SimpleXMLElement Object ( [PubmedBookArticle] => SimpleXMLElement Object ( [BookDocument] => SimpleXMLElement Object ( [PMID] => 33630482 [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => NBK567880 ) [Book] => SimpleXMLElement Object ( [Publisher] => SimpleXMLElement Object ( [PublisherName] => National Library of Medicine (US) [PublisherLocation] => Bethesda (MD) ) [BookTitle] => Drugs and Lactation Database (LactMed) [PubDate] => SimpleXMLElement Object ( [Year] => 2006 ) [BeginningDate] => SimpleXMLElement Object ( [Year] => 2006 ) [Medium] => Internet ) [ArticleTitle] => Etesevimab [Language] => eng [PublicationType] => Review [Abstract] => SimpleXMLElement Object ( [AbstractText] => Etesevimab is a monoclonal antibody given together with bamlanivimab. Both are directed against the SARS-CoV-2 virus that causes COVID-19. No information is available on the clinical use of etesevimab during breastfeeding. Because etesevimab is a large protein molecule with a molecular weight of 146,000, the amount in milk is likely to be very low and absorption is unlikely because it is probably destroyed in the infant's gastrointestinal tract. Until more data become available, etesevimab should be used with caution during breastfeeding, especially while nursing a newborn or preterm infant. Etesevimab is a human immunoglobulin G1 (IgG1) antibody. Holder pasteurization (62.5 degrees C for 30 minutes) decreases the concentration of endogenous immunoglobulin G by up to 79%.[1,2] A study of 67 colostrum samples that underwent Holder pasteurization found that IgG amounts decreased by 34 to 40%. Specific IgG subclasses decreased by different amounts, with IgG1 activity decreasing by about 37%.[3] None of the studies measured IgG activity. ) [Sections] => SimpleXMLElement Object ( [Section] => Array ( [0] => SimpleXMLElement Object ( [SectionTitle] => Drug Levels and Effects ) [1] => SimpleXMLElement Object ( [SectionTitle] => Substance Identification ) ) ) [KeywordList] => SimpleXMLElement Object ( [Keyword] => Array ( [0] => Etesevimab [1] => LYCoV016 [2] => anti-Sars-cov-2 antibody JS016 [3] => CB6 [4] => LY-3832479 [5] => LY-COV016 [6] => LY3832479 [7] => NP005 [8] => UNII-N7Q9NLF11I [9] => WHO 11873 ) ) ) [PubmedBookData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => pubmed ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 1 ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => medline ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 1 ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => entrez ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 1 ) ) ) [PublicationStatus] => ppublish [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => 33630482 ) ) ) [PubmedArticle] => Array ( [0] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => Publisher [Owner] => NLM ) [PMID] => 33631864 [DateRevised] => SimpleXMLElement Object ( [Year] => 2021 [Month] => 02 [Day] => 25 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print ) [Journal] => SimpleXMLElement Object ( [ISSN] => 1445-5994 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 51 [Issue] => 2 [PubDate] => SimpleXMLElement Object ( [Year] => 2021 [Month] => Feb ) ) [Title] => Internal medicine journal [ISOAbbreviation] => Intern Med J ) [ArticleTitle] => Outcomes for the first wave of hospitalised patients with COVID-19 in the South Australian context: a retrospective audit. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 189-198 ) [ELocationID] => 10.1111/imj.15106 [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => The first case of corona virus disease (COVID-19) was detected in South Australia on 1 February 2020. The Royal Adelaide Hospital (RAH) is the state's designated quarantine hospital. [1] => To determine the characteristics, outcomes and predictors of outcomes for hospitalised patients with coronavirus disease (COVID-19) within the RAH. [2] => We performed a retrospective audit of 103 patients diagnosed with COVID-19 who were discharged from the RAH between 14 February and 21 May 2020. We collected demographic, clinical and laboratory data through an audit of electronic medical records. The main outcome measures were: (i) the need for oxygen supplementation; (ii) need for intensive care unit (ICU) care; and (iii) death in hospital. [3] => The median age of patients was 60 years (range 19-85). A total of 55 (53%) patients was male. All patients were independent at baseline; 37 (36%) patients suffered from hypertension. Cardiovascular disease, respiratory disease and diabetes were present in fewer than 19 (18%) patients. Obesity was present in 24 (23%) patients; 39 (38%) patients required supplemental oxygen, 18 (17%) required ICU care and 4 (4%) patients died. Older patients were significantly more at risk of oxygen requirement (median 68 vs 57.5 years, P < 0.01), ICU admission (median 66.5 vs 60 years, P = 0.04) and death (median 74.5 vs 60 years, P = 0.02). We did not find a statistically significant association between gender, body mass index and poor outcomes. Lactate dehydrogenase (LDH) was the only parameter at admission associated with oxygen requirement, ICU care and death. Peak LDH, aspartate aminotransferase, alanine aminotransferase, C-reactive protein and neutrophil lymphocyte ratio were significantly associated with oxygen requirement, ICU admission and death (P < 0.05 for all of the above laboratory markers). [4] => Although our sample size was small, we found that certain comorbidities and laboratory values were associated with poor outcomes. This occurred in a setting where care was not influenced by limited hospital and intensive care beds. ) [CopyrightInformation] => © 2021 Royal Australasian College of Physicians. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Toh [ForeName] => Dylan J-W [Initials] => DJ [Identifier] => https://orcid.org/0000-0002-5487-9992 [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Rowe [ForeName] => Emily [Initials] => E [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Infectious Diseases, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Nelson [ForeName] => Renjy [Initials] => R [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Infectious Diseases, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => O'Connell [ForeName] => Alice [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lim [ForeName] => Ken [Initials] => K [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Fielke [ForeName] => Lauren [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [6] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => He [ForeName] => Jiacheng [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) [7] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Faunt [ForeName] => Jeffrey [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => General Medicine, Royal Adelaide Hospital, Adelaide, South Australia, Australia. ) ) ) ) [Language] => eng [PublicationTypeList] => SimpleXMLElement Object ( [PublicationType] => Journal Article ) ) [MedlineJournalInfo] => SimpleXMLElement Object ( [Country] => Australia [MedlineTA] => Intern Med J [NlmUniqueID] => 101092952 [ISSNLinking] => 1444-0903 ) [CitationSubset] => IM [KeywordList] => SimpleXMLElement Object ( [@attributes] => Array ( [Owner] => NOTNLM ) [Keyword] => Array ( [0] => Australia [1] => coronavirus infection [2] => infectious disease [3] => pandemic [4] => public health ) ) ) [PubmedData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => received ) [Year] => 2020 [Month] => 07 [Day] => 06 ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => revised ) [Year] => 2020 [Month] => 09 [Day] => 21 ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => accepted ) [Year] => 2020 [Month] => 09 [Day] => 21 ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => entrez ) [Year] => 2021 [Month] => 2 [Day] => 25 [Hour] => 20 [Minute] => 19 ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => pubmed ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 0 ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => medline ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 0 ) ) ) [PublicationStatus] => ppublish [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => Array ( [0] => 33631864 [1] => 10.1111/imj.15106 ) ) [ReferenceList] => SimpleXMLElement Object ( [Title] => References [Reference] => Array ( [0] => SimpleXMLElement Object ( [Citation] => Johns Hopkins University & Medicine. Coronavirus Resource Centre. 2020 [cited 2020 May 21]. Available from URL: https://coronavirus.jhu.edu/map.html ) [1] => SimpleXMLElement Object ( [Citation] => Australian Bureau of Statistics. 2016 Census Quickstats. 2016 [cited 2020 Apr 22]. Available from URL: https://quickstats.censusdata.abs.gov.au/census_services/getproduct/census/2016/quickstat/4?opendocument ) [2] => SimpleXMLElement Object ( [Citation] => Government of South Australia. Covid-19 Dashboard and Daily update. 