Antibiotics Leading Cause of Pediatric Adverse Drug Events in ER

MedicalResearch.com Interview with:
Maribeth C. Lovegrove, MPH
Division of Healthcare Quality Promotion
Centers for Disease Control and Prevention
Atlanta, GA 30333).

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There has been a lot of recent attention on reducing unnecessary antibiotic prescribing in order to reduce antibiotic resistance (a longer-term harm).  However, antibiotic use also can lead to shorter-term harms like allergic reactions and other side effects.  With this analysis, we wanted to focus on the acute harms to individual pediatric patients from antibiotic use in order to help target prevention efforts.  Specifically, we used data from two national data sources to identify the antibiotics with the highest numbers of emergency department visits for adverse drug events and the highest rates of emergency department visits for adverse drug events (accounting for amount of antibiotic prescriptions dispensed) and to identify the pediatric patients with the highest risks.

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Severe Skin Reactions TEN/SJS: Children Generally Do Better Than Adults

MedicalResearch.com Interview with:
CDC imageJames W. Antoon, MD, PhD

Pediatric Primary Care
University of Illinois Hospital

MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis?

Response: Stevens Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are potentially fatal skin conditions, most commonly caused by medications and infections. Early symptoms include fever, blistering and peeling of the skin and mucus membranes and can affect any organ system including the eyes, lungs, kidneys and intestines. While rare, the conditions often result in life-long effects. The rarity and severity of these diseases have made it a challenge for researchers and clinicians to study, especially in a pediatric population. As a result, much of the information used to drive our care for children is derived from adult studies.

MedicalResearch.com: What are the main findings? 

Response: Using the Pediatric Health Information System, a large pediatric database containing information from 45 U.S. children’s hospitals, we studied the treatment and outcomes of SJS and TEN in children. This is one of the first large-scale to benchmark clinical outcomes the conditions in children. We characterized outcomes such as cost of hospital care, length of hospital stay, mortality, recurrence, hospital readmission as well as short-term complications like kidney failure, respiratory failure and sepsis.

Overall, we found that these outcomes in children were better than in adults. We also found that children with SJS and TEN received different kinds of treatment and that treatment strategies varied by region of the country. Expensive or combination treatments did not necessarily result in better outcomes.

MedicalResearch.com: What should readers take away from your report?

Response: Overall, these findings suggest we can be cautiously optimistic about SJS and TEN outcomes in children. Mortality and short-term morbidity in children with SJS and TEN is lower than in adults. Our results also suggest we can potentially reduce the cost of care for families by selecting lower-cost treatments to achieve the same outcomes. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: We identified a large variation in the treatment kids with SJS and TEN received, yet outcomes did not differ between treatments. This usually indicates an area for improvement in the quality of care doctors provide. Further research focusing on strategies that reduce complications, hospital stays and the cost of care would help provide physicians with better evidence on how to treat these conditions. 

MedicalResearch.com: Is there anything else you would like to add?

Response: The study was performed in collaboration with Drs. Jennifer Goldman and Brian Lee of Children’s Mercy Hospital and Clinic in Kansas City, Missouri, and Dr. Samir Shah of Cincinnati Children’s Hospital Medical Center. Dr. Goldman’s work was supported in part by a grant (KL2TR000119) from the National Center for Advancing Translational Sciences, part of the National Institutes of Health.

Citation:

J Allergy Clin Immunol Pract. 2018 May 30. pii: S2213-2198(18)30346-5. doi: 10.1016/j.jaip.2018.05.024. [Epub ahead of print]
A Retrospective Cohort Study of the Management and Outcomes of Children Hospitalized with Stevens-Johnson Syndrome or Toxic Epidermal Necrolysis.
Antoon JW1, Goldman JL2, Shah SS3, Lee B4. 

Jul 16, 2018 @ 8:24 pm

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Not All Tomatoes Are Equally Allergenic

MedicalResearch.com Interview with:
“TOMATOES” by RubyGoes is licensed under CC BY 2.0Prof. Dr. rer. nat. Wilfried Schwab

Technical University of Munich
Center of Life and Food Science Weihenstephan
Biotechnology of Natural Products
Freising, Germany

MedicalResearch.com: What is the background for this study?

Response: The prevalence of food allergy is an increasing health problem. Although tomatoes are one of the most consumed vegetables worldwide and have health beneficial effects lowering the risk of cancer and cardiovascular diseases, patients suffering from birch pollen allergy can develop cross-reactivity after consumption of fresh tomatoes.

