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 23,843 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence of asthma in school children has been reported to have increased, with wide variations between countries. To allow comparison of prevalence data, objective markers of asthma should be measured. Therefore, we assessed the prevalence of bronchial hyperresponsiveness (BHR) to hypertonic saline and its relation to asthma and allergy symptoms in 507 Austrian school children, aged 12-15 yrs in a cross-sectional, community based survey. These children were selected from 3,371 children who had answered a self-administered written questionnaire on asthma, hay fever, eczema and environmental factors. The prevalence of BHR to hypertonic saline was 14% and the majority (70%) of the children had mild BHR. The prevalence of wheeze in the last 12 months was 12% and of a diagnostic label of asthma was 6%. Fifty three per cent of the children with symptoms in the last 12 months and a diagnostic label of asthma had BHR, and 33% of those with symptoms in the last 12 months regardless of a diagnostic label of asthma showed a positive response to hypertonic saline. Atopic dermatitis, a diagnostic label of asthma, night cough apart from colds, wheeze in the past 12 months (but not "former wheeze") and male gender were significantly associated with increased response to 4.5% saline in the final logistic regression model. These results show that the prevalence of asthma symptoms in the last 12 months and the prevalence of bronchial hyperresponsiveness to hypertonic saline are twice that of a diagnosis of asthma and that asthma might be underdiagnosed in the present population. The response to hypertonic saline is most strongly associated with current asthma and allergy symptoms. A combination of a "diagnostic label of asthma" and "asthma symptoms in the last 12 months" might best reflect "current asthma" in epidemiological studies in this population.
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PMID:Prevalence of bronchial hyperresponsiveness to 4.5% saline and its relation to asthma and allergy symptoms in Austrian children. 955 38

An increase in allergic diseases in Western societies has been observed in all epidemiological studies. Various risk factors have been invoked to explain this increase, but the results are still inconclusive. We examined the type of patients who visited a hospital pediatric allergology unit in terms of the type of pathology presented, environmental factors, and time from the onset of symptoms until referral for allergy study. We evaluated 200 children ranging in age from 1 month to 15 years who were distributed by pathology: 119 referrals for respiratory manifestations (asthma, rhinitis, coughing, ...), 46 for food-related pathology, and 35 for adverse reactions attributed to medications. Among the risk factors, 69% of the children had a family history, 63.5% were exposed to smoking, and all of the patients were from urban and urban-industrial areas. We found no relation between the type of pathology and birth month. The natural history of allergic disease showed the following sequence: food allergy--respiratory allergy--medication allergy. In every case there was an important delay in diagnosis. The patients who visited our department soonest were infants (for presumptive allergy to cow milk protein or suspected adverse reaction to medications). It is evident that in recent years we are seeing a major increase in allergic diseases, particularly in industrialized countries. From a clinical point of view, manifestations such as asthma, rhinitis, and atopic dermatitis are increasing, which all working groups attribute to an increase in the prevalence of allergy. Epidemiological studies of large population samples use non-standard methods, with different selection criteria, ethnic breakdown and geographic differences. This makes it difficult to compare available data. Therefore, we think that it would be advisable if epidemiological studies would attempt to follow a model, which would facilitate the comparison of studies. Our aim was to evaluate the type of patients who required allergy studies in relation to the pathologies that they present and the different diagnostic methods to determine the presence of false allergies or non-allergies, the delay until study, most frequent pathologies, and environment. We report the data obtained from a sample of 200 children who visited our department for the first time in the period of a natural year.
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PMID:[Epidemiology and chronology of allergic diseases and their risk factors]. 967 89

One hundred and ninety one subjects showing histories of immediate hypersensitive response to egg white ingestion and/or positive IgE antibody titers specific for egg white were enrolled in double-blind placebo-controlled oral challenge with freeze and dried, heated or heated and ovomucoid-depleted egg white antigens. Seventy seven were male and 114 female, and their ages ranged from 11 month to 10 years 5 month; 118 of them had atopic dermatitis, seven had asthma and 33 had both atopic dermatitis and bronchial asthma and 33 had urticaria. One hundred four children developed 147 positive symptoms including 131 immediate reactions and 16 non-immediate reactions by oral challenge tests. Respiratory symptoms were observed in 25 cases (17%) including cough alone in 12 cases (8.2%), and both wheezing and cough in 13 cases (8.8%). These were all observed as immediate reactions and accompanied with dermal symptoms. Frequency of respiratory symptoms correlated with specific IgE antibody titers for egg white. Heated and ovomucoid-depleted egg white was more hypoallergenic that heated or freeze and dried egg white with respect to respiratory symptoms as well as other symptoms. We concluded that respiratory symptoms were provoked through oral challenges with egg white in a part of egg-allergic children.
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PMID:[Respiratory symptoms by oral challenge tests with egg white antigens in egg-allergic children]. 978 Apr 44