2020 [cited 2020 Apr 22]. Available from URL: https://www.covid-19.sa.gov.au/home/dashboard ) [3] => SimpleXMLElement Object ( [Citation] => Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020; 395: 1054-62. ) [4] => SimpleXMLElement Object ( [Citation] => Bhatraju P, Ghassemieh B, Nichols M, Kim R, Jerome KR, Nalla AK et al. Covid-19 in critically ill patients in the Seattle region - case series. N Engl J Med 2020; 382: 2012-22. ) [5] => SimpleXMLElement Object ( [Citation] => Richardson S, Hirsch J, Narasimhan M, Crawford JM, McGinn T, Davidson KW et al. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area. JAMA 2020; 323: 2052-9. ) [6] => SimpleXMLElement Object ( [Citation] => Intensive Care National Audit and Research Centre (ICNARC). ICNARC report on COVID-19 in critical care, April 24 2020. Napier House, 24 High Holborn, London WC1V 6AZ, London, 2020. ) [7] => SimpleXMLElement Object ( [Citation] => KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int. Suppl. 2013; 3: 5-14. ) [8] => SimpleXMLElement Object ( [Citation] => Wang D, Hu B, Hu C. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323: 1061-9. ) [9] => SimpleXMLElement Object ( [Citation] => Health Roundtable. 2020 [cited 2020 Sep 11]. Available from URL: https://www.healthroundtable.org/ ) [10] => SimpleXMLElement Object ( [Citation] => Li M, Wang M, Chen B, Zhang H, Deng A. Association of renin-angiotensin system inhibitors with severity of risk of death in patients with hypertension hospitalized for coronavirus disease 2019 (COVID-19) infection in Wuhan, China. JAMA Cardiol 2020; 5: 825-30. ) [11] => SimpleXMLElement Object ( [Citation] => Bean D, Kraljevic Z, Searle T, Bendayan R, Pickles A, Folarin A et al. Treatment with ACE-inhibitors is associated with less severe SARS-Covid-19 infection in a multi-site UK acute hospital trust. Eur J Heart Fail 2020; 22: 967-974. ) [12] => SimpleXMLElement Object ( [Citation] => De Simone G. Position statement of the ESC Council on hypertension on ACE-inhibitors and angiotensin receptor blockers. [cited 2020 May 21]. Available from URL: https://www.escardio.org/Councils/Council-on-Hypertension-(CHT)/News/position-statement-of-the-esc-council-on-hypertension-on-ace-inhibitors-and-ang ) [13] => SimpleXMLElement Object ( [Citation] => Lagunas-Rangel F. Neutrophil-to-lymphocyte ratio and lymphocyte to C reactive protein ratio in patients with severe coronavirus disease 2019 (COVID-19): a meta-analysis. Journal of Medical Virology 2020; 92: 1733-4. ) [14] => SimpleXMLElement Object ( [Citation] => Yang A, Liu J, Tao W, Li H. The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients. Int Immunopharmacol 2020; 84: 106504. ) [15] => SimpleXMLElement Object ( [Citation] => Wang L. C-reactive protein levels in the early stage of COVID-19. Med Mal Infect 2020; 50: 332-4. ) ) ) ) ) [1] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => Publisher [Owner] => NLM ) [PMID] => 33631862 [DateRevised] => SimpleXMLElement Object ( [Year] => 2021 [Month] => 02 [Day] => 25 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print ) [Journal] => SimpleXMLElement Object ( [ISSN] => 1445-5994 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 51 [Issue] => 2 [PubDate] => SimpleXMLElement Object ( [Year] => 2021 [Month] => Feb ) ) [Title] => Internal medicine journal [ISOAbbreviation] => Intern Med J ) [ArticleTitle] => Immunosuppression as a risk factor for COVID-19: a meta-analysis. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 199-205 ) [ELocationID] => 10.1111/imj.15142 [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => While immunosuppression poses a theoretical increase in the risk of COVID-19, the nature of this relationship is yet to be ascertained. [1] => To determine whether immunosuppressed patients are at higher risk of COVID-19 to help inform the management of patients receiving immunosuppressant therapies during the pandemic. [2] => We performed a random-effects meta-analysis of data from studies that reported on the prevalence of immunosuppression among patient cohorts with COVID-19. [3] => Sixty full-text publications were identified. In total, six individual studies were included in the final analysis, contributing a total of 10 049 patients with COVID-19 disease. The prevalence of immunosuppressed patients among the study cohorts with COVID-19 ranged from 0.126% to 1.357%. In the pooled cohort a total of 64/10 049 (0.637%) patients with COVID-19 disease was immunosuppressed. Observed to expected ratios were used to compare the prevalence of immunosuppression in cohorts with confirmed COVID-19 disease to the background prevalence of immunosuppression in the general community. The observed to expected ratio of immunosuppression among patients with COVID-19 illness, relative to the general community, was 0.12 (95% confidence interval: 0.05-0.27). [4] => Compared to the general population, immunosuppressed patients were not at significantly increased risk of COVID-19 infection. This finding provides support for current expert consensus statements, which have recommended the continuation of immunosuppressant therapy in the absence of COVID-19. ) [CopyrightInformation] => © 2021 Royal Australasian College of Physicians. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Tassone [ForeName] => Daniel [Initials] => D [Identifier] => https://orcid.org/0000-0002-1882-8135 [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Thompson [ForeName] => Alexander [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Connell [ForeName] => William [Initials] => W [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lee [ForeName] => Tanya [Initials] => T [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ungaro [ForeName] => Ryan [Initials] => R [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Dr Henry D. Janowitz Division of Gastroenterology, The Susan and Leonard Feinstein Inflammatory Bowel Disease Center, Icahn School of Medicine at Mount Sinai, New York, New York, United States. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => An [ForeName] => Ping [Initials] => P [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, Key Laboratory of Hubei Province for Digestive System Disease, Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China. ) ) [6] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ding [ForeName] => Yijuan [Initials] => Y [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, Key Laboratory of Hubei Province for Digestive System Disease, Hubei Provincial Clinical Research Center for Digestive Disease Minimally Invasive Incision, Renmin Hospital of Wuhan University, Wuhan, China. ) ) [7] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ding [ForeName] => Nik S [Initials] => NS [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia. ) ) ) ) [Language] => eng [PublicationTypeList] => SimpleXMLElement Object ( [PublicationType] => Journal Article ) ) [MedlineJournalInfo] => SimpleXMLElement Object ( [Country] => Australia [MedlineTA] => Intern Med J [NlmUniqueID] => 101092952 [ISSNLinking] => 1444-0903 ) [CitationSubset] => IM [KeywordList] => SimpleXMLElement Object ( [@attributes] => Array ( [Owner] => NOTNLM ) [Keyword] => Array ( [0] => COVID-19 [1] => immunocompromised host [2] => immunosuppression [3] => infection [4] => risk ) ) ) [PubmedData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => received ) [Year] => 2020 [Month] => 08 [Day] => 24 ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => revised ) [Year] => 2020 [Month] => 11 [Day] => 02 ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => accepted ) [Year] => 2020 [Month] => 11 [Day] => 24 ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => entrez ) [Year] => 2021 [Month] => 2 [Day] => 25 [Hour] => 20 [Minute] => 19 ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => pubmed ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 0 ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => medline ) [Year] => 2021 [Month] => 2 [Day] => 26 [Hour] => 6 [Minute] => 0 ) ) ) [PublicationStatus] => ppublish [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => Array ( [0] => 33631862 [1] => 10.1111/imj.15142 ) ) [ReferenceList] => SimpleXMLElement Object ( [Title] => References [Reference] => Array ( [0] => SimpleXMLElement Object ( [Citation] => Wu Z, McGoogan JM. 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(S2k) on acute therapy and management of anaphylaxis: 2021 update: S2k-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Medical Association of German Allergologists (AeDA), the Society of Pediatric Allergology and Environmental Medicine (GPA), the German Academy of Allergology and Environmental Medicine (DAAU), the German Professional Association of Pediatricians (BVKJ), the Society for Neonatology and Pediatric Intensive Care (GNPI), the German Society of Dermatology (DDG), the Austrian Society for Allergology and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Anaesthesiology and Intensive Care Medicine (DGAI), the German Society of Pharmacology (DGP), the German Respiratory Society (DGP), the patient organization German Allergy and Asthma Association (DAAB), the German Working Group of Anaphylaxis Training and Education (AGATE). 