Conditions - Children's Health

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Programming of body composition by early growth and nutrition.

Authors: Wells JC, Chomtho S, Fewtrell MS.

Source: Proc Nutr Soc. 2007 Aug;66(3):423-34.

There is now compelling evidence that growth patterns in early life are associated with risk of the metabolic syndrome in adulthood, although the relative importance of prenatal v. postnatal growth for such associations remains controversial. Body composition may play a key role in the 'programming' of such diseases, through itself being programmed by early growth, and perhaps also by being a mediator of the programming process. Early studies reporting positive associations between birth weight and adult BMI suggested a tendency for large babies to become obese adults. Such findings appeared contradictory to the many studies linking low birth weight with increased risk of the metabolic syndrome. Recent studies now indicate that birth weight is strongly predictive of later lean mass, and has a much weaker association with later fatness. Studies that link low birth weight with a more central adipose distribution in later life remain controversial, and require confirmation using more sophisticated methodologies. Findings for infant growth rate appear population-specific, with infant weight gain predicting subsequent lean mass in developing countries, but predicting subsequent fat mass and obesity in industrialised populations. Further studies are required on this issue, to ensure that appropriate public health policies are recommended for countries across the range of economic development. Although the links between early growth and later disease risk implicate early-life nutrition, either in utero or during infancy, few prospective studies have explored the influence of early diet on later body composition. Many studies have associated breast-feeding with a reduced prevalence of obesity categorised by BMI; however, the few studies directly evaluating childhood fatness provide little support for this hypothesis. Recent advances in the ability to measure body composition during the infant period offer a major opportunity to improve the understanding of the nutritional programming of body composition and its contribution, or lack thereof, to subsequent disease risk.

Sleep patterns in children with attention-deficit/hyperactivity disorder, tic disorder, and comorbidity.

Authors: Kirov R, Kinkelbur J, Banaschewski T, Rothenberger A.

Source: J Child Psychol Psychiatry. 2007 Jun;48(6):561-70.

BACKGROUND: In children, attention-deficit/hyperactivity disorder (ADHD), tic disorder (TD), and their coexistence (ADHD + TD comorbidity) are very common and clinically important. Associated sleep patterns and their clinical role are still insufficiently investigated. This study aimed at characterizing these sleep patterns in children with ADHD, TD, and ADHD + TD comorbidity and determining whether, in ADHD + TD, the factors ADHD and TD may affect the sleep pattern in an independent (additive) or in a complex (interactive) manner.

METHOD: By means of polysomnography, sleep patterns were investigated in 4 groups of unmedicated 8.0-16.4-year-old children (healthy controls, ADHD-only, TD-only, and ADHD + TD). Each group consisted of 18 subjects matched for age, gender, and intelligence.

RESULTS: ADHD was primarily characterized by increase in rapid eye movement (REM) sleep, whereas TD patients displayed lower sleep efficiency and elevated arousal index in sleep. In children with ADHD + TD, both effects appeared. No interaction between the ADHD and TD factors was found for any of the sleep parameters. Significant correlations between sleep patterns and clinical symptoms were found.

CONCLUSIONS: ADHD and TD are characterized by specific sleep alterations. When coexisting, the two disorders alter the sleep pattern in an additive manner, suggesting a high impact on clinical and therapeutic perspectives.

Chocolate is a powerful ex vivo and in vivo antioxidant, an antiatherosclerotic agent in an animal model, and a significant contributor to antioxidants in the European and American Diets.

Authors: Vinson JA, Proch J, Bose P, Muchler S, Taffera P, Shuta D, Samman N, Agbor GA.

Source: J Agric Food Chem. 2006 Oct 18;54(21):8071-6.

