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PLoS One. 2013; 8(2): e57261.

Published online 2013 February 27. doi:  10.1371/journal.pone.0057261

PMCID: PMC3584110

Consumption of Artificially-Sweetened Soft Drinks in Pregnancy and Risk of Child Asthma and Allergic Rhinitis

Ekaterina Maslova,^1,2,* Marin Strøm,¹ Sjurdur F. Olsen,^1,2 and Thorhallur I. Halldorsson^1,3,4

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Abstract

Background

Past evidence has suggested a role of artificial sweeteners in allergic disease; yet, the evidence has been inconsistent and unclear.

Objective

To examine relation of intake of artificially-sweetened beverages during pregnancy with child asthma and allergic rhinitis at 18 months and 7 years.

Methods

We analyzed data from 60,466 women enrolled during pregnancy in the prospective longitudinal Danish National Birth Cohort between 1996 and 2003. At the 25th week of gestation we administered a validated Food Frequency Questionnaire which asked in detail about intake of artificially-sweetened soft drinks. At 18 months, we evaluated child asthma using interview data. We also assessed asthma and allergic rhinitis through a questionnaire at age 7 and by using national registries. Current asthma was defined as self-reported asthma diagnosis and wheeze in the past 12 months. We examined the relation between intake of artificially-sweetened soft drinks and child allergic disease outcomes and present here odds ratios with 95% CI comparing daily vs. no intake.

Results

At 18 months, we found that mothers who consumed more artificially-sweetened non-carbonated soft drinks were 1.23 (95% CI: 1.13, 1.33) times more likely to report a child asthma diagnosis compared to non-consumers. Similar results were found for child wheeze. Consumers of artificially-sweetened carbonated drinks were more likely to have a child asthma diagnosis in the patient (1.30, 95% CI: 1.01, 1.66) and medication (1.13, 95% CI: 0.98, 1.29) registry, as well as self-reported allergic rhinitis (1.31, 95% CI: 0.98, 1.74) during the first 7 years of follow-up. We found no associations for sugar-sweetened soft drinks.

Conclusion

Carbonated artificially-sweetened soft drinks were associated with registry-based asthma and self-reported allergic rhinitis, while early childhood outcomes were related to non-carbonated soft drinks. These results suggest that consumption of artificially-sweetened soft drinks during pregnancy may play a role in offspring allergic disease development.

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Using Text Messaging to Assess Adolescents' Health Information Needs: An Ecological Momentary Assessment

Original Paper

Using Text Messaging to Assess Adolescents' Health Information Needs: An Ecological Momentary Assessment

Rebecca Schnall¹, RN, PhD; Anastasia Okoniewski¹, MSN, PMHNP; Victoria Tiase², RN, MS; Alexander Low²; Martha Rodriguez¹, BS; Steven Kaplan², MD

¹Columbia University, School of Nursing, New York, NY, United States
²NewYork-Presbyterian Hospital, New York, NY, United States

Corresponding Author:

Rebecca Schnall, RN, PhD

Columbia University
School of Nursing
617 W 168th Street
New York, NY, 10032
United States
Phone: 1 212 342 6886
Fax: 1 212 305 6937
Email: rb897 [at] columbia.edu