The aim of the present study was the retrospective analysis (in the last 5 years) of 89 children, aged between 3 and 24 months of life, diagnosed with atopic dermatitis (D.A.) and wheezing, in comparison with a second group of 31 children admitted in the Paediatric Clinic for recurrent wheezing (R.W.) without atopic cutaneous signs. Evaluating the therapeutical response on the basis of the clinical and biological features for each child, we have noticed for the first group (with D.A.), the followings: 30% of patients didn't experience a favourable outcome and were complicated with "severe" asthma; 54% of subjects have manifested airway hyperreactivity (nocturnal and early morning cough); 81% of children have associated allergic rhinitis. The observations in the second group have suggested that, only in 12% of patients with R.W. has been manifested asthma as a major complication. The main risk factors for asthma in the first group were as follows: precocious atopic eczema, personal or family history of atopy, nourishment with non-maternal milk and passive smoke. We consider that asthma at infants and children is underestimated because of the difficulties of diagnosis at this age.
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PMID:[Recurrent respiratory manifestations in atopic dermatitis in small children]. 1075 17

Food intolerance is a reproducible adverse reaction to a specific food ingredient that is not psychologically based. Food allergy is a form of food intolerance in which there is evidence that the response is caused by an immunological reaction to food. Other mechanisms of food intolerance include enzyme defects (e.g. lactase deficiency), pharmacological effects (e.g. histamine), toxic properties (e.g. haemagglutinating lectins) and irritants (e.g. spices). Food allergy in children is a highly contentious subject and there is often a striking lack of published evidence from which to base clinical decisions. The true prevalence of food allergy in children is unknown, although there is evidence of an increasing incidence of allergic reactions to some foods, especially peanuts. Our understanding of why some children are unable to tolerate certain foods (e.g. cow's milk, egg), or how they grow out of this intolerance, is very poor. Symptoms of food allergy in children are diverse and include vomiting, poor weight gain, abdominal pain, malabsorption, cough, wheeze, rhinitis, atopic eczema, urticaria and angioedema. Despite the lack of objective data to support the notion that food intolerance contributes to behaviour in children, this is a belief firmly held by many parents and some professionals. The gold standard for diagnosing food intolerance is the double-blind placebo-controlled food challenge (DBPCFC). There is often a poor correlation between the results of food provocation tests and those of skin prick tests of radioallergosorbent tests for specific food antibodies. For proven food allergy, elimination diets are the mainstay of management. In children these must be closely supervised to avoid nutritional deficiency and compromise of growth. Some children who have had severe (anaphylactic) reactions after food need to have a supply of self-injectable adrenaline made available to their parents and teachers and must also practice strict avoidance of the offending food.
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PMID:Food allergy and food intolerance in childhood. 1113 67

Recently, the number of patients with Japanese cedar (Cryptomeria japonica) pollinosis has increased, especially in children. However, little is known about the incidence in infants. We studied on the rate of sensitization and the onset of pollinosis in children under 6 years old. The percentage of positive CAP-RAST to Japanese cedar pollen was 27.6%, in 76 infants (51 male and 25 female, 2 months-5 years old) who visited National Mie Hospital pediatric allergy clinic due to bronchial asthma and/or atopic dermatitis. The youngest child who has been sensitized to pollen was 1 year 8 month old boy. The percentage of positive rate of CAP-RAST to house dust mite was 61.8%. Twenty-seven infants (20 male and 7 female, 2-5 years of age) were diagnosed as Japanese cedar pollinosis in National Mie Hospital Otorhinolaryngology clinic in 1999 and 2000. The youngest child with pollinosis was 2 year 5 month old boy. Most of the 27 infants complained of rhinorrhea and/or eye symptoms and some of them complained cough, snoring, or epistaxis. About 40% were sensitized to Japanese cedar and/or cupressaceae pollen alone, 60% were also sensitized to house dust mite. In conclusion, it is possible that the sensitization to Japanese cedar pollen occurs after 2 season of pollen exposure and pollinosis occurs in 2 years old. Japanese cedar pollen has been an important allergen not only in school children, but also in infants.
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PMID:[Japanese cedar pollinosis in infants in the allergy clinic]. 1119 79

