ABSTRACT
OBJECTIVE: Experimental data suggest that obesity enhances the effects of ambient air pollutants on exacerbation of asthma; however, there is little supporting epidemiological evidence. The aim of present study is to evaluate whether obesity modifies the association between ambient air pollution and respiratory symptoms and asthma in children. METHODS: In Northeast China, 30 056 children aged 2-14 years were selected from 25 districts of seven cities. Parents of the children completed questionnaires that characterized the children's histories of respiratory symptoms and illness, and associated risk factors. Overweight and obesity were calculated with an age and sex-specific body mass index (BMI, kg m(-2)), with BMIs of greater than the 85th and 95th percentiles defining overweight and obesity, respectively. Average annual ambient exposure to particulate matter with an aerodynamic diameter îº10 µm (PM(10)), sulfur dioxide (SO(2)), nitrogen dioxides (NO(2)) and ozone (O(3)) was estimated from data collected at monitoring stations in each of the 25 study districts. RESULTS: We observed consistent and significant interactions between exposure and obesity on respiratory symptoms and asthma. The associations between each pollutant's yearly concentrations and respiratory symptoms and asthma were consistently larger for overweight/obese children than for normal-weight children, with odds ratios (ORs) ranging from 1.17 per 31 µg m(-3) for PM(10) on wheeze (95% confidence interval (CI): 1.01, 1.36) to 1.50 per 10 µg m(-3) for NO(2) on phlegm (95% CI: 1.21, 1.87) and cough (95% CI: 1.24, 1.81). CONCLUSION: These results showed that overweight/obesity enhanced respiratory health effects of air pollution in the study children.
Subject(s)
Air Pollution/adverse effects , Asthma/epidemiology , Environmental Exposure/adverse effects , Obesity/epidemiology , Adolescent , Air Pollutants/adverse effects , Air Pollutants/analysis , Asthma/physiopathology , Body Mass Index , Child , Child, Preschool , China/epidemiology , Cross-Sectional Studies , Disease Susceptibility , Female , Health Surveys , Humans , Male , Obesity/complications , Obesity/physiopathology , Risk Factors , Schools , Surveys and QuestionnairesABSTRACT
New antiretroviral (ARV) regimens require strict adherence if optimal suppression of HIV is to be maintained. This study is a theory-based examination of racial differences in patient-perceived barriers and reported ARV adherence. Participants (N=149) completed the Patient Medication Adherence Questionnaire (PMAQ), measuring adherence and perceived barriers to adherence. Adherence was defined as a self-report of 100% adherence in the past four weeks. Odds ratios were calculated to determine the relation of reported barriers to adherence for race and gender groups, and for the sample overall. For every ten-point increase in barrier score, there was an 86% increased risk of being non-adherent (OR=1.86; 95% CI: 1.19, 2.91). Adherence was not different between racial and gender groups, nor was total barrier score. However, individual barriers were differentially endorsed across groups. Rather than relying on demographic predictors, which may be only an indirect marker of adherence, evaluations of adherence should examine the psychological and social barriers to positive adherence outcomes in individual patients. Our findings support the use of theory-based behavioural interventions that address perceived barriers to adherence and other health promotion activities.
Subject(s)
Anti-HIV Agents/therapeutic use , HIV Seropositivity/drug therapy , Patient Compliance/psychology , Adult , Black or African American/psychology , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Memory , Middle Aged , Prospective Studies , Sex Factors , Social Support , United States/ethnology , White People/psychologyABSTRACT
The thymus glands which were excised for therapy (myasthenia gravis; MG) or experimental therapy (multiple sclerosis; MS) were compared to thymic biopsies from patients undergoing cardiac surgery. There was no difference in the weight or total cells of MG and MS thymuses or of the cell density of control, of MG or MS glands. Only 1 of 25 MS thymuses was hyperplastic, as were 2 of 9 of the MG thymuses and none of the controls. Several differences were noted for thymic lymphocyte proliferation to mitogenes in MS patients and to antigens in MS and MG patients. Ms thymuses had a decreased stimulation index to antithymocyte globulin and to optimal concentrations of pokeweed mitogen. Myasthenia gravis thymuses showed a significantly increased stimulation of myelin basic protein. The % B and % T cell counts were normal for the MS patients. No differences were noted in the incidence of mixed lymphocyte reactions between thymocytes and peripheral lymphocytes in the three groups. Fresh thymic lymphocytes did not suppress concanavalin A stimulated lymphocyte proliferation. It is not known if the differences in lymphocyte proliferation between MS, MG, and control thymuses represent a primary or secondary change.
