Health-related quality of life in children with objectively diagnosed staple food allergy assessed with a disease-specific questionnaire.

AIM: Among Swedish children of 0-12 years old, we investigated various food allergy-related exposures associated with health-related quality of life using a food allergy-specific questionnaire among children allergic to the staple foods cow's milk, hen's egg and/or wheat, and contextualised worse food allergy-associated health-related quality of life using a generic questionnaire versus controls. METHODS: In total, 85 children with objectively diagnosed allergy to the staple foods were included as cases, and 94 children matched for age and sex were included as controls. We administered a food allergy-specific parent-completed questionnaire originally developed by EuroPrevall to cases only, and a generic health-related quality of life questionnaire (EuroQol Health Questionnaire, 5 Dimensions; EQ 5-D); to both cases and controls. RESULTS: Hen's egg was the most common offending staple food, affecting 76% of cases. Approximately 7% of cases were allergic to all three staple foods. Parent-reported respiratory and cardiovascular symptoms were associated with worse health-related quality of life. Elements of disease severity [previous anaphylaxis (p < 0.001); epinephrine autoinjector prescription (p < 0.003)] were negatively associated with health-related quality of life. Cases had worse health-related quality of life measured by the EQ-5D compared to controls (p < 0.01). CONCLUSION: The use of a disease-specific questionnaire revealed that disease severity in children with objectively diagnosed allergy to the staple foods cow's milk, hen's egg and/or wheat is associated with worse health-related quality of life. The use of a generic questionnaire confirmed that cases have worse health-related quality of life than controls.

Socioeconomic evaluation of well-characterized allergy to staple foods in adults.

BACKGROUND: The aim of the present study was to evaluate if total, direct, indirect, and intangible costs differ between a cohort of adults with well-characterized allergy to staple foods ('cases') and controls. METHODS: Swedish adults with objectively diagnosed food allergy to cow's milk, hen's egg, and/or wheat were recruited at an outpatient allergy clinic. Controls age- and sex-matched to cases were recruited from the same geographic area. For assessing the household costs of food allergy, a disease-specific socioeconomic questionnaire, developed within EuroPrevall, was utilized. RESULTS: Overall annual total costs at the household level were significantly higher among adults with food allergy compared with controls (the difference amounted to 8164 €), whereas direct costs did not differ between cases and controls. However, household healthcare costs and costs for medicines were significantly higher for cases vs controls. Furthermore, indirect costs were significantly higher for households with food-allergic adults vs households without food-allergic adults. Specifically, more time was spent on performing domestic tasks due to a family member's food-allergy-related illness, as well as shopping and preparing food, and seeking food-allergy-related information. Presence of food allergy also affected intangible costs. Adults with food allergy experienced overall lower health status compared with controls. CONCLUSIONS: Swedish adults with allergy to staple foods have higher total costs determined as direct, indirect, and intangible costs using the disease-specific socioeconomic questionnaire. Thus, total costs were 8164 € higher per year in households with at least one adult allergic to staple foods compared with controls.

Age and angina as predictors of quality of life after myocardial infarction: a prospective comparative study.

OBJECTIVES: The objectives were to compare quality of life (QoL) after first myocardial infarction with an age- and sex-adjusted normative population and to test whether the 1-month QoL had predictive properties. DESIGN: QoL was assessed by self-administered questionnaires (SF-36 and Cardiac Health Profile) 1, 3 and 6 months after index-event. Participants were 60 consecutive patients (20% women) with a mean age of 58 +/- 7.4 years. RESULTS: Patients > or =59 years improved in Physical (PCS) and Mental Component Summary (MCS), scoring comparable to community norms at 6 months. However, patients <59 years improved in PCS but not in MCS. and scored significantly below community norms in both PCS (x = 44.7, CI 40.6-48.7 vs x = 50.3, CI 49.3-51.4) and MCS (x = 45.9, Cl 41.8-49.9 vs. x = 51.3, CI 50.3-52.4) at 6 months. Predictors for MCS were age (p = 0.025) and Vitality (p = 0.020) both positively related to QoL. Predictors for PCS were Physical Function (p = 0.003) and CCS score (p < 0.001) where angina grade was negatively related to QoL. CONCLUSION: Because of impaired mental recovery in younger post-infarction patients, their need of special attention in the rehabilitation process must not be overlooked.

Sample preparation with an automated robotic workstation for organic acid analysis by gas chromatography-mass spectrometry.

We attempted to automate sample preparation for analysis of organic acids by gas chromatography-mass spectrometry using a computer-controlled, automated robotic workstation that is integrated and connected to the gas chromatography-mass spectrometry (HP-5890/5971) system. Of the two methods developed, one employed solvent extraction, while the other utilized a silica, solid-phase extraction cartridge. Both automated methods were compared to a manual, solvent extraction procedure used routinely in our laboratory. Normal, spiked urine, and urine from patients with a variety of metabolic abnormalities were analyzed. The robotic workstation did not meet all our requirements for a rapid, reliable, laboratory device. Recoveries with the automated procedures were less than with the manual method, and some organic acids important in the diagnosis of inborn errors of metabolism were not detected. Additionally, the robotic device had mechanical and design problems that made it slower and less reliable than the manual procedure.

Video feedback in occupational therapy: its effects in patients with neglect syndrome.

The use of video feedback in occupational therapy was evaluated in four patients with right hemisphere stroke and hemineglect. The study followed a single-case research experimental pretest, posttest, and follow-up (A1, B, A2, A3) design. Phases A1 and A2 included four observation times and phase A3 three, with 12 weeks for each patient. Three household tasks were assessed, and the patients' neglect behavior while performing these was videorecorded. One paper-and-pencil task using a modified Albert's test was also used, but not filmed. In the intervention program, the patients watched the film, which was stopped by the occupational therapist where the neglect behavior was significant. Through dialogue, the patients were led to perceive and interpret their neglect behavior, and strategies for relearning and remediation were recommended. The program seems to be effective for remediation and relearning a functional way of working.

Ebstein's anomaly--anaesthetic problems. A case report.

A patient with Ebstein's anomaly undergoing anaesthesia for the operation of hysterectomy is reported. The considerations relating to the risk of an increased right-to-left intracardiac shunt are discussed. The patient was anaesthetized successfully with a combination of nitrous oxide, droperidol and fentanyl.