PURPOSE OF THE STUDY. To assess the frequency and characteristics of missed opportunities for influenza immunization in children with chronic medical conditions, and among unimmunized children in that group, to explore parent-reported reasons for not vaccinating their child. STUDY POPULATION. A cohort of 926 children (aged 6 to 72 months) who were identified from October 1, 2002, through January 31, 2003, as having Ն1 high-risk conditions (HRCs). A total of 594 (64%) were male, and 734 (79%) were between 24 and 72 months of age. The children were insured privately (84%) or publicly (12%) or uninsured (3%). Diagnoses included asthma only (89%), cardiac conditions (3%), immunosuppressive conditions or therapies (2%), chronic nonasthma pulmonary conditions (2%), and other HRCs (2%).

A randomized controlled trial was conducted to determine whether an education program specifically designed for patients with non-insulin-dependent diabetes and limited literacy could improve and sustain glucose and weight control. From a referral clinic, 120 obese (greater than 130 per cent of ideal body weight) diabetic patients who were not taking insulin were recruited. Of these, 55 per cent were female and 49 per cent were black; the mean age was 53 years. Mean glycosylated hemoglobin (HbA1%) was 10.2 per cent. Each subject was assigned to one of three groups: monthly group sessions with videotapes for diabetic persons with low literacy skills; monthly group sessions without videotapes; or no monthly sessions. After seven months, there had been 16 dropouts (13 per cent). Differences in weight changes between groups were significant (p less than 0.05); group 1 lost a median of 1 kg of weight (p less than 0.05) compared with a 0.1-kg loss and no change in groups 2 and 3, respectively. This weight loss was not sustained at 11 months. There was no significant change in HbA1%. Age, education, and compliance beliefs did not predict outcome. The authors conclude that the patient education programs did not result in sustained glucose or weight control.

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Kull I, Bö hme M, Wahlgren CF, Nordvall L, Pershagen G, Wickman M. J Allergy Clin Immunol. 2005;116:657-661 PURPOSE OF THE STUDY. To investigate the effect of breastfeeding in various phenotypes of eczema. STUDY POPULATION. A birth cohort of 4089 children followed up to 4 years of age.METHODS. Data on breastfeeding, allergic symptoms, and potential confounders were obtained from questionnaires when the children were 2 months and 1, 2, and 4 years old. At 4 years, blood allergen-specific immunoglobulin E was analyzed. Children with symptoms of eczema and asthma during the period of breastfeeding were excluded in most analyses on risk assessment of eczema and asthma, respectively, to avoid disease-related modification of exposure.RESULTS. Exclusive breastfeeding for Ն4 months reduced the risk for eczema at the age of 4 years (odds ratio [OR]:

RATIONALE: Patients sensitized to nsLTP comprise a heterogeneous group in terms of sensitization profile, symptom severity and complexity in diagnosis. The aim of this study is to compare sensitivity, specificity, positive and negative values (PPV and NPP) of skin prick test (SPT) and specific IgE (sIgE) in the diagnosis of peanut allergy in patients with LTP-Syndrome. METHODS: We included 67 patients with confirmed peach allergy. We performed peanut diagnosis based on positive SPT, sIgE and oral food challenge (OFC); except in those that presented > _ 2 episodes of anaphylaxis in the previous two years. RESULTS: After peanut intake, 30 patients (45%) presented symptoms and 9 (13%) tolerated. Twenty-eight patients (42%) avoid peanut intake because positive SPT and/or sIgE. After OFC, 26 patients (38.8%) were confirmed as allergic to peanut. From 41 (61.2%) who tolerated, 32 (47.7%) had positive SPT and/or sIgE. SPT and sIgE showed a moderate agreement level (kappa50.50). However, we found a fair level of agreement between SPT and OFC (kappa5 0.20), and sIgE and OFC (Kappa50.21). CONCLUSIONS: These data show the relevance of OFC for confirming the diagnosis of peanut allergy in patients with LTP-Syndrome regardless of the positivity of SPT/sIgE. Further investigations are warranted to clarify the role of LTP in allergy to other plant foods.