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Eight Tips For The Implementation Of The First Licenced Peanut Allergy Oral Immunotherapy Into Clinical Practice., Jay M. Portnoy, Christina E. Ciaccio, Janet Beausoleil, George Du Toit, Stanley Fineman, Stephen A. Tilles, June Zhang, Claire Lawrence, Mohamed Yassine, S Shahzad Mustafa 2022 Children's Mercy Hospital

Eight Tips For The Implementation Of The First Licenced Peanut Allergy Oral Immunotherapy Into Clinical Practice., Jay M. Portnoy, Christina E. Ciaccio, Janet Beausoleil, George Du Toit, Stanley Fineman, Stephen A. Tilles, June Zhang, Claire Lawrence, Mohamed Yassine, S Shahzad Mustafa

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Shared learnings from the early use of novel therapies can aid in their optimization. The recent introduction of peanut oral immunotherapy (peanut OIT; Palforzia [Peanut (Arachis hypogaea) Allergen Powder-dnfp]) for peanut allergy addresses a significant unmet need but also highlights the requirement for consideration of several factors by both prescribers and patients.

OBJECTIVE: To provide guidance for prescribers of licenced peanut OIT to facilitate treatment delivery and improve outcomes.

METHODS: Clinicians with experience of licenced peanut OIT (United States n = 6, United Kingdom n = 1) participated in a series of interviews and group discussions designed to elicit tips for ...


Likelihood Ratios For Reactions To Egg Based On Specific Ige And Oral Challenges, Melissa Anderson 2022 Children's Mercy Hospital

Likelihood Ratios For Reactions To Egg Based On Specific Ige And Oral Challenges, Melissa Anderson

Research Days

Background: Specific IgE (sIgE) to foods has been used to predict the risk of a systemic reaction (SR) when the food is ingested. An arbitrary cutoff of 0.35 is often used to separate a positive likelihood ratio (LR+) from a negative one (LR-), yet there is little evidence supporting the use of this value.

Objectives/Goal: The objective of this project was to establish a more accurate method for estimating the probability of food allergy to egg.

Methods/Design: Egg-sIgEs were measured and open oral egg challenges were performed on 155 children with a clinical history of egg allergy ...


Use Of Long-Acting Injectable Cabotegravir And Rilpivirine As An Alternative For Treatment In Hiv Positive Patients, Aravindh Nirmalan 2022 Wayne State University School of Medicine

Use Of Long-Acting Injectable Cabotegravir And Rilpivirine As An Alternative For Treatment In Hiv Positive Patients, Aravindh Nirmalan

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using

Mantsios A, Murray M, Karver TS, et al. Efficacy and Freedom: Patient Experiences with the Transition from Daily Oral to Long-Acting Injectable Antiretroviral Therapy to Treat HIV in the Context of Phase 3 Trials. AIDS Behav. 2020;24(12):3473-3481. https://doi.org/10.1007/s10461-020-02918-x

for a young adult patient struggling with adherence.


Laboratory Findings In Covid-19 - Alterations Of Hematological, Immunological, Biochemical, Hormonal And Other Lab Panels: A Narrative Review, Yousef Rasmi, Lucas Paulo Jacinto Saavedra, Matei-Alexandru Cozma, Heba El-Nashar, Shaza Aly, Nouran Fahmy, Omayma Eldahshan, Mohamed El-Shazly, Elena Codruța Dobrică, Hamed Kord-Varkaneh, Camelia Cristina Diaconu, Mihnea Alexandru Găman 2022 Carol Davila University of Medicine and Pharmacy

Laboratory Findings In Covid-19 - Alterations Of Hematological, Immunological, Biochemical, Hormonal And Other Lab Panels: A Narrative Review, Yousef Rasmi, Lucas Paulo Jacinto Saavedra, Matei-Alexandru Cozma, Heba El-Nashar, Shaza Aly, Nouran Fahmy, Omayma Eldahshan, Mohamed El-Shazly, Elena Codruța Dobrică, Hamed Kord-Varkaneh, Camelia Cristina Diaconu, Mihnea Alexandru Găman

