Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis.

Asthma, rhinitis, and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease," coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept.

Management of anaphylaxis due to COVID-19 vaccines in the elderly.

Older adults, especially men and/or those with diabetes, hypertension, and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritized to receive COVID-19 vaccines due to high risk of death. In very rare instances, the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully.

Vilnius Declaration on chronic respiratory diseases: multisectoral care pathways embedding guided self-management, mHealth and air pollution in chronic respiratory diseases.

Background: Over 1 billion people suffer from chronic respiratory diseases such as asthma, COPD, rhinitis and rhinosinusitis. They cause an enormous burden and are considered as major non-communicable diseases. Many patients are still uncontrolled and the cost of inaction is unacceptable.

Respiratory symptoms, asthma and levels of fractional exhaled nitric oxide in schoolchildren in the industrial areas of Estonia.

Objectives: Exposure to air pollutants in the ambient environment has been associated with various respiratory symptoms, and with increased asthma diagnosis, in both children and adults. Most research to date has focussed on core pollutants, such as PM, PM, SO and NO, and less attention has been given to the effects of industry-specific contamination. The current study aimed to examine the associations between respiratory symptoms, asthma, increased levels of fractional exhaled nitric oxide (FeNO) (as a marker of eosinophilic airway inflammation) and ambient levels of industrial pollutants (such as benzene, phenol, formaldehyde and non-methane hydrocarbons) for schoolchildren living near oil shale industries in Ida-Viru County, Estonia.

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.].

Health Services and Well-Being of Children in Estonia.

Estonia has a population of 1.3 million, which makes it one of the least populous member states of the European Union. The fertility rate was 1.

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network.

Differences in Gut Microbiota Between Atopic and Healthy Children.

Although gut microbiota has been studied relatively extensively in the context of allergic diseases, there have been several contradictions between these studies. By applying high-throughput sequencing, we aimed to analyze the differences in gut microbiota between atopic and healthy children at 5 and 12 years of age. 51 stool samples were collected from 14 atopic and 15 healthy children and analyzed with 454 pyrosequencing of the 16S rRNA gene.

The association of gut microbiota with body weight and body mass index in preschool children of Estonia.

Background: The gut microbiota has been shown to affect both fat storage and energy harvesting, suggesting that it plays a direct role in the development of obesity. The aim of this study was to investigate whether intestinal colonization by particular species/groups of the intestinal microbiota is related to body weight values in Estonian preschool children born in different years during the entire 1990s.

Methods: Body weight, height, body mass index (BMI), and quantitative composition of cultivable gut microbiota (staphylococci, enterococci, streptococci, enterobacteria, lactobacilli, anaerobic gram-positive cocci, bifidobacteria, eubacteria, bacteroides, clostridia, and candida) were studied in 51 healthy 5-year-old children (40 were born between 1993 and 94 and 11 were born between 1996 and 97).

Regional differences in diagnosing asthma and other allergic diseases in Estonian schoolchildren.

Unlabelled: The aim of this study was to estimate the prevalence of asthma and other allergic diseases among Estonian schoolchildren of the cities lacking special (pediatric allergological) health care.

Material And Methods: The study, carried out through 1 March to 8 May, 2003, enrolled 5th- to 12th-grade schoolchildren of 4 schools in different regions of Estonia. A three-step protocol was followed: screening questionnaire, examination by a pulmonary resident, and consultation by a pediatric allergologist.

Ampicillin versus penicillin in the empiric therapy of extremely low-birthweight neonates at risk of early onset sepsis.

Background: There are no comparative data on the impact of different empiric antibiotic regimens on early bowel colonization as well as on clinical efficacy in extremely low-birthweight (ELBW) neonates at risk of early onset sepsis (EOS).

Methods: A subgroup analysis was carried out of ELBW neonates recruited into a two-center, prospective, cluster randomized study comparing ampicillin and penicillin both combined with gentamicin, within the first 72 h of life. A composite primary end-point (need for change of antibiotics within 72 h and/or 7 day all-cause mortality) and the rate and duration of colonization by opportunistic aerobic microorganisms were assessed using hierarchical models corrected for study center and period.

Molecularly assessed shifts of Bifidobacterium ssp. and less diverse microbial communities are characteristic of 5-year-old allergic children.

The composition of intestinal microbiota and the Bifidobacterium group community in 20 allergic and 20 nonallergic 5-year-old children was visualized by PCR-denaturing gradient gel electrophoresis (DGGE). The number of dominant bands in the DGGE profiles was smaller in allergic children than in nonallergic children (P<0.001).

