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Background Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30-1500 IU/mL) and bodyweight (30-150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry ( AXR). Objectives To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants. Methods Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight). Results Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 ( IQR 632, 1747) IU/mL vs. 209 ( IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 ( IQR 650, 750) mg] compared to within-range participants [450 ( IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire ( ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire ( AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second ( FEV1) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV1. Conclusions and Clinical Relevance Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg. [ABSTRACT FROM AUTHOR]

Coccidioidomycosis is a fungal infection caused by Coccidioides species. The disease has wide clinical presentation and a distinct geographical distribution. We describe two cases of coccidioidomycosis in returned Australian travellers who presented to Nambour Hospital. Knowledge of the international geographical distribution of endemic fungal infections and their clinical manifestations can assist in earlier diagnosis and appropriate management. [ABSTRACT FROM AUTHOR]

This study focuses on the production of silica sand in the Kingdom of Saudi Arabia in the light of the Kingdom's industrialization strategies and policies, which are aimed at the diversification of income sources and widening of production fields in the context of the consecutive development plans during the period 1390 - 1430 AH. Silica sand procession/production is considered as an indicator for evaluating the range of success and applying a series of government strategies, on the top of, is the strategy of utilization of the local resources, adopted by a number of development plans, through encouraging local and foreign private sector investment, and exploring and developing unexploited mineral resources. Silica sand production, among 33 unexploited industrial minerals on the soil of the Kingdom, needs to be carefully studied. The intended study highlights the importance of the product, its production stages, and the geographical distribution of location in the Kingdom of Saudi Arabia. The economic value of silica sand will also be tackled through concentrating on its study as one of the industrial factors of development with the purpose of becoming less dependant on importation and even planning for its exportation in the future. Figures prove that the Kingdom's production of silica sand the year 1427 has amounted to 600000 tons. [ABSTRACT FROM AUTHOR]