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1.
Background
Skin prick tests (SPTs) and measurements of serum specific immunoglobulin E (sIgE) antibodies are the most commonly used diagnostic tools for confirming sensitization. However, disagreement between the tests has been observed.Objective
To compare SPT and the CAP system for diagnosis of sensitization to common inhalant allergens.Methods
Subjects included 2,635 patients 10 to 90 years old who underwent analyses by SPT and CAP at the Dong-A University Hospital (Busan, Korea) from June 2011 through May 2016. The 2 test results were compared for 17 inhalant allergens.Results
Agreement between the SPT and sIgE level was 75.3%. Overall agreement was moderate (κ = 0.59), with strong agreement for house dust mites and birch (κ > 0.7) and weak agreement for Tyrophagus putrescentiae and dog (κ < 0.3). When CAP was compared with SPT as the reference, the sensitivity was 75.8% and the specificity was 75.2%. Mean wheal size by SPT showed a positive correlation with sIgE levels (r = 0.59), which decreased with age.Conclusion
There was a discrepancy between SPT and CAP for diagnosing allergic sensitization among inhalant allergens. The allergic sensitization and correlation between the tests decreased with age. Cautious interpretation of the clinical relevance of allergen sensitization based on SPT and CAP results is required, especially in older patients. 相似文献2.
Charlotte Baker Jill Powell Dominic Le Melissa S. Creary Lori-Ann Daley Mary Anne McDonald Charmaine DM. Royal 《Journal of the National Medical Association》2018,110(6):564-573
Objective
To describe the perspectives and experiences of athletic trainers, coaches, and student-athletes approximately three years post-implementation of the NCAA sickle cell trait (SCT) screening policy.Participants
Two-hundred and eight student-athletes, 32 athletic trainers, and 43 coaches from 10 NCAA Division I (DI) institutions in North Carolina from January to June 2014.Methods
Two online surveys were used to assess knowledge, perspectives, and experiences.Results
Athletic staff were more supportive than student-athletes of the need for the policy. Noted challenges included variation in implementation and follow-up for SCT-positive athletes, financial costs to institutions and athletes, and timing of the screening.Conclusions
More education about SCT is needed for student-athletes and athletic staff in order to help make the implementation more successful. All parties need to be in agreement regarding the importance of knowing which student-athletes have SCT and how that information will be utilized. 相似文献3.
Patrick M. Brunner Donald Y.M. Leung Emma Guttman-Yassky 《Annals of allergy, asthma & immunology》2018,120(1):34-41
Objective
To provide an overview of studies contributing to the understanding of immunologic, microbial, and epithelial interactions in atopic dermatitis.Data Sources
PubMed literature review (2000–2017) and meeting abstracts from recent international dermatology conferences.Study Selections
Articles discussing primarily human disease.Results
Clinical studies showed that atopic dermatitis is a type 2 immune-centered disease with a systemic inflammatory component but with heterogeneous treatment responses. This suggests that other factors are likely involved in shaping the skin disease phenotype, including microbial dysbiosis and epidermal barrier dysfunction.Conclusion
Recent clinical investigation has significantly expanded our knowledge on disease pathogenesis in atopic dermatitis, and current and future clinical trials will most likely further help to elucidate this complex, heterogeneous skin disease. 相似文献4.
