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Biomedical subjects

E Bidat

Publications and source records attributed to E Bidat.

At least 19 recordsLinked to original sources
PubMed2006

[Food allergy in children].

Food allergy is an adverse reaction to food protein by an immunological mechanism (IgE or non IgE-mediated). Signs can involve all organs, but atopic dermatitis remains the main manifestation. In children, only few allergens are involved. In France, it is cow milk, hen eggs, kiwi, peanut, fish, nuts, shrimp. Diagnosis is based on clinical history, skin tests, specific IgE and, sometimes, food challenge. Treatment is based on specific eviction. Regime can be total or sometimes limited to large among of the specific food, or only raw food. Food allergy disappears sometimes. Tolerance or food desensitization is in progress.

Allergens↗
PubMed2006

[What type of avoidance for peanut allergic children?].

We analyzed, from the literature, the balance benefit/risk of a strict avoidance of peanut in children with peanut allergy. The benefits of a strict avoidance diet seem limited: reactions to the low doses and to the peanut oil refined are rare and most often slight. It is not proven that a strict avoidance facilitates the cure of allergy. On the other hand, strict avoidance could induce a worsening of allergy, with deterioration of quality of life, creation of food neophobia. In case of cure of allergy, it is difficult to normalize the diet after a strict avoidance. Outside of the rare sensitive patients to a very low dose of peanut, for which a strict avoidance is counseled, the report benefits risk is in favor of the prescription of adapted avoidance to the eliciting dose. For the majority of the peanut allergic children, it seems to us that the avoidance can and must be limited to the non hidden peanut.

Allergens↗
PubMed2006

Allergy to goat and sheep milk without allergy to cow's milk.

BACKGROUND: Cow's milk (CM) allergy is the most frequent cause of food allergy in infants. Most children who are allergic to CM are also sensitized to whey proteins and/or to the casein fraction and many of them cannot tolerate goat's or sheep's milk (GSM) either. Conversely, the GSM allergies that are not associated with allergic cross-reactivity to CM are rare. METHODS: Twenty-eight children who had severe allergic reactions, including anaphylaxis, after consumption of GSM products but tolerated CM products were recruited in a retrospective study. Whole casein and whey proteins were fractionated from CM and GSM. beta-Lactoglobulin and the different caseins were isolated, purified and used to perform enzyme allergosorbent tests (EAST) and EAST inhibition studies with the sera of the allergic children. RESULTS: Clinical observations, skin prick testing and immunoglobulin (Ig)E-binding studies confirmed the diagnosis of GSM allergy without associated CM allergy. EAST determinations demonstrated that GSM allergy involves the casein fraction and not whey proteins. Cow's milk caseins were not at all or poorly recognized by the patient's IgE, while alphaS(1)-, alphaS(2)- and beta-caseins from GSM were recognized with a high specificity and affinity. In all cases, increasing concentrations of CM caseins failed to inhibit the binding of patient's IgE to sheep or goat milk caseins, whereas this binding was completely inhibited by GSM caseins. CONCLUSIONS: The characteristics of GSM allergy differ from those of the CM allergy because it affects older children and appears later. CM products do not elicit any clinical manifestation in GSM allergic patients, whereas CM allergic patients, usually cross-react to GSM. In all the GSM allergic children, the IgE antibodies recognized the caseins but not the whey proteins. Moreover, IgE specificity and affinity was high to GSM and lower to CM caseins despite their marked sequence homology. Doctors and allergic individuals should be aware that GSM allergy requires a strict avoidance of GSM and milk-derived products because reactions could be severe after ingestion of minimal doses of the offending food.

Adolescent↗
PubMed2005

[Mosquito bites allergy, which prevention?].

Mosquito bites may induce allergic reactions in children. Usually underestimated, these reactions are often cutaneous and difficult to distinguish from non-specific histaminic phenomena. Recently, the identification of major allergens in mosquito saliva has allowed the achievement of recombinant allergens, which should facilitate the diagnosis and treatment of allergic reactions. Preventive cares must be performed in all children with large reactions, allergic or even non-allergic. Prevention consists in cutaneous protection, the use of repellents (with special attention to their toxicity), and antihistamines. A practical sheet for patient is provided.

Allergens↗
PubMed2005

[Hyperventilation syndrome in children].

Hyperventilation syndrome is frequent in adults. There are only very few and very ancient publications in children. Diagnosis is sometimes difficult, because the symptoms often mimic those of organic diseases. Hyperventilation syndrome and organic diseases, especially asthma, often coincide. Intensive efforts should be made to diagnose hyperventilation syndrome at an early stage because this will prevent stigmatization and fixation of symptoms and disease, and also prevent children from undergoing unnecessary medical examinations and therapies. The authors review the literature about hyperventilation syndrome in children.

Asthma↗
PubMed2005

[Written asthma action plans: a useful tool for self-management].

