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1.
Orv Hetil ; 160(33): 1311-1318, 2019 Aug.
Artigo em Húngaro | MEDLINE | ID: mdl-31401863

RESUMO

Introduction and aim: The aim of our research is to evaluate and compare commonly performed diagnostic tests, and to examine the psychological disorders induced by this food allergy. Children with symptoms suggesting cow's milk protein allergy were included in this study (n = 47). Blood and saliva samples were collected from the participants. Parents were asked to fill in a questionnaire constructed by the research team (containing the DSM-5 symptoms checklist about attention deficit hyperactivity disorder). Method: One of the most widely used diagnostic tool is the skin allergy test, which was performed in 47 subjects (n = 47, mean age: 7.36 years); only 2 children showed positive test result for cow's milk. Lymphocyte transformation test was observed to be positive in 8 children (17%), 4 subjects demonstrated questionable results. In our sub-study about psychological symptoms (n = 43, mean age: 7.88 years), the score was according to the attention deficit hyperactivity disorder symptom checklist before the diet (6.88, SD: 4.43) and showed significant decrease after 3 months of the elimination diet (4.48, SD: 3.69, p = 0.001). Scores of children with sleep disorder (10.62, SD: 4.23) also represented a significant reduction after 3 months of the diet (6.69, SD: 4.59, p = 0.009). Salivary cortisol levels did not show significant changes before and after elimination diet. Results: According to our data, skin allergy testing and lymphocyte transformation test are not reliable diagnostic tools for establishing the diagnosis. Conclusion: We conclude that a significant improvement in clinical symptoms can only be achieved with a strict elimination diet. Orv Hetil. 2019; 160(33): 1311-1318.


Assuntos
Alérgenos/imunologia , Imunoglobulina E/imunologia , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/efeitos adversos , Animais , Bovinos , Criança , Pré-Escolar , Feminino , Hipersensibilidade Alimentar , Humanos , Imunoglobulina E/sangue , Lactente , Recém-Nascido , Masculino , Proteínas do Leite/imunologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Testes Cutâneos/métodos
2.
Nutrients ; 11(7)2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31261965

RESUMO

Cow´s milk is one of the most important and basic nutrients introduced early in life in our diet but can induce IgE-associated allergy. IgE-associated allergy to cow´s milk can cause severe allergic manifestations in the gut, skin and even in the respiratory tract and may lead to life-threatening anaphylactic shock due to the stability of certain cow´s milk allergens. Here, we provide an overview about the allergen molecules in cow´s milk and the advantages of the molecular diagnosis of IgE sensitization to cow´s milk by serology. In addition, we review current strategies for prevention and treatment of cow´s milk allergy and discuss how they could be improved in the future by innovative molecular approaches that are based on defined recombinant allergens, recombinant hypoallergenic allergen derivatives and synthetic peptides.


Assuntos
Alérgenos , Imunoglobulina E/sangue , Hipersensibilidade a Leite/prevenção & controle , Hipersensibilidade a Leite/terapia , Proteínas do Leite/imunologia , Técnicas de Diagnóstico Molecular , Biomarcadores/sangue , Humanos , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/efeitos adversos , Fenótipo , Valor Preditivo dos Testes , Resultado do Tratamento
3.
Nutrients ; 11(7)2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31340611

RESUMO

Milk proteins have been hypothesized to protect against type 2 diabetes (T2DM) by beneficially modulating glycemic response, predominantly in the postprandial status. This potential is, amongst others, attributed to the high content of whey proteins, which are commonly a product of cheese production. However, native whey has received substantial attention due to its higher leucine content, and its postprandial glycemic effect has not been assessed thus far in prediabetes. In the present study, the impact of a milk protein hydrolysate of native whey origin with alpha-glucosidase inhibiting properties was determined in prediabetics in a randomized, cross-over trial. Subjects received a single dose of placebo or low- or high-dosed milk protein hydrolysate prior to a challenge meal high in carbohydrates. Concentration-time curves of glucose and insulin were assessed. Incremental areas under the curve (iAUC) of glucose as the primary outcome were significantly reduced by low-dosed milk peptides compared to placebo (p = 0.0472), and a minor insulinotropic effect was seen. A longer intervention period with the low-dosed product did not strengthen glucose response but significantly reduced HbA1c values (p = 0.0244). In conclusion, the current milk protein hydrolysate of native whey origin has the potential to modulate postprandial hyperglycemia and hence may contribute in reducing the future risk of developing T2DM.


