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M Kajosaari

Publications and source records attributed to M Kajosaari.

18 recordsLinked to original sources
PubMed2001

Prematurity at birth reduces the long-term risk of atopy.

BACKGROUND: Antigen exposure in early life has long-lasting effects on atopic sensitization. Thus the predisposition to atopy of children born preterm can be assumed to differ from that of children born at term. OBJECTIVE: The aim of this study was to evaluate the association between premature birth and atopy. METHODS: At an outpatient clinic, we examined 2 groups of 10-year-old children, 72 who were born preterm (birth weight < 1500 g) and 65 who were born at term (birth weight > 2500 g). The atopy data were collected with a questionnaire, by performing skin prick testing, and by measuring the serum total IgE level, 3 allergen-specific IgE levels, the eosinophil cationic protein level, and the blood eosinophil level. The data on perinatal and neonatal events affecting the preterm children were collected from the hospital records. RESULTS: By the age of 10 years, the children born preterm had significantly less atopy than the children born at term: 15% versus 31% of children in the 2 groups were defined as having had obvious atopy (P = .03, odds ratio 0.41, 95% CI 0.18-0.93). The mean value of total IgE level was significantly higher in the term group, 74 kU/L versus 41 kU/L (P = .02). By skin prick testing, the children born at term had positive reactions 2 to 3 times more often; 37% versus 17% of children in the groups had at least 1 positive reaction (P = .007). CONCLUSION: Our data show that prematurity at birth is linked with a decreased long-term risk of atopic sensitization.

Female↗
PubMed2000

Inhaled corticosteroids during and after respiratory syncytial virus-bronchiolitis may decrease subsequent asthma.

Respiratory syncytial virus (RSV) bronchiolitis in infancy can lead to bronchial hyper-reactivity or recurrent obstructive bronchitis. The aim of the present study was to determine whether the type of treatment has an influence on respiratory status after RSV bronchiolitis. The study involved 117 infants (mean age 2.6 months), who needed hospital treatment because of RSV bronchiolitis. The patients were divided randomly into three groups. All received the same symptomatic treatment. Group I children received symptomatic treatment only, group II children were treated for 7 days with inhaled budesonide, 500 microg three times per day, administered via a nebulizer. Group III children received nebulized budesonide, 500 microg twice per day for two months. Follow-up consisted of out-patient check-ups 2 and 6 months after the infection, and telephone contact two years after the infection. Statistically significant differences were seen between the groups. In group I 37% of the children had asthma, in group II 18%, and in group III 12%. According to the present study it seems that inhaled corticosteroid treatment during and after the acute phase of infant RSV bronchiolitis may have a beneficial effect on subsequent bronchial wheezing tendency.

Administration, Inhalation↗
PubMed1999

Infections in early childhood and risk of atopic disease.

Having more siblings has been shown to be associated with lower risk of atopic diseases. This might be due to the higher number of infections in larger families. Because children attending day care centres have more respiratory infections, we analysed the association of number of siblings and day care attendance in children aged 1-3 y with atopic disease in a cross sectional survey of 8387 schoolchildren aged 13-14 y and their parents in four regions of Finland. Having no siblings, compared to three or more siblings, was associated with significantly higher risk of lifetime history of hay fever (odds ratios (OR) 1.53, 95% confidence interval (CI) 1.25-1.86) and atopic eczema (OR 1.28, 95%CI 1.04-1.56), and higher risk (ns) of doctor-diagnosed asthma ever (OR 1.26, 95%CI 0.85-1.88). Less strong associations were observed with the number of older siblings (birth order). No associations were observed with current symptoms of these diseases during the last 12 mo. Attending a day care centre at the age of 1-3 y was not associated with decreased risk of any of the atopic diseases studied, but, in contrast to the hypothesis, was associated with slightly increased risk of current symptoms of hay fever (OR 1.34, 95%CI 1.12-1.60). The present results suggest that other factors than early childhood respiratory infections explain the association between number of siblings and future risk of atopic disease.

Age Factors↗
PubMed1998

Prevalence of allergic rhinitis and atopic dermatitis among children in four regions of Finland.

