Clinical-Hematological Changes and Predictors of Severity in Acute Food Protein-Induced Enterocolitis Syndrome Reactions at Oral Food Challenge: A Multicenter Observational Study.

BACKGROUND: Oral food challenge (OFC) is the criterion standard for diagnosis of acute food protein-induced enterocolitis syndrome (FPIES). No diagnostic/prognostic biomarkers are available, and OFC assessment criteria are not validated. OBJECTIVE: To assess clinical-hematological changes and predictors of severity of FPIES reactions at OFC. METHODS: This was an observational multicenter prospective study. Children aged 0 to 18 years diagnosed with acute FPIES were recruited at follow-up OFC in 12 tertiary centers in Spain and Italy. OFC outcomes (as positive/negative/inconclusive and mild/moderate/severe) were assessed on the basis of published "2017 FPIES Consensus" criteria. Clinical characteristics were recorded, and full blood cell count was done at baseline, reaction onset, and 4 hours later. Regression analysis was performed to assess predictors of severe reactions at OFC. RESULTS: A total of 81 children had positive OFC (mild in 11% [9 of 81], moderate in 61% [49 of 81], and severe in 28% [23 of 81]). Increase in neutrophils and reduction in eosinophils, basophils, and lymphocytes were observed (P < .05). OFC was inconclusive in 19 cases despite objective signs or neutrophilia. Regression analysis showed that a 2-day OFC protocol where only 25% of an age-appropriate portion is given on day 1 (not sex, age, culprit food, cumulative dose, and previous reaction severity) was associated with reduced odds of severe reaction compared with giving multiple doses in a single day. CONCLUSIONS: Distinct hematological changes may help support FPIES diagnosis. Current OFC assessment criteria may not capture the broad spectrum of acute FPIES presentations. This 2-day protocol may be associated with a reduced risk of severe reactions. Future work should aim to develop safer OFC and non-OFC diagnostics for FPIES.

Co-factor-enhanced food allergy.

BACKGROUND: Alcohol, exercise or non-steroidal anti-inflamatory drugs (NSAID) are frequently mentioned as amplifiers of food allergic reactions but only individual cases or small series have been previously published. METHODS: Descriptive study including 74 cases of suspected co-factor enhanced food allergy, assessed by skin-prick tests, specific IgE and oral challenges. RESULTS: Anaphylaxis accounted for 85.1% of reactions. In 99% of cases culprit food allergens were plant-derived, mainly vegetables and cereals. NSAID were involved in 58%, exercise in 52.7% and alcohol in 12.2%. Lipid transfer protein was the most frequently involved allergen. CONCLUSIONS: Co-factor enhanced food allergy should be considered when assessing food, alcohol, exercise and NSAID allergic reactions.

Component-resolved diagnosis of dog allergy

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Efecto del entrenamiento en cinta rodante sobre la marcha y el riesgo de caída en personas adultas con parálisis cerebral / Effect of training on a treadmill on gait and risk of falls in adult persons with cerebral palsy cerebral

OBJETIVOS: El objetivo de este estudio fue determinar el efecto del entrenamiento en cinta rodante combinado con terapia convencional vs. terapia convencional en personas adultas con parálisis cerebral sobre la marcha, el equilibrio y el riesgo de caída. Material y métodos Estudio longitudinal prospectivo y controlado. Participan 11 personas adultas con parálisis cerebral, nivel Gross Motor Function Classification System i-iii , divididas en 2 grupos (n = 6 intervención y n = 5 control). El grupo intervención realiza entrenamiento en cinta rodante más la terapia convenida. El grupo control solo recibe la terapia convenida. Los efectos de esta intervención se determinaron mediante el Test Up and Go, el promedio de la frecuencia cardíaca, la velocidad de marcha y la distancia recorrida en cada sesión. Resultados Mejora estadísticamente significativa en el Test Up and Go, velocidad de marcha y distancia recorrida dentro del grupo intervención. Conclusiones El entrenamiento en cinta rodante combinado con la terapia convencional puede ser un tipo de intervención terapéutica beneficiosa para la mejora de la marcha y la disminución del riesgo de caída en personas adultas con parálisis cerebral

OBJECTIVE: This study has aimed to determine the effect of training on a treadmill combined with conventional therapy versus conventional therapy in adults with cerebral palsy on gait, balance and fall risk. MATERIAL AND METHODS: A prospective, controlled, longitudinal study that included 11 adults patients with cerebral palsy, gross motor functional classification system level i-iii was performed. They were divided into two groups: intervention group (n = 6) and control group (n = 5).The intervention group received treadmill training combined with agreed therapy while the control group only received agreed therapy. The effects of this treatment were determined by analyzing the results of the Test Up and Go, average heart rate, walking speed and distance covered in each session. RESULTS: The was a statistically significant improvement in the intervention group in the Test Up and Go, walking speed and distance covered. CONCLUSIONS: Treadmill training combined with conventional therapy could be a beneficial therapeutic tool to improve gait, balance and fall risk in adult's people with cerebral palsy