Chocolate today is often viewed as a food or snack with little nutritional value. The high saturated fat content of chocolate has also contributed to the belief that its consumption increases the risk of heart disease. However, recent human studies have proven that chocolate has beneficial effects on some pathogenic mechanisms of heart disease such as endothelial function and blood pressure. Although the antioxidant properties of chocolate have been known for some time, there has been no examination of its place in the U.S. diet as a source of antioxidants. This paper demonstrates that chocolate makes a significant contribution to U.S. per capita dietary antioxidants and by inference the European Community's. In the U.S. diet chocolate is the third highest daily per capita antioxidant source. An ex vivo study shows that epicatechin, a major polyphenol in chocolate and chocolate extracts, is a powerful inhibitor of plasma lipid oxidation due to polyphenols' ability to bind to lower density lipoproteins. Conversely, the fat from chocolate alone is a pro-oxidant in this model. This is also demonstrated in an in vivo human study. After consumption of dark chocolate and cocoa powder, the lower density lipoproteins isolated from plasma were protected from oxidation compared to the lipoproteins isolated after cocoa butter consumption, which were put under oxidative stress. In an animal model of atherosclerosis, cocoa powder at a human dose equivalent of two dark chocolate bars per day significantly inhibited atherosclerosis, lowered cholesterol, low-density lipoprotein, and triglycerides, raised high-density lipoprotein, and protected the lower density lipoproteins from oxidation. Chocolate has thus been shown to have potential beneficial effects with respect to heart disease.

Neuropsychological and renal effects of dental amalgam in children: a randomized clinical trial.

Authors: Bellinger DC, Trachtenberg F, Barregard L, Tavares M, Cernichiari E, Daniel D, McKinlay S.

Source: JAMA. 2006 Apr 19;295(15):1835-6.

CONTEXT: No randomized trials have been published that address the concern that inhalation of mercury vapor released by amalgam dental restorations causes adverse health effects.

OBJECTIVE: To compare the neuropsychological and renal function of children whose dental caries were restored using amalgam or mercury-free materials.

DESIGN AND SETTING: The New England Children's Amalgam Trial was a 2-group randomized safety trial involving 5 community health dental clinics in Boston, Mass, and 1 in Farmington, Me, between September 1997 and March 2005.

PARTICIPANTS AND INTERVENTION: A total of 534 children aged 6 to 10 years at baseline with no prior amalgam restorations and 2 or more posterior teeth with caries were randomly assigned to receive dental restoration of baseline and incident caries during a 5-year follow-up period using either amalgam (n=267) or resin composite (n =267) materials.

MAIN OUTCOME MEASURES: The primary neuropsychological outcome was 5-year change in full-scale IQ scores. Secondary outcomes included tests of memory and visuomotor ability. Renal glomerular function was measured by creatinine-adjusted albumin in urine.

RESULTS: Children had a mean of 15 tooth surfaces (median, 14) restored during the 5-year period (range, 0-55). Assignment to the amalgam group was associated with a significantly higher mean urinary mercury level (0.9 vs 0.6 microg/g of creatinine at year 5, P<.001). After adjusting for randomization stratum and other covariates, no statistically significant differences were found between children in the amalgam and composite groups in 5-year change in full-scale IQ score (3.1 vs 2.1, P = .21). The difference in treatment group change scores was 1.0 (95% confidence interval, -0.6 to 2.5) full-scale IQ score point. No statistically significant differences were found for 4-year change in the general memory index (8.1 vs 7.2, P = .34), 4-year change in visuomotor composite (3.8 vs 3.7, P = .93), or year 5 urinary albumin (median, 7.5 vs 7.4 mg/g of creatinine, P = .61).

CONCLUSIONS: In this study, there were no statistically significant differences in adverse neuropsychological or renal effects observed over the 5-year period in children whose caries were restored using dental amalgam or composite materials. Although it is possible that very small IQ effects cannot be ruled out, these findings suggest that the health effects of amalgam restorations in children need not be the basis of treatment decisions when choosing restorative dental materials.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00065988.

Neurobehavioral effects of dental amalgam in children: a randomized clinical trial.

Authors: DeRouen TA, Martin MD, Leroux BG, Townes BD, Woods JS, Leitao J, Castro-Caldas A, Luis H, Bernardo M, Rosenbaum G, Martins IP.

Source: JAMA. 2006 Apr 19;295(15):1835-6.

CONTEXT: Dental (silver) amalgam is a widely used restorative material containing 50% elemental mercury that emits small amounts of mercury vapor. No randomized clinical trials have determined whether there are significant health risks associated with this low-level mercury exposure.

OBJECTIVE: To assess the safety of dental amalgam restorations in children.

DESIGN: A randomized clinical trial in which children requiring dental restorative treatment were randomized to either amalgam for posterior restorations or resin composite instead of amalgam. Enrollment commenced February 1997, with annual follow-up for 7 years concluding in July 2005.

