June 4, 2015

Usefulness of open mixed nut challenges to exclude tree nut allergy in children

Brief communication


Open AccessFrancine C. Van Erp1*André C. Knulst3Irene L. Kok2Maartje F. van Velzen1Cornelis K. van der Ent1 and Yolanda Meijer1

Abstract
Background
To minimize the risk of accidental reactions, atopic children with multiple sensitizations to tree nuts are advised to avoid all nuts. Multiple food challenges would be needed to confirm the clinical relevance, but are too burdensome to be practical.

Successful desensitization in a boy with severe cow´s milk allergy by a combination therapy using omalizumab and rush oral immunotherapy

Case report

Open Access

Masaya TakahashiShoichiro Taniuchi*Kazuhiko SoejimaYasuko HatanoSohsaku Yamanouchi and Kazunari Kaneko


Abstract (provisional)
Background Rush oral immunotherapy (OIT) combined with omalizumab (OMB) has been reported to be an effective and safe treatment for severe milk allergies. However, no report has described long-term follow-up observations after OMB discontinuation. The purpose of this case report was to evaluate the safety and efficacy of rush OIT in combination with OMB during a long period of treatment. Case presentation A 5-year-old boy presented with a past history of two severe episodes of anaphylaxis (at the age of 2 and 3 years) after consuming small amounts of cow’s milk (CM).

Real-world research and its importance in respiratory medicine

  1. Alison Chisholm1
+Author Affiliations
  1. 1Respiratory Effectiveness Group, Cambridge, UK
  2. 2University of Aberdeen, Aberdeen, UK
  3. 3Department of Respiratory Diseases, Ghent University Hospital, Ghent, Belgium
  4. 4Departments of Epidemiology and Respiratory Medicine, Erasmus MC, Rotterdam, The Netherlands
  5. 5Respiratory and Intensive Care Medicine, GH Cochin, Site Val de Grace, Paris, France
  6. 6Université Paris-Descartes (EA2511), Sorbonne Paris Cité, Paris, France
  7. 7East of England Strategic Clinical Network, Norfolk, UK
  1. David Price, Academic Centre of Primary Care, University of Aberdeen, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK. E-mail: david@rirl.org

Abstract

Educational Aims To improve understanding of:
  • The relative benefits and limitations of evidence derived from different study designs and the role that real-life asthma studies can play in addressing limitations in the classical randomised controlled trial (cRCT) evidence base.
  • The importance of guideline recommendations being modified to fit the populations studied and the model of care provided in their reference studies.

Data safety and monitoring board in non-industry trials: learning it the hard way

Letter to the Editor
Open Access
A. Hazenberg123*H. A. M. Kerstjens13 and P. J. Wijkstra123
Respiratory Research 2015, 16:63  doi:10.1186/s12931-015-0222-6
Letter to the Editor
In the majority of studies, no Data and Safety Monitoring Board (DSMB) is either needed or instituted. We report an investigator initiated study where we should have done this earlier than we did and discuss the lessons we learned.
The EOLUS study was a single center, randomized controlled trial of the initiation of chronic home mechanical ventilation (HMV) at home. Typical indications for HMV are neuromuscular diseases such as amyotrophic lateral sclerosis (ALS) and Duchenne's disease next to thoracic cage deformities. The study was set up to investigate whether the initiation of HMV at home with the help of telemonitoring was not inferior to our usual in hospital start. The primary outcome measure was change in arterial carbon dioxide pressure from baseline to 6 months, for which we calculated a necessary sample size of 52 evaluable patients.

June 3, 2015

Clinically relevant subgroups in COPD and asthma


Eur Respir Revvol. 24 no. 136 283-298
  • Neil Barnes6

  • +Author Affiliations
    1. 1Clinical and Experimental Medicine, University of Birmingham, Queen Elizabeth Hospital Birmingham, Birmingham, UK
    2. 2Dept of Respiratory Medicine, Birmingham Heartlands Hospital, Birmingham, UK
    3. 3Dept of Pulmonology, Semmelweis University, Budapest, Hungary
    4. 4Respiratory Medicine, CHU Sart-Tilman B35, Liege, Belgium
    5. 5Service of Allergology and Clinical Immunology, UHC “Mother Teresa”, Tirana, Albania
    6. 6GlaxoSmithKline, Stockley Park West, Uxbridge, UK
    1. Alice M. Turner, Clinical and Experimental Medicine, University of Birmingham, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Birmingham, B15 2WB, UK. E-mail: a.m.wood@bham.ac.uk

    2. Abstract
    As knowledge of airways disease has grown, it has become apparent that neither chronic obstructive pulmonary disease (COPD) nor asthma is a simple, easily defined disease. In the past, treatment options for both diseases were limited; thus, there was less need to define subgroups. As treatment options have grown, so has our need to predict who will respond to new drugs. To date, identifying subgroups has been largely reported by detailed clinical characterisation or differences in pathobiology. These subgroups are commonly called “phenotypes”; however, the problem of defining what constitutes a phenotype, whether this should include comorbid diseases and how to handle changes over time has led to the term being used loosely.

    Clinical asthma phenotyping: A trial for bridging gaps in asthma management

    Logo of wjcpLink to Publisher's site

    World J Clin Pediatr. 2015 May 8; 4(2): 13–18.
    Published online 2015 May 8. doi:  10.5409/wjcp.v4.i2.13
    PMCID: PMC4438436

    Abstract:
    Asthma is a common disease affecting millions of people worldwide and exerting an enormous strain on health resources in many countries. Evidence is increasing that asthma is unlikely to be a single disease but rather a series of complex, overlapping individual diseases or phenotypes, each defined by its unique interaction between genetic and environmental factors.

    June 1, 2015

    Thresholds in chemical respiratory sensitisation

  • Stella A. Cochranea
  • Josje H.E. Artsb
  • Colin Ehnesc
  • Stuart Hindled
  • Heli M. Hollnageld
  • Alan Poolee
  • Hidenori Sutof
  • Ian Kimberg

  • Abstract
    There is a continuing interest in determining whether it is possible to identify thresholds for chemical allergy. Here allergic sensitisation of the respiratory tract by chemicals is considered in this context. This is an important occupational health problem, being associated with rhinitis and asthma, and in addition provides toxicologists and risk assessors with a number of challenges.
  • Masticatory Changes in Oral Breath Secondary to Allergic Rhinitis: Integrative Review

    Logo of iaorl
    Abstract
    Introduction The III Brazilian Consensus on Rhinitis (2012) defines allergic rhinitis as a nasal mucosa inflammation, mediated by immunoglobulin E, after exposure to allergens.