Browsing by Author "Gomes-Belo, J"
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- Advances in Food Allergy DiagnosisPublication . Gomes-Belo, J; Hannachi, F; Swan, K; Santos, AFAn accurate diagnosis of food allergy is extremely important to guide safe and yet not overly restrictive dietary management. The cornerstone of the diagnosis of food allergy is the clinical history; it allows appropriate selection of the allergens to be tested and interpretation of the results of allergy tests, namely Skin Prick Test (SPT), Specific IgE (sIgE) to allergen extracts and, more recently, specific IgE to allergen components and the Basophil Activation Test (BAT). SPT and sIgE to allergen extracts are very sensitive methods to detect IgE sensitization to a specific food and assess the possibility of spontaneous resolution. Cut-offs have been generated based on the probability of clinical reactivity during oral food challenges and can improve the specificity of SPT and sIgE, helping to confirm the diagnosis of food allergy. Specific IgE to allergen components refines food allergy diagnosis as it allows differentiating species-specific from cross-reactive allergens, aiding the differential diagnosis between a true and potentially severe food allergy from pollen-food syndrome or clinically irrelevant sensitization. The BAT is a new diagnostic test which has high specificity and sensitivity and can complement specific IgE, allowing the deferral of OFC in patients with a positive BAT. Depending on the likelihood of clinical allergy determined based on the combination of the history and the results of allergy tests, an oral food challenge may be indicated to confirm or exclude the diagnosis. Oral food challenge is the gold standard for the diagnosis of food allergy, but is a resource-intensive procedure with some level of risk involved; thus they are reserved for the equivocal cases. This review article discusses the above diagnostic techniques detailing the methods, utility, advantages and disadvantages.
- Chronic Respiratory Diseases and Quality of Life in Elderly Nursing Home ResidentsPublication . Carreiro-Martins, P; Gomes-Belo, J; Papoila, AL; Caires, I; Palmeiro, T; Gaspar-Marques, J; Leiria-Pinto, P; Mendes, AS; Paulo-Teixeira, J; Botelho, MA; Neuparth, NFew studies have assessed the quality of life (QOL) related to chronic respiratory diseases in the elderly. In the framework of the geriatric study on the health effects of air quality in elderly care centers (GERIA) study, a questionnaire was completed by elderly subjects from 53 selected nursing homes. It included various sections in order to assess respiratory complaints, QOL (World Health Organization QOL (WHOQOL)-BREF), and the cognitive and depression status. The outcome variables were the presence of a score lower than 50 (<50) in each of the WHOQOL-BREF domains (physical health, psychological health, social relationships, and environmental health). Chronic bronchitis, frequent cough, current wheezing, asthma, and allergic rhinitis were considered as potential risk factors. The surveyed sample was (n = 887) 79% female, with a mean age of 84 years (SD: 7 years). In the multivariable analysis, a score of <50 in the physical domain was associated with wheezing in the previous 12 months (odds ratio (OR): 2.03, confidence interval (CI): 1.25-3.31) and asthma (OR: 1.95, CI: 1.12-3.38). The psychological domain was related with a frequent cough (OR: 1.43, CI: 0.95-2.91). A score of <50 in the environmental domain was associated with chronic bronchitis (OR: 2.89, CI: 1.34-6.23) and emphysema (OR: 3.89, CI: 1.27-11.88). In view of these findings, the presence of respiratory diseases seems to be an important risk factor for a low QOL among elderly nursing home residents.