Biomedical subjects
N E Eriksson
Publications and source records attributed to N E Eriksson.
[Infusion treatment of status asthmaticus. Hydrocortisone or betamethasone?].
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Long term treatment of steroid dependent asthmatic patients with beclomethasone dipropionate.
In the efforts to avoid the side-effects of the peroral cortisone drugs in the treatment of asthma, trials have been made since the early fifties with the administration of steroids in aerosol form applied direct on the bronchial mucosa. Hydrocortisone as well as prednisolone and dexamethasone have been used with a documented effect on the obstruction. However, the drugs were found to be resorbed and thus resulted in suppression of adrenal function and appearance of Cushing syndrome and other well-known steroid side-effects (12). More recently, beclomethasone dipropionate -- a steroid with potent topical activity -- has been used as a pressurised aerosol. In 1972 Morrow Brown et al. (1) as well as Lal et al. (10) reported a good therapeutic effect with this drug and at the same time found evidence for the opinion that its systemic effect, if any, was insignificant. Less ositive results were reported by Choo-Kang et al. (4) and also by Herxheimer (8), who considered beclomethasone spray not to possess any advantages as compared with the earlier steroids. The purpose of the present study was to assess the clinical value of beclomethasone in the treatment of adult patients previously on long-term oral steroids.
Clustering of foodstuffs in food hypersensitivity. An inquiry study in pollen allergic patients.
600 pollen allergic patients were questioned about hypersensitivity symptoms from various foodstuffs. The answers regarding one foodstuff were compared with those of other foodstuffs making 780 tables, from which the Spearmen 's correlation coefficients were calculated. Most of the combinations of foodstuffs showed statistically significant correlations. The highest value of the correlation coefficient was found for certain combinations: Various nuts reciprocally as well as nuts combined with apple and stone fruits. Stone fruits reciprocally and even stone fruits combined with apple and pear. Apple and pear. Kiwi fruit and avocado. Potato and carrot. Swede , parsnip and celery reciprocally. Strawberry and wild strawberry. Fish and bread, fish and cheese. Beer and wine. Several of the foodstuffs showing high degrees of correlation are known to be associated with birch pollen allergies. It is probable that at least some of these correlations are due to true IgE-mediated cross-reactivity with common allergens in birch pollen and foodstuffs. Other, hitherto less well understood mechanisms, might be at work as well. It is concluded that clustering of foodstuffs is common in food hypersensitivity and that in Sweden this phenomenon mostly is due to the association between birch pollen and some foodstuffs.
Diagnosis of IgE mediated allergy in clinical practise.
The basis of an allergy diagnosis is the patient's case history. In patients with inhalant allergy, an accurate diagnosis is often received when the case history is supported by the result of skin prick test (SPT) or in vitro-test for allergen specific IgE. IgE screening tests should, in cost-effective clinical routines, preferably be used in patients with a doubtful allergy history, in order to find out which patients do not require allergen specific testing. Determination of allergen specific IgE in the serum could be used when there is suspicion of allergy against only one or a few allergens, whereas SPT should be used when testing with many allergens is necessary. In patients with suspicion of allergy against food stuffs or drugs, test methods are of more limited value than in inhalant allergy and double blind placebo controlled challenge tests often have to be performed in order to get a definitive diagnosis. In insect venom allergy, the history should be supplemented with SPT and determination of venom specific IgE before starting desensitisation therapy.
Skin prick tests with standardized extracts of inhalant allergens in 7099 adult patients with asthma or rhinitis: cross-sensitizations and relationships to age, sex, month of birth and year of testing.
The results of skin prick tests (SPTs) performed between 1981 and 1992 on 7099 adult patients with asthma and/or rhinitis were retrospectively analyzed. Standardized Soluprick extracts of Dermatophagoides pteronyssinus, animals and pollen, and unstandardized extracts of Cladosporium++ and chironomids (red mosquito larvae, Chir), were used. The proportion of atopics (patients with positive SPT results) was 44 percent, decreasing from 61 percent in patients 14-20 years old to 18 percent in patients 61-70 years old. The decrease with age was most pronounced with timothy, cat and horse allergens. In the whole patient group, timothy, cat and birch gave the highest number of positive SPTs. Positive SPTs with dog and Chir were more common in asthmatics than in patients with rhinitis, whereas pollen allergy was more common in patients with rhinitis. Sensitization against D. pteronyssinus, timothy and Chir was more common in men than in women. Of the atopic patients, 65 percent were sensitized against several allergens and 35 percent had a mono-allergy, most frequently to D. pteronyssinus (7.4 percent) and timothy (70 percent). The proportion monoallergies/multi-allergies was higher in older patients than in younger ones. The degree of atopy, expressed as the sum of plusses of the test results with eight allergens for each patient, was higher in younger patients than in older ones. The size of the wheals induced by the positive histamine control increased with age, and the histamine-induced wheals were larger in men than in women and larger in non-atopics than in topics. Strong correlations were found between test results with cat, dog and horse. A greater proportion of the patients with an isolated pollen allergy were born in February-May than was to be expected. The proportion of positive SPTs with mugwort (Artemisia), in relation to positive SPTs with other pollen allergens, decreased from 1981 to 1992. It can be concluded that sensitization to various inhalant allergens is influenced by age, and to a lesser extent by sex, and that pollen sensitization is influenced by the month of birth. During a 12-year period, sensitization to mugwort showed a decrease, as compared to other pollen allergens.