Nasal inhalation of budesonide from a spacer in children with perennial rhinitis and asthma.

The standard treatment of allergic rhinitis and asthma consists of topical corticosteroids administered intranasally and inhaled through the mouth. Although this therapy is highly effective, and side-effects are few and mild, it may be possible further to improve the therapeutic index and patient compliance with the treatment. In the present study, we evaluated a nasal inhalation system used for the simultaneous treatment of rhinitis and asthma. In principle, it results in an airway deposition of the corticosteroid similar to that of inhaled allergens. Twenty-four children with perennial rhinitis and asthma inhaled budesonide through the nose from a pressurized aerosol, attached to a spacer device, in a double-blind, placebo-controlled, crossover study. Compared with placebo, budesonide treatment resulted in a significant reduction of nasal symptoms (P<0.01) and of asthma symptoms (P<0.05), and in an increase of nasal peak inspiratory flow (P < 0.001) and of oral peak expiratory flow (P=0.01). There were no differences between budesonide and placebo in local side-effects, such as dry nose, nosebleed, and hoarseness. We conclude that nasal inhalation of a corticosteroid from a spacer offers a simple and effective treatment for both rhinitis and asthma in children, but it is an open question whether the nasal inhalation system can improve the ratio of antirhinitis/antiasthma effects to side-effects.

Prevalence of asthma in Danish children aged 8-10 years.

The aim of the study was to estimate the point prevalence of asthma in schoolchildren aged 8-10 y in the County of Copenhagen, Denmark. In all, 1040 schoolchildren were randomly chosen for the study and a total of 774 completed the study. The suspicion of asthma was based on a questionnaire about respiratory symptoms and on daily registration of respiratory symptoms and peak expiratory flow rate (PEF) for 4 weeks. The conclusive diagnosis was based on interview, clinical examination, spirometry and an exercise test. The prevalence of children with asthma diagnosed by their GPs was 31/774 (4.0%). A further 20/774 (2.6%) were diagnosed as having asthma. There is evidence to suggest that asthma is less frequent in Denmark than in Great Britain, New Zealand and Australia.

Bacterial colonization of the larynx and trachea in healthy children.

Fifty healthy children were included in the study; tracheal and laryngeal aspirations were performed after oral endotracheal intubation during minor surgery. The aspirates were evaluated and examined in the same way as aspirates from children suspected of pneumonia; 31 samples were accepted for the final analysis. After culturing, specimens from 30 children exhibited growth of potential pathogenic bacteria either from the larynx, the trachea or both. Prior to culture, bacteria were seen by microscopy in 24 samples from 30 children. These results indicate that the majority of healthy children carry potential pathogenic bacteria, not only in the larynx but also to a certain extent in the trachea. We conclude that aspirates from the larynx and the trachea are of limited value in the diagnosis of bacterial pneumonia in children.

[Hospitalization of children in cities and rural areas. 1. Comparative analysis between hospital admission rate and living conditions based on registered data]. / Hospitalsindlaeggelse af børn i by og på land. 1. En sammenlignende analyse mellem indlaeggelseshyppighed og levevilkår baseret på registerdata.

In order to describe differences in hospital admission of children in urban and rural areas, a data account of all discharges in 1988 of children aged 0-14 was made from the Danish patient register. The account includes children living in Copenhagen city and the counties of Copenhagen, Vestsjaelland and Sønderjylland. Healthy liveborn children born in hospital were excluded. The hospital admission rate is compared with statistical data about living conditions for families with children, as described by family size, rate of single parent families, number of persons per room in the household, families living from cash public assistance, and the rate of day care center attendance. The highest admission rate is found in Copenhagen city, where there are 155 discharges per 1,000 children aged 0-14. The lowest rate is 89 per 1,000 children in the county of Vestsjaelland. The difference in admission rate between the capital area and the two rural counties has increased since 1979, mainly because of a rise in admissions in Copenhagen county from 116 to 134 per 1,000 0-14 year old children. During the same period, a remarkable fall in Copenhagen city from 176 to 155 was observed. The age group 0-2 years in particular is admitted significantly more often in the urban areas, where the rate of day care center attendance for this age group also is much higher. As for the other data about living conditions, there seems to be no clear correlation to admission rate although Copenhagen city still has more families with socio-economic problems.(ABSTRACT TRUNCATED AT 250 WORDS)

[Hospitalization of children in cities and rural areas. 2. What are their complaints? An analysis based on selected diagnoses]. / Hospitalsindlaeggelse af børn i by og på land. 2. Hvad fejler de? En analyse baseret på udvalgte diagnoser.

With the purpose of trying to analyse the difference in hospital admission of children in urban and rural districts, the sum of discharges of selected diagnoses was withdrawn from the Danish patient register for the year 1988. The data included children aged 0-14 living in Copenhagen city and the counties of Copenhagen, Vestsjaelland and Sønderjylland. A large group of diagnoses for respiratory tract infections and a variety of other diagnoses were chosen. The admission rate for the age group 0-2 years with upper and lower respiratory tract infections plus those with fever without an infectious focus is found to account for one third of the difference in admission rate between the urban and rural areas in this age group. For children aged 3-14 there is only a minor difference concerning the infectious diseases. All age groups of children in the capital area have higher admission rates for cerebral concussion than children in the two rural counties. As for the remainder of the selected diagnoses, there is a tendency, to slightly more admissions in the county of Copenhagen and particularly in Copenhagen city.

[Meconium peritonitis. A fetal catastrophe]. / Meconiumperitonitis. En katastrofe i føtallivet.

A material of 21 cases of meconium peritonitis treated by operation from 1972-1987 is presented. In four cases, intraabdominal anomaly was suspected on the basis of antenatal ultrasonography. The mortality was 19%. 57% developed symptoms during the first 24 hours, one at the age of one month and this case history is presented. Thirteen had intestinal atresia, 14 intrauterine volvulus, 7 open perforation, 13 pseudocyst, 1 gastroscisis. 2 had cystic fibrosis. Two patients are still attending the outpatient clinic on account of minor sequelae. The remainder have been discharged.

Secretion of parathyroid hormone after surgical trauma.

Parathyroid hormone was measured in nine patients subjected to surgery under general anaesthesia not involving operative bone trauma. Total calcium concentration, ionized serum calcium and serum albumin was also analyzed pre- and post-operatively. An increase in serum parathyroid hormone was registered postoperatively without any accompanying decrease in ionized serum calcium. The measured changes are at present unexplained, but can be caused by other mechanisms than bone trauma.