bluuebunny/crossref_metadata_2025 huggingface dataset:
The Formation of Oversized Coalitions in Parliamentary Democracies
Authors: Volden Craig , Carrubba Clifford J.
Published: December 2004

In parliamentary democracies, participating in government provides access to office perks and policy influence. Because of this, as Riker (1962) demonstrated, there is a powerful logic behind the formation of minimum winning coalitions. Thus, an important question is why we regularly observe oversized coalitions. While several theories of coalition formation have been proposed, few have been tested in competition with one another. This article offers a simultaneous test of five main theories of coalition formation using data from 24 countries over the period from 1955 to 1998. The weight of the evidence suggests that oversized governments form when maintaining coalition bargains is harder (Carrubba and Volden 2000). Also, there is mixed support for oversized governments forming when the largest party is smaller and more extreme (Crombez 1996), but not when the status quo policy is more extreme (Baron and Diermeier 2001) and not to secure upper‐house majorities (Lijphart 1984; Sjölin 1993). Finally, while we descriptively observe oversized connected coalitions (Axelrod 1970), the logic behind their formation appears to differ from what Axelrod proposes.
Democracy and the Violation of Human Rights: A Statistical Analysis from 1976 to 1996
Authors: Davenport Christian , Armstrong David A.
Published: December 2004

Most studies posit and identify a linear and negative relationship between democracy and the violation of human rights. Some research challenges this finding, however, suggesting that nonlinear influences exist. Within this article, we examine the structure of the relationship between democracy and repression during the time period from 1976 to 1996. To conduct our analysis, we utilize diverse statistical approaches which are particularly flexible in identifying influences that take a variety of functional forms (specifically LOESS and binary decomposition). Across measures and methodological techniques, we found that below a certain level, democracy has no impact on human rights violations, but above this level democracy influences repression in a negative and roughly linear manner. The implications of this research are discussed within the conclusion.
When Doves Cry: International Rivalry, Unreciprocated Cooperation, and Leadership Turnover
Authors: Colaresi Michael
Published: December 2004

Varied research traditions suggest that dovish leaders will be thrown out of office under harsh external circumstances. Below, I elaborate a model of rivalry maintenance that draws on and refines the insight from studies of leadership tenure and foreign policy. Specifically, I expect a leader who offers unreciprocated cooperation to a rival (a dove) to be more likely to be deselected from power than a leader that takes a harder line vis‐à‐vis the rival (a hawk). I test this expectation using event history techniques and data spanning the 1950–1990 time period and find strong evidence that dovish leaders pay an electoral price within a rivalry context. The findings suggest an internationally contingent domestic incentive to maintain rivalry and conflict over time.
Executive Authority, the Personal Vote, and Budget Discipline in Latin American and Caribbean Countries
Authors: Hallerberg Mark , Marier Patrik
Published: December 2004

Recent scholarship on budgeting in Latin American and Caribbean (LAC) countries indicates that political institutions impact the level of budget discipline. Building upon this previous research, we argue that the principal problem that must be addressed in both the government and the legislature to insure strong fiscal discipline is the common pool resource (CPR) problem. At the cabinet level, the CPR problem arises because ministers consider the implications of decisions on their ministries only. The level of the CPR problem in the legislature depends upon the electoral system. Using a data set of LAC countries for the period 1988–97, we find that executive power in the budget process is most effective in reducing budget deficits when electoral incentives for the personal vote is high in the legislature, while strengthening the president (or prime minister) in countries where the personal vote is low in the legislature has no effect.
ALiberalRepublican “Cato”
Authors: Mitchell Annie
Published: December 2004

In recent years the polarized debate surrounding the relative influence of the liberal and classical republican traditions on the political thought of the Founding Fathers has abated somewhat. Trenchard and Gordon'sCato's Letters,however, seen predominantly as a classical republican text, continues to be misread, resulting in a misinterpretation of the way in which it may have been read by the Revolutionary era generation. This article presents, evaluates, and subsequently rejects the arguments in favor of viewing the work of Trenchard and Gordon within the framework of either a classical republican or a neo‐roman tradition. It argues instead that the authors fall squarely within a liberal republican tradition, embracing Locke, Mandeville, Hume, and Smith and suggests that it was in this vein that they were read by the Founding Fathers.
International Conflict and the Tenure of Leaders: Is War Still Ex Post Inefficient?
Authors: Chiozza Giacomo , Goemans H. E.
Published: December 2004

Recent work in comparative politics and international relations has shown a marked shift toward leaders as the theoretical unit of analysis. In most of the new theoretical models a core assumption is that leaders act to stay in power. There exists, however, remarkably little systematic empirical knowledge about the factors that affect the tenure of leaders. To provide a baseline of empirical results we explore how a broad range of domestic and international factors affects the tenure of leaders. We focus in particular on the effect of conflict and its outcome. We find that political institutions fundamentally mediate the costs and benefits of international conflict and that war is not necessarily
ex post
inefficient for leaders. This suggests that the assumption that war is
ex post
inefficient for unitary rational actors can not be simply extended to leaders. Therefore, a focus on leaders may yield important new rationalist explanations for war.
Analyzing Roll Calls with Perfect Spatial Voting: France 1946–1958
Authors: Rosenthal Howard , Voeten Erik
Published: December 2004

