Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 734
Filter
1.
Rev. Ciênc. Plur ; 7(3): 251-271, set. 2021. tab, ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1343617

ABSTRACT

Introdução:As alergias alimentares são definidas como uma reação imunológica adversa que se repete mediante a exposição a determinado alimento. Essas reações variam da anafilaxia (mais grave) à manifestações gastrointestinais.Objetivo:avaliar a eficácia da suplementação com probióticos no tratamento de alergias alimentares em crianças, na redução dos sintomas e/ou na aquisição de tolerância, identificando cepa mais eficaz, relação dose-resposta e efeitos adversos de seu uso. Metodologia:Esta é uma revisão integrativa de literatura. Para busca de ensaios clínicos e outras revisões, utilizamos as bases científicas ScienceDirect, SciELO, BVS, LILACS, PubMed e MEDLINE, com as palavras-chave "probiotics", "treatment", "food allergy", "children", e "infant". Após a aplicação dos critérios de exclusão, foram selecionados quatro ensaios clínicos randomizados, cinco revisões e uma metanálise; a amostra de todos os estudos foi de lactentes com alergia à proteína do leite de vaca. Resultados:Os estudos apontaram que o uso de fórmula infantil extensamente hidrolisada com Lactobacillus rhamnosus, em doses de 1x106 a 5x108 cfu/g, é eficaz tanto em acelerar a melhora do eczema atópico, como em induzir tolerância em crianças na faixa de idade de 1 mês a 3 anos que não tenham reações anafiláticas ao leite de vaca. Conclusões:Há evidências escassas de que o uso de fórmula infantil extensamente hidrolisada com Lactobacillus rhamnosus, em doses de 1x10


Introduction:Food allergies are defined as an adverse immunological reaction that is repeated through exposure to a particular food. These reactions range from anaphylaxis (more severe) to gastrointestinal manifestations.Objective:To evaluate the effectiveness of probiotics in the treatment of food allergies in children, relieving symptoms or inducing tolerance, identifying the most effective strain, dosage and adverse effects. Methodology:This is an integrative literature review. We performed a systematic search using the keywords "probiotics", "treatment", "food allergy", "children", and "infant" in the following scientific databases: ScienceDirect, SciELO, BVS, LILACS, PubMed, and MEDLINE. After applying the exclusion criteria, we selected four randomized clinical trials, five reviews and one meta-analysis. In all of them, the children were diagnosed with cow's milk allergy. Results:The studies have indicated that the use of extensively hydrolysed milk formula with the addition of Lactobacillus rhamnosus with dosage ranging from 1x106 to 5x108 cfu/g is effective in inducing tolerance and reducing severity of eczema in infants with no history of anaphylactic symptoms. Conclusions:There is limited evidence that the use of extensively hydrolysed milk formula with the addition of Lactobacillus rhamnosus, at doses of 1x10


Introducción: las alergias alimentarias se definen como una reacción inmunológica adversa que se repite tras la exposición a un alimento concreto. Estas reacciones van desde la anafilaxia (la más grave) hasta las manifestaciones gastrointestinales.Objetivo:Evaluar la eficacia del suplemento con probióticos en el tratamiento de las alergias alimentarias en niños, en la reducción de los síntomas y/o en la adquisición de tolerancia, identificando la cepa más eficaz, la relación dosis-respuesta y los efectos adversos de su uso.Metodología: Se trata de una revisión bibliográfica integradora. Para la búsqueda de ensayos clínicos y otras revisiones se utilizaron las bases de datos científicas ScienceDirect, SciELO, BVS, LILACS, PubMed y MEDLINE, con las palabras clave "probiotics", "treatment", "food allergy", "children" y "infant". Después de aplicar los criterios de exclusión, se seleccionaron cuatro ensayos clínicos aleatorios, cinco revisiones y un metanálisis; la muestra de todos los estudios fue de lactantes con alergia a las proteínas de la leche de vaca. Resultados: Los estudios señalaron que el uso de fórmulas infantiles extensamente hidrolizadas con Lactobacillus rhamnosus, en dosis de 1x106 a 5x108 ufc/g, es eficaz tanto para acelerar la mejora del eczema atópico como para inducir la tolerancia en niños de entre 1 mes y 3 años de edad que no presentan reacciones anafilácticas a la leche de vaca.Conclusiones: existen pruebas limitadas de que el uso de fórmulas infantiles extensamente hidrolizadas con Lactobacillus rhamnosus, en dosis de 1x10


Subject(s)
Milk Hypersensitivity , Probiotics , Food Hypersensitivity , Brazil , Efficacy
2.
Article in English | WPRIM | ID: wpr-880362

