Relação entre desmame precoce e alergias alimentares / Relationship between early weaning and food allergies / Relación entre el destete precoz y las alergias alimentarias

Objetivo: Analisar a relação entre o desmame precoce e o desenvolvimento de alergias alimentares por meio de uma revisão integrativa. Método:Revisão integrativa da literatura realizada através das bases de dados Pubmed, Mesh e Scielo.Resultados:Através da busca pelos descritores determinados, foram selecionados 25 estudos científicos que atenderam aos critérios de inclusão. Devido sua grande composição, o leite humano é responsável pela promoção do crescimento das bactérias com efeito bifidogênico, estando em quantidades superiores nos lactentes em AME. Conclusão: Apesar de alguns dos estudos não mostrarem resultados significativos em relação ao leite materno ser um fator protetor contra as alergias alimentares, nenhum deles deixoude incentivar o AM ou mostrar os seus benefícios já cientificamente comprovados.

Objective: To analyze the relationship between early weaning and the development of food allergies through an integrative review. Method: Integrative literature review performed through the Pubmed, Mesh and Scielo databases. Results: Through the search for the descriptors determined, 25 scientific studies that met the inclusion criteria were selected. Due to its large composition, human milk is responsible for promoting the growth of bacteria with bifidogenic effect, being in higher amounts in infants in EBF. Conclusion: Although some of the studies did not show significant results regarding breast milk being a protective factor against food allergies, none of them failed to encourage BF or show its scientifically proven benefits.

Objetivo: Analizar la relación entre el destete precoz y el desarrollo de alergias alimentarias a través de una revisión integradora. Metodo:Revisión integradora de la literatura realizada a través de las bases de datos Pubmed, Mesh y Scielo. Resultados: A través de la búsqueda de los descriptores determinados, se seleccionaron 25 estudios científicos que cumplieron con los criterios de inclusión. Debido a su gran composición, la leche humana es responsable de promover el crecimiento de bacterias con efecto bifidogénico, estando en mayores cantidades en bebés en LME. Conclusión:Aunque algunos de los estudios no mostraron resultados significativos con respecto a que la leche materna sea un factor protector contra las alergias alimentarias, ninguno de ellos falló en fomentar la BF o mostrar sus beneficios científicamente probados.

Analysis of food allergies in children with asthma in urban areas / 公共卫生与预防医学

Objective To explore food allergies in children with asthma in urban areas. Methods A total of 1 462 children with asthma who were treated in Mianyang Central Hospital of Sichuan Province from January 2018 to January 2019 were enrolled as the observation group, and 1,828 children who underwent physical examination in the same hospital at the same time were selected as the control group. The types and proportions of common food allergies were summarized and calculated, and the types and proportion of clinical symptoms in the two groups were statistically analyzed. Results A total of 219 children with food allergy were found in the observation group, and the prevalence rate was 14.98%. In the control group, 72 children with food allergy were found, and the prevalence rate was 3.94%. The difference between the two groups was statistically significant (χ2=5.036, P=0.024). The peanut allergy rate in the observation group was significantly higher than that in the control group, while the fruit allergy rate was significantly lower than that in the control group. The differences were statistically significant (P<0.05). The incidence of itch, lip and mucous membrane swelling, sneezing and shock were significantly higher in the observation group than in the control group, while the incidence of skin itching and rash was significantly lower than that in the control group. The differences were statistically significant (P<0.05). Conclusion The prevalence of food allergy in children with bronchial asthma is higher than that in non-bronchial asthma children, and the common food allergies and clinical symptoms of bronchial asthma are significantly different from those of non-bronchial asthma children. The clinicians can make a preliminary diagnosis based on the common food allergies and clinical symptoms of children.

