Diseases of paranasal sinuses in children.
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Acute Disease↗
Biomedical subjects
R M Katz
Publications and source records attributed to R M Katz.
Multicentric study of beclomethasone dipropionate nasal aerosol in adults with seasonal allergic rhinitis.
A double-blind, parallel-design multicentric study, in two phases, was conducted to examine the safety and efficacy of 2-wk treatment with various doses of beclomethasone dipropionate nasal aerosol (BDNA) and placebo in adults with seasonal allergic rhinitis. In phase I, 162 patients received BDNA, 33.5 micrograms/burst (o.d.,b.i.d., t.i.d., q.i.d.), or placebo; in phase II, 189 patients received BNDA 42, micrograms/burst (b.i.d. q.i.d.), or placebo. In both phases, statistically significant (p less than 0.05) differences favoring BDNA over placebo were found for all efficacy measures (global evaluation and total and individual symptom scores). In phase I, response to treatment increased as BDNA dosage increased, with a leveling off at t.i.d. dosage. In both phases, marked improvements were seen by week 1, with maximum improvement during week 2. Eighty-seven patients had adverse reactions-sneezing and nasal burning were most common. No suppression in morning cortisol levels was seen, nor were Candida infections promoted. A 2-wk treatment with BDNA was safe and effective in the treatment of seasonal allergic rhinitis in adults.
Adult↗
Chronic sinusitis in children with respiratory allergy: the role of antimicrobials.
We evaluated the role of antimicrobials in the treatment of chronic maxillary sinusitis in children with respiratory allergy. Night and day cough, nasal obstruction, rhinorrhea, postnasal seen. Eighty-four children were treated in a double-blind manner with either amoxicillin, erythromycin, trimethoprim-sulfamethoxazole, or an antihistamine decongestant (carbinoxamine maleate-pseudoephedrine HCl). Radiographic and clinical responses were best with amoxicillin, but trimethoprim-sulfamethoxazole was an adequate alternative. This study demonstrates that allergic children with chronic sinusitis with associated chronic respiratory symptoms are likely to respond clinically and radiologically with antimicrobial treatment.
Adolescent↗
Oral albuterol in the treatment of childhood asthma.
The efficacy, safety, tolerance, and bio-equivalence of albuterol (a relatively selective beta 2-adrenergic drug) was evaluated in 20 asthmatic children (6 to 14 years of age). The study was divided into two phases: a single-blind multiple-dose treatment with placebo and three separate weekly treatments with 2, 4, and 6 mg of albuterol (tablets or syrup) administered four times a day; and a double-blind crossover period comparing 4-mg albuterol tablets to syrup and placebo. Patients recorded daily diaries and were seen weekly. Theophylline, isoproterenol, and/or epinephrine was administered as needed. In phase 1, the 4- and 6-mg albuterol doses were superior with the latter causing more side effects. In phase 2, a 4-mg dose of albuterol was superior to placebo. The syrup formulation was superior to tablets when extra medications (P less than .01) and six-hour change in pulmonary function were evaluated; the maximum effect of the 4-mg syrup dose was reached at four hours and lasted for six hours whereas the effect of the tablet peaked at two hours and was minimal after five hours. Heart rate changes from base line were greater with syrup. Four milligrams of albuterol syrup (2 mg/5 ml) four times a day is the preferred dose for the asthmatic child 6 to 14 years of age.
Administration, Oral↗
Response of individuals with reactive airway disease to sulfates and other atmospheric pollutants.
Severity of daytime and nighttime symptoms and medication requirements of 34 asthmatic volunteers were correlated to pollutant-pollen levels and to meteorologic characteristics continuously recorded over an eight-month period. Results of this longitudinal study suggest that as many as 9% of asthmatics may be sensitive to levels of sulfate in the ambient air and that reduction of sulfate levels to below 10 microgram/ml3 would significantly reduce tha frequency and severity of symptoms and needs for medication in these individuals.
Adolescent↗
Effect of theophylline on gastroesophageal reflux in normal adults.
In a randomized, double-blind manner, 15 normal adults were given a single oral loading dose of anhydrous theophylline (6.5 +/- 0.9 mg/kg) and nine normal adults were given placebo. All subjects were tested for serum theophylline levels, acid reflux (using intraesophageal pH probe), and lower esophageal sphincter pressure (LESP) at 1.5, 4, and 8 hr after treatment. Of subjects with negative baseline acid reflux tests, eight of 13 (61.5%) given theophylline developed positive acid reflux tests compared with none of eight subjects given placebo. One of nine (11%) placebo subjects reported heartburn compared with 11 of 15 (73%) subjects given theophylline. The maximum mean percent change in LESP from baseline was +5.62 +/- 28.8% in the placebo group and -25.01 +/- 23.7% in the theophylline group (p = 0.01) at 4 hr after treatment. While only two of nine (22%) adults given placebo had at least a 14% reduction in LESP following treatment, all of the 15 subjects sustained a minimum of 14% relaxation in LESP. This study confirms that oral theophylline at therapeutic serum levels inhibits LESP and induces gastroesophageal reflux (GER) measured by acid reflux tests in most normal adults.
Adult↗
Female laundry and dry cleaning workers in Wisconsin: a mortality analysis.
The mortality patterns of 671 female laundry and dry cleaning workers for the period 1963--1977 were analyzed, using Wisconsin death certificate data. Results fail to show an overall increase in malignant neoplasms, but elevated risk was found for cancers of the kidney and genitals (unspecified), along with a smaller excess of bladder and skin cancer and lymphosarcoma.
Adolescent↗
Gastroesophageal reflux-associated recurrent pneumonia and chronic asthma in children.