ABSTRACT

BACKGROUND@#Food allergy (FA) is a common disease in children, and its prevalence has increased in developed countries. The impact of overweight on children health also becomes an important social problem. However, the relationship between overweight and FA is still unclear. We examined the association between overweight and the prevalence of FA among Japanese children.@*METHODS@#We analyzed data obtained using a self-administered questionnaire from 1772 Japanese children. Weight groups according to body mass index cutoff points proposed by the International Obesity Task Force were used to create two groups: overweight and non-overweight. Children were separated into four age groups (3-6 years, 6-9 years, 9-12 years, and 12-15 years) to examine age differences. We performed univariate and multivariate logistic models to examine the association between overweight and FA.@*RESULTS@#The prevalence of FA was significantly higher in boys (10.6%, p = 0.014) than girls (4.5%) and girls (7.9%, p = 0.012) than boys (2.5%) for 6-9 and 12-15 age groups, respectively. While the prevalence of FA was significantly higher in overweight than non-overweight girls (26.1%, p = 0.005) in the 12-15 age group, no significant difference was found in boys. In girls, overweight was significantly associated with FA after adjustment for age and asthma (odds ratio 1.99, 95% confidence interval 1.01-3.89, p = 0.046).@*CONCLUSIONS@#Our results showed that being overweight was significantly associated with a higher prevalence of FA in girls, but not in boys. Further prospective studies are necessary to find the causal relationship between overweight and FA.


Subject(s)
Adolescent , Body Mass Index , Child , Child, Preschool , Cross-Sectional Studies , Female , Food Hypersensitivity/epidemiology , Humans , Japan/epidemiology , Male , Overweight/epidemiology , Prevalence , Sex Factors
3.
Arch. argent. pediatr ; 118(6): 418-422, dic 2020. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1146110

ABSTRACT

Introducción: Las alergias alimentarias afectan, mayoritariamente, a los niños en los primeros años de vida. Existen escasos datos epidemiológicos en nuestro país.Objetivos: Determinar los agentes causales, describir la prevalencia y características de los pacientes con alergia alimentaria en una población pediátrica argentina.Pacientes y métodos: Estudio retrospectivo observacional, de corte transversal, de pacientes menores de 18 años. Resultados: Se incluyeron 321 pacientes; se confirmó alergia alimentaria en un 64 % (207) de los casos. El 53 % (109) presentó mecanismo mediado por inmunoglobulina E; el 68 % (140), alergia a las proteínas de la leche de vaca; el 20 % (41), alergia al huevo, y el 12 % (24), anafilaxia como manifestación clínica. La prevalencia global de alergia alimentaria fue del 0,87 % (IC 95 %: 0,7-0,9).Conclusiones: La prevalencia global de alergia alimentaria fue del 0,87 %. La leche de vaca resultó el principal alérgeno incluso en adolescentes.


Introduction: Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce. Objectives: To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population. Patients and methods: Observational, retrospective, cross-sectional study on patients younger than 18 years. Results:A total of 321 patients were included; food allergy was confirmed in 64 % (207) of cases. An immunoglobulin E-mediated mechanism was observed in 53 % (109); cow's milk protein allergy, in 68 % (140); egg allergy, in 20 % (41); and anaphylaxis as clinical manifestation, in 12 % (24). The overall prevalence of food allergy was 0.87 % (95 % confidence interval: 0.7-0.9). Conclusions: The overall prevalence of food allergy was 0.87 %. Cow's milk was the main allergen, even among adolescents


Subject(s)
Humans , Male , Female , Child , Adolescent , Food Hypersensitivity/diagnosis , Immunoglobulin E/immunology , Epidemiologic Studies , Cross-Sectional Studies , Retrospective Studies , Milk Hypersensitivity
4.
Rev. chil. nutr ; 47(3): 463-469, jun. 2020. tab
Article in English | LILACS | ID: biblio-1126145

ABSTRACT

The addition of soy proteins, currently classified as a food allergen, into meat products is a commonly used practice due to its functional properties and low cost. Its addition to meat products can cause health problems for individuals allergic to these proteins. Allergic individuals can be affected by the ingestion of low amounts of the allergen. In Brazil, limits are set for the addition of soy proteins in meat products in order to avoide fraud. Starting in 2015 reporting the name of the added component became mandatory for all food labelling. Some studies have reported that food processing can reduce the allergenicity, either by irreversible removal of allergens or by modifying the allergen structure. However, the technological approach to decrease allergenicity has largely been empirical. This review describes the use of soy protein in meat products and the health risk for allergic individuals and consumers of these products. Finally, appropriate methodologies for the detection and quantification of these proteins must be further explored and established to avoid fraud and to preserve consumer health.


