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Of the many possible hypotheses that explain the recent increase in childhood food allergy (FA), the dual-allergen exposure hypothesis has been the most extensively investigated. This chapter serves as a review and update on the p...
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Of the many possible hypotheses that explain the recent increase in childhood food allergy (FA), the dual-allergen exposure hypothesis has been the most extensively investigated. This chapter serves as a review and update on the prevention of FA and focuses on recently published randomized controlled trials exploring the efficacy of oral tolerance induction in infancy for the prevention of FA. As a result of these RCTs, National Institutes of Health recommendations now actively encourage the early introduction of peanut for the prevention of peanut allergy, and other countries/settings recommend the inclusion of爌otential common food allergens, including peanut and egg,爄n燾omplementary feeding regimens commencing at approximately 6爉onths but not before 4爉onths of age. Further studies that explore the efficacy of oral tolerance induction to other common爁ood allergens and that focus on optimal timing, duration, and adherence are required.
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Tree nut and/or peanut allergy impairs patients' quality of life, but data on the impact of age and the type of nut or peanut on the quality of life are lacking. To evaluate the impact at different ages, age-appropriate survey que...
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Tree nut and/or peanut allergy impairs patients' quality of life, but data on the impact of age and the type of nut or peanut on the quality of life are lacking. To evaluate the impact at different ages, age-appropriate survey questionnaires accompanied by FAQLQ and FAIM were distributed to patients with suspected tree nut and/or peanut allergy who presented at the allergy departments of three hospitals in Athens. Out of 200 questionnaires distributed, 106 met the inclusion criteria (46 children, 26 teenagers, 34 adults). The median score of each age group for FAQLQ was 4.6 (3.3-5.1), 4.7 (3.9-5.5), and 3.9 (3.2-5.1) and for FAIM was 3.7 (3.0-4.0), 3.4 (2.8-4.0), and 3.2 (2.7-4.1), respectively. FAQLQ and FAIM scores were correlated with the reported probability of using the rescue anaphylaxis set upon reaction (15.4%, p = 0.04 and 17.8%, p = 0.02, respectively) and pistachio allergy (FAQLQ: 4.8 vs. 4.0, p = 0.04; FAIM: 3.5 vs. 3.2, p = 0.03). Patients with additional food allergies reported worse FAQLQ scores (4.6 vs. 3.8, p = 0.05). Worse FAIM scores were associated with younger age (?18.2%, p = 0.01) and the number of life-threatening allergic reactions (25.3%, p < 0.001). The overall impact of tree nut and/or peanut allergy on patients' quality of life is moderate but differs with age, the type of nut, the use of adrenaline, and the number of previous reactions. The aspects of life affected and contributed factors also vary across age groups.
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? 2023 Elsevier Inc.Immunoglobulin E-mediated food allergies are a concerning health problem affecting 5.5% of children and 6% of adults in the United States. Nine foods cause 90% of food allergies, with milk, eggs, and peanuts mo...
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? 2023 Elsevier Inc.Immunoglobulin E-mediated food allergies are a concerning health problem affecting 5.5% of children and 6% of adults in the United States. Nine foods cause 90% of food allergies, with milk, eggs, and peanuts most often linked to food allergies in infants and children. Prevention strategies have shifted from avoidance of foods to the early introduction of high allergenic foods. Evidence supports that the early introduction of peanuts can reduce food allergies. United States guidelines promote the optimal times for the introduction of high-allergen foods. Future research is required to ensure evidence-based best practices for patients and families.
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Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is diff...
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Several seeds have been increasingly incorporated in various food items, with consequent risk of hypersensitivity reactions that are often severe. Identification of the specific seed as the culprit is often not explored or is difficult to verify. In this article, we reviewed the English literature from January 1930 to March 2016 using PubMed and Google Scholar searching for publications relevant to hypersensitivity to common edible seeds, namely sesame, sunflower seed, poppy seed, pumpkin seed, flaxseed, and mustard seed. Considering the worldwide consumption of those seeds, the number of published articles on the subject was relatively small and was mainly as case reports rather than large series. Allergy to sesame was more reported than to other seeds, with an estimated prevalence of 0.1-0.2%. In this review, we summarize the information relevant to each of the six seeds and their oils regarding the manifestations, routes of exposure, identified major allergens, and cross-reactivity with other seeds or other foods. We also addressed the important role of a thorough history taking in suspecting seed allergy, the limited reliability of routine diagnostic procedures, and the importance of verification by appropriate challenge tests. At present, management is basically dietary avoidance and the use of symptomatic medications that may include epinephrine auto-injectors. We did not encounter any well-designed studies on immunotherapy for seed allergy, but it is hoped that such a gap be filled by the development of safe effective protocols in the near future.
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Excipients are substances in pharmaceuticals other than the active ingredients. Some excipients are foods or substances derived from foods, raising the possibility that these substances would pose a hazard to patients with food al...
