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Notes: Skin prick testing (SPT) is the standard method for diagnosing allergic sensitization but is to some extent performed differently in clinical centres across Europe. There would be advantages in harmonizing the standard panels of allergens used in different European countries, both for clinical purposes and for research, especially with increasing mobility within Europe and current trends in botany and agriculture. As well as improving diagnostic accuracy, this would allow better comparison of research findings in European allergy centres. We have compared the different SPT procedures operating in 29 allergy centres within the Global Allergy and Asthma European Network (GA2LEN). Standard SPT is performed similarly in all centres, e.g. using commercial extracts, evaluation after 15–20 min exposure with positive results defined as a wheal 〉3 mm diameter. The perennial allergens included in the standard SPT panel of inhalant allergens are largely similar (e.g. cat: pricked in all centres; dog: 26 of 29 centres and Dermatophagoides pteronyssinus: 28 of 29 centres) but the choice of pollen allergens vary considerably, reflecting different exposure and sensitization rates for regional inhalant allergens. This overview may serve as reference for the practising doctor and suggests a GA2LEN Pan-European core SPT panel.

Notes: The prevalence of asthma and bronchial hyperreactivity has been reported to be higher in athletes than in the general population. This has also been related to reported asthma in order to obtain permitted use of β2-agonists, whose assumption in athletes is ruled by anti-doping regulations. The paper addresses the issue whether the recently established and evaluated rules of the International Olympic Committee on tests and procedures for diagnosis of asthma in athletes and permitted use of β2-agonists are consistent with an adequate diagnosis and management of asthma according to international guidelines.

Notes: Background: Prevalence of asthma and quality of asthma care both influence hospital admission rates for childhood asthma. Therefore, we aimed to assess possible changes in hospital admission rate for acute asthma in Oslo, Norway, from 1980 to 1995, as well as evaluate the possible effect of changes in asthma treatment upon hospitalization for acute asthma in this period. Methods: All pediatric patient records from the two municipal hospitals in Oslo from 1980 through 1995 with the discharge diagnosis (ICD-9) acute asthma, acute bronchitis/bronchiolitis, pneumonia, and/or atelectasis were thoroughly reviewed. Results: Of the 3538 children admitted for acute asthma, 66% were boys and 75% were younger than 4 years, and the admittance rate increased significantly among children aged 0–3 years. First admissions increased throughout the study, whereas readmissions, as well as the mean duration of hospital stay, decreased significantly. Prophylactic treatment with inhaled steroids prior to admission increased over 1980–89, but stabilized thereafter. The use of a short course of systemic steroids during admission increased markedly from 1991. Conclusions: The findings of increasing first admission rate as well as overall admission rate for acute asthma in children under 4 years of age, but decreasing readmissions as well as number of treatment days in hospital, probably reflect changes in the management of the disease, as well as an increasing prevalence of childhood asthma.

Notes: The efficacy of loratadine and terfenadine in perennial allergic rhinitis was evaluated in a double-blind, selected cross-over study consisting of two phases. During the first phase, 76 patients with perennial allergic rhinitis, 8–67 years old, were included in the study. Of these, 41 patients received loratadine 10 mg daily, and 35 patients received terfenadine 60 mg twice daily, for 2 weeks. According to symptoms and side-effects, 32 patients were classified as responders to loratadine, and 28 patients as responders to terfenadine. All observed symptoms were significantly reduced in both treatment groups, but with no significant differences between the two groups. Side-effects were few and mild. In patients with normal IgE, loratadine was significantly superior to terfenadine in relieving nasal secretion, whereas terfenadine was significantly superior to loratadine in relieving nasal congestion. In patients with increased IgE, patients treated with loratadine showed significantly greater reduction in sneezing than patients treated with terfenadine. A positive correlation between total IgE and reduction in overall symptoms was found for patients treated with loratadine, whereas a negative correlation was found for patients treated with terfenadine. During the second study phase, the nonresponders received the other drug for 2 weeks. All seven nonresponders to terfenadine responded to loratadine after crossing over, whereas four of nine nonresponders to loratadine responded to terfenadine. Nonresponders to one drug may respond to the other drug. Thus, more than one antihistamine drug should be tried in perennial allergic rhinitis if the first fails.

