Kansas City, Missouri, United States
Kansas City, Missouri, United States

Time filter

Source Type

Polk B.I.,Section of Allergy Immunology | Dinakarpandian D.,University of Missouri - Kansas City | Nanda M.,Section of Allergy Immunology | Barnes C.,Section of Allergy Immunology | Dinakar C.,Section of Allergy Immunology
Annals of Allergy, Asthma and Immunology | Year: 2016

Background Coconut (Cocos nucifera), despite being a drupe, was added to the US Food and Drug Administration list of tree nuts in 2006, causing potential confusion regarding the prevalence of coconut allergy among tree nut allergic patients. Objective To determine whether sensitization to tree nuts is associated with increased odds of coconut sensitization. Methods A single-center retrospective analysis of serum specific IgE levels to coconut, tree nuts (almond, Brazil nut, cashew, chestnut, hazelnut, macadamia, pecan, pistachio, and walnut), and controls (milk and peanut) was performed using deidentified data from January 2000 to August 2012. Spearman correlation (ρ) between coconut and each tree nut was determined, followed by hierarchical clustering. Sensitization was defined as a nut specific IgE level of 0.35 kU/L or higher. Unadjusted and adjusted associations between coconut and tree nut sensitization were tested by logistic regression. Results Of 298 coconut IgE values, 90 (30%) were considered positive results, with a mean (SD) of 1.70 (8.28) kU/L. Macadamia had the strongest correlation (ρ = 0.77), whereas most other tree nuts had significant (P < .05) but low correlation (ρ < 0.5) with coconut. The adjusted odds ratio between coconut and macadamia was 7.39 (95% confidence interval, 2.60–21.02; P <.001) and 5.32 (95% confidence interval, 2.18–12.95; P <.001) between coconut and almond, with other nuts not being statistically significant. Conclusion Our findings suggest that although sensitization to most tree nuts appears to correlate with coconut, this is largely explained by sensitization to almond and macadamia. This finding has not previously been reported in the literature. Further study correlating these results with clinical symptoms is planned. © 2016 American College of Allergy, Asthma & Immunology


PubMed | University of Missouri - Kansas City and Section of Allergy Immunology
Type: Journal Article | Journal: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology | Year: 2016

Coconut (Cocos nucifera), despite being a drupe, was added to the US Food and Drug Administration list of tree nuts in 2006, causing potential confusion regarding the prevalence of coconut allergy among tree nut allergic patients.To determine whether sensitization to tree nuts is associated with increased odds of coconut sensitization.A single-center retrospective analysis of serum specific IgE levels to coconut, tree nuts (almond, Brazil nut, cashew, chestnut, hazelnut, macadamia, pecan, pistachio, and walnut), and controls (milk and peanut) was performed using deidentified data from January 2000 to August 2012. Spearman correlation () between coconut and each tree nut was determined, followed by hierarchical clustering. Sensitization was defined as a nut specific IgE level of 0.35 kU/L or higher. Unadjusted and adjusted associations between coconut and tree nut sensitization were tested by logistic regression.Of 298 coconut IgE values, 90 (30%) were considered positive results, with a mean (SD) of 1.70 (8.28) kU/L. Macadamia had the strongest correlation (= 0.77), whereas most other tree nuts had significant (P<.05) but low correlation ( < 0.5) with coconut. The adjusted odds ratio between coconut andmacadamia was 7.39 (95% confidence interval, 2.60-21.02; P < .001) and 5.32 (95% confidence interval, 2.18-12.95; P < .001) between coconut and almond, with other nuts not being statistically significant.Our findings suggest that although sensitization to most tree nuts appears to correlate with coconut, this is largely explained by sensitization to almond and macadamia. This finding has not previously been reported in the literature. Further study correlating these results with clinical symptoms is planned.


PubMed | Section of Allergy & Immunology
Type: Journal Article | Journal: The Journal of asthma : official journal of the Association for the Care of Asthma | Year: 2013

Asthmatic adults from low-income urban neighborhoods have inferior health outcomes which in part may be due to barriers accessing care and with patient-provider communication. We adapted a patient advocate (PA) intervention to overcome these barriers.To conduct a pilot study to assess feasibility, acceptability and preliminary evidence of effectiveness.A prospective randomized design was employed with mixed methods evaluation. Adults with moderate or severe asthma were randomized to 16 weeks of PA or a minimal intervention (MI) comparison condition. The PA, a non-professional, modeled preparations for a medical visit, attended the visit and confirmed understanding. The PA facilitated scheduling, obtaining insurance coverage and overcoming barriers to implementing medical advice. Outcomes included electronically-monitored inhaled corticosteroid (ICS) adherence, asthma control, quality of life, FEV1, emergency department (ED) visits and hospitalizations. Mixed-effects models guided an intention-to-treat analysis.100 adults participated: age 4714 years, 75% female, 71% African-American, 16% white, baseline FEV1 69%18%, 36% experiencing hospitalizations and 56% ED visits for asthma in the prior year. Ninety-three subjects completed all visits; 36 of 53 PA-assigned had a PA visit. Adherence declined significantly in the control (p=0.001) but not significantly in the PA group (p=0.30). Both PA and MI groups demonstrated improved asthma control (p=0.01 in both) and quality of life (p=0.001, p=0.004). Hospitalizations and ED visits for asthma did not differ between groups. The observed changes over time tended to favor the PA group, but this study was underpowered to detect differences between groups.The PA intervention was feasible and acceptable and demonstrated potential for improving asthma control and quality of life.

Loading Section of Allergy Immunology collaborators
Loading Section of Allergy Immunology collaborators