Isotonic Saline Nebulization and Lung Function in Children With Mild Respiratory Ailments.

Nebulization with saline solution, although commonly used to alleviate respiratory symptoms, particularly in children, is often questioned concerning its effectiveness. In this study, we investigated the effects of isotonic saline nebulization on lung function in 40 children (mean age of 14±1 years) suffering from different types of airway disorders. Measurements were carried out directly before and up to 15 min after nebulization, for six days in a row, always on the same day time in the morning. The children were divided into two study groups according to the baseline ratio of forced expired volume in one second/forced vital capacity (FEV1/FVC), below and above 80 %. We found significant improvements after saline nebulization in FEV1, mid-expiratory flow at 50 % and 75 % of FVC (MEF50 and MEF75), and peak expiratory flow (PEF) in the group with the baseline FEV1/FVC less than 80 %. In contradistinction, children with an index greater than 80 % displayed no appreciable changes in the lung function variables when compared with the baseline level before saline nebulization. We conclude that isotonic saline nebulization might mitigate the functional signs of threatening pulmonary obstruction and as such may be clinically useful in pediatric patients with mild respiratory problems.

Lung function in patients with gastro-esophageal reflux disease and respiratory symptoms.

The aim of this study was to investigate lung function in patients with gastro-esophageal reflux disease (GERD) who present respiratory symptoms suggestive of the possibility of co-morbid asthma. The study encompassed 20 patients (9 women and 11 men; age range from 11 to 68 years) diagnosed with GERD and presenting with chronic cough and other non-specific periodic respiratory complaints. The control group consisted of closely gender and age-matched 20 subjects without any gastrointestinal or respiratory symptoms. All patients and control subjects were tested for lung function, which encompassed spirometric and flow-volume variables. We found that none of the GERD patients had lung function abnormalities characteristic of asthma. There were, however, decreases in forced expired volume in 1 s, forced vital capacity, and in maximal instantaneous forced expiratory flows in the GERD patients compared with the healthy subjects. We conclude that cough accompanying GERD is unlikely to be associated with the presence of co-morbid asthma, but rather suggests a mild airway inflammation developing as a sequel of GERD. The corollary is that chronic cough should prompt physician's attention to consider diagnostic work-up toward the possibility of GERD.

Death as a result of violent asphyxia in autopsy reports.

Violent asphyxia can be subdivided into various kinds according to the mechanism, so that the resuscitation techniques are different in each case. The purpose of the present article was to analyze the autopsy reports of the Department of Forensic Medicine of the Medical University in Wroclaw, Poland of 2010, in which the established cause of death was violent asphyxia. We found that among the 890 autopsies performed, there were 164 cases of death due to violent asphyxia caused by drowning, choking on food, gastric fluid, or blood, hanging, manual strangulations, immobilization of the chest (positional asphyxia), environmental asphyxia due to substitution of the oxygen-rich air for some other gas, and others. The most common cause of death in the group was hanging, mostly suicidal hangings of alcohol-intoxicated males. Despite an early medical treatment consisting of removing the noose from the neck and suction the fluids from the mouth and bronchial tree to safe the central nervous system from imminent hypoxia, there were negative outcomes in most cases due to the development of critical brain ischemia, with deaths followed after several days spent in the intensive care units. No connection to gender or age of the deceased was noted. We conclude that violent asphyxia remains to be a quite commonly cause of death in the practice of forensic pathologists - among all the autopsies performed in 2010 every sixth was of an asphyxia victim.

Subglottic and tracheal stenosis due to Wegener's granulomatosis.

Wegener's granulomatosis (WG) is characterized histologically by necrotizing granulomatous angitis that most commonly involves the upper, lower respiratory tract and kidneys, but may affect any organ system. Otolaryngological manifestations are frequent and diverse but subglottic stenosis and tracheal stenosis are less common. The aim of the study was to assess the clinical features and the response to treatment in WG patients with subglottic or tracheal stenosis. The disease activity at the time of examination was scored in 55 patients with WG (29 females, 26 males) according to clinical, serological, radiological and bronchoscopic findings: subglottic and tracheal stenosis were observed in 9% and 5% of WG patients, respectively. CT scans of the larynx and trachea showed mucosal thickening extended 3-4 cm below the vocal cords in three and the thyroid cartilage in one patient. The degree of narrowing of the axial luminal diameter ranged 50-90%. Mechanical dilation of the stenosis and long-acting local corticosteroids may be of therapeutic benefit, along with conventional immunosuppressive treatment.

Atherosclerotic factors in PR3 pulmonary vasculitis.

