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Potassium containing toothpastes for dentine hypersensitivity

Dentine hypersensitivity is a sharp, sudden pain arising from the teeth when exposed to touch or hot and cold foods. If dental disease is not the cause of the pain, toothpastes containing potassium have been recommended to reduce tooth sensitivity. This review of trials found there was not enough evidence to show that potassium is effective in desensitising teeth. More research is needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

This review examines strategies to enable the continued use of the antibiotic cotrimoxazole in patients with HIV/AIDS to treat or prevent opportunistic infections in patients who previously experienced hypersensitivity to this drug.

Opportunistic infections are a threat to the lives and health of people living with HIV. Cotrimoxazole, an antibiotic also known as trimethoprim‐sulfamethoxazole, is used in the treatment and prevention of several opportunistic infections. In patients with HIV/AIDS, cotrimoxazole can cause more drug‐related side effects than in the general population. However, there are not many effective alternatives for this drug, which is also by far the cheapest option available. When a patient with HIV experiences a side effect related to cotrimoxazole, often the drug is continued (treating‐through) or reintroduced at a later date, either using increasingly larger doses (desensitization), or immediately starting at the full dose (rechallenge). This systematic review is the first to examine the differences in how patients are able to tolerate these strategies.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Probiotics in infants for prevention of allergic disease and food hypersensitivity

There is insufficient evidence to recommend the addition of probiotics to infant feeds for prevention of allergic disease or food reactions. Reactions to foods and allergies (including asthma, eczema and hay fever) are common and may be increasing in developed countries. Many infants become sensitised to foods, including infant formula, through their gastrointestinal tract, a process that may be affected by the composition of the intestinal bacteria. Attempts to promote the growth of normal gastrointestinal bacteria and prevent sensitisation to foods have included the use of probiotics. Probiotics are live bacteria that colonize the gastrointestinal tract and provide a health benefit to the host. This review found that probiotics added to infant feeds may help prevent infant eczema, with one study suggesting the benefit may persist to four years of age. However, concerns regarding the quality of studies, inconsistency of findings between studies, and the fact that the benefits did not persist if restricted to infants with evidence of sensitisation to allergens, suggests that further studies are needed to confirm these results.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Hay fever and dust mite allergies: Allergic rhinitis: Non-drug interventions

Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve the symptoms.The most effective way to prevent the symptoms is by avoiding exposure to allergens (allergy triggers) in the first place. Whereas some allergens are easy to avoid, others are very difficult or impossible to avoid. Trying to prevent contact with allergens, such as dust mites in your home, is not always worth the amount of effort involved.If the allergy symptoms are mild, saline (salt water) solutions might also help relieve symptoms in the nasal area.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 4, 2014

Hay fever and dust mite allergies: Medication for the relief of allergic rhinitis

People with seasonal hay fever often have very severe, but temporary, symptoms – for example during the grass pollen season. Others are allergic to dust mites and have allergy symptoms all year round. Whatever is causing the symptoms of allergic rhinitis, particular medications can relieve them.Although medications for the treatment of allergic rhinitis can have side effects, they are usually well tolerated. Various medications can reduce the symptoms. The most suitable one will depend on a person’s individual situation and can be discussed with a doctor.Factors that influence the choice of medication include the severity and type of allergic rhinitis (seasonal or year-round), as well as personal preferences and experiences. For instance, some people would prefer to take tablets rather than use a nasal spray. Others might feel tired when they use a certain medication, and decide to try a different one instead. Age and other things like medical conditions or pregnancy can play a role too.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 4, 2014

Hay fever and dust mite allergies: Overview

Various medications and allergen-specific immunotherapy often provide effective relief from the symptoms of hay fever or dust mite allergies. But there are also other ways to prevent or relieve the symptoms.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 4, 2014

Hay fever and dust mite allergies: Allergen-specific immunotherapy

People who have hay fever or a dust mite allergy sneeze a lot, and have a runny or stuffy nose. Many of those who have very severe and bothersome symptoms try out allergen-specific immunotherapy. This treatment aims to make the immune system “get used to” the substances triggering the allergy, so that it no longer reacts as strongly to them.The goal of allergen-specific immunotherapy is to reduce allergy symptoms in the medium to long term. It has to be repeated regularly and takes quite a long time to start working. In the past this treatment was commonly called "desensitization" or "hyposensitization." These terms describe what it aims to do: make the immune system less sensitive. In people who are allergic to something, their body is oversensitive or hypersensitive to an allergen (the substance that causes their allergic reaction). Their body produces antibodies to fight the allergen, even though the allergen is harmless. These antibodies are part of a chain reaction that leads to allergy symptoms. In allergen-specific immunotherapy, people are given allergen extracts to try to train their body to react differently: It is a bit like being “vaccinated” against your own allergy.Allergen-specific immunotherapy (SIT) cannot be used for every allergy. It is called "specific" because the allergen extract has to be tailored to the individual person's allergic response. There are still no suitable SIT extracts for some substances that cause allergies. But there are extracts for many of the common allergens found in the air, for mold, for animal allergens, and for some toxic substances (like the poison in bee stings).