Ventana óptima de introducción de alimentos y prevención de alergias alimentarias en lactantes de alto riesgo / Optimal window of food introduction and prevention of food allergies in high-risk infants

En las últimas décadas, la introducción temprana de alimentos en la dieta de los lactantes se ha descrito como un factor de riesgo para el desarrollo de ciertas patologías, entre las que destacan las alergias alimentarias. Debido a la creciente prevalencia de las alergias alimentarias, tanto en países en vías de desarrollo como en países desarrollados, resulta necesario identificar el momento óptimo de introducción de alimentos para la prevención de alergias en lactantes de alto riesgo. La evidencia más reciente, ha demostrado que las estrategias propuestas hasta el momento de retrasar la exposición a los alimentos alergénicos, no ha reducido el riesgo de desarrollar alergias. Esto ha producido un cambio de paradigma que ha derivado en la publicación de nuevas guías que recomiendan no retrasar la introducción de alimentos sólidos después de los 4-6 meses de edad, tanto en lactantes de bajo como de alto riesgo, para prevenir la alergia alimentaria. En la presente revisión, se describe la evidencia científica actual sobre la relación entre el momento de la introducción de alimentos alergénicos (maní, huevos, leche, cereales y pescado) en la dieta de los lactantes y el desarrollo de alergias alimentarias(AU)

In recent decades, the early introduction of foods in infants' diet has been described as a risk factor for developing specific pathologies, among which food allergies stand out. Due to the increasing prevalence of food allergies, both in developing and developed countries, it is necessary to identify the optimal time to introduce foods to prevent allergies in high-risk infants. The most recent evidence has shown that the strategies proposed to delay exposure to allergenic foods have not reduced the risk of developing allergies. Therefore, a paradigm shift has led to the publication of new guidelines that recommend not delaying the introduction of solid foods after 4-6 months of age, both in low-risk and high-risk infants, to prevent food allergy. In this review, we describe the current scientific evidence on the relationship between the timing of the introduction of allergenic foods (peanuts, eggs, milk, cereals, and fish) into infants' diet and the development of food allergies(AU)

Effect of 1,25-dihydroxy vitamin D3 on food allergy in mice / 中华实用儿科临床杂志

Objective To investigate the effects of 1,25-dihydroxy vitamin D3 [1,25 (OH)2D3] on food allergy(FA) in mice and its mechanism.Methods A total of 40 BALB/c mice were randomly divided into 5 groups,8 in each group,including control group (group C) and FA model group (FA group),according to the dose of 1,25 (OH)2 D3 intervention,the mice of the FA group were divided into FA0 group (0),FA1 group [10 μg/(kg · d)],FAm group [50 μg/(kg · d)] and FAh group[100 μg/(kg · d)].Egg albumin was used to establish a food allergy model,with different doses of 1,25 (OH)2D3 for gastric intervention,and the control group was replaced by 9 g/L saline.The serum levels of ovalbumin-immunoglobulin E(OVA-IgE),interleukin (IL)-9 and IL-17 of mice were measured by using enzyme linked immunosorbent assay after the last excitation,and HE staining and histopathological examination were carried out in the small intestine of mice.Results Compared with group C,FAo group and FAh group small intestinal mucosa in mice had different degrees of damage,partial peeling off,structure disorder,villi epithelial cell focal falls peeling off,necrosis,lamina propria edema,congestion,a large number of inflammatory cells infiltration,low but the FA1 group and FAm group had light mucosa damage,intestinal epithelial basically intact,with integrity,no congestion,edema,and inflammatory cells infiltration to a lesser degree.The mean concentrations of serum IgE,IL-9 and IL-17 in different groups were statistically significant (F =40.770,9.530,5.624,all P ＜ 0.05).Compared with the FA0 group [(41.87 ±3.19) ng/L],the OVA-IgE of the FA1 group [(22.71 ±4.77) ng/L] and the FAm group [(16.34 ±2.81) ng/L] were significantly reduced (t =5.533,1 1.835,all P ＜ 0.01),but there was no significant difference between the FAh group [(36.29 ± 6.52) ng/L] (t =1.673,P ＞ 0.05).Compared with the FA0 group [(161.77 ±50.44) ng/L],the IL-9 levels of the FA1 group [(94.29 ± 18.79) ng/L] and the FAm group [(84.45 ± 30.88) ng/L] were significantly lower (t =3.267,3.366,all P ＜ 0.01),while that of the FAh group [(36.29 ±6.52) ng/L] was not significantly lower (t =0.777,P ＞0.05).Compared with FA0 group [(81.55 ±29.37) ng/L],IL-17 levels of FAh group [(133.58 ± 47.05) ng/L] was significantly increased (t =2.653,P ＜0.05),while IL-17 level of FA1 group [(79.41 ± 25.15) ng/L] and FAm group [(58.81 ± 26.00) ng/L] were lower than that of FAo group [(81.55 ±29.37) ng/L],but the difference was not statistically significant (t =0.154,1.640,all P ＞ 0.05).Conclusions Low,medium dose of 1,25 (OH) 2 D3 supplements can inhibit mice food allergies,but high doses of 1,25 (OH)2 D3 improve performance in mice food allergies,and 1,25 (OH)2 D3's influence on the secretion of IL-9 is one that influences mechanism of food allergy.

