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Biomedical subjects

E Taudorf

Publications and source records attributed to E Taudorf.

At least 19 recordsLinked to original sources

Indices of asthma among atopic and non-atopic woodworkers.

AIMS: To investigate the relation between wood dust exposure and different indices of asthma among woodworkers and non-exposed subjects. METHODS: A total of 302 woodworkers and 71 non-exposed subjects answered a respiratory health questionnaire, underwent a non-specific bronchial provocation test using the Yan method, and received a skin prick test with 12 common inhalant allergens. Subgroups performed repeated peak flow monitoring and underwent a reversibility test. A total of 347 dust measurements among 234 woodworkers were performed with passive dust monitors. RESULTS: The overall geometric mean (geometric standard deviation) exposure to inhalable dust was 0.96 (2.02) mg/m3. There was a tendency to increased risk of asthma among atopic woodworkers compared to atopic non-exposed subjects, with ORs between 3.0 (0.8-11.9) (symptomatic BHR) and 1.3 (0.5-4.2) (work related symptoms). In woodworkers, asthma was associated with atopy, with ORs between 7.4 (2.8-19.7) (symptomatic BHR) and 4.2 (2.4-7.7) (asthma symptoms). Asthma was related to dust level, most pronounced for symptomatic BHR among atopics, with OR 22.9 (1.0-523.6) for the highest compared to the lowest dust level. For work related asthma symptoms the association with dust level was seen only for non-atopics. CONCLUSIONS: Wood dust exposure was associated with asthma, despite a low dust level compared to other studies. Atopy was an important effect modifier in the association between asthma and wood dust exposure.

Adult↗

A prospective evaluation of the clinical value of nation-wide DNA fingerprinting of tuberculosis isolates in Denmark.

SETTING: Denmark, a country with a low incidence of tuberculosis (TB). OBJECTIVE: To evaluate the value of the nation-wide DNA fingerprinting of Mycobacterium tuberculosis isolates performed in Denmark since 1992. DESIGN: Prospective study of consecutive patients with culture-verified TB from five large TB Departments in Denmark during a 7-month period in 1998. Results of IS6110 RFLP and spoligotyping were compared to those in the nation-wide Danish DNA-fingerprint database which covers approximately 95% of all culture-verified TB cases from 1992 onwards. Questionnaires asking about contact tracing and epidemiological links were sent to the patients' treating physicians. RESULTS: Of the 177 patients included in the study, 57 were Danes, one was from Iceland, 111 were immigrants, and eight were from Greenland. Responses to the questionnaires were obtained from 163 patients (92%). Four cases of unsuspected transmission were detected: one of nosocomial spread of TB, one of occupational acquisition of TB and two of transmission in an international school, leading to further contact tracing among 75 schoolchildren. These four cases were all the result of short-term contacts. In 22 cases, contact with one or more TB patient(s) was reported. In six of these, the DNA-fingerprint result revealed that the presumed contact could not be the source of infection, even though in two of the cases the known TB contact was from the household. CONCLUSION: Nation-wide DNA fingerprinting of TB isolates provides information that could not have been obtained otherwise, and contribute to the understanding of TB transmission in Danish society. In some cases the results lead to further contact tracing. Short-term contact can apparently result in transmission of TB.

Adult↗

[Occupational respiratory tract allergy in trout processing workers].

Out of 16 workers in a trout processing industry, ten experienced work-related cough, dyspnoea, and nasal secretion. A clinical examination was performed including specific IgE, precipitating antibodies IgG for trout and processing water, skin prick testing and peak flow monitoring. A total of four workers showed a positive allergic reaction. Processing water contained endotoxin and bacteria in high amounts. It is concluded, that work-related respiratory symptoms should be investigated and the cause at the workplace identified, so that preventive measures can be introduced.

Air Pollutants, Occupational↗

Secretory IgA response in oral immunotherapy. Investigation in birch pollinosis.

