Biomedical subjects

K Oymar

Publications and source records attributed to K Oymar.

12 recordsLinked to original sources

PubMed2003

Hospital admissions for childhood asthma in Rogaland, Norway, from 1984 to 2000.

AIM: The prevalence of childhood asthma is increasing, and it is important to monitor factors related to hospital admissions in order to understand the different aspects of the disease. The aim of this study was to investigate admissions for childhood asthma to Rogaland Central Hospital, Norway, in order to elucidate time trends related to rates of admissions and treatment modalities. METHODS: A population-based study was conducted in which data extracted from the medical records, including number of admissions, length of hospitalization, medication and symptom scores, were recorded for children aged 1 to 14 y admitted to hospital for asthma during four periods, of two years each, from 1984/1985 to 1999/2000. RESULTS: For all the children there was an increase in annual admission rates for asthma from 1984/1985 to 1989/1990 and stabilization thereafter, but there were substantial differences between age groups. For children of 1 or 2 y of age the annual admission rate increased from 43/10000 in the first period to 104/10000 in the last period (p < 0.001), with an increase in both primary admissions and re-admissions. For children aged 3 and 4 y, the admission rates increased from the first to the second period, and then declined to an annual admission rate of 40/10000 in 1999/2000. For older children, the admission rate was low and stable. There was a gradual increase in the use of inhaled corticosteroids both prior to admission and at discharge, and the percentage of children receiving systemic corticosteroids at admission increased from 19% to 45% (p < 0.001). The average hospital in-days decreased from 3.4 to 1.9 (p < 0.001). CONCLUSION: A disturbingly high and increasing rate of both primary admissions and re-admissions for asthma has been observed in children aged 1 and 2 y, which seemed to be unaffected by changes in treatment modalities during the period. The decrease in admissions for children aged 3 and 4 y may have been influenced by the increased use of inhaled corticosteroids.

Adolescent↗

PubMed2001

Urinary eosinophil protein X in children with asthma: influence of atopy and airway infections.

It has been suggested that urinary eosinophil protein X (U-EPX) can be used to monitor bronchial inflammation in childhood asthma. However, the influence of atopy and airway infections is not well elucidated. To determine the clinical value of measuring U-EPX in children with asthma and to evaluate the influence of atopy and airway infections, U-EPX was measured in 170 children with asthma (mean age 69 months, range 12-179 months), in 79 children with lower or upper respiratory tract infections (mean age 41 months, range 1-165 months), and in 64 controls. U-EPX was elevated in children with acute asthma (median 132 microg/mmol of creatinine, quartiles 77-195 microg/mmol of creatinine, n = 51, p <0.001) and chronic asthma (median 93 microg/mmol of creatinine; quartiles 46-149 microg/mmol of creatinine, n = 119, p <0.01) compared with controls (median 54 microg/mmol of creatinine, quartiles 40-89 microg/mmol of creatinine, n = 39). Atopic children had higher levels of U-EPX than non-atopics with acute asthma (median 155 microg/mmol of creatinine, quartiles 113-253 microg/mmol of creatinine, n = 27, vs. median 102 microg/mmol of creatinine, quartiles 56-168 microg/mmol of creatinine, n = 24, p <0.05), as well as with chronic asthma (median 110 microg/mmol of creatinine, quartiles 65-162 microg/mmol of creatinine, n = 63, vs. median 60 microg/mmol of creatinine, quartiles 39-123 microg/mmol of creatinine, n = 56, p <0.01). In chronic asthma, children without atopy had levels of U-EPX similar to values of controls; levels were similar in symptomatic and asymptomatic patients, and not influenced by treatment with inhaled corticosteroids. Moreover, U-EPX levels were higher in children with pneumonia (median 207 microg/mmol of creatinine, quartiles 111-280 microg/mmol of creatinine, n = 35, p <0.001), laryngitis (median 109 microg/mmol of creatinine, quartiles 65-161 microg/mmol of creatinine, n = 24, p <0.01), and rhinitis (median 172 microg/mmol of creatinine, quartiles 123-254 microg/mmol of creatinine, n = 19, p <0.001) than in controls (median 62 microg/mmol of creatinine, quartiles 41-93 microg/mmol of creatinine, n = 64). There was significant overlap among all groups of children with disease, as well as between children with disease and controls. Hence, U-EPX may reflect differences in eosinophil involvement and activation between children with atopic and non-atopic asthma, but the individual spread within groups and the influence of airway infections limits the clinical value of U-EPX in childhood asthma.

