Thirty children (25 males, five females), mean age 9.33 +/- 2.57 years, with acute infectious pulmonary diseases or acute flare-ups of chronic bronchitis, were randomly treated with either domiodol or placebo. The study was conducted between November 1986 and February 1987. Domiodol was administered orally for 14 days in doses of 0.5 mg/kg three times daily. Subjective symptoms (cough, sputum viscosity, difficulty in raising sputum and sputum characteristics) were assessed semi-quantitatively. They were all reduced significantly in the group treated with domiodol compared to those given placebo. Spirometric measures of vital capacity and peak expiratory flow rate were also improved in patients given domiodol compared with placebo. Conversely, no differences were noted in forced expiratory volume in 1 s, Tiffenau index, or mid-expiratory flow. There were no clinical side-effects and no changes in any other parameters measured; in particular, levels of thyroid hormone and thyroid stimulating hormone were unchanged. Thus, domiodol proved effective in reducing the symptoms of infection of the lower respiratory tract and in improving the consistency of mucus in children.

Adolescent↗

PubMedDate not supplied

Recurrent respiratory infections in childhood: experience with a bacterial extract plus bacterial ribosomes (Immucytal).

A total of 60 children (mean age +/- SD 7.6 +/- 3.5 years, range 2 - 14.2 years) with recurrent respiratory infections were treated with bacterial wall extract plus bacterial ribosomes (Immucytal) or placebo sprayed into the nostrils and oropharynx three times a day for 1 or 2-week periods over 3.5 months. The treatment was completed by 58 subjects; two patients in the placebo-treated group were withdrawn, one for poor compliance and the other because of headaches. Respiratory symptoms improved from the first month in the Immucytal treated children, but not in the placebo group, with a reduction in the incidence of infections in the upper and lower airways. No changes were noted in respiratory function parameters. Treatment with Immucytal significantly increased serum immunoglobulin A (P less than 0.02) and immunoglobulin M (P less than 0.01) and enhanced skin response to the in vivo lymphocyte blastization test, but there was no significant change in the circulating lymphocyte subpopulations. Both physicians and the patients' parents judged the bacterial extract to be clinically better than the placebo. Immucytal, therefore, may provide a useful alternative therapy for recurrent respiratory infections in infancy.

Adjuvants, Immunologic↗

PubMedDate not supplied

Treatment of respiratory tract infections in children: a study of a combination of amoxycillin and clavulanic acid.

In an open study, 70 in-patients and 23 out-patients aged between 1 and 14 years with sinusitis (n = 1), perforated otitis media (n = 4), pharyngotonsillitis (n = 25), tracheobronchitis (n = 30) or broncho-pneumonia (n = 33) were treated daily with a combination of 40 mg/kg amoxycillin and 10 mg/kg clavulanic acid in three equal doses for between 6 and 15 days. Purulent specimens were cultured when obtainable and pathogenic organisms identified were Staphylococcus aureus, beta-haemolytic streptococcal group A, Pseudomonas aeruginosa, Pseudococcus species and Klebsiella pneumoniae infections, of which 45.7% were beta-lactamase-producing and 54.3% were ampicillin-susceptible. After treatment, only one beta-lactamase-producing Streptococcus and one Staphylococcus infection persisted. Side-effects (vomiting, nausea, diarrhoea, maculopapular exanthema, rash) occurred in 16 patients and treatment was withdrawn in eight. It is concluded that the amoxycillin--clavulanic acid combination is a suitable first choice for the treatment of respiratory tract infections in children in whom the pathogenic organism may not have been established.

Adolescent↗

PubMedDate not supplied

The efficacy and safety of gamma-linolenic acid in the treatment of infantile atopic dermatitis.

The efficacy and safety of gamma-linolenic acid in the treatment of atopic dermatitis was evaluated. The children (mean age, 11.4 months) with atopic dermatitis (mean duration, 8.56 months) were openly treated with 3 g/day gamma-linolenic acid, for 28 days. Clinical evaluations were carried out every 7 days, and parents were asked to keep a diary, recording details of symptoms of eczema every day. Blood chemistry and immunological tests were done before and after treatment. None of the children showed complete recovery of symptoms. A gradual improvement in erythema, excoriations and lichenification was seen; significant differences were shown for itching (P < 0.01), and the use of antihistamines (P < 0.01). A significant rise in the percentage of circulating CD8 was found. No side-effects were recorded. Dietetic and pharmacological approaches are the basis of the treatment of atopic dermatitis and gamma-linolenic acid appears to be a safe and efficient additional therapy for infants and young children.

Administration, Topical↗

PubMedDate not supplied

Efficacy and tolerability of levodropropizine and dropropizine in children with non-productive cough.

The antitussive efficacy and tolerability of dropropizine and of its enantiomer levodropropizine were evaluated in children with non-productive cough; 258 were evaluable for tolerability and 254 for efficacy. Patients randomly received either 1 mg/kg dropropizine or 2 mg/kg levodropropizine orally, three times daily for 3 days. There were statistically significant decreases in the frequency of coughing spells and nocturnal awakenings after both levodropropizine and dropropizine treatments (P < 0.001). Gastro-intestinal symptoms were mild in the two groups; somnolence was twice as frequent in the dropropizine group (10.3% vs 5.3%) and the difference is clinically relevant, though not statistically significant. Levodropropizine is as effective as an antitussive as dropropizine, but appears to carry a lower risk of daytime somnolence.

Adolescent↗

PubMedDate not supplied

[Not Available].

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Adolescent↗

PubMedDate not supplied

[Evaluation of the treatment with levodropropizine of respiratory diseases in children].

