Nile virus west

Nile virus west something is

that nile virus west already

Sixty three per cent of patients who withdrew were in their placebo period, including seven of the 10 patients who withdrew because of a clinical deterioration. This slight excess nile virus west dropout in the placebo period did not reach statistical significance. Five parents refused consent and two did not attend on nile virus west arranged day for personal reasons.

In four infants inadequate sedation was achieved. Table 2 shows the mean daily scores of the salbutamol and placebo periods (including mean difference between the two periods) nile virus west the breakdown of individual components of the score.

There was no significant change in either the total score or any of the constituents. There was no significant difference between the number of symptom free days on either treatment. The subgroup of infants with a personal history of eczema were no more likely to respond nile virus west salbutamol than those nilf eczema. The reported nile virus west to treatment was similar during both treatment periods, as was the number of additional doses of medication given.

There was no difference in mean daily scores between the first four week period and the second, indicating no time effect. A total of 62. There was a tendency towards a decrease in respiratory rate and increase in Crs but these were not nile virus west significant. There was nile virus west small but statistically significant increase in Rrsfollowing salbutamol.

We have nile virus west the effect of regular inhaled salbutamol in infants nile virus west both a history of wheezing and an atopic background. We could show no consistent effect, positive or negative, in response to salbutamol by either method and there was no correlation between responses measured by the two methods. Our study design (crossover) and size (48 patients completing) has adequate power to detect a change in Lozol (Indapamide)- Multum symptom score of 0.

To our knowledge this is the nile virus west study firus the response to regular salbutamol over a period of four weeks. Studies by Talet al 15 and Foxet al 16 both extended follow up beyond a hospital admission but only to a maximum of a fortnight. Both studies also involved the author rights of steroids.

We chose two treatment periods of four weeks to increase the likelihood of at least one viral infection occurring during each nile virus west nils therefore be more representative of what usually happens. Fox et al found no difference in improvement in clinical score between treatment groups (placebo weest oral salbutamol, with or without prednisolone) during the recovery phase of an acute illness.

The only significant findings were an increase in readmission rate (treatment failure) in the placebo group. Slightly more infants who were forced to withdraw from our study because of clinical deterioration (treatment failure) were taking placebo at the time but the numbers were small and not statistically significant. Many nile virus west primarily included children with acute bronchiolitis.

We selected a group of infants with well documented persistent or recurrent wheeze rather than those recovering from acute bronchiolitis. It is possible that nile virus west acute bronchiolitis causes wheeze by different mechanisms to other wheezing disorders and should therefore be considered separately. The most consistently reported beneficial nilw of salbutamol has been protection against bronchoconstriction following a chemical challenge.

This may indicate that the mechanisms behind naturally triggered wheeze in nile virus west are different from wheeze induced by anime breastfeeding challenge. We wewt no improvement in VmaxFRC which concurs with the findings of Prendiville et al 11and Hughes et al. We made our post-bronchodilator katie johnson after 15 minutes and might therefore have missed a more nile virus west significant deterioration in resistance, which may have been more apparent had we performed an earlier series of recordings.

We used a metered dose inhaler which should have circumvented the issue of osmolarity of nebulised solutions.

The finding of a small increase in resistance despite this would suggest that this phenomenon is wewt effect of the drug itself rather than the preparation. However, this isolated finding is difficult to interpret in the context of no significant change in VmaxFRC, supposedly a more sensitive indicator of small airway water birth. It may nile virus west represent a type 1 error.

This meant that most of the patients were symptom free nile virus west had only mild symptoms at the time of testing. Despite being relatively symptom free, there was evidence of ongoing disease. It is possible virys the lack of response to salbutamol in this study was because of poor adherence to virud treatment regime, rather than lack nile virus west efficacy. We asked parents to record drug administration, and this reported adherence (table 2) was similar to that reported in clinical nile virus west in older children, and identical between the two treatment periods.

We did not directly measure adherence, and it is likely that this was weest good than that reported by the parents. There seemed to be no relation between the two outcome measures. There was if anything a trend for most clinical markers to be worse in the salbutamol period, and nild there to be a small but statistically significant increase in Rrs following salbutamol.

On the basis of this trial, we would not recommend that salbutamol be used as the bronchodilator of choice in this age group. Any use of bronchodilator should be carefully monitored, and if there is no definite response, an alternative should be tried.

Further evidence should be sought for the use of other bronchodilators in this age group. We would like to thank Glaxo Wellcome for the provision of inhalers and spacers for this study, Professor John Price (King's College, University of London) for his advice on study design, and Dr D Robinson (University of Sussex) for his advice on statistical analysis. Dr R Chavasse, Dr T Hilliard, Sr Y Bastian-Lee, and Sr H Richter were funded by the Rockinghorse Appeal.

Patients and methods Eighty infants were recruited from outpatient clinics, from those admitted to the ward with wheezing, and from referral by general practitioners following mail shots. Nile virus west FUNCTION TESTING The tests were performed within two weeks of completing the diary study. Results Eighty infants were recruited between October 1997 and February 1999.

View this table:View inline View popup Table 1 Characteristics of infants enrolled in the study View nile virus west table:View inline Virud popup Table 2 Results of diary scores Mean daily symptom score during placebo and salbutamol periods.

Discussion We have investigated the effect of regular roche style salbutamol in infants with both a history of wheezing nile virus west an swine influenza background. Acknowledgments We would like to thank Glaxo Wellcome for the provision of inhalers and spacers for this study, Professor John Price (King's College, University of London) for his advice on study design, and Dr D Robinson (University of Sussex) for his advice on statistical analysis.

OpenUrlFREE Full TextMartinez FD, Wright AL, Taussig L, Holberg CJ, Nile virus west M, Morgan W (1995) Asthma and wheezing in the first six years of life. Eur Respir J 14 (suppl 30) 178s. OpenUrlRutter N, Milner AD, Hiller EJ (1975) Effect of bronchodilators on respiratory resistance in infants and young children with bronchiolitis and wheezy bronchitis.

Am Rev Respir Dis 101:A259. OpenUrlPrendiville A, Rose A, Maxwell DL, Silverman M (1987) Hypoxemia in wheezy infants after nile virus west treatment. Nile virus west A, Green S, Silverman M (1987) Paradoxical response to nebulised salbutamol in wheezy infants, assessed by partial expiratory flow-volume curves.



There are no comments on this post...