Cofactors, age at onset, allergic comorbidities and gender are different in patients sensitized to omega-5 gliadin and Pru p 3

Aim of this study is to clarify the impact of cofactors on allergic reactions in patients sensitized to LTP and ω-5-gliadin. We retrospectively examined the charts of our outpatients from January 2015 to July 2019 and identified 157 patients seen for urticaria/angioedema or anaphylaxis after a meal, in presence or absence of cofactors and sensitized to LTPs (Pru p 3 and/or Tri a 14) and/or ω-5-gliadin (Tri a 19). we compared LTPs-positive patients and those sensitized to Tri a 19 in order to assess the difference in cofactors involved and in frequency of clinical presentation. Our data show that exercise is the most frequent cofactor in FDEIAn and the involvement of exercise, alcohol and multiple cofactors was more frequently found in males than in females. We found that exercise, pollen counts peaks and multiple cofactors were more often related to anaphylaxis than mild reactions. Finally, we performed a comparison between patients LTPs+ and Tri a 19+ that showed in the latter group a lower frequency of allergic comorbidities, a higher median age at the onset of symptoms and frequency of alcohol exposure. Our data show that the search for possible cofactors involved in food allergy is essential not only for diagnostic purposes, but also for risk assessment strategies

Demographic Characteristics as Predictors of Job Satisfaction of Commercial Bank Employees in Tanzania

This paper presents results of an analysis of job satisfaction of 234 employees of a commercial bank in Tanzania. The study’s main objective was to analyse differences in job satisfaction overall and its dimensions, based on employees’ demographic characteristics. Spector’s (1994) job satisfaction survey instrument with 36 items in nine different dimensions was used. Descriptive statistics, independent sample T-test, and analysis of variance techniques were employed. Overall job satisfaction was significantly higher for the older, married, junior, experienced, less educated, and rural based branch employees. Significant differences were found in: (i) satisfaction with pay, benefits, contingent rewards and operating procedures across education, job rank and branch location groups; (ii) satisfaction with pay, promotion, and supervision based on age, marital status and working experience groups; (ii) satisfaction with benefits, operating procedures and communication across marital status groups; (iii) satisfaction with communication across marital status; (iv) satisfaction with communication across experience groups; and (v) satisfaction with nature of work across job ranks. These results lead to a conclusion that demographic characteristics of employees are important factors that managers should take on board when designing and implementing measures to enhance employees’ satisfaction with the job overall as well as with its different facets

Harmonization service and global library of models to support country-driven global information on salt-affected soils

Abstract Global distribution of salt-affected soils (SAS) has remained at about 1 billion hectares in the literature over the years despite changes in climate, sea levels, and land use patterns which influence the distribution. Lack of periodic update of input soil data, data gaps, and inconsistency are part of the reasons for constant SAS distribution in the literature. This paper proposes harmonization as a suitable alternative for managing inconsistent data and minimizing data gaps. It developed a new harmonization service for supporting country-driven global SAS information update. The service contains a global library of harmonization models for harmonizing inconsistent soil data. It also contains models for identifying gaps in SAS database and for showing global distribution where harmonization of available data is needed. The service can be used by countries to develop national SAS information and update global SAS distribution. Its data availability index is useful in identifying countries without SAS data in the global database, which is a convenient way to identify countries to mobilize when updating global SAS information. Its application in 27 countries showed that the countries have more SAS data than they currently share with the global databases and that most of their data require SAS harmonization

