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Background and purpose: Hemodialysis (HD) may have some adverse effects on the nervous system. Headache is the most commonly reported neurological symptom amongst HD patients. Our aim was to determine the frequency, clinical characteristics and triggering factors of HD‐related headache (HRH) and to evaluate preventive strategies for reducing HRH. Method: In all, 494 patients were included. Comparative controls (CC) were classified within the same patients without headache. Arterial systolic/diastolic blood pressure, blood urea nitrogen (BUN) and creatinine were correlated before/after one HD. The urea reduction ratio during the dialysis session was determined. Results: A total of 175 patients (35.4%) with a mean age of 57.3 ± 15.7 years were diagnosed with HRH. HRH was more common in males (P < 0.001). Headache was started a mean of 2.90 ± 0.86 h after the HD. The common localization of pain was reported to be bifrontal in 41.7% (n = 73). The mean duration of headache was 6.22 ± 7.8 h, with a duration of ≤4 h reported by 64.0% of patients. The mean Visual Analog Scale score was 5.64 ± 2.05. The differences between pre/post‐dialysis BUN values were 94.6 ± 31.1 in HRH patients and 86.8 ± 28.5 in the CC group (P = 0.006). The systolic blood pressure difference between the pre/post‐dialysis measurements was 22.4 ± 16.5 mmHg in HRH patients and 12.8 ± 19.4 mmHg in CC(P < 0.001). Patients with HRH had significantly higher mean systolic and diastolic blood pressure pre‐dialysis values (systolic, P = 0.002; diastolic, P < 0.001). The differences in systolic/diastolic blood pressure between pre/post‐dialysis were higher in the HRH group (P < 0.001, P = 0.001, respectively). Conclusion: Regulating the frequency and timing of dialysis may provide better management in HRH with high BUN levels and high pre‐dialysis blood pressure. [ABSTRACT FROM AUTHOR]

Drug hypersensitivity reactions ( DHRs) are a matter of great concern, both for outpatient and in hospital care. The evaluation of these patients is complex, because in vivo tests have a suboptimal sensitivity and can be time-consuming, expensive and potentially risky, especially drug provocation tests. There are several currently available in vitro methods that can be classified into two main groups: those that help to characterize the active phase of the reaction and those that help to identify the culprit drug. The utility of these in vitro methods depends on the mechanisms involved, meaning that they cannot be used for the evaluation of all types of DHRs. Moreover, their effectiveness has not been defined by a consensus agreement between experts in the field. Thus, the European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology has organized a task force to provide data and recommendations regarding the available in vitro methods for DHR diagnosis. We have found that although there are many in vitro tests, few of them can be given a recommendation of grade B or above mainly because there is a lack of well-controlled studies, most information comes from small studies with few subjects and results are not always confirmed in later studies. Therefore, it is necessary to validate the currently available in vitro tests in a large series of well-characterized patients with DHR and to develop new tests for diagnosis. [ABSTRACT FROM AUTHOR]

We consider scheduling in networks with interference constraints and reconfiguration delays, which may be incurred when one service schedule is dropped and a distinct service schedule is adopted. Reconfiguration delays occur in a variety of communication settings, such as satellite, optical, or delay-tolerant networks. In the absence of reconfiguration delays it is well known that the celebrated Max-Weight scheduling algorithm guarantees throughput optimality without requiring any knowledge of arrival rates. As we will show, however, the Max-Weight algorithm may fail to achieve throughput optimality in case of nonzero reconfiguration delays. Motivated by the latter issue, we propose a class of adaptive scheduling algorithms which persist with the current schedule until a certain stopping criterion is reached, before switching to the next schedule. While earlier proposed Variable Frame-Based Max-Weight (VFMW) policies belong to this class, we also present Switching-Curve-Based (SCB) policies that are more adaptive to bursts in arrivals. We develop novel Lyapunov drift techniques to prove that this class of algorithms under certain conditions achieves throughput optimality by dynamically adapting the durations of the interswitching intervals. Numerical results demonstrate that these algorithms significantly outperform the ordinary Max-Weight algorithm, and that SCB policies yield a better delay performance than VFMW policies. [ABSTRACT FROM AUTHOR]