Journal of Mind and Medical Sciences

Up to the present date, according to the official reports of the World Health Organization (WHO), 205,338,159 patients have been confirmed with the coronavirus disease (COVID-19) and 4,333,094 have died as a consequence of this infectious disorder. The majority of COVID-19 patients will develop hematological, biochemical, immunological, hormonal and other complex alterations of their laboratory data which may be diagnosed using different biomarkers. In this paper, we review the alterations of the hematology, immunology, biochemistry, hormonal and other laboratory panels discovered in the subjects diagnosed with SARS-CoV-2 infection, based on the available data in the literature.


How Demographic And Social Factors Correlate With The Perception Of Gluten And Gluten Sensitivity (Gs), Grace White 2022 Olivet Nazarene University

How Demographic And Social Factors Correlate With The Perception Of Gluten And Gluten Sensitivity (Gs), Grace White

Scholar Week 2016 - present

Learning Objective: To determine which of the presented demographic and social factors correlate with GS or gluten misconceptions to discover potential contributors of GS.

Background: With an increase in GS cases, an exploration and understanding of how demographic and social factors such as gender, ethnicity, economic status, family/friend behavior, and social media correlate with GS and the perception of gluten was sought after.

Method: The researcher constructed a survey that was reviewed by 13 individuals for content, clarity, and internal consistency. The survey was sent out to the student body (2,658) at a small Midwestern university. The final ...


A Proposed Treatment Of Mixed Connective Tissue Disease By Competitive Inhibition Of Autoantibodies, Thomas Russell 2022 Liberty University

A Proposed Treatment Of Mixed Connective Tissue Disease By Competitive Inhibition Of Autoantibodies, Thomas Russell

Senior Honors Theses

Mixed Connective Tissue Disease is an autoimmune disease characterized by Raynaud’s phenomenon and arthritis among other symptoms. It is primarily caused by antibodies that target the U1-RNP 70K peptide. The treatment proposed in this paper uses competitive inhibition to prevent the binding of the anti-U1-RNP 70K antibodies with the U1-RNP 70K peptide. A method for testing the designed treatment in silico is proposed using AutoDock Vina docking software.


Impact Of Social Determinants On The Burden Of Asthma And Eczema: Results From A Us Patient Survey., Don A. Bukstein, Adam Friedman, Erika Gonzalez Reyes, Mary Hart, Bridgette Jones, Tonya Winders 2022 Children's Mercy Hospital

Impact Of Social Determinants On The Burden Of Asthma And Eczema: Results From A Us Patient Survey., Don A. Bukstein, Adam Friedman, Erika Gonzalez Reyes, Mary Hart, Bridgette Jones, Tonya Winders

Manuscripts, Articles, Book Chapters and Other Papers

INTRODUCTION: Little is known about how patients with asthma and eczema perceive their medical care and burden of disease. A survey was conducted to evaluate the perceptions among the general patient population with asthma and/or eczema regarding disease and treatment burden and barriers to adequate care.

METHODS: An online survey was completed by market research panelists in the USA between March 24, 2020 and April 6, 2020. Eligible participants were at least 18 years of age and endorsed a diagnosis of asthma and/or eczema. Survey responses are described for all participants, by designated racial/ethnic groups, and by ...


Evaluation Of The Outcomes Of Oral Challenges To Azithromycin, Cephalexin And Trimethoprim-Sulfamethoxazole In Pediatrics, Hannah N. Neuhaus, Jordan Heath MD, Salman Aljubran 2022 Children's Mercy Hospital

Evaluation Of The Outcomes Of Oral Challenges To Azithromycin, Cephalexin And Trimethoprim-Sulfamethoxazole In Pediatrics, Hannah N. Neuhaus, Jordan Heath Md, Salman Aljubran

Posters

Rationale: Antibiotic hypersensitivity complicates treatment for various infections and leads to long-term healthcare costs and antibiotic resistance. Data regarding the outcomes of oral challenges to trimethoprim-sulfamethoxazole, azithromycin and cephalexin are limited in Pediatrics.  The goal of this study was to characterize the outcomes and safety of oral challenges to these antibiotics in Pediatrics.

