Trends in the age of diagnosis of childhood asthma: a study of 1 million children

8 consecutive birth cohorts of children (1993-2000) were observed using the universal health insurance plan in Ontario, Canada.

The records of 1,059,511 children were examined, of whom 19% developed asthma in the first 8 years of life. Mean age at asthma diagnosis decreased from 4.7 years in birth year 1993 to 2.6 years in birth year 2000.

This study demonstrates an increase in asthma incidence and a decrease in the age of asthma diagnosis across multiple birth cohorts.


Trends in the age of diagnosis of childhood asthma. J Allergy Clin Immunol. 2014 Jun 27. pii: S0091-6749(14)00671-X. doi: 10.1016/j.jaci.2014.05.012. [Epub ahead of print]

High daily temperatures worsen respiratory symptoms in children with asthma, decrease PEF

An Australian national panel study of diurnal temperature range (DTR) and children's respiratory health

This study examined effects of DTR on lung function and respiratory symptoms for school children with asthma in Australia.

Increase in daily temperature induced a reduction in PEF and increased respiratory symptoms in children with asthma. The effects lasted for 3 days.


An Australian national panel study of diurnal temperature range and children's respiratory health. Annals of Allergy, Asthma & Immunology, Volume 112, Issue 4, Pages 348–353.e8, April 2014.

Image source:, public domain.

Metal hypersensitivity in total joint arthroplasty

This literature review was published in Ann Allergy Asthma Immunology in 2014.

Total joint arthroplasty procedures are increasing, as are the hypersensitivity reactions to these implants. We don't know if metal joint implants increase metal sensitivity or whether metal sensitivity leads to prosthesis failure.

How to diagnose metal hypersensitivity in total joint arthroplasty ?

Patch testing is still the most widely used method for determining metal hypersensitivity. However, there are no standardized commercial panels specific for total joint replacements available at this time.

In vitro testing has shown comparable results in some studies. However. its use in the clinical setting may be limited by the cost and need for specialized laboratories.

Hypersensitivity testing is generally recommended before surgery for patients with a reported history of metal sensitivity.

In cases of metal hypersensitivity-related joint failure, surgical revision ultimately may be required.

Evaluation of hypersensitivity reactions after total joint arthroplasty requires a systematic approach, including:

- careful history
- targeted evaluation with skin testing
- possibly in vitro studies


Metal hypersensitivity in total joint arthroplasty. Pinson ML1, Coop CA2, Webb CN2. Ann Allergy Asthma Immunol. 2014 Jun 13. pii: S1081-1206(14)00337-8. doi: 10.1016/j.anai.2014.05.012. [Epub ahead of print]

Image source:

A Mom's Thoughts on Food Allergies - ACAAI video

From ACAAI YouTube channel: Emily Kloser is the mom of two kids with food allergies. Both of her children are champion athletes. She shares what she's learned over the years about coping with food allergies.

Recombinant C1-esterase inhibitor Ruconest approved for hereditary angioedema (HAE)

The first recombinant C1-esterase inhibitor, Ruconest, was approved by the FDA as a new therapeutic option for hereditary angioedema (HAE). It is a treatment for acute episodes of HAE in adults and adolescents.

Ruconest is derived from the milk of genetically modified (transgenic) rabbits, and relieves HAE symptoms by restoring plasma C1-esterase inhibitor to normal levels. It is manufactured by Pharming Group in Leiden, the Netherlands.

HAE is rare and it affects an estimated 6,000 to 10,000 Americans. This explains why the FDA approval was obtained on the basis of a small trial with 44 patients. Ruconest-treated patients had a time to onset of symptom relief of 90 minutes vs. 152 minutes in placebo-treated patients (P=0.031).

Treatments for Hereditary Angioedema (HAE) (click to enlarge the image).


FDA approves new product to treat rare genetic disease
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