bluuebunny/crossref_metadata_2025 huggingface dataset:
Myosin heavy chain degradation during apoptosis in endothelial cells
Authors: Suarez‐Herta N. , Lecocq R. , Mosselmanst R. , Galand P. , Dumont J.e , Robaye B.
Published: March 2003

The cytoskeleton undergoes dramatic changes during apoptosis and many cytoskeletal proteins are known to be degraded during this process. The number of proteases found to be involved in apoptosis is growing but the role of the proteolysis they cause remains poorly understood. This report describes for the first time that myosin heavy chain is cleaved in aortic endothelial cell apoptosis induced either by tumour necrosis factor‐α or okadaic acid. The cleavage was specific since a well‐defined major 97 kDa fragment of myosin heavy chain was produced. The intermediate filament component vimentin was also cleaved into well‐defined fragments (31, 28 and 23 kDa). Kinetic studies showed that proteolysis occurred concomitantly with the morphological changes associated with apoptosis, i.e. cellular condensation and fragmentation in apoptotic bodies. These data suggest that the degradation of myosin and vimentin could be involved in the execution of the morphological alteratins observed during apoptotic cell death.
Proliferation in murine epidermis after minor mechanical stimulation Part 1. Sustained increase in keratinocyte production and migration
Authors: Potten C.S. , Barthel D. , Li Y.Q. , Ohlrich R. , Matthé B. , Loeffler M.
Published: March 2003

It was our objective to obtain an insight into the details and dynamics of the cell proliferative changes following minor barrier disruption, the mechanisms of recovery, and their regulation.

Hair of the dorsal area of DBA2‐mice was removed and the epidermis was tape stripped. Tritiated thymidine was injected into groups of mice at daily intervals thereafter. Labelling and nuclear densities were measured at several time intervals later in the various epidermal strata to characterize cell production and cell fluxes through the tissue.

A dramatic proliferative response was observed at 24 h when the labelling density increased more than sixfold in the basal layer. Labelled cells rapidly appeared in suprabasal layers within a few hours in large quantities while this process took over 2 days in normal skin. Some cycling cells were also found in the suprabasal layer (pulse labelling at 24 h) in contrast with the controls. The cellular flux through the suprabasal layers was drastically (20‐fold) increased and the transit time was shortened. Although the nuclear density in the basal layer showed only moderate changes it increased four‐fold in the suprabasal layer within 5 days. A kinetic model analysis suggested that the cell cycle time of proliferative cells dropped from a normal value of about 200 h to less than 12 h post tape strip. After 7 days, the proliferative activation still persisted, even though at 3 days post tape strip the stratum corneum had been re‐established.

Hence, a mild mechanical alteration with removal of some parts of the cornified layer in mouse backskin epidermis triggers a huge proliferative response with massive overproduction of cells that lasts at least 7 days. Our findings suggest that the re‐establishment of the cornified layer does not immediately shut down cell proliferation and that more complex, slower (long‐term) regulatory processes are involved.
Justice for children? Child protection and the crimino‐legal process
Authors: Sharland
Published: March 2003

Changes in the crimino‐legal process during the last few years have blurred the boundaries between criminal justice and children’s welfare in child protection. These developments have, however, received relatively little critical attention within contemporary discourses surrounding child protection. This paper draws upon primary and secondary research findings to explore the appropriateness and effectiveness of current forensically led responses to child abuse. In particular, it questions the adequacy of existing operational constructs of justice in child protection, arguing the case for a far more comprehensive notion of ‘justice for children’ than presently prevails. Research evidence is reviewed suggesting that current crimino‐legally driven practices fail to achieve even the limited objectives of criminal justice, let alone the higher goals of promoting children’s welfare or attaining ‘justice for children’. Finally the paper explores how these findings may inform and be informed by current debates and practice in social work. While a range of policy and practice remedies are suggested, these, it is argued, must be framed with recognition of the tensions and dilemmas underlying social work in a complex and uncertain social world.
A model for the assessment and management of children with multiple disabilities
Authors: Cass H. , Price K. , Reilly S. , Wisbeach A. , McConachie H.
Published: March 2003

Children with multiple disabilities present complex management problems, both for their families and for the professionals involved in their care. For any one child, the list of functional and medical problems that need to be addressed is frequently reflected in an even longer list of involved professionals, leading to conflicting advice and problems in co‐ordination of care. A hierarchical model for assessment and management is proposed, which highlights the interdependency of apparently different areas of functioning. The model aims to assist both parents and professionals in determining priorities, to improve interdisciplinary working, and to underpin staff training. Illustrative case studies indicate the importance of resolving issues in areas such as visual functioning, positioning and nutrition before integrated functions such as communication skills can be addressed successfully.
The Perceived Illness Experience Scale (PIE): reliability and validity revisited
Authors: Eiser C. , Kopel S. , Cool P. , Grimer R.
Published: March 2003

