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Biomedical subjects

M Tanner

Publications and source records attributed to M Tanner.

At least 145 records · Page 8Linked to original sources
PubMed1998

[Swarms of starlings in Basel: a natural phenomenon, a nuisance or a health risk?].

A Natural Phenomenon, Molestation or a Health Risk? For the last two decades an avenue in the centre of Basel (Altrheinweg, Klybeckquartier) is known as site for overnight accommodation and assembly of starlings (Sturnus vulgaris) during autumn. The nightly visitors cause an immense contamination that directly affects a nursery and a primary school. The aim of the present study was the evaluation of the health risk for the population due to the starlings' droppings, particularly for the children from the nursery school. Between August and December of the years 1995 and 1996 the population of starlings was observed, the contamination of the area with faeces was quantified, the presence of microorganisms in the faeces was determined and the contamination of the soil from the Altrheinweg was compared with that from other avenues and parks. Furthermore, the children attending the nursery school were monitored for possible infections due to the birds' droppings. In mid-October, when the population of starlings reached their maximum of about 15,000 birds, 1053 defecations per night and square metre were counted on an average in 1995 and 1821 in 1996. The microbiological analysis of the starlings' faeces showed a high contamination with Campylobacter spp. (1995: 95.5%; 1996: 100%), L. monocytogenes (1995: 36.5%; 1996: 26.7%) and C. psittaci (1995: 40.5%), a lower contamination with Salmonella spp. (1995: 1.0%), S. aureus (1995: 2.0%), Y. enterocolitica (1995: 1.5%) and Y. pseudotuberculosis (1995: 1.0%). Mycotic and parasitic human pathogens were not found. The contamination of the soil from the Altrheinweg with Campylobacter spp. and L. monocytogenes was significantly greater than that of the other avenues and parks in Basel. However, the investigations conducted by the school medical service showed that no infections among the children attending the nursery school could be correlated to the presence of the starlings. Even if the heavy contamination of the area with droppings of starlings presents a potential health risk, a continuous or systematic transmission of infectious agents seems rather improbable due to the contamination-avoiding behaviour of the children, the characteristics of the microorganisms involved and the climatic conditions in autumn. This situation showed however not reduce our awareness of such a potential health risk.

Animals↗
PubMed1998

[Use of a questionnaire for quick identification of the principal foci of urinary bilharziasis in central Ivory Coast].

Simple questionnaires designed for use in schools have been used to identify communities at high risk for urinary schistosomiasis in several African countries but not in the Cote d'Ivoire. The primary purpose of this study was to assess the acceptance and feasibility of the school questionnaire approach in the Cote d'Ivoire. Questionnaires were distributed to 136 schools in central Cote d'Ivoire. Responses were obtained within 6 weeks from 124 schools (91.2%). A total of 12,479 school children were interviewed. At 60 schools, reagent stick tests were performed within two weeks to detect microhematuria by trained teachers. A biomedical team was sent to 14 selected schools to check results by reagent stick testing and urine filtration. Reagent stick tests showed high specificity (97%) and moderate sensitivity (67%). A strong statistical correlation was observed between responses to two key questions concerning "blood in urine" and "having had schistosomiasis" and the results of reagent stick testing (Spearman rank correlation, p < 0.0001). Our findings are in good agreement with previous reports. Using the data obtained, we were able to accurately map the distribution of urinary schistosomiasis in the study area. Use of this questionnaire for quick identification of high risk communities for urinary schistosomiasis was recommended as a preliminary step in the planned national control program and should allow better targeted of scarce resources.

Child↗
PubMed1998

Field activity cost estimates for the first 3 years of the World Bank Loan Project for schistosomiasis control in China.