A recent methodological advance in legislative roll‐call analysis is especially relevant to the study of legislative behavior outside the setting of the United States Congress. We argue that Poole's (2000) optimal classification method for roll‐call analysis is preferable to parametric methods for studying many legislatures. This is because the nature of party discipline, near‐perfect spatial voting, and parliamentary institutions that provides incentives for strategic behavior lead to severe violations of the error assumptions underlying parametric methods. The robustness of the nonparametric method to the stochastic nature of the data makes it an ideal candidate for studying strategic behavior in legislatures. We illustrate these points with an analysis of data from the French Fourth Republic (1946–1958).
‘Cheaper than a newcomer’: on the social production of IVF policy in Israel
Authors: Birenbaum‐Carmeli Daphna
Published: December 2004

This paper explores the shaping of health policy in terms of power relations and group interests, as enacted in Israel's IVF policy. A comparison with the principles of IVF provision in other countries (UK, Canada, USA) shows Israel's policy to be substantially more ‘liberal’. In order to explain this exception, the policy is initially located within the context of the state's pro‐natalist reproductive policy, women's impaired equality and a complex system of healthcare provision. A Parliament Committee discussion on the subject is then analysed in greater detail, revealing three narratives that are used to account for the state's IVF policy: a nationalised narrative of reproductive medicine as a source of international acclaim, a personalised narrative of compassion for anguished women, and a medicalised narrative of experts as being best capable of regulating IVF. All three narratives have merged within the local IVF discourse, enabling the creation and maintenance of consensus among the participating politicians, physicians, consumers and women activists. Of significance is the muted argument regarding the state's interest in enlarging its Jewish population, which dominated other discussions on this topic. I argue that it is the demographic interest which crucially underlies the state's willingness to sustain its costly IVF policy, and that it is this interest which has enabled the various participants – who all shared an interest in unlimited IVF provision – to present a unanimous agreement. State representatives then used this consensus as a firm civil ground for the development and maintenance of Israel's exceptional IVF policy. The paper concludes with several implications regarding women's health and wellbeing.
Use of methoxamine in the resuscitation of epinephrine resistant electromechanical dissociation
Authors: Harban F. M. J.
Published: December 2004

Dr McBrien et al. describe three interesting cases of electromechanical dissociation (EMD) resistant to epinephrine treatment (McBrien et al. Anaesthesia 2001; 56: 1085–9). In these cases, an␣α adrenergic agonist (methoxamine) proved to be lifesaving. However, to ‘consider an α agonist for any case of cardiac arrest secondary to electromechanical dissociation which is unresponsive to epinephrine’ may not be appropriate. These cases involved a specific situation where the likely cause of hypotension was a fall in the systemic vascular resistance (SVR). This occurred as a result of proven type 1 hypersensitivity in two cases and direct action of methylmethacrylate cement in the other. Clearly in this case, an α agonist is a logical choice. The Advanced Life Support guidelines are designed to cover a wide range of differing conditions for use by practitioners of differing experience who may or may not be aware of the originating event. Indeed, hypotension causing EMD may be as a result of cardiac tamponade, tension pneumothorax or hypovolaemia. It is unlikely that the use of α agonists would be helpful in these situations. It would seem prudent to continue to use epinephrine as the first line treatment for an EMD cardiac arrest and to advise using an α agonist in cases of hypotension where reduced SVR is suspected as the cause when epinephrine may not be effective in restoring the blood pressure. However, as methoxamine has now been withdrawn from clinical use, other α agonists such as metaraminol or phenylephrine may be more readily available.
A simple technique to reduce the incidence of accidental dural puncture
Authors: Cohen S. , Chokkra R. , Bokhari F.
Published: December 2004

We would like to respond to recent comments (Reynolds. Anaesthesia 2001: 56: 1129) on our epidural technique. In our practice we apply loss of resistance to air technique, which helps identify a nick in the dura with a small leak of CSF. On many occasions, only a few drops of CSF and not a constant leak helped identify dural puncture, which could have been missed with the use of saline. Upon inserting the epidural needle, we remove the stylet when the needle is engaged in the interspinous ligament or the ligamentum flavum. Very often, it is difficult for our residents to advance the epidural needle with one hand and apply constant pressure on the plunger with the other hand. Excessive pressure with one hand, by a resident, had caused dural puncture when the needle was pushed in too far. By reinserting the stylet with each advancement of the needle, we remove tissues that may enter and occlude the epidural needle. It is quite possible that constant plunger pressure with saline may also avert this problem.
Clinical trials: specific problems associated with the use of a placebo control group
Authors: Cleophas T. J. M. , Meulen J. v.d. , Kalmansohn R. B.
Published: December 2004

The topic of placebos in clinical research has been recently addressed in general medical journals, and is relevant to a clinical pharmacologists’ readership as well. In this article we try to give an overview of the benefits as well as problems of this methodology. Although the use of placebos in drug development is frequently absolutely essential, important ethical and technical problems are generally involved. We conclude that the placebo‐controlled trial although methodologically pure may sometimes cause too many difficulties in the clinical setting.
Sources of variability in nicotine and cotinine levels with use of nicotine nasal spray, transdermal nicotine, and cigarette smoking
Authors: Benowitz N.L. , Zevin S. , Jacob P.
Published: December 2004

Aims Nicotine nasal spray and transdermal nicotine are effective aids to smoking cessation, and are being evaluated for treatment of other medical diseases. Wide variation in levels of nicotine and its metabolite, cotinine, have been observed with such therapies. This study aimed primarily to assess sources of individual variability in nicotine and metabolite plasma levels from these dosing systems and from cigarette smoking.

