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1.
Cell Mol Biol (Noisy-le-grand) ; 62(6): 74-9, 2016 May 30.
Article in English | MEDLINE | ID: mdl-27262807

ABSTRACT

Bioremediation is the use of microorganisms to degrade environmental contaminants (pesticides, polyaromatic hydrocarbons etc.) into less toxic forms or compounds. In this study microbial biodegradation of trifluralin was performed in liquid media with 11 different types of identified fungi and bacteria cultures and their mixtures in agiated culture media. The isolated fungi and bacteria mixtures showed the highest degradation, reaching 93% in the chemical oxygen demand (COD) parameter in four days and 82% as trifluralin active ingredient in five days. Bacteria and fungi mixtures achieved 69% and 66% degradations of trifluralin active ingredient respectively. In the fungi studies, the best removal was achieved by M.Chlamydosporia at 80%, in the bacteria studies, the best removal was achieved by Bacillus simplex about 95% in five days. These different removal rates were due to the microbial differencies.


Subject(s)
Bacteria/metabolism , Culture Media/chemistry , Fungi/metabolism , Herbicides/metabolism , Trifluralin/metabolism , Bacteria/isolation & purification , Biodegradation, Environmental , Biological Oxygen Demand Analysis , Carbon/analysis , Fungi/isolation & purification , Microbial Consortia
2.
Article in English | MEDLINE | ID: mdl-18088019

ABSTRACT

BACKGROUND AND OBJECTIVE: Specific allergen immunotherapy is believed to be the only treatment able to change the natural history of allergic airway diseases. Sublingual immunotherapy (SLIT) is especially preferred because of its easy application and safety. The aim of this study was to describe the effect of SLIT in pediatric patients who have allergic airway disease. METHODS: Children with asthma and rhinitis who were allergic to house dust mite were evaluated. The effect on clinical course of 3 years of SLIT with 50% Dermatophagoides pteronyssinus and 50% Dermatophagoides farinae in a standardized extract was assessed retrospectively. RESULTS: The records of 39 patients (23 boys, 16 girls) were studied. The mean (+/- SD) age for starting SLIT was 8.8 +/- 2.3 years. The mean number of acute asthma attacks at the onset of the disease was 8.18 +/- 3.05. The mean number of attacks after 3 years of SLIT was 0.44 +/- 0.79. There was a statistically significant difference in the number of acute asthma attacks before and after therapy (P < .001). Complete clinical remission of asthma was recorded in 37 (95%) patients. Similarly, complete clinical remission of allergic rhinitis was recorded in 32 (82%) patients. CONCLUSION: This retrospective study shows that SLIT is effective in children who have allergic airway disease which cannot be controlled effectively with allergen avoidance measures only.


Subject(s)
Asthma/therapy , Desensitization, Immunologic/methods , Pyroglyphidae/immunology , Rhinitis, Allergic, Perennial/therapy , Administration, Sublingual , Animals , Child , Female , Follow-Up Studies , Humans , Male , Retrospective Studies
3.
Sci Total Environ ; 364(1-3): 272-83, 2006 Jul 01.
Article in English | MEDLINE | ID: mdl-16239020

ABSTRACT

The aim of this research was to determine the accelerating effects of microorganisms on the biodeterioration of stone under air pollution and continental-cold climatic region in Erzurum, Turkey. Studies have been carried out on specimens of the Rustempasa Bazaar, the Lalapasa Mosque, the Erzurum Castle Mosque, the Double Minarets-Madrasah, the Great Mosque and the Haji Mehmet Fountain aged from 441 to 823 years old. The results showed that vegetative and reproductive (generative) forms of the microorganisms could develop during the winter months when the night time average temperature was even -25 degrees C. Also the reproductive forms had developed and the whole stone surface was covered with a biofilm caused by the microorganisms. Silicon, aluminum, calcium, potassium, titanium, magnesium, zinc, sulfur, iron, sodium, and niobium were found in the stones of the historical buildings with varying amounts through the SEM-EDS analysis. Some of these elements could be used as an energy resource for the microorganisms together with the air pollutants such as sulfur dioxide, nitrogen oxides and particles on the stone surfaces. Of 21 isolates, 15 species from 6 bacterium genera and 5 species from 5 fungi genera plus 1 fungi genera were identified on the deteriorated stone surfaces even during the coldest months by microbial identification system (MIS) and these findings were tested by SEM investigations.


