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Biomedical subjects

B Kjellman

Publications and source records attributed to B Kjellman.

At least 55 records · Page 3Linked to original sources
PubMed1986

Terbutaline slow-release tablets in children with bronchial asthma. Effect and pharmacokinetics compared with plain terbutaline tablets.

The effect of terbutaline sulphate in slow-release (SR) tablets (Bricanyl Depot), 5 mg twice daily, was compared with that of terbutaline sulphate in ordinary tablets (Bricanyl), 2.5 mg three times daily, in a double-blind, randomized, cross-over study during 2 consecutive weeks in 10 asthmatic children. Plasma concentrations and urinary excretion of terbutaline were measured at various times during both treatment periods. The SR tablets produced a higher mean plasma concentration in the morning and a smaller peak-trough variation over the day than the ordinary ones. No differences between the two treatments were observed concerning FEV1 (forced expiratory volume in 1 s). Tremor, measured with an opto-electronic tremorgraph, was about the same for two treatments and not significantly different from tremor seen in healthy children. The reported side effects were less frequent in the SR tablet period.

Adolescent↗
PubMed1985

Kingella kingae infections: a review and a presentation of data from 10 Swedish cases.

Kingella kingae is a fastidious gram-negative rod related to the Neisseriae. Together with data from published cases of K. kingae infection, we report the clinical and laboratory findings from 10 cases in western Sweden; a specific serological reaction is also described. The diagnoses were osteomyelitis, septic arthritis, discitis, endocarditis, occult bacteraemia and phlegmon. The data from the Swedish cases, together with those from previous reports in the literature provided the basis for an analysis of a total of 33 cases, ranging from self-limiting to potentially fatal infections. In orthopaedic infections (n = 19), including 3 cases of discitis, the course was usually protracted but subacute and benign, although the full-blown, acute septic arthritis was also encountered. Endocarditis (n = 10) was characterized by a stormy clinical course and the development of significant sequelae. The majority of the patients were previously healthy children. 42% of them had a current or recent upper respiratory tract infection. After start of antibiotic treatment patients were afebrile within a few days. Betalactam antibiotics should be regarded as the drugs of choice for coping with K. kingae. We stress the insidious course of skeletal infections in children and urge the importance of early puncture of a suspected focus to establish a correct diagnosis without delay. The clinical data suggest that K. kingae should be regarded as a significant pathogen.

Adolescent↗
PubMed1984

Clinical symptoms and IgE responses to common food proteins in atopic and healthy children.

The appearance of symptoms suggestive of allergy through the first 4 years of life was studied prospectively in eighty-six healthy newborn babies. Blood samples were obtained at birth, at 3, 8, 25 and 48 months of age and analyzed for levels of total serum IgE and for IgE antibodies to some common foods. The occurrence of IgE antibodies was related to atopic manifestations and to a detailed history of infant feeding and family history of allergy. All infants with elevated cord blood IgE (more than 1.3 kU/l) developed manifestations of atopy. Specific IgE antibodies against egg, cow's milk and soy were demonstrated at 3, 8, 25 and 48 months in nine, twenty-three, six and two children respectively. Egg was a more potent sensitizing agent than cow's milk, IgE antibodies to egg being present in thirty-one samples, to cow's milk in eleven and to soy in five samples. Nine infants developed IgE antibodies to eggs or cow's milk before the introduction of these nutrients into the food. The IgE antibody levels were generally low in healthy non-atopic children and did, with one exception, not reach RAST class 1. In contrast, the levels of IgE antibodies to egg or cow's milk were higher in eleven blood samples from atopic children. We conclude that transient low IgE antibody responses to food proteins appear relatively often even in healthy infants. High concentrations of IgE antibodies however are almost exclusively seen in infants with atopic disease. Sensitization may appear early in infancy sometimes even before the offending food has been introduced into the diet.

Age Factors↗
PubMed1984

Idiopathic pulmonary haemosiderosis in Swedish children.

During the 3 decades 1950-1979 onset of idiopathic pulmonary haemosiderosis occurred in 10 Swedish children. Complete records were available from the eight children with onset during 1960-1979, which indicates that the yearly risk of onset is 0.24 case per million children. The first symptoms started at the mean age of 5.8 years (range: 10 months-11 years). From the beginning all children had a severe microcytic, hypochromic, sideropenic anaemia. Pulmonary symptoms were present from the beginning in four children (but haemoptysis in only one) and developed in the remaining children after 1 1/2-2 1/2 years. Various therapeutical regimens were tried. Iron therapy seemed of temporary beneficial effect and most children seemed to benefit from prednisone therapy during disease bouts, although the effect of the therapy in the long run could not be determined. The four children with onsets during the 1960s died of their disease after 2-13 years. The four children with onset during the 1970s are still alive. One of them--a 20-year-old female, has for two years complete clinical remission and has normalized haematological, X-ray and pulmonary function data.

