Development of a drug allergy alert tiering algorithm for penicillins and cephalosporins.

Introduction: Limited research is available regarding recommendations about which drug allergy alerts (DAAs) in clinical decision support (CDS) systems should interrupt provider workflow. The objective was to evaluate the frequency of penicillin and cephalosporin DAA overrides at two institutions. A secondary objective was to redesign DAAs using a new tiered alerting system based on patient factors.

Ascitic fluid amylase-to-serum amylase ratio to predict pancreatic duct leaks causing ascites.

Objectives: Pancreatic duct leaks can cause ascites, and fluid amylase can be used as a marker to suggest pancreatic duct leak; however, there is no reference parameter or cutoff value for diagnosis. We assessed whether a novel ratio of ascitic fluid to serum amylase can reliably predict pancreatic leaks and need for endoscopic retrograde cholangiopancreatography (ERCP).

Materials And Methods: Patients who had fluid amylase from ascitic fluid and serum amylase within one week of confirmed pancreatic leaks via ERCP were included along with appropriate medical and surgical controls.

EUS-directed transduodenal ERCP in concomitant gastric outlet and biliary obstruction.

Background And Aims: Patients with concomitant gastric outlet obstruction (GOO) and biliary obstruction often have limited management options, particularly in the setting of severe debility. We detail the use of EUS -guided gastroduodenal placement of a lumen-apposing metal stent (LAMS) as a conduit for transduodenal ERCP: EUS-directed transduodenal ERCP.

Methods: Nine patients who developed GOO with indwelling biliary metal stents or with anticipated biliary stent placement were retrospectively included.

An International Delphi Consensus on the Management of Pollen-Food Allergy Syndrome: A Work Group Report of the AAAAI Adverse Reactions to Foods Committee.

Background: Pollen-food allergy syndrome (PFAS) is common among patients with allergic rhinitis. Treatment recommendations for patients with PFAS remain variable.

Objective: To develop consensus recommendation statements for managing patients with PFAS.

A diagnostic approach to IgE-mediated food allergy: A practical algorithm.

A food reaction history is the basis of food allergy diagnoses. Several levels of food allergy diagnostic testing can confirm or refute the presence of food allergy. The choice of food allergy testing modality should be informed by the reaction history and determined by the testing goals.