Systemic anaphylaxis after ingestion of a psyllium-containing breakfast cereal

Importance and adequacy of practice competencies for care professionals in aging-related fields: the Chinese administrator's perspective

The rapid growth of the older population has increased the need for care professionals with training in gerontology or geriatrics. This study analyzes the perceived importance and adequacy of practice competencies for entry-level care professionals in aging-related fields in Hong Kong. The administrators of non-governmental organizations that provide aging-related services were surveyed. The most important competencies were identified, as well as those that underperformed and some that were cross-culturally relevant. Potential areas and new directions for the development of competencies for care professionals were also examined. The methods used in this study could serve as a reference for further studies in gerontology and geriatrics education.

Psyllium-associated anaphylaxis and death: a case report and review of the literature

BACKGROUND

Psyllium use has increased significantly in the United States in part due to its lipid-lowering property. The increased prevalence of consumption has led to its recognition as an emerging food allergen.

OBJECTIVES

To report the case of a 42-year-old woman who experienced fatal anaphylaxis after ingesting a psyllium-based product and to review the literature.

METHODS

The MEDLINE database was searched for articles from 1966 to 2002 using the keywords psyllium or ispaghula and each of the following: allergy, hypersensitivity, anaphylaxis, and asthma. Both English and non-English articles were included.

RESULTS

Psyllium hypersensitivity has been well described in health care workers and pharmaceutical plant employees. Clinical manifestations of allergy range from upper respiratory tract symptoms on inhalation to anaphylaxis on ingestion. The prevalence of sensitization varies between these 2 groups. The allergenic epitope is not known.

CONCLUSIONS

We present a case of psyllium hypersensitivity that resulted in death. There is a clear association between atopy and psyllium allergy. The case underscores the fact that even nonprescription "natural" products can be harmful to people with allergies.

Fatal bronchospasm after oral ingestion of isphagula

We report the case of a 40-year-old asthmatic who suffered fatal bronchospasm following oral injestion of a laxative containing isphagula.