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[ELocationID] => Array ( [0] => 409 [1] => 10.3390/nu13020409 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Lupine flour is a valuable food due to its favorable nutritional properties. In spite of its allergenic potential, its use is increasing. Three lupine species, , , and . are relevant for human nutrition. The aim of this study is to clarify whether the species differ with regard to their allergen composition and whether anaphylaxis marker allergens could be identified in lupine. Patients with the following characteristics were included: lupine allergy, suspected lupine allergy, lupine sensitization only, and peanut allergy. Lupine sensitization was detected via CAP-FEIA (ImmunoCAP) and skin prick test. Protein, DNA and expressed sequence tag (EST) databases were queried for lupine proteins homologous to already known legume allergens. Different extraction methods applied on seeds from all species were examined by SDS-PAGE and screened by immunoblotting for IgE-binding proteins. The extracts underwent different and successive chromatography methods. Low-molecular-weight components were purified and investigated for IgE-reactivity. Proteomics revealed a molecular diversity of the three species, which was confirmed when investigated for IgE-reactivity. Three new allergens, profilin, and . lipid transfer protein (LTP), were identified. 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[@attributes] => Array ( [CitedMedium] => Internet ) [PubDate] => SimpleXMLElement Object ( [Year] => 2020 [Month] => Dec [Day] => 03 ) ) [Title] => Allergy [ISOAbbreviation] => Allergy ) [ArticleTitle] => Peanut induced anaphylaxis in children and adolescents: Data from the European Anaphylaxis Registry. [ELocationID] => 10.1111/all.14683 [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => 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. [1] => 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. [2] => 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). [3] => 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. ) [CopyrightInformation] => © 2021 The Authors. Allergy published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Maris [ForeName] => Ioana [Initials] => I [Identifier] => https://orcid.org/0000-0001-6734-2329 [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Bon Secours Hospital Cork/Paediatrics and Child Health, University College Cork, Cork, Ireland. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Dölle-Bierke [ForeName] => Sabine [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Renaudin [ForeName] => Jean-Marie [Initials] => JM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Allergy Vigilance Network, Vandoeuvre les Nancy, France. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lange [ForeName] => Lars [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Paediatrics, St. Marien-Hospital, Bonn, Germany. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Koehli [ForeName] => Alice [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergology, University Children's Hospital Zurich, Zürich, Switzerland. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Spindler [ForeName] => Thomas [Initials] => T [AffiliationInfo] => 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[Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 903-913 ) [ELocationID] => 10.1007/s00105-020-04692-2 [Abstract] => SimpleXMLElement Object ( [AbstractText] => For the diagnostics of food allergies several points need to be considered. Firstly, it is important to recognize the various clinical pictures that can be caused by a food allergy. The assignment to a disease decides which further examinations are necessary and reasonable. In immunoglobulin (Ig) E‑mediated allergies, the detection of sensitization by determining the specific IgE or the prick test in addition to the medical history is an important mainstay of the diagnostics. Crucial is the fact that the detection of a sensitization against an extract from an allergen source only rarely implies an actual allergy. The majority of positive findings are not clinically relevant. The modern procedure of component-resolved allergy diagnostics improves the significance. Nevertheless, the diagnosis can often only be achieved by oral provocation tests. This article points out possible difficulties with the interpretation of the findings. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lange [ForeName] => Lars [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Pädiatrie, St. Marien-Hospital, Robert-Koch-Str. 1, 53115, Bonn, Deutschland. Lars.Lange@gfo-kliniken-bonn.de. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Gernert [ForeName] => Sunhild [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Pädiatrie, St. Marien-Hospital, Robert-Koch-Str. 1, 53115, Bonn, Deutschland. ) ) ) ) [Language] => ger [PublicationTypeList] => SimpleXMLElement Object ( [PublicationType] => Journal Article ) [VernacularTitle] => Fallstricke in der Diagnostik von Nahrungsmittelallergien bei Kindern und Jugendlichen. ) [MedlineJournalInfo] => SimpleXMLElement Object ( [Country] => Germany [MedlineTA] => Hautarzt [NlmUniqueID] => 0372755 [ISSNLinking] => 0017-8470 ) [ChemicalList] => SimpleXMLElement Object ( [Chemical] => Array ( [0] => SimpleXMLElement Object ( [RegistryNumber] => 0 [NameOfSubstance] => Allergens ) [1] => SimpleXMLElement Object ( [RegistryNumber] => 37341-29-0 [NameOfSubstance] => Immunoglobulin E ) ) ) [CitationSubset] => IM [MeshHeadingList] => SimpleXMLElement Object ( [MeshHeading] => Array ( [0] => SimpleXMLElement Object ( [DescriptorName] => Adolescent ) [1] => SimpleXMLElement Object ( [DescriptorName] => Allergens ) [2] => SimpleXMLElement Object ( [DescriptorName] => Child ) [3] => SimpleXMLElement Object ( [DescriptorName] => Food Hypersensitivity [QualifierName] => diagnosis ) [4] => SimpleXMLElement Object ( [DescriptorName] => Humans ) [5] => SimpleXMLElement Object ( [DescriptorName] => Immunoglobulin E ) [6] => SimpleXMLElement Object ( [DescriptorName] => Immunologic Tests ) [7] => SimpleXMLElement Object ( [DescriptorName] => Skin Tests ) ) ) [KeywordList] => SimpleXMLElement Object ( [@attributes] => Array ( [Owner] => NOTNLM ) [Keyword] => Array ( [0] => Component resolved diagnostics [1] => Medical history [2] => Provocation test [3] => Skin prick test [4] => Specific IgE ) ) ) [PubmedData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => pubmed ) [Year] => 2020 [Month] => 10 [Day] => 1 [Hour] => 6 [Minute] => 0 ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => medline ) [Year] => 2020 [Month] => 11 [Day] => 11 [Hour] => 6 [Minute] => 0 ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => entrez ) [Year] => 2020 [Month] => 9 [Day] => 30 [Hour] => 12 [Minute] => 17 ) ) ) [PublicationStatus] => ppublish [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => Array ( [0] => 32997217 [1] => 10.1007/s00105-020-04692-2 [2] => 10.1007/s00105-020-04692-2 ) ) ) ) [8] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => In-Data-Review [Owner] => NLM ) [PMID] => 32763470 [DateRevised] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 11 [Day] => 10 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print-Electronic ) [Journal] => SimpleXMLElement Object ( [ISSN] => 2213-2201 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 8 [Issue] => 10 [PubDate] => SimpleXMLElement Object ( [MedlineDate] => 2020 Nov - Dec ) ) [Title] => The journal of allergy and clinical immunology. In practice [ISOAbbreviation] => J Allergy Clin Immunol Pract ) [ArticleTitle] => Risk Factors and Characteristics of Biphasic Anaphylaxis. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 3388-3395.e6 ) [ELocationID] => Array ( [0] => S2213-2198(20)30794-7 [1] => 10.1016/j.jaip.2020.07.036 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => Anaphylaxis is an immediate hypersensitivity reaction. However, a biphasic course with the second onset of symptoms can occur hours after the initial phase. Little is known about the causes of biphasic anaphylaxis making the identification of patients at risk difficult. [1] => To identify factors predisposing for biphasic anaphylaxis for the better understanding of these reactions. [2] => Data from the Anaphylaxis Registry (from 11 countries) including 8736 patients with monophasic and 435 biphasic anaphylaxis were analyzed. [3] => The rate of biphasic reactions in this large cohort was 4.7%. The identified risk factors were reaction severity (grade III/IV vs grade II: odds ratio [OR] = 1.34; 95% confidence interval [CI]: 1.1-1.62); multiorgan involvement; skin, gastrointestinal, severe respiratory, and cardiac symptoms; anaphylaxis caused by peanut/tree nut (OR = 1.78; 95% CI: 1.38-2.23) or an unknown elicitor (OR = 1.96; 95% CI: 1.41-2.72); exercise as a cofactor (OR = 1.44; 95% CI: 1.17-1.78); chronic urticaria as a comorbidity (OR = 2.12; 95% CI: 1.19-3.78); a prolonged interval between the contact with the elicitor and start of primary symptoms (OR for >30 vs <30 min: 1.38; 95% CI: 1.08-1.76); and antihistamine treatment (OR = 1.52; 95% CI: 1.14-2.02). [4] => A biphasic course of anaphylaxis occurs more frequently in severely affected patients with multiorgan involvement. However, we identified multiple additional predictors, suggesting that the pathogenesis of biphasic reactions is more complex than being a rebound of a severe primary reaction. ) [CopyrightInformation] => Copyright © 2020 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Kraft [ForeName] => Magdalena [Initials] => M [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Scherer Hofmeier [ForeName] => Kathrin [Initials] => K [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy, Department of Dermatology, University Hospital Basel, University of Basel, Basel, Switzerland. