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Biomedical subjects

Peter P Van Asperen

Publications and source records attributed to Peter P Van Asperen.

7 recordsLinked to original sources
PubMed2006

Cough in children: definitions and clinical evaluation.

The aetiology and management approach for cough in children differs greatly to that in adults, so the empirical approach commonly used in adults is unsuitable for children. Clinical evaluation of cough in children should include an assessment of environmental factors, particularly tobacco smoke, parental concerns and expectations. Most children with acute cough are likely to have an uncomplicated viral acute respiratory tract infection, but the possibility of a more serious problem, especially aspiration of foreign material, should always be considered. Isolated chronic cough in children is rarely asthma, and the term "cough variant asthma" should not be used. Over-the-counter and prescription medications are ineffective for the symptomatic relief of acute cough. Treatment for chronic cough should be based on aetiology. Because of the favourable natural history of cough, a "positive" response in medication trials should not be assumed to be due to the medication. Children should be reassessed within the expected timeframe of response to therapy.

Acute Disease↗
PubMed2003

Muscle function and resting energy expenditure in female athletes with cystic fibrosis.

The pathophysiology of impaired exercise tolerance in patients with cystic fibrosis (CF) is not completely understood. The objective of this study was to compare exercise ability (at clinical and cellular levels) and resting energy expenditure in female athletes with CF compared with matched control subjects. Sixteen subjects and matched control subjects participated in the study. The girls with CF not only had a significantly greater resting energy expenditure (7.6% higher; p<0.05), their habitual daily activity was also significantly greater than that of control subjects (15% greater; p<0.01). Peak aerobic capacity was similar in both groups. However, peak anaerobic power was 20% less (p<0.05) in girls with CF. The 31P magnetic resonance spectroscopy studies demonstrated that there were no differences between the groups at rest, but at 25% total work output the girls with CF were less acidotic (CF, pH 6.99 [0.06]; control subjects, 6.90 [0.05]) and had a significantly lower inorganic phosphorus-to-phosphocreatine ratio (CF, 0.34 [0.07]; control subjects, 0.41 [0.08]). These differences continued to increase to maximal exercise. This study demonstrates that in spite of normal lung function and good nutritional status, females athletes with CF still had significant deficiencies in some measures of fitness and muscle metabolism compared with healthy athletes.

Adolescent↗
PubMed2003

Validation of shuttle tests in children with cystic fibrosis.

Shuttle tests are simple, inexpensive field tests that have been used to estimate the cardiorespiratory status of children. It has yet to be validated in children with CF. The aim of this study was to assess the reproducibility and criterion validity of shuttle tests in children with cystic fibrosis (CF). Ninety-three CF patients aged 6 to 16 years of age with a wide range of disease severity performed the study. The 10-m shuttle test was used for children 7 years of age and younger and those deemed too chronically ill by their physicians to perform the longer test (n = 35.) All other children performed the 20-m shuttle test (n = 58). Reproducibility and criterion validity were assessed for each child over a two week period. Gas analysis was performed throughout testing using a polargraphic gas analyzer. The 10-m shuttle tests were reproducible (mean difference between tests VO(2) 2.41 mL/kg/min, CI 3.46,-0.18) and the difference from treadmill testing was not statistically significant (mean difference VO(2) 5.30 mL/kg/min, CI-7.46, 1.18). The 20-m shuttle tests were reproducible (mean difference between tests VO(2) 2.07 mL/kg/min, CI-3.90,0.60) and the difference from treadmill testing was not statistically significant (mean difference VO(2) 3.50 mL/kg/min, CI-4.90, 1.60). We conclude that when formal exercise testing with treadmill or cycle ergometer cannot be performed, the shuttle tests provide a reproducible and valid alternative.

Adolescent↗
PubMed2002

Current drug therapies: relievers and preventers.

What we know: The different wheezing phenotypes in early childhood may influence the response to therapy. beta-Agonists are effective in acute asthma from the first year of life and anticholinergics have been shown to provide additional benefit from at least 18 months of age. Non-steroidal preventer medications provide some benefit in early childhood asthma, but response is variable and dependent on severity. Inhaled corticosteroids are the most effective preventer medication in children with persistent asthma, but have not been shown to be effective in children with episodic viral wheeze. There is no convincing evidence to suggest that inhaled corticosteroids influence long-term outcome in childhood asthma. What we need to know: Can we distinguish different wheezing phenotypes at presentation (using clinical features or other markers of airway inflammation or airway hyperresponsiveness) in order to target therapy? What are the relative benefits of reliever and preventer medications in treating different wheezing phenotypes, and do all wheezing phenotypes require treatment? What is the dose-response curve for inhaled corticosteroids in infants and young children with asthma? Are infants and young children more susceptible than older children to growth suppression or other side effects from inhaled corticosteroids? Can early treatment with inhaled corticosteroids or non-steroidal medications influence long-term outcome in terms of asthma development and/or loss of lung function?

Administration, Inhalation↗
PubMed2002

The relationship between genotype and exercise tolerance in children with cystic fibrosis.

The relationship between fitness and genotype in children with cystic fibrosis (CF) and at least one copy of the DeltaF508 mutation was examined. Genotype was classified according to the second CF mutation. Fitness was measured by peak aerobic capacity (using a modified Bruce protocol during treadmill exercise) and anaerobic power (using the Wingate test on a cycle ergometer). The class of cystic fibrosis transmembrane regulator proteins (CFTR) mutation was statistically related with aerobic capacity, peak anaerobic power, body mass index, lung function (forced expiratory volume in one second), and disease severity as measured by the Shwachman score. Patients with mutations causing defective CFTR production (Class I) or processing (Class II) had a significantly lower peak aerobic capacity (28.6 +/- 4.2 ml/kg/min and 31.7 +/- 5.4 ml/kg/min, respectively) than those with a mutation conferring defective regulation of CFTR (Class III) (43.9 +/- 6.4 ml/kg/min). The peak anaerobic power in subjects with mutations inducing decreased CFTR conduction (Class IV) or CFTR mRNA (Class V), were significantly higher (11.4 +/- 1.7 and 11.6 +/- 1.5 watts/kg, respectively) than children with Class I (9.7 +/- 1.4 watts/kg), Class II (9.8 +/- 1.4 watts/kg), or Class III (10.5 +/- 1.8 watts/kg) mutations. There were no statistically significant differences in the lung function of patients with the different mutations. These results indicate a relationship between CF genotype and some measures of fitness, the mechanisms of which remain to be determined.

Adolescent↗