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 4, 2014

Eczema: Can eliminating particular foods help?

There is no proof that elimination diets can reduce eczema in babies or children who do not have established food allergies. There has been very little research on elimination diets in adults with eczema.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: September 26, 2013

What kinds of allergy tests are there?

Various tests can be used to find out what kind of substance is causing an allergic reaction: skin tests, blood tests and challenge tests. Your doctor will usually decide which test to use based on your description of the symptoms and your medical history.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: April 20, 2016

Pregnancy and birth: Asthma in pregnancy

Many pregnant women who have asthma worry that their medication might harm their child. But most asthma medications are considered to be safe in pregnancy too. Untreated asthma, on the other hand, can have serious consequences.It is estimated that about 1 out of 5 pregnant women with asthma need treatment for asthma attacks. But good asthma control, particularly with the regular use of inhaled corticosteroids, can prevent these attacks. And there are a number of things you can do to avoid possible triggers of asthma attacks.In many women who have asthma, being pregnant does not affect their symptoms. Their symptoms sometimes even get better at first. But the physical changes that happen during pregnancy make asthma worse in 1 out of 3 women. Towards the end of pregnancy it often becomes increasingly difficult to stay physically active. Carrying the extra weight around can even make women who do not have asthma feel out of breath. Many cannot sleep properly, and feel tired and exhausted.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

Non-drug interventions for asthma

Medication is important in the treatment of asthma, to prevent asthma attacks and keep the condition under control. But many people would like to do more than just take medication. Some of the additional things that can be done have been scientifically proven to help, whereas others have not.A lot of people use special breathing techniques to try to cope better with asthma attacks. If someone reacts to certain asthma triggers, they can try to avoid them as best as possible. Regular exercise and appropriate levels of sport can help you keep fit and prevent asthma symptoms. One of the most important things you can do is stop smoking – or not start smoking in the first place.Many people with asthma also try out “alternative” treatments like herbal medicine or acupuncture. But it is often not clear whether, and how well, these approaches work and what side effects they might have.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

Asthma: Symptoms and diagnosis

In people with asthma, the airways are overly sensitive. This chronic disease typically comes in episodes or attacks of wheezing, coughing and shortness of breath. But other diseases can have similar symptoms. So before starting with treatment, it is important to find out what exactly is causing the breathing problems.The mucous membranes lining the airways of people with chronic asthma are constantly on stand-by, ready to trigger an inflammatory response. This means that certain substances can set off a very rapid and very intense reaction. Compared to people who have healthy lungs, their mucous membranes are red and swollen, and more blood flows through them. The cells in the membranes start producing thicker mucus. If an asthma trigger is also present, the muscles surrounding the walls of the airways tighten as well. Together, all of these factors cause the bronchi (lung airway passages) to narrow and prevent air from flowing freely in and out of the lungs. This leads to shortness of breath.A severe asthma attack feels somewhat like trying to breathe only through a straw for a few minutes. Even if you blow air into it and suck air out of it as hard as you can, you are unable to get enough air into and out of your lungs.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: February 26, 2014

Fish oil (n‐3 or omega‐3) for pregnant mothers or breastfeeding mothers to prevent allergies in their young children

Fish and fish oil are the major sources of omega‐3 long chain fatty acids. Dietary marine omega‐3 fatty acid supplements during pregnancy may change the immune system of the newborn before allergic responses are established, particularly for those with a genetic predisposition to the production of the immunoglobulin E (IgE) antibody. Individuals with IgE‐mediated allergies have both the signs and symptoms of the allergic disease and a positive skin prick test (SPT) to the allergen.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Prebiotics in infants for prevention of allergic disease and food allergy

