Introduction: Aqueous allergen injections, an effective and century-old technique, is considered a second-line approach in daily clinical practice. Inconveniences still surround conventional subcutaneous immunotherapy (SCIT) administration, such as a need for frequent injections, prolonged up-dosing schedules, elevated costs, and the unlikely possibility of a systemic reaction. The intradermal immunotherapy route (IDR) might favorably impact many of the aforementioned issues (Table 1). House dust mite (HDM) allergens are the main perennial sensitizers in the tropics, and as such, are solely employed in immunotherapy treatments. Methods: We carried out a year-long real-life study in 25 perennial allergic rhinitis children, symptomatic on exposure to house dust, employing an intradermal low-dose allergen mix consisting of 50 ng of Dermatophagoides pteronyssinus/Dermatophagoides farinae and 120 ng of Blomia tropicalis, under a unique cost-wise protocol. Basal symptoms/signs and face Visual Analog Scale (fVAS) scores were recorded for 2 weeks and later compared with those registered throughout the 1-year treatment. Serum-specific IgG4 and IL-10 levels were employed in the assessment of the immune responses.Results: Symptoms/signs and fVAS scores were significantly reduced from days 42 and 49, respectively, and remained so until treatment completion. Increases in specific IgG4’s and IL-10 levels reflected significant immune responses. Injections were well tolerated and families reported improved health status (quality of life, QoL).Conclusions: A unique cost-effective immunotherapy alternative for deprived allergic communities in tropical settings is depicted; further research is needed.
Poster abstractswhich is a local tertiary referral center. Gestational age at referral was defined as time of diagnosis. The cases in which the malformation was already known for more than one week and fetuses with further malformations were excluded. The number of fetuses, mean gestational age at diagnosis, the rate of fetuses with diagnosis before 17 weeks of gestation (wks) and 25 wks and reason for referral were compared between three groups: 1994-1996 (group I), 1997-1999 (group II) und 2000-2003. Results: In 77 fetuses between 14 and 36 wks a spina bifida was detected. The number (n) and mean gestational age at diagnosis was n = 12 at 23.0 + 6.5 wks in group I, in group II n = 24 at 23.8 + 6.3 wks and in group III n = 41 at 22.2 + 5.9 wks. The rate of diagnosis before 17 wks was 0%, 12.5% and 17.0% and before 25 wks 66.0%, 62.5% and 73.2%, respectively. The reason for referral was the suspicion of a fetal malformation in 52.0% in group II and 70.7% in group III. Conclusions: Our results show a slow decrease in gestational age of the prenatal diagnosis of spina bifida and an increasing rate of fetuses referred for malformations to the tertiary centre during a decade. However, in a quarter of all affected fetuses the diagnosis is still made after 24 weeks of gestation. If the benefit of fetal surgery to prevent secondary damage will be proved, an early diagnosis of spina bifida will be important for these individuals. Cleido-cranial dysplasia (CCD) is characterized by a triad of calvarial dysostosis, hypoplasia or absence of clavicles, and supernumerary permanent teeth. The delayed calvarial ossification necessitates a planned Cesarean section in order to prevent a possible severe brain damage during birth. Therefore, early recognition of CCD is of major clinical importance. In the present case report, the patient was a 30-year-old gravida 2 para 1 with RUNX2-negative CCD. Family history comprised three generations of clinically diagnosed CCD; including the father of the patient and her first child born in 2000. An ultrasound examination was performed using a GE Voluson 730 Expert scanner at week 13 + 6. The severely delayed ossification of the vertebral spine was easily seen as echo poor, nearly black vertebral bodies, both on longitudinal as well as on transverse sections. In the calvaria, only the frontal bone showed signs of calcification, confirming severe delay in calvarial ossification. The clavicles were barely seen, lacking the typical S-shape. Except for short femurs, all other anatomic structures were normal for gestational age. Serial ultrasound examinations during pregnancy confirmed the diagnosis, but as ossification progressed the above mentioned manifestations became less distinct. A Cesarean section was performed in week 38. The infant had the same clinical signs of CCD as his affected family members. In conclusion, this case demonstrates that early ultrasound around thirteen weeks should be performed in pregnancies at risk of CCD since delayed mineralisation of the vertebral spine is an ea...
Parents of young children with newly diagnosed food allergy (FA) are at risk for poor psychosocial outcomes due to FA's lifethreatening nature and demanding management routines. Presently, there are no interventions to support FA parents during this adjustment phase. The current study explores the feasibility and acceptability of a novel, pilot intervention using peer mentorship to improve psychosocial functioning in parents of young children with newly diagnosed FA. METHODS: Parent mentors were trained in mentorship and ethics and then matched with a mentee for a 6-month intervention period. Mentees, parents of children diagnosed with FA within 1 year, completed baseline and follow-up questionnaires to assess demographic and medical characteristics, FA knowledge, self-efficacy, social support, anxiety and depression and a program evaluation. Follow up focus groups with mentors and individual interviews with mentees were conducted. RESULTS: Participants were 8 mentors and 10 mentees (M age 5 36.60 years, 80% Caucasian) of children ages 0-3 years (M age 5 16.15 months; 60% male). Mentees reported high acceptability for the intervention in program evaluation and interviews, noting improvements in their social support, FA-related stress, confidence in FA management, and positive changes in FA parenting behaviors. CONCLUSIONS: The current study supports the use of a mentorship program to support parents of children with newly diagnosed FA. Future research is needed to determine how to scale this intervention to meet the needs of a large medical division.
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