The relevance of oral food challenge in a patient allergic to peanut and tree nuts.

Peanut allergy is one of the most common food allergies in childhood. In vitro cross-sensitization between peanut and tree nuts (TN) is high, but only a subgroup of patients allergic to peanut will have a concomitant allergy to one or several TN. In this article, the authors report a case of a 12-year-old boy who experienced 1 episode of lips and mouth itching, generalized urticarial, and eyelid angioedema 20 minutes after ingestion of peanut at 4 years of age. The immunoallergological study revealed the presence of a concomitant allergy to peanut, pistachio, and cashew confirmed with medically supervised oral food challenges (OFC) in a child who had never eaten these TN. The mechanism of IgE-mediated hypersensitivity was demonstrated by positive skin prick tests (SPT) with commercial extracts, although the specific IgE (sIgE) for these foods was negative. As described in the literature, we concluded that serum peanut and TN sIgE measurements have lower sensitivity than SPT to assess IgE sensitization, and OFC is the gold standard for accurate diagnosis of food allergy. We highlight the relevance of excluding or confirming TN allergy in a peanut-allergic patient who had never ingested certain TN, and of knowing the clinical relevant cross-reactivity patterns between TN, pistachio/cashew, and walnut/pecan, that could reduce the need for OFC in clinical practice, reducing allergy rates and financial and health burdens of food allergy.

Correction: Macauba (Acrocomia aculeata) kernel has good protein quality and improves the lipid profile and short chain fatty acids content in Wistar rats.

Correction for 'Macauba (Acrocomia aculeata) kernel has good protein quality and improves the lipid profile and short chain fatty acids content in Wistar rats' by Fátima Ladeira Mendes Duarte et al., Food Funct., 2022, 13, 11342-11352, https://doi.org/10.1039/D2FO02047E.

Macauba (Acrocomia aculeata) kernel has good protein quality and improves the lipid profile and short chain fatty acids content in Wistar rats.

Macauba (Acrocomia aculeata) has aroused interest in the food industry due to the high nutritional value of its fruits. This study aimed to evaluate the protein quality and influence on biochemical markers, short chain fatty acids content, intestinal morphology, and intestinal functionality in Wistar rats of macauba kernel. Male young rats were divided into three groups (n = 8) that received a control diet (casein), and two test diets (M30: 30% semi-defatted macauba kernel flour or M50: 50% semi-defatted macauba kernel flour) for 29 days. Protein Efficiency Ratio (PER), Net Protein Ratio (NPR), True Digestibility (TD), biochemical, and intestinal morphology and functionality markers were evaluated. The PER and NPR values were lower in test groups compared to the control group. TD did not differ between M30 and M50. The animals that were fed the macauba kernel flour had lower concentrations of total cholesterol and triglycerides compared to the control group. The concentration of acetic and propionic acids was higher and the fecal pH was lower in M30 and M50 groups compared to the control group. Gene expression of aminopeptidase (AP) and sodium-glucose transport protein 1 (SGLT1) did not differ among the groups, and the M50 group had lower expression of peptide transporter 1 (PepT1) and sucrase isomaltase (SI) than the control group. Crypts thickness was higher in the M50 group compared to the other groups, while the intestinal muscle layer width did not differ among groups. Therefore, macauba kernel flour proved to be a good plant protein alternative, and its consumption reduced blood lipids and increased short chain fatty acids content.

Multiple food allergy - unexpected culprits.

Food allergy has an estimated prevalence of 6%-8% in children. Meat allergy and multiple food allergy due to sensitization to cross-reactive components in infancy is, however, less frequent. A 5-year-old girl was referred to our department with a multiple food allergy history. She had severe immediate worsening of her atopic dermatitis with hen's egg (6 months) and cow's milk introduction (7 months). At the age of 9 months, she presented with recurrent and reproducible atopic dermatitis' worsening and lip edema with the introduction of different meats (chicken, turkey, cow, pork, and rabbit), having the same complaints with fish at 12 months (salmon and hake). At her first appointment she was avoiding hen's egg, cow's milk, meat, and fish (except fresh tuna, codfish, and pollock). We performed skin prick tests (commercial extract and prick-to-prick with whole food) and specific IgE, which revealed sensitization to hen's egg, raw meat (cow, pork, chicken, turkey, duck, lamb, goat, and rabbit; negative for cooked meat), codfish and cow's milk (mild). ISAC was performed, revealing sensitization to 3 cross-reactive components (serum albumins Bosd6, Canf3, and Feld2) and specific food components of chicken's egg/meat (Gald1, 2, 3, and 5), cod (Gadc1), hazelnut (Cora9), and kiwi (Actd1). We present a rare case of multiple food allergy in infancy, where sensitization to cross-reactive components was responsible for most of the children complaints. The detection of serum albumins' involvement was especially important, because it can possibly mean tolerance to these foods in well-cooked forms, substantially improving patient and family's quality of life.