Autoimmune disease such as systemic lupus erythematosus or rheumatoid arthritis are connected with higher risk of atherosclerosis and cardiovascular complications and mortality. This results from inflammatory damage to the vessel wall by vasculitis. The aim of the present study was to evaluate whether patients with Wegener's granulomatosis (WG) and pulmonary involvement have an increased prevalence of atherosclerotic disease as characterized traditional risk factors. Twenty one patients with WG in remission and 15 control subject were entered to the study. Traditional risk factor for cardiovascular disease such as hyperglycemia, hypertension, smoking, obesity, and dyslipidemia were assessed. Both systolic and diastolic blood pressure were higher in WG patients (p<0.025). Total cholesterol, LDL and TG levels were markedly elevated in 18 of the 21 in pulmonary WG patients. Compared with controls, plasma levels of hsCRP were raised in WG patients; 3.68 (0.79-9.75) mg/l vs. 0.14 (0.12-0.59) mg/l (p<0.01). We conclude that non-pharmacological and pharmacological treatments of traditional risk factors are crucial to prevent cardiovascular disease in WG patients and thus should be part of therapy to control WG activity and damage caused by it.

Respiratory infection caused by Chlamydophila pneumoniae in children and adolescents in the Lower Silesia Region of Poland.

OBJECTIVE: To assess the incidence of Chlamydia pneumoniae respiratory tract infection in children and adolescents in the Lower Silesia Region in Poland in 2009. MATERIAL AND METHODS: 641 throat swabs obtained from 326 girls and 315 boys, aged 11 months to 18 years, were assessed diagnostically. The patients enrolled into the study were treated on an outpatient basis due to various, non-specific respiratory ailments. The most common presenting clinical symptom of a respiratory problem was dry cough, which occurred in 295 studied subjects, followed by runny nose and cough with discharge in 176 subjects, and other minor symptoms in 35 subjects. The assessment was conducted by an indirect immunofluorescence antibody (IFA) Chlamydia Testing kit (Cellabs, Sydney, Australia). RESULTS: Overall, Chlamydia infection was detected in the respiratory tract in 43.1% (276/ 641) of the children, with no clear gender differences. Of the 295 subjects presenting with dry cough, 122 (41.4%) had positive tests for Chlamydia. Of the 176 subjects with runny nose and cough and the 35 subjects with other symptoms, 83 (47.2%) and 8 (22.9%) had positive tests for Chlamydia, respectively. In the asymptomatic children who had direct contact with a Chlamydia infected person, there were 29.6% (8/27) positively tested cases, whereas in the children presenting symptoms, the percentage of positive tests was 48.3% (29/60). CONCLUSIONS: In children living in the Lower Silesia Region of Poland, there is a substantial ∼50% rate of Chlamydia infection, transmitted via airborne droplets. The finding of Chlamydia infection should be the signal for testing other subjects from the child's closest environment.

Influence of mechanical hippotherapy on skin temperature responses in lower limbs in children with cerebral palsy.

Therapeutic horse riding is often employed for disabled children. The aim of the present paper was to determine the influence of exercise in a mechanical saddle, imitating horse's walk, on the skin temperature responses in lower limbs in children with cerebral palsy. Sixteen children, aged 14-16, were enrolled into the study. Skin surface temperature was assessed with thermography, using an infrared thermovision camera, AGEMA 550, before and directly after 20 +/-5 min of exercise. The findings demonstrate that mechanical hippotherapy provides an exercise stimulus that is capable of inducing a visible change in skin temperature of paralyzed limbs. The change, however, is one of a decrease in skin temperature, which points to acute vasoconstrictive effects of exercise and to decreased skin blood flow. The results, therefore, do not support the use of mechanical hippotherapy in children suffering from cerebral palsy, with a hope to stimulate blood circulation to spastically altered limb muscles and thereby to improve physical disability, at least in a short-term exercise paradigm.

Effects of neuraminidase on apoptosis of blood lymphocytes in rats with implanted Morris tumor.

In this study we examined the influence of neuraminidase on apoptosis of peripheral blood lymphocytes in rats with an implanted Morris tumor. The main objectives of the study were to determine whether the percentage of apoptotic blood lymphocytes would depend on the dosing regimen of neuraminidase and whether neuraminidase would affect caspase-3 activity, a marker of the apoptosis, in blood lymphocytes. A total of 51 rats were used for the study. In three groups, totalling 39 animals, Morris tumor was implanted and neuraminidase was injected intravenously using two dosing regimens: 10 units three times on Day 4, Day 7, and Day 14 and 5 units as a single dose on Day 4 of the experiment or was skipped (control). The remaining 12 rats constituted a reference group of healthy animals. At the end of the experimental period on Day 21, blood was drawn from the heart, and mononuclear cells were separated and cultured. Apoptosis of blood lymphocytes was assessed in cell cultures from fluorescence spectra generated by a Sybr Green I dye forming bonds with nuclear DNA. Caspase-3 activity was measured colorimetrically in homogenates of lymphocyte cultures using a CASP-3-C kit (Sigma, St. Louis, MO). On the whole, the results demonstrate that the bigger, but not the smaller, dose of neuraminidase was markedly effective in preserving the vitality of blood lymphocytes and in decreasing both the number of apoptotic lymphocytes and capsase-3 activity in the rats with Morris tumor. Neuraminidase treatment failed, however, to lessen the tumor size. In conclusion, the study demonstrates that neuraminidase caused an appreciable decline in apoptosis of blood lymphocytes in rats with the Morris tumor; the effect was dose-dependent. Although neuraminidase failed to influence the local cancer development in terms of tumor size, its anti-apoptotic effect toward the cells of the immune system of a cancer host is of research interest as it may potentially offer a way to strengthen the host's immune response.

