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Immunization is highly effective in preventing infectious diseases and therefore an indispensable public health measure. Allergic patients deserve access to the same publicly recommended immunizations as non-allergic patients unless risks associated with vaccination outweigh the gains. Whereas the number of reported possible allergic reactions to vaccines is high, confirmed vaccine-triggered allergic reactions are rare. Anaphylaxis following vaccination is rare, affecting <1/100 000, but can occur in any patient. Some patient groups, notably those with a previous allergic reaction to a vaccine or its components, are at heightened risk of allergic reaction and require special precautions. Allergic reactions, however, may occur in patients without known risk factors and cannot be predicted by currently available tools. Unwarranted fear and uncertainty can result in incomplete vaccination coverage for children and adults with or without allergy. In addition to concerns about an allergic reaction to the vaccine itself, there is fear that routine childhood immunization may promote the development of allergic sensitization and disease. Thus, although there is no evidence that routine childhood immunization increases the risk of allergy development, such risks need to be discussed. [ABSTRACT FROM AUTHOR]

Long-term birth cohort studies are essential to understanding the life course and childhood predictors of allergy and the complex interplay between genes and the environment (including lifestyle and socioeconomic determinants). Over 100 cohorts focusing on asthma and allergy have been initiated in the world over the past 30 years. Since 2004, several research initiatives funded under the EU Framework Program for Research and Technological Development FP6-FP7 have attempted to identify, compare, and evaluate pooling data from existing European birth cohorts (GA2LEN: Global Allergy and European Network, FP6; ENRIECO: Environmental Health Risks in European Birth Cohorts, FP7; CHICOS: Developing a Child Cohort Research Strategy for Europe, FP7; MeDALL: Mechanisms of the Development of ALLergy, FP7). However, there is a general lack of knowledge about these initiatives and their potentials. The aim of this paper is to review current and past EU-funded projects in order to make a summary of their goals and achievements and to suggest future research needs of these European birth cohort networks. Copyright © 2012 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Anaphylaxis is a growing paediatric clinical emergency that is difficult to diagnose because a consensus definition was lacking until recently. Many European countries have no specific guidelines for anaphylaxis. This position paper prepared by the EAACI Taskforce on Anaphylaxis in Children aims to provide practical guidelines for managing anaphylaxis in childhood based on the limited evidence available. Intramuscular adrenaline is the acknowledged first-line therapy for anaphylaxis, in hospital and in the community, and should be given as soon as the condition is recognized. Additional therapies such as volume support, nebulized bronchodilators, antihistamines or corticosteroids are supplementary to adrenaline. There are no absolute contraindications to administering adrenaline in children. Allergy assessment is mandatory in all children with a history of anaphylaxis because it is essential to identify and avoid the allergen to prevent its recurrence. A tailored anaphylaxis management plan is needed, based on an individual risk assessment, which is influenced by the child’s previous allergic reactions, other medical conditions and social circumstances. Collaborative partnerships should be established, involving school staff, healthcare professionals and patients’ organizations. Absolute indications for prescribing self-injectable adrenaline are prior cardiorespiratory reactions, exercise-induced anaphylaxis, idiopathic anaphylaxis and persistent asthma with food allergy. Relative indications include peanut or tree nut allergy, reactions to small quantities of a given food, food allergy in teenagers and living far away from a medical facility. The creation of national and European databases is expected to generate better-quality data and help develop a stepwise approach for a better management of paediatric anaphylaxis. [ABSTRACT FROM AUTHOR]

Stapel SO, Eysink PED, de Vrieze J, Aalberse RC. IgE testing in capillary blood. Pediatr Allergy Immunol 2004: 15: 230–233. © 2004 Blackwell Munksgaard Serologic IgE testing is generally performed using serum, obtained by venepuncture. We tested whether paper-absorbed and eluted capillary blood, obtained by a less invasive method (finger prick) could be used for allergy testing in young children. This was performed by comparative IgE testing, using paper-absorbed blood/serum and serum. Practical applicability of the procedure was tested by assaying paper-absorbed and eluted blood, obtained from 640 children with complaints of prolonged coughing, for IgE to airborne allergens. We found that IgE testing, using paper-absorbed/eluted material and serum yields virtually identical results (mean ratio for positive samples: 1.01, 95% confidence interval: 0.58–1.75). Blood spot testing revealed that sensitization to inhalant allergens is not uncommon in preschool children (13% positive radioallergosorbent test [RAST] tests), which means that this procedure is a useful method for assaying allergic sensitization in children. [ABSTRACT FROM AUTHOR]

The aim of this paper is to provide an alternative and more efficient screening test for allergy with respect to traditional UNICAP and prick skin tests, which are commercially available nowadays. The proposed test is aimed at monitoring the interaction of the IgE protein with the allergen in an allergic subject. The idea relies on the fact that the interaction between the IgE and the corresponding allergen happens through binding mechanisms between the IgE and the allergen structure, changing the ionic content of the serum. This latter can be monitored by impedance measurements and confirmed by reactive oxygen species (ROS) evaluation in leukocyte subpopulations. Therefore, in this paper we propose a novel system for the detection of allergies based on impedance measurements and confirmed by ROS measurements. This type of measurement approach has never been presented in the literature for this purpose. A measurement protocol has been developed to guarantee reproducibility and repeatability of the assay. This paper describes both the instrument—specifically designed for impedance evaluation—and the measurement protocols for both methodologies, defining univocally, in this way, the overall measurement technique. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Dietary polyunsaturated fatty acids (PUFAs) have immunoregulatory properties. Breast milk is rich in PUFA, and it has been hypothesized that these PUFAs may be important in the aetiology of allergic diseases. Despite a growing body of evidence, the associations between breast milk PUFA and allergic disease have not previously been systematically reviewed. Methods: The search was performed in PubMed and EMBASE databases using breastfeeding, fatty acid and allergic disease terms. Two authors were involved in selecting papers for review according to the inclusion criteria and extracting information on study characteristics and measures of association. Only studies that reported numeric associations between concentration of breast milk fatty acids and allergic disease outcomes were included. Results: A total of 18 papers met the inclusion criteria, reporting results from 15 study populations. The majority were cohort studies (n=11), with data from only two case‐control and two cross‐sectional studies. Sample size varied between 30 and 352 participants, and follow‐up time of the cohorts varied between 3 months and 14 years. Nine studies reported on eczema, seven reported on sensitization, and only five reported on asthma/wheeze. There was heterogeneity among studies in terms of presenting the association between PUFA and allergy; therefore, estimates could not be pooled. Only a few studies observed associations between n‐3 and n‐6 PUFAs and allergic disease, and the magnitude of this effect varied greatly. Conclusions: There is insufficient evidence to suggest that colostrum or breast milk polyunsaturated fatty acids influence the risk of childhood allergic diseases. [ABSTRACT FROM AUTHOR]

