Oral and nasal provocation test in chicken egg allergy-case report.

INTRODUCTION: Allergy to chicken egg protein is a common form of food allergy. The most common clinical presentation includes gastrointestinal, skin, and respiratory symptoms. Differential diagnosis, including provocative tests, is critical in diagnosis. CASE DESCRIPTION: We present a case of a 21-year-old patient with egg allergy, who underwent a double-blind food provocation test with placebo (evaluating subjective complaints from the gastrointestinal tract) and a titrated nasal provocation test using dry chicken egg content. We assessed the response of the nasal mucosa in the provocation test using the visual analogue scale (VAS), acoustic and optical rhinometry, as well as measurements of nitric oxide concentration in the exhaled air. During the provocation test, we measured the changes in the transverse section of the nasal passages, which were accompanied by subjective complaints measured with the VAS scale, using objective techniques. In the nasal provocation test with a dose of 20 µg of chicken egg protein, we observed an increase in the reactivity of the nasal mucosa and a decrease in the level of nitric oxide in the exhaled air from the upper airways (920 ppb before the provocation test and up to 867 ppb during the early stage of the allergic reaction). During the provocation tests, we recorded typical symptoms associated with the early stage of the allergic reaction; including nasal obstruction (1.2 cm), leakage of watery discharge (0.8 cm) in the food test, and itchy nose (1.1 cm) in the food test vs. the nasal test: 4.6, 2.8, and 3.5 cm, respectively. CONCLUSIONS: The nasal mucosa provides convenient conditions for evaluation of the severity of allergy to common food allergens, including chicken egg allergens.

Lipid peroxidation as a predictive biomarker of the early stage of cancer.

Prostate cancer continues to be a major cause of morbidity and mortality in men around the world. The data concerning the antioxidant status and the degree of lipid peroxidation at the moment of the initiation of cancer is limited. The aim of this research is to assess the effect of selected minerals (zinc, selenium, iron, copper and calcium) on the growth of the neoplastic process and the concentrations of selected biomarkers of the oxidative damage in rats with implanted prostate cancer cells. It was found that the diet supplementation with selected minerals (zinc, selenium, iron, copper and calcium) affect the occurrence of prostate tumor growth in the examined rats. The intraperitoneal implantation of prostate cancer cells resulted in the occurrence of prostatic adenoma in 71% of the examined rats. In the rats that were additionally supplemented with selenium and with copper, the cancer cell aggregates constituted, respectively, 25% and 38% of the cases. As a result of implantation of cancer cells, the level of biomarkers of lipid peroxidation increased both in the urine and in tissues of the examined animals (rat group without supplementation). No relationship was found between the process of lipid peroxidation due to the supplementation with selenium and copper, and the lower incidence of cancer and the induction of apoptosis. The reduced activity of antioxidative enzymes (catalase, superoxide dismutase and glutathione peroxidase) creates favorable conditions for the formation of cancer cell aggregates, which was shown in the rats whose diet was supplemented with iron. In summary, we conclude that lipid peroxidation represents a fruitful approach to early stage cancer prevention. Supplementation of rats with trace elements correlated with the risk of developing cancer, but the mechanisms of this action is complicated and dose-dependent.

Serum Vitamin D Concentration and Markers of Bone Metabolism in Perimenopausal and Postmenopausal Women with Asthma and COPD.

