Idiopathic Anaphylaxis Grand Rounds.

Idiopathic anaphylaxis (IA) refers to recurrent, life-threatening hypersensitivity reactions without identifiable triggers, representing a diagnostic and therapeutic challenge. We describe a 17-year-old girl presenting with recurrent episodes of flushing, pruritus, and respiratory symptoms, without consistent allergen exposure or cofactor involvement. Evaluation revealed elevated acute tryptase levels with a normal baseline, negative skin testing, and negative alpha-gal and KIT mutation analysis.

Concomitant Chronic Urticaria in Children: A Distinct Severe Phenotype.

Introduction: Chronic spontaneous urticaria (CSU) presents as repetitive spontaneous hives and/or angioedema lasting for at least six weeks. In contrast, chronic inducible urticaria (CIndU) is triggered by specific stimuli. This study aimed to characterize children who have concurrent CSU and CIndU excluding children with symptomatic dermographism, and to identify factors that distinguish them from children with CSU alone or CIndU alone.

A Comparison of Chronic Spontaneous Urticaria Clinical Characteristics and Management between Canadian and Israeli Adults.

Introduction: Chronic spontaneous urticaria (CSU) is increasingly recognized as a significant health issue with significant impacts on quality of life in adult populations. Data are sparse regarding differences in clinical characteristics and management of CU in different countries. We aimed to compare adult CU populations in Canada and Israel to identify demographic, clinical, and management differences.

Comparison of the Degradability of Hyaluronic Acid by Ovine and Recombinant Human Hyaluronidase.

Background: The mainstay of treatment in HA filler adverse events is the use of hyaluronidase; however, the dose and dilution are not standardized.

Objectives: The objective of this study is to examine differential dilutions and concentrations of HYAL, as well as comparing the effectiveness of ovine to human HYAL.

Methods: Fillers were selected for study based on a variety of rheologic factors.

Induction of Antifungal Tolerance Reveals Genetic and Phenotypic Changes in .

is an opportunistic, pathogenic fungus that is increasingly isolated from hospitalized patients. The incidence of drug tolerance, heteroresistance, and resistance is on the rise due to an overuse of antifungal drugs. The aim of this study was to expose a sensitive strain to sequentially increasing concentrations of two antifungal drugs, fluconazole, an azole that targets ergosterol biosynthesis, or caspofungin, an echinocandin that targets cell wall glucan synthesis.

Diagnostic Utility of Biomarkers in Anaphylaxis: A Systematic Review and Meta-Analysis.

Background: Anaphylaxis is a life-threatening allergic reaction commonly triggered by food, venom, or drugs. Clinical criteria are central to diagnosing anaphylaxis. However, laboratory biomarkers could provide valuable confirmation when clinical diagnosis is challenging.

Proteomic characterization of clinical Candida glabrata isolates with varying degrees of virulence and resistance to fluconazole.

Candida glabrata, an opportunistic fungal pathogen, is a significant contributor to mortality among individuals with weakened immune systems. Antifungal drugs such as azoles work by inhibiting the Erg11 enzyme, altering the conversion of lanosterol to ergosterol. Resistance to azoles is increasing among Candida species worldwide, and in Lebanon.

Rise in post-resection neutrophil-to-lymphocyte ratio correlates with decreased survival in glioblastoma patients.

Background: Neutrophil-to-lymphocyte ratio (NLR) is used in the prognostication of multiple malignancies. However, the NLR value in glioblastoma (GBM) is controversial. This controversy may be due to the unaccounted effect of dexamethasone on NLR.

Serum Sickness-Like Reactions Clinical Characteristics and Management: A Systematic Review.

Background: Serum sickness-like reaction (SSLR) is an adverse reaction mainly to drugs, infectious agents, or vaccines, characterized by the presence of rash, arthralgia, or arthritis and occasionally fever.

Objective: This systematic review aimed to analyze the clinical characteristics, implicated agents, symptomatology, and management of SSLR.

Methods: We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines.

Reproduction of Original Glioblastoma and Brain Metastasis Research Findings Using Synthetic Data.

Objective: Synthetic data (SD) is artificially generated information that mimics the statistical characteristics and correlations of real-world data, enabling researchers to simulate variables that are challenging to obtain in routine practice while overcoming confidentiality barriers. This study aims to evaluate the utility, validity, and potential limitations of SD in glioblastoma (GBM) and brain metastases (BM) research.

Methods: Three published neuro-oncology studies focusing on prognostic factors were selected: 2 involving GBM patients and 1 with BM patients.

Phenotypic and genotypic characterization of Candida parapsilosis complex isolates from a Lebanese hospital.

The opportunistic pathogen Candida parapsilosis is a major causative agent of candidiasis leading to death in immunocompromised individuals. Azoles are the first line of defense in their treatment. The purpose of this study was to characterize eight fluconazole-resistant and sensitive C.

Symptomatology and Management of Adult Anaphylaxis according to Trigger: A Cross-Sectional Study.

Introduction: Anaphylaxis is an acute life-threatening allergy, most commonly provoked by food, venom, or drugs. There is limited data regarding differences in symptomatology between anaphylaxis provoked by different triggers. This study aimed to assess sociodemographic characteristics, clinical symptoms, and management of anaphylaxis, according to triggers in adults.

Comparing Two Peanut Desensitization Protocols in Preschool Children: A Real-World Clinical Practice.

Introduction: Peanut allergy is the main food allergy in childhood and poses significant health concerns. This study aimed to critically evaluate the effectiveness and safety of oral immune therapy (OIT) using crushed peanuts versus peanut puffs.

Methods: Children with an allergist diagnosed peanut allergy based on a history of an IgE-mediated reaction and a positive skin prick test for peanuts were recruited at the Montreal Children's Hospital and the Children's Clinic located in Montreal.

UPC2 mutations and development of azole resistance in Candida albicans hospital isolates from Lebanon.

Objectives: This study evaluated the role of Upc2 in the development of azole resistance in Candida albicans isolates from Lebanese hospitalized patients and determined a correlation between resistance and virulence.

Methods: The UPC2 gene which codes for an ergosterol biosynthesis regulator was sequenced and analysed in two azole-resistant and one azole-susceptible C. albicans isolates.

Phenotypic and Genotypic Characterization of Candida parapsilosis complex isolates from a Lebanese Hospital.

The opportunistic fungal pathogen is a major causative agent of candidiasis leading to death in immunocompromised individuals. Azoles are the first line of defense in treatment by inhibiting involved in the synthesis of ergosterol, the main sterol fungal sterol. Resistance to azoles is on the increase worldwide including in Lebanon.

Adhesive and biofilm-forming Candida glabrata Lebanese hospital isolates harbour mutations in subtelomeric silencers and adhesins.

Background: The prevalence of Candida glabrata healthcare-associated infections is on the rise worldwide and in Lebanon, Candida glabrata infections are difficult to treat as a result of their resistance to azole antifungals and their ability to form biofilms.

Objectives: The first objective of this study was to quantify biofilm biomass in the most virulent C. glabrata isolates detected in a Lebanese hospital.

Sequential Induction of Drug Resistance and Characterization of an Initial Drug-Sensitive Isolate.

Background: The pathogenic fungus is a leading agent of death in immunocompromised individuals with a growing trend of antifungal resistance.

Methods: The purpose is to induce resistance to drugs in a sensitive strain followed by whole-genome sequencing to determine mechanisms of resistance. Strains will be assayed for pathogenicity attributes such as ergosterol and chitin content, growth rate, virulence, and biofilm formation.