The paper discusses the classification and forms of allergic rhinitis with a special focus on seasonal allergic rhinitis (SAR). The general principles of SAR management are presented, including the role of nasal glucocorticoids, nasal and oral antihistamines, and antileukotrienes. Based on the latest guidelines, the current rules for the selection of drugs in the therapy of SAR are given, paying special attention to the initial treatment. The aim of the paper is to present updated guidelines for the pharmacological management of patients with seasonal allergic rhinitis. [ABSTRACT FROM AUTHOR]

Background Atopic diseases are among the most common chronic conditions in childhood. Causes of allergies are manifold. The aim of this paper is to evaluate risk factors for atopic diseases and unremitting wheeze and to examine if there is an association between measles, mumps and rubella (MMR) vaccination and atopic dermatitis, asthma and unremitting wheeze in Bavarian pre-schoolers. Methods Parents filled out a questionnaire on children's health and environmental and socioeconomic factors. The questionnaire was administered within the Health Monitoring Units in a cross-sectional study in Bavaria, Germany (2014/2015). Data on vaccinations were obtained via the School Entrance Examination, a mandatory examination for pre-school children in Bavaria. Rates of influential factors of atopic diseases and wheeze, MMR and DTP (diphtheria, pertussis and tetanus) vaccination were calculated for all children stratified by health outcomes. To examine if there is an association between MMR vaccination and health outcomes, a multiple logistic regression analysis was performed. Results Data were available for 3237 individuals. Symptoms and diseases were more frequent in boys. Higher parental education was associated with a higher prevalence of atopic dermatitis. There were no significant associations between any of the health outcome groups and MMR vaccination in the multiple logistic regression models with adjustment for potential confounders. Conclusions The present study is in line with the current state of research that MMR vaccination is not associated with atopic diseases. [ABSTRACT FROM AUTHOR]

Editorial. Reports on the state of the 'Pediatric Allergy and Immunology' journal at the start of 2002. Increase in number of submissions; Lag between acceptance of paper and its appearance in the journal; Stresses on the Editorial Office.

The article introduces papers within the issue, including one about hospital admissions for asthma in Taiwan demonstrating continued increases in children but not in adults, and another that indicates that nasal corticosteroids to treat persistent allergic rhinitis can improve lower airway function.

The author reflects on the policy of the publishers to increase the rejection rate of manuscripts to ensure the success of the journal. He mentions that all single case reports, all studies which clearly do not include any pediatric subjects, and any papers that clearly are of national interest shall be rejected instantly. He stresses that the staff are very keen to publish high quality studies on all subjects relevant to pediatric allergy and immunology.

The leading priority for the Polish Presidency of the Council of the European Union was to reduce health inequalities across European societies, and, within its framework, prevention and control of respiratory diseases in children. This very important paper contain proposal of international cooperation on the prevention, early detection and monitoring of asthma and allergic diseases in childhood which will be undertaken by the EU member countries as a result of EU conclusion developed during the Polish Presidency of the Council of the European Union. This will result in collaboration in the field of chronic diseases, particularly respiratory diseases, together with the activity of the network of national institutions and NGOs in this area. Paper also contains extensive analysis of the socio-economic, political, epidemiological, technological and medical factors affecting the prevention and control of childhood asthma and allergy presented during Experts presidential conference organized in Warsaw-Ossa 21-22 September 2011. [ABSTRACT FROM AUTHOR]

The author discusses the importance of closely monitoring the prevalent trends of allergic conditions in children. The study that focused on Swedish schoolchildren which outline the trends in the prevalence of asthma, allergic rhino-conjunctivitis and eczema between 1979 and 2007 in children aged seven to eight, is cited. The author also agrees with the recommendation of the study and encourages more studies into the symptoms in allergic sensitization.

The early induction of allergy is a complex process involving protective and destructive gene variants, environmental and nutritional co-factors as well as allergen exposure. Although critical doses, interactions and susceptible time frames have not been identified so far, late gestation and early childhood seem to be important time periods for allergic sensitization. At least three risk factors can be distinguished based on altered early Th1 lymphocyte development. First, the number of children with an inborn maturation defect may have increased since the beginning of the last century, when this condition would otherwise have had a lethal outcome without antibiotics and other modem health care (survival hypothesis). Second, another group of children in industrialized countries may have a deficit of environmental Th1 triggers during early life (hygiene hypothesis). A third factor may also be found predominantly in western societies. The prophylaxis of rickets with vitamin D has the apparent side effect of suppressing Th1 development (vitamin hypothesis). Experimental as well as epidemiological studies now provide evidence for the vitamin hypothesis, which is examined in this paper by a time-course analysis of vitamin D application in Germany. Also paper studies in Swedish anthroposophic school children, the Tristan da Cunha islanders, and Swiss, Austrian and Bavarian farmers may be linked to either excessive or absent early vitamin D exposure. [ABSTRACT FROM AUTHOR]

Copyright of Medical Perspectives / Medičnì Perspektivi is the property of Dnipropetrovsk Medical Academy of Health Ministry of Ukraine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Duzce University Journal of Science & Technology is the property of Duzce University Journal of Science & Technology and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduces articles in the February 2005 issue of the "Pediatric Allergy and Immunology" journal. Impact of prenatal exposure to cats and/or dogs and the transient effect in suppressing neonatal immunoglobulin E levels and sensitization to common allergens at 12 months but not four years of age; Prenatal factors which modify outcomes in relation to eczema; Dose response relationship between increasing levels of exposure to mite allergen during pregnancy.

