A280 SPECIALIZED FORMULA USE FOR THE TREATMENT OF COW MILK PROTEIN ALLERGY
Notice bibliographique
Résumé
Cow milk protein allergy (CMPA) is a common condition of infancy, with an incidence of between 2–5% amongst formula fed infants. Despite the regularity with which this condition is encountered, there is a paucity of data, in part due to the diverse clinical presentation and lack of definitive diagnostic tests. Current management beyond dietary exclusion of cow’s milk protein involves the use of a semi-elemental or elemental formula. A retrospective chart review of applications made to the Home Enteral Nutrition (HEN) program for CMPA was undertaken. The HEN program is a provincial service co-ordinating the allocation of formula to children requiring specialised formula. From 2004 - 2014, 210 patients were provided semi-elemental or elemental formula on the basis of suspected CMPA. Overall, an increasing trend in referrals was seen. In 2004 only 3 patients were provided specialized specialised formula vs 41 in 2013. The median age at application was 3.5 months (IQR: 2.0; 6.3) with 51.4% being male. Symptoms at presentation indicated that bloody diarrhoea with or without emesis was present in 53.4% of patients, with other presentations including isolated emesis in 16.2%, non-bloody diarrhoea in 13.3%, and a combination of vomiting and diarrhoea in 8.6%. Miscellaneous symptoms including failure to thrive, irritability, and others make up the remaining 8.6%. The median weight-age Z score at baseline was -0.81 (IQR: -1.85; 0.02), indicative of an underweight for age population. The referral pathway most commonly utilised included pediatric gastroenterologist in 49.6% and paediatricians in 45.2% of referrals. Family doctor referrals accounted for only 5.2% of the cases. Elemental formula was used in 66.7% of cases. Feed administration was achieved orally in 96% of patients, with only 4% of children requiring ng tube feeds. The median duration for utilisation of specialised formula was 10.5 months (IQR: 6; 12), with a median age at termination of HEN support at 13 months (IQR: 12; 18), indicative of successful transition to milk protein containing diet at one year of age in the majority of patients. The duration of formula use did not differ depending on the formula type or presentation (bloody diarrhea or not) (p=0.577). 100% of patients had discontinued the use of the specialized formula by three years of age. An increased trend was seen for the number of children utilizing specialized formula for CMPA, however the duration of formula supplementation is in keeping with other international centres. Our group did have a higher use of elemental formula (vs. semi-elemental) however this may be on account of the incremental cost of elemental formula. Presenting symptoms did not highlight a differential duration of formula use and all patients improved with time. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,008 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».