bluuebunny/crossref_metadata_2025 huggingface dataset:
An exploratory study of parents' approaches to health promotion in families of adolescents with physical disabilities
Authors: Antle B. J. , Mills W. , Steele C. , Kalnins I. , Rossen B.
Published: October 2007

Background  The life expectancy of children with physical disabilities now extends into adulthood and has been accompanied by the transfer of rehabilitation services from institutions to the home. Thus, families must increasingly partner with health service providers to promote their child's health and prevent the development of secondary conditions that may contribute to heart disease, stroke, respiratory diseases, low endurance and emotional difficulties.

Aim  To investigate within a family context the health promotion efforts of parents on behalf of a child with a physical disability.

Method  The Long Interview Method was used to interview 15 families (11 two‐parent and 4 single‐parent) having a child 11–16 years of age with a physical disability including cerebral palsy (7), spina bifida (3), muscular dystrophy (3) and other conditions (2).

Results  Parents' health promotion efforts were characterized by three main themes. First, parents emphasized traditional lifestyle health behaviours including nutrition, physical activity, tobacco, alcohol and drug use, and personal hygiene. Second, parents tried to foster their adolescent's social life and friendships. They expressed particular concern about how, and if, their child would develop a sense of purpose and have a productive future. Third, parents invested a great deal of effort into observing daily routines, making arrangements for their child's social inclusion and supporting their child in a way that balanced independence with safety and energy conservation.

Conclusions  Parents recognize that their child with a physical disability faces greater obstacles, and work hard at health promotion. Healthcare workers need to work with parents to: (1) provide information about specific lifestyle health behaviours including nutrition, physical activity and sexuality; (2) advocate for resources to foster social inclusion; and (3) discuss family strategies that balance parental involvement with their child's need for independence and energy conservation for daily activities.
Age differences in perceived social support by paediatric haematopoietic progenitor cell transplant patients: a longitudinal study
Authors: Barrera M. , Andrews G. S. , Burnes D. , Atenafu E.
Published: October 2007

Objectives  To describe longitudinally different sources of perceived social support by children and adolescents who undergo haematopoietic progenitor cell transplant (HPCT).

Methods  Thirty‐six (20 males, 16 females) survivors of paediatric HPCT, aged 8–18 years (Mean = 11.73), were assessed pre‐HPCT and 6 months, 1 year and 2 years post‐HPCT. Survivors were compared with siblings (n = 22) during the last assessment. The Social Support Scale for Children (SSSC), a self‐report measure, provided scores on perceived social support from parents, teachers, friends and classmates.

Results  Throughout the 2 years post‐HPCT, perceived social support from all sources was generally higher for survivors than for population norms. Over time, both children and adolescents reported higher social support from parents than the normative values. Over time, children perceived higher support from teachers than did adolescents, whereas adolescents' perceived social support from classmates increased but children's decreased. Survivors and siblings did not differ significantly in their perceived social support 2 years post‐BMT.

Conclusions  This exploratory study suggests that perceived parental support is equally important for children and adolescents but classmate and teacher social support varies with age. These developmental differences have important clinical implications for the care of these patients.
Elation or frustration? Outcomes following the provision of equipment during the Communication Aids Project: data from one CAP partner centre
Authors: McDonald R. , Harris E. , Price K. , Jolleff N.
Published: October 2007

Background  The Communication Aids Project (CAP) was a 4‐year initiative by the UK Department for Education and Skills to provide communication equipment for students who were unable to speak in order to facilitate their access to education. Each child was given three goals or targets which were then evaluated after 6 months of provision of the communication aid.

Methods  We evaluated the targets of 60 children, between the ages of 3 and 18 years. Six months after receipt of equipment, the targets were mailed to the initial referrer who was requested to record whether the child had achieved, partially achieved or not achieved each target. Evidence and explanations of these outcomes were also requested. Data were analysed using descriptive statistics, and the explanations were grouped into common themes using a keyword analysis.

Results  Sixty‐three per cent of targets were not achieved and 36% were achieved. We investigated any possible associations to attempt to explain some of the possible reasons for the children's non‐achievement of targets. Targets were grouped into operational, linguistic, social and academic, but there were no differences between the successes because of target type. Age may be an influence on success, but neither school placement or type of communication aid influenced success. The explanations for non‐achievement highlighted the misunderstanding or interpreting of the underlying skills of the communication aid user as a potential cause.

Conclusion  The CAP raised the profile of children with Augmentative and Alternative Communication needs within education. However, only one‐third of the targets of children using the equipment were achieved. The reasons for this include inappropriate provision of equipment, demands of the equipment, lack of appropriate support and targets. The major consequence, however, is the need for detailed assessment and provision appropriate to the individual needs of each child. There is a need for research into the best methods of providing communication aids and the support needed for successful communication.
Ocular anti‐allergic compounds selectively inhibit human mast cell cytokines in vitro and conjunctival cell infiltration in vivo
Authors: Galatowicz Grazyna , Ajayi Yetunde , Stern Michael E. , Calder Virginia L.
Published: October 2007

Background
Conjunctival mast cells (MCs) are important effector cells in seasonal allergic conjunctivitis, via histamine and cytokine secretion. Several new anti‐allergic eye drops stabilize MCs and block histamine receptors, but their anti‐inflammatory effects are unclear.

Objective
Anti‐allergic drugs were compared for their anti‐inflammatory effects in an in vitro model of human MC activation and in an experimental murine model of allergic conjunctivitis.