Background Maternal vitamin D status has been reported to be associated with childhood allergic diseases. However, this association remains to be fully elucidated. Methods A systematic review and meta-analysis was conducted using prospective cohort studies that examined the association between maternal vitamin D status and childhood allergic diseases including wheeze, eczema and asthma. We searched electronic databases of PubMed, EMBASE, the Cochrane library, the Wanfang (Chinese) database, the VIP (Chinese) database, and Chinese National Knowledge Infrastructure (CNKI) up to August 2014. Odds ratios and 95% confidence intervals (CIs) from individual studies were synthesized using a fixed effects model. Results Four studies on the association between maternal vitamin D status and childhood asthma (3666 mother-child pairs), four studies on the association between maternal vitamin D status and childhood wheeze (2225 mother-child pairs) and three papers on the association between maternal vitamin D status and childhood eczema (2172 mother-child pairs) met our inclusion criteria. Maternal vitamin D status during pregnancy was associated with childhood eczema (pooled OR=0.904, 95% CI=0.831-0.983). However, the meta-analysis showed no statistical association between maternal vitamin D status and childhood asthma (pooled OR=0.981, 95% CI=0.944-1.019) or childhood wheeze (pooled OR=0.995, 95% CI=0.982-1.009). Conclusions Our meta-analysis found that lower maternal vitamin D during pregnancy was associated with an increased risk of childhood eczema but was not associated with childhood asthma or wheeze. The role of maternal vitamin D as an important protective factor for the development of childhood eczema remains to be elucidated. [ABSTRACT FROM AUTHOR]

Allergic diseases comprise a genetically heterogeneous group of chronic, immunomediated diseases. It has been clearly reported that the prevalence of these diseases has been on the rise for the last few decades, but at different rates, in various areas of the world. This paper discusses the epidemiology of allergic diseases among children and their negative impact on affected patients, their families, and societies. These effects include the adverse effects on quality of life and economic costs. Medical interest has shifted from tertiary or secondary prevention to primary prevention of these chronic diseases among high-risk infants in early life. Being simple, practical, and cost-effective are mandatory features for any candidate methods delivering these strategies. Dietary therapy fits this model well, as it is simple, practical, and cost-effective, and involves diverse methods. The highest priority strategy is feeding these infants breast milk. For those who are not breast-fed, there should be a strategy to maintain beneficial gut flora that positively influences intestinal immunity. We review the current use of probiotics, prebiotics, and synbiotics, and safety and adverse effects. Other dietary modalities of possible potential in achieving this primary prevention, such as a Mediterranean diet, use of milk formula with modified (hydrolyzed) proteins, and the role of micronutrients, are also explored. Breast-feeding is effective in reducing the risk of asthma, allergic rhinitis, and atopic eczema among children. In addition, breast milk constitutes a major source of support for gut microbe colonization, due to its bifidobacteria and galactooligosaccharide content. The literature lacks consensus in recommending the addition of probiotics to foods for prevention and treatment of allergic diseases, while prebiotics may prove to be effective in reducing atopy in healthy children. There is insufficient evidence to support soy formulas or amino acid formulas for prevention of allergic disease. A healthy diet, such as the Mediterranean diet, may have a protective effect on the development of asthma and atopy in children. In children with asthma and allergic diseases, vitamin D deficiency correlates strongly with asthma, allergic rhinitis, and wheezing. [ABSTRACT FROM AUTHOR]

The article discusses several conferences and meetings of European Academy of Allergy and Clinical Immunology (EAACI). Topics discussed include The Allergy School organized by The Pediatrics Section that was held in Sicily, Taormina from March 5-7, 2015, the Food Allergy and Anaphylaxis Meeting 2014 (FAAM 2014) held in Dublin, Ireland, and the Pediatric Allergy and Asthma Meeting (PAAM) to be held in Berlin, Germany from October 15-17, 2015.

The author comments on several papers published in the issue about atopic dermatitis and immune response to allergies in children. Highlighting Trevor Bryant's emphasis on the CONSORT recommendations for submitting quality manuscripts, the editor reports the presentation of first definitive results of Early Treatment of the Atopic Child (ETAC) in the journal. Information on current rankings of the journal for allergy and pediatric publications is also presented.

Objective: There has been an increase in the number of cases as pediatricians mistakenly refer scabies to an allergy clinic, misdiagnosing it as allergic illnesses, particularly atopic dermatitis (AD), because of the presence of symptoms such as itching and eczematous lesions. The objective of our study was to examine the prevalence of scabies in children who were referred to the pediatric allergy clinic after being misdiagnosed with AD. We also aimed to determine the clinical and demographic distinctions between individuals with AD and scabies. Methods: The files of 610 patients those referred to Sakarya Training and Research Hospital Pediatric Allergy Clinics between February -December 2022 with complaints of 'itching and rash' were documented retrospectively. Cases of acute urticaria, chronic urticaria, mastocytosis, insect bite, maculopapular rash with viral infection, drug-induced reactions were excluded. Patients whose final diagnosis was AD and who were diagnosed with 'definite scabies' were included in the study. Results: A total of 404 patients were included in the study. The rate of definite diagnosis of scabies was 18.5% (n:75/404). The median age at presentation was 19 months (IQR 8-51) in patients diagnosed with AD and 53 months (IQR 17-117) in patients diagnosed with scabies (p<0.005). The median time from symptom onset to diagnosis was seven months (IQR 2.5-24) in the AD group and two months (IQR 1-4) in the scabies group (p<0.005). Only 20% (n:15/75) of patients with scabies had family history, 16% of patients (n:12/75) had received one or more treatments before. Pruritis was present in only 72% (54/75) of children. Hospitalization rate was 0.05% (n:4/75). Conclusion: We recommend that scabies should be considered as a potential diagnosis for patients who visit to any clinic with symptoms of itching and a skin rash. Timely identification and medical intervention for scabies in children is crucial in order to minimize the spread of the disease throughout the community and prevent potential complications. [ABSTRACT FROM AUTHOR]