The primary aim of the study was to evaluate the prevalences of allergic rhinitis and atopic dermatitis and their regional differences among Finnish children. The secondary objective was to determine whether the responses to the questions used are affected by the pollen season if asked during such a season. In 1994-5, the self-reported prevalence of allergic symptoms in four regions of Finland was studied among 11,607 schoolchildren aged 13-14 years, as part of the International Study of Asthma and Allergies in Childhood (ISAAC). The prevalence of rhinoconjunctivitis during the preceding year was 16% in eastern Finland (Kuopio County, n=2821), 23% in southern Finland (Helsinki area, n=2771), 15% in southwestern Finland (Turku and Pori County, n=2983), and 16% in northern Finland (Lapland, n=3032). The respective prevalences of flexural dermatitis were 15%, 19%, 16%, and 18%. The surveys were performed in winter, except in the Helsinki area where the survey was carried out mainly in the spring pollen season. Among the children studied in autumn in Helsinki, the prevalence of rhinoconjunctivitis was 19% and that of flexural dermatitis 17%. In multivariate analysis, flexural dermatitis was slightly more common in Lapland than in all other areas. In contrast, no significant differences were found in rhinoconjunctivitis. The prevalences of both disorders were twice as high in girls as in boys. In conclusion, regional differences in the prevalence of allergic rhinitis and atopic dermatitis were small in our country, and the prevalence figures were rather similar to those reported from other European countries. Almost half of the children had suffered from at least one atopic disorder, and over one-third had had symptoms in the past year. A clear season-of-response effect was observed; the prevalence of rhinoconjunctivitis was 25% when studied during the pollen seasons in the Helsinki area.

Adolescent↗
PubMed1997

Prevalence of asthma symptoms in video and written questionnaires among children in four regions of Finland.

The aim of this study was to determine whether there are regional differences in the prevalence of childhood asthma in Finland. A secondary objective was to assess the concordance between a written and a video questionnaire on asthma symptoms. In 1994-1995, the self-reported prevalence of asthma symptoms in four regions of Finland was studied among 11,607 schoolchildren aged 13-14 yrs, as part of the International Study of Asthma and Allergies in Childhood (ISAAC). The ISAAC written and video (AVQ 3,0) questionnaires were administered in the school setting. The prevalences of any wheezing during the previous 12 months in the ISAAC video questionnaire were 10% in East Finland (Kuopio County, n=2,821), 12% in South Finland (Helsinki area, n=2,771), 12% in Southwest Finland (Turku and Pori County, n=2,983), and 11% in North Finland (Lapland, n=3,032). The prevalences in the ISAAC written questionnaire were 13, 20, 15, and 16%, respectively. The surveys were performed during winter, except in Helsinki where the survey was carried out mainly during the spring pollen season. During autumn, the prevalence in the written questionnaire in Helsinki was 16%. In multivariate analysis, boys had a lower prevalence than girls, and smokers a threefold higher prevalence than nonsmokers. In conclusion, the prevalence of childhood asthma is lower in Finland than in other European countries, and may be even lower in the eastern part of the country. In contrast to the results from some other European countries, prevalences were lower in the video than in the written questionnaire, which suggests that translating the word "wheezing" into other languages, including Finnish, may produce results that cannot be compared. The strong association of smoking with wheeze both in the video and written questionnaires should be considered in further analysis of the ISAAC study.

Adolescent↗
PubMed1995

Breastfeeding as prophylaxis against atopic disease: prospective follow-up study until 17 years old.

Atopic diseases constitute a common health problem. For infants at hereditary risk, prophylaxis of atopy has been sought in elimination diets and other preventive measures. We followed up healthy infants during their first year, and then at ages 1, 3, 5, 10, and 17 years to determine the effect on atopic disease of breastfeeding. Of the initial 236 infants, 150 completed the follow-up, which included history taking, physical examination, and laboratory tests for allergy. The subjects were divided into three groups: prolonged (> 6 months), intermediate (1-6 months), and short or no (< 1 month) breastfeeding. The prevalence of manifest atopy throughout follow-up was highest in the group who had little or no breastfeeding (p < 0.05, analysis of variance and covariance with repeated measures [ANOVA]). Prevalence of eczema at ages 1 and 3 years was lowest (p = 0.03, ANOVA) in the prolonged breastfeeding group, prevalence of food allergy was highest in the little or no groups (p = 0.02, ANOVA) at 1-3 years, and respiratory allergy was also most prevalent in the latter group (p = 0.01, ANOVA) having risen to 65% at 17 years of age. Prevalences in the prolonged, intermediate, and little or no groups at age 17 were 42 (95% CI 31-52)%, 36 (28-44)%, and 65 (56-74)% (p = 0.02, trend test) for atopy, respectively, and 8 (6-10)%, 23 (21-25)%, and 54 (52-56)% (p = 0.0001, trend test) for substantial atopy. We conclude that breastfeeding is prophylactic against atopic disease--including atopic eczema, food allergy, and respiratory allergy--throughout childhood and adolescence.