Cytokine responses to allergens during the first 2 years of life in Estonian and Swedish children.

Background: The prevalence of atopic disease among children in the formerly socialist countries in Europe, with a life style similar to that prevailing in Western Europe 30-40 years ago, is low, whereas there has been a pronounced increase in industrialized countries over the last decades. The environment during infancy influences the risk of developing allergy for many years, perhaps even for life.

Objective: To investigate the development of allergen-specific cytokine responses during the first 2 years of life in two geographically adjacent countries with marked differences in living conditions and incidence of atopic diseases, i.

Intestinal microbiota and immunoglobulin E responses in 5-year-old Estonian children.

Background: Over the last few decades, several studies from different parts of the world have indicated an increasing prevalence of allergic diseases. This has been related to environmental factors, like changes of microbial pressure. Our previous studies have demonstrated differences in the intestinal microbiota between allergic and non-allergic children.

Atopic sensitization and atopic dermatitis in Estonian and Swedish infants.

Background: Early life events seem to have a major impact on the development of tolerance or sensitization.

Objective: The aim of the study was to compare the prevalence of sensitization and atopic dermatitis (AD) during the first 2 years of life in Estonia and in Sweden.

Methods: Two groups comprising 110 Estonian and 123 Swedish infants were followed from birth up to 2 years of age.

Atopic allergy and delayed type hypersensitivity in Estonian children.

Background: A shift in the balance ofT helper (Th) cell subsets towards a polarized Th2 population is generally accepted to occur in atopic disease, however, both Th1 and Th2 disorders have increased over the past decades in Western communities.

Objective: The aim of our study was to investigate delayed type hypersensitivity (DTH) response in atopic and non-atopic children in a population with a low prevalence of allergic disorders.

Methods: Skin prick tests (SPT) were performed with fresh egg white and extracts of five inhalant allergens, i.

Development of allergy and IgE antibodies during the first five years of life in Estonian children.

Background: Epidemiological studies have demonstrated a low prevalence of allergic diseases and atopic sensitization among schoolchildren and young adults in the formerly socialist countries of Central and Eastern Europe as compared to Western Europe.

Objective: The aim of our study was to prospectively investigate IgE responses to food and inhalant allergens and the development of allergy during early childhood in a population with a low prevalence of atopic disorders.

Methods: In a population-based prospective study, 273 children were followed from birth through the first 5 years of life, recording manifestations of allergy by questionnaires and clinical examinations at 0.

Allergy development and the intestinal microflora during the first year of life.

Background: The intestinal microflora is a likely source for the induction of immune deviation in infancy.

Objective: The purpose of this study was to prospectively relate the intestinal microflora to allergy development in 2 countries differing with respect to the prevalence of atopic diseases.

Methods: Newborn infants were followed prospectively through the first 2 years of life in Estonia (n = 24) and Sweden (n = 20).

Development of atopic sensitization and allergic diseases in early childhood.

Unlabelled: Atopic diseases and atopic sensitization were studied from birth up to 2 y in a population-based prospective study. Physical examinations were done at 6, 12 and 24 mo, including skin-prick tests and blood samples, for the determination of serum IgE level and circulating IgE antibodies to food and inhalant allergens. In addition, questionnaire surveys were done about clinical symptoms of allergy, infections and the home environment.

Indoor allergen levels and other environmental risk factors for sensitization in Estonian homes.

The prevalence of allergic disease is low in Eastern Europe for reasons that are poorly understood. Our study aimed to investigate the levels of exposure to indoor allergens and living conditions among Estonian infants in relation to sensitization. Dust samples were collected during four winter months in 1993/94 from the homes of 197 infants participating in a prospective study of sensitization.

The development of atopic sensitization in Estonian infants.

In a prospective study, 251 infants were followed from birth up to 12 months of age, recording manifestations of allergy by questionnaires at 3, 6, 9 and 12 months and by clinical examinations at 6 and/or 12 months. Blood samples were obtained at birth and at 6 and 12 months and analysed for serum IgE levels. The children were skin-prick tested with foods at 6 and 12 months of age and with inhalant allergens at 12 months.

Intestinal microflora of Estonian and Swedish infants.

The intestinal microflora of 1-y-old healthy Estonian (n = 27) and Swedish infants (n = 29) was studied by quantitative culture of faecal samples. The major differences were high counts of lactobacilli and eubacteria in the former and increased numbers of clostridia in the latter babies. Bifidobacteria and anaerobic cocci prevailed equally in both groups, while eubacteria and enterococci were the major microorganisms in many Estonian infants and bacteroides and clostridia in many Swedish infants.