This paper reports psychometric evaluation of the Perceived Illness Experience Scale (PIE). This includes eight sub‐scales developed to determine the impact of a chronic illness from the patient’s perspective. The sample included 34 patients (mean age = 17 years) successfully treated by limb salvage procedures for a primary bone tumour. Patients also completed measures of well‐being (the SF‐36) and function. To determine the relationship between patient and proxy ratings, mothers also completed the PIE. Evidence of construct validity of the PIE was obtained from significant correlations between PIE and SF‐36 scale scores. There were also significant correlations between function and three of the eight sub‐scales of PIE. Good correlations between patients’ and mothers’ ratings suggests that mothers can be useful proxy raters where patients are unable to provide data themselves. These data suggest that evaluations of patients following limb salvage surgery should not be limited to function measures alone, but need to include assessment of the perceived impact of treatment.
The relationship between lifestyle, social characteristics and obesity in 3‐year‐old Japanese children
Authors: Kagamimori S. , Yamagami T. , Sokejima S. , Numata N. , Handa K. , Nanri S. , Saito T. , Tokui N. , Yoshimura T. , Yoshida K.
Published: March 2003

SummaryIt has been observed that obese children receive genetic and environmental effects that are associated with them being overweight. With regard to the latter, lifestyles such as eating habits and physical activity have been focused on. In the present study, the social characteristics which would dominate their lifestyles were investigated as background variables. For this purpose, 9668 Japanese children aged three years who were all born in Toyama prefecture, Japan, in 1998, served as birth cohort subjects. For the comparison between obese (Kaup index; mass in kg/(height in m)218) and nonobese (Kaup index 18) children, irregular snack intake, physical inactivity and reduced sleeping hours were chosen as statistically significant obesity‐related lifestyle indicators for the children. For social characteristics, family construction (expanded family with grandparents/nonexpanded family), main caregiver (mother/other), attending a nursery school (yes/no) and mother’s employment (full‐time worker/other) were chosen. These were significantly associated with the obesity‐related lifestyles mentioned above using multiple logistic regression analysis adjusted for other variables of social characteristics as well as for gender and birth month (July–December/January–June). The two greatest population‐attributable risk percentages were observed for mother as main caregiver (−36.5%) and attending a nursery school (−28.9%) for irregular snack intake. Therefore, these two social characteristics substantially reduced the number of children with irregular snack intake. On the other hand, the two social characteristics were reversed in children with reduced sleeping hours (population‐attributable risk percentage of mother as main caregiver: 15.4%; attending a nursery school: 17%). In contrast with favourable effects on snack intake these social characteristics showed an adverse influence on the sleeping habits of children.
Parental non‐compliance — a paediatric dilemma. A medical and psychodynamic perspective
Authors: Menahem S , Halasz G
Published: March 2003

Considerable resources have been directed towards the recognition and management of child physical and sexual abuse and/or neglect. However, the issue of parental non‐compliance is less well defined and under recognized. While outwardly seeking advice, non‐compliant parents, especially if anxious, are unable or unwilling to comply with the recommendations made. Conflicts of interest between the parent(s)’ and the health professionals’ perceptions regarding the best interest of the child may arise.

Parental non‐compliance is centred around the parents’ perception of the child’s current problems and its relationship to past problems. Such non‐compliance may reflect ignorance or misunderstanding of the clinical situation. Ignorance may be readily addressed if the parents are receptive and trusting. However, non‐compliance more commonly arises from the parents’ inability to cope emotionally with the stresses surrounding the recommended treatment. Parents may be vulnerable to psychological reactions which inhibit rational thinking. Parental anxieties are best understood in terms of psychological constructs, including ‘defences’ such as ‘denial’ and ‘splitting’, ‘repetition compulsion’ and the need to ‘work through’ psychological barriers so that the child’s best interest is served. Parental non‐compliance can serve to protect the parents from overwhelming fears and anxieties, which if addressed may transform parental defensiveness to co‐operation. Extreme parental non‐compliance may represent a special form of child abuse where, due to parental psychopathology, parents are unable to consider the child’s best interest.

Clinical vignettes arising from a consultant private and hospital ambulatory setting will focus on management strategies for successful outcomes. Recommendations offered on ways to reduce the risk of parental non‐compliance include building trust, eliciting the aid of a parental partner, and organizing a second opinion, thereby improving the chances of a successful outcome.
Preparing children for venepuncture. The effect of an integrated intervention on distress before and during venepuncture
Authors: Kolk A M , Hoof R van , Dop M J C Fiedeldij
Published: March 2003

Venepuncture for routine blood sampling is a very distressing experience for a considerable number of children. Not only do they express high levels of distress during venepuncture but also in anticipation of the procedure. Therefore, prevention or reduction of distress should focus on both phases of the procedure. To this end, three preparation elements were combined: local anaesthesia of the skin, provision of sensory and procedural information, and involvement of the parent. In order to test the effect of this integrated procedure on the distress reactions of young children before as well as during venepuncture, 31 children were randomly assigned to one of two conditions: preparation or no preparation. Independent raters, who were blind to group assignments, scored segments of the videotaped behaviour of the children, according to the Groninger Distress Scale. Prepared children displayed significantly less distress before and during venepuncture than not‐prepared children, regardless of their gender, ethnical origin, age, injection history, and the tension of their parent.
Evidence‐based approach to developmental and behavioural surveillance using parents’ concerns
Authors: Glascoe F P
Published: March 2003

