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Biomedical subjects

T Foucard

Publications and source records attributed to T Foucard.

At least 55 records · Page 3Linked to original sources
PubMed1986

Defects in polymorphonuclear neutrophil function and susceptibility to infection in children.

Polymorphonuclear neutrophil (PMN) migration, phagocytosis, chemiluminescence production and chemotactic and chemokinetic activities in serum were investigated in 38 infection-prone children, aged 1 month to 15 years, and in healthy controls. The patients were grouped according to the clinical pattern, that is, into children with mainly upper respiratory tract infections, with frequent middle ear infections, with lower respiratory tract infections and with 'multifocal' infections occasionally accompanied by complications, and according to the severity of the infections. Forty-two defects were found in 28 of the 38 patients examined. Good accordance was found between clinical symptoms and abnormal PMN function. Several of the observed abnormalities are most likely inherited and primary causes of the increased susceptibility, but some of them probably occur as a consequence of the infections. The results indicate that defects in oxidative PMN metabolism and defects in Fc-receptor-dependent phagocytosis are major determinants of susceptibility to infection and that such defects seem to be especially common in patients with severe 'multifocal' infections.

Adolescent↗
PubMed1986

Combined treatment with ipratropium bromide and beta-2-adrenoceptor agonists in childhood asthma.

The effect of adding ipratropium bromide to treatment with beta-2-adrenoceptor agonists was studied in 13 asthmatic children in a double-blind cross-over trial. In the acute phase of the study inhalation of salbutamol 0.1 mg/kg followed by inhalation of 0.25 mg of ipratropium bromide was found to improve pulmonary function variables to a significantly greater extent than salbutamol followed by placebo. The combined therapy also provided significantly better protection than salbutamol plus placebo against exercise-induced asthma. Maintenance treatment with ipratropium bromide (two inhalations four times daily, 20 micrograms per inhalation) in combination with oral terbutaline and aerosolized salbutamol did not alleviate asthmatic symptoms or pulmonary function variables to a degree beyond that achieved with the beta-stimulants alone. There were no side effects associated with the ipratropium bromide treatment. These data suggest that higher doses of ipratropium bromide than are presently used should be tested for maintenance treatment of chronic asthma.

Administration, Oral↗
PubMed1985

Diagnosis and immunotherapy of mould allergy. I. Screening for mould allergy.

In order to screen for mould allergy, extracts of five common atmospheric moulds (Cladosporium, Alternaria, Penicillium, Aspergillus and Mucor) from various manufacturers were investigated in 130 patients (5-60 years old) with clinical symptoms indicating possible mould allergy. The patients were screened by skin prick test (SPT) and radioallergosorbent test (RAST). SPT seemed to be more sensitive than RAST as a diagnostic screening procedure (80% positive reactions to one or more species compared to 50%). With a partially purified, standardized preparation of Cladosporium herbarum more positive reactions were obtained than with crude extracts without evidence of any unspecific reactions. The difference between commercial and standardized extracts is most probably a result of a variation of both the biological potency of allergenic determinants and the allergenic composition. A considerable number of negative RAST reactions with standard discs were found in patients with positive skin reactions to partially purified Cladosporium, but RAST seemed to be more sensitive than SPT with the other commercial mould extracts. Based on the screening, a very convincing tendency to IgE-reactivity to other moulds was found in patients reacting to Cladosporium, the most common cause of mould allergy. The results confirm the inadequacy of most mould extracts used in diagnostic procedures and strengthen the value of using standardized extracts.

Adolescent↗
PubMed1985

The wheezy child.

Wheezing in association with viral respiratory tract infections occurs in 10-20% of all infants and young children and usually indicates hyperreactive bronchi. Signs of airway hyperreactivity can usually be demonstrated many years after the child has stopped wheezing. This hyperreactivity is partly constitutional, but it may be further aggravated by viral infections in the respiratory tract. Similarly, allergic inflammation or long-term exposure to airway irritants may also cause or aggravate a state of hyperreactivity which may be expressed as a proneness to asthmatic reactions. As viral infections are among the most potent asthma-provoking factors known, the hyperreactivity does not need to be very pronounced before wheezing develops in the infant or young child, with its small-calibred airway. As long as wheezing only occurs sporadically and only in association with viral respiratory tract infections, the prognosis is usually excellent. However, recommendations regarding avoidance of potent allergens and airway irritants in the daily environment should be given to such families. Such advice is especially important for families with a proneness to atopic reactions or if wheezing begins to occur even during infection-free periods.

Asthma↗
PubMed1985

Subclinical trace element deficiency in children with undue susceptibility to infections.

Serum concentrations of iron, copper, zinc and magnesium and also serum transferrin and ceruloplasmin were investigated in 28 children aged 10 months to 10 years with undue susceptibility to infections. None of the children had any classical immune defect. Seven of them had had frequent upper respiratory tract infections, 16 had suffered from frequent infections of the middle ear and five from mainly lower respiratory tract infections. Thirteen healthy children aged 9 to 18 years residing in the same area served as controls. The children with undue susceptibility to infections had significantly lower mean serum iron (p less than 0.05) and zinc (p less than 0.001) levels than the healthy controls. The mean serum concentrations of copper and magnesium and of transferrin and ceruloplasmin did not differ between the patients and controls. Children with frequent middle ear infections seemed to account for most of the differences in the serum levels of iron and zinc. An inverse correlation was observed between duration of breast feeding and serum concentration of zinc, and between weight as well as height and serum magnesium. The reasons for these changes and the possible role of trace element deficiency as a factor predisposing to or perpetuating undue susceptibility to infections in children are discussed.

