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Biomedical subjects

P Scheinmann

Publications and source records attributed to P Scheinmann.

At least 127 records · Page 7Linked to original sources
PubMed1991

[Mucoviscidosis and allergic bronchopulmonary aspergillosis].

Allergic bronchopulmonary aspergillosis (ABPA) is a severe disease inducing bronchopulmonary anatomic lesions which complicate those already present in patients with cystic fibrosis. The frequency of this association is estimated between 0.6 and 10% according to American studies. Diagnosis of ABPA is difficult, as findings such as sibilant rales, pulmonary infiltrates, bronchiectasies, anti-aspergillus precipitins may be present as single features in patients with cystic fibrosis. Thus it is important to ascertain the diagnosis as oral corticosteroid treatment is the only one able to prevent evolution towards bronchiectasies and pulmonary fibrosis.

Adolescent↗
PubMed1990

Blood histamine levels in HIV-1-infected infants and children.

Blood histamine levels (BHL; ng histamine base/ml blood, mean +/- SEM) were determined in 118 infants born to HIV-1-infected mothers and in children infected after blood transfusion. In asymptomatic infected infants, BHL were not significantly different from HIV-1-negative infants born to HIV-infected mothers (54.1 +/- 5.6 vs. 56.4 +/- 3.5). BHL progressively decreased in the group with polyadenopathies (40.0 +/- 4.0), in the group with AIDS-related complex (28.8 +/- 2.9), and in patients with AIDS (20.4 +/- 0.9). The decrease in BHL was associated with a decrease in blood basophil number.

Child↗
PubMed1990

[Accelerated desensitization with Dermatophagoides pteronyssinus in severe asthmatic children. Evaluation after one year of immunotherapy].

An homogeneous group of 17 children with severe chronic asthma were given a rush immunotherapy with standardized Dermatophagoides pteronyssinus extracts. Maintenance dose was injected monthly for one year. Symptom and medication scores as well as functional (lung function tests, specific nasal challenges), immunologic and allergic parameters (skin tests, total serum IgE, specific IgE and IgG4) were recorded before and at the end of the study. Rush immunotherapy was well tolerated in spite of some moderate systemic adverse reactions. Symptom and medication scores improved in 10 children. Nasal and skin sensitivity decreased in respectively 3 and 7 children. However there was no correlation between the improvement of quality of life and laboratory results. This study shows that specific immunotherapy is possible in children with severe asthma. Its efficacy should be assessed by symptom and medication scores.

Acari↗
PubMed1990

[Diagnostic approach of pleural effusion in children. Report of 59 cases].

The retrospective analysis of 59 pediatric cases of pleural effusion showed that infectious agents account for 80% of cases. Thoracentesis proved to be the first-line diagnostic tool. Pleural biopsy was diagnostic in four tuberculous and two malignant pleural effusions. The literature data shows that pleural fluid total protein, lactate deshydrogenase, glucose, pH, white blood cell count and differential should be obtained in all patients. Because of the high incidence of infection, microbiologic studies are also indicated in children. These studies are of great value in distinguishing transudates from exsudates and in deciding on pleural drainage.

Adolescent↗
PubMed1990

[Glucocorticoids in asthmatic crisis in children].

Systemic corticosteroids are misused in children with acute asthma. Their misuse is one of the factors responsible for the recent increase in asthma mortality. Since 1980, 10 of 12 double blind randomized clinical trials have shown the beneficial effects of corticosteroids in acute asthma incompletely responsive to bronchodilatators. The value of early course-high dose-short term corticosteroid therapy is emphasized. The side effects of such short corticosteroid courses are minimal and transient. Management of asthma should be reconsidered if steroid courses are too frequent.

Asthma↗
PubMed1990

[Practical diagnostic approach to anomalies of the aortic arch. Apropos of 31 pediatric cases].

