Clinical and Experimental Allergy最新文献

Data regarding Penicillin allergy labels (PALs) from India and Sri Lanka are sparse. Emerging data suggests that the proportion of patients declaring an unverified PAL in secondary care in India and Sri Lanka (1%-4%) is lesser than that reported in High Income Countries (15%-20%). However, even this relatively small percentage translates into a large absolute number, as this part of the world accounts for approximately 25% of the global population. There is a huge unmet need for allergy specialists in India and Sri Lanka. Penicillin allergy management is further compromised by unavailability of skin test reagents, lack of formal training in drug allergy, pre-emptive, non-standardised and unregulated skin testing by untrained operators and a weak health service framework. This has an adverse impact on antimicrobial stewardship, particularly in the management of rheumatic fever, rheumatic heart disease, bacterial endocarditis, syphilis and other sexually transmitted infections. This narrative review highlights the burden of PALs in India and Sri Lanka, as well as gaps in the published literature. It describes current challenges and a pragmatic, cautious and staged bespoke mitigation approach to improve and standardise antimicrobial stewardship in accordance with the World Health Organisation AWaRe guidance.

This cross-sequential study found that frequent intake of high-fat and high-protein foods was associated with higher odds of atopic dermatitis (AD). However, occasional intake across all three macronutrients significantly lowered AD odds, suggesting that moderation-not strict avoidance-may benefit AD management in allergic populations.

Background: Evidence suggests a link between food allergy and poor mental health, however, this may be explained by shared genetic and environmental factors. We aimed to investigate the association between food allergy of different severity and mental health in children, and the role of familial factors.

Methods: This population-based, longitudinal cohort study is based on the Child and Adolescent Twin Study in Sweden with questionnaire data reported by parents and/or children. Food allergy 'ever' and doctor's diagnosis were reported at age 9-12 years, and ≥ 1 recent dispensation of adrenaline was used as a marker for current severe food allergy. Outcomes were identified using validated questionnaires for anxiety; Screen for Child Anxiety Related Disorders (SCARED); Strength and Difficulties Questionnaire (SDQ) and depression; Short Mood and Feelings Questionnaire (SMFQ), Center for Epidemiological Studies Depression Scale (CES-D) and Diagnostic and Statistical manual of Mental Disorders (DSM-IV-MDE) and reported at 9-12, 15 and 18 years of age. Multivariate linear and logistic modelling was applied to the whole cohort and a co-twin control approach to remove confounding by familial factors.

Results: In total, 3039 (8.9%) children had a parent-reported food allergy. Among these, 1292 (43.5%) had non-severe food allergy without diagnosis, 1490 (49%) had non-severe food allergy with diagnosis and 257 (8.5%) had severe food allergy. Compared to children with no food allergy, non-severe food allergy with diagnosis by 9-12 years was associated with parent-reported anxiety/depression; SCARED (adjOR 2.10, 95% CI 1.48-2.98), SMFQ (adjOR 1.92, 95% CI 1.19-3.10) at 9-12 years and SDQ (adjβ 0.2, 95% CI 0.0-0.4) at 15 years. All other associations were null including for those with severe food allergy. All positive estimates in the full cohort were attenuated using co-twin controls.

Conclusion: Evidence associating paediatric food allergy severity and poor mental health was weak, and positive associations observed were likely due to familial confounding.

This study demonstrates that patient advocacy groups significantly enhance medication availability and improve diagnosis of hereditary angioedema (HAE), particularly in emerging economies within the Asia-Pacific region. This study supports integrating patient advocacy group involvement into management guidelines, emphasising their role in improving access to diagnostics and treatment for HAE.