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PubMed2002

The Wisconsin Upper Respiratory Symptom Survey (WURSS): a new research instrument for assessing the common cold.

OBJECTIVE: To develop a sensitive, reliable, responsive, easy-to-use instrument for assessing the severity and functional impact of the common cold. STUDY DESIGN: We created an illness-specific health-related quality-of-life outcomes instrument. This original questionnaire was used in a 1999 randomized trial of echinacea for the common cold. In 2000 we used cognitive interview and focus group qualitative methods to further develop the instrument. Semistructured interviews used open-ended questions to elicit symptoms, terminology, and perceived functional impact. Responses were used to improve the instrument. POPULATION: The randomized trial watched 142 University of Wisconsin students for a total of 953 days of illness. The subsequent qualitative instrument development project recruited 74 adults with self-diagnosed colds for 56 in-person interviews and 3 focus groups. OUTCOMES MEASURED: We measured specific symptoms, symptom clusters (dimensions), functional impact, and global severity. RESULTS: The original questionnaire included 20 questions: a global severity indicator, 15 symptom-severity items using 9-point severity scales, and 4 yes/no functional assessments. Data from the trial provided evidence of 4 underlying dimensions: nasal, throat, cough, and fever and aches, with reliability coefficients of 0.663, 0.668, 0.794, and 0.753, respectively. Qualitative assessments from the interviews and focus groups led us to expand from 15 to 32 symptom-specific items and from 4 to 10 functional impairment items. The original 9-point severity scale was revised to 7 points. Two global severity questions bring the item count to 44. The instrument fits comfortably on the front and back of a single sheet of paper. CONCLUSIONS: The Wisconsin Upper Respiratory Symptom Survey (WURSS) is ready for formal validity testing or practical use in common cold research.

Adult↗
PubMedDate not supplied

Naturally occurring insect growth regulators. II. Screening of insect and plant extracts as insect juvenile hormone mimics.

Ethereal extracts prepared from the larvae, pupae, or eggs of 10 species of insects and from various parts of 343 species of higher plants were screened for juvenilizing effects against Tenebrio molitor and Oncopeltus fasciatus. Activity in both species was shown by an extract of the larvae of the stable fly, Stomoxys calcitrans, whereas an extract of the pupae was active in O. fasiatus only. Extracts of two plant species (Echinacea angustifolia roots and Chamaecyparis lawsoniana seeds) showed high juvenilizing activity in T. MOLITOR, AND EXtracts of five plant species (Clethra alnifolia stems, leaves, and fruits, Sassafras albidum roots and root bark, Eucalyptus camaldulensis stems and bark, Pinus rigida twigs and leaves, and Iris douglasiana roots, stems, and fruits) were highly active in O. fasciatus an extract of Tsuga canadensis leaves showed lower activity in this insect. Extracts of 16 species of plants showed high insecticidal activity (mortality) in O. fasciatus but lacked juvenilizing properties in both species of test insects.

Animals↗
PubMed2002

Preoperative use of herbal medicines: a patient survey.

BACKGROUND: There has been recent concern in the media over the possible detrimental effects of herbal medicines on the perioperative period. Perceived by the public as 'natural' and therefore safe, herbal remedies may have led to adverse events such as myocardial infarction, bleeding, prolonged or inadequate anaesthesia and rejection of transplanted organs. In addition, herbal remedies can interact with many drugs given in the perioperative period. In this article we summarize the potential perioperative complications that can occur. METHODS: In order to determine the extent of use of herbal medicines, we conducted a survey of patients presenting for anaesthesia. During a 3-month period, patients were directly asked by anaesthetic staff if they were currently self-administering herbal medication. RESULTS: Of 2723 patients, 131 (4.8%) were taking one or more herbal remedy. In only two cases was this recorded in the patients' notes. Women and patients aged 40-60 yr were most likely to be taking a herbal product (P<0.05 and P<0.001 respectively). The most commonly used compounds were, in descending order, garlic, ginseng, ginkgo, St John's wort and echinacea. CONCLUSION: Self-administration of herbal medicines is common in patients presenting for anaesthesia. Because of the potential for side-effects and drug interactions it is important for anaesthetists to be aware of their use.

Adult↗
PubMed2002

Patterns of use and patients' attitudes toward complementary medications: a survey of adult general medicine patients at a major Canadian teaching hospital.

