Biomarkers associated with persistence and severity of IgE-mediated food allergies: a systematic review

Abstract Objective The prevalence of food allergies (FA) has increased worldwide over the last few decades. Milk, eggs, and peanuts are among the most common allergens and can cause anaphylaxis. Therefore, we aimed to identify biomarkers that could predict the persistence and/or severity of IgE-mediated allergies to milk, eggs, and peanuts via a systematic review. Methods This systematic review proceeded according to a protocol registered in the International Prospective Register of Systematic Reviews. Two independent authors extracted studies of interest from PubMed, SciELO, EMBASE, Scopus, and Ebsco databases and assessed their quality using the Newcastle-Ottawa Scale. Results We selected 14 articles describing 1,398 patients. Among eight identified biomarkers, total IgE, specific IgE (sIgE), and IgG4 were the most often cited biomarkers of persistent allergies to milk, eggs, and peanuts. Skin prick tests, endpoint tests, and sIgE cutoff levels may predict positive responses to challenges with these foods. The basophil activation test is a biomarker for the severity and/or threshold of allergic reactions to milk and peanuts. Conclusion Only a few publications identified possible prognostic indicators of the persistence or severity of FA and outcomes of oral food challenges, indicating that more accessible biomarkers are needed to determine the likelihood of having a severe food allergic reaction.

Crescimento em asmáticos pré-púberes em uso de corticosteróide inalatório / Linear growth in pre-pubertal asthmatics and inhaled corticosteroid use

Introdução: O objetivo deste estudo retrospectivo foi identificar a relação entre o uso de corticosteróide inalatório e o crescimento linear de asmáticos pré-púberes. Métodos: Análise retrospectiva de uma amostra selecionada por conveniência, constituída por pacientes pré-púberes ( dez anos de idade) com diagnóstico de asma e tratados com corticosteróide inalatório. As medidas da estatura foram avaliadas pelo escore de desvio-padrão da estatura (H505) em três ocasiões diferentes. Para análise estatística utilizaram-se os testes de ANOVA. Resultados: A média de idade dos 22 pacientes (14 do sexo masculino) foi de 7,7 anos na primeira consulta. A maior parte dos pacientes apresentava asma leve (dez casos) e mode-rada (dez) e apenas dois pacientes tinham asma de intensidade grave. O tempo médio decorrido entre as três ocasiões em que os pacientes foram avaliados foi de doze meses. Dezessete pacientes (77,2%) utilizavam corticosteróide inalatório em doses baixas (até 500 mcg/dia de beclometasona ou doses equivalentes de outros corticosteróides inalatórios). A mediana do escore H5D5 obtido na primeira, segunda e terceira consultas foi respectivamente de 0,35; 0,25 e 0,20 respectivamente (p =0, 284). Conclusões: Neste grupo de asmáticos pré-púberes a média de H505 mostrou que, independente da dose de corticosteróide inalatório utilizada, os pacientes mantiveram seu canal de crescimento.

Introduction: The aim of this study was to verify the rE tion between pre-pubertal asthmatics linear growth and use of inhaled corticosteroids. Methods: Pre-pubertal asthmatic patients (~ 10 years c under inhaled corticosteroids were included. The height mea re was determined by height standard deviation score (H5[ in three d ifferent occasions. Data were analysed by ANC tests. Results: The mean age of the 22 subjects (14 males) inc ded was 7,7 years at first visito The majority of the patie had mild asthma (10 cases) and moderate (10), and only ~ them had severe asthma. The mean time between the th occasions when the subjects were analyzed was 12 mont 5eventeen subjects (77,2%) were under low doses of inha corticosteroid (~500 mcg/day beclomethasone or equival dose of different inhaled steroid). The median H505 at fi second and third visits was respectively 0,35; 0,25 and O (p=0,284). Conclusions: ln this group of asthmatics the H5D5 rru showed that, regardless the inhaled corticosteroid dose, th was no influence on linear growth.

Acurácia da espirometria na classificação da gravidade da asma em crianças e adolescentes / Accuracy of pulmonary function test in pediatric and adolescent asthma cIassification

Objetivo: Este estudo teve como objetivo verificar a relação entre gravidade da asma e valores de espirometria em crianças e adolescentes asmáticos. Método: Foi realizado estudo retrospectivo com pacientes asmáticos submetidos a espirometria, em aparelho Collins GS 4G PFr, de acordo com os critérios estabelecidos pelas Diretrizes para Teste de Função Pulmonar (2002). A partir de dados de anamnese e exame físico foi determinada a classificação clínica da asma (GINA 1995). Os dados foram analisados por meio de teste ANOVA paramétrico e não paramétrico. Resultados: Umtotal de 234 pacientes foi incluído no estudo, com mediana de idade de 10,3 anos (5 a 18 anos), 142 pacientes (60) eram do sexo masculino. A asma foi classificada como de leve intensidade em 114 pacientes (48,7...

Sudden unexpected, unexplained death in epilepsy autopsied patients

Sudden unexpected, unexplained death in epilepsy (SUDEP) has been reported to be responsible for 2 to 17 percent of all deaths in patients with epilepsy. This study was conducted to determine the circumstances of SUDEP and the autopsy findings in these patients. Fifty-three individuals whose cause of death was related to epilepsy were identified and in 30 cases relatives or friends were interviewed about the circumstances of death and other information which allowed to classify the patients as SUDEP or not. The death certificates were also reviewed. We found 20 cases of SUDEP. Most of them were found dead lying on the bed with no evidence of seizure event, and most of them had pulmonary and/or cerebral edema as the cause of death. The incidence and the risk of SUDEP can only be fully ascertained if all sudden deaths had postmortem examination. Consensus in certifying SUDEP cases would allow better accuracy in national mortality rate