Half of all children with disabilities are not identified before school entrance, which precludes their participation in early intervention programs. Such programs have known value in reducing high school drop‐out rates, increasing employment, delaying child‐bearing and reducing criminal behaviour. Although there are many screening tests that can greatly improve detection rates, these have not been popular in primary care due to test length, difficulty managing children’s behaviour, etc. An alternative is to carefully elicit and interpret parents’ concerns. Research shows that parents’ concerns are as accurate as quality screening tests and that parents are equally able to raise important concerns regardless of differences in education and child‐rearing experience. Parents’ concerns can be elicited quickly and 92% of parents can answer questions in writing while in exam or waiting rooms. Unlike screening tests, use of parents’ concerns facilitates an evidenced‐based approach to comprehensive surveillance and aids in making a range of other important decisions about children’s developmental and behavioural needs. These include when to: offer suggestions on developmental promotion; watch children more vigilantly; screen for emotional and behavioural problems; advise families about behaviour management; offer reassurance and routine monitoring of development that is likely normal; administer a second screening test; or refer for additional testing and the kinds of testing needed.
Are infant behavioural feeding difficulties associated with congenital heart disease?
Authors: Clemente C , Barnes J , Shinebourne E , Stein A
Published: March 2003

Aim

To compare the feeding patterns and difficulties of infants with congenital heart disease (CHD) and healthy controls. Information was gathered via parental questionnaires.

Methods

A matched case controlled study of 64 infants with CHD compared with 64 healthy controls.

Results

The main findings were: (1) Feeding patterns: mothers with infants with CHD used bottle‐feeding as a first method of feeding their babies more often (CHD, 20%, controls, 2%); (2) Specific feeding difficulties: (a) infants with CHD were significantly more breathless when feeding (CHD = 16%, controls, 0%), (b) had more vomiting at mealtimes (CHD = 23%, controls = 11%), but (c) had significantly less spitting (CHD = 19%, controls, 41%); and (3) infants with CHD showed significantly reduced growth.

Conclusions

The feeding difficulties are related to the organic condition and not specific difficulties in mother–infant interaction. Professional support may be required for mothers of infants with CHD to maintain feeding routines and to deal with the difficulties that arise.
Integration of children with visual impairment in regular preschools
Authors: Brambring M
Published: March 2003

The current practice in Germany is to integrate children who are blind or partially sighted into regular preschools providing they exhibit no further severe impairments. The present study asked 72 regular preschool teachers about their experiences in integrating 24 children who were blind and 16 who were partially sighted. Results showed that integration seemed to be unproblematic except for greater emotional difficulties in children who are partially sighted. According to preschool teachers, integrating children who are blind is far more complex and difficult than integrating the partially sighted. One fifth of the blind exhibited marked to serious problems in 10 out of 28 preschool activities surveyed. Most of these difficulties involved manual, cognitive, interactive and daily living skills. When asked about difficulties that had not been anticipated before integration commenced, preschool teachers emphasized four domains: the increase in their own workload; the children's problems with concentration and motivation; fixation on one preschool teacher; and difficulties in the fine‐ and gross‐motor domain as well as in daily living skills. Findings indicate the need for improved preparations and support when integrating the blind into regular preschool.
Polymorphisms in genes involved in glucose metabolism in cases of Sudden Infant Death Syndrome
Authors: Burchell A. , Forsyth L. , Hume R.
Published: March 2003

Background Infants with intra‐uterine growth retardation have an increased risk of Sudden Infant Death Syndrome (SIDS). Hypoglycaemia is also significantly correlated with retardation of intra‐uterine growth. A number of mutations in key proteins involved in regulation of blood glucose (e.g. glucokinase) have been found to result in reduced birth weight. Heterozygous mutations in the coding region of the glucokinase gene have been shown to cause MODY (a form of early onset Type II diabetes mellitus). The aim was to screen a cohort of SIDS and control infants who were either growth retarded or appropriately grown for gestational age to determine if any mutations and/or polymorphisms were present in the glucokinase gene.

Methods PCR, denaturing high performance liquid chromatography on an automated Transgenomic WAVE DNA fragment analysis system and DNA sequencing.

Results Genomic DNA was isolated from 129 infants who were either growth retarded or appropriately grown for gestational age. We found several rare novel polymorphisms in the glucokinase gene in the infant samples. However, none of the samples contained any of the mutations in the glucokinase gene previously reported in cases of MODY.

