Food allergy in patients with respiratory allergy. Diagnostic possibilities and problems

In the past two years the authors examined 28 patients with abdominal complaints and allergic respiratory symptoms. Detailed internal, gastroenterological, allergological examinations were made. METHODS: 1 skin Prick-test (SPT) with inhalative and nutritive panel 2. measuring of food-specific (gliadin, alpha-lactalbumin beta-lactoglobulin, ovalbumin) IgG-antibody level detecting with ELISA method, 3. leukocyte migration inhibition (LMI) test against the same foodstuffs, 4. histological examination of the stomach and the duodenum especially for mucosal mastocytes (MMCs). RESULTS: 1. SPT was positive in 23/28 patients for inhalative, but in the 5 cases we did not identify any inhalative allergen. The SPT for the main foodstuffs were positive in 18 patients while in 3 other patients there was urtica only for the other antigens. 2. The food-specific IgG-antibody level was increased in 18/27 patients against one or more antigens. The SPTs and the antibody determination showed identity in 8/18 cases. 3. The LMI tests were positive against one or more main food-products in 23/27 cases. There was common positivity in respect of antigens (between LMI test and antibody identification) in 17 cases. Pathological immunological reactions were presented against the same main foodstuffs with at least two methods for flour in 11, for egg in 10 and for milk in 12 patients. Endoscopic examinations were performed in 27 cases. The number of the MMCs were increased in 22/27 patients. After a specific elimination diet open-food challenges were performed and they confirmed the results of the in vitro and in vivo examinations. CONCLUSION: It is common that the respiratory allergic symptoms in atopic patients accompanied with food allergy for the main foodstuffs caused not only more severe respiratory symptoms, but abdominal complaints too. In respect to the many positive LMI tests the late-type hypersensitivity have important pathogenetical role in it. This three methods together define well the main food-products, which can be antigens as well. The examination of the MMCs supports the local disturbance in the immunoregulatory system.     

Food allergy in children

Food allergy is a common condition among infants. The reactions are usually to milk, egg and peanut products. They frequently improve with time. It is important for the practitioner to recognise the occurrence of these reactions and to advise parents of their significance.     

Food allergy. Manifestations, evaluation, and management

Allergic reactions to food are more common among infants and children but occur in adults as well. Foods that are most often implicated in allergic reactions are eggs, cow's milk, nuts, wheat, soy products, whitefish, and crustacea. Gastrointestinal, respiratory tract, and dermatologic symptoms, as well as systemic anaphylaxis, may develop. In addition to history taking and physical examination, the workup may include skin testing, the radioallergosorbent test, and double-blind oral food challenge. Avoidance of offending antigens is the most important aspect of treatment. If exposure occurs, antihistamines and epinephrine may be needed for treatment of an acute reaction.     

Food allergy: recent findings

Food allergy induces in infancy and childhood a large variety of symptoms which may be trivial in many children, chronic and severe in others and even fatal in rare cases. According to double-blind placebo controlled oral food challenges, cow's milk, egg, wheat and fish are the most common offending foods. Elimination of the offending food(s) is imperative for the management of children with food allergy. An appropriate formula without cow's milk proteins and allergenic epitopes should be given to infants with cow's milk allergy. Breast feeding and selected weaning after the sixth month of life are recommended for the prevention of food allergy in atopic prone babies.     

More about often.

