Development of an allergy management support system in primary care.

Background: Management of allergic patients in the population is becoming more difficult because of increases in both complexity and prevalence. Although general practitioners (GPs) are expected to play an important role in the care of allergic patients, they often feel ill-equipped for this task. Therefore, the aim of this study was to develop an allergy management support system (AMSS) for primary care.

Multicentre Double-Blind Placebo-Controlled Food Challenge Study in Children Sensitised to Cashew Nut.

Background: Few studies with a limited number of patients have provided indications that cashew-allergic patients may experience severe allergic reactions to minimal amounts of cashew nut. The objectives of this multicentre study were to assess the clinical relevance of cashew nut sensitisation, to study the clinical reaction patterns in double-blind placebo-controlled food challenge tests and to establish the amount of cashew nuts that can elicit an allergic reaction.

Methods And Findings: A total of 179 children were included (median age 9.

Association of food allergy and atopic dermatitis exacerbations.

Background: Atopic dermatitis (AD) and food allergy frequently coexist in children.

Objective: To examine the association between food allergy and AD.

Methods: Between 2001 and 2011, children referred to our tertiary care center underwent double-blind, placebo-controlled food challenges (DBPCFCs) for one or more suspected food allergies as part of regular care.

Patient-reported outcome measures for asthma: a systematic review.

Background: Patient-reported outcome measures (PROMs) are measures of the outcome of treatment(s) reported directly by the patient or carer. There is increasing international policy interest in using these to assess the impact of clinical care.

Aims: To identify suitably validated PROMs for asthma and examine their potential for use in clinical settings.

Health-related quality of life in food-allergic adults from eight European countries.

Background: Food allergy can impair health-related quality of life (HRQL). Food Allergy Quality of Life Questionnaires (FAQLQs) have been developed and validated, including an adult form (FAQLQ-AF). HRQL has not, to date, been measured across different European countries using a uniform methodology.

Quality of life is more impaired in patients seeking medical care for food allergy.

Background: Food allergy (FA) affects 2-4% of adults, but only a small percentage visit an outpatient clinic for a thorough evaluation.

Methods: A matched case-control study was used to compare health-related quality of life (HRQL) of the Dutch general population that did not seek medical care for their FA with outpatients who did seek medical care. All participants were diagnosed as food allergic (i.

Food allergy and quality of life: what have we learned?

Health-related quality of life (HRQL) has become an emerging focus of interest in food allergy. Food allergy is a disease characterized by low mortality and symptoms which only occur during an allergic reaction. However, food-allergic patients continuously need to be alert when eating in order to prevent potentially severe allergic reactions, which may be fatal.

Food allergy knowledge of parents - is ignorance bliss?

Background: Food allergic children are at least partially dependent on their parents to care for their food allergy. In addition, parents are often responsible for the education of others regarding food allergy, including the family, school, neighbors, and friends. The aim of this study was to investigate food allergy knowledge, attitudes, and beliefs of parents with food allergic children in the Netherlands.

Threshold dose distributions for 5 major allergenic foods in children.

Background: For most allergenic foods, insufficient threshold dose information within the population restricts the advice on levels of unintended allergenic foods which should trigger precautionary labeling on prepackaged foods.

Objective: We wanted to derive threshold dose distributions for major allergenic foods and to elaborate the protein doses at which a proportion of the allergic population is likely to respond.

Methods: For 7 allergenic foods double-blind, placebo-controlled food challenges (DBPCFCs) with a positive outcome for allergic reactions were selected from the clinical database of children routinely tested to diagnose food allergy at the University Medical Center Groningen.

Food allergy-related quality of life after double-blind, placebo-controlled food challenges in adults, adolescents, and children.

Background: Currently, the longitudinal validity (validity over time) and responsiveness (ability to measure change over time) of the Food Allergy Quality of Life Questionnaire-Adult Form (FAQLQ-AF), the Food Allergy Quality of Life Questionnaire-Teenager Form (FAQLQ-TF), and the Food Allergy Quality of Life Questionnaire-Child Form (FAQLQ-CF) are unknown. Additionally, the self-reported impact of a double-blind, placebo-controlled food challenge (DBPCFC) on health-related quality of life (HRQL) in adults (≥18 years of age), adolescents (13-17 years of age), and children (8-12 years of age) is unknown.