Effect of 1, 25-dihydroxy vitamin D3 on food allergy in mice / 中华实用儿科临床杂志

Objective@#To investigate the effects of 1, 25-dihydroxy vitamin D3[1, 25(OH)2D3] on food allergy(FA) in mice and its mechanism.@*Methods@#A total of 40 BALB/c mice were randomly divided into 5 groups, 8 in each group, including control group (group C) and FA model group (FA group), according to the dose of 1, 25(OH)2D3 intervention, the mice of the FA group were divided into FA0 group (0), FAl group [10 μg/(kg·d)], FAm group [50 μg/(kg·d)] and FAh group[100 μg/(kg·d)]. Egg albumin was used to establish a food allergy model, with different doses of 1, 25(OH)2D3 for gastric intervention, and the control group was replaced by 9 g/L saline.The serum levels of ovalbumin-immunoglobulin E(OVA-IgE), interleukin(IL)-9 and IL-17 of mice were measured by using enzyme linked immunosorbent assay after the last excitation, and HE staining and histopathological examination were carried out in the small intestine of mice.@*Results@#Compared with group C, FA0 group and FAh group small intestinal mucosa in mice had different degrees of damage, partial peeling off, structure disorder, villi epithelial cell focal falls peeling off, necrosis, lamina propria edema, congestion, a large number of inflammatory cells infiltration, low but the FAl group and FAm group had light mucosa damage, intestinal epithelial basically intact, with integrity, no congestion, edema, and inflammatory cells infiltration to a lesser degree.The mean concentrations of serum IgE, IL-9 and IL-17 in different groups were statistically significant (F=40.770, 9.530, 5.624, all P<0.05). Compared with the FA0 group [(41.87±3.19) ng/L], the OVA-IgE of the FAl group [(22.71±4.77) ng/L] and the FAm group [(16.34±2.81) ng/L] were significantly reduced (t=5.533, 11.835, all P<0.01), but there was no significant difference between the FAh group [(36.29±6.52) ng/L] (t=1.673, P>0.05). Compared with the FA0 group [(161.77±50.44) ng/L], the IL-9 levels of the FAl group [(94.29±18.79) ng/L] and the FAm group[(84.45±30.88) ng/L] were significantly lower (t=3.267, 3.366, all P<0.01), while that of the FAh group [(36.29±6.52) ng/L] was not significantly lower (t=0.777, P>0.05). Compared with FA0 group [(81.55±29.37) ng/L], IL-17 levels of FAh group [(133.58±47.05) ng/L] was significantly increased (t=2.653, P<0.05), while IL-17 level of FAl group [(79.41±25.15) ng/L] and FAm group [(58.81±26.00) ng/L] were lower than that of FA0 group [(81.55±29.37) ng/L], but the difference was not statistically significant (t=0.154, 1.640, all P>0.05).@*Conclusions@#Low, medium dose of 1, 25(OH)2D3 supplements can inhibit mice food allergies, but high doses of 1, 25(OH)2D3 improve performance in mice food allergies, and 1, 25(OH)2D3′s influence on the secretion of IL-9 is one that influences mechanism of food allergy.

ALERGIA ALIMENTARIA EN LACTANTE ALIMENTADO CON SENO MATERNO EXCLUSIVO / Food allergy in an exclusively breastfed infant

El término alergia alimentaria se refiere a los eventos adversos a alimentos originados por mecanismo inmunológico. La alergia alimentaria puede aparecer en cualquier etapa de la vida. Es un padecimiento que, en general, se manifiesta en el lactante por llanto excesivo, cólicos, vómitos, diarreas, acompañadas de sangre y eccema en la piel. El objetivo de la investigación es demostrar la sensibilización del lactante a los alérgenos alimentarios que recibió en el útero de la madre y a través de la lactancia materna exclusiva. La metodología fue reporte de un caso al que se le suspendió la lactancia materna exclusiva y se introdujo leche en polvo hipoalergénica Puramino. La IgE total fue de 1.136 kU/l y los valores de IgE alérgeno específico para leche, el huevo y el maní mayores de 100 kU/l y para el trigo 24,4 kU/l. Se concluye así que la leche de vaca, el huevo, el maní y el trigo pueden sensibilizar al niño durante el embarazo y a través del seno materno. El uso de una dieta hipoalergénica durante el período de lactante puede revertir el proceso.(AU)

