Venom immunotherapy (VIT) is the only disease-modifying treatment for Hymenoptera venom allergy, but real-world data describing VIT-related reactions and individualized premedication practices remain limited. We retrospectively evaluated 16 adults undergoing VIT with a target maintenance dose of 100 µg administered every 4 weeks at a tertiary allergy center between January 2024 and December 2025, focusing on clinical characteristics, premedication, treatment-related reactions, and field-sting outcomes during follow-up of up to 24 months. All patients had severe index reactions (Müller grade III-IV); 13 (81.3%) received Vespula VIT and 3 (18.8%) honey bee VIT. Premedication was initiated before VIT in seven patients (43.8%), including omalizumab in five (31.3%). During the 7-week up-dosing phase, five patients (31.3%) developed local reactions, whereas no systemic reactions occurred (0/16; 95% CI: 0–20.6%). During maintenance, one systemic reaction occurred (6.3%), requiring adrenaline and one-night intensive care admission, after which VIT was discontinued. Two patients were re-stung during follow-up and developed only local reactions. In this small, selected real-world cohort, no systemic reactions were observed during the up-dosing phase, whereas one systemic reaction occurred during maintenance. Given the limited sample size, wide confidence intervals, and frequent use of individualized premedication, these findings should be interpreted as descriptive observations and not as evidence establishing the safety of VIT or the effectiveness of premedication.

Background and Objectives: Diabetic ketoacidosis (DKA) is a life-threatening acute metabolic complication of diabetes. Early identification of patients at high risk of mortality is crucial for optimal management. This study evaluated the prognostic association of the red blood cell distribution width-to-albumin ratio (RAR) and other laboratory biomarkers with in-hospital mortality and intensive care unit (ICU) admission in adult patients with DKA. Materials and Methods: In this retrospective single-center study, 86 adults hospitalized with DKA after emergency department admission between January 2021 and January 2026 were included. Demographic, laboratory, and clinical data were analyzed. The discriminatory performance of RAR, blood urea nitrogen-to-albumin ratio (BAR), and Red blood cell distribution width (RDW) for in-hospital mortality was assessed using receiver operating characteristic (ROC) analysis. Associations with in-hospital mortality were examined using logistic regression. Results: In-hospital mortality was 11.6%, and 79.1% of patients required ICU admission. Non-survivors had significantly higher inflammatory and metabolic biomarkers and lower albumin and pH. RAR showed the numerically highest Area Under the Curve (AUC) among the evaluated indices (AUC: 0.826, 95% Confidence interval (CI): 0.691–0.962), compared with BAR (AUC: 0.803, 95% CI: 0.632–0.973) and RDW (AUC: 0.713, 95% CI: 0.547–0.879). In the exploratory multivariable analysis, age (OR: 1.06), lactate (OR: 1.31), pH (OR: 0.002), albumin (OR: 0.28), and RAR (OR: 1.98) were associated with in-hospital mortality. Conclusions: RAR was associated with in-hospital mortality in adults with DKA and had the numerically highest AUC among the evaluated indices. However, these findings are exploratory, do not establish superior discrimination over other biomarkers, and require validation in larger, independent cohorts.