Smith, John Morrison (1960) Asthma in School Children. PhD thesis, University of Glasgow.
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Abstract
1. A prevalence study carried out in children attending Birmingham Schools revealed that between the ages of 5 and 15 years the overall prevalence of asthma was 1.76%. The prevalence in boys fell from 2.58% at 5-6 years, 1.96% between 13 and 15 years, while in girls, the prevalence was 1.02% at 5 - 6 years, and 1. 21% at 13 to 15 years. 2. Experience in a special clinic within the School Health Service in Birmingham, for the treatment of asthma and related disorders over a period of six years and more than 500 patients is reported. 3. Family size and circumstances were not found to have a marked influence on the occurrence of asthma, but a strong hereditary tendency was evident. 4. The most important associated disorders were found to be infantile eczema, which often preceded asthma, and hay fever, which often developed at a later age. 5. Investigation of individual cases had to be very thorough and include careful enquiry into personal and environmental history, together with physical, radiological and other special methods of investigation. 6. Of the special methods of investigation the skin tests were found to be the most generally applicable, simple, safe and reliable but then to apply the results to clinical assessment and treatment required understanding and experience. In the absence of such experience and understanding, the results would undoubtedly be misleading. 7. Asthma in children was found to have a predominantly allergic background, but many other factors also played a part. The most important allergic factors were house dust in perennial cases, and grass pollen in seasonal cases. The most important non-allergic factors were infection, emotion and non-specific irritation of the respiratory tract from air pollution. A self-perpetuating trend such as is evident in infantile eczema may also be present. 8. Palliative treatment in children requires special consideration and experience with Prednisolone given by mouth in minimal amount over prolonged periods to the most severely affected cases, has proved of great benefit without resulting in side effects. Clinical trials of hydrocortisone given by inhalation and of the active isomers of Glycyrrhetenic acid given by mouth failed to demonstrate any useful effect from either. 9. Non-specific treatment was found to be of great importance owing to uncertain results of specific treatment. Antibiotic therapy of infections of the respiratory tract, breathing exercises and open-air schools proved to be of great value in many cases. Hypnotic suggestion and tonsillectomy failed to result in significant benefit. 10. Specific treatment by removal of an offending allergen is often difficult or only partly applicable. Hypo-sensitisation to inhalant allergens proved most successful in seasonal cases with pollen allergy where 55% could be rendered symptom-free, and a further 30% improved. Hypo-sensitisation with house dust solution in perennial cases was less successful, but 49% were much improved after at least six months treatment, and a further 19% slightly improved. 11. Both experience and great care are necessary in administering hypo-sensitisation treatment to children, but given these no serious accident has occurred.
Item Type: | Thesis (PhD) |
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Qualification Level: | Doctoral |
Keywords: | Medicine, Immunology, Epidemiology |
Date of Award: | 1960 |
Depositing User: | Enlighten Team |
Unique ID: | glathesis:1960-79354 |
Copyright: | Copyright of this thesis is held by the author. |
Date Deposited: | 05 Mar 2020 10:38 |
Last Modified: | 05 Mar 2020 10:38 |
URI: | https://theses.gla.ac.uk/id/eprint/79354 |
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