Background: Environmental tobacco smoke (ETS) exposure in children is linked with the development of allergic asthma. However, its influence on allergic sensitisation in children has not been conclusively determined. Objective: To systematically review existing evidence of ETS exposure's impact on markers of allergic sensitisation in children. Methods: CENTRAL, MEDLINE and EMBASE databases were searched. Included studies assessed following markers of atopic sensitisation: total immunoglobulin E (tIgE) concentrations, at least one specific IgE (sIgE+), and positive skin-prick tests (SPTs+) in ETS-exposed and non-exposed children. Results: 8 studies on the influence of ETS on tIgE concentration (2603 patients), 6 studies on ETS and sIgE+ (9230 participants) and 14 papers on ETS and SPT (14 150 patients) met our inclusion criteria. ETS was shown to raise tIgE concentrations by 27.7 IU/mL (95% CI 7.8 to 47.7; I²=58%; results based on 3 studies) and to increase the risk of atopic sensitisation, as assessed by sIgE+ (OR=1.12, 95% CI 1.00 to 1.25; I²=54%; results based on 4 studies) and SPT+ (OR=1.15; 95% CI 1.04 to 1.28; I²=0%; results based on 10 studies). In a subgroup analysis, this effect was most pronounced in children <7 years (preschoolers) by 0R=1.20; (95% CI 1.05 to 1.38) and 0R=1.30 (95% CI 1.05 to 1.61), (for sIgE+ and SPT+, respectively). Conclusions: Current analysis supports an association between ETS exposure in early childhood and the increased risk of allergic sensitisation. Subgroup meta-analyses demonstrate that younger children suffer the most from detrimental immunomodulating effects of ETS exposure. This study underscores ETS as an important but avoidable risk factor for the development of allergic disease in children. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyse factors associated with remission of atopic dermatitis (AD) in childhood. A population-based AD cohort of 894 children aged 1-3 years from a cross-sectional baseline study in 2000 was followed up in 2005. The association between remission, background, health, lifestyle, and environmental variables was estimated with crude and multivariable logistic regression. At follow-up, 52% of the children had remission. Independent factors at baseline predicting remission were: milder eczema (adjusted odds ratio (aOR), 1.43; 95% confidence interval (95% CI) 1.16-1.77); later onset of eczema (aOR 1.40; 95% CI 1.08-1.80); non-flexural eczema (aOR 2.57; 95% CI 1.62-4.09); no food allergy (aOR 1.51; 95% CI 1.11-2.04), and rural living (aOR 1.48; 95% CI 1.07-2.05). Certain aspects of AD and rural living were important for remission, but despite the initial hypotheses to the contrary, the environmental factors examined in this paper were not substantial predictors of remission. [ABSTRACT FROM AUTHOR]

The objective of this study is to describe the clinical and laboratory features of macrophage activation syndrome (MAS) in systemic onset juvenile idiopathic arthritis (SOJIA) at a tertiary care center in northwest India. Review of medical records of all children with SOJIA admitted during the period January 1995-December 2008 in Pediatric Allergy and Immunology Unit, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, was done. Six patients (5 boys and 1 girl) with SOJIA and MAS were identified. Mean age at time of disease onset was 6.5 years. MAS was the presenting manifestation of SOJIA in 4 patients. Clinical manifestations included fever (6/6), clinical shock (6/6), encephalopathy (5/6), generalized lymphadenopathy (4/6), hepatosplenomegaly (3/6), jaundice and abdominal tenderness (3/6), cardiac involvement (3/6), and meningeal irritation (2/6). Laboratory findings at onset of MAS included decreasing total leukocyte and platelet counts, coagulopathy, elevated transaminases, hyponatremia, and lipid abnormalities. Hemophagocytosis was demonstrable in the bone marrow in 4 patients and in the lymph node in 1. For treatment, we used intravenous methylprednisolone (4/6), oral prednisolone (2/6), and intravenous immunoglobulin (2/6). Outcome was favorable in all patients except one who died of rapidly progressive disease. This paper describes the experience of JIA-related macrophage activation syndrome in a tertiary Indian center. We have shown that MAS can be the early presenting manifestation of evolving SOJIA. Early diagnosis and aggressive management can have a significant impact on the mortality associated with this syndrome. We stress on the role of glucocorticoids in the management of this condition and believe that glucocorticoids have a far more important role in the management of this condition than what has been previously reported. [ABSTRACT FROM AUTHOR]

To cite this article: Pelkonen AS, Kuitunen M, Dunder T, Reijonen T, Valovirta E, Mäkelä MJ. Allergy in children: practical recommendations of the Finnish Allergy Programme 2008-2018 for prevention, diagnosis, and treatment. Pediatr Allergy Immunol 2012: 23: 103-116. Abstract The Finnish Allergy Programme 2008-2018 is a comprehensive plan intended to reduce the burden of allergies. One basic goal is to increase immunologic tolerance and change attitudes to encourage health instead of medicalizing common and mild allergy symptoms. The main goals can be listed as to: (i) prevent the development of allergic symptoms; (ii) increase tolerance to allergens; (iii) improve diagnostics; (iv) reduce work-related allergies; (v) allocate resources to manage and prevent exacerbations of severe allergies, and (vi) reduce costs caused by allergic diseases. So far, the Allergy Programme has organized 135 educational meetings for healthcare professionals around Finland. These meetings are multidisciplinary meetings gathering together all healthcare professionals working with allergic diseases. Since the start of the program in spring 2008, more than 7000 participants have taken part. Educational material for patient care has been provided on special Web sites/therapeutic portals, which can be accessed by all physicians caring for allergic patients. Local Allergy Working Groups have been created in different parts of Finland. As a part of the Programme, a set of guidelines for child welfare clinics was prepared. Child welfare clinics have a key role in the screening of illnesses and providing advice to families with a symptomatic child. The guidelines aimed to facilitate pattern recognition and clinical decision making for public health nurses and doctors are described in this paper. [ABSTRACT FROM AUTHOR]

