Adult food-induced anaphylaxis hospital presentations in New Zealand

Background

Food allergy including anaphylaxis is an increasing clinical problem in many countries. Little information is available regarding prevalence, causative foods and time trends in the New Zealand adult population.

Objective

This cross-sectional study investigated the incidence of hospital presentation with food-induced anaphylaxis in New Zealand among adults and adolescents over a 10-year period.

Methods

Ministry of Health hospital discharge data from 2002 to 2011 were analysed using food allergy and anaphylaxis-related International Classification of Diseases (ICD) codes to identify acute hospital presentations.

Results

There was an average annualised rate of hospital food-induced anaphylaxis presentations of 4.8 per 100 000 adults (aged ≥15 years) for the period reviewed. Subgroup analyses revealed significant differences by gender, age group and ethnicity, notably higher rates in females, younger adults (15–34 years) and Pacific Island populations. Seafood was the most common food allergen group, followed by nuts. Time trend analysis revealed a 1.7-fold increase in the 10-year period, mainly attributable to an increase in rates in the Pacific Island population.

Conclusions

These data confirm food-induced anaphylaxis as an increasing problem in New Zealand and show significant differences in incidence of hospital presentation in different ethnic populations. Future research will be required to understand and address disparities in the incidence of these conditions.

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Drugs to treat obesity: do they work?

Obesity is a disease that has historically eluded effective medical therapy. Prior to 2012, phentermine and orlistat were the only medications available to treat obesity in the USA, with phentermine approved only for short-term use. However, as of 2015, the repertoire of pharmacological agents available to treat obesity has greatly expanded to include four new drugs: lorcaserin, phentermine/topiramate extended release (ER), naltrexone ER/wellbutrin ER and liraglutide. Each has a unique mechanism of action and all are intended for long-term use. These newer medications share a common strategy to promote weight loss in that they are designed to manipulate the control of hunger and satiety in the central nervous system. Interestingly, the majority of these new agents are combinations of older medications that have been used for conditions other than obesity. The amount of weight loss seen with these agents beyond placebo varies but generally falls in the range of 3–10% of starting weight and requires continual use of the drug in order for weight loss to be sustained. In addition, each drug has a unique side effect profile that should be carefully considered when selecting the best agent for a given individual. This article provides a review of these recently approved medications focusing on efficacy, side effect profiles and appropriate application to the individual patient.

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Comment on: 'Retina nerve fiber layer and choroidal thickness changes in obstructive sleep apnea syndrome by Ozge et al

We have read with interest the article entitled 'Retina nerve fiber layer and choroidal thickness changes in obstructive sleep apnea syndrome' by Ozge et al.1 We express our gratitude to the authors for demonstrating significant differences at some measurement points in macular and peripapillary retinal nerve fibre layer (RNFL) and choroidal thickness (CT) in patients with obstructive sleep apnoea syndrome (OSAS). We would like to ask for further details, and make contribution to the article.

In the abstract section, the authors proposed that the finding of choroidal thickening in patients with OSAS could be due to neurodegeneration. We suppose that the thickening in choroid may be related to the autonomic dysregulation that was observed in previous studies.23 In addition, as has been indicated in the literature, it is well known that autonomic nervous system has a major effect on CT.4 As already...

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3D time-varying simulations of Ca2+ dynamics in Arterial Coupled Cells: a massively parallel implementation

Summary

Preferential locations of atherosclerotic plaque are strongly associated with the areas of low wall shear stress (WSS) and disturbed haemodynamic characteristics such as flow detachment, flow recirculation and oscillatory flow. The areas of low WSS are also associated with the reduced production of adenosine triphosphate (ATP) in the endothelial layer, as well as the resulting reduced production of inositol trisphosphate (IP₃). The subsequent variation in Ca2+ signalling and nitric oxide (NO) synthesis could lead to the impairment of the atheroprotective function played by NO. In previous studies it has been suggested that the reduced IP₃ and v signalling can explain the correlation of atherosclerosis with induced low WSS and disturbed flow characteristics. The massively parallel implementation described in this article provides insight into the dynamics of coupled smooth muscle cells (SMCs) and endothelial cells (ECs) mapped onto the surface of an idealised arterial bifurcation. We show that variations in coupling parameters, which model normal and pathological conditions, provide vastly different SMC Ca2+ dynamics and wave propagation profiles. The extensibility of the coupled cells model and scalability of the implementation provide a solid framework for in silico investigations of the interaction between complex cellular chemistry and the macro-scale processes determined of fluid dynamics. This article is protected by copyright. All rights reserved.