Adolescent↗

PubMed2001

Eosinophil counts and urinary eosinophil protein X in children hospitalized for wheezing during the first year of life: prediction of recurrent wheezing.

UNLABELLED: Early identification of wheezing children with an increased risk of recurrent wheezing or subsequent asthma is important. The aim of the study was to determine the role of markers of eosinophil activation, along with other parameters, in the prediction of recurrent wheezing and allergic sensitization in children with early and severe wheezing. We examined 105 children without atopic dermatitis, hospitalized for wheezing during the first year of life. At a 20-mo follow-up, 101 of the children were assessed for the occurrence of recurrent wheezing (at least 3 episodes, including 1 in the previous 6 mo) and allergic sensitization (positive skin-prick test). By univariate analysis, levels of eosinophil counts at the time of hospitalization (p = 0.005, OR = 18.9), age in months (p < 0.0001, OR = 1.5), respiratory syncytial virus (RSV)-negative disease (p < 0.0001, OR = 8.8), parental atopy (p = 0.006, OR = 3.3) and male sex (0.02, OR = 2.7) were all predictive factors for recurrent wheezing at follow-up. With all parameters included in a multiple regression analysis, RSV-negative disease was not a predictive factor for recurrent wheezing. A simple model including eosinophil counts > or = 0.1 x 10(9)/L and age had a predictive accuracy of 79%, with only a 6% chance of a child being wrongly predicted as symptomatic. Urinary protein X (U-EPX) was not a predictive factor for recurrent wheezing. When included in a multiple logistic regression analysis, a level of U-EPX > or = 100 microg/mmol creatinine was the only parameter with a positive predictive value for allergic sensitization (p = 0.007, OR = 18.9), whereas age, parental allergy or parental asthma were not. CONCLUSION: Children with severe wheezing during the first year of life and subsequent recurrent wheezing are characterized by a normal or high eosinophil count in response to viral infections.

Asthma↗

PubMed2000

[Bacterial tracheitis in children].

BACKGROUND: Bacterial tracheitis is an uncommon, but serious cause of acute respiratory distress in children. The incidence is not known. MATERIAL AND METHODS: The medical records of four children with bacterial tracheitis treated in our hospital are presented, and the literature reviewed to describe symptoms, diagnosis and treatment. A questionnaire was sent to all pediatric departments in Norway to assess the incidence of bacterial tracheitis and epiglotitis during the 1994-98 period. RESULTS: The yearly incidence of bacterial tracheitis was estimated to 4 per 1,000,000 for children aged 0-15, and 8 per 1,000,000 for children aged 0-5. The incidence of epiglotitis was 1.0 per 1,000,000 for children 0-15 years. INTERPRETATION: Bacterial tracheitis is now more common than epiglotitis, and the diagnosis has to be considered in children presenting with acute illness and upper airway respiratory distress. The disease is characterised by marked purulent exudate and formation of pseudomembranes in the trachea. Staphylococcus aureus and Haemophilus influenzae type b are the predominant causes of bacterial tracheitis. Most patients require endotracheal intubation, with the highest frequency in the youngest children. Reported complications include cardiopulmonary arrest, toxic shock syndrome and pulmonary oedema. Appropriate treatment with antibiotics is essential.

Bacterial Infections↗

PubMed2000

Urinary eosinophil protein X in children with atopic dermatitis: relation to atopy and disease activity.

BACKGROUND: Parameters of eosinophil inflammation have been suggested as markers of disease activity in atopic dermatitis (AD), but the value of urinary eosinophil protein X (U-EPX) in children with AD, as well as the influence of allergic sensitization, is not known. METHODS: We measured U-EPX in 59 atopic and 29 nonatopic children with mild (n = 32), moderate (n = 34), and severe (n = 22) AD, as well as in 64 controls. RESULTS: U-EPX was increased in children with AD (110; 67-164 microg/mmol creatinine, median; quartiles) compared to controls (62; 41-95, P<0.001). Children with mild (97; 63-164, P < 0.01), moderate (108; 67-157, P < 0.01), and severe disease (152; 99-202, P < 0.001) had levels of U-EPX higher than controls. U-EPX was significantly higher in children with severe AD than in mild and moderate disease (P < 0.05 for both). Children with AD and a positive skin prick test (120; 81-176) had higher levels of U-EPX than children with a negative skin prick test (87; 56-155, P<0.05). CONCLUSIONS: U-EPX is significantly increased in children with AD and may reflect disease activity. U-EPX may also reflect differences in eosinophil activation between those sensitized and those not sensitized to common allergens.