Methods: A retrospective chart review was performed of pediatric patients who underwent oral challenges to cephalexin, azithromycin and trimethoprim-sulfamethoxazole in Allergy Clinic over the last 12 years.

Results: Ten patients underwent oral challenge to trimethoprim-sulfamethoxazole and all were successful. Thirteen patients underwent oral challenge to azithromycin and ...


Timing Of Testing For Ige-Mediated Food Allergy After Systemic Reaction, Jordan Pitt, Paul J. Dowling, Christopher Miller, Ashley Sherman, Salman Aljubran 2022 Children's Mercy Hospital

Timing Of Testing For Ige-Mediated Food Allergy After Systemic Reaction, Jordan Pitt, Paul J. Dowling, Christopher Miller, Ashley Sherman, Salman Aljubran

Posters

Rationale: A refractory period of falsely negative testing can occur following a systemic allergic reaction to Hymenoptera sting. As a result, blood specific IgE and/or skin prick tests (SPT) for other allergens are often delayed. This retrospective chart review aims to identify the proportion of patients with falsely negative test results in the 6 weeks following an allergic reaction to food, and factors that may affect it. Methods: One hundred fourteen pediatric subjects met inclusion criteria. Each had a convincing history of food allergy with a systemic allergic reaction and was tested to the culprit food within 6 weeks ...


The Emergence Of Covid-19 Associated Mucormycosis: A Review Of Cases From 18 Countries, Martin Hoenigl, Danila Seidel, Agostinho Carvalho, Shivaprakash M. Rudramurthy, Amir Arastehfar, Jean-Pierre Gangneux, Nosheen Nasir, Alexandro Bonifaz, Javier Araiza, Nikolai Klimko 2022 Medical University of Graz

The Emergence Of Covid-19 Associated Mucormycosis: A Review Of Cases From 18 Countries, Martin Hoenigl, Danila Seidel, Agostinho Carvalho, Shivaprakash M. Rudramurthy, Amir Arastehfar, Jean-Pierre Gangneux, Nosheen Nasir, Alexandro Bonifaz, Javier Araiza, Nikolai Klimko

Department of Medicine

Reports of COVID-19-associated mucormycosis have been increasing in frequency since early 2021, particularly among patients with uncontrolled diabetes. Patients with diabetes and hyperglycaemia often have an inflammatory state that could be potentiated by the activation of antiviral immunity to SARS-CoV2, which might favour secondary infections. In this Review, we analysed 80 published and unpublished cases of COVID-19-associated mucormycosis. Uncontrolled diabetes, as well as systemic corticosteroid treatment, were present in most patients with COVID-19-associated mucormycosis, and rhino-orbital cerebral mucormycosis was the most frequent disease. Mortality was high at 49%, which was particularly due to patients with pulmonary or disseminated mucormycosis or ...


The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones 2022 Virginia Commonwealth University

The Effects Of Celiac Disease On Oral Health In Children And Adults, Marissa Balducci, Katarina Jones

Dental Hygiene Student Scholarship

Objectives: Celiac disease (CD) is an autoimmune disorder characterized by intolerance to dietary gluten in genetically predisposed subjects. To ensure affected patients receive optimal dental care, it is necessary for dental professionals to recognize the oral manifestations of celiac disease in both children and adults. Upon associating oral conditions with celiac disease, the dental provider should be able to present recommendations to the patient, contributing to an improvement in their oral health.

Methods: This review of the literature used PubMed to identify relevant professional research articles with publication after 2017. MesH terms utilized in the search process were “celiac disease ...


Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss 2022 University of Kentucky

Addressing The Inpatient Penicillin Allergy: Implementing A Nurse-Driven Allergy Assessment Tool To Enhance Antimicrobial Stewardship., Shelby Ryan Bliss

DNP Projects

Background: In an acute care setting, more than half the inpatient population receives antibiotics. Approximately 10% of the general population reports an allergy to penicillin. It has been replicated in the literature with data that of those who report a penicillin allergy, up to 95% are incorrectly identified. When a patient is admitted to the hospital with a penicillin allergy on their electronic health record, they are at higher risk for adverse events such as a hospital acquired infection, the occurrence of an antibiotic resistant bacteria related to receiving broader therapy and increased healthcare utilization.

Purpose: The purpose of this ...


Inflammatory Response To Sleep Fragmentation In Skeletal, Cardiac, And Smooth Muscle Tissues In Female Mice, Patton Allen 2022 Western Kentucky University

Inflammatory Response To Sleep Fragmentation In Skeletal, Cardiac, And Smooth Muscle Tissues In Female Mice, Patton Allen

Mahurin Honors College Capstone Experience/Thesis Projects

Sleep is a critical process that the body undergoes. When sleep is interrupted, so that an individual is awakened for some period before going back into sleep, the sleep can be described as fragmented. Studies in the past have shown that sleep fragmentation (SF) promotes an inflammatory environment, especially in the brain and peripheral tissue. However, studies have not been conducted to observe inflammatory responses in muscle. To examine this, C57BL/6J female mice were subjected to either a control group (no SF) or a SF group which involved using an automated SF chamber to disrupt sleep every 2 min ...


Symmetrical Drug-Related Intertriginous And Flexural Exanthema Induced By Cellulitis Prophylaxis, Tiffany Truong, Jonathan H. Ryder, Erica Lee, Clayton Mowrer, Ashley Wysong, Jasmine R. Marcelin 2021 University of Nebraska Medical Center

Symmetrical Drug-Related Intertriginous And Flexural Exanthema Induced By Cellulitis Prophylaxis, Tiffany Truong, Jonathan H. Ryder, Erica Lee, Clayton Mowrer, Ashley Wysong, Jasmine R. Marcelin

Graduate Medical Education Research Journal

Penicillin VK and hydroxyzine are typically well-tolerated antipruritic agents that are indicated in the prophylaxis of cellulitis. We herein report a case of a unique rash occurring during penicillin VK and hydroxyzine treatment in combination with the ingestion of cashews.

A 77-year-old male presented with new onset rash. Eleven days after the administration of penicillin VK and hydroxyzine for cellulitis prophylaxis, he developed a symmetric, erythematous, scaling rash on his buttocks and perineal region with associated pruritus and bleeding without fevers, chills, adenopathy, night sweats, or any other symptoms. He was diagnosed with symmetrical drug-related intertriginous and flexural exanthema (SDRIFE ...


Gender Differences In Urothelial Bladder Cancer: Effects Of Natural Killer Lymphocyte Immunity, Charles T. Lutz, Lydia Livas, Steven R. Presnell, Morgan Sexton, Peng Wang 2021 University of Kentucky

Gender Differences In Urothelial Bladder Cancer: Effects Of Natural Killer Lymphocyte Immunity, Charles T. Lutz, Lydia Livas, Steven R. Presnell, Morgan Sexton, Peng Wang

Pathology and Laboratory Medicine Faculty Publications

Men are more likely to develop cancer than women. In fact, male predominance is one of the most consistent cancer epidemiology findings. Additionally, men have a poorer prognosis and an increased risk of secondary malignancies compared to women. These differences have been investigated in order to better understand cancer and to better treat both men and women. In this review, we discuss factors that may cause this gender difference, focusing on urothelial bladder cancer (UBC) pathogenesis. We consider physiological factors that may cause higher male cancer rates, including differences in X chromosome gene expression. We discuss how androgens may promote ...


