Atopy patch test in children with cow's milk and hen's egg allergy: Do clinical symptoms matter?

INTRODUCTION AND OBJECTIVES: Since early 2000s, atopy patch test (APT) has been used to determine non-IgE and mixed-type food allergies. Previous studies have reported conflicting results about the diagnostic value of APT in food allergies, due to non-standardized methods. We aimed to determine the diagnostic efficacy of APT compared to open oral food challenge (OFC) in patients diagnosed with cow's milk allergy (CMA) and hen's egg allergy (HEA) manifesting as atopic dermatitis (AD) and gastrointestinal system symptoms. MATERIALS AND METHODS: In patients with suspected AD and/or gastrointestinal manifestations due to CMA and HEA, the results of OFC, APT, skin prick test (SPT) and specific IgE (sIgE) were reviewed. Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of sIgE, SPT, APT and SPT+APT were calculated. RESULTS: In total 133 patients with suspected CMA (80) and HEA (53) were included in the study. In patients with CMA presenting with gastrointestinal symptoms, APT had sensitivity of 9.1%, specificity of 100%, PPV of 100% and NPV of 48.7%. In atopic dermatitis patients, sensitivity of APT was 71.4%, specificity 90.6%, PPV 62.5% and NPV 93.6%. In patients diagnosed with HEA, the sensitivity, specificity, PPV and NPV values of APT were 72.0%, 78.6%, 47.2% and 75.0%, respectively. In patients diagnosed with HEA presenting with AD, sensitivity of APT was 87.5%, specificity 70.6%, PPV 73.7% and NPV 85.7%. Atopy patch test had lower sensitivity (44.4%) and higher specificity (90.9%) in patients diagnosed with HEA presenting with gastrointestinal symptoms than those presenting with AD. CONCLUSION: Our study showed that APT provided reliable diagnostic accuracy in atopic dermatitis patients. However, APT had low sensitivity in patients with gastrointestinal symptoms

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Atopy patch test in children with cow's milk and hen's egg allergy: Do clinical symptoms matter?

INTRODUCTION AND OBJECTIVES: Since early 2000s, atopy patch test (APT) has been used to determine non-IgE and mixed-type food allergies. Previous studies have reported conflicting results about the diagnostic value of APT in food allergies, due to non-standardized methods. We aimed to determine the diagnostic efficacy of APT compared to open oral food challenge (OFC) in patients diagnosed with cow's milk allergy (CMA) and hen's egg allergy (HEA) manifesting as atopic dermatitis (AD) and gastrointestinal system symptoms. MATERIALS AND METHODS: In patients with suspected AD and/or gastrointestinal manifestations due to CMA and HEA, the results of OFC, APT, skin prick test (SPT) and specific IgE (sIgE) were reviewed. Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of sIgE, SPT, APT and SPT+APT were calculated. RESULTS: In total 133 patients with suspected CMA (80) and HEA (53) were included in the study. In patients with CMA presenting with gastrointestinal symptoms, APT had sensitivity of 9.1%, specificity of 100%, PPV of 100% and NPV of 48.7%. In atopic dermatitis patients, sensitivity of APT was 71.4%, specificity 90.6%, PPV 62.5% and NPV 93.6%. In patients diagnosed with HEA, the sensitivity, specificity, PPV and NPV values of APT were 72.0%, 78.6%, 47.2% and 75.0%, respectively. In patients diagnosed with HEA presenting with AD, sensitivity of APT was 87.5%, specificity 70.6%, PPV 73.7% and NPV 85.7%. Atopy patch test had lower sensitivity (44.4%) and higher specificity (90.9%) in patients diagnosed with HEA presenting with gastrointestinal symptoms than those presenting with AD. CONCLUSION: Our study showed that APT provided reliable diagnostic accuracy in atopic dermatitis patients. However, APT had low sensitivity in patients with gastrointestinal symptoms.

Self-sharpening induces jet-like structure in seafloor gravity currents.