Blood Proteins↗

PubMed2000

Soluble CD30 and CD23 in cord blood are not related to atopy in early childhood.

Atopic disease, including atopic dermatitis (AD), is associated with a T-helper 2 (Th2)-dependent immune response. The cytokine receptor CD30 appears to be preferentially expressed on, and its soluble form (sCD30) released by, Th2 cells. Therefore, sCD30 may be a potential marker for atopic disorders. The aim of this study was to test the hypothesis that the sCD30 level in cord blood could be used to predict the development of atopy or AD in early childhood. In a case-control study, levels of sCD30, as well as soluble low-affinity immunoglobulin E (IgE) receptor (sCD23), interleukin-4 (IL-4) and IgE, were measured in cord blood in 35 children who subsequently developed allergic sensitization and AD before the age of three, and the results were compared to those of 35 matched children without a history of atopy. There was no difference in cord blood levels of sCD30 between controls (32.5 U/ml; 19.7-80.1) and children with subsequent atopy and AD (32.2 U/ml; 22-75.9) (median; quartiles). The concentration of sCD30 showed no relation to the levels of total IgE, sCD23 or IL-4. Levels of sCD23 were similar in children with subsequent atopy (60.2 U/ml; 44.5-76.8) and controls (55.2 U/ml; 38.3-72.5), whereas IL-4 was detectable in 10 of the atopic children and in only two of the controls (p <0.05). In conclusion, cord blood levels of sCD30 or sCD23 do not seem to be related to the subsequent development of atopy or AD at the age of three.

Child↗

PubMed1998

Distinct T-cell subtypes induced with whole cell and acellular pertussis vaccines in children.

Recent clinical trials have demonstrated that new generation acellular pertussis vaccines can confer protection against whooping cough. However, the mechanism of protective immunity against Bordetella pertussis infection induced by vaccination remains to be defined. We have examined cellular immune responses in children immunized with a range of acellular and whole cell pertussis vaccines. Immunization of children with a potent whole-cell vaccine induced B. pertussis-specific T cells that secreted interferon-gamma (IFN-gamma), but not interleukin-5 (IL-5). In contrast, T cells from children immunized with acellular pertussis vaccines secreted IFN-gamma and/or IL-5 following stimulation with B. pertussis antigens in vitro. These observations suggest that protective immunity conferred by whole-cell vaccines, like natural immunity, is mediated by type 1 T cells, whereas the mechanism of immune protection generated with acellular vaccines may be more heterogeneous, involving T cells that secreted type 1 and type 2 cytokines.

Antigens, Bacterial↗

PubMed1998

Differential patterns of circulating adhesion molecules in children with bronchial asthma and acute bronchiolitis.

The object of the study was to assess the levels of circulating forms of the cellular adhesion molecules ICAM-1, VCAM-1, E-selectin, L-selectin and P-selectin in young children with asthma and acute bronchiolitis. Thirty-nine children aged 12 to 84 months with mild or moderate asthma were studied at admission for acute asthma (n = 15) or in a stable phase (n = 24). Ten of the children with acute asthma were seen again after one month. Twenty-two children aged 1 to 17 months with acute bronchiolitis and nine non-atopic controls were also included in the study. In children with acute asthma, the mean concentration of circulating soluble ICAM-1 (sICAM-1) was increased compared to children with stable asthma (mean 442 micrograms/l versus 363 micrograms/l; p < 0.001) and to controls (363 micrograms/l; p < 0.05). The levels of sICAM-1 remained high at follow up. In children with stable asthma, the mean serum concentration of soluble L-selectin (sL-selectin) (2080 micrograms) was significantly higher than in the controls (1664 micrograms/l; p < 0.05). The levels of circulating cellular adhesion molecules were similar in atopic and non-atopic asthmatics. Children with acute bronchiolitis had increased serum levels of soluble VCAM-1 (sVCAM-1) (1637 micrograms/l versus 1019 micrograms/l in the controls; p < 0.01) and sL-selectin (2041 micrograms/l versus 1664 micrograms/l in the controls; p < 0.05). There was no difference between the levels of circulating cellular adhesion molecules in children with respiratory syncytial virus (RSV) positive and RSV negative bronchiolitis. Soluble E-selectin (sE-selectin) and soluble P-selectin (sP-selectin) in serum were not significantly increased in any of the groups studied. In conclusion, our data suggest differential patterns of circulating cellular adhesion molecules in young children with acute asthma, stable asthma, and acute bronchiolitis, which may reflect differences in the underlying inflammatory processes in these obstructive pulmonary diseases.

