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Showing posts with label allergies and asthma. Show all posts

Women with more children are less prone to allergies than nulliparous women and mothers of singletons

More children a woman has, the less it seems likely to suffer from allergic rhinitis or allergic conjunctivitis in his life, suggest the results of an Italian study published in the specialized "Allergy" journal.
The fact that children from large families are less prone to childhood allergies gave birth there fifteen years, in what experts call the hygiene hypothesis, recall Dr. Francesco Forastiere and colleagues.
According to this theory, fewer children are exposed to infectious agents (which is the case in a smaller siblings), plus the maturation of the immune system is directed towards the development of allergic-type responses, including the asthma or allergic rhinitis (or hay fever) belong.
Furthermore, there is evidence that maternal atopy (predisposition to develop allergic reactions) is a risk factor of allergic diseases in children.
To analyze the relationship between the number of pregnancies, number of births and the occurrence of respiratory problems (wheezing, asthma) and allergic (rhinitis or allergic conjunctivitis), Italian researchers interviewed 1,755 non-smokers aged 35 to 74 years living in four different regions.
The analysis of the testimony of participants and their medical records they found that the number of births was inversely associated with the proportion of women who have suffered at any time in their lives, rhinitis or allergic conjunctivitis.
While 30% of women do not have more than one child reported having suffered from allergic rhinitis, only 16% of mothers with more than four children were in the same situation. Similarly, the proportion of women who have been confronted with allergic conjunctivitis from 36% among women with no or one child and 17% of mothers with more than four children.
However, the authors were able to show any link between episodes of wheezing or asthma and the number of pregnancies or births.
According to Italian researchers, different hypotheses could be advanced to explain these observations. If these results are interpreted as indicating that atopy maternal influence the course of pregnancy, it can for example think that maternal atopy is associated with a "relative infertility, voluntary or not," they note.
On the contrary, if we consider that these results reflect that pregnancy itself has an impact on maternal atopy, another possible hypothesis is that the hygiene hypothesis applies to mothers as it applies to their children advance they.

Anyway, the link between the number of children and maternal allergies should be further studies and the factors that protect not only children but also their mothers, remain to be identified, the authors conclude

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Allergy Prevention: What precautions should I take?

Despite the often-contradictory and still-inadequate results of studies examining the effectiveness of different strategies to prevent the onset of allergies to certain precautions can prevent the development of such disorders in children at risk, said Thursday Dr. Fabienne Rance, a pediatrician and pulmonologist practicing in Toulouse University Hospital.
There are three forms of prevention, she said. Primary prevention aims to prevent the development of sensitization to allergens in newborns healthy at least one parent, brother or sister, has atopy, that is to say, a predisposition to develop reactions allergic.

Secondary prevention concerns about her children already sensitized to an allergen, and is home to prevent the occurrence of allergic reactions, with an elimination diet, desensitization and / or pharmacological treatment.

Finally, tertiary prevention aims to reduce the "allergic march" in a child with an allergy proven to prevent relapses and complications.

Experts indicate by this expression is that with age, the manifestations of allergy change and often evolve into more serious forms. Thus, the infant is more prone to food allergies, which is most often manifested by gastrointestinal symptoms (vomiting, diarrhea ...) or skin (eczema, hives ...). Asthma is more common then from about five years, while at the age of ten, allergic rhinitis or "hay fever" are the predominant forms.

PRIMARY PREVENTION FOR CHILDREN HIGH RISK

To prevent children from an atopic family in turn develop an awareness of certain products, the first step recommended by experts is prolonged exclusive breastfeeding (for four to six months).

Although the available data do not yet allow to completely eliminate the risk of sensitization of the infant by the passage of certain food antigens in breast milk, the mother should not ban certain products to all of its power, otherwise to appear nutritional damage to the health of her child shortcomings, emphasized Dr. Fabienne Rance.

The only food for which an elimination diet is recommended, both during pregnancy and lactation are peanuts and tree nuts, as these allergies are associated with relatively severe manifestations. While the effectiveness of this measure is not yet proven, the act of depriving a peanut is not likely to cause a deficiency, she said.

Food diversification should not be initiated within six months and the introduction in the diet of eggs, fish, shellfish and seafood should not take place before the child reaches the age of a year, while the peanut, sesame and nuts should not be given before the age of four or five years.

In addition, fruits, vegetables and meats must always be given cooked the first time, said Dr Fabienne Rance.

Prevention also requires compliance with general measures outlaw passive smoking, limit exposure to airborne allergens (house ventilate and reduce moisture limit haunts mites, do not take cat if there has not in the house), and meet the immunization schedule of the child in particular.

Allergy prevention is complex and difficult, due to the influence of the environment, but you should know that 90% of atopic live perfectly, concluded Toulouse specialist.