Ceruloplasmin↗
PubMed1985

Development of food allergies with special reference to cow's milk allergy.

Using strict criteria, the incidence of cow's milk sensitivity is probably 1% to 2% during the first 2 years of life. Although there is a wide spectrum of sensitivity symptoms caused by cow's milk, two major groups of infants are discernible. One group consists of infants who react to small amounts of cow's milk within a few minutes up to one hour, usually with gastrointestinal symptoms or urticaria. These infants are often atopic and have positive findings on skin prick tests and radioallergosorbent test (RAST) reactions to cow's milk allergens. The other group consists of children whose reaction to cow's milk occurs one hour or longer after intake of cow's milk or cow's milk-based formula. These reactions are usually not immunoglobulin (Ig)E-mediated and different immune and nonimmune mechanisms probably cause the symptoms. The risk of developing cow's milk sensitivity seems to be influenced by the atopic constitution of the infant and the age at which cow's milk is introduced. Early exposure to cow's milk increases the risk, not only of adverse reactions to this milk but also of developing allergies to other foods. It is suggested that early introduction of cow's milk may enhance the risk of future respiratory allergies. Allergists are still not in agreement as to whether the weaning process should be rapid or should consist of a gradual change from breast milk to cow's milk in order to minimize the risk of cow's milk allergy.

Age Factors↗
PubMed1984

Serum-levels of lactoferrin, lysozyme and myeloperoxidase in normal, infection-prone and leukemic children.

Serum levels of lactoferrin, lysozyme and myeloperoxidase have been established in 31 healthy children. On average, serum lactoferrin was 330 micrograms/1, serum lysozyme 1638 micrograms/1 and serum myeloperoxidase 174 micrograms/1. Serum myeloperoxidase was, on average, significantly higher in children than in adults (p = 0.01), whereas serum lactoferrin and serum lysozyme were equal to those of adults. In a group of infection-prone children (n = 31), both serum lactoferrin and serum myeloperoxidase, but not the serum lysozyme levels, were significantly lower (p less than 0.001 and p = 0.002, respectively) than those of the reference children in spite of normal intracellular contents and even somewhat higher peripheral blood polymorphonuclear counts. Based on the assumption that serum lactoferrin and serum myeloperoxidase reflect turnover and activity of neutrophil granulocytes, the findings could suggest reduction in these respects and could be one contributing factor to the high infection propensity of these children. Serum levels of the three proteins have also been measured in 10 children with suspected or various forms of manifest leukemia. It is suggested that the levels reflect turnover and stage of maturation of the myeloid and monocytic cells and could, therefore, aid in the understanding and diagnosis of these diseases.

Adolescent↗
PubMed1984

Dose, plasma concentration, and effect of oral terbutaline in long-term treatment of childhood asthma.

Oral terbutaline in gradually increasing doses from 45 to 166 micrograms/kg three times daily was administered to asthmatic school children. There was a linear relationship between dose and steady-state plasma concentration of terbutaline within patients, but the plasma levels varied fourfold between patients taking similar doses. The consumption of beta 2-stimulants in aerosol form decreased, and the symptom score, peak expiratory flow rate, and FEV1 improved during treatment with a roughly linear dose-effect relationship. Significant increases in pulse rate and skeletal muscle tremor were also measurable. There was no clear correlation between plasma levels of terbutaline and reported side effects. Linear regression analysis revealed a statistically significant relationship between bronchodilatation and the same plasma level was considerable. Determination of the plasma terbutaline concentration therefore seems to be of limited value in clinical practice. Instead, the dose should be individualized on the basis of clinical effect and tolerance. Our data indicate that many young asthmatic children will tolerate and sometimes benefit from higher doses than are generally recommended if they are carefully titrated with stepwise increments.

Administration, Oral↗
PubMed1984

Interferon production in children with undue susceptibility to infections.

The interferon-producing ability of peripheral blood mononuclear leukocytes obtained from children with undue susceptibility to infections was investigated. Patients were grouped according to three clinical patterns, i.e. children with mainly upper respiratory tract infections, with lower respiratory tract infections and with frequent middle ear infections. There was no evidence of impaired mean interferon-alpha responses to the inducers Sendai virus and beta-hemolytic Group G streptococci in patients compared with control children, and there were no differences in this respect between the patient subgroups. A tendency to increased Concanavalin A-induced interferon-gamma production was seen in patients, particularly those with middle ear infections. Leukocytes from patients displayed a higher proliferative response to the T cell mitogens Concanavalin A and Lens culinaris lectin. In a minority of patients (5/28) reproducibly low interferon responses to Sendai virus were found but only one of these patients showed a response below the -2 SD limit for the control group. The results therefore indicate no major defects in the interferon responses of infection-prone children, and at the most suggest that a minority of such patients may be low responders to a viral interferon inducer.

