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PubMedDate not supplied

Correlation between positive serology for Plasmodium vivax-like/Plasmodium simiovale malaria parasites in the human and anopheline populations in the State of Acre, Brazil.

Antibodies against the Plasmodium vivax-like/P. simiovale malaria parasite circumsporozoite repeat peptide (APGANQEGGAA)3 were determined by enzyme-linked immunosorbent assay (ELISA) in 120 sera randomly collected in 1994 from adults in 3 localities of the malaria endemic area in the State of Acre, Brazil; antibody was detected in 18 (15%). A 'sandwich' ELISA using monoclonal antibody (mab) Pam 172, directed against the same peptide, was carried out on 1207 Anopheles oswaldoi, 12 of which (1.0%) were positive, and 168 A. deaneorum, 2 of which (1.2%) were positive. This is the first report of serological detection of the P. vivax-like parasite in anophelines and the first report linking anopheline to human serology for this parasite in the same geographical area. It is an additional indication that A. oswaldoi is a malaria vector in Acre.

Adult↗
PubMedDate not supplied

Tissue plasminogen activator coexpressed in Chinese hamster ovary cells with alpha(2,6)-sialyltransferase contains NeuAc alpha(2,6)Gal beta(1,4)Glc-N-AcR linkages.

Genetic alteration of the set of oligosaccharide biosynthesis enzymes expressed in a genetically engineered host cell line is a plausible strategy for manipulating the oligosaccharides on a cloned glycoprotein coexpressed in that cell line. This hypothesis was verified for the particular case of sialylation of recombinant human tissue plasminogen activator (tPA) expressed by an engineered Chinese hamster ovary (CHO) cell line. The gene for rat liver beta-galactoside alpha(2,6)-sialyltransferase (2,6-ST) was cloned behind the MMTV promoter in the vector pMSG and transfected into a tPA-expressing CHO cell line. Selected and screened transfectants exhibited significantly greater surface fluorescence than controls in flow cytometric analyses of cells labeled with Sambacus nigra agglutinin (SNA)-biotin and streptavidin-R-phycoerythrin; SNA specifically binds to NeuAc alpha(2,6)Gal beta(1,4)Glc-N-AcR linkages, which are synthesized by 2,6-ST and which are not normally found on CHO cells. SNA blots of partially purified tPA from the culture supernatant demonstrated that tPA synthesized in the 2,6-ST transfectants possessed terminal NeuAc alpha(2,6)Gal beta(1,4)Glc-N-AcR linkages, while tPA from the original recombinant CHO cell line did not. Besides possibly allowing the production of glycoproteins in cell culture with glycosylation more closely resembling that in humans, extensions of this strategy have the potential to tailor the pharmacokinetics, targeting, and antigenic properties of cloned glycoproteins.

Animals↗
PubMed1999

Rating the appropriateness of coronary angiography, coronary angioplasty and coronary artery bypass grafting: the ACRE study. Appropriateness of Coronary Revascularisation study.

BACKGROUND: Previous studies investigating the appropriateness of invasive management of coronary disease had not reported the internal consistency of their ratings and may now be out of date. The aim of this study was to measure the influence of clinical factors on contemporary ratings of the appropriateness of coronary angiography, percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft (CABG) in the Appropriateness of Coronary Revascularisation (ACRE) study. METHODS: The Delphi-RAND technique was used, in which an expert panel (four cardiologists, three cardiothoracic surgeons, a general physician and a general practitioner), meeting in 1995, rated mutually exclusive indications (n = 2178 for angiography, n = 995 for PTCA and n = 984 for CABG). The main outcome measures were the appropriateness category (inappropriate, uncertain or appropriate) for each of the three procedures and treatment preference. RESULTS: For revascularization, the strongest determinant of inappropriateness was coronary anatomy. The odds ratio (OR) for inappropriate PTCA was 10.6 (95 per cent confidence interval (CI) 4.8-23.5) for the effect of left main stem or three-vessel disease versus single-vessel disease, and for CABG it was 0.06 (95 per cent CI 0.03-0.15). The number of diseased vessels was strongly related to preference for medical, PTCA or CABG treatment (p for linear trend <0.001). Mild versus severe anginal symptoms were associated with inappropriate angiography (OR 2.0 (95 per cent CI 0.9-9.8), although this effect was stronger when only the cardiologists' ratings were considered (OR 10.1 (95 per cent CI 2.4-42.6)). CONCLUSION: These are the first UK ratings of appropriateness covering all three procedures. The associations with clinical factors provide evidence of the internal consistency of these ratings. Prospective validation of these ratings against clinical outcomes is under way in the ACRE study.

