bluuebunny/crossref_metadata_2025 huggingface dataset:
Addressing the Challenges of Medical Social Workers in Nigeria: A Study of Hospital-based Care Dynamics
Authors: Enemaku Omeche
Published: January 2024

Aims: Many social workers in Nigeria found it difficult to handle work-related stress, which resulted in frustration and reduced efficiency, a situation which undermined the relevance of the profession in the management of healthcare in Nigeria. This study therefore assessed the challenges medical social workers faced in hospital-based healthcare, using University of Benin Teaching Hospital (UBTH), Faith Mediplex Hospital, and Uselu Psychiatric Hospital, all in Benin City.

Study design: Survey design was adopted for this study.

Place and Duration of Study: The study was conducted using University of Benin Teaching Hospital (UBTH), Faith Mediplex Hospital, and Uselu Psychiatric Hospital as case studies. The study was conducted between March 2022 to March 2023.

Methodology: Using simple random technique, 108 respondents who were staff of the hospitals under study were selected for the study. Data were collected through the administration of questionnaire to the selected respondents.

Results: The study found that medical social workers were poorly recognized in the hospitals and they were assigned non-social work tasks. The study also found that they work in very poor conditions, were poorly remunerated and their programmes in hospitals do not attract government funding. Above all, the study revealed that medical social workers go through series of discrimination from other medical professionals in the course of carrying out their duties.

Conclusion: Policy makers in the health sector must ensure that health care reform legislation includes social workers among the professionals eligible to provide care coordination. Also, medical doctors and other medical professionals should see medical social workers as team players working towards the same goal; patient’s safety. Medical doctors should in most cases consider recommendations from medical social workers.
Effect of Soaking and Germination on Antinutritional Factors of Quinoa (Chenopodium quinoa)
Authors: Patiballa Mounika , Ravindra Usha , Benherlal P. S.  , Subbarayappa C. T. , Shivakumar N. , Mamatha H. S.  , Vijayalaxmi K. G.
Published: January 2024

Quinoa is a nutritional powerhouse, packed with protein, fiber, vitamins and minerals. However, it also contains certain compounds that impact nutrient availability. To address this, processing methods like soaking and germination have emerged as effective traditional treatments. They not only enhance the nutritional and bioactive potential but also diminish the anti-nutritional components in these grains, elevating their overall quality. This study examines the effect of soaking and germination treatments on anti-nutritional characteristics of quinoa. The result shows that an increase in germination percentages increases with longer germination times. Notably, seeds soaked in lukewarm water containing 2% salt for 24 hours showed the highest germination percentage (82.89%), while the number of non-germinated (16.27%) and abnormally germinated (0.32%) seeds decreased and greatest radical length (10.25 mm) when compared to seeds soaked in normal water. However, as the germination period extended, quinoa exhibited increased levels of vitamin C, notably more pronounced in lukewarm water with a 2% salt concentration. Additionally, germinated quinoa presents reduced levels of phytic acid (68.22 mg/100 g), tannin (0.36 mg/100 g), saponin (75.13 mg/100 g), and oxalates (42.55 mg/100 g) in comparison to raw quinoa. Hence, soaking and germination emerge as effective methods for reducing antinutritional components and enhancing the nutritional and bioactive potential of quinoa.
Effect of Organic Sources of Nutrients on Growth and Flowering of Spray Chrysanthemum
Authors: Sarkar Sampa , Sarkar Indrajit , Sarkar Dipayan , Maitra Soumen , Chatterjee Ranjit
Published: January 2024

Aims: Chrysanthemum (Dendranthema grandiflora Tzvelev) also known as “Queen of the East” is one of the most imperative and the oldest flowering plant which is grown all over the world. Organic manures and bio-fertilizers improve soil health by increasing soil microorganisms and it helps the easy uptake of nutrients when crop is required to make it from unavailable form to available form. The present study was conducted to identify the best organic sources of nutrients for quality flower production of Chrysanthemum var. Aparajita.

Experimental Design: The experiment was laid out in RCBD (Randomized Completely Block Design) where treatments comprised with control and application of enriched FYM, enriched Vermicompost, enriched poultry manures as well as spraying with seaweeds extract singly and/or in combination as per the treatment.

Place and Duration of the Experiment: The present investigation was carried out at Instructional Farm, Department of Floriculture, Medicinal and Aromatic Plants in Uttar Banga Krishi Viswavidyalaya in the year of 2018-2020. The place is situated in Terai Region of West Bengal at 260 19 N latitude and 890 23 E longitude.

Results: The results revealed that application of enriched FYM @ 12.5t/ha+ enriched vermicompost @ 2.5t/ha + Seaweeds extract spraying @ 3 ml/l (T11) recorded maximum plant height (46.19 cm), plant spread (E-W: 26.54 cm and N-S: 26.72 cm), production of more number of primary branches (7.25) and leaves per plant (105.33), minimum days taken to first flower bud initiation (68.13 days) and first flower full blooming (10.11 days), more number of flowers per plant (35.16), vase life (14.55 days) in tap water, maximum Gross return (Rs. 517957.00 per ha) and B:C ratio (1:2.53) while minimum was recorded in control (T1) as compare to other treatments.

