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Biomedical subjects

E von Mutius

Publications and source records attributed to E von Mutius.

At least 109 records · Page 6Linked to original sources
PubMed1994

Prevalence of asthma and atopy in two areas of West and East Germany.

The German reunification offers a unique opportunity to study the impact of environmental factors on the development of childhood respiratory and allergic disorders in ethnically similar populations. We investigated the prevalence of asthma, hay fever, atopy, and bronchial hyperresponsiveness (BHR) in 9- to 11-year old children in West Germany (n = 5,030) and East Germany (n = 2,623). A self-administered questionnaire was distributed to the parents. Children underwent cold air challenge and allergy skin prick tests. Atopic sensitization was considerably more frequent in West German children than in their peers in East Germany (36.7% versus 18.2%; odds ratio [OR] = 2.6, p < 0.0001). The prevalence of current asthma and hay fever was significantly higher in West Germany when compared with that in East Germany (5.9% versus 3.9%; OR = 1.5, p < 0.0001 and 8.6% versus 2.7%; OR = 3.4, p < 0.0001, respectively). Bronchitis, however, was more prevalent in East Germany than in the western part of the country. The prevalence of BHR as assessed by cold air challenge was higher in West Germany compared with that in East Germany (8.3% versus 5.5%, OR = 1.6, p < 0.001). Logistic regression showed that the West German study area was no longer a significant independent determinant of asthma once sensitization to mites, cats, and pollen was taken into account. We conclude that sensitization to aeroallergens is strikingly more frequent in West Germany than in East Germany and this may explain the differences in the prevalence of asthma and hay fever between the two parts of the country.

Asthma↗
PubMed1994

Pertussis infection and allergic sensitization.

BACKGROUND: The immunogenic activity of B. pertussis infection has been described in various laboratory, animal, and clinical studies. There is, however, no information on the impact of pertussis on allergies in the total population. OBJECTIVE: To compare the prevalence of allergic sensitization and allergic rhinitis in children with and without previous pertussis infection. METHODS: A population-based, cross-sectional study was carried out on 13,937 10-year-old children in the western (Munich and Southern Bavaria) and eastern parts of Germany (Leipzig and the region around Halle). A total of 11,969 questionnaires (85.9%) given to the parents were collected. Data from 9,484 German children (questionnaire and skin prick tests with six different allergens) were analyzed. RESULTS: Pertussis was much more common in the western than in the eastern part of Germany. The adjusted odds ratio for any allergic sensitization after pertussis was only slightly increased in western Germany with 1.3 (95% confidence limits 1.2 to 1.5) and in eastern Germany with 1.5, (1.2 to 1.8) but not for allergic rhinitis with 1.0 (0.7 to 1.4) and in Eastern Germany 1.3 (0.8 to 1.9). CONCLUSIONS: Infection with pertussis seems to have only a weak influence on allergic sensitization and does not explain the observed differences in allergic sensitization between western and eastern Germany.

Asthma↗
PubMed1994

[Bronchial asthma].

Explore the source record for details and available documents.

Activities of Daily Living↗
PubMed1993

[Bronchial asthma in childhood. Part 2: Prevention and step-wise plan for drug therapy].

On the basis of our knowledge of the pathogenesis of bronchial asthma, prophylactic measures and systematic treatment are of decisive importance. In the first instance, prophylactic measures cover the elimination of allergens and avoidance of exposure to tobacco smoke. Drug treatment of bronchial asthma should be initiated early on, be planned for the long-term, and comprise an individually matched combination of anti-inflammatory agents and drugs with an acute action. Here, inhalative steroids are of great importance in children, too. Drug therapy and physical measures should be applied systematically in a stepwise fashion tailored to the clinical severity of the symptoms. Additional instruction of the patients in respiratory techniques is also needed.

Administration, Inhalation↗
PubMed1993

[Bronchial asthma in childhood. Part 1: Clinical manifestations, diagnosis and ground rules of therapy].

The most common disease met with in childhood is bronchial asthma, the prevalence of which in Germany is reported to be as high as 8%. However, the true figure is likely to be considerably higher. Bronchial asthma is defined as a variable, episodic airways obstruction that is accompanied by hypercontractility of the bronchial system. Instead of the characteristic wheezing, in childhood the disease often presents as untypical attacks of coughing. In the differential diagnosis, aspiration of a foreign body, mucoviscidosis, tuberculosis, immune defects and an intrathoracic mass lesion must all be considered. The aim of treatment is to normalize pulmonary function and completely restore the child's physical robustness.

Administration, Inhalation↗
PubMed1993

Road traffic and adverse effects on respiratory health in children.