The aim of this study was to develop an analytical method for the quantification of the birch-pollen homologous allergen Sola l 4 in various tomatoes cultivars. Furthermore, the effect of conventional or organic cultivation as well as processing techniques on Sola l 4 content was investigated. Continue reading

Red Meat Allergy Caused by Lone Star Tick Linked to Coronary Artery Disease

MedicalResearch.com Interview with:
“Lone Star Tick” by Katja Schulz is licensed under CC BY 2.0Jeffrey Wilson, MD, PhD

Research Fellow, Allergy & Immunology
University of Virginia 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Galactose-α-1,3-galactose (α-Gal) represents an oligosaccharide that is present in mammalian products and is the causal allergen in a syndrome of delayed red meat allergy (commonly called α-Gal syndrome). Sensitization to this allergen has been linked to tick bites, specifically the lone star tick in the United States.

Thus, sensitization to α-Gal (and the prevalence of subjects with symptomatic red meat allergy) is relatively common where the lone star tick is common, i.e- the southeast.

For a variety of reasons we hypothesized that specific immune sensitization (which relates to IgE antibody production) to α-Gal would be a risk factor for coronary artery disease. To address this possibility we measured IgE specific to α-Gal in 118 adults subjects from central Virginia who had undergone advanced cardiac imaging with a technique called intravascular ultrasound. Out of the cohort 26% of the subjects in the study had the sensitivity to α-Gal.

The main finding was that subjects with the IgE sensitization to α-Gal had greater amounts of atherosclerosis, as well as atherosclerotic plaques with more unstable characteristics. This association was significant when controlled for traditional cardiovascular risk factors such as hypertension, diabetes and lipids levels.

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Food Allergies More Common in Children With ASD

MedicalResearch.com Interview with:

Wei Bao, MD, PhD Assistant Professor, Epidemiology College of Public Health University of Iowa

Dr. Wei Bao

Wei Bao, MD, PhD
Assistant Professor, Epidemiology
College of Public Health
University of Iowa

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Previous studies indicated a possible link between immunologic dysfunction and autism. The current study, based on nationally representative large-scale surveys, showed that food allergy, respiratory allergy, and skin allergy, all relevant to immunological dysfunction, were associated with autism spectrum disorder among US children.

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Allergic Rhinitis Can Impair Adolescent Sleep and School Performance

MedicalResearch.com Interview with:

Michael S. Blaiss, MD, FACAAI Executive Medical Director American College of Allergy, Asthma & Immunology Arlington Heights, IL 60005

Dr. Blaiss

Michael S. Blaiss, MD, FACAAI
Executive Medical Director
American College of Allergy, Asthma & Immunology
Arlington Heights, IL 60005

MedicalResearch.com: Is this research important? Why or why not?

Response: There has not been a comprehensive review of how allergic rhinitis impacts the adolescent population. Most studies put adolescents in with children and yet we know that how disease affects adolescents may be dramatically different than children. Adolescents is a difficult enough time with a chronic condition

MedicalResearch.com: What is the key take-home message?

Response: The symptoms associated with nasal and eye allergies can be different in adolescents compared with adults and children and lead to poor quality of life and impair learning in school. Adolescents with AR/ARC may experience difficulties falling asleep, night waking, and snoring, and generally have poorer sleep. Therefore health care providers need to aggressively control the adolescent’s allergic rhinitis.  Continue reading

Inflammatory Cells That Suppress Skin Allergic Reactions Identified

MedicalResearch.com Interview with:
elstarNidhi Malhotra PhD

Boston Children’s Hospital
Division of Allergy and Immunology
Senior Scientist at Elstar Therapeutics Inc.

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Allergies such as Atopic Dermatitis (AD) are rampant in the industrialized nations. Why are we more predisposed to developing hypersensitive reactions to innocuous proteins (allergens) is not well understood. To gain better understanding and to develop better therapies, we need to first delve deeper into how our immune system regulates homeostasis in tissues such as skin. The main cell types that thwart inflammatory reactions are known as regulatory T cells. These cells are generated in thymus and reside in secondary lymphoid tissues but they are also prominent at tissue sites such as in dermal layer of skin. In this study, I focused on understanding how Tregs resident in skin are distinct from the Tregs in secondary lymphoid organs such as lymph nodes (LNs). I uncovered that functioning of Tregs in skin is underpinned by a distinct set of genes. One main gene that I found to be highly expressed in skin Tregs but not in LN Tregs is Rora, which encodes for the transcription factor ROR alpha (RORa).