Written action plans for asthma have been recommended for many years. However, despite the fact that their effectiveness has been demonstrated, they are not used enough. The plans that we propose are serviceable and the method that we suggest makes them easy to use in the treatment of asthmatic children. These plans are made for patients who do not use a peak-flow meter (plans based on symptoms) and those who control this tool (plans based on peak expiratory flow).

Asthma↗
PubMed2005

[Compliance with and acceptability of a new electronic peak flow meter, the PiKo-1].

BACKGROUND: Monitoring airflow obstruction is an essential component of asthma management. We examined home recording of PEFR using a new electronic peak flow meter in terms of compliance and acceptability in a group of children with asthma. METHODS: Twenty three children (3 with intermittent asthma and 20 with persistent asthma) (average age 10.9 +/- 3.8 [5-18] yrs) were asked to assess their PEFR every day during a period of 5.8 +/- 1.2 [4-8] weeks and record it in a diary card. Patients were not aware that their data was also being stored on the PiKo-1. At the end of the study, the written data were compared to the stored data. A multiple choice questionnaire was given to each subjectto check the acceptability of the PiKo-1. RESULTS: 2 patients were lost to follow up. The compliance (expressed as a percent of the number of recordings that should have been made) was more that 80% for 14/21(67%) patients and less than 45% for 3/21 (14%). Compliance decreased during the study (96% in the first week, 68% during the fifth). 12% of the values were falsified. The PiKo-1 was considered to be small, attractive and useful. Some children found the mouthpiece too small. CONCLUSION: The good results for compliance that we observed might have been due to the short duration of the study. PiKo-1 was well accepted by the subjects. It will be possible to monitor PEFR and forced expiratory volume in the first second of expiration at home using this new device.

Adolescent↗
PubMed2004

[A notice for use for patients who benifit from an adrenaline pen. "Having an emergency kit is a good thing but knowing how to use it is better"].

We realized that it is essential that the patient who has an auto injector also has the direction sheet in its emergency bag. Patients, families but also young medical doctors' remarks and reflexions led us to create an explanatory didactic, precise, illustrated and practical direction sheet. The goals are to gather succinct information about the patient (personal contact information, medical history); remind emergency numbers (15 or 112) and the emergency treatment (antihistamine, broncholitor if necessary, epinephrine shots). It also indicates step by step how to use the auto injector (Anapen) and emphasizes the need for a medical supervision if the shot has been used. We present this direction sheet and the way to use it.

Anaphylaxis↗
PubMed2004

Sesame seed allergy in children.

BACKGROUND: Sesame seed allergy is becoming more common in childhood. The aim of this study is to define the clinical signs and the results of allergological work-up of this food allergy as well as the demographical data in children. Sesame seed allergy outcome is unknown. MATERIALS AND METHODS: 14 children were recruited from 3 allergy centers in France. The diagnosis of food allergy was based on a convincing clinical history and positive skin prick tests and/or an elevated sesame specific IgE. Food challenge test was done when results of history and allergological work-up were conflicting. A reintroduction test was done when a child seemed to outgrow his (or her) food allergy. RESULTS: The median age at the beginning of sesame seed allergy was 5 years (range from 5 months to 16 years old). All patients reacted immediately after sesame seed consumption and presented as a first manifestation: edema (9 cases, 48%), urticaria (5, 27%), and one of each of the following symptoms (vomiting, rhinitis, conjunctivitis, asthma and anaphylactic shock). One patient had recurrent anaphylactic shocks and another an anaphylactic shock after subsequent sesame seed exposure; these 2 patients were asthmatic. The median of the wheal size was 5 mm (range 3 to 15 mm). The commercial sesame seed extract was less sensitive than the native seed. The median of sesame seed IgE was 5.58 kUA/L (range 0.35 to 100 kUA/L). The follow up lasted from a few months to 6 years. Three patients outgrew their food allergy. All of these patients showed a previous drop of sesame seed IgE and skin prick-tests became negative. CONCLUSION: Sesame seed allergy is not very different than other food allergy. We reported the spontaneous outgrowing of sesame seed allergy without being able to define the predictive criteria for a good outcome.

Adolescent↗
PubMed2003

[Vaccination in children with egg allergy].

Vaccination of children who are allergic or assumed allergic to eggs still creates concern and complication for both the doctor and the patient. These concerns are based on a 1985 circular which has always been liberally interpreted and not well understood. Further analysis of the circular and a review of recent literature show, that most of the time, no special precautions need to be taken before vaccination of children with egg allergy.

Child↗
PubMed2003

Cashew allergy: observations of 42 children without associated peanut allergy.

