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Physicians: .25 AMA PRA Category I CreditsTM
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Alan Ehrlich, MD
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Last week 772 journal articles were evaluated via DynaMed's Systematic Literature Surveillance and summaries of 237 articles were added to DynaMed content.
Consumption of Peanut Products During Infancy May Reduce the Incidence of Peanut Allergy Compared to Peanut Avoidance in High Risk Children
Peanut allergies in children are on the rise world-wide, with an increase in self-reported childhood peanut allergies in the United States from 0.4% in 1997 to 1.4% in 2008 (World Allergy Organ J 2013 Dec 4;6(1):21, J Allergy Clin Immunol 2010 Jun;125(6):1322). In 2000, the American Academy of Pediatrics recommended excluding peanuts from the diets of pregnant and nursing mothers of infants at high risk for developing allergies and excluding peanuts from the child’s diet until 3 years of age (Pediatrics 2000 Aug;106(2 Pt 1):346). This recommendation was removed in 2008, however, with the increasing prevalence of peanut allergies and new studies finding elimination of food allergens from diet did not prevent the development of food allergies (Pediatrics 2008 Jan;121(1):183, N Engl J Med 2003 Mar 13;348(11):977, Pediatrics 2006 Feb;117(2):401), but the questions surrounding timing of food introduction for the prevention of food allergies remain. A recent randomized trial of 640 infants aged 4-11 months at high risk for developing allergies compared peanut consumption vs. peanut avoidance until age 60 months. High risk infants were defined as those with severe eczema, egg allergy, or both.
This trial suggests that early peanut consumption may decrease the development of peanut allergies in high risk children and moreover the length of this study provides particularly compelling evidence that the reduced risk of allergy is not a transient effect. These results highlight the importance of basing clinical recommendations on evidence from clinical trials whenever possible, since clinical outcomes have often proven to be counter-intuitive. Further studies are required to determine if early peanut exposure would prevent the development of peanut allergies in low-risk children showing early peanut sensitization on skin-prick test or if these results could be generalized to other common food allergens.
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The DynaMed editorial team is seeking specialist editors in the following fields: Gastroenterology, Nephrology, Oncology (especially Breast cancer, Head and neck cancer, Pancreatic cancer), Ophthalmology, and, Pediatric Neurology.
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