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1.
Mycoses ; 2023 May 16.
Article in English | MEDLINE | ID: covidwho-2314754

ABSTRACT

BACKGROUND: Factors associated with pulmonary mucormycosis (PM) among subjects with diabetes mellitus (DM) remain unclear. Following the coronavirus disease (COVID-19)-associated mucormycosis outbreak in India, specific environmental exposures (especially cattle dung exposure) were proposed as possible aetiology. We hypothesized that environmental factors are associated with PM. We compared subjects with DM with (cases) and without PM (controls). METHODS: In this case-control study, for each PM case, we included five unmatched diabetic controls (hospital [n = 2], community [n = 3]) without PM. We collected information on demography, COVID-19 infection, glycated haemoglobin% (HbA1c), the type of house (pucca vs. kutcha) where the participants reside, and other environmental factors. The primary exposure tested was cattle dung exposure (CDE; using cattle dung cakes as fuel or cattle handling). We performed a multivariate logistic regression to explore factors associated with PM and report the association as an adjusted odds ratio (OR) with 95% confidence intervals (CI). RESULTS: We enrolled 39 PM cases and 199 controls (hospital [n = 80], community [n = 119]). CDE (OR 0.68, 95% CI [0.14-3.31]; p = 0.63) was not associated with increased PM in DM. We found male sex (OR 4.07, 95% CI [1.16-14.31]), higher HbA1c (OR 1.51, 95% CI [1.18-16.32]), COVID-19 (OR 28.25, 95% CI [7.02-113.6]) and residence at kutcha house (OR 4.84, 95% CI [1.33-17.52]) associated with PM. CONCLUSION: Cattle dung exposure was not associated with PM in subjects with DM. Instead, male sex, poor glycaemic control, COVID-19 and the type of housing were associated with pulmonary mucormycosis.

2.
AJO-DO Clinical Companion ; 1(1):5-6, 2021.
Article in English | EMBASE | ID: covidwho-2284707
3.
Journal of Allergy and Clinical Immunology ; 151(2):AB200, 2023.
Article in English | EMBASE | ID: covidwho-2241044

ABSTRACT

Rationale: The Impairment Measure for Parental Food Allergy-Associated Anxiety and Coping Tool (IMPAACT) is a food-allergy anxiety questionnaire for parents of children with food allergy. While the measure has been recently validated, normative data has not yet been presented. As such, the current study provides preliminary cut-scores and percentiles to help facilitate its use as a screening tool. Methods: Parents of children with food allergy were largely recruited through national and local patient organizations and were asked to complete questionnaires aimed at assessing their demographics and IMPAACT scores pre/post COVID-19. While the data was primarily analyzed descriptively (n/N, %, mean, SD, percentiles), inferential statistics were used to assess the relationship between the IMPAACT and various participant characteristics. Results: The final sample consisted of 281 parents (mothers=92%) and ranged in age from 27-64 years. The majority of participants reported having one child with a food allergy (85%). Allergies to peanuts were most common (79%), followed by tree nuts (56%), eggs (33%), and cow's milk (24%). IMPAACT scores were significantly lower following the outbreak of COVID-19 relative to the period prior to the outbreak (mean 87.89 [SD=36.44] vs. 102.97 [SD=33.71], p<0.001;maximum possible score: 196). Given these differences in food allergy anxiety before and after the pandemic, percentiles and cut-scores for both periods are presented. IMPAACT scores greater than 125, or 112 during periods of public health restrictions/reduced socialization, may merit further evaluation. Conclusions: Findings provide preliminary cut-points and percentiles that may help identify parents with elevated levels of food allergy anxiety.

