calendar of events: - The Childrens Asthma and Allergy Network
Transcription
calendar of events: - The Childrens Asthma and Allergy Network
calendar of events: Date 29 August 2009 Saturday 1.30pm-3.30pm th ( Registration starts @ 1pm) Event “ I CAN !” Public Symposium Program Highlights: • Boosting my child’s immunity for school • Asthma & Sports • What can I do about my child’s frequent sneezing in school? The Children’s Asthma and Allergy Network @ University Children’s Medical Institute Venue Remarks Toa Payoh HDB Hub Auditorium *Pre-registration & prior payment required. Closing date: 21st August 2009 *Registration fee: $6 per person / $8 per couple -Free registration for “I CAN !” members and staff of NUHS & NUS only. -50% off registration fee for members of Abbott Family, NTUC U Family, staff of NTU, MOE & healthcare professionals. + No admission for children below 6 years old. * Details of the events are correct at the time of print. Please look out for more information through this channel or www. ican.com.sg nearer the event date. # For more details or registration, pls call 6772 5566, fax 6772 4453 or email: [email protected] Newsletter Some babies are allergic to cow’s milk. Fortunately, there’s a solution. MICA (P)061/11/2008 | JULY 09 The role of Food Allergy in children with Eczema Prof Hugo Van Bever, Department of Paediatrics, University Children’s Medical Institute, NUH Your family’s combined allergy history determines your baby’s risk. Reduction in incidence of atopic dermatitis in high-risk infants at 6 years 6 Incidence (%) 50 36% 40 30 39.1 Relative Risk Reduction 27.4 20 10 Isomil® 2 Advance® Follow-on Formula, Singapore Mothers’ No.1 Choice* of milk alternative with the goodness of milk. • While a family history of allergy increases an infant’s allergy risk, many infants without a family history go on to develop allergy. 1-3 • This has led experts to consider broader use of allergy prevention strategies, most notably a hypoallergenic formula for bottle-fed infants. 1-3 4 • The latest data confirm the long-term (until six years of age) allergy preventive effect of NAN HA, particularly against atopic dermatitis. ® • NAN HA now also contains BL BIFIDUS, live probiotics that enhance the intestinal microbiota, which has been proven to help reduce the incidence of allergy. forms in a baby. Skin rashes, wheezing, 5 NAN HA ® 6,7 the common symptoms. Fortunately there’s a NEW solution for babies who suffer from cow’s milk Based on cumulative incidence at 6 years of age. High-risk infants were exclusively fed the study formulas between birth and four months of age. All reductions statistically significant. and 100% free of cow’s milk protein. Nestlé Nutrition – Our vision is to help enhance quality of life by supporting health and providing care for consumers with special needs at every stage of life through science-based nutrition products and services. References: 1. Whan U, Chuchalin A, Kowalski ML. Chem Immunol Allergy (Karger, Basel) 2004; 84: 128-134. 2. Exl B-M, Deland U, Secretin M-C et al. Eur J Nutr 2000; 39: 145-156. 3. Hayes T, Wood RA. Arch Pediatr Adolesc Med 2005; 159: 810-816. 4. Australasian Society of Clinical Immunology and Allergy. Infant Feeding Advice, September 2008. Accessed online 05/05/09: www. allergy.org.au/content/view/350/287/ 5. von Berg A, Filipiak-Pittroff B, Krämer U et al, for the GINIplus Study Group. J Allergy Clin Immunol 2008; 121: 1442-1447. 6. Baumgartner M, Brown CA, Secretin MC et al. Nutr Res 1998; 18: 1425-1442. 7. Osborn DA, Sinn J. Cochrane Database Syst Rev 2006; 4: CD003664. Supports your baby’s growth just like cow’s milk based formulas “ The Allergic March “ g Facilitates 3-times more carbohydrate absorption than other soy formulas, so that a sensitive baby has the energy to grow Fortified with the system of vital nutrients – AA and DHA, the building blocks of brain and eye development; Iron, Taurine and Choline for mental development and functioning Let your baby taste the goodness of Isomil® Advance® today. ISO 100509 Formula, made with high quality soy protein, Important Notice: Breastmilk is the best for babies. The World Health Organisation (WHO) recommends exclusive breast-feeding for the first 6 months and should be continued for as long as possible. Unnecessary introduction of bottle-feeding or other food and drinks should be discouraged since it will have a negative effect on breast-feeding. Consult