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The Coming Week: Net Positive
(DNA) also are on tap Monday.On Tuesday, Intel is due to report, followed by Apple Computer on Wednesday and Sun Microsystems (SUNW - Get Report) on Thursday. Analysts expect Intel to earn 31 cents a share on revenue of $9.4 billion. The company raised its sales estimate for the quarter last month, citing strong demand for servers, chipsets and notebook computers. Apple is expected to post a profit of 48 cents a share compared with just 16 cents last year, as sales of the firm's iPod music player remained strong. Sun should earn a penny after losing 3 cents a share last year. On average, analysts expect earnings to rise a respectable 15.2% in the fourth quarter. But Briggs said he isn't expecting much reaction from investors. "I don't think we'll rally sharply, but don't think we're going to fall apart either," he said. While earnings will probably take center stage, a handful of economic reports also could influence trade. Import and export prices and the producer price index, due Thursday and Friday, respectively, will be particularly significant after the Fed said earlier this week that inflation could become a problem unless interest rates continue to go up. The PPI is expected to fall 0.1%, while the core rate is seen climbing 0.2%. Retail sales for December also will be closely watched. Economists are looking for a gain of 0.7%, or 0.4% excluding autos. Last month, nonfarm payrolls increased by 157,000, slightly below the consensus estimate of 175,000. In addition, wages rose a meager 0.1%, suggesting that fears of inflation might be overblown. Other reports of note next week include wholesale inventories on Monday, the trade balance and Treasury budget on Wednesday, and business inventories and industrial production data on Friday.Peter Cardillo, chief market strategist at SW Bach, believes corporate earnings will "recharge the rally" next week. Dow component Alcoa is scheduled to report a 41 cents-per-share profit on Monday compared with 34 cents last year. Nortel Networks and Genentech
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Hello, my family and I are relocating and can not bring our puppy :(. I'm looking for a home for him. he is a 3 month old Pomeranian shitzu mix. He will have leash, harness, and dog carrier to go with him. please txt me if you are interested. we are hoping to find a rehome quickly since we are moving this weekend. serious people only. 6178233104
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Skip to comments.An Open Letter to a Discouraged Teenager
Posted on 01/02/2012 7:51:59 AM PST by MosesKnows
Before we know it, fall will be here and a lot of high school graduates who have been having fun swimming, bicycling, sunning and loafing will be out looking for jobs.
Some of them will go to 10, 15 or 20 places and get turned down. They will tell you the world is against them and that life is mean and unfair. They will swear they tried their darnedest to find something, walked their feet off and there just arent any jobs out there.
Please, Ann, print this little essay that I found in an old book in our family library. It was handwritten and I have no idea who wrote it. It could be a member of the family or some well-known person. No matter who the author is, this piece deserves to be seen by large numbers of young people who will be job hunting soon.
Go get em.A Reader in Elmira, N.Y.
Dear Reader:
Thanks for sending this excellent piece my way. Here it is:
An Open Letter to a Discouraged Teenager
Dear Kid:
Today you came to me for a job. From the look of your shoulders when you walked out, I suspect youve been turned down before. Or maybe you believe nobody wants to hire a kid just out of high school.
Well, it happens that I did hire a teenager today. He had a big smile on his face and he wore a necktie. What was so special about that kid? Experience? Not really. He didnt have any. It was his attitude that put him on the payroll instead of you. Attitude, son. A-T-T-I-T-U-D-E.
He wanted that job bad enough to put on a clean shirt and take the time to find out something about our company before he came down here. He did his best to impress me. Thats where he edged you out. You see, kid, folks who do hiring look for young people who have a spark. They want someone around who looks energetic, eager and rarin to go. Your first questions were, What are the hours? How many vacations would I get? and How much do you pay? I knew when you asked those questions that you werent going to get a job here.
I couldnt care less that youre behind in your car payments. Thats your problem. What I needed was someone with enthusiasm whod keep his eyes open and work for me like hed work for himself If you have even the vaguest idea of what Im trying to say, let it show the next time you go looking for a job. If you do, youll be head and shoulders above the rest.
You know, kid, men have always gotten jobs the same way they get girls. They case the situation, wear a clean shirt, put their best foot forward and appear interested. Maybe jobs arent plentiful right now, but a lot of us can remember when master craftsmen walked the streets. By comparison, kids today dont know the meaning of the word scarce.
You may not believe this, but all around you there are employers who are looking like crazy for smart, alert, energetic young people. When they find one, they cant wait to get him or her on their payroll. If you paid a dimes worth of attention to what Ive said today youll land a job pretty darned soon. Good luck. Youre going to need it.
© 1990. Creators Syndicate
oh yeah, blame the victim
Yeah, that's been around for years. Why people think they can just walk into a business with purple hair, tatooes and piercings all over, ripped jeans, and otherwise nasty is beyond me. A friend's kid got a recent job because she was the first applicant who took pride in her appearance.
well you know around these parts, the retirees whose accounts were decimated by the 2008 crash have taken all the jobs the teens would normally get.
>>You know, kid, men have always gotten jobs the same way they get girls.
Today, they don't even bother to "get" girls. They hook-up randomly or have friends with benefits. When they get one pregnant, they wish her well and move on. If they're "kinda into each other", they marry for a while but get bored and move on.
Far too many teens and young adults sport neck tattoos and face piercings. Is this the outward appearance you want for your business?
If you do hire them, they are instantly unhappy about their "dead-end" job and treat customers like crap because they aren't store manager after two weeks on the fry station.
They blame the unfairness of society because their 50 year old parents have lots of cool stuff, but they can't afford it. So, as soon as they can lose this job, they can move back in with mom and dad and "start living the life" again.
Even if the economy wasn't in the tank, today's crop of over-entitled, self-important little brats wouldn't be good employees.
This is why I don't watch those 'talent' shows on television.
Everyone thinks they are the best, no one has ever told them the truth, that they are not the best, the brightest or the most beautiful. They are the 'everyone gets a trophy' kid, the one who has never lost anything.
I saw one girl screech out a song and was not promoted to the next round. She screamed and cried in the room with her family, saying, I know they can use equipment to make me sound as good as everyone, that is what they do for everyone else.
See. She knew she sucked but had been told she deserved things she didn't deserve her entire life. Kids applying for jobs feel that they are entitled- our veterinarian told us that she has kids come in who are in school to be vets. They think that they will walk out of graduation into a paid for clinic with all the perks instead of having to work their way up- which is what she has done.
Blood, swear and tears. This concept is completely foreign to the yutes today.
Exactly. They put in one-hundred-thousand applications on the off chance someone is foolish enough not to see through their bull****.
Being a dreg of society seems to be a plus in my corner of the world. More places I go in I see piercings,tats, bling, torn up and dishevled clothes and these are beyond little entry level jobs.
I have to agree.
I did some hiring for junior-level positions at one of my old companies...recent college grads are horrible applicants. Most of them feel as if having a degree "promises" them a job.
One young woman's first question was about our policy on "snow days." Nope, she didn't get the job. A young man came in and I wanted to go over some items on his resume. He had not brought a copy with him and asked me, "Can't you just run over to the copier and make one?" Nope, he didn't get the job. Another young woman told the waiter to box up the leftovers (mine as well as hers) at the end of a luncheon interview. Nope, she didn't get the job. A young man sent us a thank-you note after we interviewed him and offered to supply us with any other information we might need in making our decision. He got the job.
I must say, my most bizarre experience was talking to a woman who called me to find out why I didn't hire her daughter. I did not have a clue big enought to impart to her.
I'm happily farming now, glad to be out of the corporate limelight and not dealing with the "self-esteem" generation.
1990.. back when Ann Landers was written by Esther Lederer...aka "Dear Abby's" sister... sense like that is not common anymore.
I consider that a wise observation.
Rich people are rich for the exact same reason that poor people are poor. They each keep doing that which made them rich or made them poor.
I begin repeating this to my grandchildren even before they comprehend the depth and wisdom of the advice.
Do not exchange what you want most from life with what you want now.
I admire her thriftiness.
What about attending a trade school or go to college and get a marketable degree like engineering, accounting or nursing? And if you can't afford those options then join the military and learn a trade like diesel mechanic or get money to go to college after your enlistment is up.
I, too, would have admired her thriftiness if it had only been her own lunch...but you don't take home your future potential boss's half-eaten sandwich. That just ain't sanitary.
Dr. Charles Stanley, First Baptist pastor for Atlanta, Ga., yesterday morning on television, remarked that before his children were old enough to talk, he was telling them that God had a plan for their life, God made them and loved them. So before they had any idea of critical thinking he had saturated them with the belief of God. He wanted them to have complete trust in God.
Now that is wise.
It would have been thrifty if she had paid for it... but typically on luncheon interviews you don't go "dutch." The interviewer pays. The applicant was having the waiter box up food that wasn't hers.
A person of energy and enthusiasm is what employers at JP Morgan Chase are seeking to
find enslave and sodomize.
There, now it's more accurate.
She did not have the wherewithal to understand when and when not to do it. Poor judgement.
YEARS ago I was a civilian employee at a USMC PX data center. As asst. mgr., it was my job to interview the applicants. One woman showed up for a keypunch position in curlers and something that looked like a bathrobe. She DID have shoes and not slippers on, though.
My biggest problem was the Marine kids applying with the expectation that because they were Marine offspring, they immediately qualified for the job. I had a permanent computer operator job open up. One woman I worked with sent over her 20-year-old son who obviously was just looking for a place to spend the summer before next semester - the most listless "whatever" person I had ever met. His mom would no longer speak to me because I didn't hire him.
