SUMMARY Two hundred and fifty six attacks of acute bronchial asthma occurring in 169 children aged over 2 years were studied during a two year period. More

SUMMARY Forty four children with recurrent obstructive episodes after acute bronchiolitis in infancy were treated with nebulised beclomethasone dipropionate or placebo for eight weeks in a randomised double-blind study. They were seen monthly for a year afterwards, and also if they had acute respiratory illnesses with or without bronchopulmonary obstruction. The two treatment groups were well matched. The children receiving active treatment had significantly fewer symptomatic respiratory illnesses and fewer episodes of bronchopulmonary obstruction during the follow up period. The children given placebo had significantly higher obstructive scores during the study period, and they were treated with inhaled P2 agonists and theophylline for longer periods of time during the follow up period.The results suggest that nebulised beclomethasone dipropionate may have prolonged effects on subsequent asthmatic symptoms after termination of treatment in children with recurrent obstructive episodes after acute bronchiolitis.Acute bronchiolitis in infancy is most often associated with respiratory syncytial virus infection, and is associated with later episodes of bronchopulmonary obstruction and the development ofbronchial asthma in children.' 2 Inhalation of beclomethasone dipropionate, as an aerosol or as powder, is effective and safe prophylaxis of childhood asthma,3 4 possibly because it reduces the non-specific bronchial hyperreactivity in asthma.5 As the use of both aerosols and powder inhalation is difficult in infants and small children, we have investigated whether nebulised beclomethasone dipropionate could be used in infants and small children with recurrent episodes of bronchopulmonary obstruction after acute bronchiolitis, and whether treatment with beclomethasone dipropionate for eight weeks could possibly influence the outcome. We have therefore conducted a placebo controlled double blind study in children under 2 years of age to study the effect of inhaled nebulised beclomethasone dipropionate for eight weeks with a follow up period of one year. The aim of the study was to examine whether inhalation of nebulised beclomethasone dipropionate influenced the frequency of recurrent attacks of bronchopulmonary obstruction during treatment, as well as the subsequent development of episodes after the treatment. Patients and methodsA total of44 children aged between six and 24 months were randomly allocated to be treated by placebo (n=22) or beclomethasone dipropionate (n=22) in a double blind manner. To be included in the study the patients had to fulfil the following criteria: they had to be previously admitted to the paediatric department of Ullev'al hospital (the municipal hospital of Oslo) with acute bronchiolitis, and they had to have had a history of at least one attack of bronchopulmonary obstruction after the initial attack of bronchiolitis. The diagnosis of bronchiolitis was made according to the criteria of Court.6 Table 1 shows that the groups were comparable. To diagnose an episode of bronchopulmonary obstr...

The association between certain human papillomaviruses (HPV) and cervical intraepithelial neoplasia (CIN) is well documented, but there is uncertainty about the strength of association and the role of co-factors is unclear. This population-based case-control study in Norwegian women 20-44 years of age included 103 cases with histologically confirmed CIN II-III and 234 age-matched and randomly selected controls. Cytological specimens from the cervix were analyzed using the polymerase chain reaction (PCR). In all, 91% of the cases and 15% of the controls were HPV DNA positive, giving a crude odds ratio (OR) of 67.2 (95% confidence interval: 28.6-157.5). The association between HPV 16 and CIN II-III was even stronger (crude OR = 123.9; 46.7 - 328.5). In logistic regression analysis, additional to HPV, only a high number of sexual partners and a low educational level contributed independently to the risk. The adjusted OR for the association between HPV and CIN II-III was 72.8 (95% CI: 27.6-191.9). The association between HPV and CIN remains very strong even after adjustment for proposed confounding factors. The results therefore support the role of HPV as a causative agent in the development of CIN.

92 cases of acute gastroenteritis were registered among 256 individuals during an outbreak in a nursing home for the elderly, the majority of patients being between 70 and 90 years of age. Most cases appeared in 4 of the 8 wards; 66% of the inmates of these wards became ill. Characteristic symptoms were initial nausea and vomiting followed by diarrhoea and low fever. A number of patients were severely ill. One patient died. Rotavirus infection was diagnosed by virus detection and/or antibody titre rise during the acute phase of the illness in 13 of 16 patients examined. At the end of the outbreak, high titres of complement-fixing antibodies against rotavirus (greater than or equal to 64) were detected in serum from 21/22 patients convalescing from the disease, as compared to only 5/45 individuals with no signs of disease. It is tentatively suggested that the outbreak became extensive and rather severe because of lowered immunity against rotavirus infection among the elderly.

Respiratory syncytial virus (RSV) infection was diagnosed in 464 children admitted to hospital with acute respiratory disease from autumn 1972 to spring 1978. The virological surveillance was approximately 70%. As a rule, RSV infections occurred in distinct outbreaks in late autumn and winter together with a marked increase in the number of children admitted to hospital with acute lower respiratory tract disease. The incidence in children less than 1 year of age was about 10/1000 children/year. Spread of the infection from one end of the city to the other was discernible in 2 outbreaks. More children than expected with siblings were admitted to hospital because of RSV infection, but no correlation could be observed with some other socioeconomic factors. A negative correlation was observed between RSV disease and mean air temperature and hours of sunshine per month. Rapid immunofluorescence diagnosis of RSV on cells from nasopharyngeal secretions was adopted and became comparable to cell culture technique. The rapid method has become an important adjunct to the clinical management of these patients and the method will form the basis for further epidemiological studies.