This observation was intriguing as previous studies had elucidated the requirement of RORa in the development of inflammatory type-2 innate lymphoid cells (ILC2s) and it has been considered the antagonizing RORa functioning would curb allergic responses. However, I observed that Tregs require RORa to suppress allergic responses. In particular, RORa regulates the expression of a TNF receptor family member DR3, which binds to the cytokine TL1A. TL1A has a role in enhancing suppressive activity of Tregs while also enhancing type-2 cytokine production from ILC2s. Hence, in the absence of DR3 in Tregs, we believe more TL1A is available to ILC2s resulting in unrestrained allergic responses.  Continue reading

Synthetic Folic Acid Metabolites May Be Associated With Food Allergy in Children

MedicalResearch.com Interview with:
Emily Clarke McGowan, MD

Assistant Professor, Allergy/Clinical Immunology
Charlottesville, VA 22908-1355

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Folate (vitamin B9) is available in either the natural or synthetic forms and has been shown to reduce the risk of neural tube defects, like spina bifida, in newborns.  Folic acid, the synthetic form of folate, is widely consumed in the United States in infant formula, supplements, vitamins, and fortified grains.  When folic acid is consumed in high quantities, some of this folic acid does not undergo further metabolism and circulates in the blood as “unmetabolized folic acid” (UMFA).

In this study, we measured total folate, UMFA, and 5-methyltetrahydrofolate (5-MTHF), the main folate metabolite involved in biochemical processes in the body, in a subset of children from the Boston Birth Cohort.

While mean levels of total folate at birth were lower among those who developed food allergy, mean levels of the synthetic folic acid derivative, UMFA, were higher.  There was no association between total folate, 5-MTHF, or UMFA levels in early life and the development of food allergy.  Continue reading

Tick Bites Plus Blood Type Predispose to Red Meat Allergy

MedicalResearch.com Interview with:

Brestoff-Parker

Dr. Brestoff-Parker

Jonathan R. Brestoff-Parker, MD, PhD
PSTP Resident, Clinical Pathology
Department of Pathology & Immunology
Washington University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Red meat allergy is a recently recognized food allergy in which people experience a delayed allergic response about 3-6 hours after eating red meats that contain the allergen alpha-gal.

Red meat allergy is thought to be caused by tick bites which expose humans to alpha-gal, however other factors that contribute to disease risk are not well described. Alpha-gal looks a lot like the B antigen, which is one of the factors that determines blood type. So we wondered whether people with blood types B or AB are protected from getting red meat allergy. We were amazed when we found that patients who make the B antigen (blood types B or AB) are 5 times less likely to have red meat allergy than patients who do not make the B antigen (blood types O or A).  Continue reading

AI Trained Computer Program Can Monitor Health Forums To Detect Adverse Drug Reactions

MedicalResearch.com Interview with:

Kavita Sarin, M.D., Ph.D.

Dr. Sarin

Kavita Sarin, M.D., Ph.D.
Assistant Professor of Dermatology
Stanford University Medical Center

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Drug reactions occur in the majority of patients undergoing cancer therapies. Half of serious drug reactions are detected after market approval which can result in painful complications and interruption in therapy. Post-market drug surveillance platforms such as FDA monitoring rely on medical publications and physician reporting and take time to identify trends. We sought to determine if we could identify trends in patient discussions in internet health forums to more rapidly identify chemotherapeutic drug reactions. We chose skin reactions as a proof-of-principle because patients can more easily describe what they see on their skin.

Julia Ransohoff, a medical student, and Azadeh Nikfarham, an informatics postdoctoral fellow trained a computer to recognize when a patient undergoing anti-cancer treatment with PD-1 antagonists or EGFR-inhibitors described a drug reaction in their internet forum posts.

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Can Probiotics and Fish Oil Supplements During Pregnancy Reduce Childhood Allergies?

MedicalResearch.com Interview with:
Dr Robert Boyle, 
Reader in Paediatric Allergy
Department of Medicine
Imperial College London

MedicalResearch.com: What is the background for this study?

Response: Diet in early life may influence whether or not an infant develops allergies or autoimmune disease. We undertook a project for the UK Food Standards Agency to evaluate the evidence for this.