Conclusion: Based on the experiment, it had been concluded that application of enriched FYM @ 12.5t/ha+ enriched vermicompost @ 2.5t/ha + Seaweeds extract spraying @ 3 ml/l in combination was the best for organic cultivation of spray Chrysanthemum in the Terai region of West Bengal which was also economically viable for poor and marginal farmers of West Bengal.
Kajian Nilai Keberlanjutan pada Tatanan Massa Rumah Tradisional Bali
Authors: Suwondo Georgeanne Elaine , Arifin Lilianny Sigit
Published: January 2024

Di era ini, isu kelestarian lingkungan masih menjadi tantangan besar bagi umat manusia. Keberadaan dan kebutuhan manusia terbukti memberikan dampak negatif bagi bumi. Sebagai salah satu penyumbang kerusakan terbesar, adalah wajib bagi arsitektur untuk dipraktekkan dengan prinsip berkelanjutan. Prinsip berkelanjutan bertujuan untuk meminimalisir dampak negatif sambil memenuhi kebutuhan manusia semaksimal mungkin. Prinsip berkelanjutan ini bukanlah gagasan yang baru, melainkan sudah dipegang oleh nenek moyang kita. Penerapan prinsip ini dapat dilihat dalam bentuk macam-macam desain rumah tradisional di Indonesia, salah satunya rumah tradisional Bali. Tulisan ini mempelajari keunikan tatanan massa yang diterapkan pada rumah tradisional Bali dalam upaya mencapai keberlanjutan. Tulisan ini membandingkan dampak dari tatanan massa tersebut dengan parameter keberlanjutan. Hasil perbandingan menunjukkan bahwa tatanan massa rumah tradisional Bali memenuhi hampir semua kriteria keberlanjutan. Pola pembangunan dan tata ruang yang akan datang dapat mengacu pada rumah tradisional Bali.
Analisis Tektonik Artikulasi Pada Pusat Kesehatan Dan Rehabilitasi Serta Kaitannya Dengan Proses Penyembuhan Berdasarkan Teori Eduard Sekler
Authors: Agustinanda Felicya - , Sundoro Edwin Hariadi
Published: January 2024

Minimnya fasilitas pelayanan kesehatan yang memadai menyebabkan pasien sulit bangkit dari penyakitnya. Salah satu solusi yang diberikan dalam arsitektur adalah dengan menerapkan konsep healing untuk membantu proses penyembuhan, baik dari segi elemen arsitektural, struktural, maupun tektonika. Beberapa fasilitas pelayanan kesehatan seperti pusat kesehatan dan fasilitas rehabilitasi memiliki elemen arsitektural serta tektonika yang unik untuk dikulik. Fasilitas kesehatan yang dipilih sebagai studi kasus adalah Primary Healthcare Center dan Alzheimer Day's Center - Healthcare & Rehabilitation. Tujuan dari penelitian ini adalah mengidentifikasi dan mengetahui pentingnya penerapan tektonika artikulasi sebagai efek dari proses penyembuhan pada healthcare dan rehabilitation center dengan cara mengkritisi kedua studi kasus tersebut. Penelitian ini berjenis kualitatif dengan analisis deskriptif eksplanatif. Hasil dari analisis ini diharapkan mampu mengupas penerapan tektonika struktur dan konstruksi yang terdapat pada kedua studi kasus tersebut, mampu memperjelas kontribusi kedua elemen tersebut terhadap proses penyembuhan, serta mampu memberi kritik dan saran demi meningkatkan nilai desain.
Provocations with perfume in the eyes induce airway symptoms in patients with sensory hyperreactivity
Authors: Millqvist E , Bengtsson U , Löwhagen O
Published: March 2003

Background: In earlier studies, we have shown that patients with a history of sensory hyperreactivity develop asthma‐like symptoms when exposed to strong scents, even if they cannot smell any scent.

Methods: For study of possible pathophysiologic mechanisms behind sensory hyperreactivity, the patients' airways and eyes were separately exposed to a common inducing factor, perfume. Eleven patients with a history of hyperreactivity to chemical trigger factors, such as perfume, were provoked single‐blindly in a placebo‐controlled, randomized study. During airway exposure, the eyes were covered and, during the eye exposure, the patients inhaled fresh air. A special face mask or a nose clip was used to avoid any smell.

Results: During the 30‐min exposure to perfume, there was a gradual increase in three main symptoms; i.e., eye irritation, cough, and dyspnea, after both the airway and eye exposures. The increases were significant compared with placebo.

Conclusions: Asthma‐like and other symptoms, such as irritation of the eyes, may be induced by exposure of both the airways and the eyes in patients with sensory hyperreactivity. This points to the importance of studying the sensory nervous system, not only in the airways, but also in other organs.
Strain‐dependent induction of allergic rhinitis without adjuvant in mice
Authors: Okano M , Harn Jr DA , Abe M , Wang M‐M , Satoskar AR , Nishizaki K , Masuda Y , Okano M , Yoshino T
Published: March 2003

Background: To date, no murine models have been reported to show the induction of both antigen‐specific IgE and nasal eosinophilia, two of the major hallmarks of allergic rhinitis, after local sensitization in the absence of adjuvants, a phenomenon which reflects natural exposure. In this report, we attempted to establish a murine model representing an initiation of allergic rhinitis.

Methods: BALB/c, CBA/J, and C57BL/6 mice were sensitized intranasally to Schistosoma mansoni egg antigen (SEA) solely. After repeated sensitization, serum Ab titers, nasal eosinophilia, and cytokine production by nasal lymphocytes were determined.

Results: BALB/c mice produced SEA‐specific IgE after repeated sensitization. High‐dose sensitization to SEA induced IgE production in CBA/J mice, while C57BL/6 mice did not show the production throughout the period observed, suggesting that IgE production was regulated genetically. BALB/c mice also exhibited nasal eosinophilia after the nasal challenge. In addition, nasal lymphocytes sensitized with SEA intranasally produced significant amount of IL‐5 in vitro.

