Higher parental occupational social contact is associated with a reduced risk of incident pediatric type 1 diabetes: Mediation through molecular enteroviral indices.

We aimed to examine the association between parental occupational social contact and hygiene factors on type 1 diabetes (T1D) risk and possible mediation of these effects through child enteroviral infection. We interviewed 333 incident T1D cases and 660 controls from 2008-2011 in Melbourne, Australia. Enteroviral indices (ribonucleic acid by reverse transcription polymerase chain reaction and Coxsackie B virus antibody levels) in peripheral blood were measured in nested case control samples.

Determinants of Neonatal Vitamin D Levels as Measured on Neonatal Dried Blood Spot Samples.

Background: Vitamin D deficiency is linked to adverse childhood health outcomes, yet data on the distribution and quantifiable determinants of neonatal 25-hydroxyvitamin D3 (25OHD) concentration, a vitamin D biomarker, are limited.

Objective: Our aim was to identify determinants of neonatal 25OHD concentration, measured using neonatal dried blood spots (DBS).

Methods: A total of 259 ethnically diverse children aged 0-16 years born in Victoria, Australia, were recruited.

Allergen-specific IL-5 responses in early childhood predict asthma at age eight.

Background: The pattern of development of allergen-specific T cell cytokine responses in early childhood and their relation to later disease is poorly understood. Here we describe longitudinal changes in allergen-stimulated T cell cytokine responses and their relation to asthma and allergic disease during the first 8 years of life.

Methods: Subjects with a family history of asthma, who were enrolled antenatally in the Childhood Asthma Prevention Study (public trials registration number ACTRN12605000042640), had skin prick tests, clinical evaluation for asthma and eczema, and in vitro assessment of T cell cytokine responses to HDM extract performed at ages 18 months (n = 281), 3 years (n = 349), 5 years (n = 370) and 8 years (n = 275).

Gene-environment interaction in autoimmune disease.

Autoimmune disease manifests in numerous forms, but as a disease group is relatively common in the population. It is complex in aetiology, with genetic and environmental determinants. The involvement of gene variants in autoimmune disease is well established, and evidence for significant involvement of the environment in various disease forms is growing.

Comparison of anti-pneumococcal antibodies in cord blood from Australian indigenous and Gambian neonates and the implications for otitis media.

Background: Australian indigenous infants experience the highest incidence of chronic suppurative and acute otitis media in the world with many babies developing disease in the early postnatal period. Streptococcus pneumoniae is the major cause of otitis media in this population. Infants are protected against bacterial disease in the first months of life by passive transfer of maternal antibody across the placenta during the late stages of gestation.

The influence of sun exposure in childhood and adolescence on atopic disease at adolescence.

Background: It has been postulated that ultraviolet ray exposure in childhood might influence the development of allergic disease. We examined whether reported sun exposure during childhood or in adolescence is related to the occurrence of atopy or allergic disease.

Methods: Population-based longitudinal cohort study with sixteen-year follow-up (N = 415).

Intolerance to food additives - does it exist?

'Food intolerance' is often confused with a range of adverse symptoms which may be coincidental to ingestion of food. 'Food intolerance' is defined as a reaction in which symptoms must be objectively reproducible and not known to involve an immunological mechanism. A more precise term is non-allergic food hypersensitivity, which contrasts with food allergies which are due to an immunological mechanism.

Phenotypic and environmental factors associated with elevated autoantibodies at clinical onset of paediatric type 1 diabetes mellitus.

To examine possible determinants of autoantibody levels at type 1 diabetes mellitus (T1DM) onset. We assessed levels of glutamic acid decarboxylase 65 islet cell antigen (GADA) and anti-insulin antibodies (IAA) in 247 incident T1DM cases presenting <15 years of age in Melbourne from 1st March 2008 to 30th June 2010. 58.

Refractory symptoms successfully treated with leukotriene inhibition in a child with systemic mastocytosis.

Montelukast was effective in treating refractory abdominal and urinary symptoms in a child with systemic mastocytosis.

Parental perceptions and dietary adherence in children with seafood allergy.

Background: Allergy to seafood (fish, mollusc and crustacean) is increasing and is now a leading cause of food anaphylaxis, but there is only limited data on the impact of seafood allergy on affected children and their families.

