Reproducibility of Exercise-Induced Asthma in Children

The reproducibility of exercise-induced asthma (EIA) was studied in children with perennial asthma, using treadmill exercise challenge tests repeated at mean intervals of 1 week (Group I, n = 20), 1 month (Group II, n = 20) and 1 year (group III, n = 18). The protocol was standardized with respect to intensity and duration of exercise, time of last medication prior to exercise, air humidity, use of corticosteroids, asthma attacks, and 6) pollen season. The mean percentage fall in peak expiratory flow (PEF) following exercise remained significantly unchanged in the three groups. The reproducibility of EIA was improved compared with previous studies. Although the random variation of EIA tended to be greater in Group III, the individual severity of EIA was remarkably stable whatever the interval between tests. Improvements in baseline airway function between tests were not followed by a simultaneous decrease in EIA. In conclusion, the severity of EIA is reproducible in children with perennial asthma, when the exercise protocol is standardized for factors known to influence bronchial reactivity.     

Treatment Adherence Among Low-Income Children With Asthma

Objective: To investigate the adherence behaviors (MDI use,MDI/spacer technique, appointment attendance, smoking in thehome) of low-income, urban, primarily African American childrenwith asthma. Method: Participants were 55 children ages 6 to 17 with moderateto severe asthma. Adherence to MDI anti-inflammatory agentswas estimated primarily from canister weight at the follow-upappointment. Results: The mean use of MDI medication was 44%; of prescribeduse, with 27% of subjects demonstrating MDI/spacer techniquelikely to prevent drug delivery. Almost half reported that householdmembers smoked cigarettes, and 21% missed scheduled follow–upappointments. Conclusions: These findings have implications for how cliniciansshould assess and improve adherence.     

Inhalation of Racemic Epinephrine in Children with Asthma

In this study the effects of nebulized racemic epinephrine (Micronephrine) were investigated in children with asthma. The drug was inhaled by a compressor nebulizator with a plastic mask. In the first part of the study it is shown that nebulized Micronephrine has a dose-dependent bronchodilatory effect. In the second part the effect is compared with that of nebulized salbutamol 10 children (7-16 years of age) with bronchial asthma. The highest dose used in the dose-response trials (=0.9 mg Micronephrine/kg body-weight) was compared with 0.15 mg salbutamol/kg body-weight, which is the dose commonly used in Sweden
There was no significant difference between the drugs as regards increase of forced expiratory volume in 1 sec or duration of the increase.
The was a small but significant increase in systolic blood pressure, measured 5 min after the inhalation of Micronephrine but no significant change in diastolic pressure of heart rate. Four children complained of temporary sore throat after the inhalation.     

Behavior Problems in Sexually Abused Young Children

A sample of 85 children, ages 3 to 12, and sexually abused withinthe previous 24 months, were evaluated with the Child BehaviorChecklist (CBCL, Achen-bach & Edelbrock, 1983). Data relatingto the nature of the abuse were also collected. This samplewas clearly more deviant behaviorally as measured by the CBCL.Internalizing behavior was related to the frequency of abuse,the sex of the child, the relationship of the perpetrator tothe child, and the severity of abuse. Externalizing behaviorwas related to the duration, perpetrator's relationship, timeelapsed, and sex of the child. Sexual behavior in this samplewas related to frequency of abuse and number of perpetrators.     

Terbutaline Slow-Release Tablets in Children with Bronchial Asthma

The effect of terbutaline sulphate in slow-release (SR) tablets (Bricanyl Depot), 5 mg twice daily, was compared with that of terbutaline sulphate in ordinary tablets (Bricanyl), 2.5 mg three times daily, in a double-blind, randomized, cross-over study during 2 consecutive weeks in 10 asthmatic children. Plasma concentrations and urinary excretion of terbutaline were measured at various times during both treatment periods. The SR tablets produced a higher mean plasma concentration in the morning and a smaller peak-trough variation over the day than the ordinary ones. No differences between the two treatments were observed concerning FEV1 (forced expiratory volume in 1 s). Tremor, measured with an opto-electronic tremorgraph, was about the same for two treatments and not significantly different from tremor seen in healthy children. The reported side effects were less frequent in the SR tablet period.     

