August 5, 2013

Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland

Research article

Reference values for the 6-minute walk test in healthy children and adolescents in Switzerland

Silvia Ulrich, Florian F Hildenbrand, Ursula Treder, Manuel Fischler, Stephan Keusch, Rudolf Speich and Margrit Fasnacht

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BMC Pulmonary Medicine 2013, 13:49 doi:10.1186/1471-2466-13-49

Published: 5 August 2013

Abstract (provisional)

Background

The six-minute walk test (6MWT) is a simple, low tech, safe and well established, self-paced assessment tool to quantify functional exercise capacity in adults. The definition of normal 6MWT in children is especially demanding since not only parameters like height, weight and ethnical background influence the measurement, but may be as crucial as age and the developmental stage. The aim of this study is establishing reference values for the 6MWT in healthy children and adolescents in Switzerland and to investigate the influence of age, anthropometrics, heart rate, blood pressure and physical activity on the distance walked.

Methods

Children and adolescents between 5--17 years performed a 6MWT. Short questionnaire assessments about their health state and physical activities. anthropometrics and vitals were measured before and after a 6-minute walk test and were previously defined as secondary outcomes.

Results

Age, height, weight and the heart rate after the 6MWT all predicted the distance walked according to different regression models: age was the best single predictor and mostly influenced walk distance in younger age, anthropometrics were more important in adolescents and females. Heart rate after the 6MWT was an important distance predictor in addition to age and outreached anthropometrics in the majority of subgroups assessed.

Conclusions

The 6MWT in children and adolescents is feasible and practical. The 6MWTdistance depends mainly on age; however, heart rate after the 6MWT, height and weight significantly add information and should be taken into account mainly in adolescents. Reference equations allow predicting 6-minute walk test distance and may help to better assess and compare outcomes in young patients with cardiovascular and respiratory diseases and are highly warranted for different populations.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.

August 4, 2013

Regulation of Th1/Th2 cells in asthma development: A mathematical model

Regulation of Th1/Th2 cells in asthma development: A mathematical model

Pages: 1095 - 1133, Volume 10, Issue 4, August 2013

doi:10.3934/mbe.2013.10.1095

Abstract

References

Full Text (1733.0K) Related Articles

Yangjin Kim - Department of Mathematics, Konkuk University, Seoul, South Korea (email)
Seongwon Lee - Department of Mathematics, Pohang University of Science and Technology, Pohang, Gyeongbuk, South Korea(email)
You-Sun Kim - Department of Life Science, Pohang University of Science and Technology, Pohang, Gyeongbuk, South Korea (email)
Sean Lawler - Leeds Institute of Molecular Medicine, University of Leeds, Leeds, United Kingdom (email)
Yong Song Gho - Department of Life Science, Pohang University of Science and Technology, Pohang, Gyeongbuk, South Korea(email)
Yoon-Keun Kim - Department of Life Science, Pohang University of Science and Technology, Pohang, Gyeongbuk, South Korea(email)
Hyung Ju Hwang - Department of Mathematics, Pohang University of Science and Technology, Pohang, Gyeongbuk, South Korea(email)

Abstract: Airway exposure levels of lipopolysaccharide (LPS) determine type I versus type II helper T cell induced experimental asthma. While high LPS levels induce Th1-dominant responses, low LPS levels derive Th2 cell induced asthma. The present paper develops a mathematical model of asthma development which focuses on the relative balance of Th1 and Th2 cell induced asthma. In the present work we represent the complex network of interactions between cells and molecules by a mathematical model. The model describes the behaviors of cells (Th0, Th1, Th2 and macrophages) and regulatory molecules (IFN-γ, IL-4, IL-12, TNF-α) in response to high, intermediate, and low levels of LPS. The simulations show how variations in the levels of injected LPS affect the development of Th1 or Th2 cell responses through differential cytokine induction. The model also predicts the coexistence of these two types of response under certain biochemical and biomechanical conditions in the microenvironment.

Keywords: Asthma, Th1/Th2 cells, microenvironment, LPS, inflammation.

Mathematics Subject Classification: Primary: 92C45, 92C50; Secondary: 92B05.

Received: November 2012; Accepted: March 2013; Published: June 2013.