Assuntos
Glicemia/metabolismo , Suplementos Nutricionais , Inibidores de Glicosídeo Hidrolases/administração & dosagem , Proteínas do Leite/administração & dosagem , Período Pós-Prandial , Estado Pré-Diabético/dietoterapia , Hidrolisados de Proteína/administração & dosagem , Adulto , Idoso , Biomarcadores/sangue , Estudos Cross-Over , Suplementos Nutricionais/efeitos adversos , Método Duplo-Cego , Feminino , Alemanha , Hemoglobina A Glicada/metabolismo , Inibidores de Glicosídeo Hidrolases/efeitos adversos , Inibidores de Glicosídeo Hidrolases/metabolismo , Humanos , Insulina/sangue , Masculino , Pessoa de Meia-Idade , Proteínas do Leite/efeitos adversos , Proteínas do Leite/metabolismo , Estado Pré-Diabético/sangue , Estado Pré-Diabético/diagnóstico , Hidrolisados de Proteína/efeitos adversos , Hidrolisados de Proteína/metabolismo , Fatores de Tempo , Resultado do Tratamento
4.
Nutrients ; 11(6)2019 Jun 23.
Artigo em Inglês | MEDLINE | ID: mdl-31234587

RESUMO

The diurnal rhythm of bone remodeling suggests nocturnal dietary intervention to be most effective. This study investigated the effect of bedtime ingestion of a calcium-fortified, milk-derived protein matrix (MBPM) or maltodextrin (CON) on acute (0-4 h) blood and 24-h urinary change in biomarkers of bone remodeling in postmenopausal women with osteopenia. In CON, participants received 804 ± 52 mg calcium, 8.2 ± 3.2 µg vitamin D and 1.3 ± 0.2 g/kg BM protein per day. MBPM increased calcium intake to 1679 ± 196 mg, vitamin D to 9.2 ± 3.1 µg and protein to 1.6 ± 0.2 g/kg BM. Serum C-terminal cross-linked telopeptide of type I collagen (CTX) and procollagen type 1 amino-terminal propeptide (P1NP), and urinary N-telopeptide cross-links of type I collagen (NTX), pyridinoline (PYD) and deoxypyridinoline (DPD) was measured. Analyzed by AUC and compared to CON, a -32% lower CTX (p = 0.011, d = 0.83) and 24% (p = 0.52, d = 0.2) increase in P1NP was observed for MBPM. Mean total 24 h NTX excreted in MBPM was -10% (p = 0.035) lower than CON. Urinary PYD and DPD were unaffected by treatment. This study demonstrates the acute effects of bedtime ingestion of a calcium-fortified, milk-based protein matrix on bone remodeling.


Assuntos
Doenças Ósseas Metabólicas/dietoterapia , Remodelação Óssea , Cálcio na Dieta/administração & dosagem , Ritmo Circadiano , Suplementos Nutricionais , Alimentos Fortificados , Proteínas do Leite/administração & dosagem , Pós-Menopausa/sangue , Idoso , Biomarcadores/sangue , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/fisiopatologia , Cálcio na Dieta/efeitos adversos , Colágeno Tipo I/sangue , Suplementos Nutricionais/efeitos adversos , Feminino , Alimentos Fortificados/efeitos adversos , Humanos , Irlanda , Pessoa de Meia-Idade , Proteínas do Leite/efeitos adversos , Hormônio Paratireóideo/sangue , Fragmentos de Peptídeos/sangue , Peptídeos/sangue , Pró-Colágeno/sangue , Fatores de Tempo , Resultado do Tratamento , Vitamina D/administração & dosagem
5.
Nutrients ; 11(7)2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31248015

