Pediatric resident performance. The reliability and validity of rating forms.

A large pediatric residency program conducted an extensive analysis of the reliability and validity of the rating forms used to evaluate the pediatric residents enrolled in the program. Analyses were conducted on groups of residents who took the Pediatric In-Training Program (PITE) from 1977 through 1981. An average of 7.1 faculty members rated each resident on a standard form. The data indicate that although the reliability of individual ratings is very low, several factors achieved acceptable levels of reliability when aggregated. The first-year rating of history-taking ability correlated significantly with the PITE but ratings for more advanced residents did not correlate with PITE scores, mostly because of ceiling effects.     

An analysis of the action of an analogue of almitrine bismesylate in the rat model of hypoxic lung disease.

Chronically hypoxic (CH) and normoxic control rats were used to assess the action of S9581, a water-soluble analogue of almitrine bismesylate. S9581 increased ventilation (Ve) by 34% in control and 20% in CH rats. During acute hypoxia Ve was raised and S9581 caused a further increase of 20% in both groups. Low doses of S9581 and almitrine enhanced the hypoxic ventilatory response in CH rats while high doses depressed it in both groups. Effects of S9581 on the pulmonary circulation were assessed in the isolated perfused lung of rats. As with almitrine a complex relationship of dose-dependent vasoconstriction and dilatation was revealed. In low doses, S9581 enhanced the hypoxic pulmonary vasoconstrictor response to 2% O2 whilst this was attenuated by high doses in both control and CH rats. S9581 seemed to act like almitrine bismesylate on both the ventilation (peripheral chemoreceptor) and the pulmonary circulation. For studying almitrine-like activity the water solubility of S9581 provides considerable advantages for the researcher.     

An extensive study of human IgE cross-reactivity of Blo t 5 and Der p 5

BACKGROUND: Dual sensitization by Blomia tropicalis and Dermatophagoides pteronyssinus mites is common in tropical and subtropical countries. The human IgE cross-reactivity between clinical important group 5 allergens, Blo t 5 and Der p 5, remains controversial. OBJECTIVE: This study was undertaken to assess the levels of the IgE cross-reactivity between Blo t 5 and Der p 5 by using sera from a large cohort of asthmatic children in subtropical and tropical countries. METHODS: Purified recombinant Blo t 5 and Der p 5 were produced in Pichia pastoris and tested against sera from 195 asthmatic children. The IgE cross-reactivity was examined by direct, inhibitory and competitive human IgE enzyme-linked immunosorbent assay as well as skin prick tests. RESULTS: The Blo t 5 IgE responses were 91.8% (134 of 146) and 73.5% (36 of 49) for Taiwanese and Malaysian sera, respectively. The Blo t 5 specific IgE titers were significantly higher than those of Der p 5 (P <.02). The correlation of IgE reactivity between Blo t 5 and Der p 5 was low, and only limited cross-reactivity was observed. This was further confirmed by the dose-response inhibition studies. Skin prick tests performed on asthmatic children in Thailand also showed differential IgE response to Blo t 5 and Der p 5. CONCLUSION: By using a large panel of asthmatic sera and a combination of in vitro and in vivo assays, the major allergen of B tropicalis in tropical and subtropical regions, Blo t 5, exhibits low levels of IgE cross-reactivity with homologous Der p 5. These findings suggest that highly specific clinical reagents are necessary for precise diagnosis and immunotherapeutic treatment of sensitization to group 5 mite allergens.     

Dietary conjugated linoleic acid consumption during pregnancy and lactation influences growth and tissue composition in weaned pigs

We evaluated the effects of conjugated linoleic acid (CLA) on growth performance, tissue fatty acid composition and ex vivo lipogenic enzyme activity in piglets (n = 40) reared on sows fed diets supplemented with CLA or linoleic acid (LA). Weaned offspring of both sow groups were offered either a CLA- or LA-enriched starter diet for 35 d. The starter diets were formulated to contain 2 g CLA (containing 58.9 g CLA/100 g total fatty acids) or LA per 100 g feed. All piglets were slaughtered at 70 d of age and tissue samples of the back fat, omental fat and longissimus dorsi were collected. Irrespective of the dietary fat supplied in the starter period, piglets reared on the CLA sows had greater final body and warm carcass weights (P: < 0.01), and greater feed intake (P: = 0.02) than piglets reared on the LA sows. The dietary effect on the fatty acid composition was similar for the adipose and muscle tissues. Compared with the LA-enriched diets, CLA increased the level of total saturated fatty acids (P: < 0.05), whereas that of monounsaturated fatty acids was decreased (P: < 0.05). Dietary CLA increased glucose-6-phosphate dehydrogenase (P: < 0.01) and malic enzyme activities (P: < 0.06) in the fat tissues, but did not affect fatty acid synthase activity. The shift toward a higher deposition of saturated fatty acids and a lower deposition of monounsaturated fatty acids is the result of down-regulation of Delta9-desaturase activity that was induced by CLA rather than an altered rate of de novo synthesis.     

Early introduction of allergenic foods for the prevention of food allergy from an Asian perspective—An Asia Pacific Association of Pediatric Allergy,Respirology & Immunology (APAPARI) consensus statement

Emerging evidence for the early introduction of allergenic foods for the prevention of food allergies, such as peanut allergy in Western populations, has led to the recent publication of guidelines in the USA and Europe recommending early peanut introduction for high‐risk infants with severe eczema or egg allergy. Peanut allergy is, however, much less prevalent in Asia compared to the West. Varying patterns of food allergy are seen even within Asian countries—such as a predominance of wheat allergy in Japan and Thailand and shellfish allergy in Singapore and the Philippines. Customs and traditions, such as diet and infant feeding practices, also differ between Asian populations. Hence, there are unique challenges in adapting guidelines on early allergenic food introduction to the Asian setting. In this paper, we review the evidence and discuss the possible approaches to guide the timely introduction of allergenic food in high‐risk infants in Asia.     

Erratum: Rhinitis in children less than 6 years of age: current knowledge and challenges

[This corrects the article on p. 115 in vol. 1, PMID: 22053307.].