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Biomedical subjects

D Luyt

Publications and source records attributed to D Luyt.

11 recordsLinked to original sources
PubMed2002

Short term effects of adrenaline in bronchiolitis: a randomised controlled trial.

BACKGROUND: Airway narrowing in acute bronchiolitis does not respond to inhaled bronchodilators but does to adrenaline when compared to bronchodilators. Influences of supportive care were not considered in previous treatment studies. METHODS: Short term effects of nebulised adrenaline and saline placebo were compared in infants with moderately severe acute bronchiolitis. Thirty eight infants were recruited, 19 in each treatment group. After stabilisation, infants received a single 3 ml dose of either levo-adrenaline (3 mg) or 0.9% saline placebo via Pari-BABY nebuliser driven with 6 l/min oxygen for three minutes. Changes in respiratory rate (RR), heart rate (HR), oxygen saturation (SpO(2)), Respiratory Distress Assessment Instrument (RDAI), and activity levels were assessed at 20 minutes intervals at times -20, 0, 20, 40, and 60 minutes around treatment. Respiratory virology and chest x ray were performed. RESULTS: Supportive therapy prior to study treatment resulted in significant reductions in RR (by 4.3 breaths/min) and HR (by 4.6 beats/min); there were no changes in SpO(2) or RDAI. There were no further changes in any parameter in either treatment group at any assessment time after treatment. CONCLUSION: No improvement was shown with inhaled adrenaline in acute bronchiolitis, when compared with supportive care or placebo. Improvements noted pretreatment question whether prior noted improvements were through supportive care or pharmacological interventions.

Bronchiolitis↗
PubMed1999

Nut allergy: symptom and severity reporting.

Nut allergy, in particular peanut allergy, is becoming more common in children. Immune sensitisation to nuts appears to be occurring earlier in life. High incidence of other allergic diseases in children with nut allergy. Onset of anaphylactic symptoms is quick but symptoms last for a short time. Necessity for hospital admission due to severity of allergic reaction is low.

Child, Preschool↗
PubMed1997

Cost of therapy for allergic rhinitis.

OBJECTIVE: To describe the cost of medicines used in the treatment of allergic rhinitis in South Africa. DESIGN: MIMS was used as the reference for the list of drugs, drug formulation and size, and recommended dosage. These figures were then checked against the package insert of each agent. The cost of each agent was originally derived from the same source, but for standardisation purposes the blue book price was used. Measure of effectiveness was derived from the International Consensus Report on the Diagnosis and Management of Rhinitis. Costs per treatment periods of 10 days (course) and 30 days (month) were calculated. The 'cost' differs from the 'price' in that it takes efficacy into account. MAIN OUTCOME MEASURES: Cost of drugs used in the treatment of allergic rhinitis. RESULTS: The least costly treatments for allergic rhinitis are the intranasal corticosteroids. Sodium cromoglycate was the most costly, being nearly 20 times more expensive than the nasal steroids. Anticholinergic sprays and topical decongestants were also more costly than nasal steroids, as were the antihistamines. The older-generation antihistamine, ketotifen, was not only more costly than the four oral newer-generation agents in this class but has the added disadvantage of greater sedative side-effects. All oral antihistamines were outclassed by the topical antihistamine, levocabastine. CONCLUSIONS: This study in no way aims to recommend treatment for allergic rhinitis. However, it highlights the need to consider efficacy of a drug before unit price in the selection of treatment regimens. It is therefore a comment on practical issues in drug selection in the treatment of allergic rhinitis.

Dosage Forms↗
PubMed1997

Clinical characteristics of childhood asthmatics in Johannesburg.

OBJECTIVES: To describe the clinical features of Caucasian childhood asthmatics in Johannesburg in order to compare these with a similar population of black asthmatic children resident in Soweto. DESIGN: In a prospective study, a history was obtained by means of an investigator-administered questionnaire. MAIN OUTCOME MEASURES: Presenting asthma symptoms, precipitants of symptoms, concomitant diagnoses, individual and family background of allergy and 'delay to diagnosis' of asthma (age at symptom onset subtracted from age at diagnosis) from history and allergen sensitivity as assessed by skin-prick tests (SPTs). RESULTS: Of the 468 (297 boys) asthmatics studied, 456 (97.4%) presented with cough, 362 (77.3%) with wheeze, 286 (61.1%) with a tight chest and 277 (59.2%) with breathlessness. Cough as sole symptom occurred in 102 (21.8%) while only 8 (1.7%) wheezed and did not cough. Commonest symptom triggers were upper respiratory tract infections and activity/exercise. An individual atopic background was common-allergic rhinitis in 413 (88.2%)-as was a family history of atopy, present in 390 (83.3%). Prolonged symptomatic periods occurred in most patients before asthma was diagnosed (among children diagnosed after the age of 4 years, 50% had been symptomatic for more than 3 years). 'Delay to diagnosis' was not influenced by presenting symptoms or by previous hospitalisation for asthma. Other respiratory diagnoses of bronchitis and pneumonia were common, possibly because of misdiagnosis. Commonest allergens on SPT were corn pollen, Bermuda and 5-grass mix, and standardised mites. Aside from wheat, food allergy was uncommon. CONCLUSIONS: Cough was the commonest presenting symptom despite its still being regarded as a less classic symptom of asthma that may account for misdiagnosis and a high frequency of other respiratory diagnoses. Associated allergy, especially allergic rhinitis, occurred frequently. Many aspects of presentation in whites were similar to those in Soweto children, although the latter had a more frequent concomitant diagnosis of tuberculosis, and recognised dust and cold weather as more frequent triggers. Differences might be influenced by the care-giving situation.

Adolescent↗
PubMed1993

Sodium cromoglycate via inhaler and Autohaler.

One hundred and eighty-one children with asthma were entered into a randomized, controlled, crossover study comparing sodium cromoglycate via a metered dose inhaler (MDI) and a breath-actuated inhaler (Autohaler). There were no significant differences in pulmonary function tests (FEV1, FVC, PFER), symptom scores and bronchodilator use between the two devices. However both patients' and clinicians' opinions of sodium cromoglycate effectiveness were significantly better (P < 0.01) for the Autohaler. Autohaler was also thought to be easier to use (P < 0.001) and better for co-ordination of actuation with inhalation (P < 0.001). The Autohaler is as efficacious as the metered dose inhaler used by good co-ordinators. It seems to be the significantly better device with respect to ease of use, actuation and co-ordination which may aid compliance.

Adolescent↗