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ABSTRACT

Background: Use of mobile technology has made a huge impact on communication, access, and information/resource delivery to adolescents. Mobile technology is frequently used by adolescents.
Objective: The purpose of this study was to understand the health information needs of adolescents in the context of their everyday lives and to assess how they meet their information needs.
Methods: We gave 60 adolescents smartphones with unlimited text messaging and data for 30 days. Each smartphone had applications related to asthma, obesity, human immunodeficiency virus, and diet preinstalled on the phone. We sent text messages 3 times per week and asked the following questions: (1) What questions did you have about your health today? (2) Where did you look for an answer (mobile device, mobile application, online, friend, book, or parent)? (3) Was your question answered and how? (4) Anything else?
Results: Our participants ranged from 13-18 years of age, 37 (62%) participants were male and 22 (37%) were female. Of the 60 participants, 71% (42/60) participants identified themselves as Hispanic and 77% (46/60) were frequent users of mobile devices. We had a 90% (1935/2150) response rate to our text messages. Participants sent a total of 1935 text messages in response to the ecological momentary assessment questions. Adolescents sent a total of 421 text messages related to a health information needs, and 516 text messages related to the source of information to the answers of their questions, which were related to parents, friends, online, mobile apps, teachers, or coaches.
Conclusions: Text messaging technology is a useful tool for assessing adolescents’ health behavior in real-time. Adolescents are willing to use text messaging to report their health information. Findings from this study contribute to the evidence base on addressing the health information needs of adolescents. In particular, attention should be paid to issues related to diet and exercise. These findings may be the harbinger for future obesity prevention programs for adolescents.

(J Med Internet Res 2013;15(3):e54)
doi:10.2196/jmir.2395

KEYWORDS

text messaging; ecological momentary assessment; mobile health technology

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The Short Stature in Atopic Dermatitis Patients: Are Atopic Children Really Small for Their Age?

Annals of Dermatology 2013 Feb; 25(1): 23~27

The Short Stature in Atopic Dermatitis Patients: Are Atopic Children Really Small for Their Age?

Mi Kyung Park, Kui Young Park, Kapsok Li, Seong Jun Seo, Chang Kwun Hong

Department of Dermatology, Chung-Ang University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Short stature is sometimes seen in children with atopic dermatitis (AD); however, the topic has never been studied systematically. Objective: The aim of this study was to show whether AD itself affects stature in children and to evaluate the influence of other relevant factors such as genetic background, diet restrictions, and sleep disturbance on the stature of children with AD. Methods: The study population included Korean children 7 to 8 years of age who live in one district of Seoul, Korea. We used a questionnaire as an investigating tool to survey genetic backgrounds, environmental factors, and comorbidities. Student's t-test and linear regression were employed for statistical analysis. Results: In univariate analysis, the average stature in the AD group was short compared with the normal control group. Parental stature, dietary habit, and sleep patterns were also relevant factors with respect to stature. However, in multivariate analysis, AD itself had no influence on stature. Significant correlations were found for such factors as parental height, sleep disturbance, presence of asthma, and dietary restrictions, in decreasing magnitude. Conclusion: These results suggest that AD itself may not be the causative factor for short stature in children with AD. Therefore, consideration of other relevant factors related to short stature in patients with AD will be important for the proper management of the disease. (Ann Dermatol 25(1) 0∼27, 2013)

Annals of Dermatology 2013 Feb; 25(1): 23~27

Keyword : Atopic dermatitis, Diet restriction, Sleep disturbance, Stature

 Therapeutics and Clinical Risk Management

Safe medication use based on knowledge of information about contraindications concerning cross allergy and comprehensive clinical intervention

Short Report

(365) Total Article Views

Authors: Li W, Zhu LL, Zhou Q

Published Date February 2013 Volume 2013:9 Pages 65 - 72

DOI: http://dx.doi.org/10.2147/TCRM.S42013

Received:	31 December 2012
Accepted:	22 January 2013
Published:	26 February 2013

Wei Li,¹ Ling-Ling Zhu,² Quan Zhou^3
1Division of Medical Affairs, ²Cadre Department, Division of Nursing, ³Department of Pharmacy, Second Affiliated Hospital, School of Medicine, Zhejiang University, Zhejiang, People's Republic of China

