Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the International Study of Asthma and Allergies in Childhood (ISAAC)

BACKGROUND: As part of the International Study of Asthma and Allergies in Childhood (ISAAC), prevalence surveys were conducted among representative samples of school children from locations in Europe, Asia, Africa, Australia, North and South America. SUBJECTS: 257,800 children aged 6-7 years from 91 centres in 38 countries, and 463,801 children aged 13-14 years from 155 centres in 56 countries. METHODS: Written symptom questionnaires were translated from English into the local language for self-completion by the 13-14-year-olds and completion by the parents of the 6-7-year-olds. Rhinitis was described as a problem with sneezing, or a runny, or blocked nose when you (your child) DID NOT have a cold or the flu. Additional questions were asked about rhinitis associated with itchy-watery eyes, interference with activities and a history of hay fever ever. RESULTS: The prevalence of rhinitis with itchy-watery eyes ("rhinoconjunctivitis") in the past year varied across centres from 0.8% to 14.9% in the 6-7-year-olds and from 1.4% to 39.7% in the 13-14-year-olds. Within each age group, the global pattern was broadly consistent across each of the symptom categories. In centres of higher prevalence there was great variability in the proportion of rhinoconjunctivitis labelled as hay fever. The lowest prevalences of rhinoconjunctivitis were found in parts of eastern Europe, south and central Asia. High prevalences were reported from centres in several regions. CONCLUSION: These results suggest substantial worldwide variations in the prevalence and labelling of symptoms of allergic rhinoconjunctivitis which require further study. These differences, if real, may offer important clues to environmental influences on allergy.     

Measurement of allergen-specific IGG for diagnosis of atopic diseases in children]

The concentrations of allergen-specific IgE were measured in 146 children with respiratory, skin, and mixed forms of allergic diseases. The spectrum of the allergens was determined and specific features for each of the studied patient populations defined.     

Inactivation of heamolytic complement by house dust allergen in the serum of children with atopic diseases

Two experiments are presented in which lateralization of monaural, auditory input affected the evaluation of verbal passages. In Experiment 1, subjects listened to taped passages that consisted of three levels (positive, neutral, and negative) of tone of voice crossed with three similar levels of content or meaning, making a total of nine different tone/content combinations. Subjects rated these passages as positive, neutral, or negative, and although they were not instructed about which cues (tone or content) to use, 29 of 36 subjects who listened on the left ear primarily used the tone-of-voice cues to rate the passages, whereas 21 of 36 subjects who listened on the right ear used the content cues (p less than .01). In Experiment 2, subjects were asked to make objective ratings of both tone of voice and content. Subjects who listened on the right ear were more accurate in rating both cues. The lateral differences in evaluating the auditory stimuli are discussed in the framework of the left hemisphere's specialization for analytic processing of objective information and the right hemisphere's specialization for the holistic processing of subjective or emotional information. However, each hemisphere's specialization for tone and content cues can be greatly affected by the demands of the experimental task.     

Open fractures of the arm in children

We describe the results of treatment of open fractures of the humerus, radius and ulna in 61 children. Most were due to low-energy trauma and were rarely associated with head or other injuries; 72% were Gustilo type I, 15% type II and 13% type III. Fifteen children (25%) had open diaphyseal, supracondylar or T-shaped fractures of the humerus. Arterial injuries occurred in two (13%) and nerve injuries in 7 (47%). All nerve injuries recovered spontaneously. The long-term results in 13 children were excellent or good in 11 (85%) and fair in two (15%). Forty-six children (75%) had open forearm fractures. Arterial injuries occurred in one (2%), nerve injuries in five (11%) and a compartment syndrome in five (11%). Ruptured radial and ulnar arteries and median and ulnar nerves were repaired in one child. All other nerve injuries resolved spontaneously. Early compartment release in five children prevented Volkmann's ischaemic contracture. Normal union occurred in only 36 children (78%). Delayed union, nonunion, malunion and refracture frequently complicated type-II and type-III fractures of the shafts of the radius and ulna. The long-term results in 38 children were excellent or good in 33 (87%), fair in 4 (11%) and poor in one (2%). The short-term results for open fractures of the humerus were better than for open fractures of the forearm, but the long-term results were similar being excellent or good in 86% of the children.     

An explanation for the season-of-birth effect in schizophrenia and certain other diseases.

There is considerable evidence that an excessive number of schizophrenics are born in winter and spring. This season-of-birth effect is often thought to be a clue to the etiology of schizophrenia. The present authors demonstrate that the effect could be a methodological artifact: a spurious season-of-birth effect can occur when a disease has a reasonably long interval between the onset of symptoms and the time of 1st admission. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Frequencies of T cells expressing interleukin-4 and interleukin-5 in atopic asthmatic children. Comparison with atopic asthmatic adults

T-cell-derived cytokines have been implicated in the pathogenesis of asthma and it has been suggested that Th2-type cytokines (interleukin-4 [IL-4], interleukin-5 [IL-5]) are pivotal in the allergic inflammation. However, there are little data on human cytokine production by individual T cells at the protein level, in particular in asthmatic children. In this study we analyzed the cytokine production at the single cell level in peripheral blood from mild atopic asthmatic (AA) children and adults and age-matched atopic nonasthmatic (AN) and nonatopic nonasthmatic (NN) control subjects (n = 9 in each group) using the technique of intracellular cytokine detection by flow cytometry. Comparing asthmatic children with atopic and nonatopic control subjects, an increased percentage of IL-5-producing T cells (AA: median 4.9% [range 1.1 to 8.9%]; AN: 0.3% [0.2 to 0.9%], p = 0.003; NN: 0.4% [0.1 to 3.8%], p = 0.001) was detectable, with a positive correlation to the number of peripheral eosinophils and to bronchial hyperresponsiveness. The frequency of IL-4-producing T cells was increased in both atopic groups compared with nonatopic controls (AA: 1.2% [0.2 to 2.6%], p = 0.011; AN: 0.8% [0.4 to 3.7%], p = 0.007; NN: 0.4% [0.2 to 0.9%]) with a positive correlation to total IgE concentration. In adults there were no differences in IL-5- or IL-4-producing T cells between all three groups. A substantial proportion of T cells coproducing IL-4 and IL-5 was not detectable in children and adults. These findings indicate that in asthmatic children the frequencies of Th2-type-producing T cells are increased and that expression of IL-4 and IL-5 is regulated independently.     

