scholarly journals Reactivity thresholds in children allergic to cow's milk and egg, but tolerant of baked milk and baked egg.

Author(s):  
Alessandro Fiocchi ◽  
Rocco Valluzzi ◽  
Carla Riccardi ◽  
Stefania Arasi ◽  
Anna Lucia Piscitelli ◽  
...  

Background. The use of eliciting doses (EDs) for food allergens is necessary to inform individual dietary advice and food allergen risk-management. The Eliciting Dose 01 (ED01) for milk and egg, calculated from populations of allergic subjects undergoing diagnostic Oral Food Challenges (OFCs), are 0.2 mg total protein. The respective Eliciting Dose 05 (ED05) are 2.4 mg for milk and 2.3 mg for egg. As about 70% children allergic to such foods may tolerate them when baked, we sought to verify the EDs of that subpopulation of milk and egg-allergic children. Methods. We retrospectively assessed consecutive diagnostic OFC for fresh milk and egg between January 2018 and December 2020 in a population of baked food-tolerant children. Results. Among 288 children (median age 56 - IQR 36-92.5 months, 67.1% male) included, 87 (30.2%) returned positive OFC results, 38 with milk and 49 with egg. The most conservative ED01 were 0.3 mg total protein (IQR 0.03-2.9) for milk and 14.4 mg total protein (IQR 3.6-56.9) for egg. The respective ED05 were 4.2 (IQR 0.9-19.6) mg for milk and 87.7 (IQR 43-179) mg for egg. Such thresholds are respectively 1.5 (milk ED01), 1.75 (milk ED05), 72 (egg ED01), and 38.35 (egg ED05) times higher than the currently used thresholds. Conclusions The subpopulation of children allergic to milk and egg, but tolerant to baked proteins, displays higher reactivity thresholds than the general population of children allergic to milk and egg. Their risk stratification, in both individual and population terms, should consider this difference. In baked milk-tolerant children, milk causes reactions at lower doses than egg in our group of egg-tolerant children. This could be associated with the relative harmlessness of egg compared to milk in the determinism of fatal anaphylactic reactions in children

2016 ◽  
Vol 137 (2) ◽  
pp. AB406
Author(s):  
Nathan L. Marsteller ◽  
Kwame Andoh-Kumi ◽  
Stef J. Koppelman ◽  
Richard E. Goodman ◽  
Joe L. Baumert

Food systems ◽  
2022 ◽  
Vol 4 (4) ◽  
pp. 246-254
Author(s):  
E. V. Kryuchenko ◽  
Yu. A. Kuzlyakina ◽  
I. M. Chernukha ◽  
V. S. Zamula

Food allergies and allergen management are important problems of the public health and food industry. The idea of determining allergen concentrations in food ingredients and food products that are capable of causing severe allergic reactions is of great interest for regulatory bodies as well as consumer associations and the industry all over the world. In this connection, scientists proposed different approaches to determining the basis for assessment of severity of risks of food allergens for health of patients suffering from food allergy similar to methods of risk assessment for other hazards associated with food products (for example, chemical, microbiological). To assess risk of allergens, three different approaches were proposed: i) traditional risk assessment using the no observed adverse effect level (NOAEL)) and uncertainty factors; (ii) approach based on the benchmark dose (BMD)) and margin of exposure (MoE)); and (iii) probability models. These approaches can be used in risk management in food production and in the development of warning marking about the presence of allergens. The reliability of risk assessment will depend on a type, quality and quantity of data used for determining both population threshold levels (or threshold distributions) and an impact of an allergenic product/ingredient on a particular individual.


1977 ◽  
Vol 40 (10) ◽  
pp. 671-675 ◽  
Author(s):  
N. WANG ◽  
G. H. RICHARDSON

Milk sample preparation for Optical Somatic Cell Counter II operation was simplified by using a diluter to add fixative, mix, and dilute samples. Potassium dichromate preservative tablets produced a mean increase of 7,000 in somatic cell counts in fresh milk. Samples held at 20–23 C beyond 2 days or at 4–7 C beyond 4 days showed a reduction in somatic cell count. The mean somatic cells in 3 Holstein herds tested over a 6-month period was 3.8 × 105/ml. A 22-month survey of 52.6 thousand Utah Dairy Herd Improvement samples which were shipped under ambient conditions and then held at 5 C until tested, indicated 75% below 400,000 and 2.7% above 1.6 million somatic cells/ml. Casein, noncasein protein, total protein, fat and milk weight data were also obtained on the three herds. Multiple correlations were obtained. The best correlations suggested that testing for total protein and somatic cells in a central laboratory would estimate casein and noncasein protein. Such tests are most valuable for the cheese industry.


