Serum microRNAs Catalog Asthma Patients by Phenotype.

BACKGROUND AND OBJECTIVES: Asthma is a chronic inflammatory condition of the airways with a complex pathophysiology. Stratification of asthma subtypes into phenotypes and endotypes should move the field forward, making treatment more effective and personalized. Eosinophils are the key inflammatory cells involved in severe eosinophilic asthma. Given the health threat posed by eosinophilic asthma, there is a need for reliable biomarkers to identify affected patients and treat them properly with novel biologics. microRNAs (miRNAs) are a promising diagnostic tool. The aim of this study was to identify serum miRNAs that can phenotype asthma patients. METHODS: Serum miRNAs of patients with eosinophilic asthma (N=40) and patients with noneosinophilic asthma (N=36) were evaluated using next-generation sequencing, specifically miRNAs-seq, and selected miRNAs were validated using RT-qPCR. Pathway enrichment analysis of deregulated miRNAs was performed. RESULTS: Next-generation sequencing revealed 15 miRNAs that were expressed differentially between eosinophilic and noneosinophilic asthma patients, although no differences were observed in the miRNome between atopic and nonatopic asthma patients. Of the 15 miRNAs expressed differentially between eosinophilic and noneosinophilic asthma patients, hsa-miR-26a-1-3p and hsa-miR-376a-3p were validated by RT-qPCR. Expression levels of these 2 miRNAs were higher in eosinophilic than in noneosinophilic asthma patients. Furthermore, expression values of hsa-miR-26a-1-3p correlated inversely with peripheral blood eosinophil count, and hsa-miR-376a-3p expression values correlated with FeNO values and the number of exacerbations. Additionally, in silico pathway enrichment analysis revealed that these 2 miRNAs regulate signaling pathways associated with the pathogenesis of asthma. CONCLUSIONS: hsa-miR-26a-1-3p and hsa-miR-376a-3p could be used to differentiate between eosinophilic and noneosinophilic asthma.

Eosinophil Response Against Classical and Emerging Respiratory Viruses: COVID-19.

Eosinophils were discovered more than 140 years ago. These polymorphonuclear leukocytes have a very active metabolism and contain numerous intracellular secretory granules that enable multiple effects on both health and disease status. Classically, eosinophils have been considered important immune cells in the pathogenesis of inflammatory processes (eg, parasitic helminth infections) and allergic or pulmonary diseases (eg, asthma) and are always associated with a type 2 immune response. Furthermore, in recent years, eosinophils have been linked to the immune response by conferring host protection against fungi, bacteria, and viruses, which they recognize through several molecules, such as toll-like receptors and the retinoic acid-inducible gene 1-like receptor. The immune protection provided by eosinophils is exerted through multiple mechanisms and properties. Eosinophils contain numerous cytoplasmatic granules that release cationic proteins, cytokines, chemokines, and other molecules, all of which contribute to their functioning. In addition to the competence of eosinophils as effector cells, their capabilities as antigen-presenting cells enable them to act in multiple situations, thus promoting diverse aspects of the immune response. This review summarizes various aspects of eosinophil biology, with emphasis on the mechanisms used and roles played by eosinophils in host defence against viral infections and response to vaccines. The review focuses on respiratory viruses, such as the new coronavirus, SARS-CoV-2.

Eosinophil-derived exosomes contribute to asthma remodelling by activating structural lung cells.