Fan-Min Lin Jia-Yih Feng Wen-Feng Fang Chieh-Liang Wu Chong-Jen Yu Meng-Chih Lin Shih-Chi Ku Chang-Wen Chen Chih-Yen Tu Kuang-Yao Yang 《Journal of microbiology, immunology, and infection》2019,52(2):320-328
Background/purpose
It is controversial whether healthcare-associated pneumonia (HCAP) belongs to a unique clinical entity or it shares common characteristics with community-acquired pneumonia (CAP). The impact of prior pulmonary tuberculosis (PTB) in clinical presentation and treatment outcome of ICU-admitted CAP and HCAP patients also remains unknown.Methods
We report a nationwide, multi-center, retrospective study. ICU-admitted CAP and HCAP patients from six medical centers in Taiwan were enrolled for analysis. Patients were defined as either CAP or HCAP cases, and with and without prior PTB, according to the database of Taiwan CDC. The disease severity, microbiologic characteristics, and treatment outcomes between CAP and HCAP patients with or without prior PTB were compared and analyzed.Results
A total of 414 ICU-admitted patients, including 176 CAP cases and 238 HCAP cases were included for analysis during the study period. In both CAP and HCAP subgroups, the pneumonia severities, proportions of organ dysfunction, and microbiologic characteristics were similar between patients with and without prior PTB. In survival analysis, patients with prior PTB had higher 30-day mortality than those without prior PTB (38.9% vs. 16.5%, p = 0.021) in the CAP population. Multivariate analysis revealed that a history of prior PTB was an independent clinical factor associated with higher 30-day mortality rate in CAP patients (HR = 4.45, 95% CI: 1.81–10.98, P = 0.001).Conclusion
History of prior PTB is an independent clinical factor for increased 30-day mortality rate in ICU-admitted CAP patients, but not in ICU-admitted HCAP patients. 相似文献5.
Chun-Hsiang Chiu Ying-Chuan Wang Kuo-Ming Yeh Jung-Chung Lin L.K. Siu Feng-Yee Chang 《Journal of microbiology, immunology, and infection》2018,51(1):64-69
Background/Purpose
Although the prevalence of pneumonia or other extrapulmonary infections is higher in people with alcoholism or acute alcohol intoxication, the possible relationship of acute alcohol intoxication to phagocytic function has not been investigated. Our aim was to determine whether acute alcohol intoxication suppresses phagocytic function in human neutrophils.Methods
Twenty healthy individuals were enrolled for isolating neutrophils to evaluate the neutrophil phagocytic function at different alcohol concentrations. Klebsiella pneumoniae was isolated from clinical specimens of liver abscesses. The rate of K. pneumonia phagocytosis (K2 and non-K1/K2 isolates) by neutrophils was determined using flow cytometry and compared among the nine groups with different alcohol concentrations.Results
The rate of phagocytic uptake decreased significantly with increasing alcohol concentration in both the K2 and non-K1/K2 K. pneumonia groups (r = ?0.866, p = 0.03 vs. r = ?0.975, p < 0.001). Moreover, the percentage of K. pneumoniae ingested by neutrophils decreased with age.Conclusion
The ability of neutrophils to phagocytose virulent K2 K. pneumoniae was suppressed by ethanol at high concentrations. This finding may account for the higher prevalence of pneumonia or other extrapulmonary infection in people with acute alcohol intoxication. 相似文献6.
Peng Li Miao Ge Congxia Wang Jinwei He Shaofang Yang Jing Jing Dezhi Wei 《Journal of the National Medical Association》2018,110(4):334-342
Objectives
This study aims to explore the spatial characteristics of the alpha-fetoprotein (AFP) reference value in healthy Chinese adults, and its relationship to geographical location.Methods
A total of 9396 AFP reference values were collected from patients in 96 administrative units. A correlation analysis and support vector machine (SVM) were employed to extract dependent geographical factors and predict the reference values in the entire country, respectively. A geostatistics analysis was developed to reveal the spatial characteristics of the value.Results
Under the long-term influence of geographical environment, AFP reference values show spatial autocorrelation and regional variation. The values are higher in western and northern areas than in eastern and southern areas of China.Conclusions
The AFP reference values show regional differences, and this difference should be considered in clinical practice. 相似文献7.