Methods
Human cord blood stem cell‐derived (CBMC) and conjunctival biopsy‐derived MCs were stimulated via FcɛRI, degranulation and histamine release were assayed at 1 h and cytokine secretion at 24 h using multiplex arrays. Mice sensitized to short ragweed pollen were given anti‐allergics topically before allergen challenge, and conjunctival immuno‐staining was performed at 24 h.

Results
After a 1 h stimulation, 80% of the CBMC had degranulated and secreted histamine (27.9±4.7 ng/106 cells; P<0.05). Pre‐treatment by all drugs significantly reduced histamine and TNF‐α, whereas IL‐5, IL‐8, IL‐10 and TNF‐β profiles were differentially decreased. For conjunctival biopsy‐derived cultures (n=11), FcɛR1 stimulation increased histamine, TNF‐α, TNF‐β, IL‐5 and IL‐8 levels and the production of IL‐5, IL‐6 (P<0.05), histamine and IL‐8 (P<0.01) was inhibited by epinastine. In vivo, epinastine and olopatadine pre‐treatment significantly reduced the clinical scores and eosinophil numbers (n=6; P<0.05) while epinastine also reduced neutrophils (P<0.02).

Conclusion
Differential effects on MC cytokine inhibition were observed, with epinastine inhibiting MC secretion of IL‐5, IL‐8, IL‐10 and conjunctival neutrophil infiltration. The anti‐allergic drugs have anti‐histamine and mast‐cell stabilizing properties but might differ in clinical improvement depending on the individual and the cytokines involved.
Five‐aminoimidazole‐4‐carboxamide‐1‐β‐4‐ribofuranoside attenuates poly (I:C)‐induced airway inflammation in a murine model of asthma
Authors: Kim T.‐B. , Kim S. Y. , Moon K.‐A. , Park C.‐S. , Jang M. K. , Yun E. S. , Cho Y. S. , Moon H.‐B. , Lee K.‐Y.
Published: October 2007

Background
Asthma can frequently be induced or exacerbated by respiratory viral infections. Oxidative stress might also play an essential role in the pathogenesis of allergic airway diseases, indicating that antioxidant therapy may have a potential effect in controlling allergic airway diseases. Recent studies showed that 5‐aminoimidazole‐4‐carboxamide‐1‐β‐4‐ribofuranoside (AICAR) has the potential ability to modulate NADPH oxidase activity, indicating the antioxidant activity of AICAR. This study investigated the inhibitory effects of AICAR as an anti‐inflammatory modulator on allergic airway inflammation in murine animal models.

Methods
The anti‐inflammatory effects of AICAR were evaluated in two experimental asthma models: (1) an ovalbumin (OVA)‐induced experimental asthma model and (2) an OVA plus polyinosinic‐polycytidylic acid [poly (I:C)]‐induced experimental asthma model to mimic respiratory viral infections. The inhibitory effects of AICAR in poly (I:C)‐mediated signalling for NF‐κB activation and production of TNF‐α were analysed in vitro.

Results
AICAR was shown to have a marginal inhibitory effect in an OVA‐induced asthma model. Interestingly, AICAR significantly attenuated poly (I:C)‐induced airway hyperresponsiveness and airway inflammation, as shown by the attenuation of the influx of total inflammatory cells and soluble products into bronchoalveolar lavage fluid, such as macrophages, eosinophils, IL‐5, IL‐13, TNF‐α and IFN‐γ. AICAR also significantly reduced the serum levels of OVA‐specific IgE and IgG2a antibodies. Histologic and flow cytometric studies showed that AICAR inhibited poly (I:C)‐induced lung inflammation and the infiltration of CD11b+CD11c+ dendritic cells into the lung. Moreover, AICAR effectively inhibited poly (I:C)‐mediated activation of NF‐κB and the production of TNF‐α.

Conclusion
These findings suggest that AICAR may be a novel immunomodulator with promising beneficial effects for the treatment of respiratory viral infection in airway allergic diseases.
Do levels of airborne grass pollen influence asthma hospital admissions?
Authors: Erbas B. , Chang J.‐H. , Dharmage S. , Ong E. K. , Hyndman R. , Newbigin E. , Abramson M.
Published: October 2007

Background
The effects of environmental factors and ambient concentrations of grass pollen on allergic asthma are yet to be established.

Objective
We sought to estimate the independent effects of grass pollen concentrations in the air over Melbourne on asthma hospital admissions for the 1992–1993 pollen season.

Methods
Daily grass pollen concentrations were monitored over a 24‐h period at three stations in Melbourne. The outcome variable was defined as all‐age asthma hospital admissions with ICD9‐493 codes. The ambient air pollutants were average daily measures of ozone, nitrogen dioxide and sulphur dioxide, and the airborne particle index representing fine particulate pollution. Semi‐parametric Poisson regression models were used to estimate these effects, adjusted for air temperature, humidity, wind speed, rainfall, day‐of‐the‐week effects and seasonal variation.

Results
Grass pollen was a strong independent non‐linear predictor of asthma hospital admissions in a multi‐pollutant model (P=0.01). Our data suggest that grass pollen had an increasing effect on asthma hospital admissions up to a threshold of 30 grains/m3, and that the effect remains stable thereafter.