A rationale for oral immunotherapy (OIT) might be founded on two potential mechanisms: induction of a mucosal secretory IgA response, or induction of systemic hyporesponsiveness (oral tolerance). Previous studies have shown clinically that there is a beneficial effect of OIT in birch pollinosis, in both children and adults. During OIT, birch pollen antigens in enterocoated capsules were given to 20 adults (participating in a double-blind, placebo-controlled trial) and 10 children, all suffering from birch pollinosis. Saliva and tears (only adults) samples were collected before, during, and after OIT. Each sample was assayed for both IgA antibodies against birch pollen antigens and total IgA by enzyme-linked immunosorbent assay. IgA antibody levels were also expressed in relation to total IgA concentrations, to correct for variations in secretion and flow rate between subjects and at different times. Changes in birch-specific secretory IgA antibodies in saliva and tears could not explain the beneficial effect of OIT in birch pollinosis. Further studies in this field are warranted.

Administration, Oral↗

Pulmonary function changes in asthmatics associated with low-level SO2 and NO2 air pollution, weather, and medicine intake. An 8-month prospective study analyzed by neural networks.

This paper presents the response in subjects with asthma to gaseous air-pollution levels, weather, and medicine intake as identified by principal-component analysis and neural network techniques. Pulmonary function measured by respiratory peak-flow rate in nonallergic asthmatics was associated with ambient, low-level, air-pollution concentrations of sulfur dioxide and nitrogen dioxide, temperature, relative humidity, and medicine intake. Results from 27 nonallergic asthmatics aged 18-60 years with well-characterized bronchial asthma and regular medical treatment were analyzed from two cities. During an 8-month period, each subject kept a diary table, which included symptoms, lung function (evening peak flow), medicine intake, and tobacco smoking. High intake of medicine and high ambient temperatures corresponded to decreased peak flow. The changes in temperature did not occur in situations with low medicine intake. During frost periods, peak-flow values decreased independently of medicine intake and levels of SO2. During other times, increased levels of SO2 and NO2 increased temperature, and increased intake of medicine, and low relative humidity corresponded to decreased peak flow. Increased levels of SO2 and NO2 corresponded synergistically to decreased peak flow at levels above 40 micrograms/m3.

Adolescent↗

[Accumulation of respiratory diseases among employees at a recently established refuse sorting plant].

An increasing number of plants for re-use of refuse have been constructed in Denmark in recent years. The Kaastrup Plant near Skive was opened in spring 1986. The plant accepts household rubbish and industrial refuse separately. The refuse is sorted by machine (industrial refuse is sorted partially manually) and in a large partially open machine plant, refuse is converted into fuel pellets. During a period of eight months, eight out of 15 employees developed respiratory symptoms. In seven, bronchial asthma was diagnosed and chronic bronchitis in one person. Four had initial symptoms of the organic dust toxic syndrome. After further six months, another case of occupationally-conditioned asthma occurred in the plant. Only two out of nine had previously had asthma or atopic disease. The investigation did not reveal any evidence of type-I allergy. Six out of nine had specific precipitating antibodies to refuse while all had negative RAST tests to this. In spring 1989, from six to eighteen months after the onset of the symptoms, six had still dyspnoea on exertion and three had positive histamine-provocation tests and seven out of nine had left the plant. Occupational medical measurements revealed dust concentrations of 8.1 mg/cubic millimeter in September 1986 and total germs of up to 3 x 10(9) cfu/cubic meter. Construction of the plant involved considerable contact with the refuse on account of the cleansing processes and open systems and it was reconstructed in the course of 1987/1988 so that the hygienic conditions are now acceptable.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Assessment of changes in eye redness by a photographic method and the relation to sensory eye irritation.