Gravity currents are the primary means by which sediments, solutes and heat are transported across the ocean-floor. Existing theory of gravity current flow employs a statistically-stable model of turbulent diffusion that has been extant since the 1960s. Here we present the first set of detailed spatial data from a gravity current over a rough seafloor that demonstrate that this existing paradigm is not universal. Specifically, in contrast to predictions from turbulent diffusion theory, self-sharpened velocity and concentration profiles and a stable barrier to mixing are observed. Our new observations are explained by statistically-unstable mixing and self-sharpening, by boundary-induced internal gravity waves; as predicted by recent advances in fluid dynamics. Self-sharpening helps explain phenomena such as ultra-long runout of gravity currents and restricted growth of bedforms, and highlights increased geohazard risk to marine infrastructure. These processes likely have broader application, for example to wave-turbulence interaction, and mixing processes in environmental flows.

Integrated fluidic system for bio-molecule separation.

An integrated fluidic system has been fabricated, capable of separating a mixture of different bio-molecules into its components. It is composed of a filter and an actuator; the pressure generated by the actuator sustains the flow of the mixture through the filter. The actuator is made by stacking several layers of conductive polymer. Actuator strain in excess of 10% has been obtained, which corresponds to a fluid flow of 3 microL/min in the fabricated system. The filter consists of an ordered array of Si micro-pillars. A mixture composed of DNA fragments of different length (300 and 400 base-pair) has been effectively separated by using the fabricated filter and chromatographic techniques.

Evaluation of montelukast in 8 to 14 year old children with mild persistent asthma and compared with inhaled corticosteroids.

OBJECTIVES: To determine the clinical effectiveness, tolerability and reliability of montelukast and to compare this drug with inhaled corticosteroids. METHODS: We performed a randomized, 14-week, 2-period, prospective parallel group study. After a 2-week run-in period, patients received treatment for 12 weeks. Sixty-three clinically stable outpatients aged 8 to 14 years with a history of mild persistent asthma for at least 1 year and a forced expiratory volume in one second (FEV1) greater than 80 % of the predicted value were evaluated. RESULTS: Montelukast produced improvement in airway obstruction, daily symptom scores, total daily as-needed beta-agonist use, nocturnal awakenings, percentage of days and percentage of patients with asthma exacerbations, and urinary leukotriene E4 levels. These beneficial effects were similar to those produced by inhaled corticosteroids. There were no significant adverse effects requiring treatment discontinuation. CONCLUSIONS: Montelukast may be a well-tolerated and effective therapeutic option in 8 to 14-year-old patients with mild persistent asthma.

Evaluation of montelukast in 8 to 14 year old children with mild persistent asthma and compared with inhaled corticosteroids

Objectives: To determine the clinical effectiveness, tolerability and reliability of montelukast and to compare this drug with inhaled corticosteroids. Methods: We performed a randomized, 14-week, 2-period, prospective parallel group study. After a 2-week run-in period, patients received treatment for 12 weeks. Sixty-three clinically stable outpatients aged 8 to 14 years with a history of mild persistent asthma for at least 1 year and a forced expiratory volume in one second (FEV1) greater than 80 % of the predicted value were evaluated. Results: Montelukast produced improvement in airway obstruction, daily symptom scores, total daily as-needed β -agonist use, nocturnal awakenings, percentage of days and percentage of patients with asthma exacerbations, and urinary leukotriene E4 levels. These beneficial effects were similar to those produced by inhaled corticosteroids. There were no significant adverse effects requiring treatment discontinuation. Conclusions: Montelukast may be a well-tolerated and effective therapeutic option in 8 to 14-year-old patients with mild persistent asthma (AU)

Objetivos: Determinar el efecto clínico, la tolerabilidad y la fiabilidad de montelukast y compararlo con los corticosteroides inhalados. Métodos: Estudio aleatorizado, prospectivo, de dos periodos y de grupos paralelos, de 14 semanas de duración. Después de un periodo de preinclusión de dos semanas, los pacientes recibieron tratamiento durante 12 semanas. Se evaluó a 63 pacientes ambulatorios estables de 8 a 14 años de edad con asma persistente leve desde hacía al menos un año y FEV1 superior al 80 por ciento del valor teórico.Resultados: Montelukast mejoró la obstrucción de las vías respiratorias, la puntuación de los síntomas diarios, el uso diario total de beta-agonistas según las necesidades y el despertar nocturno de forma similar a los corticosteroides inhalados.Montelukast, en comparación con los corticosteroides inhalados, indujo una mejoría semejante en el porcentaje de días y el porcentaje de pacientes con exacerbaciones asmáticas y concentración urinaria de LTE4. No hubo efectos secundarios significativos que motivaran la interrupción del tratamiento. Conclusiones: Montelukast puede ser una opción terapéutica bien tolerada y eficaz para el asma persistente leve en pacientes de 8 a 14 años (AU)

Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region.