Sometimes, antitussives can be a valid adjuvant to respiratory tract infections treatment. Although not always needed, this therapeutic support can be extremely useful in selected cases, and when patient is resident and monitored. In this line, the efficacy of a new peripheral antitussive, levodropropizine (Dompé farmaceutici, Milan), has been evaluated in 70 children inpatients of the Pediatric Department at san Paolo Hospital - Milan University - from September 1987 to May 1988. Thirty one male and 29 female children, aged 4 years and 6 months +/- 3 years and 5 months, suffering from various respiratory tract diseases were included in the study. Underlying diseases were represented by 21 acute bronchitis, 20 asthmatic attacks, 18 bronchopneumonia, 11 tracheitis, 6 acute episodes of chronic bronchitis, 2 hypoglottis laryngitis, 1 pertussis, 1 spontaneous pneumothorax. All parents gave their oral informed consent. The basic treatments were antibiotics in 44 patients associated or not with beta 2 agonists (31), theophylline (15), corticosteroids via aerosol (9) or parenterally (3), immunomodulators (2). Treatment with levodropropizine in the oral drops formulation at 2 mg pro kg a day was continued for 5 days and withdrawn according to the clinical evolution. Cough was registered by means of appropriate record forms given to the parents as well as with 120' tape recording whenever possible, i.e. 60 minutes before and 60 minutes after drug administration, on day one and 2. At treatment end, parents and investigator gave an antitussive efficacy judgement. Tolerability was evaluated as per clinical evolution and laboratory parameters.

Adolescent↗

PubMedDate not supplied

[Treatment using immucytal in children with recurrent respiratory infections: an Italian multicenter experience].

120 children, 71 male and 49 female, aged between 2 years and 15 years (mean 6.15 +/- 3.52 years) with recurrent respiratory infections, were treated with Immucytal, an immunomodulator of bacterial origin, based on membrane proteoglycan fractions plus bacterial ribosomes. The children, selected on the basis of the previous year's clinical score, were treated according to a random design with either Immucytal or placebo, using the same dosage of one puff per nostril plus one puff in the oropharyngeal cavity three times a day, as follows: 1st month: two weeks' treatment, one week wash out, one week's treatment. 2nd, 3rd, 4th months: two weeks' treatment, two week's wash out. Monthly throughout the treatment period the frequency and severity of airway infections episodes were assessed using the same score as for admission. Blood chemistry test, immunological assays (circulating Ig, lymphocyte subpopulations, Merieux Multitest in vivo blastization test) and respiratory tests (spirometry using a pneumotachigraph) were done before and after the treatment. 118/120 children completed treatment; the two dropouts were in the placebo group, one for compliance and the other because of headaches. Respiratory symptoms improved significantly in the actively treated children already from the first month, but not in the placebo group. This improvement consisted of reduction of the respiratory infectious episodes in both the upper and lower airways. No changes were noted in respiratory function parameters. From the immunological viewpoint, there were significant rises in serum IgA and IgM and enhanced skin response tot he Multitest; there was no change in the percentages of different circulating lymphocyte subpopulations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Pulmonary pathology in HIV seropositive children. 4 clinical cases].

Pulmonary infections in children with acquired immunodeficiency syndrome are very common. The lung, having a very important immunological function (because in it a very important part of the secretory immunological system is present), is one of the more involved apparatus in the course of AIDS. We report 4 cases of pulmonary disease (one case of Cytomegalovirus pneumonia, one case of Pneumocystis Carinii pneumonia, and two cases of interstitial lymphoid pneumonia) found in HIV positive children followed at the 5th Pediatric Department - Regional Center, Milan.

Child, Preschool↗

PubMedDate not supplied

[Pulmonary volume and flows in asthmatic children in therapy with prompt and delayed-action theophylline: preliminary report].

12 asthmatic children, suffering from frequent asthma (Ekwo-Weiberger classification), were studied; 3 groups were selected: A group: without therapy. B group: treated with plain theophylline. C group: treated with SR theophylline. Adequate serum theophylline levels were obtained in B and C group. Every child underwent then body plethysmography (Fenyves and Gutt's Pulmostar apparatus) before and after inhaling Albuterol through IPPB apparatus. We matched the different performances provided by the subjects of the various groups and compared them with the ones of a D group of healty subjects (pollinosics out of the exposure season). The indexes of pulmonary statics, and particularly TV and RV (as well as FRC) point out a better effect of plain theophylline vs. SR theophylline. Similar impression was done examining the conductances and the volume/flow curve, referring particularly to MMEF and V 0.50 TV. Further pharmacokinetic, clinical and spirometric studies are therefore necessary to confirm that the use of SR theophylline nowadays available in Italy is as successful as plain theophylline in long-term prophylaxis of children asthma.

Asthma↗

PubMedDate not supplied

[Respiratory atopy and season of birth: epidemiologic considerations].

Numerous environmental conditions have been considered factors which may favour atopic disease. 320 children (233 males and 87 females, aged from 1 year and 10 months to 16 years and 6 months) were followed at the Out-patients' Department for Allergology of the V Pediatric Clinic (University of Milano). These children were examined in order to determine possible environmental factors, which could be related to subsequent allergic sensitization in infancy. We excluded all the subjects with a high atopic risk owing to: gestational age under 36 weeks, weight at birth under 2,500 Kg, respiratory distress in infancy, bronchiolitis in the first 6 months of life, particularly unfavourable conditions of the domestic microclimate. We did not find any correlation between the length of the period of breast feeding alone and the subsequent appearance of atopic sensitization. The only factor which could be related to atopic sensitization was the season of birth: the majority of atopic subjects were born in the period of maximum exposure to their respective allergens. Our data underline the difficulty in planning any efficacious prophylactic measure against respiratory allergy, limiting our possibilities to the improvement of assistance during pregnancy and to newborns and to the realization of better hygienic and environmental conditions.

Adolescent↗