Methods Twelve cigarette smokers, studied on a clinical research ward, received four treatments of 5 days duration each, including (1) cigarette smoking, 16 cigarettes/day; (2) transdermal nicotine, 15 mg/day; (3) nicotine nasal spray, 24–1 mg doses/day; (4) placebo nicotine nasal spray, 24 doses/day. On a different occasion, the disposition kinetics of nicotine and cotinine were determined via infusion of deuterium‐labeled nicotine and cotinine. Plasma levels of nicotine, cotinine, and 3′‐hydroxycotinine and daily intake of nicotine during various treatments were examined, as well as pharmacokinetic factors that determined plasma nicotine and cotinine levels.

Results There was considerable individual variation in plasma nicotine and cotinine levels and in the daily dose of nicotine absorbed from various delivery systems, with most variability with nicotine nasal spray (fivefold) and least for transdermal nicotine (two‐to threefold). Plasma nicotine levels were determined most strongly by nicotine clearance. Cotinine levels were determined most strongly by dose of nicotine and, to a lesser extent, the clearance of cotinine and fractional conversion of nicotine to cotinine.

Conclusions Plasma levels of nicotine and cotinine produced by nicotine therapies are highly variable, due to both wide variability in individual pharmacokinetics and in dose delivery from the products. To compensate for individual differences in clearance, individualization of nicotine dosing based on therapeutic drug monitoring with comparison to nicotine or cotinine levels during cigarette smoking prior to treatment may be necessary to optimize nicotine therapy. This study also validates a recently proposed method for estimating absolute bioavailability of a drug using drug and metabolite pharmacokinetic data, and presents novel data on plasma levels of the metabolite trans‐3′‐hydroxycotinine in people.
Frequency and characteristics of hospital admissions associated with drug‐related problems in paediatrics
Authors: Easton Kylie L. , Chapman Colin B. , Brien Jo‐anne E.
Published: December 2004

Aim

To determine the frequency of paediatric hospital admissions associated with drug‐related problems (DRPs) at two Australian hospitals.

Methods

The investigator and ward pharmacists prospectively screened eligible patients. A multidisciplinary panel reviewed data and established causality, preventability and clinical significance classifications.

Results

Over 22 weeks of data collection, a total of 11 564 patients were admitted, 2933 met eligibility criteria. Of those eligible, 127 [4.3%, 95% confidence interval (CI) 3.6, 5.0] were judged to have hospital admissions associated with DRPs. Direct costs associated with DRPs identified totalled £100 707. Of the 81 cases assessed for preventability, 46.9% were deemed preventable.

Conclusions

This research has provided information on the nature and characteristics of paediatric DRPs associated with hospital admissions.
Novel FLT3 point mutations within exon 14 found in patients with acute myeloid leukaemia
Authors: Stirewalt Derek L. , Meshinchi Soheil , Kussick Steven J. , Sheets Kayla M. , Pogosova‐Agadjanyan Era , Willman Cheryl L. , Radich Jerald P.
Published: December 2004

Internal tandem duplications in FLT3 are the most common mutation in acute myeloid leukaemia (AML), with agarose gel electrophoresis of polymerase chain reaction products (PCR/agarose) being the screening method of choice for these mutations. As PCR/agarose screening does not detect small mutations, single‐stranded conformational polymorphism analyses (PCR/SSCP) were used in an attempt to identify previously unrecognized point mutations in FLT3 exons 14 and 15 of 140 AML patients, using newly designed primers that anneal within intron sequences. Novel missense point mutations were found in exon  14, suggesting additional investigations should be performed in AML and other haematopoietic malignancies, using this sensitive technique.
Percutaneous vertebroplasty for acute vertebral body fracture and deformity in multiple myeloma: a short report
Authors: Diamond Terrence H. , Hartwell Tabitha , Clarke William , Manoharan Arumugam
Published: December 2004

We describe seven patients with multiple myeloma who were treated for acute vertebral body fractures with percutaneous vertebroplasty to a total of 14 vertebrae. Six of the seven patients had at least a 50% decrease in their pain scores at 24 h following vertebroplasty. There were no procedure‐related complications. These encouraging results prompt us to suggest further large‐scale evaluation of this procedure in myeloma patients.
Chemotherapy plus G‐CSF mobilized peripheral blood stem cell harvests from acute myeloid leukaemia patients contain large amounts of polyclonal myeloid linnegCD11cpos dendritic precursor cells
Authors: Sánchez Joaquín , Herrera Concepción , Torres Antonio , Román‐Gómez José , Álvarez Miguel A.
Published: December 2004