BACKGROUND: Eosinophils, a central factor in asthma pathogenesis, have the ability to secrete exosomes. However, the precise role played by exosomes in the biological processes leading up to asthma has not been fully defined. OBJECTIVE: We hypothesized that exosomes released by eosinophils contribute to asthma pathogenesis by activating structural lung cells. METHODS: Eosinophils from asthmatic patients and healthy volunteers were purified from peripheral blood, and exosomes were isolated from eosinophils of asthmatic and healthy individuals. All experiments were performed with eosinophil-derived exosomes from healthy and asthmatic subjects. Epithelial damage was evaluated using primary small airway epithelial cell lines through 2 types of apoptosis assays, that is, flow cytometry and TUNEL assay with confocal microscopy. Additionally, the epithelial repair was analysed by performing wound healing assays with epithelial cells. Functional studies such as proliferation and inhibition-proliferation assays were carried out in primary bronchial smooth muscle cell lines. Also, gene expression analysis of pro-inflammatory molecules was evaluated by real-time PCR on epithelial and muscle cells. Lastly, protein expression of epithelial and muscle cell signalling factors was estimated by Western blot. RESULTS: Asthmatic eosinophil-derived exosomes induced an increase in epithelial cell apoptosis at 24 hour and 48 hour, impeding wound closure. In addition, muscle cell proliferation was increased at 72 hours after exosome addition and was linked with higher phosphorylation of ERK1/2. We also found higher expression of several genes when both cell types were cultured in the presence of exosomes from asthmatics: CCR3 and VEGFA in muscle cells, and CCL26, TNF and POSTN in epithelial cells. Healthy eosinophil-derived exosomes did not exert any effect over these cell types. CONCLUSIONS AND CLINICAL RELEVANCE: Eosinophil-derived exosomes from asthmatic patients participate actively in the development of the pathological features of asthma via structural lung cells.

Eosinophils: Old Players in a New Game.

Eosinophils are terminal polymorphonuclear cells with a high number of cytoplasmic granules that originate in bone marrow. Some are exosomes, which contain multiple molecules, such as specific eosinophilic proteins, cytokines, chemokines, enzymes, and lipid mediators that contribute to the effector role of these cells. Moreover, exosomes present a large number of receptors that allow them to interact with multiple cell types. Eosinophils play an important role in defense against infestations and are a key element in asthma and allergic diseases. Eosinophils are recruited to the inflamed area in response to stimuli, modulating the immune response through the release to the extracellular medium of their granule-derived content. Various mechanisms of degranulation have been identified. Polymorphonuclear leukocytes contain multivesicular bodies that generate exosomes that are secreted into the extracellular environment. Eosinophilic exosomes participate in multiple processes and mechanisms. Eosinophils participate actively in asthma and are hallmarks of the disease. The cells migrate to the inflammatory focus and contribute to epithelial damage and airway remodeling. Given their relevance in this pathology, new therapeutic tools have been developed that target mainly eosinophils and their receptors. In this manuscript, we provide a global, updated vision of the biology of eosinophils and the role of eosinophils in respiratory diseases, particularly asthma. We also summarize asthma treatments linked to eosinophils and new therapeutic strategies based on biological products in which eosinophils and their receptors are the main targets.

[Clinical assessment of fecal incontinence in patients with anorectal malformation surgery]. / Valoración clínica de la incontinencia fecal en pacientes intervenidos de malformación anorrectal.

BACKGROUND/PURPOSE: To review our management of anorectal malformations (ARM) and to compare two quantitative scales for clinical assessment of fecal incontinence. MATERIAL AND METHODS: We reviewed all patients with ARM surgery who are currently 3 to 15 years old. Several variables were collected and fecal incontinence was evaluated using two scales: the Holschneider scale and one used previously in our Service, both were filled out through clinical interview. RESULTS: 48 patients were studied, 29 males and 19 females. According to the Peña's classification, 81% had good prognosis indicators (group A) and 19% had bad prognosis indicators (group B). Posterior sagittal anorectoplasty (PSARP) was performed in 32 patients, PSARP and abdominal approach in 3, abdomino-perineal pullthrough in 2, and a "Cut-back" anoplasty in 14 patients. There were not statistical significative differences in average age of continence between both groups. We found no significative differences on the average score of fecal incontinence between both groups using our scale (17.57/20 in group A vs 14/20 in group B; p= 0.05) but it was significantly lower in group B using the Holschneider scale (12.39/14 in group A vs 10.43/14; p= 0.04). Constipation was detected in 16 patients, half of whom had overflow pseudoincontinence. CONCLUSIONS: Our scale penalizes constipation, for this reason the average score of group A was lower and we didn't find differences with respect to group B, contrary to what it happened using Holschneider's scale, so we believe our scale could be more precise to evaluate fecal incontinence of these patients.