That's the main reason I didn't hire her. Poor judgement and worse manners. I would never have felt comfortable turning her loose on a client.
The company did indeed pay for the food she took home; she probably would not have easily made the distinction between office suplies the company paid for and stuff she was free to swipe.
Also, if she ate strangers' food leftovers, she would probably have taken quite a few sick days ;-)
Around here those jobs are taken by Russians, Bulgarians, Argentinians, Turks, Chileans, Skandahoovians and Elbonians. Anybody thinks there are jobs Americans just won't do, especially American kids, they are absolutely correct.
I just got back from the grocery store, where I noticed that all but one of the "check-out girls" were middle aged or older men.
The wisest!
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text: logging in or signing up Vocab. Building Strategies Basic eflclassroom Download Post to : URL : Related Presentations : Let's Connect Share Add to Flag Embed Email Add to Channel Copy embed code: Embed: Flash iPad Dynamic Copy Does not support media & animations Automatically changes to Flash or non-Flash embed WordPress Embed Customize Embed Use HTTPS URL: Copy Thumbnail: Copy The presentation is successfully added In Your Favorites. Views: 3427 Category: Education License: All Rights Reserved Like it (1) Dislike it (0) Added: December 06, 2010 This Presentation is Public Favorites: 7 Presentation Description No description available. Comments Posting comment... By: eflclassroom (57 month(s) ago) ulhasmita, All the presentations are available in ppt and .swf on EFL Classroom 2.0. free, just register and go to Resources and then Prof Dev. - teacher training. then use and abuse! Saving..... Post Reply Close Saving..... Edit Comment Close By: showstopper0986 (64 month(s) ago) i'm a teacher. plz let me download this ppt for teaching effectively. Saving..... Post Reply Close Saving..... Edit Comment Close By: saoudammar (65 month(s) ago) hi im mr saoud Saving..... Post Reply Close Saving..... Edit Comment Close By: Bossan (65 month(s) ago) ghjkl Saving..... Post Reply Close Saving..... Edit Comment Close Premium member Presentation Transcript The unbearable lightness of being a second language learner (or teacher): The unbearable lightness of being a second language learner (or teacher) PowerPoint Presentation: Word Talk PowerPoint Presentation: 1,000,000 words in the English lexicon PowerPoint Presentation: 20,000 / year Added What happens to things we learn?: What happens to things we learn? time knowledge The Forgetting Curve The Forgetting Curve... Aspects of Word Knowledge: Aspects of Word Knowledge Productive Writing Reading Listening Speaking Receptive Meaning Uses Forms WORD Depth Breadth PowerPoint Presentation: A WORD IS NOT A WORD PowerPoint Presentation: IDEA is not just "idea"... PowerPoint Presentation: High Frequency Low Frequency Social Academic Function words 84% Content Words 95% The Top 100 Words: The Top 100 Words OF TO AND A IN IS IT YOU THAT HE WAS FOR ON ARE WITH AS I HIS THEY BE AT ONE HAVE THIS FROM OR HAD BY HOT WORD BUT WHAT SOME WE CAN OUT OTHER WERE ALL THERE WHEN UP USE YOUR HOW SAID AN EACH SHE WHICH DO THEIR TIME IF WILL WAY ABOUT MANY THEN THEM WRITE WOULD LIKE SO THESE HER LONG MAKE THING SEE HIM TWO HAS LOOK MORE DAY COULD GO COME DID NUMBER SOUND NO MOST PEOPLE MY OVER KNOW WATER THAN CALL FIRST WHO MAY DOWN SIDE BEEN NOW FIND THE PowerPoint Presentation: WORDCOUNT Dolch List: Dolch List 1st grade Dolch Sight Board: 1 st grade Dolch Sight Board PowerPoint Presentation: How Some Strategies.... STRATEGIES: STRATEGIES A Balanced Approach: A Balanced Approach Contextual Learning Explicit Instruction Pre / Re Assessment Strategies Taught Wide Reading Luposlipophobia: The fear of being pursued by timber wolves around a kitchen table while wearing socks on a newly waxed floor.: Luposlipophobia: The fear of being pursued by timber wolves around a kitchen table while wearing socks on a newly waxed floor. PowerPoint Presentation: Cognates Brother - Bruder INFORMAL ASSESSMENT: INFORMAL ASSESSMENT WORD MAPS / CARDS: WORD MAPS / CARDS FRAYER MODEL: FRAYER MODEL WORD WALLS: WORD WALLS COMPARING: COMPARING WORD WHEELS: WORD WHEELS LANGUAGE WHEELS: LANGUAGE WHEELS PowerPoint Presentation: Word Games OTHER STRATEGIES: OTHER STRATEGIES Self-Collection Word Journals Dictionaries Contextual redefinition Word Wizard Word Origins Affixes Idioms Pg. 211 - 220 Read Alouds TPR Technology (TTS) : Technology (TTS) Answer Tips: Answer Tips PowerPoint Presentation: The End Recommended Online Sites / Resources: Recommended Online Sites / Resources COLORIN COLORADO PAUL NATION / ROBERT WARING LEARNING ARCADE GAMES FOR LANGUAGE LEARNING HOT FOR WORDS BUZZ WORDS VOCABULARY RELATED RESOURCES BEEBO'S ZOO TARHEEL READER You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.


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I currently show a modal UIViewController in the formSheet style that was presented with the coverVertical animation. I am trying to present another modal UIViewController from it, using currentContext for the presentation style and flipHorizontal for the animation style. It does work, but there is a solid white white background behind the flip as it occurs. Any advice on how to successfully present another formsheet modal UIViewController using the flipHorizontal style from a pre-existing modal UIViewController in the formSheet style would be appreciated please! Thanks
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[self presentModalViewController:modal1VC animated:YES];
[modal1VC release];
modal1VC.view.superview.bounds = CGRectMake(0, 0, 400, 400);
// Loading of second modalVC in Modal1VC
- (void)buttonTapped:(id)sender {
UIViewController *modal2VC = [[UIViewController alloc] init];
modal2VC.modalTransitionStyle = UIModalTransitionStyleFlipHorizontal;
modal2VC.modalPresentationStyle = UIModalPresentationCurrentContext;
modal2VC.view.backgroundColor = [UIColor greenColor];
[self presentModalViewController:modal2VC animated:YES];
[modal2VC release];
modal2VC.view.superview.bounds = CGRectMake(0, 0, 400, 400);


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A Helicopter Mom Is Alienating My Kid's Sports Team
We're friends, but should I throw her in the penalty box?
Dear Friend or Foe,
Loyal, caring, and supportive, my friend "Lisa" has always been there for me. We have in common the fact that our middle schoolers participate in the same organized sport. Unfortunately, she ruins it for everyone else. Competitive and obsessed, she constantly and viciously criticizes the coaches (who are volunteers). She criticizes parents to other parents, and even belittled some of the children's abilities in front of them. She has publicly accused some of buying their way onto the team because, in her opinion, their kids aren't good enough to be playing on it.
Other parents wonder how I can even be friends with her. I don't try to defend Lisa's actions, but I defend how great a friend she is to me. Mostly, I just try to stay out of those conversations or change the subject. Meanwhile, Lisa has gotten in the habit of using me as her sounding board. I've tried to get her to see other points of view, but she's so opinionated that she just ignores me. She doesn't seem to realize that she'll be involved with these families for years to come—or how negatively they view her. She also can't see that, at this age, it's supposed to be good, competitive fun. Nor does the sport have any big league options for which to strive.
Just recently, the situation reached a boiling point: Lisa may be formally sanctioned for her behavior. I'm not sure how to handle this. If I'm brutally honest with her, I fear she'll shoot the messenger. I'd also like to be there for her, just as she has been there for me. At the same time, I feel as if she deserves what's coming. How do I get myself out of the middle without losing the friendship?
It's Just a Team Sport!
Dear IJATS!,
Sometimes, it's the kids themselves who do the best job of controlling the helicopter moms (and dads). Not long ago, at my niece's soccer game in Virginia, a child on the field was heard to yell, "MOM—SHUT UP!!" in response to her overheated mother's inability to stop screaming "Kick it, Taylor!!" Meanwhile at my nephew's Little League game, a Dad-coach got so upset over a call that the teenage referee ordered him back to his car to "cool down." But there are things that the grown-ups can do to help, too. Lisa has been a good friend to you. If you want to be a good friend to her, sit her down and, in the nicest possible way, tell her she needs to a) take a step backward and b) get a grip. Rather than make it about the other parents (hearing they hate her will only further convince her that they're idiots), tell her that, in becoming obsessed, she's hurting her own kid's chances of thriving on the team.
Remind Lisa that, at this age, team sports are not just about individual achievement; they're about learning to work together as a group. Just as you told me, they're also supposed to be about having fun! If she gets defensive and tries to throw the charges back in your face, give her a chance to think it over before you get back in touch. If she finally admits to having gotten a wee bit over-involved, encourage her to make amends. She can start by skipping a few games. As for dropping you as a friend, I somehow doubt she'll do that. Given her personality, I'd guess that you're one of few who Lisa has right now. In short, she likely needs your friendship every bit as much as you've come to rely on hers.