MedicalResearch.com: What are the main findings? 

Response: We found that a probiotic supplement during the last 2-4 weeks of pregnancy and during breastfeeding may reduce an infant’s chances of developing eczema; and that omega-3 fatty acid supplements taken from the middle of pregnancy (20 weeks gestation) through the first few months of breastfeeding may reduce an infant’s chances of developing food allergy. We also found links between longer duration of breastfeeding and improved infant health, but for most other variations in diet during pregnancy or infancy we did not find evidence for a link with allergies or autoimmune disease.

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Oral Immunotherapy With Omalizmuab Resulted in Faster Food Desensitization

MedicalResearch.com Interview with:

Sandra Andorf PhD Kim and Ping Li Director of Computational Biology Sean N. Parker Center for Allergy and Asthma Research at Stanford University Instructor, Nadeau Lab Department of Medicine, Division of Pulmonary & Critical Care Medicine Stanford University School of Medicine

Dr. Andorf

Sandra Andorf PhD
Kim and Ping Li Director of Computational Biology
Sean N. Parker Center for Allergy and Asthma Research at Stanford University
Instructor, Nadeau Lab
Department of Medicine, Division of Pulmonary & Critical Care Medicine
Stanford University School of Medicine

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Food allergies are on the rise in the world. Approximately 15 million Americans have food allergies, which includes around 6 million children. Of people with food allergies, 30-40% are allergic to more than one food and therefore these people have a greater risk for an accidental ingestion resulting in an allergic reaction or anaphylaxis.

Currently there is no FDA approved treatment for food allergies but oral immunotherapy, a treatment in which the patient eats small but slowly increasing doses of their allergen until they can tolerate a specified dose, was shown in research settings to be safe in children and adults for up to 5 foods in parallel.

In this trial, we studied the efficacy and safety of Omalizmuab (an anti-IgE drug) treatment with oral immunotherapy in multifood allergic participants versus placebo with oral immunotherapy for a total of 9 months. We found that 83% of the participants who received Omalizumab could tolerate at least 2 g of at least two different food allergens at the end of the trial compared to 33% of those who received placebo. The participants that received Omalizumab were also desensitized faster, meaning they were on average able to eat 2 g of each of their allergic foods earlier in the treatment. Furthermore, we could show that the use of Omalizumab and the fast updosing is safe.

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Most Homes Harbor Multiple Allergens

MedicalResearch.com Interview with:

Dr. Salo

Dr. Salo

Dr. Pӓivi Salo, PhD Epidemiologist
National Institute of Environmental Health Sciences
NIH

MedicalResearch.com: What is the background for this study?

Response: Indoor allergens are important risk factors for asthma and respiratory allergies. Only a few studies have investigated residential allergen exposures on a national scale; the National Health and Nutrition Examination Survey (NHANES) 2005-2006 is the largest and most comprehensive study to date.

MedicalResearch.com: What are the main findings?

Response: Our findings show that exposure to multiple allergens is common in U.S. homes; over 90% of homes had three or more detectable allergens, and 73% of homes had at least one allergen at elevated levels. The presence of pets and pests contributed strongly to elevated allergen levels. Housing characteristics also mattered – elevated exposure to multiple allergens was more likely in mobile homes, older homes, rental homes, and homes in rural areas. For individual allergens, exposure levels varied greatly with age, sex, race, ethnicity, and socioeconomic status. Differences were also found between geographic locations and climatic conditions.

MedicalResearch.com: What should clinicians and patients take away from your report?

Response: Understanding factors that affect allergen levels in homes is important because elevated allergen levels can trigger and exacerbate symptoms in people who suffer from asthma and allergies. We hope that our findings provide beneficial information to a wide audience from patients to clinicians, identifying factors that influence levels of exposure to individual and multiple allergens

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: The relationships between allergen exposures, allergic sensitization, and disease are complex. Further research is needed to determine how allergen exposures interact with other environmental and genetic factors that contribute to asthma and allergies.

MedicalResearch.com: Is there anything else you would like to add?

Response: We also compared allergen exposures and previously reported allergic sensitization patterns from this national survey to provide a more complete picture. The allergy focused component in NHANES 2005-2006, which we developed in collaboration with the National Institute of Allergy and Infectious Diseases (NIAID) and the Centers for Disease Control and Prevention (CDC), allowed national comparisons for the first time. The observed differences and overlaps reflect the complex nature of the relationships between allergen exposures, allergic sensitization, and disease.