Evaluation Of The Outcomes Of Trimethoprim-Sulfamethoxazole Oral Challenges In The Pediatric Population, Hannah N. Neuhaus, Salman Aljubran 2021 Children's Mercy Hospital

Evaluation Of The Outcomes Of Trimethoprim-Sulfamethoxazole Oral Challenges In The Pediatric Population, Hannah N. Neuhaus, Salman Aljubran

Posters

Introduction: Trimethoprim-sulfamethoxazole allergy can complicate treatment for various infections. While trimethoprim-sulfamethoxazole hypersensitivity, desensitization/oral challenges are frequently reported in adults, data is limited on the outcomes/safety of oral challenges to trimethoprim-sulfamethoxazole in Pediatrics. The goal of this study was to characterize the outcomes and safety of trimethoprim-sulfamethoxazole oral challenges in Pediatrics.

Methods: An IRB-exempt retrospective chart review was performed of pediatric patients who underwent oral challenge to trimethoprim-sulfamethoxazole in Allergy Clinic over the last 12 years. We assessed characteristics including age, sex, reaction (IgE-mediated/non-IgE-mediated/indeterminate), skin testing, challenge outcome and complications to draw a conclusion regarding the overall ...


Delayed-Onset Anaphylactic Reaction With High Fever After Amoxicillin Oral Challenge And Negative Penicillin Skin Testing, Jordan Pitt, Paul J. Dowling, Christopher Miller, Aarti Pandya 2021 Children's Mercy Hospital

Delayed-Onset Anaphylactic Reaction With High Fever After Amoxicillin Oral Challenge And Negative Penicillin Skin Testing, Jordan Pitt, Paul J. Dowling, Christopher Miller, Aarti Pandya

Posters

Introduction:  Immunologic adverse drug reactions can be categorized based on Gell and Coombs’s classification system. Anaphylaxis is generally considered a type I, immediate, IgE-mediated reaction and typically occurs independent of other immunologic reactions. However, the child presented here reacted after amoxicillin challenge with features of type I and type III or IV hypersensitivity reactions. Case Description:  A 12-year-old female presented for amoxicillin allergy evaluation after treatment for scarlet fever with amoxicillin. After the second dose she developed rash with varied features, fatigue, edema, and joint swelling. Labs included a persistently low C4 level, eosinophilia, normal inflammatory markers, and normal ...


A Case Of An Elevated Tryptase, Sonya Parashar, Nikita Raje 2021 Children's Mercy Hopital

A Case Of An Elevated Tryptase, Sonya Parashar, Nikita Raje

Posters

Hereditary Alpha Tryptasemia (HαT) is an autosomal dominant disorder characterized by an elevated baseline tryptase that occurs up to 3% of the population and clinically resembles mast cell activation syndrome.


Alpha-Gal Allergy: A New Threat To Appalachia, Adam M. Franks MD, Makala Murphy BS, Madison Griffis MD, Rebekah Franks BA, CWR, Colin M. Franks, Gary Petty MD 2021 Marshall University

Alpha-Gal Allergy: A New Threat To Appalachia, Adam M. Franks Md, Makala Murphy Bs, Madison Griffis Md, Rebekah Franks Ba, Cwr, Colin M. Franks, Gary Petty Md

Marshall Journal of Medicine

Abstract

Alpha-gal allergy, or mammalian meat allergy, is described as the development of IgE antibodies to the oligosaccharide galactose-a-1,3-galactose following a bite from the tick species Amblyomma americanum (Lone Star tick) or Dermacentor variabillis (Wood tick). Dermatologic or gastrointestinal symptoms are usually delayed by four to six hours after exposure, making the diagnosis difficult. Due to the use of mammalian proteins in many common medications, surgical equipment and prosthesis, unexpected reactions can occur. In the United States, this pathology is predominately seen in the southeast, but has been associated with other tick species on every continent except Antarctica. As ...


Racial And Ethnic Data Reported For Peanut Allergy Epidemiology Do Little To Advance Its Cause, Treatment, Or Prevention, Nigel Mark Thomas 2021 CUNY Bronx Community College

Racial And Ethnic Data Reported For Peanut Allergy Epidemiology Do Little To Advance Its Cause, Treatment, Or Prevention, Nigel Mark Thomas

Publications and Research

No abstract provided.


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