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Food allergies in connection with allergic respiratory diseases

Food allergies seem to be of particular importance in the development of asthma and allergic rhinitis, suggesting a French study published in the "Allergy" review and confirm the theory of the "allergic march".
According to the authors, this study is the first to assess the prevalence of sensitization to major food allergens and symptoms of food allergy with a large sample of French schoolchildren.
Although food allergies are a significant health problem, epidemiological studies in the general population are few, report Dr. Celine Pénard Morand, the Inserm Unit 472 (Epidemiology of respiratory diseases), and colleagues. Indeed, testimonies on the declarative mode, a diagnosis of food allergy are difficult to confirm a large scale, because the necessary tests show heavy to implement consistently.
To highlight objectively sensitization to food allergen must make skin tests and specific IgE, while the involvement of a food in a food allergy can be proved by means of a test controlled food challenge and performed double-blind.
This team of French researchers sought to determine the proportion of children in school with this type of allergic diseases, which can lead to skin disorders, gastrointestinal or respiratory. Another objective of their study: clarify the relationship of food allergies with respiratory symptoms of allergy (asthma, allergic rhinitis, bronchial hyperresponsiveness to exercise) to determine the extent to which these symptoms can be the result of sensitization to inhalant allergens.
In this context, nearly 6,700 children aged 9 to 11 years were recruited from a hundred chosen so random in six French cities schools. Young participants underwent a complete physical examination, with a possible search for one of the three major food allergens characteristics of this age group (egg, fish, peanuts) with skin testing and evaluation awareness by via a standardized protocol-induced airway hyperresponsiveness by exercise. Standardized questionnaires were also submitted to the parents of the young participants to assess the presence of asthma, allergic rhinitis and clinical symptoms of food allergies.
Based on these data, it was found that 2.1% of the participating children had already presented the characteristic symptoms of a food allergy after eating a particular food. The proportion of participants in a food allergen sensitized (that is to say having at least a positive skin test) was meanwhile elevated to 1.9%. The combination of these two groups has enabled the authors to note that 0.1% of children they have taken to meet these criteria and therefore could be considered as suffering from respiratory allergy confirmed by a skin test.
Analysis of the various results of this survey showed that asthma and allergic rhinitis showed significantly more frequent in children with a food allergy or sensitization. The association between food allergic reactions and allergic respiratory diseases remained after adjustment to take into account the influence of age, sex, passive smoking, or a family history of allergic diseases, the authors report.
However, the link between asthma and allergic rhinitis and food allergy awareness or can not be fully explained by the existence of respiratory manifestations of food allergy or sensitization to inhalant allergens, the authors note.
The results of this study, which highlight the importance of food allergy in the development of asthma and allergic rhinitis, suggest that during childhood, food awareness could promote awareness of inhalant allergens, which in even represent a major risk factor for asthma and allergic rhinitis.
This work thus confirms the hypothesis of "allergic march", an expression that experts use to describe the fact that with age, the manifestations of allergy change and often evolve into more serious forms.

Thus, the infant is more prone to food allergies, which is most often manifested by gastrointestinal symptoms (vomiting, diarrhea ...) or skin (eczema, hives ...). Asthma is more common then from about five years, while at the age of ten, allergic rhinitis or "hay fever" are the predominant forms.

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Allergies in children: primary prevention through the determination of at-risk populations

In the case of primary prevention of childhood allergies, before adopting measures at the environmental level, it is important to identify populations at risk, warned Dr. Jocelyne Just (Armand Trousseau Hospital, Paris).
"The increase in the prevalence of asthma and allergies is related to a complex phenomenon involving amplifiers and the disappearance of protective factors, for which, however, must not lead to the against-messages," the Dr. Just.
According to her, it is important to determine the populations of children at risk by tracing the history of the disease in one or both parents, allergic (food allergy, eczema, rhinitis or asthma) and establishing a concept of atopy family.
"Primary prevention is then passed through the absolute rejection of passive smoking. Should, however, continue to vaccinate children (no vaccination does not protect against allergy, contrary to popular belief)," observes the specialist.
The decrease in allergen load is not obvious, she says, whether the sometimes controversial eviction of mites, as the attitude to adopt vis-à-vis the dogs and cats, while it will be resolved in secondary prevention. "For dust mites, a study has shown, in fact, that we were more exposed to it during the first 6 months of life, the less danger of developing allergies," she says.
About exposure to cats and dogs, primary prevention is more difficult to implement. "High exposure (presence of several pets in the same household) or, conversely, low, cause a potentially protective effect, while an average exposure promote the development of allergies, knowing that everything depends on the number animals present in a house and vent it, as well as genetic polymorphism. In this case, it is impossible to decide at least to establish a genetic map of each child ", noted the Dr. Just.
In terms of childcare in the community, she says, "an early entry into kindergarten before the age of one year to protect allergen sensitization but not hay fever, or asthma, knowing, moreover, that respiratory syncytial virus (RSV) causes epidemics of bronchiolitis, reveals itself no protector among predisposed patients. "
Finally, the contribution of probiotics in the diet could have, again, a protective effect against allergic sensitization, primary prevention, as well as the ouster of certain foods (eggs, peanuts), in the case of family atopy .

It is often a combination of different measures provides meaningful results. Such is the case of the reduction of the burden of mites combined with dietary intervention that has, in a population of children aged 18 months to reduce the hiss (but not asthma, however), illustrates the allergist based on the results of a study. Another showed a reduction of allergen sensitization, wheezing and asthma in older children (8 years) through a combination of several measures such as breastfeeding and the use of acaricides and dust mite covers.

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GM: no risk of allergies!

