Is Free Running Asthma screening test still useful? / ¿Es la prueba de carrera libre para el tamizaje del asma todavía útil?

OBJECTIVE: The aim of this study is to evaluate the usefulness of Free Running Asthma Screening Test (FRAST) as a method that may help the diagnosis of exercise-induced bronchospasm (EIB) in children from a rural area and to compare the results with their history of asthma. METHODS: A FRAST challenge took place at 9 schools. It lasted for 6 minutes and pupils performed it properly with the help of an athlete. The best out of three Peak Expiratory Flow Rate (PEFR) efforts was recorded before and after challenge, using a mini-Wright peak-flow-meter. A more than 15% drop in PEFR was considered an indication of EIB. A questionnaire defining asthmatic symptoms had been distributed and already completed by their parents. RESULTS: The exercise was successfully performed by 268 children. Eleven children presented a fall of PEFR of at least 15%, five or ten minutes after the exercise; among these, only three boys had a history of asthma, while the remaining 8 children were undiagnosed. No difference regarding age, gender or locations' altitude was found. CONCLUSION: FRAST can be of great use in the diagnosis of EIB in areas that lack proper tools and specialized personnel. A poor correlation between self-reported symptoms and the results of exercise challenges was confirmed.

OBJETIVO: El objetivo de este estudio fue evaluar la utilidad de la prueba de la carrera libre para el tamizaje del asma (PCLTA) como método que puede ayudar al diagnóstico del broncoespasmo inducido por ejercicio (BEI) en los niños de un área rural, y comparar los resultados con su historia de asma. MÉTODOS: Una prueba de reto PCLTA tuvo lugar en 9 escuelas. La prueba tuvo una duración de 6 minutos, y los alumnos la realizaron correctamente con la ayuda de un atleta. El mejor de tres esfuerzos de la tasa de flujo espiratorio máximo (TFEM) fue registrado antes y después de la prueba, usando un medidor Mini-Wright de flujo espiratorio máximo. Una caída de más del 15% en la TFEM fue considerada una indicación de BEI. Un cuestionario que define los síntomas asmáticos había sido distribuido y respondido por sus padres. RESULTADOS: El ejercicio se realizó con éxito por 268 niños. Once niños presentaron una caída de TFEM de por lo menos 15%, cinco o diez minutos después del ejercicio. De ellos, tres varones tenían una historia de asma, mientras los otros 8 niños restantes no tenían diagnóstico. No se halló diferencia con respecto a edad, género o altitud de las localizaciones. CONCLUSIÓN: La prueba PCLTA puede ser de gran utilidad en el diagnóstico de BEI en áreas en las que faltan las herramientas apropiadas y el personal especializado. Se confirmó la existencia de una pobre correlación entre los síntomas auto-reportados y los resultados de los ejercicios de reto.

Is Free Running Asthma Screening Test still useful?

OBJECTIVE: The aim of this study is to evaluate the usefulness of Free Running Asthma Screening Test (FRAST) as a method that may help the diagnosis of exercise-induced bronchospasm (EIB) in children from a rural area and to compare the results with their history of asthma. METHODS: A FRAST challenge took place at 9 schools. It lasted for 6 minutes and pupils performed it properly with the help of an athlete. The best out of three Peak Expiratory Flow Rate (PEFR) efforts was recorded before and after challenge, using a mini-Wright peak-flow-meter. A more than 15% drop in PEFR was considered an indication of EIB. A questionnaire defining asthmatic symptoms had been distributed and already completed by their parents. RESULTS: The exercise was successfully performed by 268 children. Eleven children presented a fall of PEFR of at least 15%, five or ten minutes after the exercise; among these, only three boys had a history of asthma, while the remaining 8 children were undiagnosed. No difference regarding age, gender or locations' altitude was found. CONCLUSION: FRAST can be of great use in the diagnosis of EIB in areas that lack proper tools and specialized personnel. A poor correlation between self-reported symptoms and the results of exercise challenges was confirmed.

Is month of birth a risk factor for subsequent development of pollen allergy in adults?

A comparison of the date of birth of 1501 adult patients with severe seasonal respiratory allergy (allergic rhinitis or bronchial asthma) due to parietaria, olive, and grass pollens with the expected births within 2,020,420 births in South Greece during the same period, was performed. The relative risk for developing respiratory allergy was characteristically increased in those born in a specific period of time different for each pollen. The relative risk for parietaria was increased (1.47) in those born in March; for olive it was 1.6 for May; 1.2 for April; and 1.4 for March, while the relative risk for grasses was 1.2 in those born in June and July. These findings are indicative of the importance of the month of birth; that is, the early exposure to pollens, for the development of respiratory allergy to certain pollens during adulthood. Because our findings do not directly correlate completely with the aerobiology studies on pollen calculation in Athens' atmosphere, we supposed that other environmental factors, e.g., the local intensity of the first pollination or the influence of weather conditions, may contribute to the final development of respiratory allergy as well. The most impressive finding was the significant influence of the month of birth in the development of respiratory allergy due to parietaria and olive pollens during adulthood.

Insect-venom allergy in Greek adults.

Relatively few studies have investigated the prevalence of insect-sting allergy and the results of diagnostic procedures in unselected populations. The prevalence of insect-sting reactions and of venom sensitization in Greece is unknown. We report the results from a stratified random sample of 480 subjects (404 men, 76 women), aged 20-60 years. They all belonged to the ground personnel of the Hellenic Air Force. A detailed history particularly focused on the reactions to Hymenoptera stings was taken in all subjects. Intradermal skin tests (concentration: 1 microgram/ml) with three venoms (honeybee, paper wasp, common wasp) were performed. The prevalence of venom sensitization (one or more positive skin tests) was 32.7%. Sensitization appears to be more common (2.69 times) in those living in rural areas than in those living in the capital (Athens). The prevalence of systemic reactions was 3.1% (86.7% of them had positive skin tests). Large local reactions were reported by 4.6% of the subjects (77.3% of them had positive skin tests). Asymptomatic sensitization (positive skin tests to venoms) was observed in 28.7% of subjects with no history of an allergic sting reaction. We concluded that the prevalence of Hymenoptera allergy and venom sensitization in Greece is rather high compared to that of other countries.

Serum total IgE levels in a representative sample of a Greek population. I. Correlation with age, sex, and skin reactivity to common aeroallergens.

The distribution of IgE in a large randomly stratified Greek population sample was determined in 1187 subjects (793 men and 394 women) aged between 20 and 60 years. Skin prick testing was performed and serum total IgE expressed in iu/ml was measured by Phadebas PRIST: the data are presented as the geometric mean. Subjects were classified as atopic (257 men, 118 women) and nonatopic (536 men, 276 women) according to the results of skin testing with various aeroallergens. At any age, atopic males (120.5 vs 38 iu/ml) and females (99.8 vs 29.3 iu/ml) had higher mean IgE levels, as compared to nonatopic subjects (P < 0.0001). In our adult nonatopic sample, IgE levels did not differ with age (P > 0.05). At any age, nonatopic males had higher (38 iu/ml) mean IgE levels than nonatopic females (29.3 iu/ml) (P < 0.05). The comparison of normal IgE values (nonatopic subjects) from this study with those reported by other investigators revealed that Greek adult males and females had higher IgE levels than populations from other nations. Our results represent the first report on reference values regarding serum total IgE in Greek adults.