Heat-labile Escherichia coli toxin enhances the induction of allergen-specific IgG antibodies in epicutaneous patch vaccination.

Epicutaneous allergen-specific immunotherapy (EPIT) is proposed as an alternative route for allergen-specific immunotherapy (AIT). The induction of allergen-specific blocking IgG antibodies represents an important mechanism underlying AIT, but has not been investigated for EPIT. Here, we compared the induction of allergen-specific blocking IgG in outbred guinea pigs which had been immunized with recombinant birch pollen allergen Bet v 1 using patch delivery system (PDS) with or without heat-labile toxin (LT) from Escherichia coli or subcutaneously with aluminum hydroxide (Alum)-adsorbed rBet v 1. Only subcutaneous immunization with Alum-adsorbed rBet v 1 and epicutaneous administration of rBet v 1 with PDS in combination with LT from E. coli induced allergen-specific IgG antibodies blocking allergic patients' IgE, but not immunization with rBet v 1 via PDS alone. Our results suggest that patch vaccination with rBet v 1 in combination with LT may be a promising strategy for allergen-specific immunotherapy against birch pollen allergy.

Heart rate variability in fibromyalgia patients and healthy controls during non-REM and REM sleep: a case-control study.

OBJECTIVES: To investigate heart rate variability (HRV) in fibromyalgia (FM) patients and healthy controls (HCs) during different sleep stages, and to examine the association of HRV with pain and sleep quality. METHOD: Polysomnography was recorded from 23 female FM patients and 22 age- and sex-matched HCs. HRV was recorded from bedtime until awakening including the standard deviation of normal-to-normal intervals (SDNN), the root mean square successive difference (RMSSD), and the low (LF; 0.04-0.15 Hz) and high (HF; 0.15-0.4 Hz) frequency power. Subjective scores of neck/shoulder pain and sleep quality were obtained at bedtime and awakening. RESULTS: Both patients and HCs showed high incidence of arousals per hour (FM: 16 ± 9.7; HCs: 17 ± 11). RMSSD was lower in patients than HCs during non-rapid eye movement (non-REM) stage 2 (N2) sleep (mean ± SD; 30 ± 12 ms vs. 42 ± 13 ms, p < 0.002) and during REM sleep (23 ± 11 ms vs. 37 ± 16 ms, p < 0.003). HRV did not differ between groups during N3 sleep (p > 0.19 for all comparisons). In patients, SDNN, RMSSD, and HF power showed modest positive correlations with sleep quality (HF power during N3 sleep showed the highest correlation; Spearman's ρ = 0.54) and modest negative correlations with neck/shoulder pain (RMSSD during N3 sleep showed the highest correlation with pain at bedtime; Spearman's ρ = -0.51). CONCLUSIONS: RMSSD, indicative of parasympathetic predominance, is attenuated in FM patients compared to HCs during N2 sleep and REM sleep. This difference was not present for the HF component. HRV during sleep in FM patients is moderately and positively associated with sleep quality and moderately and negatively associated with neck/shoulder pain.

Gender differences in work-home interplay and symptom perception among Swedish white-collar employees.

OBJECTIVE: To analyse gender differences in paid and unpaid workload and symptoms in matched groups of Swedish white-collar workers with children. DESIGN AND SETTING: Paid and unpaid workload and perceived stress from paid work, conflict between demands and control over household work were measured by a total workload (TWL) questionnaire. Some symptoms were rated with regard to frequency and severity as a measure of health. Cross-sectional analyses were performed. PARTICIPANTS: Matched groups of male (n = 440) and female (n = 529) well-educated white-collar workers in full-time employment, aged 32-58 years and living with children in the home. RESULTS: Women in higher positions in Sweden are healthier than the average population of women, but report more symptoms than men in the same position as well as more stress from paid work, more conflict between demands and a greater TWL. However, women also reported more control over household duties and TWL was not associated with more symptoms. The men were mainly focused on their paid work role and perhaps even more so than men in the general population as they were fairly resistant to feelings of conflicting demands. CONCLUSION: Even among matched groups of full-time employed, well-educated men and women, traditional gender differences in division of responsibilities and time allocation were found. Even though the women were healthy at this stage, they might risk future ill health, owing to high workload, stress and feelings of conflicting demands.