Subject(s)
Actinobacteria/metabolism , Air Pollutants/adverse effects , Bacteria, Aerobic/metabolism , Biodegradation, Environmental , Environmental Exposure , Fungi/metabolism , Actinobacteria/growth & development , Actinobacteria/ultrastructure , Air Pollutants/analysis , Archaeology , Bacteria, Aerobic/growth & development , Bacteria, Aerobic/ultrastructure , Biofilms , Climate , Cold Temperature , Construction Materials , Environmental Microbiology , Fungi/growth & development , Fungi/ultrastructure , Microscopy, Electron, Scanning/methods , Turkey
4.
J Investig Allergol Clin Immunol ; 15(3): 197-200, 2005.
Article in English | MEDLINE | ID: mdl-16261956

ABSTRACT

The acute anti-inflammatory effects of inhaled steroids at high doses and their use at home and as emergency treatment of acute asthma attacks in children have been evaluated in many clinical studies. However very little is known about their additional bronchodilator response to systemic steroids plus nebulized salbutamol in the early management in children. Asthmatic patients aged between 5-15 years were investigated in a double-blind, placebo-controlled fashion. Both the study group (Group I) and the control group (Group II) received three consecutive doses of nebulized salbutamol (0.15 mg/kg/dose) and one dose of parenteral methylprednisolone (1 mg/kg/dose, intramuscularly). After this treatment, nebulized budesonide (1 mg/dose) was administered to patients in the study group and placebo (nebulized saline) was administered to patients in the control group. Pulmonary index scoring and peak flow meter was performed to both groups before and after the treatment. There were twelve patients in Group I (mean age: 7.90 +/- 2.34 years) and fourteen patients in Group II (mean age: 9.36 +/- 2.55 years). There was no difference between the two groups with respect to age (p = 0.1421), gender (p = 1.000) and inhaled steroid prophylaxis rate (p = 0.2177). No statistically significant difference was detected between the two groups with respect to the pulmonary index score (p = 0.3528). Yet, there was a statistically significant difference between the two groups with respect to the increase in PEFR (p = 0.0155). The positive acute effect of nebulized budesonide in addition to systemic steroids and nebulized salbutamol in improving the spirometric indices in asthmatic children is an encouraging finding for further investigations of its routine use in the pediatric emergency department.


Subject(s)
Anti-Inflammatory Agents/administration & dosage , Asthma/drug therapy , Bronchodilator Agents/administration & dosage , Budesonide/administration & dosage , Administration, Inhalation , Adolescent , Asthma/physiopathology , Child , Child, Preschool , Double-Blind Method , Female , Humans , Male , Nebulizers and Vaporizers , Peak Expiratory Flow Rate/drug effects , Time Factors , Treatment Outcome
5.
Allergol Immunopathol (Madr) ; 31(1): 14-7, 2003.
Article in English | MEDLINE | ID: mdl-12573205

ABSTRACT

BACKGROUND: It has been postulated that there is an inverse association between mycobacterium tuberculosis infection and atopy. We aimed to investigate if there is a similar relation in our study group, consisting 252 asthmatic children. METHODS: In tuberculin testing indurations greater than or equal to 5 mm were accepted as positive. The most common aeroallergens were used in skin prick testing and reactions > or = 3 mm were accepted as positive. RESULTS: In 139 patients PPD was negative, where as in 113 patients PPD was positive. Among the PPD (-) patients skin prick test was positive in 64 % (n = 89). Among the PPD (+) patients skin prick test was positive in 71 % (n = 80). As the two groups were compared for having positive skin prick test reactions no statistically significant difference was detected between them (p = 0.283). CONCLUSIONS: Tuberculin reactivity is not inversely associated with atopy in asthmatic children.


