Differences in Self-Reported Food Allergy and Food-Associated Anaphylaxis by Race and Ethnicity Among SAPPHIRE Cohort Participants

The impact of the COVID-19 pandemic on multicultural families with food allergy

Background

Families with food allergy, in particular, have faced numerous challenges, often in the setting of financial and emotional stress during the coronavirus disease 2029 (COVID-19) pandemic.

Objective

We examined the impact of the pandemic in a diverse population of families with food allergy.

Methods

An online survey was administered between October 2020 and January 2021 through recruitment of adult caregivers of at least 1 child with food allergy. Survey responses were summarized by frequencies with proportions and medians with interquartile ranges or means plus or minus SDs.

Results

Of the 307 individuals who completed questionnaires, 96% were female and 4% were male, with 24% classified as African American, Hispanic or Latinx, Asian, or "other." Of the respondents, 52% experienced a decrease in household income during the pandemic. Financial stress (P < .001) and lack of access to allergen-free foods (P = .032) was seen in significantly more caregivers with an income less than $200,000. Of the respondents, 76% experienced increased stress or discord within the home. Although becoming a member of a food allergy support group increased over time, significantly fewer African American respondents were members of a support group. The hospitalization rate for COVID-19 did not differ significantly between racial/ethnic groups.

Conclusion

Our questionnaire has characterized the significant impact of economic as well as psychological stressors of the pandemic in a diverse population. Further studies on this topic are needed to help minimize the impact of future pandemics in a multicultural population.

Barriers and Enablers of Dietary Reintroduction Following Negative Oral Food Challenge: A Scoping Review

BACKGROUND

After a negative oral food challenge (OFC), it is recommended for the individual to continue to consume the historical allergen regularly. However, the proportions of families achieving sustained reintroduction, and enablers and barriers for reintroduction, are currently unclear.

OBJECTIVE

To understand the frequency and definitions of optimal food reintroduction in children and adolescents after a negative OFC, and associated barriers and enablers.

METHOD

We conducted a scoping review guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews of four databases (PubMed, Embase, CINAHL, and Web of Science) from 2000 until the present. Medical Subject Headings guided our systematic search, and dual screening and extraction were performed. We applied descriptive analysis to examine key themes aligned with our research questions.

RESULTS

In total, 2,270 articles were screened and 22 studies were included across nine countries. Peanuts were the most studied food (17 studies; 749 OFCs), followed by cow's milk (12 studies; 625 OFCs), hazelnut (four studies; 361 OFCs) and hen's egg (11 studies; 340 OFCs). What was considered to be a successful reintroduction was poorly and inconsistently described. Successful reintroduction (as defined by the authors) ranged from 14% to 86%, with failed reintroduction up to 50%. Nineteen studies (86%) examined barriers or enablers of reintroduction. Primary barriers were fear and anxiety as well as symptoms with reintroduction and aversion to or refusal of the food, whereas younger age, male sex, and guidance from clinicians were commonly reported enablers.

CONCLUSION

The number of families who do not reintroduce foods after OFC remains high, and clinicians need high-quality data to support families better.

Histopathological, Cytological and Radiological Correlations in Allergy and Public Health Concerns: A Comprehensive Review

Allergies represent a significant and growing public health concern, affecting millions worldwide and burdening healthcare systems substantially. Accurate diagnosis and understanding of allergy is crucial for effective management and treatment. This review aims to explore the historical evolution, current advances, and prospects of histopathological and cytological techniques in allergy diagnosis, highlighting their crucial role in modern medicine. Major biomedical, public health, and imaging databases such as PubMed, Scopus, Web of Science, and EMBASE were used. The search strategy used include specific keywords and Medical Subject Headings (MeSH) terms related to histopathology, cytology, radiology, allergic diseases, and public health. Histopathological and cytological studies play a pivotal role in elucidating the underlying mechanisms of allergies, offering insights into the cellular and tissue-level changes associated with allergic responses. Histopathology reveals characteristic features such as inflammation, tissue remodeling, and the presence of specific immune cells like eosinophils and mast cells. Cytological analysis can detect cellular changes and abnormalities at a finer scale, providing a complementary perspective to histopathological findings. The correlation between histopathological and cytological findings is critical for achieving accurate and reliable diagnoses. Combined histopathological and cytological studies can reveal the extent of airway inflammation, epithelial damage, and immune cell infiltration, providing a robust basis for clinical decision-making. Recent advancements in diagnostic techniques have further revolutionized the field of allergy diagnosis. These technologies offer increased accuracy, speed, and reproducibility, making them invaluable in both clinical and research settings. Despite these advancements, several challenges and limitations persist. By integrating tissue-level and cellular-level analyses, clinicians can achieve more accurate diagnoses, tailor treatments to individual patients, and ultimately improve the quality of care for those suffering from allergies. In conclusion, histopathological and cytological correlation in allergy diagnosis provides a comprehensive framework for understanding and managing allergic conditions.

Health disparities in allergic diseases

PURPOSE OF REVIEW

Healthcare disparities impact prevalence, diagnosis, and management of allergic disease. The purpose of this review is to highlight the most recent evidence of healthcare disparities in allergic conditions to provide healthcare providers with better understanding of the factors contributing to disparities and to provide potential management approaches to address them. This review comes at a time in medicine where it is well documented that disparities exist, but we seek to answer the Why , How and What to do next?

RECENT FINDINGS

The literature highlights the socioeconomic factors at play including race/ ethnicity, neighborhood, insurance status and income. Management strategies have been implemented with the hopes of mitigating the disparate health outcomes including utilization of school-based health, distribution of educational tools and more inclusive research recruitment.

SUMMARY

The studies included describe the associations between upstream structural and social factors with downstream outcomes and provide ideas that can be recreated at other institutions of how to address them. Focus on research and strategies to mitigate healthcare disparities and improve diverse research participant pools are necessary to improve patient outcomes in the future.