Biomedical subjects
G Mezei
Publications and source records attributed to G Mezei.
Nasal immunotherapy in pollen-sensitive children.
UNLABELLED: Subcutaneous specific immunotherapy has a considerable risk of side effects, including severe life-threatening ones or even death. The disadvantages and problems of this kind of therapy gave rise to looking for new ways of hyposensitization. In allergic rhinitis the local (nasal) immunotherapy may be effective. We studied the efficacy of local nasal immunotherapy (Allerkin) in grass and ragweed allergic children suffering from seasonal atopic rhinitis. PATIENTS: 36 children (12 with grass pollen, 12 with ragweed pollen immunotherapy, 12 controls). METHODS: nasal provocation tests with increasing doses of Allerkin, skin prick test, diary cards. Schedule of the investigations: enrollment of the patients and nasal provocation tests; grass pollen and ragweed pollen preseasonal immunotherapy with increasing doses of Allerkin; during pollen season registration by symptoms and drug consumption; after the season nasal provocation tests. RESULTS: grass immunotherapy: nasal provocation threshold increased (P < 0.01), symptoms became fewer (P < 0.01) and drug consumption was less in the active group compared to control. Similar but less expressed tendencies were seen in the ragweed group. After the second year of immunotherapy the need for steroid treatment was significantly (P < 0.05) fewer in the immunotherapy group than in the control group. No side effects appeared during the course of immunotherapy, but some patients suffered from mild sneezing or nasal discharge after the Allerkin application. CONCLUSION: local (nasal) immunotherapy is an effective, safe and not troublesome alternative to systemic immunotherapy.
[Seasonal allergic rhinitis and pollen count (a 5-year survey in Budapest)].
The authors compared the seasonal symptoms and the pollen allergen spectrum of pollen allergy with the 5-year aeropalynological data in Budapest. They summarized the average of symptom scores based on the diaries of 105 pollen allergic patients (mainly children) suffering from seasonal allergic rhinoconjunctivitis. The pollen allergen spectrum of the patients was defined. They constructed a local pollen calendar on the basis of the first regular pollen counting in Budapest, which had been done by them for 5 years. The symptom scores grew parallel with the increasing number of grass and ragweed pollen. Tree pollen allergy was found in 7.6 per cent of the patients. In spite of the high number of three pollen in the air in March and April the patients did not have too many complaints according to their symptom scores. Grass pollen allergy was found in 67.6 per cent of the patients and in the grass pollen season (May-July) the characteristic clinical symptoms were expressed. Weeds (in 64.8 per cent of the patients), especially ragweed (in 59.0 per cent of the patients) caused the most significant complaints in the late summer--autumn (August, September and partly October) period. Ragweed and other weeds play an important role in the etiology of seasonal allergic diseases in Hungary. The authors call the attention to the necessity of measures taken against the spread of ragweed.
[Effect of a mite-killing agent on house dust and on symptoms of house dust allergy].
UNLABELLED: The efficacy of acaricid benzyl-benzoate (Acarosan) has been followed in an open study for one year in patients with house dust mite allergy; the clinical signs and the mite allergen level have been considered. METHODS: the furniture (beds, upholstered pieces, carpets) of 17 house dust mite allergic patients suffering from bronchial asthma and/or allergic rhinitis has been investigated. The mite content of the dust gained from the furniture has been determined with the help of the semiquantitative Acarex test. This test has been done before the mite elimination and 3, 6, 9 and 12 months after it. The registered clinical signs of the patients: symptoms, drug consumption, expiratory peak flow values have been measured twice a day. RESULTS: 9/17 beds have become free from mites, 6/17 beds have had less mites than before, 1/17 no change, 1/17 augmentation of mite content. The proportion of days free from complaints has been 26.8% at the beginning of the trial and 47.1% after 12 months, the drug consumption has diminished meanwhile. At the beginning of the trial 6 children had pathologic lability index based on peak-flow measurements, they improved significantly. The information about the mite content of the furniture gives help for the elimination measures. The chemical mite elimination reduces the mite content of the flat and results in clinical improvement of house dust mite allergic patients.
Prognostic data of the second follow-up in childhood wheezy bronchitis.
206 non-selected children who had wheezy bronchitis before two years of age were observed in the first follow-up (1985) about 9 years after their clinical wheezy episode. Among them 31 patients (15%) showed bronchial hyperreactivity (B.H.) after acetylcholine challenge and 9 children became asthmatic. In the second follow-up (1988) 28 children who had B.H. and randomly 17 children who did not have B.H. participated. The prognosis of wheezy bronchitis is good, there was no new asthmatic child at this time. The B.H. was found to diminish only in 7 cases. During the last 3 years wheezy episodes developed only in 5 asthmatic patients. The skin prick test (SPT) positivity did not change (26% versus 29%). The familial atopy in the group B.H. is higher (43%) than in the group non B.H. (23%) but the difference is not significant (X2 = 1.72). No significant correlation was found between the familial atopy and SPT positivity. The familial smoking is higher in the group B.H. (78% versus 64%) but no significant influence on the B.H. (X2 = 1.03) could be detected.
Effect of parental smoking on wheezy bronchitis and bronchial hyperreactivity.
In the course of the follow-up of 206 previously obstructive bronchitis children, the effect of parental smoking upon the occurrence of respiratory diseases, the yearly frequency of wheezing episodes and the age until the obstructive episodes used to return have been investigated. Familial and maternal smoking was more frequent in this group compared to the control group. In spite of this, however, no correlation could be detected between familial smoking and frequency of respiratory diseases, as well as the above mentioned characteristics of obstructive bronchitis. The familial smoking did not seem to influence the bronchial hyperreactivity challenged with acetylcholine, although the prevalence was higher.