Aged↗
PubMed2006

Species diversity causing human cutaneous leishmaniasis in Rio Branco, state of Acre, Brazil.

OBJECTIVE: Information on Leishmania species diversity in western Brazilian Amazon and the clinical picture of human cutaneous leishmaniasis it causes is scarce. We describe clinical findings, diagnostic procedures and identification of Leishmania species in patients from that region. METHODS: The sample consisted of 50 patients, prospectively evaluated for epidemiological and clinical characteristics by means of a structured questionnaire. Conventional and molecular tools were applied to confirm the parasitological diagnosis and identify the species responsible for the disease. RESULTS: Patients were predominantly male (76.5%) and living in rural areas. Median average age was 18 years and median average disease evolution was 8 weeks. For the diagnostic procedures of leishmanin skin test, direct visualization of amastigotes in dermal scrapings and parasite culture of aspirates of the ulcer border were positive for 98%, 52% and 34%, respectively. Molecular methods applied to DNA extracted from skin biopsies of the 50 patients yielded 100%, 82% and 44% positivity by PCR minicircle kDNA, PCR-RFLP ITS1rDNA and PCR-glucose-6-phosphate (G6P), respectively. Fourteen samples from 13 patients were successfully isolated and identified. Multilocus enzyme electrophoresis, PCR-RFLP ITS1rDNA and PCR-G6P permitted identification of the Leishmania species responsible for the aetiology of American tegumentary leishmaniasis in 60% of the examined patients: 16 Leishmania (Viannia) braziliensis, 12 Leishmania (Viannia) lainsoni, 1 Leishmania (Viannia) guyanensis and 1 putative hybrid of Leishmania (Viannia) naiffi and L. (V.) lainsoni. CONCLUSION: The clinical and epidemiological behaviour of cutaneous leishmaniasis in Acre, Brazil, is similar to other Amazon scenarios previously described; however Acre's complex parasite diversity may be contributed to the concomitant circulation of at least three distinct Leishmania species. The implementation of control interventions in the studied area must take into consideration the possibility of various expected phlebotomine vectors and reservoirs.

Adolescent↗
PubMed2006

Expression of mycobacterial cell division protein, FtsZ, and dormancy proteins, DevR and Acr, within lung granulomas throughout guinea pig infection.

The ability of Mycobacterium tuberculosis to persist in a dormant state is a hallmark of tuberculosis. An insight into the expression of mycobacterial proteins will contribute to our understanding of bacterial physiology in vivo. To this end, the expression of FtsZ, Acr and DevR was assessed in the lung granulomas of guinea pigs infected with M. tuberculosis. Antigen immunostaining was then compared with the detection of acid-fast bacilli (AFB) and mycobacterial DNA. Surprisingly, immunostaining for all three antigens was observed throughout the course of infection; maximum expression of all antigens was noted at 20 weeks of infection. The intensity of immunostaining correlated well with the presence of intact bacteria, suggesting that mycobacterial antigens in the extracellular fraction have a short half-life; in contrast to protein, extracellular bacterial DNA was found to be more stable. Immunostaining for bacterial division and dormancy markers could not clearly distinguish between replicating and non-replicating organisms during the course of infection. The detection of Acr and DevR from 4 weeks onwards indicates that the dormancy proteins are expressed from early on in infection. Both antigen staining and DNA detection from intact bacilli were useful for detecting intact mycobacteria in the absence of AFB.

Animals↗
PubMed1992

A bidirectional ACR-NEMA interface between the VA's DHCP Integrated Imaging System and the Siemens-Loral PACS.

