Login to your account

Username *
Password *
Remember Me

Blog With Right Sidebar

    Vous êtes ici :  
  1. Accueil
  2. Blog With Right Sidebar

Anaphylaxis in children: A nine years retrospective study (2001-2009).

Anaphylaxis is an acute multisystemic and potentially fatal reaction, resulting from the rapid release of inflammatory mediators. Its exact prevalence is unknown. In children, foods are the most significant triggers for IgE-mediated anaphylaxis.

OBJECTIVES: To characterise the cases of anaphylaxis evaluated in an Allergy Division of a Central Paediatric Hospital.

MATERIAL AND METHODS: A review of all cases of anaphylaxis evaluated from 2001 to 2009. Anaphylaxis was defined according to Sampson's 2006 criteria.

RESULTS: Seventy-three children had anaphylactic reactions (47 male), of which 64% had history of atopy. Age at time of reaction ranged between 17 days and 15 years old (median: four years). Food was the most frequently identified cause (n=57), followed by drugs (n=8), hymenoptera venom (n=2), and cold (n=1). In five cases there was no identifiable cause. Among foods, cow's milk was the culprit agent in 27 children. The most severe reaction was a cardiorespiratory arrest. The most frequent symptoms were respiratory and cutaneous in 51 cases. Hypotension was present in nine cases. There were no fatalities. Most acute reactions were treated with corticosteroids and/or antihistamines. Adrenaline was used in only about one quarter of children.

CONCLUSIONS: The most important causes of anaphylaxis in our study were foods, and the most common symptoms were respiratory and cutaneous. The prevalence of anaphylaxis was higher in males and, in two thirds of patients there was a history of atopy. Despite being the primary and most important treatment for anaphylaxis, adrenaline is still used in only a minority of these cases.

Application of proteomics in asthma research.

Bronchial asthma is caused by allergic airway inflammation, resulting in reversible airway obstruction, characterized by airway hyper-responsiveness, bronchoconstriction, increased mucus secretion and an increase in lung vessel permeability.

The pathophysiological changes in asthma have been attributed to the altered expression of biologically plausible proteins associated with transcriptional pathways, inflammatory mediators, chemokines, cytokines, apoptosis and cell proliferation. Such multifactorial diseases characteristically involve an interplay of many genetic variations of molecular and biochemical pathways and their interactions with environmental factors. The complex nature of the asthma phenotype, together with genetic heterogeneity and environmental influences, has made it difficult to uncover the aspects that underlie this common disease. Recently, genomic and proteomic technologies have been developed to identify associations between genes, proteins and disease. This approach, called 'omics biology', aims to recognize early onset of disease, institute preventive treatment and identify new molecular targets for novel drugs in multifactorial diseases. This article reviews examples of how proteomic technology can be used to find asthma marker proteins (from the cell model to clinical samples).

Identification of protein changes in different stages of asthma could provide further insights into the complex molecular mechanisms involved in this disease. These studies provide new insights for finding novel pathological mediators and biomarkers of asthma.

Immunotherapy with peptides.

Specific allergen immunotherapy is clinically effective and disease modifying. It has a duration of effect that exceeds the treatment period and prevents both the progression of allergic rhinitis to asthma and the acquisition of new allergic sensitizations. However, immunotherapy is associated with a high frequency of adverse events related to the allergenicity of vaccines. Allergenicity is conferred by the presence of intact B-cell epitopes that crosslink allergen-specific IgE on effector cells.

The use of linear peptide sequences representing fragments of the native allergen is one approach to reduce allergenicity. Preclinical models of peptide immunotherapy have demonstrated efficacy in both autoimmunity and allergy. Translation of this technology into the clinic has gained momentum in recent years based on encouraging results from early clinical trials. To date, efforts have focused on two major allergens, but vaccines to a broader range of molecules are currently in clinical development. Mechanistically, peptide immunotherapy appears to work through the induction of adaptive, allergen-specific regulatory T cells that secrete the immunoregulatory cytokine IL-10. There is also evidence that peptide immunotherapy targeting allergen-specific T cells can indirectly modulate allergen-specific B-cell responses.

Peptide immunotherapy may provide a safe and efficacious alternative to conventional subcutaneous and/or sublingual approaches using native allergen preparations.

The importance of ultrasound in staging and gaining a pathological diagnosis in patients with lung cancer--a two year single centre experience

Conclusion The use of ultrasound gives a rapid and less invasive method of diagnosing and staging lung cancer and has become embedded into the diagnostic pathway. We advocate its increased use and availability in patients with lung cancer.

The COPD assessment test (CAT): response to pulmonary rehabilitation. A multicentre, prospective study

Conclusion The CAT score is simple to implement as an outcome measure, it improves in response to PR and can distinguish categories of response.

Search

Search