ARCHIVED - Appendix 1: Garlic And Onion Allergies: Search Strategies (Medline, Embase and FSTA) - Garlic and Onions: Insufficient Evidence to Include on the List of Priority Food Allergens in Canada: A Systematic Review [Health Canada, 2009?]

Appendix 1: Garlic And Onion Allergies: Search Strategies (Medline, Embase & FSTA)

Databases searched:

• Ovid Medline (R) In-Process & Other Non-Indexed Citations and Ovid Medline (R) 1950 to Present
• Ovid Embase 1980 to 2008 Week 45
• FSTA Direct (Last updated 10 Nov 2008)

Records exported to Reference Manager (to main database: 'garlic_allergy'):

• Medline = 149
• Embase = 363
• FSTA = 24
• Total = 536

Duplicates removed: 125

Remaining records: 411

After removing duplicate records from the main 'garlic_allergy' database (includes articles on both garlic and onion allergies), 2 additional databases were created: 'garlic_occupational_contact' and 'garlic_therapy'.

From here, articles related to occupational allergy or contact dermatitis (whether occupational or not) were moved from the 'garlic_allergy' database into the 'garlic_occupational_contact' database. Articles related to anti-asthmatic or other anti-inflammatory properties of garlic were moved into the 'garlic_therapy' database. Articles that fell entirely out of scope were fully deleted.

The final number of articles remaining in each database are as follows: garlic_allergy (65); garlic_occupational_contact (68); garlic_therapy (53). In all, there were 225 false drops.

Medline

1. exp Allium/
2. (garlic* or onion* or chive* or shallot* or leek* or allium or alliaceae or allisa* or allibessen or alloton or kwai or kyolic or salicap* or sanhelios or sapec or xund or carisano or alliin* or allicin).tw.
3. 1 or 2
4. exp Hypersensitivity/
5. exp Urticaria/
6. (allerg* or hypersensi* or intoleran* or anaphyla* or urticaria* or hive*).tw.
7. ((sensiti* or toleran*) adj2 (garlic* or onion* or chive* or shallot* or leek* or allium or alliaceae or allisa* or allibessen or alloton or kwai or kyolic or salicap* or sanhelios or sapec or xund or carisano or alliin* or allicin)).tw.
8. (food adj2 (challenge or re-challenge)).tw.
9. or/4-8
10. 3 and 9
11. limit 10 to yr="1988-2009"

Embase

1. exp Bulbous Vegetable/
2. Garlic Extract/
3. Garlic Oil/
4. Onion Extract/
5. (garlic* or onion* or chive* or shallot* or leek* or allium or alliaceae or allisa* or allibessen or alloton or kwai or kyolic or salicap* or sanhelios or sapec or xund or carisano or alliin* or allicin).tw.
6. or/1-5
7. exp Hypersensitivity/
8. exp Urticaria/
9. (allerg* or hypersensi* or intoleran* or anaphyla* or urticaria* or hive*).tw.
10. ((sensiti* or toleran*) adj2 (garlic* or onion* or chive* or shallot* or leek* or allium or alliaceae or allisa* or allibessen or alloton or kwai or kyolic or salicap* or sanhelios or sapec or xund or carisano or alliin* or allicin)).tw.
11. (food adj2 (challenge or re-challenge)).tw.
12. or/7-11
13. 6 and 12
14. limit 13 to yr="1988-2009"

FSTA

((KE = 'allium' OR KE = 'garlic' OR KE = 'garlic oils' OR KE = 'onions' OR KE = 'chives' OR KE = 'shallots' OR KE = 'leeks') OR (CONTAINS(AF, 'allium or alliaceae or "garlic*" or "onion*" or "chive*" or "shallot*" or "leek*" or "allisa*" or allibessen or alloton or kwai or kyolic or "salicap*" or sanhelios or sapec or xund or carisano or alliin* or allicin'))) AND ((KE = 'ALLERGIES' OR KE = 'INTOLERANCE' OR KE = 'ANAPHYLAXIS' OR KE = 'URTICARIA') OR (CONTAINS(AF, '"allerg*" or "hypersensi*" or "intoleran*" or "anaphyla*" or "urticaria*" or "hive*"')) OR (CONTAINS(AF, '"food challenge*" or "food re-challenge*"')))

PY: 1988-now

Appendix 2: Glossary of Medical Terms

The medical terms used throughout the document and tables are listed below alphabetically. The source of the definition is captured in the endnotes.