La adición de proteínas de soya, actualmente clasificadas como alergeno alimentario, en los productos cárnicos es una práctica comúnmente utilizada debido a sus propiedades funcionales y bajo costo. Su adición en productos cárnicos puede causar problemas de salud en personas alérgicas a estas proteínas. Las personas alérgicas pueden verse afectadas por la ingestión de cantidades diminutas de alérgeno. En Brasil, se establecen límites para la adición de proteínas de soya en los productos cárnicos con el objetivo de evitar el fraude. Solo en 2015 se hizo obligatoria la declaración en la etiqueta de todos los alimentos que indicaban la presencia de sustancias alérgicas, así como el nombre del componente. Algunos estudios se refieren al procesamiento de alimentos para reducir la alergenicidad, ya sea mediante la eliminación irreversible de alergenos o modificando la estructura del alergeno; sin embargo, el enfoque tecnológico hasta ahora para disminuir la alergenicidad ha sido en gran medida empírico. Esta revisión describe el uso de proteína de soya en los productos cárnicos y el riesgo que puede causar para la salud de las personas alérgicas y a los consumidores de estos productos. Finalmente, las metodologías apropiadas para la detección y cuantificación de estas proteínas deben explorarse en profundidad y establecerse para evitar el fraude y preservar la salud de los consumidores.


Subject(s)
Humans , Plant Proteins, Dietary/adverse effects , Soybean Proteins/adverse effects , Food Hypersensitivity/etiology , Meat Products , Allergens , Health Risk , Food Hypersensitivity/prevention & control , Epitopes
5.
Rev. chil. neuro-psiquiatr ; 58(2): 171-185, jun. 2020. tab
Article in Spanish | LILACS | ID: biblio-1115482

ABSTRACT

Resumen Introducción: El espectro evitativo/restrictivo de la conducta alimentaria, incluye el trastorno evitativo/restrictivo de la ingestión de alimentos (TERIA), y otros desórdenes que implican a veces traslapes, entrecruzamientos y virajes con otros trastornos alimentarios. Objetivo: Se realiza un análisis descriptivo del TERIA, y de otros trastornos alimentarios, en relación a sus aspectos epidemiológicos, etiopatogénicos, clínicos y terapéuticos. Se incluyen viñetas clínicas ilustrativas. Método: Se efectuó una búsqueda bibliográfica sobre el TERIA y otros trastornos alimentarios mediante las bases de datos Medline/PubMed, SciELO y textos especializados. Resultados: El TERIA, que en el DSM-5 adquiere la categoría de un trastorno alimentario bien definido, puede ser precedido por el comer selectivo/exigente. Los pacientes son principalmente hombres jóvenes con evolución prolongada del desorden. Otros trastornos alimentarios incluidos en el abanico evitativo/restrictivo son: anorexia nerviosa, alergia e intolerancia alimentaria y ortorexia nerviosa, como un concepto sindromático relativamente reciente. Existe controversia si la ortorexia nerviosa es un trastorno alimentario único o una consecuencia del desenlace de éste o un proceso obsesivo-compulsivo. El antecedente de trastorno alimentario es un factor predictivo significativo para ortorexia nerviosa. Todos estos desórdenes pueden producir diversos niveles de desnutrición e interferencia en el desempeño psicosocial. El manejo terapéutico requiere un equipo multidisciplinario que incluya médicos, psicoterapeutas, nutricionistas, psicoeducación, psicoterapia cognitivo-conductual, asesoría nutricional, y en ocasiones terapia farmacológica anti-serotoninérgica. Conclusiones: Se necesita una mayor evidencia en la investigación de estos nuevos fenotipos de trastornos alimentarios para determinar su impacto en aspectos demográficos, nosológicos, clínicos y terapéuticos.


Background: The avoidant/restrictive spectrum of eating behaviour includes the avoidant/restrictive of food intake disorder (ARFID), sometimes involving overlapping, crossing and turning with other eating disorders. Objective: A descriptive analysis of ARFID and other eating disorders is performed in relation to its epidemiological, etiopathogenic, clinical and therapeutic aspects. Illustrative clinical vignettes are included. Method: A review of specialised textbooks and the available literature in Medline/PubMed and SciELO on ARFID and other eating disorders was carried out. Results: ARFID, which in the DSM-5 acquires the category of a well-defined eating disorder, may be preceded by selective/picky eating. Patients are mainly young men with a long evolution of the disorder. Other eating disorders included in the avoidant/ restrictive range are: anorexia nervosa, food allergy and intolerance and orthorexia nervosa; the lately as a relatively recent syndromatic concept. It has been controversial whether orthorexia nervosa is a unique eating disorder, a consequence of its outcome or an obsessive-compulsive process. The historical background of an eating disorder is a significant predictive factor for orthorexia nervosa. All these disorders can produce different levels of malnutrition and interference in psychosocial performance. The therapeutic management requires a multidisciplinary team that includes physicians, psychotherapists, nutritionists, psychoeducation, cognitive-behavioural psychotherapy, nutritional counselling, and sometimes anti-serotonergic drug therapy. Conclusions: More evidence is needed in the research of these new phenotypes of eating disorders to determine their impact on demographic, nosological, clinical and therapeutic aspects.


