House dust mite allergy and shrimp allergy: a complex interaction

Summary

Background and Objective. Sensitization and allergy to shrimp among Italian house dust mite allergic patients are not well defined and were investigated in a large multicenter study. Methods. Shrimp sensitization and allergy were assessed in 526 house dust mite (HDM)-allergic patients submitted to the detection of IgE to Der p 10 and 100 atopic control not sensitized to HDM. Results. Shrimp allergy occurred in 9% of patients (vs 0% of 100 atopic controls not sensitized to HDM; p minor 0.001). Shrimp-allergic patients were less frequently hypersensitive to airborne allergens other than HDM than crustacean-tolerant subjects (35% vs 58.8%; p minor 0.005). Only 51% of tropomyosin-sensitized patients had shrimp allergy, and these showed significantly higher Der p 10 IgE levels than shrimp-tolerant ones (mean 22.2 KU/l vs 6.2 KU/l; p minor 0.05). Altogether 53% of shrimp-allergic patients did not react against tropomyosin. Conclusions. Shrimp allergy seems to occur uniquely in association with hypersensitivity to HDM allergens and tropomyosin is the main shrimp allergen but not a major one, at least in Italy. Along with tropomyosin-specific IgE levels, monosensitization to HDM seems to represent a risk factor for the development of shrimp allergy among HDM allergic patients.

Validation of an original questionnaire for patients with psoriatic arthritis: the Psoriatic Arthritis Impact Profile (PAIP)

BACKGROUND AND AIMS

There is a wide evidence that Psoriatic Arthritis (PsA) as well as Psoriasis (Ps) lead to significant health problems and interfere with the patient quality of life (QoL). Even though a validated questionnaire for Ps is available, no questionnaire for PsA is currently present in literature. The aim of our work has been to confirm the efficacy of our original questionnaire as well as to validate it, through the comparison with other existing recognised and accepted questionnaires, such as MOF-SF36, HAQ, McGill Pain Questionnaire, and Zeung Self-Rating Depression and Anxiety Scales.

MATERIALS AND METHODS

We have realized a questionnaire for PsA (Psoriatic Arthritis Impact Questionnaire, PAIP), in terms of psychological and rheumatological evaluation, QoL, social and economic assets.

RESULTS

The statistical comparisons between PAIP and the accepted questionnaires (see above) confirm that PAIP is widely validated and represents a useful tool suitable for clinical evaluation and management of patients with PsA.

CONCLUSIONS

The indexes of the correlation among the different parts of PAIP and the other questionnaires have shown positive correlations. Moreover, PAIP presents a dedicated unit for the economical and therapeutic parameters, The short time for compilation (15 minutes), the easy of comprehension of the questions, and - above all - the validation of PAIP, make our questionnaire a useful tool, suitable for the clinical management of the patients with PsA.

Lymphatic system: morphofunctional considerations

The lymphatic system, consisting of the lymph nodes and the lymphatic vessels as well as the spleen and various sites of lymphoid tissue, is deputed to important tasks: the immune response, the transport of lipids absorbed at the intestinal level and the reabsorption of water and other substances from the interstitial spaces; the lymph nodes in particular are involved in immunity and lymph filtration-depuration. Therefore, the knowledge of lymph node cellular architecture as well as of the structure and course of lymphatic vessels is of great importance. The pathologic processes that affect the lymphatic system can involve the canalicular and/or nodal part, resulting in patterns directly correlated with their respective function: lymphedema and lymphagitis on one hand, and disorders induced by accumulation, inflammation and tumors, on the other.

[Intestinal preparation for colon enema with fleet sodium phosphate: comparative study with the conventional method]

PURPOSE

To evaluate the possible optimization of a well-tolerated and versatile method of intestinal preparation able to adequately free the lumen and consequently improve diagnostic results with a lower risk of prolonged hospital stay for incorrectly prepared patients.

MATERIAL AND METHODS

We examined 40 patients, namely 20 men (mean age 70 years, range 52-87) and 20 women (mean age 68 years, range 49-81) referred to the Institute of Radiology of the Università Cattolica del Sacro Cuore, Gastrointestinal tract Unit, to undergo double contrast colonic enema. The patients were divided into two groups by one-to-one randomization: group 1 was prepared with the conventional method and group 2 with the new protocol for intestinal preparation. On the two days before the examination a low-residue diet was administered; the day before the examination a phial of Fosfo-soda fleet was administered in two times (at 8 am and 4.30 pm), which was diluted with half a glass of water. Bread, pasta and vegetables were strictly forbidden at lunch and soup or milk at supper; the patients were fasted on the examination day. Two evaluations were performed: one to assess tolerance to the preparation and the other, a radiographic study, to assess the grade of intestinal preparation, the presence of secretions/bubbles, and the degree of painting.