OBJETIVOS: Aportar nuestra experiencia en el manejo de las malformaciones anorrectales (MAR) y comparar dos escalas cuantitativas para la valoración clínica de la incontinencia fecal. MATERIAL Y METODOS: Revisamos los pacientes intervenidos de MAR con edades comprendidas entre los 3 y 15 años. Recogimos una serie de variables y evaluamos la incontinencia fecal mediante dos escalas: la de Holschneider y una utilizada previamente en nuestro Servicio, cuyos ítems se completaron mediante entrevista clínica. RESULTADOS: Estudiamos 48 pacientes, 29 niños y 19 niñas. El 81% presentaba factores de buen pronóstico (grupo A) y el 19% de mal pronóstico (grupo B) según la clasificación de Peña. El tratamiento realizado fue la anorrectoplastia sagital posterior (ARPSP) en 32 pacientes, ARPSP más descenso vía abdominal en 3, descenso abdominal en 2 y anoplastia tipo "Cut-Back" en 14. No existieron diferencias significativas en la edad media de continencia (3,41 ± 1,80 años en grupo A vs 3,92 ± 1,07 en grupo B; p= 0,35). No encontramos diferencias significativas en la media de puntuación de incontinencia utilizando nuestra escala (17,57/20 en grupo A vs 14/20 en grupo B; p= 0,05), pero fue significativamente menor en el grupo B utilizando la de Holschneider (12,39/14 en grupo A vs 10,43/14 en grupo B; p= 0,04). En 16 pacientes se detectó estreñimiento; de ellos, la mitad presentó pérdidas por rebosamiento. CONCLUSIONES: Nuestra escala penaliza el estreñimiento, por este motivo la puntuación media del grupo A fue menor y no se encontraron diferencias respecto al grupo B, contrariamente a lo ocurrido con la escala de Holschneider, por lo que podría resultar más precisa para valorar la incontinencia fecal de estos pacientes.

[Efficacy of the retroperitoneal-assisted laparoscopic pyeloplasty versus the mini posterior lumbotomy approach]. / Eficacia de la pieloplastia asistida por retroperitoneoscopia versus a la realizada por minilumbotomía posterior.

OBJECTIVE: To evaluate the results of the retroperitoneal-assisted laparoscopic pyeloplasty (RALP) versus the mini posterior lumbotomy pyeloplasty (MPLP). MATERIAL AND METHODS: A retrospective study of 77 patients diagnosed with ureteropelvic junction obstruction between 2007 and 2013 was made, analyzing the surgical technique, complications and results. The anteroposterior pelvic diameter of the kidney, the thickness of the renal parenchyma, the renal function and the morphology of the renogram curve were also evaluated and compared. RESULTS: We performed 50 RALP and 21 MPLP. Median age of intervention: 10.85 moths (ICR 86.8) in RALP and 23.30 moths (ICR 54.7) in MPLP. No significant differences were found in surgical time (p>0.05). Double J was left in 90% of the RALP and 52.4% of the MPLP. Median length of incision was 1.5 cm of the RALP and 3.0cm in MPLP(p<0.05). The Median hospital stay was 2.0 days and 3.0 respectively (p<0.05). We found surgical complications (restenosis and urinoma) in 9 patients of the RALP group and 1 in the mini lumbotomy group (p>0,05). The follow-up was performed using ultrasound in an average of 68,04 months of age (range 7.5-186.5) and diuretic renogram in an average of 50,25 months of age (range 6,6-173,8). The above parameters showed improvements in both groups of patients without significant differences. CONCLUSIONS: In our experience, the RALP is a technique with a greater rate of complications than the expected. Moreover, the MPLP, is a technique we consider safe and with adequate aesthetic and functional results.

