Ease of handling and efficacy of Bricanyl Turbuhaler in Asian asthmatic children.

Ease of handling as well as efficacy of a new terbutaline inhalation device--Bricanyl Turbuhaler--were evaluated among eighty-six Asian children with mild to moderate asthma with a mean age of 8.7 years (range 5 to 14 years) in an open, non-comparative trial. Clinical evaluations were performed on four occasions, ie at the beginning of the run-in period, at the start of the study medication, after 2 weeks of treatment and after a total of 4 weeks of treatment. Appraisal of handling technique was performed by the investigator at the start and end of treatment. Peak expiratory flow rate (PEF) was determined at each visit. Diaries were also kept throughout this time; PEF and asthma symptom scores were recorded every morning and evening. Maximum scores for inhalation technique were achieved by 73% of patients after combined written and verbal instructions at the start of the study and 99% of patients achieved this score at the end of the 4 week treatment period with Bricanyl Turbuhaler. Assessment revealed that approximately 90% of the patients considered loading, inhalation and handling of the Turbuhaler device to be easy, and 90% considered it to be effective in affording symptom relief. Improvements in PEF and reductions in asthma symptoms were observed during the Bricanyl Turbuhaler treatment, as compared to baseline values. All patients tolerated the study medication well without any serious adverse events. We concluded that this group of Asian children were able to use this new "Turbuhaler" device of terbutaline without any difficulty.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of different intervals of administration of inhaled terbutaline in children with acute asthma.

Thirty asthmatic children, 5 to 14 years of age, 20 boys and 10 girls, were studied while having acute asthmatic attacks. Each group of 10 children received either a single dose of 6 puffs (1500 micrograms) or 3 doses of 2 puffs (500 micrograms) at 5-minute or 15-minute intervals of terbutaline pressurized aerosol inhaler through a 750-ml volumetric spacer. The onset of bronchodilatation was observed within 2 minutes in all. The 3 doses at 15-minute intervals gave the greatest bronchodilatation throughout the 6-hour study period in comparing with the other two regimens. Slightly insignificant increases in systolic blood pressure and heart rate were observed in all groups and there were no statistically significant differences among them. No serious side effects were observed.

Comparison of inhaled terbutaline and inhaled terbutaline plus ipratropium bromide in acute asthmatic children.

Twenty asthmatic children, aged 4 to 15 years, consisting of 14 boys and 6 girls, were studied during acute episodes of asthmatic attacks. A group of 10 children each received either inhaled terbutaline 0.5 mg or inhaled terbutaline 0.5 mg followed by ipratropium bromide 0.04 mg 15 minutes later through a 750-ml volumetric spacer. Significant increases in FEV1 over the baseline were observed from 2 minutes to 2 hours and from 2 minutes to 6 hours following the first and second regimen respectively. A slightly greater increase and longer duration in FEV1 were observed in the combined drug treatment and very slight decreases in systolic and diastolic blood pressure below the base-line were observed. Neither regimen showed any serious adverse effect on the heart rate and respiratory rate.

Comparison of subcutaneous injections of terbutaline, salbutamol and adrenaline in acute asthmatic attacks in children.

Bronchodilating and cardiovascular effects of subcutaneously administered terbutaline, adrenaline 0.01 mg/kg and salbutamol 0.007 mg/kg were compared in a randomized single-blind manner. All drugs produced bronchodilation within 2 minutes and maintained it for 4 hours with terbutaline and adrenaline and for 3 hours with salbutamol. Bronchodilatation elicited by terbutaline was the highest. Increases in heart rate were observed in all especially during the first 30 minutes. All drugs elicited small increases in systolic blood pressure and it was highest with terbutaline from 5 to 240 minutes. Decreases in diastolic blood pressure were observed with all three. Increases in respiratory rate were small and observed within the first 5 to 30 minutes.

Atmospheric pollen and mold spores in Bangkok: a 15 year survey.

A 15-year survey of atmospheric pollen and mold spores was carried out in Bangkok, Thailand, from January 1973 to December 1987 by Durham's standard gravity slide sampler. The pollen and mold spore counts were presented. The peak of the pollen and mold spores occurred during the time of the year with lower average temperature, relative humidity and rain-fall. For pollen, this was from November to January and for mold spores from December to February. Mold spores of the Class Fungi Imperfecti were predominant and most likely the major fungi in mold allergy. Grass was the principal air-borne pollen.

Comparison of inhaled terbutaline and terbutaline injection in treatment of acute asthmatic attacks in children.