The Influence of Lung Function Information on Self-Reports of Dyspnea by Children with Asthma

Studied the influence of actual and false peak flow (PEF) informationon dyspnea (breathlessness) in two experiments, each with 30children with and 30 without asthma (7–17 years). Dyspnea,PEF, and lung function were measured before and after standardizedphysical exercise. Dyspnea was measured with a visual analogscale. PEF was measured with a peak flow meter and used formanipulation of dyspnea. The first experiment showed that therelationship between dyspnea and lung function was not strongerwhen children had knowledge of PEF values. The second experimentrevealed that asthmatic children who received false feedbackof 30% below the actual PEF reported significantly more dyspnea.Implications for the management of asthma are discussed.     

Acceptance of Fenoterol Powder for Inhalation in Children with Bronchial Asthma

Eighteen children with perennial bronchial asthma, aged 10.3 years, were studied with respect to their attitude to inhalation of fenoterol, a β₂-agonist, in power form. Treatment with fenoterol powder was performed for 3 months and questionnaires were answered after 1 and 3 months.
Almost all children showed a positive attitude towards handling capsules and inhaler. Inhalling powder was well acccepted and the effeect of the powder on asthma symptoms was regarded as good. Although the positive attitude to continue with powder inhalations declined somewhat at the end of the observation period this type of therapy seemed to be well accepted by children.     

Terbutaline Slow-Release Tablets in Children with Asthma

The effects of 5 mg slow-release terbutaline sulphate tablets (Bricanyl Depot) given twice daily were compared with those of ordinary oral beta 2-agonist treatment given three times daily. The study was open, randomized and cross-over and was carried out over 8 weeks in 18 children with bronchial asthma. Compared with ordinary medication, the slow-release tablets obtained higher morning expiratory peak flow values and an improvement in the asthma symptoms during the night and during exercise (P less than 0.05). No differences were found in side effects in spite of a higher total daily dose during the period with terbutaline slow-release tablets. The slow-release tablets were preferred by 15 of 18 children and their families when the effects, side effects and dosage were evaluated.     

学前儿童性别角色行为评定的初步研究

试用学前儿童活动调查表（PSAI）测查了湖南、河南两个省份三个幼儿园378名儿童选择玩具、日常活动和个性特征等内容，结果提示PSAI的信度、效度和区别不同性别儿童男性化和女化行为等方面均达到了理想程度，可以在国内推广应用。     

A Population-Based Analysis of Behavior Problems in Children with Cerebral Palsy

Used the National Health Interview Survey, Child Health Supplementfor 1981 and 1988, to analyze parent-reported behavior problemsof children, ages 4–17 years, with cerebral palsy (n =47), with mental retardation (n = 50), with other chronic conditions(n = 6,038), and with no known health problem (n = 5,930), usingthe Behavior Problem Index (developed by Zill & Peterson).Behaviors with scores greater than the 90th percentile of theentire sample were considered problem behaviors. Parent-reportedbehavior problems were 5 times more likely in children withcerebral palsy (25.5%) compared with children having no knownhealth problem (5.4%). The adjusted odds ratio for behaviorproblems of children with cerebral palsy without mental retardationwas 4.9 and of children with mental retardation without cerebralpalsy was 7.9. Specific behaviors that were most problematicfor children with cerebral palsy were identified as dependency,headstrong, and hyperactive.     

孟鲁司特钠治疗小儿哮喘的临床有效性分析

目的 研究孟鲁司特钠治疗小儿哮喘的临床有效性。方法 选取2016年10月~2017年11月在我院治疗的120例小儿哮喘,随机分为对照组和观察组,各60例。对照组采用常规对症治疗,观察组采用孟鲁司特钠治疗,对比两组治疗有效率、临床症状消退时间、肺功能指标及不良反应情况。结果 观察组治疗有效率为96.67%,高于对照组的78.33%,差异有统计学意义（P＜0.05）。观察组咳嗽、肺部哮鸣音、憋喘消失时间均短于对照组,差异有统计学意义（P＜0.05）。观察组VCmax、FEV1、FEV1/FVC改善优于对照组,差异有统计学意义（P＜0.05）。在治疗和观察期间,两组患儿均未发生严重不良反应。结论 孟鲁司特钠治疗小儿哮喘疗效显著,可缩短患儿临床症状消退时间,改善患儿肺功能,值得临床推广和应用。     

Goal-Directed Behavior and Perception of Self-Competence in Children with Spina Bifida

Compared a group of school-age children with spina bifida (n= 75) between the ages of 6 and 12 years with an age- and IQ-matchedcontrol group of normal children (n = 15). As predicted, thespina bifida children spent less time using goal-directed behaviorsand more time in simple manipulation of the toys compared tothe normal children. There were no group differences betweenthe spina bifida and normal children's perceived competencebut parents of the spina bifida children rated their childrenas having lower cognitive and physical competence. Associationswere found between goal-directed behaviors and perceived self-competencefor children in the spina bifida group but not the normal group.     