Introduction. Aeroallergen sensitization occurs at an earlier age than previously noted. The purpose of this paper was to identify which pollens cause early sensitization in young children presenting with rhinitis symptoms. Methods. This paper was a retrospective analysis of skin test results from 2- to 8-year-old patients presenting with a history consistent with allergic rhinitis. Patients were tested to aeroallergens common to the Great Basin along with a histamine and saline control. Pollen counts were obtained from a Reno, NV-certified counting station. Results. 123 children less than 8 years of age were identified. Over 50% of these children were sensitized to at least one aeroallergen. Chemopodaciae, timothy, alfalfa, black walnut, olive, mountain cedar and willow were predominating sensitizing aeroallergens of the Great Basin Region. Pollen counts were notable for a early spring peak for the tree season, grass season in May and weed season in August. Pollen levels continued to November at low levels. Discussion. Aeroallergens causing early sensitization differed from those which had predominately been reported in other regions of the United States. Pediatric allergists should consider performing a local review of sensitizing aeroallergens in their region to assist with identification and management of allergic rhinitis in their youngest patients. Please make style changes as appropriate. [ABSTRACT FROM AUTHOR]

Objectives. This paper reviews the relationship between anxiety and anaphylaxis in children and youth, and principles for managing anxiety in the anaphylactic child and his or her parents. Methods. A review of the medical literature (Medline) was done using the keywords "anxiety," "anaphylaxis," and "allergy," limited to children and adolescents. Findings were organized into categories used in the treatment of childhood anxiety disorders, then applied to managing anxiety in the anaphylactic child. Results. Twenty-four relevant papers were identified. These varied widely in methodology. Findings emphasized included the need to distinguish anxiety- related and organic symptoms, ameliorate the anxiety-related impact of anaphylaxis on quality of life, and address parental anxiety about the child. Conclusion. Children with anaphylaxis can function well despite anxiety, but the physical, cognitive, and behavioral aspects of anxiety associated with anaphylactic risk must be addressed, and parents must be involved in care in constructive ways. [ABSTRACT FROM AUTHOR]

Allergic contact dermatitis (ACD) in children was previously considered to be a rare occurrence. However, the growing number of case reports and cross-sectional studies through the past three decades indicate that ACD is, in fact, a highly relevant diagnosis in children. Furthermore, the frequency of ACD in children seems to be increasing. In 1999, a review of the literature reported prevalence rates of 14.5-70% in selected paediatric populations. The current paper reviews the studies on the prevalence of positive patch test reactions and ACD in the paediatric population during the past decade, and provides an overview of the main findings. We found reported sensitization rates of 26.6-95.6% in selected groups of children. The associated relevance was 51.7-100%. The most common allergens were nickel, cobalt, thimerosal, and fragrance. Tailored patch testing increases the rate of relevant patch test reactions. Children with atopic dermatitis are as frequently sensitized as children with no history of atopic dermatitis, and there are no differences associated with sex. Children and adults can be tested with equal concentrations of patch test allergens. Our findings may support the notion that the prevalence of ACD in children is increasing over time or indicate an increased awareness. [ABSTRACT FROM AUTHOR]

