ABSTRACT
Clinical significance of segmental lung perfusion defects in children with bronchiolitis obliterans (BO), have not been reported before. The aim of this study was to evaluate clinical significance of lung perfusion defects in children with BO and to reveal its impact on follow up. The study included 38 children aged 9 to 60 months (17.8 + or - 13.4 months) with BO. Diagnosis was based on persistent respiratory findings beyond six weeks and oligemic-mosaic pattern in lung high resolution computerized tomography. Chest X-ray, 24 hour esophageal pH monitoring, sweat chloride test, immunoglobulin levels and respiratory viral screening were carried out in all. Lung perfusion scintigraphy was carried out at least three months after the first clinical sign of BO. Perfusion defects were scored. Scintigraphy demonstrated perfusion defects in 24 (63.2%) patients but was normal in 14 (36.8%). Number of segments having perfusion defects was 2.9 + or - 2.6. Mean number of exacerbations and days of hospitalization during the first year of follow up were 4.7 + or - 4.4 and 26.9 + or - 29.8 respectively. It was detected that number of perfusion defects correlated significantly with the number of exacerbations and duration of hospitalization (r= 0.66 and p= 0.00). In conclusion, number and extent of segments with perfusion defects in lungs of children with BO are correlated with clinical severity. Therefore, evaluation of lung perfusion status may aid in clinical determination of disease severity and its follow-up.
Subject(s)
Bronchiolitis Obliterans/physiopathology , Lung/physiopathology , Bronchiolitis Obliterans/diagnostic imaging , Child, Preschool , Female , Follow-Up Studies , Hospitalization , Humans , Infant , Length of Stay , Lung/diagnostic imaging , Male , Prognosis , Radionuclide Imaging , Severity of Illness Index , Tomography, X-Ray Computed , Ventilation-Perfusion RatioABSTRACT
OBJECTIVE: To determine the effect of Helicobacter pylori (H. pylori) eradication on blood levels of soluble CD40 ligand, leptin, oxidative stress and body composition in patients with dyspepsia infected with H. pylori. METHODS: The infection of H. pylori was based on the presence of both (14)C urea breath test (UBT) and histology. Patients were given triple eradication therapy for 14 days and at 3 months after the treatment, (14)C UBT was reinstituted. Fasting glucose, leptin, body composition, soluble CD40 ligand, total oxidant status (TOS) were studied before and at 3 months after the treatment. RESULTS: In 33 subjects, H. pylori infection was successfully eradicated. sCD40L, and TOS levels were significantly decreased after H. pylori eradication. The percentage of body fat and body fat mass significantly decreased whereas the fat free mass (FFM) increased after eradication. However, eradication of the organism yielded no differences in leptin levels. CONCLUSION: These findings suggest that H. pylori eradication reduces the sCD40L and oxidative stress, fat mass with a significant increase in fat free mass. Thus, eradication of H. pylori infection not only improves ulcer healing, but may also reduce the presumed atherosclerosis risk.
Subject(s)
Body Fat Distribution , Helicobacter Infections/blood , Helicobacter Infections/drug therapy , Helicobacter pylori , Oxidative Stress , Peptic Ulcer/microbiology , Adult , Anti-Bacterial Agents/therapeutic use , Atherosclerosis , CD40 Ligand/blood , Drug Therapy, Combination , Female , Helicobacter pylori/isolation & purification , Humans , Leptin/blood , Male , Peptic Ulcer/blood , Peptic Ulcer/drug therapy , Prospective Studies , Risk Factors , Young AdultABSTRACT
Aerosol nebulization is and most effective ways of treating airway diseases especially in children. Failure of inhaled asthma treatment is mainly due to inadequate deposition of drugs in the peripheral area of the lungs. The aim of this study was to compare the efficacy of a traditional mask and that of a new spacer mouth-mask (Nebula, Markos Mefar, Italy) when used with a jet nebulizer, by measuring aerosol deposition in the lungs, oropharynx, upper airways, and gastrointestinal tract. Twelve children without respiratory disease aged between 8 and 13 years were included in the study. Aerosol inhalation was performed using a jet nebulizer with 2 mL of saline solution containing 20 Mci of Tc99m-DTPA. The first group initially performed aerosol inhalation using a traditional facemask and then, one week later, using the new spacer mouth-mask. The second group performed aerosol inhalation using the new spacer mouth-mask first and then, one week later, using a traditional mask. Scintigraphic ventilation images were then obtained, and aerosol deposition in the trachea, oropharynx, lungs and stomach was measured. In the first group, the radioaerosol deposition in the peripheral lung area using the new spacer mouth-mask was greater 97.8 +/- 7.0 vs. 68.5 +/- 7.9 (p = 0.04). On the other hand, the oropharyngeal radioaerosol deposition was greater using the traditional mask: 50.2 +/- 5.2 vs 20.3 +/- 11.8 (p = 0.028). Similarly, in the second group the peripheral lung deposition was greater and the oropharyngeal deposition was less using the new spacer mouth-mask: 97.3 +/- 9.4 vs. 70.2 +/- 11.2 and 20.7 +/- 8.9 vs. 46.3 +/- 16.8 (p = 0.028 and 0.046 respectively). In conclusion, the new design of the spacer mouth-mask allows greater aerosol deposition in the peripheral lung area and less in other parts such as the oropharyngeal area, the central airways and the stomach.