Friend or Foe
Dear Friend or Foe,
When my roommate, "Jessica," and I started our current lease, she and her boyfriend, "James," of over two years had just broken up. She was upset about it, but agreed it was for the best, as he had a lot of growing up to do. A few months later, they were suddenly dating again. He lived a few states away, so she started visiting him. A couple of times, he came down to visit us. It was awkward, not only because the first time I met him was right after I walked in on the two of them having sex in the living room!, but because I'd spent four months listening to how awful he'd been.
He moved to our city last month with no job or apartment or savings lined up and has been staying with us for the past three-and-a-half weeks. We live in a one-bedroom-plus-den apartment. The den is an extension of the living room—and it serves as Jessica's room, too. When he first came to stay, I had few negative feelings toward him. But after several days of having him around all the time, I started to loathe the guy. I find him immature and obnoxious. I want to keep living with Jessica, but I don't know how long I can handle it with him around. How do I tell my roommate that I can't stand her boyfriend?
Stressed from Hiding My True Feelings


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New lower price for Axon II ($78) and Axon Mote ($58).
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is a small air pump an option?
the thing is the robot can't be wider than that box so i'd have to have some sort of release mechanism for that to work.


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Allergy is a serious and apparently increasing public health problem yet relatively little is known about the types of allergy seen in routine tertiary practice, including their spatial distribution, co-occurrence or referral patterns. This study reviewed referrals over an eleven year period to a regional allergy clinic that had a well defined geographical boundary. For those patients confirmed as having an allergy we explored: (i) differences over time and by demographics, (ii) types of allergy, (iii) co-occurrence, and (iv) spatial distributions.
Data were extracted from consultant letters to GPs, from September 1998 to September 2009, for patients confirmed as having an allergy. Other data included referral statistics and population data by postcode. Simple descriptive analysis was used to describe types of allergy. We calculated 11 year standardised morbidity ratios for postcode districts and checked for spatial clustering. We present maps showing 11 year rates by postcode, and 'difference' maps which try to separate referral effect from possible environmental effect.
Of 5778 referrals, 961 patients were diagnosed with an allergy. These were referred by a total of 672 different GPs. There were marked differences in referral patterns between GP practices and also individual GPs. The mean age of patients was 35 and there were considerably more females (65%) than males. Airborne allergies were the most frequent (623), and there were very high rates of co-occurrence of pollen, house dust mite, and animal hair allergies. Less than half (410) patients had a food allergy, with nuts, fruit, and seafood being the most common allergens. Fifteen percent (142) had both a food and a non-food allergy. Certain food allergies were more likely to co-occur, for example, patients allergic to dairy products were more likely to be allergic to egg.
There were age differences by types of allergy; people referred with food allergies were on average 5 years younger than those with other allergies, and those allergic to nuts were much younger (26 Vs 38) than those with other food allergies.
There was clear evidence for spatial clustering with marked clustering around the referral hospital. However, the geographical distribution varied between allergies; airborne (particularly pollen allergies) clustered in North Dartmoor and Exmoor, food allergies (particularly nut allergies) in the South Hams, and on small numbers, some indication of seafood allergy in the far south west of Cornwall and in the Padstow area.
This study shows marked geographical differences in allergy referrals which are likely to reflect a combination of environmental factors and GP referral patterns. The data suggest that GPs may benefit from education and ongoing decision support and be supported by public education on the nature of allergy. It suggests further research into what happens to patients with allergy where there has been low use of tertiary services and further research into cross-reactivity and co-occurrence, and spatial distribution of allergy.
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Occupational seafood allergy: a review
Jeebhay, M
Robins, T
Lehrer, S
Lopata, A
Occupational and Environmental Medicine
BACKGROUND—Recent years have seen increased levels of production and consumption of seafood, leading to more frequent reporting of allergic reactions in occupational and domestic settings. This review focuses on occupational allergy in the fishing and seafood processing industry. REVIEW—Workers involved in either manual or automated processing of crabs, prawns, mussels, fish, and fishmeal production are commonly exposed to various constituents of seafood. Aerosolisation of seafood and cooking fluid during processing are potential occupational situations that could result in sensitisation through inhalation. There is great variability of aerosol exposure within and among various jobs with reported allergen concentrations ranging from 0.001 to 5.061(µg/m3). Occupational dermal exposure occurs as a result of unprotected handling of seafood and its byproducts. Occupational allergies have been reported in workers exposed to arthropods (crustaceans), molluscs, pisces (bony fish) and other agents derived from seafood. The prevalence of occupational asthma ranges from 7% to 36%, and for occupational protein contact dermatitis, from 3% to 11%. These health outcomes are mainly due to high molecular weight proteins in seafood causing an IgE mediated response. Cross reactivity between various species within a major seafood grouping also occurs. Limited evidence from dose-response relations indicate that development of symptoms is related to duration or intensity of exposure. The evidence for atopy as a risk factor for occupational sensitisation and asthma is supportive, whereas evidence for cigarette smoking is limited. Disruption of the intact skin barrier seems to be an important added risk factor for occupational protein contact dermatitis. CONCLUSION—The range of allergic disease associated with occupational exposure to crab is well characterised, whereas for other seafood agents the evidence is somewhat limited. There is a need for further epidemiological studies to better characterise this risk. More detailed characterisation of specific protein antigens in aerosols and associated establishment of dose-response relations for acute and chronic exposure to seafood; the respective roles of skin contact and inhalational exposure in allergic sensitisation and cross reactivity; and the contribution of host associated factors in the development of occupational seafood allergies are important areas for future research. Keywords: occupational seafood allergy; occupational asthma; protein contact dermatitis
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Active or Passive Exposure to Tobacco Smoking and Allergic Rhinitis, Allergic Dermatitis, and Food Allergy in Adults and Children: A Systematic Review and Meta-Analysis
Saulyte, Jurgita
Regueira, Carlos
Montes-Martínez, Agustín
Khudyakov, Polyna
Takkouche, Bahi
PLoS Medicine
In a systematic review and meta-analysis, Bahi Takkouche and colleagues examine the associations between exposure to tobacco smoke and allergic disorders in children and adults.
Please see later in the article for the Editors' Summary
Allergic rhinitis, allergic dermatitis, and food allergy are extremely common diseases, especially among children, and are frequently associated to each other and to asthma. Smoking is a potential risk factor for these conditions, but so far, results from individual studies have been conflicting. The objective of this study was to examine the evidence for an association between active smoking (AS) or passive exposure to secondhand smoke and allergic conditions.
Methods and Findings
We retrieved studies published in any language up to June 30th, 2013 by systematically searching Medline, Embase, the five regional bibliographic databases of the World Health Organization, and ISI-Proceedings databases, by manually examining the references of the original articles and reviews retrieved, and by establishing personal contact with clinical researchers. We included cohort, case-control, and cross-sectional studies reporting odds ratio (OR) or relative risk (RR) estimates and confidence intervals of smoking and allergic conditions, first among the general population and then among children.
We retrieved 97 studies on allergic rhinitis, 91 on allergic dermatitis, and eight on food allergy published in 139 different articles. When all studies were analyzed together (showing random effects model results and pooled ORs expressed as RR), allergic rhinitis was not associated with active smoking (pooled RR, 1.02 [95% CI 0.92–1.15]), but was associated with passive smoking (pooled RR 1.10 [95% CI 1.06–1.15]). Allergic dermatitis was associated with both active (pooled RR, 1.21 [95% CI 1.14–1.29]) and passive smoking (pooled RR, 1.07 [95% CI 1.03–1.12]). In children and adolescent, allergic rhinitis was associated with active (pooled RR, 1.40 (95% CI 1.24–1.59) and passive smoking (pooled RR, 1.09 [95% CI 1.04–1.14]). Allergic dermatitis was associated with active (pooled RR, 1.36 [95% CI 1.17–1.46]) and passive smoking (pooled RR, 1.06 [95% CI 1.01–1.11]). Food allergy was associated with SHS (1.43 [1.12–1.83]) when cohort studies only were examined, but not when all studies were combined.
The findings are limited by the potential for confounding and bias given that most of the individual studies used a cross-sectional design. Furthermore, the studies showed a high degree of heterogeneity and the exposure and outcome measures were assessed by self-report, which may increase the potential for misclassification.
We observed very modest associations between smoking and some allergic diseases among adults. Among children and adolescents, both active and passive exposure to SHS were associated with a modest increased risk for allergic diseases, and passive smoking was associated with an increased risk for food allergy. Additional studies with detailed measurement of exposure and better case definition are needed to further explore the role of smoking in allergic diseases.
Please see later in the article for the Editors' Summary
Editors' Summary
The immune system protects the human body from viruses, bacteria, and other pathogens. Whenever a pathogen enters the body, immune system cells called T lymphocytes recognize specific molecules on its surface and release chemical messengers that recruit and activate other types of immune cells, which then attack the pathogen. Sometimes, however, the immune system responds to harmless materials (for example, pollen; scientists call these materials allergens) and triggers an allergic disease such as allergic rhinitis (inflammation of the inside of the nose; hay fever is a type of allergic rhinitis), allergic dermatitis (also known as eczema, a disease characterized by dry, itchy patches on the skin), and food allergy. Recent studies suggest that all these allergic (atopic) diseases are part of a continuous state called the "atopic march" in which individuals develop allergic diseases in a specific sequence that starts with allergic dermatitis during infancy, and progresses to food allergy, allergic rhinitis, and finally asthma (inflammation of the airways).
Why Was This Study Done?