Auricular acupuncture in prison psychiatric units: a pilot study.

OBJECTIVE: The study explores whether auricular acupuncture can be a viable treatment form for inmates in prison psychiatric units. METHOD: Inmates in a prison psychiatric unit and in a support unit for violent behavior were offered group treatment with auricular acupuncture three times a week over a period of 9 months. Another prison psychiatric unit served as a control group. RESULTS: Twenty-two inmates received treatment, and 11 inmates received treatment for over 8 weeks. Cortisol levels were higher for inmates in the support unit than for the other two groups. Inmates treated at least 25 times were prescribed fewer psycholeptic drugs than controls. Perceived autonomy increased for treated inmates in the psychiatric unit. Inmates treated for over 8 weeks experienced improved inner harmony and calm and better clarity over future plans. CONCLUSION: Acupuncture is a non-verbal form of treatment appropriate for prison psychiatric units. The treatment facilitates contact and complements other psycho-social treatment forms.

Associations between financial strain and the diurnal salivary cortisol secretion of long-term unemployed individuals.

OBJECTIVE: The study investigated the associations between self-rated financial strain and overall diurnal salivary cortisol levels, as well as secretory patterns among long-term unemployed individuals. METHODS: Psychosocial and life-style variables were assessed by means of questionnaires among 85 participants (mean age 42+/-9 years; 56% females). Salivary cortisol was sampled on four occasions during a 24-hour period and data was analysed separately for men and women. RESULTS: Among females, high financial strain was related to higher overall cortisol levels, and to elevated levels in the evening. These associations did not reach significance among men. Multivariate analyses showed that evening levels of cortisol were positively associated with financial strain, but largely unrelated to life-style variables and psychological distress. CONCLUSIONS: The results suggest that high financial strain influences the diurnal cortisol secretion of unemployed individuals in terms of elevated cortisol levels in the evening. The mediating mechanisms are in need of further investigation.

Surface EMG and psychophysiological stress reactions in women during repetitive work.

In order to understand the high prevalence of musculoskeletal disorders associated with stressful work, it is important to explore the relationship between muscle activity and psychophysiological stress responses. The present real-life study examines surface trapezius electromyographic (sEMG) activity, heart rate, blood pressure, and levels of urinary catecholamines and salivary cortisol among 31 female employees working at supermarkets, where the prevalence of neck and shoulder disorders is high (60-70%). As expected, the results show that psychophysiological arousal was high during work. Significant correlations were found between self-reports indicating negative stress (stressed, exhausted, tense) and sEMG activity during work. No significant correlations were found between self-reports of positive reactions (stimulated, concentrated, happy) and sEMG activity. No associations were found between sEMG activity and pain or between negative stress ratings and pain. Objectively measured workload and physiological stress responses did not correlate significantly with sEMG activity. Thus, our data indicate that perceived negative stress may have a specific influence on muscle activity, which may be of importance for musculoskeletal disorders in jobs with low-to-moderate physical load and negative psychosocial factors.

Trapezius muscle activity, neck and shoulder pain, and subjective experiences during monotonous work in women.

The electromyographic (EMG) activity patterns of 18 female supermarket employees reporting neck and shoulder pain were compared with those of 6 of their female colleagues reporting no pain when doing cash-register work. It was found that the EMG activity of the trapezius muscle tended to show a lack of low and high levels among pain subjects, and that the time the trapezius muscle was at rest was longer in the group reporting no pain. In the non-dominant side, the muscle rest time was significantly longer (P < 0.05) in the group reporting no pain, and this group also showed a larger EMG activity difference between the dominant and non-dominant sides, indicating a less static bilateral muscle activation. Self-reports of negative experiences (stressed, exhausted and tense) were somewhat higher in the group reporting pain, while positive experiences during work (concentrated, stimulated and happy) appeared to be similar in the two groups of supermarket employees.

Pain perception to the cold pressor test during the menstrual cycle in relation to estrogen levels and a comparison with men.

