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Chronic sinusitis is the long-term inflammation of the sinuses, the passages connected to the nasal cavities. These nasal sinuses are involved in warming, moistening, and filtering inhaled air. Blood levels of IgG (an antibody) and response to Haemophilus influenzae and pneumococcal vaccines were assessed in 61 children with chronic sinusitis. Some of the patients also had recurrent otitis media (inflammation of the middle ear), chronic pneumonia, or asthma. Five patients had increased levels of IgE, an immune protein produced by the respiratory and intestinal tracts that increases in patients with allergies. Twenty-two patients were sensitive to environmental inhalants. These findings suggested that these patients had an allergic component to their illness. Twelve patients were sensitive to environmental allergens, possibly indicating an inherited allergy. Ig levels were low in 11 patients, and vaccine response was poor in 17 patients, whereas six patients had both a poor vaccine response and low Ig levels. (Consumer Summary produced by Reliance Medical Information, Inc.)

Objective. To compare the benefits and adverse reactions of theophylline and beclomethasone (BDP) in the long-term control of mild to moderate chronic asthma in children. Design. Multicentered, double-blind, double-placebo, randomized, controlled trial. Patients. One hundred ninety-five children between the ages of 6 and 16 years with mild to moderate asthma. Intervention. Treatment with either BDP, 84 [micro]g four times a day, or sustained-release theophylline administered twice daily I doses adjusted for optimum control of symptoms. Main Outcome Measures. Daily diary record of symptoms, peak flow rates, supplemental bronchodilator and glucocorticoid treatment, doctor and hospital visits, absence from work and school, and side effects. Results. Aerosol BDP and sustained-release theophylline were effective primary treatments for mild to moderate chronic asthma. BDP resulted in comparable symptom control with less bronchodilator use and fewer courses of systemic steroids than did theophylline. Side effects were observed significantly more frequently with theophylline than with BDP. Growth velocity suppression was noted with BDP and was more pronounced in boys. Suppression was not associated with alterations in cortisol measurements either at baseline or following stimulation. Conclusions. Both theophylline and BDP are effective therapy for mild to moderate asthma. Caution must be used with the administration of BDP in children because of possible growth velocity suppression., COMMENTARY This study contributes two important points for clinicians.[1] Theophylline dosage designed to achieve a blood level of 8 to 15 [micro]g/mL 12 hours after ingestion and inhaled beclomethasone (BDP) [...]

Focuses on the medical management of serous otitis in children. Diagnosis of serous and secretory otitis media; Pathogenesis of serous otitis media; Middle ear immune factors.

Abstract. The effectiveness of cromolyn sodium and theophylline on asthma in children was compared during a 3-month trial. Forty-six children (aged 5 to 15 years) with asthma were assigned at random to cromolyn or theophylline (Theo-Dur) treatment groups. Each subject received theophylline placebo or cromolyn placebo in addition to the active drugs. A methacholine challenge test was done at the start of the study to document asthma and was repeated during the third month. The theophylline dosage was regulated to obtain serum levels of 10 to 15 micro g/mL by a physician not involved directly with patient care. Forty patients completed the study. Both theophylline and cromolyn treatment groups showed improvement from base-line status in terms of symptom scores, pulmonary function, and decreased use of inhaled albuterol. Patients treated with theophylline had more side effects and required more frequent office visits than those treated with cromolyn. Both groups had decreased sensitivity to methacholine, and for One statistical test patients treated with cromolyn improved significantly. These results indicate that cromolyn is as effective as theophylline in treating mild to moderate asthma in children; additional benefits were fewer side effects and a possible decrease in bronchial hyperactivity. Pediatrics 1984;74:453--459; cromolyn sodium, theophylline, asthma. [ABSTRACT FROM AUTHOR]

