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Background: Oral food challenges (OFCs) are used to confirm or reject a diagnosis of food allergy. However, younger children may encounter difficulties in consuming all offered doses during an OFC in the absence of symptoms, resulting in inconclusive outcomes. Our aim is to assess the eliciting dose for objective symptoms among various age groups and determine the necessity of consuming the final dose step during an uneventful OFC to avoid false negative outcomes. Methods: OFCs for common food allergens performed between 2012 and 2019 were analyzed retrospectively. The primary outcome was the association of age with stop dose for OFCs with inconclusive outcome. Secondary outcome measures were the association of age with eliciting dose and the potential number of false negative outcomes. Results: A total of 1327 OFCs were performed in 707 patients. Of these, 514 (38.7%) were positive, 589 (44.4%) negative, and 224 (16.9%) inconclusive. In OFCs with inconclusive outcome, age appeared to be a significant predictor of the stop dose only for almond (p =.005). Objective symptoms occurred after the last dose step in 2%–13% of all OFCs with positive outcome. In our cohort, potential false negative outcomes may have been drawn in 27.6% of uneventful OFCs. Conclusions: Two third of children under 6 years of age successfully consumed all the provided doses during OFCs with a negative outcome. The eliciting dose for objective symptoms was not associated with age, and in a substantial number of OFCs with positive outcome, symptoms occurred after eating the final dose. These findings suggest that in case of an uneventful OFC, the outcome should be drawn only after a cumulative dose of 4.4 g has been consumed to avoid the risk of a potential false negative outcome. Key points: Younger children may encounter difficulties in consuming all doses during an oral food challenge (OFC).Symptoms occur after the final dose in a substantial number of patients, irrespective of age.The final outcome of uneventful OFCs should be drawn after all doses have been consumed. [ABSTRACT FROM AUTHOR]

Keywords: biomarker; children; diagnostic; food allergy; histamine; oral food challenge; tryptase EN biomarker children diagnostic food allergy histamine oral food challenge tryptase 883 886 4 08/14/23 20230801 NES 230801 Key messages Histamine and methylhistamine can be detected in saliva Histamine concentrations increased in 9/13 positive and 2/6 negative food challenges Collection of saliva using the passive drooling method was not suitable for the determination of tryptase DATA AVAILABILITY STATEMENT The data that support the findings of this study are available from the corresponding author upon reasonable request. *p-value <.001. gl Delta histamine values were calculated by the subtraction of salivary histamine concentration of the sample collected 30 min after the last dose had been eaten (T SB 30 sb ) with salivary concentration of the baseline sample. Delta histamine values of saliva samples collected on verum days (i.e. allergen administered) showed an increase of histamine concentration in 9/13 positive and 2/6 negative DBPCFCs ( I p i = .114). Solitary objective symptoms were reported once, solitary subjective symptoms occurred during two challenges and in all other cases both objective and subjective symptoms occurred. [Extracted from the article]

Background: Oral food challenge (OFC) is commonly used to diagnose food allergy. This test is time and resource intensive, and conclusions are not always unequivocal as this relies on the interpretation of symptoms. Therefore, an objective marker would improve the accuracy of the diagnostic workup of food allergy. Objectives: The aim of this study was to investigate whether tryptase can be detected in saliva of children following OFC. Method: Children from 3 to 18 years of age were eligible for inclusion if an OFC for peanut or tree nut had been recommended. Saliva samples were collected prior to the first dose and 5, 10, and 15 min following the last administered dose during OFC. Assay precision, spike-and-recovery, and assessment of lower limit of detection of the tryptase immunoassay were examined before analysis of tryptase in saliva was performed. Results: A total of 30 children were included (median age 8 years, 63.3% male, 53.3% positive OFC outcome). Tryptase was detected in saliva samples. The mean of the change in baseline tryptase value to each saliva collecting time point was significantly different in patients with a positive OFC outcome compared to a negative outcome (p < 0.01). Conclusions: This study showed that tryptase can be detected in saliva of children following OFC. Increased levels of tryptase compared to baseline were found if the OFC outcome was positive, suggesting that measuring tryptase in saliva may be useful in the diagnosis of food allergy. Further research is needed to evaluate the potential association between tryptase levels and symptoms. [ABSTRACT FROM AUTHOR]

Low health-related quality of life is associated with declining home introduction of suspected food allergens The number of food allergens advised to introduce at home, was not found to be a confounder of the association between HRQL and parental decision. Further research is needed to determine whether HRQL measurements could contribute to a higher success rate of the introduction of potential food allergens at home. Keywords: children; diagnostic; food allergy; introduction; quality of life EN children diagnostic food allergy introduction quality of life 201 204 4 01/05/22 20220101 NES 220101 Key Messages One-third of parents did not follow advice to introduce food allergens to their child at home Low quality of life scores were associated with not following advice to introduce food allergens Multivariate analysis did not confirm this; other factors such as food relevance may be important I To the Editor, i Food allergy should be adequately diagnosed or excluded to avoid anxiety and unnecessary elimination of foods.1,2 Mothers who suspect their child to be food allergic appeared to be more anxious and eliminated (multiple) foods unnecessarily.3 Furthermore, peanut-allergic children avoided tree nuts even when this food was proven to be safe or had been eaten before without symptoms.4 We recommend to gradually introduce the food at home following a standardized schedule for children who are referred due to suspected food allergy but deemed tolerant (i.e. very low probability of food allergy based on medical and dietary history) for a specific food. [Extracted from the article]

Background: Participation in voluntary work may be associated with individual and societal benefits. Because of these benefits and as a result of challenges faced by governments related to population ageing, voluntary work becomes more important for society, and policy measures are aimed at increasing participation rates. In order to effectively identify potential volunteers, insight in the determinants of volunteering is needed. Therefore, we conducted a systematic review including meta-analyses.Methods: A systematic search in MEDLINE, PsycINFO, SocINDEX, Business Source Premier, and EconLit was performed on August 12th 2015. We included longitudinal cohort studies conducted in developed countries that quantified factors associated with volunteering among samples from the general adult population. Two reviewers independently selected eligible studies, extracted the data and assessed the risk of bias of the included studies using the QUIPS tool. Estimates reported in the papers were transformed into Odds Ratios and 95% Confidence Intervals. For each determinant, random-effects meta-analyses were used to generate summary estimates.Results: We found that socioeconomic status, being married, social network size, church attendance and previous volunteer experiences are positively associated with volunteering. Age, functional limitations and transitions into parenthood were found to be inversely related to volunteering.Conclusions: Important key factors have been identified as well as gaps in the current literature. Future research should be directed towards deepening the knowledge on the associations between the factors age, education, income, employment and participation in voluntary work. Moreover, major life course transitions should be studied in relation to volunteering. [ABSTRACT FROM AUTHOR]