Hong-Yi Lee Yu-Chia Hsieh Ching-Chuan Liu Yi-Chuan Huang Kuang-Yi Chang Hsin Chi Luan-Yin Chang Yhu-Chering Huang Li-Min Huang 《Journal of microbiology, immunology, and infection》2018,51(2):199-206
Background
In Taiwan, the age group with the greatest incidence of invasive pneumococcal disease is 2–5 years of age, which is different from other countries. This study was conducted to identify risk factors and different 13-valent pneumococcal conjugate vaccine (PCV13) schedules associated with vaccine-type invasive pneumococcal pneumonia (IPP) despite prior vaccination.Methods
A case–control study was conducted prospectively between August 2012 and December 2015 at five participating medical centers. The study enrolled children <15 years of age who were admitted to one of the five medical centers for CAP. Blood samples and acute-phase serum specimens were collected and Streptococcus pneumoniae was identified by using a real-time polymerase-chain-reaction (RT-PCR) assay targeting the lytA gene.Results
A total of 25 children diagnosed with vaccine-type IPP and 124 controls were enrolled. Vaccine-type IPP occurred in 6 (28.6%), 14 (24.1%), and 5 (7.1%) children receiving vaccines on a not-age-appropriate schedule (n = 21), primary infant schedule (n = 58), and toddler catch-up schedule (n = 70) (P = 0.008), respectively. Of 25 children, the mean age at disease onset was 36 ± 11 months; serotype 19A was responsible for 84% (21/25).Conclusion
After adjustment for confounding factors, the risk of vaccine-type IPP was significantly higher among children receiving vaccines on a not-age-appropriate schedule, or on a primary infant schedule, compared with children receiving vaccines on a toddler catch-up schedule. Duration of vaccine immunity should be investigated to direct strategies for maintaining individual and population immunity against pneumococcal disease. 相似文献8.
Robert L. Jacobs Daniel A. Ramirez Cynthia G. Rather Charles P. Andrews Daniel C. Jupiter Fernando Trujillo David G. Shulman 《Annals of allergy, asthma & immunology》2017,118(1):86-93.e2
Background
There are few direct data concerning symptom dynamics of allergic conjunctivitis (AC) in an allergen challenge chamber (ACC).Objective
To determine the AC dynamics on subsequent exposures to ragweed pollen (RW) in individuals with allergic rhinitis in an ACC. To determine whether consecutive exposures in an ACC have any persistent detrimental ocular physical effects.Methods
Participants underwent 3 exposures to RW in an ACC. Ocular symptoms of itching and tearing were self-assessed. Ocular redness and lid swelling were assessed by trained ophthalmic technicians. Complete ophthalmic examinations (COEs) were performed by an ophthalmologist.Results
A total of 188 of 201 participants (93%) developed an ocular redness score of 2 or more in each eye in ACC exposure 1. Reproducibility of redness occurred in approximately 70% of individuals completing ACC exposures 1 through 3. There were no significant changes between baseline COE and end of study COE. Phenotypes were identified by redness responses during and after exposure. Baseline total ocular symptom scores, at 24 hours after a priming exposure, were identified as late-phase reactions rather than enhanced sensitivity.Conclusion
When assessed by trained professionals, AC was present with a very high frequency in selected individuals allergic to RW monitored in an ACC. Intrasubject reproducibility of redness was consistent across 3 ACC allergen exposures. Phenotypes were identified as early-phase responses, protracted early-phase responses, dual responses, and late-phase responses.9.
Kimberly S. Johnson Kevin L. Thomas Sandro O. Pinheiro Laura P. Svetkey 《Journal of the National Medical Association》2018,110(4):305-313
Background
Disparities in health and healthcare are widely documented for underrepresented racial and ethnic populations across a spectrum of diseases and care settings. An evidence base for addressing racial and ethnic disparities in health and healthcare requires investigators trained to conduct health disparities research.Objective
To increase knowledge, stimulate interest, teach skills to evaluate and conduct, and foster collaborations in health disparities research.Design
We designed, implemented and evaluated a Health Disparities Research Curriculum (HDRC).Participants were early-stage investigators.Intervention
HDRC included twelve monthly sessions during 2015–2016. Instructors were mostly HDR investigators. Sessions combined didactic presentations, discussions, small group activities, and participant presentations.Measures
Pre- and post-surveys to assess participants' perceptions of knowledge and skills.Results
Of 21 enrollees, 13 were from under-represented groups and 14 were women. Four reported some prior training in HDR, and 12 reported currently conducting HDR.Among the 12 participants who completed both the pre and post HDRC survey, initially the most commonly cited barriers to pursuing HDR were lack of knowledge (N = 6) and funding (N = 7). In the post-survey, the number citing lack of knowledge decreased (N = 2) and the number listing lack of funding increased (N = 9). There were increases in the number of participants reporting increased knowledge of HDR methods (pre-post: 4 vs. 8) and competence to design (3 vs. 7) and implement (2 vs. 9) HDR research.Conclusions
The Duke HDRC augments efforts to reduce health disparities by providing training in HDR for young investigators. Our data indicate that the course was feasible, well-received, and increased perceived knowledge and competence. HDRC and similar courses may increase the quantity, quality and scope of HDR and thus move us closer to health equity. 相似文献10.