Dendritic cells (DC) are potent antigen‐presenting cells that can induce effective tumour‐specific T‐cell responses. This study investigated leucapheresis products as source of DC precursors in 48 patients undergoing autologous peripheral blood stem cell (PBSC) transplantation for haematological malignancies. Strikingly, high‐dose cytarabine and etoposide plus granulocyte colony stimulating factor (G‐CSF) mobilized PBSC harvests from acute myeloid leukaemia (AML) patients containing the highest number of myeloid linnegCD11cpos DC (mean: 7·04 × 106/kg, range: 1·46–19·67) which was 18·1‐fold higher than in non‐AML patients mobilized using chemotherapy (CT) regimens plus G‐CSF. Clonality of purified linnegCD11cpos DC from CT plus G‐CSF mobilized AML patients (n = 8 ) was assessed using the human androgen‐receptor locus methylation, disclosing a polyclonal pattern in five female patients. These cells displayed morphological and phenotypic features of myeloid DC precursors with expression of HLA‐DR, HLA‐ABC, CD86, CCR5 and CD54 molecules but lacking CD80, CD83, CD1a and CD40 antigens. Short‐term culture with autologous leukaemic cell lysates plus tumour necrosis factor‐α yielded maturated myeloid DC capable of triggering interleukin‐2 and interferon‐γ production by autologous T‐lymphocytes. These findings suggest that the use of post‐remission CT and G‐CSF as mobilizing regimen in AML patients generates PBSC containing high doses of polyclonal myeloid linnegCD11cpos DC precursors, which could be used to design feasible immunotherapy protocols.
Molecular rescue of tumour‐specific T cell receptor idiotype from T cell lymphomas
Authors: Reddy Sunil A. , Levy Ronald
Published: December 2004

The T cell receptor (TCR) idiotype on T cell lymphomas can serve as a vaccine target. To clone the relevant genes, 5′ rapid amplification of cDNA ends (RACE) was performed on 13 T cell lymphomas and nine control samples. Two polymerase chain reactions (PCR) were performed for each TCR chain (α and β) and the proportion of the clonal TCR sequence over the total number of TCR sequences was calculated. For α, the average proportions were 0·43 vs. 0·05. For β these were 0·44 and 0·04. The TCR was identified in 10 of 13 lymphoma samples.
Contributions of the VENFISH program: meso‐zooplankton, Pacific saury (Cololabis saira) and walleye pollock (Theragra chalcogramma) in the northwestern Pacific
Authors: ITO SHIN‐ICHI , SUGISAKI HIROYA , TSUDA ATSUSHI , YAMAMURA ORIO , OKUDA KUNIAKI
Published: December 2004

The comprehensive study of the variation of the oceanic environment and fish populations in the northwestern Pacific (VENFISH) was an interdisciplinary scientific program to enhance our understanding of relationships between the ocean environment and the pelagic fishes, Pacific saury and walleye pollock. As prey of saury and walleye pollock, key species of zooplankton were selected and their life history and production were elucidated. Retrospective analyses were also conducted to investigate the mechanisms of production variation in some zooplankton species. Life history and ecology of Pacific saury and walleye pollock were also investigated and substantial improvements to our understanding of them were achieved. In addition, improved information from VENFISH were used to develop several models to investigate saury growth, and population dynamics, and predatory pressure on zooplankton from walleye pollock. Observational and model results indicate the importance of the Kuroshio and the Kuroshio–Oyashio transition region to saury recruitment and of Oyashio transport to walleye pollock recruitment. Moreover, models developed under VENFISH will become the basis of fisheries management models for saury, walleye pollock, and other fishes in the future.
Dog allergen in indoor air and dust during dog shows
Authors: Mussalo‐Rauhamaa H. , Reijula K. , Malmberg, M. , Mäkinen‐Kiljunen S. , Lapinlampi T.
Published: December 2004

Background and methods:  Dog dander is one of the most important indoor allergens in Nordic countries. Due to the population flow into cities, the number of dogs in urban areas has increased. Dog allergens can be found practically everywhere indoors. We measured allergen content in indoor air and dust during dog shows.

Results:  In facilities used for dog shows, the dog allergen content was exceptionally high, up to 2 100 000 ng Can f 1/g dust, but it can be reduced by proper cleaning. The efficiency of cleaning will remain poor if furniture and textiles are not cleaned or the distribution of airborne allergen cannot be prevented.

Conclusions:  Dog shows should not be held in public facilities, such as schools, where a significant proportion of occupants are hypersensitive to dog allergens and may therefore suffer symptoms due to the exposure to dog dander.
Milk allergy/intolerance and atopic dermatitis in infancy and childhood
Authors: Novembre E. , Vierucci A.
Published: December 2004

Adverse reactions to cow’s milk proteins are usually indicated as cow’s milk allergy/intolerance (CMPA/CMPI) because no differentiation is possible on the basis of symptoms, and there is no reliable single laboratory test available for the diagnosis of CMPA or CMPI. Elimination and challenge tests for cow’s milk proteins using strict, well‐defined diagnostic criteria are required for the diagnosis of CMPA/CMPI. Atopic dermatitis (AD) is one of the most common symptoms of CMPA/CMPI. Approximately one third of AD children have a diagnosis of CMPA/CMPI according to elimination diet and challenge tests, and about 40–50% of children <1 year of age with CMPA/CMPI have AD. Many children with AD and CMPA/CMPI develop a complete tolerance to CMP in a few years. Children with persisting forms of CMPA/CMPI have a more frequent history of familial atopic disease, change in CMPA/CMPI manifestations over time and very high frequency of multiple food intolerance and allergic diseases. Many children who outgrow their AD develop other allergic diseases, such as rhinitis or asthma. The simultaneous development of allergic tolerance in one organ and the intolerance or atopic disease in another organ suggest that genetic, immunologic and environmental factors play a complex role in the natural history of AD and other atopic diseases.
Atopy patch test in patients with atopic eczema/dermatitis syndrome: comparison of petrolatum and aqueous solution as a vehicle
Authors: Oldhoff J. M. , Bihari I. C. , Knol E. F. , Bruijnzeel‐Koomen C. A. F. M. , de Bruin‐Weller M. S.
Published: December 2004

Background:  The atopy patch test (APT) is an in vivo model to study the induction of eczema by inhalant allergens. This study was designed to compare two commonly used APT methods.

