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Journal: Allergy

139

Food allergy is a growing global health issue that affects daily life and food purchasing habits. Quality data on the global consumer perspective of food allergy is limited, particularly about thresholds and food labeling risk. Many individuals with food allergy are counseled that small amounts of allergen can potentially cause life-threatening reactions, and to avoid foods with Precautionary Advisory Labeling (PAL). The purpose of this study was to understand attitudes of consumers about food allergy thresholds and food purchasing habits related to PAL in sixteen countries.

Concepts: Asthma, Allergy, Food, Food allergy, Metaphysics, Eczema, Personal life, Maslow's hierarchy of needs

28

Hereditary angioedema (HAE) is a disease characterized by recurrent tissue swelling affecting various body locations. Recent literature shows that patients with frequent attacks may benefit from long-term prophylaxis. This study evaluated the safety and prophylactic effect of weekly administrations of recombinant C1INH (rhC1INH).

Concepts: Angioedema, Hereditary angioedema, C1-inhibitor

28

The pentavalent antimonials are considered the first-choice drugs for treatment of leishmaniasis. Intralesional therapy is used to minimize the systemic effects of the drug.

Concepts: Leishmaniasis, Cutaneous leishmaniasis, Meglumine antimoniate, Pentavalent antimonial

27

Intramuscular epinephrine is the gold standard treatment for anaphylaxis. Intramuscular injection provides more rapid and higher plasma concentrations than subcutaneous routes. Given the increasing epidemic of obesity patients are at increased risk of subcutaneous delivery, we therefore assessed the depth of subcutaneous tissue in a population of patients with anaphlaxis. Patients already prescribed epinephrine autoinjectors (EAIs) for anaphylaxis were examined with ultrasound and measurements of skin-to-muscle depth (STMD) at anterolateral thigh and anterior thigh were performed. 28 patients (23 female, 5 male) with an age range of 18-75 took part in the study and in 68% the STMD was greater than EAI needle length (15.02mm) using the anterolateral thigh, the recommended administration site. The key predictors for increased STMD were female gender (p 0.0003) and a BMI > 30 (p 0.04). EAIs require longer needles to ensure intramuscular administration and ultrasound at point of prescription would aid needle length selection. This article is protected by copyright. All rights reserved.

Concepts: Male, Gender, Epinephrine, Route of administration, All rights reserved, Anaphylaxis, Copyright, Hypodermic needle

27

Metabolomic profiling of exhaled breath condensate offers opportunities for the development of noninvasive diagnostics in asthma. We aimed to determine and validate discriminatory metabolomic profiles in adult asthma and to explore profiles in clinically relevant disease phenotypes.

Concepts: Medical terms, Spin, Nuclear magnetic resonance, Magnetic resonance imaging, In vivo magnetic resonance spectroscopy, Resonance

27

BACKGROUND: Reasons for asthma hospitalizations are dynamic and complex. Comorbid conditions are important contributors to most chronic diseases today. We aim to characterize and describe risk factors associated with hospitalizations due to asthma in the Languedoc-Roussillon region (France) in 2009. METHODS: Programme de Médicalisation des Systèmes d'Information (PMSI) data records from 2009 were sorted using selected International Classification of Diseases (ICD10) codes eliciting three groups of asthma hospitalizations according to acute severity. All available data including demographics, comorbid conditions, past hospitalizations either related or unrelated to asthma, seasonality and distance to medical facilities were used to compare the subjects within the three groups. RESULTS: One thousand two hundred and eighty-nine hospitalizations due to asthma exacerbation were found, concerning 1122 patients. We observed significant differences within the groups, using univariate analysis, concerning duration of hospitalizations (mean ± SD, 4.9 ± 5.9 days vs 6.4 ± 6.8 vs 15.8 ± 16.8, P < 0.001), deaths (percentage, 0.03% vs 1.50% vs 9.20%, P < 0.001) and numbers of comorbid conditions (0.80 ± 0.95 vs 0.75 ± 0.97 vs 1.74 ± 1.36, P < 0.001). Recurrent admissions for asthma during the period 2006-2008 were significantly more frequent in the more severe group (1.93 ± 3.91 vs 2.56 ± 4.47 vs 2.81 ± 3.97, P = 0.006). In the multivariate model, age and number of comorbid conditions were independently associated with severe hospitalizations and deaths. CONCLUSIONS: Asthma hospitalizations can be appropriately assessed using PMSI coding databases. In this study, age and the presence of comorbid conditions are the major risk factors for asthma hospitalizations and deaths.