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Salo P, Wilkerson J, Rose KM, Cohn RD, Calatroni A, Mitchell HE, Sever ML, Gergen PJ, Thorne PS, Zeldin DC. 2017. Bedroom allergen exposures in US households. J Allergy Clin Immunol; doi: 10.1016/j.jaci.2017.08.033(link is external) [Online 30 November 2017].

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

 

 

 

 

 

 

Up To 40% of Food Allergic Adolescents Experience Severe Reactions

MedicalResearch.com Interview with:
“Peanuts” by Daniella Segura is licensed under CC BY 2.0Vicki McWilliam

Murdoch Children’s Research Institute (MCRI)

MedicalResearch.com: What is the background for this study? What are the main findings?
Response: Food allergy affects up to 10% of children and 2-3% of adults, and appears to increasing in prevalence. The rise in food allergy prevalence has coincided with increased reports of anaphylaxis. Previous research has shown that adolescents are most at risk of experiencing adverse food reactions and appear to be at higher risk of anaphylaxis fatalities but are an understudied age group in food allergy research.

In a large population representative sample of 10,000 10-14 year olds in Melbourne, Australia we found that alarmingly over 40% had experienced an allergic reaction in the past year and almost 10% reported potentially life threatening reactions. Consistent with other research peanut and tree nuts were the most common trigger foods for reactions and those with nut allergy were most at risk of anaphylaxis. Having more than two food allergies doubled the risk of a food allergic reaction compared to those with a single food allergy. Surprisingly, reactions were found to occur most commonly at home rather than restaurants or school.

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EMSY Gene Linked To Peanut and Other Food Allergies

MedicalResearch.com Interview with:

“Peanuts” by Daniella Segura is licensed under CC BY 2.0

Aida Eslami, Ph.D.
Postdoctoral Research Fellow
Dr. Denise Daley’s research group
Centre for Heart and Lung innovation
Providence Heart + Lung Institute
St. Paul’s Hospital
Vancouver, BC 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Peanut allergy and food allergies in general are caused by a combination of both genetic and environmental factors. Currently, the genetic basis of peanut allergy is unclear due to a lack of studies on food related allergies.

Our study was comprised of 850 individuals with peanut allergy from the Canadian Peanut Allergy Registry (CanPAR), and nearly 1,000 individuals without peanut allergy and other food allergies. We looked at over 7.5 million genetic markers through a genome-wide association study (GWAS) to identify genes potentially associated with peanut allergy and other food allergies. Our findings are based on results from the CanPAR in combination with the results from other countries: USA, Australia, Germany and the Netherlands.

We identified a gene that is associated with both peanut allergy and other food allergies. This gene is called c11orf30/EMSY and has previously been shown to be involved in other conditions such as asthma, eczema, and allergic rhinitis.

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How Do Viruses Trigger Cough In Asthmatic Children, Even Without Allergies

MedicalResearch.com Interview with:

Giovanni Piedimonte, MD Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education Professor & Chair of Pediatrics Cleveland Clinic Lerner College of Medicine Case Western Reserve University

Dr. Piedimonte

Giovanni Piedimonte, MD
Steven and Nancy Calabrese Endowed Chair for Excellence in Pediatric Care, Research, and Education
Professor & Chair of Pediatrics
Cleveland Clinic Lerner College of Medicine
Case Western Reserve University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study proves that asthmatic children already have a hyperactive calcium channel that’s extremely sensitive to environmental triggers.

If these children contract a virus, such as RSV, the hyperactive channel causes more severe symptoms that may require care in a hospital setting.

When a child developed asthma or bronchitis in the past, doctors thought these conditions could only be triggered by environmental allergens. There was no explanation why two out of three children ages five and under who wheeze and cough – and still test negative for allergies.

We needed to explore the mechanisms of the calcium molecule and the epithelial cells, which seem to trigger these symptoms without an allergic reaction. If the molecule’s behavior is producing the cough, we just need to figure out how to control the molecule to properly deactivate the cough mechanism in the asthmatic child

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Chronic Hives In Children Resolve Slowly

MedicalResearch.com Interview with:

Hives-Urticaria Wikipedia image

Hives-Urticaria
Wikipedia image

Elena Netchiporouk, MD, FRCPC, MSc
Dermatology Resident – PGY5 and
Dr. Moshe Ben-Shoshan, MD, FRCPC, MSc
McGill University

MedicalResearch.com: What is the background for this study?

