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Biomedical subjects

F M de Benedictis

Publications and source records attributed to F M de Benedictis.

25 records · Page 2Linked to original sources

The progressive nature of childhood asthma.

Asthma is the most common chronic disease in childhood. It has been repeatedly stated that childhood asthma is a self-limiting disorder, but this is a misleading and often inaccurate generalization. Prospective studies have demonstrated that many patients who had seemingly outgrown their disease experienced symptoms again as they grew older. In addition, recent evidence suggests that, despite the lack of clinical manifestation of asthma, there is a persistence of bronchial hyperreactivity for several years. A number of epidemiologic studies have identified factors that seem to be associated with the persistence of asthma into later childhood or adult life. Information about the effects of treatment of asthma on the natural history of the disease is vital. While treatment greatly reduces the morbidity from asthma, it is not known whether early recognition and aggressive treatment of the disease have any influence on the outcome of the disease later in life.

Adolescent↗

Viral and Mycoplasma pneumoniae pneumonias in school-age children: three-year follow-up of respiratory function.

We studied the evolution of respiratory function during and for 3 years after the acute onset of viral and Mycoplasma pneumoniae pneumonias in 13 school-age children. A mixed type transient ventilatory defect (restrictive and obstructive, but mainly restrictive) with large and small airway involvement was observed during the acute phase of the pneumonias. Residual small airway involvement was found over the next 12 months, but no pulmonary function abnormalities were present after 3 years. At that time, one of the 13 subjects displayed bronchial hyperreactivity to distilled water mist challenge. The authors concluded that viral and Mycoplasma pneumoniae pneumonia in previously healthy school-age children does not cause impaired lung function in later childhood.

Adenovirus Infections, Human↗

Biodegradability of inhaled organic particles in patients with chronic bronchitis.

2 h after the inhalation of monodispersed 99mTc-labeled autologous spherocytes and of commercial human albumin microspheres (HAM), 7 patients with chronic bronchitis underwent bronchofibroscopy. The fate of organic particles along the tracheobronchial tree was verified by scanning electron microscopy and the proteolytic activity (trypsin and PZ peptidase) in mucus samples was assessed. Significant proteolytic activity was detected in bronchial secretions. Thereafter in vitro digestion of labeled spherocytes and HAM was verified after exposure to increasing concentrations of trypsin. While in vitro a similar time-course of tryptic digestion of both particles was observed, in vivo spherocytes seem to be less vulnerable to enzymatic digestion. These findings add another unexpected variable, which may influence the reproducibility of radioaerosol lung mucociliary clearance measurements, and improve its standardization.

Aerosols↗

Methacholine inhalational challenge in the evaluation of chronic cough in children.

The medical records of 58 children (age range, 7 to 16 years) who presented with chronic cough were retrospectively analyzed to determine the value of methacholine (MCH) bronchial challenge in reaching a specific diagnosis. Baseline lung function tests were normal in all subjects, apart from an elevated residual volume/total lung capacity ratio (RV/TLC) in 11 patients, and a reduced midexpiratory flow rate (FEF25-75) in five of these patients. Thirty-one patients had a positive response to MCH, but these patients could not be identified on the basis of clinical criteria or spirometric parameters. MCH-positive patients did have a significantly higher RV/TLC than did MCH-negative patients. Twenty-seven of the 31 MCH-positive patients responded to a trial of bronchodilator therapy (albuterol/theophylline), confirming the diagnosis of cough variant asthma in these patients. We conclude that children with chronic cough should be considered for methacholine challenge in order to identify patients who are likely to benefit from specific bronchodilator therapy.

Adolescent↗

Circadian rhythms of respiratory functions in asthmatics.

35 subjects underwent pulmonary function tests, plasma cortisol and urinary catecholamine measurements at 4-hour intervals, during a period of 24 h. In healthy subjects a circadian variation was not demonstrated. In asthmatic subjects circadian variation of a large number of ventilatory variables and a normal circadian pattern for plasma cortisol were demonstrated. Asthmatic patients were divided into two groups: patients with intrinsic asthma and patients with extrinsic asthma. The former showed the most impressive circadian pattern; the most severe bronchospasm occurred between 12.00 and 00.00 h; patients with extrinsic asthma, older than 20 years became worse around 03.00 h. During this period their urinary catecholamines reached the lowest values. The younger patients with extrinsic asthma presented the highest TGV values at 12.50 h. From the clinical viewpoint, it is emphasized that chronobiologic criteria could be utilized for the chronotherapeutic management of asthmatics.

Adolescent↗