Objective: The aims of this study were to assess the longitudinal validity and responsiveness of the FAQLQ-AF, FAQLQ-TF, and FAQLQ-CF and to assess the impact of a DBPCFC on HRQL.

Enzymatic treatment of whey proteins in cow's milk results in differential inhibition of IgE-mediated mast cell activation compared to T-cell activation.

Background: Cow's milk (CM) hydrolysates are frequently used as milk substitutes for children with CM allergy. In hydrolysates, allergenic epitopes within CM proteins are diminished by enzymatic treatment. The aim of this study was to examine the allergenic and immunogenic properties of whey proteins during hydrolysis.

Parental eczema increases the risk of double-blind, placebo-controlled reactions to milk but not to egg, peanut or hazelnut.

Background: While genetic factors are known to be important in the development of sensitization to foods, it is not known whether they also play a role in clinical allergic reactivity to foods.

Objective: We aimed to determine whether parental atopic diseases are associated with a higher risk of a reaction to common allergenic foods when tested in a double-blind, placebo-controlled food challenge (DBPCFC).

Methods: Parents of children suspected of being food allergic were interviewed about their own and their child's atopic history.

Extremely low prevalence of epinephrine autoinjectors in high-risk food-allergic adolescents in Dutch high schools.

The aim of the study was to estimate the prevalence of probable food allergy in adolescents aged 11-20 and to examine the frequency of epinephrine autoinjector (EAI) ownership among high-risk individuals. Adolescents were screened followed by a more detailed telephone questionnaire inquiring about suspected food(s), symptoms, diagnosis, and use of an EAI. The participating adolescents were classified as probably or unlikely to be food-allergic.

Effects of a restricted elimination diet on the behaviour of children with attention-deficit hyperactivity disorder (INCA study): a randomised controlled trial.

Background: The effects of a restricted elimination diet in children with attention-deficit hyperactivity disorder (ADHD) have mainly been investigated in selected subgroups of patients. We aimed to investigate whether there is a connection between diet and behaviour in an unselected group of children.

Methods: The Impact of Nutrition on Children with ADHD (INCA) study was a randomised controlled trial that consisted of an open-label phase with masked measurements followed by a double-blind crossover phase.

In vivo and in vitro evaluation of the residual allergenicity of partially hydrolysed infant formulas.

Hypoallergenic infant formulas are commonly used for genetically predisposed children and infants diagnosed with cow's milk allergy. This study describes both in vitro and in vivo approaches to assess residual allergenicity of partially hydrolysed infant formulas. Electrophoretic patterns indicated that β-lactoglobulin and other whey proteins were largely degraded.

Interleukin 13 and interleukin 4 receptor-α polymorphisms in rhinitis and asthma.

Background: Asthma and rhinitis may represent two manifestations of the same airway disease. Genetic research can increase our understanding of their common or distinct pathogenesis. IL13 and IL4R polymorphisms are associated with asthma and show gene-gene interaction in asthma.

Food allergy: stakeholder perspectives on acceptable risk.

We have reached a point where it is difficult to improve food allergy risk management without an agreement on levels of acceptable risk. This paper presents and discusses the perspectives of the different stakeholders (allergic consumers, health professionals, public authorities and the food industry) on acceptable risk in food allergy. Understanding where these perspectives diverge and even conflict may help develop an approach to define what is acceptable.

Profiling families enrolled in food allergy immunotherapy studies.

Background: Little is known about specific psychological factors that affect parents' decisions to take part in clinical studies. We examined factors, related to health-related quality of life (HRQoL), that may influence parents' decision to allow their children to participate in research on clinical food allergy.

Methods: Parents of children with food allergies were offered investigational oral immunotherapy (OIT) in a regular outpatient clinic.

Preeclampsia is associated with lower percentages of regulatory T cells in maternal blood.

Objective: Immunological mechanisms are involved in the pathophysiology of preeclampsia. During pregnancy there is an increase in regulatory T (Treg) cells, which has an important role in regulating tolerance to the immunologically distinct fetus. We hypothesised that percentages of Treg cells are decreased in preeclamptic patients.