Gender-specific risk factors for gout: a systematic review of cohort studies

Abstract Background: Though gout is more prevalent in men than women, it remains unclear whether gender influences risk factors for incident gout. We aimed to systematically review all cohort studies examining risk factors for the development of gout by gender. Methods: MEDLINE, EMBASE, CINAHL and the Cochrane Library were searched from inception to March 2019. Risk factors for gout examined were: age, ethnicity, consumption of alcohol, meat, seafood, dairy products, purine-rich vegetables, coffee and fructose, vitamin C intake, the Dietary Approaches to Stop Hypertension (DASH) diet, metabolic syndrome, BMI, waist and chest circumference, waist-to-hip ratio, weight change, diabetes mellitus, dyslipidaemias, renal disease, psoriasis, hypertension, diuretic use and anti-diabetic medication. Cohort studies were included if examining (at least) one of these risk factors for gout in either gender in the general population or primary care. Sample characteristics from included articles and their reported risk estimates were described using narrative synthesis. Results: Thirty-three articles were included, 20 (60.6%)directly compared risk factors by gender, 10 (30.3%) used men-only samples, 3 (9.1%) used women-only samples. Articles comparing risk across genders found similar increases in most risk factors. However, in men, metabolic syndrome (Hazard Ratio (95% CI) 1.37(1.20-1.58)) presented a risk of incident gout compared to none in women (> 50 years 1.15(0.85-1.54); ≤50 years 1.29(0.76-2.17)). Compared to men, women showed greater associated risk with higher consumption of fish and shellfish (HR (95% CI) Men: 1.02 (0.86-1.22); Women 1.36 (1.12-1.65)). Conclusions: Risk factors for developing gout did not typically differ between genders and therefore similar preventative advice can be provided. Exceptions were metabolic syndrome in men and excessive seafood consumption in women, but these singular articles need further examination and in general more research into the risk factors for gout which includes women is required.

Common Whelk (Buccinum undatum)Allergy:Identification of IgE-binding Components and Effects of Heating and Digestive Enzymes

In Korea, common whelk (Buccinum undatum) is a popular edible shellfish. The aim of this study was to observe the sensitization rate to common whelk and to characterize its allergens. We carried out skin prick test (SPT) in 1,700 patients with various allergic diseases. Specific IgE were detected by ELISA in the patient sera and ELISA inhibition tests were conducted. IgE-binding components were identified by means of SDS-PAGE and IgE-immunoblotting. The effects of diges-tive enzymes were evaluated in both raw and thermally treated extracts. SPT to common whelk was positive (> or =2+) in 83 (4.9%) patients studied. Twenty-four (38.7%) out of 62 SPT positive patients had high serum specific IgE to common whelk. ELISA inhibition test showed significant inhibitions by abalone as well as by common whelk. IgE-immunoblotting demonstrated three IgE-binding components (40, 71, 82 kDa), which were digested by simulated intestinal fluid and moderately digested by simulated gastric fluid, and the digestibility of allergens remained unchanged after thermal treatment. In conclusion, IgE-sensitization rate to com-mon whelk was 4.9% in allergy patients. IgE-immunoblotting demonstrated three IgE-binding components, which were degraded by digestive enzymes. Further studies are needed to evaluate the clinical significance of the sensitized patients to common whelk.

The relevance of specific serum IgG, IgG4 and IgE in the determination of shrimp and crab allergies in Malaysian allergic rhinitis patients.

The significance of food specific serum IgG4 antibody in food allergy is unclear and this led us to investigate the relevance of specific IgG4, along with IgG and IgE antibodies to two common food allergens in Malaysia. Enzyme-linked immunosorbent assay (ELISA) was used to measure the serum antibodies in 143 allergic rhinitis patients' sera, of which 47 were from patients with clinical indication of shrimp allergy, 46 with clinical indication of crab allergy and 50 without indication to either allergy. Clinical indication of allergy was based on answers to a questionnaire or results of the skin prick test. We found that the elevation of specific IgE or IgG4 is associated with shrimp and crab allergies but elevation of specific IgG is not associated with either allergy. However, the clinical utility of elevated specific IgG and IgG4 levels is pending further investigation.

