Biomedical subjects
Publications and source records attributed to M Debelić.
Patients history, clinical findings, pulmonary function and necessary therapy are combined for a diagram, which should easily allow to grade childhood asthma for general practitioners, pediatricians and consultants of the health insurance. The grading system is based on the cited literature, dealing in part with the matter, and on the international consensus report on asthma.
A new in vitro screening test for inhalant allergy (Phadiatop, Pharmacia Uppsala, Sweden) was evaluated for its effectiveness in identifying allergic patients. The test is based on the radio-allergo-sorbent-test (RAST). Specific IgE antibodies to different inhalant allergens are detected simultaneously. Serum samples from 300 patients and controls were run with Phadiatop. 96% of 150 patients with proved allergic disease were correctly identified by Phadiatop. 92% of 150 individuals without clinically relevant allergic hypersensitivity were found correctly to be negative. Allergic disease was proved or excluded by case history, skin prick test, RAST and, in some cases, additionally by provocation challenge.
UNLABELLED: 32 patients (15 men, 17 women) of between 15 and 28 years of age were examined in a prospective study using a staged histamine test and a running test. A special anamnesis was prepared. Following a methodic preliminary examination two methods of the exercise test were compared with one another in 16 patients based on running freely and on the endless tape ergometer-in the form of a two-stage test with measurement of the heart rate. An anamnestic pointer was seen in each of 7 patients with pronounced bronchial hyperreactivity; in moderate hyperreactivity only 1 out of 9 patients had an anamnestic pointer. In 29 of 43 patients, anamnesis and the result of the exercise test agreed. Of 9 patients with exercise induced asthma, 3 had moderate hyperreactivity and 6 a very pronounced one. Free run and two-stage test on the endless tape yield the same result in respect of exercise induced asthma in all 16 patients. CONCLUSIONS: 1. Anamnesis has a good predictive value in respect to exercise induced asthma. 2. This is confirmed: no exercise induced asthma without bronchial hyperreactivity, but the former is not necessarily always a sequence of the latter. 3. It is possible to standardise the running test on the endless tape with definite load and estimation of the efficiency; however, the simple running test in which the patient adjusts the load in accordance with his subjective feeling, is equally valid for arriving at a clinical diagnosis of exercise induced asthma.
Serum samples obtained from 55 patients with confirmed asthma induced by house dust mites, and 30 control subjects with no mite allergy, were investigated for specific IgG antibodies against the mites Dermatophagoides pt. and far. In 23 of the 55 asthmatics, specific hyposensitization treatment had previously been performed. Patients with allergic mite-induced asthma proved to have significantly higher specific IgG antibody titres than the control subjects. The difference between the groups with and without prior desensitization was not significant. All subjects with no IgE-mediated allergy vis-a-vis house dust mites (controls) had detectable specific IgG antibodies against both mites.
To investigate the question as to a possible allergic cause of disease of the airways, a new laboratory method has now become available (Phadiatop, Pharmacia Freiburg im Breisgau), which enables the physician who is not a specialist in allergology, to obtain initial orientation on the presence of an IgE-mediated allergic condition affecting the airways. The procedure is capable of identifying allergen-specific antibodies against ten different inhalation allergens, simultaneously and undifferentiated. It is available either as a radioimmunoassay or an enzyme immunoassay.
Sixteen patients were included in the analysis of this double-blind crossover study comparing the effect of sodium cromoglycate, reproterol, sodium cromoglycate plus reproterol, and placebo in exercise-induced asthma. Both the sodium cromoglycate and the reproterol-containing treatment significantly inhibited exercise-induced asthma. The best protection is effected by the combination of sodium cromoglycate and reproterol. A synergistic effect of both medications could not be confirmed statistically so that their combined effect is simply additive.
Six adolescents with allergy or intolerance to non-steroidal anti-inflammatory drugs (NSAID) showed different types of reaction (asthma, urticaria, anaphylactoid reaction). The results of 60 oral or bronchial challenges in asthmatic adolescents with no positive history of NSAID-intolerance are presented. NSAID should be prescribed very carefully after detailed medical history--especially in adolescents with obstructive lung disease. Compound drugs should be avoided. Any indication of allergy or intolerance to NSAID should lead to careful oral or bronchial challenge tests for diagnosis to find out a well-tolerated alternative drug. The patient should receive an allergy-passport and show it to any attending physician.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The influence of ketotifen on IgE-mediated skin reactivity was investigated in two studies in 20 and 14 adolescent patients with pollen allergy. In the first intraindividual, double-blind randomised study, ketotifen showed a significant decrease (P less than 0.001) of the prick test weal by 38% after a 3-day-medication of 1 mg b.i.d. orally. A minimal reduction of weal size after DNCG and placebo was not significant. The second investigation showed a decrease of weal size by 20% 14-16 hours after cessation of a 7-day-medication with ketotifen. The weal size was smaller by 10% after 3 days and by 5 or 7 days it has reached pretreatment size again. For practical allergological purposes it is concluded that ketotifen should be withdrawn three days before diagnostic skin testing because of its antianaphylactic, antihistaminic and antiallergic effects.
Pharmacological rehabilitation is defined as a decrease of bronchial hyperreactivity and a stabilization of the bronchial reactivity after treatment with drugs possessing prophylactic and therapeutic properties. The models used for the study of the effectiveness of different compounds are the bronchial provocation tests with allergens, histamine, acetylcholine or metacholine, PGF2 or SO2, as well as exercise-induced asthma or challenges with drugs and food. For the critical examination of a drug's effectiveness, the high reproducibility of the test employed is of extraordinary importance. In our own study we were able to show that the immediate reaction in allergen provocation tests can be reproduced very well. The same, is not valid for the late reaction. Controlled studies on the long-term effects of DSCG and Ketotifen on bronchial asthma in children are being discussed. The investigations of bronchial responses to mediators such as histamine and acetylcholine after DSCG and Ketotifen treatment are reviewed; furthermore the author's results are presented.
The incidence of extrinsic allergy was studied in 1,246 children and adolescents with recurrent unspecific respiratory and allergic complaints. Special attention was paid to obstructive respiratory diseases, such as bronchial asthma and obstructive of asthmatic bronchitis. Skin tests and the radio-allergo-sorbent test (RAST) showed sensitization in 77% of the cases. Challenge tests and a detailed personal history, however, revealed clinically active sensitization in only 62%. The clinical and practical significance of the findings is discussed.
On the basis of investigations in 764 healthy children aged 3--17 years (398 boys and 366 girls) normal values for the maximal pneumometric expiration were established. There were definite correlations between the pneumometer values and sex, age, height and weight. The correlation coefficients between the pneumometer values and age or height were about + 0,90. The boys have on average higher pneumometer values than the girls, but the differences are not significant.
Explore the source record for details and available documents.
Beclomethasone dipropionate, a new corticosteroid for inhalation in the form of a pressurised aerosol with a daily dosage of 300-400/mug, has been given to 130 adult asthmatics. In 56% of the steroid-dependent asthmatics, oral or parenteral corticosteroids were reduced and in a further 28% discontinued entirely. In 16% of patients a reduction of systemic corticosteroids could not be achieved. 12 patients suffering from an obstructive airway disease who had not previously been on systemic corticosteroids were treated successfully with inhalation of beclomethasone dipropionate alone. The reduced dosage of systemic corticosteroids as a result of the use of beclomethasone dipropionate was 4.24 mg of prednisone daily. Side effects, in the form of mouth candidiasis, were noted in only 2 patients.