scholarly journals Egg Reintroduction Following Oral Food Challenge in Japanese Children

2021 ◽  
Vol 2 ◽  
Author(s):  
Hiroki Masumi ◽  
Yutaka Takemura ◽  
Tomoyuki Arima ◽  
Koji Yamasaki ◽  
Megumi Nagai ◽  
...  
Keyword(s):  
Eating Habits ◽  
Psychological Intervention ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Diet Change ◽  
Negative Results ◽  
History Of ◽  
Age Range

Background: Oral food challenge (OFC) is the most reliable method for diagnosing food allergies. However, the scarcity of long-term data on eating habits of people after a negative OFC poses a challenge for provisional medical care.Objective: This study was performed to investigate the percentage of people who could reintroduce eggs into their diet several years after an OFC.Methods: Study participants included 0–6-year-old children with negative results from an OFC using one egg as the food allergen, boiled for 20 min, from January 2012–March 2017, 1–3 years after the OFC.Results: A total of 72 subjects were analyzed, out of which 52 were males (72.2%). The median age (range) was 20 months (16–32.3), and the median age (range) at the first OFC was 15 months (12.8–23.3). Eggs were reintroduced in 62 cases (86.1%), while 10 cases (13.9%) did not undergo any diet change. The adjusted odds ratio (OR, 95% CI), with post-OFC to pre-OFC anxiety ≥ 0.2, was 9.4 (1.0–86), p = 0.04; OR for allergic symptoms that occurred post-OFC was 2.2 (0.45–11), p = 0.34; OR for initial OFC at an age of ≥15 months was 3.2 (0.54–19), p = 0.2; and OR for the history of anaphylaxis from eggs was 0.17 (0.02–1.5), p = 0.11.Conclusion: Most cases reintroduced eggs after an OFC. However, reintroduction did not occur in some cases, which was associated with greater anxiety among caregivers post-OFC. If the caregiver's anxiety is intense, it is necessary to provide psychological intervention and dietary guidance when reintroducing eggs at home after an OFC and to follow-up outpatient long-term progress.

Endodontic Therapy and Surgical Excision of a Chronic Suppurative Osteomyelitic Lesion in a Horse: A Case Report

1996 ◽  
Vol 13 (4) ◽  
pp. 145-148 ◽  
Author(s):  
Steven D. Baerg ◽  
David A. Russell ◽  
Laura M. LeVan ◽  
Carl A. Kirker-Head
Keyword(s):  
Eating Habits ◽  
Surgical Excision ◽  
Maxillary Incisor ◽  
Surgical Removal ◽  
Mandibular Incisor ◽  
Surgical Extraction ◽  
History Of ◽  
Functional Position

A 22 year old thoroughbred gelding was presented for evaluation and treatment of chronic dental disease. The horse had a history of quidding and abnormal bit behavior. Intraoral examination revealed signs of chronic generalized gingival inflammation and severe dental caries affecting the maxillary and mandibular incisor teeth. Treatment was provided on two separate visits over an interval of four months. The first visit consisted of the surgical extraction of three unrestorable incisor teeth and restoration of six carious maxillary incisor teeth. The second visit consisted of conventional endodontic therapy on the remaining mandibular incisor teeth and the surgical removal of a chronic suppurative osteomyelitic lesion. Immediate and long term improvements in eating habits were noted. Three month follow-up examinations following completion of treatment have shown the teeth to be in functional position, the restorations intact, and the surgical site well healed.

scholarly journals Component-Resolved Diagnosis in Food Allergies

Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 498 ◽  
Author(s):  
Elisabetta Calamelli ◽  
Lucia Liotti ◽  
Isadora Beghetti ◽  
Valentina Piccinno ◽  
Laura Serra ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Unmet Needs ◽  
Food Challenge ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Specificity And Sensitivity ◽  
Sensitization Pattern ◽  
Molecular Components ◽  
Work Up