Genetically modified organisms (GMOs) do not exhibit allergenic risk, indicate the results of a Portuguese study published in the journal "Journal of Allergy and Clinical Immunology" (JACI).
The debate around the production and marketing of GMOs (this manipulation to improve the nutritional quality of plants or increase productivity) has mainly focused on the potential health risks posed by the consumption of GMOs or products derived . In addition to the potential risk of developing antibiotic resistance or toxicity of GMOs, the possibility that these products promote the development of allergies was also highlighted.
Indeed, without being genetically modified, of animal or vegetable origin are already an important source of allergens. Genetic engineering could therefore lead to transfer to another body of a gene encoding a protein with allergenic properties.
Rita Batista, the Instituto Nacional de Saude Dr. Ricardo Jorge in Lisbon, and colleagues sought to clear the risk associated with the consumption of GMOs, assessing the impact of three maize varieties (developed to resist certain insects ravaging crops) and a variety of soybean (designed to resist Roundup, a widely used herbicide), the seeds were placed on the market in the 90s. Some of the products tested are in the range of U.S. giant Monsanto, the others being marketed by the Swiss company Syngenta and the German Bayer. No GMO evaluated in this study contain genes from a proven source of allergens, Portuguese researchers note.
Their study focused on a group of adults and children prone to allergies have already consumed products containing GMOs at one time or another since these products were authorized in Europe.
The 77 participants underwent
nasopharyngitis
by intradermal to see if they react differently to GM products, as well as conventional corn and soybeans. The tests used to diagnose allergies involve injecting a small amount of allergen under the skin of the patient. The allergy assessment was completed by specific IgE.
These tests were positive in patients with a history of sensitivity to corn and soybeans, local inflammatory reactions observed in these tests are showing comparable with all the products tested, whether genetically modified or unmodified. Moreover, none of the participants had developed detectable antibodies against the proteins introduced into transgenic plants concentrations.

"Transgenic products tested appear to show safe in terms of allergenic potential," write the authors, however, require systematic testing after completion of the marketing of these products to detect the occurrence of any awareness encoded by the introduced genes proteins in transgenic plants.

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Asthma and allergy: the influence of overweight on the risk differs by sex in children

Being overweight affects the risk of asthma and allergy differently by gender in children, suggests a French study
This observation was made in the context of the study said the six cities, coordinated by Isabella Annesi-Maesano, INSERM U472 unit Villejuif (Val-de-Marne).
Several data have suggested a link between overweight and asthma, but most come from cross-sectional studies (which simply allow to find a relationship, not a relationship of cause and effect) explained Marie Dalitchamps, the U472, and colleagues.
They studied the association in 7781 children aged 9 to 11 years who were randomly recruited in 108 schools in six French cities (Bordeaux, Clermont-Ferrand, Créteil, Marseille, Reims, Strasbourg) between 1999 and 2001, pass evaluation of asthma and allergic diseases tests.
The researchers traced the weight gain of children during their growth using the body mass index (BMI, weight ratio of the square of height) to 10 years and weight index (PI, weight divided by the size of the cube) at birth (obtained according to the information contained in the health record). Depending on the value of these parameters, the children were classified into four groups.
In reviewing these data to take into account the possible influence of other parameters, the authors found that being overweight at birth is associated with the risk of allergic asthma significantly for girls only: it is multiplied by 2.6 in girls who have always been overweight (IP at birth and BMI at 10 years in the group of the most important values).
The overweight girls at birth are also at risk of allergic asthma doubled, even if they have lost weight to 10 years (IP at birth in the group of the most important values ​​and BMI at 10 years in the group values lowest).
In contrast, the risk of allergic asthma in boys seems associated with a low PI at birth, it is accompanied or not an excessive weight gain during growth. The risk is doubled when BMI is 10 years in the group of the weak and almost tripled (OR = 2.8) for a BMI of 10 years in the group of the most important values.
In another analysis of data from the study of six cities, Chantal Raherison, University Hospital of Bordeaux, and colleagues evaluated the association between overweight and allergic diseases such as rhinitis or atopic dermatitis.
According to the results, only one rhino was significantly associated with overweight in girls, but not boys.

These results support the hypothesis that sex modulates the link between overweight and asthma and allergic diseases, probably involving hormonal factors, the researchers conclude.

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Parents: you need to know to facilitate the early diagnosis of allergies child

While allergic phenomena and associated diseases have exploded over the last thirty years, today is the first asthma chronic childhood disease and 20 to 25% of the French population suffers from allergic phenomena at scales of variable severity, says Prof. Peter Scheinmann, head of pneumo-allergy pédiatrEtant given as eczema and food allergies in infants seem predict the onset of asthma in young children, European specialists allergy agreed last year to advocate early detection of allergies of the child, to enable early treatment and improve the prognosis of patients.

Informing doctors and patients to adopt habits to help diagnose allergies in children aged one to three years, experts hope that the transition from rhinitis to asthma, or the development of a polysensitization child initially sensitive to a single allergen is often avoided, said Dr. Pierre Scheinmann.

"Any child with allergy symptoms" severe, persistent or recurrent should undergo allergy testing. The difficulty for the physician lies in the fact that allergies manifest themselves in very different signs.

In infants, symptoms are kind of digestive (vomiting, diarrhea, colic), skin (eczema, hives, itching) respiratory (persistent wheezing), while among school-age children, allergic reactions are rather in the form of asthma or hay fever.

This evolution of the infant more susceptible to food allergens in young children more susceptible to environmental allergens, is called "allergic career" by specialists, said Dr. Fabienne Rance.

If such disorders affect your child so persistent and severe, do not hesitate to state his or her physician. It will prescribe whatever the age of your child, allergy testing that will identify the allergen to which it is sensitive. Support will then aim to try to minimize the exposure of the child to the substance and to initiate a specific treatment to relieve allergy symptoms.

In addition to these tips, Dr. Pierre Scheinmann wished to recall that in view of the role of genetic predisposition in allergic reactions, parents should not hesitate to tell the doctor treating the child familiaux.ique the history of the hospital Necker-Enfants Malades in Paris.

