TY - JOUR A1 - Fricke, Julia A1 - Ávila, Gabriela A1 - Keller, Theresa A1 - Weller, Karsten A1 - Lau, Susanne A1 - Maurer, Marcus A1 - Zuberbier, Torsten A1 - Keil, Thomas T1 - Prevalence of chronic urticaria in children and adults across the globe: Systematic review with meta‐analysis JF - Allergy N2 - Background and objectives: Urticaria is a frequent skin condition, but reliable prevalence estimates from population studies particularly of the chronic form are scarce. The objective of this study was to systematically evaluate and summarize the prevalence of chronic urticaria by evaluating population‐based studies worldwide. Methods: We performed a systematic search in PUBMED and EMBASE for population‐based studies of cross‐sectional or cohort design and studies based on health insurance/system databases. Risk of bias was assessed using a specific tool for prevalence studies. For meta‐analysis, we used a random effects model. Results: Eighteen studies were included in the systematic evaluation and 11 in the meta‐analysis including data from over 86 000 000 participants. Risk of bias was mainly moderate, whereas the statistical heterogeneity (I\(^{2}\)) between the studies was high. Asian studies combined showed a higher point prevalence of chronic urticaria (1.4%, 95%‐CI 0.5‐2.9) than those from Europe (0.5%, 0.2‐1.0) and Northern American (0.1%, 0.1‐0.1). Women were slightly more affected than men, whereas in children < 15 years we did not find a sex‐specific difference in the prevalence. The four studies that examined time trends indicated an increasing prevalence of chronic urticaria over time. Conclusions: On a global level, the prevalence of chronic urticaria showed considerable regional differences. There is a need to obtain more sex‐specific population‐based and standardized international data particularly for children and adolescents, different chronic urticaria subtypes and potential risk and protective factors. KW - chronic urticaria KW - meta‐analysis KW - prevalence KW - sex differences KW - systematic review Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-213700 VL - 75 IS - 2 SP - 423 EP - 432 ER - TY - JOUR A1 - Roßberg, Siri A1 - Keller, Theresa A1 - Icke, Katja A1 - Siedmann, Valentina A1 - Lau, Imke A1 - Keil, Thomas A1 - Lau, Susanne T1 - Orally applied bacterial lysate in infants at risk for atopy does not prevent atopic dermatitis, allergic rhinitis, asthma or allergic sensitization at school age: Follow‐up of a randomized trial JF - Allergy N2 - Background The allergy preventive effects of gut immune modulation by bacterial compounds are still not fully understood. Objective We sought to evaluate the effect of bacterial lysate applied orally from the second until seventh months of life on the prevalence of allergic diseases at school age. Methods In a randomized, placebo‐controlled trial, 606 newborns with at least one allergic parent received orally a bacterial lysate consisting of heat‐killed Gram‐negative Escherichia coli Symbio and Gram‐positive Enterococcus faecalis Symbio or placebo from week 5 until the end of month 7. A total of 402 children were followed until school age (6‐11 years) for the assessment of current atopic dermatitis (AD), allergic rhinitis (AR), asthma and sensitization against aeroallergens. Results AD was diagnosed in 11.0% (22/200) of children in the active and in 10.4% (21/202) of children in the placebo group. AR was diagnosed in 35% (70/200) of children in the active and in 38.1% (77/202) children in the placebo group. Asthma was diagnosed in 9% (18/199) of children in the active and in 6.6% (13/197) of children in the placebo group. Sensitization occurred in 46.5% (66/142) of participants in the active and 51.7% (76/147) in the placebo group. Conclusion An oral bacterial lysate of heat‐killed Gram‐negative Escherichia coli and Gram‐positive Enterococcus faecalis applied during the first 7 months of life did not influence the development of AD, asthma and AR at school age. KW - asthma KW - atopic dermatitis KW - prevention KW - rhinitis Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-213456 VL - 75 IS - 8 SP - 2020 EP - 2025 ER - TY - JOUR A1 - Fisch, Silvia A1 - Keller, Theresa A1 - Nazmy, Nurina A1 - Stasun, Ulrike A1 - Keil, Thomas A1 - Klapp, Christine T1 - Evaluation des Babylotse-Plus-Screeningbogens. Untersuchung eines einfachen Instruments zur Identifizierung psychosozial