Aging and menopause are closely related to hormonal and metabolic changes. Vitamin D is a crucial factor modulating several metabolic processes. The aim of this study was to evaluate biomarkers of bone metabolism in peri- and postmenopausal women with obstructive lung diseases. Sixty two female patients, 27 with asthma and 35 with COPD, aged over 45 years (median age 58 and 64 years, respectively) were enrolled into the study. The evaluation included lung function, bone mineral density, serum concentration of vitamin D, and bone metabolism markers. The study groups differed significantly in terms of forced expiratory volume in 1 s (FEV1); median values of 1.79 L vs. 1.16 L (p = 0.0001) and 71.2% vs. 53.0% predicted (p = 0.0072) and in vitamin D concentration (12.3 ng/ml vs. 17.6 ng/ml). Total bone mineral density (BMD) was lower in the COPD group (p = 0.0115). Serum vitamin D inversely correlated with the number of pack-years in asthma patients (r = -0.45, p = 0.0192). There was no correlation between serum vitamin D and disease duration or severity, and the Asthma Control Test (ACT) and the modified Medical Research Council (mMRC) dyspnea scores. The serum bone metabolism markers C-terminal cross-linked telopeptide of collagen type I (BCROSS), N-terminal propeptides of procollagen type-1 (tP1NP), and N-mid osteocalcin (OCN) inversely correlated with age in the COPD, but not asthma, patients (r = -0.38, p = 0.0264; r = -0.37, p = 0.0270; and r = -0.42, p = 0.0125, respectively). We conclude that peri- and postmenopausal women with obstructive lung diseases had a decreased serum concentration of vitamin D. Furthermore, vitamin D and body mineral density were appreciably lower in women with COPD than those with asthma.

Long-term outcomes of children with symptomatic congenital cytomegalovirus disease.

OBJECTIVE: To assess long-term outcomes of children with symptomatic congenital cytomegalovirus (CMV) disease detected at birth. STUDY DESIGN: We used Cox regression to assess risk factors for intellectual disability (intelligence quotient <70), sensorineural hearing loss (SNHL; hearing level ⩾25 dB in any audiometric frequency) and vision impairment (best corrected visual acuity >20 or based on ophthalmologist report). RESULTS: Among 76 case-patients followed through median age of 13 (range: 0-27) years, 56 (74%) had SNHL, 31 (43%, n=72) had intellectual disability and 18 (27%, n=66) had vision impairment; 28 (43%, n=65) had intellectual disability and SNHL with/without vision impairment. Microcephaly was significantly associated with each of the three outcomes. Tissue destruction and dysplastic growth on head computed tomography scan at birth was significantly associated with intellectual disability and SNHL. CONCLUSION: Infants with symptomatic congenital CMV disease may develop moderate to severe impairments that were associated with presence of microcephaly and brain abnormalities.

Varicella zoster virus in American Samoa: seroprevalence and predictive value of varicella disease history in elementary and college students.

The epidemiology of varicella is believed to differ between temperate and tropical countries. We conducted a varicella seroprevalence study in elementary and college students in the US territory of American Samoa before introduction of a routine varicella vaccination programme. Sera from 515 elementary and 208 college students were tested for the presence of varicella-zoster virus (VZV) IgG antibodies. VZV seroprevalence increased with age from 76·0% in the 4-6 years group to 97·7% in those aged ⩾23 years. Reported history of varicella disease for elementary students was significantly associated with VZV seropositivity. The positive and negative predictive values of varicella disease history were 93·4% and 36·4%, respectively, in elementary students and 97·6% and 3·0%, respectively, in college students. VZV seroprevalence in this Pacific island appears to be similar to that in temperate countries and suggests endemic VZV circulation.

The emergence of multidrug-resistant Klebsiella pneumoniae of international clones ST13, ST16, ST35, ST48 and ST101 in a teaching hospital in the Paris region.

Despite infection control measures, an important increase in the extended-spectrum ß-lactamase (ESBL)-producing Klebsiella pneumoniae incidence density occurred in our hospital from 2006 onwards. This study, focusing on the 2005-2007 period, was performed in an attempt to explain this increase. ESBLs were characterized, isolates were typed by ERIC2-PCR, and sequence type (ST) of clustered isolates was determined. Temporal-spatial relationships of patients were analysed to assess possible cross-contamination. Of the 74 ESBL-producing isolates, 30 (40%) were detected at admission, 53 (71∙5%) produced CTX-M enzymes, 40 displayed unique ERIC2-PCR profiles and 34 were assigned into six clusters: ST16 (n=21), ST101, ST48, ST35, ST13, and ST436. Relationships were identified in 22 of the 34 patients harbouring clustered isolates. This study highlights the complex epidemiology of ESBL-producing K. pneumoniae in the mid-2000s with potential cross-contamination for only 30% of the 74 patients in our hospital, and the emergence of clones that are currently spreading worldwide.