Replies to Hakel's (1968) study of frequency adverbs by noting that "often" may occasionally be "sometimes." Also discussed is B. E. Goocher's (1965) study of frequency adverbs, which found that Ss who disliked an activity described it as occurring more frequently than those who reported liking the activity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Food allergy to peanuts in France--evaluation of 142 observations

BACKGROUND: The increase in frequency of peanut allergy and fatal cases have been reported. OBJECTIVES: The objective of this study is to document the severity of food allergy to peanuts by evaluating the reactive dose of peanuts and to search for the role of peanut oil. METHODS: This study is carried out on the basis of 142 observations collected according to the same diagnostic methodology in two allergy centres in France. Skin-prick-tests were performed with peanut powder, peanut oil and peanut oil proteinic extract. Labial provocation tests were performed on 121 patients. The reactive dose of peanuts and the role of peanut oil were determined by standardized oral provocation tests in 50 and 62 patients respectively. The data are computerized and the data bank includes 509 food allergic patients. RESULTS: Allergy to peanuts represents 28% of food allergies and occurs under 1 year of age in 46% of cases, under 15 years of age in 93%. The clinical features were atopic dermatitis (40%), angioedema (37%), asthma (14%), anaphylactic shock (6%) and digestive symptoms (1.4%). The specific IgE were class 3 or higher in 80% of cases. The total reactive dose was less than 100 mg in 25% of cases, from 100 mg to 1 g in 62.5%. All patients reacted to a dose of less than 7.1 g. The threshold of peanut reactivity was lower than the threshold of egg reactivity. An allergy to peanut oil was demonstrated in 14 patients. CONCLUSION: The severity of peanut allergy and the early onset of the occurrence of this allergy is documented. The role of residual allergenic proteins in peanut oil is established by positive skin-prick tests to proteic extracts from peanut oil and by double-blind placebo-controlled challenges to peanut oil. The increased consumption of allergens in the form of peanut oil and fats can contribute to the occurrence or persistence of symptoms and may be suspected to increase the risk of sensitisation.     

Food preferences as an index or orality.

A self-report questionnaire dealing with food preferences (Food Preference Inventory—FPI) was proposed as a measure of Ss' contemporaneous position in respect to oral-passive vs. oral-sadistic involvement. The measure was pretested and through an item analysis found to be internally consistent enough to be utilized. The questionnaire was expanded and retested on new Ss to guarantee its stability and to increase its discriminatory potential. Finally it was subjected to validation by contrasting the scores of a group of Ss thought to be high on oral passivity (alcoholics) vs. a normal control group and by correlating it with their orality trait scores. The FPI was found to be fairly reliable and yielded data in agreement with the 2 validation predictions. It was concluded that food preferences as measured by the inventory offer a valid means of assessing an individual's position in regard to orality. (19 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Meta-analysis that conceals more than it reveals: Comment on Storm et al. (2010).

Storm, Tressoldi, and Di Risio (2010) rely on meta-analyses to justify their claim that the evidence for psi is consistent and reliable. They manufacture apparent homogeneity and consistency by eliminating many outliers and combining databases whose combined effect sizes are not significantly different—even though these combined effect sizes consist of arbitrary and meaningless composites. At best, their study provides a recipe for conducting a replicable extrasensory perception experiment. This recipe includes following a design that employs the standard ganzfeld psi methodology and uses “selected” subjects. An experiment, having adequate power and that meets these criteria, has already been conducted and failed to produce evidence for psi. Parapsychology will achieve scientific acceptability only when it provides a positive theory with evidence based on independently replicable evidence. This is something it has yet to achieve after more than a century of trying. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Food allergy in children: results of a standardized protocol for oral desensitization

BACKGROUND/AIMS: Food allergy in children is still an unresolved problem that merits investigation, particularly when the food is fundamental for the child's growth. Reports in the literature that deal with the possibility of a desensitizing treatment are sporadic and often inconsistent, and no standardized protocols are yet available. In this paper we propose a standardized oral desensitization program for food allergy in children. METHODOLOGY: The treatment was carried out in 14 cases with allergy to food (milk in 6 cases, egg in 5, fish in 2 and apple in 1 case). The control group consisted of 10 age and sex matched allergic subjects (5 to milk, 4 to egg and 1 to fish), who underwent a strict elimination diet regimen. RESULTS: Compliance to treatment was satisfactory, since 12 out of the 14 treated cases (85.7%) completed the program. Treatment was successful in 100% of the cases that completed the program: all the treated patients are now able to tolerate any food with no untoward effects or need for preventive drugs. CONCLUSIONS: The proposed standardized oral desensitization treatment may represent a safe and convenient alternative in the management of food-allergic subjects.     