The term food allergy refers to adverse events caused by immunologic mechanism. Food allergy may appear at any stage of life, it is a condition that generally manifests itself in the baby's excessive crying, colic, vomiting, diarrhea accompanied by blood and skin eczema. The objective of the research is to demonstrate awareness infant to food allergens received in the mother's womb and through the exclusive breastfeeding. The methodology was a case report that was suspended exclusive breastfeeding and milk powder was introduced into hypoallergenic Puramino. The total IgE was 1.136 kU/L and allergen specific IgE values for milk, egg and peanut higher than 100 kU/L and wheat: 24. 4 kU/L. It is concluded that cow's milk, egg, peanuts and wheat can sensitize the child during pregnancy and through the womb. The use of a hypoallergenic diet during the infant can reverse the process.(AU)

Gastroduodenitis eosinofilica: a propósito de un caso / EOSINOPHILIC GASTRODUODENITIS: CASE REPORT

Introducción: La Gastroenteritis eosinofilica, se refiere a la eosinofilia en cualquiera de las capas de la pared del tracto gastrointestinal, es una patología rara, con incidencia no reportada y de patogenia desconocida, asociada a antecedentes de atopias y alergias alimentarias. Se requiere para su diagnóstico la evidencia histológica de eosinofilia, la ausencia de ésta en órganos extraintestinales y sin presencia de infección parasitaria. Caso clínico: Se reporta el caso de una paciente femenina de 39 años de edad, con clínica de 4 meses que inició posterior a intoxicación alimentaria y caracterizada por dolor abdominal difuso con predominio de epigástrico, opresivo, de fuerte intensidad, que mejoraba con uso de antiespasmódicos y se intensificaba con la ingestión de alimentos, acompañado de náuseas y vómitos. Se planteó el diagnóstico por imágenes de litiasis vesicular, siendo sometida a colecistectomía laparoscópica. Por persistencia de la sintomatología se realizó endoscopia digestiva superior con hallazgos sugestivos de: gastroduodenitis parasitaria y la biopsia reportó: gastroduodenitis crónica severa eosinofilica. Se indicó tratamiento a base de prednisona, obteniendo resolución completa del cuadro clínico.

Background: eosinophilic gastroenteritis, refers to eosino- philia in any of the layers of the wall of the gastrointestinal tract, it is a rare condition, with no reported incidence and unknown pathogenesis associated with a history of atopy and food allergies. It required for diagnosis histologic evidence of eosinophilia, its absence in intestinal organs without presence of parasitic infection. Case report: The case of a female patient of 39 years old, with clinical started 4 months after food poisoning, characterized by a predominance of diffuse abdominal pain epigastric, oppressive, strong intensity, which improved with use is reported antispasmodics and intensified with food intake, with nausea and vomiting. The imaging of gallstones was raised, undergoing laparoscopic cholecystec- tomy. Persistence of symptoms upper endoscopy is performed with suggestive findings: parasitic gastroduodenitis and biop- sy reported: severe chronic eosinophilic gastroduodenitis. Treatment with prednisone was indicated, obtaining complete resolution of symptoms.

Perception on food allergy labelling and management of nutritional education among higher grade elementary school students in Jeju area / 한국영양학회지