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Allergy to insect stings: specific immunotherapy protects long-term

A significant proportion of children keep their Hymenoptera venom allergy growing and immunotherapy reduces the risk of new generalized even 10 to 20 years after the end of treatment response, shows a study published Thursday in the " New England Journal of Medicine "(NEJM).
Children are supposed to lose their growing Hymenoptera venom allergy (bees, wasps, hornets, ants), but there is relatively little data. Specific immunotherapy with Hymenoptera venoms and other insects that has proven its effectiveness, is for children who have had a severe generalized reaction to an insect bite.
Dr. David Golden and his colleagues at Johns Hopkins Asthma and Allergy Center, Baltimore (Maryland) wanted to check first if the loss of growing allergy is common among children and secondly to study the effectiveness long-term specific immunotherapy in children.
For this, they have made monitoring a study they published in 1990 in the NEJM on the value of specific immunotherapy in children with an allergic reaction to an insect bite between 1978 and 1985.
On 512 patients who responded to the follow-up survey (between 1997 and 2000), with a decline of 18 years on average compared to the first reaction, 163 had been treated with immunotherapy for 3.5 years. More than 40% of respondents were transplanted between 1987 and 1999.
The results show that while the majority of children lose their sensitivity to insect bites, an allergic reaction still occurs in nearly one in five children in a sting, which could occur for some up to 32 years after the first reaction.
The frequency of allergic reactions in untreated children decreased slowly over time, but more than 20 years after the first reaction she was still 13%. "Therefore, for many children, this allergy does not disappear growing," the authors write.
Furthermore, this study shows that even long after the cessation of desensitization, processing continues to take effect. Generalized reactions were very significantly less frequent in children treated (3%) than in untreated children (17%).
Reducing the risk of systemic reaction obtained with desensitization was even greater for children whose first reaction was moderate to severe (respiratory disorders, hypotension), the frequency of severe reactions was 32% in untreated children against 5% in those who were treated.
For those who had been treated for mild generalized reactions (skin only events), none of the 21 who were transplanted has been widespread reaction.
The authors recommend specific immunotherapy with Hymenoptera venoms for children with moderate to severe reactions, but not for those who have mild reactions. Moreover, the treatment may be prolonged in children with very severe reactions, they say.

In an accompanying editorial, Rebecca Gruchalla of the University of Texas Southwestern Medical Center in Dallas agrees with these recommendations and hopes that these new data will help doctors to convince parents of the value of treatment in children most at risk.

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Allergy: the protective role of farm life seems to start from fetal life

Children whose mothers were in contact with farm animals during pregnancy could be protected against allergic diseases, preliminary results suggest the PASTURE study.
The PASTURE project (Protection against Allergy - Study in Rural Environments) is a European study set up to confirm previous data from cross-sectional epidemiological studies suggesting a protective role of a rural environment, especially farms, against allergies and asthma, told Reuters Health Prof. Dominique Angèle Vuitton at the University of Franche-Comté in Besançon, co-coordinator for France with Professor Jean-Charles Dalphin CHU Besançon.
PASTURE is a prospective longitudinal study of 1,000 children who all live in rural areas but with a party at the farm (parents farmers in most cases) and the other in villages or towns. In France, the study was conducted in Franche-Comté, with the help of MSA (MSA), said Prof Vuitton.
The study began with women in the third trimester of pregnancy, included between 2002 and 2004. According to the protocol published in Allergy, parents completed questionnaires about their medical history, lifestyle, nutrition and child, breastfeeding, etc ... Blood tests were conducted with parents and children at birth and at each anniversary. Samples were, moreover, made in the environment to assess potential dust and allergens ...
The study is ongoing, with a mean follow-up of three years so far, with national funds, with the aim of having at least one and up to five years if possible until adolescence for allergic diseases can regress spontaneously or emerge by then, explains the specialist.
Researchers have the first results for cord blood: they tend to confirm the protective effect of farm life and especially that influence begins via the mother during pregnancy. This "immunological modulation arising from pregnancy" could be mainly due to the contact of large farm animals such as cows, horses and pigs, as well as the consumption of raw milk.
Immunological analyzes showed that levels of cytokines IFN-gamma, TNF-alpha and IL-10 secreted in the cord blood are higher for children whose mother lives in the farm for those families living there, suggesting that first developed an immune response that would "most likely" to be protected against allergies, says Dr. Vuitton.
These results should be confirmed by further analysis, including exposure times, and the data collected at one, two and three year follow-up. Analyzes of specific IgE are also provided and may provide interesting elements on allergies to milk protein of cow in particular, as well as the pollen present in the farms.
Analysis of "newspapers Health" weekly reports made by the parents of respiratory and skin symptoms during the first year of the child, as well as diagnostics prick tests to one year in France in particular, will show whether a farm life protects against allergic diseases. Preliminary data tend to confirm previous data suggesting a risk divided by two compared to city life, says Professor Vuitton.

The results of the cytokines measured in cord blood should be the first of PASTURE project to be published before a variety of other data

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Limit children's exposure to domestic allergens is not enough to reduce the risk of asthma or allergy

The only reduce exposure of infants to domestic allergens is not enough to reduce the incidence of respiratory allergic diseases and asthma in children five years shows published in the journal "Thorax" British study .
For twenty years, the exposure of young children to allergens at home is suspected to play a major role in the occurrence of respiratory allergies, wheezing and asthma, suggesting that reduced levels of allergens household could reduce the incidence of these diseases, recall Dr. Paul Cullinan and colleagues from the National Heart and Lung Institute in London.

In their study, the researchers followed 625 children from birth to the age of 5.5 years.