Background: An investigation of safety issues regarding information on contraindications related to cross allergy was conducted to promote clinical awareness and prevent medical errors in a 2200-bed tertiary care teaching hospital.
Methods: Prescribing information on contraindications concerning cross allergy was collected from an information system and package inserts. Data mining and descriptive analysis were performed. A risk register was used for project management and risk assessment. A Plan, Do, Check, Act cycle was used as part of continuous quality improvement. Records of drug counseling and medical errors were collected from an online reporting system. A pharmacist-led multidisciplinary team initiated an intervention program on cross allergy in August 2008.
Results: Four years of risk management at our hospital achieved successful outcomes, ie, the number of medical errors related to cross allergies decreased by 97% (10 cases monthly before August 2008 versus three cases yearly in 2012) and risk rating decreased significantly [initial risk rating:25 (high-risk) before August 2008 versus final risk rating:6 (medium-risk) in December 2012].
Conclusion: We conclude that comprehensive clinical interventions are very effective through team cooperation. Medication use has potential for safety risks if sufficient attention is not paid to contraindications concerning cross allergy. The potential for cross allergy involving drugs which belong to completely different pharmacological classes is easily overlooked and can be dangerous. Pharmacists can play an important role in reducing the risk of cross allergy as well as recommending therapeutic alternatives

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Immunotherapy

March 2013, Vol. 5, No. 3, Pages 203-206 , DOI 10.2217/imt.13.6

(doi:10.2217/imt.13.6)

Predictive biomarkers of clinical efficacy of allergen-specific immunotherapy: how to proceed

Mohamed H Shamji, Christian Ljørring & Peter A Würtzen^*

* Author for correspondence

Various mode-of-action studies have been conducted to describe and substantiate the immunologic mechanisms behind the long-lasting effect of allergen-specific immunotherapy (SIT) and how it changes the course of IgE-mediated allergic disease. These randomized, double-blind, placebo-controlled studies have reported both cellular and humoral changes systemically and in the target organ following SIT. However, demonstrating that these immunological changes can be used to monitor the effect of treatment has proven challenging. Although we are able to distinguish between actively and placebo-treated patients, candidate biomarkers of effect or biomarker combinations remain to be determined. The validation of such biomarkers may need to involve unconventional ways to evaluate clinical effect, such as challenge chambers or controlled provocation tests of individual organs, to clearly distinguish between strong and weak or early and late responders, as discussed below.

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Clinical Predictors of Primary Immunodeficiency Diseases in Children

Original Article  Open Access

|  | Full Text    |    Allergy Asthma Immunol Res. 2013 Mar;5(2):88-95. English. Published online 2012 November 02.  http://dx.doi.org/10.4168/aair.2013.5.2.88  Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease Clinical Predictors of Primary Immunodeficiency Diseases in Children Shereen M. Reda,1 Dalia H. El-Ghoneimy,1 and Hanaa M. Afifi2 1Department of Pediatric Allergy and Immunology, Children's Hospital, Faculty of Medicine, Ain Shams University, Cairo, Egypt. 2Department of Clinical Pathology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.  Correspondence to: Shereen M. Reda, MD, PhD, Department of Pediatric Allergy and Immunology, Children's Hospital, Faculty of Medicine, Ain Shams University, 110 El-Merghany Street, Heliopolis, Cairo 11341, Egypt. Tel: +202-24187440; Fax: +202-22591561; Email: shereen.m.reda@gmail.com  Received May 10, 2012; Revised July 09, 2012; Accepted July 23, 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose To promote awareness of primary immunodeficiency (PID), the "10 warning signs" of PID and an immunodeficiency-related (IDR) score were developed. However, their efficiency in identifying PID cases was not sufficiently evaluated in clinical practice. The objective of this study was to test the validity of the 10 warning signs and IDR score in identifying PID among children with recurrent infections at a tertiary pediatric hospital in Egypt. Methods A retrospective analysis of the medical records of 204 patients was performed. Of these patients, 92 had defined PID diseases and 112 were considered non-PID cases because investigations were inconclusive. Results Demonstrating two warning signs and an IDR score of 6 led to sensitivities of 94 and 66%, respectively, and specificities of 64 and 75%, respectively, in identifying PID cases. The strongest predictor of PID was family history that, if combined with the need for intravenous antibiotics, recurrent deep-seated infections, and failure to thrive, could identify 81% of PID patients. A family history of PID, sibling death, and/or parental consanguinity would predict 92% of combined immunodeficiencies, 92% of phagocyte defects, 87% of well-identified immunodeficiency syndromes, and 84% of antibody deficiency if the need for intravenous antibiotics is considered in the latter. Conclusions The 10 warning signs and IDR score do not aid in an early diagnosis of severe PID. Educational campaigns should target pediatricians aiming to increase PID awareness and to address family history of PID, parental consanguinity, and previous sibling death as key predictors of PID in communities with a high prevalence of consanguineous marriages.

