WCIM 2014
6 32nd World Congress of Internal Medicine (October 24-28, 2014)
OS-ALG-09 Allergy
Allergen Specifi c Ige Detection Performance of Aller- gyq® System in Korean Allergy Patients
Jae-Hyun LEE1, Kyung Hee PARK1, Kyung Yong JEONG2, Hye Jung PARK1, Jung-Won PARK1
Yonsei University College of Medicine, Korea1, Yonsei University College of Medicine, Korea2 Background: AllergyQ enzyme immunoassay (EIA), a screening assay for specifi c im- munoglobulin E (sIgE) for multiple allergens. While ImmunoCAP fl uorescent EIA (FEIA) has been widely used for sIgE detection. In this study, we determined to evaluate de- tection performance of AllergyQ system compared to that of ImmunoCAP.
Methods: We performed several inter-method comparisons using sera from 260 Kore- an allergy patients, including asthma (26.5%), allergic rhinitis (42.3%), atopic dermati- tis (67.7%) and food allergy (18.1%). We compared the sIgE detection performance for seven major inhalant, fi ve food allergens and four microorganism allergens
Results: 1,799 paired assay results were analyzed. Most allergen sIgE results showed above 0.5 intraclass correlation coeffi cient except mugwort and alternaria. Inter-assay class associations were reliable in most allergens (gamma=0.858-0.983, p<0.001). The inter-method concordance was good to moderate for most allergens (κ=0.713–0.898, p<0.001).
Conclusions: AllergyQ EIA system showed a good detection performance compared with ImmunoCAP FEIA system in correlation and agreement in Korean allergy patients.
However, in terms of methodological differences in these two assay systems, careful clinical implication is needed for interpretation of AllergyQ EIA results.
OS-ALG-10 Allergy
Relationship of Extended Nitric Oxide Analysis with Bronchial Hyperresponsiveness (BDR) and Brconhodila- tor Response (BDR) in Children with Asthma According to Atopy
Yoon Hee KIM1, Young A PARK1, In Suk SOL1, Seo Hee YOON1, Min Jung KIM1, Kyung Won KIM1, Myung Hyun SOHN1, Kyu-Earn KIM1
Department of Pediatrics, Severance Hospital, Institute of Allergy, Brain Korea 21 PLUS Project for Med- ical Science, Yonsei University College of Medicine, Korea1
Background: Extended nitric oxide (NO) analysis such as alveolar NO has been studied ardently because it is not affected by exhaled fl ow rate. The aim of this study is to evaluate whether extended nitric oxide analysis parameters are correlated with bron- chial hyperresponsiveness (BHR) and Brconhodilator response (BDR).
Methods: Children with a typical asthmatic symptom were evaluated. The exhaled nitric oxide test was done with methacholine challenge test for BHR for the children and spirometry before and after bronchodilator for BDR for the other children. We measured exhaled nitric oxide at 30, 50, 100, 200 mL/s and calculated JawNO (total NO fl ux). Alveolar NO, NO transfer factor and airway wall NO (CawNO) using Hogman and Merilainen algorithm. Atopy was defi ned as a positive skin test result or more than 0.7 KUa/L specifi c IgE or a more than 150 IU/ml total IgE.
Results: In atopic children, JawNO was signifi cantly higher in the positive BHR (PC20
< 16 mg/ml) than in the negative BHR subjects and correlated negatively with PC20.
In atopic children, JawNO was signifi cantly higher in the positive BDR (ΔFEV1 = 12%) than in the negative BDR subjects and correlated positively with ΔFEV1. In non-atopic children, CawNO was signifi cantly higher in the positive BHR than in the negative BHR subjects and correlated negatively with PC20. In non-atopic children, CawNO was sig- nifi cantly higher in the positive BDR than in the negative BDR subjects and correlated positively with ΔFEV1.
Conclusions: The relationship of extended nitric oxide analysis parameters with BHR and BDR was different according to atopy. The JawNO in the atopy and the CawNO in the non-atopy might give useful information for understanding BHR and BDR in chil- dren with asthma.