PURPOSE: This study was conducted to examine the prevalence of food allergy, food allergy knowledge, and perception on food allergen labelling along with management of substitute meals in school foodservice in elementary school students in Jeju, South Korea. METHODS: Six elementary schools in Jeju-si were randomly selected, and the higher grade elementary school students (n=1,500), from fourth graders to sixth graders, were surveyed using a questionnaire in July 2014. A total of 1,000 responses were used for data analysis. RESULTS: The percentage of students who had experienced food allergy was 16.7%; 26.4% had been diagnosed as having a food allergy by doctors. Milk, crabs, and shrimps were the most frequent allergenic foods with common symptoms including urticaria followed by itching, and vomiting. As the student's grade went up, the knowledge scores on food allergy showed a significant increase. Although students with and without food allergy experience had a similar level of knowledge on food allergy and perception on food allergen labelling, students with food allergy experience had a significantly lower level of healthy dietary practices. Last, only 20.4% of students with food allergies were offered substitute meals by school foodservices, and 30.8% of students received food allergy education. CONCLUSION: For prevention and management of food allergies in school foodservice, schools should provide an individualized substitute meal plan and food allergy education to students, parents, and teachers.

Características clínicas asociadas a colitis eosinofílica en lactantes con rectorragia persistente / Clinical features of Eosinophilic Colitis in infants with persistent rectal bleeding

The most common presentation of cow's milk protein allergy (CMP) in infants is known as eosinophilic colitis (EC). The aim of this study is to evaluate EC characteristics in infants evaluated with colonoscopy due to the presence of rectorrhagia. Patients and Methods: A retrospective case-control study. Left-sided colonoscopy records of infants with persistent rectal bleeding, conducted between January 2006 and March 2011, were reviewed. The cases corresponded to infants with rectal biopsy compatible with EC and controls with negative biopsy. Telephone questionnaires to parents were conducted, evaluating personal and family history. Results: Complete records were obtained in 61 (79%) of the 77 procedures. 33 (54%) of them were males. Examination average age was 6.3 ± 5.9 months. 25 (41%) patients had EC on their histology. Between cases and controls, no significant difference in gestational age, birth weight and gender, only regarding age at the time of rectal bleeding, were observed. There was also no difference in personal history regarding obstructive bronchitis, allergic rhinitis, family history of asthma, allergic rhinitis or other food allergies. Those who received artificial feeding did not presented greater risk of EC. The most common symptoms in the cases did not differ significantly from the controls. Conclusions: The prevalence of EC in the children studied was 40.9%. Our results show that there are groups of patients with persistent rectal bleeding in which there is no personal or family history that helps diagnosing EC. An endoscopic study could be considered in these patients to establish a correct diagnosis of this condition, avoid unnecessary diets and not to delay the detection of other diseases.

En lactantes, la forma de presentación más común de la alergia a la proteína de la leche de vaca (PLV) es la colitis eosinofílica (CE). El objetivo de este trabajo es evaluar características clínicas asociadas a CE en lactantes evaluados con colonoscopía por la presencia de rectorragia. Pacientes y Método: Estudio caso-control, retrospectivo. Se revisaron registros de colonoscopía izquierda de lactantes con rectorragia persistente, realizadas entre Enero 2006 y Marzo 2011. Casos fueron lactantes con rectorragia y biopsia compatible con CE y controles aquellos con biopsia negativa. Se realizó un cuestionario vía telefónica a los padres, evaluándose antecedentes personales y familiares. Resultados: En 61 (79%) de 77 procedimientos se obtuvo registros completos. 33 (54%) eran hombres. Edad promedio del examen fue 6,3 ± 5,9 meses. 25 (41%) pacientes presentaron CE en la histología. Sin diferencia significativa en edad gestacional, peso de nacimiento ni sexo, pero si en edad de presentación de la rectorragia, entre casos y controles. Tampoco hubo diferencia en antecedentes personales de bronquitis obstructivas, rinitis alérgica, ni antecedentes familiares de asma, rinitis alérgica u otras alergias alimentarias. Quienes recibieron lactancia artificial no tuvieron mayor riesgo de CE. Los síntomas más frecuentes en los casos no se diferenciaron significativamente de los controles. Conclusión: La prevalencia de CE en los niños estudiados fue de 40,9%. Nuestros resultados muestran que hay grupos de pacientes con rectorragia persistente en los cuales no existen antecedentes de la historia familiar ni personal que permitan establecer el diagnóstico de CE. Es en estos pacientes en los cuales podría considerarse el estudio endoscópico para establecer un correcto diagnóstico de esta patología, evitar dietas innecesarias y no retrasar la detección de otras enfermedades.

