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J Gerritsen

Publications and source records attributed to J Gerritsen.

At least 109 records · Page 6Linked to original sources
PubMed1990

[Once more a discussion of the RSV affair].

During autumn- and winter epidemics respiratory syncytial (RS) virus accounts for the majority of respiratory infections in infants and young children. In case of an acute lower respiratory tract infection, RS virus can induce serious symptoms. These are age-dependent. The most important symptoms in babies and toddlers are dyspnea, wheezing, cyanosis and apneas. In the case of respiratory insufficiency or fatigue, as well as recurrent apneas, mechanical ventilation is required. Diagnosis can be made using a direct immunofluorescence technique with monoclonal antibodies. To control the risk of nosocomial RS virus infections, isolation precautions are necessary. The overall mortality is low (less than 1%), but may be strikingly higher in children at risk: babies less than one month of age, preterm babies, infants with congenital heart- or pre-existent respiratory diseases, and those with severe immunodeficiency syndromes. In these subgroups therapy with ribavirin (Virazole) may be beneficial, although until now there is no strong evidence for the effectiveness of this antiviral agent. The majority of the children will have recurrent symptoms of dyspnea and wheezing over the subsequent years following the RS virus infection. In acute lower respiratory RS virus infection, there may be IgE mediated hypersensitivity reactions to viral agents, with release of chemical mediators of airway obstruction. The pathophysiological mechanisms might be comparable to those in patients with asthma.

Child, Preschool↗
PubMed1990

[Nocturnal asthma in children, symptoms and treatment].

Nocturnal airflow obstruction is a common symptom in children with asthma. The increase in airflow obstruction overnight is underassessed by children as well as their parents. Worsening of the early morning peak flow values may be an indication for an increase in airflow obstruction overnight. An increase in vagal activity does not, in contrast with the observations in adult patients, contribute to the development of nocturnal airflow obstruction in asthmatic children. However, a nocturnal increase in inflammatory mediators seems to play a role of importance. Treatment of nocturnal airflow obstruction should therefore be focussed on inflammatory processes in the lungs.

Airway Obstruction↗
PubMed1990

[CARD from childhood to adulthood].

In approximately 50 per cent of the children with asthma respiratory symptoms, these symptoms disappear during puberty. Outgrowing childhood asthma is especially estimated by: the degree of airway obstruction as a child, and the degree of bronchial hyperreactivity in childhood. Another childhood factor of influence on the prognosis of asthma seems to be the combined early and late bronchial response after inhalation of an allergen. Factors not predicting the outcome of childhood asthma are: at what age asthma symptoms started; whether the child with asthma had eczema or not, and how strong skin-allergy was. Conceivable risk-factors for the outcome of childhood asthma are: smoking of the parents and a strong degree of eosinophilia. The prognosis of asthma might be improved by more intensive treatment and continuity in treatment of the children with an increased risk.

Adolescent↗
PubMed1989

[Stridor in children].

Stridor is the presenting symptom of abnormalities of larynx and trachea in children. The anatomical differences in size and consistency of the larynx play a crucial role in stridor in children as compared with adults. From 1983 to 1988, 81 children (65 males, 16 females) with severe or prolonged stridor were admitted to our hospital. Thorough examination, including endoscopy of larynx and trachea and radiology revealed various congenital abnormalities and acquired conditions as the cause of stridor. Congenital laryngeal anomalies accounted for stridor in 26 children, there were 12 children with congenital tracheal or vascular anomalies, 28 with infectious diseases and 15 with other diseases. Intubation and (or) tracheotomy were performed in one-third of the patients: 5 of them died of severe complications. For proper treatment of children with stridor it is essential to investigate its aetiology carefully.

Child↗
PubMed1989

The reproducibility and agreement of three indices of airway responsiveness to histamine in asthmatic children.

In 12 asthmatic children, aged 8-14 years, we investigated the possibility of using a provocation concentration of histamine (PC) causing a 10% or 15% fall in baseline forced expiratory volume in 1 sec (FEV1), instead of a PC20 histamine, in the assessment of bronchial hyperreactivity. Inhalation challenge tests were performed on days 6 and 7 after withdrawal of medication. PC10, PC15, and PC20 were calculated from the dose-response curves. Reproducibilities for PC10, PC15, and PC20 values for both days, determined by Student's t-test, were not significantly different. Correlation coefficients between PC20 and PC15 values on days 6 and 7 and between PC10 values on days 6 and 7 were 0.82 and 0.76, respectively; between PC20 values on day 6 and PC15 values on day 7; and between PC20 values on day 6 and PC10 values on day 7 they were 0.84 and 0.82, respectively. (P less than 0.01 for all r values). The predictive value of PC20 for PC10 and PC15 was determined by a least-squares regression line with 95% confidence intervals. Variances between PC10, PC15, and PC20 were not significantly different on either day 6 or 7. Our data show that a PC10, as well as a PC15, can be used in the assessment of the degree of bronchial hyperreactivity in children with asthma.

