Childhood asthma: parents' perspective--a qualitative interview study.

OBJECTIVE: We aimed to describe the parents' perspective of their child's asthmatic disease, and relate it to the dialogue with the doctors and the diagnostic delay. METHODS: Qualitative studies with semi-structured interviews were carried out with 20 parents of 30 asthmatic children aged from 2 to 15 years who had had asthma for at least 1 year and were all attending a Copenhagen outpatient asthma clinic. RESULTS: The asthma symptoms, for most of the children starting during their first year, were manifold and complex, including long-lasting coughing as a frequent symptom. Parents recognized specific asthma patterns in their child, often including behaviour change. Many parents had difficulty in understanding why doctors changed the dose of medicine. The diagnostic delay was significant. The study indicated problems in doctor-patient communication: differences in the conceptual vocabulary; the doctor's reluctance to consider the patient's story and rely instead on auscultation; as well as unexpected odd differential diagnoses. All contributed to the disturbed mutual understanding. CONCLUSION: The new asthma definition from the First International Pediatric Consensus Report is a milestone because it focuses on the patient's story and emphasizes the chronic episodic course rather than asthma as attacks. The study highlights the importance of "listening to the parents" in order to make the diagnosis and to secure parents' participation in starting anti-inflammatory therapy, as well as regulating drug doses according to the symptoms, to secure the lowest possible but effective drug doses.

Aniracetam tested in chronic psychosyndrome after long-term exposure to organic solvents. A randomized, double-blind, placebo-controlled cross-over study with neuropsychological tests.

In order to examine if the nootropic drug, aniracetam, was capable of improving cognitive performance, 44 subjects suffering from chronic psychosyndrome after long-term exposure to organic solvents were included in a randomized, double-blind, placebo-controlled, cross-over study. The treatment periods were 3 months with aniracetam 1 g daily and 3 months with placebo. Neuropsychological tests as well as a physical and neurological examination were performed at entry into the study and after each treatment period, together with an evaluation of the subjects' overall condition. Neither the doctors' nor the subjects' own assessment of the overall condition indicated that the trial medication had had any effect. No significant changes in neuropsychological symptoms were observed. A statistically significant difference in favour of antiracetam was found in only 1 of the 19 neuropsychological test measures, namely a test for constructional ability. However, in another test on visuo-spatial function, a statistically significant result was found in favour of placebo. Thus, aniracetam was found to be ineffective in the treatment of subjects suffering from chronic psychosyndrome after long-term exposure to organic solvents.