Biomedical subjects

A J Veale

Publications and source records attributed to A J Veale.

3 recordsLinked to original sources

PubMed2004

Eformoterol n-of-1 trials in chronic obstructive pulmonary disease poorly reversible to salbutamol.

AIMS: Benefits of long acting beta 2 agonists are unclear for severe chronic obstructive pulmonary disease (COPD) patients with poor response to short acting bronchodilators. We aimed to evaluate 1) effects of eformoterol in such patients using a 'n-of-1' double crossover study design, and 2) aggregate data as a double-blind, double crossover randomized control trial. METHODS: Subjects with forced expiratory volume in one second (FEV1) < 60% predicted, and poor response to short acting bronchodilators were studied six times over 18 weeks. During that time they were prescribed four weeks of either eformoterol or placebo, followed by the alternate, and then a second crossover. Four-weekly measures included six minute walk distance (6MWD), FEV1, previous two weeks of symptoms, and chronic respiratory questionnaire (CRQ) including treatment goal items. RESULTS: Of 27 original subjects (21 male, mean age of 70 years, five smokers, mean prebronchodilator FEV1 36% predicted), one subject had clinically significant concordant improvement in the CRQ dyspnoea domain and 6MWD (by 51 metres), but not for other outcomes. There were no concordant improvements in any other subjects. Aggregate double crossover data analysis demonstrated no improvement in any outcome measures. CONCLUSIONS: The 'n-of-1' study design and aggregate data analysis demonstrated lack of benefit from eformoterol in COPD patients with poor response to short acting bronchodilators.

Adrenergic beta-Agonists↗

PubMed1997

'Normal' lung function in rural Australian aborigines.

BACKGROUND: Although lung diseases are a leading cause of premature mortality in Australian Aborigines, little is known about normal lung function in these people. AIM: To develop models for 'normal' spirometric function in rural Australian Aborigines. METHOD: A cross-sectional population-based study of four rural Aboriginal communities was performed in Queensland, Northern Territory and South Australia, Australia. We studied 261 children aged seven-19 years and 332 adults aged 20-80 years who were free of symptoms and had no clinical signs of chronic lung disease. The outcome measures were forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). Multiple linear regression was used to develop models for FEV1 and FVC and comparisons were made with Caucasians and indigenous people from other countries. RESULTS: The Aboriginal people studied had FEV1 and FVC values that were lower (20% and 30% respectively) than those found in Caucasians of the same height, age and gender. As a consequence, they had relatively high FEV1/FVC ratios. Those studied also had forced expiratory volumes that were lower than those found in African Americans and other indigenous peoples. CONCLUSIONS: Apparently healthy rural Aboriginal people have low forced expiratory volumes when contrasted with Caucasians and indigenous peoples such as African Americans. More research is required to determine if this is 'normal' or a product of the suboptimal environment into which many Aboriginal people are born.

Adolescent↗

PubMed1996

Asthma and atopy in four rural Australian aboriginal communities.

OBJECTIVE: To determine the prevalence and nature of asthma in four rural Australian Aboriginal communities. DESIGN: Cross-sectional population study. SETTING: Four Aboriginal communities in Queensland, the Northern Territory and South Australia, Australia. SUBJECTS: Data were collected from 1252 subjects aged 5-84 years in August 1990 and August/September 1991. MAIN OUTCOME MEASURES: Respiratory symptoms, measured by interview-administered questionnaire; airway hyperresponsiveness (AHR), measured by histamine challenge; and allergy, measured by skin-pick tests. AHR was a PD20FEV1 of histamine of less than or equal to 3.9 mumol. RESULTS: The prevalence of AHR in the four communities ranged from 2.2% to 7.5% and significantly increased with age (chi 2 trend test: P < 0.05). The prevalence of current asthma was 0.5% among 8-12 year old children and 3.3% among adults. The overall prevalence of atopy in the four communities ranged from 21% to 34%. Allergy to cats, house dust mites or cigarette smoking was a risk factor for AHR, and cat allergy was a risk factor for current asthma. CONCLUSIONS: The prevalence of asthma in rural Aboriginal adults is low in comparison with the prevalence among non-Aboriginal Australians, and asthma in Aboriginal children is almost non-existent. The low prevalence of asthma is possibly due to environmental factors that influence the acquisition of atopy and AHR.

Adolescent↗