Acute otitis media in schoolchildren: allergic diseases and skin prick test positivity

Conclusions. Single and repeated episodes of acute otitis media (AOM) in 10-year-old children were associated with reported allergic disease. Further, skin prick test (SPT)-negative children with reported asthma and allergic rhinoconjunctivitis had increased risk of AOM. We suggest that optimal treatment of allergic symptoms may have an effect on AOM in school children. Objective. The objective of the study was to estimate associations between AOM, allergic diseases and SPT positivity in 10-year-old children. Materials and methods. Population-based cross-sectional study of 3406 10-year-old children living in Oslo. Main outcome measures were questionnaire-based information on AOM and reported physician-diagnosed allergic diseases with symptoms during the last year. In addition, 2657 children were skin prick tested. Logistic regression analyses were performed to estimate associations and control for potential confounders. Results. One or more episodes of AOM were present in 13.8% (n=470) of the children; 9.7% (n=331) had single episodes, while 4.1% (n=139) had two or more infections. We found a statistically significant association between AOM and reported allergic diseases, strongest for AOM and asthma with odds ratio 2.7 (95% confidence interval 1.8–4.0) and 2.3 (95% confidence interval 1.3–4.3) for single and two or more episodes of AOM, respectively. The risk for AOM was increased in asthmatic SPT-negative children compared with asthmatic SPT-positive children, the odds ratios were 3.0 (1.7–5.4) and 1.5 (0.8–2.8), respectively. The same tendency was found for allergic rhinoconjunctivitis.     

Performance of EAST in diagnosing inhalant allergens in children with allergic rhinitis

The performance of enzyme linked immunosorbent assays (EAST) for identifying six indoor allergens was evaluated using skin prick test (SPT) as reference tests in 154 children with allergic rhinitis. Sensitivity of EAST ranged from 9% (cat) to 54% (HDM) with specificity of 74%(cockroach) to 100% (cat) with an agreement ranged from 58 to 86%. Cut off values ?> ?0.35 kU/L showed best sensitivity and specificity. Our findings agree with extant literature which suggests that the ability of EAST to determine the precipitating allergen is moderate. Assays for definitively identifying the inhalant allergen are currently not available.     

Do we still need oral food challenges for the diagnosis of food allergy?

Food challenges are standard in the diagnosis in patients suspected of being allergic to food. However, their role is regularly questioned due to the time required to perform them, and to their cost and the inherent risk of severe reactions. Food challenges have been challenged by recent advances defining threshold values for food‐specific IgE helping to predict the probability of having symptoms to the suspected food. Also, identification of major allergens to various highly allergenic foods such as peanuts or tree nuts has contributed to an increased accuracy of IgE testing. Altogether, these new data have contributed to a better definition of the role of oral food challenges in the diagnosis of food allergy. Oral food challenges are not outdated and remain the gold standard in the diagnosis of food allergy.     

Diet in infancy and bronchial hyperreactivity later in childhood.

Sixty-seven atopy-prone children (atopic family group, AFG) and 52 children with no family history of atopy (NAFG) were followed for 10 years. During infancy, the mothers of the newborn AFG children were advised to adjust their infants' diet, with a view toward minimizing the risk of atopy, and not to keep pets. Pulmonary function tests, methacholine inhalation challenge (MIC), and skin prick tests (SPT) were done in order to evaluate the bronchial reactivity and skin reactivity in the two groups. A pathological result in MIC was found in 20 (30%) of the AFG children and in 10 (19%) of the NAFG children. Such results of MIC were more common in the children with positive SPT results than in those without (67% vs. 24%). In regard to the diet consumed in infancy, MIC was pathological in 23% of children with and in 36% without prophylactic diet in infancy. For MIC, using the new, Spira electro 2 dosimeter equipment, the sensitivity was 75% and specificity 97%, but the predictive value for diagnosing bronchial asthma was only 25%. The important advantage of our method is that the degree of bronchial reactivity can be estimated by responses to increasing provocative doses. Our observations confirm that the new method is suitable for detecting bronchial asthma in clinical practice but it seems not to be optimal for epidemiological studies. We concluded that later bronchial hyperreactivity can not be diminished by avoiding home pets or providing a hypoallergenic diet during infancy.     

丘疹性荨麻疹患者粉尘螨皮肤点刺试验的检测

目的：探讨丘疹性荨麻疹与粉尘螨过敏原的相关性。方法选用粉尘螨皮肤点刺诊断试剂盒对79例丘疹性荨麻疹患者及18例正常健康人进行皮肤点刺试验,并用磷酸组胺甘油生理盐水溶液为阳性对照,甘油生理盐水溶液为阴性对照。79例丘疹性荨麻疹患者按年龄分为未成年组、青年组与中老年组。结果丘疹性荨麻疹组43例患者阳性,正常健康组3例阳性,2组间差异有统计学意义（P<0.05)。未成年组18例,9例患者阳性;青年组47例,27例患者阳性;中老年组14例,7例患者阳性,各年龄组间阳性率差异无统计学意义。结论丘疹性荨麻疹与粉尘螨过敏原有一定相关性,但粉尘螨过敏与年龄无相关性。     

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??Objective To understand the trend of inhaled allergen positive rate among 0-12-year-old children from 2006 to 2013 in Chongqing Children’s Hospital??and to provide evidence for preventing allergic rhinitis in children. Methods??All cases were collected from Otorhinolaryngological Department of the Children’s Hospital of Chongqing Medical University from 1st January??2006 to 29th October??2013. Totally 10983 children with allergic rhinitis aged 0-12 years old in Chongqing urban districts were enrolled. All the patients underwent skin prick test??SPT?? with 13 standardized common inhalant allergens. Then the children were divided into the infants group??aged??3 years????preschool children??3 years≤aged??7 years?? and school-age children??7 years≤aged??12 years?? according to age. The trend of inhaled allergen positive rate over 8 years was observed. Results From 2006 to 2013??the SPT positive rate increased sharply??then tended to be stable??and then decreased slowly??Curve Estimation??R 2??0.836??adjustment R 2??0.770. ANOVA test??F??12.727??P??0.011??. It may be related to meteorological factors. With the growth of age??the positive rates of Dermatophagoides pteronyssinus??Dermatophagus farinae??Blomia tropicalis??Cockroaches??cat fur??dog fur and mugwort increased??which were 121.200??123.060??103.237??104.784??17.042??8.515 and 11.256??respectively????P was 0.000??0.000??0.000??0.000??0.000??0.014 and 0.004??respectively??. Conclusion ??Meteorological factors and age may have effects on allergic rhinitis??AR?? in children??with the growth of age??the positive rates of inhaled allergens have tendency variation.