References

Regulatory T Cell in Stroke: A New Paradigm for Immune Regulation

Clinical and Developmental Immunology
Volume 2013 (2013), Article ID 689827, 9 pages
http://dx.doi.org/10.1155/2013/689827

Review Article

Regulatory T Cell in Stroke: A New Paradigm for Immune Regulation

Sheng Chen,^1,2 Haijian Wu,¹ Damon Klebe,² Yuan Hong,¹ Jianmin Zhang,¹ and Jiping Tang²

¹Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310009, China
²Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA

Received 30 April 2013; Accepted 4 July 2013

Academic Editor: Carlos Barcia

Copyright © 2013 Sheng Chen et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Stroke is a common, debilitating trauma that has an incompletely elucidated pathophysiology and lacks an effective therapy. FoxP3⁺CD25⁺CD4⁺ regulatory T cells (Tregs) suppress a variety of normal physiological and pathological immune responses via several pathways, such as inhibitory cytokine secretion, direct cytolysis induction, and antigen-presenting cell functional modulation. FoxP3⁺CD25⁺CD4⁺ Tregs are involved in a variety of central nervous system diseases and injuries, including axonal injury, neurodegenerative diseases, and stroke. Specifically, FoxP3⁺CD25⁺CD4⁺ Tregs exert neuroprotective effects in acute experimental stroke models. These beneficial effects, however, are difficult to elucidate. In this review, we summarized evidence of FoxP3⁺CD25⁺CD4⁺ Tregs as potentially important immunomodulators in stroke pathogenesis and highlight further investigations for possible immunotherapeutic strategies by modulating the quantity and/or functional effects of FoxP3⁺CD25⁺CD4⁺ Tregs in stroke patients.

Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy.

International Journal of Otolaryngology
Volume 2013 (2013), Article ID 603493, 5 pages
http://dx.doi.org/10.1155/2013/603493

Clinical Study

Role of Intranasal Steroid in the Prevention of Recurrent Nasal Symptoms after Adenoidectomy

Tamer S. Sobhy

Faculty of Medicine, Ain Shams University, 15 Khalifa Maamoon, Heliopolis, Cairo, Egypt

Received 13 May 2013; Accepted 4 July 2013

Academic Editor: Charles Monroe Myer

Copyright © 2013 Tamer S. Sobhy. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Intranasal steroid provides an efficient nonsurgical alternative to adenoidectomy for the improvement of adenoid nasal obstruction. Objective. To demonstrate the role of intranasal steroid in the prevention of adenoid regrowth after adenoidectomy.

Methods. Prospective randomized controlled study. Two hundred children after adenoidectomy were divided into 2 groups. Group I received postoperative intranasal steroid and group II received postoperative intranasal saline spray. Both medications were administered for 12 weeks postoperatively. Patients were followed up for 1 year. Followup was done using the nasopharyngeal lateral X-rays, reporting the degree of the symptoms.

Results. Significant difference between both groups after 6 months and after 1 year. The intranasal steroid group had significantly lower score after 6 months and after 1 year as regards nasal obstruction, nasal discharge, and snoring than the intranasal saline group. 2 weeks postoperatively, there was no difference between both groups as regards nasal obstruction, discharge, or snoring. As regards lateral radiographs, there was statistically significant difference between both groups 1 year but not 6 months postoperatively.

Conclusion. Factors influencing the outcome of intranasal steroids therapy in the prevention of adenoid regrowth have not been identified. However, this treatment may obtain successful results in children to avoid readenoidectomy.

August 3, 2013

Treatment of the Chronic Itch of Atopic Dermatitis Using Standard Drugs and Kampo Medicines

Biological and Pharmaceutical Bulletin
Vol. 36 (2013) No. 8 p. 1253-1257

Language:

Current Topics

http://dx.doi.org/10.1248/bpb.b13-00332

DN/JST.JSTAGE/bpb/b13-00332

Treatment of the Chronic Itch of Atopic Dermatitis Using Standard Drugs and Kampo Medicines

Hirotaka Yamashita¹⁾, Hiroyuki Tanaka¹⁾, Naoki Inagaki¹⁾

1) Gifu Pharmaceutical University

Released on J-STAGE 20130801

Keywords: atopic dermatitis, chronic itching, Kampo medicine, murine model, pharmacotherapy

Abstracts
References(40)

