Long-Term Outcomes After Slow Low-Dose Oral Immunotherapy for Cow's Milk.

Introduction: We previously reported the result of slow low-dose oral immunotherapy (SLOIT), which is a 1-year severity-stratified low-dose OIT for severe cow's milk allergy (CMA) (threshold dose ≤287 mg of cumulative cow's milk [CM] protein at the entry oral food challenge [OFC]). After completing the SLOIT protocol (exit-OFC to cumulative 287 mg of CM protein), the participants were instructed to gradually increase the amount of CM, roughly doubling the increasing pace, if they could consume it symptom-free for 2-3 months (SLOIT-plus). This study evaluated the long-term outcomes of SLOIT and identified the factors associated with these outcomes.

[COMPARISON OF WHEAL SIZE INDUCED BY BIFURCATED NEEDLE AND SMARTPRACTICE PRICK LANCET].

Background: There is reportedly a difference in the diameter of the skin reaction induced by different types of skin prick test (SPT) devices. We compared the SPT diagnostic accuracy and wheal size between a Bifurcated Needle (BN) and SmartPractice Prick Lancet (PL), which are commercially available in Japan.

Methods: An SPT was performed on 15 adults with and 10 without subjective symptoms of cedar pollinosis who wished to be examined for Japanese cedar pollen (JCP) sensitization.

A 60-minute dosing interval is safer than a 30- or 40-minute interval in oral food challenge.

Background: The interval between antigen ingestion may influence the safety of oral food challenge tests (OFCs), especially in patients with severe food allergies.

Methods: This retrospective chart review of OFCs eliciting objective reactions to wheat, egg, and milk that were performed between April 2012 and January 2021 evaluated an equivalent number of low-dose OFCs performed at 30-, 40-, or 60-min intervals. To avoid the influence of the potential allergy severity of the patients, the prediction scores of all intervals were matched.

Slow low-dose oral immunotherapy: Threshold and immunological change.

Background: We examined the feasibility, efficacy and safety of slow low-dose oral immunotherapy (SLOIT) for egg, milk, wheat allergies, with accepted severity-stratified initial and maintenance doses.

Methods: Children with food allergies defined by low-dose oral food challenges (LD-OFCs) to hen's egg (cumulative protein dose up to 983 mg, n = 133), cow's milk (287 mg, n = 50), and wheat (226 mg, n = 45) were recruited. Participants were divided into two groups [SLOIT and control (complete avoidance]) based on their preferences.

Changes in passively-sensitized basophil activation to αS1-casein after oral immunotherapy.

Introduction: Immune response to cow's milk allergen (CMA) has been analyzed mostly using crude milk antigen or a mixture of various caseins. This study aimed to assess the changes in the immunological response against αS1-casein during oral immunotherapy (OIT) and to investigate the mechanism of tolerance.

Methods: We have performed rush OIT to 39 patients with CMA and obtained the serum samples up to 3 years after OIT.

Pediatric surgery triage: problems and improvements.

Background: The Canadian Paediatric Triage and Acuity Scale (P-CTAS) is used and modified at hospitals as a triage tool for pediatric patients before they are seen in emergency rooms. Pediatric surgery patients account for very few of the many patients in emergency departments, but they should be triaged as emergency or urgent because they might be candidates for surgery. Problems with and improvements for triaging pediatric surgery patients using the P-CTAS were studied.

Successful endoscopic submucosal dissection for mucosal cancer of the duodenum.

We report a case of mucosal duodenal cancer in a 62-year-old woman, which was successfully removed en bloc by endoscopic submucosal dissection (ESD). The patient underwent an upper gastrointestinal endoscopy at our hospital, which revealed an elevated flat mucosal lesion (type IIa) measuring 10 mm in diameter in the second portion of the duodenum. Histopathological examination of a biopsy specimen revealed features suggestive of a tubulovillous adenoma with severe atypia.