Methods:  In the first method, the allergen is dissolved in aqueous solution, which is applied on tape‐stripped skin. In the second method, the allergen is dissolved in petrolatum and applied without tape stripping. Thirteen patients with atopic dermatitis sensitized to inhalant allergens were patch tested using both methods. Reactions were evaluated macroscopically and microscopically after 48 h.

Results:  Nine out of 13 patients displayed a positive reaction for both methods. One patient had a positive APT for the aqueous method alone and three for the petrolatum method alone. Reactions were significantly stronger when using the petrolatum method. Histological evaluation of the nine patients positive for both methods showed no significant differences in number of eosinophils, T‐cells and neutrophils.

Conclusion:  The APT using the petrolatum vehicle induces a higher number of positive reactions and is significantly stronger relative to the APT using allergen in aqueous vehicle. The cellular influx in both test methods is comparable. Both methods can be used to study the mechanisms in the induction of eczema by inhalant allergens.
A novel inhalation allergen present in the working environment of beekeepers
Authors: Rudeschko O. , Machnik A. , Dörfelt H. , Kaatz H.‐H. , Schlott B. , Kinne R. W.
Published: December 2004

Background:  Inhalation allergies, caused by allergens from various kinds of pollen, house dust mites, animal epithelium, and mould fungi, are strongly increasing in frequency. In 2.6% of the cases the allergen source remains unidentified. The present paper describes a so far unknown inhalation allergy which was observed in the case of a patient working with hives.

Methods and results:  The allergen was characterized by immunoblotting, enzyme‐linked immunosorbent assay inhibition, and isoelectrofocusing, using the serum of the patient. It is present in both the bee bodies and the larvae, has a molecular mass of 13 kDa, and an isoelectric point of 5.85. It is thermolabile and does not cross‐react with allergens from birch, mugwort and timothy grass pollen, mould fungi, or bee venom. The N‐terminal amino acid sequence of allergen from larvae was determined to be 2QIEELKTRLHT12. A similar allergen of 13 kDa was also found in Varroa mite accompanying bee populations.

Conclusion:  Honey bees (including the larva stadium) and Varroa mite contain a 13‐kDa protein causing an allergic reaction. Presently, there is no evidence whether the case described is a singular phenomenon or whether this allergen is a more common inducer of allergies among subjects exposed to honey bees. However, a bee and Varroa mite allergy has to be considered for beekeepers after exclusion of known inhalation allergies.
Respiratory allergy in apprentice bakers: do occupational allergies follow the allergic march?
Authors: Walusiak J. , Hanke W. , Górski P. , Pałczyński C.
Published: December 2004

Background:  This prospective study describes the incidence, risk factors and natural history of occupational respiratory allergy in apprentice bakers.

Methods:  Two hundred and eighty‐seven apprentice bakers were examined using a questionnaire, skin prick tests (SPTs) to common and occupational allergens, evaluation of total serum IgE level and specific anti‐flour and α‐amylase IgE, before, 1 year and 2 years after the onset of vocational training. To diagnose occupational respiratory disease, spirometry, histamine and allergen‐specific inhalation challenge tests were performed.

Results:  The incidence of work‐related chest symptoms was 4.2% in the first year and 8.6% in the second year of exposure. Hypersensitivity to occupational allergens developed in 4.6 and 8.2% of subjects, respectively. The incidence of occupational allergic rhinitis was 8.4% after 1 year and 12.5% after 2 years, and that of occupational asthma/cough‐variant asthma 6.1 and 8.7%, respectively. The latency period of work‐related rhinitis symptoms was 11.6 ± 7.1 months and chest symptoms 12.9 ± 5.5 months. Only in 20% of occupational asthmatics could allergic rhinitis be diagnosed a stage earlier. In 21 out of 25 subjects with occupational asthma, chronic cough was the sole clinical manifestation of the disease. Stepwise logistic regression analysis revealed that positive SPT to common allergens was a significant risk factor of hypersensitivity to occupational allergens (OR = 10.6, 95% CI 5.27; 21.45), occupational rhinitis (OR = 3.9, 95% CI 1.71; 9.14) and occupational asthma (OR = 7.4, 95% CI 3.01; 18.04). Moreover, positive SPT to occupational allergens on entry to the training was a significant risk factor of asthma (OR = 6.9, 95% CI 0.93; 51.38).

Conclusions:  The incidence of occupational asthma and rhinitis in apprentice bakers is high and increases z with the duration of exposure. Skin reactivity to common and occupational allergens is the main risk factor of bakers’ asthma. Most cases of work‐related respiratory symptoms among apprentice bakers are related to a specific sensitization. In most subjects who developed occupational asthma, rhinitis occurred at the same time as the chest symptoms did.
Association between nasal and bronchial symptoms in subjects with persistent allergic rhinitis
Authors: Downie S. R. , Andersson M. , Rimmer J. , Leuppi J. D. , Xuan W. , Akerlund A. , Peat J. K. , Salome C. M.
Published: December 2004

Background:  The association between nasal and bronchial symptoms, and the course of bronchial responsiveness and airway inflammation in house dust mite sensitive persistent rhinitis over a prolonged time period has not been thoroughly explored.