Carl C. Bell 《Journal of the National Medical Association》2017,109(4):224-237
Purpose
This article covers violence prevention (homicide and suicide) activities in the African American community for nearly 50 years.Method
Drawing on lived experience the works of early and recent efforts by African American physicians, the author illustrates we know a great deal about violence prevention in the African American community.Results
There remains challenges of implementation and political will. Further, most physicians, like the public, are confused about the realities of homicide and suicide because of the two different presentations both are given in the media and scientific literature.Conclusions
Responses to homicide and suicides should be based on science not distorted media reports. There are violence prevention principles that, if widely implemented, could stem the tide of violence. 相似文献11.
Chun-Lin Lee Ja-Yan Wen Ya-Wen Hsu Tzu-Ming Pan 《Journal of microbiology, immunology, and infection》2018,51(1):27-37
Background/Purposes
Monascin (MS) and ankaflavin (AK) produced by Monascus purpureus NTU 568 were proven to show excellent hypolipidemic effects in our previous studies; however, the mechanism is still unclear.Methods
This study used MS, AK, and monacolin K as test substances and performed tests on rats fed high-fat and high-cholesterol diet for 8 weeks. The lipid levels and the related protein levels of the rats were assessed to understand the effects of MS, AK, and monacolin K on lipid metabolism.Results
MS and AK lowered low-density lipoprotein cholesterol (LDL-C) and preserved high-density lipoprotein cholesterol contents. MS and AK inhibited acetyl-coenzyme A acetyltransferase, microsomal triglyceride transfer protein, and apolipoprotein (apo) B-100 expression, thereby preventing LDL assembly. In addition, enhanced LDL-receptor expression increased the transport of LDL-C to the liver for metabolism. MS and AK also significantly increase apo A1 expression, which facilitates high-density lipoprotein cholesterol formation.Conclusion
Monascus-fermented MS and AK can perform blood lipid regulation via the suppression of LDL-C assembly and stimulation of apo A1 expression in liver. 相似文献12.
Charles P. Mouton Janet H. Southerland 《Journal of the National Medical Association》2017,109(4):262-271
Background
As with many other populations, abuse of older adults is a growing problem across the Africa Diaspora. Modernization and urbanization are eroding the traditional values of respect for older adults. Also, older adults living in environments with limited social and economic resources, and having no means of economic support create a recipe for elder abuse and neglect.Methods
This article reviews the current literature on the epidemiology, risk factors, and interventions used for elder abuse across the African Diaspora.Results
Reports of elder abuse range from 24.9% to 81.1% across the Diaspora. Risk factors include cognitive and physical impairment, social isolation, lack of resources and widowhood.Conclusion
Community-based programs using the unique social networks of older populations of African descent can provide a venue to improve caregiver training and support, reinforce traditional filial and informal caregiving practices, increase the utilization of available governmental and institutional. 相似文献13.