Anaphylaxis caused by honey: a case report.

Honey allergy is a very rare, but serious health condition. In this study, we presented 1 patient who had anaphylaxis after the honey allergological investigation with skin prick-prick test with honey. Honey as a food has been associated to allergic reactions and as the increased consumption of honey in health food may increase the incidence of honey-related allergic reactions.

Sorghum, germinated millet and chia cookies: development, chemical composition and sensory analysis

The objective of this work was to develop cookies using sorghum, germinated millet and chia flours. Four formulations (F) were used: F-sorghum (100% sorghum flour); F-Sorghum + chia (50% sorghum flour and 50% chia flour), F-millet (100% millet flour) and F-millet + chia (50% millet flour and 50% chia flour). The germinated millet flour was submitted to microbiological analysis. All cookies were evaluated in relation to chemical and sensory analyses, according to AOAC and hedonic nine-point scale, respectively. The statistical analysis was performed by the variance analysis and Tukey test at 5% probability. The F-millet formulation showed the least humidity content (4.59 ± 0.25g/100g), while chia containing cookies showed lesser concentrations of carbohydrates (F-sorghum + chia: 44.35 ± 4.34g/100g and F-millet + chia: 41.03 ± 1.40g/100g) and higher ash content (F-sorghum + chia: 3.80 ± 0.02g/100g and F-millet + chia: 3.42 ± 0.24g/100g) and of protein (F-sorghum + chia: 15.38 ± 0.44 g/100g and F-millet + chia: 18.06 ± 0.53 g/100g). The caloric value and the lipids content did not differ among formulations. The sensory analysis had 57 evaluators. The cookies produced with chia and germinated millet had higher rates for flavor, texture and general impression. In general, all tested biscuits had good sensory acceptance and nutritional quality being an alternative to increase the consumption of bioactive compounds and antioxidants(AU)

El objetivo fue desarrollar galletas utilizando harina de sorgo, mijo germinado y chía. Se utilizaron cuatro formulaciones (F): F-sorgo (100% harina de sorgo); Sorgo F + chía (50% harina de sorgo y 50% harina de chía), mijo F (100% harina de mijo) y mijo F + chía (50% harina de mijo y 50% harina de chía). La harina de mijo germinada se sometió a análisis microbiológico. Las galletas fueron sometidas a análisis químico y sensorial, según la AOAC y una escala hedónica de nueve puntos, respectivamente. El análisis estadístico se realizó mediante análisis de varianza y prueba de Tukey al 5% de probabilidad. La formulación F-mijo tuvo menor contenido de humedad (4,59 ± 0,25 g/100g), mientras que las galletas que contenían chía tuvieron concentraciones más bajas de carbohidratos (F-sorgo + chía: 44,35 ± 4,34 g/100g y F-mijo + chía: 41,03 ± 1,40 g / 100g), mayor contenido de cenizas (F-sorgo + chía: 3,80 ± 0,02 g/100g y F-mijo + chía: 3,42 ± 0,24 g/100g) y proteínas (F-sorgo + chía: 15,38 ± 0,44 g/100g y F mijo + chía: 18,06 ± 0,53 g/100g). El valor calórico y el contenido de lípidos no difirieron entre las formulaciones. El análisis sensorial contó con 57 evaluadores. Las galletas producidas con chía y mijo germinado tenían notas más altas de sabor, textura e impresión general. Las galletas testadas tuvieron buena aceptación sensorial y calidad nutricional, siendo una alternativa para incrementar el consumo de compuestos bioactivos y antioxidantes(AU)