Conclusions: These results suggest that intranasal sensitization with SEA in the absence of adjuvants induces a Th2 immune reaction, reflecting the hallmarks of the initiation of allergic rhinitis both in vivo and in vitro, which is genetically regulated.
Early increase in urinary leukotriene E4 (LTE4) is dependent on allergen dose inhaled during bronchial challenge in asthmatic subjects
Authors: Bancalari L. , Conti I. , Giannessi D. , Lazzerini G. , Dente F. L. , De Caterina R. , Paggiaro P.L.
Published: March 2003

Background: Urinary leukotriene E4 (LTE4) excretion is a good marker of the rate of total body production of sulfidopeptide leukotrienes released during allergen challenge.

Methods: Twenty‐three subjects with allergic asthma were challenged with inhaled allergen, and the urinary excretion of LTE4 was determined by immunoenzymatic assay (associated with HPLC separation) at various intervals after challenge.

Results: Allergen challenge caused an early airway response (EAR) with a drop in FEV1 of 40.3±9.9%. This was associated with an increase in urine LTE4 excretion for 0–3 h after allergen inhalation (296±225.25 pg/mg creatinine) in comparison with baseline values obtained during the night before challenge (101.02±61.97 pg/mg creatinine). Urinary LTE4 excretion was significantly higher in subjects who inhaled a higher dose of allergen during challenge (LTE4 during EAR: 211±192 pg/mg creatinine in subjects with inhaled total dose of allergen <0.1 biologic units; 408±223 pg/mg creatinine in subjects with inhaled total dose >0.1 biologic units). All subjects showed a late airway response (LAR) to allergen of different severity, from mild (FEV1 fall: 15–20%) to severe (>30%); no correlation was found between the increase in urine LTE4 excreted during LAR (3–7 h after challenge) and the severity of LAR, but only subjects with severe LAR showed a significant increase in LTE4 during LAR in comparison with baseline value.

Conclusions: A release of sulfidopeptide leukotrienes, as evaluated by urinary LTE4 excretion, can be documented during EAR and LAR to allergen in relation to the dose of inhaled allergen, and it can represent a useful index of the events underlying the airway inflammatory responses during allergen challenge.
Regulation of ICAM‐3 and other adhesion molecule expressions on eosinophils in vitro. Effects of dexamethasone
Authors: Juan M. , Vilardell C. , Yagüe J. , Picado C. , Mullol J. , Roca‐Ferrer J. , Fuentes M. , Pérez M. , Picado C. , Juan M.
Published: March 2003

Background: ICAM‐3 has been recently identified as the third leukocyte‐function associated‐1 (LFA‐1) ligand. ICAM‐3 is expressed in eosinophils, but its regulation has not been studied. The objective of this study was to investigate the differential expression of ICAM‐3 and other adhesion molecules (AM) on the surface of eosinophils. We also evaluated the effects of dexamethasone on AM expression.

Methods: Normodense eosinophils were isolated from peripheral blood and incubated with calcium ionophore A23187 (calcimycin) with and without dexamethasone. Expression of AM was assessed by flow cytometry and expressed as fluorescence mean intensity (FMI).

Results: Peripheral blood eosinophils constitutively expressed low levels of ICAM‐1 and ICAM‐2 (<10 FMI), moderate levels (10–50 FMI) of CD29 and L‐selectin, and high levels (>50 FMI) of ICAM‐3, LFA‐1, and Mac‐1. Calcium ionophore (1 μM) significantly increased Mac‐1 and ICAM‐1 expression at 6 and 24 h. L‐selectin expression decreased at 6 and 24 h, but ICAM‐2, ICAM‐3, LFA‐1, and CD29 expression did not show any significant change after calcium ionophore stimulation. Dexamethasone decreased ICAM‐3 and increased L‐selectin basal expression, and it caused a dose‐related inhibition of calcium ionophore‐induced ICAM‐1 expression.

Conclusions: These findings suggest that some AM, such as ICAM‐1, Mac‐1, and L‐selectin, may be involved in adhesion during eosinophil activation and that glucocorticoids may prevent airway inflammation by regulating the expression of AM in eosinophils. The role of ICAM‐3, a leukocyte AM highly expressed in resting eosinophils, remains to be clarified.
Elevated soluble tumor necrosis factor receptor levels in seasonal allergic rhinitis patients
Authors: Kato Masashi , Kato Yoko , Nakashima Izumi , Kato Masashi , Hattori Taku , Matsumoto Yoshinari , Yamashita Tetsuji
Published: March 2003

In this study, we examined the symptom scores and tumor necrosis factor‐alpha (TNF‐α), p55 soluble tumor necrosis factor receptor (sTNFR1), and p75 soluble tumor necrosis factor receptor (sTNFR2) levels in the sera and nasal epithelial lining fluids (ELF) of 20 patients with Japanese cedar pollinosis from the pre‐ to the postseason period, and compared the results with those of 10 nonallergic control subjects. The symptom scores of the allergic subjects were significantly (P<0.01) higher than those of the nonallergic subjects during the early stage and mid‐stage of the season. There were no statistical differences between the allergic and nonallergic subjects in the TNF‐α levels in sera and ELF from the pre‐ to the post‐season. In the allergic subjects, however, the levels of sTNFR1 and sTNFR2 in ELF were significantly elevated during the early stage (P<0.05) and mid‐stage (P<0.01) of the season, whereas those in sera did not change from the pre‐ to the post‐season period. The levels of TNF‐α in ELF were more than 10 times higher than those in sera, whereas the levels of sTNFR1 and sTNFR2 in ELF were less than half of those in sera in the allergic and nonallergic subjects. These results suggest that sTNFR1 and sTNFR2 may play a role in the pathogenesis of nasal allergic reaction.
Immune responses to Aspergillus antigen in IL‐4‐/‐ mice and the effect of eosinophil ablation
Authors: Kurup VP , Murali PS , Xia J‐Q , Fink JN , Choi HY , Coffman RL
Published: March 2003

