This study set out to estimate the prevalence of atopy to a variety of common ubiquitous fungi, including A. fumigatus, in cystic fibrosis (CF), and to evaluate the investigations by which the diagnosis was made. Particular attention was paid to the usefulness of skin testing and immunoassays in detecting which patients had simple fungal atopy, and which patients were at high risk of developing allergic bronchopulmonary mycoses. This cross-sectional study included 21 adult CF patients and 20 matched controls. Serum samples were taken for the measurement of total serum IgE and specific serum IgE to nine common fungi. Immediate hypersensitivity skin prick testing to each of the fungi was also performed. Simple fungal atopy was described in subjects fulfilling the following criteria: total serum IgE > 100 KU l(-1) with specific radioimmunoassay > or = grade 1 to at least one fungus and a positive skin prick test (SPT) > or = 3 mm to the same fungus. 'High risk' for developing allergic bronchopulmonary mycosis (ABPM) was described in subjects fulfilling the following criteria: total serum IgE > 200 KU l(-1) with specific radioimmunoassay > or = grade 2 to at least one fungus and a positive skin prick test (SPT) > or = 6 mm to the same fungus. The adult CF group had a significantly higher total SPT score (P=0.005) and mean total serum IgE (P<0.05) than controls. Forty-three percent of CF patients fulfilled the criteria for fungal atopy to at least a single fungus. Over half this group had an atopic tendency to more than one fungus. Nineteen percent of the CF group were at least 'high risk' of developing ABPM. Skin prick testing is a better marker of fungal atopy and a better predictor of those adult CF patients at higher risk of developing ABPM than specific radioimmunoassay serum testing. There is a high prevalence of fungal atopy in the adult CF population. Total serum IgE and skin prick testing are good predictors of fungal atopy and help predict those at risk of developing ABPM in CF.
Introduction Physical activity is associated with cardiovascular risk in Western populations but evidence from the Chinese population is limited. Methods We examined baseline data on over 500 000 people aged 30e79 years who, during 2004e2008, were recruited into a prospective study from 10 regions in China. Information on physical activity was collected using an interviewer-administered questionnaire that enquired about the frequency, duration and intensity of work-related and leisure activities. Total physical activity (METhours/day) was calculated from the time reportedly spent on each activity and the published estimate of energy expenditure per unit time (MET) for that specific activity. Body mass index, blood pressure and capillary glucose were measured. Outcomes of interest included overweight, hypertension, diabetes status (which were all defined using established criteria) and self-reported history of ischaemic heart disease (IHD). Logistic regression analyses were performed to assess the association of physical activity with each outcome. Results Of the 456 118 participants who were free of major chronic diseases other than IHD, the mean age was 51 years and 60% were women. Physical activity was significantly inversely associated with overweight, hypertension, diabetes and IHD, after adjustment for age, sex, region, education, income and smoking status. Comparing the bottom 20% vs the top 20% of physical activity, the adjusted ORs were: 1.25 (95% CI 1.23 to 1.28) for overweight, 1.23 (1.19 to 1.26) for hypertension, 1.72 (1.63 to 1.82) for diabetes and 1.59 (1.46 to 1.73) for IHD (each p<0.0001). Conclusion In Chinese adults, low physical activity is associated with an increased prevalence of overweight, hypertension, diabetes and IHD. Introduction Alcohol is one of the top 10 risk factors for death in middle and high income countries. As average incomes in developing nations rise, disposable income will become available for alcohol. This could result in epidemics of alcohol related illness. Average national alcohol consumption has been shown to correlate with national rates of liver cirrhosis mortality in developed nations. Many countries have reversed trends of increasing cirrhosis mortality over short time periods. An improved understanding of the mechanism of these reversals would be of great benefit to policy makers. Methods Mortality data for developed nations over the past 50 years were investigated by the birth cohort approach. Data were obtained from WHO. Age specific mortality rates were plotted against age at death for each birth cohort. This permitted a comparison between age specific rates throughout the life of each birth cohorts. Results In countries where an increasing trend in alcohol consumption was sharply reversed, liver cirrhosis death rates fell dramatically. Further it did so simultaneously in all adult age groups. Subsequently each birth cohort continued to experience almost uninterrupted falls in age specific death rates. Moreover those birth cohorts which were experiencing high...
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