Elana Lavine

Humber River Regional Hospital | HRRH · Allergy and Clinical Immunology, Dept of Pediatrics

Background Current management of food protein-induced enterocolitis syndrome (FPIES) involves strict avoidance of the offending food for 12–18 months, followed by oral food challenge (OFC) under physician supervision. OFCs are resource-intensive and there is a lack of a universal standardized protocol for FPIES. Prolonged avoidance may increase the...

Anaphylaxis has occurred in preschools/schools yet there are no consistent food allergy (FA) management practices in early learning and childcare centres (ELCC) across jurisdictions. Presently, there are no reviews that have synthesized FA-related knowledge and management practices within ELCC. We aimed to perform a scoping review of FA management...

Background Current management of food protein-induced enterocolitis syndrome (FPIES) involves strict avoidance of the offending food for 12 – 18 months, followed by oral food challenge (OFC) under physician supervision. OFCs are resource-intensive and there is a lack of a universal standardized protocol for FPIES. Prolonged avoidance may increase t...

Infants at high risk for developing a food allergy have either an atopic condition (such as eczema) themselves or an immediate family member with such a condition. Breastfeeding should be promoted and supported regardless of issues pertaining to food allergy prevention, but for infants whose mothers cannot or choose not to breastfeed, using a speci...

Epinephrine is the first line treatment for anaphylaxis, an acute potentially life-threatening allergic reaction. It is typically administered intramuscularly in the anterolateral thigh at a dose of 0.01 mg/kg of 1:1000 (1 mg/ml) solution to a maximum initial dose of 0.5 mg. Currently in Canada, epinephrine autoinjectors (EAI) are available in thre...

Background: Data on the diagnostic properties of direct oral challenges without the use of skin tests in children with suspected amoxicillin allergy is sparse. Objective: Assess the use of direct oral challenges. Methods: A cohort study was conducted between March 2013 and March 2020, in Montreal and Winnipeg. All children referred with report...

Background: Serum sickness-like reactions (SSLR) are defined by the presence of rash (primarily urticaria), and joint complaints (arthralgia/arthritis) that are believed to occur due to a non-IgE mediated response to medications. However, similar reactions can occur due to viral infections, and it can be difficult to distinguish between the two. T...

Ibuprofen is the most commonly used non‐steroidal anti‐inflammatory drug (NSAID) and is the only NSAID approved for use in infants less than three months of age (1). It is available over‐the‐counter for the treatment of fever, inflammation and pain, and is often prescribed to treat inflammatory conditions. Over the past decade, there has been a rep...

Background Cow’s milk allergy is one of the most common food allergies affecting young children. A subset of milk-allergic individuals can eat baked milk without allergic symptoms which is beneficial in terms of prognostication and liberalization of the diet. A retrospective study suggested that skin prick testing (SPT) with a baked milk (muffin) s...

Case Series of 5 Patients with Anaphylaxis to Hemp Seed Ingestion Kristen Bortolin, BSc1, Moshe Ben-Shoshan, MD, MSc2, Chrystyna Kalicinsky, MD, FRCPC3, Elana Lavine, MD, FRCP(C)4, Christine Lejtenyi, MD, FRCPC.5, Richard J. Warrington, MD, PhD, FAAAAI3, Tracy Pitt, MD, FRCPC.4; 1Ross University School of Medicine, Miramar, FL, 2The Research Instit...

BACKGROUND: It is hypothesized that household exposure to allergenic proteins via an impaired skin barrier, such as atopic dermatitis, may contribute to the development of IgE sensitization. Household presence of peanut is a risk factor for the development of peanut allergy in children. Sunflower seed butter is a peanut-free alternative to peanut...

Background Studies suggest that siblings of children with peanut allergy (PNA) have a higher prevalence of PNA than the general population.Objectives The Canadian Peanut Allergy Registry was used to assess the percentage of siblings of registered index PNA children who were 1) never exposed to peanut or 2) reportedly diagnosed with PNA by a physici...

Background Siblings of children with peanut allergy (PNA) are reported to have a higher prevalence of PNA than the general population. This prevalence may have both genetic and environmental influences, but may also reflect incorrect PNA diagnoses with less rigorous usage of confirmatory tests in siblings. The Peanut Allergy Registry (PAR), a Canad...

Combined immunodeficiency comprises a heterogeneous group of disorders, characterized by lack of T cell-mediated immunity and impaired B cell function. Combined immunodeficiency has most often an early onset, frequently with protracted diarrhea, interstitial pneumonia, recurrent or persistent candidiasis, and failure to thrive. Infections are susta...

Children with croup are often treated with humidity even though this is not scientifically based, consumes time, and can be harmful. Although humidity using the traditional blow-by technique is similar to room air and no water droplets reach the nasopharynx, particles sized for laryngeal deposition (5-10 microm) could be beneficial. To determine wh...

Novice clinical clerks are expected to integrate smoothly into a medical team, often with little guidance. To explore medical residents' and attendings' perceptions of clerk behaviors that may aid or hinder this integration. Three resident focus groups and 5 attending staff interviews were conducted. Transcripts were analyzed using grounded theory....

We describe a patient with limited Wegener's granulomatosis (WG) presenting with saddle-nose deformity, pachymeningitis with prominent visual symptoms due to constriction of ophthalmic arteries at their transdural course, and positive for perinuclear antineutrophil cytoplasmic antibody. Early diagnosis of this rare presentation of WG can facilitate...

Humidification is a time-honoured therapy for childhood croup (acute laryngotracheobronchitis). Despite a paucity of evidence supporting its use, many physicians, nurses and parents still apply this treatment. Our objective was to summarize available evidence and assess the rationale for the ongoing use of humidity to treat childhood croup. Searche...

The currently recommended prehospital treatment for carbon monoxide (CO) poisoning is administration of 100% O(2). We have shown in dogs that normocapnic hyperpnea with O(2) further accelerates CO elimination. The purpose of this study was to examine the relation between minute ventilation (V E) and the rate of elimination of CO in humans. Seven he...

A major impediment to the use of hyperpnea in the treatment of CO poisoning is the development of hypocapnia or discomfort of CO2 inhalation. We examined the effect of nonrebreathing isocapnic hyperpnea on the rate of decrease of carboxyhemoglobin levels (COHb) in five pentobarbital-anesthetized ventilated dogs first exposed to CO and then ventilat...