Semi-obstrução intestinal por esclerodermia: relato de caso

A esclerodermia ou esclerose sistêmica progressiva é uma doença auto-imune de causa desconhecida que se caracteriza por fibrose da pele, vasos sanguíneos e de alguns outros órgãos, como os pulmões, coração, rins e trato gastrintestinal. Sintomas atribuíveis ao comprometimento gastrintestinal podem estar presentes em até 50% dos pacientes, sendo os mais freqüentes, relacionados às manifestações esofagianas e anorretais. Anormalidades na motilidade intestinal com freqüência levam a desnutrição, supercrescimento bacteriano e quadro de pseudo-obstrução ou mesmo semi-obstrução intestinal. É apresentado um caso de paciente com esclerodermia há 43 anos, evoluindo com quadro de semi-obstrução, apresentando distensão abdominal, cólicas recorrentes e desnutrição grave. Sem resposta ao tratamento clínico foi submetida à cirurgia que evidenciou quadro obstrutivo por comprometimento ileal, o qual foi tratado por bypass íleo-cólico. Lesão intestinal por esclerodermia levando a quadro de obstrução é raramente descrita na literatura médica e, portanto, o tratamento de escolha ainda não foi definido.<br>Scleroderma or progressive systemic sclerosis (PSS) is a self-immune illness of unknown cause that is characterized by fibrosis of the skin, blood vessels and some other tissues like the lungs, heart, kidneys and gastrointestinal system. Attributable symptoms to the gastrointestinal involvement can be present in up to 50% of the patients, esophageal and anorectal manifestations being more frequent. Abnormalities in the intestinal motility frequently lead to malnutrition, bacterial over-growth and intestinal pseudo-obstruction. We report a case of scleroderma with intestinal pseudo-obstruction presenting chronic abdominal cramps, bloating and malnutrition with no response to clinical approach. Patient underwent surgery with diagnosis of intestinal obstruction by annular ileal fibrosis treated by ileocolic bypass. Intestinal injury causing obstruction is rarely described in the literature and therefore the treatment of choice is not yet defined

Utilização da safena magna in situ para arterialização do arco venoso do pé The great saphenous vein in situ for the arterialization of the venous arch of the foot

CONTEXTO: O tratamento da isquemia crítica de membros inferiores sem leito arterial distal pode ser realizado por meio da inversão do fluxo no arco venoso do pé. OBJETIVO: O objetivo deste trabalho foi apresentar a técnica e os resultados obtidos com a arterialização do arco venoso do pé, mantendo a safena magna in situ. MÉTODOS: Dezoito pacientes, dos quais 11 com aterosclerose (AO), 6 com tromboangeíte obliterante (TO) e 1 com trombose de aneurisma de artéria poplítea (TA) foram submetidos ao método. A safena magna in situ foi anastomosada à melhor artéria doadora. O fluxo arterial derivado para o sistema venoso progride por meio da veia cujas válvulas são destruídas. As colaterais da veia safena magna são ligadas desde a anastomose até o maléolo medial, a partir do qual são preservadas. RESULTADOS: Dos pacientes, 10 (55,6%) mantiveram suas extremidades, 5 com AO e 5 com TO; 7 (38,9%) foram amputados, 5 com AO, 1 com TO e 1 com Ta; houve 1 óbito (5,5%). CONCLUSÃO: A inversão do fluxo arterial no sistema venoso do pé deve ser considerada para salvamento de extremidade com isquemia crítica sem leito arterial distal.<br>BACKGROUND: Critical lower limb ischemia in the absence of a distal arterial bed can be treated by arterialization of the venous arch of the foot. OBJETIVE: The objective of this paper was to present the technique and the results of the arterialization of the venous arch of the foot with the in situ great saphenous vein. METHODS: Eighteen patients, 11 with atherosclerosis (AO), 6 with thromboangiitis obliterans (TO) and 1 with popliteal artery aneurysm thrombosis were submitted to venous arch arterialization. The in situ great saphenous vein was anastomosed to the best donor artery. Arterial flow derived from the venous system progresses through the vein whose valves were destroyed. The collateral vessels of the great saphenous vein are linked from the anastomosis to the medial malleolus and preserved from this point onward. RESULTS: Limb salvage was achieved in 10 (55.6%) patients, 5 with AO and 5 with TO. Seven (38.9%) patients were amputated, 5 with AO, 1 with TO and 1 with Ta. One (5.5%) patient died. CONCLUSION: Arterialization of the venous system of the foot should be considered for the salvage of limbs with critical ischemia in the absence of a distal arterial bed