OBJECTIVE: To characterize the preadmission and hospital utilization of, and patients' attitudes toward, complementary medications. PATIENTS AND METHODS: Patient survey data were collected at an acute care hospital over a four-month period for 85 patients who had been admitted to the general medicine wards. Patient information about complementary medicine use and opinions were obtained through patient interviews. Patient demographic information including age, sex, ethnic background, level of education and annual household income were gathered. Patients were eligible to participate in the survey if they were on a general medicine ward on any given interview day. Patients were excluded if they were absent from their room, were sleeping, spoke no English and had no translator present, were occupied by other health care staff or friends and family on days of interviewing, or did not consent. Logistical regression was used to identify predictive factors for complementary medicine use. RESULTS: Eighty-five of 105 patients (81%) consented to complete the survey. The mean patient age was 55 years (range 19 to 91), and 45 respondents (53%) were male. About one-third of patients surveyed reported having previously visited a practitioner of natural medicine. Thirty-three patients (39%) interviewed indicated that they had used complementary medications at some time in their lives. One in six respondents (17%) reported using a complementary medicine immediately before admission to the hospital, although only two patients (3%) reported using a complementary medicine while in hospital. The most commonly reported products of use were echinacea, garlic pills and ginseng. Five patients (15%) indicated that their pharmacists were aware of their complementary medicine use, while 17 patients (52%) stated that their family doctors were aware. The majority of patients indicated they were satisfied with the information provided to them from various sources. Other data collected revealed that almost one-half would choose to take a complementary medicine for the ailment that brought them into the hospital. Univariate analysis indicated that age was a significant negative predictor for complementary medication use. CONCLUSIONS: The use of complementary medications on general medicine wards appears to be low; however, preadmission use of complementary medications appears common. The present study results suggest that use of complementary medications may go unreported; therefore, all health care providers should be aware of and knowledgeable about the potential self-administration of complementary medications by their patients.

Adult↗
PubMed2003

An overview of herbal supplement utilization with particular emphasis on possible interactions with dental drugs and oral manifestations.

Herbal medication in the United States is a popular form of therapy. This paper provides an overview of the utilization of herbal supplements with particular emphasis on possible interactions with oral health drugs and oral manifestations. Herbal supplements are regulated by the Dietary Supplement Health and Education Act (DSHEA), which limits their regulation by the U.S Food and Drug Administration (FDA). A number of studies indicate that there is a progressive increase in the utilization of herbal supplements. The majority of consumers of these products are white, middle-aged women who have some college education. Many of the consumers use pharmaceutical drugs concurrently, but most do not inform their health-care providers about their use of herbal supplements. Various herbal supplements have been reported or are suspected to interact with certain oral health drugs, the most important one being 1) bromelain, cayenne, chamomile, feverfew, dong quai, eleuthro/Seberian ginseng, garlic, ginkgo, ginger, ginseng and licorice interacting with aspirin; 2) aloe latex, ephedra, ginseng, rhubarb, cascara sagrada, licorice, and senna interacting with corticosteriods; 3) kava, St. John's wort, chamomile, and valerian interacting with central nervous system (CNS) depressant drugs; and 4) herbs acting on the gastrointestinal system, altering the absorption of several orally administered drugs. Further, the use of some herbal supplements has been reported to be associated with oral manifestations, including aphthous ulcers, lip and tongue irritation, and swelling with feverfew; gingival bleeding with feverfew and ginkgo; tongue numbness with echinacea; xerostomia with St. John's wort; oral and lingual dyskinesia with kava; and salivation with yohimbe. These potential effects of herbal supplements in conjunction with factors related to regulation restrictions suggest that the use of these products may be associated with various adverse reactions that can affect oral health and treatment. Dental hygienists should inform themselves about herbal supplements in order to offer appropriate oral health care to individuals who take these substances.

Blood Coagulation↗
PubMedDate not supplied

Herbs and other dietary supplements: healthcare professionals' knowledge, attitudes, and practices.