Adolescent↗
PubMed1989

Hypercalcaemia in a child with miliary tuberculosis.

Hypercalcaemia and hypercalciuria were diagnosed in a 21-week-old boy with miliary tuberculosis. The tuberculosis was treated with isoniazid, rifampin and streptomycin. After 2 months, streptomycin was replaced by ethambutol. The hypercalcaemia was treated initially with prednisone, which decreased the serum 1.25 (OH)2 cholecalciferol level but the serum calcium level remained unaltered. After calcium and vitamin D restriction, the serum calcium level normalized within 1 day. The patient's tuberculosis was treated and he remains well.

Calcium↗
PubMed1989

Prognosis of asthma from childhood to adulthood.

The outcome of childhood asthma was studied in 101 adults who came from a group of 119 asthmatic children (85%) 6 to 14 yr of age who had originally been investigated between 1966 and 1969. Changes in respiratory symptoms, spirometry, and airway responsiveness to histamine in childhood and adult life were analyzed. It was found that 43 of the 101 adults (43%) had current symptoms; 29 of the 43 (67%) were receiving maintenance therapy. In the first study, 83 of the 101 children (82%) showed a response on inhalation of histamine (PC10-histamine less than or equal to 16 mg/ml). The number of subjects in the second study who still had a PC10-histamine less than or equal to 16 mg/ml fell to 29, suggesting that airway responsiveness decreases from childhood to adulthood. During the second survey (in adults), 25 of the 43 (59%) subjects with current symptoms and four of the 58 (7%) without respiratory symptoms responded to histamine. Adults with current symptoms had a significantly lower %FEV1 in both childhood and adulthood than did adults without current symptoms; %FEV1 was not different in females and males or in smokers and nonsmokers in either the first or the second survey. The outcome of childhood asthma is primarily predicted by the initial degree of bronchial obstruction (p = 0.041) and airway responsiveness to histamine (p = 0.050), and does not appear to be related to sex, smoking habits, or age of onset of respiratory symptoms.

Adolescent↗
PubMed1988

Propranolol inhalation challenge in relation to histamine response in children with asthma.

The relation between airway responsiveness to propranolol and histamine was studied in 32 asthmatic children. Propranolol and histamine were given by nebuliser to a maximum dose of 16 mg/ml and 32 mg/ml respectively and the response was measured as the provocative concentration of agonist causing a 20% fall in FEV1 (PC20). A PC20 histamine value of less than 32 mg/ml was obtained in 24 of the 32 children, of whom 15 had a measurable PC20 propranolol (less than 16 mg/ml). In these 24 children the geometric mean PC20 histamine was 4.5 mg/ml and 14.4 mg/ml respectively in those with and without a measurable PC20 propranolol (p = 0.023). There was a linear relationship between histamine and propranolol PC20 values (r = 0.60), and between PC20 histamine and FEV1 % predicted (r = 0.43), but not between PC20 propranolol and FEV1 % predicted (r = 0.38). In an open time course study in 12 children with asthma recovery of FEV1 after inhaled propranolol was incomplete in seven of the children after 90 minutes. When inhaled propranolol was followed by inhaled ipratropium bromide in a further 11 children FEV1 had returned to baseline in all children after 60 minutes. Thus propranolol inhalation can be used in children with asthma to assess the contribution of the beta adrenergic system to the regulation of bronchial smooth muscle tone. The test has several disadvantages in comparison with histamine provocation-long duration, the prolonged action of propranolol, and the fact that only the children with substantial hyperreactivity to histamine react to propranolol.

Adolescent↗
PubMed1987

Recovery of FEV1 after histamine challenge in asthmatic children.

Factors that influence the time necessary for complete recovery of FEV1 after inhaling histamine were analysed in forty-five children with asthma. These included the initial bronchial obstruction (baseline FEV1), the provocation dose of histamine producing a 20% fall in FEV1 (PD20) and the fall in FEV1 after the histamine challenge. In addition it was also investigated whether a second challenge carried out after complete recovery of FEV1 would produce a reproducible PD20-histamine value. The time for complete recovery varied widely from 15 to more than 75 min. The time needed for complete recovery of FEV1 after the histamine challenge seems to be mainly determined by the PD20 value. The other factors such as initial bronchial obstruction and the fall in FEV1 after the challenge showed no significant relationship with the recovery time. A second challenge with histamine resulted in a highly reproducible PD20 value. The clinical implication of this study is that other tests can only be performed when FEV1 has returned to 95% of baseline.

Adolescent↗
PubMed1986

Cat-scratch fever.

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Cat-Scratch Disease↗