Objective:  To determine if nasal symptoms were associated with bronchial symptoms in persistent rhinitic subjects, and to assess their bronchial responsiveness and airway inflammation in comparison to nonrhinitic, nonatopic controls. The additional impact of pollen sensitivity on the lower airways in rhinitic subjects was also addressed.

Methods:  Rhinitics and controls answered telephone symptom questionnaires once every 2 weeks for 1 year. Every 3 months, exhaled nitric oxide (eNO) and bronchial responsiveness to histamine were measured.

Results:  Thirty‐seven rhinitics and 19 controls completed the study. High nasal symptom scores in rhinitic subjects were associated with bronchial symptoms (OR = 1.7, 95% CI 1.2–2.5). Bronchial hyper‐responsiveness was present in 32.4% of rhinitic subjects on at least one clinical visit during the year. Pollen allergy caused seasonal variation in eNO (P = 0.03).

Conclusion:  In persistent rhinitic subjects, high nasal symptom scores were associated with bronchial symptoms, and many subjects experienced bronchial hyper‐responsiveness during the year. Persistent rhinitic subjects were more at risk than healthy adults of bronchial symptoms and airway inflammation, which are likely risk factors for asthma.
Symptoms of persistent allergic rhinitis during a full calendar year in house dust mite‐sensitive subjects
Authors: Downie S. R. , Andersson M. , Rimmer J. , Leuppi J. D. , Xuan W. , Akerlund A. , Peat J. K. , Salome C. M.
Published: December 2004

Background:  Little is known about the natural course of persistent rhinitis symptoms over a prolonged period.

Objective:  To describe the frequency and severity of nasal symptoms and quality of life (QoL) in house dust mite‐sensitive persistent rhinitic subjects and to determine if medication use was related to symptoms.

Methods:  Rhinitics and controls were telephoned fortnightly for 1 year to monitor symptoms. QoL was measured every 3 months.

Results:  Thirty‐seven rhinitics and 19 controls completed the study. Total nasal symptom scores (TNSS) were ‘high’ for 65% (95% CI ± 6%) of the year in rhinitic subjects. When TNSS increased by 1, the likelihood of nasal medication use increased by 25% (95% CI: 7–46%). General and specific QoL were worse in rhinitic subjects than controls (P < 0.04 and <0.0001). Rhinitics with pollen allergy (n = 21) had seasonal variation in the frequency of high nasal symptom scores (P = 0.02).

Conclusion:  Nasal symptom scores were consistently high in rhinitics, and their QoL was worse than controls, even in general QoL. An increase in nasal symptom score increased the likelihood of nasal medication use. These findings help to characterize the course of persistent rhinitis over a previously unstudied period of 1 year.
Fatty acids in colostrum from mothers of children at high risk of atopy in relation to clinical and laboratory signs of allergy in the first year of life
Authors: Reichardt P. , Müller D. , Posselt U. , Vorberg B. , Diez U. , Schlink U. , Reuter W. , Borte M. ,   The Leipzig Allergy Risk Children's Study Group
Published: December 2004

Background:  It remains controversial whether fatty acid (FA) composition of breast milk relates to development of atopy in the infant. This study evaluates FA in colostrum from mothers of children at high risk of atopy in association with atopy at the age of 1 year.

Methods:  The FA of colostrum were analyzed for 218 children (60 with low birth weight between 1500 and 2500 g, 84 with a history of maternal atopy, and 74 with an elevated cord blood immunoglobulin (Ig)E of >0.9 IU/ml). Total lipids were extracted, methylated and separated by gas–liquid chromatography. Laboratory screening for allergic sensitization and clinical examination took place within the Leipzig Allergy Risk Children's Study (LARS).

Results:  Low birth weight was correlated with low percentage levels of 20:2n‐6, 22:2n‐6, and 22:3n‐3 (r = 0.14, P < 0.05; r = 0.14, P < 0.05 and r = 0.20, P < 0.01, respectively) and low gestational age at birth was correlated with low 22:3n‐3 (r = 0.15, P < 0.05). There was no association between FA and atopic eczema at the age of 1 year. However, high linoleic acid (LA, 18:2n‐6) was linked to high specific IgE against cow's milk protein (P < 0.05), and low docosapentaenoic acid (DPA, 22:5n‐3) was associated with elevated total serum IgE (P < 0.05) at the age of 1 year, respectively.

Conclusions:  The polyunsaturated fatty acid composition of colostrum in a high risk newborn population shows associations with atopic sensitization at the age of 1 year and may be predictive for later atopic disease.
High prevalence of storage mite sensitization in a general adult population
Authors: Vidal C. , Boquete O. , Gude F. , Rey J. , Meijide L. M. , Fernández‐Merino M. C. , González‐Quintela A.
Published: December 2004

Background and aim:  Occupational and nonoccupational storage mite (SM) allergy has received considerable attention in recent years. The study aimed to evaluate both the prevalence and factors associated with sensitization to SMs in a general adult population from a warm and humid area where mites are the predominant allergens.

