Local side-effects of inhaled corticosteroids in asthmatic children: influence of drug, dose, age, and device.

Background: The objective was to investigate the local side-effects of inhaled corticosteroids (ICS) in daily life in asthmatic children, particularly the younger ones, by an observational prospective cross-sectional cohort study.

Methods: Asthmatic children (n=639, 75.9+/-48.

Delivery of salbutamol pressurized metered-dose inhaler administered via small-volume spacer devices in intubated, spontaneously breathing rabbits.

Little is known about the ability of small-volume valved spacer devices to deliver a significant amount of an aerosolized drug to the lungs of babies. This study compared the in vitro delivery of salbutamol administered via Aerochamber-Infant (145 mL), Babyhaler (350 mL), and metallic NES-spacer (250 mL), as well as the in vivo delivery using an animal model. The lung deposition study of technetium-99m-labeled salbutamol was conducted in six anesthetized, intubated (3.

Delivery of HFA and CFC salbutamol from spacer devices used in infancy.

The aim of the study was to compare the in vitro delivery of four salbutamol pressurized metered-dose inhalers (pMDIs) via the three spacer devices commonly used in European infants: Aerochamber-Infant, Babyhaler, and metallic NES-spacer. Emitted dose (ED) and fine particle dose (FPD, particles<5.8 microm) of each combination of spacer device and pMDI (chlorofluorocarbon-based Ventoline, Eolène, Spréor, and hydrofluoroalkane-based Airomir were measured respectively using unit dose sampling tubes (n=30 per combination) and an 8-stage cascade impactor (n=6 per group).

[The effect of conical radiographic projection: a study in 3D].

Since 1925, the work of BROADBENT and the invention of the cephalostat (in 5), radiographic cephalometry has enabled us to have a detailed knowledge of craniofacial structures, and to better understand the form of the skull. At the same time it enabled us to understand the maxillo-facial growth and dental maturation. However, they have given rise to many controversies because of magnifying power and distortions.

[Virus and respiratory allergy in children].

Links between viruses and respiratory allergy are not easy to understand in children. For example, the risk of atopy or asthma is increased after an infection with syncytial respiratory virus. In some studies, more the child suffers from viral infections, more the risk of atopy increases.

[Inhalation spacer devices in childhood asthma: is utilization easy?].

Unlabelled: IMPROVED DRUG DELIVERY: Spacer devices improve the pulmonary deposition of drugs delivered from pressurized metered-dose inhalers because they decrease the diameter of the aerosol particles. Spacer devices are the best delivery system of inhaled drugs in children younger than 8 years.

Technical Aspects: Small volume spacer devices, with inspiratory and expiratory valves, are particularly interesting to use.

[Role of leukotriene inhibitors in the treatment of childhood asthma].

Leukotriene inhibitors are new pharmacological agents for the treatment of mild to moderate persistent asthma and exercise-induced asthma (EIA). Studies concerning their use in children remain scarce. Available data in the treatment of persistent asthma in children suggest that they could be an alternative to long-acting beta 2-agonists when asthma control cannot be obtained with inhaled steroids alone.

[Acute asthmatic crisis in children].

Acute asthma attack in children is an attack responsible for life-threatening acute respiratory distress with partial or no response to bronchodilator drugs. The severity of the episode needs to be quickly evaluated. This presupposes a perfect knowledge of the clinical signs of severity.

[Non-antibiotic treatments for community-acquired pneumonia in children].

Besides antibiotic therapy (when warranted), treatment of acute pneumonia in children usually requires only simple measures, including: fractionated feeding, analgesic and antipyretic medications and detection of hypoxemia. There is no evidence that physical chest therapy, bronchial mucus modificators and corticosteroid therapy are really useful. The best prevention relies upon vaccinations, suppression of passive smoking, and hygiene and nutritional improvements.

[Respiratory allergy in children and passive smoking].

Environmental tobacco smoke interacts with the respiratory mucosa by irritation and/or inflammation. Environmental tobacco smoke seems also modulate humoral and cellular immune activity. Thus, environmental tobacco smoke, in all children, increases the risk of superior and inferior airway infections, modifies the growth and the natural evolution of the respiratory function, increases the occurrence of asthma and exacerbates the symptoms of asthma, and creates or exacerbates a bronchial hyperresponsiveness.

[Ontogeny of the immune system].

The newborn immune system differs quantitatively and functionally from adults. At birth, the immune system is partially immature, resulting in deficiency in cell-mediated cytolysis, immunoglobulin synthesis and cytokine production. The most clearly defined deficit in neonatal phagocytosis defenses is diminished neutrophil storage.

Urinary cotinine and exposure to parental smoking in a population of children with asthma.

Background: Studies of the effects of tobacco smoke often rely on reported exposure to cigarette smoke, a measure that is subject to bias. We describe here the relationship between parental smoking exposure as assessed by urinary cotinine excretion and lung function in children with asthma.

Methods: We studied 90 children 4-14 years of age, who reported a confirmed diagnosis or symptoms of asthma.

Bronchial challenge with carbachol in 3-6-year-old children: body plethysmography assessments.

Several studies of airway responsiveness in young children (3-6 years old) have been reported, but few have attempted measurements of airway resistance by body plethysmography. Therefore, we decided to study nonspecific bronchial responsiveness following cumulative doses of inhaled carbachol in 44 children with clinical asthma (CA group), 44 children with chronic cough (CC group), 38 children with wheezy bronchitis in the first 2 years of life (WB group), and 40 controls. Specific airway resistance (sRaw) was measured in a body plethysmograph, and specific airway conductance (sGaw=1/sRaw) was calculated.

Pulmonary anthracosis in children.

We report two cases of children with malignancies and subpleural nodules found on computed tomography (CT) scan. In both cases the diagnosis was anthracosis. This pathologic condition has never been reported in children.

Possible interaction between exposure to environmental tobacco smoke and therapy in children with asthma.

1. The aim of the study was to determine the carbachol and albuterol responsiveness in treated and untreated asthmatic and allergic children exposed to environmental tobacco smoke assessed by urinary cotinine measurements. 2.

[Influence of the inhaler device on bronchodilatation in the asthmatic child].

The use of spacer devices is recommended in asthmatic children for inhaled therapeutics. Therefore, in vitro studies prove the dependent-device delivery of the drug. The aim of this study was to compare, in vivo, the effect of 200 micrograms of albuterol, delivered via one of the five spacer devices currently marketed in France (Aerochamber, Aeroscopic, Babyhaler with a face mask, Nebuhaler or Volumatic) and assessed by the induced peak expiratory flow (PEF) change.

[Thoracic standard radiology and x-ray computed tomography in mediastino-pulmonary tuberculosis in infants].

Primary mediastino pulmonary tuberculosis in infancy is increasing in France. Bacteriological diagnosis is difficult. The aim of the study is to assess the value of chest radiograph and CTscan for diagnosis of tuberculosis.

[Pulmonary tuberculosis in infants. Apropos of 6 cases].

Background: The present increased incidence of tuberculosis in children can be explained by contacts with infected adults and/or late BCG vaccination.

Patients: Six infants, 3 to 18 months-old (mean: 8 months), were admitted from November 1990 to May 1992 for various reasons; only two were admitted with a diagnosis of tuberculosis based on tuberculin test and only one was given a BCG vaccine. The disease produced a broad range of symptoms.