Adolescent↗
PubMed1983

Immunoglobulin E and immunoglobulin G4 antibodies to cow's milk in children with cow's milk allergy.

The presence of cow's milk specific antibodies of immunoglobulin E and G4 classes were studied in 47 children with a positive clinical history of cow's milk allergy. The children were challenged with cow's milk orally. The clinical diagnosis was verified by immediate reactions in 25 patients while 22 had late reactions or were provocation test negative in spite of the clinical history. There was no relation between levels of cow's milk specific IgG4 antibodies and provocation test results, i.e. neither with immediate or late reactions. Total IgE was elevated above +1 SD for age in 31 of 41 tested patients. Of these, 29 had immediate type reactions to cow's milk, wheat flour and/or egg white, while only two of 10 children with IgE of less than +1 SD had a demonstrable allergy to any of these foods. The sensitivity of the total IgE determinations for the diagnosis of food allergy was 94% and the specificity was 80%. Specific IgE antibodies to cow's milk were demonstrated in 11 of 14 children with immediate reactions and in three of 15 who were provocation test negative or had only late reactions. This means a sensitivity of 79% and a specificity of 80%. At least one of the four patients with specific IgE but negative provocation test results had earlier shown an immediate reaction when challenged with cow's milk, indicating that the specific IgE antibodies were not truly "false" positive reactions but a consequence of previous allergy. Our results confirm an association between elevated total serum IgE and food allergy and an association between positive RAST to cow's milk and positive provocations in young children. We did not find any evidence for specific IgG4 antibodies playing a role in these patients.

Animals↗
PubMed1983

Prophylaxis of atopic disease by six months' total solid food elimination. Evaluation of 135 exclusively breast-fed infants of atopic families.

One hundred and thirty-five infants of atopic parents were exclusively breast-fed for 6 months without any cow's milk based supplements. Of these infants 70 received no nourishment except breast milk during the 6 months, and 65 were started on solid foods at the age of 3 months. The diet of all the infants was similar during 6 to 12 months of age. The children were examined at the age of one year. In the exclusive breast milk group atopic eczema and food allergy were less frequent than in the solid food group. The results suggest that total solid food elimination for the first 6 months of life, in addition to exclusive breast milk feeding, is prophylactic for atopic disease in children who are at hereditary risk.

Breast Feeding↗
PubMed1982

Birch pollen allergy in children. Role of milk feeding during the first birch season of life.

The effect of exclusive breast-feeding throughout the first birch pollen season of life was examined in 59 children compared to 67 children on cow milk formula and to 27 children weaned to cow milk-based formula during their first birch season. The infants were about 3 months of age in their first birch season, and allergy to birch pollen was evaluated at 5 years of age by history and prick and provocation tests. Breast-feeding throughout the first birch season did not prevent birch pollen allergy; a similar birch allergy prevalence of about 10% was found in children initially fed on human or cow milk. Instead, weaning to cow milk-based formula during the first birch season seemed to protect from subsequent development of birch pollen allergy. Analogous results were obtained regarding allergy to grass pollen. This unexpected finding may be related to the immunologic stress on the young infant provided by introduction of cow milk proteins at an early age.

Animals↗
PubMed1982

Serum immunoglobulin E in atopic and non-atopic children aged 6 months to 5 years. A follow-up study.

In order to obtain serum IgE reference values for small children we measured the total serum IgE concentration at the ages of 6 months, 1, 3, and 5 years in 66 healthy, non-atopic children who were followed from birth to 5 years of age. From this reference group we had excluded children with symptoms or signs of atopy during the follow-up period, as well as children with blood or nasal smear eosinophilia or positive skin prick tests. We also studied serum IgE levels in groups of children having latent atopy, symptomatic atopy, or severe atopic disease. We suggest that in the definition of reference values the upper limit of normal should be replaced by a zone of uncertainty, lying between the 95th and 97.5th percentiles. Serum IgE is a useful test with high specificity but low sensitivity in the differentiation between atopy and non-atopy. Thus high levels suggest atopy, while normal or low values yield little information. A normal serum IgE level does not necessarily exclude atopic disease.

