Biomedical subjects

Hugo P Van Bever

Publications and source records attributed to Hugo P Van Bever.

6 recordsLinked to original sources

PubMed2006

A comparison of the relative growth velocities with budesonide and fluticasone propionate in children with asthma.

There have been no previous large, well-designed direct comparisons of the effects of fluticasone propionate (FP) and budesonide (BUD) on growth in children. This randomised, double-blind study compared the effects on growth of FP and BUD in children aged 6-9 years with persistent asthma. Following a 6-month run-in period (without inhaled corticosteroids), patients with normal growth velocity were randomised to 12 months' treatment with FP 100 micro g bd (n=114) or BUD 200 micro g bd (n=119). Growth velocity was determined by stadiometric height measurement. Lung function, asthma symptoms and use of relief medication were also assessed. Annualised mean growth velocity during run-in was comparable in the two groups (FP: 5.9 cm/yr; BUD: 6.0 cm/yr). During the treatment period, adjusted mean growth velocity was significantly higher in the FP than the BUD group (5.5 cm/yr vs 4.6 cm/yr; P<0.001). Asthma control improved similarly in both treatment groups. Bone mineral density and overnight urinary cortisol:creatinine ratios were similar in the two groups. Drug-related adverse events were reported among 3% of FP-treated children, compared with 2% for BUD. In conclusion, this study demonstrates that FP for childhood asthma has significantly less impact on childhood growth velocity than a therapeutically equivalent dose of BUD.

Androstadienes↗

PubMed2005

Prevalence of allergy-related symptoms in Singaporean children in the second year of life.

This study describes the cross-sectional prevalence of symptoms associated with eczema (chronic itchy rash), asthma (wheeze), and allergic rhinitis (rhinoconjunctivitis) in 1026 subjects between 18.5 and 23 months old (median age is 21 months) in Singapore. The first 2 yr cumulative prevalence of chronic itchy rash, wheeze, and rhinoconjunctivitis were 22.1% (n=227), 22.9% (n=235), and 8.4% (n=86) respectively. In total, 42.2% (414 of 979) reported ever having any of these symptoms. Eczema, although prevalent, was diagnosed only in 34.4% (n=78) of children with chronic itchy rash. Children with this eczematous rash were also more prone to wheeze (cOR=2.0, 95% CI: 1.2-3.0) and rhinoconjunctivitis (cOR=2.0, 95% CI: 1.4-2.8). Similarly, subjects who reported rhinoconjunctivitis and chronic itchy rash were 2.4 times (95% CI: 1.6-3.6) and 1.4 times (95% CI: 1.0-2.0) more at risk of wheezing respectively. Family history of allergy was a significant risk factor for chronic itchy rash (aOR=1.8, 95% CI: 1.3-2.4) and wheeze (aOR=1.7, 95% CI: 1.3-2.4). Thus, symptoms related to allergy were already prevalent during the second year of life. Significant proportions of these symptoms are likely to be due to true atopy as strong relationship with familial history and comorbidity with other potential allergic symptoms were observed.

Asthma↗

PubMed2005

Viewpoint: are doctors responsible for the increase in allergic diseases?

There is no exact explanation for the increase in allergic diseases that occurred since the last two decades. An increased allergen exposure and/or a decreased bacterial load cannot explain the phenomenon completely. Other causal factors that rose at the beginning of the 1980s must be taken into consideration. Important changes at that time in our management of children were the worldwide switch from aspirin to paracetamol, the introduction of broad-spectrum antibiotics such as cephalosporins and the advice to avoid dust and pets in newborns from allergic families. General application of these new approaches, in itself or in combination, might be responsible, at least in part, for the increase of allergic diseases in children.

Allergens↗

PubMed2005

Relationship between exhaled nitric oxide and atopy in Asian young adults.

OBJECTIVES: The relationship between exhaled nitric oxide and atopy is controversial. The aim of this study was to determine the relationship between exhaled nitric oxide (FE(NO)) and atopy in Asian young adults. METHODOLOGY: Subjects were assessed by: (i) the International Study of Asthma and Allergies in Childhood questionnaire to differentiate asthmatic from nonasthmatic and rhinitis from non-rhinitis subjects; (ii) skin prick testing to 10 allergens; and (iii) FE(NO) measurements performed online at a flow rate of 50 mL/s. RESULTS: Complete results were available for 84 subjects. FE(NO) values were highest in atopic asthmatics (n = 34; median FE(NO), 59.8 p.p.b.; interquartile range, 30.4-85.5 p.p.b), followed by atopic nonasthmatics (n = 34; median, 38.4 p.p.b.; range, 16.7-49.3 p.p.b), nonatopic asthmatics (n = 5; median, 19.1 p.p.b.; range, 17.9-33.4 p.p.b), and lowest in nonatopic nonasthmatics (n = 11; median, 15.7 p.p.b.; range, 11.5-21.7 p.p.b). FE(NO) values were significantly higher in atopic (n = 68; median, 44.7 p.p.b.; range, 27.3-75.2 p.p.b) compared to nonatopic subjects (n = 16; median, 17.0 p.p.b.; range, 11.7-23.8 p.p.b.; P < 0.0001), regardless of asthma and rhinitis status. FE(NO) levels correlated with the severity of atopy (wheal size) for both asthmatic (r = 0.44, P = 0.005) and nonasthmatic subjects (r = 0.48, P = 0.001). There was no significant difference in FE(NO) levels between nonatopic asthmatics and nonatopic nonasthmatic subjects (P = 0.25). CONCLUSIONS: Increased FE(NO) levels are more reflective of atopy rather than asthma, and increased nitric oxide production may be predominantly a feature of atopy in asthmatics.

Adolescent↗

PubMed2004

Childhood severe acute respiratory syndrome, coronavirus infections and asthma.

Severe acute respiratory syndrome (SARS) is a new infectious disease caused by a novel coronavirus. Children appear to be less susceptible to the SARS coronavirus, although the other non-SARS coronaviruses can cause respiratory infections in adults and in children of all ages. The exact reasons as to why SARS preferentially affects adults, and not children, are still unknown. Many hypotheses exist and need to be explored. During the outbreak of SARS, there did not appear to be an increase in asthma exacerbations in children.

Adolescent↗

PubMed2002

Early events in atopy.

UNLABELLED: The prevalence of allergic diseases, such as allergic asthma, allergic rhinitis and atopic dermatitis, has increased during the last decade. It is generally accepted that the increased prevalence of allergic diseases is due to a disturbed T-helper lymphocyte (T(h)) T(h1)-T(h2) balance, leading to more expression of T(h2) features. Decreased postnatal microbiological stimulation (i.e. improvements in public health, reduction in family size, increased usage of antibiotics) results in an increased possibility of ongoing postnatal T(h2) reactions. Furthermore, increased postnatal allergen exposure, especially to house dust mite, is known to facilitate the existence of T(h2) features. Therefore, identification of early markers of allergy such as increased total IgE in cord blood offers the possibility to initiate adequate primary prevention in subjects at risk. Primary prevention measures constitute merely of avoidance of early allergen contacts (foods and inhalants) and avoidance of pollution exposure (i.e. passive smoking). At the moment, insufficient data are available concerning the preventive effect of medication on the development of allergic diseases. However, studies on the early use of cetirizine suggest that the occurrence of asthma can be prevented or delayed in young children suffering from atopic eczema. CONCLUSION: because identification of the atopic newborn is now possible, adequate early prevention can be instigated.

Cytokines↗