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Jarkko Mäntylä, Tuuli Thomander, Auli Hakulinen, Kaarina Kukkonen, Kati Palosuo, Helena Voutilainen, Anna Pelkonen, Paula Kauppi
INTRODUCTION: The standard care of severe food allergy in both adults and children means avoidance of allergens. In recent years promising results of oral immunotherapy (OIT) have been reported in children. In adults, information on OIT in severe food allergy is very limited. OBJECTIVE: We aimed to study if OIT is possible in adults. METHODS: We report OIT results in 10 adult patients with milk OIT, nine adult patients with peanut OIT, and four adult patients with egg OIT...
March 15, 2018: Immunity, Inflammation and Disease
Jessica L Peck, E Katherine Larson, Stacy K Silvers
The prevalence of food allergy has risen dramatically in the last two decades. Primary care providers encounter food-allergic children on a daily basis. Although the standard of care has traditionally been strict avoidance of the allergen and advisement to carry an epinephrine autoinjector in case of an accidental exposure resulting in a severe reaction, food allergy research has progressed in the past decade concerning various immunotherapies that may provide an alternate treatment strategy. Oral immunotherapy (OIT), performed under the supervision of an allergist, is the most widely studied of these therapies...
March 12, 2018: Journal of Pediatric Health Care
Nissreen E ELBadawy, Randa S Abdel-Latif
Specific immunotherapy (SIT) is one of the important lines for the treatment of food allergy. Efficacy tests for clinical response to SIT are limited and subjective. In this study, we aimed to evaluate the validity of food specific Ig E levels as a biomarker of clinical improvement in children with food allergy treated with oral immunotherapy (OIT). We analysed 184 children with food allergy, 143 had undergone 2 years of food OIT and 41 were on allergen restricted diet and considered as control. All patients were subjected to Double-Blind Placebo-Controlled Food Challenge test (DBPCFC), allergic symptom score calculation, and serum food specific Ig E level before and after oral immunotherapy for treated patients and after 2 year of allergen restricted diet for the control group...
June 2017: Egyptian Journal of Immunology
Christopher P Parrish, Daniel Har, J Andrew Bird
PURPOSE OF REVIEW: The goal of this review is to provide the reader with an updated summary of published trial data regarding the use of oral immunotherapy (OIT), sublingual immunotherapy (SLIT), and epicutaneous immunotherapy (EPIT) for treatment of IgE-mediated food allergies. RECENT FINDINGS: Data from phase 2 trials for treatment of peanut allergy with OIT and EPIT reveal an increase in the threshold of reactivity for peanut-allergic children. Compared to EPIT, OIT promotes a greater increase in the threshold of reactivity; however, adverse events are more common with OIT...
February 22, 2018: Current Allergy and Asthma Reports
E García-Lirio, C Gonzalez Diaz, A Gonzalez Hermosa, P Gamboa, R Aranguren, M L Sanz
BACKGROUND: Oral immunotherapy (OIT) is a new approach in patients with food allergy. Various immunological mechanisms underlie the reversal of food allergy. In this paper, we study possible changes in peripheral cytokine patterns during OIT. METHODS: Determinations of cytokines in peripheral blood were made in children who had milk or egg allergy and who received OIT. The determinations were made before and after OIT, and again following a final repeat oral challenge a month after a diet excluding the culprit food...
2018: Journal of Investigational Allergology & Clinical Immunology
Aaron I Karlen, Erik J Solberg, Deborah S Quanbeck, Ann E Van Heest
OBJECTIVE: The Orthopaedic In-Training Examination (OITE) is administered annually and is used to assess medical knowledge of orthopedic surgery residents. Beginning in the 2013 to 2014 academic year, the ACGME expanded the postgraduate year (PGY)-1 curriculum from 3 to 6 months of orthopedic surgery rotations. The purpose of this study is to evaluate the effect of increased PGY-1 orthopedic surgery exposure on medical knowledge as measured by the OITE. DESIGN: From 2011 to 2013, 24 PGY-2 residents completed 3 months of PGY-1 orthopedic training (Group 1)...
February 12, 2018: Journal of Surgical Education
Adam S Martin, M Craig McMains, Andrew G Shacklett, Hisham M Awan
PURPOSE: To provide an updated analysis of the hand surgery section of the Orthopaedic In-Training Examination (OITE) from 2009 to 2015. The goal was to contribute to the existing literature on the analysis of OITE questions, to aid both residents and residency programs in preparation for the OITE and board examination. METHODS: The authors analyzed all OITE questions pertaining to hand surgery between 2009 and 2015. Hand questions were analyzed for category and subcategory of content, cited reference, treatment intervention, and imaging modality used...