Background: The hypersensitivity to cow's milk allergens is the most common allergies in children at the first year of life. The specific IgE evaluation is one of the important methods in diagnosis of allergic disease. The aim of this study was development of a sensitive and credible procedure for detection of cow's milk allergens specific IgE. Methods: The allergen discs were prepared by coating of allergens on nitrocellulose paper. After incubation of allergen discs with patients serum, anti-human IgE conjugated were used. In following optimization of any step of ELISAs test, a complete kit was designed. Efficiency of designed kits were evaluated by determination of specific IgE in normal (n= 29) and patient (n= 153) children serum samples and compared with commercial kits. Results: The specific IgE against three allergrns involving casein, α-lactalbumin and β- lactoglobulin were measured on normal and patient children serum with designed and commercial ELISA kits. Results were demonstrated specificity of 93%, 89.7% & 82.8% and sensitivity of 86.3%, 81.3% & 89.6% respectively for casein, α-lactalbumin and β- lactoglobulin specific kits and these results were similar and comparable with commercial kits. Conclusion: The Designed kits in comparison with the commercial kits were showed equivalent sensitivity and specificity. The designed kit stability was ultimately one month, probably due to don't using of stabilizers for prepared allergen discs. We suggest these kits for commercial product in Iran and we hope be helpful for easier accesses for Cow's milk allergy diagnosis and extend that for other allergens. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Sanidad Militar is the property of Direccion General de Sanidad Secretaria de la Defensa Nacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Alergia de Mexico is the property of Coleg. Mexicano de Inmunologia Clinica y Alergia A.C.; Soc. Lat. de Alergia, Asma e Inmunologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Over the last decade, a number of clinical practice guidelines that include guidance for the management of pediatric asthma have been introduced. The consistency across pediatric asthma guidelines is unknown and the emphasis on establishing asthma control may vary. The objective of this paper was to depict the evolution of guidelines for pediatric asthma and to compare current international guidelines in terms of their organization, presentation of evidence and consideration of children, with special emphasis on definitions of asthma control and severity. Methods: A systematic search to identify asthma guidelines was conducted, and guidelines were searched for pediatric terms. The approaches used by guidelines to define assessments of asthma severity and control were compared between the United States, the Global Initiative for Asthma, Canada, the United Kingdom and Australia. Results: Pediatric considerations in the management of asthma have been integrated into the various guidelines to different degrees and through varied strategies. There were differences in the conceptual and operational approach used to assess asthma which emphasized either asthma severity or control. Conclusions: It will be important for future guidelines to clearly define whether the primary assessment parameter is asthma severity or control. Delineating the guideline development process and supporting evidence may improve transparency, consistency and guideline adherence. Copyright © 2008 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background: Prospective studies of asthma and allergic conditions based on the general population are scare. Aim: To summarize the methods and main results from a prospective study among school children. Methods: In 1996, a cohort of 3525 children aged 7/8 years in Northern Sweden were invited to a questionnaire survey using an expanded ISAAC protocol, and 97% participated. The cohort has been followed up yearly with high participation rate. Skin prick tests were conducted 1996, 2000 and 2006/2007. Allergens in dust from homes and schools have been analyzed. Sub samples have participated in interviews, lung function tests, bronchial hyper reactivity test, and analyses of IgE and IgG antibodies in serum. Results: The prevalence of asthma was 6% at age 7–8 years and increased by age. The incidence of physician-diagnosed asthma after the age of 7–8 years was around 1/100/year. The prevalence of positive skin prick test increased from 21% at age 7–8 to 30% at age 11–12 years. Remission of allergic sensitization was rare, while asthma remission was 5% yearly. The main risk factor for asthma and allergic sensitization increased in importance with increasing age. Allergic and non-allergic asthma had different risk factor pattern. Environmental risk factors decreased in impact after the age of 7. Avoidance of pets at home did not protect from asthma or allergic sensitization. Conclusion: The study includes important sources of data for further longitudinal analyses that will contribute to the understanding of the development and the nature of asthma and allergic sensitization. Please cite this paper as: Rönmark E, Bjerg A, Hedman L, Perzanowski M, Sundberg S and Lundbäck B. The Obstructive Lung Disease in Northern Sweden (OLIN) longitudinal paediatric study I – the first 10 years. The Clinical Respiratory Journal 2008; 22: 26–33. [ABSTRACT FROM AUTHOR]

The School Based Asthma Therapy (SBAT) trial builds on a pilot study in which we found that school-based administration of preventive asthma medications for inner-city children reduced asthma symptoms. However, the beneficial effects of this program were seen only among children not exposed to environmental tobacco smoke (ETS). The current study is designed to establish whether this intervention can be enhanced by more stringent adherence to asthma guidelines through the addition of symptom-based medication dose adjustments, and whether smoke-exposed children benefit from the intervention when it is combined with an ETS reduction program. The intervention consists of both administration of preventive asthma medications in school (with dose adjustments according to NHLBI guidelines) and a home-based ETS reduction program utilizing motivational interviewing principles. This paper describes the methodology, conceptual framework, and lessons learned from the SBAT trial. Results of this study will help to determine whether this type of comprehensive school-based program can serve as a model to improve care for urban children and reduce disparities. [ABSTRACT FROM AUTHOR]

Risk assessment of inhaled toxicants has typically focused upon adults, with modeling used to extrapolate dosimetry and risks from lab animals to humans. However, behavioral factors such as time spent playing outdoors may lead to more exposure to inhaled toxicants in children. Depending on the inhaled agent and the age and size of the child, children may receive a greater internal dose than adults because of greater ventilation rate per body weight or lung surface area, or metabolic differences may result in different tissue burdens. Thus, modeling techniques need to be adapted to children in order to estimate inhaled dose and risk in this potentially susceptible life stage. This paper summarizes a series of inhalation dosimetry presentations from the U.S. EPA's Workshop on Inhalation Risk Assessment in Children held on June 8-9, 2006 in Washington, DC. These presentations demonstrate how existing default models for particles and gases may be adapted for children, and how more advanced modeling of toxicant deposition and interaction in respiratory airways takes into account children's anatomy and physiology. These modeling efforts identify child-adult dosimetry differences in respiratory tract regions that may have implications for children's vulnerability to inhaled toxicants. A decision framework is discussed that considers these different approaches and modeling structures including assessment of parameter values, supporting data, reliability, and selection of dose metrics. [ABSTRACT FROM AUTHOR]

Aim: Atopic infants hospitalized for wheezing not caused by respiratory syncytial virus (RSV) carry the highest risk for later asthma. In the present paper, early risk factors for later lung function abnormalities and for bronchial hyper-responsiveness (BHR) were evaluated in 81 children, hospitalized for bronchiolitis in infancy, at the median age of 12.3 years.Methods: The basic data, including data on atopy in children and viral aetiology of bronchiolitis, had been collected on entry to the study at less than 2 years of age. Lung function was studied by flow-volume spirometry (FVS), and BHR by methacholine and exercise challenge tests 11.4 years after hospitalization during infancy.Results: RSV aetiology of bronchiolitis was associated with reduced forced vital capacity (FVC; 93.65% of predicted +/- 11.05 vs. 99.57%+/- 12.59, p = 0.009). Early sensitization to inhalant allergens (OR 12.59, 95% CI 2.30-68.77) and maternal smoking during pregnancy (OR 4.58, 95% CI 1.28-16.39) were associated with BHR to exercise, and early atopic dermatitis (OR 3.48, 95% CI 1.09-11.10) was associated with BHR to methacholine.Conclusions: RSV bronchiolitis was associated with a restrictive pattern of lung function. Early atopy and maternal smoking during pregnancy may play a role in the development and persistence of BHR. [ABSTRACT FROM AUTHOR]

This paper presents the design and evaluation of the Teacher Capability and School Resource Scale for Asthma Management. Based on a sample of 589 kindergarten to eighth grade teachers, the scale yielded two factors: the Teacher Capability in Social and Emotional Aspects of Asthma Management factor (α = 0.83) and the School Resources/Institutional Capability for Asthma Management (α = 0.86). This scale fills a needed gap in the literature regarding assessment tools for school-based asthma management that focus on teacher efficacy. [ABSTRACT FROM AUTHOR]