Esofagite eosinofílica numa consulta de alergia alimentar: caracterização e comparação entre idade pediátrica e idade adulta / Eosinophilic esophagitis at a food allergy appointment: characterization and comparison between pediatric and adult ages

Introdução: Esofagite eosinofílica (EoE) é uma doença inflamatória crônica do esôfago, mediada imunologicamente e caracterizada por sintomas relacionados com disfunção esofágica e infiltração da mucosa esofágica por eosinófilos (Eo). Os objetivos foram caracterizar os doentes com diagnóstico de EoE e analisar as diferenças entre doentes com diagnóstico em idade pediátrica (Cr, < 18 anos) e adulta (Ad, ≥ 18 anos). Métodos: Estudo observacional retrospetivo dos doentes seguidos no serviço de Imunoalergologia, no período de Fev/2009 a Jul/2017, com diagnóstico de EoE. Foram divididos em dois grupos, Cr e Ad, caracterizados de acordo com dados demográficos, história de atopia, sintomas, sensibilizações alimentares, IgE Total, eosinofilia, achados na endoscopia digestiva alta e biópsias. Avaliou-se a correlação entre sensibilização alimentar, clínica grave (ClinG), ou seja, idas ao serviço de urgência ou internamento por complicações de EoE ou histologia grave (HistG), biópsia com Eo > 50 e/ou microabcessos. Resultados: 74 pacientes (81% sexo masculino, média de idades 27±17 anos), 36 Cr e 38 Ad. Os sintomas mais frequentemente reportados foram, no grupo Cr disfagia (73%) e refluxo gastroesofágico (46%), enquanto no grupo Ad impactação (85%) e disfagia (56%). Foram referidos antecedentes de atopia em 96% das Cr, e 67% dos Ad. Em 77% das Cr e 69% dos Ad havia sensibilização alimentar. Os achados endoscópicos mais frequentes no grupo Cr foram estriação (65%) e placas brancas (50%), enquanto que no grupo Ad foram placas brancas (42%) e anéis esofágicos (35%). HistG (46%) associou-se a ClinG (35%), p = 0,001, nas Cr, mas o mesmo não foi objetivado no grupo Ad [ClinG (22%) e HistG (17%), p = 0,5]. Conclusão: Os nossos resultados estão de acordo com o descrito na literatura, observando-se um predomínio do sexo masculino e uma maior frequência de história de atopia e sensibilização alimentar no grupo Cr. As situações graves de impactação e estenose esofágica foram mais frequentes nos Ad, e objetivou-se uma associação de histologia grave com clínica grave, apenas nas Cr.

Background: Eosinophilic esophagitis (EoE) is an immunologically mediated chronic inflammatory disease of the esophagus characterized by symptoms related to esophageal dysfunction and eosinophilic infiltration in the esophageal mucosa. This study aimed to characterize patients with a diagnosis of EoE and analyze differences between patients with EoE diagnosed at pediatric age (Ch, <18 years) and at adult age (Ad, ≥18 years). Methods: This was a retrospective study of patients with a diagnosis of EoE who were followed in the immunoallergology department from February 2009 to July 2017. Patients were divided into Ch and Ad groups and characterized according to demographic data, history of atopy, symptoms, food sensitization, total IgE, eosinophils (Eo), upper digestive endoscopy (UDE) findings, and biopsy findings. Correlations were assessed between food sensitization, clinical severity (SClin; determined by number of ER visits or hospital admissions for EoE complications), and severe histology (SHist; defined as biopsy with Eo >50 and/or microabscesses). Results: 74 patients (81% male, mean age 27±17 years), 36 Ch and 38 Ad. The most commonly reported symptoms were dysphagia (73%) and gastroesophageal reflux (46%) in the Ch group, and impaction (85%) and dysphagia (56%) in the Ad group. History of atopy was reported in 96% of Ch vs 67% of Ad. Food sensitization was found in 77% of Ch vs 69% of Ad. The most common UDE findings were striation (65%) and white plaques (50%) in the Ch group, and white plaques (42%) and esophageal rings (35%) in the Ad group. SHist (46%) was associated with SClin (35%) in Ch (p=0.001), but not in Ad (SClin [22%] and SHist [17%], p=0.5). Conclusion: Our results are consistent with those reported in the literature, with a male predominance and a higher prevalence of atopy and food sensitization in Ch. Severe impaction and esophageal stenosis were more frequent in Ad, but an association between SHist and SClin was found only in Ch.

