Mould-specific immunoglobulin G antibodies in students from moisture- and mould-damaged schools: A 3-year follow-up study

Immunoglobulin G (IgG) antibodies to moulds have been used as biomarkers of mould exposure, though their role reflecting exposure is not confirmed. The purpose of the present study was to evaluate the changes in mould-specific IgG antibodies in children during a 3-year follow-up in relation to changes in exposure, and to allergic and respiratory morbidity. In 1996, 212 primary school students with asthma, wheezing or prolonged cough participated in a clinical study, including clinical examination, skin-prick tests to 12 moulds and mould-specific IgG determinations to 24 moulds. In 1999, 144 students of the same cohort participated in an identical follow-up study; among them, mould-specific IgG was measured in 121 students. No association was found between IgG antibodies to moulds and exposure to moisture or moulds in schools. Likewise, changes in mould-specific antibodies were only weakly associated with changes in exposure. Mould-specific IgG antibodies had no significant association with asthma, wheezing or cough episodes. IgG antibodies to moulds seem to be poor markers of exposure among children exposed to moisture or moulds at school.     

Diagnostic, clinical and laboratory turnaround times in troponin T testing

BACKGROUND: At present, measurements of troponins play a key role in the diagnosis of myocardial infarction. There is a consensus that a turnaround time (TAT) of 1 h or less should be achieved for cardiac marker assays. However, little is known about the real delays between the patient's arrival at the emergency department (ED) and the reporting of the test. METHODS: In the present study, the TATs of a cardiac marker, troponin T (TnT), were analyzed at a central laboratory at Kuopio University Hospital in a population consisting of 215 patients who were admitted to the hospital ED. Four specific time points were recorded: 1) the time of the patient's arrival to the ED, 2) the time of the ordering of the test, 3) the time when blood samples arrived at the laboratory, and 4) the time of completion and reporting of the test. RESULTS: The median diagnostic TAT from patient's arrival to the reporting of the TnT result was 122 min. The clinical median TAT was 46 min and the laboratory median TAT was 69 min. Laboratory TAT consisted of the preanalytical TAT at the ED (median 14 min), pre- and postanalytical TAT in the laboratory (median 40 min), and the analytical TAT (on average 10 min). The laboratory TAT was approximately half of the complete diagnostic TAT. CONCLUSIONS: On the basis of this analysis, we propose new concepts for the TATs in the diagnostic process: diagnostic TAT which consists of clinical and laboratory TAT. The focus should be shifted from the analytical TAT to the diagnostic process as a whole.     

Indoor air particles and bioaerosols before and after renovation of moisture-damaged buildings: the effect on biological activity and microbial flora

Many building-related health problems coincide with moisture damage and mold growth within a building. Their elimination is assumed to improve indoor air quality. The aim of this study was to follow the success of remediation in two individual buildings by analyzing the microbial flora and immunotoxicological activity of filter samples. We compare results from samples collected from indoor air in the moisture-damaged buildings before and after renovation and results from matched reference buildings and outdoor air. The microbial characteristics of the samples were studied by analyzing ergosterol content and determining the composition of fungal flora with quantitative polymerase chain reaction (QPCR). In addition, the concentrations of particles were monitored with optical particle counter (OPC). The immunotoxicological activity of collected particle samples was tested by exposing mouse macrophages (RAW264.7) for 24 h to particle suspension extracted from the filters, and measuring the viability of the exposed cells (MTT-test) and production of inflammatory mediators (nitric oxide, IL-6 and TNFα) in cell culture medium by enzyme-linked immunoassay (ELISA). The results show that for Location 1 the renovation decreased the immunotoxicological activity of the particles collected from damaged building, whereas no difference was detected in the corresponding samples collected from the reference building. Interestingly, only slight differences were seen in the concentration of fungi. In the Location 2, a decrease was seen in the concentration of fungi after the renovation, whereas no effect on the immunotoxicological responses was detected. In this case, the immunotoxicological responses to the indoor air samples were almost identical to those caused by the samples from outdoor air. This indicates that the effects of remediation on the indoor air quality may not necessarily be readily measurable either with microbial or toxicological parameters. This may be associated with different spectrum of harmful agents in different mold and moisture-damaged buildings.     