This analysis of 31 cases of anomalies of the aortic arch has confirmed the predominance of subclavian retro-oesophageal arteries and double aortic arches (74% of cases). The age at which the first clinical signs presented was less than one year in 75% of cases. Respiratory signs predominated with recurrent bronchitis (16 cases) and bronchial congestion (9 cases). These signs were not specific for the type of aetiology and were characterised by their chronicity and recurrent nature. Inspiratory and expiratory stridor was found on 8 occasions and was very suggestive of the diagnosis. There was a frequent association of asthma and anomalies of the aortic arch in this series (13 cases) with 6 cases of atopic asthma in early childhood and 7 cases of asthma in infancy. The oesophago-gastroduodenal transit was the key diagnosis which enabled the vascular anomaly to be confirmed. There was, however, a failure on 5 occasions with 2 false negatives and 3 cases where the wrong type was suspected. Fibreoptic bronchoscopy enabled the topography to be established more precisely including the degree of compression (in 14 cases) and showed evidence of associated tracheomalacia in 7 cases. Nuclear magnetic resonance was very helpful, giving a better definition of the anatomical type and of the relationship of the vascular arch with the oesophago-tracheal axis. Broncho-fibroscopy and nuclear magnetic resonance make strong contributions towards the indications for operation.

Adolescent↗
PubMed1990

[Consensus conference. The management of asthma in children].

At this international consensus conference, a number of conclusions concerning the diagnosis and management of childhood asthma were reached. The following practical definition was given to asthma: intermittent wheezing and/or cough in a clinical situation where asthma is likely and less common diseases have been outruled. A thorough clinical history is essential to the diagnosis of asthma. Additional tests are used only to confirm the clinical impression and to provide objective evidence supporting therapeutic recommendations. Multidisciplinary management includes an evaluation of psychosocial factors and patient information. Drugs should be selected according to the severity of the condition: beta-2-agonists for intermittent mild wheezing; cromolyn sodium for moderate to severe asthma; xanthines, ipratropium bromide, and oral corticosteroids in more persistent and severe forms. The child and parents should be told that a normal, physically active life is quite possible if the disease is correctly controlled. The reward for correct management of asthma is resumption, in nearly every case, of a normal life including active participation in sports.

Adolescent↗
PubMed1990

[Allergy to latex gloves. A cause of surgical shock].

Latex induced anaphylaxis was observed in 2 children during surgical procedures. Anaphylaxis was due to exposure to surgical latex gloves. The diagnosis should be suspected in patients with a previous history of rubber induced urticaria and is confirmed by positive skin tests to latex. In patients presenting with allergy to latex, prophylaxis is based on the use or surgical gloves made of vinyl or neoprene.

Child↗
PubMed1989

Hymenoptera venom immunotherapy. I. Induction of T cell-mediated immunity by honeybee venom immunotherapy: relationships with specific antibody responses.

The specific cell-mediated and humoral immune responses of 14 children allergic to honeybee venom were studied. An 8-day rush venom immunotherapy induced an increase in T proliferative (p less than 0.04) and T suppressive (p less than 0.003) cell-specific activities. Antibody variations, an increase in specific IgG4 (p not equal to 0.05), and a decrease in specific IgE (p less than 0.01) were observed 1 year later. Initial high T suppressive cell activity prevents T proliferative cell increase during rush venom immunotherapy. High initial levels of specific IgG1 and specific IgG4 have opposing effects on the increase in T suppressive cell activity, the former being positively correlated with intensive increase (r = 0.840; p less than 0.005), the latter negatively with T suppressive cell increase (r = -0.709; p less than 0.001). These data indicate that there are interrelationships between the cell-mediated immunity and the antibody responses in honeybee allergy.

Adolescent↗
PubMed1989

Hymenoptera venom immunotherapy. II. T proliferative and T suppressive activities induced by Vespula immunotherapy: effects on long-term antibody responses.

Thirty-five children who had exhibited major clinical reactions to yellow jacket stings were desensitized during an 8-day rush immunotherapy (RIT). Maintenance treatment was continued for at least 1 year in all cases and for 2 years in 21 cases. Blood samples, obtained before, during, and after RIT, were analyzed for specific T proliferative (TP) and T suppressive (TS) cell activities and for specific IgE, IgG1, and IgG4 levels. TS and TP cell activities increased during RIT (p less than 0.001) and remained elevated throughout the 2-year follow-up. There were transient rises in specific IgG1 and IgE during RIT, but the levels of both decreased thereafter. Specific IgG4 increased throughout the follow-up period. The data indicate that the levels of specific IgE and specific IgG1 were correlated with TP cell responses (inducers) and TS cells responses (suppressors) and therefore might be controlled by them; data also suggest that TS cell responses should play a role in the IgG4 response. These changes in TS and TP cell responses and antibody responses have been incorporated into a model of antibody-response regulation by cell-mediated immunity in this type of allergy.