Conclusions We have found rare novel polymorphisms in the glucokinase gene in the infant samples. In contrast in these samples, we have not found any examples of the previously reported mutations in the coding region of the glucokinase gene found in MODY. This clearly shows that while MODY babies are often small, MODY is not a common cause of either intra‐uterine growth retardation or of SIDS.
Epidemiological investigation of Sudden Infant Death Syndrome infants – recommendations for future studies
Authors: Blair P. , Fleming P.
Published: March 2003

In recent years the study of infant care practices within the sleeping environment has proved to be the single most important set of observations for reducing the risk of Sudden Infant Death Syndrome (SIDS). To further reduce the number of deaths and resolve the debate on safe infant care practice, a closer scrutiny of this environment is required. However, anecdotal observation from uncontrolled death‐scene investigations and a reluctance to diagnose SIDS because of adverse social conditions or circumstantial evidence at the time of death is undermining future research. To investigate SIDS now means investigating the wider umbrella of all Sudden Unexpected Deaths in Infancy (SUDI) because of the potential for misdiagnosis. In trying to find out why SIDS infants die we have increasingly been forced to search for why infants survive in the first few months of life and it is this comparative component of epidemiological observation that has saved so many lives. A death‐scene investigation is vital to any planned future investigation of SIDS but equally essential is a sleep‐scene investigation of surviving infants to put any findings into context. SIDS infants are no longer scattered across the social strata and the cot is not the only environment in which they are found, social deprivation and use of the parental bed are now more discernable. Future studies should therefore reflect these changes with a second control group of surviving infants more closely matched to the type of environment in which SIDS infants might be found.
Triadic bed‐sharing and infant temperature
Authors: Ball H. L.
Published: March 2003

The effects on infants of sleeping with their parents is currently the subject of much debate. One concern regarding infants who sleep in their parents’ bed involves the possibility of overheating. Previous research reported a significantly greater core temperature of 0.1°C among a cohort of bed‐sharing infants compared with a matched cohort of infants sleeping alone. This paper presents a preliminary analysis of the overnight rectal temperature of 12 of the 20 infants who were monitored sleeping alone and with their parents on separate nights at the University of Durham Parent‐Infant Sleep Lab. No significant differences were found in all night rectal temperature, or temperature from 2 h after sleep onset between bed‐sharing and cot sleeping nights. These preliminary analyses suggest a night‐time difference in rectal temperature between routine bed‐sharers and routine cot sleepers, however, these findings will be further explored in the full analyses for this study.
Management of hip dislocation with postural management
Authors: Pountney Teresa , Mandy Anne , Green Elizabeth , Gard Paul
Published: March 2003

BackgroundHip dislocation in children with cerebral palsy has a well‐documented history and morbidity.

ObjectiveThis paper presents a retrospective study of children with bilateral cerebral palsy who had various postural management and its effect on hip deformity. The most widely accepted theoretical model of hip subluxation/dislocation is that an imbalance in muscle length and strength around the hip leads to acetabular dysplasia and consequent hip subluxation. Maintenance of muscle length and strength and loadbearing is therefore a logical prevention. Research on normal infants’ postures has provided biomechanical data to form the theoretical basis of 24 h postural management equipment.

MethodsThe notes and X‐rays of 59 children with bilateral cerebral palsy from East and West Sussex and Oxfordshire were examined and measured to determine whether a relationship existed between postural management and the level of hip subluxation/dislocation. X‐rays were measured using Reimers’ hip migration percentage. Postural management support was divided into three groups for analysis. Category 1: use of a 24‐h postural management approach using Chailey Adjustable Postural Support (CAPS) systems in lying, sitting and standing; category 2: two items of CAPS (either lying/sitting or sitting/standing supports); category 3: use of the CAPS seat only and/or any other postural supports. Hip status was recorded for analysis as both hips safe (under 33% migrated), or one/both hips subluxed.

ResultsChildren using ‘All CAPS’ before hip subluxation maintained significantly more hip integrity than other groups (χ2P< 0.05).

ConclusionsPostural management interventions have an important role in the prevention of hip dysplasia.
Variations in the orthotic management of cerebral palsy
Authors: Morris Christopher , Newdick Helen , Johnson Ann
Published: March 2003

ObjectiveAnecdotal reports that children with cerebral palsy were provided different orthoses in two adjacent UK health districts were investigated using an observational comparative case study.

MethodThe populations were compared using an epidemiological register of children with cerebral palsy, which confirmed that a comparable health service response could be expected. Merging data from the register with the orthotic patient database facilitated comparison of the orthoses prescribed in each district. A survey questionnaire was used to gather the perceptions of clinicians in both districts to understand how each team decides which orthosis to prescribe.

ResultsThere was considerable variation in the types of orthoses prescribed between districts, and particularly of ankle foot orthoses. Survey respondents from the same profession described having the same roles, although clinicians expressed different responsibilities for initiating and sanctioning orthotic prescriptions in their district programmes. The survey also suggested that most clinicians were uncertain when prescribing orthoses, and clinical practice was therefore largely determined by professional preference.

ConclusionDefining the spectrum of activity limitation in geographically defined populations would enhance health services research and assist in the development of trials using different interventions to reduce those limitations.
Child care decisions: parental choice or chance?
Authors: Anderson E. S. , Jackson A. , Wailoo M. P. , Petersen S. A.
Published: March 2003

Aim

A study of the context of child care decision making by inner city and suburban mothers, using parents to help develop and administer a semi‐structured questionnaire.

Methods

A total of 131 mothers were interviewed (73 inner city and 58 suburban) at home.