Subject(s)
Asthma/epidemiology , Hypersensitivity, Delayed/immunology , Hypersensitivity, Immediate/epidemiology , Mycobacterium tuberculosis/immunology , Tuberculin Test , Tuberculosis/epidemiology , Asthma/immunology , BCG Vaccine/immunology , Child , Female , Humans , Hypersensitivity, Immediate/immunology , Lymphocyte Count , Male , Models, Immunological , Prevalence , Skin Tests , Th1 Cells/immunology , Th2 Cells/immunology , Tuberculosis/diagnosis , Tuberculosis/immunology , Turkey/epidemiology , Vaccination
6.
Allergol. immunopatol ; 31(1): 14-17, ene. 2003.
Article in En | IBECS | ID: ibc-17550

ABSTRACT

Background: It has been postulated that there is an inverse association between mycobacterium tuberculosis infection and atopy. We aimed to investigate if there is a similar relation in our study group, consisting 252 asthmatic children. Methods: In tuberculin testing indurations greater than or equal to 5 mm were accepted as positive. The most common aeroallergens were used in skin prick testing and reactions ≥ 3 mm were accepted as positive. Results: In 139 patients PPD was negative, where as in 113 patients PPD was positive. Among the PPD (-) patients skin prick test was positive in 64 % (n = 89). Among the PPD (+) patients skin prick test was positive in 71 % (n = 80). As the two groups were compared for having positive skin prick test reactions no statistically significant difference was detected between them (p = 0.283). Conclusions: Tuberculin reactivity is not inversely associated with atopy in asthmatic children (AU)


Información básica: Se ha propuesto que existe una asociación inversa entre la infección por Mycobacterium tuberculosis y la atopia. Nuestro objetivo era investigar si había una relación semejante en nuestro grupo de estudio, constituido por 252 niños asmáticos. Método: Se aceptaron como positivas induraciones superiores o iguales a 5 mm en la prueba de tuberculina. Se utilizaron los aeroalergenos más comunes en las pruebas cutáneas (prick-test) y se consideraron positivas las reacciones 3 mm. Resultados: En 139 pacientes la PPD fue negativa y en 113, positiva. Entre los pacientes (-) la prueba cutánea fue positiva en el 64 per cent (n = 89). Entre los pacientes ( +) la prueba cutánea fue positiva en el 71 per cent (n = 80). Como los dos grupos se compararon con respecto a su reacción positiva en las pruebas cutáneas, no se detectaron diferencias estadísticas entre ellos (p = 0,283).Conclusiones: La reactividad a la tuberculina no se asocia de manera inversa a la atopia en niños asmáticos (AU)


Subject(s)
Child , Male , Female , Humans , Tuberculin Test , Tuberculosis , Turkey , Vaccination , Prevalence , Th1 Cells , Lymphocyte Count , Models, Immunological , Th2 Cells , Mycobacterium tuberculosis , Asthma , BCG Vaccine , Hypersensitivity, Immediate , Hypersensitivity, Delayed , Skin Tests
7.
Bioresour Technol ; 85(3): 331-3, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12365504

ABSTRACT

In this work, adsorption of copper(II) ions on alga has been studied by using batch adsorption techniques. The equilibrium biosorption level was determined as a function of contact time at several initial metal ion concentrations. The effect of adsorbent concentration on the amount adsorbed was also investigated. The experimental adsorption data were fitted to the Langmuir adsorption model. The free energy change (deltaG0) for the adsorption process was found to be -12.60 kJ/mol. The results indicated that the biomass of Ulothrix zonata is a suitable biosorbent for both the removal and recovery of heavy metals from wastewater.


Subject(s)
Chlorophyta/metabolism , Copper/analysis , Waste Disposal, Fluid/methods , Water Microbiology , Water Purification/methods , Adsorption , Biodegradation, Environmental , Bioreactors , Copper Sulfate/metabolism , Hydrogen-Ion Concentration , Sensitivity and Specificity , Water Pollutants
8.
J Asthma ; 38(6): 461-7, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11642412

