| 1. |
- Wennergren, Göran, 1947, et al.
(författare)
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Wheezing bronchitis reinvestigated at the age of 10 years.
- 1997
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 86:4, s. 351-5
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Tidskriftsartikel (refereegranskat)abstract
- We have reinvestigated 92/101 children aged 10, who before the age of 2 years were admitted to a paediatric ward due to wheezing bronchitis. At the present time, 70% are symptom-free without medication, 20% have mild asthma, 8% moderate and 2% severe asthma. Persistent asthma correlated significantly to the presence of some other atopic disease in recent years, to early start of wheezing during infancy and to intense obstructive disease as a young child, while initial respiratory syncytial virus infection did not. A clear-cut relationship between smoking in the home in infancy and persistent asthma emerged (not visible at a preschool follow-up). The histamine challenge results correlated to the clinical picture. A normal histamine challenge was seen in 63%, mild hyperresponsiveness in 19%, moderate in 12% and pronounced hyperresponsiveness in 6%. The figures for persistent asthma and bronchial hyperresponsiveness are high compared with the prevalence of asthma in the overall population of schoolchildren.
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| 2. |
- Gatzinsky, Vladimir, 1966, et al.
(författare)
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Impaired peripheral airway function in adults following repair of esophageal atresia.
- 2014
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Ingår i: Journal of pediatric surgery. - : Elsevier BV. - 1531-5037 .- 0022-3468. ; 49:9, s. 1347-52
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Tidskriftsartikel (refereegranskat)abstract
- Esophageal atresia (EA) often leads to persistent symptoms and impaired respiratory function in adulthood. The role of peripheral airways in this impairment has not been previously investigated. Furthermore, asthma-like symptoms are common in these patients.
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| 3. |
- Gudnadottir, Gunnhildur, et al.
(författare)
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Respiratory polygraphy in children with sleep-disordered breathing.
- 2019
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Ingår i: Journal of sleep research. - : Wiley. - 1365-2869 .- 0962-1105. ; 28:6
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Tidskriftsartikel (refereegranskat)abstract
- At-home respiratory polygraphy has been shown to be a reliable substitute for in-laboratory polysomnography in adults for diagnosing obstructive sleep apnea, but this is less well studied in children. One aim of this study was to examine the quality of at-home respiratory polygraphy in children with sleep-disordered breathing and to evaluate the interrater reliability of the results. Another aim was to study whether calibrated respiratory inductance plethysmography (RIP) flow can be used for the scoring of respiratory events when the airflow measurements are unreliable. Children aged 4-10years, with sleep-disordered breathing, underwent at-home respiratory polygraphy. Of 113 polygraphies, only 46% were of acceptable quality, with missing nasal airflow being the most common problem (40%). The median recorded time with artifact-free signal present in three traces simultaneously was 228min (0-610min). Seventeen polygraphy studies were selected for further study. Each study was scored by two independent scorers, with and without the nasal airflow signal present, the latter relying on RIP flow for the scoring of respiratory events. The apnea-hypopnea index (AHI) from the four different measurements was compared using intraclass correlation coefficients (ICC). Comparison of the two scorers showed moderate agreement, with (ICC=0.66) and without (ICC=0.53) nasal airflow. One scorer had good agreement between AHI with and without nasal airflow (ICC=0.81), whereas the other had poor agreement (ICC=0.12). In conclusion, the scoring of respiratory events based on RIP flow is scorer dependent even for experienced scorers. The nasal airflow signal is frequently missing in paediatric respiratory polygraphies, which limits the usefulness of the method.
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| 4. |
- Holmgren, Daniel, 1945, et al.
(författare)
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Histamine provocation in young, awake children with bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction.
- 1999
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Ingår i: Acta paediatrica (Oslo, Norway : 1992). - 0803-5253. ; 88:5, s. 545-9
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Tidskriftsartikel (refereegranskat)abstract
- Bronchial provocation with histamine was performed in 11 boys and 6 girls, age range 2.7-7.4 y, with unspecific respiratory symptoms or bronchial asthma, using a fall in oxygenation as the only indicator of a bronchial reaction. In addition to transcutaneous oxygen tension (tcPO2), transcutaneous carbon dioxide tension (tcPCO2) was continuously monitored during the provocation procedure in order to identify possible changes in ventilation. A fall of 20% or more in the tcPO2 below a "floating" baseline value, defined as the highest tcPO2 value between the inhalations of histamine up to that point, was regarded as indicating a significant bronchial reaction. One child was excluded from the study because of an "early, false-positive" reaction due to hyperventilation during the inhalation, verified by a decrease in the tcPCO2 followed by a compensatory period of hypoventilation, resulting in a fall of more than 15% in the tcPO2 after the inhalation of saline. In the vast majority of the children, however, the tcPO2 values remained stable during the first dose stages of saline and histamine, with either a gradual fall immediately before or a distinct fall in conjunction with the reaction. The mean reaction concentration was significantly lower in the group of children with clinical asthma, 0.74 mg/ml, compared with the group of children with unspecific respiratory symptoms, 2.00 mg/ml (p = 0.03). In conclusion, a 20% fall in the tcPO2 can be used as the only indicator of a bronchial reaction during bronchial provocation tests in young, awake children. Changes in ventilation evaluated by monitoring tcPCO2, makes it possible to distinguish between a fall in oxygen tension due to an early, "false" reaction as a result of hypoventilation and a "true" bronchial reaction.
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| 5. |
- Lagerkvist, Anna-Lena, 1956, et al.
