Lipid transfer protein cross-reactivity assessed in vivo and in vitro in the office: pros and cons.
BACKGROUND: Few studies analyze cross-reactivity between lipid transfer proteins (LTP) from a large spectrum of botanically unrelated plant-derived foods using routine diagnostic tests. OBJECTIVE: To assess the clinical usefulness of currently available in vivo and in vitro tests in LTP-hypersensitive patients. METHODS: An in vitro and in vivo study was performed of 15 peach-allergic adults monosensitized to LTP in order to analyze their allergy and hypersensitivity to apple, hazelnut, walnut, peanut, soybean, lentil, maize, celery, carrot, banana, melon, tomato, kiwi, buckwheat, and sunflower, poppy, mustard, and sesame seeds. RESULTS: The study revealed that 8, 7, 10, 5, 3, 2, 1, 1, and 1 patients were allergic to apple, hazelnut, walnut, peanut, tomato, kiwi, melon, lentil, and maize, respectively. Immunoglobulin (Ig) E levels for peach were strongly associated with the total number of offending foods other than peach and with levels of IgE specific for all the study foods except carrot. Both in vivo and in vitro tests showed excellent sensitivity and negative predictive value, but poor specificity and positive predictive value. Sensitized but tolerant patients showed lower IgE levels than those with a history of local or systemic symptoms, although the difference between the 3 subsets was not statistically significant. CONCLUSION: This study confirms that peach is the primary sensitizer to LTP and that the level of IgE to peach LTP is the main factor associated with cross-reactivity (and clinical allergy) to non-Rosaceae foods. Clinically irrelevant sensitization is common in LTP-hypersensitive patients, and positive in vivo and/or in vitro test results are of little help in detecting potential clinical reactors. (+info)
Healthy buildings: impact on nurses and nursing practice.
Mounting evidence indicates that buildings can be a significant cause of human illness and environmental degradation. According to the United States (US) Environmental Protection Agency, indoor air pollution is one of the top five environmental risks to public health in the US. This may be related, to a large extent, to the fact that US citizens spend as much as 95% of their time indoors. Health care leaders, designers, and architects, recognizing the connection between health and the buildings in which much time is spent, are engaging in sustainable design and construction for healthy, 'green' buildings. The purpose of this article is to assist nurses in understanding the impact that unhealthy buildings can have on nurses and nursing practice and to provide tools and resources to assist nurses in transforming the health care industry with the goal of creating healing environments and reducing the negative environmental impact of the health care industry. First definitions, current initiatives, and motivations related to sustainable designs will be presented. Next sustainable health care design strategies, such as site planning, clean transportation, water conservation, healthy materials selection, indoor environmental quality, and also the benefits of sustainable design will be discussed. The article will conclude by sharing a variety of resources nurses can use to create healing environments in health care settings. (+info)