your doctor for advice if you are unable to breastfeed. To receive a FREE sample of Isomil® 2 Advance®, simply complete this coupon and mail or fax it to us at 6274 5141. Please allow 4-6 weeks for delivery of sample. The information in this publication is meant for educational purposes and should not be used as a substitute for medical diagnosis or treatment. Please seek your doctor’s advice before starting any treatment or if any questions related to your health, physical fitness or medical condition. Mother’s Name (as in NRIC): NRIC: Figure 1: The Allergic March Address: Tel: (O) (H) Name of Child: Email: Date of Birth: Current Milk Brand: By filling this form, I accept and agree to future contact from Abbott. (Note: All sections must be completed. Limited to 1 sample per household. While stocks last. For first time users only.) ABBOTT LABORATORIES (S) PTE. LTD. 1 Maritime Square #12-01 HarbourFront Centre, Singapore 099253 Abbott Nutrition Careline at 6278 6220 www.abbott.com.sg/family Brought to you by the leader in paediatric nutrition I CAN JULY 09 EDITOR: Dr. Irvin Francis Gerez EDITORIAL TEAM: A/Prof Lynette Shek, A/Prof Daniel Goh, Prof Hugo Van Bever, Dr Chan Poh Chong, Dr Wendy S Sinnathamby, Dr Chng Seo Yi, Dr Irene Melinda Louis, Dr Eugene Han, Ms Michelle Tan, Ms Sharmaine Poh, Ms Chrsitine Loh, Ms Siti Dahlia & Mr Cruz Jerome Ocampo The highest degree of allergy (measured by concentrations of specific IgE in the blood or degree of positive skin prick tests to allergens) has been detected in children suffering from both eczema and asthma. It is not yet known whether there is a real causal relationship between these high levels of allergy and eczema, or whether this is just an expression of the atopic constitution (being genetically determined). In some patients, however, IgE might be important in the pathogenesis of eczema, while in others it is not. From the literature, the following observations have been described: 1. Increased total serum IgE has been recorded in about 80% of patients (less in infants). In addition, there is a correlation between total serum IgE and severity of eczema (also in infants). *Based on full year 2008 sales value data reported by Nielsen MarketTrack for Infant Milk category, Specialty Segment (LF, HA, Soy, Goat’s Milk) in Total Singapore. © 2009, The Nielsen Company. 6/24/09 11:01 AM This educational publication is printed with the kind sponsorship of: 30% of all children with eczema will develop asthma, and when considering severe eczema, the prevalence is even higher (60 – 80%). Switching from eczema to asthma and, subsequently, rhinitis is also called: “The Allergic March” (Figure 1). The underlying mechanisms of switching from eczema to asthma or rhinitis are unknown, but might be related to specific organ sensitivity to an allergy and to the type of allergen to which an allergic reaction is developed. Isomil® 2 Advance® Follow-on Formula is also suitable for infants with diarrhoea, lactose intolerance and galactosemia. For babies after 6 months EDITORIAL TEAM • protein allergy. Isomil® 2 Advance® Follow-on Clinically Proven Confidence™ NAN HA RANGE_JAD(A4)_SG.indd 1 • vomiting, diarrhoea and nausea are some of ® Standard formula • Cow’s milk protein allergy shows up in many • A hypoallergenic formula, proven in clinical trials, is recommended for the prevention of allergy in bottle-fed infants at risk. ® 0 A considerable number of children with eczema (also known as atopic dermatitis) have signs of other allergic diseases, such as asthma, rhinitis or food allergy (i.e. urticaria and angioedema). Usually, the respiratory symptoms (such as asthma or allergic rhinitis) begin later than the skin symptoms and many clinicians have noted the peculiar and unexplained tendency for eczema and asthma to alternate in their courses. This phenomenon is not constant, however both can flare simultaneously. Moreover, about HLIGHTS HIG 1-2 llergy of Food A ma The role e cz E h it w n in childre posium, Public Sym ildren !” N A C I 1.“ In Ch Diseases 2. Allergic 3 ME “I CAN !” ER ORN MBERS’ C 5 4 CAL “I CAN !” S: F EVENT N E DAR O 2. Positive skin prick tests and specific IgE to a number of inhaled allergens as well as food allergens are found in the majority of patients with moderate to severe eczema (not in children with mild eczema). 