Results

Inner city mothers were more likely to bottle feed, smoke and adopt risky infant sleeping positions, for example the settee. Virtually all babies (98%) were fully vaccinated and placed prone (95%) to sleep at night. Inner city mothers smoked (71%) despite the known health risks and continued postnatally (55%), mainly as a means of relieving stress. In total, 30% of inner city mothers wanted to breast feed; 19% had succeeded to 6–8 weeks postnatally. Bottle feeding helped both mother and baby to have uninterrupted nights of sleep. Suburban mothers (59%) succeeded in breast feeding, with others choosing bottle feeding mostly because of returning to work. The average weekly alcohol consumption, 32 units inner city and 15 units suburban, was taken in weekend binges by inner city parents, but in daily small amounts by suburban mothers.

Conclusions

The well‐being of the baby was the prime concern of all mothers, irrespective of social background. However, inner city mothers made rational decisions to smoke and bottle feed to reduce the impact of stress and allow the mother much needed respite for the good of the entire family.
Gender identity problems in autistic children
Authors: Mukaddes N. M.
Published: March 2003

Several psychiatric and behavioural problems have been described in children with autism. The aim of this case report is to discuss the developmental pattern of cross‐gender behaviour in children with autistic disorder. Two boys are described with high functioning autism, followed for about 4 years, who showed persistent gender identity problems.
Mite control with low temperature washing–II. Elimination of living mites on clothing
Authors: Bischoff  , Fischer  , Liebenberg  , Kniest
Published: March 2003

Background

Allergens produced by mites are one of the principal causes of allergic disease. House dust mites can be found in significant numbers living in textile garments, and therefore development of optimal washing conditions for delicate textiles represents an important aim for domestic mite control.

Objectives

Investigation of methods to eliminate house dust mites from clothing under low temperature washing conditions.

Methods

Domestic house dust mites Dermatophagoides farinae were cultured on garments under favourable conditions. The breeding success was monitored in terms of population and distribution using the free‐mite Mobility Test. The mite containing garments were washed at low temperature with different commercial detergents in the presence or absence of a mite control additive containing 0.03% benzyl benzoate, and the numbers of mites surviving the washing process were assessed using the Heat Escape Method.

Results

The successful culture of mites in textile garments led to mite numbers of a total of at least 9000 to 10000 mites in 10 garments (Mobility Test). After washing in a domestic washing machine with detergents alone ≈ 6000 remaining mites were detected in 10 garment halfs (Heat Escape Method). In contrast, mite control by the application of the same detergents together with an additive achieved a reduction to almost 50 mites. This is an additional reduction in mite numbers of 99.2%.

Conclusions

It is possible to achieve mite control in delicate garments by washing at low temperature in the presence of a mite control additive providing a final concentration of 0.03% benzyl benzoate.
Molecular analysis of DRB and DQB1 alleles in German spina bifida patients with and without IgE responsiveness to the latex major allergen Hev b 1
Authors: Rihs H.‐P. , Cremer R. , Chen Z. , Baur X.
Published: March 2003

Background and Objective

Spina bifida patients are at a high risk of developing latex allergy. Recently, we found a relationship between the IgE responsiveness to latex allergen hevein and human leucocyte antigen (HLA) alleles DRB1*04 (DR4) as well as DQB1*0302 (DQ8). This study was carried out to investigate the association between HLA class II alleles and the specific IgE response to latex allergen Hev b 1 in spina bifida patients.

Methods

Blood samples from 103 unrelated German spina bifida patients exposed to latex products and from 90 unsensitized controls were examined. Genomic DNA isolation followed by HLA‐D‐specifc polymerase chain reaction (PCR) amplification was used to perform HLA typing of allelic polymorphisms in exon 2 of DQB1 and of DRB1,3,4,5 with sequence‐specific oligonucleotide probes (SSOPs).

Results

Fifty‐one out of 103 spina bifida patients were found to have anti‐latex IgE antibodies; 40 had also anti‐Hev b 1 antibodies. Further, we observed that 80% of the Hev b 1 responders underwent five or more surgeries whereas 55% of the Hev b 1 non‐responders and 75% of the latex‐non‐responders underwent less than five surgical interventions. From the latex‐sensitized group 33% showed an elevated phenotype frequency of DRB1*0701 (DR7) when compared with unsensitized patients (12%, P = 0.0095, Pc = NS) and with controls (17%; P = 0.035, Pc = ns). Fifteen out of 40 Hev b 1 responders also exhibited an elevated DR7 frequency when compared with latex‐sensitive but Hev b 1‐negative patients (38% vs 18%, P = NS) or with unsensitized controls (38% vs 17%, P = 0.013, Pc = NS).

Conclusions

Although we found that the DRB1*0701 (DR7) phenotype frequency was elevated in SB patients with latex‐ as well as with Hev b 1‐IgE responsiveness, the analyses of the other class II alleles clearly demonstrate that the HLA‐D region does not play a major role in the pathogenetic way of sensitization to Hev b 1.
Seasonal variations in cyclic AMP production by peripheral blood mononuclear cells in allergic asthmatics
Authors: Hoekstra  , Weersink  , Postma  , Kauffman
Published: March 2003

Background

Dysfunction of the β‐adrenoceptor (βAR)/adenylyl cyclase (AC) system can impair the response of different cell types, including lymphocytes. In asthma, impairment of this system as well as changes in cytokine production by lymphocytes have been described. Because the severity of asthma can change over the year, a circannual pattern of the βAR/AC system activity may also exist.

