Peanut‐induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry

Background Peanut allergy has a rising prevalence in high-income countries, affecting 0.5%-1.4% of children. This study aimed to better understand peanut anaphylaxis in comparison to anaphylaxis to other food triggers in European children and adolescents. Methods Data was sourced from the European Anaphylaxis Registry via an online questionnaire, after in-depth review of food-induced anaphylaxis cases in a tertiary paediatric allergy centre. Results 3514 cases of food anaphylaxis were reported between July 2007 - March 2018, 56% in patients younger than 18 years. Peanut anaphylaxis was recorded in 459 children and adolescents (85% of all peanut anaphylaxis cases). Previous reactions (42% vs. 38%; p = .001), asthma comorbidity (47% vs. 35%; p < .001), relevant cofactors (29% vs. 22%; p = .004) and biphasic reactions (10% vs. 4%; p = .001) were more commonly reported in peanut anaphylaxis. Most cases were labelled as severe anaphylaxis (Ring&Messmer grade III 65% vs. 56% and grade IV 1.1% vs. 0.9%; p = .001). Self-administration of intramuscular adrenaline was low (17% vs. 15%), professional adrenaline administration was higher in non-peanut food anaphylaxis (34% vs. 26%; p = .003). Hospitalization was higher for peanut anaphylaxis (67% vs. 54%; p = .004). Conclusions The European Anaphylaxis Registry data confirmed peanut as one of the major causes of severe, potentially life-threatening allergic reactions in European children, with some characteristic features e.g., presence of asthma comorbidity and increased rate of biphasic reactions. Usage of intramuscular adrenaline as first-line treatment is low and needs to be improved. The Registry, designed as the largest database on anaphylaxis, allows continuous assessment of this condition

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P &lt; 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P &lt; 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P &lt; 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P &lt; 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P &lt; 0.001; OR(BP) = 2.4, P &lt; 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P &lt; 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P &lt; 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Book Review: Writing Grief: Margaret Laurence and the Work of Mourning

Writing Grief promises two departures in Laurence criticism: a study of the literary output in the context of the author\u27s life, and a theoretically informed work on the psychology of grief. In his introduction the author asserts that mourning is pervasive in Margaret Laurence\u27s work and that her personal life was deeply informed by her first hand experience of death ; he then proposes that for Laurence, this work of mourning involved writing texts that explored autobiographical materials. One expects, therefore, an exploration of fictional texts informed at each turn by biographical and autobiographical materials, an innovation in Laurence study that would be led by what now seems a logical progression in Laurence\u27s work - from fiction based far from her prairie roots, through the Manawaka home ground fictions, to what Laurence herself called her spiritual autobiography, The Diviners, and the memoir of her last years, Dance on the Earth - to show the effect of her first hand experience on her art, and perhaps even the effect of her art on her own work of mourning

"The Dear Domestic Circle": Frameworks for the Literary Study of Women's Personal Narratives in Archival Collections

Theorists and critics concerned with the recovery of a woman's tradition in literature must expand the realm of what is considered worthy of literary examination to include material by women once thought valuable only as social history -- journals, diaries, letters, memoirs, autobiographies, and essays. Since these documents are just now beginning to be examined by literary scholars, it is an appropriate time to establish some frameworks for this task: one must identify the generic influences of the accounts; one must discover the context of each account; and, finally, one must be aware of the possibility of influence from other non-public texts, such as private letters, reports, and journals. This framework is applied to two nineteenth-century travel journals written ten years apart by two sisters who travelled with the Hudson's Bay Company from England to the Red River Settlement: Frances R. Simpson and Isabel (Simpson) Finlayson

Reading Margaret Laurence’s Life Writing: Toward a Postcolonial Feminist Subjectivity for a White Female Critic

I propose feminist, postcolonial readings of Margaret Laurence’s two book-length autobiographical works: The Prophet’s Camel Bell, memoirs of the year she spent in Somalia in 1951-1952, and Dance on the Earth: A Memoir, the book she completed shortly before her death in 1987. My purpose is to suggest how white female critics, such as myself, can begin to approach their critical tasks in ways that neither slight their own culture’s supportive and positive accomplishments, nor lead them to crit..