Subject(s)
Humans , Anorexia Nervosa , Malnutrition , Feeding Behavior , Food Hypersensitivity , Food Intolerance , Avoidant Restrictive Food Intake Disorder
6.
Einstein (Säo Paulo) ; 18: eRC5478, 2020. graf
Article in English | LILACS | ID: biblio-1142868

ABSTRACT

ABSTRACT A 33-year-old male with house dust mite allergic rhinitis and asthma reported an episode of facial and lip angioedema, dyspnea, cough and dysphagia at the age of 25, minutes after eating a mushroom ( Agaricus bisporus ) pizza. He denied any drug intake, hymenoptera stings or other possible triggers, and no identifiable cofactors were present. Since then he avoided all types of mushrooms, however an accidental contact occurred with mushroom sauce that resulted in angioedema of the lip within minutes. The allergy workup included measurements of total IgE and specific IgE to mushroom, and skin prick test to aeroallergens sources, possible food allergen sources and mushroom extract, a prick to prick test with raw and cooked A. bisporus , in addition to a SDS-PAGE and immunoblotting assay. The study revealed a specific IgE to mushroom of 0.76kUA/L positive skin prick test to mushroom extract, and prick to prick test positive to white and brown A. bisporus (raw and cooked). The immunoblotting identified two IgE binding proteins with 10kDa and 27kDa. We report a case of A. bisporus anaphylaxis probably due to primary mushroom sensitization. We detected two IgE-reactive proteins with 10kDa and 27kDa as possible culprit allergens.


RESUMO Paciente do sexo masculino, 33 anos, com asma e rinite alérgica desencadeadas por ácaros, relatou episódio de angioedema facial e labial, dispneia, tosse e disfagia aos 25 anos, minutos após a ingestão de uma pizza de cogumelo ( Agaricus bisporus ). O paciente negou consumo de medicamentos, picadas de himenópteros, ou quaisquer outros possíveis desencadeadores ou cofatores que pudessem estar presentes. Desde então, evita todos os tipos de cogumelos, até a ocorrência de um contato acidental com molho de cogumelo, que resultou em angioedema labial minutos após. O estudo imunoalergológico incluiu doseamento de IgE total e específica para cogumelos, testes cutâneos para aeroalérgenos, possíveis alérgenos alimentares e extrato de cogumelos, teste prick to prick com A. bisporus cru e cozido e teste de SDS-PAGE immunoblotting . O estudo revelou IgE específica para cogumelos de 0,76kUA/L, teste cutâneo positivo para extrato de cogumelos e teste prick to prick positivo para A. bisporus branco e castanho (cru e cozido). O immunoblotting identificou duas proteínas de ligação de IgE, de 10kDa e 27kDa. Relatamos, assim, um caso de anafilaxia por ingestão de A. bisporus , provavelmente explicado por sensibilização primária a cogumelos. Detectamos duas proteínas IgE-reativas de 10kDa e 27kDa como os possíveis alérgenos responsáveis.


Subject(s)
Humans , Animals , Male , Adult , Cats , Agaricus , Deglutition Disorders/etiology , Cough/etiology , Dyspnea/etiology , Food Hypersensitivity/immunology , Anaphylaxis/etiology , Angioedema/etiology , Immunoglobulin E/blood , Skin Tests , Allergens , Alternaria , Flour , Anaphylaxis/chemically induced
7.
Article in English | WPRIM | ID: wpr-826305

ABSTRACT

BACKGROUND@#Adjuvants used in inactivated vaccines often upregulate type 2 immunity, which is dominant in allergic diseases. We hypothesised that cumulative adjuvant exposure in infancy may influence the development of allergies later in life by changing the balance of type 1/type 2 immunity. We examined the relationship between immunisation with different vaccine types and later allergic disease development.@*METHODS@#We obtained information regarding vaccinations and allergic diseases through questionnaires that were used in The Japan Environment and Children's Study (JECS), which is a nationwide, multicentre, prospective birth cohort study that included 103,099 pregnant women and their children. We examined potential associations between the initial vaccination before 6 months of age and symptoms related to allergies at 12 months of age.@*RESULTS@#Our statistical analyses included 56,277 children. Physician-diagnosed asthma was associated with receiving three (aOR 1.395, 95% CI 1.028-1.893) or four to five different inactivated vaccines (aOR 1.544, 95% CI 1.149-2.075), compared with children who received only one inactivated vaccine. Similar results were found for two questionnaire-based symptoms, i.e. wheeze (aOR 1.238, 95% CI 1.094-1.401; three vaccines vs. a single vaccine) and eczema (aOR 1.144, 95% CI 1.007-1.299; four or five vaccines vs. a single vaccine).@*CONCLUSIONS@#Our results, which should be cautiously interpreted, suggest that the prevalence of asthma, wheeze and eczema among children at 12 months of age might be related to the amount of inactivated vaccine exposure before 6 months of age. Future work should assess if this association is due to cumulative adjuvant exposure. Despite this possible association, we strongly support the global vaccination strategy and recommend that immunisations continue.@*TRIAL REGISTRATION@#UMIN000030786 .


