Can Platelet Transfusions Trigger Severe Reaction in Those With Peanut Allergies? Case report suggests that it's possible, but experts say there is no cause for alarm

Can Platelet Transfusions Trigger Severe Reaction in Those With Peanut Allergies? Case report suggests that it's possible, but experts say there is no cause for alarm WEDNESDAY, May 18 (HealthDay News) -- A boy with a peanut allergy had a severe reaction after receiving a blood platelet transfusion that may have contained bits of undigested peanut protein, according to a new case report published in a major medical journal. Though the findings suggest that people with nut allergies may be susceptible to an allergic reaction from blood products, experts stressed there is no cause for alarm. Not only does the report document only a single case, the boy received a platelet transfusion, which contain lots of blood serum (the liquid components of blood that don't contain red or white blood cells), explained Dr. Scott Sicherer, chair of the American Academy of Pediatrics' section on allergy and immunology. That's different from a typical blood transfusion, in which the blood is "washed" and only red blood cells are transfused, said Sicherer, also a researcher at Jaffe Food Allergy Institute at Mount Sinai School of Medicine in New York City. "A blood transfusion would have a lot less of the liquid from the bloodstream, and that would presumably mean if there was any peanut in the blood it would have been washed away," Sicherer noted. The case report was published in the May 18 issue of the New England Journal of Medicine. After a person eats nuts, some of the proteins circulate in the blood, Sicherer said. That's led experts to speculate whether or not someone with a nut allergy who receive donated blood products could react to peanut proteins in the blood. For people with severe peanut allergies, ingesting even tiny amounts of peanut protein can set off a life-threatening allergic reaction called anaphylaxis. But it's premature to encourage blood donors not to eat peanuts before giving blood or for questions about diet to become part of the screening process, said the report authors. "Our case report will not change any of the current protocols surrounding blood donations," said Dr. Johannes F.M. Jacobs, of Radboud University Nijmegen Medical Center in the Netherlands. "Further research is needed before evidence-based decisions on this point can be taken. In our case report, we only wanted to create awareness for this phenomenon among clinicians." Sicherer agreed that the possibility that peanuts in blood products -- or other tree nuts or other foods, for that matter -- could cause an allergic reaction is worth further study. The 6-year-old boy in the case report was being treated for leukemia and received a platelet transfusion, which helps with clotting. The boy experienced swelling, low blood pressure and difficulty breathing, all signs of anaphylaxis. The boys' mother said he'd had a similar reaction after eating peanuts as a 1-year-old. He was given adrenalin and recovered, according to the report. Three of the five platelet donors reported eating several handfuls of peanuts less than 24 hours before donating blood. Researchers never actually tested the blood product that the boy received, but they did test the boy's blood for peanut-specific IgE antibodies, the results of which indicated the boy had a peanut allergy. In addition, the boy had other prior platelet transfusions and had no reaction, Jacobs said. Peanut proteins are more resistant to digestion that other foods, according to the authors. "One percent of the population has peanut allergy and people get blood transfusions all the time," Sicherer said. "Allergic reactions seem to be exceedingly rare if it happens." SOURCES: Johannes F.M. Jacobs, Ph.D., M.D., Radboud University, Nijmegen Medical Center, the Netherlands; Scott Sicherer, M.D., chair, American Academy of Pediatrics, section on allergy and immunology; associate professor, pediatrics, and researcher, Jaffe Food Allergy Institute, Mount Sinai School of Medicine, New York City; May 18, 2011, New England Journal of Medicine

Aortic Aneurysm Also called: AAA, TAA

Aortic Aneurysm Also called: AAA, TAA Most aneurysms -- abnormal bulges or "ballooning" in the wall of an artery -- occur in the aorta. The aorta is the main artery that carries blood from the heart to the rest of the body. There are two types of aortic aneurysm: Thoracic aortic aneurysms occur in the part of the aorta running through the chest. Abdominal aortic aneurysms occur in the part of the aorta running through the abdomen. Because aneurysms can develop and become large before causing any symptoms, it is important to look for them in people who are at high risk. Ultrasound screening for abdominal aortic aneurysms is recommended for men who have ever smoked and are between the ages of 65 and 75. Medicines and surgery are the two main treatments for aneurysms. NIH: National Heart, Lung, and Blood Institute