Allergic diseases are extremely common, particularly in children. Allergic rhinitis alone affects 10%–30% of the world's population and up to 40% of children in some countries. Moreover, allergic diseases are becoming increasingly common. Allergic diseases affect the quality of life of patients and are financially costly to both patients and health systems. It is important, therefore, to identify the factors that cause or potentiate their development. One potential risk factor for allergic diseases is active or passive exposure to tobacco smoke. In some countries up to 80% of children are exposed to second-hand smoke so, from a public health point of view, it would be useful to know whether exposure to tobacco smoke is associated with the development of allergic diseases. Here, the researchers undertake a systematic review (a study that uses predefined criteria to identify all the research on a given topic) and a meta-analysis (a statistical approach for combining the results of several studies) to investigate this issue.
What Did the Researchers Do and Find?
The researchers identified 196 observational studies (investigations that observe outcomes in populations without trying to affect these outcomes in any way) that examined the association between smoke exposure and allergic rhinitis, allergic dermatitis, or food allergy. When all studies were analyzed together, allergic rhinitis was not associated with active smoking but was slightly associated with exposure to second-hand smoke. Specifically, compared to people not exposed to second-hand smoke, the pooled relative risk (RR) of allergic rhinitis among people exposed to second-hand smoke was 1.10 (an RR of greater than 1 indicates an increased risk of disease development in an exposed population compared to an unexposed population). Allergic dermatitis was associated with both active smoking (RR = 1.21) and exposure to second-hand smoke (RR = 1.07). In the populations of children and adolescents included in the studies, allergic rhinitis was associated with both active smoking and exposure to second-hand smoke (RRs of 1.40 and 1.09, respectively), as was allergic dermatitis (RRs of 1.36 and 1.06, respectively). Finally food allergy was associated with exposure to second-hand smoke (RR = 1.43) when cohort studies (a specific type of observational study) only were examined but not when all the studies were combined.
What Do These Findings Mean?
These findings provide limited evidence for a weak association between smoke exposure and allergic disease in adults but suggest that both active and passive smoking are associated with a modestly increased risk of allergic diseases in children and adolescents. The accuracy of these findings may be affected by the use of questionnaires to assess smoke exposure and allergic disease development in most of the studies in the meta-analysis and by the possibility that individuals exposed to smoke may have shared other characteristics that were actually responsible for their increased risk of allergic diseases. To shed more light on the role of smoking in allergic diseases, additional studies are needed that accurately measure exposure and outcomes. However, the present findings suggest that, in countries where many people smoke, 14% and 13% of allergic rhinitis and allergic dermatitis, respectively, among children may be attributable to active smoking. Thus, the elimination of active smoking among children and adolescents could prevent one in seven cases of allergic rhinitis and one in eight cases of allergic dermatitis in such countries.
Additional Information
Please access these websites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.1001611.
The UK National Health Service Choices website provides information about allergic rhinitis, hay fever (including personal stories), allergic dermatitis (including personal stories), and food allergy (including personal stories)
The US National Institute of Allergy and Infectious Disease provides information about allergic diseases
The UK not-for-profit organization Allergy UK provides information about all aspects of allergic diseases and a description of the atopic march
MedlinePlus encyclopedia has pages on allergic rhinitis and allergic dermatitis (in English and Spanish)
MedlinePlus provides links to further resources about allergies, eczema, and food allergy (in English and Spanish)
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Prevalence and characteristics of reported penicillin allergy in an urban outpatient adult population
Albin, Stephanie
Agarwal, Shradha
Allergy and Asthma Proceedings
Penicillin allergy remains the most common drug allergy, with a reported prevalence of 10% in the United States. Epidemiology of penicillin allergy in outpatient populations is relatively scarce. This study sought to determine the prevalence and characteristics of reported penicillin allergy in an urban outpatient population and to identify trends in clinical evaluation and management from a tertiary center serving a large inner-city population. A retrospective review of electronic medical records was performed of adult patients seen in the Internal Medicine Associates Clinic of Mount Sinai Hospital between January 31, 2012, and July 31, 2012. Medical records were selected based on the documentation of penicillin in patient's allergy section. Of the 11,761 patients seen in the clinic, 1348 patients (11.5%) reported a history of penicillin allergy. The most common allergic reactions were rash (37%), unknown/undocumented (20.2%), hives (18.9%), swelling/angioedema (11.8%), and anaphylaxis (6.8%). There was an increased prevalence of penicillin allergy in female patients compared with male patients (odds ratio [OR] = 1.82; 95% CI = 1.60, 2.08; p < 0.0001), and there were significantly fewer Asians with penicillin allergy compared with Caucasians (OR = 0.51; 95% CI = 0.32, 0.83; p = 0.007). However, only 78 (6%) of the patients reporting penicillin allergy had a referral to an allergy specialist. Overall, improved referral to an allergist will help to identify patients who have penicillin allergy requiring avoidance.
Adverse drug reactions; anaphylaxis; drug allergy; electronic medical record; epidemiology; outpatient; penicillin
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Seafood consumption among pregnant and non-pregnant women of childbearing age in the United States, NHANES 1999–2006
Razzaghi, Hilda
Tinker, Sarah C.
Food & Nutrition Research
Long-chain polyunsaturated fatty acids found in seafood are essential for optimal neurodevelopment of the fetus. However, concerns about mercury contamination of seafood and its potential harm to the developing fetus have created uncertainty about seafood consumption for pregnant women. We compared fish and shellfish consumption patterns, as well as their predictors, among pregnant and non-pregnant women of childbearing age in the US.
Data from 1,260 pregnant and 5,848 non-pregnant women aged 16–49 years from the 1999 to 2006 National Health and Nutrition Examination Survey (NHANES) were analyzed. Frequency and type of seafood consumed and adjusted associations of multiple characteristics with seafood consumption were estimated for pregnant and non-pregnant women, separately. Time trends were also examined.
There were no significant differences in the prevalence of fish or shellfish consumption, separately or combined, between pregnant and non-pregnant women using either the 30-day questionnaire or the Day 1, 24-h recall. Seafood consumption was associated with higher age, income, and education among pregnant and non-pregnant women, and among fish consumers these groups were more likely to consume ≥3 servings in the past 30 days. Tuna and shrimp were the most frequently reported fish and shellfish, respectively, among both pregnant and non-pregnant women. We observed no significant time trends.
There were no differences in seafood consumption between pregnant and non-pregnant women, and the factors related to seafood consumption were similar for both groups. Our data suggest that many women consume less than the recommended two servings of seafood a week.
pregnant; fish; seafood; NHANES; mercury
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Food allergies in developing and emerging economies: need for comprehensive data on prevalence rates
Boye, Joyce Irene
Clinical and Translational Allergy
Although much is known today about the prevalence of food allergy in the developed world, there are serious knowledge gaps about the prevalence rates of food allergy in developing countries. Food allergy affects up to 6% of children and 4% of adults. Symptoms include urticaria, gastrointestinal distress, failure to thrive, anaphylaxis and even death. There are over 170 foods known to provoke allergic reactions. Of these, the most common foods responsible for inducing 90% of reported allergic reactions are peanuts, milk, eggs, wheat, nuts (e.g., hazelnuts, walnuts, almonds, cashews, pecans, etc.), soybeans, fish, crustaceans and shellfish. Current assumptions are that prevalence rates are lower in developing countries and emerging economies such as China, Brazil and India which raises questions about potential health impacts should the assumptions not be supported by evidence. As the health and social burden of food allergy can be significant, national and international efforts focusing on food security, food safety, food quality and dietary diversity need to pay special attention to the role of food allergy in order to avoid marginalization of sub-populations in the community. More importantly, as the major food sources used in international food aid programs are frequently priority allergens (e.g., peanut, milk, eggs, soybean, fish, wheat), and due to the similarities between food allergy and some malnutrition symptoms, it will be increasingly important to understand and assess the interplay between food allergy and nutrition in order to protect and identify appropriate sources of foods for sensitized sub-populations especially in economically disadvantaged countries and communities.
Food allergy; Food hypersensitivity; Nutrition; Developing countries
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Shellfish allergy and relation to iodinated contrast media: United Kingdom survey
Baig, Mudassar
Farag, Ahmad
Sajid, Jamal
Potluri, Rahul
Irwin, R Bruce
Khalid, Hafiz Mohammed Idrees
World Journal of Cardiology
AIM: To assess current practice of United Kingdom cardiologists with respect to patients with reported shellfish/iodine allergy, and in particular the use of iodinated contrast for elective coronary angiography. Moreover we have reviewed the current evidence-base and guidelines available in this area.
METHODS: A questionnaire survey was send to 500 senior United Kingdom cardiologists (almost 50% cardiologists registered with British Cardiovascular Society) using email and first 100 responses used to analyze practise. We involved cardiologists performing coronary angiograms routinely both at secondary and tertiary centres. Three specific questions relating to allergy were asked: (1) History of shellfish/iodine allergy in pre-angiography assessment; (2) Treatments offered for shellfish/iodine allergy individuals; and (3) Any specific treatment protocol for shellfish/iodine allergy cases. We aimed to establish routine practice in United Kingdom for patients undergoing elective coronary angiography. We also performed comprehensive PubMed search for the available evidence of relationship between shellfish/iodine allergy and contrast media.