CONTEXT: Herbs and other dietary supplements (H/DS) are frequently used by the public. They have significant health implications, yet little is known about health professionals' knowledge, attitudes, or clinical practices related to H/DS. DESIGN: Cross-sectional survey of clinicians prior to participation in an Internet-based educational program on herbs and dietary supplements. PARTICIPANTS: The 537 participants included 111 physicians (MD), 30 advanced practice nurses (RN), 46 pharmacists (PharmD), and 350 dietitians (RD). In addition to demographic information, participants were asked about their knowledge, attitudes, and practices related to H/DS. RESULTS: Most participants were involved in direct patient care (85%), in practice or on faculty (84%), and from outside our local institutions (76%); 66% reported receiving professional education about H/DS in the past year. There were statistically significant differences between professional groups, with RDs scoring better than others, but even their average scores were less than 60% of possible. The average score on knowledge questions was 10/20; the average confidence score was 4 out of 10 possible, and the average communication score was 1.4 out of 4 possible. Most respondents knew the most common clinical uses of echinacea and St. John's wort, and felt confident that they knew more than their colleagues about H/DS. Key deficits were in knowledge about adverse effects, confidence in reporting side effects, routinely communicating with patients about H/DS, and recording H/DS information in the medical record. CONCLUSIONS: Despite significant interest and previous training in H/DS, these clinicians had substantial room for improvement in knowledge, attitudes, and clinical practices about H/DS. Educational interventions and institutional policies are needed to improve the quality of patient care regarding H/DS, and such interventions should be rigorously evaluated to ensure that continuous improvements occur.

Adult↗
PubMed2003

[Surgery patients' intake of herbal preparations and dietary supplements].

INTRODUCTION: Herbal medicine is being frequently used by patients around the world. Several products may interact with ordinary medicine, so it is important for doctors to know what kind of herbal medicines their patients take. MATERIAL AND METHODS: A questionnaire was given to presurgery patients during a two-month period. RESULTS: A total of 115 consecutive patients responded, 69 women (60%) and 46 men (40%). 50.4% had taken or still took herbal medicine, with the following distribution of gender: women 69.8%, men 30.2%. The age group was 18-82 years. The frequently used herbal medicines were fish oil, ginkgo, Echinacea, Co-Q10, garlic, and hip. Twenty-five patients took nutritional supplements with the following spread of gender: 84% women and 16% men. The frequently used nutritional supplements were Gerimax, LongoVital, and Melbrosia. Not all patients would inform their doctor about their use of herbal medicine. 28.6% retained information because of the doctor and 64.3%, did not perceive herbal medicine as "real medicine". DISCUSSION: It is important for anaesthesiologists to know what specific kind of herbal medicines patients are using before they anaesthetize them as interactions between herbal medicine and anaesthesia are prevalent. Anaesthesiologists have to ask specific questions to receive full information regarding herbal medicines during the preoperative period.

Adolescent↗
PubMed2002

Characterizing adverse events reported to the California Poison Control System on herbal remedies and dietary supplements: a pilot study.

OBJECTIVE: The purpose of this study was to (1) characterize the population who uses and reports adverse events to the California Poison Control System (CPCS) related to herbal remedies (HR) and dietary supplements (DS), (2) to assess whether adverse drug reactions (ADRs) occur within the usual recommended dosing, and (3) to describe the nature of adverse events. METHODS: A retrospective search of HR and DS related calls was conducted between January 1997 and June 1998. Data collection included the demographics of callers, types of exposures, substances involved, amounts ingested and severity. RESULTS: Of the 918 HR and DS calls received, 259 (28.2%) were drug information queries, 599 (65.3%) were exposures, and 60 (6.5%) were excluded. Exposures occurred most often in pediatric patients 324 (54.1%), but exposures resulting in ADRs occurred most often in adults at recommended doses. There were 233 ADRs, of which 67 (28.8%) occurred in children. The most common products involved in ADRs were zinc (38.2%), echinacea (7.7%), chromium picolinate (6.4%) and witch hazel (6%). Severity of ADRs required no treatment or was minor in a majority of cases, but may have contributed to hospitalization in three. CONCLUSION: Children were involved in a majority of exposure calls to the CPCS involving HR and DS. Adults, however, were more likely to develop an ADR from these products due to intentional exposure. Overall, the ADRs caused by HR and DS were mild, could be managed at home and rarely resulted in a severe outcome or other sequelae. Products involved in ADRs were consistent with the most common HR and DS products used by adult U.S. consumers.

Journal Article↗
PubMed2004

Dietary supplements in primary care. Botanicals can affect surgical outcomes and follow-up.