El programa de salud del adolescente del Estado de São Paulo / The adolescent health program of Sao Paulo State

El Programa de Salud del Adolescente del Estado de São Paulo tiene por objetivo la implementación e implementación de una política pública universal de juventud en el área de salud, con servicio integral y gratuito para jóvenes de ambos sexos, de 10 a 20 años de edad. Tiene como objetivo el desarrollo de actividades para promover, proteger, recobrar y rehabilitar la salud integral del adolescente, con provisión de habilidades para la vida, autoestima, juicio crítico, creatividad, disminución de las diferencias de género, salud reproductiva y sexual, ética, equidad, derechos humanos, poder de decisión de vida y salud, estilos de vida saludables, planes de vida, jóvenes y adolescentes multiplicadores, conquista de derechos y ejercicio de ciudadanía. Serán presentados un resumen de las actividades desarrolladas desde 1987, en un total de 21 millones de servicios realizados en 2012, por equipos multiprofesionales e interdisciplinarios en 31 Casas de Adolescentes del Estado de São Paulo. Resultados exitosos como la reducción de la primera gestación en un 34% de las adolescentes, y en 18,2% para adolescentes gestantes entre 10-14 años de edad, entre 1998 y 2013, sin muertes durante la gestación y parto en esta franja etaria, y 68% de alumbramientos vaginales y 32% de cesáreas para el año de 2013. Reducción del segundo embarazo en un 47%, además de la disminución de la mortalidad infantil de hijos de madres adolescentes. Otros datos son presentados, inclusive la capacitación de 11.567 profesionales de diversas áreas en las atenciones de salud y atención primaria de adolescentes. Se demuestra así un impacto importante y como modelo de política pública en el mejoramiento de las condiciones de salud y prevención de los problemas de salud durante la fase de adolescencia(AU)

The Adolescent Health Program of São Paulo State Program aims to implement and development of a universal public youth politic in the health area, with total and free service for youth of both of sex, from 10 to 20 years old. It aims to develop activities for to promote, to protect, recover and rehabilitate the comprehensive health of adolescents, with provision of life skills, self-esteem, critical thinking, creativity, reduced gender differences, reproductive and sexual health, ethics, equity, human rights, empowerment of life and health, healthy lifestyles, life plans, young people and adolescents multipliers, conquest and exercise of citizenship rights. It will be present a summary of the activities developed since 1987 in a total of 21 million services performed in 2012, for multidisciplinary and interdisciplinary teams in 31 Adolescents houses of São Paulo. Successful results as reducing the first pregnancy by 34% of adolescents, and 18.2% for pregnant adolescents between 10-14 years of age between 1998 and 2013; no deaths during pregnancy and childbirth in this age group, and 68% of vaginal childbirth and 32% cesarean childbirth in the year of 2013. Then, reduction of 47% in the second pregnancy, addition to the reduction of infant mortality in children of teenagers mothers. Other data are presented, including the training of 11.567 professionals in many areas of health care and primary care for adolescents. It shows like an impact model of public politics in improving health conditions on preventing health problems during the adolescence phase(AU)

Comportamiento del niño en el consultorio odontológico / Child behavior in the dental office

La investigación se estableció en explicar el comportamiento del niño en el consultorio odontológico sobre la base de condicionantes innatas y las que derivan del entorno social. Acorde con el propósito se observaron en 90 niños entre 3 y 8 años de edad, las expresiones de colaboración, agresividad y miedo, correlacionándolas con características intrínsecas y otras que derivan del medio ambiente social. La prueba Chi Cuadrado fue aplicada a las Hipótesis Nula (Ho) formuladas y los valores obtenidos permitieron verificar relación entre las variables características físico ambientales de los consultorios odontológicos, género, edad y percepción de los padres y representantes de la primera experiencia odontológica del niño con el miedo observado en la sala clínica. Se concluyó que el miedo y la baja colaboración, son las formas de comportamiento a través de las cuales los sujetos observados expresaron su temor al acto odontológico