The World Bank Loan Project for schistosomiasis in China commenced field activities in 1992. In this paper, we describe disease control strategies for levels of different endemicity, and estimate unit costs and total expenditure of screening, treatment (cattle and humans) and snail control for 8 provinces where Schistosoma japonicum infection is endemic. Overall, we estimate that more than 21 million US dollars were spent on field activities during the first three years of the project. Mollusciciding (43% of the total expenditure) and screening (28% of the total) are estimated to have the most expensive field activities. However, despite the expense of screening, a simple model predicts that selective chemotherapy could have been cheaper than mass chemotherapy in areas where infection prevalence was higher than 15%, which was the threshold for mass chemotherapy intervention. It is concluded that considerable cost savings could be made in the future by narrowing the scope of snail control activities, redefining the threshold infection prevalence for mass chemotherapy, defining smaller administrative units, and developing rapid assessment tools.

Animals↗
PubMed1998

Molecular cytogenetics of primary breast cancer by CGH.

Comparative genomic hybridization (CGH) reveals DNA sequence copy number changes that are shared among the different cell subpopulations present in a tumor and may help to delineate the average progression pathways of breast cancer. Previous CGH studies of breast cancer have concentrated on selected subgroups of breast cancer. Here, 55 unselected primary breast carcinomas were analyzed using optimized quality-controlled CGH procedures. Gains of 1q (67%) and 8q (49%) were the most frequent aberrations. Other recurrent gains were found at 33 chromosomal regions, with 16p, 5p12-14, 19q, 11q13-14, 17q12, 17q22-24, 19p, and 20q13 being most often (> 18%) involved. Losses found in > 18% of the tumors involved 8p, 16q, 13q, 17p, 9p, Xq, 6q, 11q, and 18q. The total number of aberrations per tumor was highest in poorly differentiated (P = 0.01) and in DNA aneuploid (P = 0.05) tumors. The high frequency of 1q gains and presence of +1q as the sole abnormality suggest that it is an early genetic event. In contrast, gains of 8q were most common in genetically and phenotypically advanced breast cancers. The vast majority of breast cancers (80%) have gains of 1q, 8q, or both, and 3 changes (+1q, +8q, or -13q) account for 91% of the tumors. In conclusion, CGH results indicate that certain chromosomal imbalances are very often selected for, sometimes in a preferential order, during the progression of breast cancer. Further studies of such common changes may form the basis for a molecular cytogenetic classification of breast cancer.

Adult↗
PubMed1997

Randomised placebo-controlled trial of iron supplementation and malaria chemoprophylaxis for prevention of severe anaemia and malaria in Tanzanian infants.

BACKGROUND: Malaria and anaemia, especially that due to iron deficiency, are two leading causes of morbidity worldwide. Little is known about the relative contribution of Plasmodium falciparum infection and iron deficiency to the aetiology of anaemia in malaria-endemic areas. We undertook a randomised comparison of different strategies for control of anaemia and malaria in infants, including an assessment of the effect of iron supplementation on malaria susceptibility. METHODS: 832 infants born at one hospital in a malaria-hyperendemic area of Tanzania between January and October, 1995, were randomly assigned to group DI, receiving daily oral iron (2 mg/kg daily) plus weekly Deltaprim (3.125 mg pyrimethamine plus 25 mg dapsone); group IP, receiving iron plus weekly placebo; group DP, receiving daily placebo plus weekly Deltaprim; or group PP. supplementation was given from 8 to 24 weeks of age, and the weekly chemoprophylaxis from 8 to 48 weeks. The frequency of severe anaemia (packed-cell volume < 25%) and malaria episodes was assessed through a combination of passive case detection and cross-sectional surveys. FINDINGS: The groups that received iron supplementation had a lower frequency of severe anaemia than those that did not receive iron (0.62 vs 0.87 cases per person-year; protective efficacy 28.8% [95% CI 6.3-45.8). Iron supplementation had no effect on the frequency of malaria (0.87 vs 1.00 cases per person-year; protective efficacy 12.8% [-12.8 to 32.5]). The groups that received malaria prophylaxis had lower frequencies of both severe anaemia (0.45 vs 1.04 episodes per person-year; protective efficacy 57.3% [43.0-67.9]) and malaria (0.53 vs 1.34 episodes per person-year; protective efficacy 60.5% [48.2-69.9]) than the groups that did not receive prophylaxis. After the end of the intervention period, children who had received malaria chemoprophylaxis had higher rates of severe anaemia and malaria than non-chemoprophylaxis groups (relative risks 2.2 [1.3-3.7] and 1.8 [1.3-2.6]). INTERPRETATION: Malaria chemoprophylaxis during the first year of life was effective in prevention of malaria and anaemia but apparently impaired the development of natural immunity. Iron supplementation was effective in preventing severe anaemia without increasing susceptibility to malaria. Our findings support iron supplementation of infants to prevent iron-deficiency anaemia, even in malaria-endemic areas.