2020 ◽  
Vol 145 (2) ◽  
pp. AB223
Author(s):  
Jennifer Yonkof ◽  
Irene Mikhail ◽  
Benjamin Prince ◽  
David Stukus

2013 ◽  
Vol 131 (2) ◽  
pp. AB87
Author(s):  
Rushani W. Saltzman ◽  
Mary E. Kelleher ◽  
Jonathan M. Spergel

2016 ◽  
Vol 64 (4) ◽  
pp. 848-853 ◽  
Author(s):  
Alexander Goldfarb-Rumyantzev ◽  
Shiva Gautam ◽  
Robert S Brown

This study proposed to validate a prediction model and risk-stratification tool of 2-year mortality rates of individuals in the general population suitable for office practice use. A risk indicator (R) derived from data in the literature was based on only 6 variables: to calculate R for an individual, starting with 0, for each year of age above 60, add 0.14; for a male, add 0.9; for diabetes mellitus, add 0.7; for albuminuria >30 mg/g of creatinine, add 0.7; for stage ≥3 chronic kidney disease (CKD), add 0.9; for cardiovascular disease (CVD), add 1.4; or for both CKD and CVD, add 1.7. We developed a univariate logistic regression model predicting 2-year individual mortality rates. The National Health and Nutrition Examination Survey (NHANES) data set (1999–2004 with deaths through 2006) was used as the target for validation. These 12,515 subjects had a mean age of 48.9±18.1 years, 48% males, 9.5% diabetes, 11.7% albuminuria, 6.8% CVD, 5.4% CKD, and 2.8% both CKD and CVD. Using the risk indicator R alone to predict mortality demonstrated good performance with area under the receiver operating characteristic (ROC) curve of 0.84. Dividing subjects into low-risk (R=0–1.0), low intermediate risk (R>1.0–3.0), high intermediate risk (R>3.0–5.0) or high-risk (R>5.0) categories predicted 2-year mortality rates of 0.52%, 1.44%, 5.19% and 15.24%, respectively, by the prediction model compared with actual mortality rates of 0.29%, 2.48%, 5.13% and 13.40%, respectively. We have validated a model of risk stratification using easily identified clinical characteristics to predict 2-year mortality rates of individuals in the general population. The model demonstrated performance adequate for its potential use for clinical practice and research decisions.


2009 ◽  
Vol 27 (12) ◽  
pp. 2351-2357 ◽  
Author(s):  
Thomas Sehestedt ◽  
Jørgen Jeppesen ◽  
Tine W Hansen ◽  
Susanne Rasmussen ◽  
Kristian Wachtell ◽  
...  

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e042225
Author(s):  
W David Strain ◽  
Janusz Jankowski ◽  
Angharad P Davies ◽  
Peter English ◽  
Ellis Friedman ◽  
...  

ObjectivesHealthcare workers have greater exposure to SARS-CoV-2 and an estimated 2.5-fold increased risk of contracting COVID-19 than the general population. We wished to explore the predictive role of basic demographics to establish a simple tool that could help risk stratify healthcare workers.SettingWe undertook a review of the published literature (including multiple search strategies in MEDLINE with PubMed interface) and critically assessed early reports on preprint servers. We explored the relative risk of mortality from readily available demographics to identify the population at the highest risk.ResultsThe published studies specifically assessing the risk of healthcare workers had limited demographics available; therefore, we explored the general population in the literature. Clinician demographics: Mortality increased with increasing age from 50 years onwards. Male sex at birth, and people of black and minority ethnicity groups had higher susceptibility to both hospitalisation and mortality. Comorbid disease. Vascular disease, renal disease, diabetes and chronic pulmonary disease further increased risk. Risk stratification tool: A risk stratification tool was compiled using a white female aged <50 years with no comorbidities as a reference. A point allocated to risk factors was associated with an approximate doubling in risk. This tool provides numerical support for healthcare workers when determining which team members should be allocated to patient facing clinical duties compared with remote supportive roles.ConclusionsWe generated a tool that provides a framework for objective risk stratification of doctors and healthcare professionals during the COVID-19 pandemic, without requiring disclosure of information that an individual may not wish to share with their direct line manager during the risk assessment process. This tool has been made freely available through the British Medical Association website and is widely used in the National Health Service and other external organisations.


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