4.
Journal of Pharmaceutical Negative Results ; 14(2):313-319, 2023.
Article in English | EMBASE | ID: covidwho-2240475

ABSTRACT

Background: Diabetes mellitus (DM) represents one of the most common metabolic diseases in the world, with rising prevalence in recent decades. Most cases are generally classified into two major pathophysiological categories: type 1 diabetes mellitus (DM1), which progresses with absolute insulin deficiency and can be identified by genetic and pancreatic islet autoimmunity markers, and type 2 diabetes mellitus (DM2), which is the most prevalent form and involves a combination of resistance to the action of insulin with an insufficient compensatory response of insulin secretion. In the last two decades, in parallel with the increase in childhood obesity, there has also been an increase in the incidence of DM2 in young people in some populations. Other forms of diabetes may affect children and adolescents, such as monogenic diabetes (neonatal diabetes, MODY – maturity onset diabetes of the young, mitochondrial diabetes, and lipoatrophic diabetes), diabetes secondary to other pancreatic diseases, endocrinopathies, infections and cytotoxic drugs, and diabetes related to certain genetic syndromes, which may involve different treatments and prognoses. DM1 is considered an immuno-mediated disease that develops as a result of gradual destruction of insulin-producing pancreatic beta cells that eventually results in their total loss and complete dependence on exogenous insulin. Clinical presentation can occur at any age, but most patients will be diagnosed before the age of 30 years

5.
J Membr Biol ; 2022 Jun 20.
Article in English | MEDLINE | ID: covidwho-2229470

ABSTRACT

Shielding of the specific body organ using the biocompatible material helps preventing direct exposure of that part to the foreign entities responsible for infections. Here we show the potential of the A2 milk protein recovered from the milk of cow from Indian origin for possible prevention of the direct exposure to other foreign molecules. We measured the surface pressure of the monolayers of different types of protein samples using Langmuir isotherm experiments. The surface pressure measurements for the monolayer of four types of protein macromolecules have been carried out using the Wilhelmy plate micro pressure sensor. We studied the self-organization of different protein macromolecules and their monolayer compression characteristics. The electrochemical behaviour is studied using electrochemical impedance spectroscopy. We found the highest surface pressure for the monolayer of A2 protein. Further, it is also found that A2 protein exhibited the highest surface activity amongst the other proteins. This property can be effectively used for making the envelope of the A2 protein surrounding the targeted entity.

6.
Asian Pacific Journal of Allergy and Immunology ; 40(4):353-358, 2022.
Article in English | ProQuest Central | ID: covidwho-2217626

ABSTRACT

Background: Tolerance of baked milk indicates a good prognosis in IgE-mediated cow's milk allergy. Objective: The present study aims to investigate the predictors of baked milk tolerance, particularly the amount of milk tolerated in the first oral food challenge (OFC) test, in children with IgE-mediated cow's milk allergy. Methods: The study included 35 cases who were diagnosed with IgE-mediated cow's milk allergy upon open OFC testing in the Pediatric Allergy Clinic. Four weeks after the diagnosis, skin prick test (SPT) and OFC were performed with baked milk. Cases who did and did not develop reactions during OFC with baked milk were compared regarding clinical and laboratory parameters. Results: Twelve cases (33.3%) did not develop a reaction during OFC with baked milk. Those who had low levels of casein sIgE, ß-lactoglobulin sIgE, and a-lactoalbumin sIgE;small SPT wheal diameter for baked milk and a-lactoalbumin;and a large amount of unheated milk tolerated in the first OFC were found to be tolerant to baked milk (p < 0.05). For predicting baked milk tolerance, a cut-off level of the amount of unheated milk tolerated in OFC was calculated as 620 mg [with the area under the curve (AUC) 0.88 (95% confidence interval 0.77-0.99) in ROC curve analysis]. Conclusion: If a child with cow's milk allergy is able to tolerate more than 620 mg of milk protein during challenge with unheated milk, this may show that this child will tolerate baked milk, meaning that the child will be able to tolerate cow's milk in the future.