Component-resolved diagnostics (CRD) in food allergies is an approach utilized to characterize the molecular components of each allergen involved in a specific IgE (sIgE)-mediated response. In the clinical practice, CRD can improve diagnostic accuracy and assist the physician in many aspects of the allergy work-up. CRD allows for discriminatory co-sensitization versus cross-sensitization phenomena and can be useful to stratify the clinical risk associated with a specific sensitization pattern, in addition to the oral food challenge (OFC). Despite this, there are still some unmet needs, such as the risk of over-prescribing unnecessary elimination diets and adrenaline auto-injectors. Moreover, up until now, none of the identified sIgE cutoff have shown a specificity and sensitivity profile as accurate as the OFC, which is the gold standard in diagnosing food allergies. In light of this, the aim of this review is to summarize the most relevant concepts in the field of CRD in food allergy and to provide a practical approach useful in clinical practice.

scholarly journals Short-term skin problems in infants aged 0–3 months affect food allergies or atopic dermatitis until 2 years of age, among infants of the general population

2019 ◽  
Vol 15 (1) ◽  
Author(s):  
Kaori Yonezawa ◽  
Megumi Haruna
Keyword(s):  
Atopic Dermatitis ◽  
Family History ◽  
Food Allergies ◽  
Control Group ◽  
Short Term ◽  
Skin Problem ◽  
Significant Difference ◽  
History Of

Abstract Background This study examined whether infants aged 0–3 months exhibited long-term effects of using a moisturizer skincare intervention and whether a short-term skin problem resulted in the subsequent development of food allergies or atopic dermatitis (AD) until the age of 2 years. Methods This study was a follow-up of a completed randomized control trial (RCT) of moisturizer skincare for infants aged 0–3 months. A self-reported questionnaire was mailed to the parents of children aged 1–2 years who had participated in the RCT. Data were analyzed using a Chi square test, by intention to treat analysis, and by multiple logistic regression. Results Of 155 infants, 22 (14.2%) and 28 (18.1%) had food allergies and AD/eczema until 2 years of age, respectively. No significant difference was seen in food allergies or AD between the group that received moisturizer skincare intervention and the control group. On the contrary, food allergies until 2 years of age were significantly associated with short-term (4–7 days) and long-term (more than 7 days) body skin problems occurring in the first 3 months of life, a family history of AD, and the time of starting complementary food. High value of face transepidermal water loss at 3 months of age was also associated with food allergies. Moreover, a short duration of severe diaper dermatitis during the first 3 months, a family history of AD, and being male were significantly associated with AD/eczema until the age of 2 years. Conclusions After adjusting for family history of AD, a short-term skin problem in the first 3 months of life was significantly associated with the development of food allergies or AD/eczema until the age of 2 years. Prevention or prompt treatment of skin problems in newborns is essential for preventing future allergic diseases. Trial registration This was a follow-up study conducted 2 years after the completed RCT of a moisturizer skincare intervention for early infants, which was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000013260)

scholarly journals An algorithm to safely manage oral food challenge in an office-based setting for children with multiple food allergies

2021 ◽  
Vol 5 (1) ◽  
pp. 030-037
Author(s):  
Cottel Nathalie ◽  
Dieme Aïcha ◽  
Orcel Véronique ◽  
Chantran Yannick ◽  
Bourgoin-Heck Mélisande ◽  
...  
Keyword(s):  
Negative Predictive Value ◽  
Predictive Value ◽  
Validation Cohort ◽  
Hospital Setting ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Low Risk ◽  
Food Allergies ◽  
Machine Learning Approach ◽  
High Positive Predictive Value

Background: In France, from 30% to 35% of children suffer from multiple food allergies (MFA). The gold standard to diagnosis a food allergy is the oral food challenge (OFC) which is conducted in a hospital setting due to risk of anaphylaxis. The aim of this study was to evaluate an algorithm to predict OFCs at low risk of anaphylaxis that could safely be performed in an office-based setting. Methods: Children with MFA and at least one open OFC reactive or non-reactive to other allergens were included. The algorithm was based on multiple clinical and biological parameters related to food allergens, and designed mainly to predict “low-risk” OFCs i.e., practicable in an office-based setting. The algorithm was secondarily tested in a validation cohort. Results: Ninety-one children (median age 9 years) were included; 94% had at least one allergic comorbidity with an average of three OFCs per child. Of the 261 OFCs analyzed, most (192/261, 74%) were non-reactive. The algorithm failed to correctly predict 32 OFCs with a potentially detrimental consequence but among these only three children had severe symptoms. One hundred eighty-four of the 212 “low-risk” OFCs, (88%) were correctly predicted with a high positive predictive value (87%) and low negative predictive value (44%). These results were confirmed with a validation cohort giving a specificity of 98% and negative predictive value of 100%. Conclusion: This study suggests that the algorithm we present here can predict “low-risk” OFCs in children with MFA which could be safely conducted in an office-based setting. Our results must be confirmed with an algorithm-based machine-learning approach.

