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Agabriel C.,APHM Assistance Publique Hopitaux de Marseille | Ghazouani O.,Immunology Laboratory | Birnbaum J.,APHM Assistance Publique Hopitaux de Marseille | Liabeuf V.,APHM Assistance Publique Hopitaux de Marseille | And 12 more authors.
Pediatric Allergy and Immunology | Year: 2014

Background: Peanut allergy (PA) management was improved by the introduction of molecular allergology, but guidelines for Mediterranean patients are lacking. We aimed at evaluating peanut component-resolved diagnosis as a diagnostic and prognostic tool in children from Southern France. Methods: In 181 pediatric patients, PA diagnosis was founded on medical history, skin prick testing, serum-specific IgE to Arachis hypogea extract and components, Pru p 4, and plant carbohydrates, and oral food challenge. Allergen microarray was also performed in 68 of these patients. Results: In peanut-allergic children (n = 117), IgE to Ara h 6 were most prevalent (64%), followed by Ara h 2 (63%), Ara h 1 (60%), and Ara h 9 (52%). Ara h 6 was the best predictor of PA. The second best predictor was the ratio of Ara h 2 IgE to peanut IgE (cutoff 0.113). Persistent childhood PA was associated with complex molecular profiles. Comparison of singleplex and microarray results showed poor concordance for Ara h 2 and Ara h 9. Conclusion: Ara h 6 and Ara h 2 are the best predictors of PA at diagnosis in Mediterranean pediatric patients. Ara h 1, Ara h 8, and molecular complexity are associated with PA persistence. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Renolleau-Courtois D.,ARARD | Lamouroux-Delay A.,Ecole de Lasthme | Delpierre S.,Aix - Marseille University | Badier M.,Aix - Marseille University | And 9 more authors.
Journal of Asthma | Year: 2014

Objective: We assessed retrospectively the feasibility of a home-based respiratory rehabilitation (RR) program for asthmatics under optimal pharmacological treatment, as this type of care can reduce costs and offer a more patient-friendly approach for subjects with persistent asthma. Methods: Fifty-two patients with persistent asthma were recruited to the RR program (20 males, 32 females, 54±11 (SD) years, forced expiratory volume in one second 71±33% of predicted mean value, BMI 29.9±7.9kg/m 2). This two-month protocol comprised education sessions, respiratory physiotherapy and an exercise training program at home and in groups supervised by an adapted physical activity instructor. Results: Thirty-nine patients completed the whole RR program, i.e. 25% dropout. The dropout rate was significantly higher with respect to younger patients in employment. The number of exacerbations decreased significantly during the year following the program, regardless of whether the patients had dropped out (p<0.02) or not (p<0.001). The distance walked during a 6-min walking test increased by 33m (p<0.001). Several indices measured during a cycle ergometer test increased significantly after RR: peak oxygen uptake (10%), oxygen uptake at ventilatory threshold (12%) and maximum load (19%), all at a similar maximum heart rate. Concerning quality of life assessment, the Short-Form-36 Item Health Survey revealed a non-significant improvement in the "health change" item after RR (p<0.07). Conclusions: This study demonstrates the potential of a home-based program in the treatment and rehabilitation of patients with asthma. Both functional and physiologic indices improved during the follow-up period. © 2014 Informa Healthcare USA, Inc.

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