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Biomedical subjects

K Huss

Publications and source records attributed to K Huss.

At least 37 records · Page 2Linked to original sources
PubMed1995

Social factors associated with behavioral problems in children with asthma.

The objective of this study was to describe the proportion of children with a behavior problem and examine which independent variables are associated with the presence of a behavior problem in a group of 392 inner-city children with asthma. Data on child asthma symptoms, medication use, health-care utilization, and school absences were obtained from the parent during a structured telephone interview. Included in the interview was a measure of behavior problems and social support questions. Children classified with a high level of asthma symptoms were more than twice as likely to experience a behavior problem than children classified with a low level of asthma symptoms (P = 0.002). Use of theophylline medication was not correlated with behavior problems (P = 0.45). Significant variables were low level of social support and high or moderate level of asthma symptoms. We have identified a group of children at risk for behavior problems, specifically in families that lack adequate social and financial resources.

Black or African American↗
PubMed1994

Mite allergen control with acaricide fails.

BACKGROUND: We compared the effects of an acaricide, benzyl benzoate, with the effects of baking soda control applied to bedroom and living room carpets on house dust mite allergen levels, lung function, and medication use in 12 adult patients with asthma for 12 months. METHODS: This was a randomized, double-blind, placebo-controlled study. Patients were enrolled from the allergy clinic of a large tertiary care center in a metropolitan area. All patients had positive dust mite puncture test results. Six patients used benzyl benzoate, and six used baking soda. Other aggressive mite control measures were implemented uniformly in each group. Subjects were to make two carpet applications, at baseline and at 6 months according to the manufacturer's recommendations. Dust samples were collected in bedroom and living room carpets at 0, 3, 6, 9, and 12 months; and quantities of Der p I and Der f I allergens were determined. Spirometry was done every 3 months, and peak flow rates were recorded for 10 days after each dust sampling. RESULTS: There were no significant differences in mean allergen levels between the two groups over time at either site. There were no significant changes in lung function or medication use for either group. CONCLUSIONS: Benzyl benzoate powder applications may not be effective when done according to manufacturer's instructions. Further studies are necessary to test effectiveness when applied more frequently and for longer periods.

Adult↗
PubMed1994

Use of community health workers with inner-city children who have asthma.

Use of community health workers (CHWs) to obtain health, social, and environmental information from African-American inner-city children with asthma was one component of a larger intervention study designed to reduce morbidity in African-American children with asthma. A subset of 140 school-aged children with asthma was recruited and enrolled in a program to receive home visits by CHWs for the purposes of obtaining medical information and teaching basic asthma education to the families. Data obtained by the CHWs revealed low inhaled steroid use, high beta 2 agonist use, frequent emergency-room visits, decreased primary-care visits, and increased allergen and irritant exposure. Appropriately recruited and trained CHWs are effective in obtaining useful medical information from inner-city families with children with asthma and providing basic asthma education in the home.

Asthma↗
PubMed1994

Home environmental risk factors in urban minority asthmatic children.

Urban minority families with children with asthma often live in homes with allergen and irritant exposures harmful to these children. We enrolled 392 African-American asthmatic children, male and female, aged 5 to 12, from 42 schools in Washington, DC and Baltimore, MD. The project is designed to test the effectiveness of school-based asthma education interventions, community-based asthma health workers' programs, and the combination on these children. Baseline telephone interviews were carried out with the primary home care-givers for demographic data and for environmental home exposures that exacerbated asthma. Exposures stated to cause wheezing in the children were cigarette smoke in 72%, dust in 53%, cats in 34%, dogs in 27%, and roach exposure in 15%. Fifty-six percent of children live with cigarette smoke exposure, 73% of which is from mothers. This was a highly symptomatic group with 44% reporting two or more days per week of restricted activity and 62% reporting two or more episodes of night symptoms per week. Those with mattress covers on beds had significantly fewer emergency department visits in the past 6 months than those without covers. Over one-third of parents reported children taking two bronchodilators without anti-inflammatory agents. Less than 20% were reported using anti-inflammatory medications. Decreasing asthma severity in this population entails the prevention and control of known risk factors in the home environment. Emphasis must be placed on cigarette smoking cessation programs, covering mattresses, and dust and animal dander control. Primary care physicians require education on the role of anti-inflammatory medications.