scholarly journals Evaluation of early skin or laryngeal reaction at oral food challenge

2021 ◽  
Author(s):  
Toshinori Nakamura ◽  
Yuki Okada ◽  
Mayu Maeda ◽  
Taro Kamiya ◽  
Takanori Imai
Keyword(s):  
Prediction Models ◽  
Immunoglobulin E ◽  
Food Challenge ◽  
Serum Levels ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Specific Immunoglobulin E ◽  
Allergic Skin ◽  
Test Initiation ◽  
Skin Signs

Background: An oral food challenge (OFC) is required for diagnosing food allergies; however, uncertain reactions can impair the determination of when to stop the test. We aimed to determine the associations between immediately occurring mild allergic skin signs/laryngeal symptoms and positive OFC results. Methods: We retrospectively included children (aged 6 months to 15 years) who underwent open OFC for hen’s egg (HE), cow’s milk (CM), or wheat at a single centre between May 2012 and March 2020. Participants with mild skin signs or laryngeal symptoms at OFC initiation were classified as “skin” or “laryngeal” cases, respectively. Using logistic regression, the risk of positive OFC results, in a skin or laryngeal case, was assessed using univariate and multivariate analyses. Age, sex, total target dose, and serum levels of total and food-specific immunoglobulin E were used as covariates in prediction models. Results: In total, 2954, 1126, and 850 tests for HE, CM, and wheat, respectively, were included and comprised 115 (4%) and 25 (0.9%), 92 (9%) and 24 (2%), and 7 (1.3%) and 0 (0%) skin and laryngeal cases, respectively. Children with reactions to both HE and CM had a higher risk of a positive OFC than controls (odds ratio [95% confidence interval]: 4.6 [3.3–6.4], 2.9 [2.0–4.1] and 6.5 [3.0–10.9], 4.9 [2.2–10.9], respectively). Areas under the curves of prediction models ranged from 0.61 to 0.71. Conclusions: Uncertain reactions immediately after test initiation could not robustly predict OFC results, indicating the OFC could be continued under careful observation.

The utility of implantable loop recorders (ILR) in patient management: an age and indication stratified study in the outpatient-implant era

2021 ◽  
Author(s):  
Mihir M Sanghvi ◽  
Daniel M Jones ◽  
Jeremy Kalindjian ◽  
Christopher Monkhouse ◽  
Rui Providencia ◽  
...  
Keyword(s):  
Cryptogenic Stroke ◽  
Cardiac Monitoring ◽  
Management Decision ◽  
Device Implantation ◽  
History Of ◽  
Recorded Data ◽  
Implantable Loop Recorders ◽  
Age Range ◽  
Made In

Abstract Introduction Implantable loop recorders (ILR) are now routinely implanted for long-term cardiac monitoring in the clinic setting. This study examined the real-world performance of these devices, focusing on the management decision changes made in response to ILR-recorded data. Methods and Results This was a single centre, prospective observational study of consecutive patients undergoing ILR implantation. All patients who underwent implantation of a Medtronic Reveal LINQ device from September 2017 to June 2019 at Barts Heart Centre were included. 501 patients were included. 302 (60%) patients underwent ILR implantation for an indication of pre-syncope/syncope, 96 (19%) for palpitations, 72 (14%) for atrial fibrillation (AF) detection with a history of cryptogenic stroke and 31 (6%) for patients deemed to be high risk of serious cardiac arrhythmia. The primary outcome of this study was that an ILR-derived diagnosis altered management in 110 (22%) of patients. Secondary outcomes concerned sub-group analyses by indication: in patients who presented with syncope/presyncope, a change in management resulting from ILR data was positively associated with age (HR: 1.04 [95%CI 1.02–1.06]; p < 0.001) and negatively associated with a normal ECG at baseline (HR 0.54 [0.31–0.93]; p = 0.03). Few patients (1/57, 2%) aged < 40 years in this group underwent device implantation, compared to 19/62 patients (31%) aged 75 years and over (p = 0.0024). 22/183 (12%) of patients in the 40–74 age range had a device implanted. In patients who underwent ILR insertion following cryptogenic stroke, 13/72 patients (18%) had AF detected leading to a decision to commence anticoagulation. Conclusion These results inform the utility of ILR in the clinical setting. Diagnoses provided by ILR that lead to changes in management are rare in patients under age 40, particularly following syncope, presyncope or palpitations. In older patients new diagnoses are frequently made and trigger important changes in treatment.