Thirty asthmatic children, aged 4 to 13 years, 22 boys and 8 girls, were studied during acute asthmatic attacks. Each group of 15 children received either a 0.01 mg/kg subcutaneous injection of terbutaline or 2 puffs from terbutaline pressurized aerosol (0.25 mg/puff) inhaler through a 750-ml volumetric spacer. A slightly greater increase in PEFR following injection compared with inhalation throughout the 6 hours study period was observed. Significant increases in systolic blood pressure and pulse rate were observed only after injection. Therefore, it was concluded that inhaled terbutaline is safe and effective for treating children over 4 years of age with acute bronchospasm and has less cardiovascular side effects than injected terbutaline.

Budesonide aerosols in Thai asthmatic children.

Thirteen children with chronic bronchial asthma, 8 boys and 5 girls, aged between 5 and 15 (mean 10) years, with a duration of asthma ranging from 1 to 12 (mean 6) years, were studied by a control, oral prednisolone 5 mg twice a day and inhaled budesonide 100 micrograms twice daily, each for 3 weeks. The clinical efficacy assessed daily by day and night symptom scores, cough, limitation of activity and inhaled terbutaline used, showed improvement of the parameters measured during budesonide and prednisolone treatment period but did not reach statistical significance except for the night symptom scores (p less than 0.05) between the control and inhaled budesonide period and the cough between the control and oral prednisolone period. Slight improvement in pulmonary function was observed during budesonide and prednisolone. No changes of complete blood counts before and after inhaled budesonide were noted. No oral and pharyngeal thrush were observed in any studied period. Inhaled budesonide appears to be effective for treatment of chronic bronchial asthma but still requires long-term studies with higher dosages to be certain that its effect is better and maintained and without systemic side effects.

Inhaled budesonide aerosols in treatment of childhood asthma.

Twenty-six children with chronic bronchial asthma, 19 boys and 7 girls, aged between 6 and 16 years with duration of asthma ranging from 1-12 years, were studied by a control, oral prednisolone 5 mg twice a day and inhaled budesonide 200 micrograms twice daily, each for 3 weeks. The clinical efficacy assessed daily by day and night symptom scores of cough, wheeze, sleep disturbance, limitation of activity, symptomatic inhaled terbutaline usage, daily morning and afternoon Peak Expiratory Flow Rate (PEFR), and weekly PEFR and Forced Expiratory Volume in 1 second (FEV1) in percent of predict, showed statistically significant improvement during the inhaled budesonide aerosol and oral prednisolone treatment periods in comparison with the control. No side effect was observed during any study periods.

Hemostatic derangement in dengue haemorrhagic fever.

Forty children, aged 1/2-14 years, with serologically proven dengue haemorrhagic fever were daily studied for hemostatic tests. There were 4, 20 and 16 cases of grade I, II III respectively. Hemostatic derangements in DHF is a multifactorial mechanism. Vasculopathy, thrombocytopenia, platelet dysfunction were found in most cases. Mild to moderate degree of prothrombin complex deficiency was observed in 15% and 50% of grade II and grade III respectively while laboratory evidence of consumptive coagulopathy was noted in 30% of shock cases and 10% of non-shock cases. Hypofibrinogenemia and increased PTT are commonly seen in grade III reflect the presence of stimulation of intrinsic coagulation pathway probably from immunologic reaction. Frank DIC is very rarely observed. FDP is slightly increased but not as high as in classical DIC. Further study on the role of platelet-endothelial interaction should be elucidated including the efficient management to stop bleeding in severe shock cases.

Immunoglobulins in maternal and umbilical cord blood of Thais.

Quantitative determination of serum immunoglobulins was carried out by radial diffusion technique in 17 mothers and 43 cord blood samples. Mean maternal serum IgG, IgM and IgA were 1471 +/- 349 mg%, 109 +/- 21 mg% and 240 +/- 62 mg% respectively, and these were equivalent to maternal levels in Thai adults. Mean umbilical cord IgG was 1571 +/- 298 mg% and IgM was 10 +/- 5 mg%. IgA was not detected in the cord blood. There were no differences in the immunoglobulin levels between male and female infants. The IgG levels in the maternal sera and those in the cord sera of the corresponding offsprings were almost identical, but those of IgM were markedly different, suggesting a placenta barrier of this latter immunoglobulin. Thus, IgM level above the normal cord blood suggest intrauterine infection.

Atmosperic pollens and molds survey in Bangkok.

Pollens and molds survey was done by the standard gravity slide sampler at Ramathibodi Hospital for a 3 year period from January 1978 to December 1980. The mold and pollen counts were presented. Fungi Imperfecti was predominant and most likely the major fungi in mold allergy. Grass was the principal air-borne pollen.