OS-CAD-01 Cardiology
Clinical Profi le, Outcomes, and Mortality Predictors of Patients with Venous Thromboembolism at Philippine Heart Center
Garol Franz Albert GO1, Maribel TANQUE1 Philippine Heart Center, Philippines1
Background: VTE incorporates 2 distinct but interrelated disease conditions, deep vein thrombosis (DVT) and pulmonary embolism (PE). Prompt recognition of the disease is equally important in the diagnostic and therapeutic approach to this condition.
Methods: This is a retrospective cohort study of 408 PHC patients with VTE from 2000 to 2013. This study aims to present the clinical profi les, outcomes and mortality/
survival predictors.
Results: There was female predominance with mean age of 55 years old. Immobility and HF were the most common risk factors. HPN, DM and CAD were the most com- mon comorbidities. Dyspnea, extremity swelling and pain were the most common complaints during initial presentation. The lower extremities were most commonly involved in DVT. Most common fi ndings on workup include cardiomegaly (CXR), ab- normal D-dimer, DVT (VDS), intermediate probability for PE (VQ Scan), PE (CTscan), pulmonary hypertension and RV enlargement (2DED), hypoxemia (ABG), and sinus rhythm (ECG). A diagnosis of PE was made in 93%, DVT in 84%, and post-thrombotic syndrome in 8%. Anti-coagulation with heparin and warfarin was the most common treatment given. For the outcomes, 78% were discharged improved, 32% suffered in-hospital mortality or death, 7% had bleeding and 13% had thromboembolic events.
Conclusions: The clinical profi les and outcomes of these VTE patients were similar with existing international data. There were signifi cant correlation with survival among females, pay category, previous DVT/PE, recent surgery, malignancy, PAD, hypercoag- ulability, extremity swelling, extremity pain, extremity erythema, alert level of con- sciousness, regular auscultatory and electrocardiographic rhythm, low probability PE on perfusion scan, and heparin anticoagulation. There was signifi cant association with mortality among patients with edema, DVT on venous duplex scan, metabolic acidosis on arterial blood gas, and use of IVC fi lter & mechanical ventilation.n
OS-CAD-02 Cardiology
Atrial Fibrillation Complicates Postoperative Adverse Outcomes of Patients Receiving Non-Cardiac Surgery:
A Nationwide Matched Cohort Study
Chien-Chang LIAO1, Hui-Chin LAI2, Ta-Liang CHEN1
Taipei Medical University Hospital, Taiwan R.O.C1, Taichung Veterans General Hospital, Taiwan R.O.C2 Background: Patients with atrial fi brillation (AF) were known to have a higher risk of complications during hospitalization. The purpose of this study is to investigate post- operative adverse events for surgical patients with AF.
Methods: We conducted a population-based study of 8239 patients with preop- erative AF receiving non-cardiac major surgeries from the Taiwan National Health Insurance Research Database within the years 2004 and 2007 compared with 8239 surgical patients without AF. Eight major postoperative complications and mortality after complications were analyzed among patients with or without AF by multivariate logistic regressions.
Results: After adjustment, patients with AF had higher risk for postoperative pulmo- nary embolism (odds ratio [OR]: 3.73, 95% confi dence interval [CI]: 1.62-8.60), stroke (OR=1.46, 95% CI=1.26-1.69), septicemia (OR: 1.27, 95% CI: 1.13-1.44), and 30-day postoperative mortality (adjusted OR: 1.42, 95% CI: 1.09-1.86), than surgical patients without AF. Previous cardiovascular surgery (OR: 2.14, 95% CI: 1.26-3.66), preopera- tive hospitalization for AF (OR: 2.06, 95% CI: 1.40-3.02) and ischemic heart disease (OR: 2.25, 95% CI: 1.43-3.54) and emergency care for AF (OR: 1.81, 95% CI: 1.12-2.91) were predictors for postoperative mortality in patients with AF.
Conclusions: Surgical patients with AF showed signifi cantly higher adverse events rates and 30-day mortality after non-cardiac surgeries when compared with patients without AF.
