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Biomedical subjects

J de Blic

Publications and source records attributed to J de Blic.

135 records · Page 8Linked to original sources

[Continuous treatment of asthma in children with theophylline retard].

Continuous sustained-release theophylline therapy was used in 61 children with severe asthma, aged 5 to 16 years. Mean treatment duration was 5 months 8 days (range: 8 days-16 months). The necessary dosage to obtain correct blood theophylline levels was 18 +/- 3.6 mg/kg/day (range: 10-31 mg/kg/day). The adaptation of the doses to blood theophylline levels and regular check-ups confirmed intrapatient variability and the dose-dependent disposition of theophylline. In 35 of the 42 children (82%) who were observed for more than 3 months, theophylline induced a decrease of the frequency of the attacks and a better attendance to school. Nine times out of 30, oral steroid administration or sustained-release cosyntropin injections could be stopped and in 15, the dosages could be decreased by at least 50%. Evaluations of pulmonary function, performed several times in 12 children, showed that theophylline induces significant bronchodilatation, mostly of the large bronchi.

Adolescent↗

[Measurement of blood theophylline levels in the child: will this affect methods of prescription? (author's transl)].

Twelve children aged between 2 and 13 years received an oral dose of 5 mg/kg of pure theophylline, and 28 children aged between 2 and 15 years were given 10 mg/kg/day of the same drug in 3 or 4 divided doses for 3 days. In the first group blood theophylline levels were higher than 10 microgram/ml, after 1 or 3 hours, in only 3 children, two of whom were receiving erythromycin at the same time. Six hours and 12 hours later, none of the serum levels were higher than 10 microgram/ml. In the second group, estimations were performed on the 4th day. At 8 a.m., when the last dose had been given 12 hours previously, blood theophylline levels were all less than 10 microgram/ml (mean: 4.03 +/- 0,88 microgram/ml). Two hours and four hours after the usual morning dose, serum levels of greater than 10 microgram/ml were found in respectively 35 and 25% of the children only. Since the bronchodilator effect of theophylline is optimal for serum levels of greater than 10 microgram/ml, the dose currently recommended in France (10 mg/kg/day) would thus appear to be insufficient in most instances. However, increase in individual doses must be guided by serum estimations, which make it possible to avoid complications related to overdosage.

Adolescent↗

Assessment of anxiety disorders in asthmatic children.

The study's objective was to determine whether the State Trait Anxiety Inventory for Children, Trait version (STAIC), is suitable for the assessment of DSM-IV anxiety disorders in asthmatic children and adolescents. Ninety-two outpatients were given a semistructured diagnostic interview. They completed STAIC; another questionnaire about anxiety, the Echelle Comportementale d'Anxiété et de Peurs (ECAP); and the Child Depression Inventory. The parents filled in the Child Behavior Check-List (CBCL) and the Conners Parent Rating Scale (CPRS). A group of healthy children was assessed with STAIC. Thirty asthmatic children had anxiety disorders. They had significantly higher STAIC scores than the nonanxious asthmatic and the nonasthmatic children. STAIC scores were independent of age and sex and were correlated with ECAP, CPRS anxiety subscore, CBCL total score, internalizing score, and CBCL anxiety-depression subscore. Internal consistency was 0.75. With a threshold value of 34 for anxiety disorders, this method had a sensitivity of 73% and a specificity of 70%. STAIC was thus a useful method for anxiety disorder screening in a pediatric population.

Adolescent↗

Treatment of asthma with tulobuterol or albuterol in school-age children.

The subjects were 40 children aged 6 to 16 years with stable chronic asthma; 20 were randomly assigned to receive 40 micrograms/kg of tulobuterol twice daily and 20 received 100 micrograms/kg of albuterol three times daily for three months. Patients were assessed by spirometry after the morning dose of medication at 0, 2, 4, 8, and 12 weeks of treatment. After initial dosing, the mean percentage increases in forced expiratory volume in one second (FEV1) were significantly higher in the tulobuterol-treated patients than in the albuterol-treated patients: at 30 minutes after dosing, the mean increase was 17.2% in the tulobuterol group and 5% in the albuterol group; at one hour, 20.3% and 6.8%. Similar results were found at 12 weeks. Mean changes in forced vital capacity and peak expiratory flow rate were similar to the changes in FEV1. Treatment side effects were reported by seven tulobuterol-treated patients and by four albuterol-treated patients. Tulobuterol treatment was withdrawn in one patient because of severe vomiting and headache of unknown cause. No changes in cardiovascular function were found in any patient. It is concluded that tulobuterol taken twice daily was more effective than albuterol taken three times daily in the treatment of asthma in children.

Adolescent↗