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ruëff [ForeName] => Franziska [Initials] => F [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Dermatology and Allergology, Klinikum der Universität München, Munich, Germany. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Pföhler [ForeName] => Claudia [Initials] => C [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Dermatology, The Saarland University Medical Center, Homburg/Saar, Germany. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Renaudin [ForeName] => Jean-Marie [Initials] => JM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Presidency on behalf of Allergy Vigilance Network, Vandoeuvre les Nancy, France. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bilò [ForeName] => Maria Beatrice [Initials] => MB [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Clinical and Molecular Sciences, Marche Polytechnic University - Allergy Unit, University Hospital Ospedali Riuniti di Ancona, Ancona, Italy. ) ) [6] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Treudler [ForeName] => Regina [Initials] => R [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Dermatology, Venereology and Allergology and Leipzig Interdisciplinary Center of Allergology (LICA) - Comprehensive Allergy Center, University Hospital, Leipzig, Germany. ) ) [7] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lang [ForeName] => Roland [Initials] => R [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Dermatology and Allergology, University Hospital Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria. ) ) [8] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Cichocka-Jarosz [ForeName] => Ewa [Initials] => E [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, Jagiellonian University Medical College, Krakow, Poland. ) ) [9] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Fernandez-Rivas [ForeName] => Montserrat [Initials] => M [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Allergy, Hospital Clinico San Carlos, Universidad Complutense, IdISSC, Madrid, Spain. ) ) [10] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Christoff [ForeName] => George [Initials] => G [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Faculty of Public Health, Medical University - Sofia, Sofia, Bulgaria; Allergy Out-patient Department, Acibadem CityClinic, Tokuda Medical Centre, Sofia, Bulgaria. ) ) [11] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Papadopoulos [ForeName] => Nikolaos G [Initials] => NG [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Allergy Department, 2nd Pediatric Clinic, National and Kapodistrian University of Athens, Athens, Greece; Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester, United Kingdom. ) ) [12] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ensina [ForeName] => Luis Felipe [Initials] => LF [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil. ) ) [13] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Hourihane [ForeName] => Jonathan O'B [Initials] => JO [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Royal College of Surgeons in Ireland and Childrens Health Ireland, Dublin, Ireland; University College Cork, Cork, Ireland. ) ) [14] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Maris [ForeName] => Ioana [Initials] => I [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Bon Secours Hospital Cork/Department of Paediatrics and Child Health, University College Cork, Cork, Ireland. ) ) [15] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Koehli [ForeName] => Alice [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergology, University Children's Hospital Zurich, Zurich, Switzerland. ) ) [16] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => García [ForeName] => Blanca E [Initials] => BE [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Allergology Service, Complejo Hospitalario de Navarra, Pamplona, Spain. ) ) [17] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Jappe [ForeName] => Uta [Initials] => U [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Clinical and Molecular Allergology, Research Center Borstel, Airway Research Center North (ARCN), German Center for Lung Research, Borstel, Germany; Interdisciplinary Outpatient Clinic, University of Lübeck, Lübeck, Germany. ) ) [18] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Vogelberg [ForeName] => Christian [Initials] => C [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatric Pneumology and Allergology, University Hospital Carl Gustav Carus, Technical University of Dresden, Dresden, Germany. ) ) [19] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ott [ForeName] => Hagen [Initials] => H [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Pediatric Dermatology and Allergology, Children's Hospital Auf der Bult, Hannover, Germany. ) ) [20] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lange [ForeName] => Lars [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department for Pediatrics, St. Marien-Hospital, Bonn, Germany. ) ) [21] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Spindler [ForeName] => Thomas [Initials] => T [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Medicine Campus Davos, Hochgebirgsklinik Davos, Davos, Switzerland. ) ) [22] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Dölle-Bierke [ForeName] => Sabine [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. ) ) [23] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Worm [ForeName] => Margitta [Initials] => M [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, Department of Dermatology, Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. Electronic address: margitta.worm@charite.de. ) ) ) ) [Language] => eng [PublicationTypeList] => SimpleXMLElement Object ( [PublicationType] => Journal Article ) [ArticleDate] => SimpleXMLElement Object ( [@attributes] => Array ( [DateType] => Electronic ) [Year] => 2020 [Month] => 08 [Day] => 04 ) ) [MedlineJournalInfo] => SimpleXMLElement Object ( [Country] => United States [MedlineTA] => J Allergy Clin Immunol Pract [NlmUniqueID] => 101597220 ) [CitationSubset] => IM [KeywordList] => SimpleXMLElement Object ( [@attributes] => Array ( [Owner] => NOTNLM ) [Keyword] => Array ( [0] => Anaphylactic reaction [1] => Anaphylactic shock [2] => Anaphylaxis [3] => Anaphylaxis to peanut [4] => Anaphylaxis to tree nut [5] => Biphasic anaphylaxis [6] => Biphasic reaction [7] => Chronic urticaria [8] => Exercise-induced anaphylaxis [9] => Idiopathic anaphylaxis ) ) ) [PubmedData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => received ) [Year] => 2020 [Month] => 03 [Day] => 04 ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => revised ) [Year] => 2020 [Month] => 07 [Day] => 09 ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => accepted ) [Year] => 2020 [Month] => 07 [Day] => 20 ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => pubmed ) [Year] => 2020 [Month] => 8 [Day] => 9 [Hour] => 6 [Minute] => 0 ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => medline ) [Year] => 2020 [Month] => 8 [Day] => 9 [Hour] => 6 [Minute] => 0 ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => entrez ) [Year] => 2020 [Month] => 8 [Day] => 9 [Hour] => 6 [Minute] => 0 ) ) ) [PublicationStatus] => ppublish [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => Array ( [0] => 32763470 [1] => S2213-2198(20)30794-7 [2] => 10.1016/j.jaip.2020.07.036 ) ) ) ) [9] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => In-Data-Review [Owner] => NLM ) [PMID] => 32659313 [DateRevised] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 10 [Day] => 09 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print-Electronic ) [Journal] => SimpleXMLElement Object ( [ISSN] => 1097-6825 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 146 [Issue] => 4 [PubDate] => SimpleXMLElement Object ( [Year] => 2020 [Month] => Oct ) ) [Title] => The Journal of allergy and clinical immunology [ISOAbbreviation] => J Allergy Clin Immunol ) [ArticleTitle] => Long-term, open-label extension study of the efficacy and safety of epicutaneous immunotherapy for peanut allergy in children: PEOPLE 3-year results. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 863-874 ) [ELocationID] => Array ( [0] => S0091-6749(20)30957-X [1] => 10.1016/j.jaci.2020.06.028 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => The PEPITES (Peanut EPIT Efficacy and Safety) trial, a 12-month randomized controlled study of children with peanut allergy and 4 to 11 years old, previously reported the safety and efficacy of epicutaneous immunotherapy (EPIT) for peanut allergy (250 μg, daily epicutaneous peanut protein; DBV712 250 μg). [1] => We sought to assess interim safety and efficacy of an additional 2 years of EPIT from the ongoing (5-year treatment) PEOPLE (PEPITES Open-Label Extension) study. [2] => Subjects who completed PEPITES were offered enrollment in PEOPLE. Following an additional 2 years of daily DBV712 250 μg, subjects who had received DBV712 250 μg in PEPITES underwent month-36 double-blind, placebo-controlled food challenge with an optional month-38 sustained unresponsiveness assessment. [3] => Of 213 eligible subjects who had received DBV712 250 μg in PEPITES, 198 (93%) entered PEOPLE, of whom 141 (71%) had assessable double-blind, placebo-controlled food challenge at month 36. At month 36, 51.8% of subjects (73 of 141) reached an eliciting dose of ≥1000 mg, compared with 40.4% (57 of 141) at month 12; 75.9% (107 of 141) demonstrated increased eliciting dose compared with baseline; and 13.5% (19 of 141) tolerated the full double-blind, placebo-controlled food challenge of 5444 mg. Median cumulative reactive dose increased from 144 to 944 mg. Eighteen subjects underwent an optional sustained unresponsiveness assessment; 14 of those (77.8%) maintained an eliciting dose of ≥1000 mg at month 38. Local patch-site skin reactions were common but decreased over time. There was no treatment-related epinephrine use in years 2 or 3. Compliance was high (96.9%), and withdrawals due to treatment-related adverse events were low (1%). [4] => These results demonstrate that daily EPIT treatment for peanut allergy beyond 1 year leads to continued response from a well-tolerated, simple-to-use regimen. ) [CopyrightInformation] => Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Fleischer [ForeName] => David M [Initials] => DM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colo. Electronic address: david.fleischer@childrenscolorado.org. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Shreffler [ForeName] => Wayne G [Initials] => WG [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Food Allergy Center, Departments of Pediatrics and Medicine, Massachusetts General Hospital, Boston, Mass. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Campbell [ForeName] => Dianne E [Initials] => DE [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, Australia; DBV Technologies, Montrouge, France. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Green [ForeName] => Todd D [Initials] => TD [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => DBV Technologies, Montrouge, France; Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pa. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Anvari [ForeName] => Sara [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Section of Immunology, Allergy and Rheumatology, Texas Children's Hospital, Houston, Tex; Department of Pediatrics, Allergy and Immunology Section, Baylor College of Medicine, Houston, Tex. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Assa'ad [ForeName] => Amal [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, Cincinnati Children's Hospital Medical Center, The University of Cincinnati, Cincinnati, Ohio. ) ) [6] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bégin [ForeName] => Philippe [Initials] => P [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Clinical Immunology and Allergy, Department of Medicine, Université de Montréal, Montreal, Quebec, Canada. ) ) [7] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Beyer [ForeName] => Kirsten [Initials] => K [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatric Pneumology, Immunology and Intensive Care Medicine, Charité Universitatsmedizin Berlin, Berlin, Germany. ) ) [8] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bird [ForeName] => J Andrew [Initials] => JA [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Tex. ) ) [9] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Brown-Whitehorn [ForeName] => Terri [Initials] => T [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, The Children's Hospital of Philadelphia, Philadelphia, Pa; Department of Pediatrics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pa. ) ) [10] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Byrne [ForeName] => Aideen [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Paediatric Allergy Department, Our Lady's Children's Hospital, Dublin, Ireland. ) ) [11] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Chan [ForeName] => Edmond S [Initials] => ES [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada. ) ) [12] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Cheema [ForeName] => Amarjit [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Cheema Research Inc, Mississauga, Ontario, Canada. ) ) [13] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Chinthrajah [ForeName] => Sharon [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Sean N. Parker Center for Allergy and Asthma Research, Stanford University, Palo Alto, Calif. ) ) [14] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Chong [ForeName] => Hey Jin [Initials] => HJ [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pa. ) ) [15] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Davis [ForeName] => Carla M [Initials] => CM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, Allergy and Immunology Section, Baylor College of Medicine, Houston, Tex. ) ) [16] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ford [ForeName] => Lara S [Initials] => LS [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Allergy and Immunology, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Child and Adolescent Health, University of Sydney, Sydney, Australia. ) ) [17] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Gagnon [ForeName] => Rémi [Initials] => R [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Service d'Allergie et Immunologie, Département de Médecine, Centre Hospitalier Universitaire de Québec, Quebec, Canada. ) ) [18] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Greenhawt [ForeName] => Matthew [Initials] => M [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Section of Allergy and Immunology, Department of Pediatrics, Children's Hospital Colorado, University of Colorado Denver School of Medicine, Aurora, Colo. ) ) [19] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Hourihane [ForeName] => Jonathan O'B [Initials] => JO [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Paediatrics and Child Health, INFANT Centre and Health Research Board-Clinical Research Facility, University College Cork, Cork, Ireland; Department of Paediatrics, Royal College of Surgeons, Dublin, Ireland. ) ) [20] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Jones [ForeName] => Stacie M [Initials] => SM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Pediatrics - Allergy and Immunology, University of Arkansas for Medical Sciences, Arkansas Children's Hospital, Little Rock, Ark. ) ) [21] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Kim [ForeName] => Edwin H [Initials] => EH [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Rheumatology, Allergy and Immunology, University of North Carolina School of Medicine, Chapel Hill, NC. ) ) [22] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lange [ForeName] => Lars [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, St. Marien Hospital Bonn, Bonn, Germany. ) ) [23] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lanser [ForeName] => Bruce J [Initials] => BJ [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Pediatric Allergy and Clinical Immunology, National Jewish Health, Denver, Colo. ) ) [24] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Leonard [ForeName] => Stephanie [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, University of California San Diego, San Diego, Calif; 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[Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 901-910 ) [ELocationID] => 10.1111/all.14069 [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction. [1] => Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anaphylaxis. Our analysis included 7788 cases from 10 European countries and Brazil. [2] => The secondary prevention measures offered varied across the elicitors. A remarkable discrepancy was observed between prevention measures offered in specialized allergy centers (84% of patients were prescribed adrenaline autoinjectors following EAACI guidelines) and outside the centers: Here, EAACI guideline adherence was only 37%. In the multivariate analysis, the elicitor of the reaction, age of the patient, mastocytosis as comorbidity, severity of the reaction, and reimbursement/availability of the autoinjector influence physician's decision to prescribe one. [3] => Based on the low implementation of guidelines concerning secondary prevention measures outside of specialized allergy centers, our findings highlight the importance of these specialized centers and the requirement of better education for primary healthcare and emergency physicians. ) [CopyrightInformation] => © 2019 The Authors. Allergy published by John Wiley & Sons Ltd. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Kraft [ForeName] => Magdalena [Initials] => M [Identifier] => 0000-0002-2770-9947 [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy and Immunology, Department of Dermatology Venerology and Allergology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Knop [ForeName] => Macarena Pia [Initials] => MP [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Dermatology and Allergy, University Hospital, LMU Munich, Munich, Germany. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Renaudin [ForeName] => Jean-Marie [Initials] => JM [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Presidency, Allergy Vigilance Network, Nancy, France. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Scherer Hofmeier [ForeName] => Kathrin [Initials] => K [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Division of Allergy, Department of Dermatology, University Hospital Basel, University of Basel, Basel, Switzerland. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Pföhler [ForeName] => Claudia [Initials] => C [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Dermatology, The Saarland University Medical Center, Homburg/Saar, Germany. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bilò [ForeName] => Maria Beatrice [Initials] => MB [AffiliationInfo] => Array ( [0] => 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Prevention of Anaphylaxis: The Role of the Epinephrine Auto-Injector. Am J Med. 2016;129(12):1244-1250. ) [18] => SimpleXMLElement Object ( [Citation] => Fineman S, Dowling P, O'Rourke D. Allergists' self-reported adherence to anaphylaxis practice parameters and perceived barriers to care: an American college of allergy, asthma, and immunology member survey. Ann Allergy Asthma Immunol. 2013;111(6):529-536. ) [19] => SimpleXMLElement Object ( [Citation] => Worm M, Francuzik W, Renaudin JM, et al. Factors increasing the risk for a severe reaction in anaphylaxis: an analysis of data from the European anaphylaxis registry. Allergy. 2018;73(6):1322-1330. ) [20] => SimpleXMLElement Object ( [Citation] => Aurich S, Dölle-Bierke S, Francuzik W, et al. Anaphylaxis in elderly patients-data from the European Anaphylaxis Registry. Front Immunol. 2019;10:750. ) ) ) ) ) [11] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => MEDLINE [Owner] => NLM ) [PMID] => 30794314 [DateCompleted] => SimpleXMLElement Object ( [Year] => 2019 [Month] => 08 [Day] => 16 ) [DateRevised] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 04 [Day] => 25 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print ) [Journal] => SimpleXMLElement Object ( [ISSN] => 1538-3598 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 321 [Issue] => 10 [PubDate] => SimpleXMLElement Object ( [Year] => 2019 [Month] => 03 [Day] => 12 ) ) [Title] => JAMA [ISOAbbreviation] => JAMA ) [ArticleTitle] => Effect of Epicutaneous Immunotherapy vs Placebo on Reaction to Peanut Protein Ingestion Among Children With Peanut Allergy: The PEPITES Randomized Clinical Trial. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 946-955 ) [ELocationID] => 10.1001/jama.2019.1113 [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => There are currently no approved treatments for peanut allergy. [1] => To assess the efficacy and adverse events of epicutaneous immunotherapy with a peanut patch among peanut-allergic children. [2] => Phase 3, randomized, double-blind, placebo-controlled trial conducted at 31 sites in 5 countries between January 8, 2016, and August 18, 2017. Participants included peanut-allergic children (aged 4-11 years [n = 356] without a history of a severe anaphylactic reaction) developing objective symptoms during a double-blind, placebo-controlled food challenge at an eliciting dose of 300 mg or less of peanut protein. [3] => Daily treatment with peanut patch containing either 250 μg of peanut protein (n = 238) or placebo (n = 118) for 12 months. [4] => The primary outcome was the percentage difference in responders between the peanut patch and placebo patch based on eliciting dose (highest dose at which objective signs/symptoms of an immediate hypersensitivity reaction developed) determined by food challenges at baseline and month 12. Participants with baseline eliciting dose of 10 mg or less were responders if the posttreatment eliciting dose was 300 mg or more; participants with baseline eliciting dose greater than 10 to 300 mg were responders if the posttreatment eliciting dose was 1000 mg or more. A threshold of 15% or more on the lower bound of a 95% CI around responder rate difference was prespecified to determine a positive trial result. Adverse event evaluation included collection of treatment-emergent adverse events (TEAEs). [5] => Among 356 participants randomized (median age, 7 years; 61.2% male), 89.9% completed the trial; the mean treatment adherence was 98.5%. The responder rate was 35.3% with peanut-patch treatment vs 13.6% with placebo (difference, 21.7% [95% CI, 12.4%-29.8%; P < .001]). The prespecified lower bound of the CI threshold was not met. TEAEs, primarily patch application site reactions, occurred in 95.4% and 89% of active and placebo groups, respectively. The all-causes rate of discontinuation was 10.5% in the peanut-patch group vs 9.3% in the placebo group. [6] => Among peanut-allergic children aged 4 to 11 years, the percentage difference in responders at 12 months with the 250-μg peanut-patch therapy vs placebo was 21.7% and was statistically significant, but did not meet the prespecified lower bound of the confidence interval criterion for a positive trial result. The clinical relevance of not meeting this lower bound of the confidence interval with respect to the treatment of peanut-allergic children with epicutaneous immunotherapy remains to be determined. 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=> NLM ) [PMID] => 30708144 [DateCompleted] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 08 [Day] => 17 ) [DateRevised] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 08 [Day] => 17 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print-Electronic ) [Journal] => SimpleXMLElement Object ( [ISSN] => 2213-2201 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Internet ) [Volume] => 7 [Issue] => 5 [PubDate] => SimpleXMLElement Object ( [MedlineDate] => 2019 May - Jun ) ) [Title] => The journal of allergy and clinical immunology. In practice [ISOAbbreviation] => J Allergy Clin Immunol Pract ) [ArticleTitle] => Allergen Recognition Patterns in Walnut Allergy Are Age Dependent and Correlate with the Severity of Allergic Reactions. [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 1560-1567.e6 ) [ELocationID] => Array ( [0] => S2213-2198(19)30099-6 [1] => 10.1016/j.jaip.2019.01.029 ) [Abstract] => SimpleXMLElement Object ( [AbstractText] => Array ( [0] => Walnut is an important elicitor of food allergy in children and adults with a high rate of severe reactions. Multicenter studies using a common clinical protocol and a comprehensive allergen are lacking. [1] => To investigate potential correlations between molecular sensitization patterns and clinical characteristics of walnut-allergic patients. [2] => A total of 91 walnut-allergic subjects and 24 tolerant controls from Switzerland, Germany, and Spain were included. Walnut allergy was established by food challenge in all but anaphylactic subjects. Specific IgE (sIgE) to walnut extract, rJug r 1 (2S albumin), rJug r 3 (nonspecific lipid transfer protein 1), nJug r 4 (11S globulin), rJug r 5 (PR-10 protein), 2 vicilin fractions, profiling, and cross-reactive carbohydrate determinant was determined by ImmunoCAP. A threshold of 0.10 kU/L was used for positivity. [3] => Sensitivity of sIgE to walnut extract was 87% and increased to 96% for the sum of all walnut components. sIgE to walnut extract and all walnut components, except rJug r 5, was significantly higher in patients younger than 14 years at inclusion. Stratification by age at onset of walnut allergy led to similar results. All patients younger than 14 years had severe reactions, whereas 38% of patients 14 years or older were mild reactors. Severe reactors (n = 70) had higher sIgE levels than did mild reactors (n = 21) to walnut extract (P < .0001), rJug r 1 (P < .0001), nJug r 4 (P = .0003), and both vicilin fractions (P < .0001), but not to Jug r 3 and Jug r 5. [4] => Sensitization to walnut storage proteins is acquired in childhood and correlates with severe reactions. sIgE levels to storage proteins Jug r 1 and Jug r 4 and vicilin fractions, but not to nonspecific lipid transfer protein and PR-10 proteins, correlate with systemic reactions to walnut. ) [CopyrightInformation] => Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ballmer-Weber [ForeName] => Barbara K [Initials] => BK [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland; Clinic for Dermatology and Allergology, Kantonsspital St Gallen, Switzerland. Electronic address: barbara.ballmer@usz.ch. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lidholm [ForeName] => Jonas [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Thermo Fisher Scientific, Uppsala, Sweden. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lange [ForeName] => Lars [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, St Marien Hospital, Bonn, Germany. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Pascal [ForeName] => Mariona [Initials] => M [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Servei d'Immunologia, CDB, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lang [ForeName] => Claudia [Initials] => C [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Allergy Unit, Department of Dermatology, University Hospital, Zurich, Switzerland; Faculty of Medicine, University of Zurich, Zurich, Switzerland. ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Gernert [ForeName] => Sunhild [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, St Marien Hospital, Bonn, Germany. ) ) [6] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lozano-Blasco [ForeName] => Jaime [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatric Allergy and Clinical Immunology, Hospital Sant Joan de Déu, Universitat de Barcelona, Esplugues de Llobregat (Barcelona), Barcelona, Spain. ) ) [7] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Gräni [ForeName] => Nora [Initials] => N [AffiliationInfo] => SimpleXMLElement 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Paul-Ehrlich-Institut, Langen, Germany. ) ) [11] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Pontoppidan [ForeName] => Bo [Initials] => B [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Thermo Fisher Scientific, Uppsala, Sweden. ) ) [12] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Tjäder [ForeName] => Linda [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Thermo Fisher Scientific, Uppsala, Sweden. ) ) [13] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bartra [ForeName] => Joan [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Secció d'Allèrgia, Servei de Pneumologia, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain. ) ) [14] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Vieths [ForeName] => Stefan [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Paul-Ehrlich-Institut, Langen, Germany. ) ) ) ) [Language] => eng [PublicationTypeList] => SimpleXMLElement Object ( [PublicationType] => Array ( [0] => Journal Article [1] => Research Support, Non-U.S. Gov't ) ) [ArticleDate] => SimpleXMLElement Object ( [@attributes] => Array ( [DateType] => Electronic ) [Year] => 2019 [Month] => 01 [Day] => 30 ) ) [MedlineJournalInfo] => SimpleXMLElement Object ( [Country] => United States [MedlineTA] => J Allergy Clin Immunol Pract [NlmUniqueID] => 101597220 ) [ChemicalList] => SimpleXMLElement Object ( [Chemical] => Array ( [0] => SimpleXMLElement Object ( [RegistryNumber] => 0 [NameOfSubstance] => 2S Albumins, Plant ) [1] => SimpleXMLElement Object ( [RegistryNumber] => 0 [NameOfSubstance] => Antigens, Plant ) [2] => SimpleXMLElement Object ( [RegistryNumber] => 0 [NameOfSubstance] => Carrier Proteins ) [3] => SimpleXMLElement Object ( [RegistryNumber] => 0 [NameOfSubstance] => Jug r 4 allergen ) [4] => 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[DescriptorName] => Middle Aged ) [17] => SimpleXMLElement Object ( [DescriptorName] => Nut Hypersensitivity [QualifierName] => immunology ) [18] => SimpleXMLElement Object ( [DescriptorName] => Plant Extracts [QualifierName] => immunology ) [19] => SimpleXMLElement Object ( [DescriptorName] => Plant Proteins [QualifierName] => immunology ) [20] => SimpleXMLElement Object ( [DescriptorName] => Seed Storage Proteins [QualifierName] => immunology ) [21] => SimpleXMLElement Object ( [DescriptorName] => Severity of Illness Index ) [22] => SimpleXMLElement Object ( [DescriptorName] => Young Adult ) ) ) [KeywordList] => SimpleXMLElement Object ( [@attributes] => Array ( [Owner] => NOTNLM ) [Keyword] => Array ( [0] => Age [1] => Component-resolved diagnosis [2] => Food allergy [3] => Food challenge [4] => Severity [5] => Vicilin [6] => Walnut ) ) ) [PubmedData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => received ) [Year] => 2018 [Month] => 11 [Day] => 07 ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => revised ) [Year] => 2018 [Month] => 12 [Day] => 19 ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => accepted ) [Year] => 2019 [Month] => 01 [Day] => 11 ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => pubmed ) [Year] => 2019 [Month] => 2 [Day] => 2 [Hour] => 6 [Minute] => 0 ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => medline ) [Year] => 2020 [Month] => 8 [Day] => 18 [Hour] => 6 [Minute] => 0 ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => entrez ) [Year] => 2019 [Month] => 2 [Day] => 2 [Hour] => 6 [Minute] => 0 ) ) ) [PublicationStatus] => ppublish [ArticleIdList] => SimpleXMLElement Object ( [ArticleId] => Array ( [0] => 30708144 [1] => S2213-2198(19)30099-6 [2] => 10.1016/j.jaip.2019.01.029 ) ) ) ) [13] => SimpleXMLElement Object ( [MedlineCitation] => SimpleXMLElement Object ( [@attributes] => Array ( [Status] => PubMed-not-MEDLINE [Owner] => NLM ) [PMID] => 30294520 [DateRevised] => SimpleXMLElement Object ( [Year] => 2020 [Month] => 10 [Day] => 01 ) [Article] => SimpleXMLElement Object ( [@attributes] => Array ( [PubModel] => Print-Electronic ) [Journal] => SimpleXMLElement Object ( [ISSN] => 2197-0378 [JournalIssue] => SimpleXMLElement Object ( [@attributes] => Array ( [CitedMedium] => Print ) [Volume] => 27 [Issue] => 5 [PubDate] => SimpleXMLElement Object ( [Year] => 2018 ) ) [Title] => Allergo journal international [ISOAbbreviation] => Allergo J Int ) [ArticleTitle] => Non-celiac gluten/wheat sensitivity (NCGS)-a currently undefined disorder without validated diagnostic criteria and of unknown prevalence: Position statement of the task force on food allergy of the German Society of Allergology and Clinical Immunology (DGAKI). [Pagination] => SimpleXMLElement Object ( [MedlinePgn] => 147-151 ) [ELocationID] => 10.1007/s40629-018-0070-2 [Abstract] => SimpleXMLElement Object ( [AbstractText] => Within the last decade, non-celiac gluten/wheat sensitivity (NCGS) has been increasingly discussed not only in the media but also among medical specialties. The existence and the possible triggers of NCGS are controversial. Three international expert meetings which proposed recommendations for NCGS were not independently organized and only partially transparent regarding potential conflicts of interest of the participants. The present position statement reflects the following aspects about NCGS from an allergist's and nutritionist's point of view: (A) Validated diagnostic criteria and/or reliable biomarkers are still required. Currently, this condition is frequently self-diagnosed, of unknown prevalence and non-validated etiology. (B) Gluten has not been reliably identified as an elicitor of NCGS because of high nocebo and placebo effects. Double-blind, placebo-controlled provocation tests are of limited value for the diagnosis of NCGS and should be performed in a modified manner (changed relation of placebo and active substance). (C) Several confounders hamper the assessment of subjective symptoms during gluten-reduced or gluten-free diets. Depending on the selection of food items, e.g., an increased vegetable intake with soluble fibers, diets may induce physiological digestive effects and can modify gastrointestinal transit times independent from the avoidance of gluten. (D) A gluten-free diet is mandatory in celiac disease based on scientific evidence. However, a medically unjustified avoidance of gluten may bear potential disadvantages and risks. (E) Due to a lack of diagnostic criteria, a thorough differential diagnostic work-up is recommended when NCGS is suspected. This includes a careful patient history together with a food-intake and symptom diary, if necessary an allergy diagnostic workup and a reliable exclusion of celiac disease. We recommend such a structured procedure since a medically proven diagnosis is required before considering the avoidance of gluten. ) [AuthorList] => SimpleXMLElement Object ( [@attributes] => Array ( [CompleteYN] => Y ) [Author] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Reese [ForeName] => Imke [Initials] => I [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Dietary Counseling and Nutrition Therapy with Specialization in Allergology, Ansprenger Str. 19, 80803 Munich, Germany. ) ) [1] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Schäfer [ForeName] => Christiane [Initials] => C [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Outpatient Center of Allergy and Pulmonology (Schwerpunktpraxis Collonaden), Dietary Counseling and Nutrition Therapy, Hamburg, Germany. ) ) [2] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Kleine-Tebbe [ForeName] => Jörg [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Outpatient & Clinical Research Center, Allergy and Asthma Center Westend, Berlin, Germany. ) ) [3] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ahrens [ForeName] => Birgit [Initials] => B [AffiliationInfo] => Array ( [0] => SimpleXMLElement Object ( [Affiliation] => 4Division of Allergology, Paul Ehrlich