The purpose of the present study was to evaluate the relation between photographically assessed changes in eye redness and sensory eye irritation in 17 patients suffering from hayfever, provoked by increasing doses of birch pollen in the eye. Pre- and post-exposure diapositives were compared in a randomized and double blind design by a panel of five members. By evaluating the photographs we found a high reproducibility between panel members and for repeated evaluation by the individual panel member. Furthermore, we found that the photographic method was more sensitive for measurements of changes in eye redness than the observations normally performed during such conjunctival provocation tests. The correlations of the objective findings with the symptoms reported were good at high pollen doses, but at lower doses of birch pollen (about half the effective dose) a decreased eye redness was observed. We found that sensory irritation (often expressed as dryness) measured simultaneously by questionnaires, in general occurred before any increased eye redness. The study indicates that photographic measurement of eye redness is reproducible, sensitive, unbiased and therefore a useful tool in environmental studies. Furthermore we demonstrated that the relation between eye redness and eye irritation is interestingly biphasic and may need further clarification.

Conjunctivitis, Allergic↗

Hyposensitization in asthmatics with mPEG-modified and unmodified house dust mite extract. IV. Occurrence and prediction of side effects.

A double-blind study on hyposensitization (HS) with two extracts prepared from the house dust mite Dermatophagoides pteronyssinus (Dp) was performed on a group of asthmatics with bronchial sensitivity to Dp. In 18 patients, aluminium-hydroxide was added to the Dp-extract to give a depot effect (Dp-group). Nineteen patients were treated with a similar extract in which allergenicity had been reduced by coupling to monomethoxypolyethylene glycol (mPEG-Dp-group). This extract had previously been shown to have less effect on clinical symptoms and skin sensitivity compared to the Dp-extract. In the Dp- and mPEG-Dp-groups, 778 and 675 injections were administered. Fifteen and 12 patients in the Dp- and mPEG-Dp-groups had systemic reactions (P greater than 0.05). The frequency of injections giving systemic reactions was reduced in the mPEG-Dp-group: 5.1% compared to 9.0% in the Dp-group (P less than 0.01). In the mPEG-Dp-group, reactions were mild to moderate, mainly late-occurring asthma and urticaria, whereas two episodes of anaphylaxis and four of severe asthma occurred in the Dp-group. The reduction in side effects seems promising, but a further dose increase in the mPEG-Dp-group would be necessary to compare the side effects of doses with equal therapeutic effectiveness. High frequency of late local reactions made dose increase impossible with the present slightly modified extract. The systemic side effects occurred more frequently in patients highly skin test-sensitive to Dp prior to treatment. All patients skin test-positive to less than or equal to 100 BU had systemic reactions. Systemic side effects could not be predicted from the size of previous local reactions.

Animals↗

Specific IgE, IgG, and IgA antibody response to oral immunotherapy in birch pollinosis.

Thirty-nine patients with birch pollinosis participated in a double-blind, placebo-controlled trial of oral immunotherapy (OIT) for 18 months. They were treated with increasing doses of freeze-dried birch-pollen antigens for 16 months, reaching a cumulative dose of 280 x 10(6) biologic units. This is about 200 times more than the dose used in conventional subcutaneous immunotherapy (IT). In the placebo-treated group, but not in the actively treated group, there was a rise in postseasonal birch-specific IgE antibody levels. A significant decline in postseasonal values after 1 year of treatment was recorded in the actively treated, but not in the placebo-treated, group. Compared to the placebo treatment, there was a significant rise in birch-specific IgG antibodies in patients administered active treatment; however, the rise was less than that usually observed during subcutaneous IT. No significant change in birch-specific serum IgA was found in either group. The changes in IgE and IgG antibody levels demonstrate that OIT affects the immune system. This supports our recent findings that OIT demonstrates a beneficial effect in the treatment of birch pollinosis in adults. But, as with subcutaneous IT, there was no clear relationship between antibody response and clinical findings in the patients. The underlying mechanisms responsible for the relief of symptoms thus remain unknown.

Administration, Oral↗

Hyposensitization in asthmatics with mPEG modified and unmodified house dust mite extract. I. Clinical effect evaluated by diary cards and a retrospective assessment.

