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Biomedical subjects

H Odelram

Publications and source records attributed to H Odelram.

14 recordsLinked to original sources
PubMed1998

[Early discharge after delivery, a safe and cost-effective form of care].

Early discharge after delivery, followed by home care, has been offered to maternity patients at Motala General Hospital since 1983. The results have been analysed retrospectively with regard to home care quality, morbidity, mortality, and cost-effectiveness. During the period, 1983-95, about 10,000 children were born at Motala General Hospital. Morbidity and mortality data have been elicited from the patients' records and from Statistics Sweden, the national bureau of statistics. The frequency of early discharge increased from about 20 per cent in 1984 to 66 per cent (79% of normal deliveries) in 1995. Hyperbilirubinaemia and nutritional problems were the predominant forms of morbidity among newborns in the early discharge subgroup, and mortality was zero. The numbers of nurses, assistant nurses and midwives were reduced by 50 per cent during the period, partly due to the early discharge programme, but also due to economies in Swedish health care expenditure. Provided a stable and well organised system is established, with home visits by a midwife and examination by a paediatrician 5-7 days after delivery, and alertness to the possibility of jaundice and nutritional problems is maintained, early discharge is a safe procedure.

Adolescent↗
PubMed1996

Whey hydrolysate compared with cow's milk-based formula for weaning at about 6 months of age in high allergy-risk infants: effects on atopic disease and sensitization.

Ninety-one high atopy-risk infants were prospectively followed up to 18 months of age with regard to the development of allergic/atopic manifestations and sensitization. They were randomized into one of two feeding groups, i.e., a hydrolyzed, ultrafiltered cow's milk whey formula, Profylac (n = 32), or an ordinary cow's milk formula (n = 39), for 12 months, started after exclusive breast-feeding for 0-9 (median 6.0) months. Lactating mothers avoided milk, egg, and fish, as did the infants up to 12 months of age. Twenty of the 91 infants were breast-fed exclusively for more than 9 months and regarded as a control group. All infants were followed-up by questionnaires, physical examinations, skin prick tests, and determination of serum total IgE and cow' milk-specific IgE. The frequency of allergic/atopic disease was similar in the three groups. However, all three infants who developed cow's milk allergy with skin symptoms belonged to the cow's milk formula group. The skin prick test with whey hydrolysate was negative in all, while with cow's milk it was positive in eight infants. Growth was similar in the three groups. The study comprises too few infants to allow us to make statistically based statements. However, the difficulties encountered and the limited effects obtained by the use of whey hydrolysate at weaning at about 6 months of age made us conclude that we can spare high atopy-risk families this extra burden.

Animals↗
PubMed1995

Peripheral blood eosinophilia in infants at 3 months of age is associated with subsequent development of atopic disease in early childhood.

BACKGROUND: We tested the hypothesis that eosinophilia in peripheral blood and nasal mucosa of infants is an early sign of allergic disease. METHODS: The appearance of eosinophilic leukocytes in peripheral blood and nasal mucosa was studied prospectively in 67 infants up to 18 months of age, with or without a family history of atopy. RESULTS: Eosinophilia was associated with simultaneous presence or subsequent development of atopic disease at 3, 9, and 18 months of age, but not significantly so at 6 months. At 3 months children in whom atopic disease developed later during the observation period had significantly higher numbers of blood eosinophils than children without atopy (p < 0.01). Thus pronounced eosinophilia (> 7 x 10(8) cells/L) at that age was associated with moderate or severe allergic disease during the 18-month observation period. These children continued to have eosinophilia throughout the follow-up period. Blood eosinophilia at 3 months of age also correlated significantly to cord blood IgE levels and to skin prick test reactivity later during the follow-up period. Nasal eosinophilia was a common finding and therefore had little diagnostic or predictive value. CONCLUSIONS: Elevated eosinophil counts in peripheral blood of apparently healthy infants at 3 months of age is associated with a subsequent diagnosis of atopic disease.

Dermatitis, Atopic↗
PubMed1995

Predictors of atopy in newborn babies.