OBJECTIVES: To examine whether road traffic in a big city has a direct effect on pulmonary function and respiratory symptoms in children. DESIGN: Cross sectional study. SETTING: Of all 7445 fourth grade children (aged 9-11 years) in Munich, 6537 were examined. Of the children with German nationality and the same residence during the past five years and known exposure data, 4678 questionnaires and 4320 pulmonary function tests could be analysed. MAIN OUTCOME MEASURES: Variables of pulmonary function by forced expiration and respiratory symptoms reported in a questionnaire; census data on car traffic collected in the school district. RESULTS: Density of car traffic ranged from 7000 to 125,000 cars per 24 hours. Multiple regression analysis of peak expiratory flow showed a significant decrease of 0.71% (95% confidence interval 1.08% to 0.33%) per increase of 25,000 cars daily passing through the school district on the main road. Maximum expiratory flow when 25% vital capacity had been expired was decreased by 0.68% (1.11% to 0.25%). In contrast, response to cold air challenge was not increased. The adjusted odds ratio for the cumulative prevalence of recurrent wheezing with the same exposure was 1.08 (1.01 to 1.16). Cumulative prevalence of recurrent dyspnoea was increased, with an odds ratio of 1.10 (1.00 to 1.20). Lifetime prevalence of asthma (odds ratio 1.04; 0.89 to 1.21) and recurrent bronchitis (1.05; 0.98 to 1.12) were not significantly increased. CONCLUSIONS: High rates of road traffic diminish forced expiratory flow and increase respiratory symptoms in children.

Automobiles↗
PubMed1993

Evaluation of cold air challenge data in a population sample using a model of bronchial hyperreactivity and disposition to bronchial obstruction.

To explore the role of bronchial hyperreactivity and obstruction after cold air challenge, data from a cross-sectional study of more than 7,000 10-year-old children were used. Current knowledge of hyperreactivity is primarily based on pharmacological provocation tests with variable prechallenge flow rates and their decrease relative to baseline. Using forced expiratory volume (FEV) in 1 sec values before and after cold air challenge, however, it is possible to define a subsample of children with predominant hyperreactivity and a subsample with predominant obstruction after challenge. The prevalence of respiratory symptoms and the diagnoses in the two subsamples were compared. The analysis showed that children with bronchial obstruction have nearly the same frequency of respiratory symptoms as those with bronchial hyperreactivity. A combined model of bronchial obstruction and hyperreactivity was, therefore, more predictive of symptoms than a model of hyperreactivity alone.

Air↗
PubMed1993

Prematurity as a risk factor for asthma in preadolescent children.

Information on long-term respiratory symptoms in prematurely born children is scanty. We studied an unselected population of 9- to 11-year-old schoolchildren. A self-administered questionnaire was distributed to the parents. Children underwent lung function testing, cold air challenge, and skin prick tests. A gestational age < 37 weeks in children with a birth weight < or = 2500 gm was reported by 5% of the parents. Premature girls had significantly more current asthma (odds ratio (OR) 2.6; 95% confidence interval (CI) 1.4, 4.7; p < 0.05), recurrent wheezing (OR 1.7; 95% CI 1.1, 2.7; p < 0.001), recurrent shortness of breath (OR 2.4; 95% CI 1.5, 3.9; p < 0.001), and frequent cough with exercise (OR 1.8; 95% CI 1.1, 2.9; p < 0.05) than term girls, especially if they required mechanical ventilation after birth. No such differences could be shown in boys. More prematurely born children who required mechanical ventilation (OR 3.7; 95% CI 2.2, 6.4; p < 0.0001) had a family history of asthma than children born at term. Significant decrements could be demonstrated for different measurements of lung function in premature girls. These results remained significant after control for confounders in a multivariate regression analysis. No difference was found between groups for bronchial hyperresponsiveness to cold, dry air or for atopic sensitization. We conclude that a family history of asthma may predispose premature children to more severe respiratory disease. Respiratory symptoms and decrements in lung function seen in girls may reflect abnormalities of lung function in survivors of severe neonatal respiratory disease.

Asthma↗
PubMed1993

[The language of pediatric asthma patients. A study of symptom description].

BACKGROUND: Questions on asthma symptoms like "wheezing" or "whistling in the chest" must be easily understood by the general population. In preparation of a standardized German questionnaire we investigated, how children with asthma and their parents would describe symptoms during an asthma attack. METHODS: From June until December 1991, 72 children aged 13-15 years, and parents of 138 children aged 7-15 years with diagnosed asthma, where interviewed whilst they visited the outpatient department of the universities of Berlin, Leipzig, and Munich. The parents and children were asked to answer a questionnaire which included a list of adjectives and descriptions proposed to describe the child's breathing during an asthma attack. The items included descriptions which have been used on German questionnaires, others which we considered possibly useful, anc control items which we considered inappropriate. Parents and children were asked to rate on scales how much they would agree or disagree to the proposed items as possible descriptors. Descriptive and cluster analyses revealed those descriptions which received the best ratings. RESULTS: The rating was rather independent of the sex of the child, the respondent (child vs parent) and the severity of attacks, but differences between regions were observed. CONCLUSION: The verbal descriptors with the best rating will be used for the wording of a German questionnaire on asthma symptoms.

