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Query: UMLS:C0010200 (cough)
 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cessation of smoking in the home is one of the most important nonpharmacologic actions to be recommended. There is a highly significant increase in wheezing, coughing, and respiratory infections in children with smoking mothers, and this increase is directly proportional to the number of cigarettes smoked. Cord blood IgE levels are increased in babies whose mothers smoke during pregnancy. Other agents, such as sulpur dioxide and chemical pollutants from industrial processes may play a role in the development or exacerbation, of asthma symptoms and should be avoided. One of the most interesting areas in food allergy is whether breast feeding causes sensitization or induces tolerance in infants to foods ingested by the mother. There is an increase in asthma in second-generation immigrant populations who are exposed, from birth, to the Western style of living which increases their exposure to house dust mite. Several studies have shown that month of birth is important in the development of specific allergies, for example, in the incidence of birch pollen allergy in Scandinavia. The presence of a pet in the home at birth is associated with a greater incidence of allergy to that animal. Our study in asthmatic children has shown a strong association (p less than 0.001) between the presence of allergens in the air in their homes (sampled retrospectively in the month of birth) with a positive skin test to those allergens.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Nonpharmacologic means of preventing asthma. 211 30

Both upper and lower respiratory tracts can be affected by food allergy. In infants these symptoms may be due exclusively to food allergy or may result from the effect of food allergy and another co-factor (gastro-esophageal reflux, immunodeficiency, concomitant allergy to inhalants, etc.). The incidence of food-induced asthma is not well know. In this study, using open and double blind food challenge, we found that the incidence of IgE-mediated, food-induced asthma in children is 5.7%. The most offending foods were milk, eggs, and peanuts. Food allergy respiratory symptoms were almost always associated with other clinical manifestations (cutaneous, gastrointestinal). In fact we have been able to demonstrate only one isolated case of cough due to food allergy. It follows that the recognition of food dependent-IgE-mediated asthma is essentially limited to these cases characterized by food allergy with asthmatic expression.
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PMID:[Incidence of asthma caused by food allergy in childhood]. 369 22

Both upper and lower respiratory tracts can be affected by food allergy. Manifestations in either may be exclusively due to food allergy (common in infants) or may result from the combined effects of food allergy plus another defect such as gastroesophageal reflux, a congenital defect of the heart or tracheo-bronchial tree, an immunodeficiency syndrome such as isolated IgA or IgG4 deficiency, or a concomitant inhalant allergy. Chronic rhinitis is the most common respiratory tract manifestation of food allergy. When it occurs in conjunction with lung disease, it may be a helpful indicator of activity of the allergic lung disease and of the patient's compliance in following a specific diet. Recurrent serous otitis media may be solely or partially due to food allergy. Large tonsillar and adenoid tissues, sometimes with upper airway obstruction, may be caused, or aggravated by, food allergies. Lower respiratory tract disease manifested by chronic coughing, wheezing, pulmonary infiltrates, or alveolar bleeding may also occur. Lower respiratory tract involvement is generally associated with a greater delay in onset of symptoms and with a larger quantity of allergen ingestion than chronic rhinitis. Food allergy should be considered when there is a history of prior intolerance to a food in childhood or of symptoms beginning soon after a particular food was introduced into the diet. It is an important consideration in patients who have chronic respiratory tract disease which does not respond adequately to the usual therapeutic measures and is otherwise unexplained.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Respiratory diseases and food allergy. 623 77

We report 8 infants with immediate hypersensitivity reactions to foods (milk, egg, or peanut), occurring at the first-known exposure. Each developed symptoms within the first hour, but these generally settled within 2 hours. Sensitisation to the food concerned was demonstrated by positive immediate allergen skin prick tests in every case. Symptoms experienced included irritability, erythematous rash, urticaria, angio-oedema, vomiting, rhinorrhoea, and cough. Five infants were being followed prospectively and 4 were clinically tolerant of the food by age 16 months. The most likely route of sensitisation was via breast milk. None of the infants experienced similar reactions while being breast fed, suggesting that the reaction was dose dependent. As 5 out of a group of 80 infants being followed prospectively developed an immediate reaction at their first known exposure to a food, this appeared to be a not uncommon presentation of food hypersensitivity in infancy.
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PMID:Immediate food hypersensitivity reactions on the first known exposure to the food. 684 27