OBJETIVO: Evaluar la pieloplastia asistida por retroperitoneoscopia, exteriorizando la unión pieloureteral (PAR) versus la pieloplastia por minilumbotomía posterior en ángulo costovertebral (PMLP). MATERIAL Y METODOS: Estudio retrospectivo de 77 pacientes diagnosticados de estenosis pieloureteral (2007-2013), se analizaron técnica, complicaciones y resultados, mediante la valoración del diámetro anteroposterior de la pelvis renal, grosor del parénquima renal, función renal y morfología de la curva del renograma. RESULTADOS: Realizamos 50 PAR y 21 PMLP. Edad mediana de intervención: 10,85 meses [rango intercuartílico (IC) 86,8] en PAR y 23,3 meses (rango IC 54,7) en PMLP. No hubo diferencias significativas en tiempo quirúrgico. Se dejó doble J en 90% de las PAR y en 52,4% de las PMLP. La incisión fue 1,5 cm en la PAR y 3,0 cm de mediana (rango IC 1,0) en la PMLP (p<0,05). La mediana de estancia fue 2,0 días y 3,0 respectivamente (p<0,05). Encontramos complicaciones (reestenosis y urinomas) en 9 pacientes del grupo PAR y en uno en el grupo de minilumbotomía (p>0,05). El seguimiento mediante ecografía en una media de 68,04 meses de edad (rango 7,5-186,5) y renograma diurético en una media de 50,25 meses de edad (rango 6,6-173,8), evidenciaron mejora en los parámetros arriba señalados en ambos grupos de pacientes, sin diferencias significativas. CONCLUSIONES: En nuestra serie, la PAR es un abordaje con un índice de complicaciones mayor al esperado. Por otra parte, la PMLP es un abordaje seguro y con resultados estéticos y funcionales adecuados.

[Endocrine disrupting chemicals exposure and other parental factors in hypospadias and cryptorchidism etiology]. / Exposición a disruptores endocrinos y otros factores paternos en la etiología del hipospadias y la criptorquidia.

AIM OF THE STUDY: To investigate the association between endocrine disrupting chemicals (EDC) exposure and other paternal factors in the etiology of hipospadias and cryptorchidism. METHODS: A case-control study. Cases were infants between 0 and 6 years of age diagnosed with hypospadias or cryptorchidism in our pediatric urology and general pediatric surgery services during a period of 6 months, and controls were infants with the same range of age attending the same services without any urological problem. Several variables were collected by face-to-face interviews with both parents. After data abstraction, we compared the characteristics of both groups using parametric statistical tests. MAIN RESULTS: A total of 180 patients were studied, 90 cases (45 hypospadias/45 cryptorchidism) and 90 controls with a mean age of 2,37 ± 1.50 years [range 0,5-6]. Median of mother´s age was significantly greater in case group (34,40 ± 5,64 versus 31,74 ± 5,05; p= 0,001). Significant differences were observed between cases and controls in regard to maternal occupational exposure to EDC (mainly phthalates), adjusted Odds ratio (OR) was 3.67 [95% confidence interval (CI): 1.28-10.51; p= 0,018] and regarding the paternal occupational exposure to EDC (mainly pesticides and herbicides), adjusted OR was 6.65 [95% CI: 2.60-17.02; p= 0,001]. Increased risk was also observed in smoking fathers and fathers who drink alcohol, adjusted Odds ratio were 2.36 [95% CI: 1.11. CONCLUSIONS: This study represents a little contribution to the possible etiologic factors of hypospadias and cryptorchidism, further studies with higher statistical power would be needed to prove it.