Methods: We assessed dietary adherence and perceptions of seafood allergy amongst the parents of 94 children presenting to a specialist allergy clinic with proven seafood allergy, by means of a postal questionnaire and cross-referencing the data obtained to clinical records.

Results: One-quarter of parents were unable to correctly recall the dietary advice provided.

Allergic rhinitis in children.

Allergic rhinitis affects up to 40% of children but is commonly undiagnosed. Careful assessment of nasal symptoms allows for the most appropriate therapeutic options to be chosen. Allergen avoidance is often difficult in practice.

Effects of early cat or dog ownership on sensitisation and asthma in a high-risk cohort without disease-related modification of exposure.

Variation in the observed association between pet ownership and allergic disease may be attributable to selection bias and confounding. The aim of this study was to suggest a method to assess disease-related modification of exposure and second to examine how cat acquisition or dog ownership in early life affects atopy and asthma at 5 years. Information on sociodemographic factors and cat and dog ownership was collected longitudinally in an initially cat-free Australian birth cohort based on children with a family history of asthma.

CICADA: Cough in Children and Adults: Diagnosis and Assessment. Australian cough guidelines summary statement.

Cough is a common and distressing symptom that results in significant health care costs from medical consultations and medication use. Cough is a reflex activity with elements of voluntary control that forms part of the somatosensory system involving visceral sensation, a reflex motor response and associated behavioural responses. At the initial assessment for chronic cough, the clinician should elicit any alarm symptoms that might indicate a serious underlying disease and identify whether there is a specific disease present that is associated with chronic cough.

Action on anaphylaxis action plans.

The provision of a written anaphylaxis action plan is considered to be an essential component of the management of food-allergic children prescribed self-injectable adrenaline. Literature review indicates that the evidence that such plans are of benefit is incomplete; however, commonsense would suggest that this is the case. Controlled trials are unlikely to be performed.

Management of cow's milk protein allergy in infants and young children: an expert panel perspective.

Cow's milk protein allergy is a condition commonly managed by general practitioners and paediatricians. The diagnosis is usually made in the first 12 months of life. Management of immediate allergic reactions and anaphylaxis includes the prevention of accidental food ingestion and provision of an adrenaline autoinjector, if appropriate.

Allergic rhinitis.

Childhood rhinitis may be classified into non-allergic and allergic. Allergic rhinitis is further divided into seasonal and perennial. Seasonal rhinitis is a disease particularly of teenagers and young adults and appears to be less common in primary and pre school age children.

Dietary advice, dietary adherence and the acquisition of tolerance in egg-allergic children: a 5-yr follow-up.

IgE-mediated egg allergy is a common childhood food allergy affecting about 1-2% of 2-yr-old children. Egg avoidance is the mainstay of treatment for egg allergy; however, it is unclear what type of dietary advice parents of children with egg allergy receive and to what extent this dietary advice is adhered to. This study aimed to assess: (i) the type and source of dietary advice parents receive in a tertiary hospital setting, (ii) how closely parents adhere to advice given, (iii) what patient characteristics influenced adherence to diet and (iv) whether strict adherence to dietary advice was an identifiable factor in whether children outgrew their egg allergy.

New action plans for the management of anaphylaxis.

The Australasian Society for Clinical Immunology and Allergy has developed new anaphylaxis action plans intended for use across Australasia. These educational tools aim to give patients and carers easily accessible information about key steps in the emergency treatment of acute allergic reactions and anaphylaxis. This article outlines the rationale for these plans, introduces two new action plans and key practice points to consider when providing these plans.

Parental perceptions in egg allergy: does egg challenge make a difference?

The aim of the study was to determine the effect of an oral egg challenge in egg sensitized children on parental perceptions relating to their child's allergy. A questionnaire was completed by parents for 167 children attending a tertiary paediatric clinic with egg sensitization. The questionnaires included 10 questions concerning parental perceptions of their child's egg allergy.

Food protein-induced enterocolitis syndrome: 16-year experience.

Objective: The goal was to examine the demographic characteristics, causative foods, clinical features, treatments, and outcomes for children presenting with acute food protein-induced enterocolitis syndrome.

Methods: This was a retrospective study of children with food protein-induced enterocolitis syndrome who presented to the Children's Hospital at Westmead (Sydney, Australia) over 16 years.

Results: Thirty-five children experienced 66 episodes of food protein-induced enterocolitis syndrome.