Dietary supplements are commonly used by patients of all ages, yet few patients reveal use of these products to their medical providers. Certain dietary supplements can react or interact with frequently used surgical medications--including anesthesia--and may cause serious unforeseen consequences or complications. Arrhythmias, poor wound healing, bleeding, photosensitivity reaction, and prolonged sedation are among the serious reactions during and after surgical and diagnostic procedures that have been attributed to these products. This article reviews the effects of the Few Gs (feverfew, ginkgo biloba, garlic, ginseng, and ginger), valerian, kava, St. John's wort, ephedra (Ma huang or metabolite), and echinacea. We recommend that all patients be advised to stop all dietary supplements at least 1 week prior to major surgical or diagnostic procedures; if a complication is noted, continued use of these products should be reviewed with patients.

Dietary Supplements↗
PubMed2004

Acute bacterial rhinosinusitis in adults: part II. Treatment.

Although most cases of acute rhinosinusitis are caused by viruses, acute bacterial rhinosinusitis is a fairly common complication. Even though most patients with acute rhinosinusitis recover promptly without it, antibiotic therapy should be considered in patients with prolonged or more severe symptoms. To avoid the emergence and spread of antibiotic-resistant bacteria, narrow-spectrum antibiotics such as amoxicillin should be used for 10 to 14 days. In patients with mild disease who have beta-lactam allergy, trimethoprim/sulfamethoxazole or doxycycline are options. Second-line antibiotics should be considered if the patient has moderate disease, recent antibiotic use (past six weeks), or no response to treatment within 72 hours. Amoxicillin-clavulanate potassium and fluoroquinolones have the best coverage for Haemophilus influenzae and Streptococcus pneumoniae. In patients with beta-lactam hypersensitivity who have moderate disease, a fluoroquinolone should be prescribed. The evidence supporting the use of ancillary treatments is limited. Decongestants often are recommended, and there is some evidence to support their use, although topical decongestants should not be used for more than three days to avoid rebound congestion. Topical ipratropium and the sedating antihistamines have anticholinergic effects that maybe beneficial, but there are no clinical studies supporting this possibility. Nasal irrigation with hypertonic and normal saline has been beneficial in chronic sinusitis and has no serious adverse effects. Nasal corticosteroids also may be beneficial in treating chronic sinusitis. Mist, zinc salt lozenges, echinacea extract, and vitamin C have no proven benefit in the treatment of acute bacterial rhinosinusitis.

Acute Disease↗
PubMed2005

Use of complementary and alternative medicine for the treatment of genital herpes.

Conventional antiviral drugs have proven effectiveness for genital herpes; however, patients continue to use a variety of complementary and alternative medicine (CAM) treatments. Given that patients may be using these products, it is important that healthcare providers become familiar with the data regarding safety and efficacy. We have reviewed available scientific data on six commonly used treatments (echinacea, eleuthero, L-lysine, zinc, bee products and aloe). In addition, information about a number of other products is presented in tabular form. Currently, there are insufficient clinical data to be confident of the efficacy and safety of any of these products for the treatment of genital herpes. It is hoped that future clinical trials will be conducted with sufficient rigour to provide guidance to the patients using these products.

Antiviral Agents↗
PubMed2005

[Complementary and alternative medical approaches to infection prophylaxis in the elderly].

Protection against infection encompasses appropriate medical treatment of existing diseases as well as counseling on social, psychological, disease-specific and individual factors--and this also applies to the old patient. In appropriate cases, complementary and alternative medicine (CAM) or relevant substances may be administered in addition to conventional medicine as supportive measures in preventing infection and preserving health. Acupuncture and homeopathy are widely established, and must be considered largely free of side effects. However, in light of the currently unsatisfactory situation in terms of good scientific studies, these forms of treatment cannot yet be definitively recommended. The administration of synthetic vitamins as dietary supplements may compensate deficiencies due to malnutrition or malabsorption problems in the elderly. However, neither supplementation with vitamin C or E, nor zink has any positive effect as cold treatment. The latest studies also fail to show any prophylactic effect of Echinacea extracts on the duration or severity of colds.

Aged↗
PubMedDate not supplied

[Natural remedies and hormone preparations--potential risk for breast cancer patients. A study surveys the use of agents which possibly counteract with the treatment].

