E. O. Terho

Farm environment in childhood prevents the development of allergies

A protective effect of infections in early life might explain the firmly reported finding of an inverse association between atopic disorders and large sibships.

Validation of a new questionnaire on asthma, allergic rhinitis, and conjunctivitis in young adults

Background: Epidemiologic data on asthma and allergies among adults are mainly based on questionnaires: this study validates the questions on asthma, allergic rhinitis, and conjunctivitis of a new Finnish questionnaire.

Stressful life events promote the manifestation of asthma and atopic diseases.

Background Psychosocial stress is known to aggravate asthma. Less is known about the impact of stressful life events on the expression of asthma and atopic disorders.

Allergy to Storage Mites or Cow Dander as a Cause of Rhinitis among Finnish Dairy Farmers

The role of storage mites Acarus siro, Lepidoglyphus destructor, and Tyrophagus putrescentiae, compared with that of cow dander, as a cause of allergic rhinitis was studied by nasal challenges in a population of 106 non‐smoking dairy farmers. Thirty‐six of the subjects were challenged with storage mites alone, each with only one of the three species in consecutive order, 43 with cow dander alone, and 27 with both. Thus mite challenges were performed on 63 farmers and cow dander challenges on 70. Challenges with any one of the storage mite species were positive in 18% and with cow dander in 20 % of farmers with allergic rhinitis. All challenges to asymptomatic farmers were negative. Five of the eight positive reactions to storage mites were due to Lepidoglyphus destructor, and three to Tyrophagus putrescentiae. Acarus siro was not responsible for any of the positive reactions. The results indicate that, among dairy farmers, storage mites are as common as cow dander as a cause of allergic occupational rhinitis.

Prevalence of asthma, allergic rhinoconjunctivitis and allergic sensitization in Mongolia

Background:  Studies in countries, such as Mongolia, which are in transition from farming to industrial society permit evaluation of the impact of environmental change on atopic diseases.

Childhood farm environment and asthma and sensitization in young adulthood

Background: Farm environment in childhood may protect against sensitization, allergic rhinitis, and asthma.

The common cold: Effects of intranasal fluticasone propionate treatment ☆ ☆☆ ★ ★★

OBJECTIVE A double-blind, randomized, placebo-controlled trial was conducted to study the effect of the intranasal corticosteroid, fluticasone propionate (FP), in the naturally occurring common cold. METHODS One hundred ninety-nine young adults received high-dose FP (200 microg four times daily) or placebo beginning 24 to 48 hours after onset of the common cold for 6 days. All symptoms were recorded on diary cards on days 1 to 20, and clinical examinations were carried out on days 1, 7, and 21. Nasopharyngeal aspirates were collected on days 1 and 7 for detection of rhinoviruses (found in 105 subjects) and Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis (found in 52 subjects) in the nasopharynx. RESULTS In general, FP treatment had no clinically recognizable effects on the symptoms of the common cold, although it significantly reduced nasal congestion and cough on some study days. After treatment, rhinoviruses were cultured more often in the FP treatment group (37% vs 14%, p < 0.001), but this had no effect on the symptoms of common cold. FP treatment produced no changes in the colonization of pathogenic bacteria in the nasopharynx. Some symptoms of common cold were significantly more severe during days 1 to 10 (p < 0.05) in subjects found to have positive cultures for S. pneumoniae, H. influenzae, or M. catarrhalis in the nasopharynx on day 1 (n = 33). CONCLUSION FP treatment does not have any marked effects on the symptoms of the common cold. FP treatment induced prolonged shedding of viable rhinoviruses. Some symptoms of the common cold were significantly more severe in subjects with pathogenic bacteria in the nasopharynx.

IgG antibodies, chronic bronchitis, and pulmonary function values in farmer's lung patients and matched controls

We measured IgG antibody levels against eight different microbes in farmers lung (FL) patients an average of 14 years after the first diagnosed episode of FL and in matched controls. The study population consisted of 87 FL patients and 81 control farmers, matched by age, sex, and smoking habits. Clinical studies included the measurement of IgG antibody levels against Absidia corym‐bifera, Aspergillusumbrosus, A. fumigatus, Humicola grisea, Saccharopolyspora rectivirgula, Penicillium brevicompactum, Rhodotorula glutinis, andThermoactinomyces vulgaris, in addition to spirometry, pulmonary diffusing capacity (DLCO), and the evaluation of chronic bronchitis. Median IgG antibody levels were two or more times higher in FL patients than control farmers against Ab. corymbifera, S. rectivirgula, and T. vulgaris (P<0.001). Against A. fumigatus, H. grisea, and R. glutinis, FL patients also had significantly higher antibody levels. FL patients often had positive antibody titers against several microbes, whereas control farmers usually had a positive titer against one or two microbes. A positive association between IgG antibody levels and chronic bronchitis and DLCO was observed in FL patients, but not in control farmers. It is suggested that the high antibody levels noted in FL patients were due not only to high exposure but also to individual sensitivity to environmental microbes.

Reproducibility of the skin prick test.

Reproducibility of the skin prick method of testing for allergy was studied in 20 subjects examined by four nurses. Hypodermic needles were used for pricking and the test panel included a histamine control, a diluent control, and nine allergens. The reproducibility of the method was best when the size of the weal reaction caused by an allergen was expressed as the geometric area of the weal. When the weal reaction was expressed as the ratio of the weal reaction caused by an allergen to that caused by histamine, the reproducibility of the method was decreased considerably. When the ratios were further classified into three class ratings, reproducibility was very low. The reduction in reproducibility was due to the low reproducibility of histamine reactions. According to these results, at least in epidemiological studies the weal reactions should be expressed as geometric areas. In clinical practice it might also be preferable to express prick test results as the diameters of the weals without adjusting them by histamine reactions.

Food hypersensitivity among Finnish university students: association with atopic diseases.

Background Food hypersensitivity (FH) is commonly suspected, especially among adults with atopic diseases. Symptoms of FH vary from oral allergy syndrome (OAS) to gastrointestinal, respiratory and systemic reactions. More data are needed regarding patient groups at risk for FH, and symptoms and foods responsible for the reactions.