There is a wide range of requirements for digital hospital imaging systems. Radiology needs very high resolution black and white images. Other diagnostic disciplines need high resolution color imaging capabilities. Images need to be displayed in many locations throughout the hospital. Different imaging systems within a hospital need to cooperate in order to show the whole picture. At the Baltimore VA Medical Center, the DHCP Integrated Imaging System and a commercial Picture Archiving and Communication System (PACS) work in concert to provide a wide-range of departmental and hospital-wide imaging capabilities. An interface between the DHCP and the Siemens-Loral PACS systems enables patient text and image data to be passed between the two systems. The interface uses ACR-NEMA 2.0 Standard messages extended with shadow groups based on draft ACR-NEMA 3.0 prototypes. A Novell file server, accessible to both systems via Ethernet, is used to communicate all the messages. Patient identification information, orders, ADT, procedure status, changes, patient reports, and images are sent between the two systems across the interface. The systems together provide an extensive set of imaging capabilities for both the specialist and the general practitioner.

Data Display↗
PubMed2002

Identification of a Mycobacterium tuberculosis putative classical nitroreductase gene whose expression is coregulated with that of the acr aene within macrophages, in standing versus shaking cultures, and under low oxygen conditions.

Tuberculosis remains a leading killer worldwide, and new approaches for its treatment and prevention are urgently needed. This effort will benefit greatly from a better understanding of gene regulation in Mycobacterium tuberculosis, particularly with respect to this pathogen's response to its host environment. We examined the behavior of two promoters from the divergently transcribed M. tuberculosis genes acr/hspX/Rv2031c (alpha-crystallin homolog) and Rv2032/acg (acr-coregulated gene) by using a promoter-GFP fusion assay in Mycobacterium bovis BCG. We found that Rv2032 is a novel macrophage-induced gene whose expression is coregulated with that of acr. Relative levels of intracellular induction for both promoters were significantly affected by shallow standing versus shaking bacterial culture conditions prior to macrophage infection, and both promoters were strongly induced under low oxygen conditions. Deletion analyses showed that DNA sequences within a 43-bp region were required for expression of these promoters under all conditions. Multiple sequence alignment and database searches performed with PROBE indicated that Rv2032 is one of eight M. tuberculosis genes of previously unknown function that belong to an unusual superfamily of classical nitroreductases, which may have a role for bacteria within the host environment. These findings show that mycobacterial culture conditions can greatly influence the results and interpretation of subsequent gene regulation experiments. We propose that these differences might be exploited for dissection of the regulatory factors that affect mycobacterial gene expression within the host.

Amino Acid Motifs↗
PubMed1997

Antiperinuclear factors are present in polyarthritis before ACR criteria for rheumatoid arthritis are fulfilled.

OBJECTIVE: To show that antiperinuclear factor (APF) may be useful for the diagnosis of rheumatoid arthritis at a time when the American College of Rheumatology (ACR) criteria are not yet fulfilled. METHODS: Testing for APF-IgG (1:100 threshold) and rheumatoid factors (RF) was done in 60 patients with polyarthritis of recent onset during a three year follow up. RESULTS: At the end of the study, 21/40 rheumatoid arthritis were positive for RF and 31/40 for APF, including 18/40 cases (45%) in which ACR criteria were not yet fulfilled. CONCLUSIONS: APF are useful in the diagnosis of early rheumatoid arthritis.

Antibodies, Antinuclear↗
PubMed1992

PACS mini refresher course. Network and ACR-NEMA protocols.

The backbone of the picture archiving and communication system (PACS) is the electronic network used to move information. Communications networks require electronic rules of operation or protocols so that a set of data being transmitted reaches the intended destination and does not collide with another set of transmitted data. The most efficient protocol is flexible and can respond to the fluctuations in volume of data transmitted via the network. Successful network connection of PACS devices requires standardized interfaces so that equipment from multiple vendors can use the network protocol. The American College of Radiology (ACR) and the National Electrical Manufacturers Association (NEMA) have developed a standard for imaging equipment interfaces: DICOM (Digital Imaging and Communications in Medicine). The DICOM standard allows interoperability among different computers and operating systems. It is flexible and will allow modification and expansions as new imaging techniques evolve. The authors and the ACR-NEMA committee believe that the DICOM standard represents an important choice for radiologists, since it was developed with their interests in mind.

Computer Communication Networks↗
PubMed1988

ACR-NEMA digital imaging and communications standards: minimum requirements.

The purposes, implications, and history of development of the American College of Radiology-National Electrical Manufacturers Association (ACR-NEMA) Digital Imaging and Communication Standard and its contents are briefly described, and the minimum requirements of the ACR-NEMA Digital Imaging and Communication Standard are described with a concise introduction of each layer. The usefulness, validity, current status, and future development of the standard are also discussed.

