President of MiraVista Diagnostics. D.C.V. receives clinical trial funding from CSL Behring Canada, Shire Canada, and Cidara and an honorarium from Novartis Canada. The rest of the authors declare that they have no relevant conflicts of interest.

Background:The same dosing schedule, 1000 SQ-U times three, with one-month intervals, have been evaluated in most trials of intralymphatic immunotherapy (ILIT) for the treatment of allergic rhinitis (AR). The present studies evaluated if a dose escalation in ILIT can enhance the clinical and immunological effects, without compromising safety.Methods: Two randomized double-blind placebo-controlled trials of ILIT for grass pollen-induced AR were performed. The first included 29 patients that had recently ended 3 years of SCIT and the second contained 39 not previously vaccinated patients. An up-dosage of 1000-3000-10,000 (5000 + 5000 with 30 minutes apart) SQ-U with 1 month in between was evaluated.Results: Doses up to 10,000 SQ-U were safe after recent SCIT. The combined symptom-medication scores (CSMS) were reduced by 31% and the grass-specific IgG4 levels in blood were doubled. In ILIT de novo, the two first patients that received active treatment developed serious adverse reactions at 5000 SQ-U. A modified up-dosing schedule; 1000-3000-3000 SQ-U appeared to be safe but failed to improve the CSMS. Flow cytometry analyses showed increased activation of lymph

In all, 76% of the patients underwent sleep recordings preoperatively and postoperatively. The oxygen desaturation index (ODI(4)) decreased from median 23 (range 6-100) to 8 (range 0-60), p<0.001. Criteria of success (>50% reduction and ODI<20), was 64%. The ESS value decreased from median 12 (range 0-21) to 6 (0-22), p<0.001. In all, 88% of the patients were satisfied. Four of 158 patients (2.5%) had serious postoperative complications. There was neither sequel of complications nor mortality.

No abstract

Contributor´s Statement PageKarin Lundkvist, MD: Has contributed to conception and design, analysis and interpretation of data and drafting the article and final approval of the version to be published.Kristina Sundquist, MD, PhD: Has contributed to conception and design, acquisition of data, analysis and interpretation of data, revising the article critically for important intellectual content and final approval of the version to be published.Xinjun Li, MD, PhD: Has contributed to conception and design, analysis and interpretation of data and revising the article critically for important intellectual content and final approval of the version to be published. Results: After accounting for socioeconomic status, age, and geographic region, the SIR of OSAS in sons with parental OSAS was 3.09 (95% CI 1.83-4.90), and in daughters 4.46 (95% CI 2.68-6.98). The SIR of adenotonsillar or tonsillar hypertrophy in offspring with parental OSAS was 1.82 (95% CI 1.54-2.14) in sons and 1.56 (95% CI 1.30-1.87) in daughters. Conclusion:The study indicates a familial clustering of sleep-disordered breathing, which represents important information for clinicians.