Background The atopic march is well documented, but the inter-relationship of food allergy (FA) and asthma is not well understood. Objective To examine the strength of the association and temporal relationships between food allergy and asthma. Methods This analysis included 271 children ≥6 years (older group) and 296 children <6 years (younger group) from a family-based FA cohort in Chicago, IL. Asthma was determined by parental report of physician diagnosis. FA status was determined based on type and timing of clinical symptoms after ingestion of a specific food, and results of prick skin test (Multi-Test II) and allergen specific IgE (Phadia ImmunoCAP). Analyses were carried out using logistic regression accounting for important covariates and autocorrelations among siblings. Kaplan-Meier curves were used to compare the time to onset of asthma by FA status. Results Symptomatic FA was associated with asthma in both older (OR=4.9, 95%CI:2.5–9.5) and younger children (OR=5.3, 95%CI:1.7–16.2). The association was stronger among children with multiple or severe food allergies, especially in older children. Children with FA developed asthma earlier and at higher prevalence than children without FA (Cox Proportional hazard ratio=3.7, 95%CI:2.2–6.3 for children ≥6 years and hazard ratio=3.3, 95%CI:1.1–10 for children <6 years of age). No associations were seen between asymptomatic food sensitization and asthma. Conclusions Independent of markers of atopy such as aeroallergen sensitization and family history of asthma, there was a significant association between FA and asthma. This association was even stronger in subjects with multiple food allergies or severe food allergy.

SummaryBackground-The increasing prevalence of food allergy (FA) is a growing clinical and public health problem. The contribution of genetic factors to FA remains largely unknown.

Background Intravenous (IV) acetaminophen may be an effective component of multimodal postoperative pain management. The primary objective of this study was to evaluate the impact of IV acetaminophen on total opioid use in postoperative patients. The secondary objective was to evaluate the effect of IV acetaminophen on hospital length of stay. Methods This retrospective, case–control study evaluated the impact of IV acetaminophen on total opioid use in surgical patients. Patients were included if they received at least one perioperative dose of IV acetaminophen and underwent a surgical knee procedure. Controls were matched and randomly selected based on procedure type, age, and severity of illness. Postoperative opioids were converted into oral morphine equivalents, and overall use was compared between groups. Results One hundred patients were enrolled, with 25 patients receiving IV acetaminophen and 75 matched controls. A total of 135 mg versus 112.5 mg oral morphine equivalents were used in the IV acetaminophen group and control group, respectively (p=0.987). There were 45 mg/day oral morphine equivalents used in the IV acetaminophen group versus 37.5 mg in the control group (p=0.845). The median hospital length of stay in both groups was 3 days (p=0.799). Conclusion IV acetaminophen did not significantly decrease postoperative opioid use in patients who underwent surgical knee procedures. In addition, there was a nonsignificant trend toward increased opioid use in the IV acetaminophen group. There was no significant difference in hospital length of stay between the IV acetaminophen group and the control group. These findings require further study in larger patient populations and in other orthopedic procedures that typically require longer hospital stays.

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A hospital-wide medication review service for patients with enteral tubes at our community teaching medical center was developed.