Computer Systems↗
PubMed2004

ACR classification criteria for systemic lupus erythematosus: limitations and revisions to neuropsychiatric variables.

There are a wide variety of neurologic (N) and psychiatric (P) manifestations of systemic lupus erythematosus (SLE) which extend beyond those identified in the current American College of Rheumatology (ACR) classification criteria for SLE. Several attempts have been made to devise a classification of NP-SLE manifestations. The most recent is the ACR nomenclature and case definitions for 19 NP lupus syndromes which currently provides the best means of a standardized approach to categorize NP events in SLE patients. Data from a number of studies has indicated a wide variability in the prevalence of the 19 NP syndromes. On the basis of these findings and utilizing the guidelines provided in the case definitions for diagnosis and exclusion of confounding variables, it is proposed to examine a number of NP manifestations for possible inclusion in revised classification and diagnostic criteria for SLE.

Humans↗
PubMed2006

[Evaluation of the sorologic pre-selection for the hepatitis B virus marker (total anti-HBc) in candidates to blood donation in the State of Acre, 2002].

The aim of this research was to evaluate previous serum screening for hepatitis B (total anti-HBc) among blood donation candidates, verifying the link between the variables: gender, age, degree of education and native-born. A transverse study with retrospective data carried out on a target population, blood donation candidates from districts of the interior of Acre State, who came to the Acre Hematology and Hemoterapy Center during the period January to December, 2002. The research indicated reactivity in 54.8% of the total anti-HBc among the 673 candidates included. Greater reactivity of total anti-HBc was observed among males, older candidates and those with lower education levels (p<0.005). Previous serum screening for hepatitis B among blood donation candidates is a viable alternative, since it reduces cost and increases transfusional safety. Attracting female donors, youths and those who have higher education levels, would signify potential blood donors for HEMOACRE.

Adult↗
PubMed2005

[Patient-physician relationship in Acre, Rio Branco, from the patient's point of view].

BACKGROUND: The main objective of the present paper is to evaluate the satisfaction levels with the physician-patient relationship (PPR) practiced at a health care unit of Rio Branco, Acre, Brazil. Interviews were carried out right after patients' dismissal from the "Fundação Hospital Estadual do Acre". METHODS: Descriptive and analytical analyses were performed. Fifty patients 18 to 50 years of age were studied. Semi-structured questionnaires were used. Patients with altered states of consciousness, mental deficiency or verbal communication impairment and those who were not willing to participate in the research were excluded. Descriptive data were appraised for SPSS. RESULTS: Sixty-four percent of the patients (32/50) believe that the physician-patient relationship interferes with patients' improvement; Seventy percent (35/50) evaluated their physician-patient relationship as satisfactory and seventy two percent (36/50) considered positive, the attention received from physicians. Albeit results are in accordance with the cultural expectations, further research on this subject is recommended. CONCLUSIONS: the satisfaction with PPR, showed association with the variables related to the personal form of communication practiced between physicians and patients.

Adolescent↗
PubMed1992

Hypercard coding system for the ACR Index for Radiological Diagnoses.

We describe a computer version of the Index for Radiological Diagnoses of the American College of Radiology (ACR). This system combines a graphics interface with a search mechanism while preserving the hierarchical structure of the Index. The graphics interface allows easy selection of an anatomic part, while the search mechanism provides the code numbers associated with an entered term. The computer system and the paperback version of the ACR Index were compared by having 52 volunteers (21 radiology faculty members, 21 radiology residents, and 10 medical students) each code 30 cases with the book and a matched set of 30 cases with the computer. The average time to code cases was shorter when the computer was used (52.2 vs 64.5 sec; p less than .0001). Accuracy was higher when the computer was used (96.4% vs 90.4%; p less than .0001). The average confidence in the computer diagnosis was also higher (9.73 vs 9.51, on a scale of 1-10; p = .0016). This system demonstrates the ability of a computer program to outperform an analogous noncomputerized system.

Disease↗
PubMedDate not supplied

ACR remission criteria and response criteria.