Conclusion
Our findings suggest that grass pollen levels influence asthma hospital admissions. High grass pollen days, currently defined as more than 50 grains/m3, are days when most sensitive individuals will experience allergic symptoms. However, some asthmatic patients may be at a significant risk even when airborne grass pollen levels are below this level. Patients with pollen allergies and asthma would be advised to take additional preventive medication at lower ambient concentrations.
Combined analysis of intracellular signalling and immunophenotype of human peripheral blood basophils by flow cytometry: a proof of concept
Authors: Ebo D. G. , Dombrecht E. J. , Bridts C. H. , Aerts N. E. , De Clerck L. S. , Stevens W. J.
Published: October 2007

Background
The signal transduction pathways and control mechanisms involved in IgE‐mediated basophil activation remain incompletely understood.

Objectives
To investigate whether basophilic intracellular signal transduction and immunophenotype can be analysed simultaneously by flow cytometry.

Methods
Basophils in whole blood were stimulated with anti‐IgE and latex antigen at various concentrations and during different time courses. Phosphorylation of p38 mitogen‐activated protein kinase (MAPK) as a representative of the intracellular signal transduction pathway and surface expression of CD63 was assessed simultaneously flow cytometrically. The effect of pre‐incubation with IL‐3 was assessed.

Results
Stimulation of the basophils with anti‐IgE and allergen induces a rapid phosphorylation of p38 MAPK that peaks between 1 and 5 min and returns to baseline levels after 60 min. In contrast, CD63 up‐regulation demonstrates a maximal but more continuous expression that peaks approximately 5 min later than phosphorylation of p38 MAPK. Specific inhibition of p38 MAPK reduced or almost completely abrogated up‐regulation of CD63. Pre‐incubation of the basophils with IL‐3 produces a rapid p38 MAPK phosphorylation over basal levels, but this was weaker and shorter than for anti‐IgE stimulation. Pre‐incubation of the basophils with IL‐3 did not potentiate anti‐IgE‐induced phosphorylation of p38 MAPK and did affect spontaneous or IgE‐mediated CD63 up‐regulation.

Conclusions
This study provides the proof that the flow cytometer allows an integrated analysis of basophilic intracellular signalling and immunophenotyping. Owing to its technical simplicity, the low number of cells required and rapid analysis, the technique seems promising for use in the clinic as a diagnostic tool or to monitor therapy.

Capsule summary
This study is the first to provide evidence for a combined analysis of basophilic intracellular signalling and immunophenotyping by flow cytometry. Owing to its technical simplicity, the low number of cells required and rapid analysis, the technique seems promising for use in the clinic as a diagnostic tool or to monitor therapy.
Association between genetic variations in prostaglandin E2 receptor subtype EP3 gene (Ptger3) and asthma in the Korean population
Authors: Park H.‐W. , Shin E.‐S. , Lee J.‐E. , Kim S.‐H. , Kim S.‐S. , Chang Y.‐S. , Kim Y.‐K. , Min K.‐U. , Kim Y.‐Y. , Cho S.‐H.
Published: October 2007

Background
Recent investigations suggest that prostaglandin E2 (PGE2) is important in the pathogenesis of not only aspirin‐intolerant asthma but also asthma unrelated to aspirin intolerance.

Objectives
This study was conducted to evaluate the effects of variations in the gene coding PGE2 receptor subtype EP1–4 (Ptger1–4) on the risk of asthma in the Korean population.

Methods
Nineteen single nucleotide polymorphisms (SNPs) were selected after re‐sequencing Ptger1–4 and were genotyped in 480 asthmatics and 140 healthy controls, who were randomly recruited.

Results
By logistic regression analyses controlling for age and sex, 1388T>C in Ptger3 was found to be significantly associated with asthma [P=0.002, odds ratio (95% confidence interval)=0.63 (0.46–0.85) in the allele model], and this remained significant after applying the Bonferroni correction. In terms of haplotype, the frequency of the C–C–A–A haplotype in Ptger3 was significantly lower in asthmatics than in healthy controls (P=0.004). Moreover, the prevalence of this haplotype was significantly lower in moderate‐to‐severe asthmatics than in mild asthmatics (P=0.045; mild vs. moderate and P=0.034; mild vs. severe). However, no association was found between any genetic variation in Ptger1, Ptger2, or Ptger4 and asthma.

Conclusion
The present study demonstrated that genetic variations in Ptger3 are significantly associated with the risk and severity of asthma in the Korean population.
Will Systematized Nomenclature of Medicine‐Clinical Terms improve our understanding of the disease burden posed by allergic disorders?
Authors: Simpson C. R. , Anandan C. , Fischbacher C. , Lefevre K. , Sheikh A.
Published: October 2007

Analysis of data collected through the use of high‐quality computerized systems is vital if we are to understand the health burden from allergic disease. Coding systems currently used, such as the World Health Organization's International Classification of Diseases and the Read system, have however been criticized as being unduly restrictive and hence inadequate for the detailed coding of allergic problems. Greater granularity of coding can be achieved by using the Systematized Nomenclature of Medicine‐Clinical Terms (SNOMED‐CT) system, which will be adopted by several countries including the United States and United Kingdom. Before the introduction of SNOMED‐CT, it is important that several issues are resolved, including ensuring that adequate mapping occurs from existing systems, that the SNOMED‐CT is trialled before general implementation, and that training is provided for users new to coding as part of their clinical practice. Of particular importance is that the allergy fraternity bring to light any gaps in allergy coding through the creation of a working group to advise the newly formed International Healthcare Terminology Standards Development Organisation. There is also a role for allergy experts, working in conjunction with government agencies and professional bodies, to determine a recommended set of codes, which will obviate some of the inevitable challenges raised by a very fluid coding structure for those wishing to undertake secondary analysis of health care datasets.
Atopy and new‐onset asthma in young Danish farmers and CD14, TLR2, and TLR4 genetic polymorphisms: a nested case‐control study
Authors: Smit L. A. M. , Bongers S. I. M. , Ruven H. J. T. , Rijkers G. T. , Wouters I. M. , Heederik D. , Omland Ø. , Sigsgaard T.
Published: October 2007

Background
Evidence exists that exposure to high levels of microbial agents such as endotoxin in the farm environment decreases the risk of atopic sensitization. Genetic variation in innate immunity genes may modulate the response to microbial agents and thus influence susceptibility to asthma and atopy.

