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  • 1
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: In order to study the effect of high-dose, intravenous immunoglobulin (IVIG) in severe childhood asthma, we investigated 31 children and adolescents (15 girls, 16 boys) aged 9–22 years (median age of 14 years) suffering from severe bronchial asthma.〈section xml:id="abs1-2"〉〈title type="main"〉MethodsIn a prospective, double-blind fashion, patients received either four doses of IVIG (1 g/kg body weight) or identical doses of intravenous human serum albumin. The first two doses were given on two consecutive days, followed by two further doses at 4 week intervals.〈section xml:id="abs1-3"〉〈title type="main"〉ResultsThere was no statistical difference in the actively treated group when compared with the placebo group in symptom-score, bronchial hyperreactivity or peak-flow-variability. There was a trend for fewer total days of upper respiratory tract infections and also symptom-scores in the IVIG group but these did not reach statistical significance.〈section xml:id="abs1-4"〉〈title type="main"〉ConclusionOur data indicate that treatment with IVIG in asthmatic children did not show a significant reduction in the incidence of upper respiratory tract infections, but the patients who did have upper respiratory infections in the IVIG-group appear to have less protracted infections. Severity and bronchial hyperreactivity do not seem to be affected by the treatment as performed in our study.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 35 (2005), S. 0 
    ISSN: 1365-2222
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background Atopic Dermatitis (AD), hayfever and asthma are commonly summarized as atopic diseases. The spatial distribution of AD differs from that of asthma and hayfever, suggesting that AD might follow a different risk pattern than these diseases. AD can be differentiated into an allergic extrinsic form (EAD) and a non-allergic intrinsic form (IAD). Only EAD might follow the distribution and risk pattern that have been ascribed to asthma and hayfever.Objective To investigate the distribution and risk factor profile of AD and EAD focusing on environmental factors relating to the hygiene hypothesis.Methods Population-based cross-sectional study on 12 601 children aged 5–7 and 9–11 years from Dresden (Eastern Germany) and Munich (Western Germany). Information was obtained by International Study of Asthma and Allergic Childhood questionnaires, dermatological examinations and skin prick testing. AD-diagnosis ever, current AD-symptoms and visible eczema were investigated with their respective extrinsic forms.Results Maternal and paternal history of AD were equally strong determinants of the child's AD status. Factors related to the hygiene hypothesis like day-care attendance and number of older siblings were not associated with a decreased risk of AD. The proportion of EAD within AD was higher in Eastern than in Western Germany. The determinants of the diseases appeared to be similar for both EAD and IAD.Conclusions There was no evidence of the hygiene hypothesis holding true for AD or EAD. AD might be a separate entity than respiratory atopic diseases. Little is known about the risk factors of AD and factors different from those of respiratory allergic diseases should be considered in future research.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  A polymorphism in the promoter region of the CD14 gene, C-159T, has been shown to be associated with increased levels of soluble CD14 (sCD14) and decreased serum immunoglobulin E (IgE) and the expression of a more severe atopic phenotype in previous studies.Methods:  To test if these associations are consistently found in different populations and different age groups, we genotyped 2048 children of different age groups as well as 888 adults from different regions of Germany for the CD14 C-159T polymorphism.Results:  While an association between this promoter polymorphism and levels of sCD14 could be confirmed in our study population (CC: 1017 ng/ml vs TT: 1370 ng/ml, P = 0.03), no association between CD14 C-159T genotypes and IgE levels or the prevalence of atopic diseases was seen.Conclusions:  The lack of association between CD14 genotypes and IgE as well as atopic outcomes in this large German study population seems to indicate that CD14 genotypes may not directly be involved in the development of allergies during childhood.