Prevalence of Autoantibodies in Patients with Hereditary Alpha-Tryptasemia.

Introduction: Hereditary alpha-tryptasemia (HαT) is associated with postural orthostatic tachycardia syndrome (POTS), hypermobile Ehlers-Danlos syndrome (hEDS), and mast cell activation syndrome (MCAS). While POTS, hEDS, and MCAS have all demonstrated increased prevalence of autoimmunity, this has not been investigated in HαT populations. Our objective was to describe the prevalence of autoantibodies in individuals with HαT.

Avapritinib versus Placebo in Indolent Systemic Mastocytosis.

BACKGROUND: Indolent systemic mastocytosis (ISM) is a clonal mast-cell disease driven by the KIT D816V mutation. We assessed the efficacy and safety of avapritinib versus placebo, both with best supportive care, in patients with ISM. METHODS: We randomized patients with moderate to severe ISM (total symptom score [TSS] of ≥28; scores range from 0 to 110, with higher numbers indicating more severe symptoms) two to one to avapritinib 25 mg once daily (n=141) or placebo (n=71).

Extrinsic and Intrinsic Modulators of Anaphylaxis.

The severity of anaphylaxis is determined by many factors. The allergenic source as well as the age of the affected individual and the route of allergen exposure encompass the major contributors of the clinical outcome. Moreover, the severity can be modulated further by intrinsic and extrinsic factors.

Platelet Activating Factor (PAF): A Mediator of Inflammation.

Platelet-activating factor (PAF) is a phospholipid-derived mediator with an established role in multiple inflammatory states. PAF is synthesized and secreted by multiple cell types and is then rapidly hydrolyzed and degraded to an inactive metabolite, lyso-PAF, by the enzyme PAF acetylhydrolase. In addition to its role in platelet aggregation and activation, PAF contributes to allergic and nonallergic inflammatory diseases such as anaphylaxis, sepsis, cardiovascular disease, neurological disease, and malignancy as demonstrated in multiple animal models and, increasingly, in human disease states.

Tillage and manure effects on runoff nitrogen and phosphorus losses from frozen soils.

In cold regions, nutrient losses from dairy agroecosystems are a longstanding and recurring problem, especially when manure is applied during winter over snow-covered frozen soils. This study evaluated two tillage (fall chisel tillage [CT] and no-tillage [NT]) and three manure-type management treatments (unmanured control, liquid manure [<5% solids], and solid manure [>20% solids]). The liquid and solid manure used in this study were from the same animal species (Bos taurus) and facility.

Envisioning the manureshed: Toward comprehensive integration of modern crop and animal production.

The specialization and intensification of agriculture have produced incredible gains in productivity, quality, and availability of agricultural commodities but have resulted in the separation of crop and animal production. A by-product of this separation has been the accumulation of manure regions where animal production is concentrated. Enter the "manureshed," an organizing framework for integrating animal and crop production where budgeting of manure nutrients is used to strategically guide their recycling and reuse in agricultural production systems where manure resources are of highest value.

Platelet-activating factor acetylhydrolase is a biomarker of severe anaphylaxis in children.

Background: There is limited ability to predict the severity of allergic reactions in children. Data derived predominantly from adults have implicated the platelet-activating factor pathway as a potential contributor to severe anaphylaxis. In this study, we sought to prospectively assess involvement of key components of the platelet-activating factor pathway in pediatric patients with anaphylaxis.

Sensitivity and uncertainty analysis for predicted soil test phosphorus using the Annual Phosphorus Loss Estimator model.

In this study we conducted a sensitivity and uncertainty analysis using the Annual P Loss Estimator (APLE) model focusing on model predictions of soil test phosphorus (STP). We calculated and evaluated the sensitivity coefficients of predicted STP and changes in STP using 1- and 10-yr simulations with and without P application. We also compared two methods for estimating prediction uncertainties: first-order variance approximation (FOVA) and Monte Carlo simulation (MCS).

Reproducibility of Symptom Sequences Across Episodes of Recurrent Anaphylaxis.