Adolescent↗
PubMed1992

Effective education of adults with asthma who are allergic to dust mites.

The effects of supplementary computer instruction in house dust mite-avoidance measures on adherence to implementing measures, on home dust mite-allergen levels, and on symptomatology were investigated in 52 adult patients with mite-associated asthma. Twenty-six patients received conventional instruction (counseling and written instruction) and the other 26 patients received conventional plus 22 minutes of interactive computer-assisted instruction. Instructions were aimed at mite-avoidance measures. Pre- and postinstruction dust samples were collected, and adherence was monitored. All patients kept symptom diaries twice a day. Patients' progress was followed for 12 weeks, and all patients completed the study. Adherence, number of observed and self-reported mite-avoidance measures implemented after visit, was higher for the computer group (p = 0.023). The computer-instructed group achieved significantly lower levels of mite allergen in bedroom carpets (p = 0.004) with mean levels of mite allergen declining from 6.5 +/- 7.6 to 2.2 +/- 4.3 micrograms/gm of dust (two-site monoclonal antibody assays), whereas levels for the conventional-instructed group did not change. Moreover, by study weeks 9 and 10, the computer-instructed group was significantly less symptomatic (p = 0.033). Mean symptom scores for this group decreased from 12.4 to 7.7, compared with 16.4 to 14.3. Conventional instruction supplemented with computer instruction is suggested in mite education.

Adolescent↗
PubMed1992

Allergen avoidance in the treatment of dust-mite allergy and asthma.

House-dust-mite allergen is one of the primary causes of asthma. In many instances, asthma is an immunoglobulin gamma E mediated atopy (i.e., allergen-specific hypersensitivity) that leads to non-specific bronchial hyper-reactivity and subsequent symptom manifestations. These symptoms may range from an annoying cough to full-blown respiratory failure. Allergen-avoidance measures should be a primary mode of treatment for atopic asthmatics. This article focuses on the dust-mite allergen and its relationship to asthma. It details specific avoidance measures that should be implemented by the majority of asthmatics. Studies are cited that support the aggressive use of these measures to decrease allergen exposure, and to subsequently prevent or significantly reduce asthma symptoms. When health care providers have a better understanding of avoidance measures and the rationale underlying their use, these measures are more likely to be valued and given greater emphasis in education and treatment plans. Renewed emphasis on an immunomodulatory approach to asthma treatment may help to reverse the rise in asthma morbidity and mortality rates.

Allergens↗
PubMed1991

Computer-assisted reinforcement of instruction: effects on adherence in adult atopic asthmatics.

A randomized comparison group pretest-posttest experimental design was used to determine computer-assisted instruction effects on adherence to implementing house dust mite avoidance measures in adult atopic asthmatics. Fifty-two subjects were randomly assigned to comparison and experimental groups. The comparison group received traditional instruction in avoidance measures while the experimental group received traditional instruction supplemented by identical information provided by computer-assisted reinforcement of instruction. Adherence was measured by subjects' self-ratings and investigators' observations. Data were collected during two home visits 12 weeks apart. The computer group had significantly (p less than .05) greater adherence scores than the comparison group. The results indicate that computer-assisted reinforcement of instruction is an effective method of increasing self-care behaviors about allergen avoidance activities.

Adolescent↗
PubMed1989

Point substitutions in Japanese alloalbumins.

We have completed the structural study of five rare types of inherited albumin variants (alloalbumins) discovered in the Biochemical Genetics Study of 15,581 unrelated children in Hiroshima and Nagasaki. We have also identified the structural change in five other alloalbumin specimens detected during clinical electrophoresis of sera from Japanese living near Tokyo. Each of the five albumin variants from Nagasaki and Hiroshima has a single amino acid substitution. All of these substitutions differ, and none has been reported in non-Japanese populations. No instances of proalbumin variants or of albumin B (the most frequent alloalbumins in Caucasians) were detected in the children in Hiroshima and Nagasaki. However, one instance of a variant proalbumin and two examples of albumin B occurred in Japanese from the vicinity of Tokyo. In addition a previously unreported point substitution was found in albumin Tochigi, which is present in two unrelated persons from Tochigi prefecture. Four of the point mutations in the Japanese alloalbumins are in close proximity in a short segment of the polypeptide chain (residues 354-382) in which three additional point substitutions have been reported in diverse populations. These results, combined with earlier data, suggest that point substitutions are grouped in certain segments of the albumin molecule.

