Behavior Abnormalities and Poor School Performance Due to Oral Theophylline Use

PEDIATRICS ◽  
1986 ◽  
Vol 78 (6) ◽  
pp. 1133-1138 ◽  
Author(s):  
Gary S. Rachelefsky ◽  
Julie Wo ◽  
Judith Adelson ◽  
M. Ray Mickey ◽  
Sheldon L. Spector ◽  
...  
Keyword(s):  
School Performance ◽  
Serum Levels ◽  
Treatment Modalities ◽  
School Behavior ◽  
Double Blind ◽  
Asthmatic Children ◽  
Oral Theophylline ◽  
Standardized Report ◽  
Children With Asthma ◽  
And Behavior

Studies evaluating adverse effects of oral theophylline on learning and behavior have been performed on children with asthma receiving long-term theophylline therapy. To further differentiate the effects of asthma itself from the drugs used, we evaluated 20 asthmatic children (6 to 12 years of age) who had not received oral bronchodilators for at least 6 months. A double blind, placebo-controlled, parallel format was used with a 4-week theophylline or placebo period preceded by a 2-week baseline. Theophylline serum levels were maintained between 10 to 20 µg/mL. During baseline and treatment periods, the child's home and school behavior/performance were monitored independently by their parents and teachers using standardized report forms. A battery of psychologic tests was administered at the end of baseline and treatment periods. Seven children receiving theophylline were noted to have a change in school behavior and/or performance during their 4 weeks on drug compared to baseline, whereas none of the children receiving placebo were noted to be different (P = .004). Thus, the short-term administration of theophylline to asymptomatic asthmatic children not receiving oral bronchodilators can adversely affect school performance and behavior. Because this population represents the majority of asthmatic children, one needs to use theophylline cautiously in this age group, monitor school performance closely, or seek other treatment modalities.

School Performance and Theophylline

PEDIATRICS ◽  
1987 ◽  
Vol 80 (1) ◽  
pp. 124-125
Author(s):  
MILES WEINBERGER ◽  
SCOTT LINDGREN ◽  
JESSE JOAD
Keyword(s):  
School Performance ◽  
Short Term ◽  
Asthmatic Children ◽  
Term Administration ◽  
Usa Today ◽  
And Behavior

To the Editor.— Dr Rachelefsky and his colleagues reported, first in USA Today (Dec 2, 1986, p 1) and later in Pediatrics (1986;78:1133-1138) that theophylline adversely affected school performance. Specifically, they stated, "Teachers said kids couldn't sit still, they weren't remembering as well, they were acting up, and their handwriting had changed" (USA Today). They concluded that "the short-term administration of theophylline to asymptomatic asthmatic children not receiving oral bronchodilators can adversely affect school performance and behavior" (Pediatrics).

scholarly journals Research on the improvement of allergic rhinitis in asthmatic children after reducing dust mite exposure: a randomized, double-blind, cross-placebo study protocol

2020 ◽  
Author(s):  
Ming Chen ◽  
YuFen Wu ◽  
Shuhua Yuan ◽  
Jiande Chen ◽  
Luanluan Li ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Allergic Diseases ◽  
House Dust Mites ◽  
Life Questionnaire ◽  
Dust Mites ◽  
Double Blind ◽  
Asthma Control Questionnaire ◽  
Asthmatic Children ◽  
Dust Mite ◽  
Children With Asthma

Abstract Background: Allergic rhinitis (AR) in children has become a major respiratory inflammatory disease with a high incidence that is increasing yearly. In China, 54.93% of children with asthma have AR, which often requires synchronous treatment. House dust mites (HDMs) are common allergens that often cause attacks of AR and asthma. Reducing allergen exposure is one of the most important measures to control and treat AR and asthma attacks. Hestelia Mite Bait, containing 0.1% emamectin, is a new tool for trapping and killing dust mites that can reduce the number of dust mites on mattresses, thereby may reduce stimulation by allergens and ultimately improve asthma and rhinitis symptoms. This single-centre, randomized double-blind cross-placebo trial will explore the improvement of allergic rhinitis in asthmatic children after reducing dust mite exposure.Methods: We will recruit 60 children (aged 3-12 years) who have been diagnosed with allergic rhinitis and asthma and are allergic to dust mites as confirmed by a serum allergen test. Participants will randomly receive the Hestelia Mite Bait intervention for 8 weeks and the placebo intervention for 8 weeks. There will be a 4-week washout period between the two interventions. The primary outcome is the v isual analogue scale (VAS) score of AR symptoms; the secondary outcomes include the Rhinitis Control Assessment Test (RCAT) score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score , changes in the dust mite level, drug usage for asthma and AR , Asthma Control Questionnaire-5 (ACQ-5) score, frequency of acute asthma attacks and emergency visits, and frequency of hospitalization.Discussion: This study will scientifically and objectively evaluate the improvement effect on rhinitis and asthma after reducing dust mite exposure and provide a convenient means for the prevention and treatment of children's airway allergic diseases in the future.Trial registration : ChiCTR1900024688 (www.chictr.org.cn) registration date: July 21, 2019