OBJETIVOS: Investigar la asociación entre la exposición a disruptores endocrinos (DE) y otros factores en el desarrollo del hipospadias y la criptorquidia. MATERIAL Y METODS: Estudio de casos y controles. Consideramos como casos a los niños de entre 6 meses y 6 años de edad diagnosticados de hipospadias y/o criptorquidia que acudieron a las consultas de Urología/Cirugía durante un período de estudio de 6 meses y como controles, a los niños con mismo rango de edad que acudieron a las mismas consultas con otros diagnósticos. Recogimos las variables de interés mediante una encuesta epidemiológica y comparamos los resultados obtenidos en cada grupo mediante tests estadísticos paramétricos. RESULTADOS: Estudiamos 180 pacientes, 90 casos (45 hipospadias/45 criptorquidias) y 90 controles, con edad media de 2,60 ± 1,72 años [rango 0,5-6]. Las medias de edad gestacional y peso al nacer fueron menores en el grupo-caso sin objetivarse diferencias significativas. La edad media materna fue significativamente mayor en el grupo-caso (34,40 ± 5,64 versus 31,74 ± 5,05; p= 0,001). Encontramos asociación significativa entre la exposición ocupacional materna a DE (ftalatos principalmente) y el grupo-caso siendo la Odds ratio (OR) de 3,67 (IC 95%: 1,28-10,51; p= 0,018) y también en la paterna (principalmente a pesticidas/herbicidas) con OR= 6,65 (IC 95%: 2,60-17,02; p= 0,001). Encontramos asociación significativa entre el consumo de tabaco y alcohol paternos y el grupo-caso: OR= 2,08 (IC 95%: 1,11-3,87; p= 0,029) y OR= 2,50 (IC 95%: 1,36-4,57; p= 0,003) respectivamente. CONCLUSIONES: Este estudio supone una pequeña aportación respecto a los posibles factores etiológicos del hipospadias y la criptorquidia, y demuestra la necesidad de estudios ulteriores con mayor potencia estadística para aumentar la evidencia científica de nuestros hallazgos.

[What can we do to improve our management of intestinal atresia?]. / ¿Qué podemos mejorar en el tratamiento de las atresias intestinales?

OBJECTIVE: To review our management of intestinal atresia (AI). MATERIAL AND METHODS: A retrospective review of patientes with AI, from 1995 to 2011. RESULTS: AI was identified in 41 patients, 29,2% had maternal polyhydramnios and 48,7% were diagnosed prenatally. Four of them had Down Syndrome and 18 had cardiopathy. Duodenal atresia-stenosis (AD) was present in 21 patients, that were treated by 19 duodenoduodenostomy, 1 duodenojejunostomy and 1 duodenotomy with duodenal membrane resection. Jejunoileal atresia (AYI) was present in 20 patients and we performed 15 end to end anastomosis, 1 íleo-colic anastomosis, 1 ileostomy, 2 jejunostomies and 1 end to end anastomosis with jejunostomy. Nine AYI were reoperated: 6 bowel obstructions, 1 evisceration and 2 colo-rectal atresia. The average time on parenteral nutrition was 29 days and average hospital stay was 37,3 days. One AD died due to heart disease. In AYI, 2 required transfer to another center due to short bowel. CONCLUSIONS: Prenatal diagnosis of AI is difficult, especially AYI, which is only prenatally diagnosed in 35% of cases. AD respond better to surgery and rarely require reoperation, but mortality is higher than AYI because 57% suffer from heart disease. Reoperations are frecuent in AYI (45% of our patients), usually due to obstruction, ostomy closure and problems resulting from extensive bowel resections. It's important to keep in mind colorectal atresias, which can not be identified.

[Puberal gynecomastia: a comparison between the inferior periareolar approach and the concentric circle technique]. / Ginecomastia puberal: comparación entre el abordaje periareolar inferior y el de doble anillo cutáneo.