Objective
To study potential associations between single nucleotide polymorphisms (SNPs) in CD14, Toll‐like receptor 2 (TLR2), and TLR4 genes, and atopy and new‐onset asthma in young farmers.

Methods
A nested case–control study was conducted within a cohort of 1901 young Danish farmers. We genotyped 100 new‐onset asthma cases and 88 control subjects for three CD14 SNPs, three TLR2 SNPs, and two TLR4 SNPs. Atopy at baseline (defined as a positive skin prick test to one or more common inhalant allergens) was found in 17 asthma cases (17.0%) and in 17 controls (19.3%).

Results
The CD14/−260T allele was significantly associated with less atopy [odds ratio (OR) 0.39; 95% confidence interval (CI) 0.21–0.72, additive genetic model], whereas the CD14/−651T allele was positively associated with atopy (OR 2.53; 95% CI 1.33–4.80). Similar results were obtained by haplotype analysis. Stratified analysis by farm childhood showed stronger effects of both CD14 SNPs on atopy among farmers who were born and raised on a farm, although no significant interaction was found. No associations between CD14, TLR2, or TLR4 genotypes and new‐onset asthma were found.

Conclusion
The CD14/−260 and CD14/−651 promoter polymorphisms are associated with atopy prevalence among young adults exposed to farm environments.
Quantitative analysis of immunoglobulin E reactivity profiles in patients allergic or sensitized to natural rubber latex (Hevea brasiliensis)
Authors: Raulf‐Heimsoth M. , Rihs H.‐P. , Rozynek P. , Cremer R. , Gaspar Â. , Pires G. , Yeang H. Y. , Arif S. A. M. , Hamilton R. G. , Sander I. , Lundberg M. , Brüning T.
Published: October 2007

Background
Characterized native and recombinant Hevea brasiliensis (rHev b) natural rubber latex (NRL) allergens are available to assess patient allergen sensitization profiles.

Objective
Quantification of individual IgE responses to the spectrum of documented NRL allergens and evaluation of cross‐reactive carbohydrate determinants (CCDs) for more definitive diagnosis.

Methods
Sera of 104 healthcare workers (HCW; 51 German, 21 Portuguese, 32 American), 31 spina bifida patients (SB; 11 German, 20 Portuguese) and 10 Portuguese with multiple surgeries (MS) were analysed for allergen‐specific IgE antibody (sIgE) to NRL, single Hev b allergens and CCDs with ImmunoCAP™ technology.

Results
In all patient groups rHev b 5‐sIgE concentrations were the most pronounced. Hev b 2, 5, 6.01 and 13 were identified as the major allergens in HCW and combined with Hev b 1 and Hev b 3 in SB. In MS Hev b 1 displayed an intermediate relevance. Different sIgE antibody levels to native Hevea brasiliensis (nHev b) 2 and rHev b 6.01 allowed discrimination of SB with clinical relevant latex allergy vs. those with latex sensitization. Sensitization profiles of German, Portuguese and American patients were equivalent. rHev b 5, 6.01 and nHev b 13 combined detected 100% of the latex‐allergic HCW and 80.1% of the SB. Only 8.3% of the sera showed sIgE response to CCDs.

Conclusions
Hev b 1, 2, 5, 6.01 and 13 were identified as the major Hev b allergens and they should be present in standardized latex extracts and in vitro allergosorbents. CCDs are only of minor relevance in patients with clinical relevant latex allergy. Component‐resolved diagnostic analyses for latex allergy set the stage for an allergen‐directed immunotherapy strategy.
Local immunoglobulin production in nasal polyposis is modulated by superantigens
Authors: Van Zele T. , Gevaert P. , Holtappels G. , Van Cauwenberge P. , Bachert C.
Published: October 2007

Background
Chronic rhinosinusitis (CRS) with nasal polyps (NP) represents a persistent inflammation often characterized by local hyper‐immunoglobulinaemia and the presence of specific IgE to Staphylococcus aureus enterotoxins (SAEs). We aimed to study the systemic and local production of Igs in relation to plasma cells, B cells and specific IgE to SAEs.

Methods
Concentrations of IgE, IgG, IgM, IgA, IgG subclasses and specific IgE to SAE were determined on tissue homogenates and serum from 15 CRS patients with NP, 15 CRS without NP and 10 control patients. Tissue cryo‐sections were stained for CD19, CD20 and CD138 to demonstrate B and plasma cells.

Results
IgA, IgG and IgE concentrations were significantly higher in tissue homogenates, but not in serum, of NP compared with CRS and control subjects. NP with specific IgE to SAEs had significantly higher concentrations of IgG and IgE, and also showed a significantly higher fraction of IgG4 (P=0.003) and a lower fraction of IgG2 (P=0.04) than those without specific IgE production. Furthermore, naïve CD19+ B cell and plasma cell counts (CD138+) were significantly higher in NP tissue compared with controls or CRS.