Adult↗
PubMed1997

SDZ RAD, a new rapamycin derivative: synergism with cyclosporine.

BACKGROUND: SDZ RAD is a new rapamycin analog with potent immunosuppressive activity. Compounds of the rapamycin class differ in their mode of action from cyclosporine, thus providing a rationale for potential synergism of these two potent immunosuppressants. METHODS: The two-way mouse mixed lymphocyte reaction (BALB/c-CBA strain combination) was applied. Orthotopic kidney and heterotopic heart allografting was performed in the stringent DA-to-Lewis rat strain combination, with administration of compounds orally as microemulsion preconcentrate (i.e., Neoral in the case of cyclosporine). RESULTS: Isobologram analysis of checkerboard titrations of SDZ RAD and cyclosporine in two-way mouse mixed lymphocyte reactions indicates a synergistic interaction in vitro. In vivo, the minimal effective dose of microemulsion cyclosporine giving long-term graft survival was 5.0 mg/kg/day; for SDZ RAD, the minimal effective dose was 5.0 mg/kg/day in kidney transplantation and >5.0 mg/kg/day in heart transplantation. Long-term allograft survival was noted for combinations of microemulsion cyclosporine administered at 1.0 or 2.0 mg/kg/day and SDZ RAD given at between 0.5 and 2.0 mg/kg/day. The index of synergy in different combinations ranged between 0.3 and 0.7. CONCLUSIONS: SDZ RAD and cyclosporine show synergism in immunosuppression, both in vitro and in vitro. They form a promising synergistic drug combination in allotransplantation.

Animals↗
PubMed1997

[Asylum seekers and refugees in ambulatory health care: communication between physician and patient].

Communication between asylum seekers/refugees and general practitioners/physicians of the three main outpatient sectors for the Swiss national Health System (general practice, medical outpatient and accident & emergency departments) are being described and analysed. The data have been collected during three cross-sectional studies investigating the health status of asylum seekers and refugees and the health services provided to them. These studies addressed the problem exclusively from the point of view of the health care providers. Data on language capabilities, sociocultural aspects of communication and the necessity and availability of interpreters have been collected with questionnaires. The main results of the questionnaires have been followed up in group discussions with general practitioners. The majority of general practitioners/physicians felt that most of the communication problems were related to speaking a common language. Only about one out of two adult asylum seekers/refugees knew German, French, Italian or English. Particularly during the group discussions it was brought forward that cultural and social factors additionally complicate communication during patient-doctor interactions. When the data of the outpatient consultations of the main studies were analysed, it became obvious that interpreters were significantly more often present in consultations with patients with psychological/psychosocial diagnoses than those with somatic diagnoses (72% vs. 55%). This can be interpreted in two ways: (1) if a patient suffers from a psychological/psychosocial problem, it is more likely that an interpreter will be asked to assist during the consultation or (2) if an interpreter is present during a consultation, it is more likely that a psychological/psychosocial problem will be detected. With the exception of children, most of the general practitioners/physicians felt that non-professional interpreters (relatives, friends) were adequate for coping with most of the tasks. The following areas for improvements were identified: (1) availability of professional interpreters and quality as well as organisational issues related to interpretation, (2) language training for asylum seekers and refugees and (3) creation of awareness among general practitioners/physicians towards cultural and socioeconomic determinants of patient-doctor interactions and training.

Adult↗
PubMed1997

Genetic heterogeneity and clonal evolution underlying development of asynchronous metastasis in human breast cancer.

