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Biomedical subjects

I Engström

Publications and source records attributed to I Engström.

At least 37 records · Page 2Linked to original sources

Effects of the ionophore gramicidin D on energy metabolism in human erythrocytes.

Washed human erythrocytes were incubated in phosphate-buffered saline at 37 degrees C with different concentrations (2-80 mg l-1) of the monovalent cationophore gramicidin D. The ionophore induced a decrease of ATP content and energy charge (EC) and a concomitant increase in ADP and AMP contents. At a concentration of 10 mg l-1 of the ionophore the reduction of EC and ATP concentration was about 50%. Increasing the concentration of the ionophore resulted in a substantial haemolysis with no further effect on the nucleotide levels. Lowering the concentration of the ionophore to 5 mg l-1 (to avoid haemolysis) lead to a similar effect on the energy status. Ouabain at 0.5 mmol l-1 in incubation medium distinctly blunted the ionophoric effect on EC and adenine nucleotides. Addition of glucose on the contrary reversed these effects by about 80%. Hence, the glucose-induced increase in glycolytic flux as evidenced by an increase in lactate production was not sufficient to restore energy state.

Adenosine Diphosphate↗

Transcutaneous blood gas monitoring during salbutamol inhalations in young children with acute asthmatic symptoms.

The effect of salbutamol inhalations on transcutaneous blood gases was investigated in 23 children (aged 11 months-2.5 years) with asthmatic symptoms. After one salbutamol inhalation there was a mean increase in transcutaneous PO2 (tcPO2) of 0.5 kPa (P less than 0.01); after a second dose given 30 minutes later, the mean increase was 1.2 kPa (P less than 0.001). The increase in tcPO2 after only one dose of salbutamol was significantly correlated to age (P less than 0.01). No such correlation was observed after a second dose. The overall increase in tcPO2 after two salbutamol inhalations showed a negative correlation to the duration of the current symptomatic period (P less than 0.05). We conclude that salbutamol inhalations have beneficial effects in young children with acute asthmatic symptoms, even below the age of 18 months, provided that an adequate dose reaches the lung and preferably at an early stage of obstruction.

Acute Disease↗

Mental health and psychological functioning in children and adolescents with inflammatory bowel disease: a comparison with children having other chronic illnesses and with healthy children.

Psychiatric disorders and behaviour problems were found to be commoner in children and adolescents with inflammatory bowel disease (IBD) than in matched comparison groups with tension headache and diabetes as well as in healthy children. Depression, anxiety and low self-esteem were common. Many children denied their problems. This may be due to the type of illness, its social consequences and the embarrassment experienced by the children. Discrepancies were found between the children's and their mothers' replies. These results are discussed in terms of their implication for paediatric practice.

Adolescent↗

Characteristics and prognosis of hospital-treated obstructive bronchitis in children aged less than two years.

In a prospective study 101 children aged less than 2 years (median age 10 months), were examined the first time they were admitted to a paediatric ward for asthmatic symptoms. Two-thirds were boys and 58 had parents or siblings with allergic symptoms. During winter-spring, respiratory syncytial (RS) virus was verified in 50% of children. Other viral agents were adenovirus, parainfluenza 3, coxsackie B 2, ECHO 6 and rotavirus. At the acute stage, 54% of the children displayed changes on pulmonary X-ray. The total IgE value was greater than or equal to +2 SD score units in 14 children. At reinvestigation after 3-4.5 years, when the children were aged 3.3-6.3 years, 53% were free from asthmatic symptoms; the median age for the last episode was 2 years. A total of 33% had mild asthma, 8% moderate and 6% severe asthma. The factors which correlated significantly with persistent asthma were: (1) The need for daily medication for at least 6 months. (2) A young age in conjunction with the first wheezing episode and on the first admission to a paediatric ward because of asthmatic symptoms. (3) Other past or present atopic symptoms. Heredity, tobacco smoking at home, having a furry pet, RS virus infection, or high total IgE at the time of the first admission did not correlate significantly with the persistence of asthma 3-4.5 years later. The results emphasize the good overall prognosis of wheezing in early childhood, even when the wheezing is severe enough to lead to inpatient treatment.

Age Factors↗

Elimination diet in young children with atopic dermatitis.

Thirteen children with severe current atopic dermatitis unresponsive to topical treatment were started on an elimination diet. One child was excluded because she could only keep to the diet for 3 days. Twelve children aged 0.8-4.1 years maintained the diet for 2-4 weeks. In six children the dermatologist's score showed a clear improvement while on diet, in 2 children there was a minor improvement and in 4 children the dermatologist's score did not change during elimination diet. Challenges were performed with egg, milk and wheat in 6 children and with milk and wheat in 2 children. The challenges were done in an open way except for the dermatologist, who was unaware of which food the child had received. No child in the study had an immediate reaction but 3 children had late reactions, one after egg, one after milk and one child after challenge with wheat.