Conclusions
The difference in IgE, IgG and IgA expression between NP tissue and serum, supported by increased numbers of plasma cells, suggests a local production of these Igs in NP in response to a chronic microbial trigger. The local immune response to SAE is associated with a further increased production of IgE and IgG, and a shift in IgG subclasses.
Eosinophilic airway inflammation and the prognosis of childhood asthma
Authors: Lovett C. J. , Whitehead B. F. , Gibson P. G.
Published: October 2007

Background
Eosinophilic airway inflammation is a key pathophysiological feature of asthma that can predict treatment response. However, the prognostic value of sputum eosinophilia is not established.

Objective
The aim of this study was to determine the influence of induced sputum eosinophilia on the prognosis of childhood asthma.

Methods
A cohort of children with asthma was evaluated by induced sputum analysis at inception and classified as having either eosinophilic asthma (EA) (sputum eosinophils >2.5%) or non‐eosinophilic asthma (NEA). After a mean follow‐up period of 5 years, eligible subjects (n=83) were contacted and 69 subjects (33 EA, 36 NEA) evaluated. The children had a mean age of 15.9 years, and 61% were male.

Results
Children with EA reported more wheeze during the follow‐up period (27% vs. 6% wheezed most years; P<0.0001), increased night waking during the past 12 months (28% vs. 3% reported weekly waking; P=0.01), and greater impairment of quality of life due to asthma (P=0.04). Subsequent β2‐agonist use was increased in children with EA (P=0.02), although there was no difference in corticosteroid use. In EA, subsequent forced expiratory volume in 1 s/forced vital capacity was lower (79% vs. 86%; P=0.01) and grass pollen allergy was more prevalent (77% vs. 27%; P=0.006).

Conclusion
In children, eosinophilic airway inflammation is associated with deteriorating asthma over time. This is consistent with the hypothesis that airway inflammation has an adverse impact on the prognosis of childhood asthma, and suggests a role for monitoring inflammation in asthma management.
Lipopolysaccharide administration to the allergic nose contributes to lower airway inflammation
Authors: Bachar O. , Gustafsson J. , Jansson L. , Adner M. , Cardell L. O.
Published: October 2007

Background
Allergic rhinitis (AR) is an inflammatory reaction not confined to a single local compartment, but rather involving the whole airway system. Allergens known to induce AR are not always the sole trigger of the inflammatory reaction as infections and organic dust might also cause exacerbations of rhinitis and associated conditions.

Objective
To examine the effects of intranasal lipopolysaccharide (LPS) exposure, as a surrogate for upper airway bacterial infections, in patients with symptomatic AR.

Methods
Fourteen patients with a history of moderate to severe pollen‐induced AR were challenged intranasally with LPS. After 3–6 weeks, the same patients were challenged again, first with allergen and 24 h later with LPS. Nasal symptom scores, nasal lavage leucocyte counts and nasal airway resistance were assessed at 6–24 h after each provocation along with measurements of nitric oxide (NO) levels in the nose and lung.

Results
Six hours after the LPS challenge, an increased level of leucocytes could be obtained in the lavage fluid, but no symptoms were experienced and no increase in nasal resistance could be recorded. The NO production in the upper and lower airways was similar before and 6 h after the provocation. In contrast, in patients exposed to pollen before the LPS challenge, both the nasal and the pulmonary NO levels were enhanced. This was accompanied by an increase in leucocytes.

Conclusion
The present study demonstrates a priming effect of allergen on the nasal response to LPS as well as the presence of a systemic link between airway mucosal sites in the upper and lower airways. This suggests that exogenously derived signals, like upper airway infections, can interfere with the initiation, maintenance and progression of asthma.
Effects of 4 months of smoking in mice with ovalbumin‐induced airway inflammation
Authors: Melgert B. N. , Timens W. , Kerstjens H. A. , Geerlings M. , Luinge M. A. , Schouten J. P. , Postma D. S. , Hylkema M. N.
Published: October 2007

Background
The effects of smoking on asthma pathogenesis are complex and not well studied. We have shown recently that 3 weeks of smoking attenuates ovalbumin (OVA)‐induced airway inflammation in mice and that 4–6 months of smoking induces emphysema in mice without airway inflammation. Effects of combined long‐term smoking and OVA exposure have not been investigated so far.

Objective
To study whether long‐term smoking affects progression of allergic airway inflammation and/or enhances the development of emphysema in mice.

Methods
Mice were sensitized to OVA and challenged with saline or OVA aerosols for 6 months. From 2 months onwards, mice were also exposed to air or smoke. Lung tissue was analysed for extent of inflammation, emphysema, remodelling and for cytokine levels, and serum for OVA‐specific IgE levels.

Results
Chronic OVA exposure of 6 months resulted in a T helper type 2 (Th2)‐type inflammation with increased levels of IL‐4, IL‐5, IL‐6 and infiltration of eosinophils, CD4+ T cells, macrophages and plasma cells. Smoking induced a Th17‐type of airway inflammation, characterized by neutrophils, macrophages, B cells and increased levels of IL‐17, IL‐6, granulocyte‐macrophage colony‐stimulating factor, granulocyte colony‐stimulating factor and monocyte chemoattractant protein‐1. Concomittant smoking and OVA exposure resulted in inflammation similar to OVA exposure alone. OVA exposure increased IgE levels compared with saline exposure, and smoking did not further increase these levels.