Prevalencia de alergias en niños entre 5 y 14 años con trastorno de déficitde atención e hiperactividad. Medellín, 2012 / Prevalence of allergies in children between 5 and 14 years of age with Attention Deficit and Hyperactivity Disorder. Medellin, 2012

Las enfermedades alérgicas y el trastorno por déficit de atención son entidades frecuentes enla niñez. Alguno autores han sugerido una asociación entre estas.Objetivos: Establecer la prevalencia de alergias en niños con déficit de atención y sus características clínicasy socio-demográficas en la consulta de neurología hecha por los autores.Materiales y Métodos: Estudio descriptivo, prospectivo, de corte transversal, con muestreo no aleatorio yselección de los casos de forma consecutiva. Se entrevistaron 113 niños que cumplían los criterios de inclusión,entre junio y diciembre de 2012. La información fue consignada en un formulario que contenía variables sociodemográficasy clínicas relacionadas con el déficit de atención y con los diferentes tipos de alergias.Resultados: Entre los pacientes entrevistados, la enfermedad alérgica mas frecuente fue la rinitis alérgica conel 37.2%, seguida por el asma, con 31.9%. Sin embargo, solo el asma presentó mayor prevalencia en pacientescon trastorno de déficit de atención e hiperactividad que en la población general. La dermatitis atópica se presentóen 8.8% y alergia alimentaria en 2.7%. En el análisis exploratorio, los niños con dermatitis atópica fueronlos únicos que presentaron una asociación significativa con insomnio (OR 4.23; IC 95%, 1.06-16; p=0.02).Conclusiones: La prevalencia de asma fue mayor en los pacientes estudiados con trastorno de déficit deatención e hiperactividad que la reportada en estudios poblacionales. Para los otros tipos de alergias la prevalencia fue similar...

Allergic diseases and attention deficit disorder are both common in pediatric population.Several authors had suggested an association between this two disorders.Objectives: To establish the prevalence of allergies in children with Attention Deficit and HyperactivityDisorder and their clinical and socio-demographic characteristics. Children included in the study were patientsin the neurologic practice of the authorscriteria were interviewed using a questionnaire that included clinical and socio-demographic variables relatedto Attention Deficit and Hyperactivity Disorder and allergies.Results: Among the 113 patients interviewed, the most common allergic disease was Allergic Rhinitis, whichaccounted for 37.2% of the cases, followed by asthma, which accounted for 31.9%. Asthma presents a higherprevalence in patients with Attention Deficit and Hyperactivity Disorder. Atopic Dermatitis was present in8.8% of the cases and Food Allergy in 2.7%. In an exploratory study, children with Atopic Dermatitis werethe only ones who presented a significant association with Insomnia (OR 4.23; CI 95%, 1.06-16; p=0.02).Conclusions: The prevalence of asthma was greater in those patients with Attention Deficit and HyperactivityDisorder than in those reported in population studies. For other types of allergies, this prevalence was similar....

Alergias alimentarias y la influenciade los métodos de procesado / Food allergies and the influence of processing methods / Alergias alimentares e a influênciados métodos de processamento

La incidencia de alergias alimentarias en los países desarrollados se estima que puede ser de un 3-4% en adultos y de un 6-8% en niños y sigue aumentando rápidamente. Los alérgenos alimentarios son principalmente proteínas que causan una respuesta inmune mediada por IgE, pero el mecanismo de esta respuesta todavía no es claro. La alergia al huevo es una causa frecuente de hipersensibilidad durante la niñez. La resistencia a la digestión es un criterio usado en los ensayos de alergenicidad de una proteína. En adición, es necesario tener en cuenta el efecto sobre las proteínas de los tratamientos comúnmente aplicados a los alimentos. Estos tratamientos pueden modificar la estructura de la proteína, cambiando su digestibilidad y alterando su alergenicidad.

The incidence of food allergy in developed countries is estimated to be 3-4% in adults and up to 6-8% in children, and it seems to be rising rapidly. Food allergens are mainly proteins that cause an IgE-mediated immune response, but the mechanism for this response still remains unclear. Egg allergy is a common cause of hypersensitivity in children. The resistance to digestion is one of the criteria used to assess the allergenicity of a protein. In addition, it is necessary to take into account the effect on proteins of the treatments that are commonly applied to foods. These treatments can modify the protein structure, changing the digestibility of the protein and thus altering its allergenicity.