ABSTRACT

Although anti-inflammatory potency of inhaled corticosteroids is well established, little is known about their role in the acute phase. The aim of this study was to compare the acute anti-inflammatory effect of inhaled budesonide with systemic dexamethasone on allergen-induced inflammatory changes in asthmatic rats. Eighty-four Sprague Dawley rats were divided into four groups; group I (control, n = 24), group II (ovalbumin sensitized, n = 24), group III (systemic dexamethasone, n = 24), and group IV (budesonide, n = 12). All groups except group I were given ovalbumin aerosol challenges 14 days after sensitization with ovalbumin. The same procedure was applied to the control group using 0.9% saline. Group III received dexamethasone 0.3 mg/kg intraperitoneally and group IV received inhaled budesonide 10mL (0.5mg/mL) twice before the challenge. Eight hours after the challenge, bronchi of all the rats were evaluated for the degree of peribronchial inflammation. The most severe inflammation was seen in 8 of 24 rats (33%) in the second group, in 1 of 24 rats (4%) in the third group, and in 1 of 24 rats (4%) in the control group. None of the rats in group IV showed severe inflammation. No statistically significant difference was detected with respect to the presence of 3+ inflammation between the control vs. dexamethasone-, control vs. budesonide-, and dexamethasone vs. budesonide-receiving groups. Budesonide administration via nebulizer prior to exposure to an allergen may attenuate bronchial inflammation as effectively as systemic dexamethasone in rats.


Subject(s)
Asthma/drug therapy , Bronchitis/drug therapy , Budesonide/administration & dosage , Dexamethasone/administration & dosage , Acute Disease , Administration, Inhalation , Animals , Asthma/complications , Bronchitis/etiology , Budesonide/pharmacology , Dexamethasone/pharmacology , Rats , Rats, Sprague-Dawley
9.
Ann Allergy Asthma Immunol ; 86(4): 449-55, 2001 Apr.
Article in English | MEDLINE | ID: mdl-11345291

ABSTRACT

OBJECTIVE: To evaluate the parameters which could predict the persistence of respiratory symptoms in asthmatic children who have been treated with a considerably uniform therapy. METHODS: A retrospective review was performed on the records of 279 children with asthma. An end of study visit, results of spirometry and prick tests completed the data. The mean age at referral and at final visit was 6.2 +/- 3.7 years and 8.9 +/- 4.1 years, respectively; and the children were followed up for a mean of 3 +/- 1.2 years. RESULTS: Eighty-five of the 279 patients (30%) experienced no respiratory symptoms in the previous 12 months. There was no significant difference between those with and without current respiratory symptoms with respect to age, sex, age at onset of symptoms, duration of followup, age at referral, therapeutic choice, severity of asthma and duration of symptoms at referral. For subjects with current respiratory symptoms the initial serum total IgE level, and the percentage of RAST/prick test positivity was significantly higher than those without current respiratory symptoms (P = 0.0027, P = 0.011, respectively). Although the initial FEF 25%-75%, FEV1, and FEV1/FVC was significantly lower in those with current respiratory symptoms (P = 0.003; P = 0.005; and P = 0.04, respectively), there was no statistically significant difference between lung functions of the two groups at the end of followup. The persistence of respiratory symptoms was significantly predicted by initial FEF25%-75% and sensitivity to allergens (P = 0.03 and P = 0.04, respectively). CONCLUSIONS: We concluded that the risk factors for the persistence of respiratory symptoms in our patient population have been low FEF25%-75% value and sensitivity to allergens at referral.


Subject(s)
Asthma/epidemiology , Adolescent , Age of Onset , Asthma/diagnosis , Asthma/physiopathology , Child , Child, Preschool , Chronic Disease , Female , Humans , Immunoglobulin E/blood , Infant , Male , Maximal Midexpiratory Flow Rate , Pulmonary Ventilation , Retrospective Studies , Risk Factors , Sex Factors
10.
Ann Allergy Asthma Immunol ; 86(3): 318-22, 2001 Mar.
Article in English | MEDLINE | ID: mdl-11289332