Subject(s)
Asthma , Epidemiology , Cohort Studies , Dermatitis, Atopic , Epidemiology , Female , Food Hypersensitivity , Epidemiology , Humans , Hypersensitivity , Epidemiology , Infant , Infant, Newborn , Japan , Male , Vaccines, Inactivated , Viral Vaccines
8.
Article in English | WPRIM | ID: wpr-811415

ABSTRACT

PURPOSE: The Cow's Milk-related Symptom Score (CoMiSS™), which considers crying, regurgitation, stools, skin and respiratory symptoms, was developed as an awareness tool for evaluating cow's milk-related symptoms. The scoring ranges from 0 to 33. A score ≥12 was proposed as being likely cow's milk-related and suggestive of allergy to cow's milk. This study aimed to determine the age-related CoMiSS™ values in presumed healthy infants in Poland.METHODS: This was a cross-sectional study conducted in well-child clinics in two locations. Parents of the presumed healthy infants aged ≤6 months were approached during a routine checkup/vaccination visit. The exclusion criteria were as follows: presence of acute or chronic diseases, preterm delivery, treatment with therapeutic formula, and use of any food supplements (except vitamins) or medications.RESULTS: Data from 226 infants were obtained (median age [Q1–Q3], 4 months [3–4]). The overall median (Q1–Q3) and mean (standard deviation) CoMiSS™ values were 4 (2–7) and 4.7 (3.5), respectively. The 95th percentile was 11. Scores on some, albeit not all, components of the CoMiSS™ significantly differed between age groups (crying, stools) or feeding type groups (stools and skin symptoms). Eleven children (4.9%) scored ≥12.CONCLUSION: This study adds to earlier age-related CoMiSS™ data by providing CoMiSS™ values in presumed healthy infants in Poland.


Subject(s)
Child , Chronic Disease , Cross-Sectional Studies , Crying , Dietary Supplements , Food Hypersensitivity , Humans , Hypersensitivity , Infant , Milk , Parents , Poland , Skin
9.
Article in English | WPRIM | ID: wpr-811064

ABSTRACT

PURPOSE: Details of patients hospitalized for asthma exacerbation in mainland China are lacking. To improve disease control and reduce economic burden, a large sample survey among this patient population is indispensable. This study aimed to investigate the clinical characteristics and outcomes of such patients.METHODS: A retrospective study was conducted on patients hospitalized for asthma exacerbation in 29 hospitals of 29 regions in mainland China during the period 2013 to 2014. Demographic features, pre-admission conditions, exacerbation details, and outcomes were summarized. Risk factors for exacerbation severity were analyzed.RESULTS: There were 3,240 asthmatic patients included in this study (57.7% females, 42.3% males). Only 28.0% used daily controller medications; 1,287 (39.7%) patients were not currently on inhaled corticosteroids. Acute upper airway infection was the most common trigger of exacerbation (42.3%). Patients with severe to life-threatening exacerbation tended to have a longer disease course, a smoking history, and had comorbidities such as hypertension, chronic obstructive pulmonary disease (COPD), and food allergy. The multivariate analysis showed that smoking history, comorbidities of hypertension, COPD, and food allergy were independent risk factors for more severe exacerbation. The number of patients hospitalized for asthma exacerbation varied with seasons, peaking in March and September. Eight patients died during the study period (mortality 0.25%).CONCLUSIONS: Despite enhanced education on asthma self-management in China during recent years, few patients were using daily controller medications before the onset of their exacerbation, indicating that more educational efforts and considerations are needed. The findings of this study may improve our understanding of hospital admission for asthma exacerbation in mainland China and provide evidence for decision-making.


Subject(s)
Adrenal Cortex Hormones , Asthma , China , Comorbidity , Disease Progression , Education , Female , Food Hypersensitivity , Hospitalization , Humans , Hypertension , Inpatients , Medication Adherence , Mortality , Multivariate Analysis , Pulmonary Disease, Chronic Obstructive , Retrospective Studies , Risk Factors , Seasons , Self Care , Smoke , Smoking
11.
Asia Pacific Allergy ; (4): 1-2020.
Article in English | WPRIM | ID: wpr-785464

ABSTRACT

BACKGROUND: In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.OBJECTIVE: Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.METHODS: Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the National Institute of Allergy and Infectious Disease and the Food Allergy and Anaphylaxis Network (NIAID/FAAN) were included. Data collected included demographics, signs and symptoms, triggers and management.RESULTS: A total of 105 cases were evaluated. Incidence of anaphylaxis for the 3-year study period was 0.03%. Of the 105 cases, 35 (33%) were diagnosed as “urticaria” or “hypersensitivity reaction” despite fulfilling the NIAID/FAAN anaphylaxis criteria. There was a significant difference in epinephrine administration between those given the diagnosis of anaphylaxis versus misdiagnosed cases (61 [87%] vs. 12 [34%], χ² = 30.77, p < 0.01); and a significant difference in time interval from arrival at the ED to epinephrine administration, with those diagnosed as anaphylaxis (48%) receiving epinephrine within 10 minutes, versus ≥ 60 minutes for most of the misdiagnosed group (χ² = 52.97, p < 0.01).CONCLUSION: Despite current guidelines, anaphylaxis is still misdiagnosed in the ED. Having an ED diagnosis of anaphylaxis significantly increases the likelihood of epinephrine administration, and at a shorter time interval.


