No abstract

RATIONALE: Walnut is a relevant allergenic food in paediatric population. An accurate diagnosis is essential. The aim of this study was to assess the diagnostic capacity of natural and three commercial walnut extracts to perform skin prick tests (SPT). METHODS: Fifty-one atopic children were included in the study; 39 with a clinical history of walnut allergy and positive specific IgE values to walnut (> _ 0.35 KU/L) and 12 atopic controls tolerating walnut. SPT whit three commercial walnut extracts (ALKÒ, LetiÒ, RoxallÒ) as well as prick-prick test (PPT) with natural walnut were performed. Wheals > _3 mm were considered positive. The sensitivity and specificity for SPTs with commercial extracts and natural walnut, as well as wheal sizes (WS), were analyzed. RESULTS: SPTs with ALKÒ, RoxallÒ and LetiÒ walnut extracts as well as natural walnut, showed high sensitivity (100; 100; 97.44; 100) but moderate to low specificity (75; 41.66; 41.66; 58,33) values with no differences between them. In walnut allergic patients, the median WS with Roxall'sÒ walnut extract (9.5mm) was significantly larger than Leti'sÒ (7.5mm; p <0.001) and ALK'sÒ (7.5mm; p <0.001) but similar to those of the PPT (9.5mm; p 5 0.566), while ALK'sÒ and Leti'sÒ WSs were significantly smaller compared to those of the PPT (p5 0,003; p<0,001). CONCLUSIONS: Commercial walnut extracts from ALKÒ, RoxallÒ and LetiÒ have a similar diagnostic accuracy. However, in walnut allergic patients, the WS of the SPT with Roxall's walnut extract is significantly larger than those performed with ALK's and Leti's extracts and similar to the PPT.

No abstract

Type I and type II diabetes are closely associated with a pro-inflammatory state and to a pro-thrombotic state. The role of glycemic control in pulmonary embolism (PE) is poorly understood and requires additional investigation. The aim of this study is to investigate the relationship between glycemic control and thrombo-inflammatory biomarkers in a PE patient cohort compared to normal samples. Demographic and clinical information for 86 diabetic patients and 106 non-diabetic patients presenting with acute PE was collected via retrospective chart review. Plasma levels of pro-inflammatory (C-reactive protein [CRP], tumor necrosis factor-alpha [TNF-α], interleukin-6 [IL-6]) and pro-thrombotic (d-dimer, plasminogen activator inhibitor-1 [PAI-1], tissue plasminogen activator [tPA], thrombin activatable fibrinolysis inhibitor [TAFI], von-Willebrand factor [vWF], endogenous glycosaminoglycans [GAGs]) biomarkers were drawn within 24 hours of diagnosis of acute PE. Data was also obtained for a population of healthy adult controls. All the pro-inflammatory and pro-thrombotic biomarkers were elevated in diabetic PE patients in comparison to healthy controls. None of the biomarkers were elevated in diabetic PE patients when compared to non-diabetic PE patients. There was no difference in the levels of the pro-inflammatory biomarkers according to glycemic control. The plasma level of TAFI was elevated in diabetic patients with poor glycemic control. Diabetic patients were more likely to have a more severe PE. These studies demonstrate that thrombo-inflammatory biomarkers are elevated in diabetic PE patients with associated comorbidities in comparison to normal individuals. However, there is no difference between the PE cohort alone in comparison to PE with diabetes. The role of TAFI within the continuum of diabetic vascular disease warrants additional investigation.

No abstract