1,971 research outputs found
Food allergy: the perspectives of prevention using vitamin D.
No full textWe reviewed the scientific publications in the last 2 years on the connections between vitamin D and food allergy, and endeavor to focus on the possible indications for supplementation in order to prevent allergies
Preschool asthma in Italy: Prevalence, risk factors and health resource utilization
No full textSummaryAsthma in preschool children is greatly under-diagnosed worldwide. Aim was to investigate prevalence of wheezing, and asthma risk factors, doctor diagnosis, treatment and health resource utilization in preschool children.About 1402 children (3–5 years) attending local kindergartens participated in the study. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire (WQ) was used with additional questions on risk factors, asthma diagnosis, treatments, resource utilization. Allergic sensitisation was evaluated by skin prick tests for the common allergens.Prevalence of “wheezing in previous 12 months” and “doctor diagnosed asthma” were 12.1% and 8.6%, respectively. 4.7% of children have had both wheezing in the last 12 months and asthma diagnosis. Significant risk factors for wheezing were rhinitis, parental history of atopy and sensitivity to mites and grass pollens. 27.3% of children with asthma diagnosis, but only 4.9% of children without diagnosis, received regular treatment during the previous year (p<0.0001). Children with more than 4 episodes of wheezing a year received more frequently an asthma diagnosis, but 68.6% were not on regular treatment. Asthma diagnosis was associated with a significant increase in control visits for wheezing (p<0.0001). The prevalence of children requiring at least one hospital emergency visit in the previous year was not different among the two groups (83.3% vs. 82.5%).In preschool children the prevalence of wheezing and asthma is elevated. Preschool asthma seems to be under-treated with few cases receiving regular therapy. The social cost of the disease at this age seems to be elevated because of the high frequency of control and emergency visits
Efficacy of sublingual immunotherapy in asthma and eczema
No full textSublingual immunotherapy (SLIT) is the local route of administration of allergen extracts investigated in several controlled clinical trials. In a number of countries, particularly Italy, France and Spain, this has become common in office practice. At variance with subcutaneous immunotherapy, the knowledge of mechanisms of action of SLIT is still at the beginning: some studies, in animal models, provided interesting information: the dendritic cells of oral mucosa act as efficient antigen-presenting cells and produce IL-12, which directs the immune response towards a Th1 profile away from IgE-Th2 profile. Its clinical efficacy (improvement of symptoms and reduction of drug intake) for both asthma and rhinitis has been assessed in detail for the most common allergens: house dust mites, grass pollen, Parietaria, birch pollen and olive tree. SLIT requires further evaluation concerning the treatment of the extrinsic form of atopic dermatitis. The induction of immunologic tolerance rather than immunoreactivity should be worth pursuing due to the immunologic pathway involved in the pathophysiology of atopic dermatitis. The safety profile of SLIT, derived from the clinical trials and postmarketing surveillance studies, turned out to be satisfactory in adults and children. SLIT represents an important step towards an efficacious and safe treatment of patients with allergic respiratory diseases; nevertheless, further studies are necessary to establish it as a viable alternative to subcutaneous immunotherapy
Transforming growth factor-beta is elevated in unpasteurized cow's milk.
No full textUnpasteurized milk consumption was associated with less atopy prevalence. Not
only microbial load but also fatty acids and cytokines such as transforming
growth factor-beta(1) (TGF-beta(1)) may play a role on the effect of
unpasteurized milk. Levels of TGF-beta(1) in different cow's milk samples were
evaluated: we consider raw unpasteurized milk before and after boiling,
commercial pasteurized and micro-filtrated cow's milk and different commercially
available cow's milk formulas. TGF-beta(1) concentration in raw unpasteurized
cow's milk was 642.0 +/- 52.9 pg/ml before boiling and decreased significantly
after boiling (302.7 +/- 50.59 pg/ml) (p < 0.05). TGF-beta(1) concentrations were
also significantly lower in commercial pasteurized milk (246.2 +/- 43.15 pg/ml)
and in commercial micro-filtrated milk (213.0 +/- 31.6 pg/ml) in comparison to
unpasteurized unboiled milk (p = 0.002). The levels of TGF-beta(1) in all formula
samples were below the threshold of detectability for the assays. As TGF-beta(1)
in the milk may contribute to the development of the immature gastrointestinal
tract by influencing IgA production and oral tolerance induction, we suggest to
consider not only the microbial compounds but also the cytokine patterns to
explain the protective effect of unpasteurized cow's milk on allergic disorders
Cow's milk allergic children can present sensitisation to probiotics.
No full textAIM: To evaluate sensitivity to different probiotics in children with cow's milk
allergy.
METHODS: Eighty-five patients (age range: 4 months -12 years) presenting atopic
dermatitis (AD) were enrolled. Skin prick test (SPT) responses to three different
probiotics preparations (Fiorilac, Dicoflor and Reuterin) were evaluated in
addition to relevant food allergens.
RESULTS: Thirty-nine patients out of 85 (45.8%) had a positive skin response to
prick test for cow's milk (3 with reaction <3 mm). Of the thirty-six patients
with a cow's milk weal reaction >3 mm, twenty-eight (77.8%) had a skin response
to Fiorilac, four patients (11%) to Dicoflor and four (11%) to Reuterin. The
proportion of SPT reaction to all the investigated probiotics preparations was
significantly lower than cow's milk (r = 9.406; p = 0.002). A significantly
higher sensitization was observed for Fiorilac versus Dicoflor (r = 30.916; p <
0.001) and versus Reuterin (r = 34.133; p < 0.001).
