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In this paper the existence and uniqueness of weak and strong solutions for a non-autonomous non-local reaction–diffusion equation is proved. Furthermore, the existence of minimal pullback attractors in the L2-norm in the frameworks of universes of fixed bounded sets and those given by a tempered growth condition is established, along with some relationships between them. Finally, we prove the existence of minimal pullback attractors in the H1-norm and study relationships among these new families and those given previously in the L2 context. We also present new results in the autonomous framework that ensure the existence of global compact attractors as a particular case.

This case series explores sea urchin spine injuries, a growing concern due to increased travel. These injuries, even in non-coastal areas, can mimic other foreign bodies and lack inflammation, posing a diagnostic challenge. Dermoscopy aided in visualization and extraction of retained spines, highlighting its utility in managing these injuries.

Bee stings are very common worldwide. About 5% to 15% of those afflicted have a large local reaction, defined as a skin reaction around the sting site with edema, erythema, itching, and an injury diameter >10 cm. Standard treatments for large local reactions include ice, nonsteroidal anti-inflammatory medications, antihistamine medications, and topical or systemic corticosteroids, none of which immediately treat the pain associated with the symptoms nor initiate immediate treatment of the allergic and inflammatory response. We present a dramatic and rapid reversal of a periorbital large local reaction treated with subcutaneous and intradermal injection of 1% lidocaine with epinephrine into the sting area. The lidocaine rapidly reversed the symptoms of pain and pressure, and the low dose of epinephrine, within 2 hours, significantly reversed the allergic periorbital and eyelid edema. No further symptoms evolved, suggesting that the epinephrine terminated the allergic cascade.

For delayed non-local reaction–diffusion equations arising from population biology, selection mechanisms of the speed sign for the bistable travelling wavefront have not been found. In this paper, based on the theory of asymptotic speeds of spread for monotone semiflows, we firstly provide an interval of values of wave speed and a novel general condition for determining the speed sign by applying the comparison principle and the globally asymptotic stability of the bistable travelling wave. Moreover, through constructing novel upper/lower solutions, we give explicit conditions for the speed sign to be positive or negative. The obtained results are efficiently applied to three classical forms of the kernel functions.

Though typically mild, side effects to the influenza virus vaccine are common and may contribute to negative perceptions including the belief that the vaccine can cause the flu. However, the extent to which subjective symptoms correspond with biological response indicators is poorly understood. This study examined associations among subjective side effects (soreness at the site of injection and illness-like symptoms), serum proinflammatory cytokines and body temperature a baseline, 1, 2, and 3 days following receipt of trivalent inactivated influenza vaccine (IIV3) in a sample of 56 women 18–40 years in age. In relation to local reactions, women reporting being very sore at the injection site at 1 day post-vaccination exhibited greater increases in serum TNF-α and MIF in the days following vaccination compared to those with no or mild soreness. In addition, higher basal body temperature was observed in this group compared to other groups (98.7°F versus 98.0–98.1°). In relation to systemic reactions, women endorsing illness-like symptoms (headache, fatigue, nausea, sore throat, dizziness, achiness, or mild fever) exhibited marginally higher IL-6 at baseline (p=0.055) and greater increases in serum MIF at 2 days post-vaccination than those reporting no systemic symptoms. Associations of systemic symptoms with inflammatory responses were not accounted for by concomitant local reactions. As expected, antibody responses to the vaccine were highly similar in women regardless of local or systemic symptoms. These results are consistent with the notion that subjective reports of local and systemic reactions following vaccination may be predicted by and correspond with biological indicators of inflammatory status, but are not meaningful predictors of antibody responses. To improve adherence to vaccine recommendations, clinicians should provide assurance that such symptoms may be related to normal mild inflammatory responses to the vaccine and do not reflect immunogenicity.

Previous studies involving predominantly adults concluded that the patients developing frequent large local reactions (LLRs) might be at greater risk for systemic reactions (SRs) during subcutaneous allergen immunotherapy (SCIT). To determine the rate of side effects to SCIT and evaluate frequency of LLR among pediatric patients with SRs. The retrospective study included pediatric patients receiving SCIT. Data on the demographic features, season at onset of SCIT, the indication for treatment, additional allergic diseases, laboratory results, the allergens applied, side effects after injection, grade of SRs, and the total number of injections for each patient were collected retrospectively from the medical records and injection charts. A total of 19,562 injections were administered to 261 patients with conventional SCIT. The incidence LLRs was 0.2% per injection; 1.15% of all patients (n = 3) experienced LLRs on at least two consecutive visits. Systemic side effects were seen in 1% of all SCIT injections. No grade 3 or grade 4 SRs were observed. Logistic regression analysis showed that having an LLR was 3.32 times (95% CI, 1.313-8. 440; P = 0.011) and initiation of SCIT in summer and spring was 4.309 and 3.056 times than autumn (95% CI, 1.527-12.157, P = 0.006; 95% CI, 1.358-6.849, P = 0.007), respectively, increased risk for an SR. Having LLRs might predict the risk of SRs at any time during immunotherapy in also pediatric patients. Knowing the risk factors is important for developing a personalized protocol in these patients.