Adolescent↗
PubMed1989

Comparison between number of basophils, blood histamine, and histamine release in cancer and noncancer patients.

In cancer patients with primary tumor with or without metastasis or metastasis alone, by comparison with healthy subjects and noncancer patients, the decrease in blood histamine levels is due to a decrease in total basophil number. These basophils have a normal content of histamine (1 to 2 pg per basophil) and are able to release histamine. The percentage of anti IgE-induced histamine release is not significantly different than in noncancer patients. The scarcity of basophils in cancer patients is not due to a leukopenia. Blood histamine levels and total basophil number are normal in patients after successful excision of their primary tumor without metastasis.

Adult↗
PubMed1989

Congenital ciliary aplasia in two siblings. A primitive disregulation of ciliogenesis?

Congenital ciliary aplasia was demonstrated in two siblings with clinical history of primary ciliary dyskinesia. Ultrastructural histochemistry of successive bronchial biopsies revealed the predominance of immature mucous cells and the total absence of ciliated or preciliated cells in the respiratory epithelium. This original disorder may represent a unique variant of primary ciliary dyskinesia with primitive disregulation of ciliogenesis.

Biopsy↗
PubMed1989

Bronchoalveolar lavage in HIV infected patients with interstitial pneumonitis.

The value of taking microbiological and cytological specimens by flexible bronchoscopy and bronchoalveolar lavage under local anaesthesia was assessed on 43 occasions in 35 HIV infected children, aged 3 months to 16 years, with interstitial pneumonitis. In acute interstitial pneumonitis (n = 22, 26 specimens from bronchoalveolar lavages) the microbiological yield was 73%, Pneumocystis carinii being the commonest infective agent (n = 14). P carinii pneumonia was found only in children with deficient antigen induced lymphocyte proliferative responses who had not been treated with long term prophylactic co-trimoxazole. In contrast, in 13 children with chronic interstitial pneumonitis that was consistent with a diagnosis of pulmonary lymphoid hyperplasia who underwent bronchoalveolar lavage on 17 occasions, there were two isolates of cytomegalovirus and one of adenovirus, but P carinii was not found. Ten of the 13 children had normal antigen induced lymphocyte proliferative responses. Useful cytological data were also gleaned from bronchoalveolar lavage specimens. Lymphocytosis was significantly higher in pulmonary lymphoid hyperplasia (36(SD 11)%) than in P carinii pneumonia (24(19)%) whereas the percentage of polymorphonuclear neutrophils was significantly lower (3(2)% compared with 12(13)%). Flexible bronchoscopy with bronchoalveolar lavage is safe even in young infants and should reduce the necessity for open lung biopsy in the management of HIV infected children with interstitial pneumonitis.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Beta 2 adrenergic and synthetic atropine drugs as inhalants in asthma in children].

Inhaled medication is a well-known treatment for asthma in childhood, because it is rapidly effective, in low doses, and without resultant side effects. The usual methods of aerosol formation are nebulization, metered-dose inhaler and spacers. We have reviewed the standard devices available and their use with sympathomimetic agents and synthetic atropines.

Administration, Inhalation↗
PubMed1989

[Anaphylaxis syndrome induced by exercise].

The authors report the case of a 12 year-old boy with exercise-induced anaphylaxis. Angioedema was the main symptom and was accentuated by ingestion of an orange prior to exercise. Exercise-induced anaphylaxis is due to mast cell degranulation that is triggered by exercise alone or, less commonly, by the combination of a sensitizing food and exercise. The symptoms of exercise-induced anaphylaxis may be moderate or severe, with laryngeal dyspnea and shock. Prevention is based on avoidance of the offending food before exercise and a reduction of the intensity (and even the suppression) of exertion.

Anaphylaxis↗