Concepts: Asthma, Chronic, 1000, Univariate, Acute, Languedoc wine, Languedoc-Roussillon, Pyrénées-Orientales

26

IgE sensitization tests, such as skin prick testing and serum specific IgE, have been used to diagnose IgE-mediated clinical allergy for many years. Their prime drawback is that they detect sensitization which is only loosely related to clinical allergy. Many patients therefore require provocation tests to make a definitive diagnosis; these are often expensive and potentially associated with severe reactions. The likelihood of clinical allergy can be semi-quantified from an IgE sensitization test results. This relationship varies though according to the patients' age, ethnicity, nature of the putative allergic reaction and co-existing clinical diseases such as eczema. The likelihood of clinical allergy can be more precisely estimated from an IgE sensitization test result, by taking into account the patient’s presenting features (pre-test probability). The presence of each of these patient specific factors may mean that a patient is more or less likely to have clinically allergy with a given test result (post-test probability). We present two approaches to including pre-test probabilities in the interpretation of results. These approaches are currently limited by a lack of data to allow us to derive pre-test probabilities for diverse setting, regions and allergens. Also, co-factors, such as exercise, may be necessary for exposure to an allergen to result in an allergic reaction in specific IgE positive patients. The diagnosis of IgE-mediated allergy is now being aided by the introduction of allergen component testing which may identify clinically relevant sensitization. Other approaches are in development with basophil activation testing being closest to clinical application. This article is protected by copyright. All rights reserved.

Concepts: Immune system, Asthma, Immunology, Allergy, Atopy, Food allergy, Eczema, Allergen immunotherapy

26

Google Trends is a web-based surveillance tool used to explore the searching trends of specific queries on Google. Recent studies have suggested the utility of Google Trends in predicting outbreaks of influenza and other diseases. However, this utility has not been thoroughly evaluated for allergic diseases. Therefore, we investigated the utility of Google Trends for predicting the epidemiology of allergic rhinitis. In the US, Google Trends for allergic rhinitis showed repetitive seasonality that peaked in late April and early May and then rapidly decreased, and a second small peak occurred in September. These trends are highly correlated with the searching trends for other queries such as ‘pollen count’, antihistamines such as loratadine and cetirizine (all r > 0.88 and all P < 0.001), and even the total pollen count collected from 21 pollen counters across the US (r = 0.928, P < 0.001). Google Trends for allergic rhinitis was similar to the monthly changes in rhinitis symptoms according to the US National Health and Nutrition Examination Survey III, sales for Claritin(®) and all over-the-counter antihistamines, and the number of monthly page views of 'claritin. com'. In conclusion, Google Trends closely reflects the real world epidemiology of allergic rhinitis in the US and could potentially be used as a monitoring tool for allergic rhinitis. This article is protected by copyright. All rights reserved.

Concepts: Asthma, Allergy, Over-the-counter drug, World Wide Web, Pollen, All rights reserved, Rhinitis, Copyright

25

Allergen immunotherapy is a treatment modality which can be applied using different vaccines. The aim of this study was to quantify and compare the allergen content of different house dust mites' sublingual treatments and to review the evidence on their efficacy.

Concepts: Immune system, Asthma, Immunology, Allergen immunotherapy, Mite, House dust mite, House, Dust

25

Evidence regarding drug provocation test (DPT) with antineoplastic and biological agents is scarce. Our aim is to assess the usefulness of including DPT as a paramount Gold Standard diagnostic tool (prior to desensitization).

Concepts: Greek loanwords