Background Many children encounter unusual or “exaggerated” reactions such as large local, atypical or systemic reactions after mosquito bites. Objective The aim of this study was to document the clinical features of children with mosquito allergy and investigate the possible associations between demographic features and type of reactions in this population. Methods Children with large local or unusual reactions after mosquito bites who attended to our outpatient pediatric allergy department were enrolled in the study along with control subjects. Results A total of 180 children (94 with mosquito allergy and 86 age and sex-matched control subjects) with a median age of 6.8 years (IQR 5.5–9.3) were enrolled. Atopy (35.1% vs. 11.6%, p < 0.001) and grass pollen sensitization (28.7% vs. 8.1%, p < 0.001) were significantly more frequent in children with mosquito allergy. Skin prick test with mosquito allergen was positive in only 6 children (6,4%). Grass pollen sensitization was most common in children (28.7%) followed by sensitization to house dust mite (9.6%). 30 children (31.9%) had an accompanying atopic disease such as allergic rhinitis, asthma or atopic dermatitis. Bullae were significantly more frequent in children with asthma (41.7% vs.15.9, p = 0.034). The median duration of symptoms after onset were significantly longer in patients with ecchymosis, with immediate wheals and in children whose symptoms start in 20 min to 4 hours after mosquito bites. Conclusion There is an association between unusual, large local or exaggerated reactions after mosquito bites and allergic diseases in children. The severity of reactions increases with age and particularly in children with atopic background.

GTPase molecules are important regulators in cells that continuously run through an activation/deactivation and membrane-attachment/membrane-detachment cycle. Activated GTPase is able to localize in parts of the membranes and to induce cell polarity. As feedback loops contribute to the GTPase cycle and as the coupling between membrane-bound and cytoplasmic processes introduces different diffusion coefficients a Turing mechanism is a natural candidate for this symmetry breaking. We formulate a mathematical model that couples a reaction–diffusion system in the inner volume to a reaction–diffusion system on the membrane via a flux condition and an attachment/detachment law at the membrane. We present a reduction to a simpler non-local reaction–diffusion model and perform a stability analysis and numerical simulations for this reduction. Our model in principle does support Turing instabilities but only if the lateral diffusion of inactivated GTPase is much faster than the diffusion of activated GTPase.

•Taiwan increased the age to 5 months for BCG immunization to decrease BCG-osteitis.•The typical local reactions are unknown in infants vaccinated at this age.•We evaluate the sequences of skin changes at the injection site.•The infants have a more potent skin response with longer induration and ulceration.•All infants developed a scar at the injection site. Taiwan increased the Bacillus Calmette-Guerin (BCG) vaccination age from 24 h after birth to 5–8 months of age to lower BCG-related osteitis/osteomyelitis in 2016. However, the sequences of skin changes at the injection site and in the corresponding lymph nodes are unknown for infants vaccinated at an older age. We prospectively collected the photographs of skin reactions within 6 months after vaccination. The type, size, onset time, and duration of the skin reactions were recorded and analyzed. We enrolled 532 infants. The types and median times at onset of skin reactions were as follows: erythema at week 1, induration at week 3, ecchymosis at week 4, and ulceration at week 6. The peak skin responses were at week 6, with average sizes of 8.4 mm, 7.4 mm, and 8.2 mm for erythema, induration, and ecchymosis, respectively. The duration of induration was long, with 57.6 % and 23 % of the infants still having a response at week 12 and 24, respectively. The rate of induration size ≥ 20 mm was 1.7 % (95 % confidence interval: 0.8 %–3.2 %). Overall, 46.4 % of the infants experienced ulcerative change, with most occurring at week 6 (34.1 %), and 9.5 % and 4.1 % of the infants still had ulceration at week 12 and 16, respectively. Twelve infants (2.3 %) had spontaneous resolution of regional lymphadenitis, with the onset time ranging from week 1 to 12. All infants had developed a scar at the end of follow-up. Our study demonstrates the typical appearance and time courses of skin reactions in infants who received the BCG vaccination at older than 5 months of age. Infants vaccinated at this age may have a more potent skin response with longer induration and ulceration than those vaccinated at birth.

Background In the few studies available, the risk of developing systemic reactions (SR) to hymenoptera stings in patients with previous large local reactions (LLRs) to stings ranges from 0 to 7 %. We evaluated both retrospectively and prospectively the risk of SRs in patients with LLRs to stings. Methods An overall number of 477 patients, 396 with an SR as the first manifestation of allergy and 81 with a history of only LLRs after hymenoptera stings, were included in the study. All patients had clinical history and allergy testing (skin tests and/or specific IgE) indicative of allergy to venom of only one kind of Hymenoptera. Of the 81 patient with LLRs, 53 were followed-up for 3 years by annual control visits, while the 396 patients with SR were evaluated retrospectively. Results Among the 396 patients with an SR, only 17 (4.2 %) had had a previous LLR as debut of allergy, after an history of normal local reactions to Hymenoptera stings. All the 81 patients with a history of only LLRs had previously had at least two LLRs, with an overall number of 238 stings and no SR. Among the 53 patients who were prospectively evaluated we found that 31 of them (58.3 %) were restung by the same type of insect, with an overall number of 59 stings, presenting only LLRs and no SR. Conclusions Our findings confirm that patients with repeated LLRs to stings had no risk of SR, while a single LLR does not exclude such risk. This has to be considered in the management of patients with LLRs.