AIM:Component-resolved diagnostics (CRD) improve diagnosis and risk stratification in peanut allergy. We evaluated the diagnostic performance of five recombinant peanut allergens for predicting peanut-induced anaphylaxis. METHODS:We retrospectively analysed 164 children with peanut sensitization and elevated IgE to recombinant allergens. Patients were classified as Group A (no/mild symptoms) or Group B (anaphylaxis). Specific IgE levels were compared, ROC curves identified optimal cut-offs, and odds ratios were estimated using Firth penalized logistic regression. RESULTS:Ara h 1-, Ara h 2- and Ara h 3-specific IgE levels were significantly higher in Group B. The strongest association was observed for Ara h 2 (OR 19.65, 95% CI 5.83-72.56; p < 0.001), followed by Ara h 3 (OR 7.27, 95% CI 2.31-26.34; p = 0.001) and Ara h 1 (OR 6.21, 95% CI 1.77-20.73; p = 0.006). Ara h 8 was not associated with anaphylaxis, whereas Ara h 9 showed an inverse association (OR 0.23, 95% CI 0.06-0.73; p = 0.012). Optimal cut-offs were Ara h 1 ≥ 2.60, Ara h 2 ≥ 10.36 and Ara h 3 ≥ 0.18 kUA/L. CONCLUSIONS:Specific IgE to Ara h 1, Ara h 2 and Ara h 3, particularly Ara h 2, was associated with peanut-induced anaphylaxis. The proposed cut-offs require prospective validation.
AIM:This observational follow-up study of very preterm infants evaluated home videos for General Movements Assessments (GMA), the remote Ages and Stages Questionnaire (ASQ) and associations between the two tools at 3-4 months of corrected age. METHODS:We enrolled 232 infants born before 32 weeks of gestation from eight neonatal units in Eastern Denmark during 2021-2023. Parents received In-Motion video instructions, based on the General Movements Trust guidelines and submitted home recordings via the Baby Moves app. They completed the ASQ electronically. Experienced GMA observers independently assessed the videos. RESULTS:Parents submitted videos for 184 infants (79%) and all were suitable for evaluation. They also completed the ASQ for 199 infants (86%). Interobserver agreement for typical GMA versus atypical classifications was excellent (Gwet's AC1 = 0.97). Eight infants (4%) showed atypical GMA, indicating a high risk of cerebral palsy. ASQ data were available for seven of these infants. GMA and ASQ classifications showed a weak association (p = 0.03, Phi = 0.19). Four of the seven children with atypical GMA had low total ASQ scores, whereas 31/35 children with low total ASQ scores had typical GMA. CONCLUSION:Home videos enabled reliable early GMA assessments for cerebral palsy risks. ASQ and GMA classifications showed weak associations.
AIMS:The aims were as follows: (1) to adapt the Sophia Observation withdrawal Symptoms-Paediatric Delirium (SOS-PD) screening tool for use in neonates (SOS-ND), (2) to estimate the accuracy of SOS-ND (used by nurses) compared to assessment by a child psychiatrist using an adapted version of Vanderbilt Assessment of Delirium in Infants and Children and (3) to compare the outcome of assessments of the child psychiatrist and neonatologists. METHODS:A descriptive and comparative design was used. An interdisciplinary group adapted the SOS-PD to develop the SOS-ND. We compared three assessments done on the same day in hospitalized neonates with postmenstrual age at 35-44 weeks in a Danish level IV neonatal intensive care unit. RESULTS:Twenty-six neonates were assessed and five were diagnosed with delirium by the child psychiatrist. An accuracy of 88% [CI 69.9-97.6] was found between SOS-ND screenings during the preceding 24 h and the child psychiatrist's assessment. Neonatologists did not positively identify delirium in the 26 neonates. CONCLUSION:The findings suggest that nurses and the child psychiatrist observe the same condition. By contrast, the absence of delirium diagnosed by experienced neonatologists suggests differences in the conceptualization of the underlying neuropsychological condition.
AIM:This study aimed to explore clinical and laboratory markers of omalizumab response in paediatric and adult chronic spontaneous urticaria (CSU) patients. METHODS:The study included 32 children and 67 adults with CSU receiving omalizumab, and 29 paediatric and 30 adult healthy controls; associations with treatment response were evaluated. RESULTS:In adults, higher baseline Systemic Inflammation Response Index (SIRI) (OR = 0.207, p < 0.001), monocyte count (OR = 0.276, p = 0.002), neutrophil-to-lymphocyte ratio (NLR) (OR = 0.455, p = 0.012), and Systemic Immune-Inflammation Index (SII) (OR = 0.487, p = 0.022) were associated with lower odds of treatment response. In paediatric patients, higher baseline SII was significantly associated with lower odds of response (OR = 0.349, p = 0.040). Interaction analyses showed nominally significant age interactions for baseline SIRI (B = -0.169, p = 0.027) and monocyte count (B = -0.193, p = 0.025). During follow-up, SIRI was lower in responders from baseline through 12 months in adults, and at 3 and 6 months in children. SII was lower in responders at baseline in adults, and at baseline, 3, and 6 months in children (all p < 0.05). CONCLUSION:Our findings suggest potential differences in the associations between inflammatory markers and omalizumab response across age groups, though further studies are needed to clarify age-related differences.