Eun Lee Si Hyeon Lee Young-Ho Kim Hyun-Ju Cho Jisun Yoon Song-I. Yang Young-Ho Jung Hyung Young Kim Ju-Hee Seo Ji-Won Kwon Hyo-Bin Kim So Yeon Lee Ho-Jang Kwon Soo-Jong Hong 《Annals of allergy, asthma & immunology》2017,118(5):542-550.e1
Background
Although previous studies have investigated the association between atopy phenotypes and allergic diseases, atopy characterizations in association with the development of allergic diseases remain poorly understood.Objective
To identify atopy phenotypes in school-age children and to evaluate the association between atopy phenotypes and allergic diseases.Methods
We enrolled 616 children with atopy defined as 1 or more positive allergen responses on skin prick tests and 665 children without atopy from the Children's Health and Environmental Research (CHEER) study. All children were followed up for 4 years at 2-year intervals. Atopy phenotypes were classified using latent class analysis.Results
Four atopy phenotypes were characterized: later sensitization to indoor allergens (cluster 1); multiple early sensitization (cluster 2); early sensitization to outdoor allergens, especially Alternaria, and later sensitization to indoor allergens, including Aspergillus (cluster 3); and early sensitization to indoor allergens and later sensitization to outdoor allergens (cluster 4). New cases of asthma during follow-up were increased in clusters 2 and 3 (adjusted odds ratio [aOR], 2.76 and 4.25, respectively). The risk of new-onset bronchial hyperresponsiveness was highest in cluster 3 (aOR, 5.03). Clusters 2 and 4 had an increased risk of allergic rhinitis (aOR, 7.21 and 2.37, respectively).Conclusion
Identification of atopy phenotypes facilitates prediction of the development of asthma and bronchial hyperresponsiveness in school-age children. Our study suggests prevention of additional sensitization is required to modify the progression of allergic diseases. 相似文献14.
15.
Gianenrico Senna Marco Caminati Clara Bovo Giorgio Walter Canonica Giovanni Passalacqua 《Annals of allergy, asthma & immunology》2017,118(2):161-165
Objective
Pharmacists play a relevant role in the real-life management of asthma because they are a first-line referral for patients. In fact, the role of pharmacies has been underlined and evidenced also in guidelines. Nonetheless, the true effect of pharmacy-based management of asthma has been assessed in only a few studies. We review the available literature on asthma management in a territorial pharmacy setting.Data Sources
The literature was searched for the keywords pharmacy, bronchial asthma, control, and management.Study Selections
The available studies were subdivided into observational and interventional and described.Results
Seven observational studies and 14 interventional trials were found, involving approximately 20,000 individuals. Most of those studies were performed in Europe and Australia. A high proportion of patients had poorly controlled asthma in the observational studies. The active involvement of pharmacists, in the interventional trials, consistently led to an improvement of the quality of life, a better inhalation technique, and a reduction of exacerbations.Conclusion
The literature analysis confirms the relevance of the role of pharmacists in the real-life management of bronchial asthma and underlines the need for a more specific training for those health care professionals. 相似文献16.
Derek A. DuBay Nataliya Ivankova Ivan Herby Yu-Mei Schoenberger David T. Redden Cheryl Holt Laura Siminoff Mona Fouad Michelle Y. Martin 《Journal of the National Medical Association》2017,109(4):287-293
Background
African Americans (AA) are a third as likely as Caucasians to become registered organ donors at the Department of Motorized Vehicles (DMV). The Department of Health and Human Services has set the goal that at least 50% of adults in each state are registered donors.Aims
The purpose of this study was to explore the personal, behavioral and environmental factors associated with AA donor registration decision-making at the DMV.Methods
Guided by the Social Cognitive Theory, 13 focus groups (n = 100 participants) were conducted with AAs within 3 months of visiting a DMV and making a decision regarding whether to become or to not become a registered donor. The data were analyzed using inductive thematic and qualitative content analyses.Results
Study participants expressed a desire to learn more information while waiting in line at the DMV. Knowing a family member or friend in need of an organ transplant, and the desire to make one's own decision were two salient factors associated with the decision to become a registered organ donor. Several aspects of the DMV environment (e.g., noisy, overcrowded, lacking privacy) were cited as deterrents to becoming a registered donor.Discussion
This study highlights the personal, behavioral and environmental factors associated with AA organ donor registration decision-making at the DMV.Conclusion
The DMV is a setting where many adults make a decision about organ donation. Policies that create an environment in the DMV to support informed decision-making (e.g., privacy, informed clerks, available educational materials, etc.) are indicated. 相似文献17.