The Influence of the Time and Temperature of Heat Treatment on the Allergenicity of Egg White Proteins

Original Article  Open Access

|  | Full Text    |    Allergy Asthma Immunol Res. 2013 Mar;5(2):96-101. English. Published online 2012 November 02.  http://dx.doi.org/10.4168/aair.2013.5.2.96  Copyright © 2013 The Korean Academy of Asthma, Allergy and Clinical Immunology • The Korean Academy of Pediatric Allergy and Respiratory Disease The Influence of the Time and Temperature of Heat Treatment on the Allergenicity of Egg White Proteins Meeyong Shin,1 Youngshin Han,2 and Kangmo Ahn3 1Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea. 2Environmental Health Center for Atopic Dermatitis, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.  Correspondence to: Kangmo Ahn, MD, PhD, Department of Pediatrics, Sungkyunkwan University Samsung Medical Center, 80 Irwon-ro, Gangnam-gu, Seoul 135-710, Korea. Tel: +82-2-3410-3530; Fax: +82-2-3410-3669; Email:kmaped@skku.edu  Received July 27, 2012; Revised August 24, 2012; Accepted September 17, 2012. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose The present study was performed to determine the factor, either duration or the temperature of heat treatment, exerting maximal and significant influence on the composition and allergenicity of egg white (EW) proteins. Methods Raw EW and 4 kinds of heated EW (fried EW, boiled EW for 10 minutes, boiled EW for 30 minutes, and baked EW for 20 minutes at 170℃) were prepared, and subsequently protein extraction was carried out. The proteins were separated by SDS-PAGE, and then immunoglobulin E (IgE) immunoblots were performed with the sera of 7 egg-allergic patients. Furthermore, the antigenic activities of ovalbumin (OVA), ovomucoid (OM), and ovotransferrin (OT) in different EW samples were measured by inhibition enzyme-linked Immuno-sorbent assay (ELISA). Results In SDS-PAGE analysis, the intensity of the protein band at 45 kD (corresponding to OVA) decreased significantly in boiled EW (30 minutes) and baked EW, but no change was observed in the case of boiled EW for 10 minutes. In IgE immunoblots, the IgE response to 34-50 kD (OM and OVA) in boiled EW for 30 minutes decreased significantly, when compared with raw EW and other heated EWs. In inhibition ELISA, a significant decrease in the OVA antigenic activity was observed in boiled EW for 30 minutes amongst other heated EW samples. However, OM antigenic activity in all kinds of heated EW including boiled EW for 30 minutes did not reduce after heat treatment. The OT antigenic activity nearly disappeared in heated EWs except in the case of boiled EW for 10 minutes. Conclusions Amongst 4 kinds of heated EWs, the boiled EW for 30 minutes showed the most significant changes both in composition and reduction in allergenicity. Our results revealed that the duration of heat treatment had more influence on the composition and allergenicity of EW proteins than the temperature.

Intraoperative anaphylaxis: a case report of allergy to ranitidine

European Annals of Allergy and Clinical Immunology Vol 44, No 6 (2012) > Antonicelli

Intraoperative anaphylaxis: a case report of allergy to ranitidine

L. Antonicelli, G. Stagnozzi, C. Massaccesi, et al.

Abstract

We report the case of a 18-year old male who developed intraoperative anaphylaxis. The presence of specific IgE to ranitidine was documented. This case confirms the possibility of anaphylaxis at first exposure.

Keywords

Ranitidine, hypersensitivity, intraoperative anaphylaxis

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