SETTING AND PARTICIPANTS: A total of 507 children in Lisbon, Portugal, aged 8 to 10 years with at least 1 carious lesion on a permanent tooth, no previous exposure to amalgam, urinary mercury level <10 microg/L, blood lead level <15 microg/dL, Comprehensive Test of Nonverbal Intelligence IQ > or =67, and with no interfering health conditions.

INTERVENTION: Routine, standard-of-care dental treatment, with one group receiving amalgam restorations for posterior lesions (n = 253) and the other group receiving resin composite restorations instead of amalgam (n = 254).

MAIN OUTCOME MEASURES: Neurobehavioral assessments of memory, attention/concentration, and motor/visuomotor domains, as well as nerve conduction velocities.

RESULTS: During the 7-year trial period, children had a mean of 18.7 tooth surfaces (median, 16) restored in the amalgam group and 21.3 (median, 18) restored in the composite group. Baseline mean creatinine-adjusted urinary mercury levels were 1.8 microg/g in the amalgam group and 1.9 microg/g in the composite group, but during follow-up were 1.0 to 1.5 microg/g higher in the amalgam group than in the composite group (P<.001). There were no statistically significant differences in measures of memory, attention, visuomotor function, or nerve conduction velocities (average z scores were very similar, near zero) for the amalgam and composite groups over all 7 years of follow-up, with no statistically significant differences observed at any time point (P values from .29 to .91). Starting at 5 years after initial treatment, the need for additional restorative treatment was approximately 50% higher in the composite group.

CONCLUSIONS: In this study, children who received dental restorative treatment with amalgam did not, on average, have statistically significant differences in neurobehavioral assessments or in nerve conduction velocity when compared with children who received resin composite materials without amalgam. These findings, combined with the trend of higher treatment need later among those receiving composite, suggest that amalgam should remain a viable dental restorative option for children.

TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00066118.

Safety and efficacy of zinc supplementation for children with HIV-1 infection in South Africa: a randomised double-blind placebo-controlled trial.

Authors: Bobat R., Coovadia, H., Stephen C., Naidoo K. L., McKerrow N., Black, R. E., Moss, W. J

Source: Lancet. 2005 Nov 26;366(9500):1862-7.

BACKGROUND: Zinc deficiency is associated with impaired immune function and an increased risk of infection. Supplementation can decrease the incidence of diarrhoea and pneumonia in children in resource-poor countries. However, in children with HIV-1 infection, the safety of zinc supplementation is uncertain. We aimed to assess the role of zinc in HIV-1 replication before mass zinc supplementation is recommended in regions of high HIV-1 prevalence.

METHODS: We did a randomised double-blind placebo-controlled equivalence trial of zinc supplementation at Grey's Hospital in Pietermaritzburg, South Africa. 96 children with HIV-1 infection were randomly assigned to receive 10 mg of elemental zinc as sulphate or placebo daily for 6 months. Baseline measurements of plasma HIV-1 viral load and the percentage of CD4+ T lymphocytes were established at two study visits before randomisation, and measurements were repeated 3, 6, and 9 months after the start of supplementation. The primary outcome measure was plasma HIV-1 viral load. Analysis was per protocol.

FINDINGS: The mean log(10) HIV-1 viral load was 5.4 (SD 0.61) for the placebo group and 5.4 (SD 0.66) for the zinc-supplemented group 6 months after supplementation began (difference 0.0002, 95% CI -0.27 to 0.27). 3 months after supplementation ended, the corresponding values were 5.5 (SD 0.77) and 5.4 (SD 0.61), a difference of 0.05 (-0.24 to 0.35). The mean percentage of CD4+ T lymphocytes and median haemoglobin concentrations were also similar between the two groups after zinc supplementation. Two deaths occurred in the zinc supplementation group and seven in the placebo group (p=0.1). Children given zinc supplementation were less likely to get watery diarrhoea than those given placebo. Watery diarrhoea was diagnosed at 30 (7.4%) of 407 clinic visits in the zinc-supplemented group versus 65 (14.5%) of 447 visits in the placebo group (p=0.001).

INTERPRETATION: Zinc supplementation of HIV-1-infected children does not result in an increase in plasma HIV-1 viral load and could reduce morbidity caused by diarrhoea.

RELEVANCE TO PRACTICE: Programmes to enhance zinc intake in deficient populations with a high prevalence of HIV-1 infection can be implemented without concern for adverse effects on HIV-1 replication. In view of the reductions in diarrhoea and pneumonia morbidity, zinc supplementation should be used as adjunct therapy for children with HIV-1 infection.