ABSTRACT

BACKGROUND: International guidelines recommend the use of systemic steroids for the treatment of acute asthma attack if it has not been resolved within 24 to 36 hours of home management with regular beta2 mimetic inhalation. Such therapy for infrequent exacerbations is unlikely to have serious systemic effects. Unfortunately, many patients receiving frequent courses are potentially at risk for corticosteroid-induced side effects such as adrenal suppression, depression of linear growth, and osteoporosis. OBJECTIVE: To decrease the use of frequent oral corticosteroid courses in children, this study was designed to evaluate the efficacy of high-dose inhaled steroids in comparison with oral steroids, in the therapy of acute asthma exacerbations in children. METHODS: Sixty children who have experienced an acute exacerbation of asthma unresponsive to home management with regular use of inhaled beta2 mimetics, yet not severe enough to hospitalize, were randomized to be treated with either high-dose inhaled budesonide (1,600 microg daily) or oral methylprednisolone (1 mg/kg daily) plus medium-dose inhaled budesonide (800 microg daily, both in addition to inhaled terbutaline, 2,000 microg daily). Pre- and posttreatment pulmonary index scores, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC and forced expiratory flow 25% to 75% (FEF25%-75%) were evaluated. RESULTS: The mean number of decrease in pulmonary index score was 2.61 +/- 1.12 in the high-dose budesonide-receiving group (group I) and 1.90 +/- 1.08 in the oral steroid-receiving group (group II). There was a statistically significant difference between the two groups, in favor of group I (P = .038). No statistically significant difference was detected between the two groups with respect to the increase in lung function test measurements (FEV1, FEV1/FVC, FEF25%-75%; P = .790, .959, .819, respectively). CONCLUSIONS: Short-term high-dose budesonide therapy can be considered an alternative for children who are experiencing an acute asthma attack that is unresponsive to home management with regular use of an inhaled beta2 mimetic, yet who are not severe enough to hospitalize.


Subject(s)
Anti-Inflammatory Agents/administration & dosage , Asthma/drug therapy , Budesonide/administration & dosage , Acute Disease , Administration, Inhalation , Administration, Oral , Asthma/physiopathology , Child , Female , Humans , Male , Methylprednisolone/administration & dosage , Methylprednisolone/therapeutic use , Respiratory Function Tests , Sympathomimetics/therapeutic use , Terbutaline/therapeutic use
11.
Pediatr Infect Dis J ; 19(3): 215-8, 2000 Mar.
Article in English | MEDLINE | ID: mdl-10749462

ABSTRACT

BACKGROUND: Although treatment with oral corticosteroids can cause reactivation of latent Mycobacterium tuberculosis (TB) infection in purified protein derivative (PPD)-positive individuals with no evidence of clinical disease, little is known about the effects of inhaled corticosteroids in this respect. OBJECTIVE: This study was undertaken to assess whether inhaled corticosteroid (CS) therapy reactivates latent TB infection in PPD-positive asthmatic children. METHOD: We studied 32 PPD skin test-positive (> or =10 mm) children [age (mean +/- SD), 7.9 +/- 4.1 years] with no family history and no evidence of TB infection on chest radiograms who were receiving inhaled budesonide for the treatment of asthma. They were further evaluated with thorax computed tomography (CT) and erythrocyte sedimentation rate and closely observed for an additional 9 months. RESULTS: At enrollment the mean diameter of PPD reaction was 12.8 +/- 2.7 mm. The mean duration of inhaled CS treatment and the mean cumulative CS dose were 9.8 +/- 7.6 months and 275 +/-199 mg, respectively. Thorax CT studies revealed mediastinal lymph nodes in 7 of the 32 patients. There was no significant difference between children with and without mediastinal lymph nodes according to age, gender, size of PPD skin testing, erythrocyte sedimentation rate and duration and cumulative CS dose of inhaled budesonide therapy before study. A second thorax CT was obtained 9 months later in those 7 patients with lymphadenopathy (additional mean cumulative CS dose, 222.57 mg). There was no change in the size of their lymph nodes. CONCLUSION: Long term inhaled budesonide therapy appears to be safe in PPD-positive asthmatic children.


Subject(s)
Adrenal Cortex Hormones/therapeutic use , Asthma/drug therapy , Budesonide/therapeutic use , Glucocorticoids/therapeutic use , Administration, Inhalation , Adolescent , Adrenal Cortex Hormones/administration & dosage , Asthma/complications , Budesonide/administration & dosage , Child , Child, Preschool , Female , Glucocorticoids/administration & dosage , Humans , Male , Risk Factors , Tomography, X-Ray Computed , Tuberculin Test , Tuberculosis/complications , Tuberculosis/immunology
12.
Allergol Immunopathol (Madr) ; 28(6): 307-9, 2000.
Article in English | MEDLINE | ID: mdl-11269897