scholarly journals Food Allergy Management Has Been Negatively Impacted During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Elif Soyak Aytekin ◽  
Sevda Tüten Dal ◽  
Hilal Ünsal ◽  
Ayşegül Akarsu ◽  
Melike Ocak ◽  
...  
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Dietary Compliance ◽  
Trial Experience ◽  
Related Risk ◽  
Home Food

ABSTRACT Objective: The coronavirus disease 2019 (COVID-19) pandemic creates secondary problems for the health care system, and understanding specific issues can guide the management of the pandemic and its future consequences. We aimed to characterize the problems and related risk factors experienced with outpatient compliance and dietary compliance of children with food allergies during the COVID-19 pandemic. Materials and Methods: A cross-sectional survey was conducted on the mothers of children with ongoing food allergies, eight months after Turkey’s first confirmed case of COVID 19. Results: Of the 288 patients, 76.3% and 40.2% were non-adherent to their scheduled appointments and oral food challenge, respectively, during the pandemic. The group non-adherent to their scheduled visit was significantly older (p=0.005), had more frequent home food trials without the consent of their physicians (p<0.001), and had less usable epinephrine auto-injectors (EAI) available compared with the adherent group (p<0.001). Eighty-nine patients (30.9%) with home food trial experience had more essential food allergies (p<0.001) and experienced more allergic reactions (p=0.002), compared with patients who adhered to dietary elimination. Thirty parents (10.4%) eliminated some foods from their children’s diet because of the suspected reactions. Conclusion: The COVID-19 pandemic, significantly reduces adherence with scheduled appointments and OFC, and increases home food trials and food eliminations without physician approval. Keywords: The COVID-19 pandemic, food allergy, compliance, telemedicine, oral food challenge

scholarly journals Oral Food Challenge

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 651
Author(s):  
Calvani ◽  
Bianchi ◽  
Reginelli ◽  
Peresso ◽  
Testa
Keyword(s):  
Food Allergy ◽  
Food Challenge ◽  
Clinical History ◽  
Specific Ige ◽  
Oral Food Challenge ◽  
Food Allergies ◽  
Pediatric Allergy ◽  
Expert Review ◽  
Ige Mediated ◽  
Food Specific Ige

: Oral food challenge (OFC) is the gold standard for diagnosis of IgE-mediated and non-IgE mediated food allergy. It is usually conducted to make diagnosis, to monitor for resolution of a food allergy, or to identify the threshold of responsiveness. Clinical history and lab tests have poor diagnostic accuracy and they are not sufficient to make a strict diagnosis of food allergy. Higher concentrations of food-specific IgE or larger allergy prick skin test wheal sizes correlate with an increased likelihood of a reaction upon ingestion. Several cut-off values, to make a diagnosis of some food allergies (e.g., milk, egg, peanut, etc.) without performing an OFC, have been suggested, but their use is still debated. The oral food challenge should be carried out by experienced physicians in a proper environment equipped for emergency, in order to carefully assess symptoms and signs and correctly manage any possible allergic reaction. This review does not intend to analyse comprehensively all the issues related to the diagnosis of food allergies, but to summarize some practical information on the OFC procedure, as reported in a recent issue by The Expert Review of Food Allergy Committee of Italian Society of Pediatric Allergy and Immunology (SIAIP)

Sign in / Sign up

Export Citation Format

Share Document