Is Oral Food Challenge (OFC) test safe for preschool children?

BACKGROUND: Oral food challenges (OFCs) are performed for diagnosis of a food allergy in cases where the allergy is not supported by patient history, or when a newly developed tolerance level needs to be established. OBJECTIVE: We aimed to investigate the prevalence and severity of reactions during OFCs in preschool children. METHODS: A retrospective study was conducted on children younger than 5 years, for whom OFC had been performed with milk, egg white and egg yolk. All children had been admitted to the Department of Pediatric Allergy at Behçet Uz Children's Hospital between 1 January 2010 and 31 December 2014. Any symptoms developed during the OFC were classified and recorded. RESULTS: A total of 122 patients who underwent an OFC were included in this study. The patients included 85 males (69.7%), and 50.8% of patients (n = 62) had a history of IgE-mediated food allergy. Co-existing allergies were found for 57.4% (n = 70) of patients. Of the OFCs performed, tests for milk, egg white and egg yolk made up 46.5, 30.5 and 23.0%, respectively. Of these, 19% (n = 33) were mild and 4.5% (n = 7) were moderate allergies in terms of symptom development. It was determined that the skin prick test (SPT) wheal size and the food-specific IgE levels did not effect in determining whether the allergic reaction would develop by OFC if the SPT wheal size and the food-specific IgE levels were below the cut-off point of a 95% positive predictive value (p > 0.05). CONCLUSION: The severity of egg and milk allergy symptoms resulting from the frequently used OFC in preschool children are generally mild and easy to manage, particularly if the OFC is only conducted if serum-specific IgE or SPT wheal size is below the cut-off point.

The diagnostic role of dual-phase (18)F-FDG PET/CT in the characterization of solitary pulmonary nodules.

OBJECTIVE: Our objective was to evaluate the diagnostic role of dual-phase (18)F-fluorodeoxyglucose ((18)F-FDG) PET/computed tomography (CT) in the characterization of solitary pulmonary nodules (SPNs). PATIENTS AND METHODS: A total of 48 SPNs in 48 patients were included in this retrospective study. The final diagnosis was confirmed histopathologically or by follow-up CT. Two PET/CT scans were performed: the first (early scan) was performed 1 h after injection and the second (delayed scan) was performed 2 h later. Standardized uptake values (SUVs) [early and delayed SUVmax and SUVmean adjusted to body weight, body surface area (BSA), lean body mass (LBM) and blood glucose level (Glc)], retention index and nodule-to-mediastinum (nodule activity/subcarinal region of interest activity) ratios were calculated, along with the receiver operating characteristic curve. Intraobserver and interobserver variabilities among nuclear medicine physicians were analysed for the two phases. RESULTS: Eighteen patients had malignant tumour, whereas 30 had benign lesions. The median (min-max) SUVmax was 1.5 (0.5-4.1) in the benign group and 3.6 (1.3-38) in the malignant group. With the threshold value of early SUVmax as 2.5 and 2.75 using the receiver operating characteristic curve, a sensitivity of 94-75%, specificity of 75-80% and an accuracy of 83-78% were calculated. With the same threshold values for delayed images, 94-100% sensitivity, 77-80% specificity and 83-88% accuracy were obtained. BSA-SUVmax, LBM-SUVmax and Glc-SUVmax did not show any advantage over other quantitative parameters in the SPN characterization. There was no variability in the results obtained between the two nuclear medicine physicians. CONCLUSION: Dual-phase PET/CT may increase the diagnostic potential of PET/CT in the characterization of SPNs. In this particular study group, a threshold value could not be determined for the retention index, but higher retention indices may show higher malignant potential in SPNs.

[Does exposure to biomass and occupational dust can be causative for asthma among women?]. / Kadinlarda biomass ve mesleksel toza maruziyet astima yol açabilir mi?

In the developing countries, most of the house energy necessity is supplied from the biomass. Because of this reason, chronicle airway diseases and the respiratory symptoms that have been triggered by the house inside air pollution is very common. As an example from the real life of this entity, an asthmatic woman who has an history of using biomass in her house for heating, cleaning and cooking in all her life (because of the economical difficulties) and also an history of occupational organic dust exposure as a seasonal worker during the last 20 years was reported. After the medical investigation, the case was diagnosed as severe persistent asthma. The case was externated after ordering the appropriate inhaler treatment and she was taken to the follow up programme.

Pneumoconiosis and work-related health complaints in Turkish dental laboratory workers.

Dental technicians make the missing tooth and complementary prosthesis and bridges according to the dentist's measurements. They use various materials including silica. Exposure to these materials increases the multi-systemic health problems in addition to respiratory health problems related with work. We planned to evaluate the work history, working conditions and frequency of health problems including pneumoconiosis. Two hundred and fourteen cases in total from 9 workplaces were evaluated. A face to face questionnaire was used to determine the demographic features of workers and standard chest X-rays were evaluated by an expert reader according to ILO 1980 standards. Mean age of the workers was 28.1 + or - 8.3. Seventy four cases were non-smoker. Mean daily working time was 11.0 + or - 1.6 hours. Mean total working period in this sector was 12.1 + or - 9.0 years. One hundred cases had at least 1 respiratory complaint. Radiological findings were correlated with pneumoconiosis in 33 (23.6%) workers. Pneumoconiosis frequency was 50.0% in cases with sandblasting history. There was not any significant correlation between pneumoconiosis and cough, sputum, dyspnea, wheezing, physical examination findings and tenure. Dental technicians have serious respiratory risks including dermal and muscle-skeleton system arising from occupational setting in Turkey. Working conditions in dental laboratories must be improved by informing the workers and workplaces must be regularly controlled for worker health and hygiene.