Attribution of responsibility to the self and other in children and adults.

240 Ss from 5 age groups (6–7.5, 8–9.5, 10–11.5, 12–13.5 yrs and adult graduate and undergraduate students) were administered stories representing F. Heider"s (1958) criteria for responsibility attribution under 1 of 2 conditions—the actor was either a hypothetical other or the self. As predicted, an Age?×?Stimulus Level interaction was found, although its nature differed for attribution of blame and causality. In relation to the moral judgment measure, a further interaction of Story Character?×?Age was found, and response patterns formed a Guttman scalogram. However, scale types were not clearly age linked. Although these data confirm the utility of Heider"s responsibility-attribution criteria, no strong evidence was obtained to support a developmental interpretation of his theory. Results are also discussed in terms of Piagetian research and an extension of Heider"s schema. (22 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Managing atopic eczema: the needs of children

Atopic eczema is a common inflammatory condition of the skin. The disability and psychosocial impact of atopic eczema can be considerable. Existing dermatology clinics usually do not provide the time and the educational facilities essential for children with atopic eczema and their families.     

Behavioral effects of caffeine and other methylxanthines on children.

Subjective, performance-enhancing, dependence-producing, and adverse effects of methylxanthines are examined, based on computerized searches (i.e., Medline and PsycLIT). High doses (>3 mg/kg) of caffeine in children who consume little caffeine produce negative subjective effects such as nervousness, jitteriness, stomachaches, and nausea. Whether lower doses produce positive subjective effects has not been adequately tested. Caffeine appears to slightly improve vigilance performance and decrease reaction time in healthy children who habitually consume caffeine but does not consistently improve performance in children with attention deficit-hyperactivity disorder. Early studies suggest caffeine self-administration and withdrawal can occur in some adolescent soda drinkers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Efficacy trial of bioresonance in children with atopic dermatitis

The unfavorable breast contours resulting from a reductive mammaplasty or a mastopexy influenced the authors into developing a technique that provided reduction of the breast base and axillary pole, convenient medial position of the lateral pole and substantial conification of the breast tissue to help project the areolomamillary complex to the apex of that cone. From March 1987 to May 1996 two hundred and seventeen operations were performed with this technique that consists of construction of three glandular flaps and maximum preservation of the skin covering. The results obtained showed to be very satisfactory and more lasting.     

IL-4 and interferon-gamma production in children with atopic disease

The mechanism by which 7,12-dimethylbenz[a]anthracene (DMBA) produces cytotoxicity in lymphocytes was investigated in these studies using the murine A20.1 B cell lymphoma. Results show that in vitro exposure of these cells to 10-30 microM DMBA for 4 hr produced an increase in intracellular Ca2+, DNA fragmentation, and subsequent cell death. Elevation of Ca2+ and DNA fragmentation induced by DMBA were greatly pronounced when the A20.1 cells were exposed at high cell density (10(7) cells/ml). DMBA-induced DNA fragmentation and cell death were inhibited by coexposure of A20.1 cells to a calcium chelator (EDTA), a general nuclease and polymerase inhibitor (aurintricarboxylic acid), and a protein synthesis inhibitor (cycloheximide). These agents have been previously shown to inhibit apoptosis in lymphocytes and other cells exposed to chemical agents. We also found that cyclosporin A, an inhibitor of Ca(2+)-dependent pathways of T and B cell activation, prevented apoptosis in the A20.1 cell line. These results demonstrate that DMBA induces programmed cell death (apoptosis) in the A20.1 murine B cell lymphoma by Ca(2+)-dependent pathways. The increased sensitivity of A20.1 at high cell density to Ca2+ elevation and DNA fragmentation suggests that cell to cell interactions may also be important in this process.     

Diagnostic tests in children with atopic dermatitis and food allergy

BACKGROUND: Skin testing is a common diagnostic procedure in food allergy. The skin prick test is the test of first choice for investigating the immediate IgE-mediated reaction. The skin application food test (SAFT) has been developed on the basis of the mechanism of the contact urticaria syndrome (CUS). METHODS: We studied the relevance of the SAFT in children younger than 4 years with atopic dermatitis and (suspected) food allergy as compared with the prick-prick test, the radioallergosorbent test (RAST), and the oral challenge. In the skin tests, we used fresh food, in the same state as it was consumed. RESULTS: There was a good agreement between the SAFT and the prick-prick test. A moderate agreement was observed between the SAFT and the serologic test (RAST). Significantly more positive results in the RAST were observed than in the SAFT. There was very good agreement between the SAFT and the oral challenge (kappa = 0.86). CONCLUSIONS: The SAFT is a reliable and child-friendly skin test for evaluating (suspected) food allergy in children younger than 4 years with atopic dermatitis. The very good correlation with the oral challenge indicates that one may probably consider the SAFT a "skin provocation" in children younger than 4 years.