Objectives: Behçet's disease (BD) is a systemic vasculitis involving diverse sizes of arteries and veins. The aim of this study was to evaluate the relationship between central blood pressures, pulse wave velocity (PWV) measurements, and biochemical parameters in patients with inactive and active BD and control subjects. Method: Ninety-six patients with BD were recruited in this study. Each subject was evaluated in active and inactive disease periods. For the control group, 54 healthy age- and sex-matched subjects were enrolled. All patients completed a standard questionnaire form and various laboratory parameters were evaluated. Vascular measurements were performed with a Mobil-O-Graph 24-h PWA Monitor, an automatic oscillometric device. Results: According to the vascular function parameters of patients with active and inactive BD, 24-h, day, and night PWV values were higher in patients with active BD than in patients with inactive BD (p < 0.05). When we performed a linear regression analysis, 24-h PWV was positively correlated with age and duration of BD. Cardiac output (CO) values and day central diastolic blood pressure (DBP) were higher in patients with BD than in the control group (p < 0.05). Conclusions: PWV values were higher in patients with active BD than in patients with inactive BD. This may be explained by more prominent inflammatory changes in the vascular wall in the active disease period. Further studies in large populations are required to confirm our results. [ABSTRACT FROM AUTHOR]

Background and Objectives: The significant rise in food borne infections is mainly caused by Campylobacter spp., Salmonella serovars and Verotoxigenic Escherichia coli. As the emerging food borne pathogens cause disease, more studies have been conducted for rapid detection of these pathogens. The combination of immunomagnetic separation and polymerase chain reaction (IMS-PCR) is the most accurate and rapid test preferred by almost every researcher. Fourier Transform Infrared Spectroscopy (FTIR) is preferred for being a new, user friendly and rapid technique in microbiological analyses. The main aim of this study is to detect application of IMS-FTIR for Salmonella identification from foods in a short time with a higher sensitivity. Materials and Methods: Conventional Culture Technique (CC), IMS-CC, IMS-PCR and IMS-FTIR techniques were compared with each other for rapid detection in artificially contaminated minced beef with Salmonella Typhimurium, as of the 2nd, 4th and 8th hours of contamination. The method was evaluated in different food matrices and sensitivity, specifity and overall recovery was calculated. Results: The results indicate that IMS-FTIR can detect S. Typhimurium as of the 8th hour with sensitivity of 95.6667, accuracy of 91.69329, false positive ratio of 0.04333 and overall recovery of 95.66%. Conclusion: It can be suggested that the IMS-FTIR method is capable of detecting S.Typhimurium in a short time with lower cost. [ABSTRACT FROM AUTHOR]

Co3V2O8 is a member of kagomé staircase oxides, represented by general formula M3V2O8 (M = Ni, Co, Mn). It attracted great attention due to strong magnetic anisotropy, magnetic phase transition, genuine macroscopic quantum effects, strong quantum fluctuations, low-temperature ferroelectricity, field-induced magnetic transitions, complicated phase diagram and displays long-range magnetic order because of geometrical frustration. Different routes to prepare the frustrated magnetic material was reported such as floating zone technique and conventional high temperature method. Co3V2O8 (International Centre for Diffraction Data (ICDD): 16-675) was synthesized with Co3O4 (ICDD: 80-1536) as binary phase by microwave assisted preparation using Co(NO3)2.6H2O and NH4VO3. The synthesized material was characterization by powder X-ray diffraction, the Fourier transform infrared spectroscopy, and thermogravimetric-differential thermal analysis. [ABSTRACT FROM AUTHOR]

A response by G. Celik, J. Schroeder and N.F. Adkinson to a letter to the editor about their article "Effect of in vitro aspirin stimulation on basophils in patients with aspirinexacerbated respiratory disease," is presented.

Drug hypersensitivity reactions (DHRs) affect an unknown proportion of the general population, and are an important public health problem due to their potential to cause life-threatening anaphylaxis and rare severe cutaneous allergic reactions. DHR evaluations are frequently needed in both ambulatory and hospital settings and have a complex diagnosis that requires a detailed clinical history and other tests that may include in vitro tests and in vivo procedures such as skin tests and drug provocation tests. Although over the years both European and U.S. experts have published statements on general procedures for evaluating DHRs, a substantial discordance in their daily management exists. In this review, we highlight both the differences and the similarities between the European and U.S. perspectives. While a general consensus exists on the importance of skin tests for evaluating DHRs, concordance between Americans and Europeans exists solely regarding their use in immediate reactions and the fact that a confirmation of a presumptive diagnosis by drug provocation tests is often the only reliable way to establish a diagnosis. Finally, great heterogeneity exists in the application of in vitro tests, which require further study to be well validated. [ABSTRACT FROM AUTHOR]

