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See the. PhD thesis The University of Sydney February, This study commenced at Royal Prince Alfred Hospital RPAH in Aprilafter Dr. Anne swain phd thesis chemicals that were implicated included the naturally occurring salicylates in food as well as artificially added preservatives and colourings. As a result of the favourable findings reported by Warin and Smith Dr. Clancy decided to investigate dietary management as an alternative, and approached Ms. Hosking Head Therapeutic Dietitian in order to develop a suitable elimination diet.
At this time the author was consulted while working as an intern dietitian in the Dermatology Ward anne swain phd thesis RPAH. Under the guidance of Ms. Hosking and Ms. Juhlin et al. In Michaelsson and Juhlin reported 52 patients who were challenged with aspirin, sodium benzoate, 4-OH benzoic acid, and three azo dyes anne swain phd thesis, sunset yellow and new coccine.
Of these, thirty five reacted to aspirin, twenty seven to benzoic acid compounds and twenty seven to azo dyes. Using a battery of challenge tests Thune and Granholt in and Warin and Smith, and Ros et al. Settipane et al. Seventy-five percent of the patients studied by Warin and Smith became either asymptomatic or improved after being on an appropriate diet for a two-month period. This improvement was similar to the results obtained by Michaelsson and Juhlin and Doeglas InRos et al.
This approach had the dual advantage that patients would be able to discontinue antihistamines, which might otherwise mask challenge reactions, as well as reducing background symptoms from substances included in a normal diet which might otherwise produce false positive results. We began with a diet based mainly on the elimination diets of Rowe, ShelleyFeingold and Warin designed to exclude the common food "allergens" as well as salicylates, preservatives and azo-dyes, but clinical experience with our first two patients suggested that this information was inadequate, anne swain phd thesis.
Since pineapple and pears were the only fruits allowed, both patients consumed large amounts of pineapple juice and fresh pineapple, and detailed review of the literature revealed that, where available, analytical data on the content of salicylates and benzoates occurring naturally in foods was incomplete, scattered, and sometimes contradictory Table 2, anne swain phd thesis.
It was therefore decided to underly eaten foods under the supervision of Professor A. Truswell in the Human Nutrition Unit, University of Sydney. Clancy left RPAH inand clinical evaluation of patients undergoing dietary elimination and challenge testing continued with Professor A.
Basten, Drs. Gatenby, S. Krilis and S. Van Nunen. In Dr. Loblay joined the RPAH Allergy Clinic as Clinical Immunologist. Since there has been a gradual change in the spectrum of patients attending the RPAH Allergy Clinic Figure 1. Another factor was the increasing public interest in "food allergy" which in the late 's and early 's was anne swain phd thesis promoted by fringe and alternative practitioners as anne swain phd thesis responsible for a vast array of symptoms and diseases Anne swain phd thesis, ; Airola, ; Mackarness, ; Crook, By the Allergy Clinic at RPAH had become well known for its interest in food intolerance, and many patients were therefore referred with a variety of clinical problems, which they suspected might be attributable to dietary factors.
These included migraine, irritable bowel syndrome IBSasthma and eczema, as well as patients who experienced symptoms referable to multiple organ systems, often together with vague constitutional symptoms suggestive of psychoneurosis. This latter group of patients was designated as having "systemic" symptoms.
A Pediatrician, Dr. Soutter, also began attending the Clinic inand a significant number of "hyperactive" children have undergone dietary evaluation since then. At the same time the range of challenge substances was extended, and starch and sucrose were introduced as placebos in place of lactose, which was sometimes found to provoke abdominal symptoms.
Since many of these additional symptoms were of a subjective nature the challenge protocol was made "double-blind", with numbered challenge capsules administered in an arbitrary order. in the final Chapter the results of the previous chapters are discussed.
Observations about the range of food chemical implicated, the symptoms provoked on challenge and the clinical behaviour of reactions provided valuable clues as to anne swain phd thesis underlying mechanisms of adverse food reactions. ALLEN, D. and SWAIN, A. CHAMPION, R. and ROGER, J. A review of patients. DOEGLAS H. DOEGLAS, H. Dermatologica, FEINGOLD, B.
Allergy, GIBSON, A. and CLANCY, R. Deutsche Medizinische Wochenschrift, JAMES, J and WARIN, R. JUHLIN, L. Allergy Clin. LOCKEY, S. Scientific Exhibit "Hidden Allergens", anne swain phd thesis, AMA Annual Convention, New York, July and JUHLIN, L. MOORE-ROBINSON, M. and WARIN, R. ROS, A-M. ROWE, A. and ROWE, A. A Compendium. Charles C. Springfield, Illinois. and MASHMAN, J. Science, SETTIPANE, G. A, CHAFEE, F. and KLEIN, D. Immunol, SHELLEY, W.
A study in salicylate hypersensitivity. THUNE, anne swain phd thesis, P. and GRANHOLT, A. WAIN, R. and CHAMPION, R. Volume 1 in Major Problems in Dermatology. Saunders, London. WARIN, R. and SMITH, R. Royal Prince Alfred Hospital Allergy Unit. Development of the elimination diet Included here is the introduction from the PhD thesis of our head dietitian Anne Swain. The Clinical Spectrum of Food Intolerance Dr. Health Plus. Phoenix, Arizona. CALNAN, C.
Lancet, CROOK, W, anne swain phd thesis. Professional Books, Jackson, Tennessee. Random House, New York. HANINGTON, E. KWOK, R. Pan Books Ltd.
Making Sense of Everything: The Wisdom of Integral Theory w/ Ken Wilber
, time: 1:47:13History of our elimination diet - Allergy Unit - Royal Prince Alfred Hospital
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