Skin-prick test findings in students from moisture- and mould-damaged schools:A 3-year follow-up study

Dampness and moisture problems in a building may cause growth of moulds, leading to sensitization and symptoms in the inhabitants. The mechanism by which sensitization to moulds takes place has remained obscure; in particular, the role of atopy is not clear. In 1996, 622 pupils (7–13 years of age) attending a school with a moisture problem (index school; 414 pupils) and a control school (208 pupils) were screened using a questionnaire. Two-hundred and twelve children had doctor-diagnosed asthma, parental-reported wheezing or prolonged cough, and they participated in a clinical study, which included skin prick tests (SPT) to 12 moulds. An identical, follow-up study was performed 3 years later in 1999. In the follow-up study, 144 of the original 212 students participated. They were now attending four different schools: the index primary school had been renovated and the control school remained unchanged, but the two secondary schools had moisture and mould problems. The purpose of the study was to evaluate the occurence of mould allergy in children of school age and to compare sensitization to moulds in relation to age, exposure, asthma, and atopy. In 1999, SPT responses to moulds were demonstrated in 17 (12%) of the 144 children. Six children had SPT reactions ≥ 3 mm and all but one were older than 14 years. During the 3-year follow-up period, mould allergy developed in five children and disappeared in two children. Five of the six children with reactions ≥ 3 mm to moulds had positive responses to other allergens, five had clinical atopy but only two had asthma. Likewise, all six children had been exposed to moisture and dampness in the school buildings. In conclusion, mould allergy diagnosed by SPTs was rare in students. Most reactions to moulds were in students older than 14 years with multiple SPT reactions to common allergens, and there was no significant association with asthma.     

A low high density lipoprotein (HDL) level is associated with carotid artery intima-media thickness in asymptomatic members of low HDL families

Low serum high-density lipoprotein cholesterol (HDL-C) is a strong predictor of coronary heart disease (CHD). The aim of the present study was to evaluate the metabolic parameters predicting the atherosclerotic changes in asymptomatic members of low HDL-C families. We performed carotid B-mode ultrasonography with intima-media thickness (IMT) measurement for 89 asymptomatic members of Finnish low HDL-C families. The family members were categorized as affected or unaffected according to the 10th age-gender specific HDL-C percentile. In the affected group, the most marked decrease of HDL subclasses was observed for HDL2-C when compared with the unaffected (109% difference). In the partial correlation analyses, age and gender showed significant correlations with the mean IMT (for age, r=0.880, P<0.001, and for gender, r=-0.361, P=0.018). Importantly, HDL-C and HDL2-C were significantly inversely related to the mean carotid IMT, also after correction for age (for HDL-C, r=-0.186, P=0.043, for HDL2-C, r=-0.208, P=0.029, when adjusted for age). The correlation for HDL-C was significant also when adjusted for gender. In conclusion, low HDL-C is associated with increased carotid artery IMT in asymptomatic members of low HDL-C families.     

High percentage of oral lichen planus and lichenoid lesion in oral squamous cell carcinomas

Objective: Oral lichen planus (OLP) and lichenoid lesions (OLL) are regarded as precursor lesions of oral squamous cell carcinoma (OSCC) with potential for malignant transformation. This potential is not clear due to difficulties in diagnosis of OLP and OLL. Our aim was therefore to evaluate previously identified OLP and OLL as precursor lesions in OSCC and to identify cancer related etiological factors such as smoking and alcohol consumption.

Material and methods: We retrospectively reviewed all cases (total 323, comprising 164 females and 159 males) with OSCC treated at the Department of Oral and Maxillofacial Diseases and Surgery, Helsinki University Hospital during 2015. Confirmed by histopathological biopsy, 58 (17.9%) had OLP and 13 had OLL (4.0%) as precursor lesion.

Results: Patients with OLP were slightly older than those without it. OLP was more common in females than in males (p?p?=?.006) and cancer relapses less common (p?=?.005). Smoking was less frequent in patients with OLP and OLL (p?p?Conclusion: Our findings confirm the importance of active follow-up of all patients with OLP and OLL even in patients who do not fit a traditional high-risk category for OSCC.