Background: The knowledge of the natural history of asthma from birth to adulthood could provide important clues for its cause and for the understanding of epidemiologic findings.
Objective: This ...study is aimed at assessing the incidence and remission of asthma from birth to the age of 44 years by using data from 18,873 subjects involved in a large, nationally representative, cross-sectional study carried out in Italy from 1998 through 2000.
Methods: The onset of asthma was defined as the age at the first attack, and remission was considered present when a subject was neither under treatment nor had experienced an asthma attack in the last 24 months. Person-years and survival techniques were used for the analysis.
Results: The average annual incidence rate for the 1953 to 2000 period was 2.56/1000 persons per year. Incidence peaked in boys less than 10 years of age (4.38/1000 persons per year) and in women 30 years of age or older (3.1/1000 persons per year) and showed a generational increase (incident rate ratio = 2.63 and 95% CI = 2.20-3.12 for 1974-1979 vs 1953-1958 birth cohort). The overall remission rate was 45.8% (41.6% in women and 49.5% in men,
P < .001). Asthmatic patients in remission had an earlier age at onset (7.8 vs 15.9 years,
P < .001) and a shorter duration of the disease (5.6 vs 16.1 years,
P < .001) than patients with current asthma. The probability of remission was strongly (
P < .001) and inversely related to the age at onset (62.8% and 15.0% in the <10- and ≥20-years age-at-onset groups, respectively).
Conclusion: With respect to its natural history, asthma presents 2 different forms: early-onset asthma, which occurs early in childhood, affects mainly boys, and has a good prognosis, and late-onset asthma, which generally occurs during or after puberty, mainly affects women, and has a poor prognosis. The minority of patients with early-onset asthma who do not remit represents more than 35% of patients with current asthma in the general young adult population. (J Allergy Clin Immunol 2002;110:228-35.)
Effective therapy for prion diseases is currently unavailable. Recently, vaccination was shown to be effective in mouse models of a particular neurodegenerative conditions: Alzheimer's disease (AD). ...Here, we report that vaccination with synthetic oligopeptides homologous to the hamster (
Mesocricetus auratus) prion protein augments survival time in animals infected intraperitoneally with 263K scrapie agent. For each hamster included in the study, prion-specific serum antibodies as well as deposition of pathological prion protein (PrP
res), glial fibrillary acidic protein (GFAP), and mRNA expression for cytokines (TNFα, IL-1β, IL-10) in brain tissues were evaluated. In immunized animals, increased survival after challenge was associated with a reduction of cerebral lesion, PrP deposition and GFAP expression; in these animals, anti-prion protein peptide antibody levels were increased, and the expression of pro-inflammatory cytokines (TNFα and IL-1β) was reduced. Vaccination could be an effective therapeutic approach to postpone disease onset.
Over the past 50 years, education has become more complex. The demand for quality and accountability in education had also increased. These demands have increased pressure on teachers, with the ...result that teaching is now regarded by teachers as highly stressful. The purpose of the study was to examine burnout among teachers in a region of Italy including the risk factors of burnout and the strategies used by teachers to prevent and deal with stress. The research was carried out on a sample of 508 teachers. The questionnaire incorporated the Maslach Burnout Inventory modified for Italian teachers--a 22 item questionnaire designed to assess the three aspects of burnout syndrome: emotional exhaustion, depersonalization and lack of personal achievement. The results highlight the presence of substantial levels of emotional exhaustion in a significant number of teachers. The rate of burnout among teachers is 19.7%. The data are lower than for a sample of Italy as a whole and than for European countries where rates of burnout range between 25% and 35%.
HIV-specific cytotoxic T-cell (CTL) responses are defective in HIV-infected patients undergoing antiretroviral therapy (ART). This defect has been attributed to the decreased antigenic burden ...secondary to ART-associated suppression of HIV-replication, and is responsible for the rebounds of viraemia that occur when patients interrupt therapy. CTL are stimulated by type 1 cytokines and can kill targets via granule-dependent (perforin and granzymes) and -independent (tumour necrosis factor-alpha, CD95) mechanisms.
Granule-dependent and granule-independent mechanisms of CTL killing, as well as type 1 cytokine production by CD4 T cells, were analysed in 57 chronically HIV-infected ART-treated or ART-untreated individuals.
The results can be summarized as follows: the frequency of gp160 (env)-specific interferon-gamma-secreting CD8 T lymphocytes correlates positively with HIV viraemia in ART-treated and -untreated patients; Env-specific perforin- and granzymes-expressing CD8 T lymphocytes, and Env-stimulated perforin and granzymes mRNA, are reduced in ART-treated patients independently of HIV viral load and of type 1 cytokine production; tumour necrosis factor-alpha production is increased in ART-treated individuals; and Env-specific immature CD8+28+27+ cells are only marginally augmented in ART-treated patients, Similar results are observed in cytomegalovirus-specific CD8 T cells and peripheral blood mononuclear cells.
A defect of CTL function that selectively affects the granule-dependent mechanisms of lysis is observed in ART-treated individuals. Because interferon-gamma production is higher in these patients, this could be a defect primarily involving CTL. These data suggest an independence of CD8 T-cell numbers and their lytic ability in HIV-infected, ART-receiving patients. Immunomodulants are needed to successfully treat HIV infection.