Bronchial Hyperresponsiveness to Methacholine and AMP in Children With Atopic Asthma

Purpose

Bronchial hyperresponsiveness (BHR) is typically measured by bronchial challenge tests that employ direct stimulation by methacholine or indirect stimulation by adenosine 5''-monophosphate (AMP). Some studies have shown that the AMP challenge test provides a better reflection of airway inflammation, but few studies have examined the relationship between the AMP and methacholine challenge tests in children with asthma. We investigated the relationship between AMP and methacholine testing in children and adolescents with atopic asthma.

Methods

The medical records of 130 children with atopic asthma (mean age, 10.63 years) were reviewed retrospectively. Methacholine and AMP test results, spirometry, skin prick test results, and blood tests for inflammatory markers (total IgE, eosinophils [total count, percent of white blood cells]) were analyzed.

Results

The concentration of AMP that induces a 20% decline in forced expiratory volume in 1 second [FEV1] (PC20) of methacholine correlated with the PC20 of AMP (r²=0.189, P<0.001). No significant differences were observed in the levels of inflammatory markers (total eosinophil count, eosinophil percentage, and total IgE) between groups that were positive and negative for BHR to methacholine. However, significant differences in inflammatory markers were observed in groups that were positive and negative for BHR to AMP (log total eosinophil count, P=0.023; log total IgE, P=0.020, eosinophil percentage, P<0.001). In contrast, body mass index (BMI) was significantly different in the methacholine positive and negative groups (P=0.027), but not in the AMP positive and negative groups (P=0.62). The PC20 of methacholine correlated with FEV1, FEV1/forced vital capacity (FVC), and maximum mid-expiratory flow (MMEF) (P=0.001, 0.011, 0.001, respectively), and the PC20 of AMP correlated with FEV1, FEV1/FVC, and MMEF (P=0.008, 0.046, 0.001, respectively).

Conclusions

Our results suggest that the AMP and methacholine challenge test results correlated well with respect to determining BHR. The BHR to AMP more likely implicated airway inflammation in children with atopic asthma. In contrast, the BHR to methacholine was related to BMI.     

血清骨膜蛋白和脂联素联检诊断儿童支气管哮喘价值研究

目的 探讨支气管哮喘患儿血清骨膜蛋白及脂联素（ADP）水平检测对诊断支气管哮喘的临床价值。方法 选取选取2017年1月~12月在常州儿童医院儿科就诊的40例支气管哮喘患儿（哮喘组）和40名同期健康儿童体检者（对照组）作为研究对象,ELISA法检测哮喘组急性发作期和缓解期及对照组的血清Periostin、ADP及IgE水平;采用ROC曲线评价Periostin及ADP对支气管哮喘病情评估效能预测。结果 哮喘组患儿发作期及缓解期血清Periostin和血清ADP水平均高于对照组（P＜0.05）且发作期高于缓解期（P＜0.05）;采用血清Periostin和ADP水平诊断支气管哮喘,其诊断灵敏度分别为85.02%和80.48%,特异度为92.51%和81.98%,当血清Periostin和血清ADP分别在147.52 μg/L和20.31 mg/L时,其Youden 值最大,分别为0.7752和0.7504,其AUC分别为0.8262和0.7823,两者联检可将灵敏度和特异性分别提高到87.03%和95.52%。支气管哮喘急性发作期和缓解期血清Periostin与IgE的相关系数分别为0.9916和0.9358,而急性发作期和缓解期血清ADP与IgE的相关系数分别为0.4767和0.2344。结论　动态监测支气管哮喘患儿血清中Periostin及ADP水平有助于判断支气管哮喘病情转归效果;二者联检可作为排查儿童支气管哮喘的指标,血清Periostin可作为诊断支气管哮喘良好血清学指标。     