7.
Norsk Veterinaertidsskrift ; 129(9):579-581, 2022.
Article in Norwegian | CAB Abstracts | ID: covidwho-2167278

ABSTRACT

This article is the first in a series regarding the Norwegian Rogalands project's prevention and control of bovine coronavirus, Bovine respiratory syncytial virus, bovine coronavirus, digital dermatitis and other infectious diseases in cattle. Hygiene during transport and in the barn environment are emphasized.

8.
Indian Journal of Animal Sciences ; 92(11):1360-1363, 2022.
Article in English | EMBASE | ID: covidwho-2114660

ABSTRACT

This study was conducted among the Maldhari community to understand the sustainability of migratory pastoralism during Covid-19. Bhuj and Lakpat Talukas of Kachchh district, Gujarat were selected to study the effect of profile variables on the annual income and net income of the families. The study revealed that family size and taluka were the significant factors influencing total income whereas taluka was the only significant factor influencing net income. Due to reduced sale of milk resulting from Covid-19, most of the milk was converted into khoa and the income generated from its sale was the major source of income for the migratory families. Cow dung fetched a minimal price which served as major source of their livelihood with no input cost. The value addition with better marketing facilities can significantly enhance the income of the pastoralists in the Kachchh district. Copyright © 2022 Indian Council of Agricultural Research. All rights reserved.

9.
Trace Elements and Electrolytes ; 39(2), 2022.
Article in English | EMBASE | ID: covidwho-1912854

ABSTRACT

The proceedings contain 4 papers. The topics discussed include: relevance of magnesium for the fresh cow;ionized magnesium: update 2021;serum magnesium assessment needs for standardization;and microvascular dysfunction and magnesium - impact in COVID times and further on.

10.
Mycoses ; 65(11): 1024-1029, 2022 Nov.
Article in English | MEDLINE | ID: covidwho-1896015

ABSTRACT

BACKGROUND: Several hypotheses have been proposed for explaining the outbreak of coronavirus disease 2019 (COVID-19)-associated mucormycosis in India, including the burning of cattle dung cakes, though no study has yet been conducted to support this claim. METHODS: We conducted an aero-mycological study to evaluate whether Mucorales in the air increased during or after burning cattle dung cakes. We further compared the growth of Mucorales in the indoor air samples from houses with and without cattle. We also cultured fresh and dried cattle dung and soil samples for Mucorales. RESULTS: We noted no significant difference in the proportion of air samples growing Mucorales during (4/22 [18.2%]) and after (3/2 [13.6%]) cattle dung burning than that collected immediately before (4/22 [18.2%]). Mucorales were isolated in 15.4% of the indoor air samples obtained from different houses (both rural and urban); the proportion of samples growing Mucorales was not significantly different in households with and without cattle. We also observed growth of Mucorales in 6 of the 8 [75%] fresh and 3 of the 6 [50%] dried dung samples. The most common Mucorales isolated from soil and dung samples was Lichtheimia corymbifera, while Rhizopus arrhizus was the most common species isolated from indoor air samples. CONCLUSIONS: We found no significant increase in the proportion of air samples growing Mucorales during or after burning cattle dung cake than that before. It seems unlikely that cattle dung burning contributes to the occurrence of mucormycosis.


Subject(s)
COVID-19 , Mucormycosis , Animals , COVID-19/epidemiology , COVID-19/veterinary , Cattle , India/epidemiology , Mucormycosis/epidemiology , Soil
11.
J Anim Sci ; 100(8)2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1890963

