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Paediatric pulmonology and allergology
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Michael L.Burr. The epidemiology of bronchial asthma in children Arunas Valiulis, Saulius Rocka. Bronchial asthma mask of toxocariasis Jurgis Bojarskas, Laima Dauksiene, Valdone Miseviciene. The prevalence of asthma and asthma related symptoms among schoolchildren Andrew Bush. Asthma in children: who should be investigated and how? Max Klein. Management of croup: south Africanian protocol Arnas Berzanskis, Nijole Tilindiene. Gastroesophageal reflux and recurrent bronchial obstruction in children Irena Narkeviciute. Current trends of the antimicrobial treatment of otitis, sinusitis and tonsilitis in children Regina Emuzyte. Allergic rhinitis in children Ieva Laimute Indrejaityte, Iveta Skurvydiene, Nijole Tilindiene, Giedre Liepaite. Prevalence of bacterial infection of respiratory tract in children with cystic fibrosis Marius Zolubas. Today possibilities of avoidance of indoor allergy Göran Wennergren, Mainor Amark, Karstin Amark, Solveig Oskarsdottir, Gunilla Sten, Steffan Redfos. Weezing broncitis reinvestigated at the age of 10 years Andrew Bush. Treatment of cystic fibrosis children with RhDNase Bengt Lindström. Conception of quality of life for disabled children Algimantas Vingras, Jovile Vingraite. Food allergy in children Iveta Skurvydiene, Jovita Briediene, Ieva Laimute Indrejaityte, Arunas Valiulis. Basal nasal potential differrences in children with diffrerent respiratory diseases Melonija Gabriele Kiauleikiene. Historical view on paediatric pulmonology in Vilnius university (1781-1998) Danë Slapkauskaite, Dalija Gaidamoniene, Palmyra Butkiene, Ramute Steigviliene, Birute Semenaite, Elena Uleviciene. Tuberculosis in Lithuanian children: epidemic situation? Ramune Urbonaviciene, Marija Zygiene, Arunas Valiulis. Electrocardiogram in children with bronchial asthma and bronchopneumonia Proceedings of the II International Paediatric Asthma Conference School: Poster thesis |
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The epidemiology of bronchial asthma in children
Michael L.Burr
The field of epidemiological investigations is the prevalence of disease and the prevalence of various factors having effects on it. Estimating the prevalence of bronchial asthma we face a difficulty, that this disease is not strictly separated form other sicknesses or even the norm. Some people undoubtedly have asthma, others - undoubtedly not. Epidemiological studies provide us with information about our asthma definition. These studies reveals the prevalence of asthma in various geographical regions, but in the whole world the prevalence in increasing. This is determinated by changes in environmental factors, by controlling these factors we can access the full control of bronchial asthma.
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Bronchial asthma mask of toxocariasis
Arunas Valiulis, Saulius Rocka
The variation of prevalence, symptoms and course in bronchial asthma suggest a doubt is it an independent disease of is it a syndrome, occurring on the case of different illnesses. We carries out a randomized investigation of 169 children of 1-16 years of age. 125 of them were hospitalized due to exacerbation of bronchial asthma, recurrent bronchitis, and pneumonia. The control group included 44 children. Using the Enzyme Linked Immunosorbent Assay (ELISA) an examination of toxoplasmosis and toxocariasis was performed to all of them. There were no links between the recurrent bronchial obstruction and toxoplasmosis. It was found high correlation between the antibodies against the toxocara antigens rate and the morbidity of bronchial asthma (p<0.001). Toxocariasis was confirmed in 16 children, suffering form bronchial asthma (31.4 percent), while only 3 cases (6.8 percent) were diagnosed in the control group. Toxocariasis was mainly diagnosed in children with moderate asthma (40.0 percent vs. 12.9 percent in the control group, p<0.02). It seem to be that bronchial asthma and toxocariasis overlaps in some parts of pathogenesis. Each childe, suffering from recurrent bronchial obstruction, particularly mild or moderate bronchial asthma, must be examined on toxocariasis.
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The prevalence of asthma and asthma related symptoms among schoolchildren
Jurgis Bojarskas, Laima Dauksiene, Valdone Miseviciene
The data of the prevalence of asthma among children in various countries and about in influence different environmental factors on the prevalence of asthma are presented in this article. The newest results form ISAAC epidemiological study in Kaunas and Siauliai are described.
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Asthma in children: who should be investigated and how?
