[Vaccination and intensified sanitary regime for prevention of viral hepatitis type B among medical personnel at the Center for Health of the Child]. / Szczepienia ochronne i zaostrzenie rezimu sanitarnego w zapobieganiu wirusowemu zapaleniu watroby typu B wsród personelu Centrum Zdrowia Dziecka.

Paper concerns the question of infections by hepatitis B virus among health care workers. Authors have reported the improvement of epidemiological situation among employees of the Child Health Center in the years 1987-1994 and analysed factors which were the probably cause of improvement (protective vaccination, infection control, and education of workers). In the first year of observation, among ca. 1700 health care workers 32 new hepatitis B infections were noted, while in 1994 there were no hepatitis B cases.

[A vascular ring as a rare cause of recurrent obstructive bronchitis in children]. / Pierscien naczyniowy jako jedna z rzadko wystepujacych przyczyn obturacyjnego zapalenia oskrzeli u dzieci.

The authors have described two cases of vascular ring in small children. Recurrent obstructive bronchitis and pneumonitis with severe dyspnoea, stridor and wheezing predominated in clinical manifestation. Early diagnosis and proper surgical treatment were the most important for the prognosis of the children.

Immunological and genetic studies on hereditary angioedema.

Ca. eighty patients with hereditary angioedema due to C1-inhibitor deficiency were diagnosed and treated in Poland during last the 15 yrs, mainly in centers from Warsaw, Cracow and Bydgoszcz. The detailed description concerns 17 patients, 14 females (82%) and 3 males (18%). Important diagnostic points, response to treatment, and critical serum values of C1-inhibitor were evaluated. In the experimental part, we have established fibroblasts cell lines from 5 patients with type I HAE, with characteristic profound deficits of C1-INH (antigenic and functional) and C4. Fibroblasts from all the patients synthesized only ca. 20% of the normal values of C1-INH. We have confirmed the data from other authors that C1-INH synthesis can be substantially increased (11 to 20-fold) by IFN-gamma at a pretranslational level.

[Results of electroencephalographic tests in children with bronchial asthma]. / Wyniki badan elektroencefalograficznych u dzieci chorych na astme oskrzelowa.

In the years 1988-1990, 100 children aged from 2 to 18 years were examined, who were hospitalized for bronchial asthma of moderately severe and severe clinical course. In all children the examinations were performed twice at intervals of several weeks or several months during administration of the full set of drugs, including euphylline. The results were estimated according to the number and character of electric discharges. Out of the total number of 100 children in 52 cases abnormal EEG record was found. Generalized paroxysmal discharges were found in 16 children mainly with severe and moderately severe course of asthma. Generalized changes were recorded in 12 children mainly with moderately severe course of the disease. Milder focal changes were found in 23 children. Most evident changes occurred in children with over five years of disease duration and with history of unconsciousness episodes. The studies carried out indicate a relatively frequent, that is in half the cases, damage to the central nervous system following repeated episodes of hypoxia.

[Epilepsy as a complication of bronchial asthma]. / Padaczka jako powiklanie astmy oskrzelowej u dzieci.

UNLABELLED: Epilepsy was recognized in 9 of 120 patients with bronchial asthma, aged 7-15 years, hospitalized in the Department of Allergology and Infectious Diseases in the Years 1989-1992. All the children had severe asthma attacks previously, six of them required hospitalisation at Intensive Care Unit. In 8 of the patients grand mal (generalised, tonic-clonic) seizures was observed, one child had absence state. Seizures were present both in the acute state of the asthma and during improvement. Anticonvulsant therapy was started immediately after diagnosis of epilepsy has been established. Clinical improvement with cease of seizures was noted there after. All the 9 patients had EEG examinations: 22 out of 29 performed, were abnormal. CONCLUSIONS: 1. Severe asthma attacks lasting for a considerable period of time, mainly 5 years, evoke epilepsy. 2. Undesirable signs of the antiasthmatic therapy on CNS was not found. 3. Accurate treatment of asthma seems to be the best prophylaxis of epilepsy.

[The problem of allergic pulmonary aspergillosis in children in light of personal observations]. / Zagadnienie alergicznej aspergilozy oskrzelowo-plucnej u dzieci w swietle obserwacji wlasnych.

67 children (age range 4-17 years) with severe asthma were examined for the presence of allergic pulmonary aspergillosis 28 of these underwent long term steroid therapy. The following parameters were analysed: medical history, clinical state, chest radiograms, microbiological examination of the sputum, precipitating IgG antibodies, skin prick tests with aspergillus, level of specific IgE antibodies. The authors did not find any single child that met the diagnostical criteria of allergic pulmonary aspergillosis. Only in 4 serum specific IgE antibodies were found but the precipitin and skin prick tests were negative. The children did not present typical clinical symptoms of pulmonary allergic aspergillosis. It seems worthwhile to re-examine these children in a few years.

Effect of salbutamol on specific airway resistance in infants with a history of wheezing.