RESULTS: A total of 100 responses were received, representing 20% of all United Kingdom cardiologists. Ninety-three replies were received from consultant cardiologists, 4 from non-consultant grades and 3 from cardiology specialist nurses. Amongst the respondents, 66% routinely asked about a previous history of shellfish/iodine allergy. Fifty-six percent would pre-treat these patients with steroids and anti-histamines. The other 44% do nothing, or do nonspecific testing based on their personal experience as following: (1) Skin test with 1 mL of subcutaneous contrast before intravenous contrast; (2) Test dose 2 mL contrast before coronary injection; (3) Close observation for shellfish allergy patients; and (4) Minimal evidence that the steroid and anti-histamine regime is effective but it makes us feel better.
CONCLUSION: There is no evidence that allergy to shellfish alters the risk of reaction to intravenous contrast more than any other allergy and asking about such allergies in pre-angiogram assessment will not provide any additional information except propagating the myth.
Shellfish allergy; Contrast allergy; Iodinated contrast allergy; Low osmolarity contrast media; High osmolarity contrast media; Pre-angiography assessment
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IgE mediated food allergy in Korean children: focused on plant food allergy
Lee, Soo-Young
Asia Pacific Allergy
Food allergy (FA) is a worldwide problem, with increasing prevalence in many countries, and it poses a clearly increasing health problem in Korea. In Korea, as a part of International Study of Asthma and Allergy in Childhood (ISAAC), a series of nation-wide population studies for prevalence of allergic disease in children were carried out, with the Korean version of ISAAC in 1995, 2000, and 2010. From the survey, the twelve-month prevalence of FA showed no significant differences from 1995 to 2000 in both age groups (6-12 years-old, 6.5% in 1995 and 5.7% in 2000; 12-15 year-olds, 7.4% in 1995 and 8.6% in 2000). The mean lifetime prevalence of FA which had ever been diagnosed by medical doctor was 4.7% in 6-12 year-olds and 5.1% in 12-15 year-olds respectively in 2000. In Korean children, the major causes of FA are almost same as in other countries, although the order prevalence may vary, a prime example of which being that peanut and tree nut allergies are not prevalent, as in western countries. Both pediatric emergency department (ED) visits and deaths relating to food induced anaphylaxis have also increased in western countries. From a study which based on data from the Korean Health Insurance Review and Assessment Service (KHIRA) from 2001 to 2007, the incidence of anaphylaxis under the age of 19 was 0.7-1 per 100,000 person-year, and foods (24.9%) were the most commonly identified cause of childhood anaphylaxis. In another epidemiologic study, involving 78889 patients aged 0-18 years who visited the EDs of 9 hospitals during June 2008 to Mar 2009, the incidence of food related anaphylaxis was 4.56 per 10,000 pediatric ED visits. From these studies, common causes of food related anaphylaxis were seafood, buckwheat, cow's milk, fruits, peanut and tree nuts. Although systematic epidemiologic studies have not reported on the matter, recently, plant foods related allergy has increased in Korean children. Among 804 children with moderate to severe atopic dermatitis, we reveals that the peanut sensitization rate in Korea reaches 18%, and that, when sensitized to peanut, patients showed a significant tendency to have co-sensitization with house dust mites, egg white, wheat, and soybean. The higher specific IgE to peanut was related to the likelihood of the patient developing severe systemic reactions. In another study, based on the data analysis of 69 patients under 4 years of age who had suspected peanut and tree nut allergy, 22 (31.9%) were sensitized to walnut (>0.35 kU/L, 0.45-27.4 kU/L) and 6 (8.7%) experienced anaphylaxis due to a small amount of walnut exposure. Furthermore, in this review, clinical and immunological studies on plant food allergies, such as buckwheat allergy, rice allergy, barley allergy, and kiwi fruit allergy, in Korean children are discussed.
Food allergy; Korean children; Anaphylaxis; Plant food allergy
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Season of Birth is Associated with Food Allergy in Children
Vassallo, Milo F
Banerji, Aleena
Rudders, Susan A
Clark, Sunday
Mullins, Raymond J
Camargo, Carlos A
Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
The prevalence of food allergy is rising and etiologic factors remain uncertain. Evidence implicates a role of vitamin D in the development of atopic diseases. Based on seasonal patterns of UVB exposure (and consequent vitamin D status), we hypothesized that food allergy patients are more often born in fall or winter.
Investigate whether season of birth is associated with food allergy.
We performed a multicenter chart review of all patients presenting to three Boston emergency departments (EDs) for food-related acute allergic reactions between 1/1/01 and 12/31/06. Months of birth among food allergy patients were compared to those of patients visiting the ED for reasons other than food allergy.
We studied 1,002 food allergy patients. Among younger children with food allergy (age <5 years) – but not among older children or adults – 41% were born in spring/summer compared to 59% in fall/winter (P=0.002). This approximately 40/60 ratio differed from birth season of children treated in the ED for non-food allergy reasons (P=0.002). Children <5 years old born in fall/winter had a 53% higher odds of food allergy compared to controls. This finding was independent of the suspected triggering food and allergic comorbidities.
Food allergy is more common in Boston children who were born in the fall and winter seasons. We propose that these findings are mediated by seasonal differences in UVB exposure. These results add support to the hypothesis that seasonal fluctuations in sunlight and perhaps vitamin D may be involved in the pathogenesis of food allergy.
Food allergy; season of birth; epidemiology; UVB; vitamin D
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Maternal fish and shellfish consumption and wheeze, eczema and food allergy at age two: a prospective cohort study in Brittany, France
Pelé, Fabienne
Bajeux, Emma
Gendron, Hélène
Monfort, Christine
Rouget, Florence
Multigner, Luc
Viel, Jean-François
Cordier, Sylvaine
Environmental Health
Environmental exposures, including dietary contaminants, may influence the developing immune system. This study assesses the association between maternal pre-parturition consumption of seafood and wheeze, eczema, and food allergy in preschool children. Fish and shellfish were studied separately as they differ according to their levels of omega-3 polyunsaturated fatty acids (which have anti-allergic properties) and their levels of contaminants.
The PELAGIE cohort included 3421 women recruited at the beginning of pregnancy. Maternal fish and shellfish intake was measured at inclusion by a food frequency questionnaire. Wheeze, eczema, and food allergy were evaluated by a questionnaire completed by the mother when the child was 2 years old (n = 1500). Examination of the associations between seafood intake and outcomes took major confounders into account. Complementary sensitivity analyses with multiple imputation enabled us to handle missing data, due mostly to attrition.
Moderate maternal pre-parturition fish intake (1 to 4 times a month) was, at borderline significance, associated with a lower risk of wheeze (adjusted OR = 0.69 (0.45-1.05)) before age 2, compared with low intake (< once/month). This result was not, however, consistent: after multiple imputation, the adjusted OR was 0.86 (0.63-1.17). Shellfish intake at least once a month was associated with a higher risk of food allergy before age 2 (adjusted OR = 1.62 (1.11-2.37)) compared to low or no intake (< once/month). Multiple imputation confirmed this association (adjusted OR = 1.52 (1.05-2.21)).
This study suggests that maternal pre-parturition shellfish consumption may increase the risk of food allergy. Further large-scale epidemiologic studies are needed to corroborate these results, identify the contaminants or components of shellfish responsible for the effects observed, determine the persistence of the associations seen at age 2, and investigate potential associations with health effects observable at later ages, such as allergic asthma.
Fish intake; Shellfish intake; Pregnancy; Wheeze; Allergy; Children
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Identification and validation of shrimp-tropomyosin specific CD4 T cell epitopes
Ravkov, Eugene V.
Pavlov, Igor Y.
Martins, Thomas B.
Gleich, Gerald J.
Wagner, Lori A.
Hill, Harry R.
Delgado, Julio C.
Human immunology
Shellfish allergy is an immune-mediated adverse reaction to allergenic shellfish and is responsible for significant morbidity and mortality. CD4 T cell responses play an important role in the pathophysiological mechanisms of sensitization and in production of IgE.
We sought to identify and validate CD4 T cell shrimp tropomyosin-derived epitopes and characterize CD4 T cell responses in subjects with a clinical history of shellfish allergy.
Using an in vitro MHC-peptide binding assay, we screened 91 overlapping peptides and identified 28 epitopes with moderate and strong binding capacities; 3 additional peptides were included based on MHC binding prediction score. These peptides were then examined in proliferation and cytokine release assays with T cells from allergic subjects.
17 epitopes restricted to DRB*01:01, DRB1*03:01, DRB1*04:01, DRB1*09:01, DQB1*02:01, DQB1*03:02 and DQB1*05:01 alleles were identified and validated by both the MHC binding and the functional assays. Two peptides showed specificities to more than one MHC class II allele. We demonstrated that these peptides exert functional responses in an epitope specific manner, eliciting predominantly IL-6 and IL-13.
The identified epitopes are specific to common MHC class II alleles in the general population. Our study provides important data for the design of peptide-based immunotherapy of shrimp-allergic patients.