ABSTRACT

BACKGROUND: The decline in infections in childhood may contribute to the rising severity and prevalence of atopic disorders in developed countries. Support for this hypothesis has been obtained from findings of an inverse association between tuberculin responses and atopy and from findings of high prevalence of asthma in certain islands with low prevalence of respiratory infections. With this regard, we investigated the association between serum anti-streptolysin-O (ASO) titers and the frequency of exacerbations of asthma in childhood. METHODS: Thirty atopic asthmatic children who has no sign of upper respiratory tract infection at the time of presentation or during the previous two months were included in the study. Serum ASO titer was measured as an indicator of past streptococcal upper respiratory tract infections. ASO titer > or = 200 Todd units was accepted as positive. RESULTS: A statistically significant association is found between high anti-streptolysin-O titers and decreased number of exacerbations in those children. CONCLUSIONS: Our data suggests that streptococcal infections might be a factor attenuating asthma in childhood.


Subject(s)
Asthma/blood , Streptolysins/blood , Adolescent , Age Factors , Anti-Asthmatic Agents/therapeutic use , Asthma/drug therapy , Bacterial Proteins , Biomarkers/blood , Child , Child, Preschool , Female , Humans , Male , Odds Ratio , Prospective Studies , Respiratory Tract Infections/blood , Sex Factors , Streptococcal Infections/immunology
13.
Allergol Immunopathol (Madr) ; 28(5): 278-82, 2000.
Article in English | MEDLINE | ID: mdl-11270089

ABSTRACT

BACKGROUND: Serum eosinophil cationic protein (ECP) has been promoted as a direct marker of eosinophilic inflammation of the airways in patients with asthma. However, its role in monitoring disease activity and management of inhaled corticosteroid (ICS) therapy is not well defined. METHODS: We determined serum ECP (s-ECP) levels in 95 children (mean +/- SD age, 6.2 +/- 3.9 years) with asthma. At the time of measurements, 34 out of 95 children were symptomatic whereas 61 were in stable condition; and 56 of 95 patients were on maintenance ICS therapy. ICS prophylaxis was withdrawn in 16 of those 56 patients who remained asymptomatic with a dose of 100 micrograms/day of budesonide for 8 weeks. Eight out of these 16 children had to restart ICS therapy within the following 12 weeks, while the remaining 8 children continued to be asymptomatic within the same period. RESULTS: ECP values and number of patients with a high ECP level (> or = 15 micrograms/L) were significantly higher in the symptomatic group (p = 0.01 and p = 0.006, respectively). Also, ECP levels were significantly lower in the group who achieved clinical remission (n = 16) in which ICS therapy was withdrawn when compared with those who needed to continue ICS prophylaxis. On the other hand, no difference was observed in the comparison of the ECP levels of children who had to restart ICS therapy and those who did not. CONCLUSION: Our results suggest that, although the determination of s-ECP levels are in accordance with clinical evaluation of disease activity, it is not useful in determining discontinuation of ICS therapy.


Subject(s)
Anti-Asthmatic Agents/therapeutic use , Asthma/blood , Asthma/drug therapy , Blood Proteins/analysis , Ribonucleases , Administration, Topical , Adolescent , Anti-Inflammatory Agents/therapeutic use , Asthma/complications , Biomarkers/blood , Budesonide/therapeutic use , Child , Child, Preschool , Eosinophil Granule Proteins , Female , Glucocorticoids , Humans , Infant , Male
14.
J Asthma ; 36(2): 171-5, 1999.
Article in English | MEDLINE | ID: mdl-10227268

ABSTRACT

To determine whether parental reports of smoking habits and modifications in smoking behavior are associated with urinary cotinine levels (UCLs), UCLs were measured in 77 asthmatic children. Parental reports and UCLs agreed for 58 of the 77 children (75%). Although UCLs of children whose parents smoked indoors and outdoors were significantly higher than UCLs of children whose parents did not smoke (p<0.0001, p<0.002, respectively), there was no statistically significant difference between the UCLs of children whose parents smoked indoors and outdoors (p = 0.286). We concluded that encouraging smoking parents of asthmatic children to smoke outdoors may not be an effective way to lessen exposure.


