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Biomedical subjects

W Xuan

Publications and source records attributed to W Xuan.

23 records · Page 2Linked to original sources

Accuracy of asthma treatment in schoolchildren in NSW, Australia.

Insufficient use of anti-inflammatory drugs, such as inhaled corticosteroids and cromoglycate, may contribute to the disease burden associated with asthma. Conversely, aggressive treatment of mild disease may result in avoidable costs and/or adverse drug effects. The aim of this study was to determine the relationship between asthma severity and inhaled corticosteroid/cromoglycate use in a large (n=4,909) random sample of children, aged 8-11 yrs, in NSW, Australia. Asthma and its treatment were assessed by questionnaire responses. Asthma, defined as diagnosis plus current wheeze, was present in 901 children (18% of the sample), of whom 225 (5%) had moderate asthma, defined as asthma plus additional symptoms (sleep disturbance), utilization (hospital, casualty), or disability (reduced activity, school absence). Use of inhaled corticosteroid/cromoglycate was reported by 636 children (13% of the sample). Determinants of use included: asthma diagnosis, current wheeze, and troublesome dry nocturnal cough. There was also a strong relationship between anti-inflammatory treatment and a multicomponent asthma severity score constructed for each child. Inhaled corticosteroids and/or cromoglycate were used by 56% of the children with asthma (24% daily) and by 76% of children with moderate asthma (42% daily). Undertreatment, defined as less than daily inhaled corticosteroids/cromoglycate in moderate asthma, was identified in 130 children (14% of those with asthma or 3% of the sample). Conversely, apparently aggressive treatment, defined as inhaled corticosteroid/cromoglycate use in children with persistent minimal symptoms (asthma severity score of less than 3) was identified in 101 children (2% of the sample). Although there were significant differences between regions in the choice of anti-inflammatory drugs and in the prevalence both of undertreatment and apparently aggressive treatment, there was no clear relationship to regional utilization of emergency and hospital services for asthma. Nevertheless, the frequency of undertreatment suggests an opportunity to reduce asthma morbidity by more consistent application of current therapeutic guidelines.

Administration, Inhalation↗

Consumption of oily fish and childhood asthma risk.

OBJECTIVE: To investigate the association between diet and airway disease in children in the light of epidemiological studies suggesting that consumption of fish more than once a week reduces the risk of developing airway hyperresponsiveness (AHR). DESIGN: Diet was assessed by a detailed food frequency questionnaire and airway disease by respiratory symptoms or airway responsiveness to exercise. METHODS: A questionnaire, containing questions about the frequency of eating more than 200 foods, was sent to the parents of 574 children in whom we had measured recent wheeze (by questionnaire), AHR (by exercise) and atopy (by skin prick tests) six months before this study. We defined current asthma as the presence of both recent wheeze and AHR. RESULTS: Response rate to the questionnaire was 81.5% (n=468.) After adjusting for confounders such as sex, ethnicity, country of birth, atopy, respiratory infection in the first two years of life and a parental history of asthma or smoking, children who ate fresh, oily fish (>2% fat) had a significantly reduced risk of current asthma (odds ratio, 0.26; 95% confidence interval, 0.09-0.72; P<0.01). No other food groups or nutrients were significantly associated with either an increased or reduced risk of current asthma. CONCLUSION: These data suggest that consumption of oily fish may protect against asthma in childhood.

Asthma↗

On adjusting measurements of airway responsiveness for lung size and airway caliber.

It has been suggested that during bronchial challenge with a pharmacologic agent, subjects with small lungs receive a proportionally greater dose of agonist than do those with larger lungs. This infers that measurements of airway hyperresponsiveness (AHR) between different age and gender groups may not be comparable. To examine this, we analyzed data from population samples of 1,613 children 7 to 12 yr of age and 1,484 adults 25 to 50 yr of age in whom we measured airway responsiveness by histamine inhalation test. We used FVC as a surrogate measurement for lung size and FEV1/FVC as a surrogate measurement for airway caliber. When AHR was adjusted for FVC, FEV1/FVC, and gender, the differences in prevalence between age groups was reduced. The prevalence of AHR in those between 7 and 9 yr of age decreased from 20.2% (95% CI, 17.7 to 22.7) to 15.7% (95% CI, 13.4 to 18.0), but the prevalence of AHR in those 35 to 44 yr of age remained the same at 7.6% (95% CI, 5.9 to 9.3). We conclude that FVC and FEV1/FVC have a small but significant effect on the measurement of airway responsiveness and that more precise measurements of the prevalence of AHR can be obtained by standardization for these parameters.

Adult↗

Comparative study on the mechanism of formation of pulse manifestations in coronary heart disease and hematopathic patients.

Most patients suffering from coronary heart disease have string--like pulse due mainly to disorder of cardiac function, lowered arterial compliance and increased total peripheral resistance. The common type of pulse in hematopathy patients is rapid, thready, string--like and slippery, due mainly to increased compensatory pumping action of heart, shortening of ejection time of left ventricle, relatively better vessel compliance and blood rheology as well as low total peripheral resistance.

Adolescent↗

Effects of compound injection of Pyrola rotundifolia L and Astragalus membranaceus Bge on experimental guinea pigs' gentamicin ototoxicity.

In attempting to find drugs effective in preventing and remedying ototoxic injury caused by aminoglycoside antibiotics, we relied on the theory that the induction of ototoxic injury by aminoglycoside antibiotics is related to a decrease of cyclic adenosine monophosphate and RNA content in the cochlea or a dysfunction of the kidney. We selected Pyrola rotundifolia L and Astragalus membranaceus Bge from traditional Chinese herbal medicine, made a compound injection of them, and observed the effect on the pattern of gentamicin ototoxicity in guinea pigs. By electrocochleography and morphology by scanning electron microscopy, the experimental results indicated that the Chinese herbal compound possessed the definite effect of protecting the guinea pig cochlea. The determination of blood urea nitrogen, urinary N-acetyl-D-aminoglucosidase, and urinary protein and observation of renal morphology showed that it also protected the kidney against nephrotoxic nephritis of gentamicin. The conjecture that protection of the kidney by the Chinese herbs may be one of the important factors in preventing ototoxicity supports some explanations of ototoxic mechanisms induced by aminoglycoside antibiotics.

Aminoglycosides↗