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Contamination by Vibrio parahaemolyticus and Its Virulent Strains in Seafood Marketed in Thailand, Vietnam, Malaysia, and Indonesia
Nakaguchi, Yoshitsugu
Tropical Medicine and Health
Infections by virulent strains of Vibrio parahaemolyticus are frequently reported in Southeast Asia. This is due to the frequent seafood contamination by virulent strains. In this study conducted from 2008 to 2011, seafood like fish, shrimp, squid, crab, and molluscan shellfish were purchased from provinces in Thailand and three Southeast Asian countries and examined for the prevalence of three genetic markers of V. parahaemolyticus (species-specific gene: toxR gene, virulence genes: tdh and trh genes). An enrichment culture of seafood was examined for these markers using PCR methods. Molluscan shellfish showed a high frequency of contamination in Thailand. The shellfish harvested from the Gulf of Thailand were significantly more contaminated with virulence genes than those from the Andaman Sea. The seafood purchased from three Southeast Asian countries was positive for the three markers of V. parahaemolytcus at differing frequencies. The virulence markers (tdh and trh markers) were frequently detected in molluscan shellfish from Vietnam (17.9 and 8.0%, respectively), Malaysia (11.1 and 16.7%), and Indonesia (9.1 and 13.6%). These data suggest that the molluscan shellfish sold in Southeast Asian markets are highly contaminated with virulent strains of V. parahaemolyticus.
Vibrio parahaemolyticus; Southeast Asia; seafood; molluscan shellfish
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The Clinical Characteristics of Anisakis Allergy in Korea
Choi, Sung-Jin
Lee, Jae-Chun
Kim, Moo-Jung
Hur, Gyu-Young
Shin, Seung-Youp
Park, Hae-Sim
The Korean Journal of Internal Medicine
Anisakidae larvae can cause anisakiasis when ingested by humans. Although several groups have reported a gastrointestinal Anisakis allergy among people in Spain and Japan, our report is the first to summarize the clinical features of 10 Anisakis allergy cases in Korea. We enrolled 10 Korean patients (6 men and 4 women) who complained of aggravated allergic symptoms after ingesting raw fish or seafood. Sensitization to Anisakis was confirmed by detecting serum specific IgE to Anisakis simplex. The most common manifestation of anisakiasis was urticaria (100%), followed by abdominal pain (30%) and anaphylaxis (30%). All patients presenting with these symptoms also exhibited high serum specific IgE (0.45 to 100 kU/L) to A. simplex. Nine patients (90%) exhibited atopy and increased total serum IgE levels. The fish species suspected of carrying the Anisakis parasite were flatfish (40%), congers (40%), squid (30%), whelk (10%), and tuna (10%). Anisakis simplex should be considered as a possible causative food allergen in adult patients presenting with urticaria, angioedema, and anaphylaxis following the consumption of raw fish or seafood.
Anisakis simplex; Fish; Food allergy
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Specific IgE to fish extracts does not predict allergy to specific species within an adult fish allergic population
Schulkes, Karlijn JG
Klemans, Rob JB
Knigge, Lidy
de Bruin-Weller, Marjolein
Bruijnzeel-Koomen, Carla AFM
Marknell deWitt, Åsa
Lidholm, Jonas
Knulst, André C
Clinical and Translational Allergy
Fish is an important cause of food allergy. Studies on fish allergy are scarce and in most cases limited to serological evaluation. Our objective was to study patterns of self-reported allergy and tolerance to different commonly consumed fish species and its correlation to IgE sensitization to the same species.
Thirty-eight adult fish allergic patients completed a questionnaire regarding atopy, age of onset and symptoms to 13 commonly consumed fish species in the Netherlands (pangasius, cod, herring, eel, hake, pollock, mackerel, tilapia, salmon, sardine, tuna, plaice and swordfish). Specific IgE to these fish extracts were analyzed by ImmunoCAP.
Median age of onset of fish allergy was 8.5 years. Severe reactions were reported by the majority of patients (n = 20 (53%) respiratory and of these 20 patients, 6 also had cardiovascular symptoms). After diagnosis, 66% of the patients had eliminated all fish from their diet. Allergy to all species ever tried was reported by 59%. In relation to species ever tried, cod (84%) and herring (79%) were the most frequently reported culprit species while hake (57%) and swordfish (55%) were the least frequent. A positive sIgE (value ≥ 0.35 kUA/L) to the culprit species ranged between 50% (swordfish) and 100% (hake). In tolerant patients, a negative sIgE (value < 0.35 kUA/L) ranged from 0% (hake, pollock and swordfish) to 75% (sardine). For cod, the agreement between sIgE test results and reported allergy or tolerance was 82% and 25%, respectively. Sensitization to cod parvalbumin (Gad c 1) was present in 77% of all patients.
Serological cross-reactivity between fish species is frequent, but in a significant proportion of patients, clinical relevance appears to be limited to only certain species. A well-taken history or food challenge is required for discrimination between allergy to the different fish species.
Fish allergy; Fish species; Food allergy; Sensitization; Specific IgE
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Muzzarelli, Riccardo A. A.
Marine Drugs
Due to the fact that some individuals are allergic to crustaceans, the presumed relationship between allergy and the presence of chitin in crustaceans has been investigated. In vivo, chitin is part of complex structures with other organic and inorganic compounds: in arthropods chitin is covalently linked to proteins and tanned by quinones, in fungi it is covalently linked to glucans, while in bacteria chitin is diversely combined according to Gram(+/−) classification. On the other hand, isolated, purified chitin is a plain polysaccharide that, at the nano level, presents itself as a highly associated structure, recently refined in terms of regularity, nature of bonds, crystallinity degree and unusual colloidal behavior. Chitins and modified chitins exert a number of beneficial actions, i.e., (i) they stimulate macrophages by interacting with receptors on the macrophage surface that mediate the internalization of chitin particles to be degraded by lysozyme and N-acetyl-β-glucosaminidase (such as Nod-like, Toll-like, lectin, Dectin-1, leukotriene 134 and mannose receptors); (ii) the macrophages produce cytokines and other compounds that confer non-specific host resistance against bacterial and viral infections, and anti-tumor activity; (iii) chitin is a strong Th1 adjuvant that up-regulates Th1 immunity induced by heat-killed Mycobacterium bovis, while down- regulating Th2 immunity induced by mycobacterial protein; (iv) direct intranasal application of chitin microparticles into the lung was also able to significantly down-regulate allergic response to Dermatophagoids pteronyssinus and Aspergillus fumigatus in a murine model of allergy; (v) chitin microparticles had a beneficial effect in preventing and treating histopathologic changes in the airways of asthmatic mice; (vi) authors support the fact that chitin depresses the development of adaptive type 2 allergic responses. Since the expression of chitinases, chitrotriosidase and chitinase-like proteins is greatly amplified during many infections and diseases, the common feature of chitinase-like proteins and chitinase activity in all organisms appears to be the biochemical defense of the host. Unfortunately, conceptual and methodological errors are present in certain recent articles dealing with chitin and allergy, i.e., (1) omitted consideration of mammalian chitinase and/or chitotriosidase secretion, accompanied by inactive chitinase-like proteins, as an ancestral defensive means against invasion, capable to prevent the insurgence of allergy; (2) omitted consideration of the fact that the mammalian organism recognizes more promptly the secreted water soluble chitinase produced by a pathogen, rather than the insoluble and well protected chitin within the pathogen itself; (3) superficial and incomplete reports and investigations on chitin as an allergen, without mentioning the potent allergen from crustacean flesh, tropomyosine; (4) limited perception of the importance of the chemical/biochemical characteristics of the isolated chitin or chitosan for the replication of experiments and optimization of results; and (5) lack of interdisciplinarity. There is quite a large body of knowledge today on the use of chitosans as biomaterials, and more specifically as drug carriers for a variety of applications: the delivery routes being the same as those adopted for the immunological studies. Said articles, that devote attention to the safety and biocompatibility aspects, never reported intolerance or allergy in individuals and animals, even when the quantities of chitosan used in single experiments were quite large. Therefore, it is concluded that crab, shrimp, prawn and lobster chitins, as well as chitosans of all grades, once purified, should not be considered as "crustacean derivatives", because the isolation procedures have removed proteins, fats and other contaminants to such an extent as to allow them to be classified as chemicals regardless of their origin.
chitin; chitosan; chitinase; chitinase-like proteins; immunology
Related Articles
Jeebhay, Mohamed F
Robins, Thomas G
Miller, Mary E
Bateman, Eric
Smuts, Marius
Baatjies, Roslynn
Lopata, Andreas L
American journal of industrial medicine
Fish processing is a common economic activity in Southern Africa. The aim of this study was to determine the prevalence and host determinants of allergic symptoms, allergic sensitization, bronchial hyper-responsiveness and asthma among workers processing saltwater fish.
A cross-sectional study was conducted on 594 currently employed workers in two processing plants involved in pilchard canning and fishmeal processing. A modified European Community Respiratory Health Survey (ECRHS) questionnaire was used. Skin prick tests (SPT) used extracts of common airborne allergens, fresh fish (pilchard, anchovy, maasbanker, mackerel, red eye) and fishmeal. Spirometry and methacholine challenge tests (tidal breathing method) used ATS guidelines.
Work-related ocular-nasal symptoms (26%) were more common than asthma symptoms (16%). The prevalence of atopy was 36%, while 7% were sensitized to fish species and 26% had NSBH (PC20 ≤ 8 mg/ml or ≥12% increase in FEV1 post bronchodilator). The prevalence of probable occupational asthma was 1.8% and fish allergic rhino-conjunctivitis 2.6%. Women were more likely to report work-related asthma symptoms (OR=1.94) and have NSBH (OR=3.09), while men were more likely to be sensitized to fish (OR=2.06) and have airway obstruction (OR=4.17). Atopy (OR=3.16) and current smoking (OR=2.37), but not habitual seafood consumption were associated with sensitization to fish.