At baseline, parents were tested at different skin allergens and were questioned about their possible respiratory symptoms. Then, when the children reached the age of two months, different levels of household allergens were measured in dust collected at home. Finally, during the last year of follow-up, parents were asked about any respiratory symptoms occurred in their children, who then underwent a skin allergy test.

The results of these analyzes revealed that 10% of participants were young, at the age of 5.5 years, sensitized to cat allergens or mites in dust. This means that their tests showed that they react to these allergens, but not necessarily imply that they develop clinical manifestations (asthma, eczema ...) in their presence. In addition, 7% of children with atopic wheezing.

The overall analysis did not show a link between exposure to allergens and allergic sensitization or wheezing.

However, a closer examination of the data showed an association between the risk and the level of exposure to allergens: the risk of allergy and wheezing increases for low allergen levels and decreases for higher rates, with boost when the father is allergic or when the child is the first of the siblings.

These results suggest that the link between exposure to indoor allergens and the risk of atopy, wheezing or asthma is complex, involving interactions between genes and the environment more important than you think the authors conclude.

Household allergens may play a role in the development of asthma and respiratory allergies but at a level likely to be extremely low, they say.

This study also suggests that a strategy only to reduce the levels of exposure to indoor allergens will have no major impact on the incidence of respiratory allergies and asthma, they add.

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Peanut allergy: the "french kiss" can pose a real risk

The peanut-allergic people, especially teenagers, should be warned of the risk posed by the fact that kissing someone who recently ate peanuts or peanut products merely, even if that person is then brushed teeth, U.S. researchers warn.
Last November, a young Quebec allergic apparently died after exchanging a kiss with her boyfriend when it came to eating peanut butter and this information was widely relayed around the world. The results of the autopsy, released in early February, has since contradicted this hypothesis, but "there is a risk that allergens are transferred via saliva," said Dr. Jennifer Maloney, Mount Sinai Medical Center New York, during a press conference in connection with this conference.
A "passionate" kiss shared with a partner who consumed a peanut-based product could expose a person with an allergy to peanut allergens to which it is sensible.Pour verify this point, members of the team led by Dr. Jennifer Maloney evaluated the evolution of the peanut allergen concentration in the saliva after a meal and the effectiveness of different strategies to remove them.
For this, samples were taken repeatedly from ten healthy volunteers who ate a sandwich with two tablespoons of peanut butter as they are or unwashed teeth then, whether or not they is a mouthwash and whether or not they took a chewing gum.
Increasing the concentration of the major salivary peanut allergen, Ara h 1, recorded immediately after ingestion of the sandwich is very variable from one person to another, the authors note. Thus, the allergen is then remained undetectable in the saliva of three participants.
An hour after the meal, six of the seven people in which the first screening test was positive had their salivary concentration of Ara h 1 become undetectable. Finally, half past four after ingestion of the sandwich, all participants had a saliva devoid of any trace of peanut allergen.
Moreover, none of the strategies implemented immediately after ingestion (brushing and / or mouthwash, chewing gum) has helped increase the concentration of allergens below the detection threshold. If these interventions help to reduce the amount of Ara h 1 present in saliva, none of them will not make it disappear entirely, notes the American researchers.
Practitioners must inform their patients with peanut allergy, especially adolescents-the risk that may arise to embrace the fact that someone has to consume a product containing peanuts, and even he washed his teeth, the authors conclude.

The safest approach they recommend, would be that of an allergic person's partner adopted a total eviction of the food concerned regime. In practice, it may be sufficient after having consumed a product containing the allergen, it wait several hours and thoroughly brush your teeth before any kiss. However, a study on a larger scale should be conducted to clarify this point.

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Allergy to cow's milk proteins: a step toward earlier support

Allergy to cow's milk protein is a very common condition that affects nearly 10% of infants less than three months, but can also affect older children.
Often associated with other food allergies, it also predisposes to the occurrence of asthma.
The first bottle of baby milk (which contains cow's milk) they receive, some of the children who were breastfed by their mothers vomit and become "pale, quite gray", described Dr Edwige Antier pediatrician practicing in Paris. This sometimes dramatic as it can go up to anaphylactic shock, is that are grouped under the term "manifestations of immediate type of allergy", allows the physician to easily diagnosis of allergy protein from cow's milk.
But this disease is most often manifested more ambiguously, through symptoms persist and interfere with everyday life of the child who consumes daily milk, and that of his parents. Chronic diarrhea, colic and abdominal pain, constipation, gastroesophageal reflux disease, sleep disorders, eczema or poor weight gain among these are the "delayed-type events," noted Dr. Delphine de Boissieu, gastroenterologist and allergist in the Neonatal Medicine, Saint Vincent de Paul Hospital in Paris (XIV arrondissement).
FACILITATE THE DIAGNOSIS ...
But these symptoms may also be due to other conditions, and so far the only reliable tests to determine with certainty that a child had a delayed allergic to cow's milk protein should form be made in the context of a consulting firm specializing in hospital for allergy service.
Test, marketed by DBV Technologies, a French company for biomedical research involving pediatricians and engineers, avoids all these complications. On the advice of the attending physician (general practitioner or pediatrician), parents of a child with symptoms suggestive of delayed allergic to cow's milk proteins form can buy this device in pharmacies. They can easily put themselves patch containing allergens milk and empty patch (control) through two applicators, they withdraw coated after 48 hours and allow the physician interpreting the test 72 hours after installation.
In fact, the finely powdered milk powder adheres to patch through electrostatic interactions, said Dr. Pierre-Henri Benhamou, a gastroenterologist in the service of Professor Christophe Dupont and member of the DBV Technology company. When installing the device, the sweat will moisturize milk powder and "reconstitute the milk as we reconstitute in a bottle", thus inducing an allergic reaction, he added.
... BETTER TO SUPPORT
The test is considered positive when the skin is much more red on the side of the test milk compared to the control test. In this case, the milk protein allergy is confirmed. The doctor will then prescribe what is called a total elimination diet, which is to completely eliminate the offending allergen from the diet of the young patient.
"It is not easy for the doctor and it is very difficult for the parents decision," summed Edwige Lantier. Indeed, it is difficult to avoid the allergic child does not consume yogurt, a biscuit, mashed potatoes or any other food containing milk when he is with his nanny, school or birthday party a comrade, said the Parisian pediatrician.
But if "we really removes very strict allergen" for a duration defined by the physician, "the reintroduction, it is likely that the child is not allergic," she insisted. For unlike the adult allergy-definitively, that the child may be reversible.

