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2014 ; 23
(6
): 186-199
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
S3-Guideline on allergy prevention: 2014 update: Guideline of the German Society
for Allergology and Clinical Immunology (DGAKI) and the German Society for
Pediatric and Adolescent Medicine (DGKJ)
#MMPMID26120530
Schäfer T
; Bauer CP
; Beyer K
; Bufe A
; Friedrichs F
; Gieler U
; Gronke G
; Hamelmann E
; Hellermann M
; Kleinheinz A
; Klimek L
; Koletzko S
; Kopp M
; Lau S
; Müsken H
; Reese I
; Schmidt S
; Schnadt S
; Sitter H
; Strömer K
; Vagts J
; Vogelberg C
; Wahn U
; Werfel T
; Worm M
; Muche-Borowski C
Allergo J Int
2014[]; 23
(6
): 186-199
PMID26120530
show ga
The continued high prevalence of allergic diseases in Western industrialized
nations combined with the limited options for causal therapy make evidence-based
primary prevention necessary. The recommendations last published in the
S3-guideline on allergy prevention in 2009 have been revised and a consensus
reached on the basis of an up-to-date systematic literature search. Evidence was
sought for the period between May 2008 and May 2013 in the Cochrane and MEDLINE
electronic databases, as well as in the reference lists of recent review
articles. In addition, experts were surveyed for their opinions. The relevance of
retrieved literature was checked by means of two filter processes: firstly
according to title and abstract, and secondly based on the full text of the
articles. Included studies were given an evidence grade, and a bias potential
(low/high) was specified for study quality. A formal consensus on the revised
recommendations was reached by representatives of the relevant specialist
societies and (self-help) organizations (nominal group process). Of 3,284 hits,
165 studies (one meta-analysis, 15 systematic reviews, 31 randomized controlled
trials, 65 cohort studies, 12 case-control studies and 41 cross-sectional
studies) were included and evaluated. Recommendations on the following remain
largely unaltered: full breastfeeding for 4 months as a means of allergy
prevention (hypoallergenic infant formula in the case of infants at risk);
avoidance of overweight; fish consumption (during pregnancy/lactation and in the
introduction of solid foods for infants); vaccination according to the
recommendations of the German Standing Committee on Vaccination (Ständige
Impfkommission, STIKO); avoidance of air pollutants and tobacco exposure and
avoidance of indoor conditions conducive to the development of mold. The
assertion that a reduction in house-dust mite allergen content as a primary
preventive measure is not recommended also remains unchanged. The introduction of
solid foods into infant diet should not be delayed. In the case of children at
risk cats should not be acquired as domestic pets. Keeping dogs is not associated
with an increased risk of allergy. The updated guideline includes a new
recommendation to consider the increased risk of asthma following delivery by
cesarean section. Additional statements have been formulated on pre- and
probiotic agents, psychosocial factors, medications, and various nutritional
components. Revising the guideline by using an extensive evidence base has
resulted not only in an endorsement of the existing recommendations, but also in
modifications and in the addition of new recommendations. The updated guideline
enables evidence-based and up-to-date recommendations to be made on allergy
prevention. ELECTRONIC SUPPLEMENTARY MATERIAL: Supplementary material is
available for this article at 10.1007/s40629-014-0022-4 and is accessible for
authorized users.