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Biomedical subjects

E Wooler

Publications and source records attributed to E Wooler.

5 recordsLinked to original sources
PubMed1994

Prednisolone and salbutamol in the hospital treatment of acute asthma.

The use of oral prednisolone (2 mg/kg) to treat children admitted to hospital with acute asthma was assessed in a placebo controlled study. Children were further randomised to receive either 0.15 mg/kg salbutamol every 30 minutes for the first three hours of admission, or 5 mg salbutamol every one to four hours as needed. Treatment was double blind and the assessor was unaware of the nebuliser regimen given. Children were examined before and after treatment with salbutamol on arrival and reassessed four hours after admission. Seventy children completed the study. Seventeen (46%) of 37 children receiving prednisolone and six (9%) of 33 receiving placebo were fit for discharge after four hours of treatment. There was no significant difference between the two nebuliser regimens. Clinical parameters indicative of asthma severity were improved in all groups. Between group comparisons at reassessment showed higher peak flows in those receiving prednisolone and nebulisers every 30 minutes but differences were not significant for other parameters. Objective parameters indicating steroid efficacy over placebo were minimal. Despite this, those receiving prednisolone were more readily identifiable as being fit for discharge within four hours of treatment.

Acute Disease↗
PubMed1993

Audit strategies to reduce hospital admissions for acute asthma.

An eightfold rise in hospital admissions for acute asthma from 1971-85 prompted two studies to audit the admissions policy at the Royal Alexandra Hospital. In the first study the on call senior house officer (SHO) was replaced by an experienced registrar and over a four month period 53 children out of 158 were sent home from the receiving room compared with six out of 39 seen by the SHOs. In the second study an SHO training programme was established together with a home treatment package. Over a 12 month period the on call SHOs assessed 687 children with acute asthma; 229 (43.5%) were deemed fit to be sent home. Only seven of these were readmitted within one week. Diary symptom score cards filled in by parents indicated that children sent home without admission fared no worse at home than those admitted and then discharged for the two weeks after leaving hospital. The development of strategies to improve assessment and immediate management in the hospital receiving room can reduce hospital admissions for acute asthma, allowing more children to be safely managed in the community.

Acute Disease↗
PubMed1993

Use of budesonide in severe asthmatics aged 1-3 years.

The treatment of severe asthmatics aged 1-3 years with budesonide administered via Nebuhaler and Laerdal facemask was assessed in a six month, double blind, placebo controlled study. Patients were randomised to budesonide (n = 20) or placebo (n = 20) treatment. Daily symptom scores were recorded by parents and clinic visits occurred every six weeks. Cough scores improved significantly with budesonide: nocturnal and daytime cough scores (0-2) fell by a mean (SEM) of 0.4 (0.2) and 0.5 (0.2); while with placebo the nocturnal score increased by 0.1 (0.2) and daytime score was unchanged at 0.0 (0.2). All other data showed improvements for active over placebo treatment. Thirteen children in each group completed six months' treatment. Parents of 25 of these found the delivery system convenient and easy to use. While blinded to treatment it was assessed to be beneficial in nine of 13 receiving budesonide and four of 13 receiving placebo. The Nebuhaler and facemask is an acceptable delivery system for long term asthma treatment. Symptoms are significantly reduced when it is used to give 400-800 micrograms budesonide/day to children aged 1-3 years who cannot use other delivery systems.

Administration, Topical↗