There is some evidence that prebiotic added to infant formula may prevent eczema and asthma in infants. However, there is some concern about the reliability of the evidence due to not all trials reporting allergy outcomes and trials not reporting the outcome for all infants. Reactions to foods and allergies (including asthma, eczema and hay fever) are common and may be increasing. Many infants become sensitised to foods, including infant formula, through their gastrointestinal tract, a process that may be affected by the composition of the intestinal bacteria. Attempts to promote the growth of normal gastrointestinal bacteria and prevent sensitisation to foods have included the addition of prebiotic to infant formula. Prebiotics are nondigestible food components that help by selectively stimulating the growth or activity of 'healthy' bacteria in the colon. This review found some evidence that a prebiotic supplement added to infant feeds may prevent eczema in infants up to two years of age. It is unclear whether the use of prebiotic should be restricted to infants at high risk of allergy or may have an effect in low risk populations; or whether it may have an effect on other allergic diseases including asthma. However, further research is needed to confirm the findings before routine use of prebiotics can be recommended for prevention of allergy.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2013

Dietary exclusions for improving established atopic eczema in adults and children

Atopic eczema is the most common inflammatory skin disease of childhood in developed countries. The cause of atopic eczema is probably due to a combination of genetic and environmental factors. Atopic eczema varies in severity, often from one hour to the next and the disease can be associated with complications such as bacterial and viral infections. There is a substantial economic cost not only to the family of the person with atopic eczema but also to health services. Although there is currently no cure for atopic eczema, a wide range of treatments are used to control the symptoms. One such approach is a dietary one, whereby certain foods such as cows' milk are excluded on the basis that they are thought to cause eczema to worsen. The reason for undertaking this review is because the effectiveness of removing various foods from the diet in the short term management of atopic eczema is unclear.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Soy formula for prevention of allergy and food intolerance in infants

When babies are not exclusively breastfed, evidence suggests that using a soy formula instead of a cow's milk formula does not reduce allergies in infants and children. Infant formulas have been designed to try to lower the chances of developing allergy or food intolerance. These formulas include hydrolysed cow's milk and soy formulas. A review of trials found that in infants at high risk of allergy who are unable to completely breastfeed, there is no reduction in allergies in later infancy and childhood associated with feeding soy formula compared to a cow's milk formula. No eligible studies were found that compared a soy with a hydrolysed protein formula.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2008

Interventions for preventing reactions to snake antivenom

People die or can be seriously disabled after being bitten by a venomous snake. Different venomous snake species have different effects on the body, but initial treatment is similar ‐ to try and prevent venom entering the general circulation. If it becomes apparent that the venom has reached the bloodstream, the patients start becoming extremely unwell and in these circumstances health staff may give a specific antivenom (made from horse serum). However, antivenom frequently causes adverse effects which can, in themselves, be severe and result in death.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Maternal dietary antigen avoidance during pregnancy or lactation, or both, for preventing or treating atopic disease in the child

Evidence is inadequate to advise women to avoid specific foods during pregnancy or breastfeeding to protect their children from allergic diseases like eczema and asthma.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Repetitive, increasing doses of daily milk for treatment of milk allergy

To date, the only option to treat food allergy is strict avoidance of the food and carrying an epinephrine injector (Epipen/Twinject) in case of an allergic reaction. For a food like cow's milk, avoidance is very difficult because it is found in many foods. The constant fear of accidentally eating or drinking cow's milk and anxiety related to carrying an injector has negative effects on quality of life. Accidentally having milk can cause life‐threatening reactions. Oral immunotherapy involves initially taking a very small amount of the allergen, in the case of milk allergy, cow's milk, and slowly increasing the amount each day until a full serving is reached. This may change the way the body's immune system sees the allergen, thereby increasing the amount of milk that can be eaten or drunk with no reaction.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Formulas containing hydrolysed protein for prevention of allergy and food intolerance in infants

When babies are not exclusively breastfed, use of hydrolysed infant formula instead of ordinary cow's milk formula may reduce allergies in babies and children, although further studies are needed to confirm this. Infant formulas have been designed to try to lower the chances of developing allergy or food intolerance. These include hydrolysed cow's and soy milk formulas. Hydrolysed formulas break down the milk proteins into smaller, potentially less allergy producing proteins. The review of trials found that there is no evidence to support feeding with a hydrolysed formula to prevent allergy in preference to exclusive breastfeeding. In infants at high risk for allergy who are unable to be completely breastfed, there is limited evidence that feeding with a hydrolysed formula compared to a cow's milk formula reduces allergies in babies and children, including cow's milk allergy. Concerns regarding quality of the evidence and consistency of the results indicates further studies are needed.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

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