This "healing" of the allergy of the child, the frequency of which depends on the food (very rare for peanuts in nearly eight out of ten for the egg) is not yet fully explained by researchers argue that including the fact that the immune system of the child is still maturing, said Dr. Delphine de Boissieu.

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Allergies: the last antihistamines can drive without drowsiness

Only third-generation antihistamines do not exhibit sedative effect and thus allow to drive safely, indicate the results of a synthesis performed by a Dutch team, published in the journal "Annals of Allergy, Asthma and Immunology."
Histamine acts as a chemical mediator in allergic reactions massively released during an allergen contact, it causes vasodilation of blood vessels responsible for the appearance of edema during attacks hives, but the contraction of smooth muscles bronchi causing asthma attacks.
Many affected by allergic disease, some of which are likely to be brought to drive people, so are prescribed antihistamines.
But these drugs can cross the blood-brain barrier, a physiological boundary between the blood and the brain, which protects it from potentially harmful substances. As histamine is involved in the activation of certain neurons belonging to the circuit of awakening, the consumption of antihistamines can cause drowsiness.
Dr. Joris Verster, Institute of Pharmacology, Utrecht (Netherlands), and his colleagues decided to review all the data on this class of drugs obtained through studies "in position" that is to say on the road in normal traffic conditions.
Their analysis shows the first generation antihistamines significantly impair performance on driving, as after a single administration after repeated administration (daily). Driving with such drugs should be considered dangerous, the authors write.
The second-generation antihistamines, usually presented as less sedating, they actually induce less drowsiness, still affect the ability to drive with a variable magnitude and duration by sex, dose, and the time between testing and decision.
However, two third-generation antihistamines may be considered non-sedating and therefore safe for patients who want to drive, conclude the authors of this summary. Dr. Joris Verster and his colleagues did not want, in this analysis, decide on a third representative of this class, for which only laboratory data not involving tests in real conditions were available at the time of writing their article.

One study showed that third antihistamine does not affect the ability to drive a vehicle on the road, and Dr. Joris Vester now considers these three third-generation antihistamines such as non-sedating.

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Cancer: the crucial role of nurses in case of allergy treatment

The role of oncology nurses is crucial in case of allergic reaction to cancer treatment, observed in more than one third of the patients condition.
Several studies have shown that 35% of cancer patients are likely to experience anaphylactoid reactions (occurring without prior exposure) or anaphylaxis (after first exposure) to their treatment, forcing their doctor to change it to an often less effective therapy .
The severity of the reaction depends on the reuse of the product in question, as part of a process of desensitization or retry, or prescription of a new drug, said Jeanne Held-Warmkessel nurse at Cancer Center Fox Chase in Philadelphia.
Before administering to a new cancer treatment that caused him a violent allergic patient, the physician must evaluate the effectiveness of alternative approaches, assess the loss or delay of a possible cure, analyze the likelihood of new allergy and reduce patient anxiety.
Monitoring patients before, during and after they have received their treatment is particularly critical, says the nurse. The success of their care is the knowledge of the nurse on the treatment given, the risk of reaction it causes, and symptoms suggestive of allergy.
In case of unexpected reaction, the nurse should discontinue treatment immediately and provide necessary relief to the patient care. Its role is to educate the patient and his entourage to recognize the signs indicating an allergy and to report, even if they seem trivial.

"The oncology nurses are the first to respond and represent the best resource for patients at a time as difficult [as an allergic reaction to treatment]," concluded Jeanne Held-Warmkessel.

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Asthma: wheezing and allergies in childhood predict adult disease

The presence of wheezing and allergies in children are predictive of asthma in adulthood, suggests a study published in "Chest".
The development and prognosis of asthma have been extensively studied in populations at risk. However, the evolution and risk factors for this disease in the general population remain poorly understood.
Celeste Porsbjerg of Bispebjerg University Hospital of Copenhagen (Denmark), and colleagues followed 291 volunteers aged between 7 and 17 years, 12 years, to determine the predictors of onset and remission of asthma . Participants completed a questionnaire about their history of asthma, allergies or general factors of quality of life at the start of the study in 1987 and 1998. Respiratory and allergy tests were also conducted at both stages.
At the beginning of the study, asthma concerned 4% of volunteers against 11.7% at the end of it, in 1998. During the monitoring period, approximately 19.6% of the volunteers experienced at least once asthma symptoms.
Bronchial hyperresponsiveness to histamine, wheezing, allergic sensitivity to dust mites and dermatitis, an inflammatory disease of the skin, are, according to their results, the predictive factors for the development of asthma at age young adulthood. The presence of these factors multiplied by three to five times the risk of subsequent asthma in young volunteers.
The simultaneous presence of more than one of these risk factors was associated with a high probability (61.5%) of developing asthma during the study follow-up. In contrast, among the volunteers with any of these risk factors, only 4% developed asthma during the follow-up period.