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Excipients are substances in pharmaceuticals other than the active ingredients. Some excipients are foods or substances derived from foods, raising the possibility that these substances would pose a hazard to patients with food allergy. This review describes which food-derived substances are used as pharmaceutical excipients in which medications and reviews published data regarding the safety of the administration of these medications to recipients with food allergy. Such reactions are rare, usually because the amount of food protein is not present in a large enough quantity to elicit a reaction. When a food protein appears as an unintentional contaminant, the amount, if any, that is present might be variable and might elicit reactions only from some lots of medication or only in some patients. In most circumstances these medications should not be routinely withheld from patients who have particular food allergies because most will tolerate the medications uneventfully. However, if a particular patient has had an apparent allergic reaction to the medication, potential allergy to the food component should be investigated.
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Allergies are increasing in prevalence worldwide, with socioeconomic impacts and effects on quality of life. The aim of this study was to explore the health behavior and the utilization of different treatment options via questionn...
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Allergies are increasing in prevalence worldwide, with socioeconomic impacts and effects on quality of life. The aim of this study was to explore the health behavior and the utilization of different treatment options via questionnaires and to investigate for relationships of the above with socioeconomic factors. This cross-sectional survey was carried out among pollen allergic subjects in 2016, using questionnaires. A total of 679 allergics participated in the study (61.2% females). Their average age was 26.8 +/- 8.8years. Their symptom severity was 6.1 +/- 1.9, measured on a 10-step scale and symptoms lasted for 9.0 +/- 6.8weeks during pollen season. Of all allergics, 9.1% were not aware of the causative agent of their allergy and 17.4% had never undergone allergy testing. Symptoms, especially in females, had strong impact on social life, everyday routines and sleep quality. Almost half of the participants treated their allergy without medical supervision, while only 32.3% sought medical support. Nevertheless, three quarters reported self-management of their allergies with oral antihistamines. Compared to males, females sought significantly more medical support, medications and allergen avoidance strategies. Knowledge about allergy increased the likelihood of treatment under supervision of a medical expert than no treatment, as well as symptom severity and interaction between female gender and symptom severity. The attitude of not considering allergy as a serious disease significantly reduced the likelihood of undergoing specific immunotherapy. This survey not only highlights the negative impact of pollen allergies on everyday life of allergics, but also that allergies are often neglected and untreated because of their trivialization by allergic subjects themselves.
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The role of screening younger siblings of peanut allergic children with allergy testing before peanut introduction is controversial. Although certain guidelines note some value in screening this population, it is not a direct indi...
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The role of screening younger siblings of peanut allergic children with allergy testing before peanut introduction is controversial. Although certain guidelines note some value in screening this population, it is not a direct indication in the recent National Institute of Allergy and Infectious Diseases guideline. Some studies suggest that siblings of peanut allergic children are at increased risk of peanut allergy, whereas others note that delayed ingestion or mislabeling of allergy in these children may be the main factors accounting for this increased risk. The low risk of severe reaction with first ingestion and risks of pre-emptive testing must be balanced against data suggesting that families are reluctant to introduce peanut in siblings without testing. The goal of this article is to critically appraise the debated issues in this topic, providing a practical approach to this common clinical dilemma. (C) 2018 American Academy of Allergy, Asthma & Immunology
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Allergic conditions in children such as food allergy, eczema, hay fever are very common. They are seen in various clinical set-ups within paediatric units and also elsewhere. Putting some structure into the services that are provi...
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Allergic conditions in children such as food allergy, eczema, hay fever are very common. They are seen in various clinical set-ups within paediatric units and also elsewhere. Putting some structure into the services that are provided for these children contributes strongly to managing them appropriately. The following is a description of how an allergy service was established in a teaching district general hospital.
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Antibiotic allergies are reported in up to 1 in 4 immunocompromised hosts with significant impacts on antibiotic utilization and patient outcomes. Health services programs focused on de-labeling beta-lactam and sulfonamide allergy...
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Antibiotic allergies are reported in up to 1 in 4 immunocompromised hosts with significant impacts on antibiotic utilization and patient outcomes. Health services programs focused on de-labeling beta-lactam and sulfonamide allergy labels should be a standard of care in immunocompromised hosts. (C) 2019 American Academy of Allergy, Asthma & Immunology
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Thus far, the most effective strategy for the prevention of food allergy is early introduction of allergenic solids to at-risk infants. Early skin moisturization may have a role in food allergy prevention. There is insufficient ev...
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Thus far, the most effective strategy for the prevention of food allergy is early introduction of allergenic solids to at-risk infants. Early skin moisturization may have a role in food allergy prevention. There is insufficient evidence for hydrolyzed formula as a means of allergy prevention. Studies on vitamin D, omega 3, and probiotic supplementation; breastfeeding; early infant dietary diversity; and maternal peanut ingestion during pregnancy and breastfeeding are inconsistent.
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