Conclusion
We did not find evidence for increased inflammation, IgE levels or emphysema in mice with allergic airway inflammation after 4 months of smoking compared with non‐smoking. However, a 4‐month exposure to smoke alone did enhance neutrophilic airway inflammation characterized by high pulmonary IL‐17 levels. A Th2 inflammatory environment due to OVA exposure may be one explanation as to why no further detrimental effects of smoking on allergic airway inflammation were found.
Neurokinin‐1 receptor activation induces reactive oxygen species and epithelial damage in allergic airway inflammation
Authors: Springer J. , Groneberg D. A. , Dinh Q. T. , Quarcoo D. , Hamelmann E. , Braun‐Dullaeus R. C. , Geppetti P. , Anker S. D. , Fischer A.
Published: October 2007

Background
An induction of reactive oxygen species (ROS) is characteristic for inflammation but the exact pathways have not been identified for allergic airway diseases so far.

Objective
The aim of this study was to characterize the role of the tachykinin NK‐1 receptor on ROS production during allergen challenge and subsequent inflammation and remodelling.

Methods
Precision‐cut lung slices of ovalbumin (OVA)‐sensitized mice were cultivated and ROS‐generation in response to OVA challenge (10 μg/mL) was examined by the 2′,7′‐dichloroflourescein‐diacetate method. Long‐term ROS effects on epithelial proliferation were investigated by 5‐bromo‐2′‐deoxyuridine incorporation (72 h). In vivo, the results were validated in OVA‐sensitized animals which were treated intra‐nasally with either placebo, the tachykinin neurokinin 1 (NK‐1) receptor antagonist SR 140333 or the anti‐oxidant N‐acetylcystein (NAC) before allergen challenge. Inflammatory infiltration and remodelling were assessed 48 h after allergen challenge.

Results
ROS generation was increased by 3.7‐fold, which was inhibited by SR 140333. [Sar9,Met11(O2)]‐Substance P (5 nm) caused a tachykinin NK‐1 receptor‐dependent fourfold increase in ROS generation. Epithelial proliferation was decreased by 68% by incubation with [Sar9,Met11(O2)]‐SP over 72 h. In‐vivo, treatment with SR 140333 and NAC reduced epithelial damage (91.4% and 76.8% vs. placebo, respectively, P<0.01) and goblet cell hyperplasia (67.4% and 50.1% vs. placebo, respectively, P<0.05), and decreased inflammatory cell influx (65.3% and 45.3% vs. placebo, respectively, P<0.01).

Conclusion
Allergen challenge induces ROS in a tachykinin NK‐1 receptor‐dependent manner. Inhibition of the tachykinin NK‐1 receptor reduces epithelial damage and subsequent remodelling in vivo. Therefore, patients may possibly benefit from treatment regime that includes radical scavengers or tachykinin NK‐1 receptor antagonists.
Increased long‐term cardiovascular morbidity among patients treated with radioactive iodine for hyperthyroidism
Authors: Metso Saara , Auvinen Anssi , Salmi Jorma , Huhtala Heini , Jaatinen Pia
Published: October 2007

Objective  Previous studies suggest that hyperthyroid patients remain at increased risk of cardiovascular morbidity after restoring euthyroidism. The aim of this study was to compare the rate and causes of hospitalization of hyperthyroid patients treated with radioactive iodine (RAI) with those of an age‐ and gender‐matched reference population in a long‐term follow‐up study.

Patients and measurements  A population‐based cohort study with a median follow‐up time of 9 years was conducted among 2611 hyperthyroid patients treated with RAI between 1969 and 2002 in Tampere University Hospital, and among 2611 reference subjects. Information on hospitalizations was obtained from the nationwide Hospital Discharge Registry. New events were analysed as the main outcome, including only the first hospitalization due to a given indication.

Results  The rate of hospitalization due to cardiovascular disease (CVD) was higher among patients with hyperthyroidism than among the control population [637·1 vs. 476·4 per 10 000 person‐years, rate ratio (RR) 1·12, 95% confidence interval (CI) 1·03–1·21]. The risk remained elevated up to 35 years after the RAI treatment. Hospitalizations due to atrial fibrillation (RR 1·35), cerebrovascular disease (RR 1·31), diseases of other arteries and veins (RR 1·22), hypertension (RR 1·20) and heart failure (RR 1·48) were more frequent in the patients than controls, while no such difference was found for coronary artery disease. Hospitalizations due to cancer, infectious and gastrointestinal diseases, and fractures were also more common in patients than in controls.

Conclusions  Hyperthyroidism increases hospitalizations due to CVDs. The excess risk is sustained decades after treatment. Patients treated for hyperthyroidism constitute a high‐risk group for CVD and may benefit from preventive interventions.
Extracorporeal shockwave lithotripsy: urine cytology findings
Authors: Kumar P. V. , Salami K. , Tadayyon A. R.
Published: October 2007

Objectives:  To describe the urine cytology findings before and after stone therapy with extracorporeal shock wave lithotripsy (ESWL) and discuss its importance.

Methods:  The study consisted of 100 patients with a urinary tract stone (79 renal pelvic stones and 21 upper ureteric stones), 74 were male and 26 were female. The ages ranged 30–55 years. The average duration of symptoms was 3–8 years. The size of the stones varied from case to case ranging from 10.2 to 40 mm. Urine samples were obtained on three consecutive days before and after lithotripsy. The smears were stained by the Papanicolaou method.