The capacity of laboratory tests and clinical signs to predict allergic manifestations up to 18 months of age was assessed in 129 newborn babies, most of whom had family members with atopic disease. The parameters assessed included family history; skin dryness; erythema toxicum; skin reactivity to histamine and IgE levels; eosinophil counts; and peripheral white blood cell, leukocyte differential, and platelet counts in cord blood (CB). Erythema toxicum and white blood cell and platelet counts were of no value as predictors of allergy. The sensitivity of family history, skin dryness, and sensitivity to histamine, as well as IgE levels and eosinophil counts, varied 25-79% and the specificity 40-74%. The efficiency was never higher than 58%. Logistic regression, applied in order to evaluate the joint predictive power of the five parameters, showed a P value of < 0.001. The estimated probability for atopy before 18 months of age was 0.33 for neonates with normal skin texture, a CB IgE of less than 0.5 kU/l, and a history of fewer than two family members with atopy. The probability increased to 0.89 for babies with a dry skin, a history of two or more atopic family members, and a CB IgE of > or = 0.5 kU/l. In conclusion, not one parameter nor any combination of them seems suitable for general screening. However, a combination of family history and CB IgE and skin assessment may be used to identify babies at high risk of allergy for participation in prevention studies.

Child Development↗
PubMed1994

High anti-IgE levels at birth are associated with a reduced allergy prevalence in infants at risk: a prospective study.

Development of atopic disease was prospectively studied in 148 children from birth to the age of 18 months and related to serum levels of IgG anti-IgE antibody. Children with a dual heredity of allergy, but remaining healthy, had significantly higher IgG anti-IgE levels at birth than children with a similar predisposition to allergy, who became allergic. Children with increased allergy risk, defined by elevated IgE levels at birth (> = 0.53 kU/l) and with probable allergy symptoms had also significantly higher IgG anti-IgE levels at birth than children of the same risk group, developing definite allergy. Independent of allergy risk, there was a significantly lower prevalence of atopic disease in children with cord serum levels of IgG anti-IgE above 350 AU/l than in children with lower levels. Additionally, we showed that the allergy predictive capacity of IgE levels in cord serum was slightly improved in specificity, sensitivity and efficiency by including not only the family history of allergy, but also cord serum levels of IgG anti-IgE. Our results thus raise the possibility that high levels of IgG anti-IgE protect children of increased allergy risk from early development of atopic disease and reduce the severity of symptoms.

Antibodies, Anti-Idiotypic↗
PubMed1994

Neonatal leukocyte cAMP-phosphodiesterase determination is not suitable for allergy prediction.

The atopy-predictive value of cord blood (CB) cyclic adenosine monophosphate-phosphodiesterase (cAMP-PDE) in mononuclear leukocytes (MN) was studied prospectively in 57 neonates. Reliable determination of cAMP-PDE was achieved in only 20 CB samples. The levels tended to be higher in infants developing signs of atopy up to 18 months of age. The combination of CB cAMP-PDE and family history (FH) of allergy showed a higher predictive value (P = 0.040) than each of them separately (P = 0.370 and P = 0.102, respectively). The cAMP-PDE levels in CB also correlated to FH of allergy/atopy in accordance with earlier studies (P = 0.027). In conclusion, determination of cAMP-PDE in neonates may have some predictive value, but it is not suitable for general screening.

3',5'-Cyclic-AMP Phosphodiesterases↗
PubMed1994

Immunoglobulin E and G responses to pertussis toxin after booster immunization in relation to atopy, local reactions and aluminium content of the vaccines.

The role of aluminium for IgG and IgE responses to pertussis toxin (PT), as well as for side effects, was investigated in 49 children with known atopy status. Primary immunization had been given with an adsorbed monocomponent or an adsorbed two-component acellular pertussis vaccine. The children were then randomized to receive a booster immunization with either aluminium-adsorbed or non-adsorbed, whole cell, pertussis vaccine. Both vaccines induced good IgG responses with the adsorbed vaccine giving higher post-booster levels (p < 0.05). The adsorbed vaccine was, however, associated with more local side effects (p < 0.05) and tended to induce higher PT-IgE responses than the non-adsorbed vaccine. Furthermore, individuals who had received the two-component vaccine as primary immunization had higher PT-IgE responses after the booster, compared with individuals initially receiving the monocomponent vaccine (p = 0.041). No correlation between PT-IgE and PT-IgG levels was seen in any of the groups. Total serum IgE levels correlated to PT IgE levels, particularly in children with atopy (r = 0.950, p < 0.001). The addition of aluminium to the pertussis vaccine, was, thus, associated with a stronger IgG antibody response, but tended also to induce a stronger IgE antibody response. The correlation between total IgE and PT-IgE, which was most prominent in children with atopy, indicates that the role of immunization for the development of allergy merits further studies.

