RESUMEN
To describe the clinical spectrum of interstitial lung disease in children, we reviewed our experience with 48 patients during a 12-year period. Most patients initially had typical findings of restrictive lung disease and hypoxemia. Growth failure or pulmonary hypertension or both were found in more than one third. Specific diagnosis, made in 35 patients (70%), most often required invasive studies, particularly open lung biopsy. Although the diagnostic yield from open lung biopsy was high, the diagnosis of many patients remained uncertain. Many different disorders were encountered. The response to corticosteroids, bronchodilators, and chloroquine was inconsistent. Six patients died, five within 1 year after the initial evaluation. The spectrum of pediatric interstitial lung disease includes a large, heterogeneous group of rare disorders associated with high morbidity and mortality rates.
Asunto(s)
Fibrosis Pulmonar/diagnóstico , Adolescente , Biopsia , Niño , Preescolar , Enfermedad Crónica , Colorado/epidemiología , Estudios de Seguimiento , Humanos , Lactante , Pulmón/diagnóstico por imagen , Pulmón/patología , Prevalencia , Fibrosis Pulmonar/epidemiología , Fibrosis Pulmonar/terapia , Radiografía , Pruebas de Función Respiratoria , Estudios Retrospectivos , Resultado del TratamientoAsunto(s)
Asma/tratamiento farmacológico , Beclometasona/efectos adversos , Broncodilatadores/efectos adversos , Sistema Hipotálamo-Hipofisario/efectos de los fármacos , Sistema Hipófiso-Suprarrenal/efectos de los fármacos , Administración por Inhalación , Aerosoles , Beclometasona/administración & dosificación , Broncodilatadores/administración & dosificación , Budesonida , Niño , Depresión Química , Humanos , Pregnenodionas/administración & dosificación , Pregnenodionas/efectos adversosRESUMEN
Chronic cough in childhood has many possible causes. The two most common are asthma and viral upper respiratory infection. Although usually associated with wheezing, dyspnea, or both, cough may be the sole manifestation of asthma ("cough-variant asthma"). Most important to initial evaluation are physical examination, patient history, and chest radiograph. Bronchial provocation testing may also prove helpful but is usually unnecessary. A trial of antiasthma therapy is appropriate when the pattern of symptoms is typical of asthma (excepting the lack of wheezing) and when nothing incompatible with asthma is present in the clinical picture. Drug therapy for cough-variant asthma is the same as that for more typical asthma. A vigorous trial of antiasthma therapy should not be considered complete unless a short course of high oral doses of corticosteroids has been included. The presence of clinical signs or symptoms atypical or incompatible with asthma and the failure of symptoms to respond to aggressive antiasthma therapy both warrant a more aggressive and complete diagnostic study.
Asunto(s)
Tos/etiología , Algoritmos , Asma/complicaciones , Niño , Preescolar , Enfermedad Crónica , Tos/tratamiento farmacológico , HumanosRESUMEN
Hepatic lysosomes were exposed in vitro to microwave radiation (2450 MHz) either prior to or simultaneously with treatment with retinol (vitamin A), and the release of the lysosomal enzymes, beta-glucuronidase, acid phosphatase, and cathepsin D, determined. A 60-min microwave exposure (10 or 100 mW/g) of retinol-treated lysosomes had no effect on the amount of release of beta-glucuronidase, cathepsin D, or acid phosphatase. In addition, 10 and 100 mW/g irradiation of lysosome fractions for 40 min prior to a 20-min retinol and microwave treatment, had no influence on the release of these enzymes. Finally, the effect of microwave radiation on the loss of latency of acid phosphatase and beta-glucuronidase from retinol-treated lysosomes was determined. Microwave radiation had no influence on the rate of appearance of these enzymes in the suspending medium. The results indicate that microwave radiation had no effect on the retinol-induced lysosomal enzyme release.