Animal and human research has shown that pain sensitivity changes during the menstrual cycle. This has sometimes been ascribed to hormonal variations. The aim of the present study was to examine how perception of pain, induced by the cold pressor test to the dominant hand, was related to gender and phases of the menstrual cycle. A repeated-measures design was used, where twenty-two female students participated at two different phases of the menstrual cycle (days 2-4 and days 20-24). A control group of nineteen male students participated on two occasions, separated by a three week period. The cycle phase during which each woman began her participation was randomized. Pain was induced using the cold pressor test. Pain threshold was determined as the duration of time between when the subject first reported pain and exposure to the painful stimulus. Pain tolerance was determined as the duration of time until the subject withdraw her/his hand from the test water because the pain was too intensive. The results showed that men tolerated significantly greater pain than women. Women's pain threshold was significantly higher during the second phase of the menstrual cycle. Systolic pressure was higher in men than women, increasing more in men in response to cold pressor testing than women. Further research, including measurements of plasma hormone levels during the menstrual cycle, is needed to clarify the role played by estrogens in pain perception.

Fibrinogen Caracas V, an abnormal fibrinogen with an Aalpha 532 Ser-->Cys substitution associated with thrombosis.

A new dysfibrinogenemia associated with thrombophilia has been identified in a Venezuelan kindred. Thrombin and Reptilase times were prolonged and the accelerating capacity of the patient's fibrin on the t-PA-induced plasminogen activation was decreased. In addition the affinity of fibrinogen for plasminogen was diminished. Permeability and electron microscopy studies revealed that the abnormal clot was made up of thin and densely packed fibres giving rise to a reduced fibrin gel porosity. This was confirmed by turbidity studies showing a decreased fibre mass/length ratio. Affected members were heterozygous for an Aalpha 532 Ser-->Cys mutation as demonstrated by genetic analyses. This abnormal fibrinogen has been designated as Fibrinogen Caracas V. The family study showed a convincing association between the mutation and thrombotic manifestations. The thrombotic tendency may be ascribed to lack of accelerating capacity of fibrin to induce fibrinolysis caused by an abnormal clot structure with thin fibres and reduced porosity.

Experimental thrombosis I: relation with fibrinogen and other haemostatic parameters.

Epidemiological studies have shown that the haemostatic parameters Fibrinogen (Fg), Factor VII (F VII), Factor VIII (F VIII), von Willebrand factor (vWF), Tissue Plasminogen Activator (t-PA), Plasminogen Activator Inhibitors (PAI) are risk factors/markers of ischemic cardiovascular disease. Ferritin (sFER) and Leukocytosis have also been implicated. In the present study we have followed the levels of fibrinogen, von Willebrand factor and thrombomodulin in relation to lipids, iron and the appearance of atherosclerotic lesions in New Zealand rabbits fed with a cholesterol enriched diet for a two-month period compared with a group of control rabbits. Hematocrit and white blood cell count (WBC) were measured in parallel. In hyperchlesterolemic rabbits the levels of fibrinogen and von Willebrand factor increased progressively, showing a positive correlation with the increasing cholesterol levels. There was an increase in soluble thrombomodulin beginning at the eighth week of study. In addition, these animals showed gross intimal atherosclerotic lesions in the whole extension of their aortas. Immunohistochemical studies showed the presence of fibrin(ogen) related antigen throughout the arterial wall and in the central portions of the atheromas. In the control group there was no formation of atherosclerotic plaques and all haemostatic, haematological and biochemical parameters were within the normal range. WBC and sFER levels were unaffected in both groups. Our results show that increased levels of fibrinogen and von Willebrand factor, known coronary risk factors, are strongly associated with the formation of atherosclerotic plaques in rabbits. The plaques contain a considerable amount of fibrinogen related antigen.

Women's work roles and their impact on health, well-being, and career: comparisons between the United States, Sweden, and The Netherlands.