Use of Complementary and Alternative Medicine in Pediatric Pain Management Service: A Survey.

Authors: Lin Y.C., Lee A.C., Kemper K.J., Berde C.B.

Source: Pain Med. 2005 Nov-Dec;6(6):452-8.

Objective. To survey the use of complementary and alternative medical therapies by pediatric pain management services affiliated with major universities.

Design. A telephone survey was conducted of pediatric anesthesia training programs accredited by the Accreditation Council for Graduate Medical Education in the United States. The survey instrument included questions on the provision of complementary and alternative medical therapies in their pediatric pain programs. Results. Forty-three pediatric anesthesia fellowship programs (100%) responded to the survey. Thirty-eight institutions (86%) offered one or more complementary and alternative medical therapies for their patients. Those therapies included biofeedback (65%), guided imagery (49%), relaxation therapy (33%), massage (35%), hypnosis (44%), acupuncture (33%), art therapy (21%), and meditation (21%).

Conclusions. This report documents trends in complementary and alternative medical therapies usage in the tertiary pediatric pain management service. There is a high prevalence in the integration of complementary and alternative medical therapies in pediatric pain management programs. Additional clinical research in the safety and efficacy in complementary and alternative medical therapies for pediatric pain management is urgently needed.

Treatment Expectations for CAM Interventions in Pediatric Chronic Pain Patients and their Parents.

Authors: Tsao J.C., Meldrum M., Bursch B., Jacob M.C., Kim S.C., Zeltzer L.K.

Source: Evid Based Complement Alternat Med. 2005 Dec;2(4):521-7. Epub 2005 Oct 10.

Patient expectations regarding complementary and alternative medicine (CAM) interventions have important implications for treatment adherence, attrition and clinical outcome. Little is known, however, about parent and child treatment expectations regarding CAM approaches for pediatric chronic pain problems. The present study examined ratings of the expected benefits of CAM (i.e. hypnosis, massage, acupuncture, yoga and relaxation) and conventional medicine (i.e. medications, surgery) interventions in 45 children (32 girls; mean age = 13.8 years +/- 2.5) and parents (39 mothers) presenting for treatment at a specialty clinic for chronic pediatric pain. Among children, medications and relaxation were expected to be significantly more helpful than the remaining approaches (P < 0.01). However, children expected the three lowest rated interventions, acupuncture, surgery and hypnosis, to be of equal benefit. Results among parents were similar to those found in children but there were fewer significant differences between ratings of the various interventions. Only surgery was expected by parents to be significantly less helpful than the other approaches (P < 0.01). When parent and child perceptions were compared, parents expected hypnosis, acupuncture and yoga, to be more beneficial than did children, whereas children expected surgery to be more helpful than did parents (P < 0.01). Overall, children expected the benefits of CAM to be fairly low with parents' expectations only somewhat more positive. The current findings suggest that educational efforts directed at enhancing treatment expectations regarding CAM, particularly among children with chronic pain, are warranted.

Essential fatty acids and the brain: From infancy to aging.

Authors: Yehuda S, Rabinovitz S, Mostofsky DI.

Source: Neurobiol Aging. 2005 Dec;26 Suppl 1:98-102. Epub 2005 Oct 13.

The major effects of essential fatty acids (EFA) on brain structure and functions are reviewed. EFA determine the fluidity of neuronal membrane and control the physiological functions of the brain. EFA is also involved in synthesis and functions of brain neurotransmitters, and in the molecules of the immune system. Since they must be supplied from the diet, a decreased bioavailability is bound to induce major disturbances. While the brain needs a continuous supply during the life span, there are two particularly sensitive periods-infancy and aging. EFA deficiency during infancy delays brain development, and in aging will accelerate deterioration of brain functions. In discussing the role of EFA two issues must be considered-the blood-brain barrier, which determines the bioavailability, and the myelination process, which determines the efficiency of brain and retinal functions.

The International Research on Infant Supplementation initiative.

Authors: Gross R, Benade S, Lopez G;

Source: J Nutr. 2005 Mar;135(3):628S-630S.