Animals↗

Parental distress and social interaction in families with children with inflammatory bowel disease.

Twenty families who had children with inflammatory bowel disease (IBD) and 20 comparison families with healthy children were studied concerning parental distress and social interaction. The mothers in the IBD group scored very high on parental distress, whereas the fathers did not differ from the comparison group. Both parents in the IBD group reported significantly lower scores on a social support scale. The dimension of social integration was normal, but deeper relations and attachment were negatively affected among parents in the IBD group. The mental health of the children with IBD correlated with the social support, especially the qualitative aspects.

Adaptation, Psychological↗

Family interaction and locus of control in children and adolescents with inflammatory bowel disease.

This study showed that children and adolescents with inflammatory bowel disease (IBD) had a more external locus of control than did matched diabetic and healthy children. An external locus of control correlated with severity of physical illness and presence of psychiatric disorders. It also correlated significantly with family dysfunction, which was found to be more common in the IBD group than in the groups compared. Tendencies toward a tense and negative family climate were observed in the IBD families. Awareness of the interaction between physical and psychosocial factors in IBD is essential in the management of therapy.

Adolescent↗

Psychological and respiratory physiological effects of a physical exercise programme on boys with severe asthma.

Ten boys 9-12 years of age with severe perennial asthma participated in a physical exercise programme lasting 8 months. Pulmonary function and psychological tests were performed before training, immediately after, and one year after the end of the exercise programme. Static lung volumes, flow-volume variables and histamine tolerance were used as indicators of pulmonary function. Ego structure, body image, social development and concentration capacity were used as indicators of personality development. Before the study, the group had high FRC (p less than 0.05) and RV (p less than 0.001), low FEV1, MEF50 and MEF25 (all p less than 0.001) and low histamine tolerance. They showed marked disturbances in their personality development with low scores in psychological variables. During the training period, MEF50 and MEF25 increased slightly (p less than 0.01). Marked improvement was observed in all psychological variables (p less than 0.001). The positive effects remained during the following year. The marked and lasting improvement in personality development was regarded as an essential factor behind the more modest positive clinical and pulmonary function changes. The results emphasize the importance of including exercise programmes in the treatment of children with asthma.

Asthma↗

Long-term treatment with glucocorticoids/ACTH in asthmatic children. III. Effects on growth and adult height.

The effect on growth of long-term treatment with prednisolone and/or ACTH (tetracosactrin) depot preparation was studied in 40 children with severe bronchial asthma. Height velocity was subnormal before treatment. During treatment the group of 17 children primarily treated with ACTH showed a moderate increase in mean velocity. Their height was not significantly altered, and neither was the age at peak height velocity nor adult height. In the group of 23 children treated with prednisolone the mean velocity decreased, resulting in a relative decrease in height. Peak height velocity was delayed by about 2 years in the boys but occurred at the expected time in the girls, as did menarche. Mean adult height was lower than expected after adjustment for mid-parenteral height. In 10 children ACTH was substituted for prednisolone, and their height velocity increased but not enough to affect adult height, which was just as low as in the patients treated with prednisolone only.

Adrenocorticotropic Hormone↗

Natural history of allergic diseases in children.

Questionnaire data from 1335 14-year-old children with a history of past or present asthma, allergic rhinitis or eczema were analysed regarding age at onset and cessation of symptoms. Incidence of asthma and eczema was highest during the first years of life. Early incidence of asthma was higher in boys than in girls but the sex ratio equalized gradually during childhood. Early incidence of eczema was equal between the sexes but the proportion of girls increased gradually with later age at onset. In 24% of the children more than one symptom was found. Cessation of symptoms was common in asthma (55%), in particular in those with early onset (74%), but less common in eczema (34%). Cessation of symptoms was less common in both diseases when associated with other allergic symptoms. Incidence of allergic rhinitis was fairly constant during childhood and cessation of symptoms was uncommon. A high risk of allergic airways disease was found after early eczema.

Adolescent↗

Childhood asthma in a rural county.

As part of a questionnaire study of allergic diseases in Swedish children, information about asthma reported in a rural county was evaluated. Of a total population of approx. 9,000 children 4, 7, 10 and 14 years of age, 5.1% reported a history of asthma and 2.4% reported symptoms during the last year. The incidence was highest during the first 2 years of life. A higher incidence in boys than in girls was found only during the first 4 years of life. Cessation of symptoms was most common in children with onset during the first 2 years of life. By checking the medical case records, a high accuracy of the reported information was confirmed.

Adolescent↗

Allergic diseases in Swedish school children.

