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  • 1
    Electronic Resource
    Electronic Resource
    Distinct patterns of cow's milk allergy in infancy defined by prolonged, two-stage double-blind, placebo-controlled food challenges (1996)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 26 (1996), S. 0 
    Details
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background The clinical manifestations of cow's milk allergy (CMA) are highly variable, and challenges usually identify only immediate. IgE mediated reactions.Objective To clearly identify CMA of immediate and delayed types using a two-stage. double-blind, placebo-controlled food challenge (DBPCFC), and to prospectively compare the clinical history and analyses of specific IgE antibodies to milk in predicting outcome of DBPCFC.Methods A total of 69 patients (33 girls, 36 boys) were recruited for sludy based on a history highly suggestive of CMA and resolution of symptoms on a bovine protein-free diet. After skin-prick tests (SPTs) and search for allergen-specific serum IgE antibodies by enzyme allergosorbent test (EAST), a two-stage DBPCFC was performed over several days.Results Of 16 patients (mean age 36.9 months) classified as probable immediate reactors based on the history, 10 (62.5%) had a positive DBPCFC with similar patterns to historical adverse reactions (≥ 2 h after milk exposure). The other 53 (77%) patients (17.3 months) had a history of probable delayed type CMA presenting with predominantly gastrointestimal symptoms from 2h and up to 6 days after milk exposure. Of these. 15 (28.8%) had a positive DBPCFC. again with a symptom pattern similar to the history. Sensitivity/specificity of SPT was similar to that of EAST for both immediate (70/83% and 62/83% respectively. NS) or delayed (0/97% and 0/97%) CMA confirmed by DBPCFC.Conclusions Using our two-stage, prolonged DBPCFC, we clearly identified two groups of children with CMA, reflecting different pathogenesis of either immediatetype IgE-dependent, or delayed-type IgE-independent allergy. Although useful in immediate reactors. IgE antibody determination cannot predict the outcome of DBPCFC in delayed reactors. A thorough clinical history was the mo.st helpful tool to predict the type of response in challenge positive patients.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1365-2222.1996.tb00089.x
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  • 2
    Electronic Resource
    Electronic Resource
    The effect of inflammation severity and of treatment on the production and release of TNFα by colonic explants in inflammatory bowel disease (2000)
    Oxford UK : Blackwell Science Ltd
    Alimentary pharmacology & therapeutics 14 (2000), S. 0 
    Details
    ISSN: 1365-2036
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Despite its pivotal role in mucosal inflammation, data on TNFα levels in inflammatory bowel diseases have been contradictory.〈section xml:id="abs1-2"〉〈title type="main"〉Aim:To examine TNFα production in relation to the type and severity of inflammation and therapy, using colonic explant cultures.〈section xml:id="abs1-3"〉〈title type="main"〉Materials and methods:Rectal mucosal biopsies from 271 paediatric patients (178 inflammatory bowel disease, 27 inflammatory controls, 66 normal) were cultured for 4 or 18 h. Basal TNFα tissue content and release into the medium were measured by ELISA and compared to histological severity and clinical parameters.〈section xml:id="abs1-4"〉〈title type="main"〉Results:TNFα release as well as tissue-associated TNFα levels were significantly increased in rectal biopsies from involved inflammatory bowel disease tissue. The amount of TNFα correlated with inflammation severity scores. TNFα levels were higher at 18 compared to 4 h in all groups, whether inflamed or not. TNFα released from rectal biopsies was lower among treated patients at 18 h. The presence of proximal colonic involvement was associated with higher TNFα release by uninvolved Crohn’s disease rectal biopsies compared to patients with ileitis alone.〈section xml:id="abs1-5"〉〈title type="main"〉Conclusions:TNFα production and release is increased in involved rectal explants from inflammatory bowel disease. Anti-inflammatory treatment diminishes this response.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1365-2036.2000.00851.x
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  • 3
    Electronic Resource
    Electronic Resource
    Nutritional therapy of Crohn's disease in childhood (1987)
    Springer
    Digestive diseases and sciences 32 (1987), S. S82 
    Details
    ISSN: 1573-2568
    Keywords: Crohn's disease ; nutritional therapy ; growth failure ; elemental diet
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Crohn's disease is a chronic, incurable inflammatory bowel disease commonly diagnosed in childhood and adolescence. Growth failure represents a common, serious complication unique to the pediatric age group. Although the etiology of growth failure is multifactorial, malnutrition due to inadequate nutrient intake is the primary cause. Recent studies have demonstrated that nutritional supplementation through an enteral or parenteral route restores body composition and reverses linear and ponderal growth failure. The development of elemental diets that can be administered nasogastrically at home has afforded a more practical, less expensive, and less hazardous method of providing Crohn's disease patients with nutritional supplementation and bowel rest. Elemental-diet therapy has also been shown to be a safe, effective method of inducing a remission in acute Crohn's disease. Further studies are required to develop optimal nutritional therapy which may sustain long-term remission in this disease.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01312470
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