Results:  The smears before lithotripsy revealed a few red blood cells, inflammatory cells, epithelial cells and crystals (calcium oxalate, uric acid and triple phosphate). Atypical malignant looking cells and epithelial cell clusters were not noticed. After lithotripsy, the urine samples were examined at different periods, 24 hours, 2 weeks, 1 month, 2 months and 3 months. The smears revealed papillary clusters in all 100 patients within 24 hours and were always associated with inflammation. Atypical malignant looking cells appeared later, within 1–2 months in 21 patients, and were associated with inflammation (19 patients), RBC, crystals and papillary clusters. Most of the papillary clusters and atypical malignant looking cells disappeared before 3 months.

Conclusion:  The epithelial cell clusters and atypical cells were seen in urine smears after ESWL. Without knowing the previous history these findings can be confused with urothelial neoplasms.
Ultrasonographically and stereotactically guided fine‐needle aspiration cytology of non‐palpable breast lesions: cyto‐histological correlation
Authors: Pogačnik A. , Strojan Fležar M. , Rener M.
Published: October 2007

Objective:  To determine the diagnostic accuracy of ultrasonographically (US) and stereotactically guided fine needle aspiration cytology (FNAC) for the diagnosis of non‐palpable breast lesions.

Patients and methods:  From January 2002 to December 2004, 470 women with 478 mammographically detected non‐palpable breast lesions had US or stereotactically guided FNAC of the breast lesion. Subsequent histological evaluation of the same lesion was performed at the Institute of Oncology Ljubljana, Slovenia. The correlation between the original cytological and histological diagnosis was assessed and the sensitivity, specificity, positive predictive value and negative predictive value were calculated.

Results:  Among US‐guided FNACs, 144 (53.5%) were histologically verified benign lesions and 125 (46.5%) were carcinomas. Cytological diagnoses were: true positive (TP) in 63 cases (50.4%), suspicious in 35 (28%), false negative (FN) in eight (6.4%), and in 19 (15.2%) cases, the material was inadequate for diagnosis. In the stereotactically guided FNAC group, there were 209 women with 209 lesions, with 95 (45%) histologically proven carcinomas and 114 (55%) benign lesions. Cytological diagnoses were TP in 49 (51.6%) cases, true suspicious in 21 (22.1%), FN in nine (9.5%), and in 16 (16.8%) cases, the material was not adequate for the diagnosis.

Conclusion:  The sensitivity of 88.7% and specificity of 98.6% for US‐guided FNAC and 84.5% and 100% for stereotactically guided FNAC, respectively, suggest that clinicians can rely upon cytological diagnosis for planning further management of women with non‐palpable breast lesions.
Decrease in numbers of glandular cell groups in post‐LLETZ liquid‐based cytology preparations
Authors: Maguire A. , Turner L. , Magee D. , Gibbons D.
Published: October 2007

Objective:  Large loop excision of the transformation zone (LLETZ) has become standard of care in the management of cervical squamous neoplasia and with cone biopsy glandular intraepithelial neoplasia. Controversy remains about the long‐term effects of this traumatic procedure. The aim of this study was to count and compare the number of endocervical glandular cell groups in pre‐ and post‐LLETZ cervical preparations using liquid‐based cytology to establish a cyto‐morphological correlate of destruction of the transformation zone.

Methods:  The cytology/histology correlation audit records of the Cytopathology Department of St Luke’s Hospital in 2003 and early 2004 were used to select patients with a cytological diagnosis of high grade dyskaryosis followed by LLETZ. Only those cases with post‐LLETZ cytological follow‐up were selected. Cases using conventional smears were excluded. One hundred and twenty slides (60 pairs of slides) in total were retrieved. The cases underwent review and all groups of >3 glandular cells in each slide were counted by AM while blinded as to whether smears were pre‐ or post‐LLETZ. Medians were compared using a Mann–Whitney U‐test.

Results:  The median number of groups of endocervical glandular cells of the pre‐treatment group was 5.5 and of the post‐treatment group was 2.0. There were significantly fewer endocervical glandular cell groups in the post‐LLETZ population (P = 0.03).

Conclusions:  The number of endocervical glandular groups in cervical cytological preparations decreases significantly following LLETZ procedure. This suggests that cytological follow‐up may not be as useful in glandular neoplasia cases. Few or absent glandular cell groups in post‐LLETZ preparations may have implications for adequacy assessment.
Fish as sources and sinks of nutrients in lakes
Authors: SEREDA JEFF M. , HUDSON JEFF J. , TAYLOR WILLIAM D. , DEMERS ERIC
Published: October 2007

1. The release of total phosphorus (TP) and nitrogen (N in ammonium) was measured for the five most abundant fish species (>85% of biomass) in Mouse and Ranger Lakes, two biomanipulated, oligotrophic lakes in Ontario.

2. The specific release rate of both nutrients was significantly related to fish mass; log10 TP release rate (μg h−1) = 0.793 (±0.109) [log10 wet mass (g)] + 0.7817 (±0.145), and log10 N release rate (μg h−1) = 0.6946 (±0.079) [log10wet mass (g)] + 1.7481 (±0.108).

3. When fish nutrient release was standardized for abundance (all populations, 1993–95) and epilimnetic volume, fish were estimated to contribute 0.083 (±0.061) μg TP L−1 day−1, and 0.41 (±0.17) μg N L−1 day−1 in Mouse L., and 0.062 (±0.020) μg TP L−1 day−1 and 0.31 (±0.08) μg N L−1 day−1 in Ranger L.

4. In comparison, concurrent rates of total planktonic P regeneration were 1.02 (±0.45) μg L−1 day−1 (Mouse L.) and 0.85 (±0.19) μg L−1 day−1 (Ranger L.). Fish represented 8% of planktonic P release in Mouse L. and 7% in Ranger L.