Cells, Cultured↗
PubMed1984

A prospective 12-year follow-up study of children with wheezy bronchitis.

Eighty children with wheezy bronchitis were followed prospectively for 12 years. At the end of the follow-up period only 22 (28%) still had symptoms of asthma. Forty-three children (54%) had ceased to wheeze before the age of 3 years, four children between 3 and 7 years of age and 11 children between 7 and 11 years of age. Of the 22 children who still had asthma, all but one were much improved, although 70% of them noticed asthmatic symptoms during exercise. Heredity for asthma/wheezing, allergy, the occurrence of eczema, and onset of wheezing after 18 months of age were associated with an increased risk of persistent asthma. Allergy had developed in 59% of the children with persistent asthma and in 10% of those who had stopped wheezing. Serum IgE was above the mean +1 SD in 45% and above the mean +2 SD in 24% of the children at the end of the 12-year follow-up. A serum IgE above the mean +2 SD was found in 8 of 13 children with asthma combined with proven allergy, but only in 1 of 9 children with asthma without allergy. Surprisingly, 8 of 48 children who had stopped wheezing and had no clinical allergy had as high IgE levels as the children with asthma and allergy, which reduced the allergy predictive value of a high serum IgE to 36%. Some of these high IgE levels seemed to be a family trait.

Asthma↗
PubMed1984

Hypoparathyroidism and liver disease--evidence for a vitamin D hydroxylation defect. A case report.

The case history of a 4 year old girl with primary hypoparathyroidism is reported. Treatment with oral 1 alpha-hydroxyvitamin D3 did not result in normal calcium and phosphate levels, whereas treatment with oral 1 alpha,25-dihydroxyvitamin D3 did. During the treatment period, the patient developed signs of severe liver disease and died in a picture of increased intracranial pressure. Post-mortem examination revealed a giant cell hepatitis and severe cirrhosis. The clinical course is consistent with a liver vitamin D3 hydroxylation defect.

Calcitriol↗
PubMed1984

Oral terbutaline in chronic childhood asthma; effects related to plasma concentrations.

Nine children, 10-15 years old with chronic asthma, were treated for weekly periods with gradually increasing doses of oral terbutaline sulphate: 45, 79, 118 and 166 micrograms/kg (mean values) 3 times daily. There was a linear relationship between dose and steady-state plasma concentration of terbutaline within patients, but the plasma levels varied 3-fold between patients taking similar doses. Symptom score, peak expiratory flow rate (PEFR) and volume of air expelled in the first second of forced expiration (FEV1) improved with increasing doses, and the need for inhalation therapy decreased. An increase in pulse rate and tremor was measurable at all dose levels, but reported side-effects were few and mild. Linear regression analysis showed a statistically significant relationship between the plasma concentration of terbutaline and the effect on FEV1 (p less than 0.01) and PEFR (p less than 0.05) within patients.

Asthma↗
PubMed1983

Allergy to apple, carrot and potato in children with birch pollen allergy.

Skin sensitivity to apple, carrot and potato, clinically related to birch pollinosis was investigated. Different skin test techniques using fresh fruit were compared. A simple prick test (SPT) technique with a lancet piercing the apple peel just before pricking the skin was shown to be the most practical and to give reproducible results. The allergenic activity in apple was found to be heat labile and deteriorated during storage at room temperature. Apple, carrot, potato, hazelnut and birch reactivity was transferable in Prausnitz-Küstner test like IgE antibodies. SPT reactivity to fresh material from apple, carrot and potato was investigated in 174 children of whom 128 suffered from pollen allergy. Positive SPT results were obtained almost exclusively in children who were SPT positive to a birch pollen extract. Children who noticed clinical symptoms when eating apple, raw carrot or potato were found to have a significantly larger SPT reaction than children with a negative history.

Adolescent↗
PubMed1981

Combined treatment with sustained-release theophylline and beta2-adrenoceptor-stimulating agents in chronic childhood asthma.

The effect of adding theophylline to treatment with a beta2-adrenoceptor stimulant was studied in 18 asthmatic children in a double-blind cross-over trial. Most patients were taking cromolyn sodium (cromoglycic acid) or beclomethasone aerosol, or both. A sustained-release preparation of theophylline was administered in individually titrated doses, producing a mean plasma theophylline concentration of about 8 micrograms/ml. Statistically significant improvements were found during the theophylline treatment in symptom score, consumption of beta2 stimulants in aerosol form, and morning peak expiratory flow rate and forced expiratory volume in one second. There was also a reduced need for emergency-room treatment during the theophylline period. Reported side effects were few and mild and were similar during the theophylline and placebo periods. Of the 17 patients who completed the trial, 14 preferred theophylline and three expressed no preference between theophylline and placebo. Adding submaximal doses of sustained-release theophylline to treatment with a beta2 stimulant gave further relief of asthmatic symptoms without appreciable side effects, suggesting that the drug combination has a favourable therapeutic index.

Adolescent↗