A 10-year review found increasing incidence trends of emergency egg allergy reactions and food-induced anaphylaxis in children.

AIM: International reports have suggested that food allergies and food-induced anaphylaxis have increased in children. We investigated the incidence of emergency food reactions over a 10-year period. METHODS: This study retrospectively reviewed the medical records of children presenting to Umeå University hospital, Sweden, with an emergency food reaction from January 1, 2006 to December 31, 2015. Cases were identified using discharge codes for allergies and anaphylaxis. Anaphylaxis cases were included if they fulfilled the international criteria. RESULTS: We found emergency food allergy reactions in 519 children (58% boys) from 2006-2015 at a median age of 1.3 years. One-third were hospitalised (32%) including 71/99 cases of anaphylaxis. Milk and eggs were the most commonly identified triggers. Emergency reactions to eggs increased during the study period with a Spearman rank correlation coefficient of 0.770 (p < 0.01) and the figures for anaphylaxis were 0.745 (p = 0.013). The incidence of food-induced anaphylaxis increased and was 30 per 100 000 person-years for the study period. CONCLUSION: Most of the emergency reactions, treated by secondary care paediatricians and emergency physicians, were to milk and eggs. Allergic reactions to eggs increased from 2006 to 2015, as did food-related anaphylaxis.

Reintroduction failure is common among adolescents after double-blind placebo-controlled food challenges.

AIM: There has been a lack of research on adolescents who undergo double-blind placebo-controlled food challenges. The aim of this study was to investigate food allergic adolescents' experiences and consequences of double-blind placebo-controlled food challenges. METHODS: This qualitative, descriptive interview study included 17 adolescents aged 14-15 years with total elimination of cows' milk, hens' eggs or cod due to food allergies. The participants, who were initially identified from a large population-based cohort study, were interviewed 18 months after completing their challenges. RESULTS: The double-blind placebo-controlled food challenge proved to be a complex experience for the adolescents, involving fear of potential reactions and the hope that the food could be reintroduced. Experiences during the challenge were described in three themes: facing fears in a secure environment, being hesitant but curious about unknown tastes and waiting for unknown food reactions. Experiences after the challenge were described in two themes: gaining control and freedom and continuing old habits. A negative challenge was not consistently associated with the reintroduction of the challenged food. CONCLUSION: This study highlighted the importance of considering the adolescents' expectations and experiences of the challenge and the reintroduction process to ensure desirable changes in their dietary habits. Follow-ups should be performed regardless of the outcome of challenges.

7-Ethoxycoumarin O-deethylation and methylumbelliferone conjugation in isolated fetal and adult bovine hepatocytes.

Hepatocytes were isolated from fetal and adult bovine liver by perfusion of a piece of liver. The yield was 0.3-4.5 and 5.8-44.7 x 10(6) cells/g for adult and fetal liver, respectively. The viability was between 60 and 90%. 7-Ethoxycoumarin O-deethylase activity in adult hepatocytes was about 10 times higher than in fetal hepatocytes. The same was true for the glucuronidation of methylumbelliferone, but sulfate conjugation was fully developed already in fetal cells. The results show that the use of isolated cells can be extended to larger species, which is of value in interspecies studies as well as in finding models for humans.