Estima-se que a incidência de alergias alimentares nospaíses desenvolvidos pode ser 3-4% em adultos e 6-8%em crianças e continua aumentando rapidamente. Osalérgenos alimentares são principalmente as proteínasque causam uma resposta imune mediado por IgE, maso mecanismo desta resposta ainda não é claro. A alergia ao ovo é uma causa frequente da hipersensibilidade durante a infância. A resistência à digestão é um critério usado nos ensaios de alergenicidade de uma proteína. Além disso, é preciso ter em conta o efeito sobre as proteínas dos tratamentos normalmente aplicados aos alimentos. Estes tratamentos podem modificar a estrutura da proteína, alterando a sua digestibilidade e modificando a sua alergenicidade.

Dolor abdominal de origen orgánico en niños y adolescentes / Abdominal pain of organic origin in children and adolescents

El dolor abdominal constituye un motivo frecuente de consulta de niños y adolescentes. Éste puede ser de origen orgánico o funcional. En menores las causas son predominantemente orgánicas, y en los mayores de 5 años sólo el de 33 por ciento tiene este origen, y el 67 por ciento es funcional. Mediante una anamnesis acuciosa y un examen físico completo, el clínico podrá hacer una aproximación diagnóstica y orientar la solicitud de exámenes de manera dirigida. El objetivo de este artículo es entregar las herramientas semiológicas para lograr este objetivo.

Abdominal pain is a frequent complain of children and adolescents. This may have an organic or functional origin. In preschool children the causes are predominantly organic, and in those older than 5 years only percent have this origin, and 67 per cent are functional. Through a diligent history and physical examination, the clinician may make a proper approach to diagnosis and ask for complementary tests, if neccesary, in a target manner The aim of this article is to provide the semiologic tools to achieve this goal.

Doença celíaca, hábitos e práticas alimentares e qualidade de vida / Celiac disease, eating habits and practices and life quality of life

Esta comunicação apresenta o cenário da doença celíaca e suas implicações em hábitos, práticas alimentares e qualidade de vida de indivíduos intolerantes ao glúten. Apresenta dados importantes sobre a questão que, mundialmente, é considerada problema de saúde pública. Por ser uma doença cujo tratamento é fundamentalmente dietético, a terapia durante a transição alimentar deve ser bem conduzida pelo nutricionista para melhor adesão do paciente à dieta, considerando que a inclusão de novas práticas alimentares pode significar uma ruptura com a identidade individual e cultural: a alimentação de cada cidadão não pode ser deslocada da sociedade. Nesse contexto, a melhoria da qualidade de vida passa a ser um dos resultados esperados tanto das práticas assistenciais quanto das políticas públicas para o setor nos campos da promoção da saúde e da prevenção de doenças. A vigilância sanitária contempla as ações capazes de eliminar, diminuir ou prevenir riscos à saúde e de intervir nos problemas sanitários decorrentes do meio ambiente, da produção e circulação de bens e da prestação de serviços de interesse da saúde. O conhecimento do cenário da doença celíaca no País se justifica pela necessidade de fundamentar as ações da política de alimentação e nutrição ancoradas no conceito de alimentação saudável com ênfase na dieta isenta de glúten. Os artigos pesquisados foram selecionados nas bases de dados MedLine e SciELO, considerando o período de 1995 a 2006.

This study presents information on celiac disease and its implications on the eating habits and practices, as well as on the quality of life, of gluten-intolerant patients. Papers published from 1995 to 2006 were searched in the MedLine and SciELO databases. This paper includes important data about this disease, which is considered a public health problem throughout the world. Since it is a disease whose treatment is essentially dietary, therapy during food transition must be well conducted by the dietician in order to improve the patient's adherence to the diet since the introduction of new food practices may mean a rupture with the individual's culture and identity: the diet of each citizen cannot be disconnected from the society in which he or she lives in. In this context, quality of life is included, as quality of life is expected to improve both because of the care provided and because of the public policies for the sector in the areas of health promotion and prevention of diseases. Sanitary surveillance contemplates the activities that are capable of eliminating, reducing or preventing health risks and intervene in the sanitation problems that are secondary to the environment, production and circulation of goods and provision of health-related services. Knowledge about celiac disease in the country is justified because of the need to base food and nutrition policies on the concept of healthy eating, emphasizing a gluten-free diet.