Potato crisps without pancreatic extracts supplements: a potential cause of the distal intestinal obstruction in cystic fibrosis

Three cases of the distal intestinal obstruction syndrome (DIOS) are reported to be caused by a consumption of potato crisps without appropriate pancreatic enzyme supplements.

The use of oscillometry as a measure of airway responsiveness in asthmatic children after histamine and methacholine bronchoprovocation with dosimeter-MedicAid and DeVilbiss nebulizers

To explore the use of oscillometry as a measure of airway responsiveness, 69 asthmatic children underwent histamine and methacholine bronchoprovocation using dosimeter-MedicAid (Jaeger Co.; Germany) and DeVilbiss nebulizers (DeVilbiss, Bornemouth; England). The mean increase in R5 resistance in challenge testing measured after methacholine with the dosimeter-MedicAid nebulizer was 77.14% compared with 65.05% using histamine. Using the dosimeter-DeVilbiss nebulizer, the mean increases in R5 resistance following methacholine and histamine testing were 57.50% and 59.36%, respectively. The resistance R5 over R20 significantly correlated with forced expiratory volume in 1 second (FEV1). The MedicAid produced a more aggressive challenge than the DeVilbliss nebulizer. Oscillometry can be used to monitor the level of airway hyperresponsiveness following bronchoprovocation tests.

[Study of the eosinophilic inflammation activity in bronchial asthma]

BACKGROUND

Bronchial asthma is a chronic inflammatory disease of the respiratory tract where variety of cells plays a role, particularly mast cells, eosinophils (Eo), and T lymphocytes. At present, there is no clear-cut clinical or laboratory parameter to monitor the activity of this disease. Our study was designed to examine and compare serum eosinophilic cationic protein (S-ECP) levels, plasma ET-1 (P-ET) levels and percentage of eosinophils with CD44 (EoCD44) in paediatric asthmatic patients.

METHODS AND RESULTS

In our study, a group of 97 atopic children with persisting mild asthma, had a detailed analysis of their personal history. In addition, S-ECP, P-ET, EoCD44, eosinophil blood count (Eo) and serum levels of IgE(S-IgE) in peripheral blood were determined. Subsequently, children were treated with montelukast (singular), a leukotriene receptor antagonist for a period of three weeks (montelukast tablets in a dose of 5 mg once a day). A second S-ECP, P-ET, EoCD44 were determined in the interval of 3 months from the first collection. In 97 asthmatic children a correlation between P-ET and EoCD44 (p=0.002; r= -0.5) were found.

CONCLUSIONS

Our follow-up study surprisingly confirmed a correlation between P-ET and EoCD44. The lower percentage of EoCD44 in peripheral blood in asthmatic children is due to Eo inflammation activity and attests the massive Eo invasion into the airways. The determination of combination - S-ECP, P-ET, EoCD44 - provides an indirect evidence of the multiple features of Eo inflammation.

Monitoring of serum eosinophil cationic protein (ECP) level and its clinical value in paediatric practice

The article deals with the clinical value of monitoring serum eosinophil cationic protein (ECP) in patients with allergic diseases, especially bronchial asthma in paediatric practice. We confirmed the seasonal increase of serum ECP level in group of patients with bronchial asthma especially with higher total IgE level.

Spondyloepiphyseal dysplasia with nephrotic syndrome (Schimke immunoosseous dysplasia)

The first symptoms of immunooseous dysplasia were growth retardation and myopia. Nephrotic syndrome was diagnosed at the age of 8 years. Skeletal roentgenograms showed spondyloepiphyseal dysplasia. In the renal biopsy there was nodular accumulations of PAS-positive hyaline material at the base of the granular stalks. There was lymphopenia with decreased CD4 and CD8 subpopulations. The condition of the patient gradually worsened until she died unexpectedly at 10 years with clinical symptoms of encephalitis. Autopsy documented cytomegaloviral pneumonia and advanced mesangioproliferative glomerulonephritis. In the spleen there was PAS-positive hyaline material massively infiltrating the walls of the central arterioles of the splenic follicles. There was marked depletion of lymphocytes in the spleen and in lymph nodes. The differential diagnosis of immunooseous dysplasia in the framework of spondyloepiphyseal dysplasia is discussed.

High-resolution CT in the assessment of bronchiectasis in children

To assess the possibilities and limitations of high-resolution CT (HRCT) in the evaluation of bronchiectasis in children, we conducted a prospective study of 20 children with clinical and/or chest film findings suggestive of this diagnosis. The 2-mm collimation, 4.3-s HRCT scans with 10 mm interslice spacing were obtained in areas of suspected bronchiectasis; in nonsuspect areas 25-30 mm interslice spacing was used. No preparation for examination was required. Bronchiectasis was revealed in ten patients (50%), being bilateral in four cases and unilateral in six cases. All types of bronchiectatic patterns were found. Cooperation during the examination was the only difference when compared with an investigation of adults. It was not a serious problem in children aged 7 years and older; scans in 6-year-old children were diagnostic but not ideal. Nondiagnostic scans were obtained in a 3-year-old girl. At the time of the scans only one patient had undergone surgery. Preoperative bronchography confirmed the CT findings. The authors conclude that HRCT can limit the need for bronchography in children with a CT finding of focal bronchiectasis in whom surgery is contemplated. When using longer scanning times it is not possible to obtain good results without sedation of children younger than 6 years.