ABSTRACT
BACKGROUND: Induced sputum in children with bronchial asthma represents a non-invasive method of bronchial inflammation assessment. The main objective of our study was to analyze the cellularity of sputum in patients with bronchial asthma according to the level of disease control and the controlling therapy (with/without inhaled glucocorticoids). The second objective was to establish the correlation between sputum cellularity and other indirect parameters used to evidence bronchial inflammation (exhaled nitric oxide) and obstruction (forced expiratory volume in 1 second). METHODS: The study included children with bronchial asthma that were assessed clinically (physical exam, questionnaire on the control of bronchial asthma in children) and by medical tests (induced sputum, exhaled nitric oxide, spirometry). RESULTS: In patients with partially controlled asthma and those with uncontrolled asthma, the eosinophils percentage in the sputum was higher than in patients with controlled asthma (19.8±26.4% respectively 9.2±20.5% versus 4.5±14.6%, p<0.001). Higher percentage of neutrophils in the sputum was found in the partially controlled and uncontrolled asthma than in the controlled asthma (43.9±20.1% respectively 51.6±38.3% versus 35±19.7%, p=0.009). We also evidenced a direct and statistically significant correlation between the exhaled nitric oxide and the neutrophils percentage in the sputum (r=0.67, p=0.0003). Also, an indirect, moderate to good correlation (r=-0.56, p=0.005) was evidenced between the values of the forced expiratory volume in 1 second and the high eosinophils percentage in the sputum. CONCLUSIONS: In partially controlled and uncontrolled bronchial asthma the eosinophils and neutrophils count in the sputum is significantly higher than in patients with controlled asthma. There is an indirect correlation between the high eosinophils count in the sputum and the forced expiratory volume in 1 second, as well as a direct correlation between the neutrophils count and the exhaled nitric oxide, suggesting that induced sputum should be used in combination with other indirect parameters for the evidence of bronchial inflammation.
ABSTRACT
BACKGROUND: Exhaled nitric oxide (eNO) assessment in children with bronchial asthma (BA) is an easy and non-invasive test that provides informations on the presence of bronchial inflammation. METHODS: The study included 110 children aged between 5-18 years with a diagnosis of BA. The patients were assessed clinically (objective examination, questionnaire regarding the disease control) and by medical tests (exhaled breath analysis for nitric oxide, induced sputum, spirometry). RESULTS: Of the 33 patients with non-atopic BA, 9 (27.27%) presented normal eNO values, and 24 (72.72%) had higher than normal levels. There were 26 patients with controlled BA, 59 with partially controlled BA and 25 with uncontrolled BA, the levels of eNO demonstrating the existence of the statistically significant differences between the mean values of the variables obtained in the studied groups (p=0.003). Increased individual values were more frequently noted in patients with an exacerbation of asthma in the last month (70% vs 56.6%), but the differences were not statistically significant. Of the 77 patients with atopic BA, 35 (45.45%) had normal eNO, while 42 (54.54%) had increased values. The normal values of the eNO were most frequently noted in patients undergoing treatment with inhaled glucocorticoids (IGC). Patients with low percent of eosinophils in sputum had increased eNO values (p=0.03). CONCLUSIONS: The investigation of the airways by measuring the eNO levels is a useful method of assessing bronchial inflammation in children with bronchial asthma, in order to establish the disease responsiveness and therapy.
ABSTRACT
UNLABELLED: The AIM of the study was to validate some of the imaging criteria for voiding dysfunction in children. MATERIAL AND METHODS: The study included a number of 55 children with voiding dysfunction symptoms. They were investigated clinically as well as through imaging techniques: renourinary ultrasound, voiding cystourethrography and cystometry. RESULTS: The most common symptoms were urgency (87.3%), increased frequency (81.8%), and daytime urinary incontinence (76.3%). Ultrasound scans detected a reduced bladder capacity in 65.5% patients. The voiding cystourethrography detected bladder trabeculations (58.2%) and spinning top urethra (63.6%). Cystometric recordings indicated overactive bladder in 70.9% patients. Reduced bladder capacity detected by ultrasound associated with trabeculated bladder and spinning top urethra detected by voiding cystourethrography in a patient with specific symptoms may suggest an overactive bladder. In CONCLUSION, voiding dysfunction in child can be diagnosed by minimal or non-invasive methods.