Acute Disease↗

PubMed1998

Is serum eosinophil cationic protein in bronchiolitis a predictor of asthma?

To examine their possible predictive value for the development of asthma, the serum concentration of eosinophil cationic protein (ECP) and the total eosinophil count were measured at admission in 25 children aged 1-17 months hospitalized for their first episode of bronchiolitis. After an average of three years the parents of 23 index patients answered a questionnaire to determine development of asthma. Eight children were defined as having asthma at follow-up based on at least three episodes of wheezing. The remaining 15 children had experienced only one or two episodes of wheezing, and all of these children had been wheeze free for the last year. The serum concentrations of ECP were similar in children who subsequently developed asthma (8.0 microg/l; 3.6 to 14.2 (median; quartiles)) and in those who did not (12 microg/l; 4.5 to 16.8). Moreover, the total eosinophil counts were similar in asthmatic (0.10 x 10(9)/l; 0.04 to 0.20) and non-asthmatic patients (0.09 x 10(9)/l; 0.02 to 0.13). In conclusion, our study suggest that neither the serum concentration of ECP nor the total eosinophil count can predict the development of asthma when measured in children admitted for their first episode of bronchiolitis, but larger studies need to be carried out to confirm these results.

Asthma↗

PubMed1997

[Discitis in children. Description of the condition illustrated by two case reports].

Discitis in children is usually a self-limiting and non-infectious inflammation in the intervertebral disc. The symptoms are diffuse and vary from patient to patient; most often back pain, walking difficulties, crying and irritability. Radiology is often negative initially, and there may be a long delay from onset of symptoms to diagnosis. Magnetic resonance imaging may help in making an early diagnosis. Treatment is controversial; most authors recommend antibiotics only in special cases. It is important to be aware of the condition in order to avoid unnecessary investigations and treatment. We describe two patients, to illustrate the etiology, symptoms and treatment.

Child, Preschool↗

PubMed1996

Serum eosinophil cationic protein and interleukin-5 in children with bronchial asthma and acute bronchiolitis.

The aim of our study was to evaluate the clinical applicability of serum eosinophil cationic protein (ECP), interleukin-5 (IL-5) and total eosinophil counts in childhood asthma and bronchiolitis. These parameters were measured in 44 children aged 12-84 months with moderate and mild asthma during symptomatic and asymptomatic phases of disease. Fifteen of the patients were included at the time of admission to hospital due to an acute asthmatic attack, and ten of these were also examined one month after discharge. None of the patients were treated with glucocorticoids or cromoglycate at any time during the study. Serum ECP was significantly increased in the children with acute asthma compared to children with stable moderate asthma, stable mild asthma, as well as to controls. There was no difference between the groups with stable asthma or between stable asthma and controls, and there was large overlap between all groups of asthmatics and controls. Detectable levels of circulating IL-5 were demonstrated in eight of 15 children with acute asthma, with significantly higher levels in atopic children, whereas all samples from children with stable asthma and controls were negative. The results suggest that even though serum ECP and IL-5 increases during acute asthmatic attacks, these parameters cannot alone be used to discriminate between different groups of young children with stable asthma, nor between asthmatics and healthy controls. In addition, the same parameters of eosinophil inflammation were examined in serum samples from 25 children aged 1-17 months undergoing their first episode of acute bronchiolitis. Children with acute respiratory syncytial virus (RSV) bronchiolitis had significantly higher levels of serum ECP than those with RSV negative disease, whereas the total eosinophil counts were significantly decreased in all patients with acute bronchiolitis. Serum IL-5 was only detected in two children with acute bronchiolitis. The results suggest that the inflammation in RSV bronchiolitis differs from that induced by other viruses.

Acute Disease↗

PubMed1993

[Recurrent abdominal pain. A prospective study of 68 children].

We followed 68 children with recurrent abdominal pain in a prospective study including a standard investigation programme and abdominal ultrasound. We found an organic disease which explained the pain in eight patients (12%). Most children with recurrent abdominal pain can be dealt with by a general practitioner. In our opinion, further investigation, including abdominal ultrasound should only be carried out in the event of specific suspicion of organic disease. At follow-up 16-34 months later, 55 children (85%) had improved or were free of pain. We discuss the differential diagnoses and propose a plan of investigation for these children.

Abdominal Pain↗