Response: We have followed a pediatric cohort of 139 patients with chronic urticaria (CU) (hives) between 2013 and 2015 in a single tertiary care center and assessed the comorbidities, the rate of resolution and determined predictors of resolution.

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Small Kit Can Easily Detect Food Allergens On-Site

MedicalResearch.com Interview with:

Lee, Hakho, PhD Department of Systems Biology Harvard Medical School Boston, Massachusetts

Dr. Lee

Lee, Hakho, PhD
Department of Systems Biology
Harvard Medical School
Boston, Massachusetts

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The incidence of food allergy is increasing worldwide, particularly among children, and yet no handy test is available for general public. We wanted to solve this issue. Our pilot test showed wide variation in allergen contents in packaged food products and restaurant meals. Hidden allergens (like gluten in salad dressing, likely from additives) were also found.

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When Should Babies Be Introduced To Peanuts, Eggs and Cow’s Milk?

MedicalResearch.com Interview with:

Dr. Malcolm Sears, Professor  MB, ChB, FRACP, FRCPC, FAAAAI Co-director of the CHILD Study Division of Respirology, Department of Medicine, McMaster Universi

Dr. Sears

Dr. Malcolm Sears, Professor
MB, ChB, FRACP, FRCPC, FAAAAI
Co-director of the CHILD Study
Division of Respirology, Department of Medicine,
McMaster University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The Canadian Healthy Infant Longitudinal Development (CHILD) Study is a longitudinal birth cohort study commenced in 2008 with 3,495 families across Canada.  We recruited the mothers during pregnancy and are following their children to age 5 with the intent of determining the underlying developmental causes of allergy and asthma.

In the current analysis, we have looked at the relationship between the timing of first introduction of three “allergenic” foods (milk products, egg and peanut) and the likelihood of sensitization to these foods at age 1 year.  We found that earlier introduction was associated with a reduced risk of sensitization, which is consistent with some recent randomized controlled trials.  For instance, infants who avoided cow’s milk product in their first year of life were nearly four times as likely to be sensitized to cow’s milk compared with infants who did consume cow’s milk products before age 12 months.  Similarly, infants who avoided egg or peanut in the first year were nearly twice as likely to be sensitized to those foods compared to infants who consumed them before 12 months of age.

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Asthma Outcomes Worse in Low Income Groups

MedicalResearch.com Interview with:

Wanda Phipatanakul, MD, MS Associate Professor of Pediatrics Harvard Medical School Director, Asthma Clinical Research Center Boston Children's Hospital Asthma, Allergy and Immunology Boston, MA 02115

Dr. Phipatanakul

Wanda Phipatanakul, MD, MS
Associate Professor of Pediatrics
Harvard Medical School
Director, Asthma Clinical Research Center
Boston Children’s Hospital
Asthma, Allergy and Immunology
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Observational studies have limitations in their ability to examine disparities in asthma, as these studies have relied on self-reported measures of medication use, asthma diagnosis, severity, outcomes, and access to care.

Using data collected from a randomized controlled trial, we found that subjects with lower income had a significantly higher number of asthma treatment failures and asthma exacerbations, independent of race, BMI, education, perceived stress, baseline lung function, hospitalizations, inhaled corticosteroid adherence, inhaled corticosteroid dose, environmental allergen sensitization, and second-hand smoke exposure.

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Vitamin D Supplements Will Probably Not Help Asthma or Atopic Dermatitis

MedicalResearch.com Interview with:

Brent Richards, MD, MSc</strong> Associate Professor of Medicine William Dawson Scholar / FRQS Clinical Research Scholar Departments of Medicine, Human Genetics, Epidemiology and Biostatistics McGill University Senior Lecturer, King's College London (Honorary)

Dr. Brent Richards

Brent Richards, MD, MSc
Associate Professor of Medicine
William Dawson Scholar / FRQS Clinical Research Scholar
Departments of Medicine, Human Genetics, Epidemiology and Biostatistics McGill University
Senior Lecturer, King’s College London (Honorary)

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Some previous epidemiological studies have suggested that low vitamin D levels are associated with increased rates of asthma, atopic dermatitis—an itchy inflammation of the skin—and elevated levels of IgE, an immune molecule linked to atopic disease (allergies). In our study, we looked at genetic and health data on more than 100,000 individuals from previous large studies to determine whether genetic alterations that are associated with vitamin D levels predispose people to the aforementioned conditions.