Anna L. Chien Ji Qi Radhika Grandhi Tamia Harris-Tryon Noori Kim Min Soo Jang Omolara Olowoyeye Diane Kuhn Sherry Leung Barbara M. Rainer Flora Poon Sabrina Sisto Alessi César Jean Suh Nancy Cheng Ginette A. Okoye Sewon Kang 《Journal of the National Medical Association》2018,110(6):534-539
Background
Increased photoprotection by natural melanin allows for African-Americans to be less impacted by photoaging than Caucasians. However, less is known about chronological aging in this population.Objective
To create a photonumeric scale for African-Americans to evaluate chronological skin aging and to explore contributing elements to intrinsic aging.Methods
Standardized photographs of the upper inner arm were taken from 75 African-American participants. Five participants were chosen as standards to create a 9-point photonumeric scale (0 = none, 8 = most severe). The scale was utilized by three blinded dermatologists to independently rate participants' photographs.Results
The interrater agreements were 0.768 (95% CI: 0.671–0.834) for trial 1 and 0.725 (0.608–0.794) for trial 2. The intrarater agreements were 0.757 (0.596–0.875), 0.850 (0.771–0.903), and 0.790 (0.686–0.855) for the three raters. Averaged chronological aging scores were correlated with participants' survey responses, which revealed age as a significant predictor (r = 0.72, p < 0.001).Limitation
Our study was limited by the sample size, although the number of study participants was similar on a investigation in Caucasians.Conclusion
This study created the first reliable photonumeric scale for chronologic skin aging in African-Americans and found increased age and greater BMI as contributors to intrinsic skin aging phenotype in this population. 相似文献18.
Xin Hu Qian Zhang Jia Ning Wenmeng Wu Changyi Li 《Journal of the National Medical Association》2018,110(3):250-255
Introduction
The purpose of this study was to evaluate the two-body wear resistances of natural enamel and four dental materials in vitro.Methods
The testing machine was modified to form a type of pin-on-disk wear test apparatus. Four dental material specimens (Au-Pd alloy, Ag-Pd alloy, FiltekTMP60 and FiltekTMZ350 composite resins) and enamel were used as the pins, and a steatite ceramic grinding wheel was used as the abrasive counter face. The wear volume loss and the rigidity value was measured. The worn surface and the element analysis of the debris were analyzed.Result
The wear volume loss of Au-Pd alloy and its steatite antagonists were the nearest to those of the dental enamel. SEM microphotographs showed that, the main wear mechanism of the dental materials was abrasive and adhesive wear.Conclusions
Au-Pd alloy had good wear resistance and was more suitable for dental applications than other three dental materials. 相似文献19.
Background
The clinical characteristics of patients with chronic obstructive pulmonary disease overlapped with bronchial asthma (COPD-BA) have not been discussed thoroughly.Objective
To reveal the clinical features of patients with COPD-BA, to evaluate the risk factors of COPD-BA, and to provide suggestions for COPD individualized therapy.Methods
A retrospective observational study was performed. A total of 182 patients with COPD (90 with COPD-BA and 92 with pure COPD) were recruited in the study. Information on the following items was collected: demographics, clinical manifestations, complications, laboratory findings, other histories, and inpatient treatments during exacerbation.Results
A total of 182 patients were diagnosed with COPD, with 90 (49.45%) being classified as having COPD-BA. Patients with COPD-BA were more likely to be female (P = .004) and experienced more severe respiratory exacerbations (P = .04) despite being younger (P = .008). Those patients at onset of recurrent cough and sputum production were younger (P = .001). Significantly, a positive asthmatic family history (P = .03) was observed. Patients with COPD-BA usually had higher level of total serum IgE (although no differences were observed), had higher positive rates of the serum specific IgE (P = .004), and were more like to have an allergic history (P = .003). Allergic factor was the risk factor of COPD-BA (odds ratio, 4.477). During hospitalization, patients with COPD-BA tended to be treated with systemic corticosteroids (P = .008).Conclusion
Patients with COPD-BA were characterized by persistent airflow limitation with unique clinical features. Allergic factor was associated with the presence of asthmatic characteristics in patients with COPD. When hospitalized for exacerbation, the individualized therapy for COPD-BA might include the use of corticosteroids systemically. 相似文献20.
Steven S. Coughlin Lovoria B. Williams Gina M. Besenyi Lorraine W. Jackson Judith Anglin 《Journal of the National Medical Association》2018,110(4):391-395