The International Research on Infant Supplementation trials emerged as an attempt to develop a credible evidence base to guide policy decision making in this area. The fact that infant diets in developing country settings are more often deficient in multiple micronutrients rather than in single nutrients and/or energy was increasingly recognized during the 1990s. The concept of a "foodlet," a crushable hybrid between a tablet and a food that is water dispersible, was developed at the first IRIS meeting in Rio de Janeiro in 1999. Trials were performed in 4 countries: Indonesia, Peru, South Africa, and Vietnam. Four different formulations of foodlets were tested: a daily placebo supplement, a daily iron supplement, a daily multiple micronutrient supplement, and a weekly multiple micronutrient supplement with a placebo on the other 6 d. The multiple micronutrient foodlets contained adequate daily intakes of 13 micronutrients considered most likely to be inadequate in infant diets. The foodlets were produced in Peru and distributed to all 4 of the country study sites. The methods used in the efficacy trials were standardized across countries, and the trials were carried out in infants 6-11 mo of age for 6 mo. Anthropometry was measured monthly and morbidity checked daily. Blood samples were collected at baseline and at the end of the trial. The data and the biological samples collected in each country were analyzed centrally. The results of this remarkable international collaboration are encouraging and, hopefully, will spur the development of programs in this area of nutrition interventions.

Obesity and the metabolic syndrome in children and adolescents.

Authors: Weiss R, Dziura J, Burgert TS, Tamborlane WV, Taksali SE, Yeckel CW, Allen K, Lopes M, Savoye M, Morrison J, Sherwin RS, Caprio S.

Source: N Engl J Med. 2004 Jun 3;350(23):2362-74.

BACKGROUND: The prevalence and magnitude of childhood obesity are increasing dramatically. We examined the effect of varying degrees of obesity on the prevalence of the metabolic syndrome and its relation to insulin resistance and to C-reactive protein and adiponectin levels in a large, multiethnic, multiracial cohort of children and adolescents.

METHODS: We administered a standard glucose-tolerance test to 439 obese, 31 overweight, and 20 nonobese children and adolescents. Baseline measurements included blood pressure and plasma lipid, C-reactive protein, and adiponectin levels. Levels of triglycerides, high-density lipoprotein cholesterol, and blood pressure were adjusted for age and sex. Because the body-mass index varies according to age, we standardized the value for age and sex with the use of conversion to a z score.

RESULTS: The prevalence of the metabolic syndrome increased with the severity of obesity and reached 50 percent in severely obese youngsters. Each half-unit increase in the body-mass index, converted to a z score, was associated with an increase in the risk of the metabolic syndrome among overweight and obese subjects (odds ratio, 1.55; 95 percent confidence interval, 1.16 to 2.08), as was each unit of increase in insulin resistance as assessed with the homeostatic model (odds ratio, 1.12; 95 percent confidence interval, 1.07 to 1.18 for each additional unit of insulin resistance). The prevalence of the metabolic syndrome increased significantly with increasing insulin resistance (P for trend, <0.001) after adjustment for race or ethnic group and the degree of obesity. C-reactive protein levels increased and adiponectin levels decreased with increasing obesity.

CONCLUSIONS: The prevalence of the metabolic syndrome is high among obese children and adolescents, and it increases with worsening obesity. Biomarkers of an increased risk of adverse cardiovascular outcomes are already present in these youngsters. Copyright 2004 Massachusetts Medical Society

Structurally related antitumor effects of flavanones in vitro and in vivo: involvement of caspase 3 activation, p21 gene expression, and reactive oxygen species production.

Authors: Shen SC, Ko CH, Tseng SW, Tsai SH, Chen YC.

Source: Toxicol Appl Pharmacol. 2004 Jun 1;197(2):84-95.