Background: Exposure to Aspergillus fumigatus allergens results in enhanced total serum IgE and peripheral blood eosinophils in mice. The associated pulmonary inflammation and immunologic responses are comparable to those detected in human allergic bronchopulmonary aspergillosis. Allergen‐induced cytokines are thought to regulate the inflammatory and immune responses in these animals.

Methods: In the present study, we exposed C57BL/6 and BALB/c mice to A. fumigatus antigen. Both wild‐type and IL‐4 knockout phenotypes of animals of both strains were used. Some animals were also treated with anti‐IL‐5 or anti‐IFN‐γ. Total serum IgE, Aspergillus species IgG subclass, peripheral blood eosinophils, and lung histology were studied.

Results: The results demonstrate similar lung inflammation in all wild‐type and IL‐4‐/‐ animals exposed to A. fumigatus antigen. Similarly, in spite of the diverse immune response produced by the anticytokine treatment, no major differences were detected among any of the animal groups studied.

Conclusions: It can be concluded that A. fumigatus exposure in an immunologically unaltered host is predominantly of a Th2 type, and that depletion of the Th2 cytokine leads to a similar lung inflammation but with a characteristic Th1 response, suggesting that the pathogenesis of allergic aspergillosis is the result of multiple induction pathways.
The frequency of phospholipase A2 binding of basophilic granulocytes does not decrease during bee‐venom‐specific immunotherapy
Authors: Irsch J , Löhndorf A , Radbruch A , König C , Krieg T , Hunzelmann N , Tesch H , Merk H , Radbruch A
Published: March 2003

Background: The major allergenic component of bee venom is phospholipase A2 (PLA2).

Methods: In this study, PLA2 was used to analyze and enrich PLA2‐binding cells from peripheral blood by high gradient magnetic cell sorting.

Results: In normal donors, the frequency of allergen (PLA2)‐binding cells among peripheral blood mononuclear cells (PBMC) as determined by flow cytometry is below 0.1%, whereas in bee‐venom‐allergic patients, PLA2‐binding cells are readily detectable at frequencies of up to 2.3%. In severely bee‐venom‐allergic patients, many basophilic granulocytes are present, as defined by anti‐CD9, CD25, and CD38 mAb, comprising up to 95% of the PLA2‐binding cells. From blood of allergic and normal donors, about equal absolute numbers of allergen‐binding CD19/21‐positive B cells can be enriched. Severe anaphylactic reactions (Mueller grade IV) and failure of or adverse reactions during immunotherapy are associated with high numbers of circulating allergen‐binding basophils. Interestingly, in the patients studied, the number of PLA2‐binding basophilic granulocytes did not markedly change during rush immunotherapy and up to 6 months of maintenance immunotherapy.

Conclusions: The specific and reproducible enrichment of PLA2‐binding cells provides a new tool for the analysis and monitoring of effector cells in bee‐venom‐allergic patients with immediate‐type hypersensitivity.
Cyclosporin A (CyA) reduces sCD30 serum levels in atopic dermatitis: a possible new immune intervention
Authors: Bottari V , Frezzolini A , Ruffelli M , Puddu P , De Pità O , Fontana L
Published: March 2003

Atopic dermatitis (AD) is a chronic inflammatory skin disease frequently associated with asthma, rhinitis, and food allergy. Lymphocytes producing Th2‐type cytokines (such as interleukin [IL]‐3, IL‐4, and IL‐5) have been thought to have a key role in the pathogenesis of the disease. We have recently demonstrated that elevated serum levels of the soluble form of CD30 (sCD30), an activation marker of Th2‐cell clones, correlates with disease activity in pediatric patients suffering from AD. Clinical trials have demonstrated that cyclosporin A (CyA) treatment resulted in significant improvement of clinical symptoms in patients affected with AD. In this study, we evaluated the role of CyA in modulating sCD30 release in a group of adult patients affected by severe AD treated with CyA at the dosage of 3.5 mg/kg body weight for 12 weeks. Our results demonstrated, in parallel with an improvement of clinical symptoms, a significant reduction of serum levels of both IL‐4 and sCD30, thus suggesting that CyA can prevent the activation of Th2 cells observed in AD.
Survey of recognition and utilization of guidelines for the diagnosis and management of bronchial asthma in Japan
Authors: Makino S. , Miyamoto T. , Nakajima S. , Kabe J. , Baba M. , Mikawa H. , Furusho M. , Fukuda K. , Nakagawa T. , Naitou H.
Published: March 2003

Background: In Japan in 1993, the Japanese Society of Allergology (JSA) developed guidelines for diagnosis and management of asthma (JGL), which were based on the concept that asthma is a chronic inflammatory disorder of the airway.

Methods: This survey study was intended to investigate the recognition and utilization of JGL among physicians who had treated asthma. The survey comprised two methods: a quantitative mail survey and a qualitative door‐to‐door survey conducted by trained interviewers.

