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  • 1
    Digitale Medien
    Digitale Medien
    Coincidence of immune-mediated diseases driven by Th1 and Th 2 subsets suggests a common aetiology. A population-based study using computerized General Practice data (2002)
    Oxford, UK : Blackwell Science, Ltd
    Clinical & experimental allergy 32 (2002), S. 0 
    Details
    ISSN: 1365-2222
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background The recent rise in the prevalence of immune-mediated diseases has been attributed to environmental factors such as a lack of microbial challenge, or dietary change, that deviate the overall balance between mutually antagonistic subsets of T helper (Th) cells.Objective An alternative proposal is that recent environmental changes have resulted in an immune system that is more likely to produce both Th1 and Th 2 responses against benign antigens. The prediction of this hypothesis, that Th1 and Th 2-mediated diseases are not mutually exclusive, and may be positively associated, is tested here in a whole population.Methods Data from General Practices participating in the Scottish Continuous Morbidity Recording (CMR) project were used to determine the coincidence of the major Th 2-mediated atopic diseases; asthma, eczema and allergic rhinitis, with the Th1-mediated autoimmune conditions; type I diabetes, rheumatoid arthritis and psoriasis. We also identified the prescription rates of inhaled therapy for asthma in patients with Th1-mediated disease.Results There was a significant increase in the risk of presenting with a Th1-mediated autoimmune condition in patients with a history of allergic disease (standardized prevalence ratio (95% confidence interval) 1.28 (1.18–1.37)). Likewise, the standardized prevalence ratios of presenting with either eczema (1.67 (1.48–1.87)) or allergic rhinitis (1.22 (1.02–1.44)) were significantly increased in subjects with a history of Th1-mediated disease. There was a particularly strong association between current psoriasis and current eczema (standardized prevalence ratio of psoriasis in subjects with eczema 2.88, 95% confidence interval (CI) 2.38–3.45). There was also a significant increase in prescriptions for inhaled asthma therapy in patients with Th1 disease.Conclusion It is concluded that Th1- and Th 2-mediated diseases are significantly associated in a large General Practice population. This finding supports the proposal that autoimmune and atopic diseases share risk factors that increase the propensity of the immune system to generate both Th1- and Th 2-mediated inappropriate responses to non-pathological antigens.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.0022-0477.2001.01250.x
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  • 2
    Digitale Medien
    Digitale Medien
    Wheezing infants (1994)
    Oxford, UK : Blackwell Publishing Ltd
    Clinical & experimental allergy 24 (1994), S. 0 
    Details
    ISSN: 1365-2222
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2222.1994.tb00203.x
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  • 3
    Digitale Medien
    Digitale Medien
    Eosinophil activation and cysteinyl leukotriene production in infants with respiratory syncytial virus bronchiolitis (2004)
    Oxford, UK : Blackwell Science Ltd
    Clinical & experimental allergy 34 (2004), S. 0 
    Details
    ISSN: 1365-2222
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Background It has been suggested that acute infantile bronchiolitis associated with respiratory syncytial virus (RSV) may share some pathogenic features with atopic asthma in that virus-specific IgE is produced and cysteinyl leukotrienes (cLTs) and eosinophil cationic protein (ECP) have been detected in airway secretions. ECP is a specific marker of eosinophil activation although leukotrienes can be released from a variety of cells including mast cells, eosinophils and monocytes.Objective To test the association between eosinophil activation and cysteinyl leukotriene production in the upper airway secretions of infants with RSV positive (RSV+ve) bronchiolitis.Methods Nasal lavage samples were performed in 78 infants (0.0–11.5 months) admitted to hospital with RSV+ve bronchiolitis soon after admission (0–48 h). Leukotriene C4 (LTC4) was assayed by enzyme immunoassay (EIA) and eosinophil cationic protein (ECP) by fluoroimmunoassay (FIA).Results LTC4 was detectable in 51 and ECP in 57 of 78 samples with a significant positive relationship between LTC4 and ECP (r=0.557, P〈0.001).Conclusion In the majority of our subjects with RSV+ve bronchiolitis ECP and LTC4 were detectable in upper airway secretions and were significantly associated with each other. In this clinical setting much of the detected LTC4 within upper airway secretions is likely to originate from the eosinophil, an observation that may have implications for clinical management and for delineation of the underlying mechanisms associated with this illness.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2222.2004.1918.x
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  • 4
    Digitale Medien
    Digitale Medien
    Early introduction of inhaled steroids in wheezing children presenting in primary care. A pilot study (2000)
    Oxford BSL : Blackwell Science Ltd
    Clinical & experimental allergy 30 (2000), S. 0 
    Details
    ISSN: 1365-2222
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Recurrent wheezing illness in childhood is a frequent reason for consultation in both primary and secondary care and whilst there is widespread support for the earlier introduction of inhaled corticosteroids(ICS) concerns remain about potential adverse systemic effects.〈section xml:id="abs1-2"〉〈title type="main"〉ObjectiveWe sought to identify the feasibility and size of study required to assess the benefits, adverse effects and cost-effectiveness of early introduction of ICS.〈section xml:id="abs1-3"〉〈title type="main"〉MethodsWe entered 86 children (mean age 4.5 years) with at least two consecutive wheezing episodes into a pragmatic randomized controlled trial. All children were already being prescribed β2-agonist and those allocated to ICS were prescribed twice daily beclomethasone dipropionate 200 μg or budesonide 200 μg. At entry and 3 and 6 months age appropriate lung function (FEV1, Tptef:Te), respiratory symptoms, quality of life of children and carers, growth and sexual maturation, bone mass and bone turnover, and health care costs were assessed.〈section xml:id="abs1-4"〉〈title type="main"〉ResultsDrop out rate was 8% (7 of 86). No significant differences were found in FEV1 or Tptef:Te at 6 months. Respiratory symptoms and health-related quality of life of children and carers improved equally in both groups. No significant differences were found in growth rates or in bone mass. In the ICS group markers of bone turnover (Pyd:Cr) fell (271 vs 237 nmol/mmol) in contrast to a rise in those on β2 alone (255 vs 319 nmol/mmol) P 〈 0.05. Combined health care costs were higher in the ICS group.〈section xml:id="abs1-5"〉〈title type="main"〉ConclusionsThe low drop out rate provided evidence that the protocol was practical and acceptable. In order to confirm these results, and using the same study design, power estimates indicated that 260 children would need to be randomized.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.1365-2222.2000.00941.x
