Low dietary adherence after a positive food challenge in food allergic adults.

Background: After a positive food challenge (FC), patients receive dietary advice regarding avoidance of the culprit food. We examined the frequency and variables associated with dietary adherence after a positive FC in adults.

Methods: In this prospective daily practice study, adults with a positive FC were included.

Accurate Prediction of Peanut Allergy in One-Third of Adults Using a Validated Ara h 2 Cutoff.

Background: The diagnostic value of peanut components is extensively studied in children, but to a lesser extent in adults with suspected peanut allergy. The use of peanut components in daily practice may reduce the need for double-blind placebo-controlled food challenges (DBPCFCs); however, validation studies are currently lacking.

Objective: To evaluate the diagnostic value of (combined) peanut components and validate a previously found Ara h 2 cutoff level with 100% positive predictive value (PPV) in adults with suspected peanut allergy.

[Non-healing wounds].

The incidence of non-healing wounds is increasing. Identification of the underlying cause of a wound is of essential importance for adequate treatment. In this article, we present three female patients aged 50, 65 and 85 years with respectively pyoderma gangraenosum, livedoid vasculopathy and Martorell hypertensive ischaemic leg ulcer.

Risk factors for atopic diseases and recurrent respiratory tract infections in children.

Introduction: The simultaneously increased prevalence of atopic diseases and decreased prevalence of infectious diseases might point to a link between the two entities. Past work mainly focused on either atopic diseases or recurrent infections. We aim to investigate whether risk factors for atopic diseases (ie, asthma, allergic rhinitis, atopic dermatitis, and/or food allergy) differ from risk factors for recurrent respiratory tract infections (RRTIs) in children.

Prevalence and Predictors of Uncontrolled Asthma in Children Referred for Asthma and Other Atopic Diseases.

Background: Uncontrolled asthma in children is still highly prevalent despite the availability of effective asthma treatment. We investigated 1) the prevalence of uncontrolled asthma among children referred for asthma and referred for atopic diseases other than asthma (ie food allergy, allergic rhinitis or atopic dermatitis) to secondary care; and 2) the predictors associated with uncontrolled asthma.

Methods: All children (4 to 18 years) referred for asthma or atopic diseases other than asthma to 8 secondary care centers in The Netherlands were invited to an electronic portal (EP).

Reintroduction failure after negative food challenges in adults is common and mainly due to atypical symptoms.

Background: Reintroduction of a food after negative food challenge (FC) faces many obstacles. There are no studies available about this subject in adults.

Objective: To investigate the frequency, reasons and risk factors of reintroduction failure in adults.

Perceived triggers of asthma impair quality of life in children with asthma.

Background: Data on the impact of the number and nature of perceived asthma triggers on health-related quality of life (HRQL) in children are scarce.

Objective: To investigate the impact of perceived asthma triggers on both asthma-specific and generic HRQL in children.

Methods: A cross-sectional study was conducted among children (7-18 years) with asthma in secondary and tertiary care.

The impact of oral food challenges for food allergy on quality of life: A systematic review.

Background: Food allergy significantly impairs health-related quality of life (HRQL). Currently, it is still unknown whether diagnostic interventions for food allergy improve HRQL. We aim to assess the impact of diagnostic interventions for food allergy on HRQL.

Atopic dermatitis characteristics and medication-use patterns in school-age children with AD and asthma symptoms.

Background: Atopic dermatitis (AD) and asthma often coexist. Both diseases can have a major impact on the lives of children with AD and their caregivers.

Aim: To investigate the association of patient characteristics, comorbidities and impact of AD on children who have both asthma and AD.

Using Component-Resolved Diagnostics in the Management of Peanut-Allergic Patients.

Instead of relying on crude peanut extract, component-resolved diagnostics (CRD) uses sensitization to allergenic proteins within peanut. In this review, we describe the recent advances and future perspectives of the use of CRD in the management of peanut-allergic patients. There is strong evidence that sensitization to Ara h 2 is the best predictor for clinically relevant peanut allergy in children and adults.

Characteristics and severity of asthma in children with and without atopic conditions: a cross-sectional study.

Background: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children with certain combinations of co-morbid allergic conditions.

Usefulness of open mixed nut challenges to exclude tree nut allergy in children.

Background: To minimize the risk of accidental reactions, atopic children with multiple sensitizations to tree nuts are advised to avoid all nuts. Multiple food challenges would be needed to confirm the clinical relevance, but are too burdensome to be practical. The usefulness of open mixed nut challenges in terms of safety, reactions during challenge, tolerance of the challenge material, effect on the elimination diet and satisfaction of the parents was evaluated.

Objective eliciting doses of peanut-allergic adults and children can be combined for risk assessment purposes.

Background: To improve food labelling strategies, information regarding eliciting doses (EDs) and the effect of patient characteristics on these EDs is necessary.

Objective: To establish EDs for objective and subjective symptoms and analyse the effect of sensitization levels and other patient characteristics on threshold distribution curves (TDCs).

Methods: Threshold data from 100 adults and 262 children with a positive food challenge were analysed with interval-censoring survival analysis (ICSA) and fitted to a TDC from which EDs could be extracted.

Standardized food challenges are subject to variability in interpretation of clinical symptoms.

Background: Food challenge tests are the gold standard in diagnosing food allergy. Guidelines provide scoring systems to classify symptoms during challenge and typically recommend that challenges are considered positive when objective symptoms occur. However, currently no standard criteria for the definition of a positive challenge outcome exists and interpretation of food challenges mainly depends on clinical judgment.

Reintroduction failure after negative peanut challenges in children.

Background: A negative double-blind placebo-controlled food challenge (DBPCFC) should normally be followed by reintroduction of the food. However, reintroduction fails in a subset of children. The observed reintroduction problems could be due to refusal of the food that long has been avoided, to other behavioural/psychological factors or to false negative DBPCFC outcome.

After the introduction into the national newborn screening program: who is receiving genetic counseling for hemoglobinopathies in the Netherlands?

Objective: Universal newborn screening for hemoglobinopathies started in The Netherlands in 2007. Herewith severe conditions, such as sickle cell disease, β-thalassemia major and hemoglobin H disease are putatively identified. Additionally, at least 1,800 carriers of hemoglobin variants associated with severe conditions in homozygote or compound heterozygote forms are identified yearly.

Can we predict severe reactions during peanut challenges in children?

Background: Limited and contrasting data are available about risk factors for severe reactions during double-blind, placebo-controlled food challenge (DBPCFC). Knowing these risk factors would help to improve safety precautions and choosing the best setting for challenge. We assessed whether we could determine predictors for positive and severe food challenge outcome (FCO) with regular available patient data in children suspected for peanut allergy.

Inflammatory phenotypes underlying uncontrolled childhood asthma despite inhaled corticosteroid treatment: rationale and design of the PACMAN2 study.

Background: The diagnosis of childhood asthma covers a broad spectrum of pathological mechanisms that can lead to similarly presenting clinical symptoms, but may nonetheless require different treatment approaches. Distinct underlying inflammatory patterns are thought to influence responsiveness to standard asthma medication.

Methods/design: The purpose of the PACMAN2 study is to identify inflammatory phenotypes that can discriminate uncontrolled childhood asthma from controlled childhood asthma by measures in peripheral blood and exhaled air.

The expert network and electronic portal for children with respiratory and allergic symptoms: rationale and design.

Data on baseline characteristics of children with asthma to predict individual treatment responses are lacking. We aimed to set up a data-collection system which can easily fill this gap in clinical practice.A web-based application was developed, named 'Portal for children with respiratory and allergic symptoms', hereafter called Electronic Portal (EP).