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Restoration of hookworm egg development after prolonged storage in stool suspension

Abstract

Hookworm infection is still prevalent in southern Thailand despite control measures. Hookworm eggs submerged for an extended period under water from rainfall or in latrines may not survive, but they may recover their ability to develop into infective larvae when exposed to atmospheric air. This study examined the survival of the hookworm eggs in stool suspension and the restoration of development capability after prolonged storage. In stool mass, eggs developed normally and yielded infective filariform larvae (FL) in 7 days. On the contrary, in 1:10 stool suspension, hookworm eggs were found to remain at the 4–8 cell stage; degenerated eggs were observed after 15 days of storage, and the number of degenerated eggs reached 80 % on day 30. Aeration of the suspension, or transferring to a Petri dish or agar plate, restored the capacity of eggs stored for up to 15 days to develop into FL; thereafter, the capacity declined sharply. Retardation of egg development under water or in stool suspension may be due to a lack of atmospheric air. Use of "night soil" from latrines as fertilizer may be one factor in maintaining hookworm transmission, as worm eggs can undergo normal development upon exposure to atmospheric air.

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Tick infestation in birds and prevalence of pathogens in ticks collected from different places in Germany

Abstract

The importance of ticks and tick-borne pathogens for human and animal health has been increasing over the past decades. For their transportation and dissemination, birds may play a more important role than wingless hosts. In this study, tick infestation of birds in Germany was examined. Eight hundred ninety-two captured birds were infested with ticks and belonged to 48 different species, of which blackbirds (Turdus merula) and song thrushes (Turdus philomelos) were most strongly infested. Ground feeders were more strongly infested than non-ground feeders, sedentary birds more strongly than migratory birds, and short-distance migratory birds more strongly than long-distance migratory birds. Mean tick infestation per bird ranged between 2 (long-distance migratory bird) and 4.7 (sedentary bird), in some single cases up to 55 ticks per bird were found. With the exception of three nymphs of Haemaphysalis spp., all ticks belonged to Ixodes spp., the most frequently detected tick species was Ixodes ricinus. Birds were mostly infested by nymphs (65.1 %), followed by larvae (32.96 %). Additionally, ticks collected from birds were examined for several pathogens: Tick-borne encephalitis virus (TBEV) and Sindbisvirus with real-time RT-PCR, Flaviviruses, Simbuviruses and Lyssaviruses with broad-range standard RT-PCR-assays, and Borrelia spp. with a Pan-Borrelia real-time PCR. Interestingly, no viral pathogens could be detected, but Borrelia spp. positive ticks were collected from 76 birds. Borrelia (B.) garinii, B. valaisiaina, B. burgdorferi s.s. and B. afzelii were determined. The screening of ticks and birds for viral pathogens with broad range PCR-assays was tested and the use as an "early warning system" is discussed.

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Identification of host proteins, Spata3 and Dkk2, interacting with Toxoplasma gondii micronemal protein MIC3

Abstract

As an obligate intracellular protozoan, Toxoplasma gondii is a successful pathogen infecting a variety of animals, including humans. As an adhesin involving in host invasion, the micronemal protein MIC3 plays important roles in host cell attachment, as well as modulation of host EGFR signaling cascade. However, the specific host proteins that interact with MIC3 are unknown and the identification of such proteins will increase our understanding of how MIC3 exerts its functions. This study was designed to identify host proteins interacting with MIC3 by yeast two-hybrid screens. Using MIC3 as bait, a library expressing mouse proteins was screened, uncovering eight mouse proteins that showed positive interactions with MIC3. Two of which, spermatogenesis-associated protein 3 (Spata3) and dickkopf-related protein 2 (Dkk2), were further confirmed to interact with MIC3 by additional protein-protein interaction tests. The results also revealed that the tandem repeat EGF domains of MIC3 were critical in mediating the interactions with the identified host proteins. This is the first study to show that MIC3 interacts with host proteins that are involved in reproduction, growth, and development. The results will provide a clearer understanding of the functions of adhesion-associated micronemal proteins in T. gondii.

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