Subject(s)
Anaphylaxis , Classification , Clinical Coding , Communicable Diseases , Demography , Diagnosis , Emergencies , Emergency Service, Hospital , Epinephrine , Food Hypersensitivity , Hospitals, Urban , Humans , Hypersensitivity , Incidence , Philippines , Retrospective Studies , Tertiary Care Centers
12.
Asia Pacific Allergy ; (4): 4-2020.
Article in English | WPRIM | ID: wpr-785461

ABSTRACT

BACKGROUND: Banana fruit has been recognized as an important food allergen source. Nowadays banana hypersensitivity had been reported more frequently with various presentations from oral allergy syndrome to anaphylaxis.OBJECTIVE: This study aims to describe the pattern of banana hypersensitivity and the sensitivity of diagnostic test.METHODS: Six patients who experienced banana hypersensitivity were recruited from adult allergy clinic, Ramathibodi Hospital, Mahidol University between 2015–2018. Demographic data, pattern of banana allergy consisted of the onset of reaction, symptoms, severity, cross-reactivity to kiwi, avocado, latex including type and amount of banana were collected. Skin test, serum specific IgE to banana and open-label food challenge test had been applied.RESULTS: All patients experienced multiple episodes of banana anaphylaxis. Regarding the diagnostic investigation, prick-to-prick skin test had higher sensitivity (sensitivity, 100%; 95% confidence interval [CI], 54.07%–100%) than the commercial banana extract (sensitivity, 83.33%; 95% CI, 35.88%–99.58%) and serum specific IgE to banana (sensitivity, 50%; 95% CI, 11.81%–88.19%). The discordance between skin prick test using commercial banana extract and skin test was reported. The cross-reactivity between the species of banana, kiwi, the avocado was documented in all patients. Latex skin prick test and application test were applied with negative results. From the oral food challenge test, a case of banana anaphylaxis patient can tolerate heated banana.CONCLUSION: The various phenotypes of banana hypersensitivity were identified. The prick-to-prick test showed the highest sensitivity for diagnosis of banana allergy. However, component resolved diagnostics might be needed for conclusive diagnosis.


Subject(s)
Adult , Anaphylaxis , Diagnosis , Diagnostic Tests, Routine , Food Hypersensitivity , Fruit , Hot Temperature , Humans , Hypersensitivity , Hypersensitivity, Immediate , Immunoglobulin E , Latex , Musa , Persea , Phenotype , Skin , Skin Tests , Thailand
13.
Asia Pacific Allergy ; (4): 9-2020.
Article in English | WPRIM | ID: wpr-785456

ABSTRACT

BACKGROUND: Recently, the prevalence of food allergies during childhood is increasing, with fruits being common allergens. However, data on allergens that cause fruit and vegetable allergies and pollen-food allergy syndrome (PFAS) in childhood are relatively few. This study aimed to examine the allergens in fruit and vegetable allergies in pediatric patients and to determine the association between fruit and vegetable allergies and PFAS.OBJECTIVE: This study aimed to examine the current status of fruit and vegetable allergies in Japanese children.METHODS: This was a multicenter case series observational study. The participants included children aged <15 years who developed allergic symptoms after eating fruits and vegetables and subsequently received treatment in the Pediatric Department of 6 hospitals in the Osaka Prefecture in Japan during the study period from August 2016 to July 2017. Participants' information was obtained using a questionnaire, and data were obtained by performing several types of allergy tests using blood samples.RESULTS: A total of 97 children (median age, 9 years; 56 males) were included in the study. Apple was the most common allergen, followed by peach, kiwi, cantaloupe, and watermelon. A total of 74 participants (76%) exhibited allergic symptoms due to PFAS; moreover, pathogenesis-related protein-10 (PR-10) was the most common allergen superfamily. On the contrary, in the group where neither PR-10 nor profilin was sensitized, kiwi and banana were the most common allergens, and the age of onset was lower than that in the PFAS group. Specific antibody titer was significantly associated with Birch for Bet v1 and latex for Bet v2 (r = 0.99 and r = 0.89).CONCLUSION: When we examine patients with fruit and vegetable allergies, we should first consider PFAS even in childhood specifically for children greater than 4 years old.