Child↗
PubMed1984

Patterns of antimicrobial therapy for pediatric patients.

The pattern of antimicrobial prescribing for outpatients and inpatients in a Swedish pediatric department was evaluated in 1975 and 1982. The changes in the pattern during these 7 yr were small and, with regard to outpatients, very similar to those in the whole of Sweden. In these children phenoxymethylpenicillin (penicillin V) was the predominant antimicrobial (approximately 70%), followed by erythromycin and medium wide-spectrum penicillins (ampicillin/amoxycillin). Prescriptions for erythromycin in outpatients increased from 8 to 16%. The corresponding figures for Sweden as a whole were from 13 to 20%. This increase might partly be explained by the higher frequency of pertussis in Sweden in the last few years, but it is probably also a manifestation of an insufficiently motivated widening of the range of indications for erythromycin. A comparison between the prescribing patterns in Sweden and North America showed an obvious difference. In the USA the medium wide-spectrum penicillins are more used than penicillin V. This difference is discussed and found to be probably due to a real difference in antimicrobial policy. Penicillin V and G also dominated the inpatient prescriptions (51% in 1975 and 42% in 1982), which also differed from some North American hospitals.

Anti-Bacterial Agents↗
PubMed1984

Kinetics of terbutaline in asthmatic children.

Seven asthmatic children (8-12 years) were given terbutaline sulphate intravenously (5.5 micrograms/kg) and orally (50 micrograms/kg) one week apart. Unchanged terbutaline was measured in plasma and urine. In urine, conjugates were also assayed. The intravenous plasma concentration-time curve declined in a multiexponential manner. The terminal half-life ranged from 8.8 to 15.8 (mean 12.1) h. Body clearance (mean +/- SD) was 3.76 +/- 0.86, renal clearance 2.42 +/- 0.49 mL/min/kg. The volume of distribution at steady state was 1.57 +/- 0.19 L/kg. The extrapolated recovery of intact terbutaline in urine was 65.4 +/- 6.5% of the dose and the total recovery 80.8 +/- 8.4%. After oral administration, the recovery of intact terbutaline in urine was 6.2 +/- 1.1%. Absorption was on average 33%, but because of a mean first-pass elimination of 70%, bioavailability was 9.5 +/- 2.4%. It seems that children as a group have shorter terminal half-lives than adults and slightly higher weight-corrected clearances.

Administration, Oral↗
PubMed1983

The problem of furred pets in childhood atopic disease. Failure of an information program.

This epidemiological study is based on all schoolchildren (n = 40,010) in a Swedish county (population: 270,000) and analyses by questionnaire, 1) the prevalence of regular direct contact with furred animals, 2) the prevalence of allergy to animal danders, 3) the prevalence among child asthmatics of regular direct contacts with furred animals correlated to the efforts made to impart information on allergy. 4) A comparison between levels of medical care/medicine-intake in dander-allergic and non-dander-allergic child asthmatics. This method gave the following results: 1) 52% of schoolchildren have furred pets in their homes (urban area: 39%, rural area: 77%), and 24% ride and/or have contact with animals in barns and stables. 2) The overall prevalence of dander allergy was 5.3%, in child asthmatics 57%; and in children with allergic rhinitis 30%. 3) Non-dander-allergic child asthmatics have more regular direct contact with furred animals than non-asthmatics. The incidence of domestic pet-keeping by dander-allergic child-asthmatics is less than half that of non-asthmatics. 4) Dander-allergic child-asthmatics have a higher level of medical care/medicine-intake, than the non-allergic. It is stressed that the family with an atopic child should be informed as soon as possible of the furred animal problem, i.e. before they have bought such a pet.

Adolescent↗
PubMed1983

MMEF or FEV1 in estimating bronchial obstruction in asthmatic children.

In this study the maximal mid-expiratory flow (MMEF) was compared with forced expiratory volume in 1 sec (FEV1) by a spirometric investigation of healthy children and children with slight bronchial obstruction. We found that the reproducibility of MMEF was good in both healthy and asthmatic children and that both methods had the same ability to detect abnormality before inhalation of a beta 2-receptor agonist. After such an inhalation the discriminatory power was greater for FEV1 than for MMEF and we therefore prefer FEV1 in estimating bronchial obstruction in children.

Administration, Intranasal↗
PubMed1983

Dextran-reactive antibodies in children. Appearance during the first 4 years of life and relation to E. coli infections in the urinary tract.