Amino Acid Sequence↗
PubMed1989

Identical structural changes in inherited albumin variants from different populations.

Alloalbuminemia is rare and has a cumulative frequency of only approximately 1 in 3,000 in Europeans and Japanese. The worldwide ethnic and geographic distribution of certain albumin genetic variants appears to be nonrandom. Moreover, we have found that structurally identical variants may occur at different frequencies in ethnically distinct populations, presumably owing to independent mutations. In this study, albumin B and two types of proalbumins, which as a group are the most common European albumin variants, have also been found in Asians. We have identified the amino acid substitution characteristic of albumin B (glutamic acid----lysine at position 570) in alloalbumins from six unrelated individuals of five different European descents and also in two Japanese and one Cambodian. The two types of proalbumins most common in Europe (Lille type, arginine----histidine at position -2; Christchurch type, arginine----glutamic acid at position -1) also occur in Japan. These results provide evidence for independent mutations at single sites in the albumin genome. The clustering of these and of several other amino acid exchanges in certain regions of the albumin molecule suggests two possibilities: that certain sites are hypermutable or that mutants involving certain sites are more subject to selection than mutants involving others.

Amino Acid Sequence↗
PubMed1989

Amino acid substitutions in albumin variants found in Brazil.

Conventional horizontal starch-gel electrophoresis in four buffer systems and structural studies were performed on four albumin variants, and the findings were compared with similar previous data. Albumins Coari I and Porto Alegre I have a previously unreported amino acid substitution (glutamic acid replaced by lysine at position 358, denoted 358 Glu----Lys). The alteration in albumin Porto Alegre II (501 Glu----Lys) is the same as that found for three alloalbumins of Asiatic origin, designated Vancouver, Birmingham, and Adana. Albumin Oriximiná I has the same exchange as albumin Maku (541 Lys----Glu). Some of these findings can be explained only by the occurrence of independent mutations at the same site in the albumin gene. They also point to a third cluster of mutations in that gene, indicating hypermutability in some of its segments.

Amino Acid Sequence↗
PubMed1988

The same substitution, glutamic acid----lysine at position 501, occurs in three alloalbumins of Asiatic origin: albumins Vancouver, Birmingham, and Adana.

A strategy is described for identifying structural changes in genetic variants of human serum albumin (alloalbumins). By use of this strategy we have determined an amino acid substitution in three alloalbumins of Asiatic origin. The same amino acid exchange, glutamic acid----lysine at position 501, occurs in albumins Vancouver and Birmingham, both from families that migrated from northern India, and also in albumin Adana from Turkey. This exchange corresponds to a single base mutation in the codon GAG to AAG and accords with the slow mobility of the three albumins at pH 8.6. Each of the three alloalbumins had been reported to be a new variant, yet they have the same substitution. These results emphasize the need for structural study of genetic variants that have been differentiated only by nonspecific physical criteria such as dye binding and electrophoretic mobility. We know of no other description of the substitution involved in an alloalbumin originating from the Indian subcontinent. However, the same change of glutamic acid----lysine at position 501 may be present in several other named variants reported for populations in north India and the surrounding regions.

Amino Acid Sequence↗
PubMed1988

Albumin Cooperstown: a serum albumin variant with the same (313 Lys----Asn) mutation found in albumins in Italy and New Zealand.

Albumin Cooperstown is an electrophoretically fast genetic variant (alloalbumin) inherited in a family in New York State. To determine the structural change, we separated the alloalbumin from normal albumin A by "high-performance" liquid chromatography, reduced and carboxymethylated it, and cleaved it with CNBr. Isoelectric focusing showed that the substitution was in fragment CB4 (residues 299 to 329). The variant CNBr fragment from the albumin of two siblings was purified by liquid chromatography. Automated sequence analysis established the substitution of lysine-313 by asparagine (313 Lys----Asn), which corresponds to mutation of a single nucleotide base. The same substitution has recently been reported in albumin variants in Italy and New Zealand. This provides the first evidence for independent mutations at a single site within the structure of the mature albumin molecule. Because of the significance of albumin for study of protein evolution, clinical chemists are asked to be on the alert for cases of bisalbuminemia.

Amino Acid Sequence↗