As women have become more assimilated into the work-force over recent decades, they have realized considerable changes in their work roles which may contribute to health problems and other negative outcomes such as marital strain and diminished job status. The purpose of this review was threefold: (1) to synthesize data on the distribution of women's work efforts in the areas of paid employment, household chores, and childcare; (2) to outline research which addresses the impact of women's workload on their well-being and careers; and (3) to make international and gender comparisons regarding women's work responsibilities. Our findings showed that women from each of the three countries examined--the United States, Sweden, and The Netherlands--contribute more effort to household chores and childcare and less to the workplace than men do. As a result, their total workloads appear to be somewhat greater and more diffusely distributed than those of men. Heavy workloads may adversely affect women's health, especially in the presence of certain role characteristics (e.g., having a clerical, managerial, professional, or executive position, or caring for young children). Heavy work responsibilities may also undermine marital happiness, particularly if there is perceived inequity in the way partners share household work. Finally, women's total work responsibilities often impact their careers due to compensatory reductions in work commitment and job status. These observations point to the need for further research on women's workload and work roles, on the relationship of work to well-being, and on methods of preventing or alleviating adverse effects on overburdened workers.

Psychophysiological stress responses, muscle tension, and neck and shoulder pain among supermarket cashiers.

This study examined psychological and physiological stress, as well as muscle tension and musculoskeletal symptoms, among 72 female supermarket cashiers. Stress levels were found to be significantly elevated at work, as reflected in the catecholamines, blood pressure, heart rate, electromyographic (EMG) activity, and self-reports. Fifty cashiers (70%) suffering from neck-shoulder pain (trapezius myalgia) were found to have higher EMG activity at work and reported more tension after work. Women who kept a diary for 1 week and reported more musculoskeletal pain (above the median) were older, had higher blood pressure, and reported more work stress and psychosomatic symptoms. The elevated stress levels at work are consistent with data from workers involved in other types of repetitive tasks and can be important for the high prevalence of neck and shoulder symptoms among the cashiers.

Growth phase-regulated induction of Salmonella-induced macrophage apoptosis correlates with transient expression of SPI-1 genes.

Invasive Salmonella has been reported to induce apoptosis in a fraction of infected macrophages within 2 to 14 h from the time of infection by a mechanism involving the type III secretion machinery encoded by the Salmonella pathogenicity island 1 (SPI-1). Here, we show that bacteria in the transition from logarithmic to stationary phase cause 90% of the macrophages to undergo phagocytosis-independent, caspase-mediated apoptosis within 30 to 60 min of infection. The ability of Salmonella to induce this rapid apoptosis was growth phase regulated and cell type restricted, with epithelial cells being resistant. Apoptosis induction was also abrogated by disruption of the hilA gene (encoding a regulator of SPI-1 genes) and by the expression of a constitutively active PhoPQ. hilA itself and a subset of SPI-1 genes were transiently expressed during aerobic growth in liquid medium. Interestingly, however, hilA was found to be required only for the expression of the prgH gene, while sipB, invA, and invF were expressed in a hilA-independent manner. The expression of SPI-1 genes and the secretion of invasion-associated proteins correlated temporally with the induction of apoptosis and are likely to represent its molecular basis. Thus, growth phase transition regulates the expression and secretion of virulence determinants and represents the most efficient environmental cue for apoptosis induction reported to date.

Stress and workload of men and women in high-ranking positions.

Psychological and physiological stress responses related to work and family were investigated in 21 female and 21 male managers and professional specialists in high-ranking positions. The main result was that both women and men experienced their jobs as challenging and stimulating, although almost all data indicated a more favorable situation for men than for women. In addition, women were more stressed by their greater unpaid workload and by a greater responsibility for duties related to home and family. Women had higher norepinephrine levels than men did, both during and after work, which reflected their greater workload. Women with children at home had significantly higher norepinephrine levels after work than did the other participants. The possible long-term health consequences of women's higher stress levels are discussed.

Stress responses in low-status jobs and their relationship to health risks: musculoskeletal disorders.