Unlabelled: As milk represents the main source of nutrition for infants, the question of an effective human milk substitute becomes mandatory when a formula-fed baby is allergic to cows' milk proteins. In this case, formulas containing extensively hydrolysed milk proteins should be preferred, but even such a formula may cause allergic reactions in highly sensitive patients. If there is evidence of cows' milk allergy with IgE-associated symptoms, after 6 mo of age, a soy bean formula may be recommended only when tolerance to soy protein has been established by clinical challenge. In infants with allergic reactions to cows' milk proteins, even after extensive hydrolyzation, proteomic techniques coupled to immunological methods may make it possible to select other milk products that do not contain the same allergens as ordinary cow's milk. In this paper, evidence will be presented that proteomic evaluation of proteins from different mammalian species may be a suitable method of testing whether proteins from the milk of different mammalian species may be used as a substitute for untreated bovine milk.Conclusion: Proteomic evaluation of milk from different mammalian species may not only be of help when recommending suitable feeding in cases of cows' milk allergy but also gives new insight into the background to allergic reactions caused by milk proteins. [ABSTRACT FROM AUTHOR]

This paper presents the concept of implementing different dielectric properties of surroundings to monitor the sleep of eczema patients through the use of an electric field mattress. Different sensor methods, as well as different arrangements of electrodes in the E-field mattress, are discussed to find out which would achieve optimum results. This paper also explains how readings taken from the electrodes can be used to analyze the sleep pattern of eczema patients. [ABSTRACT FROM AUTHOR]

Hedman L, Lindgren B, Perzanowski M, Rönmark E. Agreement between parental and self-completed questionnaires about asthma in teenagers.Pediatr Allergy Immunol 2005.© 2005 Blackwell MunksgaardIn studies of asthma in children, a common method is for the parents to complete questionnaires about their child's asthma symptoms. With longitudinal studies of asthma, children reach an age when they can complete the questionnaire themselves. The aim of this paper was to compare the prevalence of asthma symptoms as well as the agreement between responses to an asthma questionnaire completed by teenagers and their parents. As a part of the Obstructive Lung Disease in Northern Sweden Study (OLIN) pediatric study, where 3345, 13–14-yr-old children completed an asthma questionnaire, 294 (84%) randomly selected parents also completed the questionnaire, which included the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. There were no significant differences in the prevalence of wheeze in the last 12 months, ever asthma, or physician diagnosed asthma as reported by the parents compared with the teenagers. However, the teenagers reported a significantly higher prevalence of wheeze during or after exercise. The absolute agreement was generally very high while the level of agreement (kappa-value) was slightly lower. The highest results in both absolute agreement and kappa-value, were reached by the questions on diagnosis of asthma (98.9% and 0.93), use of asthma medicines (95.5% and 0.78), and whether the child ever had had asthma (97.2% and 0.86), respectively. In conclusion, the agreement between the parents’ and the teenagers’ responses to the asthma questionnaire was good. The change in methodology from parental to self-completion of the questionnaire did not affect the results in the study. [ABSTRACT FROM AUTHOR]

Primary herpetic gingivostomatitis is a relatively common and well-recognized condition that the dental practitioner may encounter in clinical practice. A primary herpetic infection in a child with atopic dermatitis such as eczema, however, predisposes them to eczema herpeticum. This can be a severe and potentially life-threatening condition. This paper describes one such case, discusses the aetiology, presentation and management of this condition, and highlights the importance of early recognition by the clinician. [ABSTRACT FROM AUTHOR]

Brooks K, Samms-Vaughan M, Karmaus W. Are oral contraceptive use and pregnancy complications risk factors for atopic disorders among offspring?Pediatr Allergy Immunol 2004: 15: 487–496.© 2004 Blackwell MunksgaardIn uteroprogramming of atopic manifestations has been suggested. We investigated the association between oral contraceptive (OC) use before, and complications during pregnancy (CDP) and asthma, along with other atopic manifestations. The study is based on neonates from Kingston and St Andrew, a geographic subcohort from the Jamaican Perinatal Morbidity, Mortality Survey conducted in 1986–1987. Information on OC use and CDP was extracted from maternal interviews and medical records. In a follow up in 1997–1998, via interviews with mothers, trained nurses collected information on asthma/wheezing, coughing, eczema, and hay fever. Data, specific to this paper, from birth and 11–12 yr of age was available for a total of 1040 of the 1720 members of the geographic subcohort. Using logistic regression, controlling for confounders, we estimated adjusted odds ratio (aOR) and corresponding 95% confidence intervals (CI). For asthma or wheezing, and coughing, aOR for OC use were 1.81 (95% CI: 1.25–2.61), and 2.72 (95% CI: 1.41–5.24), respectively. CDP was only shown to be a significant risk factor for hay fever. Additionally, a higher number of older siblings were protective for hay fever. The results suggest that asthma in childhood may be programmedin utero. [ABSTRACT FROM AUTHOR]

Sánchez-Borges M, Capriles-Behrens E, Caballero-Fonseca F. Hypersensitivity to non-steroidal anti-inflammatory drugs in childhood. Pediatr Allergy Immunol 2004: 15: 376–380. © 2004 Blackwell Munksgaard Although largely investigated in adults, the issue of hypersensitivity to non-steroidal anti-inflammatory drugs (NSAIDs) in childhood is unsettled due to lack of sufficient data. The purpose of this study is to examine the clinical syndromes of hypersensitivity to NSAIDs in children and adolescents. We performed a review of relevant papers on cutaneous and respiratory adverse reactions triggered by NSAIDs in pediatric patients, and a recount of our own experience in 43 well-characterized NSAID-sensitive children with cutaneous reactions who were submitted to controlled oral challenges with NSAIDs and the new inhibitors of the enzyme isoform cyclooxygenase-2 (COX-2). Although it has been suggested that allergic and pseudoallergic reactions to NSAIDs in children occur rarely, their prevalence remains largely unknown due to the scarcity of studies. About 23% of NSAID-sensitive patients seen in our institutions are young patients aged 8–18 yr who more frequently develop facial angioedema as their main clinical manifestation. Most patients are atopic and show reactions to more than one drug (cross-reactors). Drugs that inhibit COX-2 with higher specificity than classic NSAIDs are better tolerated in young NSAID-hypersensitive patients. [ABSTRACT FROM AUTHOR]

Comments on several issues concerning misinformation perpetrated by the media that immunization may increase the risk of developing allergic diseases. Research findings on the issue; Analysis of pertinent topics and relevant issues; Implications on pediatric allergy immunology.