Subject(s)
Age of Onset , Allergens , Asian Continental Ancestry Group , Betula , Child , Citrullus , Clinical Study , Cucumis melo , Eating , Food Hypersensitivity , Fruit , Humans , Hypersensitivity , Japan , Latex , Musa , Observational Study , Prevalence , Profilins , Prunus persica , Rhinitis , Rhinitis, Allergic, Seasonal , Vegetables
14.
Rev. salud pública ; 21(6): e169898, Nov.-Dec. 2019. tab
Article in English | LILACS | ID: biblio-1099277

ABSTRACT

ABSTRACT Objective This study aimed to determine the dietary habits related to fish consumption and the risk factors associated with acquiring an ichthyo-zoonotic disease. Materials and Methods A descriptive, cross-sectional study was carried out by means of a structured survey administered to 150 individuals in the city of Cali, Colombia. Results Epidemiological variables regarding fish consumption and preparation were contrasted with the medical records of the respondents. The median fish consumption in the surveyed population was three times a month, with raw or salted/marinated fish once a month. A positive correlation between fish consumption and allergic conditions was confirmed. There was no infectious or parasitic history associated with the data on fish consumption. Conclusions A relationship between fish consumption and allergies was confirmed. Further research is necessary to establish the possible pathogens associated with hypersensitivity, such as parasites of the Anisakidae family.(AU)


RESUMEN Objetivo Este estudio tuvo como fin determinar los hábitos alimenticios relacionados con el consumo de pescado y los factores de riesgo asociados con la adquisición de una enfermedad ictio-zoonótica. Materiales y Métodos Se realizó un estudio descriptivo de corte transversal mediante una encuesta estructurada a 150 individuos de la ciudad de Cali, Colombia. Resultados Las variables epidemiológicas del consumo y preparación de pescado se relacionaron con la historia clínica de los encuestados. El consumo medio de pescado en los encuestados fue de tres veces al mes, con pescado crudo o salado/marinado una vez al mes. Se confirmó una correlación positiva entre el consumo de pescado y las condiciones alérgicas. No se asociaron antecedentes infecciosos o parasitarios con los datos sobre el consumo de pescado. Conclusión Fue posible confirmar una relación entre el consumo de pescado y las condiciones alérgicas. Se necesita investigación para establecer los posibles patógenos asociados con la hipersensibilidad, como los parásitos de la familia Anisakidae.(AU)


Subject(s)
Humans , Zoonoses/etiology , Food Hypersensitivity/etiology , Foodborne Diseases/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Cohort Studies , Colombia
15.
Arch. argent. pediatr ; 117(5): 306-313, oct. 2019. ilus, tab
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1054957

ABSTRACT

Objetivo. La alergia alimentaria es un problema de salud pública. Los objetivos fueron determinar la asociación entre la alergia a la proteína de la leche de vaca (APLV) y la vitamina 25(OH)D en los lactantes diagnosticados con APLV y la asociación entre la 25(OH)D y (a) tamaño de la zona indurada en la prueba intraepidérmica, (b) IgE específica para leche y (c) IgE específica para caseína. Métodos. Estudio de casos y controles prospectivo, observacional con niños < 2 años con APLV confirmada mediante prueba de exposición oral al alimento. Se incluyó a lactantes sanos como controles. La concentración sérica de 25(OH)D se obtuvo en ambos grupos. Se estudió la correlación entre la vitamina D y la APLV. Resultados. Entre los pacientes (n: 56), el 41,1 % (n: 23) tenía alergia mediada por la IgE y el 58,9 % (n: 33), alergia no mediada por la IgE. No hubo diferencias estadísticamente significativas entre los grupos con APLV y de referencia (n: 55) en la 25(OH)D (33,85 ± 16,18 ng/ml, 30,70 ± 14,90 ng/ml; respectivamente, p : 0,289). No hubo diferencias estadísticamente significativas entre los grupos según la 25(OH)D (adecuada, insuficiencia, deficiencia; p = 0,099). Con la prueba intraepidérmica, se determinó una correlación negativa sin significancia estadística entre la zona indurada del antígeno de la leche y la 25(OH)D (p: 0,794; r = -0,037). Conclusiones. No se observaron diferencias significativas en la 25(OH)D entre ambos grupos. Estos resultados no respaldan la solicitud de rutina de análisis de 25(OH)D en los lactantes con APLV.