BACKGROUND/PURPOSE: The main reason to indicate the surgical treatment in pubertal gynecomastia is the psychological effect on the adolescent. The aim of this paper is to describe our experience in the surgical treatment of this condition, comparing the results obtained depending on the type of approach used. MATERIAL AND METHODS: In our department, the approach for the subtotal mastectomy depends mainly on the gynecomastia grade. We use an inferior periareolar incision in grades I and II, and a concentric circle technique in grade III of Simon's classification. A retrospective review was conducted to identify all adolescent patients that underwent to gynecomastia surgical treatment between 2007 and 2012. We compared the results obtained in each incision group by parametric statistical tests, RESULTS: A total of 29 mastectomies were performed in 15 patients. The mean age of surgery was 13.75 +/- 1.06 years ([11-15] years). The presentation in all cases consisted in a progressive increase in size of the mammary gland, without associated symptoms. In half of patients there was a history of obesity or overweight. We performed the concentric circle technique in 5 patients (CCT-group) and inferior periareolar incision in 10 (IPI-group). There was a higher incidence of pathologic scarring in the CCT-group, and this difference was statistically significant (p = 0.007). No recurrences were observed after a mean follow-up of 15.86 +/- 19.47 months ([3-60) months). CONCLUSIONS: Long term results were satisfactory in both groups. Despite of the higher incidence of hypertrophic and keloid scars observed in concentric circle technique, it remains aesthetically advantageous in cases of gynecomastia with extra skin.

Bioabsorbable staple-line reinforcement for pancreatectomy in a porcine model: a preliminary study.

BACKGROUND: We conducted an exploratory study to assess the use of FOREseal® bioabsorbable reinforcement sleeves in stapling of the pancreatic parenchyma. METHODS: A left pancreatectomy was carried out with linear stapler on 12 pigs: in the FOREseal group (n = 6), the stapling was reinforced with FOREseal, while in the control group (n = 6), simple stapling was applied. RESULTS: The mean operating time was not different between the two groups. No additional haemostasis of the stapling transection was necessary with FOREseal, while in the control group, four pigs required additional haemostasis (p = 0.03). The mean postoperative drainage volume and the mean duration of drainage were, respectively, in the FOREseal group versus the control group: 82 versus 204 ml (p = 0.2) and 3.2 versus 4.7 days (p = 0.3). No adverse event occurred in the FOREseal group. There was no anatomopathological difference between the two groups. CONCLUSION: A good tolerance of FOREseal was observed when used on the pancreatic stump. In this study, it was demonstrated a better haemostatic control of the pancreatic stump with FOREseal which also tends to reduce the volume of postoperative drainage liquid.

[Fertility survey of patients operated on of cryptorchidism in the pediatric age]. / Encuesta de fertilidad en pacientes operados de criptorquidia en edad pediátrica.

OBJECTIVES: To analyze the fertility survey made in a cohort of adults operated on as children for cryptorchidism and for whom clinical and surgical data is available and who were studied 10 years ago by spermiogram and hypophyseal axis. METHODS: A fertility survey including data on style of life and work conditions was sent to the homes of 278 adult patients operated on for cryptorchidism. The 94 surveys received (33.8% of those sent) were analyzed using the SPSS 15.0, carrying out a descriptive and analytic study. We consider persons who achieve pregnancy within a maximum of 12 months with regular sexual activity without the use of contraceptives as having normal fertility. RESULTS: A total of 53 cases of those surveyed (56.4%) attempted to have children, 44 (83.1%) being successful. A total of 34 patients (64.2%) were considered fertile with a mean time of 4.15 months to become pregnant. Nineteen patients (35.8%) had attempted to become parents for more than 12 months and only 10 achieved it (18.9%), 5% in a natural way, 2 with ovulation treatment and 3 by in vitro fertilization, with a mean of 26.8 months. There was no success in becoming parents in 9 cases (16.9%). There are no significant differences between fertilization and localization in laterality of the testicle, age at time of surgery and density on spermiogram. There are significant differences between natural paternity and unilateral or bilateral cryptorchidia. CONCLUSIONS: There is a greater proportion of unilateral cryptorchidias in the group that was successful in having children. We need to increase the number of those surveyed in order to draw significant conclusions in regards to fertility and other clinical situations.

[Currarino triad: different forms of presentation]. / Triada de Currarino: sus diferentes formas de presentación.

