Medical Diseases

The development of radically new treatments for cystic fibrosis (CF) proceeds apace. In February 2018 Archivist reported on trials of double-modulator therapies (tezacaftor-ivacaftor) that produced modest benefits (doi:10.1136/archdischild-2017–3 14 602). Adding a third agent could, in theory, further enhance the intracellular functioning of the defective CFTR protein by binding to different sites on the molecule, particularly in those with the most common Phe508del mutation. Two such agents which showed promise in vitro were used in parallel multinational phase two randomised controlled trials, published simultaneously in the NEJM . Both involved adults only, but the implications for children are obvious. In both trials, about 120 CF patients with the Phe508del genotype who were already receiving tezacaftor-ivacaftor double therapy were randomised to receive in addition one of the two new oral agents, known as VX-659 and VX-445, or placebo, over 4 weeks. In the VX-659 trial the main...

Anaphylaxis is a serious systemic allergic reaction that is rapid in onset and may cause death. Despite numerous national and international guidelines and consensus statements, common misconceptions still persist in terms of diagnosis and appropriate management, both among healthcare professionals and patient/carers. We address some of these misconceptions and highlight the optimal approach for patients who experience potentially life-threatening allergic reactions. from Archives of Disease in Childhood current issue https://ift.tt/2CbgAY7

In type-one diabetes (T1D), pumps delivering continuous insulin infusions alongside continuous blood glucose monitoring are increasingly becoming standard management. The next logical step is to link these devices intelligently, so that the patient does not have to check their glucose levels at all: known as a ‘closed-loop’ system, it is effectively an electronic ‘artificial pancreas’. But does this advanced technology actually improve diabetic control? Some early small adult-only trials were inconclusive, but a more definitive randomised controlled trial from six centres in the UK and USA is more enlightening (Tauschmann M et al. Lancet 2018. doi.org/10.1016/S0140-6736(18)31947-0). They recruited adults and children over 6 years old with T1D, who were already using insulin pumps but still had poor control. Of the 86 patients randomised, half were under 21 and a quarter under 12 years. Both groups used a Medtronic 640G insulin pump, and an Enlite-3 glucose sensor. In the cases,... ...

Under-represented Not uncommonly, the issue of the generalisability or representativeness of a study population to the ’real world' is raised. There are some pretty big issues here, not least the idea that studies are undertaken in an unreal world, where troubles melt like chimney tops and sail above your lemon drops. Avoiding those sorts of mangled lyrics though—what’s the challenge of ‘representativeness’? If we simply and split in into the patients, and the interventions, we can think about the threats to using study data to inform practice. As for patients—we need to ask the question—‘In what ways do the patients in-study vary from the patients out of study?’ They may be older, sicker, whiter or have fewer comorbidities. In themselves, these things may have no effect. The follow-up question ‘How do these differences change how the illness/condition behaves?’ holds the key. For if older patients have a greater response to... from Archives of Disease in Childhood current issu...

CTI Foods LLC, Recalls Ready-To-Eat Pork and Poultry Sausage Products due to Possible Foreign Matter Contamination CTI Foods LLC, an Owingsville, Ky. establishment, is recalling approximately 29,028 pounds of frozen, ready-to-eat (RTE) pork and poultry sausage links products that may be contaminated with extraneous materials, specifically pieces of metal. Published December 11, 2018 at 01:44AM

3-D Meats, LLC Recalls Ready-To-Eat Beef Snack Stick Products due to Misbranding and Undeclared Allergens 3-D Meats, LLC, a Dalton, Ohio establishment, is recalling approximately 47 pounds of ready-to-eat (RTE) beef snack stick products because the products are misbranded and may contain milk, a known allergen, which was not declared on the finished product label. Published December 09, 2018 at 08:44PM

Amboy Group, LLC Recalls Poultry Products due to Misbranding and Undeclared Allergens Amboy Group, LLC, a Woodbridge, N.J. establishment, is recalling an undetermined amount of raw boneless and skinless poultry products because the products are misbranded and may contain milk, egg, and soy, known allergens, which are not declared on the finished product label. Published December 07, 2018 at 08:44PM

JBS Tolleson, Inc. Recalls Raw Beef Products due to Possible Salmonella Newport Contamination JBS Tolleson, Inc., a Tolleson, Ariz. establishment, is recalling approximately 12,093,271 pounds of non-intact raw beef products that may be contaminated with Salmonella Newport. Published December 04, 2018 at 07:00AM

Tres Hermanos Bakery Issues Allergy Alert on Undeclared Milk in Telera and Bolillo Breads Tres Hermanos Bakery of Wyoming, MI is recalling its white Telera and Bolillo Mexican salt breads because they may contain undeclared milk. People who have allergies to milk run the risk of serious or life-threatening allergic reaction if they consume these products. Published December 01, 2018 at 05:35AM