Molecular confirmation of oysters as the vector for hepatitis A in a 2005 multistate outbreak.

Numerous hepatitis A outbreaks were linked to the consumption of raw molluscan shellfish in the United States between 1960 and 1989. However, there had been no major molluscan shellfish-associated hepatitis A outbreaks reported in the United States for more than a decade (1989 to 2004). Beginning in late August 2005, at least 10 clusters of hepatitis A illnesses, totaling 39 persons, occurred in four states among restaurant patrons who ate oysters. Epidemiologic data indicated that oysters were the source of the outbreak. Traceback information showed that the implicated oysters were harvested from specific Gulf Coast areas. A voluntary recall of oysters was initiated in September. Hepatitis A virus (HAV) was detected in multiple 25-g portions in one of two recalled samples, indicating that as many as 1 of every 15 oysters from this source was contaminated. Comparing 315 nucleotides within the HAV VPl-2B region, 100% homology was found among four amplicons recovered from a total of six independent experiments of the implicated oysters, and an identical HAV sequence was detected in sera from all 28 patient serum specimens tested. Ten percent heterogeneity over 315 nucleotides (31 variants) was observed between the outbreak strain (subgenotype 1A) and an HM-175 strain (subgenotype 1B) used in the laboratory where the oysters were processed. To our knowledge, this investigation is the first in the United States to identify an HAV-identical strain in persons with hepatitis A as well as in the food that was implicated as the source of their infections.

[The concentration of IgE antibodies in patients with cystic fibrosis]. / Stezenie IgE u pacjentów z mukowiscydoza.

The aim of the study was to evaluate the total IgE levels and correlation between total IgE concentration in CF and allergy rhinitis patients and in healthy donors, as well as estimation of the activity of some groups of allergens by measurement of specific IgE concentration. The purpose of the study was to estimate correlation between concentration of specific IgE and skin prick tests. The concentration of total and specific IgE was measured by immunoassay. The study groups contained 16 with CF and 10 with allergy rhinitis patients, the control group contain 15 healthy donors. The highest concentration of total IgE we noted in rhinitis subjects, statistically higher than in CF patients and in the control group. The analysis of the concentration of specific IgE showed that allergens as dermatophagoides, food and grasses are the most effective in CF patients. We did not found correlation between specific IgE level and skin prick tests.

[Steroid therapy and surgical treatment of nasal polyps: cytological analysis]. / Steroidoterapia i leczenie operacyjne polipów nosa w ocenie cytologicznej.

We have studies influence of steroids applied topically (intranasally) in patients with polyps (both operated on and not operated) on the cytology of nasal mucosa in conjunction with the level of serum ECP.

Nonsteroidal anti-inflammatory drugs alter chloride and fluid transport in bovine retinal pigment epithelium.

Nonsteroidal anti-inflammatory drugs (NSAIDs) were added to the solutions bathing the apical membrane of bovine retinal pigment epithelium (RPE)-choroid explants. For example, niflumic acid (100 microM) depolarized the basolateral membrane voltage (VB) by approximately 12 mV, increased transepithelial potential by 4.5 mV, decreased intracellular Cl activity by 13 mM, decreased transepithelial resistance by 17 omega.cm2, and increased the ratio of apical to basolateral membrane resistance nearly threefold. All of these changes are consistent with an increase in basolateral membrane Cl conductance. In addition, niflumic acid caused intracellular Ca concentration to decrease by 16 nM and fluid transport rate to increase by 1.5 microliters.cm-2.h-1. Flufenamic acid, which is structurally very similar to niflumic acid, had the opposite effects on membrane voltage and resistance. Basal application of the Cl channel blocker 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid or current clamping VB to the reversal potential for Cl practically abolished the niflumic acid response. The niflumic acid results suggest that certain NSAIDs can directly alter Cl conductance in the bovine RPE, apparently independently of cyclooxygenase inhibition.

