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Biomedical subjects

J Puskás

Publications and source records attributed to J Puskás.

6 recordsLinked to original sources

[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.

Ambulatory Care↗

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.

Asthma↗

Positive skin prick tests of immediate type in non-allergic children.

Prick tests with twenty different Beneard antigens were performed in 300 children aged 2-16 years, all having a negative individual and familial history for allergic disease. At least one positive result was obtained in 64% of the children and among the 6000 tests a total of 727 were positive. Of the positive tests 93% were + or ++, 7% were +++ or ++++. No relationship was found between age and the incidence of positive skin tests. Mild reactions against more than one antigen in the same individual were quite frequent, pronounced reactions (+++ or ++++) against more than one antigen were exceptional. The incidence of mild reactions was found to be independent of the gender; strong reactions occurred in girls twice as often as in boys. The highest incidence of positive reactions was observed with house-dust mite, pollens, hay and straw dust, and canine and feline hairs. The diagnostic value of mild positivity is slight but pronounced positivity, especially against more than one antigen, must carefully be considered and in any case followed by a bronchial provocation test.

Adolescent↗

Wheezy bronchitis: results of treatment with ketotifen.

The authors consider that infants and young children with recurrent obstructive bronchitis require systematic follow-up care and treatment. To evaluate the severity of the disease, a rating scale was developed. Using this criteria, the severity of the disease in 132 infants and young children was evaluated. The patients were divided into a group of more severely ill and a group of less severely ill patients. The members of the more severely ill group were given long-term prophylactic treatment with ketotifen at a dose of 0.5 to 1.0 mg twice daily, in addition to standard symptomatic medication. Treatment with ketotifen afforded a decrease, although insignificant, in the number of coughing attacks, a significant decrease in the number of episodes of dyspnoea (p less than 0.025) and a significant decrease in the number of episodes of airway obstruction (p less than 0.0005). The authors conclude that patients with recurrent severe obstructive bronchitis should be given prophylactic treatment with ketotifen either during autumn and winter or throughout the year, depending on the severity of the symptoms.

Airway Obstruction↗

Thorax deformity and asthma bronchial.

In patients with bronchial asthma thorax deformity aggravates the respiratory function. The authors performed follow up examinations on 381 young adults who suffered from bronchial asthma in childhood. Thorax deformities were was found in 70 patients (28 pectus excavatum, 8 pectus carinatum, 19 thorax emphysematicus . 15 other and combined deformities). Comparing the recovered and non-recovered asthmatic patients, the state of the ill one was significantly worse with regards to thorax deformity. In the seriously ill patients thorax deformities occurred significantly more frequently than in the total number of patients. In the thorax deformity group asthma had an earlier onset and lasted longer in comparison with the whole of patients studied. Bronchial hyperreactivity and lung function values referring to chronic obstruction were significantly more frequent in patients with thorax deformity. Investigating physical exercise, the ratio of patients pursuing some sporting activity was similar, i.e. 50%, both in the total patient group and in the group of patients with pectus excavatum and pectus carinatum, while 90% of the patients belonging to the thorax emphysematicus group did not pursue any physical training.

Adolescent↗