Sensitization to aeroallergens of Aegean region is not well decumented. In this study we evaluated the epidermal skin prick test results of the patients who applied to allergy outpatient department retrospectively. Epidermal skin prick test of the 5055 patients were evaluated. Of these patients 2638 (52 %) were female, 2417 (48 %) male, 1213 (24 %) adult and 3842 (76 %) pediatric patient, 1163 (23 %) patients were allergic rhinitis, 2477 (49 %) were bronchial asthma, 505 (10 %) were allergic rhinitis with bronchial asthma, 556 (11 %) were chronic urticaria, 253 (5 %) were wheezy infant and 101 (2 %) patients were atopic dermatitis, 2932 (58 %) had atopy history in their first and second degree relatives. Patients were aged between 3.5 months and 79 years (mean 14.1 3.2 years and median 11 years). In epidermal skin prick tests sensitization to house dust mites (D. farinae, D. pteroniyssinus), pollens (grass, cereals and trees), moulds, animal danders, foods (especially in early childhood) and cockroach were evaluated. Our data indicate that allergens that may be the cause of the high prevalence of allergic diseases in Izmir are probably produced by pollens and mites.

Retrospective evaluation of epidermal skin prick tests in patients living in Aegean region

Sensitization to aeroallergens of Aegean region is not well decumented. In this study we evaluated the epidermal skin prick test results of the patients who applied to allergy outpatient department retrospectively. Epidermal skin prick test of the 5055 patients were evaluated. Of these patients 2638 (52 %) were female, 2417 (48 %) male, 1213 (24 %) adult and 3842 (76 %) pediatric patient, 1163 (23 %) patients were allergic rhinitis, 2477 (49 %) were bronchial asthma, 505 (10 %) were allergic rhinitis with bronchial asthma, 556 (11 %) were chronic urticaria, 253 (5 %) were wheezy infant and 101 (2 %) patients were atopic dermatitis, 2932 (58 %) had atopy history in their first and second degree relatives. Patients were aged between 3.5 months and 79 years (mean 14.1 ± 3.2 years and median 11 years). In epidermal skin prick tests sensitization to house dust mites (D. farinae, D. pteroniyssinus), pollens (grass, cereals and trees), moulds, animal danders, foods (especially in early childhood) and cockroach were evaluated. Our data indicate that allergens that may be the cause of the high prevalence of allergic diseases in I(dot)zmir are probably produced by pollens and mites (AU)

La sensibilización a los aeroalergenos en la región del Egeo no está bien documentada. En este estudio evaluamos de manera retrospectiva los resultados de las pruebas cutáneas (prick test) de los pacientes que acudieron al departamento de alergia del ambulatorio. Se examinaron las pruebas cutáneas de 5.055 pacientes. De estos pacientes, 2.638 (52 por ciento) eran mujeres, 2.417 (48 por ciento) varones, 1.213 (24 por ciento) adultos y 3.842 (76 por ciento) niños; 1.163 (23 por ciento) pacientes presentaban rinitis alérgica, 2.477 (49 por ciento) asma bronquial, 505 (10 por ciento) rinitis alérgica con asma bronquial y 556 (11 por ciento) urticaria crónica; 253 (5 por ciento) eran lactantes con sibilancias y 101 (2 por ciento) pacientes con dermatitis atópica; y 2.932 (58 por ciento) tenían antecedentes de atopia en sus parientes de primer y segundo grado. Los pacientes tenían entre 3,5 meses y 79 años de edad (media 14,1 ñ 3,2 años y mediana 11 años). En las pruebas cutáneas se evaluó la sensibilización a los ácaros del polvo doméstico (D. farinae, D. pteroniyssinus), pólenes (gramíneas, cereales y árboles), mohos, caspas de animales, alimentos (especialmente en la primera infancia) y cucarachas. Nuestros datos indican que los alergenos que pueden ser la causa de la gran prevalencia de enfermedades alérgicas en Izmir están probablemente producidos por pólenes y ácaros (AU)