Flavonoids exist extensively in plants and Chinese herbs, and several biological effects of flavonoids have been demonstrated. The antitumor effects in colorectal carcinoma cells (HT29, COLO205, and COLO320HSR) of eight flavanones including flavanone, 2'-OH flavanone, 4'-OH flavanone, 6-OH flavanone, 7-OH flavanone, naringenin, nargin, and taxifolin were investigated. Results of the MTT assay indicate that 2'-OH flavanone showed the most potent cytotoxic effect on these three cells, and cell death induced by 2'-OH flavanone was via the occurrence of DNA ladders, apoptotic bodies, and hypodiploid cells, all characteristics of apoptosis. Induction of caspase 3 protein processing and enzyme activity associated with cleavage of poly(ADP-ribose) polymerase (PARP) was identified in 2'-OH flavanone-treated cells, and a peptidyl inhibitor (Ac-DEVD-FMK) of caspase 3 attenuated the cytotoxicity of 2'-OH flavanone in COLO205 and HT-29 cells. Elevation of p21 (but not p53) and a decrease in Mcl-1 protein were found in 2'-OH flavanone-treated COLO205 and HT-29 cells. Elevation of intracellular reactive oxygen species (ROS) was detected in 2'-OH flavanone-treated cells by the 2',7'-dichlorodihydrofluorescein diacetate (DCHF-DA) assay, and ROS scavengers including 4,5-dihydro-1,3-benzene disulfonic acid (tiron), catalase, superoxide dismutase (SOD), and pyrrolidine dithiocarbamate (PDTC) suppressed the 2'-OH flavanone-induced cytotoxic effect. Subcutaneous injection of COLO205 induced tumor formation in nude mice, and 2'-OH flavanone showed a significant inhibitory effect on tumor formation. The appearance of apoptotic cells with H&E staining, and an increase in p21, but not p53, protein by immunohistochemistry were observed in tumor tissues under 2'-OH flavanone treatment. Primary tumor cells (COLO205-X) derived from a tumor specimen elicited by COLO205 were established, and 2'-OH flavanone showed an significant apoptotic effect in COLO205-X cells in accordance with the appearance of DNA ladders, caspase 3 protein processing, PARP protein cleavage, and increasing p21 protein. These results revealed in vitro, ex vivo, and in vivo antitumor activities of 2'-OH flavanone via apoptosis induction, and indicates that 2'-OH flavanone is an active compound worthy of development for cancer chemotherapy.

Toxicity of over-the-counter cough and cold medications.

Authors: Gunn VL, Taha SH, Liebelt EL, Serwint JR.

Source: Pediatrics. 2001 Sep;108(3):E52

Over-the-counter (OTC) cough and cold medications are marketed widely for relief of common cold symptoms, and yet studies have failed to demonstrate a benefit of these medications for young children. In addition, OTC medications can be associated with significant morbidity and even mortality in both acute overdoses and when administered in correct doses for chronic periods of time. Physicians often do not inquire about OTC medication use, and parents (or other caregivers) often do not perceive OTCs as medications. We present 3 cases of adverse outcomes over a 13-month period-including 1 death-as a result of OTC cough and cold medication use. We explore the toxicities of OTC cough and cold medications, discuss mechanisms of dosing errors, and suggest why physicians should be more vigilant in specifically inquiring about OTCs when evaluating an ill child.

Details about the three cases: In the first case a three year old boy ended up in the emergency room due to lethargy, hypertension, and racing heart after being given Dimetapp (phenylpropanolamine and brompheniramine: antihystamine and sympathomemetic).

In the second case a three year old boy was seen in the emergency room after 3 weeks of intermittent fever during which time his parents administered Children's Tylenol Cold (acetaminophen, chlorpheniramin, destromethorphan and pseudoephedrine). He had racing heartbeat and a midly dilated left ventricle.

In the third case a nine month old boy was seen twice by the emergency room. Twelve hours after the first discharge the infant returned in full cariopulmonary arrest. Attempts were made to bring him back to life, but they were futile. It was determined on autopsy that he had been given toxic doses of OTC cough and cold medicines.

Treatment of children prone to infection with Padma 28

Authors: Jankowski A, Jankowska R, Brzosko WJ

Source: SchweizZschr für GanzheitsMed 1992; 7/8 (Suppl 1): 22-23

The 3 year study covered 305 children. Only those children were included who during the preceding 9 months had suffered at least one infection per month, including at least 3 times bronchitis and/or pneumonia. Three months before treatment with Padma 28 medication with steroids was discontinued. The same applied to medication with antibiotics which was discontinued at least two weeks before medication with Pamda 28. The efficacy of the treatment was evaluated by the frequency and severity of respiratory infection during 9 months of treatment. 71.5% of the patients showed a clear improvement in their condition.

Other studies have shown the following effects of Padma 28 on the immune system of patients: it improves the phagocytic activities of macrophages versus bacteria and immune complexes. It can normalize the CD4/CD8 index of the T-lymphocytes. Furthermore, Padma 28 can increase the synthesis of interferons, Interleukin-1, Interleukin-2 and the migration inhibition factor.