Abstract. Twenty-eight children with persistent bronchospasm after outpatient therapy were treated for eight days with methylprednisolone or placebo in a prerandomized double-blind manner, in addition to treatment with optimal oral bronchodilators. At follow-up visits 1, 7, and 14 days after onset of therapy, a history was taken and physical examination and pulmonary function tests were performed. Initially and on the 14th day, patients underwent cosyntropin tests of adrenal function. Patients kept daily peak flow charts. Both groups improved with time. However, by 24 hours after starting methylprednisolone therapy, the placebo group continued to show reversibility after isoproterenol inhalation whereas the methylprednisolone group did not. By day 7 there were significantly more patients with normal 1-second forced expiratory volume (FEV[sub 1]) and forced expiratory flow in the middle half of the forced vital capacity (FEF[sub 25-75%]) in the methylprednisolone group and mean FEF[sub 25-75%] was significantly higher for this group (P < .02). By day 14, six days after finishing treatment with the study drugs, more patients in the placebo group had residual wheezing, but pulmonary function tests were now similar for the two groups. Although both groups showed a decline in cosyntropin responsiveness on day 14 compared with day 1, there was no difference between the steroid- and placebotreated patients. This study proves that short-term corticosteroid therapy will accelerate resolution of moderately severe and severe-acute attacks of asthma without significant suppression of adrenal function. Pediatrics 1983;71:510-514; asthma, steroids, methylprednisolone. [ABSTRACT FROM AUTHOR]

Abstract. During the 1980 influenza B outbreak in King County, Washington, 11 children whose asthma had previously been controlled with a stable theophylline dose, developed theophylline toxicity on this same dose. Two had seizures, eight had nausea and vomiting, and three had headaches. All had clinical evidence of a febrile viral illness. The toxicity appeared to be related to decreased theophylline clearance, which gradually returned to preillness levels over a period of one to three months. Six of ten children had serologic evidence of influenza B, which is presumed to be the cause of the altered clearance. In children receiving chronic theophylline therapy, symptoms of vomiting, headaches, or seizures during a viral illness may be due to theophylline toxicity rather than the virus. Such patients should have an immediate serum theophylline determination, even if previous levels have been in the therapeutic range. [ABSTRACT FROM AUTHOR]

Focuses on issues posed by various studies on the role of food additives in hyperkinesis in children. Inconsistencies in the findings of the studies; Issues and questions which the studies failed to address.

Reviews the article `An Estimate of the Prevalence of Asthma and Wheezing Among Inner-City Children,' by E.F. Crain et al, published in the 1994 issue of `Pediatrics.' Reasons for high incidence of asthma among inner-city children; Indication of inadequate diagnosis and treatment of inner-city children with asthma; Association of poverty with a higher prevalence of asthma; Study population from Bronx County, New York.

Provides information on a study which examined the effect of intranasal nedocromil sodium on viral upper respiratory tract infections in human. Information on the study population; Methodology; Findings.

Presents a study on the effect of maternal avoidance of eggs, cow's milk and fish during lactation upon allergic manifestations in infants. Purpose of the study; Description of the method; Incidents of atopic dermatitis in infants; Conclusions of the study.

Presents an abstract of the study titled `Independent Parental Administration of Prednisone in Acute Asthma: A Double-Blind, Placebo-Controlled, Crossover Study,' by C.C. Grant, A.K. Duggan, et al, published in the 96th volume 1995 issue of `Pediatrics.'

Reviews the article `Aminophylline Therapy Does Not Improve Outcome and Increase Adverse Effects in Children Hospitalized With Acute Asthmatic Exacerbations,' by R.E. Strauss et al, published in the 1994 issue of `Pediatrics.' Evaluation of the efficacy of aminophylline for hospitalized asthmatic children; Adequacy of intravenous steroid and albuterol nebulization.

Presents a summary of the research article `The Effect of Genetic and Environmental Factors on the Prevalence of Allergic Disorders at the Age of Two Years,' by S.H. Arshad, M. Stevens et al, published in a 1993 issue of `Clinical & Experimental Allergy.' Effect of genetic and environmental factors on prevalence of allergic disorders by two years of age; Important factors in the environment.

Discusses a study which investigated the risk of developing food allergy during third trimester and early breast-feeding ages. Information on the study population; Methodology; Relationship between immunoglobulin (Ig) E and IgC antibody response for egg; Correlation between radioallergosorbent and skin-prick tests.