February 2, 2018: Journal of Hand Surgery
Fátima R Oliveira, Victor H Oliveira, Ítalo M Oliveira, José W Lima, Daniela Calderaro, Danielle M Gualandro, Bruno Caramelli
BACKGROUND: Delirium is a common complication after cardiac surgery in older adult patients. However, risk factors and the influence of delirium on patient outcomes are not well established. We aimed to determine the incidence, predisposing and triggering factors of delirium following cardiac surgery. METHODS: One hundred seventy-three consecutive patients aged ≥60 years were studied. Patients' characteristics and two cognitive function assessment tests were recorded preoperatively...
February 1, 2018: BMC Anesthesiology
Ken-Ichi Nagakura, Sakura Sato, Noriyuki Yanagida, Makoto Nishino, Tomoyuki Asaumi, Kiyotake Ogura, Motohiro Ebisawa
BACKGROUND: Reports on oral immunotherapy (OIT) for anaphylactic food allergy are lacking. We investigated the efficacy and safety of peanut OIT for anaphylactic patients. METHODS: We enrolled 22 peanut anaphylactic patients who underwent OIT between 2011 and 2013, all of whom demonstrated anaphylaxis during a baseline double-blind, placebo-controlled food challenge. After starting in-hospital OIT, participants gradually increased ingestion to 795 mg of peanut protein per day at home and then took a maintenance dose (795 mg) daily...
January 16, 2018: International Archives of Allergy and Immunology
Akihiro Maeta, Marin Matsushima, Nozomi Muraki, Mariko Asano, Yuri Takaoka, Makoto Kameda, Kyoko Takahashi
BACKGROUND: We evaluated the safety and efficacy of low-egg-allergen cookies (LAC) as low-dose oral immunotherapy (OIT) in children with severe egg allergy. We also examined the relationship between mild desensitization by low-dose OIT and serum biomarkers of allergy. METHODS: We enrolled 13 children with egg allergy who could not receive OIT with hard-boiled egg white (EW). For 11 participants, OIT was carried out using LAC for 3-4 months. Open food challenges with hard-boiled EW and blood samplings were performed before and after OIT...
January 13, 2018: International Archives of Allergy and Immunology
Michael D Kulis, Sarita U Patil, Erik Wambre, Brian P Vickery
Oral immunotherapy (OIT) has reproducibly demonstrated successful desensitization in food-allergic subjects completing clinical trials and, in some studies, sustained unresponsiveness. These clinical outcomes have been associated with characteristic modifications in the allergen-specific immune response, but a detailed synthesis of OIT's mechanisms of action is lacking. In this Rostrum, we review the current evidence regarding the human immune response to OIT, explore possible mechanisms, and identify knowledge gaps for future research...
December 26, 2017: Journal of Allergy and Clinical Immunology
Masaya Takahashi, Kazuhiko Soejima, Shoichiro Taniuchi, Yasuko Hatano, Sohsaku Yamanouchi, Hideki Ishikawa, Makoto Irahara, Youhei Sasaki, Hiroshi Kido, Kazunari Kaneko
We evaluated the efficacy and safety of oral immunotherapy (OIT) combined with 24 weeks of omalizumab (OMB) at inducing desensitization in children with cow's milk allergy (CM) compared with an untreated group. The present study was a prospective randomized controlled trial. Sixteen patients (age, 6-14 years) with high IgE levels to CM were enrolled in the present study. Patients were randomized 1:1 to receive OMB-OIT group or untreated group. The primary outcome was the induction of desensitization at 8 weeks after OMB was discontinued in OMB-OIT treated group and at 32 weeks after study entry...
December 12, 2017: Scientific Reports
Jia-Zhuang Xu, Keith K Wannomae, Orhun K Muratoglu, Ebru Oral
Vitamin E stabilization successfully improved long-term oxidation resistance of wear-resistant ultra-high-molecular-weight polyethylene (UHMWPE) used for joint implants. Stabilization can be achieved by blending an antioxidant into the UHMWPE resin powder before consolidation and irradiation. Balancing the wear resistance and vitamin E content in the blend is the current challenge with this approach, because vitamin E hinders crosslinking of UHMWPE during irradiation, which decreases wear resistance. The vitamin E concentration in the blend is generally limited to less than 0...