3. Positive family histories of allergic diseases are found in the majority of children with eczema. A positive allergy test (i.e. a skin prick test or the presence of specific IgE in serum) need not necessarily mean that the eczema lesions are triggered by this particular allergen. The prick test (or the determination of specific IgE in the blood) is known to yield both false positive and false negative results. A possible explanation for the false negative results is that the skin lesions are induced by nonIgE-dependent mechanisms. On the other hand, a positive prick test corresponds to a clinically detectable allergy (by a positive provocation test) in only about 25% of eczema patients. Moreover, in young children, prick tests are more frequently negative than in older children. This is because eczema is often associated with allergic reactions, and the presence of allergic reactions does not prove that the eczema lesions are really caused by the underlying allergy. Therefore, 3 different situations are possible: 1. food allergens will induce skin reactions, such as eczema lesions, or urticaria (hives) on top of the eczema lesions. 2. the underlying allergy is not involved in the eczema lesions, and has to be considered as an independent finding. 3. the allergy is a consequence of the eczema, and is caused because the eczematous skin allows allergens to penetrate easily into the body (as a consequence of skin barrier defects). The allergy can then become involved in the maintaining of the eczema lesions or remain as a separate phenomenon. To prove whether or not an allergy is really involved in AD, the only valuable test is a provocation test: give the allergen (usual food) to the child and see what happens. There are strict scientific criteria for provocation tests. The best design is the double-blind placebo-controlled test. In this test neither the investigator nor the patient knows what allergen is administrated and results are compared to those of a placebo administration, mainly to exclude the role of possible underlying psychological factors. Provocation testing with allergens should always be performed in a hospital (never at home), as severe reactions can occur. Therefore, the need of a provocation test should be judged against its therapeutic consequences, and against possible risks that can occur. TABLE: Most common food allergies in children (independent of presence of eczema) INFANTS - cow's milk PRESCHOOOLERS - cow's milk OLDER CHILDREN - peanut - eggs - eggs - tree-nuts - wheat - peanut - fish - soy - tree-nuts - shellfish - fish - sesame - shellfish - fruits - sesame - bird’s nest “I CAN !” Public Symposium Dr. Irvin Francis A. Gerez Public education is one of the many aspects of our “I CAN !” Programme. This is in keeping with our objective to update our patients continually, as well as their parents, on the latest developments and current available issues in childhood asthma and allergies. - fruits In general, the role of food allergy is greater in infants with eczema compared to older children, or adults whose eczema is rarely influenced by dietary factors. In older children with eczema, the main triggers are chronic skin infection (with Staphylococcus aureus) and house dust mite allergy. The prevalence of food allergy in infants with eczema has been estimated at up to 40%. However, prevalence of food allergy is very much dependent on severity of eczema. In infants with severe eczema, food allergy can be involved in more than 70% of them. In mild eczema, food allergy is seldom the cause. The results from different studies have shown that food allergy can play a role in eczema, and most positive reactions to food occur in young children with severe types of eczema. However, The first public symposium for 2009 was held on 7 March at the HDB Hub Convention Centre Auditorium, Toa Payoh. It was well attended by our “I CAN !” patients, their families and members of the public. Common questions encountered in the clinics such as: (a) Are my child’s problems due to food allergy? (b) Is my child’s cough due to asthma? and (c) What tests can I do to confirm allergies?, were extensively addressed by our doctors from University Children’s Medical Institute, Associate Professor Lynette Shek Pei-Chi, Dr. Wendy S. Sinnathamby and myself. and wheat. Other food allergies in eczemacan occur, but are rare, especially in older children. The main manifestation of food allergy in older children is urticaria and/or angioedema In addition, useful