New tests of U.S. airport scanners find radiation OK

New tests of U.S. airport scanners find radiation OK WASHINGTON (Reuters) - New tests of full-body scanners deployed at airports found that the radiation they emit was within acceptable levels, the Transportation Security Administration said on Tuesday after previous checks found some anomalies in results. The machines, which have provoked health concerns about excessive radiation exposure, have been deployed at dozens of airports to thwart attacks on the U.S. aviation system which has continued to be a prime target of al Qaeda militants. "The latest reports confirm previous testing and show that every backscatter unit currently used for passenger screening in U.S. airports is operating well within applicable national safety standards," said TSA spokesman Nicholas Kimball. There are about 486 full-body scanners in 78 airports in the United States, of which 247 are so-called backscatter machines made by Rapiscan Systems, a unit of OSI Systems Inc. They expose a person to about 0.0025 millirem of radiation. Test results released by TSA in March showed some anomalies, such as missing data or calculation errors unrelated to safety. The agency ordered new tests for the scanners as well as other X-ray equipment used to screen baggage that had problematic reports. The machines cannot produce more than 0.005 millirem per scan, according to TSA. In comparison, a chest X-ray will expose someone to 10 millirem of radiation and the maximum recommended exposure to radiation from man-made sources is 100 millirem per year, according to TSA. TSA posted the new test results on its website: http://www.tsa.gov/research/reading/xray_screening_technology_safety_reports.shtm. TSA has accelerated deploying full-body scanners and other machines to detect explosives after a Nigerian man tried but failed to detonate a bomb hidden in his underwear on a flight from Amsterdam as it approached Detroit on Christmas Day 2009. The full-body scanners have also provoked a backlash among some travelers who were upset because they produce revealing body images. (Reporting by Jeremy Pelofsky, Editing by Cynthia Osterman)

What Is Chest MRI?

What Is Chest MRI? Chest MRI (magnetic resonance imaging) is a safe, noninvasive test. "Noninvasive" means that no surgery is done and no instruments are inserted into your body. This test creates detailed pictures of the structures in your chest, such as your chest wall, heart, and blood vessels. Chest MRI uses radio waves, magnets, and a computer to create these pictures. The test is used to: Look for tumors in the chest Look at blood vessels, lymph (limf) nodes, and other structures in the chest Help explain the results of other tests, such as a chest x ray or chest computed tomography (to-MOG-rah-fee) scan, also called a chest CT scan. As part of some chest MRIs, a substance called contrast dye is injected into a vein in your arm. This dye allows the MRI to take more detailed pictures of the structures in your chest. Chest MRI has few risks. Unlike a CT scan or standard x ray, MRI doesn't use radiation or pose any risk of cancer. Rarely, the contrast dye used for some chest MRIs may cause an allergic reaction or worsen kidney function in people who have kidney disease.

Health Tip: Signs That You May Have Periodontal Disease Sometimes called gingivitis

Health Tip: Signs That You May Have Periodontal Disease Sometimes called gingivitis By Diana Kohnle (HealthDay News) -- Periodontal disease refers to a group of problems that affect the spaces between the gums and teeth. Proper and consistent oral hygiene can help prevent the disease. The ADAM Encyclopedia says symptoms of periodontal disease may include: Gums that are red and swollen. Gums that bleed, even from just brushing your teeth. Chronic bad breath. Teeth that loosen. As the disease progresses, the gums recede, which could affect the way the upper and lower teeth meet when you bite down.

