectious pathogens, occur in consanguineous populations and are associated with severe recurrent infections with Salmonella species and mycobacteria.¶In conclusion, no human cytokine deficiency syndromes are known, and it remains uncertain whether genetically determined differences in the production rate of pro-inflammatory cytokines alter the outcome of sepsis. In contrast, mutations in the IL-12 and IFNγ receptor (and possibly the endotoxin receptor) genes are associated with recurrent bacterial infections, whereas TNFR1 mutations cause fever of unknown origin.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001340051125
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  • 8
    Electronic Resource
    Electronic Resource
    Inflammatory bowel disease and the genes for the natural resistance-associated macrophage protein-1 and the interferon-Á receptor 1 (1999)
    Springer
    International journal of colorectal disease 14 (1999), S. 13-17 
    Details
    ISSN: 1432-1262
    Keywords: Key words Crohn's disease ; Inflammatory bowel disease ; Interferon-γ receptor1 ; Natural resistance associated macrophage protein-1 ; Polymorphisms ; Ulcerative colitis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The genes for the interferon-γ receptor1 and the natural resistance-associated macrophage protein1 (NRAMP1) control the immune response to intracellular microbial pathogens. Such pathogens, in particular Mycobacterium paratuberculosis, have been implicated in the pathogenesis of Crohn's disease. We studied markers in the genes for NRAMP1 and two mutations in the interferon-γ receptor in relation to inflammatory bowel disease (IBD) in the following groups: 270 healthy individuals, 74 patients with Crohn's disease, 72 patients with ulcerative colitis, and 40 patients with primary sclerosing cholangitis. We studied the allele frequencies of two restriction fragment length polymorphisms in the gene for NRAMP1 and the prevalence of two mutations in the interferon-γ receptor1 gene. The markers in the NRAMP1 gene were not associated with inflammatory bowel disease. Also, the mutations in the interferon-γ receptor1 were not found in the 186 IBD patients. Genetic markers in NRAMP1 are thus not associated with IBD. Therefore this gene is not likely to play a role in the pathogenesis of IBD. The mutation in the interferon-γ receptor was not found in our IBD patients group.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003840050177
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  • 9
    Electronic Resource
    Electronic Resource
    Laparoscopic-assisted vs open ileocolic resection for Crohn's disease (2000)
    Springer
    Surgical endoscopy and other interventional techniques 14 (2000), S. 721 -725 
    Details
    ISSN: 1432-2218
    Keywords: Key words: Laparoscopy — Ileocolic resection — Crohn's disease — Distal ileum — Small bowel
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: The objective of this study was to compare laparoscopic-assisted ileocolic resection for Crohn's disease of the distal ileum with open surgery in two consecutive groups of patients. Methods: From 1995 until 1998, 48 patients underwent open ileocolic resection at the Academic Medical Center (AMC) in Amsterdam, while 30 patients had laparoscopic-assisted ileocolic resection at the Leiden University Medical Center (LUMC). Patient characteristics, perioperative course, and recovery were compared. Differences between the groups were tested using Student's t-test for independent groups and chi-square tests when appropriate. Results: The open and the laparoscopic patient groups were comparable for age, gender, body mass index (BMI), prior abdominal surgery, and length of resected bowel. The conversion rate was 6.6%. Laparoscopic operating times (138 ± SD 36 min) were significantly longer than those observed in the open group (104 ± SD 34 min). Discharge was significantly earlier in the laparoscopic group than the open group (5.7 vs 10.2 postoperative days, p 〈 0.007). Postoperative morbidity did not differ significantly between the patients treated traditionally (14.6%) and laparoscopically (10%). Conclusion: Compared to open surgery, laparoscopic ileocolic resection for Crohn's disease is associated with similar morbidity rates, a shorter hospital stay, and improved cosmetic results, justifying the laparoscopic approach as the procedure of choice.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s004640000186
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  • 10
    Electronic Resource
    Electronic Resource
    Cytokines and host defense in pneumonia (1999)
    Springer
    Intensivmedizin und Notfallmedizin 36 (1999), S. 270-275 
    Details
    ISSN: 1435-1420
    Keywords: Schlüsselwörter Pneumonie ; Entzündung ; Zytokine ; Key words Pneumonia ; inflammation ; cytokines
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Summary In pneumonia the initiation, maintenance, and resolution of inflammation is dependent upon the complex network of pro-inflammatory and anti-inflammatory cytokines. Much of our knowledge of the role of cytokines in the pathogenesis of pneumonia is derived from animal studies on experimental pneumonia. In contrast to systemic infection, where excessive production of pro-inflammatory cytokines is detrimental, causing organ failure and death, local production of pro-inflammatory cytokines is necessary for host defense against the invasive pathogen. Conversely, the anti-inflammatory cytokine IL-10 impairs host defense in local infections like pneumonia, while it protects against excessive immune activation, like sepsis. Studies on the role of cytokines in pneumonia in humans and animals are discussed in detail.
    Notes: Zusammenfassung Bei einer Pneumonie hängen das Aufkommen, das Fortbestehen und der Ausgang einer Entzündung von einem komplexen Netzwerk pro- und anti-entzündliche Zytokine ab. Vieles, was wir über die Rolle der Zytokine in der Pathogenese der Pneumonie wissen, wurde in tierexperimentellen Pneumoniestudien erhoben. Gegenüber systemischen Infektionen, in welchen eine Überproduktion der pro-entzündlichen Zytokine schädlich ist und zum Organversagen und zum Tod führt, ist eine lokale Produktion von pro-entzündlichen Zytokinen notwendig zur Immuna-Abwehr gegen die invasiven Erreger. Umgekehrt hindert das anti-entzündliche Zytokin IL-10 die Host-Abwehr bei lokalen Infekten wie der Pneumonie, während es gegen einer übermäßige Immunaktivierung, wie Sepsis, schützt. Studien über die Rolle der Zytokine bei einer Pneumonie bei Mensch und Tier werden ausführlich diskutiert.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s003900050238
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