Conditions typical of many low-status jobs are known to induce elevated stress. In keeping with this, blue-collar workers show elevated psychophysiological stress levels both during and after work compared with workers in more stimulating and flexible jobs. Health-related behaviors, such as cigarette smoking and drug abuse, that are known to contribute to the social gradient in health, can be seen as ways of coping with a stressful work situation in order to get short-term relief. Negative emotional states associated with low-status jobs, combined with a lack of economic resources, are also likely to reduce the individual's motivation to seek proper medical treatment and, thus, increase the risk that transient symptoms develop into chronic illness. With regard to musculoskeletal disorders, it is well documented that physically monotonous or repetitive work is associated with an increase in neck, shoulder, and low back pain problems. However, recent studies also report an association between psychosocial factors and muscle pain syndromes. Possible mechanisms explaining these findings involve the assumption that psychological stress may induce sustained activation of small, low-threshold motor units that may lead to degenerative processes, damage, and pain. Analysis of short periods of very low muscular electrical activity (EMG gaps) shows that female workers with a high frequency of EMG gaps seem to have less risk of developing myalgia problems than do workers with fewer gaps. Stress induced by psychosocial conditions at work, which is usually more lasting than that resulting from physical demands, may prevent the individual from shutting off their physiological activation and reduces the time for rest and recovery. In the modern work environment, with strong emphasis on a high work pace, competitiveness, and efficiency, it is possible that lack of relaxation is an even more important health problem than is the absolute level of contraction or the frequency of muscular activation.

Psychological correlates of salivary cortisol secretion among unemployed men and women.

The aim of the present study was to examine the association between psychological factors and salivary cortisol secretion (baseline level, reactivity to laboratory stressors) in a sample of 59 long-term unemployed men and women (mean age 42+/-10 years). Subjects were divided into four groups according to their basal levels of salivary cortisol as well as their reactivity to experimental stress (stress level minus baseline): (1) low base/ low reactivity; (2) high base/low reactivity; (3) low base/high reactivity; and (4) high base/ high reactivity. The low base/low reactivity group was characterized by significantly higher somatic anxiety, muscular tension, irritability, and depression (Beck's Depression Inventory) and lower perceived control (mastery) than the other groups. The low base/high reactivity group was also characterized by depression and low perceived control. The high base/low reactivity group was higher in terms of monotony avoidance, Type-A behavior (JAS) and mastery, but lower in depression. The results indicate that (1) individuals with personality traits reflecting emotional distress are more vulnerable to exhaustion of the HPA-axis following long-term unemployment and (2) monotony avoidance and Type-A behavior, at least temporarily, seem to exert a beneficial influence on mental well-being among long-term unemployed individuals.

Fibrinogen Caracas I: a dysfibrinogenemia with a hemorrhagic diathesis associated with diminished fibrin fiber diameter and reduced fibrin gel porosity.

Fibrinogen Caracas I is a dysfibrinogenemia with a mild bleeding diathesis and a defective wound healing. We have characterized this abnormal fibrinogen using transmission electron microscopy (TEM) in combination with turbidity and permeation studies. Turbidometric and permeability analysis showed that the abnormal fibrin had a significantly decreased mass:length ratio and fiber diameter. In addition, the permeability studies of plasma fibrin clots showed that the gel porosity of the abnormal fibrinogen was reduced. Images of the abnormal fibrin structure obtained using TEM showed that the fibers were thinner, much less branched and less ordered than normal fibers. Diminished fibrin fiber diameter and reduced fibrin gel porosity have been taken as hallmarks of thrombophilic dysfibrinogenemias. The results of the present study show that these features are not necessarily predictive of thrombophilia. Further studies performed on a larger number of dysfibrinogenemias need to be conducted in order to establish the implications of these parameters on the clinical outcome.

Influence of paid and unpaid work on psychophysiological stress responses of men and women.

Female labor force participation has increased considerably, but women's traditional responsibility for home and family has not changed accordingly. Although women's employment per se does not seem to have negative health consequences, studies show that stress from role conflicts and work overload is reflected in women's elevated psychophysiological arousal not only at work but also off work, which may induce psychosomatic symptoms (e.g., cardiovascular and musculoskeletal disorders). In addition, multiple role demands reduce women's possibilities to make a professional career on the same terms as men. Data emphasize the need for a new allocation of work functions between the sexes and the need for organizational changes leading to more influence and control over work to make it possible for both men and women to combine a qualified job with a meaningful family life.