Influence of PADMA 28 on the spontaneous bactericidal activity of blood serum in children suffering from recurrent infections of the respiratory tract

Authors: Jankowski S, Jankowski A, Zielinska S, Walczuk M, Brzosko WJ

Source: Phytotherapy Research 1991;5:120-123

The effect of PADMA 28 on spontaneous bactericidal activity (SBA) of blood serum was tested in 19 children suffering from recurrent infections of the respiratory tract (RIRT). SBA was tested against three bacterial strains; Salmonella typhimurium 568, and Escherichia coli strains 044 and 055. A considerable increase (bactericidal index <2) of SBA was noted in 12 children (63.1%). In four children (21%) the increase of SBA was less pronounced (bactericidal index >2). In three children (15.7%) no effect of PADMA 28 on SBA of the serum was observed.

Influence of PADMA 28 and thymus extract on clinical and laboratory parameters of children with juvenile chronic arthritis

Authors: Brzosko WJ, Jankowski A, Prusek W, Ollendiek H

Source: Int. Journal of Immunotherapy 1991;VII/3:143-147

Nineteen children with juvenile chronic arthritis (JCA), divided into two groups of 12 and 7 children, were treated with PADMA 28 and thymus extract, respectively. PADMA 28 (P28), a herbal remedy prepared according to an old lamaistic formula, is a definite immunocorrective remedy confirmed by in vivo and in vitro studies on animals and human subjects. Thymus extract (ThE), prepared as suppositories, was found to be a very effective immunoregulatory preparation when tested on human diverse chronic inflammatory diseases. The influence of P28 and ThE suppositories was evaluated after 6 weeks of treatment with P28 and after 4 weeks of therapy with ThE. P28 was given in a dose of two to four tablets daily, and ThE one suppository per day. It was found that the preparations positively influenced both clinical and laboratory parameters and thus may be used as an alternative (heterodox) to orthodox treatment. Besides their clinical efficacy, the preparations gave no side-effects and this is an additional important parameter which should encourage doctors to use them for the treatment of patients with JCA.

Influencing recurring respiratory system infections in children via immunostimulation

Authors: Mansfeld HJ

Source: Therapeutikon 1988;2/12:707-712

Nonspecific respiratory illnesses play a dominant part in childhood. Causal therapy to improve the immunologic defence mechanism does not exist as yet. Treatment with so-called immunostimulating and immunoregulating products is widespread, their effectiveness, however, is controversial. PADMA 28, a Tibetan herbal remedy, appears to have demonstrable immunoregulating characteristics. It also has a positive influence on the frequency and severity of respiratory infections in children.

Immunostimulation in recurrent respiratory tract infections therapy in children

Authors: Prusek W, Jankowski A, Radomska G, Wieczorek E, Podwysocka M

Source: Archivum Immunologiae et Therapiae Experimentalis 1987;35:289-302

Selected immunologic parameters and effectivity of immunotherapy was evaluated in 117 children (12-month – 10-year-old) suffering from recurrent respiratory tract infections. All the children displayed a profound depression of T lymphocytes number, which resemble the situation seen in AIDS patients. An increase of serum IgM concentration was also noted. Immunotherapy included treatment with the following preparations: TFX and Levamisol which stimulate T cells functions, Broncho-Vaxom which stimulates specific antibody production and a complex herb preparation PADMA showing undefined general stimulatory activity. Separate group of children was subjected to climatotherapy in Czerniawa Sanatorium and received no immunostimulants. All methods of treatment employed had beneficial effect. The highest percentage of positive results was obtained in children receiving TFX and Levamisol. In all groups under study, an elevation of T cells percentage was observed. This was especially evident in Levamisol treated patients. There was no correlation, however, between T cells number and clinical improvement.

Treatment with PADMA 28 of children with recurrent infections of the respiratory tract

Authors: Jankowski A, Drabik E, Szysko Z, Stasiewin W, Brzosko WJ

Source: Therapiewoche Schweiz 1986;2/1:25-32

61 children with recurrent infections of the respiratory tract were treated with a herbal, the immune system stimulating drug. During the treatment and the 9 month follow-up the frequency of infections diminished in 80.4% of the cases. An aggravation of the clinical state and side effects were not observed. The age-related IgG, IgM and IgA levels did not change while the percentage of early and late T-lymphocytes, T-gamma lymphocytes and the phagocytic activity of granulocytes increased significantly. The action is explained by immunocorrective properties of the drug.

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