Efficacy of C1Inhibitor concentrate in hereditary angioedema with C1Inhibitor deficiency: analysis in the French Cohort

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Aude Belbézier, Isabelle Boccon-Gibod, Aurélie Du Thanh, Olivier Fain, Laurence Bouillet




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Successful desensitization in a pediatric patient with acetazolamide allergy

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Annette Carlisle, Joshua L. Kennedy, Sheva Chervinskiy, Stacie M. Jones, Robert D Pesek




https://ift.tt/2KC8Sb6

Chronic Tearing Induced by Apremilast

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Matthew R. Norris, Leonard Bielory




https://ift.tt/2NcOzCV

Specific-IgE to galactose-alpha-1,3-galactose (alpha-gal) has limited utility in diagnosing meat allergy in a tick-endemic population

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Dr Jamma Li, Mr Richard B. Fulton, RachelO'Connell, Dr Helena S. Jang, Prof. Suran L. Fernando




https://ift.tt/2ICNfG1

Health Literacy and Asthma Among Hispanic and African American Urban Adolescents with Undiagnosed Asthma

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Melissa A. Valerio, Maureen George, Jianfang Liu, Zainab T. Osakwe, Jean-Marie Bruzzese




https://ift.tt/2NfGs8D

Mechanisms of allergen-specific immunotherapy: diverse mechanisms of immune tolerance to allergens

Publication date: Available online 30 June 2018
Source:Annals of Allergy, Asthma & Immunology
Author(s): Anna Głobińska, Tadech Boonpiyathad, Pattraporn Satitsuksanoa, Mirelle Kleuskens, Willem van de Veen, Milena Sokołowska, Mübeccel Akdis




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Agenesis of dorsal pancreas associated with pancreatic neuroendocrine tumor: a case report and review of the literature

Agenesis of the dorsal pancreas is very rare. Less than 70 cases have been reported to date. Some of these cases had an association with a tumor. The literature of agenesis of the dorsal pancreas and agenesis ...

https://ift.tt/2IDGrbe

Novel vaccines: Technology and development

Publication date: Available online 30 June 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Sarita U. Patil, Wayne G. Shreffler
The development and widespread use of vaccines, which are defined by the World Health Organization as "biological preparations that improve immunity to a particular disease," represents one of the most significant strides in medicine. Vaccination was first applied to reduce mortality and morbidity from infectious diseases. The World Health Organization estimates that vaccines prevent 2 to 3 million human deaths annually, and these numbers would increase by at least 6 million if all children received the recommended vaccination schedule. However, the origins of allergen immunotherapy share the same intellectual paradigm, and subsequent innovations in vaccine technology have been applied beyond the prevention of infection, including in the treatment of cancer and allergic diseases. This review will focus on how new and more rational approaches to vaccine development use novel biotechnology, target new mechanisms, and shape the immune system response, with an emphasis on discoveries that have direct translational relevance to the treatment of allergic diseases.



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Oral corticosteroids in preschool children with severe episodes of virus-associated wheeze: to treat or not to treat?

Publication date: Available online 30 June 2018
Source:Journal of Allergy and Clinical Immunology
Author(s): Avraham Beigelman, Leonard B. Bacharier




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Survival impact and toxicity of metformin in head and neck cancer: An analysis of the SEER-Medicare dataset

Publication date: September 2018
Source:Oral Oncology, Volume 84
Author(s): William A. Stokes, Megan Eguchi, Arya Amini, Mohammad K. Hararah, Ding Ding, Jessica D. McDermott, Cathy J. Bradley, Sana D. Karam
ObjectivesRecent preclinical research has renewed interest in the interplay between glucose dysregulation and cancer. Metformin holds promise as an adjunctive antineoplastic agent in head and neck cancer (HNC). We aimed to explore the impact of metformin in HNC patients from a population-based dataset.Patients & MethodsPatients diagnosed with HNC from 2008 to 2011 were identified from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked dataset and categorized into three groups: non-diabetics (nD), diabetics not taking metformin (DnM), and diabetics taking metformin (D + M). Overall survival (OS) and cancer-specific survival (CSS) were compared between groups using Kaplan-Meier and Cox regression controlling for sociodemographic, clinical, and treatment covariates. The incidence of toxicities associated with HNC therapy was compared among groups using χ² analysis.ResultsAmong 1646 patients, there were 1144 nD, 378 DnM, and 124 D + M. 2-year OS rates was 65.6% for nD, 57.7% for DnM, and 73.4% for D + M by Kaplan-Meier (p < 0.01), and corresponding rates of 2-year CSS were 73.7%, 66.1%, and 88.8% (p < 0.01), respectively. On Cox multivariable analysis, OS among the three groups did not significantly differ; however, CSS was significantly worse among both nD versus DnM as compared to D + M. Toxicity rates were not significantly increased among D + M.ConclusionHNC patients with diabetes taking metformin experience improved CSS. Prospective investigation of the addition of metformin to standard-of-care HNC therapy is warranted.