Adolescent↗
PubMed1993

[Bronchial hyperreactivity and epidemiology of bronchial asthma in childhood].

Respiratory symptoms are common in childhood with as many as 25% of children aged 7-10 years being troubled by recurrent episodes of cough and wheeze. Subjects with and without asthma differ both in the ease with which airway narrowing is produced by inhalation of nonallergic or nonsensitizing stimuli. A few epidemiologic studies are concerned with the prevalence of bronchial hyperresponsiveness in unselected children. Although increased airway responsiveness is predominantly reported in atopic individuals, even children with no history of atopy or symptoms suggesting asthma produce a bronchial obstruction being challenged by physical exercise, inhalation of cold air or distilled water and pharmacologic stimuli. The relationship between responsiveness to different challenges was investigated in 2 large epidemiological studies on school aged children. The following reports are an informative survey on acceptance, sensitivity, specificity and predictive value of epidemiologic instruments estimating bronchial responsiveness.

Asthma↗
PubMed1993

[Cold air hyperventilation provocation].

The prevalence of asthma was determined by a parental questionnaire in 9403 schoolchildren aged 9-11 years. A cold air challenge was done in 7248 of these children to test for bronchial hyperresponsiveness. Regarding the doctor diagnoses of asthma as reported by the parental questionnaire the specificity of the cold air challenge was 92.5%, the sensitivity 28.7%, the positive predictive value 9.1% and the negative predictive value 98%.

Asthma↗
PubMed1992

Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison.

OBJECTIVES: To compare the prevalence of asthma and allergic disorders among children in Munich, western Germany, and Leipzig, eastern Germany, where environmental exposure, particularly air concentrations of sulphur dioxide and particulate matter, and living conditions have differed over the past 45 years. DESIGN: Prevalence surveys among school-children aged 9-11 years in Leipzig and Munich. Self completion of written questionnaire by the children's parents and lung function measurements. SUBJECTS: 1051 children in Leipzig and 5030 in Munich. SETTING: Primary schools. MAIN OUTCOME MEASURES: Reported lifetime prevalence of asthma and allergic disorders, and bronchial hyperresponsiveness assessed by cold air inhalation challenge. RESULTS: The lifetime prevalence of asthma diagnosed by a doctor was 7.3% (72) in Leipzig and 9.3% (435) in Munich; prevalence of wheezing were 20% (191) and 17% (786) respectively. The prevalence of diagnosed bronchitis was higher in Leipzig than Munich (30.9% (303) v 15.9% (739); p < 0.01). A significant drop in forced expiratory volume (> 9%) after cold air challenge was measured in 6.4% (57) of children in Leipzig and in 7.7% (345) of those in Munich. Hay fever (2.4% (24) v 8.6% (410); p < 0.01) and typical symptoms of rhinitis (16.6% (171) v 19.7% (961); p < 0.05) were reported less often in Leipzig than in Munich. CONCLUSIONS: No significant differences were seen in the lifetime prevalence of asthma, wheezing, and bronchial hyperresponsiveness between children in Leipzig and Munich. The lifetime prevalence of bronchitis was higher in Leipzig than in Munich. The lower prevalence rates of allergic disorders in Leipzig could point toward aetiological factors that are associated with Western lifestyle and living conditions.

Asthma↗
PubMed1992

Genetic risk for asthma, allergic rhinitis, and atopic dermatitis.

In order to explore the genetic risk of a child with a family history of allergies developing asthma, allergic rhinitis, or atopic dermatitis, questionnaires filled in by 6665 families were analysed. The data were collected in a population based cross sectional survey of 9-11 year old schoolchildren living in Munich and southern Bavaria. The relation between asthma, allergic rhinitis, and atopic dermatitis and the number of allergic first degree relatives, and the type of allergic disease was examined. Analyses were done separately for families with single or multiple allergic diseases. In families with one allergic parent the risk of the child developing asthma was increased by asthma in a parent, with an odds ratio (OR) of 2.6 (95% confidence interval 1.7 to 4.0) but not by parental allergic rhinitis with OR 1.0 (0.7 to 1.5) or atopic dermatitis, OR 1.0 (0.6 to 1.6). For allergic rhinitis the highest risk with OR 3.6 (2.9 to 4.6) was observed with allergic rhinitis of one parent, apparently lower for asthma of one parent, OR 2.5 (1.6 to 4.0) or atopic dermatitis, OR 1.7 (1.1 to 2.5). Children with parental atopic dermatitis had a high risk for atopic dermatitis, OR 3.4 (2.6 to 4.4), compared with children with parental asthma, OR 1.5 (1.0 to 2.2), or parental allergic rhinitis, OR 1.4 (1.1 to 1.8). Risk factors in families with combined allergies of two relatives (parents and siblings) were analysed separately for the different combinations. These results support the hypothesis that asthma, allergic rhinitis, and atopic dermatitis are multifactorial diseases brought about by various familial and environmental influences.

