The Basophil Activation Test Is Not a Useful Screening Tool for Hymenoptera Venom-Related Anaphylaxis in Patients with Systemic Mastocytosis

Background: Systemic mastocytosis (SM) patients are at a high risk for anaphylaxis, with Hymenoptera as the main culprit. A screening instrument to identify which patients are sensitized to Hymenoptera before they experience anaphylaxis would therefore be of great value. The basophil activation test (BAT) is proposed as a possible tool for diagnosing Hymenoptera venom-related allergy (HVA), especially in patients in whom conventional allergy tests yield contradictory results. Methods: We included outpatients with SM, according to WHO criteria, from September 2011 to January 2012. Next, to obtain various clinical data including intradermal test results, specific immunoglobulin E (sIgE) measurements and BAT were performed. Results: We included 29 patients, 9 of whom had a history of HVA and 4 of whom had experienced anaphylaxis due to other triggers. Sixteen patients had no history of anaphylaxis. sIgE was detected in 6 patients with HVA and in 2 patients with anaphylaxis due to other triggers. The BAT was positive in only 1 patient, in whom the skin test and sIgE were also positive. Compared to patients with skin lesions, those without skin lesions had significantly more anaphylaxis and sIgE to Hymenoptera. During a 3-year follow-up, no one experienced new anaphylactic episodes. Conclusion: The BAT is not a reliable tool for randomly screening SM patients for HVA

The Basophil Activation Test Is Not a Useful Screening Tool for Hymenoptera Venom-Related Anaphylaxis in Patients with Systemic Mastocytosis

Background: Systemic mastocytosis (SM) patients are at a high risk for anaphylaxis, with Hymenoptera as the main culprit. A screening instrument to identify which patients are sensitized to Hymenoptera before they experience anaphylaxis would therefore be of great value. The basophil activation test (BAT) is proposed as a possible tool for diagnosing Hymenoptera venom-related allergy (HVA), especially in patients in whom conventional allergy tests yield contradictory results. Methods: We included outpatients with SM, according to WHO criteria, from September 2011 to January 2012. Next, to obtain various clinical data including intradermal test results, specific immunoglobulin E (sIgE) measurements and BAT were performed. Results: We included 29 patients, 9 of whom had a history of HVA and 4 of whom had experienced anaphylaxis due to other triggers. Sixteen patients had no history of anaphylaxis. sIgE was detected in 6 patients with HVA and in 2 patients with anaphylaxis due to other triggers. The BAT was positive in only 1 patient, in whom the skin test and sIgE were also positive. Compared to patients with skin lesions, those without skin lesions had significantly more anaphylaxis and sIgE to Hymenoptera. During a 3-year follow-up, no one experienced new anaphylactic episodes. Conclusion: The BAT is not a reliable tool for randomly screening SM patients for HVA. (C) 2016 S. Karger AG, Base

Estimation of the determinents of bicycle mode share for the journey to work using census data

A model is presented that relates the proportion of bicycle journeys to work for English and Welsh electoral wards to relevant socio-economic, transport and physical variables. A number of previous studies have exploited existing disaggregate data sets. This study uses UK 2001 census data, is based on a logistic regression model and provides complementary evidence based on aggregate data for the determinants of cycle choice. It suggests a saturation level for bicycle use of 43%. Smaller proportions cycle in wards with more females and higher car ownership. The physical condition of the highway, rainfall and temperature each have an effect on the proportion that cycles to work, but the most significant physical variable is hilliness. The proportion of bicycle route that is off-road is shown to be significant, although it displays a low elasticity (+0.049) and this contrasts with more significant changes usually forecast by models constructed from stated preference based data. Forecasting shows the trend in car ownership has a significant effect on cycle use and offsets the positive effect of the provision of off-road routes for cycle traffic but only in districts that are moderately hilly or hilly. The provision of infrastructure alone appears insufficient to engender higher levels of cycling