The occurrence of allergic diseases in children was studied on the basis of a questionnaire sent to the parents of 20,000 school children, 7, 10 and 14 years of age, in 3 parts of Sweden with different climatic conditions. The prevalence of asthma was 2.4%, allergic rhinoconjunctivitis 7.4%, eczema 7.8% and total allergic diseases 16.9%. The prevalence of all diseases was significantly higher in the northern part of the country than in the southern parts. This geographic variation was not related to heredity, infant feeding pattern or known exposure variables other than the cold and dry climate. Parental history of allergic diseases increased the incidence in the offspring 2-9 times, with a pattern of symptom specificity and a cumulative effect of double parental history. Breast-feeding postponed the onset of allergic disease only in children with double parental history.

Adolescent↗

Analysis of linear growth using a mathematical model. I. From birth to three years.

According to the "ICP-growth model" (ICP = Infancy, Childhood and Puberty components), linear growth during the first three years of life can be represented mathematically by a combination of a sharply decelerating Infancy component and a slowly decelerating Childhood component. Growth as measured by supine length is analysed for 191 longitudinally followed healthy infants using this model. The main aim is to devise ICP-based methods for biological and clinical applications. The onset of the Childhood component, which occurs some time between 6 and 12 months of age and is typically abrupt, can be detected on an individual basis. Its starting point probably defines the as yet unknown age at which growth hormone begins to exert a significant influence. The analyses have also revealed some new facets of linear growth. Most infants are found to have a non-linear decelerating Infancy component, free from seasonal influence. Age at onset of the Childhood component is earlier for girls than for boys and is positively related to the magnitude of the Infancy component. During the second year of life the variation in growth rate of the cohort increases. This fluctuation is found to be seasonal and greater for those with late onset of the Childhood component. During the third year of life the growth pattern is stabilized.

Age Factors↗

Analysis of linear growth using a mathematical model. II. From 3 to 21 years of age.

The 'ICP growth model' (ICP = Infancy, Childhood and Puberty components) represents linear growth from 3 years of age to maturity by a combination of a slowly decelerating childhood component together with a sigmoid puberty component, the latter acting only during adolescence. Linear growth is analysed for 157 longitudinally followed healthy infants using this model. The main aim is to assess the ability of the ICP model to describe and evaluate individual growth patterns in healthy children with particular emphasis on the considerable individual variation in the timing of puberty and the shape of the pubertal growth spurt. The use of the model to evaluate growth longitudinally over both short and long periods is also outlined. Reference values based on the ICP approach, the ICP Standard, seem to have a number of advantages in comparison with cross-sectional standards. In the 'Prepubertal ICP Standard', the contribution of the puberty component is omitted. The standard can be applied on an individual basis to evaluate prepubertal growth and pubertal onset, independently of the timing of puberty. By using the 'Pubertal ICP Standard' both the difference in pubertal maturation and the negative relationship between the size of the pubertal gain and the timing of puberty are taken into account. The fact that the gain in the puberty component is time-invariant, and can thus be aligned with the timing of puberty for an individual child, forms the basis of this approach. The analyses have also revealed a new predictor for final height, which is termed HAPO (height adjusted for pubertal onset). This predictor is based on age and attained size at onset of puberty--the 'onset' regression line.

Adolescent↗

Long-term treatment with corticosteroids/ACTH in asthmatic children. II. Hypothalamic-pituitary-adrenal function.

Hypothalamic-pituitary-adrenal (HPA) function was studied in 23 children with severe bronchial asthma during and after long-term treatment with prednisolone and/or ACTH1-24 depot tetracosactrin) by means of ACTH stimulation test and insulin tolerance test. In the 14 children primarily treated with depot tetracosactrin, the cortisol levels in insulin tests were within normal limits both during and after treatment. An enhanced response to ACTH stimulation was found during the treatment period. During treatment with prednisolone a marked impairment of the adrenocortical function was found, with low basal plasma cortisol levels and subnormal response to ACTH stimulation, more marked the lower the age at the start of treatment and the higher the dose per kg body weight. After substitution with depot tetracosactrin the HPA-function was restituted, with plasma cortisol levels within normal limits. Growth hormone levels after insulin induced hypoglycemia were greater than or equal to 7 ng/ml during and after treatment with depot tetracosactrin. As long-term treatment with depot tetracosactrin has little side-effects in terms of suppression of the HPA-axis it is a useful alternative to oral prednisolone in severe asthma in children.

Adolescent↗

Transcutaneous oxygen and carbon dioxide levels and a clinical symptom scale for monitoring the acute asthmatic state in infants and young children.

Measurement of transcutaneous PO2 and PCO2 in addition to a clinical symptom grading system was used to monitor the acute asthmatic attack in children under two years of age. tcPO2 was lowered already at signs of mild obstruction and decreased in parallel with clinical deterioration. tcPCO2 was almost unchanged at mild to moderate obstructive symptoms. With clinical deterioration tcPCO2 rose steadily. An increase of the oxygen concentration to 30-40% in the inspired air increased tcPO2, on the average by 70%, but did not change the tcPCO2, level. Continuous recording of tcPO2 and tcPCO2 as well as the clinical grading system are valuable tools when monitoring severely obstructive infants and young children.

Acute Disease↗