It has not been adequately evaluated whether the outcome of infections differs by body-weight category. We performed a systematic review of relevant studies. Eleven studies (one retrospective and 10 prospective cohort studies) were included in this review, involving a total of 3159 hospitalized patients or nursing home residents. Most studies (6/11) referred to lower respiratory tract infections. Seven studies showed an association of patient outcome (mortality in 6/7 studies) with body-weight category. This was shown in multivariate analysis in 4/5 studies that reported relevant data. Obese or morbidly obese patients with infections had worse outcome compared with the rest of the patients or with normal-weight patients, in 4/7 studies that reported relevant data; findings were not significant in the remaining three studies. Patients in the lowest body mass index (BMI) group had worse outcome compared with all other groups combined, in 3/5 studies that reported relevant data; findings were not significant in the remaining two studies. Low BMI was associated with worse outcome in patients with lower respiratory tract infections in 3/4 relevant studies. Although not consistently reported, an association of both ends of the BMI distribution with worse outcome of infections is plausible and merits further investigation.

BackgroundTo examine and compare the research productivity on selected fields related to health literacy of the current members of the European Union, the four candidate countries waiting to join the EU, Norway, Switzerland, and the United States.Methodology/Principal findingsA bibliometric analysis (1991–2005). Data sources included papers published by authors from each country separately. The 25 European countries produce less than 1/3 health literacy research when compared to the U.S. (13,710 and 49,523 articles were published by authors with main affiliation in the European Union and the four candidate countries, and the U.S., respectively). The Netherlands and Sweden (followed by Germany, Italy, and France) are the European countries with the highest number of research published in fields related to health literacy. After adjustment for population Sweden, Finland, and Norway, were on the top of the relevant list. In addition, Sweden, Finland, and Ireland, were on the top of the list of countries regarding research productivity on the selected fields after adjustment for gross domestic product (GDP).Conclusions/SignificanceInequalities in research published on the topic of health literacy exist among Europe, Norway, Switzerland, and the U.S. More research may need to be done in all areas of health literacy in Europe and the potential detrimental effects of this gap should be further investigated.

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BackgroundHuman myeloid-derived suppressor cells (MDSC) have been described as a group of immature myeloid cells which exert immunosuppressive action by inhibiting function of T lymphocytes. While there is a huge scientific interest to study these cells in multiple human diseases, the methodological approach varies substantially between published studies. This is problematic as human MDSC seem to be a sensible cell type concerning not only cryopreservation but also time point after blood draw. To date data on delayed blood processing influencing cell numbers and phenotype is missing. We therefore evaluated the kinetics of granulocytic MDSC (gMDSC) and monocytic MDSC (mMDSC) frequencies after blood draw in order to determine the best time point for analysis of this recently defined cell type.MethodsIn this study, we isolated peripheral blood mononuclear cells (PBMC) of patients with HIV infection or solid tumors directly after blood draw. We then analyzed the frequencies of gMDSC and mMDSC 2, 4 and 6 h after blood draw and after an overnight rest by FACS analysis using the standard phenotypic markers. In addition, part of the cells was frozen directly after PBMC preparation and was measured after thawing.ResultsgMDSC levels showed no significant difference using fresh PBMC over time with a limitation for the overnight sample. However they were massively diminished after freezing (p = 0.0001 for all subjects). In contrast, frequencies of fresh mMDSC varied over time with no difference between time point 2 and 4 h but a significantly reduction after 6 h and overnight rest (p = 0.0005 and p = 0.005 respectively). Freezing of PBMC decreased the yield of mMDSC reaching statistical significance (p = 0.04). For both MDSC subgroups, FACS analysis became more difficult over time due to less sharp divisions between populations.ConclusionsAccording to our data human MDSC need to be studied on fresh PBMC. gMDSC can be studied with delay, mMDSC however should be studied no later than 4 h after blood draw. These results are crucial as an increasing number of clinical trials aim at analyzing MDSC nowadays and the logistics of blood processing implies delayed sample processing in some cases.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-015-0755-y) contains supplementary material, which is available to authorized users.

Objectives: Several studies reported decreased quality of life (QoL) and sleep as well as increased rates of depression for patients with pituitary adenomas. Our aim was to explore to what extent differences in depression and sleep quality contribute to differences in QoL between patients with pituitary adenomas and controls. Design: A cross-sectional case-control study. Setting: Endocrine Outpatient Unit of the Max Planck Institute of Psychiatry, Munich, Department of Internal Medicine, Ludwig-Maximilians-University, Munich, and the Institute of Clinical Psychology and Psychotherapy, Technical University, Dresden. Participants: Patients with pituitary adenomas (nZ247) and controls (from the DETECT cohort, a large epidemiological study in primary care patients) matched individually by age and gender (nZ757). Measurements: Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) and QoL was measured by the generic EQ-5D and calculated by the time trade-off-and VAS-method. Depression was categorized as 'no depression', 'subclinical depression', and 'clinical depression' according to the Beck Depressions Inventory for patients and the Depression Screening Questionnaire for control subjects. Statistical analyses: General linear and generalized, logistic mixed models as well as proportional odds mixed models were calculated for analyzing differences in baseline characteristics and in different subgroups. Results: Patients with pituitary adenomas showed decreased QoL (VAS index: 0.73G0.19) and sleep (PSQI score: 6.75G4.17) as well as increased rates of depression (subclinical or clinical depression: 41.4%) compared with their matched control subjects (VAS index: 0.79G0.18, PSQI score: 5.66G4.31, subclinical or clinical depression: 25.9%). We have shown that a substantial proportion of the reduced QoL (48% respectively 65%) was due to the incidence of depression and reduced sleep quality. Conclusions: These findings emphasize the importance of diagnosing depressive symptoms and sleep disturbances in patients with pituitary disease, with the ultimate goal to improve QoL in patients with pituitary adenomas.