Background: Anaphylactic reactions may present with varying levels of severity, ranging from mild multisystem involvement to severe, and sometimes fatal, anaphylaxis. The severity of anaphylaxis is variable from one reaction to the next within the same individuals.

Objective: To compare the temporal sequence of symptoms within individuals and between individuals across multiple anaphylactic reactions.

Characterizing telemedicine use in clinical immunology and allergy in Canada before the COVID-19 pandemic.

Rationale: There exists a geographic barrier to access CIA care for patients who live in rural communities; telemedicine may bridge this gap in care. Herein we characterized the use of telemedicine in CIA at a population-based level and single centre.

Methods: Before the COVID-19 pandemic, telemedicine care was provided via the Ontario Telemedicine Network (OTN) in Ontario, Canada.

Effect of omalizumab for autoimmune progesterone dermatitis refractory to bilateral oophorectomy: a case report.

Background: Autoimmune progesterone dermatitis (APD) is a rare skin condition caused by sensitivity to high levels of progesterone secreted during the luteal phase of the menstrual cycle. This may be due to various pathophysiological mechanisms including a Type I and Type IV hypersensitivity reaction. Here we present the case of a patient with APD whose episodic flares were controlled by the addition of omalizumab, after a bilateral oophorectomy failed to resolve her symptoms.

Anaphylaxis to Oatmeal and Psocid Crisps.

Occasionally, a seemingly straightforward history of food-induced anaphylaxis may prove to be misleading.  Both patients and their physicians have a tendency to attribute the cause of an allergic reaction to the most conspicuous ingredient that had been ingested while overlooking less likely causes.  Here, we describe a patient whose history pointed to oatmeal allergy, but skin prick tests to oats and serologic testing for oat-specific IgE were negative.

Hydrochlorothiazide-induced systemic capillary leak.

Hypersensitivity reactions to drugs may cause very rapid physiologic derangements that can be fatal in the absence of adequate compensatory mechanisms or definitive treatment. For the most part, adverse drug reactions that progress over the course of minutes are mediated either by mast cell or complement activation. If a patient survives the acute event, appropriate long-term management requires the identification and future avoidance of the inciting drug.

Effects of feeding a quebracho-chestnut tannin extract on lactating cow performance and nitrogen utilization efficiency.

The effects of feeding a quebracho-chestnut tannin extract mixture on performance and nitrogen (N) utilization were assessed with 36 multiparous lactating Holstein cows (mean ± standard deviation; 706 ± 59 kg of body weight; 126 ± 20 d in milk) randomly assigned to 3 dietary treatments in a randomized complete block design. Following a 2-wk covariate adjustment period, cows were fed their assigned treatment diets for 13 wk. Rice hulls were removed from a total mixed ration with a 54:46 forage:concentrate ratio (% of dry matter; DM), and a tannin extract mixture from quebracho and chestnut trees (2:1 ratio) was included at 0, 0.

Utilization of the 2017 diagnostic criteria for hEDS by the Toronto GoodHope Ehlers-Danlos syndrome clinic: A retrospective review.

The new 2017 diagnostic criteria for hypermobile Ehlers-Danlos Syndrome (hEDS) provide a framework for diagnosing hEDS but are more stringent than the previous Villefranche criteria. Our clinical experience at the GoodHope EDS clinic was that the 2017 criteria left many highly symptomatic patients without a diagnosis of hEDS. We conducted a retrospective cohort study to confirm our clinic experience and assess the accuracy of the 2017 diagnostic criteria for hEDS in patients who had a previous hEDS diagnosis based on the Villefranche criteria.

Efficacy of Omalizumab in Indolent Systemic Mastocytosis.

Background: Systemic mastocytosis (SM) comprises a heterogeneous group of disorders characterized by the proliferation of clonal mast cells in skin and various internal organs. Omalizumab is an established, labelled therapy for allergic asthma and chronic urticaria, but its experience in the efficacy of SM is limited.

Methods: A retrospective analysis of 6 patients diagnosed with indolent SM treated with omalizumab at St.