To understand the genetic basis and clonal evolution underlying metastatic progression of human breast cancer in vivo, we analyzed the genetic composition of 29 primary breast carcinomas and their paired asynchronous metastases by comparative genomic hybridization and fluorescence in situ hybridization. The mean number of genetic changes by comparative genomic hybridization was 8.7 +/- 5.3 in primary tumors and 9.0 +/- 5.7 in their metastases. Although most of the genetic changes occurred equally often in the two groups, gains of the Xq12-q22 region were enriched in the metastases. According to a statistical analysis of shared genetic changes and breakpoints in paired specimens, 20 of the metastases (69%) showed a high degree of clonal relationship with the corresponding primary tumor, whereas the genetic composition of 9 metastases (31%) differed almost completely from that of the paired primary tumors. In both groups, however, chromosome X inactivation patterns suggested that the metastatic lesions originated from the same clone as the primary tumor. Fluorescence in situ hybridization analysis with probes specific to metastatic clones usually failed to find such cells in the primary tumor sample. In conclusion, detailed characterization of the in vivo progression pathways of metastatic breast cancer indicates that a linear progression model is unlikely to account for the progression of primary tumors to metastases. An early stem line clone apparently evolves independently in the primary tumor and its metastasis, eventually leading to multiple, genetically almost completely different, clones in the various tumor locations in a given patient. The resulting heterogeneity of metastatic breast cancer may underlie its poor responsiveness to therapy and explain why biomarkers of prognosis or therapy responsiveness measured exclusively from primary tumors give a restricted view of the biological properties of metastatic breast cancer.

Adenocarcinoma↗
PubMed1997

Distinct somatic genetic changes associated with tumor progression in carriers of BRCA1 and BRCA2 germ-line mutations.

BRCA1 and BRCA2 mutations confer increased risk for development of breast cancer, but a number of additional, currently largely unknown, somatic genetic defects must also accumulate in the breast epithelial cells before malignancy develops. To evaluate the nature of these additional somatic genetic defects, we performed a genome-wide survey by comparative genomic hybridization on breast cancers from 21 BRCA1 mutation carriers, 15 BRCA2 mutation carriers, and 55 unselected controls. The total number of genetic changes was almost two times higher in tumors from both BRCA1 and BRCA2 mutation carriers than in the control group. In BRCA1 tumors, losses of 5q (86%), 4q (81%), 4p (64%), 2q (40%), and 12q (40%) were significantly more common than in the control group (7-13%). BRCA2 tumors were characterized by a higher frequency of 13q (73%) and 6q (60%) losses and gains of 17q22-q24 (87%) and 20q13 (60%) as compared to the prevalence of these changes in the control group (12-18%). In conclusion, accumulation of somatic genetic changes during tumor progression may follow a unique pathway in individuals genetically predisposed to cancer, especially by the BRCA1 gene. Activation or loss of genes in the affected chromosomal regions may be selected for during tumor progression in cells lacking functional BRCA1 or BRCA2. Identification of such genes could provide targets for therapeutic intervention and early diagnosis.

Adult↗
PubMed1997

Genetic aberrations in pediatric acute lymphoblastic leukemia by comparative genomic hybridization.

Classical cytogenetic analysis plays an important role in the diagnosis and classification of childhood acute lymphoblastic leukemia (ALL). However, poor in vitro growth of the malignant cells and suboptimal quality of metaphase spreads may sometimes cause false-negative findings (normal karyotype). We used comparative genomic hybridization (CGH) to study whether this new method is able to detect and characterize genetic aberrations not detected by karyotyping. CGH showed clonal genetic aberrations in 8 of 13 cases, most of which showed gains of several chromosomes, indicating hyperdiploidy. The sensitivity of CGH was sufficient to detect a small interstitial deletion of 6q. One karyotypically complex case was resolved by CGH showing a high-level amplification of DNA sequences originating from the 12p12-13. Interphase fluorescence in situ hybridization (FISH) analyses confirmed the CGH findings in 2 cases, validating the accuracy of CGH. In conclusion, CGH experiments established the known fact that hyperdiploidy is the most common finding in pediatric ALLs and that CGH may detect aberrations that are not seen in the G-banded karyotype. CGH was also able to further characterize genetic aberrations such as gene amplification, which is occasionally involved in pediatric ALL as well as in other leukemias.