Atopic dermatitis is a typical chronic inflammatory skin disease that usually occurs in individuals with a personal or family history of atopy. Children with atopic dermatitis frequently present IgE-mediated food sensitization, the most commonly involved foods being egg and cow's milk. However, controversy currently surrounds whether food allergy is an etiological factor in atopic dermatitis or whether it is simply an associated factor, accompanying this disease as one more expression of the patient's atopic predisposition. Approximately 40 % of neonates and small children with moderate-to-severe atopic dermatitis present food allergy confirmed by double-blind provocation tests but this allergy does not seem to be the cause of dermatitis since in many cases onset occurs before the food responsible for allergic sensitization is introduced into the newborn's diet.Studies of double-blind provocation tests with food in patients with atopic dermatitis demonstrate mainly immediate reactions compatible with an IgE-mediated allergy. These reactions occur between 5 minutes and 2 hours and present mainly cutaneous symptoms (pruritus, erythema, morbilliform exanthema, wheals) and to a lesser extent, digestive manifestations (nausea, vomiting, abdominal pain, diarrhea), as well as respiratory symptoms (wheezing, nasal congestion, sneezing, coughing). However, these reactions do not indicate the development of dermatitis.Some authors believe that responses to the food in provocation tests may also be delayed, appearing mainly in the following 48 hours, and clinically manifested as exacerbation of dermatitis. However, delayed symptoms are difficult to diagnose and attributing these symptoms to a particular foodstuff may not be possible.Delayed reactions have been attributed to a non-IgE-mediated immunological mechanism and patch tests with food have been proposed for their diagnosis. In our experience and in that of other authors, the results of patch tests with cow's milk do not seem very specific and could be due, at least in part, to the irritant effect of these patches on the reactive skin of children with atopic dermatitis.The involvement of foods in atopic dermatitis will always be difficult to demonstrate given that an exclusion diet is not usually required for its resolution. Food is just one among several possible exacerbating factors and consequently identification of its precise role in the course of the disease is difficult. Further double-blind prospective studies are required to demonstrate the effectiveness of exclusion diets in the treatment of atopic dermatitis.Apart from the controversy surrounding the etiological role of foods, the most important point in atopic dermatitis is to understand that the child is atopic, that is, predisposed to developing sensitivity to environmental allergens; in the first few years of life to foods and subsequently to aeroallergens. Consequently, possible allergic sensitization to foods should be evaluated in children with atopic dermatitis to avoid allergic reactions and to prevent the possible development of allergic respiratory disease later in life.
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PMID:[Etiologic implication of foods in atopic dermatitis: evidence against]. 1198 42

We investigated the effect of house dust mite (HDM)-allergen avoidance on the development of respiratory symptoms, atopic dermatitis, and atopic sensitization by performing a double blind, placebo-controlled trial. In total, 1,282 allergic pregnant women were selected (416 received HDM allergen-impermeable mattress covers for the parents' and child's mattress in the third trimester of pregnancy [active], 394 received placebo covers, 472 received no intervention). Data on allergen exposure, clinical symptoms, and immunoglobulin E were collected prospectively. The prevalence of night cough without a cold in the second year of life was lower in the group with active covers compared with the group with placebo covers (adjusted odds ratio 0.65; 95% confidence interval 0.4-1.0). No effect of the intervention was seen on other respiratory symptoms, atopic dermatitis, and total and specific immunoglobulin E. It can be concluded that application of HDM-impermeable mattress covers on the child's and parents' beds reduced night cough, but not other respiratory symptoms, atopic dermatitis, and atopic sensitization in the first 2 years of life. Follow-up will determine the long-term effect of the intervention on the development of atopic disease.
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PMID:Placebo-controlled trial of house dust mite-impermeable mattress covers: effect on symptoms in early childhood. 1284 Jun 96

Matthew, age 24 months, is brought into the clinic by his frantic mother. She reports Matthew started wheezing and broke out in a blotchy skin rash within 5 minutes of eating a cracker with peanut butter. Matthew has a history of mild, intermittent asthma treated with nebulized albuterol, which the mother administered without improvement in the child's breathing pattern. He also has a history of moderate atopic dermatitis and a prior milk intolerance that he has since outgrown. No other food allergies are noted in his history, and the mother believes this is the first time Matthew has eaten peanut butter. It has been approximately fi hour since he ingested the peanut butter. Matthew's vital signs are temperature 98.6 degrees F, pulse 90, and respirations 60 with audible wheezing and repetitive cough. His blood pressure is 80/60. His face and chest are flushed with urticaria, and some swelling is noted around his mouth.
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PMID:Peanut allergy: an increasing health risk for children. 1242 85

A relationship between distance from major roads and the prevalence of allergic disorders and general symptoms among junior high school students was assessed, separating the effects of distance of residence and school from the roads. Study subjects were 5,652 students aged 12 to 15 years. This study used diagnostic criteria from the International Study of Asthma and Allergies in Childhood. The questionnaire also asked about symptoms of headache, stomachache, tiredness, and cough and the shortest distance from residence to major roads. Distance from school to the nearest major road was measured on a map. Adjustment was made for gender, grade, the number of older siblings, smoking in the household, and maternal history of allergy. A shorter distance between residence and major roads was associated with an increased prevalence of headache, stomachache, tiredness, and cough. There was a marginally significant positive association between residence facing major roads and the prevalence of allergic rhinoconjunctivitis. Residence within 100 m of major roads showed a tendency for a positive relationship with the prevalence of wheeze and atopic dermatitis. There was no apparent relationship between distance of school from major roads and allergic disorders or the general symptoms. The findings suggest that proximity of residence, not school, to major roads may be associated with an increased prevalence of allergic disorders, headache, stomachache, and tiredness among Japanese adolescents. Further investigations with more precise and detailed exposure and health outcome measurements are needed to corroborate the relationship between traffic related factors and allergic disorders and general symptoms.
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PMID:Relationship between distance from major roads and adolescent health in Japan. 1246 76


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