Providing medical care in the Peruvian Amazon.
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Biomedical subjects
Publications and source records attributed to Barbara Fraser.
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PURPOSE: The prevalence of allergy and asthma symptoms and asthma medication use, which has been extensively studied in elite athletes, has received little attention in recreational roadrunners. METHODS: A validated questionnaire was used to determine the prevalence of allergy and asthma symptoms, the use of medication, and allergy specialty attention among recreational roadrunners. Comparison with the published prevalence of allergy and asthma symptoms in Olympic athletes was made. RESULTS: The prevalence of allergy and asthma symptoms were similar in two consecutive yearly surveys (2003, 2004). The response from 2004 was 11% (484 of 4398 runners). The study population was 60% male, 56% Caucasian, 10% non-Caucasian, and 34% undesignated. Subjects competed for 13.2 +/- 10.5 yr. Prevalence was 44% for symptoms of allergy, 31% for asthma, and 21% for both. Of those reporting allergy symptoms alone, 0.5% had prescription medications or medication before the race. Those with asthma and allergy or asthma alone were more likely to have prescription medication (allergy and asthma, 32%, P = 0.0001; asthma, 6%, P = 0.001), to take medication before the race (asthma and allergy, 27%, P = 0.0001; asthma, 5%, P = 0.007), or to seek specialty attention and medication (asthma and allergy, 39%, P = 0.0001; asthma, 7%, P = 0.004) than those with allergy symptoms alone. The comparison with results from a survey of Olympic athletes indicates that symptoms of allergy and asthma were more prevalent in recreational athletes (P = 0.0001 to 0.007), but roadrunners were less likely to be taking prescription medication (P = 0.025). CONCLUSION: These results suggest that the recreational roadrunner is more likely to report symptoms of allergy and/or asthma but less likely to have prescription medication than the Olympic athlete.
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We describe a representative patient diagnosed with anaphylaxis to latex occurring during elective surgery in the absence of any previous risk factors for latex allergy. Latex allergy was identified by skin prick testing and confirmed by serological diagnosis testing. We review our experience screening patients for latex allergy in Connecticut over the period 1995-present. Patients without known risk factors for latex allergy in a highly atopic population had a low rate (approximately 1%) of positive skin tests to latex when screened using an allergenic extract characterized for latex allergen by serological diagnosis at 200-500 AU/ml. Our experience suggests that skin prick test screening with serological diagnosis standardized latex extracts can be used to rapidly screen and identify individuals with latex allergy although the cost-effectiveness, sensitivity and safety of screening remains to be determined. Clinicians should consider the diagnosis of latex allergy in all cases of anaphylaxis without identified causes, even in patients without identified risk factors for latex allergy.
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Previous observations have shown that the syndrome of thyroid autoimmunity and idiopathic urticaria and angioedema (ICUA) can be associated with a marked worsening of reactive airway disease. Possibly, mediators released in this syndrome may contribute to acute bronchospasm and associated respiratory symptoms in some patients. In this study, two patients presenting with overlapping clinical presentations of the syndrome of thyroid immunity and ICUA are described in whom a diagnosis of anaphylaxis to food and antibiotics, respectively, was initially suspected but ruled out by testing and challenges. These cases illustrate clinical overlap between presentations of ICUA and anaphylaxis. We suggest that patients with idiopathic anaphylaxis be evaluated for the presence of antithyroid microsomal (peroxidase) antibodies or antithyroglobulin antibodies, particularly because the diagnosis of thyroid antibody-positive ICUA may suggest additional therapeutic options.