The purpose of this study was to assess the effectiveness of nebulized salbutamol in infants with a history of wheezing. Eighty-eight children aged 3-24 months with a history of wheezing were studied, in seven groups: I (n = 15) and I/A (n = 17) with elevated specific airway resistance (SRaw); II (n = 17) with normal SRaw; III (n = 23), III/A (n = 17), and IV (n = 18) with normal SRaw exposed to carbachol bronchial challenge (CBC); and V (n = 13) serving as control. Infants for groups I/A and III/A were selected to match by age and by baseline and post-carbachol SRaw values, respectively. Baseline airway resistance and thoracic gas volume (TGV) were measured plethysmographically. Specific airway resistance was selected as an index of bronchial function. Thereafter every child in groups I, I/A and II inhaled 200 micrograms of salbutamol by tidal breathing, and the children in groups III, III/A, and IV were exposed to CBC. Following positive reaction to carbachol, children of groups III and III/A inhaled salbutamol (200 micrograms, tidal breathing), and those of group IV received no drug. Controls from group V with normal SRaw received placebo (phosphate-buffered saline). Plethysmography was repeated in all children at 5 minute intervals. Following salbutamol SRaw was reduced in children with elevated and normal SRaw. In contrast, children not receiving salbutamol had unchanged SRaw value. The response to salbutamol measured by SRaw, Raw, and TGV was not significantly different in the spontaneously obstructed infants compared to those who received carbachol. In conclusion, infants with a history of wheezing do respond to inhaled salbutamol.

[Ten years of experience with specific desensitization in children with bronchial asthma]. / 10-letnie doswiadczenie w zakresie odczulania swoistego dzieci chorych na dyschawice oskrzelowa.

Hundred eighty five children, aged between 6 and 15 years, with bronchial asthma and diagnosed allergy to Dermatophagoides pteronyssinus were followed-up for 2-3 years between 1978 and 1988. Children were treated with HDM vaccine Bencard. Administered doses were increased gradually at the beginning of therapy whereas they remained the same for further 1-3 years. Excellent and favourable results were achieved in 78.4% of cases. The treatment as postponed in 36 children (19.4%) because of the lack of improvement after one year of the follow-up. Easily manageable adverse reactions and complications were seen in 4 patients (2.2%).

[The value of Phadiatop screening tests for diagnosing allergic respiratory diseases in children]. / Wartosc testu przesiewowego Phadiatop w diagnostyce chorób alergicznych dróg oddechowych u dzieci.

Phadiatop test was performed in 174 children aged between 1 and 16 years (mean: 9 6/12 years) referred to the hospital because of the bronchial asthma, obstructive bronchitis and perennial or seasonal allergic rhinitis. Positive results were obtained in over 93% of children with atopic allergy. Comparing with PRIST, multiple allergen assay proved more sensitive (93.5%), specific (90%), and accurate (91.4%). The same data for PRIST were: 91.7%, 80.3%, 87.4%, respectively. False negative and false positive results were also less frequent than for PRIST. Therefore, Phadiatop, is considered an appropriate screening in vitro diagnostic test for inhalant allergy which should be performed at the beginning of respiratory tract diagnosis.

[Is bronchial hypersensitivity in early childhood genetically determined?]. / Czy wczesnodziecieca nadreaktywnosc oskrzeli ma podloze rodzinne?

In order to study the familial occurrence of bronchial hypereactivity (BH) the parents of infants with BH were evaluated. 47 pairs of parents of infants aged 10-33 months were studied. All infants following spastic bronchitis developed BH. All parents had bronchial reactivity assessed. All answered a questionnaire from which the following data were retrieved: family history, personal history, environmental data and smoking habits. A similar analysis was carried out on a group of 19 pairs of parents forming a control group, derived randomly from hospital personnel. In parents of children with BH a higher incidence of BH was found in comparison with the control chi 2 = 11.52; p less than 0.01). In 14 subjects a positive familial history was found. This did not differ from the control. The smoking habit was seen more often in the study group that in the control (chi 2 = 9.82; p less than 0.01). These results allow us to state that familial factors play a role in bronchial hypereactivity in early infancy.

[Functional status of the bronchial tree in infants with gastroesophageal reflux]. / Stan czynnosciowy drzewa oskrzelowego u niemowlat z odplywem zoladkowo-przelykowym (OZP).

Airway resistance (Raw) and functional residual capacity (FRC pl) were determined by plethysmography in 17 children aged 3 to 12 months. Gastroesophageal reflux was diagnosed on the ground of longterm monitoring of esophageal pH or the X-ray examination of the stomach. No elevated airway resistance was found. In 41% of the cases FRC (per kg of body weight) was increased. This indirectly indicates the diminished small airways patency.

[Hormonal inhalation preparations in the treatment of bronchial asthma in children]. / Inhalacyjne preparaty hormonalne w leczeniu astmy oskrzelowej u dzieci.

Hormonal inhalation preparations (Becotide, Beclomet) were given to 59 children aged 3 to 18 years with severe and long-standing asthma. In most cases (70% a striking improvement of the general condition was achieved with complete regression or alleviation of dyspnoeic attacks. In 15 out of 17 children prednisone could have been withdrawn. No side effects were noted. In 4 children administration of Becotide or Beclomet was not possible.