ABSTRACT
Tuberculin skin test (TST) application in children can be eased by topical anesthesia, but no study has determined whether lidocaine-prilocaine mixture application modifies TST skin reactions. We compared TST performed with and without topical anesthesia in 46 children (range, 0.4-15.9 years), and found that topical lidocaine-prilocaine did not affect the TST size reaction. Topical lidocaine-prilocaine can be used for TST.
Subject(s)
Anesthesia, Local , Tuberculin Test/methods , Adolescent , Anesthetics, Local/administration & dosage , Child , Child, Preschool , Diagnostic Errors/statistics & numerical data , Female , Humans , Infant , Lidocaine/administration & dosage , Male , Prilocaine/administration & dosageABSTRACT
Inhaled treatments are very common in cystic fibrosis (CF) patients. We sent a questionnaire to the 49 French Cystic Fibrosis Care Centers (CFCCs) to see how the inhalation technique of CF patients was initiated and monitored (composition and formation of a potential educational team, use of a manual for use, amount of devices available for demonstration, education to disinfection procedure, realization and frequency of the inhalation technique monitoring, use of the patient's own device, and frequency of checking when a pediatric patient transfers to an adult CFCC). Results were expressed in percent and compared with the test of the difference between two correlated proportions. Education for aerosol therapy was not performed in about 20% of the CFCCs. A specific educational member was present in 33 CFCCs (68%). CFCCs owned statistically less nebulizers for demonstration than other devices. Disinfection advices were always given for nebulizers, but less frequently for spacers (80%) and dry powder inhalers (50%). The inhalation technique was monitored less than once a year or never in 22% of the cases, and rarely with the patient's own material. This monitoring was device dependent (56% with nebulizers vs. 76% with the other devices, p < 0.05). For nebulizers, monitoring depended on the presence of an educational member (p < 0.01) and of a manual for use (p = 0.03). When transferring to an adult CFCC, the inhalation technique was checked in less than a third of the patients. The inhalation technique is poorly and insufficiently initiated and monitored in CF patients. Educational teams and programs are urgently required.
Subject(s)
Cystic Fibrosis/therapy , Patient Education as Topic , Respiratory Therapy , Adult , Female , France , Humans , Male , Surveys and QuestionnairesABSTRACT
BACKGROUND: This randomised cross-over pilot study was undertaken in 10 cystic fibrosis children aged 10 to 63 months to describe lung absorption of tobramycin delivered by the PariLC+/PariTurboboyN (Pari GmbH) and the disposable NL9M/AtomisorBoxPlus (Diffusion Technique Française) nebulising systems. METHODS: Each child inhaled 300 mg tobramycin delivered with one or the other apparatus via a facemask in two separate and standardised sessions. Urine was collected for 6 h. Tobramycin concentrations determined by immunoprecipitation were expressed in mg per g of creatinine and compared by a Wilcoxon test for matched pairs. The influences of age, weight and Brasfield score on this parameter were evaluated by correlation tests, and those of sex, previous nebulisation treatment, and crying or coughing were evaluated by Student's t-test. RESULTS: The amount of tobramycin measured in urines was low and variable. Median values for urinary tobramycin concentration were 47.6 mg/g (14.9-79.6) with the PariLC+ and 42.6 mg/g (6.3-112.8) with the NL9M (p=0.6). PariLC+ delivered tobramycin in 22 min and NL9M in 12 min (p=0.005). Crying or coughing dramatically reduced the amount of tobramycin collected. CONCLUSION: This pilot study shows that evaluation of nebulisers based on tobramycin renal excretion is feasible in young children with cystic fibrosis.