belasteter Eltern von Neugeborenen der Berliner Charité T1 - Evaluation of the Babylotse-Plus screening form. Evaluation of a simple instrument to systematically identify parents of newborns with severe psychosocial stress at Charite Berlin JF - Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz N2 - Hintergrund. Die Entwicklung und das Wohl von Kindern aus Familien mit schweren psychosozialen Belastungen können schon in der Schwangerschaft und im Säuglingsalter gefährdet sein. In der Geburtsmedizin in Deutschland fehlen einfache, valide Frühwarnsysteme, um Risikofamilien rechtzeitig zu identifizieren. Zielsetzung. Unser Ziel war es, die diagnostische Genauigkeit eines perinatal eingesetzten, einfachen Screeningbogens zur Identifizierung psychosozial belasteter Familien zu evaluieren. Methoden. Für alle Geburten der Berliner Charité im Zeitraum 1.1.–31.8.2013 füllte medizinisches Personal im Rahmen des Projekts Babylotse-Plus einen 5-minütigen Screeningbogen mit 27 Items aus. Ein daraus resultierender Summenscore ≥3 wurde als „auffällig“ definiert. Anschließend erfolgte zur genauen Erfassung der familiären Ressourcen undmöglicher psychosozialer Belastungen ein einstündiges, standardisiertes Elterninterview, welches als Referenzstandard für die Evaluation des Screeningbogens verwendet wurde. Ergebnisse. In die vorliegende Analyse konnten 279 Familien eingeschlossen werden. Beim Vergleich der 215 Familien mit „auffälligem“ Score mit einer Zufallsauswahl von 64 Familien mit „unauffälligem“ Score <3, zeigte sich für den Screeningbogen eine hervorragende Sensitivität (98,9%; 95%- Konfidenzintervall 93,4–99,9%), jedoch nur eine geringe Spezifität (33,0%; 95%- Konfidenzintervall 30,5–33,5%). Die daraus resultierende positive Likelihood Ratio fiel mit 1,5 schwach, die negative Likelihood Ratio dagegen mit 0,03 sehr gut aus. Schlussfolgerungen. Mithilfe des Screeningbogens konnten psychosoziale Risikofamilien sehr gut identifiziert werden, jedoch wurden auch viele Familien ohne oder mit nur einem geringen Risiko fälschlicherweise als unterstützungsbedürftig eingestuft. Weitere Studien sollten in anderen Settings und zur Verbesserung der Spezifität bei möglichst gleichbleibender Sensitivität des Screeningbogens durchgeführt werden. N2 - Background. The well-being and healthy development of children are at risk in families with severe psychosocial stress. In Germany, simple and valid screening instruments are lacking to identify families in need of early support. Objectives. We aimed to examine the diagnostic accuracy of a simple perinatal screening form to identify families at high psychosocial risk. Methods. For every mother giving birth at Charite Berlin between January and August 2013 the short Babylotse-Plus screening form with 27 items was filled out by medical staff. Completing the form took about 5 min. After calculating a sum score, values of >= 3 were defined as "likely at risk". A one-hour comprehensive standardized interview with the parents after birth served as the reference standard for assessing family resources and stress factors. Results. Among the 279 participants included in the analyses, 215 were "likely at risk" and 64 had a low or no risk, the latter were randomly selected among all families with scores <3. The screening form had an excellent sensitivity (98.9%; 95% confidence interval 93.4-99.9%) to detect families likely at risk, whereas its specificity was only low (33.0%; 95% confidence interval 30.5-33.5%). This resulted in a rather poor positive likelihood ratio of 1.5 but a very good negative likelihood ratio of 0.03. Conclusions. The screening form identified families with psychosocial risks well, but many families with low or no risk were falsely defined as being at risk. Before recommending the screening instrument for clinical practice, further studies are needed in different settings to improve the specificity without reducing its high sensitivity. KW - Child Maltreatment KW - Early prevention KW - Health-care KW - Risk KW - Intervention KW - Abuse KW - Cooperation KW - Protection KW - Networking KW - Families KW - Early prevention program KW - Screening KW - Diagnostic accuracy KW - Babylotse-Plus KW - Child welfare KW - Frühe Hilfen KW - Screening KW - Diagnostische Genauigkeit KW - Babylotse-Plus KW - Kinderschutz Y1 - 2016 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-187194 VL - 59 IS - 10 ER -