The appearance of dextran-reactive antibodies (DRA) was investigated in 88 children with sampling of serum at birth (n = 87), at 3 months of age (n = 87), at 8 months (n = 88), at 2 years (n = 86) and at 4 1/2 years of age (n = 87). Serum DRA appeared at 3 months of age and a peak level exceeding the levels in adults was noted at 8 months of age. At 4 1/2 years the titres were close to those in adults. Investigation of DRA in 8 children with acute pyelonephritis and in 8 children with asymptomatic bacteriuria caused by E. coli did not indicate that the appearance of DRA was a consequence of Gram-negative infections. The practical conclusion drawn is that if therapy with i.v. dextran is considered for infants or children, they should undergo preventive therapy with hapten dextran similar to the procedure recommended for adults.

Anaphylaxis↗
PubMed1982

Evaluation of two spirometers and two flowmeters in asthmatic children.

The reliability of a Monaghan (M 403) spirometer and a Vitalograph spirometer was evaluated in 46 children with "subclinical" asthma. As in previous studies of healthy children the vital capacity (VC) and the forced expiratory volume in one second (FEV1.0) were close to those of a Bernstein spirometer. The sensitivity of the spirometers and of two flowmeters (Wright's peak flow meter and Airflometer-Glaxo) was evaluated in the asthmatic children after inhalation of salbutamol and the changes after inhalation were compared to those obtained in a previous study of healthy children. The "simple" equipment gave substantial information about the degree of bronchial obstruction. It is concluded that the additional information obtained by using simple pulmonary function tests form a good basis for aggressive therapy.

Adolescent↗
PubMed1982

Oral solutions for gastroenteritis--optimal glucose concentration.

About half of all infants and toddlers with infectious diarrhoea of probable virus aetiology and treated with an oral rehydration solution containing 4.6% glucose had faecal glucose greater than or equal to 0.3%. In most of them the faecal concentration of glucose was higher than 0.50%. From the physiological point of view, it seems wise to decrease the glucose concentration substantially from that so often recommended for the treatment of diarrhoea in developed countries.

Administration, Oral↗
PubMed1982

Dextran-reactive antibodies in healthy infants and toddlers--relation to type of feeding.

The appearance of dextran-reactive antibodies (DRA) during the first 2 years of life was studied in 88 healthy newborn babies in an effort to provide information about the origin of DRA in normal persons. The results were related to type of feeding, immunizations and to blood group of infants and their mothers. No DRA were detected in cord sera by passive hemagglutination. At 3 months of age 42% had DRA, at 8 months 95% and at 27 months 84%. The latter figure corresponds to previous reports of DRA in healthy adults. Peak titers were also seen at 8 months (mean 2 log titers at 3, 8 and 27 months; 2.1, 6.2 and 4.9, respectively). Breast-feeding influenced the time of appearance of DRA and the magnitude of the titers. Babies breast-fed at 3 months more often were DRA negative than those that had received cow's milk-based formula at that time (p less than 0.005). However, in those breast-fed babies that were DRA positive the titers were higher than in the formula-fed infants (p less than 0.001). Other types of feeding e.g. juices did not influence the DRA levels. The appearance of DRA could not be explained by polyclonal stimulation of antibody production since changes of DRA titers in 11 tested patients could not be clearly related to similar changes of levels of antibodies to an unrelated hapten, trinitrophenyl. The study demonstrates that DRA appear during the first year of life, and that the appearance is influenced by exogenous factors. The most likely source of the antigen stimulation is the gastrointestinal flora which is altered by introduction of cow's milk into the diet.

Age Factors↗
PubMed1981

Screening of Rh-antibodies in Rh-negative female infants with Rh-positive mothers.

The sera of 96 consecutive Rh-negative female infants born to Rh-positive mothers were examined at birth, and sera from 88 of these infants were examined for the presence of Rh-antibodies at the ages of about three and eight months. A two-stage papain test and an AutoAnalyzer method were used for antibody screening and identification. Weak anti-D antibodies were found by the papain and AutoAnalyzer techniques in two cord sera, In neither case could the antibodies be demonstrated in samples taken on later occasions. Weak anti-D antibodies were found by the AutoAnalyzer technique but not by the manual methods in the sera of two other infants at the age of eight months. These antibodies could still be demonstrated by the same technique in samples taken about one month later. Though far from conclusively, the results support the "grandmother theory", but because of the low incidence of sensitization and uncertain nature of the anti-D antibodies demonstrable only by the AutoAnalyzer technique, anti-D prophylaxis is not recommended for newborn Rh-negative female infants with Rh-positive mothers.

Antibody Formation↗