Methylation of mercury and tin by estuarine microbial mats.

After tin and mercury salts were added to estuarine microbial mats increasing amounts of methyltin and methylmercury, respectively, were formed over a 30 to 100 hour time period. Inhibition of the methylation by molybdate, a metabolic inhibitor of sulfate reduction, stimulation by pyruvate addition and lack of methylation by sterilized mats, were evidence that sulfate reducing bacteria within the mats were responsible for the tin and mercury methylation. Methyl mercury was formed from mercuric chloride and mercuric cysteine, but not from mercuric sulfide.

A practical focus on multi-food oral immunotherapy.

Approximately one-third of patients who present for oral immunotherapy (OIT) will be allergic to more than one food. Those patients with more than one food allergy have the option of sequential courses of single-food OIT or, in the right situation, combining several foods as part of multifood OIT. The time and cost savings can be substantial.

Food Sublingual Immunotherapy: Safety and Simplicity of a Real Food Updosing Protocol.

Background: Sublingual immunotherapy (SLIT) using food extracts is safe and effective in desensitizing patients with food allergy, yet not often used in clinical practice.

Objectives: To propose a cost-effective, expedited SLIT protocol using real food.

Methods: Patients with food allergy aged 5 to 50 years (median, 11 years) initiated food SLIT in a single-clinic setting.

Preparing Patients for Oral Immunotherapy (PPOINT): International Delphi consensus for procedural preparation and consent.

Background: Despite the promise of oral immunotherapy (OIT) to treat food allergies, this procedure is associated with potential risk. There is no current agreement about what elements should be included in the preparatory or consent process.

Objective: We developed consensus recommendations about the OIT process considerations and patient-specific factors that should be addressed before initiating OIT and developed a consensus OIT consent process and information form.

An Approach to the Office-Based Practice of Food Oral Immunotherapy.

Oral immunotherapy (OIT) provides an active treatment option for patients with food allergies. OIT may improve quality of life and raise the threshold at which a patient with food allergy may react to an allergen, but it is a rigorous therapy that requires a high degree of commitment by the clinician, patients, and families. Recent guidelines from the Canadian Society for Allergy and Clinical Immunology have provided a framework for the ethical, evidence-based, and patient-oriented clinical practice of OIT, and the European Academy of Allergy, Asthma, and Immunology guidelines have also recommended that OIT can be used as a potential treatment.

Penicillin Allergy Evaluation: A Prospective, Multicenter, Open-Label Evaluation of a Comprehensive Penicillin Skin Test Kit.

Background: Ten percent of the population claims an allergy to penicillin, but 90% of these individuals are not allergic. Patients labeled as penicillin-allergic have higher medical costs, longer hospital stays, are more likely to be treated with broad-spectrum antibiotics, and develop drug-resistant bacterial infections. Most penicillin skin test reagents are not approved by the Food and drug Administration or readily available to evaluate patients labeled penicillin-allergic.

AR101 Oral Immunotherapy for Peanut Allergy.

Background: Peanut allergy, for which there are no approved treatment options, affects patients who are at risk for unpredictable and occasionally life-threatening allergic reactions.

Methods: In a phase 3 trial, we screened participants 4 to 55 years of age with peanut allergy for allergic dose-limiting symptoms at a challenge dose of 100 mg or less of peanut protein (approximately one third of a peanut kernel) in a double-blind, placebo-controlled food challenge. Participants with an allergic response were randomly assigned, in a 3:1 ratio, to receive AR101 (a peanut-derived investigational biologic oral immunotherapy drug) or placebo in an escalating-dose program.

Clinical associations in the diagnosis of vocal cord dysfunction.

Background: Diagnosis of VCD is complicated by its symptom similarities to asthma. Although clinical history, spirometry, and fiberoptic nasolaryngoscopy are used for VCD diagnosis, videostroboscopy is considered the gold standard. However, little is know about patient characteristics that might suggest a VCD diagnosis is more likely.

History of human activity in coastal southern Brazil from sediment.

This study reports results of analysis of sediment cores collected from the Patos Lagoon estuary. This estuary receives materials from land runoff into Patos and Mirim lagoons and from exchange with the adjacent South Atlantic Ocean through a narrow inlet. Sediment from these sources is mostly natural, but additional contributions associated with source/activities related to the port of Rio Grande.

An update on the safety of specific immunotherapy.

Purpose Of Review: As allergen sublingual immunotherapy becomes more widely used in Europe and draws the attention of physicians of the USA, it is important to compare and contrast the safety aspects of this therapy versus allergen subcutaneous immunotherapy.

Recent Findings: There are reports of severe systemic reactions associated with sublingual immunotherapy, but no fatalities. There are various studies of systemic reactions, including those that result in death, associated with subcutaneous immunotherapy over its nearly 100-year worldwide experience.

Omalizumab improves asthma-related quality of life in patients with severe allergic asthma.

Background: We have previously shown that omalizumab, a recombinant humanized monoclonal anti-IgE antibody, reduces asthma exacerbations and decreases inhaled corticosteroid (ICS) requirement in patients with severe allergic asthma who were symptomatic despite moderate-to-high doses of ICSs.

Objective: The aim of the present study was to assess the effects of omalizumab on asthma-related quality of life (QOL).

Methods: These analyses were part of a multicenter, 52-week, randomized, double-blind, placebo-controlled study assessing the efficacy, safety, and tolerability of subcutaneous omalizumab (> or =0.

Safe administration of influenza vaccine to patients with egg allergy.

Objectives: Specific recommendations for administering the influenza vaccine to patients with egg allergy are based on limited scientific data. The objectives of this investigation were to determine the safety of a 2-dose administration of an influenza vaccine to patients with egg allergy and to evaluate the usefulness of skin testing with the influenza vaccine before administration.

Study Design: In this multicenter clinical trial, clinical histories of egg allergy were confirmed by skin testing with egg and, if possible, by oral challenges with egg.

Distribution of total mercury and methyl mercury in water, sediment, and fish from south Florida estuaries.

Concentrations of total mercury and methyl mercury were determined in sediment and fish collected from estuarine waters of Florida to understand their distribution and partitioning. Total mercury concentrations in sediments ranged from 1 to 219 ng/g dry wt. Methyl mercury accounted for, on average, 0.

Inadequate outpatient medical therapy for patients with asthma admitted to two urban hospitals.

Purpose: To determine the patterns of chronic outpatient management in urban patients with moderate and severe asthma, and to assess medical practice adherence to the Guidelines for the Diagnosis and Management of Asthma from the National Asthma Education Program (NAEP).

Patients And Methods: This is a cross-sectional survey of adult patients with asthma admitted to the general medical services at the Johns Hopkins Medical Institutes (Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center) Baltimore, Maryland. Subjects were 101 adults admitted with an asthma exacerbation from February 1992 through January 1993.

Neopterin quantification in acute severe asthma.

To investigate the pathogenic role of cell-mediated immunity (CMI) in acute severe asthma, 10 patients with acute asthma requiring admission to hospital had measurements of serum and urine absolute neopterin and neopterin/creatinine ratios. Serum was collected upon entry to hospital, 24 hr later and at 2 weeks; and urine at 24 hr and at 2 weeks after admission. Comparisons were made with 12 stable asthmatic patients, healthy control subjects, and six renal transplant patients undergoing transplant rejection.