We have studied the use of complimentary alternative medicine (CAM) among 233 consecutive breast cancer patients operated on at the Lund University Hospital, Sweden between 2002 and 2004. Questionnaires were administered preoperatively (n = 233), and again 3-6 months post-operatively (n = 167) and one year after surgery (n = 88). At baseline, 14,5% used CAM, 3-6 months post-operatively 14,4% used CAM and one year after surgery 18,2% used CAM. The most common products contained omega-3, garlic, ginseng and roseroot. We identified use of 35 different types of CAM products and seven of these could potentially increase the risk of breast cancer or interact with tamoxifen or aromatase inhibitors: soy, garlic, ginko biloba, echinacea, ginseng, valerian and phytoestrogens (excluding soy). Five and a half percent of the patients used either hormone replacement therapy (HRT) or hormonal contraception at the pre-operative visit, after they had received their breast cancer diagnosis. In conclusion, it is important that doctors discuss the use of CAM and exogenous hormone therapy with their breast cancer patients given the prevalence of these drugs.

Antineoplastic Agents↗
PubMed2006

[Comparative study of homeopathic remedies clinical efficacy in comprehensive treatment of inflammatory periodontal diseases in patients with burdened allergic status].

Comparative analysis of clinical efficacy of 3 antihomotoxic homeopathic preparations (Traumeel S, Engistol and Echinacea compositum S) with non-specific immunostimulating and anti-inflammatory effects was performed. The study showed that Traumeel S had maximal anti-inflammatory effect. In proportion as destructive process weighting the efficacy of homeopathic preparations was decreased. The preparations are indicated for comprehensive treatment of inflammatory periodontal diseases in patients with burdened allergic status or heavy concomitant pathology.

Adolescent↗
PubMedDate not supplied

Determination of aflatoxins and ochratoxin A in ginseng and other botanical roots by immunoaffinity column cleanup and liquid chromatography with fluorescence detection.

Mycotoxins are toxic secondary metabolites produced by certain molds and are common contaminants of many important food crops, such as grains, nuts, and spices. Some mycotoxins are found in fruits, vegetables, and botanical roots. These contaminants have a broad range of toxic effects, including carcinogenicity, immunotoxicity, neurotoxicity, and reproductive and developmental toxicity. The public health concerns related to both acute and chronic effects of mycotoxins in animals have prompted more than 100 countries to establish regulatory limits for some of the well-known mycotoxins, such as the aflatoxins (AFL). Our research focused on method development for 2 of these toxins, AFL and ochratoxin A (OTA), in ginseng and other selected botanical roots. Methods using an immunoaffinity column (IAC) cleanup, liquid chromatographic separation, and fluorescence detection were modified and evaluated. Two types of IAC cleanup were evaluated: IAC for AFL, and IAC for both AFL and OTA. Three derivatization techniques to enhance the fluorescence of the AFL were compared: precolumn trifluoroacetic acid, postcolumn bromination, and postcolumn ultraviolet irradiation. No derivatization was needed for OTA. Results for AFL using the single analyte IAC cleanup and the 3 derivatization techniques were all comparable for ginseng and for other roots such as ginger, licorice, and kava-kava. Recoveries of added AFL for ginseng at levels from 2 to 16 ng/g were about 80%. Using IAC cleanup for both AFL and OTA recoveries of added AFL for ginseng at 4-16 ng/g were about 70%, and for ginger, licorice, and kava-kava were about 60%. Recoveries of added OTA for ginseng, ginger, and echinacea at 4 ng/g were about 55%.

Aflatoxins↗
PubMed2006

Modulation of cytokine expression by traditional medicines: a review of herbal immunomodulators.