As additional DMARDs have been added to the armamentarium of rheumatologists over the last 60 years, the approach to the treatment of rheumatoid arthritis has changed. Many clinical studies now are geared toward evaluating the concept of eradicating inflammation as a method to seek the elusive goal of sustained remission in RA. One of the first descriptions of remission in 'RA' was by Short et al in 1948, when he documented the natural progression of the disease. Since that time, various criteria have been developed to define RA remission utilizing clinical, radiographic, and laboratory measures. The most stringent of criteria is the American College of Rheumatology Remission Criteria, developed in 1980, which consists of clinical symptoms and signs of inflammation including fatigue, joint pain, morning stiffness, joint tenderness, joint swelling, and erythrocyte sedimentation rate (ESR). Several reports have compared ACR remission criteria to Disease Activity Score (DAS) values to identify equivalent DAS remission values, and these have been extrapolated to modified versions of the DAS, the Simple Disease Activity Index (SDAI), and Clinical Disease Activity Index (CDAI). The ACR remission criteria and the response measures were not designed for use as the target or goal for the clinical management of individual RA patients in routine clinical practice. Nevertheless, rheumatologists yearn for the eradication of inflammation in all RA patients, and attaining remission may be achievable in the future.

Antirheumatic Agents↗
PubMed1983

[Clinical responses and side effects of aclarubicin (ACR) in the treatment of multiple myeloma].

Fifteen patients with multiple myeloma received Aclarubicin (ACR) alone intravenously. Nine of fourteen patients (one patient with non-secretory myeloma was excluded) achieved more than a 25% reduction in M-protein (limited response = LR). Two of LR patients obtained more than a 50% reduction (good response = GR). The median total dose of ACR and the median time required to reach LR or GR were 210 mg and 28 days, respectively. One of two patients achieved a marked regression of tumor mass and two patients showed a remarkable improvement in subjective symptom. Hematological toxicities were frequently observed. However, cardiac toxicity was not detected and epilation was mild.

Aclarubicin↗
PubMed1998

Why not use OSRA? A comparison of Overall Status in Rheumatoid Arthritis (RA) with ACR core set and other indices of disease activity in RA.

OBJECTIVE: The Overall Status in Rheumatoid Arthritis (OSRA) is a recently validated measure designed for routine immediate clinical use in patients with rheumatoid arthritis (RA). It is composed of demographic data, activity score (activity total), damage score (damage total), and drug treatment. We tested the hypothesis that this tool relates to existing measures and pooled indices of disease activity, including the SF-36. METHODS: Demographic information, OSRA, SF-36, and the ACR core set [inflammatory indicators (ESR, CRP), tender and swollen joints, visual analog scale for pain, Patient and Physician Global Assessment, and Health Assessment Questionnaire (HAQ)] were collected for 86 consecutive outpatients with RA who were starting or changing second-line therapy and again at 6 months. OSRA measures were examined for their relationship to all core set variables (SF-36, HAQ, Stoke Index, Disease Activity Score, and Mallya-Mace) using Spearman's rank correlation. OSRA was used to audit 246 consecutive outpatients with RA to determine its clinical utility. RESULTS: The median age was 58 years (range 29-82); median disease duration 63 mo (range 3-384); OSRA disease activity (mean 3.8, range 0-8) and damage (mean 2.7, range 0-7) scores were strongly associated with specific ACR core set and SF-36 measures, and all pooled indices examined. OSRA disease activity was significantly higher in outpatients in whom second-line therapy was changed. CONCLUSION: (1) The OSRA was highly correlated with HAQ and core set measures of disease activity: (2) the OSRA damage total was strongly associated with HAQ and correlated strongly with both duration and Larsen score; (3) OSRA scores also correlated well with specific SF-36 measures (activity total with Physical Functioning and Bodily Pain; damage total with Physical and Social Functioning); (4) OSRA shows good correlation with pooled indices that cannot be performed immediately in clinic; and (5) the OSRA activity score shows a strong association with clinical decisions made in the outpatient department.

Adolescent↗
PubMed1989

The gene encoding the human preproacrosin (ACR) maps to the q13-qter region on chromosome 22.

Human proproacrosin is specified by a single gene (ACR). Using a series of human-rodent somatic cell hybrids containing variant complements of human chromosomes, the preproacrosin gene was found to cosegregate with human chromosome 22. Somatic cell hybrids containing translocation chromosomes carrying parts of chromosome 22 were used to locate the preproacrosin gene to the region 22q13-22qter. By probing the DNA of 82 individuals, a restriction fragment length polymorphism was found with SstI in 14 cases.

Acrosin↗