Based on comparison with previous published studies, the prevalence of occupational asthma to salt water fish is lower than due to shellfish. The gendered distribution of work and exposures in fish processing operations together with atopy and cigarette smoking are important determinants of occupational allergy and asthma.
fish processing; occupational allergy; work-related asthma; atopy; smoking; gender
Related Articles
Intake of Seafood in the US Varies by Age, Income, and Education Level but Not by Race-Ethnicity
Jahns, Lisa
Raatz, Susan K.
Johnson, LuAnn K.
Kranz, Sibylle
Silverstein, Jeffrey T.
Picklo, Matthew J.
Current US federal dietary guidance recommends regular consumption of seafood (fish + shellfish) to promote health; however, little is known about how well Americans meet the guideline, particularly population subgroups that may be at risk for inadequate intake. The purposes of this study were to describe the prevalence of seafood consumption and, among consumers, the amounts of seafood eaten by sex, age group, income and education level, and race-ethnicity. Data from 15,407 adults aged 19+ participating in the 2005–2010 National Health and Nutrition Examination Surveys were analyzed using methods to account for sporadic intake of seafood. Over 80% of Americans reported consuming any seafood over the past 30 days, 74% reported consuming fish, and 54% reported eating shellfish. The percentages varied by socio-demographic group. Younger age and lower income and education levels were associated with lower odds of being a seafood consumer (p < 0.0001). Among those who reported eating seafood, the average amount eaten of any seafood was 158.2 ± 5.6 g/week. Among seafood consumers, women and individuals of lower age and education levels consumed less seafood. Approximately 80%–90% of seafood consumers did not meet seafood recommendations when needs were estimated by energy requirements. A great deal of work remains to move Americans toward seafood consumption at current recommended levels.
seafood intake; fish; shellfish
Related Articles
Hair Mercury Concentrations and Fish Consumption Patterns in Florida Residents
Schaefer, Adam M.
Jensen, Emily L.
Bossart, Gregory D.
Reif, John S.
International Journal of Environmental Research and Public Health
Mercury exposure through the consumption of fish and shellfish represents a significant public health concern in the United States. Recent research has demonstrated higher seafood consumption and subsequent increased risk of methylmercury exposure among subpopulations living in coastal areas. The identification of high concentrations of total mercury in blood and skin among resident Atlantic bottlenose dolphins (Tursiops truncatus) in the Indian River Lagoon (IRL), a coastal estuary in Florida, alerted us to a potential public health hazard in the contiguous human population. Therefore, we analyzed hair mercury concentrations of residents living along the IRL and ascertained their sources and patterns of seafood consumption. The total mean mercury concentration for 135 residents was 1.53 ± 1.89 µg/g. The concentration of hair mercury among males (2.02 ± 2.38 µg/g) was significantly higher than that for females (0.96 ± 0.74 µg/g) (p < 0.01). Log transformed hair mercury concentration was significantly associated with the frequency of total seafood consumption (p < 0.01). Individuals who reported consuming seafood once a day or more were 3.71 (95% CI 0.84–16.38) times more likely to have a total hair mercury concentration over 1.0 µg/g, which corresponds approximately to the U.S. EPA reference dose, compared to those who consumed seafood once a week or less. Hair mercury concentration was also significantly higher among individuals who obtained all or most of their seafood from local recreational sources (p < 0.01). The elevated human mercury concentrations mirror the elevated concentrations observed in resident dolphins in the same geographical region. The current study is one of the first to apply the concept of a sentinel animal to a contiguous human population.
mercury; dietary exposure; fish consumption; sentinel species; Florida; bottlenose dolphins
Related Articles
Not all shellfish "allergy" is allergy!
Woo, Chee K
Bahna, Sami L
Clinical and Translational Allergy
The popularity of shellfish has been increasing worldwide, with a consequent increase in adverse reactions that can be allergic or toxic. The approximate prevalence of shellfish allergy is estimated at 0.5-2.5% of the general population, depending on degree of consumption by age and geographic regions. The manifestations of shellfish allergy vary widely, but it tends to be more severe than most other food allergens.
Tropomyosin is the major allergen and is responsible for cross-reactivity between members of the shellfish family, particularly among the crustacea. Newly described allergens and subtle differences in the structures of tropomyosin between different species of shellfish could account for the discrepancy between in vitro cross-antigenicity and clinical cross-allergenicity. The diagnosis requires a thorough medical history supported by skin testing or measurement of specific IgE level, and confirmed by appropriate oral challenge testing unless the reaction was life-threatening.
Management of shellfish allergy is basically strict elimination, which in highly allergic subjects may include avoidance of touching or smelling and the availability of self-administered epinephrine. Specific immunotherapy is not currently available and requires the development of safe and effective protocols.
Related Articles
Nutritional Aspects in Diagnosis and Management of Food Hypersensitivity—The Dietitians Role
Venter, Carina
Laitinen, Kirsi
Vlieg-Boerstra, Berber
Journal of Allergy
Many common foods including cow's milk, hen's egg, soya, peanut, tree nuts, fish, shellfish, and wheat may cause food allergies. The prevalence of these immune-mediated adverse reactions to foods ranges from 0.5% to 9% in different populations. In simple terms, the cornerstone of managing food allergy is to avoid consumption of foods causing symptoms and to replace them with nutritionally equivalent foods. If poorly managed, food allergy impairs quality of life more than necessary, affects normal growth in children, and causes an additional economic burden to society. Delay in diagnosis may be a further incremental factor. Thus, an increased awareness of the appropriate procedures for both diagnosis and management is of importance. This paper sets out to present principles for taking an allergy-focused diet history as part of the diagnostic work-up of food allergy. A short overview of guidelines and principles for dietary management of food allergy is discussed focusing on the nutritional management of food allergies and the particular role of the dietitian in this process.
Related Articles
Egg baked in product open oral food challenges are safe in selected egg-allergic patients
Buelow, Becky J.
Lee, Carrie
Zafra, Heidi T.
Dasgupta, Mahua
Hoffmann, Ray G.
Vasudev, Monica
Allergy & Rhinology
Egg allergy is one of the most common food allergies in children. Most egg-allergic children are able to tolerate egg baked in product (EBP) and will likely outgrow his/her egg allergy. By introducing EBP in the diet of an egg-allergic child, diet can be expanded and family stress can be reduced. Recent evidence suggests that children who tolerate EBP and continue to consume it will have quicker resolution of egg allergy than those who strictly avoid EBP; therefore, we aimed to evaluate the egg-allergic children who underwent EBP oral food challenge (OFC) in our allergy clinic to help define any specific predictors to be used in predicting the outcome of such challenges. We performed a retrospective chart review and 43 egg-allergic patients underwent EBP OFC in our outpatient allergy office from January 2011 to December 2012 were excluded. Nine patients who did not have a prior history of symptomatic egg ingestion. Clinical characteristics and laboratory findings of the remaining 34 patients were all recorded and analyzed. Of the remaining 34 patients, 22 (64.7%) were boys. Average age of first reaction to egg was 12.90 months, with average age at EBP OFC of 71.32 months. The average of the most recent skin-prick test wheal size was 10.10 mm and serum-specific IgE to egg white was 3.21 kU/L. Twenty-eight of the 34 patients (82.4%) passed the EBP OFC. Of the six patients who failed, none required epinephrine. After analysis of all of the clinical characteristics and laboratory findings, no risk factors, such as skin-prick test wheal size, were identified to be associated with an increased risk of failing EBP OFC. EBP OFC is a valuable tool to assess tolerance. As seen in our group of patients, the majority of egg-allergic patients pass EBP OFC. Thus, OFC should be considered as a clinical tool to expand a patient's diet and to improve quality of life as early as possible. Because we were unable to determine any clinical or laboratory predictors helpful to select egg-allergic patients who are likely to pass EBP OFC, additional prospective studies are necessary to determine the ideal egg-allergic patient who is likely to pass EBP OFC.
Baked egg; baked egg oral food challenge; egg allergy; egg baked in product; egg baked in product oral food challenge; food allergy; oral food challenge; serum-specific IgE; skin-prick testing
Related Articles
Utility of penicillin allergy testing in patients presenting with a history of penicillin allergy
Sagar, Priyanka S
Katelaris, Constance H
Asia Pacific Allergy
Current statistics show that approximately 10% of patients claim to be allergic to penicillin yet only 10% of these have demonstrable allergy. The most appropriate and cost-effective antibiotics are sometimes withheld on the basis of patient history of drug allergy.
Investigation of IgE hypersensitivity and delayed hypersensitivity in patients with a history of penicillin allergy to a teaching hospital allergy clinic.
Patients underwent skin prick and intradermal testing (IDT) with major and minor penicillin determinants. Those with negative skin tests were administered a three-day oral challenge. Demographic and clinical details about the reactions were noted.
One hundred twenty eight patients underwent testing, of these, one hundred and ten had self-reported histories of penicillin allergy and eighteen were referred because of other antibiotic allergies. Seventeen patients with self-reported penicillin allergy had either positive skin tests or oral challenge results, corresponding to 15% of patients having proven allergy. None reacted on skin prick testing, four reacted to IDT, thirteen reacted to oral challenge (five immediate and eight delayed). Analysis of clinical histories showed that patients with a well-defined history of allergy and a history of anaphylaxis were more likely to have a positive test compared to patients with vague histories. Skin testing proved to be less sensitive than oral challenge.
