Impact of physical performance on prognosis among patients with heart failure: Systematic review and meta-analysis.

BACKGROUND: This study aimed to clarify the relationship between physical performance and prognosis of patients with heart failure using a meta-analysis given the inconsistencies in published studies regarding the same. METHODS: A total of 22 studies with 10,368 patients were included in this review. Hazard ratios were used for analysis, while meta-analysis was performed using the inverse-variance method. Among all physical performance tests reported in the literature, the six-minute walk distance (6MD) test was most frequently used. However, short physical performance battery (SPPB) and walking speed were more frequently used as outcomes among studies investigating patients with a higher mean age. RESULTS: The results of our meta-analysis showed that 6MD cut-off values were significantly associated with mortality [hazard ratio (HR), 2.04; 95% confidence interval (CI), 1.48-2.83; p<0.001] and cardiovascular disease (HR, 2.18; 95% CI, 1.68-2.83; p<0.001). Although a number of studies have also reported on the relationship between other physical performance tests and prognosis, meta-analysis could not be performed. Our results revealed that physical performance was strongly correlated with prognosis among patients with heart failure. CONCLUSIONS: Our meta-analysis showed a strong relationship between 6MD and prognosis. However, studies investigating more elderly patients have tended to more frequently utilize walking speed and SPPB as outcomes.

Study on the correlation between age and changes in mosquito bite response.

Mosquito bite reactions consist of an immediate response characterized by an erythema and a wheal, which peaks at 20 min, and a delayed response characterized by a papule and/or an erythema, which peaks at 24 h. Mosquito bite reactions progress from stage I to stage V as an individual is repeatedly bitten as follows: stage I, neither immediate nor delayed reaction; stage II, delayed reaction; stage III, both immediate and delayed reaction; stage IV, immediate reaction; and stage V, neither immediate nor delayed reaction. In 1985, we conducted a cross-sectional study that demonstrated a positive association between age and stage in response to an Aedes albopictus bite among 162 healthy volunteers. However, it remains unknown how the mosquito bite reaction stage progresses in the same individual over decades. In the present study, the mosquito bite reaction of 10 subjects from the 1985 cross-sectional cohort was longitudinally evaluated over 30 years. We confirmed the time-dependent progression of stage in four subjects. One stage II subject and three stage III subjects had advanced to the next stage. We went on to find that, contrasting with the general trend found in the previous studies, the majority of the subjects (6/10) remained of stage III over the 30-year study period. Upon closer inspection, this apparently non-progressive group demonstrated a reduction in the size of the delayed reactions. The present study demonstrated a marked individual variability in course of the stage progression.

Two cases of eruptive pseudoangiomatosis induced by mosquito bites.

Eruptive pseudoangiomatosis is a skin eruption characterized by millet-sized erythema with an anemic halo appearing on exposed body areas. Insect bites, particularly mosquito bites, have been reported as one of the causes of eruptive pseudoangiomatosis. We experienced two cases of eruptive pseudoangiomatosis and the eruption was seen on the face and upper extremities of two women aged 48 and 77 years old. The two cases consented to be experimentally bitten by Culex pipiens mosquitoes and Aedes albopictus to determine if eruptive pseudoangiomatosis could be experimentally elicited by these mosquitoes. Our results showed that several minutes after a C. pipiens mosquito bite, an erythematous spot appeared on the bite site, followed by the formation of an anemic halo surrounding the erythema in 30 min; a successful reproduction of eruptive pseudoangiomatosis. The erythema lasted for more than a week and was not accompanied by any pruritus. With A. albopictus, we were able to reproduce a milder eruptive pseudoangiomatosis eruption: in case 1, a smaller erythematous spot with an ill-defined halo which disappeared within 1 week; and in case 2, an immediate response consisting of a wheal and erythema but not eruptive pseudoangiomatosis. We demonstrated that eruptive pseudoangiomatosis was the response manifested in individuals who normally did not demonstrate any immediate or delayed reaction to insect bites; and the typical eruptive pseudoangiomatosis eruption was elicited by C. pipiens mosquito bites. However, the mechanism resulting in the manifestation of eruptive pseudoangiomatosis is still unknown.

Flexibility and strictness in functional replacement of domain III of cry insecticidal proteins from Bacillus thuringiensis.

Cry1C, one of the lepidopteran-specific insecticidal proteins from Bacillus thuringiensis, exhibits potent cytotoxicity against Sf9, an insect cell line. Cry1Aa and Cry4A, which are lepidopteran- and dipteran-specific insecticidal proteins, respectively, show no cytotoxicity against Sf9. When domain III of Cry1C was replaced with that of Cry1Aa or Cry4A, the hybrid Cry1C protein retained the cytotoxicity. These results suggest that domain III of Cry1C is not crucial in determining the cytocidal specificity of Cry1C against Sf9.

A study of cross-reactions between mango contact allergens and urushiol.

The allergens causing mango dermatitis have long been suspected to be alk(en)yl catechols and/or alk(en)yl resorcinols on the basis of observed cross-sensitivity reactions to mango in patients known to be sensitive to poison ivy and oak (Toxicodendron spp.). Earlier, we reported the 3 resorcinol derivatives: heptadecadienylresorcinol (I), heptadecenylresorcinol (II) and pentadecylresorcinol (III); collectively named 'mangol', as mango allergens. In this study, we extracted the 1st 2 components (I and II) from the Philippine mango, adjusted them to 0.05% concentration in petrolatum and patch tested the components on 2 subjects with mango dermatitis. Both subjects reacted to I. 1 subject also elicited a weaker positive reaction to II. To investigate the cross-reaction between mangol and urushiol, we also patch tested the same subjects with urushiol. The subject sensitive to II reacted to urushiol. 6 subjects with a history of lacquer contact dermatitis and positive reactions to urushiol were similarly patch tested. 5 persons reacted to I. 2 subjects also exhibited a slower but positive reaction to II. This is the 1st report in which heptadec(adi)enyl resorcinols known to be present in mango have been shown to elicit positive patch test reactions in mango-sensitive patients.