Forty-six asthmatics with verified allergy to the house dust mite, D. pteronyssinus (Dp), participated in a double-blind study comparing the effect of 2 years' hyposensitization with two different Dp extracts. Two groups received either monomethoxypolyethylene glycol modified (mPEG) Dp extract or the corresponding non-modified extract, and a third group acted as controls receiving no injections. Medicine consumption, symptom scores, and peak expiratory flow (PEF) were recorded daily from September to December prior to and after 6 and 18 months of treatment. Changes were calculated choosing changes greater than or equal to 10% as relevant. In addition, patients were asked to give their direct assessment of the clinical effect at the end of the study. After 6 months, there was an improvement in symptoms + medication in 11/14 of Dp-treated, 6/17 of the mPEG-Dp group (P greater than 0.05) and 3/15 of openly treated controls. Few patients had changed in PEF. During the second year, several Dp-treated relapsed and some controls improved. At the end of the study the same improvement rate was seen in all groups. Similarly, the retrospective questionnaire data did not disclose any significant differences between groups after 2 years. In conclusion, hyposensitization with unmodified Dp extract seemed to have a favourable short-term effect on bronchial symptoms + medication in the majority of patients. When mainly on maintenance dose, the beneficial effect was reduced. The mPEG modification of the extract had reduced not only allergenicity but also the clinical effect of equal doses. Changes in medicine and symptom scores only partly correlated to retrospective assessment, thus stressing the problems in this kind of evaluation.

Animals↗

Hyposensitization in asthmatics with mPEG modified and unmodified house dust mite extract. II. Effect evaluated by challenges with allergen and histamine.

In a 2-year study, 46 asthmatics with verified allergy to the house dust mite D. pteronyssinus (Dp) were included either as controls (Ctls) or receiving hyposensitization (HS) with unmodified or monomethoxypolyethylene glycol (mPEG) modified Dp-extract. Patients were monitored by annual challenges with histamine in bronchi, and Dp allergen in bronchi, nose and conjunctiva. mPEG-modified extract was not inferior to unmodified Dp-extract; both were to some extent able to improve tolerance to Dp and histamine in bronchi and to Dp in nose and eyes. During the 1st year, the bronchial sensitivity to Dp decreased significantly in the HS groups but not in the Ctls. During the 2nd year, improvement was more pronounced in the Ctl group. The relative increase in Dp or histamine tolerance did not differ significantly between groups after either 1 or 2 years; the only exception was conjunctival sensitivity, which in the Ctl group was unchanged, and a 10-fold increase in tolerance in the HS groups. No direct benefit was seen on late-phase bronchial reactions. In patients with improved pulmonary symptoms a tendency was seen towards reduced sensitivity to histamine and Dp. Variation within groups was extensive.

Animals↗

Fiberoptic bronchoscopy and bronchial mucosal biopsies in asthmatics undergoing long-term high-dose budesonide aerosol treatment.

Mucosal biopsies from the pharynx, right main stem bronchus and right lower lobe were obtained during flexible fiberoptic bronchoscopy and were examined with light microscopy (LM) and electron microscopy (EM) in 10 asthmatics after 11 months' (range 7-15 months) treatment with high doses of inhaled budesonide via the Nebuhaler, i.e. 1600 micrograms daily. Results were compared with biopsies from 10 controls suspected of having focal, malignant lung diseases. Visual inspection of the tracheobronchial tree showed no signs of atrophy, ulcerations or thrush patches, and LM and EM showed no specific signs of mucosa and connective tissue atrophy; however, epithelial desquamation was seen in the asthmatics. No complications were observed.

Adolescent↗

In vitro studies of degradation of birch and timothy pollen allergen preparations by human duodenal juice.

The hydrolysis of birch and timothy pollen allergen preparations by duodenal juice from an adult volunteer was studied in vitro with the aid of rocket immunoelectrophoresis, radiorocket immunoelectrophoresis and RAST-inhibition. The results achieved with all methods were similar. The duodenal juice had the capacity to hydrolyse both the grass and tree pollen proteins, and after 30 min preincubation only 10% of the original birch and timothy allergenic activity remained. Heat treatment of the duodenal juice completely destroyed the proteolytic activity (i.e. no hydrolysis occurred) while protease inhibitors only marginally prevented the hydrolysis.

Adult↗