十类特殊家庭子女心理卫生状况的研究

目的 :探讨特殊家庭子女心理卫生的状况。方法 :对上海市 2 0个区县中离异、丧偶、再婚、特困、分居、本人残疾、寄养、父母残疾、服刑和孤儿这 10类家庭中 2 0 5 5名 8-2 1岁的子女进行了心理卫生状况的调查。结果 :显示特殊家庭行为问题发生率为 8 1%,其中男性 9 6 %,女性 6 4 %,男性行为问题发生率明显高于女性 (P <0 0 5 ) ,十类家庭中 ,每个家庭类型中男女性别行为问题发生率分别为 :本人残疾家庭 18 2 %,离异家庭 10 2 %,再婚家庭 8 4 %,丧偶家庭 4 3%,分居家庭 6 9%,寄养家庭 4 1%,服刑家庭 10 1%,父母残疾家庭 2 3%,孤儿家庭 1 5 %和特困家庭 6 0 %。与正常儿童相比 ,特殊家庭子女的行为总是都与居住地的社会风气、父母亲的教育方式和教育态度有关。结论 :特殊家庭子女心理健康状况需要引起社会的重视。     

Specific Diagnosis of Exogenous Bronchial Asthma in Children

Twenty-six children with exogenous asthma were studied by case history (CH), skin tests (ST), allergen-specific serum IgE (RAST), basophil histamine release (HR), and bronchial provocation tests (BPT). Nine standardized allergens were used from the following groups: house dust mite, animal dander, pollen, and mould fungi. For each allergen, the same batch was used throughout for all in vivo and in vitro studies, and the tests were carried out in a controlled, double-blinded manner, independent of each other. Different allergen concentrations were used and the results graded on a semi-quantitative scale. Approximately 120 comparable investigations, using in vivo and in vitro tests were carried out, followed by calculations of the sensitivity and specificity for each test alone, as well as for various combinations of tests, at various allergen-concentrations, and compared with the result of BPT, i.e. the true diagnosis. In this way the results could be used to directly compare the diagnostic value of each test, and combinations of tests. In general, a careful CH combined with ST gave the most reliable results. RAST was the most unreliable single analysis. When pollen or mite allergy was suspected, a combination of ST with either RAST or HR gave a further diagnostic reliability. HR as a single analysis did not seem to offer advantages over existing methods. None of the tests, or combinations of tests offered 100% sensitivity and specificity. By altering the concentration of allergen, the sensitivity, or specificity could be increased, but only at the expense of a decrease in the other. BPT is still necessary in many instances when a specific diagnosis is required.     

Behavior Problems of Obese Children Enrolling in a Weight Reduction Program

The mothers of 50 children enrolling in a behavioral weightreduction program completed Achenbach's (1978) Child BehaviorChecklist prior to any intervention. Examination of the behaviorproblem and social competence scores of these children suggestthat they are experiencing difficulties to a greater degreethan the general population but to a lesser extent than childrenreferred to psychological/psychiatric clinics. Social withdrawalfor boys and somatic complaints for girls seem to be particularlyproblematic. The relationship of both degree of overweight andsocial stigmatization to behavior problems among obese childrenremains unclear.     

哮喘儿童行为问题及其主观生活质量研究

随着医学模式、健康概念的转变 ,社会心理因素和行为方式与健康之间的相互影响已日益受到重视。人们对慢性疾病的认识不再局限于对躯体和生命数量的影响 ,其对心理行为和生活质量的影响也同样受到关注[1] 。哮喘作为儿童时期最常见的慢性疾病之一[2 ] ,且近年来患病率及死亡率有所上升[3] ,已严重危害了儿童的健康。本次研究旨在通过对不同程度的哮喘儿童与正常儿童的行为问题进行比较 ,了解哮喘儿童行为问题的发生 ,同时对哮喘儿童和主观生活质量进行了初步的探讨 ,以求在新的医学模式观点指导下 ,对哮喘儿童进行综合治疗 ,全面提高哮喘儿…     

哮喘儿童垂体-甲状腺功能的研究

目的 探讨不同哮喘状态下,机体内分泌系统中垂体-甲状腺轴的功能状态.方法 选择60例（3～12）岁的哮喘儿童作为研究对象,根据病情分为轻中度哮喘组和重度哮喘组,健康儿童（3～12）岁为对照组,每组30例.用放射免疫分析测定上述儿童血清促甲状腺素（TSH）、三碘甲腺原氨酸（T3）和甲状腺素（T4）水平.结果 重度哮喘组TSH水平增高,而T3和T4水平明显减低,同正常儿童组比较有显著差异（P〈0.01）,但轻中度哮喘组TSH、T3和T4与正常儿童组比较差异无统计学意义.结论 轻、中度哮喘儿童组甲状腺功能基本正常,而重度哮喘儿童组存在甲状腺功能的紊乱.