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Especially in childhood, sublingual immunotherapy (SLIT) could offer advantages over subcutaneous therapy. However, limited data on its efficacy is available.Methods:  In four German centres 97 children (age 3–14 years) with allergic rhinoconjunctivitis to grass pollen were enrolled in a prospective, double-blind trial comparing SLIT (Pangramin SLIT®; ALK-SCHERAX, 0.5 μg major allergens, three times per week, 32 months) with placebo. Primary endpoint was a multiple symptom-medication score for changes in seasonal diary entries between the first and third year of the study (SLIT n = 39; placebo n = 38).Results:  The multiple symptom-medication score was significantly reduced by SLIT to 77.3% of the placebo group (P = 0.0498). The subsequent analysis of the single endpoints did not reveal significant differences for symptom scores in favour of SLIT (85.1% of placebo group; P = 0.22). However, the medication score improved significantly (67.1% of placebo group; P = 0.0025). Furthermore, secondary endpoints assessing in vivo immune responses did not differ significantly between the groups. However, retrospective analysis showed some inhomogeneity for clinical and in vitro parameters at the beginning of the study. Allergic side effects with possible relation to the study drug were reported in both groups (SLIT 49%, placebo 27%, P = 0.026).Conclusion:  Our study indicates that SLIT had a positive effect on the reduction of a multiple symptom-medication score, mainly by significantly reducing rescue medication use, but had no significant effect on symptoms alone in children with rhinoconjunctivitis to grass pollen compared with a placebo.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: It has been hypothesized that changes in heating systems and insulation of homes in developed countries have generated an indoor climate favorable to organisms that excrete allergens inducing sensitization and allergic disease. The purpose of this study was to determine the influence of the installation of highly insulated windows and central heating systems on indoor climate, and mite-allergen (Der f 1) and mold spore concentrations. Methods: The bedrooms of 98 apartments were examined before and 7 months (mean) after installation of insulated windows and central heating systems. The air-exchange rate, temperature, and humidity were measured. In settled dust on carpets and mattresses, the number of colony-forming mold spores and the Der f 1 concentration were determined. The inhabitants completed a questionnaire about their lifestyles and housing conditions. Results: The air-exchange rate decreased from geometric mean 0.73 to 0.52 per hour (P=0.029). Temperature (mean 13.4 vs 17.5°C, P〈0.001), and absolute humidity (mean 4.6 g vs 6.2 g H2O/kg air, P〈0.001) increased. Relative humidity remained nearly unchanged (mean 47.6 vs 49.1%). Der f 1 concentrations on carpets (geometric mean 0.65 vs 1.28 μg/g dust, P〈0.001) and mattresses (geometric mean 1.56 vs 2.40 μg/g, P=0.002) increased. Among the fungi that were analyzed, only the thermotolerant species Aspergillus fumigatus increased (geometric mean 20 vs 60 colony-forming units/g carpet dust, P=0.02). Conclusions: The findings of this study suggest that the installation of insulated windows and central heating systems is associated with an increase of Der f 1 concentrations in carpet and mattress dust and A. fumigatus in carpet dust in apartment bedrooms.
    Type of Medium: Electronic Resource
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  • 6
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Pediatric allergy and immunology 8 (1997), S. 0 
    ISSN: 1399-3038
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Safety and efficacy of sublingual (sublingual-swallow) immunotherapy (IT) with house dust mite extract were evaluated in 30 children (6 - 152/3 years of age) over the first 12 months of an ongoing study. The cumulative dose was 570 μg Der p I (five times that administered with subcutaneous therapy). Safety: One patient on active treatment dropped out after 8 weeks because of a subjective feeling of severe weakness, questionably induced by the therapy. Five patients on active therapy and one patient on placebo reported minor local side effects. Efficacy: Pulmonary symptoms were reduced after 12 months in actively treated asthmatics, but this was not consistent with the lack of improvement in bronchial reactivity, skin sensitivity and specific IgG and IgG4 against D. pt. in this group. In patients with rhinitis nasal sensitivity was reduced in the placebo group without concomitant improvement in the nasal symptom score. Specific IgE (D. pt. and D. f.) in creased significantly more in the active treatment group after 3 and 12 months. We conclude that sublingual IT over 12 months with the fivefold Der p 1 dose of subcutaneous IT was well tolerated, but there was no consistent clinical or immunological benefit compared to placebo.
    Type of Medium: Electronic Resource
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  • 7
    ISSN: 1433-0474
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Das Erstmanifestationsalter liegt mit über 80% vor dem 10. Lebensjahr; das Maximum sogar zwischen 3. und 5. Lebensjahr. Jeder Pädiater sollte sich also in Diagnostik und Therapie dieser Erkrankung auskennen.
    Type of Medium: Electronic Resource
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