What influences the level of oxidative stress as measured by 8-hydroxy-2'-deoxyguanosine in patients on hemodialysis?

Oxidative stress is at play in the progression of chronic renal failure (CRF) and in the genesis of atherosclerosis. The aim of the present study was to evaluate the factors that might influence the oxidative-antioxidative balance in patients on hemodialysis. The study group consisted of 71 hemodialysis patients due to CRF. Sixteen healthy subjects constituted a control group. The levels of 8-hydroxy-2'-deoxyguanosine (8-OHdG), C-reactive protein (CRP), and the blood lipid profile were measured in both groups. The results showed significantly higher mean levels of both 8-OHdG and CRP in the hemodialysis patients compared with that in the control subjects. The highest level of 8-OHdG was found in the subgroups of the patients with CRF primarily caused by diabetes (16.4 ng/ml) and with hypertensive nephropathy (15.8 ng/ml). More than a 2.5-fold higher level of 8-OHdG in the hemodialysis patients compared with the control subjects points to the presence of intensive oxidative stress in the patients.

[Evaluation of soluble components of receptors with weak affinity for IgE (sCD23) in children with pollinosis given specific immunotherapy]. / Ocena rozpuszczalnej skladowej receptora o slabym powinowactwie dla IgE (sCD23) u dzieci z pylkowica poddanych immunoterapii swoistej.

The aim of this study was the evaluation of the measurement of sCD23 and IgE levels before and after immunotherapy. The research was conducted in a group of 23 children aged 6 to 18 years with pollinosis diagnosed on the basis of the patient's history, increased IgE level and positive skin tests with pollen allergens. The control group consisted of 10 healthy children in the same age with normal IgE level. The treated children were examined before and 6 weeks after immunotherapy. Before immunotherapy in both groups of children (with the high and medium IgE level) the sCD23 concentration was statistically higher (level of significance p < 0.001) compared to the sCD23 level in the healthy children. After immunotherapy we observed significant decrease of the sCD23 level. We did not found correlation between sCD23 and IgE in children with pollinosis before and after immunotherapy.

[Effect of immunotherapy on selected immunologic indices in children with pollinosis]. / Wplyw odczulania swoistego na wybrane wskazniki immunologiczne u dzieci z pylkowica.

The study was carried out on 15 children with pollinosis. The children were treated with "Pollinex-Bencard" before the pollen season. We looked for changes of serum IgE levels and percentages of T (CD3) cells and their subsets CD4, CD8. After immunotherapy we observed a significant decrease of CD3, CD4 and CD8 cells, whereas no statistical difference was observed in the CD4/CD8 ratio. Three months after immunotherapy, serum IgE levels were significantly elevated, while after 9 months, markedly decreased.

Specific IgE against milk allergens in children with insulin dependent diabetes mellitus.

Cow's milk has been considered as a possible trigger of the autoimmune response that destroys pancreatic B-cells, thus causing insulin dependent diabetes mellitus. We investigated 46 children with IDDM. In this group we showed an increased total IgE in 58.6% of cases and the presence of specific IgE antibodies induced by milk allergens in 32.5% of cases. These results suggests that antibodies probably play an important role in IDDM pathogenesis.

[Preliminary evaluation of efficacy for the preparation DNCG-compositum in treatment of atopic bronchial asthma in children]. / Wstepna ocena skutecznosci preparatu DNCG-compositum w leczeniu atopowej astmy oskrzelowej u dzieci.

Preparations, in which composition disodium cromoglycate goes into, have been for many years the admitted way of bronchial asthma treatment. The introduction, to the therapy, of preparation that contains reproterol as well makes possible the early remission of disease symptoms. The aim of the study was the estimation of the effectiveness of DNCG-comp. preparation. Twenty one children, aged 7-17 years, with recognized bronchial asthma were examined. The atopic basis of the disease was found on the ground of results of skin prick tests, and elevated concentration of serum IgE and positive atopic family interview. We resigned the hitherto treatment for 3 days, carried out the spirometric measurements (PEF, FEV1, FEV1%VC, MEF25,50,75). DNCG-comp. was given 4-times per twenty-four hours in 2 inhalations at each time, for three weeks. Every day, the PEF value and the score of disease symptoms were established. After the study, side effects were not observed and final results of spirometric estimation evidence the possibility of wide application of DNCG-comp. preparation in the treatment of bronchial asthma in childhood.