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Oral tongue carcinoma among young patients: An analysis of risk factors and survival

Publication date: September 2018
Source:Oral Oncology, Volume 84
Author(s): Douglas R. Farquhar, April M. Tanner, Maheer M. Masood, Sagar R. Patel, Trevor G. Hackman, Andrew F. Olshan, Angela L. Mazul, Jose P. Zevallos
IntroductionThe incidence of oral tongue squamous cell carcinoma (OTSCC) in younger adults has rapidly increased over the past two decades. While tobacco and alcohol use may be less likely to cause these tumors, it remains controversial whether differences also exist in their prognosis. Our aim is to examine the risk factors for cancer among young (<45 years old) OTSCC patients at our institution, and to compare their recurrence and survival with older patients in a matched cohort.Materials and methodsAll OTSCC patients seen at our institution between 2000 and 2015 were reviewed. Patients under 45 who with sufficient treatment information were matched 1:1 on race, T-stage, and N-stage with patients 45 and older. Three-year recurrence and survival were determined in stratified and adjusted Cox regression models.ResultsOf 397 OTSCC patients were seen at our institution, 117 (29%) were less than 45 years old. Younger patients were significantly more likely to be female, (50% vs. 39%; p = 0.04) and to abstain from tobacco (51% vs. 39%; p < 0.01). Young patients in the matched cohort were significantly more likely to have a recurrence (HR 3.9 95% CI 1.4–10.5). There was no difference in overall survival.ConclusionYounger OTSCC patients in a matched cohort were more likely to recur within 3 years, although there was no difference in overall mortality. Differences in risk factors and recurrence between older and younger patients suggest that some cancer among younger patients may be distinct from traditional OTSCC.



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Exposure to air pollution and risk of prevalence of childhood allergic rhinitis: A meta-analysis

Publication date: September 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 112
Author(s): Qi-Yuan Zou, Yang Shen, Xia Ke, Su-Ling Hong, Hou-Yong Kang
ObjectivesAllergic rhinitis (AR), a common chronic inflammatory disease in the upper airways. The prevalence of AR in children seems to be increasing recently, and the most significant causes of the increase are thought to be changes in environmental factors, especially air pollution. However, we could not find any meta-analysis on the risk of air pollution exposure on the prevalence of AR in childhood. The aim of this research was to carry out a meta-analysis on the results of recent studies (21 s t century) to present valid information about exposure to air pollution and risk of prevalence of childhood AR.MethodsPubMed, Science, Google Scholar, Elsevier and MDPI web database were searched up to January 1, 2000 to February 28, 2018. Including of air pollution and AR in childhood related to the observation of literature. Meta-analysis, study quality assessment, heterogeneity analysis and publication bias test were using Stata-MP 14.1 and Review Manager version 5.3 software.Results13 studies will be included in the meta-analysis (8 cross-sectional studies, 5 cohort studies). Exposure to NO2 (OREurope = 1.031, 95%CI [1.002,1.060], P = 0.033; ORAsia = 1.236, 95%CI [1.099,1.390], P = 0.000; ORoverall = 1.138, 95%CI [1.052,1.231], P = 0.001); Exposure to SO2 (OREurope = 1.148, 95%CI [1.030,1.279], P = 0.012; ORAsia = 1.044, 95%CI [0.954,1.142], P = 0.352; ORoverall = 1.085, 95%CI [1.013,1.163], P = 0.020); Exposure to PM10 (OREurope = 1.190, 95%CI [1.092,1.297], P = 0.000; ORAsia = 1.075, 95%CI [0.995,1.161], P = 0.066; ORoverall = 1.125, 95%CI [1.062,1.191], P = 0.000); Exposure to PM2.5 (OREurope = 1.195, 95%CI [1.050,1.360], P = 0.007; ORAsia = 1.163, 95%CI [1.074,1.260], P = 0.000; ORoverall = 1.172, 95%CI [1.095,1.254], P = 0.000).ConclusionsExposed to air pollution probable is a risk of prevalence of childhood AR. And the prevalence of AR will be increase when exposed to NO2, SO2, PM10 and PM2.5, but maybe the relationship between SO2/PM10 and prevalence of AR are not closely in Asia.



