Heart-lung transplantation: all the facts

Article Abstract:

Certain respiratory illnesses in children, such as cystic fibrosis, may lead to an inability to breathe that is incurable. Terminal respiratory disease can be treated by transplantation of the heart and lungs. Studies suggest that transplantation improves survival in children to the same extent as in adults and gives children the opportunity to resume normal activities within five to 17 months of surgery. The outcomes of 27 children referred for assessment of suitability for heart-lung transplantation were examined. Referral can lead to: (a) acceptance into a waiting list for heart-lung transplant; (b) placement on a provisional, or holding, list, usually for those with disease not considered severe enough to require transplant; or (c) lack of acceptance due to severe illness or physical or psychological difficulties. Ten children underwent heart-lung transplantation; six had survived for from three months to three years following transplantation. Two thirds of the patients died during the study. Although transplantation improved the quality of life for some children, it prolonged and exaggerated needless suffering in others. Transplant programs must be designed with consideration of various factors, such as family support and interaction, presence of diseases that preclude transplantation, donor supply, and chances of transplant rejection. Furthermore, efforts to manage chronic disease and improve care of the terminally ill must continue. (Consumer Summary produced by Reliance Medical Information, Inc.)

Management, Lungs, Heart, Heart transplantation, Respiratory tract diseases, Lung transplantation

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Tuberculosis in a contact

Article Abstract:

Tuberculosis (TB) is an infectious disease caused by the bacteria Mycobacterium tuberculosis. This disease is characterized by inflammation, formation of tubercles (node-like growths), tissue death, abscesses, and fiber-like tissue and calcium deposits. TB commonly affects the respiratory system, but may also involve other organ systems. A case is described of a 12-year-old girl who developed a large tuberculous pleural effusion (fluid within the chest cavity). She had been exposed to an adult with confirmed primary TB. Although the patient had been treated according to the guidelines of the British Thoracic Society for those who come into contact with pulmonary TB, she developed the tuberculous pleural effusion due to improper follow-up. At her initial visit, her medical history indicated that she was previously vaccinated with BCG, which provides incomplete protection against TB. The girl, in fact, had not actually received this immunization. After exposure, her chest X-ray was normal and she was discharged without preventative drug therapy. Children should be followed for six weeks after the last known contact regardless of whether they have received the BCG vaccine. This vaccine provides only incomplete protection against TB and the duration of protection after vaccination is not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Disease transmission, Tuberculosis, Tuberculosis in children, Pediatric respiratory diseases, BCG vaccination

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Effect of artificial food colours on childhood behaviour

Article Abstract:

Ingestion of artificial food additives may cause asthma and urticaria, a blood vessel reaction of the skin, characterized by wheals, or hives, and intense itching. Although some studies show that food additives may cause hyperactivity in disturbed children with a high incidence of allergic reactions, other studies are unable to show this adverse effect of food additives. The conflicting results may be due to differences in study design. The prevalence and mechanism of intolerance to organic food additives were assessed in 39 children. The parents of the children reported that their child's behavior improved when the child was on a diet free of food additives, but worsened during dietary lapses. Only 19 children were assessed according to acceptable experimental design methods. Food additives were shown to have an adverse effect on the behavior of these children according to a standard behavioral test, called the Conners' rating of behavior. Most parents were unable to detect the adverse changes in their children's behavior. A mechanism involving food additive-induced release of histamine, a naturally occurring substance, that may cause physiological and behavioral effects, is proposed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Food additives, Physiological aspects, Behavior, Children, Child behavior

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