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Biomedical subjects

M Zach

Publications and source records attributed to M Zach.

At least 55 records · Page 3Linked to original sources
PubMed1985

[Physical training program in the long-term care of children with bronchial asthma. A concept].

The planning of future training programs for children with asthma should be based on existent practical experience plus the results of the scarce relevant literature. Participation can be limited to patients with moderate to severe airway hyperreactivity; training programs should ideally follow after pharmacological stabilization of airway reactivity, thereby supporting reintegration into age-related normal physical activity and school sports. There are several pathophysiological similarities between allergen- and exercise-induced bronchoconstriction; this indicates the risk of an exercise-induced increase in bronchial reactivity and underlines the necessity for future assessment of reactivity before and after exercise training programs. Carefully controlled premedication should protect the patients against exercise-induced bronchoconstriction and the risk of a possible subsequent increase in airway reactivity. Exercise programs should be planned and conducted by a team, consisting of a physiotherapist, a physician and a physical education teacher; they should offer physical training and treatment of secondary handicaps, and should ideally offer an initial less asthmogenic swimming course and a follow-up program of gymnastics, sports, and group games.

Airway Resistance↗
PubMed1984

[New aspects of recurrent pseudocroup].

Three consecutive studies were concerned with clinical, pathophysiologic, and immunologic aspects of recurrent croup. The first investigation demonstrated that recurrent croup is a distinct disease entity which shares many clinical features with asthma and should be distinguished from viral laryngotracheobronchitis. In the second study a high incidence of airway hyperreactivity was found in children with recurrent croup. This specific type of hyperreactivity suggested an involvement of both the lower and the upper respiratory tract. The third study demonstrated a tendency towards low serum IgA levels in children with recurrent croup; hence immunoregulatory defects may be conducive to the development of this disorder.

Asthma↗
PubMed1984

Cold air challenge of airway hyperreactivity in children: practical application and theoretical aspects.

In 23 children with asthma and 18 healthy controls, cold air challenge ( CACh ) was done twice during the same half day, and in the asthmatics a third time together with a histamine challenge (HCh) 2 wk later. Pulmonary functions were tested before and after each challenge. No overlapping of individual responses to CACh in seven forced expiratory flow tests proved the power of discrimination of this technique in children. The limits of "normal" reactions ranged from minus 9% for larger airway-related to 26% for smaller airway-related flows. Short-term reproducibility of induced changes, in percentage of baseline, was excellent (r = 0.815-0.954); in percentage of predicted postchallenge abnormality it was even better (r = 0.926-0.975). The response in small airway-related flow rates (-43.1 +/- 12.8 to -51.9 +/- 16.8% of baseline) was much larger than in others (-27.6 +/- 14.6 to -32.1 +/- 17.3% of baseline). This, the different baseline-to-response correlations in various measurements, and the divergent dose response to colder versus less cold air in large (60.7 +/- 21.9 versus 65.4 +/- 21.5% predicted, postchallenge values) and small airway-related tests (28.9 +/- 18.7 versus 29.5 +/- 15.1% predicted, postchallenge values) in asthmatic children suggest a predetermined, small airway-related limitation of individual reactivity, which is independent of the baseline situation. All asthmatics responded positively to HCh but quantitative results of the two methods did not correlate. Responses to CACh also better characterized the clinical severity of asthma than those of HCh.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1982

Cystic fibrosis: physical exercise versus chest physiotherapy.

Twelve children with cystic fibrosis were admitted to a paediatric rehabilitation hospital for 17 days to take part in a training programme of vigorous physical exercise and sport. The daily inhalation-physiotherapy routine was stopped. Ventilatory status was assessed by spirometry and measurement of lung volumes one day before admission, one day after the end of the hospital stay, and 8 weeks later. Flow measurements of forced expiration had improved appreciably by the end of the course, but most of them returned to pretraining levels 8 weeks later. Lung volumes did not change significantly. Daily recordings of peak flow indicated improvement of airways function plus some ventilatory muscle training. Regular physical exercise could replace the inhalation-physiotherapy routine in some children with cystic fibrosis.

Adolescent↗
PubMed1982

[Sympathomimetic drugs in the treatment of childhood asthma].

Sympathomimetic bronchodilators relax bronchial smooth muscle via stimulation of the enzyme adenylcyclase. Furthermore, they stabilize the membrane of the bronchial mast cell. Therefore, they are used in the treatment of acute asthma as well as in long-term prophylaxis. A new generation of beta 2-receptor binding derivates of isoproterenol offers increased therapeutic safety because of a reduced risk of cardiovascular side effects. Three routes of medication are available. Parenteral therapy is reserved for the treatment of acute severe asthma. The oral route can be used for long-term medication in smaller children. Mist therapy offers the advantage of topic medication. Efficient handling of a metered-dose aerosol is beyond the capabilities of small children; these patients get their topic treatment by nebulized solutions. The relevant data of clinical pharmacology are summarized for all forms of medication. Focusing on the role of sympathomimetic drugs, a medication strategy for the treatment of acute asthma as well as for long-term prophylaxis is described.

Administration, Oral↗
PubMed1982

[Theophylline in the treatment of childhood asthma].

Theophylline reduces asthmatic bronchial obstruction; this desired therapeutic action but also the occurrence of unpleasant and dangerous side effects depends directly on its tissue and serum concentration. An effective therapy therefore requires repeated determinations of this serum concentration. Safe dosage is complicated by complex pharmacokinetics such as considerable interindividual differences in distribution space and hepatic clearance. Children eliminate theophylline faster than adults; thus they require larger doses and demonstrate higher fluctuations of their serum levels. Various exo- and endogenous factors can alter the clearance rate and therefore have to be considered. Intravenous infusions of theophylline are the mainstay in the treatment of status asthmaticus. A flow chart of therapeutic actions is presented and supportive intensive care is described. In prophylactic oral therapy slow-release preparations are preferred. Optimal long-term medication is best initiated via stepwise increments of the daily dosage plus one or more final adjustments after the determination of the drug's serum concentration.

Asthma↗
PubMed1981

Croup, recurrent group, allergy, and airways hyper-reactivity.

One hundred and ten children were studied 9 years after each had been in hospital for croup. They were evaluated with a questionnaire, physical examination, allergy skin testing, pulmonary function tests, and a histamine inhalation challenge. Fifty-seven of them had recurrent episodes of croup, and 33 were defined as allergic. The association between allergy and recurrent croup was highly significant. Airways hyper-reactivity was found in 23 of them, and was associated with allergy and recurrent croup. The group of children with a history of recurrent croup could be distinguished from the group with one or two episodes by male predominance, onset of the disease at a younger age, familial predisposition, a significantly greater association with allergy and airways hyper-reactivity, slightly lower expiratory flow rates in pulmonary function tests, and a tendency towards the subsequent development of asthma.

Adolescent↗
PubMed1981

[Simple nebulization of racemic epinephrine in the treatment of acute laryngitis (croup) (author's transl)].

Five infants with acute laryngitis (croup) were treated with nebulized racemic epinephrine. In contrast to previous reports the mist was not delivered by intermittent positive pressure ventilation via a respirator but by simple inhalation via a jet-type nebulizer and face mask. Immediate though only transitory relief of symptoms without any significant alteration of heart rate was achieved by low doses of the diluted drug. Increase in dosage resulted in a moderate elevation of heart rate without improvement in therapeutic action. Inhalations had to be repeated frequently; there were no significant side effects of treatment. Altogether the observed therapeutic actions resembled the reported effects of nebulized epinephrine delivered by intermittent positive pressure ventilation.

Croup↗