Side Effects May Sway Drug Choices for Tough-to-Manage Diabetes Study looks at options for type 2 patients who need more than metformin or a sulfonylurea

Side Effects May Sway Drug Choices for Tough-to-Manage Diabetes Study looks at options for type 2 patients who need more than metformin or a sulfonylurea THURSDAY, May 19 (HealthDay News) -- When someone with type 2 diabetes needs a third medication to control blood sugar levels, the choice may come down to which drug has the least undesirable side effects, because the available medications all lower blood sugar in a similar manner. That's the conclusion of a new review of data that shows there were no great differences in the ability of various classes of medication to lower blood sugar among type 2 diabetics, when used as "third-line" treatment (after a first and second drug don't suffice). However, the study also found that some medications could cause weight gain, and some caused episodes of low blood sugar levels (hypoglycemia). In any event, "type 2 diabetes is a progressive disease and most patients will need the combination of two or three anti-hyperglycemic agents to reach good glucose control in the long-term," noted the study's lead author, Dr. Jorge Gross, a professor of medicine at the Hospital de Clinicas de Porto Alegre, Brazil. "The choice of the third agent should be individualized according to the characteristics of the patients and the undesirable effects of the medications, so you can't elect one agent to be used in all patients with type 2 diabetes," he explained. The study results were published in this week's issue of the Annals of Internal Medicine. Metformin, an older medication that's available as a generic, is generally recommended as a first-line treatment for type 2 diabetes, along with physical activity and diet changes. If metformin and lifestyle changes fail to control blood sugar well, a second drug is generally added. For this study, the researchers chose the commonly used combination of metformin and a sulfonylurea. Drugs in the sulfonylurea class are usually available as generics and include: glyburide, glipizide, chlorpropamide, tolbutamide and tolazamide. "This study looked at what's probably the most common combination of diabetes medications, but even the second-line therapy should be individualized based on the patient's needs," said Dr. Robert Henry, president of medicine and science for the American Diabetes Association. Third-line medications in the current study included alpha-glucosidase inhibitors (acarbose), thiazolidinediones (which include Avandia and Actos), glucagon-like peptide-1 (GLP-1) agonists, and dipeptidyl peptidase-4 (DPP-4) inhibitors. The review included 18 clinical trials with a total of more than 4,500 people. The studies lasted an average of more than 31 weeks. When the researchers compared reductions in hemoglobin A1C (HbA1C) levels, they found no statistically significant differences between the third-line medications. HbA1C is a blood test that measures long-term (about two to three months) blood sugar levels. Weight gain was more common in people taking insulin or a thiazolidinedione. The average weight gain for those on insulin was about six pounds, according to the study. For those on thiazolidinediones, the average weight gain was more than nine pounds. An average weight loss of 3.6 pounds was seen in people taking GLP-1 agonists, reported the study. Insulin was most likely to reduce blood sugar levels too much, raising the odds for hypoglycemia, according to the study. Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, stressed, however, that "these are mostly drug company studies, and they're not long-term studies." This review "shows that giving a third agent can help, and it also shows us that these medications have both good and bad effects," he said. "But we really need long-term studies on combinations that aren't sponsored by the pharmaceutical companies." The bottom line, according to Zonszein: "Each patient should be treated individually. Are they obese? If yes, there are certain medications like insulin and thiazolidinediones that may cause weight gain we don't want." When it comes to third-line agents, Henry said, another factor may be price. Some medications aren't always available in generic form, which may make them significantly more expensive. If you have specific concerns, such as weight gain or cost, Henry said it's important to bring these concerns to your doctor's attention when you're talking about adding another diabetes medication. "If a third medication is needed because glucose control isn't adequate, get one that's tailored to your unique needs," he advised. "We think that the results of this study offer a wide range of choices of anti-hyperglycemic agents that might be used as the third option in patients with type 2 diabetes not controlled using metformin and sulphonylurea based on efficacy. The final decision would depend on the effects in weight and risk of hypoglycemic episodes," said Gross. SOURCES: Jorge Gross, M.D., Ph.D., professor, medicine, Hospital de Clinicas de Porto Alegre, Brazil; Joel Zonszein, M.D., director, clinical diabetes center, Montefiore Medical Center, New York City; Robert Henry, M.D., president, medicine and science, American Diabetes Association; May 17, 2011, Annals of Internal Medicine