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Biomedical subjects

C M Mellis

Publications and source records attributed to C M Mellis.

78 records · Page 5Linked to original sources
PubMed1978

The response to exercise in normal and asthmatic children.

Twenty-five normal and 105 asthmatic children were exercised on a treadmill. Pulmonary function was assessed before and after exercise. The maximum fall from the resting value in normal subjects depended on the test used: PEFR 12.5%; FEV1 10%; MMEF 26%; V50 30%; V25 33%. Using these criteria, PEFR and FEV1 detected 99% of those asthmatic children who had a positive exercise response. The largest fall from the resting value was seen with the MMEF, but this test detected only 70% of the positive responders. The pre-exercise function did not affect the severity of the response but did have an effect on the incidence of exercise-induced bronchospasm.

Adolescent↗
PubMed1978

Comparative study of histamine and exercise challenges in asthmatic children.

Fifty asthmatic children were tested with both a standardized treadmill exercise and a histamine inhalation on 2 separate days. Ninety per cent had a positive response to histamine, whereas 74 per cent had demonstrable exercise-induced bronchoconstriction. There was a close relationship between responsiveness to histamine and exercise, because all patients who responded to histamine had exercise-induced bronchoconstriction. Eight children (16 per cent) responded to histamine only. Although prechallenge pulmonary function has an effect on the incidence of exercise-induced bronchoconstriction, it does not appear to influence the responsiveness to histamine. Therefore, when provocation testing is being done for the purpose of diagnosing asthma, histamine is preferable to exercise.

Adolescent↗
PubMed1978

Bronchial reactivity in cystic fibrosis.

There is considerable dispute regarding the prevalence of asthma in patients with cystic fibrosis (CF). We studied 50 patients with CF and compared their responsiveness to inhaled histamine with that of asthmatic children. The incidence of positive responses to inhaled histamine was 24% in the patients with CF and more than 90% in the asthmatic patients. We found no correlation, in the patients with CF, between the histamine response and several indexes of atopy (clinical allergic disease and positive allergen skin tests). Positive responders to histamine were not evenly distributed over the disease spectrum of CF. Instead, positive responses occurred only in those patients whose prechallenge pulmonary function was abnormal. We conclude that the heightened bronchial reactivity in patients with CF reflects the severity of their underlying lung disease rather than the presence of coexistent asthma.

Adolescent↗
PubMed1977

Asthma deaths in children--a continuing problem.

The clinical and pathological features of five children who died of asthma over a recent 12-month period are reported. All had severe, chronic asthma requiring maintenance corticosteroid therapy. Three had been receiving beclomethasone dipropionate by inhalation and these had acute inflammation of the tracheobronchial tree at necropsy. Adrenal atrophy was found in all four cases examined histologically, despite normal short tetracosactrin tests in three of these shortly before they died. The need for high-dose corticosteroid by mouth for exacerbations of asthma in those weaned from oral steroids is emphasized by these deaths. The introduction of beclomethasone dipropionate by inhalation has led to an increase in the number of children in this high-risk group.

Adolescent↗
PubMed1976

Beclomethasone dipropionate aerosol for asthmatic children requiring maintenance oral steroid therapy.

A single-blind crossover trial comparing beclomethasone dipropionate by inhalation with prednisolone by mouth in the treatment of asthmatic children over a period of 10 months is reported. Fourteen children aged between nine and 16 years entered the trial. All had severe chronic asthma requiring maintenance oral prednisolone therapy in doses ranging from 2 to 7-5 mg/day. Beclomethasone dipropionate given by inhalation in a dose of 400 mug/day was found to be a satisfactory alternative to prednisolone by mouth for controlling the symptoms of asthma. During the course of this trial, three of the children died suddenly during acute exacerbations of asthma. All three had evidence of extensive inflammation of the tracheobronchial tree.

Adolescent↗