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To evaluate cultural differences in sociodemographic factors, illness severity and parents' perception of their adolescent's quality of life for Icelandic and USA families of adolescents with asthma; and to determine predictors of parent-rated quality of life.Asthma is known to have an impact on the quality of life of affected adolescents and their families, but few studies have addressed parents' perception of their adolescent's health-related quality of life.Cross-sectional exploratory study.The study involved families of adolescents with asthma included 15 from Iceland and 15 from USA, recruited from paediatric practices. Parent and adolescent participants completed questionnaires; this study is based on the parent responses. Data were collected from January-May 2006.While parents from Iceland and USA were similar in demographic characteristics, parents from Iceland rated their children's health-related quality of life (PedsQL(TM) 3.0, Varni 1998) more positively than did USA parents, even though Icelandic parents were more likely than their USA counterparts to report that their adolescent's asthma is severe. Significant predictors of parent-rated quality of life included location (higher scores for Icelandic parents), gender (higher scores for parents of boys), exposure to second hand smoke in the home (higher scores for those not exposed) and frequency of troublesome wheezing (higher scores for lower frequency).Quality of life has been acknowledged as an essential health outcome measure. Even though gender difference was not found in asthma severity, parents of boys perceived their adolescent's quality of life as more positive compared with parents of girls. It might be helpful for Icelandic and USA families to integrate into care delivery models, cultural differences in parent-rated quality of life.Asthma management interventions may improve quality of life for adolescents with asthma by reducing symptoms. Interventions promoting smoke-free homes and enhanced self-monitoring to prevent exacerbations may improve quality of life.

The purpose of this research was to characterize CYP2D6, GST-M1 and GST-T1 enzyme expression in human parathyroid tissue, and to determine whether or not there is any association between deficiencies in these enzymes and serum parathyroid hormone concentrations in patients with end-stage renal disease.Surgical human parathyroid tissue was obtained and evaluated by immunohistochemistry for cellular localization of CYP2D6, GST-M1 and GST-T1 and colocalization of CYP2D6 with parathyroid hormone. Blood samples were collected from 328 Caucasian patients with end-stage renal disease for genetic testing of CYP2D6*3, *4, *5, *6, *7 and GST-M1*0 and GST-T1*0 alleles. Clinical chemistry data and serum intact parathyroid hormone (iPTH) concentrations were obtained from patient medical records. In 277 of the patients, the same laboratory performed all clinical tests.CYP2D6, GST-M1 and GST-T1 were present in human parathyroid tissue. CYP2D6 was colocalized with parathyroid hormone in parathyroid chief cells. Within the end-stage renal disease population, a nonfunctional CYP2D6 genotype was present in 18.2%[95% confidence interval (CI) 8.0, 28.4] of patients in the 1st iPTH concentration quintile (iPTH64 pg x mL(-1)), in 0% (95% CI 0, 7.5) of those in the 2nd quintile, in 1.8% (95% CI 0, 9.3) of those in the 3rd quintile, in 9.1% (95% CI 1.5, 16.7) of those in the 4th quintile, and in 16.7% (95% CI 6.8, 26.5) of those in the 5th quintile (iPTH347 pg x mL(-1)) (P = 0.001). Out of 12 CYP2D6-deficient females, seven were in the 1st iPTH concentration quintile and the remaining five were in the 5th quintile. Patients deficient in the GST-M1 and GST-T1 enzymes displayed a far more uniform frequency distribution relative to serum iPTH concentrations.The presence of CYP2D6, GST-M1 and GST-T1 in parathyroid cells was observed. An association is reported between a lack of CYP2D6 and iPTH concentrations in newly diagnosed end-stage renal disease patients. Gender and concomitant deficiency in GST-M1 and/or GST-T1 appear to define this association further. It remains to be established whether these associations reflect a cause-effect relationship between deficient expression of metabolizing enzymes and severity of secondary manifestation of renal failure.