ABSTRACT

Passive transfer of colostral immunoglobulins from the cow to the calf is essential for calf health. The objective of this study was to determine if prepartum administration of a vaccine stimulates increased concentrations of colostral immunoglobulins of dairy cows beyond what is explained by vaccine-specific immunoglobulins. A prospective cohort study was conducted on a spring-calving commercial dairy farm that had a policy of only vaccinating cows with even ear tag numbers with a calf diarrhea vaccine, whereas cows with odd ear tag numbers were left unvaccinated. Cows in the vaccinated group (even ear tag numbers, n = 204) received a sensitizer and booster vaccination with a vaccine against bovine rotavirus (serotypes G6 and G10), bovine coronavirus, and E. coli having the K99 pili adherence factor. A sensitizer was given because the study vaccine was different from the vaccine previously used. Cows in the control group (odd ear tag numbers, n = 194) received a 2-mL subcutaneous sterile saline solution. Both groups received two treatments at a 3-wk interval, completing the treatments approximately 2 wk prior to the planned start of calving. During the calving period, technicians separated calves from cows immediately after parturition and prior to suckling, and cows were completely milked out within 6 h of parturition. Vaccine-specific, total, and nonvaccine-specific (total minus vaccine-specific) concentrations of immunoglobulin classes A, G1, G2a, and M (IgA, IgG1, IgG2a, and IgM, respectively) were quantified by mass spectrometry for 20 colostrum samples from each treatment group. Predicted mean non-vaccine-specific colostral IgM concentrations were 8.76 (95% CI = 7.18-10.67) and 5.78 (95% CI = 4.74-7.05) mg/mL for vaccinated and control cows, respectively (P = 0.005). Predicted mean non-vaccine-specific colostral IgG1 concentrations were 106.08 (95% CI = 92.07-120.08) and 95.30 (95% CI = 81.30-109.31) mg/mL among vaccinated and control cows, respectively; however, these means were not significantly different (P = 0.278). It is thus possible that the vaccine, in addition to specifically managing infectious calf diarrhea, may also have non-specific benefits by improving colostrum quality through increased non-vaccine-specific colostrum IgM concentrations. Further research is necessary to determine the mechanism for these preliminary findings, whether the effect may occur in other immunoglobulin classes, and what impacts it may have on calf health outcomes.


Unlike human babies, calves do not receive protective immune proteins (immunoglobulins) from the mother before birth, so a sufficient volume of immunoglobulin-rich colostrum of adequate quality must be consumed within hours of birth. It can be a challenge to meet this requirement for all dairy calves. Prior to calving, cows can be vaccinated with a vaccine against specific infectious causes of calf diarrhea to stimulate elevated concentrations of specific immunoglobulins in their colostrum, which is consumed by their calves to protect them until their own immune systems develop. We enrolled cows that were either vaccinated or not with a calf diarrhea vaccine and, using novel laboratory techniques, measured concentrations of immunoglobulin classes A, G, and M in their colostrum. As expected, vaccinated cows had elevated concentrations of vaccine-specific immunoglobulins in their colostrum. However, they also had elevated non-vaccine-specific concentrations of immunoglobulin M. The vaccine may therefore have stimulated a nonspecific increase in colostral immunoglobulin M concentrations. Further research is necessary to confirm the preliminary findings of the present study and determine the mechanism for this apparent nonspecific increase in colostral immunoglobulin M concentrations, whether it may occur in other immunoglobulin classes, and whether it may benefit calf health and growth.


Subject(s)
Colostrum , Vaccines , Animals , Animals, Newborn , Cattle , Colostrum/chemistry , Diarrhea/prevention & control , Diarrhea/veterinary , Escherichia coli , Female , Humans , Immunoglobulin G/analysis , Immunoglobulin M , Pregnancy , Prospective Studies
12.
Sustainability ; 14(10):6249, 2022.
Article in English | ProQuest Central | ID: covidwho-1870595

