Purpose of review Allergen immunotherapy is the only modality that can modify the immune response upon exposure to aeroallergens and venom allergens. This review will update the allergist on recent studies evaluating safety of sublingual and subcutaneous allergen immunotherapy. Recent findings Multiple clinical trials and retrospective studies have been published evaluating overall safety of these therapies. The risk of systemic reactions with subcutaneous immunotherapy remains quite low, but near-fatal and fatal anaphylaxis does occur, requiring physicians to be aware of potential risks for such events. Sublingual immunotherapy has a high incidence of local site application reactions, but severe anaphylactic events are very uncommon. Summary Subcutaneous immunotherapy and sublingual immunotherapy are beneficial in treating allergic rhinitis and venom hypersensitivity but should be administered only by physicians familiar with potential risk factors and able to manage treatment-related local and systemic allergic reactions.

We determined concentrations of selected trace elements in tissues of king and common eiders at three locations in the Canadian arctic. Renal and hepatic cadmium concentrations in king eiders at a location in the eastern arctic were among the highest ever recorded in eider ducks: there, they were higher in king eiders than in common eiders. Cadmium concentrations were lower in king eiders from the western arctic than in those from the east. In the western arctic, cadmium concentrations did not differ between species. Hepatic mercury and zinc were higher in king eiders than in common eiders. Zinc and selenium were higher in eiders from the western arctic than in those from the eastern arctic. Trace element concentrations in these two duck species were below published toxicity thresholds. Positive correlations in trace element concentrations in both species were found between total and organic hepatic mercury, renal and hepatic cadmium as well as hepatic zinc, copper, mercury, and cadmium. Body mass of common but not king eiders and spleen mass of both species were negatively correlated with mercury concentrations. In common eiders, the number of nematode parasites was positively correlated with total and organic mercury. Histopathological evidence of kidney or liver lesions that are typical of trace metal poisoning was not found. We did not find evidence to support the hypothesis that trace metal exposure may be contributing to adverse effects on the health of individuals of these species.

No abstract

FA phenotypes and health care utilization differ among children of different racial and/or ethnic backgrounds in the United States that put AA and Hispanic children at higher risks of adverse outcome than white children. These differences include coexistent atopic conditions, less well recognized food allergens, and higher rates of anaphylaxis.

Introduction Angioedema, a sudden, self-limited swelling of localized areas of any part of the body that may or may not be associated with urticaria, is thought to be the result of a mast-cell mediated process versus a bradykinin etiology. Understanding the mechanism is key in determining the proper treatment. Areas Covered Clinical presentation of varying angioedema types may be similar; however, the appropriate treatment algorithm is dependent upon clinicians’ knowledge of the underlying pathophysiology and classification of angioedema. Literature review of recent guidelines, available medications, and alternative therapies was completed to provide an overview of options. Conclusion There are no formal guidelines for treatment of acute or chronic histamine-mediated angioedema, and therefore, algorithms for the treatment of acute and chronic urticaria should be followed until such information becomes available. Differentiating histamine-mediated versus bradykinin mediated angioedema is essential, as treatments and treatment responses are quite different. Further research is needed to better understand idiopathic angioedema that is unresponsive to H1/H2 antagonists, LTMAs, or medications designed to treat bradykinin-mediated angioedema.