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  • 5
    Digitale Medien
    Digitale Medien
    Assisted ventilation and the Servo ventilator in infants (1986)
    Oxford, UK : Blackwell Publishing Ltd
    Anaesthesia 41 (1986), S. 0 
    Details
    ISSN: 1365-2044
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: A laboratory assessment was made of systems used for Continuous Positive Airway Pressurel lntermittent Mandatory Ventilation (Cpapiimv) with the Servo 900B and 900C ventilators. Pressure-volume loops recorded during sine wave oscillation using an external Cpapiimv system were similar to those found during normal respiration. Pressure-volume loops using the systems based on the ventilator's inbuilt trigger mechanism were very djflerent. particularly for the 900B. The results were conjirmed by measurements in two infants. The implications of these jindings with reference to the weaning of infants from mechanical ventilation are discussed.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1365-2044.1986.tb13174.x
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  • 6
    Digitale Medien
    Digitale Medien
    Intensive care management of children following heart and heart-lung transplantation (1990)
    Springer
    Intensive care medicine 16 (1990), S. 426-430 
    Details
    ISSN: 1432-1238
    Schlagwort(e): Paediatric ; Cardiac ; Pulmonary ; Transplantation ; Intensive care
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We report the intensive care management of 23 children (age 3–15 years) following orthotopic heart (HT) and combined heart and lung transplantation (HLT) performed at our 2 institutes between February 1985 and August 1989. Cyclosporin A, azathioprine and steroids were given as routine immunosuppression, whilst anti-thymocyte globulin (ATG) was used for the first 3 post-operative days. Mean ventilation time was 24.6 h (range 4–74 h). Cardiovascular support comprised isoprenaline infusions in all patients (mean period 65.7 h) whilst dopamine and other inotropic agents were used less frequently. Sequential atrioventricular pacing was required more often in the HT patients (n=9) than in the HLT patients (n=4). Fluid input was restricted to maintain a plasma osmolality of 290–300 mosm/kg. There were 2 perioperative deaths both due to acute right heart failure. Other post-operative complications included: bleeding (n=3); acute graft rejection (n=4); infection (n=3); systemic hypertension (n=6); neurological abnormalities (n=2); renal dysfunction (n=6) and hyperglycaemia (n=6).
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01711219
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  • 7
    Digitale Medien
    Digitale Medien
    A comparative trial of choline theophyllinate and controlled release aminophylline in chronic childhood asthma (1983)
    Springer
    European journal of pediatrics 141 (1983), S. 89-91 
    Details
    ISSN: 1432-1076
    Schlagwort(e): Asthma ; Theophyllines ; Therapy
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract A comparison of pharmacokinetics and therapeutic effects of a standard oral theophylline preparation (Choline Theophyllinate) and controlled release aminophylline (Phyllocontin) was made in two parallel double blind trials in 25 children with chronic asthma. Fourteen children entered a double blind cross-over trial; the remaining 11 were allocated to a parallel trial with no change of theophylline preparation throughout. Sustained plasma theophylline levels were observed with the controlled release preparation in contrast to the low morning levels obtained with Choline Theophyllinate. No significant differences were found for peak theophylline levels, morning or evening peak flow rates or required access to other bronchodilators. However nocturnal symptoms were significantly reduced and daytime activity scores improved (P〈0.05) on the controlled release preparation. The sustained plasma theophylline levels found in children taking the controlled release aminophylline may have provided a small but useful therapeutic advantage over the standard preparation.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00496796
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  • 8
    Digitale Medien
    Digitale Medien
    Once a day theophylline in chronic childhood asthma? (1986)
    Springer
    European journal of pediatrics 145 (1986), S. 258-259 
    Details
    ISSN: 1432-1076
    Schlagwort(e): Asthma ; Children ; Theophylline
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract The therapeutic effects of either morning or evening administration of a once-daily controlled release theophylline preparation (Uniphyllin) were studied in 17 asthmatic children. Neither morning nor evening administration produced therapeutic plasma theophylline levels throughout 24 h. Similarly, bronchodilation was not maintained during the same period. However, morning peak expiratory flow rates were significantly improved following evening dosage, suggesting a role for evening administration when nocturnal symptoms predominate.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00439396
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  • 9
    Digitale Medien
    Digitale Medien
    Spinal cord dysfunction in neonatal meningococcal meningitis (1994)
    Springer
    European journal of pediatrics 153 (1994), S. 367-368 
    Details
    ISSN: 1432-1076
    Schlagwort(e): Key words: Meningitis, meningococcal – Paraplegia – Spinal cord diseases – Infant, newborn, diseases
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract. A 3-week-old infant with meningococcal meningitis is described whose clinical course was complicated by paraparesis and urinary retention. This rare complication of meningococcal meningitis has not previously been reported in the neonatal age group.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01956421
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