RESUMO

Allergy risk has become a significant public health issue with increasing prevalence. Exclusive breastfeeding is recommended for the first six months of life, but this recommendation is poorly adhered to in many parts of the world, including the Middle-East region, putting infants at risk of developing allergic sensitization and disorders. When breastfeeding is not possible or not adequate, a partially hydrolyzed whey formula (pHF-W) has shown proven benefits of preventing allergy, mainly atopic eczema, in children with a genetic risk. Therefore, besides stimulating breastfeeding, early identification of infants at risk for developing atopic disease and replacing commonly used formula based on intact cow milk protein (CMP) with a clinically proven pHF-W formula is of paramount importance for allergy prevention. If the child is affected by cow's milk protein allergy (CMPA), expert guidelines recommend extensively hydrolyzed formula (eHF), or an amino acid formula (AAF) in case of severe symptoms. The Middle-East region has a unique practice of utilizing pHF-W as a step-down between eHF or AAF and intact CMP, which could be of benefit. The region is very heterogeneous with different levels of clinical practice, and as allergic disorders may be seen by healthcare professionals of different specialties with different levels of expertise, there is a great variability in preventive and treatment approaches within the region itself. During a consensus meeting, a new approach was discussed and unanimously approved by all participants, introducing the use of pHF-W in the therapeutic management of CMPA. This novel approach could be of worldwide benefit.


Assuntos
Aminoácidos/administração & dosagem , Alimentação Artificial , Aleitamento Materno , Fórmulas Infantis , Hipersensibilidade a Leite/terapia , Proteínas do Leite/imunologia , Hidrolisados de Proteína/administração & dosagem , Aminoácidos/efeitos adversos , Aminoácidos/imunologia , Alimentação Artificial/efeitos adversos , Consenso , Humanos , Testes Imunológicos , Lactente , Fórmulas Infantis/efeitos adversos , Recém-Nascido , Oriente Médio/epidemiologia , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/efeitos adversos , Hidrolisados de Proteína/efeitos adversos , Hidrolisados de Proteína/imunologia , Fatores de Risco , Resultado do Tratamento
6.
Rev Alerg Mex ; 66(1): 123-127, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31013413

RESUMO

BACKGROUND: Allergy to cow's milk protein is a common problem in children. The clinical manifestations of the reactions that are mediated by IgE are varied and the anaphylactic reactions can be life-threatening. CLINICAL CASE: A girl at an age of four months and a half that, five minutes after consuming cereal with cow's milk, had rashes in the perioral area and extensive pruritic micropapular lesions associated with vomit and inspiratory stridor. She received adrenaline by intramuscular injection and antihistamines by intravenous injection. She was first evaluated in a service of allergy treatment when she was six months and twenty days old. The results of the allergen-specific immunoglobulin E test were positive. The treatment was initiated with a hydrolyzed rice formula and supplementary feeding. CONCLUSIONS: Anaphylaxis can be the first and last manifestation of a food allergy. The right education for parents about strictly avoiding the food that triggered the allergic reaction and the right training in the use of intramuscular adrenalin may result in a better prognosis for patients.


Assuntos
Anafilaxia/etiologia , Hipersensibilidade a Leite/complicações , Proteínas do Leite/efeitos adversos , Feminino , Humanos , Lactente
8.
Arch Pediatr ; 26(4): 238-246, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30979632