UNLABELLED: Modulation of cytokine secretion may offer novel approaches in the treatment of a variety of diseases. One strategy in the modulation of cytokine expression may be through the use of herbal medicines. A class of herbal medicines, known as immunomodulators, alters the activity of immune function through the dynamic regulation of informational molecules such as cytokines. This may offer an explanation of the effects of herbs on the immune system and other tissues. For this informal review, the authors surveyed the primary literature on medicinal plants and their effects on cytokine expression, taking special care to analyze research that utilized the multi-component extracts equivalent to or similar to what are used in traditional medicine, clinical phytotherapy, or in the marketplace. METHODOLOGY: MEDLINE, EBSCO, and BIOSIS were used to identify research on botanical medicines, in whole or standardized form, that act on cytokine activity through different models, i.e., in vivo (human and animal), ex vivo, or in vitro. RESULTS: Many medicinal plant extracts had effects on at least one cytokine. The most frequently studied cytokines were IL-1, IL-6, TNF, and IFN. Acalypha wilkesiana, Acanthopanax gracilistylus, Allium sativum, Ananus comosus, Cissampelos sympodialis, Coriolus versicolor, Curcuma longa, Echinacea purpurea, Grifola frondosa, Harpagophytum procumbens, Panax ginseng, Polygala tenuifolia, Poria cocos, Silybum marianum, Smilax glabra, Tinospora cordifolia, Uncaria tomentosa, and Withania somnifera demonstrate modulation of multiple cytokines. CONCLUSION: The in vitro and in vivo research demonstrates that the reviewed botanical medicines modulate the secretion of multiple cytokines. The reported therapeutic success of these plants by traditional cultures and modern clinicians may be partially due to their effects on cytokines. Phytotherapy offers a potential therapeutic modality for the treatment of many differing conditions involving cytokines. Given the activity demonstrated by many of the reviewed herbal medicines and the increasing awareness of the broad-spectrum effects of cytokines on autoimmune conditions and chronic degenerative processes, further study of phytotherapy for cytokine-related diseases and syndromes is warranted.

Cytokines↗
PubMed2006

Natural health product use in Canada: analysis of the National Population Health Survey.

BACKGROUND: The use of natural health products (NHPs) in Western countries has increased dramatically over the past two decades. Although prevalence estimates have been published in the U.S. and elsewhere, little is known about the characteristics of persons who use NHPs. OBJECTIVES: To measure the prevalence of NHP use among adults in Canada, identify the most commonly used agents, and determine the socioeconomic, demographic, and health-related correlates of use. METHODS: NHP use by adults was assessed using the 2000-2001 National Population Health Survey (NPHS), a biennial general health survey conducted by Statistics Canada. A total of 11,424 adults completed the survey in 2000-2001. NHPs were defined as botanical and naturally-derived non-botanical products, excluding essential vitamins and minerals. Prevalence of use estimates were calculated nationally, and by age, gender, socioeconomic status, disease states, and health care practices. Multivariate logistic regression modeling was used to simultaneously assess the correlations of these variables with NHP use. RESULTS: The prevalence of past 2-day NHP use in Canada was 9.3% in 2000-2001. Fifty-seven percent of users also reported taking a conventional medicine in the same period. Glucosamine, echinacea, and garlic were the most frequently used products. Women reported NHP use more frequently than men (11.5% vs. 7.1%). As compared to young adults, NHP use was about 50% higher in middle-aged and older Canadians. There were no associations with either income or education level. Several disease states were associated with a high prevalence of NHP use: respondents with fibromyalgia (23.3%), inflammatory bowel disease (17.4%), and urinary incontinence (16.8%) were most likely to be NHP users. However, in the multivariate analysis, age and the use of vitamins or minerals were most predictive of NHP use, while health status variables were of less importance. CONCLUSIONS: NHP use is an important health phenomenon in Canada. Although respondents in poor health were more likely to use NHPs, a significant proportion of healthy Canadians also reported NHP use. The use of NHPs also cut across different socioeconomic groups. Concurrent use of conventional medications was common and suggests a need for health professionals to monitor for potential interactions.

Adult↗
PubMed1990

[Immunomodulating effect of lysed immunoactive fractions of selected Escherichia coli strains on the macrophage system. An in vitro study].

The immunomodulator Uro-Vaxom (an immunoactive fraction of E. coli, FEC) is a therapeutic agent used to control bacterial infections. FEC was applied to macrophages of C57BL/6 mice to investigate the in vitro activation of these cells of the unspecific immune system. Experiments were designed to test the secretory, immuno-regulatory and cytotoxic function of macrophages after application of FEC. As presented here, production of Interleukin-6 and tumor-necrosis-factor were significantly and dose-dependent way increased, whereas it was not possible to induce a secretion of Interleukin-1. In addition, FEC activated macrophages kill Leishmania donovani promastigotes, Candida albicans and Staphylococcus aureus. In comparison to a pressed echinaceae-preparation, FEC activated mouse macrophages secrete Interleukin-6 and tumor-necrosis-factor and kill protozoa, fungi and bacteria, with higher efficiency.

Animals↗