The combined presence of symptoms of bronchial hyperresponsiveness to histamine and allergic symptoms in children should be recognized as an important prognostic marker for the development of asthma in adults and prompt treatment with immunotherapy, the authors suggest .

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Allergy: half of Europe concerned in 2015

Half of Europeans could become allergic to 2015, said the president of the French Society of Allergology and Clinical Immunology (SFAIC), Professor Gabrielle Pauli (CHU Strasbourg) during the first French Congress of Allergology in Paris.
Currently in France, the prevalence (total number of cases per year) is more than 20%, which represents 15 million people affected.
But "these figures, suggesting a real public health problem, not émeuvent person because allergies are not considered life-threatening diseases," for his part lamented Professor Pascal Demoly (CHU Montpellier).
"However, since the beginning of the year, three fatal cases were reported to the allergy and coordinated by the University Hospital of Nancy network has identified 50 accidents requiring emergency. Everyone is also not declared" reported Dr. Jean-Pol Dumur, president of the National Association of training in allergy (Anaforcal).
Continuing to advocate for the recognition of allergy, it stated that "the cost of diagnosis and care less medical wanderings, the cost of medicines and hospitalization patients misdiagnosed and therefore mistreated" and that indirect costs associated with work stoppages-up two to three times lower.
At the opening press conference of the Congress, the President of the Anaforcal hoped that "the founder of the whole community allergy act raise awareness" of the government but also the people.

In its statement, the Snaf also calls allergic "to defend all the allergy." A study is underway with patient organizations to "take steps in consultation," concluded Dr. Farid Marmouz, allergist at Pontoise

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Allergy medications: take a picture of her skin

Take a picture of yourself is the first thing to do if skin reaction to a drug, a process that will help the allergist to be a good initial diagnosis and provide optimal care.
The drug allergy concern less than ten French, according to an estimate based primarily on the statements of individuals and not on the results of tests. Its reliability is questionable, said Prof. Pascal Demoly (CH Montpellier), for which she is probably over-estimated.
Indeed, non-allergic side effects can perfectly mimic an allergic reaction, causing patients to feel sensitive to the drug absorbed and leading them to adopt a predatory conduct. This is the case for example of cortisone, which can cause redness of the skin, or certain antibiotics that cause photosensitivity reactions that do not have an allergic nature, he cited as an example.
Therefore, it is essential to make allergy tests in specialized areas, to determine with certainty whether or not an allergy medication.
Very heterogeneous, allergic reactions to drugs primarily concern the skin and occur mostly in hives, but can sometimes take the form of edema of the eyelids, of angioedema or small buttons scattered throughout body.
Faced with a skin reaction, the Montpellier specialist recommends taking a photo of his skin, thereby avoiding subsequent to the allergist who take care of the patient to wander from a diagnostic standpoint. The interruption of the drug in question must be immediate. Emergency treatment based on corticosteroids and antihistamines, and in the case of immediate reactions, adrenaline.
The drugs most often by patients suspected of being responsible for a penicillin allergy (35% of applications) non-steroidal anti-inflammatory drugs (22%) and anesthetics (6%). The concern about generics for the simple reason that they are a copy is, however, unfounded, unless be allergic to any of the excipients which differ from the original product, which is very rare, says Dr. Demoly.
For the latter, if known allergy, it is better to have a list of products that can be taken rather than a list of those to avoid them being brought to disappear or be replaced by new drugs.

It also recommends to make his allergy, especially in case of hospitalization, and check medications that are administered.

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Allergy: altitude, a beneficial effect on asthma mites

Stay aloft appears to improve asthma control and reduce consumption of corticosteroids in children and adolescents with severe allergic asthma due to mites, according to a small French study
Allergic asthma can be influenced by environmental factors such as allergens, infectious agents or contaminants in the air, but also the type of habitat, exposure, quality of ventilation and heating, the researchers said in the abstract of their paper.
Climatic factors are also involved, whether the moisture in the air, the temperature, the number of sunny days or barometric pressure, which have an impact on the development of allergen.
Dr. Hassan Razzouk European Medical Center bioclimatic research and university education (Cembreu) ​​to Villard-Saint-Pancras (Hautes-Alpes) and his colleagues at the Centre of pneumo-allergy Les Acacias, as well as two children's homes sanitary and social (MECSS) Briancon, conducted a study to assess the effect of climate altitude living in 40 children and adolescents (6-16 years) with severe allergic asthma due to mites.
The authors note that Briançon (climate station assigned), the mites rate is significantly lower than Martigues (Bouches-du-Rhône), for example, with 0.35 mg per gram of dust, against 17 8 mg / g. The concentration of spores of various fungi is also lower compared to Brussels and Nice.
The pollen season lasts only two months, June and July, with lower concentrations compared to Marseille and Gap. Finally, the chemical pollution is negligible, including a rate of sulfur dioxide from 10 ppb to 1,000 ppb against Paris or London 1400 ppb.
Three months after the arrival of children, it is an improvement of asthma, 90% of the days are spent with well-controlled, against 20% before symptoms stay.
Consumption of inhaled corticosteroids is also significantly reduced to three months and the quality of life improved significantly, the researchers add.
Laboratory data indicate that the total IgE levels decreased in three, six and nine months, down to the specific IgE to mites was even faster, they say.
Bronchial hyperresponsiveness has also decreased, with a mean dose of methacholine required to reduce the forced expiratory volume in one second (FEV) 20% of 129 g at the beginning of the stay, against 600 g for three months.
Finally, the oxide (NO) in exhaled air, a marker of airway inflammation was significantly reduced, with an average concentration of 68.6 ppb at the finish, against 61.3 ppb after three months.