December 12, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
G B Pajno, M Fernandez-Rivas, S Arasi, G Roberts, C A Akdis, M Alvaro-Lozano, K Beyer, C Bindslev-Jensen, W Burks, M Ebisawa, P Eigenmann, E Knol, K C Nadeau, L K Poulsen, R van Ree, A F Santos, G du Toit, S Dhami, U Nurmatov, Y Boloh, M Makela, L O'Mahony, N Papadopoulos, C Sackesen, I Agache, E Angier, S Halken, M Jutel, S Lau, O Pfaar, D Ryan, G Sturm, E-M Varga, R G van Wijk, A Sheikh, A Muraro
Food allergy can result in considerable morbidity, impairment of quality of life, and healthcare expenditure. There is therefore interest in novel strategies for its treatment, particularly food allergen immunotherapy (FA-AIT) through the oral (OIT), sublingual (SLIT), or epicutaneous (EPIT) routes. This Guideline, prepared by the European Academy of Allergy and Clinical Immunology (EAACI) Task Force on Allergen Immunotherapy for IgE-mediated Food Allergy, aims to provide evidence-based recommendations for active treatment of IgE-mediated food allergy with FA-AIT...
September 27, 2017: Allergy
Kazuma Kiyotani, Tu H Mai, Rui Yamaguchi, Poh Yin Yew, Mike Kulis, Kelly Orgel, Seiya Imoto, Satoru Miyano, A Wesley Burks, Yusuke Nakamura
B-cell receptors (BCRs) play a critical role in adaptive immunity as they generate highly diverse immunoglobulin repertoires to recognize a wide variety of antigens. To better understand immune responses, it is critically important to establish a quantitative and rapid method to analyze BCR repertoire comprehensively. Here, we developed "Bcrip", a novel approach to characterize BCR repertoire by sequencing millions of BCR cDNA using next-generation sequencer. Using this method and quantitative real-time PCR, we analyzed expression levels and repertoires of BCRs in a total of 17 peanut allergic subjects' peripheral blood samples before and after receiving oral immunotherapy (OIT) or placebo...
February 2018: Journal of Human Genetics
Rishi Baweja, Matthew J Kraeutler, Mary K Mulcahey, Eric C McCarty
Background: Orthopaedic surgery residencies and certain fellowships are becoming increasingly competitive. Several studies have identified important factors to be taken into account when selecting medical students for residency interviews. Similar information for selecting orthopaedic sports medicine fellows does not exist. Purpose: To determine the most important factors that orthopaedic sports medicine fellowship program directors (PDs) take into account when ranking applicants...
November 2017: Orthopaedic Journal of Sports Medicine
Rima Rachid, Corinne A Keet
Although there is no FDA approved therapy for food allergy, over the past decades, several routes of immunotherapy have been investigated for food allergy. Thus far, these therapies have shown variable levels of efficacy at desensitizing to foods, with oral immunotherapy (OIT) far more successful than sublingual immunotherapy (SLIT) or epicutaneous immunotherapy (EPIT). However, desensitization tends to be temporary, and safety remains a major concern with OIT. Moreover, although it seems logical that desensitization will result in fewer reactions, it is not clear whether OIT or other immunotherapies are associated with an overall lower or higher risk of reactions over the long term...
November 18, 2017: Journal of Allergy and Clinical Immunology in Practice
Wenyin Loh, Mimi Tang
Finding an effective curative treatment for food allergy is a research priority. Although oral immunotherapy (OIT) is effective at inducing desensitization, the temporary nature of this effect and high rates of adverse reactions have highlighted a need for novel strategies to improve tolerance induction and safety. One such strategy is the use of an adjuvant together with food immunotherapy to either suppress allergic reactions and/or modulate the underlying allergic immune response. In particular, the use of bacterial adjuvants seems to be a promising means of enhancing OIT-induced sustained unresponsiveness and warrants further investigation...
February 2018: Immunology and Allergy Clinics of North America
Nishant Ganesh Kumar, Michael A Benvenuti, Brian C Drolet
BACKGROUND: In-service training examinations (ITEs) are used to assess residents across specialties. However, it is not clear how they are integrated with the Accreditation Council for Graduate Medical Education Milestones and competencies. OBJECTIVE: This study explored the distribution of specialty-specific milestones and competencies in ITEs for plastic surgery and orthopaedic surgery. METHODS: In-service training examinations were publicly available for plastic surgery (PSITE) and orthopaedics (OITE)...
October 2017: Journal of Graduate Medical Education
Paolo Meglio, Paolo Gianni Giampietro, Rossella Carello, Elena Galli
BACKGROUND: The present report was a follow-up investigation at 2.5- and 7-year intervals of a previous study of 20 children with moderate-to-severe immunoglobulin E (IgE) mediated hen's egg (HE) allergy who received oral immunotherapy (OIT) with raw HE. The study design of the previous study divided the 20 subjects into two groups of 10 each: (1) group 1, the OIT group (OIT-G), and, (2) group 2, an age-matched control group (C-G). In that study, 8 of 10 of the children in the OIT-G were successfully desensitized, one child was partially desensitized, and desensitization failed in one child...
October 1, 2017: Allergy & Rhinology
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