Acupuncture in children and adolescents with bronchial asthma: a randomised controlled study.

OBJECTIVE: This randomised controlled trial evaluates the immediate effects of acupuncture as an add-on therapy in in-patient rehabilitation of children and adolescents with bronchial asthma. PATIENTS AND METHODS: In a pre-post design, the severity of symptoms, lung function, illness-specific quality of life (Paediatric Asthma Quality of Life Questionnaire - PAQLQ) and general and asthma-specific level of anxiety (State-Trait Anxiety Inventory for Children - STAIC) were investigated in 46 acupuncture and 47 control patients. In addition to asthma sports, climate therapy and behavioural training, the intervention group received acupuncture treatment with a standardised needle pattern (12 × 30 min.). RESULTS: With acupuncture, the peak expiratory flow variability differs significantly (p<0.01) from that of the control patients' group. Moreover, the acupuncture group differs significantly in their rehabilitation response at the time of discharge concerning perceived anxiety (STAIC-S). The lung function tests do not present differences between groups. CONCLUSION: After additional acupuncture, amelioration of peak expiratory flow variability and anxiety can be shown, without any difference in objective lung function tests and quality of life between study groups. Further studies might evaluate the effects of acupuncture on childhood asthma in an outpatient setting.

[Medication behavior of children and adolescents with asthma before and after in-patient rehabilitation--results of a multicenter study]. / Medikationsverhalten asthmakranker Kinder und Jugendlicher vor und nach stationärer Rehabilitation - Ergebnisse einer multizentrischen Studie.

The article presented is based on data of a multicenter study examining the effectiveness of an inpatient rehabilitation program for children and adolescents with asthma. The study took place from August 1996 to November 2001. It shows more noticeable long-term improvement of disease management and lung function parameters after in-patient rehabilitation (n = 226) than after out-patient rehabilitation programs (n = 92). The re-analysis of the data examines the influence of medication on these results. A decisive effect on treatment results for both in- and outpatients can be achieved by complying with the guidelines recommended by the medical societies. However, at the same time the results demonstrate that prescribing a correct treatment plan is not always sufficient. The significant improvement of outcome parameters (functional restriction, lung function, days absent from school, visits to a physician) of the rehabilitation group shows the importance of rehabilitation for teaching strategies for disease management and increase in compliance.

Treatment of hyperinsulinaemic hypoglycaemia with nifedipine.

UNLABELLED: We report on two children with mild persistent hyperinsulinaemic hypoglycaemia. In both, oral nifedipine treatment (0.7 and 2.0 mg/kg per day respectively) had a significant clinical effect. In one case, nifedipine monotherapy prevented hypoglycaemia; in the second case, the dosage and the side-effects of other substances could be reduced, thus circumventing surgical therapy. CONCLUSION: Nifedipine treatment has a favourable effect on the clinical course of patients with mild hyperinsulinism. It represents a valuable new substance for the treatment of this disorder.

[Primary sclerosing cholangitis in isolated IgA deficiency]. / Primär sklerosierende Cholangitis bei isoliertem IgA-Mangel.

Primary sclerosing cholangitis was diagnosed in a patient with isolated IgA deficiency. Similar reports in the literature suggest that the two conditions are related. Patients with primary sclerosing cholangitis associated with isolated IgA deficiency are distinguished by the fact that it is mainly the intrahepatic bile ducts that are narrowed by the fibrosing process. The disease manifests itself comparatively early. Recurrent bouts of fever, in combination with elevated AP, can become the leading symptom even before the onset of jaundice. The prognosis seems somewhat more favourable than in other patients with primary sclerosing cholangitis.