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Biomedical subjects

P A Ostergaard

Publications and source records attributed to P A Ostergaard.

At least 19 recordsLinked to original sources
PubMed1994

Adverse reactions to food additives in children with atopic symptoms.

In a multicenter study conducted at four Danish hospital pediatric departments, the parents of 472 consecutive children were informed of this project to determine the incidence of intolerance of food additives among children referred to an allergy clinic with symptoms of asthma, atopic dermatitis, rhinitis, or urticaria. After a 2-week period on an additive-free diet, the children were challenged with the eliminated additives. The food additives investigated were coloring agents, preservatives, citric acid, and flavoring agents. Carbonated "lemonade" containing the dissolved additives was used for the open challenge. Two doses were used: a low dose and a 10-fold higher dose. Gelatin capsules were used for a double-blind challenge. The children were 4-15 years old, and they were attending an outpatient pediatric clinic for the first time. Of the 379 patients who entered the study, 44 were excluded and 335 were subjected to open challenge. A total of 23 children developed positive reactions after the open challenge. Sixteen of these patients accepted the double-blind challenge, and six showed a positive reaction to preservatives (atopic dermatitis, asthma, rhinitis), coloring agents (atopic dermatitis, asthma, urticaria, gastrointestinal symptoms), and citric acid (atopic dermatitis, gastrointestinal symptoms). The incidence of intolerance of food additives was 2% (6/335), as based on the double-blind challenge, and 7% (23/335), as based on the open challenge with lemonade. Children with atopic skin symptoms had a statistically increased risk of a positive reaction. This may have consequences for the future clinical investigation of children with atopic cutaneous symptoms.

Adolescent↗
PubMed1994

Medical treatment of asthmatic children before referral to a clinic for allergy. A comparison between the periods 1979-83 and 1988-91.

The use of antiasthmatic agents in children before referral to a children's clinic for allergy was studied in two periods (1979-83 and 1988-91). In the latter period, in contrast to the former, significantly more children were treated with peroral (73 and 43%, respectively) or inhaled beta 2-agonists (40 and 22%, respectively). In addition, considerably more children in the latter than the former period were or had been treated with inhaled steroids. On the other hand, most children used these agents either in short courses (41%) or on demand (30%). We conclude that, although there have been intensive educational programs specifically focusing on the proper use of antiasthmatic drugs during the last 10 years, still more information is needed by general practitioners.

Administration, Inhalation↗
PubMed1994

Maternal antibodies and acquired serological response to Moraxella catarrhalis in children determined by an enzyme-linked immunosorbent assay.

An enzyme-linked immunosorbent assay (ELISA) for determination of serum immunoglobulin G (IgG) antibodies to Moraxella catarrhalis was developed, with an ultrasonic extract of M. catarrhalis immobilized on polystyrene microtiter plates serving as the antigen. The specificity was determined by adsorption tests. All of the 541 women tested showed a high level of maternal IgG antibodies to M. catarrhalis in umbilical cord blood specimens. One hundred eighty-nine children aged 0 to 15 years were examined. A low level of IgG antibodies to M. catarrhalis in serum was found in children aged up to 1 year; in older children, the levels increased with age. Levels in the same range as maternal IgG antibody levels were reached at the age of 10 years. The level of antibodies in children did not correlate with the state of colonization with M. catarrhalis or with the state of acute lower respiratory tract infection. Pairs of acute-phase and convalescent-phase serum samples did not discriminate between the children with M. catarrhalis in pure culture and those with mixed cultures of M. catarrhalis, Haemophilus influenzae, and Streptococcus pneumoniae. In adult women, high IgG antibody levels and low colonization rates with M. catarrhalis were found, whereas in small children, low IgG antibody levels and high colonization rates were found.

Adult↗
PubMed1992

Comparison of CLA with BPT, SPT, and RAST in children with asthma.

Bronchial provocation tests (BPT) with allergen extracts were performed in 82 children with asthma, and the results were compared with the chemiluminescent assay (CLA), the radio-allergo-sorbent-test (RAST) and skin prick test (SPT). It was found that CLA matched BPT with a concordance of 87% (77-93%), RAST with a concordance of 74% (64-83%) and SPT with 80% (70-88%). Most often, CLA and RAST gave similar results, although their classes did not match precisely.

Adolescent↗
PubMed1990

Basophil histamine release in the diagnosis of house dust mite and dander allergy of asthmatic children. Comparison between prick test, RAST, basophil histamine release and bronchial provocation.

The aim of the study is to compare the glass fibre-based basophil histamine release test with skin test (Phazet), RAST (Phadebas) and bronchial provocation test in children with allergic asthma. The study comprised 68 selected children with a case history of extrinsic allergic asthma to danders (cat and dog) and house-dust mite. Skin prick test, RAST, and histamine release were performed in all children and the bronchial provocation test was used as a reference of "true allergic asthma". A total of 81 allergen bronchial challenges were performed and 44 children experienced 49 positive provocations. In 2.9% (2/68) of the children histamine release could not be performed due to technical difficulties (low histamine release with anti-IgE). Concordances in the range 76-87% were observed with no significant difference between the tests. The highest concordance (87%) was found between histamine release and bronchial provocation test followed by skin prick test vs bronchial provocation (84%) and RAST vs bronchial provocation (80%). The sensitivity and specificity were calculated for each test. All tests showed sensitivities in the range 90-94% and no significant difference between them was observed. The specificity of histamine release, skin prick test, and RAST was 0.78, 0.69, and 0.63, respectively. The specificity of histamine release was better than RAST demonstrated by 95% confidence intervals. In conclusion, it was found that the histamine release test is a convenient diagnostic method and the study indicates a diagnostic value comparable to the common diagnostic methods in clinical allergy.