RESUMO

Foods for special medical purposes (FSMPs) with a protein fraction made of hydrolyzed rice protein (HRPs) have been on the market in Europe since the 2000s for the treatment of cow's milk protein allergy (CMPA). HRP formulas (HRPFs) are proposed as a plant-based alternative to cow's milk protein-based extensively hydrolyzed formulas (CMP-eHF) beside the soy protein formulas whose use in CMPA is controversial. HRPFs do not contain phytoestrogens and are derived from non-genetically modified rice. HRPFs are strictly plant-based apart from the addition of vitamin D3 (cholecalciferol). As the amino acid content of rice proteins differs from that of human milk proteins, the protein quality of these formulas is improved by supplementation with free lysine, threonine, and tryptophan. The consumption of HRPFs has risen: for example, in France HRPFs account for 4.9% in volume of all formulas for children aged 0-3 years. Several studies have shown the adequacy of HRPFs in treating CMPA. They ensure satisfactory growth from the 1st weeks of life for infants and toddlers, both in healthy children and in those with CMPA. HRPFs can be used to treat children with CMPA either straightaway or in second intention in cases of poor tolerance to CMP-eHF for organoleptic reasons or for lack of efficacy. In France, the cost of HRPFs is close to that of regular infant or follow-on formulas.


Assuntos
Fórmulas Infantis , Hipersensibilidade a Leite/dietoterapia , Oryza , Proteínas de Vegetais Comestíveis/administração & dosagem , Hidrolisados de Proteína/administração & dosagem , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/análise , Humanos , Lactente , Fórmulas Infantis/química , Lipídeos/administração & dosagem , Lipídeos/análise , Proteínas do Leite/efeitos adversos , Proteínas de Vegetais Comestíveis/análise , Hidrolisados de Proteína/análise
9.
Arch Pediatr ; 26(4): 226-231, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30885604

RESUMO

OBJECTIVES: This French multicenter, cross-sectional, observational study aimed to describe the family history of atopy in infants with cow's milk protein allergy (CMPA), and the related diagnostic approaches used by specialists in a real-life ambulatory setting. PATIENTS AND METHODS: In total, 1674 infants with suspected CMPA [median age 4.5 months (range: 0.1-18.0), males 54%] were enrolled in the study by 466 private physicians (pediatricians: 97%). Family history of atopy was defined as a known history of atopy in at least one first- (father, mother, and/or sibling) and/or second-degree relative (grandparents, uncles, and aunts), as reported by parents to physicians. RESULTS: Atopy in a first-degree relative was more common among infants with documented or high probability of CMPA (in 84% and 80% of cases, respectively, vs. the other subgroups, P=0.005). Most infants experienced digestive (92%) and skin (61%) symptoms suggestive of CMPA. Delayed reactions were reported in 64% of infants. According to a post-classification based on the results of previous diagnostic tests and procedures, 1133 infants (68%) had highly probable (52%) or documented CMPA (16%). In these infants, a history of atopy was reported in first- and/or second-degree relative(s) in 86% of cases (81% in first-degree relatives). Whatever the family history of atopy, the characteristics of the infants were similar, except for fewer pets in the case of negative family atopy (14% vs. 25%, P<0.001). Atopy in a parent was more frequent in infants who presented with the first signs suggestive of CMPA within the first 6 months of life vs. those with later first symptoms (75% vs. 65%, P=0.063). CONCLUSION: This French study confirms the high rate of family history of atopy in first-degree relatives of infants with probable or documented CMPA.


Assuntos
Predisposição Genética para Doença , Hipersensibilidade a Leite/etiologia , Proteínas do Leite/efeitos adversos , Animais , Estudos Transversais , Feminino , França/epidemiologia , Humanos , Hipersensibilidade Tardia/epidemiologia , Hipersensibilidade Tardia/etiologia , Lactente , Recém-Nascido , Masculino , Anamnese , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/epidemiologia
11.
Nutrition ; 57: 268-274, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30223233

