Long-term effects of allergen sensitization and exposure in adult asthma: a prospective study.

BACKGROUND: : We investigated the effects of sensitization and exposure to common domestic allergens on longitudinal changes in lung function and bronchial hyperresponsiveness. METHODS: : Subjects attended 2 visits that were 4 years apart. Skin prick testing was performed and household dust samples were collected for quantification of mite, dog, and cat allergens at baseline. Measurements of lung function, exhaled nitric oxide, and bronchial hyperresponsiveness were completed at both visits. RESULTS: : Dust samples were collected in 165 of the 200 subjects completing both visits. Mean length of follow-up was 47 months. Bronchial hyperresponsiveness, measured at both visits in 86 subjects, deteriorated in those exposed to high mite allergen levels compared with those not exposed [mean (95% CI) doubling dose change PD20 = -0.44 (-1.07 to 0.19) vs 0.82 (0.27 to 1.36)], but improved in those exposed to high dog allergen levels compared with those not exposed [1.10 (0.33 to 1.86) vs 0.10 (-0.39 to 0.58)]. The associations were significant in the multivariate models. Cat allergen exposure was not associated with any changes in lung function, exhaled nitric oxide, or bronchial hyperresponsiveness. CONCLUSIONS: : In a 4-year prospective cohort of persons with asthma, exposure to high levels of dust mite allergens at baseline was associated with a subsequent increase in bronchial hyperresponsiveness

Oxo-crown-ethers as comonomers for tuning polyester properties

2-Oxo-12-crown-4-ether (OC) was procured in a novel, two-step procedure in a 37% overall yield. This interesting hydrophilic lactone was effectively polymd. with Novozym 435 as the catalyst: within 10 min, the monomer conversion was greater than 95%. Poly(2-oxo-12-crown-4-ether) [poly(OC)] was obtained as a viscous oil with a glass-transition temp. of approx. -40 DegC, and it was sol. in water. Subsequently, OC was copolymd. with w-pentadecanolactone (PDL). A kinetic evaluation of both monomers showed that for OC, the Michaelis-Menten const. (KM) and the maximal rate of polymn. (Vmax) were 2.7 mol/L and 0.24 mol/L min, resp., whereas for PDL, KM and Vmax were 0.5 mol/L and 0.09 mol/L min, resp. Although OC polymd. five times faster than PDL, 1H NMR anal. of the copolymers revealed a random copolymer structure. Differential scanning calorimetry traces of the copolymers showed that they were semicryst. and that the melting temp. and melting enthalpy of the copolymers linearly decreased with an increasing amt. of OC. The melting temp. of the copolymers could be adequately predicted by the Baur equation, and this suggested that poly (OC) was rejected from the poly(w-pentadecanolactone) [poly(PDL)] crystals. Solid-state NMR studies confirmed that the cryst. phase exclusively consisted of poly (PDL), whereas the amorphous phase was a mixt. of OC and PDL units

Repeated measurements of mite and pet allergen levels in house dust over a time period of 8 years

Studies of the association between indoor allergen exposure and the development of allergic diseases have often measured allergen exposure at one point in time. We investigated the variability of house dust mite (Der p 1, Der f 1) and cat (Fel d 1) allergen in Dutch homes over a period of 8 years. Data were obtained in the Dutch PIAMA birth cohort study. Dust from the child's mattress, the parents' mattress and the living room floor was collected at four points in time, when the child was 3 months, 4, 6 and 8 years old. Dust samples were analysed for Der p 1, Der f 1 and Fel d 1 by sandwich enzyme immuno assay. Mite allergen concentrations for the child's mattress, the parents' mattress and the living room floor were moderately correlated between time-points. Agreement was better for cat allergen. For Der p 1 and Der f 1 on the child's mattress, the within-home variance was close to or smaller than the between-home variance in most cases. For Fel d 1, the within-home variance was almost always smaller than the between-home variance. Results were similar for allergen levels expressed per gram of dust and allergen levels expressed per square metre of the sampled surface. Variance ratios were smaller when samples were taken at shorter time intervals than at longer time intervals. Over a period of 4 years, mite and cat allergens measured in house dust are sufficiently stable to use single measurements with confidence in epidemiological studies. The within-home variance was larger when samples were taken 8 years apart so that over such long periods, repetition of sampling is recommende

Type D Personality as a Risk Factor for Adverse Outcome in Patients With Cardiovascular Disease: An Individual Patient-Data Meta-analysis

Objective Type D personality, a joint tendency toward negative affectivity and social inhibition, has been linked to adverse events in patients with heart disease, although with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies (N = 11,151) to investigate the prediction of adverse outcomes by type D personality in patients with acquired cardiovascular disease. Method For each outcome (all-cause mortality, cardiac mortality, myocardial infarction, coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event, any adverse event), we estimated type D's prognostic influence and the moderation by age, sex, and disease type. Results In patients with cardiovascular disease, evidence for a type D effect in terms of the Bayes factor (BF) was strong for major adverse cardiac event (BF = 42.5; odds ratio [OR] = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99), and myocardial infarction (BF = 16.9; OR = 1.12), suggesting that type D had no effect on these outcomes. This evidence was similar in the subset of patients with coronary artery disease (CAD), but inconclusive for patients with heart failure (HF). Positive effects were found for negative affectivity on cardiac and all-cause mortality, with the latter being more pronounced in male than female patients. Conclusion Across 19 prospective cohort studies, type D predicts adverse events in patients with CAD, whereas evidence in patients with HF was inconclusive. In both patients with CAD and HF, we found evidence for a null effect of type D on cardiac and all-cause mortality

Type D personality as a risk factor for adverse outcome in patients with cardiovascular disease: An individual patient data meta-analysis

Objective:  Type D personality, a joint tendency toward negative affectivity (NA) and social inhibition (SI), has been linked to adverse events in patients with heart disease, though with inconsistent findings. Here, we apply an individual patient-data meta-analysis to data from 19 prospective cohort studies (N = 11151), to investigate the prediction of adverse outcomes by Type D personality in acquired cardiovascular disease (CVD) patients. Method:  For each outcome (all-cause mortality, cardiac mortality, myocardial infarction (MI), coronary artery bypass grafting, percutaneous coronary intervention, major adverse cardiac event (MACE), any adverse event), we estimated Type D's prognostic influence and the moderation by age, sex, and disease type. Results:  In CVD patients, evidence for a Type D effect in terms of the Bayes factor (BF) was strong for MACE (BF = 42.5; OR = 1.14) and any adverse event (BF = 129.4; OR = 1.15). Evidence for the null hypothesis was found for all-cause mortality (BF = 45.9; OR = 1.03), cardiac mortality (BF = 23.7; OR = 0.99) and MI (BF = 16.9; OR = 1.12), suggesting Type D had no effect on these outcomes. This evidence was similar in the subset of coronary artery disease (CAD) patients, but inconclusive for heart failure (HF) patients. Positive effects were found for NA on cardiac- and all-cause mortality, the latter being more pronounced in males than females. Conclusion:  Across 19 prospective cohort studies, Type D predicts adverse events in CAD patients, while evidence in HF patients was inconclusive. In both CAD and HF patients, we found evidence for a null effect of Type D on cardiac- and all-cause mortality