Andrew Bush
In the vast majority of children with asthma, the diagnosis will be made after a detailed history and physical examination, supplemented by simple physiological testing and possibly a chest radiograph. No other investigations are or need to be done. For a small minority of children, the diagnosis is in doubt at the outset or the right treatment strategy is not clear. This paper addresses the correct use of investigaions in this group of children.
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Management of croup: south Africanian protocol
Max Klein
Croup is the single most common cause of death from airway obstruction in Africa. The patients general condition is an extremely unreliable guide to the severity of the obstruction in croup and specific signs must be used in the assessment. The article deals with the main pathophysiologic aspects, diagnostic and management methods used in South Africa.
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Gastroesophageal reflux and recurrent bronchial obstruction in children
Arnas Berzanskis, Nijole Tilindiene
Gastroesophageal reflux is an important cause of some respiratory diseases. Abnormal reflux is diagnosed in 45-78 percentages of asthmatic children. Specific respiratory problems of infancy are also associated with pathologic regurgitation. Children more likely to have functional disorders of gastrointestinal tract, and the recent theory of reflux pathogenesis declares some possibilities to create the physiological way of treatment. We elaborated the algorithm, which enables practitioner to treat children with gastroesophageal reflux diseases.
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Current trends of the antimicrobial treatment of otitis, sinusitis and tonsillitis in children
Irena Narkeviciute
Acute infectious diseases of upper respiratory tract are very common and widespread. These diseases are commonly managed with antibacterial medication. increasing drug resistance, efforts to protect the patient from potential complications and trend of management price reduction, stimulates an interest for new antibiotics. This article deals with main pathogenic agents of upper respiratory tract diseases as well as with sensitiveness of these agents to common used antibiotics.
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Allergic rhinitis in children
Regina Emuzyte
During the infancy and early childhood, foods are offending allergen, while inhaled allergens become more important with increasing age. Thereafter there is a progressive increase in the incidence of allergic rhinitis to reach 15-20 percentages in adolescents. The article presents some diagnostic and therapeutic considerations. Treatment of allergic rhinitis in children should depend predominantly upon prevention.
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Prevalence of bacterial infection of respiratory tract in children with cystic fibrosis
Ieva Laimute Indrejaityte, Iveta Skurvydiene, Nijole Tilindiene, Giedre Liepaite
Changes in mucociliary clearance and increased viscosity of sputum are the main cause of chronic inflammatory diseases of the respiratory system. More than 90 percentages of all the respiratory system disorders in patients with cystic fibrosis are caused by infection. In order to avoid the infection, the proper correction of cystic fibrosis is necessary. Our investigation revealed that the most common pathogenic infections were Staphylococcus aureus, Pseudomonas aeruginosa, H.influenzae, Klebsiela pneumonia, Streptococcus pneumoniae, Candida, Streptococcus b haemolyticus, E.coli, Acinetobacter. Staphylococcus aureus was sensitive to fucidin, ceftazidime, tobramycin, gentamycin, amikacin and especially to rifampicin. Pseudomonas aeruginosa colonies were most sensitive to ceftazidime, amikacin, tobramycin and antipseudomonic antibiotics (piperacillin, azlocillin). Recent studies revealed the high sensitivity of Staphylococcus aureus to ceftriaxone, and Pseudomonas aeruginosa - to meropenem.
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Today possibilities of avoidance of indoor allergy
Marius Zolubas
The article deals with concepts of causative role of exposure to indoor allergens in emerging allergy epidemic in modern societies. Data on their epidemiology are analyzed. Allergen avoidance measures and their efficiency are debated. Scarce data on this problem in Lithuania are described. Acute need of studies in this field in Lithuania - country with ongoing lifestyles westernization - is stressed.
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Wheezing bronchitis reinvestigated at the age of 10 years
Göran Wennergren, Mainor Amark, Karstin Amark, Solveig Oskarsdottir, Gunilla Sten, Steffan Redfors
We have reinvestigated 92 children aged 10, who before the age of 2 years were admitted to a paediatric ward due to wheezing bronchitis. At the present time, 70% are symptom-free without medication, 20% have mild asthma, 8% moderate and 2% severe asthma. Persistent asthma correlated significantly to the presence of some other atopic disease in recent years, to early start of wheezing during infancy and to intense obstructive disease as a young child. A clear-cut relationship between smoking in the home in infancy and persistent asthma emerged. The histamine challenge results correlated to the clinical picture. A normal histamine challenge was seen in results correlated to the clinical picture. A normal histamine challenge was seen in 63%, mild hyperresponsiveness in 19%, moderate in 12% and pronounced hyperresponsiveness in 6%.