Asthma↗
PubMed1992

[Effects of passive smoking on the pediatric respiratory tract].

OBJECTIVE: To explore the risk of parental smoking to the respiratory health of their children data of a cross sectional study on fourth-grade schoolchildren in Munich and Southern Bavaria were analysed. METHODS: Allergic and asthmatic diseases and symptoms, risk factors like family history, indoor pollution and parental smoking were evaluated by a questionnaire. Pulmonary function tests were performed in 7284 school children aged (9-11 years). Lung function values were adjusted for height, weight, sex and other confounders. RESULTS: The children, whose parents smoke at home, had significantly lower levels of peak flow, MEF75, MEF50 and MEF25 compared to children from non-smoking families, with a dose-response relationship. Smoking of more than 20 cigarettes at home is associated with a mean decrease in MEF75 of 5.7%, in MEF50 of 4.9% and in Peak Flow of 4.9% (p < 0.001). The prevalence of cough and wheezing increased with increasing smoking rates of the parents. CONCLUSIONS: Passive exposure to smoke has direct measurable dose-dependent effects on the respiratory system of children.

Asthma↗
PubMed1992

[Does breast feeding prevent asthma and allergies? Results of the Munich asthma and allergy study].

The relationship of breast feeding to atopic diseases is studied in a population-based cross sectional study in Munich and Bavaria 1989/1990 in 6,535 german ten year old children. According to the questionnaire answers 1914 (29.3%) children were not breast fed, 2,368 (36.2%) shorter than 2 months, 1,744 (26.7%) 2 to 6 months and 509 (7.8%) more than 6 months. Compared to controls without any allergic disease the relative risk of later asthma, hayfever, atopic dermatitis and of allergic skin sensitization was not diminished by breast feeding. The same result pertained to high risk subgroups defined by positive family history of asthma or hayfever. It is concluded that breast feeding alone has no long term protective effect against atopic diseases.

Asthma↗
PubMed1989

[Are there risk factors for stenosing laryngitis? Results of the Southern Bavaria pseudo-croup study].

We tried to find a correlation between elevated air pollution levels and incidences of laryngitis (pseudocroup). Clinical data-obtained by questionnaire-from 418 children with laryngitis, viral shedding in rhinal secretion and data on air pollution as SO2, NO2 and dust levels were compared via correlation analyses. Boys with allergic diathesis and with signs for bronchial hyperreactivity were identified as a high risk group. The high incidence of laryngitis especially seen in the month of October could be explained by the increased number of RSV positive patients. There was no significant correlation between laryngitis and the air pollution levels during the time of observation.

Air Pollution↗
PubMedDate not supplied

The use of anti-asthmatic drugs in children: results of a community-based survey in Germany.

PURPOSE: To describe the use of anti-asthma drugs in children in the general population and in children with asthma using data from two large surveys in Germany. METHODS: Community-based random sample of 5-7 and 9-11-year-old children in Dresden and Munich were studied in 1995/96 by parental questionnaires using the Phase II protocol of the International Study of Asthma and Allergies in Childhood (ISAAC). A total of 11,094 children participated in the surveys (response rate 83%). RESULTS: In all children, inhaled beta 2-agonists were used most frequently during the last 12 months (2.6%), followed by inhaled cromolyns (2.5%), oral beta 2-agonists (1.5%), and inhaled steroids (0.9%). Drug use was significantly higher among boys than girls and in older children compared to younger ones (P < 0.05 for both). Among children with current asthma, 47% had used inhaled beta 2-agonists, 43% inhaled cromolyns, 22% oral beta 2-agonists, and 16% inhaled steroids. Inhaled steroids were used significantly more often in Dresden (21.7%) than in Munich (11.2%) (P < 0.05). CONCLUSIONS: Among anti-asthma drugs, agents used for symptomatic relief were the most frequently reported followed by inhaled anti-inflammatory agents. Most of the anti-inflammatory drugs used were SCG, which may indicate under-treatment with inhaled steroids.

Adrenergic beta-Agonists↗