Active play exercise intervention in children with asthma: a PILOT STUDY.

OBJECTIVE: Increased physical activity (PA) may be beneficial for children with asthma. Knowledge about how to intervene and encourage children with asthma to be physically active is required. In the present study, we aimed to pilot a 6-week exercise intervention designed as active play and examine attendance rate, exercise intensity and children's perceptions of participating. METHODS: 6 children with asthma (4 boys, 2 girls) aged 10-12 years, participated in 60 min of active play exercise twice weekly. A mixed-methods design was applied. The data analysed included attendance rate, exercise intensity assessed by heart rate (HR) monitoring during exercise sessions, registration and description of the active play exercise programme, 3 semistructured focus groups, field observations of 5 exercise sessions, and preintervention and postintervention testing. FINDINGS: The average attendance rate was 90%. Intensity ≥ 80% of maximal HR (HRmax) was recorded for a median (IQR) time of 22 (8) out of 60 min per session. Median (IQR) HR during the sessions was 146 (9; 74% of HRmax) bpm. Children reported increased health-related quality of life (HRQoL) post-test compared with baseline. Children enjoyed participating and reported no limitations by asthma or serious asthma attacks. Instead, they perceived that their asthma and fitness had improved after the programme. The instructors created an inclusive atmosphere that was characterised by easy-to-master games, fair competition, humour and mutual participation. CONCLUSIONS: The exercise intervention pilot focusing on active play had a high attendance rate, relatively high exercise intensity, and satisfaction; the children perceived that their fitness and asthma had improved, and reported increased HRQoL. A randomised controlled trial of active play exercise including children with asthma should be conducted to evaluate effect on PA level, physical fitness, asthma control and HRQoL.

[Young girl with abscesses in the face]. / Ung jente med abscesser i ansiktet.

Skin and soft tissue infections are most often caused by Staphylococcus aureus or various species of streptococcus. This case report summarizes the clinical features, diagnosis, treatment and clinical outcome of a facial infection presenting as multiple abscesses in a young and otherwise healthy girl. Nocardia brasiliensis was recovered from abscess aspiration, and treatment failure was eventually recognized for the recommended empirical antibiotic treatment, broad-spectrum antibiotics and surgery.

[A three-year-old boy with hypoglycaemia]. / Tre år gammel gutt med hypoglykemi og astma.

Inhaled corticosteroids are a well established and effective treatment for asthma in children. However, some children develop systemic side effects including adrenal suppression when using moderate to high doses. Over the last few years, several severe acute adrenal crises with hypoglycaemia in patients using inhaled corticosteroids have been reported. Normally these patients do not develop a Cushingoid appearance and their height is not necessarily affected. We present a three-years-old boy that was unconscious at admittance. From the age of 6 months he had had asthma, treated with fluticasone propionate. The last year his asthma had been difficult to control, and he was given 750-1000 g/day in combination with salmeterol and a leucotriene antagonist. The day before admittance he had been ill with fever, had poor intake of food, and no intake of his regular medication. He was found unconscious in the morning. At admittance the blood glucose was 1.8. His cortisol axis was partially suppressed, probably as a result of the high doses of fluticasone propionate that had been administered. When treating asthmatic children it is important to use the lowest possible dose of inhaled corticosteroids. Those in need of higher doses should be carefully followed up with respect to systemic side effects. In emergency situations, systemic steroids should be used liberally in these children.