RESUMO

OBJECTIVES: Guidance and evidence supporting routine use of partially hydrolyzed formula (pHF) versus intact cows' milk protein (CMP) formula are limited in non-exclusively breastfed infants. The aim of this review was to better clarify issues of routine use of pHF in non-exclusively breastfed infants who are not at risk for allergic disease by using a systematic review and Delphi Panel consensus. METHODS: A systematic review and Delphi consensus panel (consisting of eight8 international pediatric allergists and gastroenterologists) was conducted to evaluate evidence supporting growth, tolerability, and effectiveness of pHF in non-exclusively breastfed infants. RESULTS: None of the studies reviewed identified potential harm of pHF use compared with CMP in non-exclusively breastfed infants. There was an expert consensus that pHF use is likely as safe as intact CMP formula, given studies suggesting these have comparable nutritional parameters. No high-quality studies were identified evaluating the use of pHF to prevent allergic disease in non-exclusively breastfed infants who are not at risk for allergic disease (e.g., lacking a parental history of allergy). Limited data suggest that pHF use in non-exclusively breastfed infants may be associated with improved gastric emptying, decreased colic incidence, and other common functional gastrointestinal symptoms compared with CMP. However, because the data are of insufficient quality, the findings from these studies have to be taken with caution. No studies were identified that directly compared the different types of pHF, but there was an expert consensus that growth, allergenicity, tolerability, effectiveness, and clinical role among such pHF products may differ. CONCLUSIONS: Limited data exist evaluating routine use of pHFs in non-exclusively breastfed infants, with no contraindications identified in the systematic review. An expert consensus considers pHFs for which data were available to be as safe as CMP formula as growth is normal. The preventive effect on allergy of pHF in infants who are not at risk for allergic disease has been poorly studied. Cost of pHF versus starter formula with intact protein differs from country to country. However, further studies in larger populations are needed to clinically confirm the benefits of routine use of pHF in non-exclusively breastfed infants. These studies should also address potential consumer preference bias.


Assuntos
Fórmulas Infantis/química , Fenômenos Fisiológicos da Nutrição do Lactente/efeitos dos fármacos , Proteínas do Leite/farmacologia , Hidrolisados de Proteína/farmacologia , Animais , Aleitamento Materno , Bovinos , Consenso , Humanos , Hidrólise , Lactente , Fórmulas Infantis/efeitos adversos , Leite , Proteínas do Leite/efeitos adversos , Hidrolisados de Proteína/efeitos adversos
14.
Rev. esp. ped. (Ed. impr.) ; 74(1): 17-20, oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-179179

RESUMO

La eosinofilia en el recién nacido puede ser secundaria a múltiples etiologías. Presentamos el caso de un recién nacido que presentó eosinofilia severa, rectorragia y desmedro como manifestación de proctocolitis alérgica a proteínas de leche de vaca. Hacemos el diagnóstico diferencial de la eosinofilia en el período neonatal


Eosinophilia in newborn is caused for several causes. We presented a newborn who showed severe eosinofilia, rectorrhagia and lose weight due to allergic proctocolitis. We revised the differencial diagnosis of eosinophilia in newborn


Assuntos
Humanos , Masculino , Recém-Nascido , Eosinofilia/diagnóstico , Proctocolite/imunologia , Hipersensibilidade Alimentar/imunologia , Proteínas do Leite/efeitos adversos , Hipersensibilidade a Leite/imunologia , Hemorragia Gastrointestinal/etiologia
15.
An. pediatr. (2003. Ed. impr.) ; 89(4): 222-229, oct. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-177102