Objectives

We set out to examine the activity of this βAR/AC signal transduction system in peripheral blood mononuclear cells (PBMCs) of allergic asthmatics to asses whether differences existed between seasons. We investigated whether changes were associated with asthma severity and circannual changes in serum cortisol levels.

Methods

During 19 months, 41 allergic asthmatics (mean age 28 years) with nocturnal airway obstruction were enrolled in the study. AC activity was measured by cyclic AMP production. Resting, stimulated and potentiated AC activities and their relationships with clinical parameters, seasonal influences and serum cortisol levels were assessed.

Results

The AC activity in resting, stimulated and potentiated cells varied during the year. AC activity was relatively low in the periods June–August and September–November, and higher in December–February and March–May. Receptor‐mediated and potentiated responses expressed as percentage of the resting response were equivalent throughout the year. Serum cortisol levels were positively related to AC activity. No relationships were found between clinical parameters and AC activity or serum cortisol levels.

Conclusions

These results indicate that AC activity in PBMCs of allergic asthmatics shows a seasonal variation. However, seasonal differences in AC activity seems to be unrelated with clinical parameters. Other factors such as serum cortisol levels may have a modulating influence on AC activity. Future studies of AC systems in blood cells of asthmatic patients need to take into account these seasonal influences.
Atopy in children with otitis media with effusion
Authors: Caffarelli  , Savini  , Giordano  , Gianlupi  , Cavagni
Published: March 2003

Background

Contrasting data have been found on the prevalence of atopy in children with otitis media with effusion (OME). A major issue would be to determine whether screening for atopy should be recommended.

Setting

Centre for Study of Otitis Media with Effusion, Tabiano Terme, Parma, Italy.

Objective

The purpose of this study was to investigate the relation of OME to atopy.

Methods

The subjects were 172 children with OME and a control group of 200 children. The protocol included a questionnaire survey of diseases associated with atopy, a skin‐prick test and a clinical evaluation of allergic symptoms and hypersensitivity to aeroallergens.

Results

No significant difference between patients and control group was observed for family history of atopy or positive skin‐prick test reactions. Symptoms associated with atopy occurred significantly more frequently in the group with OME (P < 0.001), though only the presence of rhinitis or atopic eczema was significantly associated with OME.

Conclusions

Prevalence of positive skin‐prick tests results is not enhanced in children with OME. Nevertheless, the association of OME with symptoms associated with atopy suggests that such concomitant diseases may play a part in the pathogenesis of the disorder. Children with allergic rhinitis or atopic eczema should be investigated by tympanometry for OME.
Comparison between eosinophilic markers in induced sputum and blood in asthmatic patients
Authors: Bacci  , Cianchetti  , Ruocco  , Bartoli  , Carnevali  , Dente  , DI Franco  , Giannini  , Macchioni  , Vagaggini  , Morelli  , Paggiaro
Published: March 2003

Background

The usefulness and safety of the analysis of blood inflammatory markers in asthma are widely recognized. Recently, the analysis of induced sputum has been proposed as a safe, non‐invasive tool in the study of airway inflammation in asthma.

Objective

Our aim was to test whether sputum analysis is more useful than blood analysis in the evaluation of airway inflammation in untreated and treated asthmatic patients.

Methods

Twelve untreated patients with mild to moderate asthma underwent a methacholine challenge test, sputum induction and blood sampling. A group of 14 normal subjects was also evaluated for baseline comparison. The same evaluation was repeated after 3 months of budesonide treatment. Before and after treatment, we tested the relationship of eosinophilic markers in induced sputum and blood with clinical and functional data. We also compared eosinophilic markers in induced sputum with the same markers in blood.

Results

Untreated patients showed a significant relationship between sputum eosinophils and symptom score, and between sputum eosinophilic cationic protein and symptom score, FEV1 and PD20FEV1. No relationship between blood eosinophilic markers and clinical or functional data was observed. In budesonide‐treated patients, both sputum and blood eosinophils were significantly lower than in untreated patients, but eosinophil decrease was greater in sputum than in blood. Sputum eosinophilic proteins were also significantly lower in treated patients, whereas serum eosinophilic proteins were low at baseline and remained unchanged after treatment. Sputum eosinophilic markers were lower in normal subjects than in both untreated and treated patients, while blood eosinophils, but not serum eosinophilic cationic protein, were lower in normals than in untreated patients.

Conclusions

The analysis of induced sputum is more useful than the analysis of blood in the evaluation of asthma severity and of the effect of glucocorticoid treatment in patients with mild to moderate asthma.
Food allergy with monovalent sensitivity to poultry meat
Authors: Cahen  , Fritsch  , WÜthrich
Published: March 2003

Background

Allergy to poultry meat is only rarely covered in science. The few reports are usually related to patients allergic to eggs or bird feathers.