[Incidence of obstructive respiratory diseases in 1839-1850 at the Hospital for Poor Children in Pest].
According to the observations of several authors the number of obstructive respiratory diseases kept rising during the past decades, at the same time this disease was infrequent in the last century as indicated by the sporadically detectable data pertinent to adult patients. The 1st Pediatric Department of the Semmelweis University of Medicine, legal successor of the Poor-Children's Hospital of Pest is in possession of the complete case reports of 5050 out-patients of the period between 1839-1850. It can be established on the basis of these records that the diseases of the lower respiratory tract were frequent. Approximately 7 disease forms were distinguished with 323 children who suffered from bronchopathies. Of them only 13 (0.26% of the total patient material) were spasmodic bronchitis. Agoston Schopf, director of the hospital wrote at this period his book on Pediatrc. This work as well as the preparatory material of further tomes show clearly that the doctors of the hospital were well acquainted with the method of physical diagnostics and were capable to diagnose obstructive respiratory diseases. These case records are assumably the only pediatric patient material of this period not only in Hungary but also in Europe. Data confirm that obstructive respiratory diseases were infrequent at this period in children.
[Clinical and pathological features of mixed odontogenic tumors (ameloblastic fibroma and ameloblastic fibro-odontoma)].
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[Relation between hay fever and asthma].
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[Clinical considerations on exercise-induced bronchoconstriction].
With 378 children suffering from asthma authors performed three types of physical exercises. The correlation between the exercise induced bronchospasm and the clinical symptoms of asthmatics, first of all the severity of asthma, has been investigated. No significant correlation was found between the EIB and age, sex, somatic development, start and duration of asthma and frequent respiratory infections. The seriously ill patients had more serious and frequent EIB. As practical conclusion it can be established that the examination of asthmatic children with exercise induced bronchospasm is important from the point of view of sports, but also in judging the severity of asthma.
Results of bronchial challenge after infantile obstructive bronchitis.
The bronchial hyperreactivity was examined in a follow-up of 206 children having had obstructive bronchitis before two years of age. The acetylcholine challenge was done with 0.5% and 1% Pharmalgen solutions. The bronchial hyperreactivity was established over a 20% decrease of PEF and/or FEV1 values. Summarizing the results produced by 0.5% and 1% solutions a significant difference could be found in the bronchial hyperreactivity between the follow-up and control groups. Similarly the PC20 (provocative concentrations) values were suitable for differentiating the two groups. Upon physical exercise, EIB occurred in 2%. With the skin prick test (SPT) by 10 allergens 3+ or 4+ positivity was found in 17% of the children. Between the bronchial hyperreactivity and SPT positivity a significant correlation could be established.
[Significance of serum theophylline levels in the management of childhood asthma].
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Complete recovery from paraquat poisoning causing severe unilateral pulmonary lesion.
Poisoning by paraquat, a plant-protecting agent, its clinical manifestations and treatment are discussed. The case of a 5-year-old boy who had ingested an unknown quantity of paraquat is described. Peritoneal dialysis proved to be effective in overcoming renal and hepatic failure. Subsequently, a pulmonary lesion with unilateral preponderance developed; this showed marked radiological regression and in a year nearly complete functional recovery ensued.
[Development of clinical symptoms in asthmatic children under long-term treatment of ketotifen].
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Bronchial hyperreactivity after infantile obstructive bronchitis.
A follow-up study was performed on 406 patients treated for infantile obstructive bronchitis during the period between 1964 and 1973. Their mean age was 12.6 years at the time of the study. The male: female ratio was 1.7. Forty-three patients (11%) became asthmatic within 10 years after onset of the wheezy episode of infancy. In one-third of the 363 non-asthmatic children, bronchial hyperreactivity was shown by acetylcholine and histamine provocation. There was a significant correlation between the number of recurrent obstructive episodes and the length of the period of recurrent wheezing on the one hand and bronchial hyperreactivity on the other hand.
Late prognosis of bronchial asthma in children.
The authors present data on the natural course of childhood bronchial asthma. They made a follow-up on 441 formerly asthmatic patients after the age of 14 years. The follow-up was based on questionnaires accompanied with personal interviews, physical examination, etc. The disease began in 167 (38%) patients before the age of 2; at the 'end' of childhood, at the age of 14, 34% were still asthmatic. In young adult age symptoms recurred in some cases and at the age of 26, 43% of the patients showed asthmatic complaints. The frequency of asthmatic attacks was significantly less in the young adults compared with that of childhood. Death occurred in 5 former patients, but only 2 of them died as a consequence of asthmatic disease. The authors constructed a diagram on the natural course of childhood asthma and show the practical use of this curve.
Study of exercise induced bronchospasm by various loading tests.
In 378 children affected by asthma and 87 healthy children, physical loading was carried out by three kinds of test, viz. free running, stairstep test or skipping, and bicycle ergometry. In 32% of healthy children physical exercise led to improved respiratory function, while this value was only 7% in asthmatics. An improvement in respiratory function exceeding 20%, i.e. appreciable bronchial dilatation, never occurred in asthma patients. The bronchospasm of healthy children showed no consistent time course, in asthmatics it was most pronounced three minutes after exercise. Exercise induced bronchospasm occurred most frequently after free running, least frequently after ergometric loading. The stairstep test and skipping provoked exercise induced bronchospasm in a nearly identical proportion. Severity of exercise induced bronchospasm exhibited a similar distribution. In addition to cases with a positive response to running test, some of the other methods revealed further 5-6% of cases. Free running is the most suitable method for demonstration of exercise induced bronchospasm, ergometric loading appears the least sensitive test in this respect. By application of three loading tests exercise induced bronchospasm could be demonstrated in 52% of paediatric asthma patients.
[Folic acid prevention of the adverse effects of methotrexate].
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