ABSTRACT

This study aimed to realize Sustainable Development Goals (SDGs), i.e., no poverty, zero hunger, and sustainable cities and communities through the implementation of an intelligent cattle-monitoring system to enhance dairy production. Livestock industries in developing countries lack the technology that can directly impact meat and dairy products, where human resources are a major factor. This study proposed a novel, cost-effective, smart dairy-monitoring system by implementing intelligent wireless sensor nodes, the Internet of Things (IoT), and a Node-Micro controller Unit (Node-MCU). The proposed system comprises three modules, including an intelligent environmental parameter regularization system, a cow collar (equipped with a temperature sensor, a GPS module to locate the animal, and a stethoscope to update the heart rate), and an automatic water-filling unit for drinking water. Furthermore, a novel IoT-based front end has been developed to take data from prescribed modules and maintain a separate database for further analysis. The presented Wireless Sensor Nodes (WSNs) can intelligently determine the case of any instability in environmental parameters. Moreover, the cow collar is designed to obtain precise values of the temperature, heart rate, and accurate location of the animal. Additionally, auto-notification to the concerned party is a valuable addition developed in the cow collar design. It employed a plug-and-play design to provide ease in implementation. Moreover, automation reduces human intervention, hence labor costs are decreased when a farm has hundreds of animals. The proposed system also increases the production of dairy and meat products by improving animal health via the regularization of the environment and automated food and watering. The current study represents a comprehensive comparative analysis of the proposed implementation with the existing systems that validate the novelty of this work. This implementation can be further stretched for other applications, i.e., smart monitoring of zoo animals and poultry.

13.
Cleft Palate-Craniofacial Journal ; 59(4 SUPPL):22, 2022.
Article in English | EMBASE | ID: covidwho-1868927

ABSTRACT

Background/Purpose: The Covid-19 pandemic has restricted in person care at our cleft treatment center, delayed patient turnout, and led to financial losses and an increased number of missed scheduled appointments. Thus, we have sought new ways to monitor the nutritional status of infant patients with clefts, by using the WhatsApp® application, so as to conduct timely nutritional interventions and to prevent malnutrition and anemia. The purpose was to monitor the nutritional status of newborn babies with cleft, using the WhatsApp® application, and to validate its use. Methods/Description: 71% of internet users in Brazil use WhatsApp® to send and receive messages. This application is easy to use, with privacy ensured by cryptography. This research project was approved by the Institutional Review Board. The protocol established: 1) new cases of infants up to 30 days old, with cleft lip and/or cleft palate;2) consent form signed by parent or guardian;3) the first appointment was in person;with mothers receiving training and guidance to send information about their children's height and weight every month;4) data comparisons were conducted against WHO benchmarks (WAZ score between 0 and - 1 = healthy weight;between - 1 and - 2 = nutritional risk;< - 2 = underweight);6) nutritional interventions considering RDI's. Results: 18 patients were followed up by regular data submission through the WhatsApp® application;8 had cleft lips, 3 cleft palates, and 7 cleft lip and palates. Among these patients, 1 had a gastrostomy tube, 2 had cow milk protein allergy, and 1 had cardiac disease. Thus far, 8 have already been submitted to lip surgery, and 10 are waiting to reach the appropriate age for surgery. Twelve were classified as coming from low-income families, and 6 from medium income families. Most of them (no. = 17) travelled between 100-500 km to receive care, and 1 more than 100 km. Eight received transportation and food subsidized by public funds, and 10 used their own funds. Thirteen children were fed breast milk for 120 days, 8 were breast fed directly and 5 were fed pumped breast milk;5 were fed formula. Nine began eating additional foods at 6 months, the remaining patients were not old enough for that yet. Eleven children had normal weight (eutrophic) since the onset, 3 were malnourished when the study began and recovered after about 54 days, 4 were at risk when the study began and recovered after about 26.5 days. No patient had to delay surgery because of anemia (mean Hb = 11.45g/ dL). Nutritional interventions included encouraging breast feeding and different breastfeeding positions, guidance regarding the appropriate concentration of infant formula and how /when to introduce of additional foods. Milk formula, bottles, scales, and measuring tapes were donated. Conclusions: The use of the WhatsApp® application for nutritional follow up proved to be a valid and effective way tomonitor the patients' growth and development, yielding efficient nutritional recovery.