A minority of patients presenting with a history of penicillin allergy have evidence of immune-mediated hypersensitivity (17/110, 15%) in this study. Of these, eight out of seventeen (47%) had delayed reactions, demonstrating the usefulness and discriminating power of objective testing, which must include three-day oral challenge. Discriminating factors for immune-mediated allergy from patient history were a clear description of the original reaction and a history of anaphylaxis. Negative allergy testing enables the use of penicillin as first-line treatment when necessary and this can significantly reduce costs of antibiotics.
Penicillin allergy; Skin prick testing; Oral challenge
Related Articles
Establishment of a seafood index to assess the seafood consumption in pregnant women
Markhus, Maria W.
Graff, Ingvild E.
Dahl, Lisbeth
Seldal, Camilla F.
Skotheim, Siv
Braarud, Hanne C.
Stormark, Kjell M.
Malde, Marian K.
Food & Nutrition Research
Seafood (fish and shellfish) is an excellent source of several essential nutrients for pregnant and lactating women. A short food frequency questionnaire (FFQ) that can be used to quantitatively estimate seafood consumption would be a valuable tool to assess seafood consumption in this group. Currently there is no such validated FFQ in Norway.
The objective of this study was to establish and validate a seafood index from a seafood FFQ against blood biomarkers (the omega-3 index, the omega-3 HUFA score, and serum 25OH vitamin D).
We assessed maternal seafood consumption during the 28th gestation week in healthy Norwegian women (n=54) with a seafood FFQ. A seafood index was developed to convert ordinal frequency data from the FFQ into numerical scale data. The following blood biomarkers were used as a validation method: omega-3 index, omega-3 HUFA score, and the serum 25OH vitamin D.
The reported frequency of seafood as dinner and as spread was strongly correlated with the estimated frequencies of seafood as dinner and as spread. This indicated that the seafood index is a valuable tool to aggregate reported frequencies from the seafood FFQ. The seafood index composed of the frequency of seafood consumption and intake of omega-3 supplements, termed the total seafood index, correlated positively with the omega-3 index, omega-3 HUFA score, and 25OH vitamin D.
We established and validated a seafood index from a seafood FFQ. The developed seafood index can be used when studying health effects of seafood consumption in large populations. This seafood FFQ captures seafood consumption and omega-3 supplement intake considerably well in a group of pregnant women.
seafood consumption; marine omega-3 fatty acids; 25OH vitamin D; FFQ; biomarkers; pregnancy
Related Articles
Food allergy knowledge, perception of food allergy labeling, and level of dietary practice: A comparison between children with and without food allergy experience
Choi, Yongmi
Ju, Seyoung
Chang, Hyeja
Nutrition Research and Practice
The prevalence of food allergies in Korean children aged 6 to 12 years increased from 10.9% in 1995 to 12.6% in 2012 according to nationwide population studies. Treatment for food allergies is avoidance of allergenic-related foods and epinephrine auto-injector (EPI) for accidental allergic reactions. This study compared knowledge and perception of food allergy labeling and dietary practices of students.
The study was conducted with the fourth to sixth grade students from an elementary school in Yongin. A total of 437 response rate (95%) questionnaires were collected and statistically analyzed.
The prevalence of food allergy among respondents was 19.7%, and the most common food allergy-related symptoms were urticaria, followed by itching, vomiting and nausea. Food allergens, other than 12 statutory food allergens, included cheese, cucumber, kiwi, melon, clam, green tea, walnut, grape, apricot and pineapple. Children with and without food allergy experience had a similar level of knowledge on food allergies. Children with food allergy experience thought that food allergy-related labeling on school menus was not clear or informative.
To understand food allergies and prevent allergic reactions to school foodservice among children, schools must provide more concrete and customized food allergy education.
Elementary students; food allergy; labeling; dietary practice
Related Articles
Association between cancer and contact allergy: a linkage study
Engkilde, Kaare
Thyssen, Jacob P
Menné, Torkil
Johansen, Jeanne D
BMJ Open
Contact allergy is a prevalent disorder. It is estimated that about 20% of the general population are allergic to one or more of the chemicals that constitute the European baseline patch test panel. While many studies have investigated associations between type I allergic disorders and cancer, few have looked into the association between cancer and contact allergy, a type IV allergy. By linking two clinical databases, the authors investigate the possible association between contact allergy and cancer.
Record linkage of two different registers was performed: (1) a tertiary hospital register of dermatitis patients patch tested for contact allergy and (2) a nationwide cancer register (the Danish Cancer Register). After linking the two registers, only cancer subtypes with 40 or more patients registered were included in the analysis. The final associations were evaluated by logistic regression analysis.
An inverse association between contact allergy and non-melanoma skin- and breast cancer, respectively, was identified in both sexes, and an inverse trend for brain cancer was found in women with contact allergy. Additionally, a positive association between contact allergy and bladder cancer was found.
The inverse associations support the immunosurveillance hypothesis (ie, individuals with an allergy are less likely to get cancer due to a triggered immune system), while the positive association with bladder cancer could be due to accumulations of chemical metabolites in the bladder. The authors' findings add to the limited knowledge about contact allergy and the risk of cancer.
Article summary
Article focus
Cancer and allergy have previously been shown to be associated. The associations are mostly inverse, adding weight to the theory that enhanced tumour immunosurveillance is present in allergic individuals.
The epidemiological studies showing these findings were predominantly on type I allergy; the present study investigated the association between type IV allergy and cancer.
Key messages
An association seemingly exists between contact allergy and cancer. In light of previous findings of an association between bladder cancer and hair-dye use, the association between bladder cancer and contact allergy we found is interesting.
Strengths and limitations of this study
This is a novel study investigating cancer and its possible association with a type IV allergy. The analysis was possible due to large, validated patient registers.
As this is not a prospective cohort study, it lacks the ability to prove causation.
Related Articles
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Morfoulas Studios
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Aloha Tournaments
The Famous Autumn Classic Lacrosse Tournament
November 14-15, 2015
All Aloha Tournament events are smoke free, pet free and alcohol free events. No grills, air horns or noisemakers are allowed at any venue. Thank you for respecting our fans and players!
The Famous Autumn Classic Lacrosse Tournament is a tournament for Boys Middle School and Boys High School lacrosse teams. Games will be played at Cedar Lane Park in Bel Air, Maryland.
The weekend will consist of two 1-day tournaments. Middle School "A" teams will play on Saturday, November 14th. Middle School "AA" and HS teams will play on Sunday, November 15th. The middle school divisions will play a Championship format - 3 games with a playoff to determine a Champion. Awards will be given to the Champions of each Middle School division. The high school divisions will play a 3 game, round robin tournament with no playoffs.
Saturday, November 14th - Middle School "A" Teams (2020, 2021, 2022, and 2023)
Sunday, November 15th - Middle School "AA" Teams (2020, 2021, 2022, and 2023) and HS Teams (2017, 2018, and 2019)
Aloha Tournaments is pleased to be working in conjunction with Ryan McClernan and B'more Lax Company on the Famous Autumn Classic Lacrosse Tournament. Feel free to contact us at email@example.com or Ryan at firstname.lastname@example.com
Registration Fee:
Middle School: $1,000 or $900 if paid prior to September
High School: $1,200 or $1100 if paid prior to September
Registration is currently underway. This year's tournament will be one of the largest and most competitive middle school and high school lacrosse tournaments in the region. Space in the tournament is limited and registrations will be accepted on a first come basis.
A $400.00 nonrefundable deposit will hold a team's spot in the tournament until October 1, 2015 at which time nonrefundable full payment is due.
Click HERE to download a Registration Form.
By submitting a registration form for a team each coach acknowledges that he/she has read, understands and will adhere to the rules of play and eligibility requirements.
Click HERE to be directed to The Famous Autumn Classic Rules page.
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All parents/players should complete a Waiver of Liability/Medical Release Form. These should be turned in at the Registration Desk, as a team, prior to the team's first game.
Click HERE to download a Waiver of Liability/Medical Release Form.
All teams need to submit a complete team roster by November 1, 2015. These rosters can be emailed, in EXCEL format only, to firstname.lastname@example.com. Rosters should include player's uniform #, name, complete address, DOB, school, graduation year, phone # and parent's email address. Rosters for High School teams submitted on our Roster Form will be compiled into one, easy to use, spreadsheet and supplied to all college coaches.
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The Famous Autumn Classic Lacrosse Tournament has gone mobile. Get all the current news, schedules, scores, links to our favorite sites and valuable coupons. Pull up www.autumnclassiclax.mobi on your mobile device or scan the QR code below.


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May 5, 2016
Forty teens serve as messengers and pages at the Capitol for a week for each of the nine weeks in the legislative session. They are easily recognizable in their blue blazers.
Mark Foley's name has never come up in conjunction with the messengers or pages. Unlike Washington, these kids are strictly supervised.
Towsen Fraser, House Spokesman, said, "The older kids do go out throughout the building, but they check in, they check out. We make sure we know where they are at all times. [I'm] not saying it couldn't happen here. I'm saying that we try and do the best we can to make sure we monitor the kids and keep 'em safe."
Senate employees remember the former senator for throwing an end of the session party for staffers and little else. The latest scandal has prompted a review of how the page and messenger program is run.
Even Gov. Jeb Bush says it is prudent to take another look at the program.
Gov. Jeb Bush said, "This is a vivid reminder that there are some wackos out there, that we need to protect children."
The names of former messengers that were here while Foley served in the Legislature include now Congressman Adam Putnam. If Foley made advances while he was here, it's only a matter of time before someone comes forward.
Click Here to access the online Public Inspection File
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