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Comparison of click auditory brainstem response and chirp auditory steady-state response thresholds in children

Publication date: September 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 112
Author(s): Konstantinos Mourtzouchos, Maria Riga, Mario Cebulla, Vasilios Danielides, Stefanos Naxakis
ObjectivesDuring the last twenty years, auditory steady-state responses (ASSRs) are being used as an alternative and adjunct to the auditory brainstem response (ABR) for threshold estimation. This study aims at comparing and finding correlations between air-conduction thresholds using the traditional click ABR and the relatively recently used chirp ASSR test methods, for a large pediatric population.MethodsOne hundred and thirty children referred to our Clinic from Hospitals and Clinics of Western Greece ranging in age from 5 to 79 months (mean age = 32.7 ± 14.0 months) participated prospectively.ResultsStrong and statistically significant correlations were found between the average of the 1000, 2000 and 4000 Hz chirp ASSR thresholds and click ABR thresholds (rs = .826, p < .001), and the average of the 2000 and 4000 Hz chirp ASSR and click ABR thresholds (rs = .824, p < .001). Additionally, there have been measurements for some children with hearing loss in the severe-to-profound range during the ASSR test, but no ABR at the upper limits of the equipment. Click ABR and chirp ASSR thresholds averaged at 2000 and 4000 Hz were within 20 dB in 90% of the ears tested.ConclusionsThe results of this study support the inclusion of chirp ASSRs into the pediatric test battery and indicate that they may provide an essential adjunct to the click ABR, especially in the management of very young children with severe-to-profound hearing loss.



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Transcanal incision and drainage of a parapharyngeal abscess in a pediatric patient: A novel technique

Publication date: September 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 112
Author(s): Tyler R. Schwartz, Miranda D. Colletta, Michael E. McCormick
The disease of parapharyngeal abscess is well known to the otolaryngologist and is commonly managed via transoral, transcervical, or combined incision and drainage. We report a novel approach to an abscess that was drained through the external auditory canal (EAC). An otherwise healthy 2-year-old female presented with a 4-day history of fevers, decreased oral intake, neck stiffness, and voice changes. CT neck with contrast revealed a deep abscess in the left neck extending from the peritonsillar space into the parapharyngeal space in close proximity to the anterior aspect of the EAC. Because the EAC was the closest surface to the abscess collection, we elected to attempt drainage through this route. Successful incision and drainage was performed via transcanal approach. She received intravenous antibiotics and steroids post-operatively and surgical packing was removed. She was discharged home on post-operative day 5 afebrile and tolerating a regular diet and continued to do well at most recent outpatient follow-up.



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Evaluation of clinical approaches and physician adherence to guidelines for otitis media with effusion

Publication date: September 2018
Source:International Journal of Pediatric Otorhinolaryngology, Volume 112
Author(s): Nisa Eda Cullas Ilarslan, Fatih Gunay, Seda Topcu, Ergin Ciftci
ObjectivesOtitis media with effusion (OME) is an important clinical entity because of its high prevalence, difficulties in diagnosis, complications and diversities in management. Herein, we aimed to evaluate current physician approaches on OME and determine clinical adherence to current guidelines.Methods and materialsA total of 370 physicians [Group 1: pediatricians (n = 256, 69.2%), Group 2: otorhinolarynologists (n = 114, 30.8%)] completed a survey instrument addressing demographic data and clinical practice parameters on OME in children. We also compared clinical approaches of Group 1 and Group 2. In addition, multiple logistic regression analysis was performed to evaluate factors which may effect correct approaches.ResultsThe mean period of clinical experience was 9.30 ± 8.35 [median 6 (1–40)] years. A total of 311 (84%) respondents reported satisfactory level of self-confidence as regards of clinical approaches to OME. Reduced mobility of the tympanic membrane and preference of pneumatic otoscopy was signified by 107 (28.9%) and 64 (17.3%) respondents, respectively. Fifty-six (15.1%) physicians identified "watchful waiting" for 3 months for children who are not at risk while 314 (84.9%) reported preference of medications, with antibiotics the most preferred prescription (n = 223, 63%). Comparison of Group 1 and Group 2 indicated similar results except better, yet insufficient, characterization of physical examination findings of OME by Group 2 (p < 0.001, for each parameter). Group 2 preferred tympanometry more in uncertain cases (p < 0.001) and handled chronic cases better (p < 0.001). Multiple logistic regression analysis revealed lower signification of reduced mobility of the tympanic membrane for respondents who denoted depending on personal experience ([OR] = 3.077 [95% CI 1.042–9.09]) or following clinical guidelines ([OR] = 3.365 [95% CI 1.38–8.20]) rather than combining them both. Rate of antibiotic avoidance was lowest in physicians with a period of clinical experience<5 years ([OR] = 2.14 [95% CI 1.32–3.48]).ConclusionsDespite notifying high self-confidence and adherence to current guidelines on OME, both pediatricians and otorhinolaryngologists lacked to exhibit proper approaches. Further research is warranted to evaluate the causes of poor adherence to current guidelines and bring suggestions for the maintenance of consistent and correct clinical approaches to OME.



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