PurposeThe purpose of this study was to assess choroidal thickness in migraine patients during acute migraine attacks and compare them with healthy controls, using spectral domain optical coherence tomography (OCT).Patients and methodsIn this prospective case-control study, choroidal thicknesses of 46 migraine patients during acute migraine attacks and 46 age- and sex-matched healthy subjects were measured using a high-speed, high-resolution frequency domain-OCT device. All patients underwent a complete ophthalmic examination before the measurements. OCT measurements were taken at the same time of day (0900 hours), in order to minimize the effects of diurnal variation.ResultsThere was a statistically significant difference in mean choroidal thickness between the migraine patients during acute migraine attacks (356.3±21.46 μm) and the controls (302.3±18.34 μm; P=0.000). There were significant differences at all measurement points (P<0.001 for all).ConclusionThe increased choroidal thickness of the migraine patients during acute migraine attacks might be related to the vascular pathology of the disease. Further studies are needed to evaluate the etiopathologic relationship between choroidal thickness and acute migraine attack. [ABSTRACT FROM AUTHOR]

Galectin-1 is an important mediator that regulates the T-cell-mediated immune response. It has many other biological functions such as cell growth, immunomodulation, and wound healing. The aim of this study was to reveal the role of galectin-1 on liver morphology, cell proliferation, apoptosis, inflammatory and anti-inflammatory mediators, oxidative stress, and antioxidant system in colitis-mediated hepatotoxicity induced by dextran sulfate sodium (DSS). In the present study, adult mice were divided into four groups: The control group intraperitoneally injected with phosphate buffer saline (I), the group which was orally administered with DSS (II), the control group which was injected with galectin-1 (III), and the group which was given DSS and galectin-1 (IV). DSS administration caused degenerative changes and diffuse necrotic damage, an increase in caspase-3 and cyclooxygenase-2 expression, the levels of lipid peroxidation and tumor necrosis factor-alpha, lactate dehydrogenase, and myeloperoxidase activities, and a decrease in cell proliferation, interleukin-10 levels, and antioxidant system parameters in liver tissues. Treatment of DSS group with galectin-1 reversed these effects and prevented liver damage. This study showed that galectin-1 has proliferative, antiapoptotic, anti-inflammatory, and antioxidant effects against DSS-induced liver injury in mice. It is expected considering all results of this study that galectin-1 may be useful as a protective agent against liver toxicity. [ABSTRACT FROM AUTHOR]

Viral infections lead to significant morbidity and mortality in kidney transplant recipients. We evaluated 49 kidney transplant recipients for human herpesvirus 8 (HHV-8) and BK polyomavirus infections in conjunction with data obtained from 43 donors. The seroprevalence of HHV-8 was 6.9% in donors and 12.2% in recipients. HHV-8 DNA was detected below the limit of quantification (<5000 copies/mL) in a recipient with HHV-8 seropositivity at the pretransplant period and was undetectable at month 3 after transplantation. Transient viruria with BK polyomavirus was recorded in 10.2% of recipients without viremia. Multiple factors contribute to viral reactivation, particularly immunosuppressive treatment. Reduction in maintenance immunosuppression seems beneficial in terms of viral reactivation. At our center, routine use of valganciclovir for antiviral prophylaxis may be effective for the prevention of HHV-8 reactivation. [ABSTRACT FROM AUTHOR]

The strongest and best-documented risk factor for drug hypersensitivity ( DH) is the history of a previous reaction. Accidental exposures to drugs may lead to severe or even fatal reactions in sensitized patients. Preventable prescription errors are common. They are often due to inadequate medical history or poor risk assessment of recurrence of drug reaction. Proper documentation is essential information for the doctor to make sound therapeutic decision. The European Network on Drug Allergy and Drug Allergy Interest Group of the European Academy of Allergy and Clinical Immunology have formed a task force and developed a drug allergy passport as well as general guidelines of drug allergy documentation. A drug allergy passport, a drug allergy alert card, a certificate, and a discharge letter after medical evaluation are adequate means to document DH in a patient. They are to be handed to the patient who is advised to carry the documentation at all times especially when away from home. A drug allergy passport should at least contain information on the culprit drug(s) including international nonproprietary name, clinical manifestations including severity, diagnostic measures, potential cross-reactivity, alternative drugs to prescribe, and where more detailed information can be obtained from the issuer. It should be given to patients only after full allergy workup. In the future, electronic prescription systems with alert functions will become more common and should include the same information as in paper-based documentation. [ABSTRACT FROM AUTHOR]