Adjuvants, Immunologic↗
PubMed1989

Topical levocabastine versus sodium cromoglycate in allergic conjunctivitis.

The aim of this study was to evaluate the effect of levocabastine, a new H1-blocking antihistamine for topical use, in comparison with sodium cromoglycate on conjunctival symptoms of birch pollinosis. The two drugs were compared in a randomized double-blind comparative study over 5 weeks in 37 children and adolescents (6-19 years of age) with birch pollen conjunctivitis. Nasal symptoms occurred in 31 of the children and were treated with beclomethasone dipropionate nasal spray. An oral antihistamine was offered as rescue medication for eye symptoms. Initially, the patients received placebo four times a day for a 7-day run-in period. Conjunctival symptoms were recorded daily on diary cards on a 100 mm visual analogue scale. The pollen counts indicated a short but intensive birch pollen season. There was no statistically significant difference between the two treatment groups with regard to eye symptom scores before and during active treatment. However, the patients' evaluation of the efficacy of the therapy was in favour of levocabastine (P less than 0.01). Topical levocabastine, an H1-blocker, applied twice daily, seems to protect from symptoms of allergic conjunctivities as favourably as sodium cromoglycate applied four times a day. There was no difference in number or character of reported adverse reactions between the two treatment groups.

Adolescent↗
PubMed1986

Gastrointestinal permeability in children with cow's milk allergy: effect of milk challenge and sodium cromoglycate as assessed with polyethyleneglycols (PEG 400 and PEG 1000).

Sixteen children with immediate-type cow's milk allergy were challenged with increasing amounts of cow's milk. Gastrointestinal permeability was investigated before and after challenge by the 6-hr urinary recovery of a mixture of different-sized polyethyleneglycols (PEG 400 and PEG 1000). The results were related to clinical symptoms in the individual patients. The majority of the children displayed changed permeability characteristics after the challenge, both with respect to the maximum uptake of a small test molecule (usually 370 dalton PEG) and/or a large molecule (1074 dalton PEG), and to size-dependent exclusion of probe molecules. When corrected for the dose of milk taken, the children showing the most severe immediate-type symptoms also displayed the greatest alteration of permeability. Treatment with sodium cromoglycate (SCG) before the challenge diminished the effect on the uptake of probe molecules, usually decreased the severity of elicited symptoms, allowing about a ten-fold increase in the milk dose. Cow's milk challenge in healthy children caused only minor permeability changes, whereas challenge in the sensitized subjects significantly changed (increased or decreased) the recovery of a large test molecule. The difference between healthy and allergic subjects was most obvious when correcting for dose of milk ingested. We conclude that oral challenge with cow's milk in allergic subjects affects the mucosal barrier, and peroral treatment with SCG moderates immediate hypersensitivity reactions with respect to both tolerated antigen dose and intestinal permeability properties.

Administration, Oral↗
PubMed1980

Salbutamol by powder or spray inhalation in childhood asthma.

Forty-three children from 3-16 years of age suffering from moderate bronchial asthma completed a double-blind cross-over study on the clinical effect of inhaled salbutamol (Ventoline) powder (0.2 mg/dosis) compared with spray (0.1 mg/dosis) over two 4-week periods. Both administrations gave significant improvement in air flow meter (AFM) results. There was no significant difference between the periods on active powder or spray regarding daily symptom scores, adjuvant medication or AFM values. The powder caused cough in four children but in 12 of 28 children it was considered as easy or easier to accept as the spray; nine of these 12 children were younger than 10 years of age. It is concluded that salbutamol inhaled as a powder is a useful alternative when using a spray is difficult or unwanted.

Administration, Intranasal↗
PubMedDate not supplied

Prediction of allergy in infancy.

There is still no test that can predict allergy in infancy with 100% accuracy. For practical purposes, the best we can do is combine a carefully taken family history with a blood sample in early infancy, preferably during the first week of life, on which a sensitive IgE test is applied. If cord blood samples are used, contamination with maternal blood must be avoided as far as possible and samples with high IgE should be checked for possible contamination with maternal blood. Certainly, predictive tests are of no value unless there is a possibility of offering prophylactic measures that prevent or at least delay the onset of the symptoms of allergy. A search for ideal prophylactic measures and screening methods is in progress.

Amniotic Fluid↗