RESUMO
Atopic dermatitis (AD) is a common chronic inflammatory skin disorder in childhood. Skin barrier impairment exposes infants to food allergens, potentially causing sensitization followed by IgE-mediated food allergy. We describe the case of an infant with severe AD in whom several sensitizations to foods are detected, with consequently difficult weaning, and a history of anaphylaxis to cashew nut. Foods for which skin tests were negative were introduced into the infant's diet. Then, when AD control was managed, oral food challenges (OFCs) for foods to which the patient was sensitized, with the exception of cashew nut, were performed. The simultaneous presence of sensitization toward multiple foods made it difficult to introduce them using classic OFC. Therefore, it was decided to perform the low-dose, gradual controlled OFC. This led to an introduction of sensitized foods into the infant's diet, with the exception of cashew nut, avoiding allergic reactions. Absolute recommendations on how, when, and where to perform OFCs with allergenic food to which the child with AD is sensitized are lacking so far. In our opinion, OFCs and the subsequent ntroduction of allergenic foods should be individualized, evaluating some factors such as their social and nutritional importance, the patient's age and clinical phenotype (including the history of anaphylaxis), and the sensitization profile. There is agreement on the fact that the dietary approach in children with moderate-severe AD should no longer include a strict elimination diet. We believe that an early, gradual controlled introduction of all allergenics to identify the amount of food tolerated in the absence of reactions, even if low dose, may improve patients' and families' quality of life. However, even if discussing a vast relevant literature, the limitation of our work is that we describe the management of a single patient. Extensive and high-quality research is needed in this field to improve the available evidence in the area.
RESUMO
We describe a Kelvin Probe Force Microscopy (KPFM) study on the morphological and electronic properties of complex mono and bi-molecular ultrathin films self-assembled on mica. These architectures are made up from an electron-donor (D), a synthetic all-benzenoid polycyclic aromatic hydrocarbon, and an electron-acceptor (A), perylene-bis-dicarboximide. The former molecule self-assembles into fibers in single component films, while the latter molecule forms discontinuous layers. Taking advantage of the different solubility and self-organizing properties of the A and D molecules, multicomponent ultrathin films characterized by nanoscale phase segregated fibers of D embedded in a discontinuous layer of A are formed. The direct estimation of the surface potential, and consequently the local workfunction from KPFM images allow a comparison of the local electronic properties of the blend with those of the monocomponent films. A change in the average workfunction values of the A and D nanostructures in the blend occurs which is primarily caused by the intimate contact between the two components and the molecular order within the nanostructure self-assembled at the surface. Additional roles can be ascribed to the molecular packing density, to the presence of defects in the film, to the different conformation of the aliphatic peripheral chains that might cover the conjugated core and to the long-range nature of the electrostatic interactions employed to map the surface by KPFM limiting the spatial and potential resolution. The local workfunction studies of heterojunctions can be of help to tune the electronic properties of active multicomponent films, which is crucial for the fabrication of efficient organic electronic devices as solar cells.