Background Few studies investigated hypersensitivity to nonsteroidal anti-inflammatory drugs ( NSAIDs) in children. The objective was to determine the frequency of true NSAID hypersensitivity ( NSAID-H) and whether there were any parameters in the history of children that would predict NSAID-H. Secondly, an investigation was conducted into whether NSAID-hypersensitive children could tolerate safe alternatives. Differing from previous studies, the researchers followed the recent diagnostic algorithm proposed for acute reactions in NSAID-H. Methods Children with a history suggesting NSAID-H were evaluated by an allergist. The patients with a single NSAID in history were tested first with a skin prick test and if negative challenged with the culprit NSAID. The patients who had reactions with multiple NSAIDs were directly challenged with their culprit drugs. Safe alternatives in children with a confirmed NSAID-H were found by oral provocation tests ( OPTs). Results Fifty-eight of 61 patients participated in the study. Thirty-eight patients (65.5%) described a reaction to a single NSAID and 20 mentioned reactions with ≥2 different NSAIDs. Single-drug-induced and cross-reactive NSAID- Hs were proven in 5 of 36 (14%) and 8 of 18 (44%) of patients, respectively. Acetaminophen and nimesulide were tolerated in 60% and 88.8% of the study patients as safe alternatives, respectively. Family history of NSAID-H was found as the only significant predictor of OPT ( OR: 5.4; 95% CI: 1.02-28.6). Conclusion Histories of both single and multiple NSAID-Hs are poor predictors of actual drug hypersensitivity. Therefore, diagnostic tests should be performed in all children if no contraindication exits. Family history of NSAID-H is the only significant parameter predicting OPT results. [ABSTRACT FROM AUTHOR]

Hypersensitivity reactions to aspirin (acetylsalicylic acid) and other nonsteroidal anti-inflammatory drugs ( NSAIDs) constitute only a subset of all adverse reactions to these drugs, but due to their severity pose a significant burden to patients and are a challenge to the allergist. In susceptible individuals, NSAIDs induce a wide spectrum of hypersensitivity reactions with various timing, organ manifestations, and severity, involving either immunological (allergic) or nonimmunological mechanisms. Proper classification of reactions based on clinical manifestations and suspected mechanism is a prerequisite for the implementation of rational diagnostic procedures and adequate patient management. This document, prepared by a panel of experts from the European Academy of Allergy and Clinical Immunology Task Force on NSAIDs Hypersensitivity, aims at reviewing the current knowledge in the field and proposes uniform definitions and clinically useful classification of hypersensitivity reactions to NSAIDs. The document proposes also practical algorithms for the diagnosis of specific types of NSAIDs hypersensitivity (which include drug provocations, skin testing and in vitro testing) and provides, when data are available, evidence-based recommendations for the management of hypersensitive patients, including drug avoidance and drug desensitization. [ABSTRACT FROM AUTHOR]

Nonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 21–25% of reported adverse drug events which include immunological and nonimmunological hypersensitivity reactions. This study presents up-to-date information on pathomechanisms, clinical spectrum, diagnostic tools and management of hypersensitivity reactions to NSAIDs. Clinically, NSAID hypersensitivity is particularly manifested by bronchial asthma, rhinosinusitis, anaphylaxis or urticaria and variety of late cutaneous and organ-specific reactions. Diagnosis of hypersensitivity to a NSAID includes understanding of the underlying mechanism and is necessary for prevention and management. A stepwise approach to the diagnosis of hypersensitivity to NSAIDs is proposed, including clinical history, in vitro testing and/ or provocation test with a culprit or alternative drug depending on the type of the reaction. The diagnostic process should result in providing the patient with written information both on forbidden and on alternative drugs. [ABSTRACT FROM AUTHOR]

Nonsteroidal anti-inflammatory drugs (NSAIDs) are responsible for 21-25% of reported adverse drug events which include immunological and nonimmunological hypersensitivity reactions. This study presents up-to-date information on pathomechanisms, clinical spectrum, diagnostic tools and management of hyper-sensitivity reactions to NSAIDs. Clinically, NSAID hypersensitivity is particularly manifested by bronchial asthma, rhinosinusitis, anaphylaxis or urticaria and variety of late cutaneous and organ-specific reactions. Diagnosis of hypersensitivity to a NSAID includes understanding of the underlying mechanism and is necessary for prevention and management. A stepwise approach to the diagnosis of hypersensitivity to NSAIDs is proposed, including clinical history, in vitro testing and/or provocation test with a culprit or alternative drug depending on the type of the reaction. The diagnostic process should result in providing the patient with written information both on forbidden and on alternative drugs. [ABSTRACT FROM AUTHOR]

A patient with hepatitis C virus (HCV) infection was diagnosed with cutaneous, pulmonary and hepatic sarcoidosis following interferon alpha therapy. There are only a few cases of sarcoidosis associated with this treatment. This is the first case who not only developed sarcoidosis, but also autoimmune hypothyroidism and thrombocytopenia during interferon alpha therapy due to the immunomodulatory effects of the drug. [ABSTRACT FROM AUTHOR]