RESUMO

Introducción: La alergia alimentaria es un problema creciente, siendo la proteína de leche de vaca la principal causa en niños. Sin un proceso diagnóstico adecuado, existe un elevado riesgo de sobrediagnóstico e infradiagnóstico y, por lo tanto, de sobretratamiento e infratratamiento. El objetivo de nuestro estudio fue analizar la variabilidad en el manejo de la alergia a proteína de leche de vaca (APLV) por los gastroenterólogos pediátricos españoles. Métodos: Se envió un cuestionario de 50 preguntas a través de la lista de email de la Sociedad Española de Gastroenterología, Hepatología y Nutrición Pediátricas. Resultados: Recibimos 73 cuestionarios de los 321 enviados. Solo 3 de las respuestas lograron más del 90% de acuerdo. El 33% considera que la provocación oral es necesaria para el diagnóstico de APLV siempre. El 25% considera que la mejoría clínica tras la retirada de las proteínas de leche de vaca es suficiente para el diagnóstico. La provocación oral es realizada en domicilio por el 83,5% de los encuestados en APLV no IgE mediada. Los hidrolizados extensos de caseína son el tratamiento de elección (69,9%). Las fórmulas de soja, la última opción. Casi todos los encuestados conocían la existencia de guías de manejo de APLV, siendo las de la Sociedad Europea de Gastroenterología, Hepatología y Nutrición Pediátrica las más utilizadas (64,4%). El 23% considera que su conocimiento sobre alergia es inadecuado. Conclusiones: Aunque la APLV es una patología prevalente que los gastroenterólogos pediátricos llevan décadas tratando, hemos encontrado una gran variabilidad en su manejo. Existe posibilidad de mejora en este campo en el futuro


Introduction: Food allergy is an increasing health problem in the developed world. Cow's milk protein is the main cause of food allergy in infants. Without an appropriate diagnostic workup, there is a high risk of both over- and underdiagnosis and therefore, over and undertreatment. The objective of our study was to analyze the variability in cow's milk protein allergy (CMPA) management by pediatric gastroenterologists in Spain. Methods: A fifty item questionnaire, including open and closed items in a Likert's scale from 0 to 5, was drafted and distributed through the Spanish Society for Pediatric Gastroenterology, Hepatology and Nutrition (SEGHNP) e-mail list. Results: Seventy-three questionnaires were received back out of 321. Only 3 of the items achieved concordance greater than 90%. Thirty-three percent considered oral challenge to be necessary for the diagnosis of CMPA under any circumstance. Twenty-five percent considered that symptom improvement after cow's milk removal was enough for the diagnosis. Oral challenge was performed at home by 83.5% in non-IgE mediated cases. Extensively hydrolyzed casein formulas were the treatment of choice for 69.9%. Soy formulas were the last option. Almost all respondents were aware of the existence of clinical guidelines on CMPA, being European Society of Pediatric Gastroenterology, Hepatology and Nutrition guidelines the most followed (64.4%). Twenty-three percent considered that their knowledge about allergy was inadequate. Conclusions: Although CMPA is a prevalent condition that pediatric gastroenterologists have been treating for decades, we found a huge variability on its management. There is potential for improvement in this field among pediatric gastroenterologist in the future


Assuntos
Humanos , Lactente , Atitude do Pessoal de Saúde , Gastroenterologia , Hipersensibilidade a Leite/terapia , Proteínas do Leite/efeitos adversos , Padrões de Prática Médica , Hipersensibilidade a Leite/etiologia , Pesquisas sobre Serviços de Saúde , Inquéritos e Questionários
18.
J Int Med Res ; 46(12): 5099-5106, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30092694

RESUMO

OBJECTIVE: Cow's milk allergy is the most common food allergy in childhood. Changes occur in the protein structure of milk during yogurt fermentation. This study aimed to determine whether children who are diagnosed with a cow's milk allergy can tolerate yogurt. METHODS: We performed a yogurt challenge test on 34 children who were diagnosed with a cow's milk allergy in our Pediatric Allergy Outpatient Clinic. The mean age of 24 male and 10 female children was 24 ± 13 months. RESULTS: A reaction was observed in 17 (50%) patients, whereas no reaction was observed in the other 17 (50%) during an oral yogurt challenge test that was performed in all of the 34 patients with a cow's milk allergy. Cow's milk-specific immunoglobulin E levels were significantly lower in the group of children who could tolerate yogurt than in the group of children who could not tolerate yogurt. CONCLUSION: Yogurt is tolerated by half of children with a cow's milk allergy when subjected to a challenge test performed with yogurt, which is consumed as much as milk in Turkey.


