Background. Drug hypersensitivity in children impacts the quality of life of the patients and their caregivers. Measurements of the quality of life in children are different from adults, because children cannot answer the questions. This research aimed to develop and validate the Parent-reported Drug Hypersensitivity Quality of Life Questionnaire (P-DrHy-Q). Methods. The 21-item scale was initially generated by researchers. Then, 3 experts were asked for their opinion about the scale. After adjusting the contents and language, the scale was answered by 97 caregivers. A factor analysis was carried out to select the items for the final scale, and Cronbach's alpha assessed the internal consistency. Finally, we examined the test-retest reliability in another group of 10 caregivers. Results. The 21-item scale was grouped into 6 factors. However, some factors were inappropriate. Therefore, the number of factors was reduced using a statistical analysis. The final 12-item scale included two factors: mental health and social activity. The scale had good internal consistency (Cronbach's α = 0.897) and the test-retest associations were good (R = 0.9439; p < 0.001). Conclusions. The P-DrHy-Q is the first scale for assessment to consider the interaction of biopsychosocial factors on drug allergy that includes the carer-child dyad. It shows good internal consistency and reliability. Its application might be relevant for future research, and provide clinicians and researchers with a solid tool to define which type of psychosocial support is required to provide more comprehensive care in drug hypersensitivity. such as asthma (5,6) and food allergy (7,8). To date, no questionnaire is available to measure the quality of life in caregivers who have children with drug hypersensitivity. Therefore, we aimed to develop a questionnaire for the specific burden of drug hypersensitivity from the caregiver's perspective. Our goal was to develop a tool that would capture the health-related quality of life (9) using a multi-dimensional concept to examine the impact of the health status on the quality of life of caregivers who have children with a history of drug hypersensitivity. We have named this new tool the Parent-reported Drug Hypersensitivity Quality of Life Questionnaire
Background: Anaphylaxis is a serious allergic reaction that needs early administration of intramuscular epinephrine for treatment. Currently, structured education on epinephrine prefilled syringe usage for anaphylaxis does not exist. Objective: This study aimed to examine the effectiveness of the epinephrine prefilled syringe usage video, compared with routine teaching method. Methods: This was a randomized controlled trial. A total of 129 medical students were assigned either to the routine teaching group or the video teaching group. The main outcome is the total number of medical students who passed (>70%) the test. The pre-, posttest, and objective structured clinical examination (OSCE) were used to evaluate the students. Results: At the 2-week follow-up, the individual scores increased significantly after both interventions (p < 0.001). The percentages of medical students who passed the exam in the pre-, posttests, and OSCE were not significantly different between the groups. In the routine teaching group and video teaching group, the percentages of students who passed increased from 32.2% to 96.6% and 28.1% to 95.3%, respectively (p = 0.99). Using univariate logistic regression analysis, previous knowledge of anaphylaxis was a factor to pass the test (odds ratio, 5.07; 95% confidence interval, 1.93-13.31; p < 0.01). Conclusion: The study demonstrated that the scores after the video education intervention were not inferior to the routine teaching group. This technique might be applied for patients in clinical practice. However, the further researches in general population are needed to confirm the efficacy of this method.
LEAP-On studies demonstrated decreased risk of peanut allergy with early peanut introduction in non-allergic, at-risk children. This retrospective chart review highlights a practical implementation of these findings. METHODS: Retrospective chart review of young children at risk for peanut allergy evaluated at Children's Hospital of Pittsburgh of UPMC with a peanut food challenge between March 1, 2015 and July 31, 2016. Primary outcome was symptoms during challenge. Study was IRB exempt approved. RESULTS: Fourteen challenges have been analyzed to date. Six patients (43%) were female and 8 (57%) male. Average age was 11 months, range 6-16 months. Seventy-one percent had eczema and 36% had egg allergy. Four (29%) had a peanut-allergic sibling. All 14 had skin prick testing performed, with mean wheal size 2.7mm (95% CI [1.7, 3.7]). Eight had serum peanut-specific IgE measured, mean 1.3 kU/L (95% CI [0.3, 2.3]). Two (14%, 95% CI [1.8, 42.8]) had symptoms during food challenge, both facial hives successfully treated with oral diphenhydramine alone. The remaining 12 were advised to consume 2 grams peanut butter or 2/3 of Bamba 1oz pack three times weekly. CONCLUSIONS: This study demonstrates a safe, practical means to implement LEAP study findings. We modified criteria to include infants with a peanut allergic sibling. We are aware this is controversial, but because of significant family anxiety around home introduction in these children, we included them. Challenges to date have been appropriate for the outpatient setting, with reactions easily managed.
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