Child↗
PubMed1997

Resistance to antifolates in Plasmodium falciparum monitored by sequence analysis of dihydropteroate synthetase and dihydrofolate reductase alleles in a large number of field samples of diverse origins.

Resistance of Plasmodium falciparum to antifolate chemotherapy is a significant problem where combinations such as Fansidar (pyrimethamine-sulfadoxine; PYR-SDX) are used in the treatment of chloroquine-resistant malaria. Antifolate resistance has been associated with variant sequences of dihydrofolate reductase (DHFR) and dihydropteroate synthetase (DHPS), the targets of PYR and SDX respectively. However, while the nature and distribution of mutations in the dhfr gene are well established, this is not yet the case for dhps. We have thus examined by DNA sequence analysis 141 field samples from several geographical regions with differing Fansidar usage (West and East Africa, the Middle East and Viet Nam) to establish a database of the frequency and repertoire of dhps mutations, which were found in 60% of the samples. We have also simultaneously determined from all samples their dhfr sequences, to better understand the relationship of both types of mutation to Fansidar resistance. Whilst the distribution of mutations was quite different across the regions surveyed, it broadly mirrored our understanding of relative Fansidar usage. In samples taken from individual patients before and after drug treatment, we found an association between the more highly mutated forms of dhps and/or dhfr and parasites that were not cleared by antifolate therapy. We also report a novel mutation in a Pakistani sample at position 16 of DHFR (A16S) that is combined with the familiar C59R mutation, but is wild-type at position 108. This is the first observation in a field sample of a mutant dhfr allele where the 108 codon is unchanged.

Africa↗
PubMed1997

Analysis of multiple Plasmodium falciparum infections in Tanzanian children during the phase III trial of the malaria vaccine SPf66.

In the first phase III efficacy trial of the malaria vaccine SPf66 in Africa, MOIs in SPf66- and placebo-vaccinated children were analyzed by polymerase chain reaction-restriction fragment length polymorphism of the Plasmodium falciparum merozoite surface antigen 2 (MSA2). MOIs were significantly reduced in asymptomatic vaccine recipients compared with those in asymptomatic placebo recipients; however, no differences were observed among symptomatic children in the vaccine and control groups. These results show that immunization with SPf66 modulates the course of naturally occurring infections, as reflected by reduced MOIs. In placebo recipients, however, there was a significant negative correlation between numbers of infecting genotypes, as identified by MSA2, and morbidity. Asymptomatic placebo recipients had an average of 5 concurrent infections, whereas children with clinical cases had an average of 3.4 infections. These data provide further evidence that premunition from concurrent infections is important in immunity against clinical malaria. No such effect of multiple infections was found in the vaccinated group.

Animals↗
PubMed1997

The role of low level Plasmodium falciparum parasitaemia in anaemia among infants living in an area of intense and perennial transmission.

Children under one year of age in an area of intense and perennial Plasmodium falciparum transmission were followed up for one year to establish to what extent chronic, low parasitaemia was associated with severe anaemia. There was a significant increase in the prevalence of anaemia (PCV < or = 25%) with increase in parasite density. PCV levels were related not only to concurrent parasite density but also decreased with densities measured one month previously. At any point in time, the mean PCV level in infants with low parasitaemia (< 1000 parasites/microliter) was higher than that of infants with intermediate (1000-9999/microliter) and high parasite densities (> or 10000/microliter). After the age of 7 months, infants with low parasite densities tend to recover, probably as a result of developing immunity. At the age of 12 months, they have similar PCV levels to infants with no detectable parasitaemia by microscopy. The maintenance of low parasite density appears crucial to the survival of infants in malaria endemic areas. The findings suggest that interventions which lower parasite densities in areas of intense transmission reduce the development of severe malarial anaemia and thus malaria-related mortality and morbidity in infants.