Assuntos
Hipersensibilidade a Leite/prevenção & controle , Proteínas do Leite/efeitos adversos , Iogurte , Animais , Bovinos , Pré-Escolar , Feminino , Humanos , Imunoglobulina E/imunologia , Lactente , Masculino , Hipersensibilidade a Leite/epidemiologia , Hipersensibilidade a Leite/etiologia , Prevalência , Turquia/epidemiologia
19.
Rev Chil Pediatr ; 89(3): 310-317, 2018 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-29999135

RESUMO

Cow's milk protein allergy (CMPA) is a common disease with a prevalence of 2-7%, increasingly so. It is characterized by an allergic reaction to one or more cow's milk proteins. There are not pathog nomonic clinical symptoms, and these will depend on the type of immune reaction involved. A good diagnostic approach avoids under and over diagnosis and, therefore, under and over treatment. The CMPA treatment is the elimination of cow's milk protein from the diet. A restricted diet in a child does not require it or who has developed tolerance can alter growth, quality of life, including unne cessary costs. The objective of this review is to present the different milk formulas available in Chile to treat CMPA in those cases where breastfeeding with exclusion diet is not possible. For this purpose, nutritional composition, ingredients and other relevant characteristics of all the milk formulas and juices marketed in Chile as CMPA treatment were reviewed. The information was obtained from the official distributors or sellers or failing that, from the official websites. There are multiple milk formulas and beverages used for the treatment of CMPA, and not all of them are nutritionally or immunologically secure. Knowing them in detail will help the pediatrician to indicate them in a more informed way according to their benefits and their deficiencies for the proper management of this pathology.


Assuntos
Fórmulas Infantis , Hipersensibilidade a Leite/dietoterapia , Proteínas do Leite/efeitos adversos , Aleitamento Materno , Humanos , Lactente , Fórmulas Infantis/química , Recém-Nascido , Hipersensibilidade a Leite/diagnóstico , Hipersensibilidade a Leite/imunologia , Proteínas do Leite/imunologia , Resultado do Tratamento
20.
Arch. argent. pediatr ; 116(3): 219-223, jun. 2018. graf, tab
Artigo em Inglês, Espanhol | LILACS, BINACIS | ID: biblio-1038424

RESUMO

La alergia a la proteína de la leche de vaca (APLV) es la alergia alimentaria más frecuente en pediatría. Existen pocos estudios que han evaluado la prevalencia de esta enfermedad en Argentina. Objetivos. Estimar la prevalencia de la APLV y describir su variación durante un período de 11 años. Pacientes y métodos. Se realizó un estudio de cohorte retrospectivo en recién nacidos vivos pertenecientes al programa de atención médica de un hospital universitario de comunidad. Resultados. Se identificaron 116 casos de niños con APLV. La prevalencia acumulada fue de 0,8% (intervalo de confianza -le- 95%: 0,65-0,95). Se observó un incremento porcentual de casos por año, de 0,4% en 2004 a 1,2% en 2014. Conclusión. La prevalencia de APLV fue del 1,2% en 2014, tres veces superior a la prevalencia en 2004.


Cow's milk protein allergy (CMPA) is the most common food allergy in pediatrics. In Argentina, the prevalence of this dis-ease has been evaluated in a few trials.Objectives. To estimate the prevalence of CMPA and describe its variation throughout a period of 11 years.Population and methods. A retrospective cohort study was carried out in live newborn infants enrolled in a health care program of a university community hospital.Results. One hundred and sixteen cases of children with CMPA were identified. Cumulative prevalence was 0.8% (95% confi-dence interval [CI]: 0.65-0.95). A percent increase of 0.4% in 2004 to 1.2% in 2014 was observed in the number of cases per year.Conclusion. In 2014, CMPA prevalence was 1.2%, i.e. three times that of 2004.


Assuntos
Humanos , Recém-Nascido , Recém-Nascido , Prevalência , Substitutos do Leite Humano , Hipersensibilidade Alimentar , Proteínas do Leite/efeitos adversos
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