Chronic Low-Grade Systemic Inflammation in Children with Asthma and Obesity

2018 ◽  
Vol 11 (2) ◽  
pp. 128-134
Author(s):  
Niya A. Krasteva ◽  
Boiko R. Shentov ◽  
Adelaida L. Ruseva ◽  
Chaika K. Petrova ◽  
Simeon P. Petkov
Keyword(s):  
Bronchial Asthma ◽  
Systemic Inflammation ◽  
Inflammatory Markers ◽  
Serum Levels ◽  
Control Group ◽  
Low Grade ◽  
Obese Children ◽  
Asthmatic Children ◽  
Children With Asthma ◽  
Hs Crp

Summary The rising incidence of bronchial asthma and obesity in children raises the question of whether there is a link between them. Chronic low-grade systemic inflammation could be one of the linking mechanisms. We aimed to determine the serum concentrations of high-sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6) and tumour necrosis factor a (TNF-a) in children with asthma and obesity and to seek a relationship between these inflammatory markers and asthma control. We investigated 88 children aged 6 to 17 years - 25 asthmatic obese children (AsOb), 25 asthmatic non-obese children (AsNOb), 19 obese non-asthmatic children (ObNAs), and 19 non-obese non-asthmatic children as controls. Serum levels of IL-6 and hs-CRP were significantly increased in asthmatic obese and ObNAs compared to AsNOb and the control group. Serum TNF-a concentration was similar in the four studied groups. There were no statistically significant differences in serum levels of these inflammatory markers between controlled and partially controlled/uncontrolled asthmatics (obese and non-obese). Knowing the possible mechanisms of interaction between bronchial asthma and obesity would contribute to a more effective therapeutic approach in these patients.

A Retrospective Comparative Analysis of Factors Affecting the Decision and Outcome of Initial Intravenous Immunoglobulin Alone or Intravenous Immunoglobulin Plus Methylprednisolone Use in Children With the Multisystem Inflammatory Syndrome

2021 ◽  
Author(s):  
İlker Devrim ◽  
Elif Böncüoğlu ◽  
Elif Kıymet ◽  
Şahika Şahinkaya ◽  
Miray Yılmaz Çelebi ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Pediatric Intensive Care ◽  
Serum Levels ◽  
Intravenous Immunoglobulins ◽  
Treatment Modalities ◽  
Double Blind ◽  
Factors Affecting ◽  
Group I ◽  
Group Ii ◽  
Inflammatory Syndrome

Abstract Background: Use of intravenous immunoglobulins (IVIG) with or without methylprednisolone is the most preferred therapeutic strategy for the multisystem inflammatory syndrome in children (MIS-C). This study aimed to compare the use of IVIG plus methylprednisolone vs IVIG alone in children with MIS-C. Methods: This retrospective cohort study was conducted during the period between April 1, 2020, and November 1, 2021. All children with MIS-C were included in the study. The patients were divided in two groups according to whether they were administered IVIG alone or IVIG plus methylprednisolone as an initial treatment for MIS-C. While the patients in group I were administered IVIG with a dosage of 2 gr/kg, the patients in group II were administered IVIG (dosage of 2 gr/kg) plus methylprednisolone (2 mg/kg/day). The re-occurrence of fever, duration of hospital stay, admission to pediatric intensive care unit were compared between these two groups. Results: A cohort of 91 patients under 18 years old and diagnosed as MIS-C was included in the study. Of these patients, 42 (46.2%) were in IVIG alone group. (group I) and 49 (53.8%) were in IVIG plus methylprednisolone (group II). The ratio of severe MIS-C was 36.7% for patients in the group II and significantly higher compared to the rate of severe MIS-C patients in the group I (9.5%) (p=0.01). The rate of hypotension was significantly higher in the group II (30.6 %) compared to the group I (9.5%) (p=0.014). Moreover, the mean serum levels of C-reactive protein were significantly higher for the patients in group II. The re-occurrence of fever was 26.5% in the group II and 33.3% in the group, however this difference was not statistically significant (p>0.05). Conclusions: The decision of the treatment choice of patients with MIS-C should be individually evaluated. In the clinically severe MIS-C patients who were with hypotension, and/or admitted to PICU should be treated with IVIG plus methylprednisolone. However, randomized double-blind studies are required for the treatment modalities of children with MIS-C.