Allergic diseases affect at least 15% of the population and are the cause of much ill-health. 'Clinical immunology and allergy', the term used by the Department of Health in England and Wales for this area of specialization, is recognized as a separate specialty of medicine under the National Health Service. Many organ-based hospital consultants (e.g. chest physicians) have allergy as a special interest or subspecialty. Allergists deal largely with 'itch, sneeze, cough and wheeze' and so are experts in: summer hay fever (seasonal, allergic, conjunctivorhinitis); perennial rhinitis (symptoms of a 'permanent cold'); allergic asthma (including occupational asthma); allergy to stinging insects (especially wasps and bees); allergy to drugs; allergy-related skin disorders, i.e. urticaria, angioedema, atopic eczema and contact dermatitis; food allergy and food intolerance; anaphylaxis (acute generalized allergic reaction); evaluating the role of allergy in non-specific/polysymptomatic illness. Children with allergic disease should be under the overall care of a paediatrician since the progression of allergies in children differs from that in adults. Good allergy practice involves teamwork by doctors, nurses and dietitians. The investigation of allergy patients includes skin tests and challenge procedures (e.g. food allergy tests) as well as various specialized laboratory investigations. Good clinical practice by providers and the effective use of allergy services by purchasers should improve prognosis and cut costs of treatment in allergic disease.
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PMID:Good allergy practice--standards of care for providers and purchasers of allergy services within the National Health Service. Royal College of Physicians and Royal College of Pathologists. 852 Nov 76

To investigate the possible pathogenic role of food allergy in asthma, airway hyperresponsiveness was measured by methacholine inhalation challenges (MIC) performed before and after double-blind, placebo-controlled food challenges (DBPCFC) in 26 food-allergic, asthmatic patients. Airway hyperresponsiveness was classified as severe in two cases (PD20FEV1 < 2 breath units, BU), moderate in 18 (PD20FEV1: 2-20 BU), and mild in six (PD20FEV1 > 20 BU). Medications included albuterol (81%), inhaled steroids (38%), cromolyn (35%), and theophylline (23%). MICs were performed in the afternoon after DBPCFC. Of the 22 positive DBPCFC, 12 involved chest symptoms (cough, wheezing, or both). Another 10 positive DBPCFCs included laryngeal, gastrointestinal, and/or skin symptoms without any chest symptoms. Significant increases in airway hyperresponsiveness were evident in seven of 12 patients experiencing chest symptoms during DBPCFC. Significant increases in airway hyperresponsiveness were observed in one patient without chest symptoms during a positive DBPCFC and one patient after a negative DBPCFC. However, this last patient had a negative MIC with the same antigen 1 yr later. These studies indicate that food-induced allergic reactions can increase airway reactivity, and may do so without inducing acute asthma.
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PMID:Airway reactivity changes in asthmatic patients undergoing blinded food challenges. 856 4

Our objective was to evaluate the diagnostic value of RAST in children with symptoms of airways allergy and probable food allergy. We studied 17 children under 6 years old with rhinitis or asthma. The underwent a food elimination diet during 4 weeks followed by weekly ambulatory oral food challenge. Cough, wheezing, dyspnea, rhinorrea and nasal itch and blockage were evaluated, daily by their parents and weekly at the hospital. We found no difference between the clinical evaluation made by their parents and at the hospital. We found 16/76 positive oral food challenges. RAST was positive in 44 foods. Cow's milk and egg were the more frequent positive foods both in oral challenge and RAST, 5 and 6, and 14 and 14, respectively. Serum IgE had an average of 350 UI/ml. RAST evaluation results were sensitivily 62.5%, specificity 43.3%; positive predictive value 22.7%, negative predictive value 81.3% and total efficacy 47.4%. We can conclude that food allergy can be a frequent cause of airways allergy symptoms in children under 6 years old and although in cases, RAST is considered the best in vitro diagnostic test, its results should be symptoms related and cautiosly interpreted.
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PMID:[Evaluation of the RAST in the diagnosis of children with food allergy]. 890 Oct 34

An increase in allergic diseases in Western societies has been observed in all epidemiological studies. Various risk factors have been invoked to explain this increase, but the results are still inconclusive. We examined the type of patients who visited a hospital pediatric allergology unit in terms of the type of pathology presented, environmental factors, and time from the onset of symptoms until referral for allergy study. We evaluated 200 children ranging in age from 1 month to 15 years who were distributed by pathology: 119 referrals for respiratory manifestations (asthma, rhinitis, coughing, ...), 46 for food-related pathology, and 35 for adverse reactions attributed to medications. Among the risk factors, 69% of the children had a family history, 63.5% were exposed to smoking, and all of the patients were from urban and urban-industrial areas. We found no relation between the type of pathology and birth month. The natural history of allergic disease showed the following sequence: food allergy--respiratory allergy--medication allergy. In every case there was an important delay in diagnosis. The patients who visited our department soonest were infants (for presumptive allergy to cow milk protein or suspected adverse reaction to medications). It is evident that in recent years we are seeing a major increase in allergic diseases, particularly in industrialized countries. From a clinical point of view, manifestations such as asthma, rhinitis, and atopic dermatitis are increasing, which all working groups attribute to an increase in the prevalence of allergy. Epidemiological studies of large population samples use non-standard methods, with different selection criteria, ethnic breakdown and geographic differences. This makes it difficult to compare available data. Therefore, we think that it would be advisable if epidemiological studies would attempt to follow a model, which would facilitate the comparison of studies. Our aim was to evaluate the type of patients who required allergy studies in relation to the pathologies that they present and the different diagnostic methods to determine the presence of false allergies or non-allergies, the delay until study, most frequent pathologies, and environment. We report the data obtained from a sample of 200 children who visited our department for the first time in the period of a natural year.
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PMID:[Epidemiology and chronology of allergic diseases and their risk factors]. 967 89