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Treatment of cystic fibrosis children with RhDNase
Andrew Bush
Important in the pathogenesis of cystic fibrosis is the accumulation and persistence of viscous purulent secretion in the airways. Treatment strategies to improve lung function include vigorous antibiotic usage and chest physiotherapy to clear secretions. Recombinant DNase is a major advance in the treatment of cystic fibrosis, which will significantly improve the lung function of one third of children. It is not a panacea - some will not respond, and it will not ultimately halt the relentless progression of the disease. Used responsibly, recombinant DNase will benefit many with cystic fibrosis, in some cases very dramatically. The key will be controlled therapeutic trials, continuing the medication only in individuals who show clear benefit.
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Conception of quality of life for disabled children
Bengt Lindström
During the last years, the term quality of life is frequently used in everyday and scientific languages. The medicine and Public Health organizations are interested in quality of life related with medicine, because its a reflection of appreciable welfare in comparison with functional status. Indetermination and abstractness of the quality of life definition makes the research work difficult. But this difficulty provides with a good conditions for and interdisciplinary studies, because there are no clear relations between disciplinary and professional knowledge. The quality of life of healthy and disabled children was studied. We can confirm, that children in the Northern countries live under a good quality of life conditions. Some of disabled children life conditions were improved, but not all efforts for improving the quality of life are sufficient.
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Food allergy in children
Algimantas Vingras, Jovile Vingraite
The diagnostics, differential diagnostics, out-patient treatment, prognosis of cow mild and other food allergy as well as indications for consultation of the specialists are described in detail in this article. Clinical picture of acute and late food allergic reactions, characteristics of the largest food antigens, cross reactions with respiratory allergens are presented.
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Basal nasal potential differences in children with different respiratory diseases
Iveta Skurvydiene, Jovita Briediene, Ieva Laimute Indrejaityte, Arunas Valiulis
We investigated 30 children (average age 11.7 years) with different respiratory diseases: 2 cystic fibrosis patients with borderline sweat chloride values not exceeding 60mmol/l and unrecognized genotype, 10 patients with chronic obstructive bronchitis and negative sweat test values, 10 patients with bronchial asthma, 8 patients with acute rhinitis. Basal nasal potential difference measurements were obtained according to Alton et al. (1990). Results did not confirm cystic fibrosis diagnosis in 2 patients with borderline sweat test values and unrecognized genotypes. Basal nasal potential difference values were similar in patients with bronchial asthma and chronic obstructive bronchitis, and less negative in patients with acute rhinitis. Our findings support the opinion, that basal nasal potential difference measurement is important in each case when cystic fibrosis is suspected.
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Historical view on paediatric pulmonology in Vilnius university (1781-1998)
Melonija Gabriele Kiauleikiene
The beginning of the paediatrics and one of the most important sphere of it - pulmonology is closely connected with the foundation of Vilnius University. The most famous past doctors and their greatest scientific works are mentioned in the article. Our days paediatrics and paediatric pulmonology is the result of selfless scientific work of these distinguished people.
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Tuberculosis in Lithuanian children: epidemic situation?
Dane Slapkauskaite, Dalija Gaidamoniene, Palmyra Butkiene, Ramute Setigviliene, Birute Semenaite, Elena Uleviciene
During the last ten years incidence of tuberculosis increased in twice. The sickness rate of tuberculosis became close to epidemy in eight districts of Lithuania. Patients with asthma and other chronic lung diseases belong to risk tuberculosis group. At present the risk to be infected with tuberculosis increase for children, because this disease is widespread not only between asocial persons, but even among teachers. Diagnostics and treatment of TBC in adults is the main way of prevention of tuberculosis in today Lithuania.
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Electrocardiogram in children with bronchial asthma and bronchopneumonia
Ramune Urbonaviciene, Marija Zygiene, Arunas Valiulis
There were investigated 116 children with bronchial asthma (102 children with mild and moderate asthma - Ist group, 14 with severe - IInd group). IIIrd group is included 64 children with bronchopneumonia. The most electrocardiographic changes were determined in IInd group (disturbance of cardiac rhythm, especially sinus tachicardia, conduction delay, abnormalities of repolarisation process). Right ventricular overload was found in 14.3 perc. of cases. There were more rare and less specific changes of electrocardiograms in children with bronchopneumonia.
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April, 1998, Vol. I, No. 1 (p. 1-151)