5. Fish dry mass had mean elemental body compositions of 39.3% carbon, 10.9% nitrogen, and 4.0% phosphorus (all fish combined), with a mean molar C : N : P ratio of 27 : 6 : 1. This comprised about 55% and 23% of the total epilimnetic particulate P and N respectively.

6. Turnover times of P and N in fish were approximately 103 and 48 days respectively. In comparison, planktonic turnover times of particulate P in Mouse and Ranger Lakes were 4.3 and 4.4 days respectively. Given their high P content and low turnover rates, fish appear to be important P sinks in lakes.
CO2 balance of boreal, temperate, and tropical forests derived from a global database
Authors: LUYSSAERT S. , INGLIMA I. , JUNG M. , RICHARDSON A. D. , REICHSTEIN M. , PAPALE D. , PIAO S. L. , SCHULZE E. ‐D. , WINGATE L. , MATTEUCCI G. , ARAGAO L. , AUBINET M. , BEER C. , BERNHOFER C. , BLACK K. G. , BONAL D. , BONNEFOND J. ‐M. , CHAMBERS J. , CIAIS P. , COOK B. , DAVIS K. J. , DOLMAN A. J. , GIELEN B. , GOULDEN M. , GRACE J. , GRANIER A. , GRELLE A. , GRIFFIS T. , GRÜNWALD T. , GUIDOLOTTI G. , HANSON P. J. , HARDING R. , HOLLINGER D. Y. , HUTYRA L. R. , KOLARI P. , KRUIJT B. , KUTSCH W. , LAGERGREN F. , LAURILA T. , LAW B. E. , LE MAIRE G. , LINDROTH A. , LOUSTAU D. , MALHI Y. , MATEUS J. , MIGLIAVACCA M. , MISSON L. , MONTAGNANI L. , MONCRIEFF J. , MOORS E. , MUNGER J. W. , NIKINMAA E. , OLLINGER S. V. , PITA G. , REBMANN C. , ROUPSARD O. , SAIGUSA N. , SANZ M. J. , SEUFERT G. , SIERRA C. , SMITH M. ‐L. , TANG J. , VALENTINI R. , VESALA T. , JANSSENS I. A.
Published: October 2007

Terrestrial ecosystems sequester 2.1 Pg of atmospheric carbon annually. A large amount of the terrestrial sink is realized by forests. However, considerable uncertainties remain regarding the fate of this carbon over both short and long timescales. Relevant data to address these uncertainties are being collected at many sites around the world, but syntheses of these data are still sparse. To facilitate future synthesis activities, we have assembled a comprehensive global database for forest ecosystems, which includes carbon budget variables (fluxes and stocks), ecosystem traits (e.g. leaf area index, age), as well as ancillary site information such as management regime, climate, and soil characteristics. This publicly available database can be used to quantify global, regional or biome‐specific carbon budgets; to re‐examine established relationships; to test emerging hypotheses about ecosystem functioning [e.g. a constant net ecosystem production (NEP) to gross primary production (GPP) ratio]; and as benchmarks for model evaluations. In this paper, we present the first analysis of this database. We discuss the climatic influences on GPP, net primary production (NPP) and NEP and present the CO2 balances for boreal, temperate, and tropical forest biomes based on micrometeorological, ecophysiological, and biometric flux and inventory estimates. Globally, GPP of forests benefited from higher temperatures and precipitation whereas NPP saturated above either a threshold of 1500 mm precipitation or a mean annual temperature of 10 °C. The global pattern in NEP was insensitive to climate and is hypothesized to be mainly determined by nonclimatic conditions such as successional stage, management, site history, and site disturbance. In all biomes, closing the CO2 balance required the introduction of substantial biome‐specific closure terms. Nonclosure was taken as an indication that respiratory processes, advection, and non‐CO2 carbon fluxes are not presently being adequately accounted for.
The effect of soil warming on bulk soil vs. rhizosphere respiration
Authors: HARTLEY IAIN P. , HEINEMEYER ANDREAS , EVANS SAM P. , INESON PHIL
Published: October 2007

There has been considerable debate on whether root/rhizosphere respiration or bulk soil respiration is more sensitive to long‐term temperature changes. We investigated the response of belowground respiration to soil warming by 3 °C above ambient in bare soil plots and plots planted with wheat and maize. Initially, belowground respiration responded more to the soil warming in bare soil plots than in planted plots. However, as the growing season progressed, a greater soil‐warming response developed in the planted plots as the contribution of root/rhizosphere respiration to belowground respiration declined. A negative correlation was observed between the contribution of root/rhizosphere respiration to total belowground respiration and the magnitude of the soil‐warming response indicating that bulk soil respiration is more temperature sensitive than root/rhizosphere respiration. The dependence of root/rhizosphere respiration on substrate provision from photosynthesis is the most probable explanation for the observed lower temperature sensitivity of root/rhizosphere respiration. At harvest in late September, final crop biomass did not differ between the two soil temperature treatments in either the maize or wheat plots. Postharvest, flux measurements during the winter months indicated that the response of belowground respiration to the soil‐warming treatment increased in magnitude (response equated to a Q10 value of 5.7 compared with ∼2.3 during the growing season). However, it appeared that this response was partly caused by a strong indirect effect of soil warming. When measurements were made at a common temperature, belowground respiration remained higher in the warmed subplots suggesting soil warming had maintained a more active microbial community through the winter months. It is proposed that any changes in winter temperatures, resulting from global warming, could alter the sink strength of terrestrial ecosystems considerably.