insights on the practical solutions to common allergic dilemmas seen by parents and caregivers were also discussed during the question and answer session. The participants were then treated to a sumptuous tea reception that ended yet another successful “I CAN !” event. Based on the feedback received, participants had found the talk very informative, useful and interesting. Join us at our next public symposium on 29 August 2009 at Toa Payoh HDB Hub, Auditorium. Look out for more details on our website www.ican.com.sg. See you there! Peck Ern Wei In a year, Ern-Wei could compete in up to 5 competitions, each lasting for about a week. In the week, he will play one match everyday. As the physical exertion was especially intense and demanding, he looked and felt totally worn-out after each match. Unlike his peers, we observed that his recovery from fatigue was slow. This prompted us to take action. Ern-Wei was referred to Dr Irvin Gerez from the University Children’s Medical Institute at NUH, whose diagnosis was Exercise Induced Asthma (EIA) after performing several tests on him. Dr Irvin has been treating his asthmatic condition for the past year. As per Dr Irvin’s advice, Ern-Wei now gives himself 2 puffs of Salbutamol (reliever medication), before any intense or prolonged exercise (such as jogging, badminton training, competition, etc.), and he is happier now. As parents, we are more reassured and relaxed as we know that he can push himself to the limits because he is coping well with his asthma. We would like to thank Dr Irvin and nurses in the Asthma Clinic at NUH for treating and taking care of Ern-Wei. Mr & Mrs Peck Thian Guan (Parents of Peck Ern Wei) ALLERGIC DISEASES IN CHILDREN Dr Hugo Van Bever Department of Paediatrics, National University Hospital The Science, the Superstition and the Stories Allergies in children are a common and growing problem. From the author’s experience, many parents lack correct information on allergy. This has led to wrong approaches in dealing with the problem, with some parents experimenting with all kinds of non-scientifically proven testing and treatments. Sometimes these treatments can be harmful for the child. The purpose of this book is to share information and knowledge on allergic disorders in children with everybody, especially parents. The book comprises twelve chapters, each covering a specific aspect of allergy in children. The first part covers general issues such as underlying mechanisms, allergens, and epidemiology of allergic diseases. In the second part, specific allergic diseases are covered. The book ends with considerations on diagnosis and treatment, and offers suggestions for future research on allergy in children. This book will provide useful information to the public, especially parents of allergic children. Based on current scientific information, the book should help allergic children obtain optimal diagnosis and treatment of their allergic diseases. only a limited number of foods are involved in eczema. These include eggs, cow’s milk, soy, “I CAN !” MEMBERS’ CORNER Get a copy free at the next 20% DISCOUNT! “I CAN !” public symposium! Limited to the 1st 100 participants. For more details, please refer to the calendar of events. Please quote ADC7304 when you order online at www.worldscibooks. com/medsci/7304.html $48 What is “I CAN !”? • The Children’s Asthma and Allergy Network (“1 CAN !”) Programme is a comprehensive integrated programme for children with asthma and/or allergies, focusing on achieving the internationally established management goals to achieve a normal, healthy and unrestricted lifestyle for all children with asthma and/or allergies. What are the benefits? • Learn more about asthma and allergies and improve your control. • Free “1 CAN !” newsletter. • First to be updated on “1 CAN !” activities Talks, Seminars and Sports/Outdoor Activities. • Free registration for “1 CAN !” activities. • Privileges and discounts when you present your “I CAN !” membership card* at participating shops. Who can register as a member? • Any child age 0 to 16-years-old with asthma and/or allergies How to register as a member? • Pick-up a registration form at the NUH Children’s Clinic Lung Function Room 17B or www.ican.com.sg • Registration fee is S$15.00 for 2 years (non-refundable) • Registration is FREE for all University Children’s Medical Institute @ NUH Paediatric Asthma and Allergy Clinic patients