Aumento de sensibilidad alérgica a la ingesta de mariscos en pacientes bajo protocolos de inmunoterapia específica [SIT] para ácaros / Increase of allergic sensitization to shellfish consumption in patients treated with specific immunotherapy [SIT] for mites

Seis pacientes que consultaron por síntomas respiratorios alérgicos (RSP y ASMA) diagnosticados por Skin prick test (SPT), fueron tratados con inmunoterapia específica (SIT) para ácaros por un lapso promedio de 23,3 meses. Tres (N2, N4 y N5) referían a su ingreso, síntomas leves a la ingesta de mariscos y se hizo SPT e IgE específica por Radio Allergo Sorbent Test (RAST) para "pool" de mariscos antes de la SIT. Ante la aparición y/o intensificación de síntomas en estos 6 pacientes por ingesta de frutos de mar luego de SIT prolongada, se realizó RAST clase 1 y 2 para N4 y N2; y N1 entre clase 0 y 1 (0,35 PRU/ml). El SPT de N2 se mantuvo positivo y el de N5 negativo, tal como antes de SIT. Sólo N4 cambió a SPT positivo al "pool" de marisco. Doce controles asintomáticos con SIT similares fueron negativos a la provocación oral, al SPT y al RAST. La presencia de un antígeno común a ambos alergenos (tropomiosina) al ser administrado en SIT para ácaros, provocaría una sensibilización nueva o aumentada en estos pacientes aunque no se pudo descartar sensibilización por ingesta habitual de mariscos

Recuperación e identificación de vibrio choloerae en mariscos provenientes de diferentes mercados de Lima Metropolitana y Callao / Identification and recuperation of vibrio cholerae en sellfish from Lima and Callao market

A fines de 1991, se inició en el Perú una epidemia de cólera de gran inagnitud, en cuanto a morbi-mortalidad y extensión geográfica, que invadió a 19 países produciendo 600,000 casos y más de 6000 muertes. Esta enfermedad ha sido relacionada con el consumo de numerosos productos de pesca, entre ellos los mariscos como vehículos de transmisión del vibrio cholerae. El método utilizado fue el reconocimiento por el ICMSF modificado. Se analizó 104 muestras de mariscos, obteniéndose 0.96 por ciento de positividad correspondiente a la muestra de marisco tipo almeja, comprobándose mediantes pruebas serológicas, pertenecia al serotipo inaba. Asimismo, se comprobó la localización del microorganismo en las valvas del marisco y no en el músculo. También se puso de manifiesto la efectividad del método mediante un segundo enriquecimiento en APA pH=8,6 que proporcionó una mayor selectividad.

Foodborne disease outbreaks of chemical etiology in Thailand, 1981-1987.

A study was conducted to determine the current situation of chemical foodborne outbreaks in Thailand for the period 1981-1987. Seventy-three outbreaks of chemical poisoning involving 1236 persons of whom 54 died were reported. Twenty outbreaks affecting 722 cases were caused by insecticide poisoning and methomyl was the most commonly recognized insecticide involved. Poisonous plants were responsible for 43 outbreaks with 420 cases. Mushroom poisoning was the most common entity (21 outbreaks, 211 cases), with plant seed poisoning next (9 outbreaks, 179 cases). There were 8 outbreaks following consumption of poisonous seafoods. Mussels were identified to be the vector in the outbreak of PSP. Horseshoe crabs which served as the vehicles for 4 outbreaks were also suspected to be associated with PSP. Puffer fish accounted for the remaining 3 outbreaks involving 6 cases of tetradotoxin poisoning. More complete reporting and more effort in outbreak investigations are needed for appropriate preventive and control measures.