The allergy of toothpaste: a case report

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The allergy of toothpaste: a case report.

Toothpastes are definitely one of the indispensable elements of oral health care. They are produced to serve multiple purposes and possess complex chemical structures. Slight abrasion, froth, sweetening, bleaching, prevention of plaque, calculus and decay are properties expected from an ideal toothpaste. In recent years, allergic reactions have started to appear more frequently in dental practice. The present case describes the progression of an allergic response to toothpastes, one of the basic agents of oral hygiene.

Bilateral re-expansion pulmonary edema in a child: a reminder.

Re-expansion pulmonary edema (RPE) is an uncommon complication of sudden reinflation of a lung collapsed by pneumothorax or pleural effusion. We present a case of bilateral pulmonary edema following unilateral drainage of a pleural effusion in a young child with non-Hodgkin's lymphoma.

Circulating ICAM-1 levels in bronchial asthma and the effect of inhaled corticosteroids.

BACKGROUND: Even mild asthma has an inflammatory component. Intercellular adhesion molecule-1 (ICAM-1) plays an important role in inflammation. Higher levels of circulating ICAM-1 (cICAM-1) in sera may reflect the upregulation of ICAM-1 expression in allergic inflammation. OBJECTIVE: The aim of this study was to assess cICAM-1 levels in children with atopic bronchial asthma and to determine the effects of inhaled glucocorticoids on cICAM-1 levels. METHODS: The study group consisted of 25 children with moderate atopic bronchial asthma with a mean age of 9.9 +/- 4.2 years, and the control group consisted of 18 healthy children with a mean age of 9.6 +/- 2.6 years. Serum cICAM-1 levels and pulmonary function tests were measured. The patients were treated 2 months with inhaled budesonide 400 to 800 microg (mean 440 microg) per day. After this treatment, cICAM-1 levels and pulmonary function tests were compared with pretreatment levels. The pretreatment cICAM-1 values were compared with healthy control group. RESULTS: The initial cICAM-1 levels of the patient group were significantly higher than the cICAM-1 levels of the control group (P = .001). The post-treatment cICAM-1 levels of the patient group were significantly lower than the pretreatment values (P = .007). Pulmonary function test results (FEV1, FEF25-75, and PEFR) rose significantly with the treatment in patients (P < .05). CONCLUSION: This study revealed the presence of inflammation in children with even moderate atopic asthma as reflected with elevated levels of cICAM-1 levels, which decreased following corticosteroid treatment as a result of decreased inflammation.

Evaluation of immunotherapy by nasal antigen challenge.

BACKGROUND: Nasal antigen challenge test is used to evaluate the allergic conditions within different diagnostic procedures. OBJECTIVE: This study was conducted to evaluate the efficacy of immunotherapy (IT) in an objective and simple way in children with perennial allergic rhinitis. METHOD: This study was a double-blind, placebo-controlled procedure. Nineteen patients (mean age 10 +/- 6 years) were treated only with IT and 17 patients (mean age 11 +/- 5 years) constituted the control group without any treatment. The patients were evaluated at the beginning and at 3 and 6 months of IT. Nasal provocation reactions were evaluated and scored at 5-, 10-, and 30-minute intervals. RESULTS: In the IT group, mean clinical scores and mean nasal provocation scores decreased significantly between the initial value and at 3 and 6 months of IT, whereas there was no significant change in the value for the control group. There were no significant differences among the 5-, 10-, 15-, and 30-minute evaluations within both the IT and control groups. CONCLUSION: The efficacy of IT in perennial allergic rhinitis may be assessed by the nasal antigen challenge test in a simple and objective way within a 5-minute period.

Childhood tuberculosis: a report of 2,205 cases.

A total of 2,205 children with the diagnosis of tuberculosis followed at Hacettepe University Ihsan Dogramaci Children's Hospital between the years 1972 and 1992 were investigated in this retrospective study. Sixty-two percent of the patients were less than six years old. There was no gender preponderance among the cases. Thirty-four percent of the patients had predisposing diseases for tuberculosis, such as malnutrition, measles and pertussis. Thirty-five percent of the patients had a history of contact with a tuberculous patient. The most common type of tuberculosis was pulmonary (39%), but extrapulmonary cases outnumbered pulmonary tuberculosis patients. Thirty-three percent of the patients had been vaccinated with BCG. The Mantoux test was found positive in 62 percent of patients. The tuberculous culture was found to be positive in the sputum of 28 percent of pulmonary tuberculosis cases. Patients were treated with daily (59%) or intermittent (41%) antituberculous therapy regimens. The response to treatment was excellent. Relapse was observed in five cases. Mortality from tuberculosis was eight percent, 23 percent of which were from tuberculous meningitis. Although there was a decrease in the number of children with tuberculosis seen at our hospital between 1972 and 1992, the prevention and control of tuberculosis are still significant health problems for our country.