Notes: Background:  Hypoxic gas inhalation has been reported to enhance airway responsiveness and results in bronchoconstriction in animal models and in humans with asthma. However, the data have so far been conflicting. The aim of the present study was to examine the effect of reduced barometric pressure on exercise-induced bronchoconstriction (EIB) in subjects with asthma.Methods:  Twenty subjects (10–45 years old, ♂/♀ = 13/7) with asthma (at least 10% reduction in forced expiratory volume in 1-second postexercise) participated in exercise testing in barometric pressure corresponding to altitudes of 200 (normobaric) and 2500 (hypobaric) m above sea level in random order on separate days. Lung function was measured before and after exercise, as well as after inhalation of salbutamol. Heart rate, oxygen uptake (〈inlineGraphic alt="inline image" href="urn:x-wiley:01054538:ALL914:ALL_914_mu1" location="equation/ALL_914_mu1.gif"/〉), arterial oxygen saturation (SpO2), respiratory gas exchange ratio (RER) and minute ventilation (〈inlineGraphic alt="inline image" href="urn:x-wiley:01054538:ALL914:ALL_914_mu2" location="equation/ALL_914_mu2.gif"/〉) were measured during exercise.Results:  There was no difference in lung function after exercise. The 〈inlineGraphic alt="inline image" href="urn:x-wiley:01054538:ALL914:ALL_914_mu3" location="equation/ALL_914_mu3.gif"/〉 and HRpeak during exercise did not differ. The RERpeak was higher (P = 0.04) in hypobaric environment. The 〈inlineGraphic alt="inline image" href="urn:x-wiley:01054538:ALL914:ALL_914_mu4" location="equation/ALL_914_mu4.gif"/〉 decreased 10.1% (7.2–13.0) [mean (95% confidence intervals)] (P 〈 0.001) from normobaric to hypobaric environment. At the same time, SpO2 at 〈inlineGraphic alt="inline image" href="urn:x-wiley:01054538:ALL914:ALL_914_mu5" location="equation/ALL_914_mu5.gif"/〉 decreased from 94.4 (92.2–96.6) to 85.6% (82.8–88.4) (P 〈 0.001).Conclusions:  A barometric pressure corresponding to altitude of 2500 m did not increase EIB in subjects with asthma. The reduction in 〈inlineGraphic alt="inline image" href="urn:x-wiley:01054538:ALL914:ALL_914_mu6" location="equation/ALL_914_mu6.gif"/〉 is most probably due to the lower SpO2 in hypobaric environment.

Notes: Background: Little is known about cockroach sensitization in Scandinavia, whereas cockroaches are implicated in allergic diseases throughout large parts of the world. In association with the Genetics of Asthma International Network (GAIN) study, we report sensitization to cockroaches and possible association with IgE-mediated diseases in Norway. Methods: 100 Norwegian families (426 subjects) of 7–35-year-old sibling-pairs with asthma and their parents underwent questionnaire/interview (medical and exposure history), skin prick test (SPT) to common local inhalant allergens and German cockroach, and IgE specific to mites, mosquito, shrimp and cockroach. Cockroach sensitization was defined as positive if there was a positive (≥ 3 mm) skin prick test and/or presence of IgE antibody of class 2 or more. Results: Thirty-one subjects (7.5%) were sensitized (five monosensitized) to cockroach (27 by skin prick test and seven by IgE antibody, all with additional inhalant allergy). Co-sensitization was most common to grass (in 61%), cat (48%), dog (48%) and mites (42%). Reported allergic diseases in cockroach-sensitized subjects were asthma and rhinitis (n = 10), asthma only (n = 9), rhinitis only (n = 2) and neither asthma nor rhinitis (n = 10). Conclusions: Since cockroach sensitization was relatively frequent in Norwegian atopic families, albeit with unclear clinical implications, we suggest that cockroach allergy should be considered in atopic subjects with respiratory disease.

Notes: Our objective was to study whether children with reported asthma differed from children with wheeze but without asthma, and from children with neither asthma nor wheeze, regarding lung function, bronchial hyper-responsiveness (BHR) using methacholine inhalation, exercise-induced bronchoconstriction (EIB), and skin prick test (SPT) reactivity. School children (n=2188), enrolled in a survey of asthma, were classified into three mutually exclusive groups by parental report of: asthma, wheeze, and no asthma/no wheeze. A random sample of 80 children in each group was tested (n=240). Among asthmatics, 68% (95% confidence interval (CI), 57–79) had a BHR (measured as PD20 forced expiratory volume in 1 s (FEV1) ≤ 8.16 μmol using methacholine) compared to 31% (CI 20–42%) and 30% (CI 19–40%) in the wheeze and no asthma/no wheeze groups. The dose–response slope (DRS) confirmed the PD20 data and distinguished equally between groups. EIB (≥10% fall in FEV1) was more frequent (40%, CI 29–52%) among asthmatics than among children with wheeze (12%, CI 4–19%) and no asthma/no wheeze (7%, CI 1–13%). The prevalence of at least one positive SPT was twice as high in the asthma group (58%, 47–69%) than in the wheeze (27%, CI 16–37%) and the no asthma/no wheeze (25%, 15–35%) groups. These results indicate that children with asthma differ from children with wheeze and children with no asthma/no wheeze regarding lung function, BHR, EIB, and SPT reactivity. Children with wheeze are more similar to children with no asthma/no wheeze with respect to these parameters.