CONCLUSION: Probiotic use in patients with cow's milk allergy has to be limited
to products that do not contain milk. This should be clearly reported in the
label. In selected patients, it is advisable to perform a screening SPT with the
product to evaluate its potential contamination with milk
Childhood Asthma Control Test and airway inflammation evaluation in asthmatic children
No full textBACKGROUND:
The Childhood Asthma Control Test (C-ACT) has been proposed as a tool in assessing the level of disease control in asthmatic children. To evaluate the position of C-ACT in the clinical management of asthmatic children, in relationship to the level of airway inflammation as assessed by fractional exhaled nitric oxide (FeNO) and with lung function.
METHODS:
A total of 200 asthmatic children were included in the study: 47 children with newly diagnosed asthma ('New') and without any regular controller therapy; and 153 children with previously diagnosed asthma, treated according to GINA guidelines, and evaluated during a scheduled follow-up visit ('Follow-up'). Childhood Asthma Control Test, FeNO and lung function [forced expiratory volume 1 (FEV1) and forced vital capacity (FVC)] were evaluated.
RESULTS:
In New vs Follow-up participants, C-ACT score (P < 0.001), FVC (P < 0.005) and FEV1 (P < 0.05) were significantly lower, and FeNO (P = 0.011) were significantly higher. In New, but not in Follow-up participants, significant correlations were observed between C-ACT score and FeNO (r = -0.51; P < 0.001), FEV1 (r = 0.34; P = 0.022) and FEV1/FVC (r = 0.32; P = 0.03). This lack of correlation in Follow-up visits seemed attributable to dissociation between inadequately controlled asthma by C-ACT ratings with normalization of other measures such as FeNO levels.
CONCLUSIONS:
This study confirms and expands the concept that C-ACT is complementary to, but not a substitute for, other markers of disease control in asthmatic children, especially in the context of follow-up visits
Perioperative allergy: clinical manifestations.
No full textAdverse drug reactions or side effects are usually expected, dose dependent, and occur at therapeutic doses. Anaphylactic and anaphylactoid reactions are unexpected and dose independent and can occur at the first exposure to drugs used during anesthesia. Perioperative anaphylaxis is a severe and rapid clinical condition that can be lethal even in previously healthy patients. The initial diagnosis of anaphylaxis is presumptive. A precise identification of the drug responsible for the adverse reaction is more difficult to establish in the case of anaphylactoid reaction because the adverse reaction could result from additive side effects of different drugs injected simultaneously. The timing of the reaction in relation to events, e.g. induction, start of surgery, administration of other drugs, i.v. fluids, is essential for the diagnosis. Generally, reactions are predominant in the induction and recovery phases, and manifested mainly as cutaneous symptoms. Reactions to drugs coincide with the phases when they are administered. Reactions to antibiotics are more frequent in the induction phase, to neuromuscular agents in the initiation and maintenance phases and to non-steroidal anti-inflammatory agents in the recovery phase. The differential diagnosis of any adverse reaction during or following anesthesia should include the possibility of anaphylaxis
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Letter from A.L. Monmerqué de Courmont.
No full textLetter from A.L. Monmerqué de Courmont, possibly Adélaïde Louise de Monmerqué (1767-1835) who had been married to Louis Marie Le Bas de Courmont (1741-1794), dated 10 pluvoise. It is not addressed but was presumably sent to Philippe-Antoine Merlin, as it comprises the verso of one of his requisitions from 1802. In this letter the author requests a day and an hour when she (or he) might meet with the recipient
Determination of serum eosinophil cationic protein, eosinophil count, and total IgE in children with different severities of atopic diseases
No full textEosinophil cationic protein (ECP) levels may be of value in assessing tissue inflammation in atopic diseases. However, conflicting results have been reported regarding levels of serum ECP (s-ECP) and symptom activity in asthma, atopic dermatitis, or allergic rhinitis. To examine s-ECP levels, eosinophil counts and total immunoglobulin E (IgE) in relation to atopic disease activity in a random population of children admitted to hospital for atopic and nonatopic conditions. s-ECP, eosinophil counts, and total IgE were evaluated in all the children admitted, to a pediatric ward, excluding patients treated with systemic steroids. A total of 216 children were studied. Shin prick tests (SPT) and a validated questionnaire for asthma, atopic: dermatitis, and allergic rhinitis were obtained. s-ECP was significantly higher in children with symptomatic atopic disease (19.88 mu g/L) compared with nonatopic control patients (8.58 mu g/L). The levels of s-ECP were also elevated in patients with a positive response to the ISAAC Questionnaire for symptoms of asthma, atopic dermatitis, or rhinitis in the previous 12 months (9.12 mu g/L) or a positive SPT to relevant allergens (8.58 mu g/L), but no symptoms of atopy at the time of examination. Intermediate values of s-ECP were found in children with combined positive SPT and positive response to the ISAAC Questionnaire (13.7 mu g/L), but no symptoms of atopic disease at the time of examination. s-ECP is more elevated in symptomatic atopic subjects than in nonallergic patients. Subjects with latent (nonsymptomatic) allergy conditions show intermediate values probably reflecting allergen exposure and minimal persistent tissue inflammation
Re: Farm unprocessed milk contains high levels of transforming growth factor-β(1) that could protect from allergic disease development.
No full textThe farm milk contains high levels of TGF-beta1 that are reduced by pastorizatio
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