Effect of oral and inhaled salbutamol in infants with bronchiolitis.

The response of bronchiolitis to bronchodilator drugs is controversial. The present study was designed to evaluate the efficacy of oral or metered dose inhaler (MDI) salbutamol using a coffee cup as a spacer device in bronchiolitis. In the trial, 31 hospitalized patients between 6 and 24 months of age, who exhibited the first episode of acute bronchiolitis without any other predisposing illness such as cystic fibrosis, congenital heart disease etc., were randomly assigned to receive oral salbutamol (n = 11, 0.1 mg/kg per dose, four times a day), or MDI salbutamol (n = 12, 200 micrograms per dose, every 3 h) or formed the control group without any bronchodilator therapy (n = 8). All of the patients were given supplemental oxygen as needed and adequate hydration was maintained. The patients were evaluated with clinical symptom scores. There were no differences in the beneficial or side effects of salbutamol, or the number of days in hospital between the treatment groups and the control group. It was concluded that there is no beneficial effect in using bronchodilators in infants with bronchiolitis. Supplemental oxygen and maintenance of normal hydration may be adequate.

Changes in nasal metachromatic cells during allergen immunotherapy in children.

Immunotherapy (IT) has been successfully used in the treatment of allergic rhinitis for years. Several mechanisms have been postulated for the clinical efficacy of IT. In this study we investigated the effect of IT on the number of metachromatic cells on the nasal surface in children with perennial allergic rhinitis (PAR). Nineteen subjects were treated with IT and 12 subjects, who did not receive any treatment, constituted the 3rd and 6th months of IT by symptom scores, physical examination findings, metachromatic cell counts from nasal mucosal epithelial scrapings and nasal provocation scores. At the 3rd and 6th months of IT, nasal symptom scores, nasal provocation scores and the number of metachromatic cells in epithelial scrapings were significantly reduced compared with the pretreatment values in the IT group. These reductions were not observed in the control group. It is concluded that the reduction in the number of metachromatic cells could be at least partially responsible for the clinical efficacy of IT in children with PAR.

Short course intermittent chemotherapy in childhood tuberculosis.

A total of 130 children diagnosed as having pulmonary and extrapulmonary tuberculosis who received short course intermittent chemotherapy between 1978-1992 were evaluated retrospectively. One hundred and ten children with tuberculosis were treated with isoniazid (10-15 mg/kg, maximum 400 mg), rifampin (10-15 mg/kg, maximum 600 mg), and streptomycin (30 mg/kg, maximum 1 g) daily, for 15 days. Treatment was completed with similar doses of isoniazid and rifampin twice a week for a period of 9 months. Since 1986, 20 children with tuberculosis were being treated with the same regimen but without streptomycin. The majority of patients in these cases had pulmonary tuberculosis (75%), followed by lymph nodes (9%), pleural (7%), bone and joint (5%), miliary (3%), and abdominal tuberculosis (1%). The clinicoradiologic response to treatment was observed to be excellent. Only one case of relapse was detected, which was the case of a patient with lymph node tuberculosis that occurred 18 months after the completion of treatment. No serious adverse drug reaction was observed in any of the cases mentioned. In conclusion, short-course low-dose intermittent chemotherapy is an effective and economical treatment with minimal side effects for pulmonary and extrapulmonary tuberculosis in childhood.

Conservative treatment of empyema in children.

Seventy-two children with no underlying diseases were treated for empyema. Radical surgical approaches like decortication were necessary for only 3 children. In 66 children tube drainage was applied. Staphylococcus aureus was cultured or was shown in Gram's stain in 32 (44%) and children with this microorganism had longer duration of tube drainage (p < 0.05). The period for normalization of chest X-ray was positively related with the age of the patient (p < 0.05). In 60 of 72 children, chest X-ray was normal after 3 months. Follow-up of the patients 18 months after the infection revealed that pulmonary radiograms were normal in all cases and pulmonary function tests were within normal limits in all of the tested children (n = 25). It is emphasized that avoiding major surgical approaches must be encouraged in childhood empyema.

[Efficacy of intravenous ceftazidime in childhood infections]. / Cocukluk çagi enfeksiyonlarinda intravenöz seftazidim'in etkinligi.

Ceftazidime, a beta-lactamase resistant cephalosporin, was administered intravenously to 33 patients with various infections. The age range was between 3 days and 15 years and substantial underlying disease was present in 90% of the patients and 72% had malignancy. Seventeen (51.5%) were in critical condition and twenty had granulocytopenia. Clinical and microbiological results were evaluated and overall clinical response was 88%. No major adverse effects were encountered. Ceftazidime was an effective and safe therapy for serious infections and neutropenic patients.