Latex allergy: implementation of an agency program

Allergy to latex has been increasing in both the healthcare consumer and healthcare provider populations over the past decade. Realizing that sensitivity/allergy to latex is an issue for both patients and staff, the authors created an interdisciplinary task force to address latex safety in a healthcare agency that provides care within inpatient, public health, and outpatient settings. In this article, the authors discuss allergic response to latex and testing for latex sensitivity as well as latex allergy in the general population, among patient populations, and among healthcare providers. The authors outline the development of a latex-free product cart, an agency policy and procedure, and staff and patient education strategies.     

Food and food additives hypersensitivity in adult asthmatics. II. Oral allergy syndrome in adult asthmatic with or without Japanese cedar hay fever

The number of individuals with early brain injury and multiple disabilities discharged from institutions had increased steadily over the past 10 years. The most frequently encountered problems by patients with early brain injury and epilepsy placed in the community were reviewed. Unavailability of specialized services, inadequate reimbursement, high turnover and lack of knowledge by caregivers, lack of understanding/acceptance of the concepts of seizure intractability and pseudoseizures, unrealistic expectations by overseeing agencies and/or family, and side effects of antiepileptic medications were the most common seizure-related problems afflicting these patients. Everything else being equal, good exchange of information between the various caregivers and continued education of caregivers, both time consuming endeavors, are the crucial factors for the successful management of seizures in this population.     

Food addiction.

80 obese women were administered the Clinical Analysis Questionnaire before admission to an Optifast weight reduction program to isolate factors predictive of diet program adherence and weight loss. Ss were highly functional, emotionally stable, and psychologically mature, contrary to popular stereotypes of obese women. A cluster analysis isolated 5 varying personality tendencies: depressive, anxiety-prone, addictive, controlling, and caretaking (nurturing yet independent). Regression analysis revealed anxiety as well as the ability to differentiate feelings as predictive of diet success. Emotional maturity was predictive of program adherence as well as sustained weight loss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fracture of the anterior superior process of the calcaneus: an often misdiagnosed fracture

Fracture of the anterior superior process of the calcaneus has been considered an unusual injury. Following a sudden twist there is immediate pain on the outer aspect of the mid-portion of the foot and discomfort on weight-bearing. Three mechanisms of injury have been reported to cause the fracture. The diagnosis is often missed, and prolonged disability and local pain at the calcaneocuboid joint deserve further consideration. Oblique X-rays of the foot are helpful to visualize the fracture. Type III fractures may cause cartilage lesions and arthrosis; therefore, one should not wait long before excision or refixation of the fragment.     

Birth in triplet pregnancies. Vaginal delivery--how often is it possible?

The patient was born by emergency cesarean section for fetal distress at 35 weeks gestation with a weight of 2740 g. The early neonatal course was complicated by transient tachypnea and renal failure. He was receiving oxygen and diureticus in incubator for 5 days and his condition was very improved on day 5. On day 7 he became lethargy and there was inability to tolerate feeding. Investigation of the cerebrospinal fluid revealed 8,000 leukocytes/microliter. S. marcescens was grown from cultures of both blood and cerebrospinal fluid. Treatment was started with cefotaxime and ampicillin every 6 hour. On day 14 the CT showed a brain abscess located parietooccipitally on the left side and diffuse infarction on the right side. On day 14 and 23 recurrence of increased leukocytes in the cerebrospinal fluid, high values of serum CRP and deterioration of clinical symptoms were observed. It is thought that the episodes show rupture of the abscess into the lateral ventricle. On day 55 surgical drainage was performed for the hydrocephalus. On day 110 the abscess was not found in the brain CT scan. His psychomotor development 3 years later was equivalent to two years old and he had secondary epilepsy.