Forty of 82 patients with recurrent pneumonias and/or clinical asthma were found to have gastroesophageal reflux (GER) by the criteria of two or more of five tests positive for GER. Of 36 patients with GER followed for response to therapy, 32 patients attempted medical therapy and four had fundoplications. Ten of 32 (31%) patients on medical therapy had improvement in symptoms but none became asymptomatic. Twenty patients who failed a trial of medical therapy also had fundoplications for a total of 24 patients surgically treated. Of these, 22 (92%) had improvement or became asymptomatic. All seven patients with diagnosed GER and recurrent pneumonias responded to medical antireflux management or fundoplication. GER is an important treatable cause of recurrent pneumonias and/or chronic asthma in children.
Adolescent↗
Albuterol syrup in the treatment of the young asthmatic child.
Albuterol (salbutamol) syrup was studied in 14 asthmatic children (three to six years of age) in a four-week, double-blind, crossover (with placebo) trial to determine efficacy, safety and tolerance. Albuterol was found to be more effective as evaluated by measurements of symptom scores (p less than .01) daily WPF meter (p less than .01) and need for additional medications. Albuterol provided a significant (p less than .01) increase in FEV1 and FEF 25%-75% over three hours. Clinically unimportant effects on heart rate, personality and tremors were noted in most subjects. The authors conclude that albuterol syrup is effective and safe in the young asthmatic.
Albuterol↗
Gastroesophageal fundoplication for the management of chronic pulmonary disease in children.
Gastroesophageal reflux is a common cause of chronic pulmonary disease in children. Forty-two children with recurrent pneumonia or severe asthma were evaluated and shown to have signicant reflux. Esophagography and esophageal pH testing proved the best diagnostic tests for determining reflux. Although the pulmonary symptoms were often due to repeated aspiration, they appeared in several cases to be related to bronchospasm caused by acid in the upper esophagus. All of the children underwent Nissen fundoplication and gastrostomy an average of 30 months after the onset of pulmonary symptoms. Of the children who had preoperative pneumonia, 87 percent had no recurrence after operation. In 13 of the 14 asthmatic children who underwent operation, symptoms improved and less bronchodilator medication was required. Morbidity and mortality were closely related to the duration and severity of pulmonary disease.
Adolescent↗
Unit dose packaging for long-term mental health facilities.
A study was conducted by two mental health institutions to determine the usage and the cost of providing oral solid unit dosage medications to 1400 patients. The results in the two institutions were as follows: 1) 257,732 (12%) and 73,956 (17%) doses were not commercially available; 2) 656 and 134 technician hours per year could be saved by employing a vendor packaging service; 3) only 119,802 (5%) and 66,627 (15%) of the doses were available commercially at little or no additional cost compared to bulk purchase; and 4) 1,856,752 (83%) and 298,712 (63%) doses were available commercially at a premium price of $34,138 and $8,544 per year. The unusually high quantity of medications not commercially available in unit dose packages and the high cost of purchasing those that are available may be the result of the specialized care provided by a mental health facility. Therefore, methods of providing unit dose products in acute-care hospitals may not be adaptable to mental health facilities or to other specialized care providers.
Commerce↗
Metaproterenol and theophylline in asthmatic children.
Metaproterenol (M) and theophylline (T) were compared in an eight-week randomized, double-blind, crossover study in 20 moderately severe asthmatic children. All subjects were clinically maintained on both M and T. T was superior when evaluating cough, attacks, extra medicines, and PEFR values. Diary analysis revealed T better in 11, M in six and M/T equal in three subjects. Side effects were more common with T. M might be an adequate alternative to T in the treatment of asthmatic children requiring daily bronchodilators.
Adolescent↗
Prednisone and beclomethasone for treatment of asthma.
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Asthma↗
Pharmacologic management of pediatric allergic disorders.
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Acute Disease↗
Nursing education program: fundamental to successful drug distribution.
This paper provides a step-by-step, illustrative example of an inservice program which aided in the successful conversion of a chronic care facility from a routine floor stock drug distribution system to a non-traditional unit dose system. The program remains operational as a part of the orientation program for new nurses. The program is composed of a policy and procedure manual handout, a lecture on the mechanics of the system, a videotape module, a demonstration, practice session, return demonstration, and post-test. One aspect of the system is the utilization of a demonstration cassette and Kardex. This teaching tool enables the lecturer to demonstrate the system, the nurses to practice with the system, and the nursing supervisor to evaluate performance before actual administration of medications. A unique aspect of the program is a videotape module, which had added flexibility to instruction times. The program is beneficial to the entire nursing staff when converting to the unit dose system, and to the newly hired nurse prior to assignment. Because of the success of this videotape module, the use of videotaping has been expanded to other pharmacy education programs.
Humans↗
Recurrent pulmonary disease in children: a complication of gastroesophageal reflux.
To evaluate the role of gastroesophageal reflux (GER) as a possible cause of recurrent pulmonary disease, 30 children, aged 1 to 18 years, were studied prospectively with esophageal function tests. These included esophagram (30 patients), esophageal manometry (29 patients), pH probe (Tuttle) test (29 patients), and esophagoscopy with esophageal biopsy (23 patients). The patients studied had either chronic asthma or two or more documented pneumonias within a one-year period. Nineteen (63%) had GER based on two or more positive tests. Eighteen had positive Tuttle tests; 13 had abnormal manometry studies; nine had esophagitis on biopsy; six had esophagitis on esophagoscopy; and five had reflux on esophagram. Of those with GER, 17 had a history of nocturnal cough and eight vomited during infancy. Children with recurrent pulmonary disease should have esophageal function testing to exclude GER as the cause.
Adolescent↗
Sinus disease in children with respiratory allergy.
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Adolescent↗