Child, Preschool↗
PubMed1982

Food allergy in Finnish children aged 1 to 6 years.

Food allergy was studied in a total of 866 Finnish children aged 1, 2, 3 and 6 years in the Helsinki region. The diagnosis was based on history as well as on elimination and challenge performed at home concerning fish, citrus fruit and eggs. The prevalence of food allergy was 19% at one year of age, increased to a peak of 27% at three years, and thereafter decreased to 8% at six years of age. The most common allergenic foods were citrus fruit, tomato, eggs, strawberry and fish. A positive history of food allergy could be confirmed by challenge in about half of the cases in the younger age groups and in 100% at six years of age. The data indicate that food allergy is common in Finnish children.

Allergens↗
PubMed1981

Evaluation of laboratory tests in childhood allergy. Total serum IgE, blood eosinophilia and eosinophil and mast cells in nasal mucosa of 178 children aged 3 years.

The diagnosis of atopic disease is often difficult in small children because of differences in symptoms and lack of specific and reliable laboratory tests. We evaluated the significance of four commonly used laboratory tests--blood eosinophil count, total serum IgE, and eosinophil and mast cells in the nasal smear--as indicators of atopy in 178 children aged 3 years. The children were followed from birth and examined at the age of 3 years. Symptoms of immediate hypersensitivity including atopic dermatitis, food allergy and pollen or animal allergy were recorded. Severe or obvious atopy correlated with the highest levels of serum IgE. A total serum IgE level higher than 150 U/ml was found to be strongly suggestive of atopic disease. A blood eosinophil count higher than 600 X 10(9)/l as well as an increased number of eosinophil and mast cells in the nasal smear were associated with atopy. On the other hand, normal levels of these laboratory tests did not exclude atopic disease. In other words, all of the tests were high in specificity, but low in sensitivity. Consequently, when small children's atopic disease is being diagnosed, emphasis can be laid on the elevated levels of serum total IgE, blood eosinophil count and eosinophil and mast cells in the nasal smear, all of which separately, but especially together, give valuable information on atopy.

Cell Count↗
PubMed1981

Children's atopy and mastocytosis in the nasal smear.

Nasal secretion samples from 473 children aged 0--15 years were studied in order to evaluate the role of mast cells in the nasal smear in different types of atopy and food allergy. The occurrence of eosinophils in the nasal secretion and in the blood, and susceptibility to upper respiratory infection were recorded. A mast cell count of more than 20 cells per slide was indicative of atopy and there was a clear correlation between eosinophilia and mastocytosis in the nasal smear. No type of allergy seemed to be significantly predominant in the total material, but in young children aged 0--3 years mastocytosis was clearly related to food allergy. The examination of nasal smears for mast cells is a valuable test in diagnosing atopy in children and especially food allergy among young children. However, the test is not reliable enough to be used as a single screening test.

Adolescent↗
PubMed1980

Does dietary elimination in infancy prevent or only postpone a food allergy? A study of fish and citrus allergy in 375 children.

In a study of fish and citrus allergy these foods were strictly avoided in 177 children up to 1 year of age, whereas 152 children had started taking fish before age 6 months and 145 children had started taking citrus fruits beofre 3 months. Both fish and citrus allergy, defined by a positive challenge, were found at age 3 years in a similar frequency (about 3%) in children with and without the first-year elimination. The results suggest that food allergy in childhood can be postponed but not prevented by dietary elimination in infancy.

Age Factors↗
PubMed1979

Prolonged breast-feeding as prophylaxis for atopic disease.

54 babies who had been solely breast-fed for more than 6 months, 77 babies who had been breast-fed for 2--6 months, and 105 babies who had been weaned to cow's-milk-based formulas at less than 2 months were followed for the first 3 years of life. All the babies had the same pattern of solid food intake until 1 year of age. Compared with formula feeding, prolonged breast-feeding resulted in a lower incidence of severe or obvious atopic disease particularly in babies with family history of atopy.

Asthma↗