Anemia↗
PubMed1997

MRP 8/14 as marker for Plasmodium falciparum-induced malaria episodes in individuals in a holoendemic area.

Presence of Plasmodium falciparum parasites in the peripheral blood of patients in a holoendemic area does not necessarily show that their illness is due to malaria. The aim of the present project was therefore to look for biological markers related to symptomatology or clinical events during a malaria episode. We focused our work on a complex of heterodimeric calcium-binding proteins secreted by stimulated neutrophils and monocytes, named MIF or myeloid-related proteins (MRP 8/14). In a longitudinal study including 51 adults from Ifakara, Tanzania (84.7% prevalence for P. falciparum in adults during the study), the level of MRP 8/14 in the serum was significantly related to the parasite load (Spearman correlation coefficient, 0.52; P < 0.0001). In the serum from children up to 6 years admitted at a health post the MRP 8/14 levels were closely related to parasitemia but also to fever episodes (Spearman correlation coefficients, 0.96 and 0.736; P < 0.0001 and P < 0.001, respectively). Although not specific to malaria, the measurement of MRP 8/14 could be an additional tool in assessing malaria-related morbidity.

Adolescent↗
PubMed1997

Genetic changes in intraductal breast cancer detected by comparative genomic hybridization.

Ductal carcinoma in situ (DCIS) is considered a direct precursor of invasive ductal breast cancer (IDC). We combined tissue microdissection and comparative genomic hybridization to identify genetic changes in five DCIS lesions with no invasion and in two that were adjacent to IDC. Extensive genetic changes characterized pure DCIS cases with gains of 1q, 6q, 8q, and Xq as well as losses of 17p and chromosome 22 being most often involved. Except for the Xq gain, these changes are also common to IDC. Separate analysis of DCIS and IDC components in the same tumor revealed an almost identical pattern of genetic changes in one case, whereas substantial differences were found in another. We conclude that many of the common genetic changes in IDC may take place before development of invasive growth. However, a simple linear progression model may not always account for the DCIS-IDC transition.

Breast Neoplasms↗
PubMed1997

Optimizing DOP-PCR for universal amplification of small DNA samples in comparative genomic hybridization.

The standard comparative genomic hybridization (CGH) protocol relies on availability of macroscopic tumor samples, which do not contain too much interfering normal cells. Recently, CGH after universal amplification of genomic DNA with degenerate oligonucleotide primed PCR (DOP-PCR) has been used to detect genetic aberrations in microdissected tumor specimens. However, owing to the technical difficulties, CGH results of only few microdissected samples have so far been published. We have developed an improved protocol for DOP-PCR, which includes direct incorporation of fluorochrome-conjugated nucleotides into the PCR product. Among the four polymerase enzymes tested. ThermoSequenase gave the best yield, with PCR products ranging from 100-4,000 bp. A two-step PCR-procedure was used, consisting of a preamplification with low stringency conditions followed by amplification in more stringent conditions. The method was first validated by hybridizing DOP-PCR-amplified normal DNA against nick-translated reference DNA, which showed uniform amd even hybridization result for all chromosomes. Comparison of DOP-PCR CGH to conventional CGH in MCF-7 breast cancer cell line further indicated that genetic aberrations can be reliable detected after DOP-PCR amplification. The sensitivity of the DOP-PCR-CGH was tested by serial dilution of MCF-7 DNA. Fifty picograms of sample DNA (corresponding roughly to two MCF-7 cells) was sufficient for high quality CGH. Experiments with cells microdissected from intraductal breast cancer demonstrated that carcinoma cells from 1 to 2 ducts were sufficient for a successful DOP-PCR CGH analysis. We conclude that the improved DOP-PCR-CGH protocol provides a powerful tool to study genetic aberrations in different histological subpopulations of malignant as well as precancerous lesions. DOP-PCR also improves the success rate of conventional paraffin-block CGH, because a poor quality or a too low yield of extracted DNA can be compensated by universal DNA amplification by DOP-PCR.

DNA, Neoplasm↗