(författare)
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Immediate changes in blood-gas tensions during chest physiotherapy with positive expiratory pressure and oscillating positive expiratory pressure in patients with cystic fibrosis.
- 2006
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Ingår i: Respiratory care. - 0020-1324. ; 51:10, s. 1154-61
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To assess and compare immediate effects of chest physiotherapy with positive expiratory pressure (PEP) versus oscillating PEP on transcutaneously measured blood-gas tensions in patients with cystic fibrosis. METHODS: Fifteen patients (mean age 12.5 y, range 6.9-21.5 y) participated. The treatments were randomized and performed on 2 separate occasions, 8 weeks apart. Spirometry was conducted before and after each treatment. We transcutaneously measured oxygen tension (P(tO2). RESULTS: There were no changes in spirometry values. During PEP, different trends in blood-gas tension were seen, and there were no consistent changes. During oscillating PEP, P(tO2) increased and P(tCO2) decreased. During oscillating PEP, P(tCO2) was lower and the intra-individual change in P(tCO2) was more pronounced than during PEP. The results obtained immediately after oscillating PEP showed a higher P(tO2) and a lower P(tCO2) than with PEP. CONCLUSION: PEP and oscillating PEP can both cause transitory effects on blood gases in patients with cystic fibrosis. However, oscillating PEP alters blood-gas tensions more than does PEP, and hyperventilation during oscillating PEP may reduce treatment time.
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| 6. |
- Lagerkvist, Anna-Lena, 1956, et al.
(författare)
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Repeated blood gas monitoring in healthy children and adolescents by the transcutaneous route.
- 2003
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Ingår i: Pediatric pulmonology. - : Wiley. - 8755-6863 .- 1099-0496. ; 35:4, s. 274-9
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to establish transcutaneous oxygen tension (tcPO(2)), carbon dioxide tension (tcPCO(2)), and oxygen saturation (tcSO(2)) values and to investigate the intra- and interindividual variation in these values in healthy children and adolescents. Forty-one healthy children/adolescents (21 girls; mean age, 12.1 years; SD, 3.5; range, 5.0-19.0 years) participated. Continuous recordings of tcPO(2), tcPCO(2), tcSO(2), and heart rate (HR) were made for 30 min on two occasions, with a mean interval of 10.3 days, with the child/adolescent in a sitting position. The respiratory rate (RR) was counted manually during the last 5 min of each recording. The mean values of tcPO(2), tcPCO(2), tcSO(2), HR, and RR during the last 5 min of the recordings were reported. At the first recording, the mean value for tcPO(2) was 10.8 kPa (SD 1.0), for tcPCO(2) 5.1 kPa (0.4), for tcSO(2) 97.4% (1.1), for HR 82.2 min(-1) (9.9), and for RR 19.0 min(-1) (2.8). The coefficient of variation for tcPO(2) was 9.3%, for tcPCO(2) 7.8%, for tcSO(2) 1.1%, for HR 12.0%, and for RR 14.7%. The mean intraindividual variation in tcPO(2) was 0.3 kPa (SD 1.0), tcPCO(2) 0.0 kPa (0.5), tcSO(2) 0.1% (1.3), HR 0.1 min(-1) (7.7), and RR 0.5 min(-1) (2.7). No significant differences were observed in tcPO(2), tcPCO(2), tcSO(2), HR, or RR between the two recordings. In conclusion, the reproducibility of tcPO(2), tcPCO(2), and tcSO(2) monitoring during 30 min in healthy children and adolescents was good. This indicates that transcutaneous blood gas monitoring may be used to document significant changes in blood gas tensions and oxygen saturation over time.
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| 7. |
- Reims, Annika, 1962, et al.
(författare)
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Cysteinyl leukotrienes are secretagogues in atrophic coeliac and in normal duodenal mucosa of children
- 2005
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Ingår i: Scand J Gastroenterol. - : Informa UK Limited. - 0036-5521. ; 40:2, s. 160-8
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The pathophysiology of intestinal inflammation and diarrhoea is complex and involves the arachidonic acid cascade. Prostaglandins induce chloride secretion in healthy subjects and in patients with coeliac disease. Leukotrienes (LTs) are also known inflammatory mediators which have been shown to stimulate ion secretion in ileum and colon of rats and rabbits. The aim of this study was to determine the effects of leukotrienes C(4) (LTC(4)) and D(4) (LTD(4)) in normal and atrophic intestinal mucosa in children. MATERIAL AND METHODS: Routine paediatric intestinal biopsies were obtained from 109 children. Sixty-seven control biopsies and 42 biopsies from children with different stages of coeliac disease were mounted in a modified Ussing chamber. Potential difference (Pd) was measured continuously and tissue resistance (R(t)) and the generated current (I(m)) were calculated. RESULTS: In morphologically normal mucosa of duodenum, LTC(4) and LTD(4) increased Pd and I(m) in a dose-dependent manner. The increase was more pronounced in the distal than in the proximal part, similar to the response to prostaglandin E(2). The induced current was chloride-mediated, since replacement of Cl(-) with SO(4)(2-) in the bathing solution eliminated the response to the LTs. The LTC(4)-induced secretion was significantly decreased in atrophic mucosa, but the response was partially restored after preincubation with the cyclooxygenase inhibitor indomethacin. CONCLUSIONS: The results showed that LTC(4) and LTD(4) are secretagogues in the duodenal mucosa from healthy children by inducing a net chloride secretion. Restoration of the response in coeliac disease by cyclooxygenase inhibition suggests interactions between the different pathways of the arachidonic cascade in the intestinal mucosa.
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