Subject(s)
Asthma/urine , Cotinine/urine , Smoking/adverse effects , Tobacco Smoke Pollution/adverse effects , Adult , Child , Female , Humans , Male , Parents
15.
Ann Allergy Asthma Immunol ; 82(3): 311-4, 1999 Mar.
Article in English | MEDLINE | ID: mdl-10094224

ABSTRACT

BACKGROUND: It has been consistently observed in high resolution computerized tomography (HRCT) scans that asthmatic patients manifest more abnormalities related to airways remodeling than do normal subjects. OBJECTIVE: To find the underlying abnormalities in the lungs of asthmatic children with unusual manifestations. METHOD: Asthmatic children not responding as expected to inhaled steroid therapy with or without localized permanent or temporary recurrent auscultation findings (rales) were evaluated with chest radiographs and HRCT scans. Bronchoscopy was performed on the ones with localized rales. RESULTS: The sample consisted of 16 asthmatic children (6 girls and 10 boys, mean age = 7.75+/-4.43 years). Chest radiograph abnormality rate was 44% and the thorax HRCT scan abnormality rate was 75% (56% fibrotic retractions, 38% atelectasis, 19% bronchiectasis, and 19% bronchial wall thickening). Two patients with localized permanent rales and with right middle lobe (RML) atelectasis in HRCT scan underwent bronchoscopy which revealed RML syndrome due to mucus plugging in one and lymph node pressure in the other. In one patient with localized temporary recurrent rales and major bronchiectasis in HRCT scan, bronchoscopy revealed bronchitis. The patient with RML syndrome due to mucus plugging required lobectomy. CONCLUSION: We conclude with this experience that thorax HRCT scanning may be a helpful adjunct in the evaluation of an asthmatic children with atypical clinical findings.


Subject(s)
Asthma/diagnostic imaging , Tomography, X-Ray Computed/methods , Anti-Asthmatic Agents/therapeutic use , Asthma/complications , Asthma/drug therapy , Asthma/immunology , Bronchiectasis/diagnostic imaging , Bronchiectasis/etiology , Bronchoscopy , Child , Female , Fibrosis , Forced Expiratory Flow Rates , Forced Expiratory Volume , Humans , Hypersensitivity, Immediate/complications , Immunoglobulin E/blood , Lymphadenitis/diagnostic imaging , Male , Pneumonia/complications , Pneumonia/diagnostic imaging , Pulmonary Atelectasis/diagnostic imaging , Pulmonary Atelectasis/etiology , Respiratory Sounds , Respiratory Tract Infections/complications , Respiratory Tract Infections/diagnostic imaging
16.
Ann Allergy Asthma Immunol ; 80(5): 395-8, 1998 May.
Article in English | MEDLINE | ID: mdl-9609609

ABSTRACT

BACKGROUND: The role of aminophylline (ethylene diamine salt of theophylline) in the treatment of acute exacerbation of asthma has not been well established in children. OBJECTIVE: The aim of the study was to determine the additional therapeutic benefit of intravenous aminophylline in the treatment of children hospitalized for acute asthmatic exacerbation and treated with inhaled bronchodilators and glucocorticoid therapy. METHODS: Thirty-eight children aged from 2 to 16 years (mean age 5.64 +/- 3.31), admitted for acute exacerbation of asthma, participated in a prospective, randomized, double-blind, placebo-controlled study. All the subjects received methylprednisolone, administered intravenously, and nebulized salbutamol. The treatment group received intravenous aminophylline therapy and the placebo group received 0.9% saline solution for 24 hours. RESULTS: The number of salbutamol nebulizations needed and the clinical asthma scoring were recorded both at onset and at the end of 24 hours. There was no significant difference in either the mean number of nebulizations or the clinical asthma scores between the two groups (P = .7843, P = .8452). CONCLUSION: Intravenous aminophylline (ethylene diamine salt of theophylline) demonstrated no additional beneficial effect to the combination of beta adrenergic agonists and glucocorticoid treatment in acute asthma attack in children.


Subject(s)
Aminophylline/therapeutic use , Asthma/drug therapy , Acute Disease , Adolescent , Child , Child, Preschool , Double-Blind Method , Female , Humans , Male , Prospective Studies , Theophylline/blood
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