Background
The diagnosis of food allergies needs to be confirmed through an oral food challenge (OFC). However, specific immunoglobulin E (sIgE) concentrations analyzed by serological tests are also helpful in determining OFC items and predicting the presence of allergic reactions. Unfortunately, there is a limit to the number of antigens that can be simultaneously evaluated at one time. The purpose of this study was to analyze the possibility of detecting sIgE antibodies against food using clues in self-reported food allergy symptoms.
Methods
Medical records of 377 patients aged 3 years or younger were collected for egg white-, cow’s milk-, walnut- and soybean-sIgE sensitization, and related clinical history. Each clinical history was classified into class 1: direct-isolated intake resulting in anaphylaxis or hives with consistent clincical history; class 2a: class 1 with inconsistency; class 2b: indirect-mixed intake resulting in anaphylaxis or hives regardless of consistency; class 2c: direct/indirect-isolated/mixed intake resulting in itching without hives, vomiting, or diarrhea with consistent clincical history; or class 3: class 2c with inconsistency or asymptomatic to direct, isolated exposure.
Results
The area under the curve (AUC) of class 1 for cow’s milk was 0.790, and the accuracy was 78.0%. The AUC of class 1 and 2 for egg white was better than that of class 1 (0.750), and the accuracy rate was 77.6%. The AUCs of class 1 for walnut and soybean were 0.775 and 0.662, respectively.
Conclusion
In conclusion, sIgE sensitization to foods could be predicted by the combination of exposure and selfreported symptoms in children under 3 years of age.

Citations

• Oral Food Challenge in Children with Tree Nut and Peanut Allergy: The Predictive Value of Diagnostic Tests
  Ludovica Cela, Alessandro Gravina, Antonio Semeraro, Francesca Pastore, Rebecca Morelli, Lavinia Marchetti, Giulia Brindisi, Francesca Olivero, Maria Grazia Piccioni, Anna Maria Zicari, Caterina Anania
  Diagnostics.2024; 14(18): 2069.     CrossRef

Background
: A considerable portion of patients in primary care are thought to have mental disorders in Korea. But they are not easily noticed and are thus underdiagnosed and approached improperly. This study was done to assess the prevalence of common mental disorders in a hospital-based family practice and to evaluate the utility of a diagnostic tool, the Patient Health Questionnaire (PHQ).

Methods : Ten or more patients each day were systematically selected in family practice clinics for two weeks in a university and a community hospital-based family practice clinics in Seoul, Korea. Routine care was delivered as a control during the first week and the PHQ was administered to patients during the second week and the physicians were allowed to review the PHQ just before making clinical decisions. Physicians were asked to answer whether they recognized patients' with mental disorders before reviewing the PHQ.

Results : The prevalence of mental disorders was higher in the test group than the control except for eating disorders and other anxiety disorders (P＜0.05)(test vs. control group): major depressive disorders 1.75% vs. 3.8%, other depressive disorders 6.8% vs. 11.4%, panic disorders 0.6% vs. 2.3, somatoform disorders 3% vs. 5%, alcohol abuse 2.2% vs. 8.7%, and any mental disorders 20.9% vs. 29.4%. In the test group, the percentage (95% confidence interval in parenthesis) of newly diagnosed mental disorders after physicians' review of the PHQ were 66% (49∼82) in major depressive disorders, 70% (50∼90) in panic disorders, 70% (56∼83) in somatoform disorders, 84% (75∼92) in alcohol abuse, and 68% (62∼74) in any mental disorders. Patients' response to the PHQ was overall very receptive.

Conclusion : One-week prevalence of common mental disorders in the hospital-based family practice was 29.4% and the PHQ tool was efficient to help the family physicians recognize hidden mental disorders.