Aim. Food allergy is an important public health concern with an increasing prevalence. The objectives were to determine the possible association between cow's milk protein allergy (CMPA) and 25(OH)D (vitamin-D) levels of infants with an initial diagnosis of CMPA and the association between 25(OH)D levels and (a) SPT (skin prick test) induration size, (b) specific IgE to milk, (c) specific IgE to casein. Methods. Prospective, observational, case control study; the study group was composed of children < 2 years of age with a diagnosis of CMPA confirmed by an oral food challenge test. Healthy infants were enrolled as controls. Serum 25(OH) D levels were obtained at the initial workup in both groups. The correlation of vitamin-D levels was investigated in the development of CMPA. Results. Among the study group of patients (n:56) 41,1% (n:23) had IgE-mediated and 58,9% (n:33) had non-IgE-mediated allergies There were no statistically significant differences between the CMPA and control groups (n: 55), in terms of serum 25(OH)D levels (33.85 ± 16.18ng/ml, 30.70 ± 14.90ng/ml; respectively, p:0.289). No statistically significant difference was found between study and controls according to 25(OH) D levels (adequate, insufficiency, deficiency; p=0.099). In the SPT of the CMPA group, a negative weak correlation without statistical significance was determined between the induration diameter of milk antigen and serum levels of 25(OH)D (p:0,794; r= -0,037). Conclusions. No significant difference was found in serum 25 (OH)D levels between infants with CMPA and healthy controls. Our results do not support the routine request for 25(OH)D levels in pediatric age CMPA patients at their initial workup.


Subject(s)
Humans , Infant, Newborn , Infant , Vitamin D , Milk Hypersensitivity , Food Hypersensitivity
18.
Gastroenterol. latinoam ; 30(supl.1): S39-S43, 2019. tab
Article in Spanish | LILACS | ID: biblio-1116437

ABSTRACT

Fluctuating abdominal pain and bloating suggest gastrointestinal origin with multiple causes. In adults, patients fulfilling the Rome criteria for irritable bowel syndrome (IBS) have a low probability of neoplasms or intestinal inflammatory diseases. In these patients it is cost effective to request fecal calprotectin and celiac disease serology. Due to the high probability of nocebo effect, the diagnosis of sensitivity to non celiac and food allergies should require a blind rechallenge. It is recommended to evaluate other non ominous diagnostic options in a second stage if there is not good control of symptoms. In adults that do not fulfil the criteria of IBS or in adults older than 50 it is often necessary to request more studies, including endoscopic examinations. In children, abdominal pain and bloating occur frequently in the context of excessive consumption of sugar (including fructose, lactose and sorbitol). In infants it can occur in the context of congenital malformations, infant colics and food allergies. An active search for symptoms and signs of alarm is recommended. In their absence the performance of an endoscopic study is low. The use of celiac disease serology is also recommended, but the use of fecal calprotectin has the limitation that normal values are not present below age 4, so its use is not recommended under that age.


El dolor abdominal y la distensión abdominal fluctuantes sugieren origen gastrointestinal, con múltiples causas. En adultos, los pacientes que cumplen criterios de Roma para Síndrome de Intestino Irritable (SII) tienen una baja probabilidad de neoplasias o enfermedades inflamatorias intestinales (EII). En estos pacientes, es costoefectivo solicitar calprotectina fecal y serología de enfermedad celiaca. Por la alta probabilidad de efecto nocebo, el diagnóstico de sensibilidad al gluten no celiaca (SGNC) y alergias alimentarias debería requerir un rechallenge ciego. Es recomendable evaluar otras opciones diagnósticas no ominosas en una segunda etapa, si no hay buen control sintomático. En adultos que no cumplen criterios de SII o en adultos mayores de 50 años, suele requerirse más cantidad de estudios, incluyendo endoscópicos. En niños, el dolor abdominal y distensión ocurren frecuentemente en el contexto de consumo excesivo de azúcares (incluyendo fructosa, lactosa y sorbitol). En lactantes puede ocurrir también en el contexto de malformaciones congénitas, cólicos del lactante y alergia alimentaria. Se recomienda la búsqueda activa de signos y síntomas de alarma. En su ausencia el rendimiento del estudio endoscópico es bajo. También se recomienda el uso de serología de enfermedad celíaca, pero el uso de calprotectina fecal tiene la limitación de ausencia de valores de normalidad hasta los 4 años, por lo que su uso no se recomienda bajo esa edad.


Subject(s)
Humans , Child , Adult , Abdominal Pain/diagnosis , Abdominal Pain/etiology , Dilatation, Pathologic/diagnosis , Dilatation, Pathologic/etiology , Abdomen/pathology , Celiac Disease/complications , Irritable Bowel Syndrome/complications , Carbohydrate Metabolism , Food Hypersensitivity , Malabsorption Syndromes/complications
20.
Article in Korean | WPRIM | ID: wpr-786257

ABSTRACT

OBJECTIVES: The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate.METHODS: A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification.RESULTS: The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, ‘needs to provide nutrition counseling in children's hospitals’, ‘providing nutrition counseling services in working hospitals’, and ‘whether there is a nutrition counseling room’ scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, ‘self-assessment of food allergy knowledge understanding level’, ‘awareness of open oral food challenge (OFC)’, ‘recognition of the need for education and counseling on food allergy for patients/guardians’, and ‘food allergy related educational experience’ scored higher among holders of clinical dietitians certificates than in non-holders.CONCLUSIONS: Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.


Subject(s)
Certification , Counseling , Education , Food Hypersensitivity , Hypersensitivity , Korea , Nutritionists
SELECTION OF CITATIONS
SEARCH DETAIL