Atopic dermatitis is a common skin disease accompanied by intense itching. Relapsing eczema is caused by immune imbalances and skin-barrier disruption. The immunopathy and barrier dysfunction are closely related to the onset of itching and subsequent scratching, and intractable dermatitis is amplified by the itch-scratch cycle. The standard therapy for atopic dermatitis is topical corticosteroids and immunosuppressants to lessen the inflammation, along with moisturizing agents to improve the physiologic skin dysfunction. Corticosteroids are the primary treatment for the inflammation in atopic dermatitis. Some clinical trials demonstrated a tendency for the alleviation of pruritus with long-term treatment. Tacrolimus results in instant burning and itching in the short term, but they resolve a few days after the beginning of use and then are relieved. Substance P is a neuropeptide released from sensory nerve fibers and a neurotransmitter of pain and itching. Basic experimental reports indicated that the antipruritic effect of tacrolimus is probably dependent on depleting substance P, followed by transient induction. Oral administration of antihistamines and antiallergics is used as adjunctive pharmacotherapy for pruritus. It is known that second-generation antihistamines are less sedative or nonsedative drugs compared with the first generation, and the drugs have additional efficacy in blocking some chemical mediators. Japanese traditional Kampo medicines are also used for the treatment of atopic dermatitis. This paper discusses the efficacy of representative Kampo medicines in the treatment of inflammation and itching based on murine atopic dermatitis models. Information on the mechanism of action of Kampo medicines will result in more choice of pharmacotherapeutic agents for complex diseases such as atopic dermatitis.

An Update on Peripheral Mechanisms and Treatments of Itch

Biological and Pharmaceutical Bulletin
Vol. 36 (2013) No. 8 p. 1241-1247

Language:

Current Topics

http://dx.doi.org/10.1248/bpb.b13-00319

DN/JST.JSTAGE/bpb/b13-00319

An Update on Peripheral Mechanisms and Treatments of Itch

Mitsutoshi Tominaga¹⁾, Kenji Takamori^{1) 2)}

1) Institute for Environmental and Gender Specific Medicine, Graduate School of Medicine, Juntendo University 2) Department of Dermatology, Juntendo University Urayasu Hospital

Released on J-STAGE 20130801

Keywords: atopic dermatitis, epidermal keratinocyte, semaphorin 3A, sensory nerve fiber, UV-based therapy

Abstracts
References(80)

Histamine H₁-receptor blockers are used to treat all types of itch resulting from serious skin diseases such as atopic dermatitis, as well as from renal and liver diseases. However, they often lack efficacy in chronic itch, a profound clinical problem that decreases quality of life. The development of effective treatments requires a full understanding of the fundamental mechanisms of itch. Recent studies have indicated that the pathogenic mechanisms of itch also involve agonists other than histamine, including proteases, neuropeptides, cytokines, and opioids, as well as their cognate receptors. Release of these pruritogenic mediators and modulators into the periphery may directly activate itch-mediating C-fibers via specific receptors on the nerve terminals. Histological observations have shown increased epidermal nerve densities in patients with atopic dermatitis, suggesting that the higher density is at least partly responsible for itch sensitization. This hyperinnervation is likely induced by an imbalance between nerve elongation and repulsion factors produced by keratinocytes. Neuronal matrix metalloproteinases are also involved in the penetration of nerve fibers into the extracellular matrix. Moreover, itch-mediating fibers such as gastrin-releasing peptide⁺ (GRP⁺) and Mas-related G-protein coupled receptor A3⁺ (MrgprA3⁺) fibers are present in the skin. Clinically, emollients or UV-based therapies can partly control epidermal nerve density, but new substances and classes of antipruritic drugs are needed. This review highlights recent knowledge regarding epidermal nerve fibers that are partly involved in itch sensitization, and discuss peripheral mechanisms and treatments of itch, especially in atopic dermatitis.

Bone marrow-derived progenitor cells in end-stage lung disease patients

Research article

Bone marrow-derived progenitor cells in end-stage lung disease patients

Sarah E Gilpin, Kalvin Lung, Geoffrey T de Couto, Marcelo Cypel, Masaaki Sato, Lianne G Singer, Shaf Keshavjee andThomas K Waddell

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BMC Pulmonary Medicine 2013, 13:48 doi:10.1186/1471-2466-13-48

Published: 3 August 2013