School Performance and Theophylline

PEDIATRICS ◽  
1987 ◽  
Vol 80 (1) ◽  
pp. 125-126
Author(s):  
LEONARD RAPPAPORT ◽  
TERRANCE FENTON ◽  
FRANCIS TWAROG
Keyword(s):  
School Performance ◽  
Recent Article ◽  
Oral Theophylline ◽  
Poor School Performance ◽  
Behavioral Abnormalities ◽  
Children With Asthma ◽  
Poor School

To the Editor.— In a recent article, Rachelefsky et al (Pediatrics 1986;78:1133-1138) described behavioral abnormalities and poor school performance due to oral theophylline preparations in children with asthma. There were a number of methodologic and reporting issues that we believe should be elucidated by the authors. First, Table 4, which contains the only positive findings in the study, does not make sense. The legend says that the scores in this table are a sum of 53 items, each of which were scored as 1, 2, or 3.

scholarly journals Research on the improvement of allergic rhinitis in asthmatic children after reducing dust mite exposure: a randomized, double-blind, cross-placebo study protocol

2020 ◽  
Author(s):  
Ming Chen ◽  
YuFen Wu ◽  
Shuhua Yuan ◽  
Jiande Chen ◽  
Luanluan Li ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Allergic Diseases ◽  
House Dust Mites ◽  
Life Questionnaire ◽  
Dust Mites ◽  
Double Blind ◽  
Asthma Control Questionnaire ◽  
Asthmatic Children ◽  
Dust Mite ◽  
Children With Asthma

Abstract Background: Allergic rhinitis (AR) in children has become a major respiratory inflammatory disease with a high incidence that is increasing yearly. In China, 54.93% of children with asthma have AR, which often requires synchronous treatment. House dust mites (HDMs) are common allergens that often cause attacks of AR and asthma. Reducing allergen exposure is one of the most important measures to control and treat AR and asthma attacks. Hestelia Mite Bait, containing 0.1% emamectin, is a new tool for trapping and killing dust mites that can reduce the number of dust mites on mattresses, thereby potentially reducing stimulation by allergens and ultimately improving asthma and rhinitis symptoms. This single-centre, randomized double-blind crossa-placebo trial will explore the improvement of allergic rhinitis in asthmatic children after reducing dust mite exposure.Methods: We will recruit 60 children (aged 3-12 years) who have been diagnosed with allergic rhinitis and asthma and are allergic to dust mites as confirmed by a serum allergen test. Participants will randomly receive the Hestelia Mite Bait intervention for 8 weeks and the placebo intervention for 8 weeks. There will be a 4-week washout period between the two interventions. The primary outcome is the visual analogue scale (VAS) score of AR symptoms; the secondary outcomes include the Rhinitis Control Assessment Test (RCAT) score, Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score, changes in the dust mite level, drug usage for asthma and AR, Asthma Control Questionnaire-5 (ACQ-5) score, and frequencies of acute asthma attacks, emergency visits, and hospitalization.Discussion: This study will scientifically and objectively evaluate the improvement effects on rhinitis and asthma after reducing dust mite exposure and will provide a convenient means for the prevention and treatment of children's airway allergic diseases in the future.Trial registration: ChiCTR1900024688 (www.chictr.org.cn) registration date: July 21, 2019

The Montelukast Therapy in Asthmatic Children with and without Food Allergy: Does It Make Any Difference?

2021 ◽  
pp. 1-10
Author(s):  
Umit Murat Sahiner ◽  
Ebru Arik Yilmaz ◽  
Sara Fontanella ◽  
Sadia Haider ◽  
Ozge Soyer ◽  
...  
Keyword(s):  
Food Allergy ◽  
Exhaled Breath Condensate ◽  
Food Allergies ◽  
Exhaled Breath ◽  
Double Blind ◽  
Asthma Morbidity ◽  
Asthmatic Children ◽  
Increased Risk ◽  
Significant Difference ◽  
Children With Asthma