BACKGROUND: Cashew allergy seems to be increasingly frequent. The goal of the present study was to analyse the clinical features and results of investigations of 42 children with cashew allergy. METHODS: The clinical features and results of skin prick tests, specific IgE assays, and food challenges were analysed. RESULTS: The mean age at first allergic reaction was 2 years and the mean age at diagnosis of cashew allergy was 2.7 years. One in five children (12%) had a prior history of exposure to cashew nuts. Fifty-six per cent had skin symptoms, 25% had respiratory signs and 17% had digestive signs. Eighteen children had proven, associated food allergies (pistachio, seven; egg, five; mustard, three; shrimp, two; cow milk, one). The mean wheal diameter of the skin prick tests was 7 mm (3-16 mm) and the mean specific IgE level was 3.1 kUA/L (<0.35->100 kUA/L). Eight children had positive food challenges. CONCLUSION: The increase in cashew allergy is worrying because it affects young children who may have a reaction without ever having been exposed to cashews. Almost one-third of children are allergic to pistachios, which belong to the same botanical family as cashews. Clinical history is generally and sufficiently suggestive to diagnose cashew allergy without recourse to food challenges.

Anacardium↗
PubMed2002

[Food allergy: one only finds what one seeks].

We report three observations of food allergy to Penicillium. A systematic approach has allowed the retention of the surprising diagnosis in the first observation that we met. For those following we were content with a diagnosis of strong suspicion, without making a provocation test. The indications of provocation tests are discussed. As in these observations, it is possible that certain food allergens which are considered as rare are in fact more frequent than those reported in the literature; when an allergy does not bother the patient, when exclusion of the food is easy, food allergy is "forgotten" and not reported to the physician.

Adolescent↗
PubMed2001

[Allergy examination in the child].

More than one child in five is allergic. This pathology therefore makes an everyday problem of consultations. Allergy should always be considered, after many symptoms, but allergy is often only one of the etiological factors. An illness with an allergy component may also be triggered by other etiological factors. Many diagnoses may certainly be responsible for the same symptoms as those met in the symptoms with an allergy component. In practice, when the symptoms recur, an assessment is always necessary. The allergy investigation is primarily clinical and complementary examinations only have a confirmatory role; in effect to the sensitising allergen. The sensitisation corresponds to the manufacture by an individual of allergen-specific IgE; this sensitisation finds expression by the presence of IgE. After a new contact with an allergen, an individual may not present clinical symptoms, a simple sensitisation exists; if there are clinical symptoms an allergy is indicated. In order to succeed as quickly as possible and at least cost to a diagnosis of the symptoms of the allergy component, it is essential to adopt a strategy. The strategy that we suggest is in accord with the decree of 19th October 1994.

Adolescent↗
PubMed2000

Educational program for children with peanut allergy.

The best approach to managing peanut allergy is to educate patient and family. We developed specific consultation for children with peanut allergy. We follow a structurized program in a pedagogical manner. The objectives of this program are to encourage appropriate understanding, recognition of the signs of allergy, and if it is necessary, to teach how to inject oneself with an epinephrine injection. The aim of these sessions is to improve knowledge on basic allergy, recognition of hidden foods, on reading labelling, on recognition of earliest signs and finally on use of epinephrine as a rescue treatment. Behaviour in restaurant and most of all at school is also precised. The interview began with the parents and children, followed by discussions and pedagogical games. Our subjects experiences, described below, suggest that these educational programs are beneficial. As the others chronic pathologies, patients with this program seem to have less allergic reactions, and are able to respond with the appropriate behaviour when symptoms appear. Three months later, we conduct the efficiency of the treaning.

Adolescent↗
PubMed1995

[Comparative study of nebulized sambutol against placebo in the acute phase of bronchiolitis in 33 infants aged 1 to 6 months].

BACKGROUND: The therapeutic role of bronchodilators in bronchiolitis remains controversial. The aim of this study is to evaluate the safety and the clinical response to nebulized salbutamol in infants with mild acute bronchiolitis. PATIENTS AND METHODS: Thirty-three infants, aged 1 month to 5 months and 22 days (mean: 92.4 days) were included in the study. Patients received either nebulized salbutamol (0.15 mg/kg per dose: 16 infants) or a placebo (normal saline aerosol: 17 infants), delivered by an oxygen propellent, three times at intervals of 1 hour, as part of a double-blind randomized trial. Effect of treatment was evaluated by measuring respiratory and heart rate, clinical scores based on the degree of retraction and wheezing, and oxygen saturation. Clinical assessment was repeated 30 minutes after each nebulization. A nasopharyngeal swab was obtained for detection of respiratory syncytial virus (VRS) antigens by immunofluorescence assay in all patients. RESULTS: Patients in the salbutamol group exhibited significantly greater improvement in respiratory rate (P = 0.01), accessory muscle score (P < 0.001) and wheezing score (P < 0.001). There was no significant difference in oxygen saturation between both groups. Infants treated with salbutamol exhibited a non-significant increase in heart rate after the three sprays; no other adverse effects were noted. VRS was identified in 78% of the children tested. CONCLUSIONS: Salbutamol is safe and effective in relieving the respiratory distress of young infants with acute bronchiolitis. Our study confirms previous observations that infants younger than six months of age respond as well as older children when given three doses of nebulized salbutamol. Responders could not be differentiated from non responders by personal or family histories of atopy and VRS isolation. A longitudinal study could establish a correlation between response to bronchodilator therapy and later development of asthma.

Acute Disease↗