Patients and methods:  An age‐stratified random sample of 720 subjects was drawn from the population older than 18 years of A‐Estrada (Galicia, Spain). From 697 eligible subjects, 469 (67%, median age 54 years, range 18–92 years, 44% males, 75% of cases from a rural environment) agreed to participate. Skin prick tests to SMs (Lepidoglyphus destructor and Tyrophagus putrescentiae), house dust mite (Dermatophagoides pteronyssinus), pollens, moulds and animal danders were performed in all cases. Wheals ≥ 4 mm were considered positive. Epidemiological data were assessed by questionnaire. A design‐based analysis was performed and all calculations were weighted to give unbiased estimates.

Results:  Tyrophagus putrescentiae and L. destructor were the leading causes of allergic sensitization throughout all ages. SM sensitization was found in 104 cases (weighted value 24.4%, 95% CI 20.6–28.2). SM sensitization was inversely associated with age. Multivariate analysis showed that SM sensitization was not significantly associated with sex, smoking, educational level, farming profession, rural environment, indoor humidity, presence of pets, livestock or grain storage facilities near home.

Conclusions:  SMs (T. putrescentiae and L. destructor) are major aeroallergens in adults in the region studied, even in subjects without occupational exposure.
Interpretation of subjective symptoms in double‐blind placebo‐controlled food challenges – interobserver reliability
Authors: Gellerstedt M. , Magnusson J. , Gråjö U. , Ahlstedt S. , Bengtsson U.
Published: December 2004

Background:  Subjective symptoms after food challenges are difficult to interpret and no standard is available. We discuss a strategy for how to interpret a diary. Furthermore, the interobserver reliability is evaluated.

Methods:  Diaries for 32 patients with subjective symptoms were used. The diaries were re‐evaluated with a predefined strategy by three independent observers.

Results:  The proportion of positives was 21.9% among the old diagnoses, according to the new approach 34.4% (observers I and II) and 37.5% (observer III) were positive. The new approach had high interobserver reliability (97 and 100%).

Conclusions:  The proportion of positives depends on how subjective symptoms are interpreted. Interpretations of subjective symptoms in diaries could be made with high interobserver reliability.
MCP‐1 gene regulatory region polymorphism in Chinese children with mild, moderate and near‐fatal asthma
Authors: Yao T.‐C. , Wu K.‐C. , Chung H.‐T. , Shaw C.‐K. , Kuo M.‐L. , Wu C.‐J. , Huang J.‐L.
Published: December 2004

Background:  A polymorphism in the monocyte chemoattractant protein 1 (MCP‐1) gene regulatory region has been associated with asthma in Caucasians. This polymorphism is possibly endemic to the Asian region, but its impact on Asian populations is unclear. In addition, the relationship of this marker with life‐threatening asthma has not been clarified. The aim of this study was to test the genetic association between the MCP‐1 –2518A/G polymorphism and asthma/atopy in a cohort of Chinese children, with particular emphasis on those patients who had experienced life‐threatening asthma attacks.

Methods:  Forty‐eight children with near‐fatal asthma, 134 mild‐to‐moderate asthmatics, 69 allergic‐disorder cases without asthma, and 107 nonasthmatic, nonatopic control children were genotyped by a polymerase chain reaction‐based assay.

Results:  Comparison of the four groups of children (n = 358) revealed no detectable differences in genotype or allele frequencies of the MCP‐1 –2518A/G polymorphism. There was no evidence of association between the polymorphism and any of the outcomes of interest including clinical severity, blood eosinophil count, atopy, total serum IgE levels, and degree of bronchial hyper‐responsiveness.

Conclusion:  These results suggest that the MCP‐1 –2518A/G polymorphism is not a risk factor for near‐fatal asthma. Furthermore, this polymorphism seems to play no role in the development of asthma or atopy in Chinese subjects, possibly as a result of the genetic heterogeneity between Asian and Caucasian populations with respect to regulation of MCP‐1 expression. Our results underscore the necessity of accounting for ethnic background in the investigation of asthma‐predisposition genes.
Eosinophils: ‘new’ roles for ‘old’ cells
Authors: Munitz A. , Levi‐Schaffer F.
Published: December 2004

Prominent blood and tissue eosinophilia is manifested in a number of inflammatory states, particularly in allergic diseases. Eosinophils are a source of numerous cytokines and growth factors, thus in principle they can display both pro‐inflammatory and anti‐inflammatory activities as well as immunoregulatory ones. In this review, we will discuss the cross‐talk between eosinophils and other cell types that they come in contact with in the inflammatory milieu, such as mast cells, fibroblasts and endothelial cells. ‘New’ roles for eosinophils in cancer and novel activatory signals will also be described.
Isolation and characterization of a heat‐resistant beef allergen: myoglobin
Authors: Fuentes Mª. M. , Palacios R. , Garcés Mª. M. , Caballero M. L. , Moneo I.
Published: December 2004

Background:  Meat allergy is rarely reported. Most of the described cases are sensitizations to bovine serum albumin.

Objective:  The aim of the study was to describe a case of allergy to a new meat allergen and, after its characterization.

Methods:  A 35‐year‐old nonatopic female with allergic episodes after ingestion of several types of meat was studied. Skin tests (prick and prick‐to‐prick); total and specific immunoglobulin E (IgE) determination; sodium dodecyl sulphate‐polyacrylamide gel electrophoresis and specific IgE determination by immunoblotting under different conditions were performed. A 17‐kDa allergen was semipurified by ethanol fractionation and its amino‐terminal sequence was determined. The existence of specific IgE directed to this protein was studied by immunoblot in 80 atopic patients.