<b><i>Introduction:</i></b> Children with food allergy are at increased risk for asthma and asthma morbidity. Since leukotrienes are implicated in the pathogenesis of both asthma and probably in food allergies, we hypothesized that asthmatic children with concomitant food allergy may have a favorable response to antileukotriene treatment. <b><i>Methods:</i></b> Asthmatic children aged 6–18 years with and without food allergy were treated with montelukast and placebo in a double-blind, placebo-controlled cross-over parallel-group study. The primary outcome of the study was improvement in FEV1%. Asthma control tests, spirometry and methacholine challenges were performed as well as Fractional Exhaled Nitric Oxide (FeNO) levels. PGD2, CystLT, and lipoxin levels were measured in exhaled breath condensate (EBC). <b><i>Results:</i></b> A total of 113 children were enrolled and 87 completed the study in accordance with the protocol. At baseline, children with food allergy and asthma (FAA) had higher levels of PGD2 and CysLT levels in the EBC than children with asthma alone (AA) (<i>p</i> &#x3c; 0.001 for each). In the montelukast arm, although FEV1% was significantly higher in the FAA group compared to AA (<i>p</i> = 0.005), this effect was linked to the baseline difference of FEV1% between both arms. Montelukast treatment failed to improve FEV1% in both groups compared to the placebo. No effect of montelukast was observed in the remaining study parameters. <b><i>Conclusion:</i></b> Although children with FAA do not show a more favorable response to montelukast treatment compared to AA, a significant difference between baseline PGD2 and CystLT levels between FAA and AA groups may point to a different endotype of childhood asthma.

scholarly journals Vitamin D status in asthmatic children and its correlation to asthma control

2018 ◽  
Vol 5 (2) ◽  
pp. 520
Author(s):  
Sandeep Karanam ◽  
Soumya Reddy ◽  
Ramesh H.
Keyword(s):  
Vitamin D ◽  
Asthma Control ◽  
Serum Vitamin ◽  
Serum Levels ◽  
Inverse Association ◽  
Vitamin D Status ◽  
Asthmatic Children ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Children With Asthma

Background: Asthma is a common chronic inflammatory disease of the airways, affecting around 330 million individuals worldwide. Factors like genetic predisposition, early allergen exposure, diet and vitamin D status are all proposed to influence the development and severity of asthma. Epidemiologic data suggests that low serum vitamin D (<30 ng/mL) in children with asthma is associated with more symptoms and exacerbations. The objectives of this study were to determine serum levels of vitamin D in asthmatic children (6-15 years) and to establish a relation between serum vitamin D levels and asthma control.Methods: We conducted a cross sectional observational study. A total of 60 children with asthma were studied to know the relationship between serum vitamin D levels and asthma control, assessed according to Global Initiative for Asthma guidelines (GINA).Results: Only 33.33% of children had sufficient vitamin D levels. Mean±SD vitamin D level of study population was 23.38±8.75. 45% children had well controlled asthma, 28.3% were partly controlled and 26.7% were uncontrolled. Significant (p <0.001) inverse association was found between level of asthma control and vitamin D status. Significant positive correlation was found between percent predicted forced expiratory volume in 1 second and forced vital capacity (P <0.01). Subjects with well controlled asthma had higher serum levels of 25 (OH) D than children with partially controlled or uncontrolled asthma.Conclusions: Hypovitaminosis D is frequent in children with asthma and is associated with exacerbations, decreased lung functions and severe disease.

scholarly journals Evaluation of the Use of Sterilized and Non-Sterilized Peruibe Black Mud in Patients with Knee Osteoarthritis

2021 ◽  
Vol 18 (4) ◽  
pp. 1666 ◽  
Author(s):  
Paulo Fávio Macedo Gouvêa ◽  
Zélia Maria Nogueira Britschka ◽  
Cristina de Oliveira Massoco Salles Gomes ◽  
Nicolle Gilda Teixeira de Queiroz ◽  
Pablo Antonio Vásquez Salvador ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Short Form ◽  
Serum Levels ◽  
Double Blind ◽  
Sf 36 ◽  
Radiographic Grade ◽  
Physical Functions ◽  
Kellgren And Lawrence

This study aimed to evaluate the effects of treatment with Peruíbe Black Mud (PBM) on the clinical parameters and quality of life of patients with knee osteoarthritis and to compare the effects of PBM samples simply matured in seawater and PBM sterilized by gamma radiation. A controlled, double-blind trial was conducted with 41 patients divided into two treatment groups composed of 20 and 21 patients: one group was treated with matured PBM and the other with sterilized PBM. Evaluations were done using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the Medical Outcomes Study Short Form 36 (SF-36) questionnaires, the Kellgren and Lawrence (KL) radiographic scale, and the quantification of the serum levels of inflammatory biomarkers. An improvement in pain, physical functions, and quality of life was observed in all of the patients who underwent treatment with both simply matured and sterilized PBM. Nine patients showed remission in the KL radiographic scale, but no statistically significant differences were observed in the serum levels of inflammatory mediators before or after treatment. Peruíbe Black Mud proves to be a useful tool as an adjuvant treatment for knee osteoarthritis (OA), as shown by the results of the WOMAC and SF-36 questionnaires and by the remission of the radiographic grade of some patients on the Kellgren and Lawrence scale.

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