Objective

Two patients with a clear history of monovalent, ingestive allergy to chicken and turkey meat, without other food allergies, were analysed. The relevant allergens were to be identified by immunoblotting.

Methods

Both patients were evaluated with skin tests and specific IgE determination (CAP). Allergens were identified by SDS‐PAGE and immunoblotting. Crossreactivity of chicken and turkey meat was examined by IgE inhibition experiments.

Results

Skin tests and specific IgE were positive for chicken and turkey in both patients. Crossreactivities to other poultry meats were documented for duck and goose meat. No sensitization to egg components or poultry feathers could be found. Allergenic proteins of poultry meat were detected at molecular weights of 21, 23 and 50 kDa (distinct bands) and 13, 27 and 33 kDa (faint bands). An additional band at 91 kDa for turkey, can probably not be considered a distinct allergenic epitope. Immunoblot inhibition confirmed cross‐reactivity of chicken and turkey meat allergens.

Conclusion

Food allergy to poultry meat is a distinct disorder with crossreactivity among chicken, turkey and other poultries. The relevant allergens were identified by immunoblotting. Associated food allergy to egg‐components is unlikely as the patients were able to tolerate egg and eggs products.
Vβ8+ T lymphocytes are essential in the regulation of airway hyperresponsiveness and bronchoalveolar eosinophilia but not in allergen‐specific IgE in a murine model of allergic asthma
Authors: Hofstra  , Van Ark  , Savelkoul  , Cruikshank  , Nijkamp  , Van Oosterhout
Published: March 2003

Background

There is increasing evidence that in allergic asthma the inflammatory process is regulated by T lymphocytes. In BALB/c mice the majority of ovalbumin responsive T lymphocytes express the Vβ8.1+ and Vβ8.2+ T‐cell receptor.

Objective

We analysed the contribution of Vβ8+ T lymphocytes during the sensitization and challenge phase in the regulation of antigen‐specific IgE, airway hyperresponsiveness and cellular infiltration in the airways in a murine model of allergic asthma.

Methods

Mice strains genetically lacking (SJL/J and SJA/9) and expressing (BALB/c) the Vβ8+ T cell receptor were used. In addition, prior to the sensitization and prior to the challenge BALB/c mice were treated with antibodies to Vβ8. Mice were sensitized with ovalbumin, followed by repeated challenge with ovalbumin or saline aerosols.

Results

In ovalbumin challenged BALB/c mice treated with control antibody a significant increase in eosinophils in the bronchoalveolar lavage, airway hyperresponsiveness and increased serum levels of ovalbumin‐specific IgE were observed compared to control mice. Treatment of BALB/c mice with antibodies to Vβ8 prior to the sensitization or prior to the challenge period completely inhibited the ovalbumin induced infiltration of eosinophils and airway hyperresponsiveness, while ovalbumin‐specific IgE was slightly decreased. In SJA/9 and SJL/J mice ovalbumin challenge did not induce eosinophilic infiltration and airway hyperresponsiveness. In SJL/J mice ovalbumin challenge induced an upregulation of ovalbumin‐specific IgE, however, in SJA/9 mice no upregulation was observed.

Conclusion

It is demonstrated that Vβ8+ T lymphocytes are essential for infiltration of eosinophils in the airways and development of airway hyperresponsiveness in a murine model of allergic asthma. In contrast, although Vβ8+ T lymphocytes seem to be important for the extent of IgE levels, no essential role for Vβ8+ T lymphocytes in the induction of antigen‐specific IgE was observed.
Reduced interferon gamma production by antigen‐stimulated cord blood mononuclear cells is a risk factor of allergic disorders — 6‐year follow‐up study
Authors: Kondo  , Kobayashi  , Shinoda  , Takenaka  , Teramoto  , Kaneko  , Fukao  , Matsui  , Kasahara  , Yokoyama
Published: March 2003

Background

It is not sufficient to predict ‘high allergic risk newborns’ on the basis of increased IgE concentrations of cord blood alone, because a raised cord blood IgE concentration is specific but not sensitive in the prediction of the development of allergic disorders. Warner et al. have reported that interferon gamma (IFN‐γ) production by allergen‐triggered cord blood cells is a predictor of atopic eczema, based on the 1‐year follow‐up study.

Objective

We examined whether IFN‐γ production by antigen‐stimulated cord blood mononuclear cells (CBMCs) is a risk factor of allergic disorders, based on the 6‐year follow‐up study.

Methods

The relationships among cord blood IgE concentrations, IFN‐γ and interleukin‐2 (IL‐2) productions by antigen‐stimulated CBMCs, and the development of allergic disorders in 21 infants for 6 years were investigated.

Results

Atopic dermatitis, atopic dermatitis and allergic rhinitis, or atopic dermatitis and bronchial asthma developed in seven of 21 subjects. The maximal IFN‐γ concentration in culture supernatants of ovalbumin (OA) or bovine serum albumin (BSA) stimulated CBMCs in infants who developed allergic disorders was significantly lower (P < 0.01) than that in infants who did not develop any allergic disorders. In contrast, the maximal IL‐2 concentration in culture supernatants of OA‐ or BSA‐stimulated CBMCs in infants who developed allergic disorders was not lower than in infants who did not develop any allergic disorders. Moreover, the IFN‐γ concentrations were negatively correlated with cord blood IgE concentrations.

