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Rationale Several studies have evaluated the associations between cord blood cellular responses and atopic diseases in children, but the results of these studies are inconsistent. Variations in blood processing factors and maternal and infant characteristics are typically not accounted for and may contribute to these inconsistencies. Methods Cord blood samples were obtained from 287 subjects participating in the Childhood Origins of ASThma project, a prospective study of children at high risk for the development of asthma/allergies. Mononuclear cells were stimulated with phytohaemagglutinin (PHA), phorbal myristate acetate/ionomycin or a suspension of killed staphylococcus, and IFN-γ, IL-10 and IL-13 were quantitated by ELISA. Cell yields and cytokine production were related to processing factors and maternal and infant characteristics. Results The strongest relationships between independent variables and cell yield or cytokine responses occurred with the season of birth. The highest median cell yields were seen in fall, and the lowest in summer (difference of 47%, P=0.0027). Furthermore, PHA-induced IL-5 and IL-13 responses were approximately 50% higher in spring and summer than in fall or winter ( P<0.0001). Clots in the cord blood samples were associated with a reduced median cell yield (42% reduction, P<0.0001), and an increased PHA-induced IL-10 secretion (27% increase, P=0.004). Conclusions These data suggest that season of collection, and to a lesser extent clotting in samples, affect cord blood mononuclear cell yield and cytokine responses. Careful documentation and analysis of processing and environmental variables are important in understanding biological relationships with cytokine responses, and also lead to greater comparability among studies using these techniques. [ABSTRACT FROM AUTHOR]

OBJECTIVE: Based on a stress-coping perspective, the present study was designed to examine links between patients' beliefs (barriers), coping (analgesic use), and quality of life (QOL) outcomes. DESIGN: Not given. SETTING: Outpatient clinic. POPULATION: Participants were outpatients from either a comprehensive cancer center or a private oncology clinic. Inclusion criteria for the parent (intervention) study were diagnosis of metastatic breast or prostate cancer, lung cancer or multiple myeloma. Three hundred sixteen persons were invited to join the study and 240 did so. Of those, 182 reported cancer-related pain; these are the participants involved in this report. Participants were 114 women and 68 men who ranged in age from 31 to 84 years. INTERVENTIONS: Eligible patients were approached by a nurse in the outpatient clinic. After consent, study personnel interviewed the patient to collect data about pain history and recent (past week) analgesic use. The patient was asked to complete the packet of self-report questionnaires while waiting to be seen by a clinician. The Barriers Questionnaire (BQ) is a 27-item instrument designed to measure the extent to which patients have concerns about reporting pain and using analgesics. Three items from the Brief Pain Inventory (BPI) were used to assess pain severity. Coping was operationalized as analgesic use and was measured with a revised version of the Pain Management Index (PMI). The Medication Side-Effect Checklist (MSEC) was used to assess severity of analgesic side-effects. Three facets of impaired QOL were examined. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depressed mood. MAIN OUTCOME MEASURE(S): Means for pain severity, barriers, side-effect severity, and interference with life activities were low to moderate. Depression scores were moderate to high. Perceived health varied, with 2 (1%) of the patients viewing their health as very poor, 25 (14%) seeing it as poor, 50 (28%) as fair, 87 (48%) as good, and 17 (9%) as excellent. Coping was inversely associated with pain severity: the more effective the analgesic use the lower was the patient's 'pain now' score. Unexpectedly, coping was not associated with side-effect severity. However, both pain severity and side effects were positively related to impairments in QOL, with the exception that pain severity was not significantly related to depression. RESULTS/CONCLUSIONS: Taken as a whole, the findings point to two areas in which interventions are needed in order to maximize QOL. First, it would be useful to test the impact of informational interventions on beliefs that are barriers to analgesic use. In addition, further attention should be given to refining a measure of coping. As recommended by current practice guidelines (U.S. Department of Health and Human Services, 1994), proactive management of analgesic side effects needs to become a routine facet of pain management. [CINAHL abstract] [ABSTRACT FROM AUTHOR]

Background: Exposure to furred pets might confer protection against the development of allergic sensitization through a mechanism that is incompletely understood., Objective: The objective of this study was to determine the effects of pet exposure and genotype on immunologic development and the incidence of atopic markers and diseases in the first year of life., Methods: Pet exposure in the home was compared with cytokine secretion patterns (mitogen-stimulated mononuclear cells at birth and age 1 year) and indicators of atopy (allergen-specific and total IgE, eosinophilia, food allergy, atopic dermatitis) in 285 infants. Interactions with genotype at the CD14 locus were also evaluated in the data analyses., Results: Exposure to dogs was associated with reduced allergen sensitization (19% vs 33%, P =.020) and atopic dermatitis (30% vs 51%, P <.001). The risk for atopic dermatitis was further influenced by genotype at the CD14 locus (P =.006), even after adjusting for exposure to dogs (P =.003). Furthermore, infants with the genotype -159TT were less likely to develop atopic dermatitis if they were exposed to a dog (5% vs 43%, P =.04). Last, dog exposure was associated with increased IL-10 (117 vs 79 pg/mL, P =.002) and IL-13 (280 vs 226 pg/mL, P =.013) responses at age 1 year., Conclusions: Having a dog in infancy is associated with higher IL-10 and IL-13 cytokine secretion profiles and reduced allergic sensitization and atopic dermatitis. These findings suggest that postnatal exposure to dogs can influence immune development in a genotype-specific fashion and thereby attenuate the development of atopy in at-risk children.