The delayed basolateral membrane hyperpolarization of the bovine retinal pigment epithelium: mechanism of generation.

1. Conventional and ion-selective double-barrelled microelectrodes were used in an in vitro preparation of bovine retinal pigment epithelium (RPE)-choroid to measure the changes in membrane voltage, resistance and intracellular Cl- activity (aCli) produced by small, physiological changes in extracellular potassium concentration ([K+]o). These apical [K+]o changes approximate those produced in the extracellular (subretinal) space between the photoreceptors and the RPE following transitions between light and dark. 2. Changing apical [K+]o from 5 to 2 mM in vitro elicited membrane voltage responses with three distinct phases. The first phase was generated by an apical membrane hyperpolarization, followed by a (delayed) basolateral membrane hyperpolarization (DBMH); the third phase was an apical membrane depolarization. The present experiments focus on the membrane and cellular mechanisms that generate phase 2 of the response, the DBMH. 3. The DBMH was abolished in the presence of apical bumetanide (100 microM); this response was completely restored after bumetanide removal. 4. Reducing apical [K+]o, adding apical bumetanide (500 mM), or removing apical Cl- decreased aCli by 25 +/- 6 (n = 8), 28 +/- 1 (n = 2) and 26 +/- 5 mM (n = 3), respectively; adding 100 microM apical bumetanide decreased aCli by 12 +/- 2 mM (n = 3). Adding apical bumetanide or removing apical bath Cl- hyperpolarized the basolateral membrane and decreased the apparent basolateral membrane conductance (GB). 5. DIDS (4,4'-diisothiocyanostilbene-2,2'-disulphonic acid) blocked the RPE basolateral membrane Cl- conductance and inhibited the DBMH and the basolateral membrane hyperpolarization produced by apical bumetanide addition or by removal of apical Cl-o. The present results show that the DBMH is caused by delta[K]o-induced inhibition of the apical membrane Na(+)-K(+)-2Cl- cotransporter; the subsequent decrease in aCli generated a hyperpolarization at the basolateral membrane Cl- channel.

K+ and Cl- transport mechanisms in bovine pigment epithelium that could modulate subretinal space volume and composition.

1. Conventional and ion-selective double-barrelled microelectrodes were used in an in vitro bovine retinal pigment epithelium (RPE)-choroid preparation to measure the changes in membrane voltage, resistance and intracellular K+ and Cl- activities produced by small, physiological changes in extracellular potassium ([K+]o). 2. In the intact eye, light-induced changes in [K+]o occur in the extracellular (or subretinal) space that separates the neural retina and the RPE apical membrane. These [K+]o changes can be approximated in vitro by decreasing apical bath [K+]o from 5 to 2 mM. 3. This in vitro change in [K+]o simultaneously decreased intracellular Cl- and K+ activities (aCli and aKi) by 25 +/- 6 mM (n = 8) and 19 +/- 7 mM (n = 4) (mean +/- S.D.), respectively. In control Ringer solution (5 mM [K+]o) aCli and aKi were 65 +/- 10 mM (n = 28) and 65 +/- 8 mM (n = 6), respectively. 4. The [K+]o-induced decreases in aCli and aKi were both significantly inhibited, either by blocking the apical membrane K+ conductance with Ba2+ or the basolateral membrane Cl- conductance with DIDS (4,4'-diisothiocyano-stilbene-2,2'-disulphonic acid). 5. Transepithelial current pulses were used to determine the relative basolateral membrane Cl- conductance, TClBAS, was approximately 0.6 (n = 3), and the relative apical membrane K+ conductance, TKAP, was approximately 0.7 (n = 2). Step changes in basal bath [K+]o were used to estimate the relative basolateral membrane K+ conductance, TKBAS, was approximately 0.34 (n = 3). 6. These data show that the apical membrane K+ conductance and the basolateral membrane Cl- conductance are electrically coupled. In vivo, this coupling could have significant functional importance by modulating the relative hydration of the subretinal space, regulating RPE cell volume, and buffering the chemical composition of the subretinal space.