Results: In the mail survey, a total of 1028 physicians responded; 552 members of the JSA and 476 nonmembers. Ninety‐four percent of JSA members were aware of adult asthma management guidelines, while 53 nonmembers were aware of them. Although approximately half of the physicians, both member and nonmember, found differences between the asthma management policies in JGL and their previous policies, most of them utilized JGL, once they read it. In the qualitative door‐to‐door survey, 80–90% of physicians evaluated JGL as good after they read it.

Conclusions: JGL was recognized and utilized by most JSA members, but only half of nonmember physicians were aware of JGL, although they utilized JGL after they read it. Further action to implement JGL among nonspecialist physicians is needed to improve management of asthma.
2S methionine‐rich protein (SSA) from sunflower seed isan IgE‐binding protein*
Authors: Kelly J. D. , Hefle S. L.
Published: March 2003

Background: Sunflower seed contains 2S albumins that in other crops have been associated with allergenicity. The sunflower seed methionine‐rich 2S albumin (SSA) may be an IgE‐binding protein responsible for anaphylactic reactions in some sunflower seed‐sensitive subjects. The objective was to demonstrate that SSA is an IgE‐binding protein.

Methods: SSA was purified and the amino‐acid sequence determined. The degree of purity of SSA was evaluated by silver staining, and its IgE‐binding capacity by immunoblotting with serum from a subject with a convincing clinical history of anaphylaxis to sunflower seed.

Results: The amino‐acid sequence confirmed that the purified protein was the mature form of the methionine‐rich storage protein SSA from sunflower seed (Helianthus annuus). The SSA was specifically recognized by IgE from the serum of the sunflower seed‐allergic subject.

Conclusions: SSA is an IgE‐binding protein, and subjects allergic to sunflower seed whose IgE binds to SSA are at risk of developing allergic reactions if they consume SSA.
Marker antigens to assess exposure to molds and their allergens.I. Aspergillus fumigatus
Authors: Wijnands L. M. , Deisz W. D. C. , Van Leusden F. M.
Published: March 2003

Background:  Exposure to molds and mold products in the indoor environment may lead to allergies, asthma, or respiratory complaints in general. Enumeration of viable parts of molds in the environment is insufficient to estimate exposure. Therefore, other methods have to be developed.

Methods:
 
Aspergillus fumigatus (Af) was grown under various circumstances (22°C and 30°C, high and low water activity) in the laboratory. At various moments during culture, extracts were taken, and antigen and allergen content was examined by acrylamide electrophoresis and immunoblot.

Results:  In extracts of the culture filtrate, two antigens were found to be produced under all studied growth conditions (common antigens). In the extracts of the water‐soluble portion of the mycelium, one common antigen was found.

Conclusions:
 The three common antigens may serve as marker antigens for exposure to Af and its products. In view of the simultaneous presence of two of these common antigens with Af allergens, these two marker antigens may be used to estimate exposure to allergens of Af.
A new method for collecting airborne allergens
Authors: Parvaneh S. , Ahlf E. , Elfman L. H. M. , Van Hage‐Hamsten M. , Elfman L. , Nybom R.
Published: March 2003

xxBackground: Measurement of airborne allergens has hitherto been done with the use of fixed‐location pumps or personal air samplers. Our objective was to find out whether ionizers could be good tools for collecting airborne allergens. As a model we have used cat allergen (Fel d 1). We have compared Fel d 1 levels collected by the ionizer at different time periods, as well as comparing Fel d 1 levels obtained with the ionizer with those of low‐ and high‐volume pumps.

Methods: Dust samples from floors and air samples collected with ionizers and pumps, obtained in 31 homes with cat, 23 homes without cats, and 28 day‐care centres, were analysed for cat allergen content (Fel d 1) by ELISA.

Results: Fel d 1 was present in the reservoir in all homes with cats, ranging from 660 to 375000 ng/g (GM 75000) and in the air collected by the ionizer from 2.0 to 204 ng/24 h (GM 19.3). The allergen in homes without cat varied from <55 to 1800 ng/g (GM 166). Corresponding levels in air were found in two of these homes (2.3 and 7.3 ng/24 h). There was a correlation between the number of cats and the amount of airborne cat allergen (r: 0.47; P<0.05). The levels in day‐care centres were <55 to 3070 ng/g in dust (GM 360) and <1.1 to 7.9 ng/24 h in the air (GM 1.6). We obtained a moderately strong correlation between air and dust samples in homes with cats (rs: 0.64; P<0.001) and in day‐care centres (rs: 0.49; P<0.05). We found that a collection period of 24 h is preferable for the ionizer. The intrahome reliability coefficient was nearly two times higher for the ionizer (r: 0.69) than the pump (r: 0.39).

Conclusions: The ionizer seems to be a good tool for monitoring the environment. It is easy to use and silent and does not disturb the airflow in the room.
CD30 expression on circulating memory CD4+ T cells as a Th2‐dominated situation in patients with atopic dermatitis
Authors: Yamamoto J. , Adachi Y. , Onoue Y. , Kanegane H. , Miyawaki T. , Toyoda M. , Seki T. , Morohashi M.
Published: March 2003

