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Background
The prevalence of tree nut allergy has increased worldwide, and cashew has become one of the most common food allergens. More critically, cashew allergy is frequently associated with severe anaphylaxis. Despite the high medical need, no approved treatment is available and strict avoidance and preparedness for prompt treatment of allergic reactions are considered dual standard of care. In the meantime, Phase III study results suggest investigational epicutaneous immunotherapy (EPIT) may be a relevant and safe treatment for peanut allergy and may improve the quality of life for many peanut allergic children.Objective
We aimed to evaluate the capacity of EPIT to provide protection against cashew-induced anaphylaxis in a relevant mouse model.Methods
The efficacy of EPIT was evaluated by applying patches containing cashew allergens to cashew-sensitized mice. As negative control, sham mice received patches containing excipient. Following treatment, mice were challenged orally to cashew and anaphylactic symptoms, as well as plasmatic levels of mast-cell proteases (mMCP)-1/7, were quantified.Results
Of 16 weeks of EPIT significantly protects against anaphylaxis by promoting a faster recovery of challenged mice. This protection was characterized by a significant reduction of temperature drop and clinical symptoms, 60 minutes after challenge. This was associated with a decrease in mast-cell reactivity as attested by the reduction of mMCP-1/7 in plasma, suggesting that EPIT specifically decrease IgE-mediated anaphylaxis.Conclusion
We demonstrate that EPIT markedly reduced IgE-mediated allergic reactions in a mouse model of cashew allergy, which suggests that EPIT may be a relevant approach to treating cashew allergy.Health agencies call for the immediate mobilization of existing interventions in response to numerous child and family mental health concerns that have arisen as result of the COVID-19 pandemic. Answering this call, this pilot study describes the rapid, full-scale change from a primarily clinic-based Parent–Child Interaction Therapy (PCIT) model to a virtual service model (i.e., I-PCIT) in an academic and community-based program in Miami, Florida. First, we describe the virtual service training model our program developed and its implementation with 17 therapists (MAge?=?32.35, 88.2% female, 47.1% Hispanic) to enable our clinic to shift from providing virtual services to a small portion of the families served (29.1%) to all of the families served. Second, we examine the effect of I-PCIT on child and caregiver outcomes during the 2-month stay-at-home period between March 16, 2020, and May 16, 2020, in 86 families (MChildAge?=?4.75, 71% Hispanic). Due to the rapid nature of the current study, all active participants were transferred to virtual services, and therefore there was no comparison or control group, and outcomes represent the most recently available scores and not treatment completion. Results reveal that I-PCIT reduced child externalizing and internalizing problems and caregiver stress, and increased parenting skills and child compliance with medium to large effects even in the midst of the COVID-19 pandemic. Finally, the study examined components of our virtual service training model associated with the greatest improvements in child and caregiver outcomes. Preliminary findings revealed that locally and collaboratively developed strategies (e.g., online communities of practice, training videos and guides) had the strongest association with child and caregiver outcomes. Implications for virtual service delivery, implementation, and practice in the midst of the COVID-19 pandemic are discussed.
相似文献This study aimed at reporting a head-to-head comparison between water vapor thermal therapy using the Rezūm? system and prostatic urethral lift using the Urolift? system in men with lower urinary tract symptoms due to benign prostatic hyperplasia (BPH).
Patients and methodsFrom December 2017 to November 2019, consecutive patients who underwent Rezūm? and Urolift? procedures in two urology centers have been retrospectively considered. Only patients with a prostate size less than 80 mL were included. We used the PSM method to adjust baseline differences between both groups. The co-primary endpoint included the change in International Prostate Symptom Score (IPSS) and IPSS- quality of life (QoL) from baseline to 12 months.
ResultsA total of 61 (52.1%) and 56 (47.9%) patients underwent Rezum? and Urolift? procedures, respectively. After PSM adjustment, 24 patients were included in both groups. No serious adverse events occurred (>?Clavien II) in both groups. At 12 months, higher IPSS improvement was observed in the Rezum? group (median:4 [IQR 3–5]) than in the Urolift? group (median:8 [IQR 7–12]), without statistical difference (p?=?0.08). The improvement in term of QoL at 12 m was similar (p?=?0.43). The retreatment rates were 25% (Urolift?) and 8.3% (Rezum?), p?=?0.24. Erection and ejaculatory function scores did not change significantly in either treatment group. Results in the full cohort showed that Rezum? appeared to deliver greater improvements for IPSS and IPSS-QoL (p?<?0.001 and p?=?0.006, respectively) and lower reintervention rate (p?=?0.006) than Urolift?.
ConclusionsIn this small retrospective study, our results indicate that both Rezum? and Urolift? provide a clinically significant improvement in symptoms and QoL, although some of these improvements were greater in the Rezum? arm. Future studies are needed to definitively assess which treatment would be best suited for each patient.
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