Institute (Federal Institute for Vaccines and Biomedicines), Langen, Germany. [Identifier] => Array ( [0] => 0000 0001 1019 0926 [1] => grid.425396.f ) ) [1] => SimpleXMLElement Object ( [Affiliation] => 5Department of Pediatrics, Division of Pulmonology, Immunology and Intensive Care Medicine, Charité University Hospital, Berlin, Germany. [Identifier] => Array ( [0] => 0000 0001 2218 4662 [1] => grid.6363.0 ) ) ) ) [4] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bachmann [ForeName] => Oliver [Initials] => O [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 6Department of Gastroenterology, Hepatology and Endocrinology, Hanover Medical School, Hanover, Germany. [Identifier] => Array ( [0] => 0000 0000 9529 9877 [1] => grid.10423.34 ) ) ) [5] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ballmer-Weber [ForeName] => Barbara [Initials] => B [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 7Allergy Unit, Department of Dermatology, University Hospital Zurich, Zurich, Switzerland. [Identifier] => Array ( [0] => 0000 0004 0478 9977 [1] => grid.412004.3 ) ) ) [6] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Beyer [ForeName] => Kirsten [Initials] => K [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 5Department of Pediatrics, Division of Pulmonology, Immunology and Intensive Care Medicine, Charité University Hospital, Berlin, Germany. [Identifier] => Array ( [0] => 0000 0001 2218 4662 [1] => grid.6363.0 ) ) ) [7] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Bischoff [ForeName] => Stephan C [Initials] => SC [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 8Institute of Clinical Nutrition, University of Hohenheim, Stuttgart, Germany. [Identifier] => Array ( [0] => 0000 0001 2290 1502 [1] => grid.9464.f ) ) ) [8] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Blümchen [ForeName] => Katharina [Initials] => K [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 9Department of Pediatrics, Division of Allergy, Pulmonology and Cystic Fibrosis, University Hospital Frankfurt, Frankfurt am Main, Germany. [Identifier] => Array ( [0] => 0000 0004 0578 8220 [1] => grid.411088.4 ) ) ) [9] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Dölle [ForeName] => Sabine [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 10Department of Dermatology, Venereology and Allergology, Allergy Center Charité (ACC), Charité University Hospital, Berlin, Germany. [Identifier] => Array ( [0] => 0000 0001 2218 4662 [1] => grid.6363.0 ) ) ) [10] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Enck [ForeName] => Paul [Initials] => P [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 11Department of Internal Medicine VI, Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany. [Identifier] => Array ( [0] => 0000 0001 0196 8249 [1] => grid.411544.1 ) ) ) [11] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Enninger [ForeName] => Axel [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 12Derpartment of General and Special Pediatrics, Olga Hospital (Klinikum Stuttgart), Stuttgart, Germany. [Identifier] => Array ( [0] => 0000 0001 0341 9964 [1] => grid.419842.2 ) ) ) [12] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Huttegger [ForeName] => Isidor [Initials] => I [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Pediatric Allergology and Pulmonology, Department of Pediatrics and Adolescent Medicine, Salzburg State Clinics, Paracelsus Medical Private University, Salzburg, Austria. ) ) [13] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lämmel [ForeName] => Sonja [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Patient Support Group: Deutscher Allergie- und Asthmabund, DAAB, German Allergy and Asthma Association, Mönchengladbach, Germany. ) ) [14] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lange [ForeName] => Lars [Initials] => L [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Pediatrics, St. Marien Hospital, Bonn, Germany. ) ) [15] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Lepp [ForeName] => Ute [Initials] => U [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Respiratory Medicine and Allergology Outpatient Center Dr. Lepp, Buxtehude, Germany. ) ) [16] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Mahler [ForeName] => Vera [Initials] => V [AffiliationInfo] => Array ( [0] => SimpleXMLElement Object ( [Affiliation] => 4Division of Allergology, Paul Ehrlich Institute (Federal Institute for Vaccines and Biomedicines), Langen, Germany. [Identifier] => Array ( [0] => 0000 0001 1019 0926 [1] => grid.425396.f ) ) [1] => SimpleXMLElement Object ( [Affiliation] => 17Department of Dermatology, Faculty of Medicine, Friedrich Alexander University Erlangen-Nürnberg, Erlangen, Germany. [Identifier] => Array ( [0] => 0000 0001 2107 3311 [1] => grid.5330.5 ) ) ) ) [17] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Mönnikes [ForeName] => Hubert [Initials] => H [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Department of Internal Medicine and Institute of Neurogastroenterology, Martin-Luther Hospital, Berlin, Germany. ) ) [18] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Ockenga [ForeName] => Johann [Initials] => J [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 19Department of Gastroenterology, Endocrinology and Clinical Nutrition, Klinikum Bremen Mitte, Bremen, Germany. [Identifier] => Array ( [0] => 0000 0004 0636 7065 [1] => grid.419807.3 ) ) ) [19] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Otto [ForeName] => Barbara [Initials] => B [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 20Institute for Medical Education, University Hospital, Ludwig Maximilian University of Munich, Munich, Germany. [Identifier] => Array ( [0] => 0000 0004 1936 973X [1] => grid.5252.0 ) ) ) [20] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Schnadt [ForeName] => Sabine [Initials] => S [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Patient Support Group: Deutscher Allergie- und Asthmabund, DAAB, German Allergy and Asthma Association, Mönchengladbach, Germany. ) ) [21] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Szepfalusi [ForeName] => Zsolt [Initials] => Z [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 21Pediatric Pulmonology, Allergy and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria. [Identifier] => Array ( [0] => 0000 0000 9259 8492 [1] => grid.22937.3d ) ) ) [22] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Treudler [ForeName] => Regina [Initials] => R [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 22Department of Dermatology, Venereology and Allergology, Interdisciplinary Center of Allergology, University Medical Center Leipzig, Leipzig, Germany. [Identifier] => Array ( [0] => 0000 0000 8517 9062 [1] => grid.411339.d ) ) ) [23] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Wassmann-Otto [ForeName] => Anja [Initials] => A [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => Dermatology Outpatient Center Hamburg-Alstertal, Hamburg, Germany. ) ) [24] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Zuberbier [ForeName] => Torsten [Initials] => T [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 10Department of Dermatology, Venereology and Allergology, Allergy Center Charité (ACC), Charité University Hospital, Berlin, Germany. [Identifier] => Array ( [0] => 0000 0001 2218 4662 [1] => grid.6363.0 ) ) ) [25] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Werfel [ForeName] => Thomas [Initials] => T [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 24Department of Dermatology, Allergology and Venereology, Department of Immunodermatology and Experimental Allergology, Hanover Medical School (MHH), Hanover, Germany. [Identifier] => Array ( [0] => 0000 0000 9529 9877 [1] => grid.10423.34 ) ) ) [26] => SimpleXMLElement Object ( [@attributes] => Array ( [ValidYN] => Y ) [LastName] => Worm [ForeName] => Margitta [Initials] => M [AffiliationInfo] => SimpleXMLElement Object ( [Affiliation] => 10Department of Dermatology, Venereology and Allergology, Allergy Center Charité (ACC), Charité University Hospital, Berlin, Germany. [Identifier] => Array ( [0] => 0000 0001 2218 4662 [1] => grid.6363.0 ) ) ) ) ) [Language] => eng [PublicationTypeList] => SimpleXMLElement Object ( [PublicationType] => Journal Article ) [ArticleDate] => SimpleXMLElement Object ( [@attributes] => Array ( [DateType] => Electronic ) [Year] => 2018 [Month] => 05 [Day] => 28 ) ) [MedlineJournalInfo] => SimpleXMLElement Object ( [Country] => Germany [MedlineTA] => Allergo J Int [NlmUniqueID] => 101659261 [ISSNLinking] => 2197-0378 ) [KeywordList] => SimpleXMLElement Object ( [@attributes] => Array ( [Owner] => NOTNLM ) [Keyword] => Array ( [0] => Gluten-free [1] => Irritable bowel syndrome [2] => Nocebo effects [3] => Placebo effects [4] => Self-diagnosis ) ) [CoiStatement] => The authors declare that they have no competing interests. ) [PubmedData] => SimpleXMLElement Object ( [History] => SimpleXMLElement Object ( [PubMedPubDate] => Array ( [0] => SimpleXMLElement Object ( [@attributes] => Array ( [PubStatus] => received ) [Year] => 2018 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