Th2 clones have been reported to express CD30 preferentially, but whether T cells producing Th2‐type cytokines may favor CD30 expression in the in vivo state remains unknown. We investigated the expression of CD30 on circulating T cells in atopic dermatitis (AD) as a Th2‐dominated disorder. Peripheral blood mononuclear cells were prepared from 51 AD patients and 14 nonatopic controls, and their phenotypes were analyzed with flow cytometry. Cytokine production by stimulated CD4+ T cells was also assessed by the single‐cell‐staining method. Flow cytometric analysis clearly revealed that CD30+ T cells were identifiable in the blood of AD patients with greater frequency compared to controls. The important finding was that CD30 expression was restricted to a small but substantial population of memory (CD45RO+) CD4+ T cells, but not CD8+ ones. In AD patients, it was demonstrated that the percentages of CD30+ cells within CD45RO+ CD4+ T cells correlated well with the disease severity, serum IgE levels, peripheral eosinophil counts, and tendency toward Th2‐dominant cytokine pattern as determined by the ratio of interleukin‐4 to interferon‐gamma production. This study suggests that CD30 expression in circulating T cells might serve as an in vivo marker for the Th2‐dominated condition.
Occupational all_ergic contact urticaria to yucca (Yucca aloifolia), weeping fig (Ficus benjamina), and spathe flower (Spathiphyllum wall_isii)
Authors: Kanerva L. , Estlander T. , Petman L. , Mäkinen‐Kiljunen S.
Published: March 2003

Background: Occupational contact urticaria (CU) from plants is often reported, but it is less often attributed to decorative houseplants. We present an atopic gardener and caretaker of plants who developed CU when occupationall_y exposed to weeping fig, spathe flower, and yucca.

Methods: Sensitization was evaluated by skin prick tests (SPT) and analyses for IgE antibodies.

Results: SPT were positive to all_ three plants, and IgE antibodies were found to weeping fig and spathe flower. SPT were also performed with several decorative houseplants in more than 600 patients. Positive SPT was found to weeping fig (12%), African milk tree (8.3%), yucca (5.8%), Chinese rose (4.7%), massangana (4.6%), bird's nest fern (3.2%), and spathe flower (3.2%).

Conclusions: Our study indicates that SPT and tests for IgE antibody are useful in detecting occupational CU caused by houseplants.
Decongestant efficacy of desloratadine in patients with seasonal allergic rhinitis
Authors: Bachert C.
Published: March 2003

Recent advances in experimental immunologic approaches to seasonal allergic rhinitis (SAR) have led to a shift in the concepts of its pathogenesis. The conventional view of SAR as a local response to inhaled allergens has largely given way to a new view of this disorder as a systemic condition with local tissue manifestations. This concept, together with an increasing recognition of specific mediators' distinct roles in driving the early‐ and late‐phase allergic responses, has opened multiple lines of therapeutic attack within the allergic cascade. Potent inhibition of inflammatory mediator release at distinct points in this cascade is conferred by desloratadine. In addition to the familiar range of SAR symptoms amenable to antihistamine therapy, desloratadine uniquely attenuates patient ratings of nasal congestion. This novel, nonsedating histamine H1‐receptor antagonist is the only once‐daily antiallergic product with a consistent decongestant effect that begins within hours of the first morning dose and is sustained for the entire treatment period.
Clinical health education for patients with asthma‐like symptoms but negative asthma tests
Authors: Ringsberg K. C. , Timpka T.
Published: March 2003

Background: Patients with asthma‐like symptoms but negative asthma tests often state that they lack strategies to cope with their symptoms. The aim of the study was to determine whether a problem‐based health education program had a beneficial effect on the participants' experience of symptoms and subjective health.

Methods: Thirty‐eight patients, consecutively drawn from an outpatient clinic for asthma and allergy, were randomly allocated to an intervention group (I group, n=18) and a control group (C group, n=20). The I group, divided into three subgroups, met on seven occasions over 5 months. The program had a multidisciplinary approach, used exercises inspired by cognitive behavioral therapy, and was performed according to the principles of problem‐based learning. All patients answered the Nijmegen Symptom Questionnaire (NQ) and the SF‐36 health survey before and 2 months after the training was terminated.

Results: Before the program, there were no significant differences between the groups in their earlier experience of symptoms. After it, the I group scored significantly lower on shortness of breath (P=0.001) and central tetany (P=0.05) than the C group. On both test occasions, the asthma‐like patients scored lower on all variables of the SF‐36 than the reference groups of asthmatics and healthy subjects. No significant differences were seen between the I group and the C group except for vitality, in which the C group scored lower before the intervention.

Conclusions: Patients with asthma‐like symptoms but negative asthma tests benefit from taking part in a problem‐based health education program. It mainly reduces the frequency of symptoms.
Functional human IgE specific for Dermatophagoides farinae antigen is produced in SCID mice reconstituted with peripheral mononuclear cells derived from healthy persons and patients with asthma
Authors: Noma T. , Yoshizawa I. , Kawano Y. , Matsuura N. , Nakajima T. , Aoki K.
Published: March 2003

Background: Whether normal peripheral blood mononuclear cells (PBMCs) transferred to severe combined immunodeficient (SCID) mice produce specific IgE remains unclear.

Methods: Mice received injections of Dermatophagoides farinae antigen (Df)‐stimulated PBMCs from healthy persons (IgE RAST score of 0).

Results: High titers of Df‐specific IgE were detected. The Df‐specific IgE activity produced was comparable to or higher than that produced by cells from patients with asthma although the time to maximal production was longer. IgE derived from PMBCs of healthy persons or patients with asthma induced histamine release from cultured human basophils that had been stimulated with Df antigen or an anti‐IgE antibody. Treatment of Df‐stimulated PBMCs with a high dose, but not a low dose, of interleukin‐4 stimulated production of Df‐specific IgE by PMBCs from healthy persons or patients with asthma. In contrast, intravenous injection of IFN‐γ into reconstituted SCID mice decreased Df‐specific IgE production by PBMCs from patients with asthma. In PMBCs from healthy persons, IgE class‐switching may occur later and block the effects of treatment with IFN‐γ.