BACKGROUND: We describe our experience in Currarino syndrome (CS) and our clinical findings. METHODS: Case 1: Newborn female with prenatal diagnosis of myelomeningocele which was confirmed at birth as a lipomyelomeningocele, associated with partial sacral agenesis, horseshoe kidney and complex anorectal malformation with colonic vascular anomaly. Case 2: A 14-month-old male with constipation. The physical examination detected an anal stricture and radiological findings of a presacral lipomeningocele plus teratoma and a partial sacral agenesis. Case 3: An 8-month-old male with recurrent meningitis associated with anterior sacral meningocele and rectal fistula. An anal stricture and hemisacrum were also demonstrated. RESULTS: In case 1, an abdomino-perineal pull-through was performed but it failed because of her colonic vascular anomaly. Nowadays she is 3 years old and has a cecostomy, controls her micturition and is able to walk. Case 2 is two years old with satisfactory flow-up-after the teratoma and meningocele removal plus anal dilation. In case 3 a colostomy was necessary because after mass excision a recto-cutaneous fistula appeared during postoperative period. A ventriculoperitoneal valve implantation due to his hydrocephaly was also performed. CONCLUSIONS: The constipation is the most common symptom in the CS. Recurrent meningitis has a high mortality rate (56%) due to rectomeningeal fistula. The most common anorectal malformation is the anal stricture, and the more complex the malformation is, higher will the risk of incontinence be. The success of the management and follow-up is a multidisciplinary responsability.

Tropomyosin IgE-positive results are a good predictor of shrimp allergy.

BACKGROUND: Shrimp is a common cause of food allergy. Our aims were to determine the value of IgE antibodies in the diagnosis of shrimp allergy and to study red shrimp (Solenocera melantho) tropomyosin both as a new allergen and as a cross-reactive IgE-binding protein. METHODS: We have studied 45 subjects. Skin prick test (SPT) was carried out in all subjects, and specific IgE (sIgE) to shrimp, recombinant and natural shrimp tropomyosins rPen a 1 and nPen m 1, recombinant Der p 10, and Dermatophagoides pteronyssinus was assessed by fluoroimmunoassay and/or immunoblotting. Double-blind, placebo-controlled food challenges were carried out to confirm diagnosis of shrimp allergy. Also, in vitro inhibition tests were performed to evaluate cross-reactivity. RESULTS: Shrimp allergy was confirmed in 18 shrimp-allergic patients. Skin prick test and IgE antibodies to shrimp were positive in all shrimp-allergic patients; sIgE to rPen a 1 was detected in 98% of these patients. Of the 18 shrimp-tolerant patients, 61% had positive SPT to shrimp, 55% were IgE-positive to shrimp, and 33% showed IgE antibodies to rPen a 1. Determination of IgE to rPen a 1 yielded a positive predictive value of 0.72 and a negative predictive value of 0.91. CONCLUSION: IgE levels to rPen a 1 provided additional value to the diagnosis of shrimp allergy. Some allergens in mite extract are recognized by patients who are allergic to shrimp, though their clinical relevance remains unknown.

Colorectal cancer complicating inflammatory bowel disease: a comparative study of Crohn's disease vs ulcerative colitis in 34 patients.

AIM: Colorectal cancer (CRC) complicating inflammatory bowel disease (IBD) accounts for 10-15% of all IBD deaths. Survival of patients with IBD-related CRC was reviewed to analyse differences between ulcerative colitis (UC) and Crohn's disease (CD). METHOD: We analysed (24 men and 10 women) patients with CD (n = 14) or UC (n = 20) with CRC, who presented between 1990 and 2007, and were followed to October, 2009. RESULTS: The mean age of patients was 56 ± 12 years for patients with UC and 49 ± 17 years for patients with CD, and the mean duration of symptoms was 22 ± 11 and 16 ± 8 years, respectively. The median duration of follow up after the diagnosis of CRC was 49 (1-157) months. Recurrence occurred in five patients with UC and in nine with CD (P = 0.02). The overall and disease free five year survivals were significantly higher in patients with UC than CD [70%vs 43% (P = 0.01) and 63%vs 31% (P = 0.01), respectively]. CONCLUSION: The results showed a poorer prognosis of CRC in patients with CD than with UC.