Results:  The patient showed specific IgE antibodies to a 17‐kDa protein. During the isolation of this allergen it was found that a 70–90% (vol/vol) ethanol concentration was able to purify the protein. The characterization revealed that it was a heat‐resistant protein without disulfide bonds. N‐terminal amino acid sequence (16 residues) showed identity with myoglobin. The study of specific IgE to this allergen among atopic patients showed that it was recognized by about 1% of the subjects.

Conclusions:  We describe a case of meat allergy caused by myoglobin. This is the first described case of monosensitization to this protein.
A promoter polymorphism in the CD14 gene is associated with elevated levels of soluble CD14 but not with IgE or atopic diseases
Authors: Kabesch M. , Hasemann K. , Schickinger V. , Tzotcheva I. , Bohnert A. , Carr D. , Baldini M. , Hackstein H. , Leupold W. , Weiland S. K. , Martinez F. D. , von Mutius E. , Bein G.
Published: December 2004

Background:  A polymorphism in the promoter region of the CD14 gene, C‐159T, has been shown to be associated with increased levels of soluble CD14 (sCD14) and decreased serum immunoglobulin E (IgE) and the expression of a more severe atopic phenotype in previous studies.

Methods:  To test if these associations are consistently found in different populations and different age groups, we genotyped 2048 children of different age groups as well as 888 adults from different regions of Germany for the CD14 C‐159T polymorphism.

Results:  While an association between this promoter polymorphism and levels of sCD14 could be confirmed in our study population (CC: 1017 ng/ml vs TT: 1370 ng/ml, P = 0.03), no association between CD14 C‐159T genotypes and IgE levels or the prevalence of atopic diseases was seen.

Conclusions:  The lack of association between CD14 genotypes and IgE as well as atopic outcomes in this large German study population seems to indicate that CD14 genotypes may not directly be involved in the development of allergies during childhood.
Differential expression of IL‐10 receptor by epithelial cells and alveolar macrophages
Authors: Lim S. , Caramori G. , Tomita K. , Jazrawi E. , Oates T. , Chung K. F. , Barnes P. J. , Adcock I. M.
Published: December 2004

Background:  Interleukin (IL)‐10 is a pleiotropic cytokine with a broad spectrum of immunosuppressive and anti‐inflammatory effects. IL‐10 secretion from alveolar macrophages is defective in patients with asthma and lower concentrations of IL‐10 are found in bronchoalveolar lavage (BAL) from asthmatic patients than in normal control subjects. Reduced IL‐10 may result in exaggerated and more prolonged inflammatory responses in asthmatic airways. IL‐10 acting through the IL‐10 receptor (IL‐10R) stimulates the transcription factors STAT1 and STAT3.

Methods:  We investigated IL‐10 and IL‐10R expression in normal and asthmatic bronchial epithelium and BAL macrophages using reverse transcription‐polymerase chain reaction, immunohistochemistry and Western blotting. The functional effect of IL‐10 was examined using granulocyte–macrophage‐colony stimulating factor, enzyme‐linked immunosorbent assay and Western blotting for phosphorylated STAT1 and STAT3.

Results:  IL‐10 was not expressed in epithelial cells; furthermore these cells did not express the IL‐10R and had no functional response to exogenous IL‐10. Bronchial epithelial cells expressed variable levels of phosphorylated STAT1 and STAT3 with no change in expression between normal subjects and asthmatics. IL‐10 protein and IL‐10R expression was detected in alveolar macrophages from all subjects.

Conclusion:  Our study suggests that the bronchial epithelium is not a source of IL‐10 and cannot respond to exogenous IL‐10 because of a lack of IL‐10R expression.
Allergic rhinitis due to house dust mites: evaluation of the efficacy of specific sublingual immunotherapy
Authors: Tonnel A. B. , Scherpereel A. , Douay B. , Mellin B. , Leprince D. , Goldstein N. , Delecluse P. , Andre C.
Published: December 2004

Background:  The efficacy and safety of sublingual immunotherapy (SLIT) in patients with chronic rhinitis related to sensitization to house dust mites are still controversial.

Methods:  After application of an anti‐mite mattress cover, patients were only included in the study when the cumulative symptom score over a fortnight was greater than 70 out of a possible total of 168. Thirty‐two of the 120 patients selected were randomized to receive SLIT for 2 years: 17 received placebo and 15 received the Dermatophagoides pteronyssinus and D. farinae 50/50 allergen extract.

Results:  Significant between‐group differences were observed after 1 year and persisted at the end of the second year for the rhinitis total score (P < 0.02), blocked nose score (P < 0.01) and nasal itching score (P < 0.01). Skin reactivity to house dust mites was significantly reduced in the group receiving house dust mite extract (P < 0.03). No statistical difference was observed between the two groups for medication scores, but a low medication consumption was observed in all patients. No serious and no systemic adverse reactions were reported.

Conclusion:  This study indicates the superiority of active treatment vs. placebo, evaluated on efficacy criteria (rhinitis score) or objective criteria (skin reactivity). The availability of a solid form (tablet) could represent a progress in terms of patient acceptability.