We found no statistically significant difference between rates of asthma (including childhood-onset asthma), atopic dermatitis, or IgE levels in people with and without any of the four genetic changes associated with lower levels of 25-hydroxyvitamin D, the form of vitamin D routinely measured in the blood.

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Exposure To Furry Pets During Pregnancy and Babyhood May Help Keep Your Child Lean

MedicalResearch.com Interview with:

Anita Kozyrskyj, PhD Department of Pediatrics Faculty of Medicine & Dentistry University of Alberta

Dr. Anita Kozyrskyj

Anita Kozyrskyj, PhD
Department of Pediatrics
Faculty of Medicine & Dentistry
University of Alberta

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We have known for a while that early-life exposure to household pets can reduce risk for allergic disease; new studies also suggest a benefit in preventing overweight. Our pilot study in 2013 showed that postnatal pet exposure increases the number of different beneficial microbes in the infant gut. My team of 12, including first author and Albert Innovates-Health Solutions (AIHS) postdoctoral fellow Hein Min Tun, took the science one step closer to understanding this connection in our recently published work in the Microbiome journal. In a study of 746 infants from the Canadian Healthy Infant Longitudinal Development Study (CHILD) birth cohort, we investigated the impact of pet exposure during pregnancy or afterwards on infant gut microbes, and whether this depended on how infants were born.

In infants born vaginally or by cesarean section, pet exposure during pregnancy or pre and postnatally up to 3 months after birth increased the amounts of 2 bacteria found on dogs and cats. One is Ruminococcus, linked to lower rates of allergies in children. The other is a relatively unknown microbe, Oscillospira, reported to promote leanness. Another important finding suggested that contact with pets during pregnancy could reduce transmission of vaginal GBS (group B Streptococcus) during birth.

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Could Babies From Wealthier Families Reduce Egg Allergies By Eating Them Earlier?

MedicalResearch.com Interview with:

Dr. Debra Palmer (BSc, BND, PhD) on behalf of my fellow co-authors on this publication Childhood Allergy and Immunology Research University of Western Australia

Dr. Debra Palmer

Dr. Debra Palmer (BSc, BND, PhD)
on behalf of my fellow co-authors on this publication
Childhood Allergy and Immunology Research
University of Western Australia

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We conducted a multicentre trial, Starting Time of Egg Protein (STEP) involving 820 infants, and found a 25% risk reduction in egg allergy with early regular egg intake from 4-6.5 months compared with egg avoidance to 10 months of age, although this did not achieve statistical significance.

So we also investigated in exploratory analyses whether the effect of regular egg introduction in solid foods was modified by any maternal, family or infant characteristics. Our results found that infants from families of higher socioeconomic status and those families who consume few eggs per week could benefit by less egg allergy at 12 months of age from regular egg intake once they start eating solid foods.

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Number Of Epipen Prescriptions for Kids Skyrockets

MedicalResearch.com Interview with:
Lavanya Diwakar, FRCPath

Honorary consultant in immunology
Queen Elizabeth Hospital, Birmingham, and
Research fellow in health economic
University of Birmingham
Birmingham UK

MedicalResearch.com: What is the background for this study?

Response: The rate of anaphylaxis (serious, potentially life threatening manifestation of allergy) has increased in the last decade. There have been some reports from other countries about an increase in the number of adrenaline autoinjectors being prescribed in children, but this has not been systematically examined in the UK.
We looked at a database of patient records from over 500 general practices, THIN (the Health Improvement Network), between 2000 and 2012. We found nearly 24,000 children who had been identified as being at risk of anaphylaxis by General Practitioners and prescribed epipens.

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Many Summer Camps Need More Training On Food Allergy Treatment

MedicalResearch.com Interview with:
Margaret T. RedmondMD
Nationwide Children’s Hospital
Columbus, Ohio 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Food allergies are becoming more prevalent and can cause a life threatening reaction if not managed correctly. Much of the previous focus has been on food allergy in the school setting and little was known about the camp setting.

Analysis of survey data from camp directors, medical personnel and staff reveal that there are deficiencies of training and policy at camps that could place food allergic campers at increased risk of reaction. A prospective registry of epinephrine administration from 51 camps revealed an increased rate of epinephrine administration compared to school data. Continue reading