Anaphylaxis

A systemic allergic reaction that can be fatal within minutes, either through swelling that shuts off airways or through a dramatic drop in blood pressure. Contact with or ingestion of an allergen may set off a chain reaction in a person's immune system that may lead to swelling of the airways, loss of blood pressure, and loss of consciousness, resulting in anaphylactic shock. Some anaphylactic reactions involve only one organ system, such as the respiratory tract or skin. However, in anaphylaxis, several systems are usually affected simultaneously, including the upper and lower respiratory tracts, cardiovascular system, and gastrointestinal tract. ^{Footnote i}

Asthma

A common disorder in which chronic inflammation of the bronchial tubes (bronchi) makes them swell, narrowing the airways. Asthma involves only the bronchial tubes and does not affect the air sacs (alveoli) or the lung tissue (the parenchyma of the lung) itself ^{Footnote i}

Atopic dermatitis

Dermatitis is an umbrella term for local inflammation of the skin; Atopic Dermatitis refers to the underlying inflammation being dominated by an IgE-antibody associated reaction ^{Footnote ii}

Atopy

A personal or familial tendency to produce IgE antibodies in response to low doses of allergens, usually proteins, and develop typical symptoms such as asthma, rhinoconjunctivitis or eczema/dermatitis ^{Footnote ii}

Angioedema

Characterized by locally diffuse and painful soft-tissue swelling that may be asymmetric, especially on the eyelids, lips, face, and tongue but also on the back of hands or feet and on the genitals. Edema of the upper airways may cause respiratory distress. Complete airway obstruction may occur ^{Footnote iii}

Bronchial Asthma

Refer to the definition of asthma.

Bronchospasm

Spasmodic contraction of the muscular walls of the bronchial air passages to the lungs, as in asthma, which makes breathing difficult ^{Footnote iv}

Conjunctivitis

Inflammation of the mucous membrane lining the inner surface of the eyelids and covering the front part of the eyeball ^{Footnote iv}

Cardiovascular

The heart and the blood vessels as a unified body system ^{Footnote iv}

Diaphoresis

Perspiration, especially when profuse ^{Footnote iv}

Dyspnea

Shortness of breath ^{Footnote iv}

Eczema

A non-contiguous skin disorder, characterized by inflammation, itching, and the formation of scales ^{Footnote iv}

Erythema

An abnormal redness of the skin caused by various agents, as sunlight, drugs, etc., that irritate and congest the capillaries ^{Footnote iv}

Exercise induced Anaphylaxis

Exercise can induce an allergic reaction to food. The usual scenario is that of a person eating a specific food and then exercising. As the individual exercises and their body temperature increases, they begins to itch, gets lightheaded, and soon develops the characteristic allergic reactions of hives, asthma, abdominal symptoms, and even anaphylaxis. Refer to the definition of anaphylaxis or systemic reaction. ^{Footnote i}

Glottis

The opening between the vocal cords in the larynx ^{Footnote iv}

Gastrointestinal

The stomach and the intestines ^{Footnote iv}

Hypotension

A bnormally low blood pressure ^{Footnote iv}

Hypoxia

An abnormal condition resulting from a decrease in the oxygen supplied to or utilized by body tissue ^{Footnote iv}

Incontinence

Inability to restrain a natural discharge of urine from the body ^{Footnote iv}

Oral Allergy Syndrome

Oral allergy syndrome is a type of cross-reactivity. This syndrome occurs in people who are highly sensitive, for example, to ragweed or birch pollen. During the seasons that these allergens pollinate, the affected individual may find that when he or she tries to eat fruits, chiefly melons and apples, a rapid onset of itching is experienced in the mouth and throat, and the fruit cannot be eaten. The symptoms of this allergy, which is caused simply by the direct contact of the food with the lining of the mouth and throat, resolve rapidly. ^{Footnote i}

Rhinitis

Hypersensitivity symptoms from the nose, eg, itching, sneezing, increased secretion, and blockage ^{Footnote i}

Rhinoconjunctivitis

Allergic conjunctivitis, is also called "rhinoconjunctivitis," it is the most common allergic eye disorder. The condition is usually seasonal and is associated with hay fever. The main cause is pollens, although indoor allergens such as dust mites, molds, and dander from household pets such as cats and dogs may affect the eyes year-round. Typical complaints include itching, redness, tearing, burning, watery discharge, and eyelid swelling. To a large degree, the acute (initial) symptoms appear related to histamine release ^{Footnote i}

Stridor

A harsh, high-pitched whistling sound, produced in breathing by an obstruction in the bronchi, trachea, or larynx ^{Footnote iv}

Syncope

The temporary loss of consciousness followed by the return to full wakefulness; fainting ^{Footnote i}

Systemic reactions

Several systems within the body are affected simultaneously, including the upper and lower respiratory tracts, cardiovascular system, and gastrointestinal tract. ^{Footnote iv} Refer to Anaphylaxis.

Urticaria

A n allergic skin condition characterized by itching, burning, stinging, and the formation of smooth patches, or wheals, usually red; hives ^{Footnote iv}