14.
Food Sci Nutr ; 10(8): 2786-2793, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1819360

ABSTRACT

In the light of the Covid-19 pandemic outbreak, and the need-of-the-hour to boost immunity to residents, especially those residing in an arid environment, a comparative study was made on the physical and biochemical properties of dairy milk. This novel study in Kuwait revealed the lesser consumed pseudoruminant camel milk as a better potential source of dietary inclusion and an immune booster over true ruminants-cow's and goat's milk. Analysis using a wide array of instruments determining the physical characteristics in camel's milk (pH, conductivity, specific gravity, moisture, and total solids), biochemical constituents (crude protein (CP), nonprotein (NP), and fat), and inorganic constituents (K-919; Ca-907; Zn-4.2 mg/100 mg) revealed conducive properties that validate immunity to consumers when compared to the regularly used cow's milk (K-841; Ca-776; Zn-2.43 mg/100 mg) and goat's milk (K-914; Ca-849; Zn-2.45 mg/100 mg). Log-transformed results revealed high vitamin C in camel's milk (0.42 mg/100 g), indicating high antioxidant properties compared to those of goat's milk (0.12 mg/100 g) and cow's milk (0.04 mg/100 g). Statistical tests by analysis of variance (ANOVA) revealed significant differences and the correlation coefficient between the three milk samples validating the multiple reasons to use camel's milk over the cow's and goat's milk. Furthermore, this study recommends the consumption of camel's milk due to its low concentrations of contaminants as well, their status below permissible limits in Kuwait, set by global standards over the other sampled milks.

15.
Biochemical and Cellular Archives ; 21(2):1-2, 2021.
Article in English | EMBASE | ID: covidwho-1812557
16.
mBio ; 13(2): e0047322, 2022 04 26.
Article in English | MEDLINE | ID: covidwho-1769826

ABSTRACT

The exact cause of the disproportionate increase in COVID-19-associated mucormycosis (CAM) cases in India remains unknown. Most researchers consider the major cause of India's CAM epidemic to be the conjunction of the COVID-19 pandemic and associated corticosteroid treatment with the enormous number of Indians with diabetes mellitus (DM). However, excess CAM cases were not seen to the same extent in the Western world, where diabetes is prevalent and corticosteroids are also used extensively for COVID-19 treatment. Herein, we hypothesize that previously overlooked environmental factors specific to India were important contributors to the country's CAM epidemic. Specifically, we propose that the spread of fungal spores, mainly through fumes generated from the burning of Mucorales-rich biomass, like cow dung and crop stubble, caused extensive environmental exposure in the context of a large population of highly vulnerable patients with DM and COVID-19. Testing this hypothesis with epidemiologic studies, phylogenetic analyses, and strategic environmental sampling may have implications for preventing future epidemics.


Subject(s)
COVID-19 Drug Treatment , COVID-19 , Mucormycosis , Adrenal Cortex Hormones , COVID-19/epidemiology , Humans , Mucormycosis/epidemiology , Pandemics , Phylogeny
17.
Irish Medical Journal ; 114(10), 2021.
Article in English | EMBASE | ID: covidwho-1733143
18.
Borneo Journal of Pharmacy ; 4(4):260-272, 2021.
Article in English | EMBASE | ID: covidwho-1649493

ABSTRACT

Coronaviruses cause some severe forms of respiratory infections such as Severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and Coronavirus disease 2019 (Covid-19). These viruses cause diarrhea in pigs and cows and upper respiratory disease in chickens, while other symptoms may differ. In humans, a total of six coronaviruses have been identified HCoVs-NL63, HCoVs-OC43, HCoVs-229E, HCoVs-HKU1, MERS-CoV, and SARS-CoV. The world health organization (WHO) has done a great deal of hard work regarding combating the monstrous effects of this virus. So far, no specific antiviral drugs have been developed for the treatment of Covid-19. Therefore, the medicinal plants used for the previous epidemic outbreaks are getting attention for their potential treatment against the virus. It has been reported that 70 to 80% of people in developing countries depend on medicinal plants or phytomedicine compared to allopathic drugs for their primary healthcare. The south Asian subcontinents have used almost up to 25,000 formulations and extracts obtained from medicinal plants for treatment in folk medicine. The present review discusses an overview of the coronavirus, its immune responses, and some immunity-boosting herbs to combat Covid-19.

