ABSTRACT
Five infants with congenital immune defects are presented. Three had various combined immune deficiencies (CID) and two had thymic deficiencies only. As bone marrow or thymus transplantations were not feasible in these patients, we attempted treatment with thymic humoral factor (THF), a thymic hormone, by daily i.m. injections during biweekly courses. In one CID patient, a partial improvement in immune indices and temporary clinical improvement were achieved. In the other two, THF did not arrest the patients' demise. The two patients with thymic dysplasia benefitted repeatedly from THF treatment, as exemplified by the disappearance of wasting, diarrhea and infections and by reconstitution of T cell parameters. Nevertheless, the patients relapsed after prolonged periods without THF administration. We therefore propose the administration of long-term, continuous or intermittent thymic hormone replacement therapy in infants with congenital thymic defects. Early diagnosis and immediate institution of treatment will probably improve prognosis.
Subject(s)
Immunologic Deficiency Syndromes/drug therapy , Thymus Hormones/therapeutic use , Female , Humans , Immunologic Deficiency Syndromes/congenital , Immunologic Deficiency Syndromes/diagnosis , Immunologic Techniques , Infant , Lymphopenia/immunology , Male , Recurrence , Thymus Gland/abnormalitiesABSTRACT
To evaluate the effect of negative ionisation of inspired air on bronchial reactivity, 11 asthmatic children were challenged twice by exercise and 10 were challenged twice by histamine inhalation. The children breathed negatively ionised air (4 X 10(5) - 10 X 10(5) ions/cm3) or control room air in random order in a double-blind fashion. All challenges were matched in terms of basal lung function and the exercise tests were matched in terms of ventilation and respiratory heat loss. Exercise-induced asthma was significantly attenuated by exposure to negatively ionised air, the mean postexercise fall in one-second forced expiratory volume (FEV1) being 29% (SE 5%) of the initial value after the control and 21% (3%) after the ionised air test (p less than 0.02). Ten of the 11 subjects developed less exercise-induced asthma while breathing ionised air. Although the median dose of histamine (cumulative breath units) which caused a constant fall in FEV1 for each individual was higher with the ionised air challenge than with the control challenge the difference was not significant. Five of the 10 subjects were less sensitive to histamine and the other five more sensitive when breathing ionised air. It is concluded that negative ionisation of inspired air can modulate the bronchial response to exercise but the effect on the response to histamine is much more variable.
Subject(s)
Air Ionization , Asthma, Exercise-Induced/therapy , Asthma/therapy , Histamine , Physical Exertion , Adolescent , Adult , Asthma, Exercise-Induced/physiopathology , Bronchial Provocation Tests , Child , Clinical Trials as Topic , Female , Forced Expiratory Volume , Humans , MaleABSTRACT
Pneumatoceles were found in 2.4 per cent of 493 infants and children with pneumonia. In all cases, attempts were made to establish the etiology by means of blood cultures and of deep tracheal aspirations or pleural punctures, when indicated. A definite cause was established in 9 of 12 cases. Seven were due to infection: in two Hemophilus influenzae was involved; two others were due to Pseudomonas aeruginosa; and Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus pneumoniae were each isolated in one case. Two pneumatoceles were seen following kerosene ingestion. A coagulase negative staphylococcus isolated only on blood culture in one other child may have been related to the illness. Two patients experienced spontaneous pneumothorax and died of progressive respiratory failure due to enlargement of the pneumatocele, but all the other patients recovered without complication. Pneumatoceles in childhood can result from a variety of bacterologic infections as well as from kerosene ingestion.
Subject(s)
Bacterial Infections/complications , Cysts/etiology , Lung Diseases/etiology , Pneumonia/complications , Child , Child, Preschool , Female , Humans , Infant , Kerosene/poisoning , MaleABSTRACT
Two infants with hypernatremic dehydration (HD) who developed peripheral gangrene are described. A review of the literature revealed 10 infants who had HD and gangrene of the extremities. This combination could occur because of hypoperfusion and sluggish blood movement due to hyperviscosity, which coexist in HD, resulting in a disturbed microcirculation. We feel that the association of peripheral gangrene with HD may be a more frequent phenomenon than previously believed.
Subject(s)
Dehydration/complications , Gangrene/complications , Hypernatremia/complications , Dehydration/therapy , Female , Foot , Gangrene/therapy , Humans , Hypernatremia/therapy , Infant , Infant, Newborn , MaleSubject(s)
Body Height , Hip Dislocation, Congenital/etiology , Adult , Child , Child, Preschool , Female , Humans , Infant , MaleABSTRACT
Following ingestion of the mushroom Inocybe tristis, a 2 1/2-yr-old girl had sudden onset of diarrhea, vomiting, stupor and myosis. Subsequently, she developed excessive hypertension, a purpuric rash and transient hepatic, muscular, renal and cutaneous damage. The patient completely recovered after supportive therapy. This is an instance of severe multisystemic toxicity caused by the mushroom Inocybe tristis, Malençon and Bertault, previously unreported.