Conclusions: PBMCs from healthy persons and persons with asthma have clones reactive to allergen and produce functional IgE specific for relevant antigens in mite‐sensitive bronchial asthma.
Sublingual tryptase and ECP in children treated with grass pollen sublingual immunotherapy (SLIT): safety and immunologic implications
Authors: Marcucci F. , Sensi L. , Frati F. , Senna G. E. , Canonica G. W. , Parmiani S. , Passalacqua G.
Published: March 2003

Background: The clinical safety of sublingual immunotherapy (SLIT) has been repeatedly confirmed; nevertheless, the possible onset of local oral symptoms is still a concern, and nothing is known about the pathogenesis of this effect. We aimed to determine whether the administration of SLIT in allergic children can evoke an IgE‐mediated reaction, by measuring the levels of sublingual tryptase and ECP.

Methods: Thirty children (7–12 years old) with allergic rhinitis/asthma due to grass pollen were prescribed SLIT. In these children, an allergen‐specific nasal challenge was performed, and nasal tryptase and ECP were measured before and after. Sublingual ECP and tryptase were also assessed before the SLIT, after 1 month, and after 6 months of treatment. Ten matched allergic children and 10 healthy ones served as controls for the baseline levels of sublingual ECP and tryptase.

Results: The levels of nasal tryptase and ECP significantly increased after nasal challenge (P<0.001), whereas no change during the SLIT course (at the beginning, after 1 month, and after 6 months) could be detected in sublingual tryptase either before or after SLIT administration. The sublingual ECP significantly decreased after 6 months of SLIT. The baseline levels of nasal tryptase and ECP were significantly higher in allergic subjects than in healthy controls, as was the level of sublingual ECP.

Conclusions: In the presence of an IgE‐mediated reaction (ASNC), a significant increase of tryptase and ECP can be seen. When SLIT is administered, such a phenomenon does not occur; therefore, SLIT does not elicit any IgE reaction in the mouth. It is noteworthy that allergic subjects display higher levels of nasal ECP and tryptase than healthy subjects, even when symptom‐free, and these observations may indicate the presence of subclinical inflammation.
Effect of cetirizine on bronchial hyperresponsiveness in patients with seasonal allergic rhinitis and asthma
Authors: Aubier M. , Neukirch C. , Peiffer C. , Melac M.
Published: March 2003

Although H1 antihistamine compounds (H1) are highly effective in the treatment of allergic rhinitis (AR), their role in the treatment of asthma is still controversial. Because a strong association between AR and bronchial hyperresponsiveness (BHR) has been reported, this study was designed to assess the effect of a new H1 anti histamine, cetirizine (C), on nonspecific BHR in patients with AR. Twelve patients were included in a double‐blind, crossover, placebo‐controlled trial. All patients had positive skin tests for common allergens and showed BHR to inhaled methacholine after specific nasal allergenic challenge. After a washout period of 1 week to ensure the stability of the BHR, the patients received, by crossover randomization, C 10 mg daily or placebo (P) for 2 weeks. After each treatment period, BHR and nasal blocking index (NBI) were measured 1 and 6 h after nasal challenge. Bronchial responsiveness was expressed as methacholine PD20, the provocation dose of methacholine causing a 20% decrease in FEV1. Measurements were then performed after 2 weeks of C and after 2 weeks of P. Baseline values of PD20 (median) measured before challenge showed no difference after cetirizine or after placebo (1.36 mg). Results 1 h after allergen did not show significant differences between C (methacholine PD20=0.522 mg) and placebo (methacholine PD20=0.455 mg). By contrast, 6 h after challenge, methacholine PD20 was 0.918 mg for C and 0.483 mg for P (P=0.042). Similarly, NBI showed no change between C and P 1 h after challenge, whereas the difference was significant 6 h after challenge (P=0.011). These data demonstrate a protective nasal effect of C against BHR measured 6 h after nasal allergen challenge in patients with AR. They suggest that C may be useful in patients with asthma associated with AR.
Eotaxin but not MCP−3 induces eosinophil influx into nasal fluid in allergic patients
Authors: Górski P. , Wittczak T. , Walusiak J. , Pałczyński C. , Ruta U. , Kuna P. , Alam R.
Published: March 2003

Background: Eotaxin and MCP‐3 (CC chemokines), owing to their preferential action on eosinophils, seem to be the very importance in the patophysiology of allergic rhinitis and asthma. The purpose of this study was to examine the effect of intranasally administered eotaxin and MCP‐3 after specific allergen priming on the influx of inflammatory cells and their soluble mediators into the nasal mucosa.

Methods:  Eotaxin and MCP‐3 have been applied intranasally at the increasing doses of 1, 5 and 10 µg to allergic patients after allergen priming. The ‘nasal pool’ technique was used. The cell count and biochemical parameters in nasal lavage were evaluated before 30 min, and 4 and 24 h after the challenge with chemokines.

Results:  Both eotaxin and MCP‐3 induced the increase in clinical ‘score’ lasting till 24 h. Eosinophil influx into nasal mucosa after provocation with eotaxin was also observed. The challenge with MCP‐3 did not induce any significant changes in nasal lavage fluid.