RESULTS

Of the 20 patients given X-prep, 3 had to discontinue it and 4 exhibited severe side-effects, but completed the treatment; tolerance was satisfactory in the remaining 13 patients. The grade of intestinal preparation, the presence of secretions/bubbles, and the degree of painting were considered satisfactory in 9, 17 and 16 patients respectively. None of the patients given Fosfo-soda fleet had to discontinue it and tolerance was satisfactory in 19 patients. The grade of intestinal preparation, the presence of secretions/bubbles, and the degree of painting were considered satisfactory in 15, 18 and 18 patients respectively. The statistical analysis of all data was performed with Wilcoxon test.

DISCUSSION

Intestinal preparation with Fosfo-soda fleet appeared to be definitely better than the conventional method relative to tolerance (p = .02, a statistically significant difference), while providing similarly satisfactory data relative to the other parameters.

CONCLUSIONS

Our results, coupled with the versatility of Fosfo-soda fleet (possible application in colonoscopy) and its ease of use recommend this preparation not only for inpatients but also for outpatients in whom self-administration is feasible.

Diagnostic imaging of abdominal tuberculosis: gastrointestinal tract, peritoneum, lymph nodes

Abdominal tuberculosis is usually associated to pulmonary tuberculosis. The most frequent gastrointestinal form is ulcerative illeocecal tuberculosis. Esophageal, gastric and duodenal locations are rare; jejunal and proximal ileal tuberculosis are rare during tuberculous peritonitis. The most common form with liver and spleen involvement is miliary tuberculosis, the macronodular form being rare. Tuberculous peritonitis is a common manifestation of abdominal tuberculosis with various aspects according to the presence of ascitis and the predominant fibrotic reaction. Most common abdominal manifestation is represented by lymph node involvement with four patterns recognized on CT. In AIDS patients together with Mycobacterium tuberculosis infection, there may be Mycobacterium avium complex infection with often indistinguishable imaging findings. Patterns are similar to those of immunocompetent patients, except for markedly immunocompromised subjects in whom disseminated forms are observed.

[Magnetic resonance and computerized tomography of posterior cranial fossa tumors in childhood. Differential diagnosis and assessment of lesion extent]

In the last thirty years much progress has been made in the treatment of brain tumors in children, thanks to modern diagnostic imaging techniques, together with neurosurgery and radiotherapy, for the diagnosis and follow-up of these lesions. MRI and paramagnetic contrast agents have revolutionized the imaging of intracranial conditions, especially in the posterior cranial fossa. The superiority of MRI over CT is well known and reported in the literature, but the adequacy of the two methods has rarely been compared. Therefore, this study was aimed at assessing and quantitating the accuracy of MRI and CT relative to two essential parameters: preoperative "histologic" diagnosis and local and distant intracranial tumor extent. In 52 selected patients the final histologic diagnosis was cerebellar medulloblastoma in 20 cases, cerebellar astrocytoma in 12 cases, brain stem glioma in 12 cases and ependymoma in 8 cases. CT allowed the correct diagnosis to be made in 25 patients (48%), with questionable findings in 21 patients (40%) and 6 misdiagnoses (12%). MRI allowed the correct diagnosis to be made in 43 patients (83%), with questionable findings in 9 patients (17%) and no misdiagnoses. MRI depicted local and distant tumor spread in 34 patients while CT showed it in 22 patients only. The analysis of the results confirmed the superiority of MRI over CT, relative to the parameters considered, i.e. histology and the assessment of tumor spread. In the clinical suspicion of brain tumors of the posterior cranial fossa in children, MRI--if available--should be the examination of choice if the patient's clinical status does not prevent its use. CT should be used only in emergency cases (acute intracranial hypertension) to identify hydrocephalus and intratumoral hemorrhages. Unenhanced CT also yields useful pieces of information for lesion "histology" and may be used to integrate MR findings in selected cases.

Radiation chemistry of ices of planetological interest at low temperature

We present the results of recent experiments on some physico-chemical effects induced by fast ion colliding with solids of relevance for the physics of planetary objects. The production of molecular solids, polymer-like materials and amorphous carbon by irradiation of frozen hydrocarbons and pentacene is discussed. We also report on a set of experimental results obtained irradiating methanol and water-methanol mixtures. Because of bombardment different species form. The techniques used for the analysis are "in situ" infrared (IR) and Raman spectroscopy. The experimental results are finally discussed in the light of their relevance for planetary physics.