Animals↗
PubMed1989

Immunotherapy with dog and cat extracts in children.

Hypersensitivity to dogs and cats causes asthma in many children. In this open controlled clinical study we wanted to establish whether immunotherapy can be recommended as a supplement to conventional medical therapy in dog- and cat-induced asthma in children. Twenty-seven children with mean age 10 7/12 years and with allergy to dog or cat according to anamnesis, skin prick test (SPT), specific IgE (RAST) and bronchial provocation test (BPT) entered the study. On the basis of age and bronchial sensitivity they were randomly allocated to either immunotherapy with dog or cat extract (active group, n = 14) or conventional medical therapy (control group, n = 13). Immunotherapy comprised subcutaneous injections with an alum-adsorbed depot extract (Alutard-SQ), and a maintenance dose of 100,000 SQ-U or the maximum tolerated dose. Before entering the study and after 9 months' therapy the patients were evaluated by BPT, SPT, RAST - and IgG4 analyses. The active group showed statistically significant change in bronchial tolerance (P less than 0.02), whereas no such change was found in the control group (P greater than 0.05). The change in skin sensitivity was significantly greater in the active group than in the control group (P less than 0.05), whereas no significant differences were found in RAST and IgG4. However, a significant (P = 0.05) increase in IgG4 was seen in the active but not in the control group. Frequency and degree of side effects in this study were acceptable.

Adolescent↗
PubMed1989

Farmer's lung in infants and small children.

A boy and a girl, 10 weeks and 3 years of age, respectively, were admitted to our department with low temperature, dry cough, fatigue and weight loss. In both patients pulmonary X-rays showed diffuse, bilateral, micronodular infiltrations, and sparse signs of fibrosis. Serum IgG and blood eosinophils were abnormally high. After a stay in hospital for 3 weeks, the patients recovered slowly. However, after a few days at home, they were readmitted with the same symptoms. Family histories revealed that the children lived on farms with huge grain magazines and dryers, where moist grain and straw were stored. Massive amounts of mould spores were cultured from the residential areas, and, in addition, the male patient had an elevated titer to Micropolyspora faeni and the female patient, elevated titers to Thermoactinomyces vulgaris, Micropolyspora faeni, Aspergillus fumigatus and Alternaria alternans. The patients and their families moved from the farms and, for approximately a year, have been without lung symptoms. Farmer's disease in infants and small children is extremely rare. However, the incidence may be increasing due to the tendency in latter years to decentralize grain dryers and store moist grain and straw in big magazines, often close to residential areas.

Child, Preschool↗
PubMed1989

[The tresh dust lung syndrome in children].

Farmer's lung, caused by the inhalation of microspores--particularly of the genus, Thermoactinomyces--has been recognised for the past 30-40 years as a condition affecting adult farm workers, especially up to the mid-sixties when undried crops were still threshed indoors. Although it used to be extremely rare in children, between 1985 and 1989 occurred five of the seven cases reported hitherto. The possibility is suggested that with the increasingly large scale use of grain drying plant and stubble burn-off on Danish farms, we shall see an increase in the incidence of the disease, even in infants.

Actinomycetales↗
PubMed1988

A prospective study on non-IgE-mediated asthma in children.

From 1977 to 1980, seventy-two children were found to have intrinsic (non-IgE-mediated) asthma. Except for five patients, 4 boys and one girl, who apparently grew out of their asthma, the remaining 67 patients were followed for six years. During the study period, 12 patients, 10 boys and 2 girls, developed extrinsic (IgE-mediated) asthma. Nine of them (75%) had a positive family history of atopic disease, which was only the case in 12 (22%) of the patients who did not develop extrinsic disease. Hence, a change from intrinsic into extrinsic asthma is apparently common in boys, but seems to be rare in girls. In addition, in girls with intrinsic asthma, fixed or declining lung function tests followed by signs of pulmonary hyperinflation and lung fibrosis is common. Further, in the present series of children with intrinsic asthma, 5 patients, 4 girls and 1 boy, developed severe bronchiectasis. The majority of patients, who on repeated chest X-rays showed persistent hyperinflation of the lungs associated with fixed FEV1/FVC levels and a marked increase of serum IgG-concentrations were those at risk to develop severe lung disease.

Adolescent↗
PubMed1986

A prospective study on the safety of immunotherapy in children with severe asthma.

One hundred and six of 503 (21%) consecutive children with asthma, who from 1979 to 1983 commenced hyposensitization therapy, were prospectively studied on the safety of immunotherapy. More than 80% of the patients completed therapy without side effects. Thirteen patients were withdrawn from hyposensitization due to moderate and predictable, but intolerable, side effects such as asthma/rhinitis, urticaria and subcutaneous nodules and hypersensitivity to aluminium. However, more alarming was the outcome in six children, who after an uneventful course of immunotherapy and after several months on maintenance therapy, suddenly, 5 to 20 min (mean 10 min) following an earlier tolerable allergen injection, developed severe, anaphylactic reactions, in three of them nearly fatal. Mould extracts were responsible for the most frequent and serious side effects (Alternaria iridis/alternata, 3 patients, Cladosporium herbarum, 8 patients). Furthermore, serious, but not immediately life-threatening, anaphylactic reactions occurred in two children treated with Phleum pratense. On the other hand, hyposensitization with Dermatophagoides pteronyssinus was very well tolerated.

Adolescent↗