Introduces the articles featured in the December 2003 issue of "Pediatric Allergy and Immunology".

Unlabelled: The fundamental abnormality in asthma is inflammation of the airways. T-helper 2 (Th2) lymphocytes are the key orchestrators of this inflammation, initiating and propagating inflammation through the release of Th2 cytokines. Interleukins(IL)-4, IL-5 and IL-13. IL-4 and IL-13 promote IgE production by B-cells, mast cell growth and differentiation, and upregulate adhesion molecule expression on vascular endothelium. IL-4 also promotes differentiation of uncommitted Th0 lymphocytes into Th2 lymphocytes. IL-5 promotes differentiation and recruitment of eosinophils and activates them to degranulate within tissues, resulting in damage to the respiratory epithelium. Current treatment of childhood asthma relies predominantly on corticosteroids that have nonspecific anti-inflammatory activity and are associated with potential side-effects. Novel therapies that selectively target the underlying immunopathogenesis hold great promise. Disruption of the Th2 lymphocyte induced allergic inflammatory response represents a novel approach to selectively inhibiting allergic inflammation at its origin. Possible therapeutic interventions include inhibition of Th2 response (CpG oligonucleotides, vaccination, CTLA4Ig fusion protein, IL-12, IL-10), inhibition of IgE (the anti-IgE antibody rhuMAb-E25 omalizumab, which is undergoing clinical trials), inhibition of mediator activity (leukotriene modifiers, which are approved for use in childhood asthma), and targeting Th2 cytokines (soluble IL-4 receptors, IL-5 antibody, IL-13). Other therapeutic approaches targeting downstream events in the allergic inflammatory cascade are also currently under investigation (chemokine receptors CCR3, tryptase inhibitors, and inhibitors of cyclic AMP-specific phosphodiesterase 4).Conclusion: As we further understand the pathophysiology of asthma, the potential to develop novel treatments increases. This paper addresses current possible new treatments for the future. [ABSTRACT FROM AUTHOR]

Previews the contents of the January 2002 issue of the journal 'Pediatric Allergy and Immunology.' Pragmatic study from Finland on the efficacy and safety of inhaled steroid and cromones in the treatment of school-age children; Genetic study highlighting associations between atopy and asthma and particular candidate genes; Insect venom hypersensitivity.

An estimated 2-8% of children have either probable or confirmed food allergy; this corresponds to an average of 1-2 children in a classroom. Food-allergy training for teachers ranges from national-level guidance to variable levels of training, or even none. An estimated 8% to 18% of all food-induced anaphylaxis occurs in school settings. Adrenalin or epinephrine, the first-line medication for the treatment of anaphylaxis, is much more commonly used when reactions occur at school (including childcare centres), but compared to the use when reactions occur elsewhere adrenalin is underused. Individual health plans should be available in schools to help prevent allergic reactions and to serve as support for the use of adrenalin if a reaction does occur. To promote the psychological safety of children with food allergy at schools, a shared decision-making model may be appropriate. The family (and child, when appropriate) and teachers are encouraged to have timely discussions about food-allergy management. But at no time should children be systematically excluded because of their food allergy and zero-tolerance policies about bullying, including food-allergy bullying, are strongly encouraged. This article offers some guidance about managing food allergy in schools, which is intended to promote the physical and psychological safety of children with a food allergy. [ABSTRACT FROM AUTHOR]

Atopic diseases of infants and children are common, debilitating, chronic and sometimes even life-threatening. Several well-conducted studies in high risk babies have demonstrated a significant reduction in the prevalence and severity of atopic diseases with dietary and environmental manipulations. The currently available cow's milk (CM) substitutes for infants are soy protein (SP) formulas (SPFs), hydrolyzed formulas (HF), and home-made meat-based formulas. Soybeans have been cultivated in Eastern countries for many centuries and were first used to feed US babies with CM allergy (CMA) in 1929. Since then, SPFs containing purified SP, a mixture of vegetable oils, and purified carbohydrate have been developed. From a nutritional point of view, SPFs are adequate, support normal growth, protein status, bone mineralization, are well accepted, and economical. SPFs are used for different conditions including CMA, lactose and galactose intolerance and in the management of severe gastroenteritis, and some studies show that feeding SPFs for the first six months of life significantly reduces the prevalence of atopic diseases in high risk babies. Although gastrointestinal symptoms and atopic dermatitis (AD) may occur in some SPF-fed children, anaphylaxis following the ingestion of soybean is extremely rare in children. However, in the past few years the antigenicity/allergenicity of SPFs has been over-emphasized in the medical literature. In this paper on the natural history of soy antigenicity/allergenicity we discuss all the pros and cons of SPFs, their composition and nutritional value, the basic immune definitions, chemistry and characterization of SPs. We then discuss the antigenicity and allergenicity of SPFs in animals, recent data on the use of SPFs and the incidence of soy allergy in children, clinical reactions to SPFs, and the clinical relevance of skin testing and IgE anti-bodies to soy, challenge test procedure, clinical indication of SPFs, and... [ABSTRACT FROM AUTHOR]