ABSTRACT
Introduction: Periodic fever, aphthous stomatitis, pharyngitis and adenitis syndrome (PFAPA) is the most frequent periodic fever syndrome in children. Its pathogenesis is still unknown, but some disease-modifying factors were observed. Several medications were tested for the long-term prophylaxis of inflammatory flares; however, none are standardly used. Methods: This prospective clinical trial enrolled 142 children (71 girls, 50%) meeting diagnostic criteria for PFAPA syndrome. We analysed selected clinical characteristics and compared laboratory parameters during the flare and attack-free period (at least two weeks after the attack). Moreover, we assessed the possible therapeutic effect of ketotifen on the duration of attack free-periods and clinical picture. Results: The mean age of patients was 6.81 ± 3.03 years and the mean age of onset of symptoms was 2.31 ± 2.02 years. No significant differences were observed between genders.We recorded a positive family history for PFAPA in 31.69% of patients. Attacks lasted for 2.8 ± 1.2 days, with intervals between attacks of 4 ± 1 weeks. We administered ketotifen in 111 (77.8%) patients, and a positive effect was observed in 86 (77.5%) of patients. We observed prolonged attack-free intervals in patients treated with ketotifen (14.7 ± 8.9 days in comparison with 4.4 ± 1.9 days before the treatment; p<0.001). The used dose of ketotifen was 0.08 ± 0.01 mg/kg/day. Mild side effects were observed in four patients (restlessness, irritability, agitation and constipation). Discussion: Our data supports the use of ketotifen for long-term prophylaxis in children with PFAPA syndrome with positive effects on the attenuation of disease activity and the prolongation of attack-free periods. Further well-designed studies should confirm the preliminary data.
Subject(s)
Lymphadenitis , Lymphadenopathy , Pharyngitis , Stomatitis, Aphthous , Child , Humans , Male , Female , Child, Preschool , Infant , Ketotifen/therapeutic use , Stomatitis, Aphthous/drug therapy , Stomatitis, Aphthous/diagnosis , Pharyngitis/drug therapy , Lymphadenitis/drug therapy , Syndrome , Anti-Inflammatory AgentsABSTRACT
BACKGROUND: The reference values of young athletes for cardiopulmonary exercise testing are lacking. Expert opinions encourage production of local values specific for certain population. PATIENTS AND METHODS: The study population consisted of 136 healthy male caucasian athletic children and adolescents coming from one specific football school in northern Slovakia. Exercise testing with continuous electrocardiography was performed, and ventilatory parameters, oxygen uptake (VO2), and carbon dioxide (CO2) production were measured continuously with a respiratory gas analysis system. RESULTS: Peak VO2max/kg was changing very little across the childhood, whereas the peak work rate, heart rate and O2Pulse were. Linear regression analysis showed a significant effect of age on VE/VCO2. CONCLUSION: This work provides a reference values for the most important cardiopulmonary variables that can be obtained during cardiopulmonary exercise testing in athletic children.
Subject(s)
Athletes , Exercise Test , Adolescent , Carbon Dioxide/metabolism , Child , Electrocardiography , Humans , Male , Oxygen/metabolism , Reference Values , Respiratory Function Tests , Slovakia/epidemiologyABSTRACT
Chronic Fatigue Syndrome (CFS), also known as myalgic encephalomyelitis (ME), is a complicated disease characterized by extreme fatigue of at least six months duration. It is necessary to rule out the organic cause of CFS in the pediatric patient in order not to overlook the preventable or the treatable condition. In our case report we present a case of a patient with a surprising origin OF CFS/ME diagnosed by cardiopulmonary exercise testing.
