Microarray Immunodiagnostics for Aeroallergens

Abstract

Purpose of Review

The impact of new technologies, especially multiplexed molecular allergy diagnostics based on allergen arrays, on the management of complex patients with respiratory allergies has been important.

Recent Findings

Currently, the detailed characteristics of the IgE profile of the patient, such as sensitization to genuine or cross-reacting components or the sensitization to potentially harmful allergens, allow an allergist to tailor treatment in the context of precision medicine rules.

Summary

A number of relevant articles have been published in recent years on this topic, and, in this review, the new added values of allergen array-based diagnostics are reported.

http://bit.ly/2SVBjYY

Meta‐analysis of three‐in‐one single capsule bismuth‐containing quadruple therapy for the eradication of Helicobacter pylori

Abstract

Background

Bismuth‐containing quadruple therapy has been suggested as first‐line and rescue alternative for Helicobacter pylori eradication. Our objective was to perform a meta‐analysis evaluating the efficacy and safety of single capsule Pylera^® (bismuth, metronidazole, and tetracycline) plus a proton‐pump inhibitor (PPI) in any line of treatment.

Methods

Studies were selected up to October 2018. Outcomes were eradication and adverse events (AEs) rates pooled using the generic inverse variance method.

Results

In total, 30 studies (6482 patients) were included in the systematic review. The intention‐to‐treat (ITT) efficacy was 90% (95% CI: 87%‐92%, 21 studies, I ² = 88%) in first‐line therapy, 89% (95% CI: 86%‐93%, 12 studies, I ² = 78%) in second‐line and 82% (95% CI: 78%‐87%, nine studies, I ² = 60%) in third‐line; with no differences by the type or dosage of PPI used. For metronidazole‐resistant infection, the ITT efficacy as first‐line therapy was 93% (95% CI: 90%‐96%, six studies, I ² = 0%). In second‐line therapies where patients had been previously treated with clarithromycin, the ITT efficacy was 90% (95% CI: 87%‐93%, 11 studies, I ² = 78%). The overall incidence of AEs was 43% (95% CI: 35%‐50%, 24 studies, I ² = 92%) and they were mostly mild. In nearly 3% of the cases, treatment was interrupted due to AEs.

Conclusions

A 10‐day treatment with Pylera^® achieved an effective eradication rate of approximately 90% both in first‐ and second‐line therapy. This applies regardless of the type and dose of the PPI, in patients with clarithromycin‐ or metronidazole‐resistant strains, and in those previously treated with clarithromycin.

http://bit.ly/2SPManr

Predicting glottal closure insufficiency using fundamental frequency contour analysis

Abstract

Background

Voice analysis has a limited role in a day‐to‐day voice clinic. We developed objective measurements of vocal folds (VF) glottal closure insufficiency (GCI) during phonation.

Methods

We examined 18 subjects with no history of voice impairment and 20 patients with unilateral VF paralysis before and after injection medialization laryngoplasty. Voice analysis was extracted. We measured settling time, slope, and area under the fundamental frequency curve from the phonation onset to its settling‐time.

Results

The measured parameters, settling time, slope, and area under the curve were in correlation with the traditional acoustic voice assessments and clinical findings before treatment and after injection medialization laryngoplasty.

Conclusion

We found that the fundamental frequency curve has several typical contours which correspond to different glottal closure conditions. We proposed a new set of parameters that captures the contour type, and showed that they could be used to quantitatively assess individuals with GCI.

http://bit.ly/2SRRJl3

Meta‐analysis of three‐in‐one single capsule bismuth‐containing quadruple therapy for the eradication of Helicobacter pylori

Abstract

Background

Bismuth‐containing quadruple therapy has been suggested as first‐line and rescue alternative for Helicobacter pylori eradication. Our objective was to perform a meta‐analysis evaluating the efficacy and safety of single capsule Pylera^® (bismuth, metronidazole, and tetracycline) plus a proton‐pump inhibitor (PPI) in any line of treatment.

Methods

Studies were selected up to October 2018. Outcomes were eradication and adverse events (AEs) rates pooled using the generic inverse variance method.

Results

In total, 30 studies (6482 patients) were included in the systematic review. The intention‐to‐treat (ITT) efficacy was 90% (95% CI: 87%‐92%, 21 studies, I ² = 88%) in first‐line therapy, 89% (95% CI: 86%‐93%, 12 studies, I ² = 78%) in second‐line and 82% (95% CI: 78%‐87%, nine studies, I ² = 60%) in third‐line; with no differences by the type or dosage of PPI used. For metronidazole‐resistant infection, the ITT efficacy as first‐line therapy was 93% (95% CI: 90%‐96%, six studies, I ² = 0%). In second‐line therapies where patients had been previously treated with clarithromycin, the ITT efficacy was 90% (95% CI: 87%‐93%, 11 studies, I ² = 78%). The overall incidence of AEs was 43% (95% CI: 35%‐50%, 24 studies, I ² = 92%) and they were mostly mild. In nearly 3% of the cases, treatment was interrupted due to AEs.

Conclusions

A 10‐day treatment with Pylera^® achieved an effective eradication rate of approximately 90% both in first‐ and second‐line therapy. This applies regardless of the type and dose of the PPI, in patients with clarithromycin‐ or metronidazole‐resistant strains, and in those previously treated with clarithromycin.

http://bit.ly/2SPManr

Evolution of self‐perceived swallowing function, tongue strength and swallow‐related quality of life during radiotherapy in head and neck cancer patients

Abstract

Background

Radiation‐associated‐dysphagia is a serious side effect of radiotherapy (RT) for head and neck cancer (HNC).

Methods

Seventy‐six patients had a weekly prospective follow‐up from baseline until one week post‐RT. Combined mixed model analysis (n = 43) determined the evolution of self‐perceived swallowing function, isometric tongue strength (MIP), tongue strength (TS) during swallowing (Pswal), and quality of life (QoL) in these patients during RT.

Results

Swallowing deteriorated from the third week on, resulting in an increase of tube dependency from 10% at baseline toward 31% post‐RT. Both MIP and Pswal are reduced, with anterior MIP decreasing in 29% of patients and posterior MIP in 17%. Pswal decreases for saliva and a bolus swallow. All QoL subscales except "sleep" were affected during RT.

Conclusions

Self‐perceived swallowing function, TS and QoL decrease during RT for HNC. Current findings highlight the need for early monitoring of these parameters.

http://bit.ly/2N82yKF

Pituitary crush

http://bit.ly/2DKqlfd

Single nucleotide polymorphisms in renal transplantation: Can’t see the wood for the trees.

No abstract available

http://bit.ly/2GsuxnW