19.
Fermentation ; 8(1):4, 2022.
Article in English | ProQuest Central | ID: covidwho-1629772

ABSTRACT

Enzymes excreted by rumen microbiome facilitate the conversion of ingested plant materials into major nutrients (e.g., volatile fatty acids (VFA) and microbial proteins) required for animal growth. Diet, animal age, and health affect the structure of the rumen microbial community. Pathogenic organisms in the rumen negatively affect fermentation processes in favor of energy loss and animal deprivation of nutrients in ingested feed. Drawing from the ban on antibiotic use during the last decade, the livestock industry has been focused on increasing rumen microbial nutrient supply to ruminants through the use of natural supplements that are capable of promoting the activity of beneficial rumen microflora. Selenium (Se) is a trace mineral commonly used as a supplement to regulate animal metabolism. However, a clear understanding of its effects on rumen microbial composition and rumen fermentation is not available. This review summarized the available literature for the effects of Se on specific rumen microorganisms along with consequences for rumen fermentation and digestibility. Some positive effects on total VFA, the molar proportion of propionate, acetate to propionate ratio, ruminal NH3-N, pH, enzymatic activity, ruminal microbiome composition, and digestibility were recorded. Because Se nanoparticles (SeNPs) were more effective than other forms of Se, more studies are needed to compare the effectiveness of synthetic SeNPs and lactic acid bacteria enriched with sodium selenite as a biological source of SeNPs and probiotics. Future studies also need to evaluate the effect of dietary Se on methane emissions.

20.
J Allergy Clin Immunol Pract ; 10(1): 215-221.e2, 2022 01.
Article in English | MEDLINE | ID: covidwho-1604349

ABSTRACT

BACKGROUND: Food desensitization via oral immunotherapy (OIT) is gaining acceptance in clinical practice. Owing to adverse reactions, the duration of the buildup phase until a maintenance dose is achieved may be prolonged, and in a minority of cases, OIT is stopped. OBJECTIVE: We aimed to assess factors associated with the probability of reaching the maintenance dose in cow's milk (CM) OIT. METHODS: We collected data from patients undergoing CM OIT at the Montreal Children's Hospital, BC Children's Hospital, and Hospital for Sick Children. We compared univariable and multivariable Cox regressions to evaluate sociodemographic factors, comorbidities, clinical characteristics, and biomarkers at study entry associated with the likelihood of reaching a maintenance dose of 200 mL of CM. RESULTS: Among 69 children who reached 4 mL of milk, the median age was 12 years (interquartile range, 9-15 years); 59% were male. Median duration of buildup phase from 4 to 200 mL was 24.0 weeks (interquartile range, 17.7-33.4 weeks). After adjusting for age and sex, higher baseline levels of specific IgE antibodies for α-lactalbumin (hazard ratio [HR] = 0.80; 95% confidence interval [CI], 0.67-0.95), ß-lactoglobulin (HR = 0.86; 95% CI, 0.76-0.98), casein (HR = 0.82; 95% CI, 0.72-0.94), and total CM (HR = 0.79; 95% CI, 0.65-0.97) were associated with a decreased probability of reaching maintenance. In addition, for every 10-mL increase in CM tolerated at entry challenge, the probability of reaching maintenance increased by 10%. CONCLUSIONS: The data suggest that higher levels of CM-specific IgE decreased the likelihood of reaching maintenance, whereas an increased cumulative CM dose at entry challenge increased the likelihood. Assessing these factors before therapy may assist in predicting the success of CM OIT.


Subject(s)
Milk Hypersensitivity , Milk , Administration, Oral , Animals , Cattle , Child , Desensitization, Immunologic , Female , Humans , Immunoglobulin E , Male , Milk Hypersensitivity/therapy , Probability
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