These results suggest that climate stay high in special homes for children with asthma is useful in reducing symptoms and medication use, the researchers conclude.

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Prevention of food allergies: experts take stock of food diversification

A varied diet should not be too early and exclusive breastfeeding should be maintained until a baby reaches six months of age, reminiscent of specialists in the "Annals of Allergy, Asthma and Immunology."
Dr. Alessandro Fiocchi, Faculty of Medicine, University of Milan, and his committee colleagues unwanted food to the American college of allergy, asthma and Immunology (ACAAI) reactions have reviewed the published data about food diversification, in order to clarify how to proceed dietary diversification and when an infant can start solid foods other than breast milk or infant formula.
These Italian and American allergists fired four main findings of 52 studies they included. In particular, they observed that carry too early dietary diversification increases the risk of developing food allergies child while avoiding solid foods for a while involved in prevention. They also noted that some products are more likely to trigger allergies than others, and some food allergies are more persistent than others.
This work has enabled specialists to reach a consensus through which they invite especially pediatricians and allergists to be cautious. Main recommendation: the introduction of solids in feeding a baby should be made on an individual basis, depending on the risk of food allergy which the infant is exposed because of family history of atopy or allergy .
According to them, the optimal general scheme is to maintain exclusive breastfeeding until the child reaches the age of six months, knowing that in any case the food diversification should not be initiated during the first four months of a child's life.
Solid foods can be introduced in the diet from the age of six months, in small quantities, always presenting the food cooked during the first exposure and offering one new product at a time, so able to identify any food allergies or intolerances, say experts. "Do not give mixtures before making sure that the child is not allergic to various ingredients of" they continue.

Cow's milk and dairy products can be offered from the age of twelve months, the eggs from 24 months, while it must wait until the child has reached the age of at least three years before making him taste peanuts, tree nuts (such as walnuts, hazelnuts, cashews ...), fish and seafood, say experts on the data available.

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Food allergies children allergic to nuts shoulds learn to Distinguish

More than one in four children with an allergy to fruit and nuts can not Recognize the kind of nuts All which it is sensitive, warn the authors of a U.S. study published in the "Annals of Allergy, Asthma & Immunology."
As with any food allergy, the walnuts, hazelnuts, pistachios, peanuts and / or other kinds of nuts required to follow a diet allergen avoidance, All which Requires knowing how to Identify and Recognize.
Indeed, accidental ingestion May lead some patients to anaphylactic shock Requiring emergency administration of epinephrine and hospitalization, remember Dr. Ronald Ferdman, of Children's Hospital Los Angeles, and Dr. Joseph Church, of University of Southern California, Los Angeles.
Seeking to determined at what age children can betweens Distinguish different kinds of nuts as well as Specify Whether Such Those with allergies are ble to Recognize the types of fruit and nuts to All which They are sensitive, two thesis Researchers built a "box nuts" they Placed eleven different varieties of nuts in a glass container.
They then Interviewed one hundred children aged four to 19 years, Including 37 suffering from allergies to nuts, asking 'em to name the different kinds of nuts. Young patients allergic aussi Abebooks web sites to Identify the nuts They and What They Could eat shoulds not eat.
Each child was ble to Identify an average of 2.7 nuts, this Amount Increases with age, with wide variations goal from one child to Reviews another, the authors report. A total of 59 children Were not ble to Identify more than two nuts.
Fruits MOST frequently reconnu shell peanuts are 89% of the children in APPROBATION Their shell and 52% When peeled. In contrast, other kinds of nuts SEEM much less known, the proportion of children Correctly Have you APPROBATION the kind of nut That was presented to 'em from 32% to 0% for pistachio nuts from Brazil.
Regarding allergic children, Almost three-quarters (73%) Correctly APPROBATION the fruit or nuts to All which They Were allergic, or said They Did not eat nuts That Were presented to 'em.
In other words, this Means That 27% of Them (ten children) Have Agreed to eat the fruit and nuts to All which They are allergic. Thesis of ten children, six young allergic Were ble to Identify the allergen To Avoid When the issue was still in nut in shell icts aim They said Would eat When They Were presented shelled.
So It Seems That Children, Including Those with an allergy to nuts, are ble to Recognize a small number of different nuts, All which unfortunately exposed young allergic to an Increased Risk of accidental ingestion, the authors Conclude.
Malthus, if Parents of children allergic to nuts too well intentioned are a little too protective of Their children and are totally disappear allergen environment of the young patient, it n 'will never Have the opportunity to discover what kind of nuts like this and then Will be quite Unable to Recognize, All which Increases the risk of accidental ingestion.
For U.S. Researchers, teach children allergic to nuts to Recognize the different kinds of nuts They are allergic to All which shoulds be an integral portion of Their therapeutic education.
Indeed, even if the total eviction strategy remains the Most appropriate for a young child with an allergy to nuts, Because of the Relatively frequent cross-reactions, this shoulds not Prevent Parents to Teach Their Children allergic to Distinguish different kinds of nuts, hazelnuts, pistachios, almonds and others by showing em pictures, or learning to Recognize it on the shelves of grocery stores.

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