Differential Effects of Obesity,Hyperlipidaemia, Dietary Intake and Physical Inactivity on Type I versus Type IV Allergies

Background: Alongside metabolic diseases (esp. obesity), allergic disorders are becoming increasingly prevalent. Since both obesity and allergies are highly impacted by environmental determinants, with this study we assessed the potential link between metabolic implications and two distinct types of allergies. Methods: Using cross-sectional data from the German FoCus cohort, n = 385 allergy cases, either hay fever (=type I allergy, n = 183) or contact allergy (=type IV allergy, n = 202) were compared to age- and sex-matched healthy control subjects (1:1 ratio, in total n = 770) regarding their metabolic phenotype, diet, physical activity, sleep, gut microbial composition, and serum metabolite profile using suitable BMI-adjusted models. Results: Obesity and metabolic alterations were found significantly more prevalent in subjects with allergies. In fact, this relation was more pronounced in contact allergy than hay fever. Subsequent BMI-adjusted analysis reveals particular importance of co-occurring hyperlipidaemia for both allergy types. For contact allergy, we revealed a strong association to the dietary intake of poly-unsaturated fatty acids, particularly α-linolenic acid, as well as the enrichment of the corresponding metabolic pathway. For hay fever, there were no major associations to the diet but to a lower physical activity level, shorter duration of sleep, and an altered gut microbial composition. Finally, genetic predisposition for hyperlipidaemia was associated to both contact allergy and hay fever. Conclusions: Reflected by higher allergy prevalence, our findings indicate an impaired immune response in obesity and hyperlipidaemia, which is differentially regulated in type I and type IV allergies by an unfavourable lifestyle constellation and subsequent microbial and metabolic dysfunctions.     

Use of Medications of Questionable Benefit During the Last Year of Life of Older Adults With Dementia

Objectives

To investigate the prevalence and factors associated with the use of medications of questionable benefit throughout the final year of life of older adults who died with dementia.

HIV infection, aging, and immune function: implications for cancer risk and prevention

PURPOSE OF REVIEW: Combination antiretroviral therapy (ART) has turned HIV infection into a complex chronic disease. This article documents cancer risk among HIV-infected persons, reviews immune system effects of HIV infection in relation to cancer risk, discusses implications for cancer prevention, and suggests future research directions. RECENT FINDINGS: There has been a shift in the cancer spectrum from AIDS-defining cancers (ADC) to non-ADC, although the burden of ADC remains high. Although a high prevalence of non-HIV cancer risk factors among HIV-infected persons contributes to cancer risk, substantial evidence has accumulated in favor of an independent association between HIV-induced immunodeficiency and elevated risk of many specific cancer types, most of viral cause, although further work is needed to disentangle immunodeficiency and smoking effects for lung cancer, and immunodeficiency and hepatitis virus effects for liver cancer. Relationships between cancer risk and two other immune system hallmarks of HIV infection, chronic inflammation, and immune dysfunction/senescence, remain poorly understood. SUMMARY: Early, sustained ART is a crucial component of cancer prevention. Continued epidemiologic monitoring is needed to detect possible effects on cancer risk of specific ART classes or medications, long-term exposure to systemic inflammation or immune dysfunction, or earlier or more effective ART.     

Cultivar Effect on Moringa oleifera Glucosinolate Content and Taste: A Pilot Study

Leaves of the tropical tree Moringa oleifera are widely promoted in areas of chronic malnutrition as nutritional supplements for weaning infants and nursing mothers. Adoption, in these circumstances may hinge upon taste, which can vary greatly amongst cultivars. It is widely assumed that this taste variation is primarily germplasm-dependent, and results from the breakdown of glucosinolates to isothiocyanates. Leaves of 30 accessions, grown at a single field plot, were sampled 3 times over the course of a year. Taste, assessed in a masked protocol, was not related to glucosinolate content of the leaves.     

The Eating Disorder Examination Questionnaire (EDE-Q) among university men and women at different levels of athleticism

The aim of the current study was to establish norms for the Eating Disorder (ED) Examination Questionnaire (EDE-Q) among competitive athletes and to explore the contribution of level of athletic involvement and gender to ED psychopathology, as measured by the EDE-Q. University students (n = 1637) from ten United States universities were recruited online via a social networking website and asked to complete an anonymous survey. The sample was then divided according to gender and level of sports participation. Females scored higher than males regardless of level of athleticism. Lower mean scores were frequently observed among those involved in competitive sports exclusively and highest scores among those involved in recreational sports (alone or in addition to competitive athletics). Recreational activity seems to be important in stratifying risk among competitive athletes; gender is an important interaction term in athletic populations.     

An Application of Differential Reinforcement of Other Behavior and Self-Monitoring to Address Repetitive Behavior

Differential reinforcement of other behavior (DRO) and self-monitoring was used to reduce repetitive challenging behavior in the form of eyelash, eyebrow, and hair pulling exhibited by a 19-year-old woman with an autism spectrum disorder. Treatment evaluation included DRO with competing and non-competing stimuli in a private therapy room. Once the DRO interval exceeded 10 min, treatment was conducted in the participant’s classroom. Results of the study suggested DRO was successful in both environments and across both stimulus types.     

Routine diagnostics for neural antibodies,clinical correlates,treatment and functional outcome

Objective

To determine frequencies, interlaboratory reproducibility, clinical ratings, and prognostic implications of neural antibodies in a routine laboratory setting in patients with suspected neuropsychiatric autoimmune conditions.

Methods

Earliest available samples from 10,919 patients were tested for a broad panel of neural antibodies. Sera that reacted with leucine-rich glioma-inactivated protein 1 (LGI1), contactin-associated protein-2 (CASPR2), or the voltage-gated potassium channel (VGKC) complex were retested for LGI1 and CASPR2 antibodies by another laboratory. Physicians in charge of patients with positive antibody results retrospectively reported on clinical, treatment, and outcome parameters.

Results

Positive results were obtained for 576 patients (5.3%). Median disease duration was 6 months (interquartile range 0.6–46 months). In most patients, antibodies were detected both in CSF and serum. However, in 16 (28%) patients with N-methyl-d-aspartate receptor (NMDAR) antibodies, this diagnosis could be made only in cerebrospinal fluid (CSF). The two laboratories agreed largely on LGI1 and CASPR2 antibody diagnoses (κ = 0.95). The clinicians (413 responses, 71.7%) rated two-thirds of the antibody-positive patients as autoimmune. Antibodies against the α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR), NMDAR (CSF or high serum titer), γ-aminobutyric acid-B receptor (GABABR), and LGI1 had ≥ 90% positive ratings, whereas antibodies against the glycine receptor, VGKC complex, or otherwise unspecified neuropil had ≤ 40% positive ratings. Of the patients with surface antibodies, 64% improved after ≥ 3 months, mostly with ≥ 1 immunotherapy intervention.

Conclusions

This novel approach starting from routine diagnostics in a dedicated laboratory provides reliable and useful results with therapeutic implications. Counseling should consider clinical presentation, demographic features, and antibody titers of the individual patient.