Conclusions:  Eotaxin is likely to play an important role in the pathogenesis of allergic conditions in humans. MCP‐3 did not induce inflammatory cell influx into nasal mucosa. The role of this chemokine in the pathogenesis of allergic inflammation is difficult to assess and requires further studies.
The association between synthetic bedding and adverse respiratory outcomes among skin‐prick test positive and skin‐prick test negative children
Authors: Ponsonby A.‐L. , Gatenby P. , Glasgow N. , Mullins R. , Hurwitz M. , McDonald T.
Published: March 2003

Background: Synthetic bedding has been associated with increased child wheeze and also higher allergen levels in several studies. We aimed to examine whether the association between synthetic bedding and adverse respiratory outcomes was more evident among skin‐prick test (SPT) positive children.

Methods: A cross‐sectional survey involving a population sample of 758 (81% of eligible) school children aged 8–10 years from randomly selected schools in the Australian Capital Territory in 1999. Parental questionnaires for ISAAC respiratory symptoms and child bedding were obtained. SPT results of 10 common allergens were available on 722 of the subjects (77% of those eligible). Synthetic pillow or quilt use was termed synthetic upper bedding.

Results: Synthetic quilt use was associated with asthma (Adjusted Odds Ratio 1.67 (1.05, 2.65)), recent wheeze (AOR 1.63 (1.03, 2.59)) and allergic rhinoconjunctivitis (AOR 2.11 (1.33, 3.34)) among SPT‐positive children. However, these associations were not apparent for SPT‐negative children. Similarly, increasing synthetic upper bedding use was associated with more than 12 episodes of wheeze among SPT‐positive children (AOR 1.69 (1.08, 2.64), P=0.02, per category) but not SPT‐negative children (AOR 0.77 (0.26, 2.21), P=0.6, per category).

Conclusion: The apparent association between synthetic upper bedding and adverse respiratory outcomes was evident among SPT‐positive but not SPT‐negative children. Prospective intervention studies that aim to examine the effect of upper bedding composition on child asthma among SPT‐positive children are required.
Characterization of monocyte subtypes in the allergic form of atopic eczema/dermatitis syndrome
Authors: Novak N. , Allam P. , Geiger E. , Bieber T.
Published: March 2003

Background:  Monocyte (Mo) subsets exhibiting distinct phenotypic and functional properties identified in peripheral blood are assumed to be under the control of soluble factors from their surrounding micromilieu. Atopic eczema/dermatitis syndrome (AEDS) is accompanied by humoral and cellular alterations among which an increased expression of the high‐affinity receptor for IgE (FcεRI) on antigen presenting cells, like Mo, could be found. Therefore we analyzed the assembly of circulating Mo populations and their FcεRI surface expression during the course of AEDS.

Methods:  Blood samples were taken from AEDS patients before and after topical treatment as well as from psoriasis patients and healthy control donors. Detailed analysis of Mo subsets was done by flow cytometry. Meticulous clinical scoring included quantification of the surface damage using the eczema area and severity index (EASI score) as well as evaluation of the serum level of thymus‐ and activation‐regulated chemokine (TARC); this was done before and after 2 weeks of topical treatment with tacrolimus ointment 0.1%.

Results:  During the exacerbation phase of AEDS, patients harboured a different assembly of Mo subtypes from normal nonatopic individuals and patients with psoriasis with a significant increased population of CD14+CD64– CD16+ Mo. Clinical improvement led to a significant decrease of this subpopulation in favor of CD14+CD64+CD16– Mo, leading to a composition of Mo subsets similar to the state found in healthy donors. Interestingly, FcεRI expression was confined to the CD14+CD64+CD16– Mo subpopulation and the percentage of this FcεRI+ Mo subset increased significantly in the peripheral blood after topical treatment.

Conclusion:  Our data provide for the first time clear evidence that fluctuations of Mo subsets in AEDS might reflect qualitatively and quantitatively distinct contributions of Mo subsets to the development of AEDS.
A genetic analysis of lupus
Authors: Theofilopoulos A. N. , Kono D. H.
Published: March 2003

Systemic lupus erythematosus (SLE) is a complex multigenic inherited disease with susceptibility determined by a combination of genetic, environmental and stochastic factors. Although not yet defined, recent technical advances have provided the means to dissect the component genetic contributions of polygenic traits. We have applied such approaches to mouse models of spontaneous SLE and, in this report, summarize our genome wide mapping studies that identified loci predisposing to several major lupus‐related traits. Through the generation and study of interval congenic lines, precise mapping, and screening of candidate genes, identification of the specific genes and mechanisms associated with some of the major loci is currently being pursued.
The rise of atopy and links to infection
Authors: Hopkin J M.
Published: March 2003

Atopy is the state of allergy to common environmental antigens. Genetic and environmental factors promote the disorder. The impressive rise in prevalence, mainly centred on socio‐economically developed communites around the world, emphasizes the potent action of environmental factors in moulding this immune disorder which is characterized by inadequately restrained Th‐2 immune mechanisms and IgE production. Reversing the epidemiological trend depends on our identifying the major environmental inputs and acting against these. As yet, the nature of these environmental factors remains to be clarified. Candidate factors include changes in diet, chemical air pollution and microbial exposures in developed countries. This article limits its scope to changing microbial exposures as a potential mechanism. (a) It records epidemiological data that have associated atopic status with less natural exposure to pathogens, parasites and commensal micro‐organisms, but with more exposure to certain antibiotics and public health immunizations in early life. (b) It records studies in mice that support the concept that certain microbial exposures can inhibit experimental allergy. (c) It considers potential immune mechanisms for such an action, including the possibility that certain natural infections promote immune regulatory processes that can restrain atopy. It is concluded that the hypothesis that changing patterns of microbial exposure may have promoted the rise in atopy is viable, and that exciting possibilities for reversing the rise of atopy may be derived from further studies.