Conclusion

Reduced IFN‐γ production by antigen‐stimulated CBMCs is a risk factor of allergic disorders.
Probiotic bacteria down‐regulate the milk‐induced inflammatory response in milk‐hypersensitive subjects but have an immunostimulatory effect in healthy subjects
Authors: Pelto  , Isolauri  , Lilius  , Nuutila  , Salminen
Published: March 2003

Background

Probiotic bacteria can influence immune responses both specifically by stimulating antibody production and nonspecifically by enhancing phagocytosis of pathogens and modifying cytokine production.

Objective

The authors hypothesized that probiotic bacteria can alleviate hypersensitivity by influencing phagocytes. The modulation of phagocytes may be different in healthy subjects compared with hypersensitive subjects.

Subjects and methods

In a double‐blind, cross‐over study, challenges with milk in milk‐hypersensitive and healthy adults with or without an intestinal bacterial strain, Lactobacillus GG (ATCC 53103) were performed. The challenge‐induced immunoinflammatory response was recorded by measuring the expression of phagocytosis receptors prior to and after the challenge using flow cytometry.

Results

In milk‐hypersensitive subjects, milk challenge increased significantly the expression of CR1, FcγRI and FcαR in neutrophils and CR1, CR3 and FcαR in monocytes. Milk with Lactobacillus GG prevented the increase of the receptor expression. In healthy subjects, milk challenge did not influence receptor expression while milk with Lactobacillus GG increased significantly the expression of CR1, CR3, FcγRIII and FcαR in neutrophils.

Conclusion

Probiotic bacteria appear to modulate the nonspecific immune response differently in healthy and hypersensitive subjects. This is seen as an immunostimulatory effect in healthy subjects, and as a down‐regulation of immunoinflammatory response in milk‐hypersensitive subjects.
Classification of asthma severity: should the international guidelines be changed?
Authors: Sawyer  , Miles  , Lewis  , Fitzharris  , Pearce  , Beasley
Published: March 2003

Background

International guidelines recommend that, in addition to symptoms and medication requirements, measurements of forced expiratory volume in one second (FEV1) and peak expiratory flow (PEF) are necessary for the objective assessment of asthma severity. The guidelines suggest that parity exists between measurements of FEV1 and PEF when expressed as percentage of predicted normal values, and that asthma severity can be classified as mild, moderate or severe on the basis of FEV1 and PEF measurements of > 80%, 60–80% and < 60% of predicted values, respectively.

Objective

To determine the relationship between measurements of FEV1 and PEF when expressed as percentage predicted values.

Methods

A total of 1198 paired measurements of FEV1 and PEF were obtained from the medical records of a random sample of 25 adult asthmatic patients attending a hospital‐based chest clinic. Measurements of lung function were expressed as a percentage of predicted normal values, using the European Respiratory Society prediction equations for PEF and FEV1. For the individual paired measurements, the mean differences between PEF and FEV1 percentage predicted were calculated. Measurements of lung function were used to determine asthma severity with < 60%, 60–80%, and > 80% predicted FEV1 and PEF values representing severe, moderate and mild asthma, respectively. The proportion of paired measurements in which differences in classification resulted from the use of FEV1 or PEF percentage predicted values was then calculated.

Results

In asthma of differing severity, there was considerable variability between measurements of FEV1 and PEF when expressed as percentage predicted values; calculation of the FEV1% predicted resulted in lower values than those of the PEF percentage predicted, with a mean difference of −17.2% (95% CI −16.3%, −18.1%). There was agreement in classification of asthma severity in only 49.9% (598/1198) of paired measurements. Different prediction equations, while variably altering the degree of misclassification, did not correct the basic differences in the assessment of asthma severity dependent on the use of FEV1 or PEF.

Conclusion

FEV1 and PEF values, expressed as percentage predicted, are not equivalent. Pending further evaluation, the authors suggest that published asthma guidelines should avoid the assumption of parity between these two measurements.
Use of cohorts with extensive longitudinal data in investigating the molecular genetics of asthma
Authors: Le SouËf
Published: March 2003

Recent studies have associated several chromosomal regions and specific polymorphisms with asthma, atopy and airway hyperresponsiveness. Most of these studies have been cross‐sectional which substantially limits their power to analyse genotype/phenotype associations. Asthma is a such a highly variable condition that future genotype/phenotype studies should use longitudinal data. Populations with extensive long‐term longitudinal data will facilitate more precise definition of phenotype and allow analysis of asthma's natural history. Longitudinal information also means that each phenotypic attribute can be quantified and considered with respect to age. Collecting longitudinal data prospectively would be extremely expensive and take many years. Using existing longitudinal data sets would clearly be much quicker and more economical, but there are very few suitable data sets to be found. Studying a normal and an asthmatic population is ideal and would provide complementary genotype/phenotype information. This approach is a logical step to using the genotypic information obtained from cross‐sectional molecular genetic studies to more critically establish the effect of genotype on phenotype.