Food intolerance is a reproducible adverse reaction to a specific food ingredient that is not psychologically based. Food allergy is a form of food intolerance in which there is evidence that the response is caused by an immunological reaction to food. Other mechanisms of food intolerance include enzyme defects (e.g. lactase deficiency), pharmacological effects (e.g. histamine), toxic properties (e.g. haemagglutinating lectins) and irritants (e.g. spices). Food allergy in children is a highly contentious subject and there is often a striking lack of published evidence from which to base clinical decisions. The true prevalence of food allergy in children is unknown, although there is evidence of an increasing incidence of allergic reactions to some foods, especially peanuts. Our understanding of why some children are unable to tolerate certain foods (e.g. cow's milk, egg), or how they grow out of this intolerance, is very poor. Symptoms of food allergy in children are diverse and include vomiting, poor weight gain, abdominal pain, malabsorption, cough, wheeze, rhinitis, atopic eczema, urticaria and angioedema. Despite the lack of objective data to support the notion that food intolerance contributes to behaviour in children, this is a belief firmly held by many parents and some professionals. The gold standard for diagnosing food intolerance is the double-blind placebo-controlled food challenge (DBPCFC). There is often a poor correlation between the results of food provocation tests and those of skin prick tests of radioallergosorbent tests for specific food antibodies. For proven food allergy, elimination diets are the mainstay of management. In children these must be closely supervised to avoid nutritional deficiency and compromise of growth. Some children who have had severe (anaphylactic) reactions after food need to have a supply of self-injectable adrenaline made available to their parents and teachers and must also practice strict avoidance of the offending food.
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PMID:Food allergy and food intolerance in childhood. 1113 67

Atopic dermatitis is a typical chronic inflammatory skin disease that usually occurs in individuals with a personal or family history of atopy. Children with atopic dermatitis frequently present IgE-mediated food sensitization, the most commonly involved foods being egg and cow's milk. However, controversy currently surrounds whether food allergy is an etiological factor in atopic dermatitis or whether it is simply an associated factor, accompanying this disease as one more expression of the patient's atopic predisposition. Approximately 40 % of neonates and small children with moderate-to-severe atopic dermatitis present food allergy confirmed by double-blind provocation tests but this allergy does not seem to be the cause of dermatitis since in many cases onset occurs before the food responsible for allergic sensitization is introduced into the newborn's diet.Studies of double-blind provocation tests with food in patients with atopic dermatitis demonstrate mainly immediate reactions compatible with an IgE-mediated allergy. These reactions occur between 5 minutes and 2 hours and present mainly cutaneous symptoms (pruritus, erythema, morbilliform exanthema, wheals) and to a lesser extent, digestive manifestations (nausea, vomiting, abdominal pain, diarrhea), as well as respiratory symptoms (wheezing, nasal congestion, sneezing, coughing). However, these reactions do not indicate the development of dermatitis.Some authors believe that responses to the food in provocation tests may also be delayed, appearing mainly in the following 48 hours, and clinically manifested as exacerbation of dermatitis. However, delayed symptoms are difficult to diagnose and attributing these symptoms to a particular foodstuff may not be possible.Delayed reactions have been attributed to a non-IgE-mediated immunological mechanism and patch tests with food have been proposed for their diagnosis. In our experience and in that of other authors, the results of patch tests with cow's milk do not seem very specific and could be due, at least in part, to the irritant effect of these patches on the reactive skin of children with atopic dermatitis.The involvement of foods in atopic dermatitis will always be difficult to demonstrate given that an exclusion diet is not usually required for its resolution. Food is just one among several possible exacerbating factors and consequently identification of its precise role in the course of the disease is difficult. Further double-blind prospective studies are required to demonstrate the effectiveness of exclusion diets in the treatment of atopic dermatitis.Apart from the controversy surrounding the etiological role of foods, the most important point in atopic dermatitis is to understand that the child is atopic, that is, predisposed to developing sensitivity to environmental allergens; in the first few years of life to foods and subsequently to aeroallergens. Consequently, possible allergic sensitization to foods should be evaluated in children with atopic dermatitis to avoid allergic reactions and to prevent the possible development of allergic respiratory disease later in life.
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PMID:[Etiologic implication of foods in atopic dermatitis: evidence against]. 1198 42


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