Impact of oral corticosteroids on respiratory outcomes in acute preschool wheeze: a randomised clinical trial.

Abstract:

OBJECTIVE:To determine if administration of oral prednisolone to preschool children with acute wheeze alters respiratory outcomes. DESIGN:Double-blind, randomised, placebo-controlled equivalence trial. SETTING:Three hospitals in New Zealand. PATIENTS:477 children aged 24-59 months with acute wheeze associated with respiratory illness. INTERVENTIONS:2 mg/kg (maximum 40 mg) oral prednisolone or similar placebo, once daily for 3 days. MAIN OUTCOME MEASURES:Primary outcome was change in Preschool Respiratory Assessment Measure (PRAM) score 24 hours after intervention. Secondary outcomes included PRAM score at 4 hours, length of emergency department and inpatient stays, admission and representation rates, time to return to normal activities and use of additional oral prednisolone or intravenous medications. Analysis was by intention-to-treat. RESULTS:There was no difference between groups for change in PRAM score at 24 hours (difference between means -0.39, 95% CI -0.84 to 0.06, p=0.09). Absolute PRAM score was lower in the prednisolone group at 4 hours (median (IQR) 1 (0-2) vs 2 (0-3), p=0.01) and 24 hours (0 (0-1) vs 0 (0-1), p=0.01), when symptoms had resolved for most children regardless of initial treatment. Admission rate, requirement for additional oral prednisolone and use of intravenous medication were lower in the prednisolone group, although there were no differences between groups for time taken to return to normal activities or rates of representation within 7 days. CONCLUSION:Oral prednisolone does not alter respiratory outcomes at 24 hours or beyond in preschool children presenting with acute wheeze.

journal_name

Arch Dis Child

authors

Wallace A,Sinclair O,Shepherd M,Neutze J,Trenholme A,Tan E,Brabyn C,Bonisch M,Grey N,Johnson DW,McNamara D,Thompson JMD,Asher I,Dalziel SR

doi

10.1136/archdischild-2020-318971

subject

Has Abstract

pub_date

2020-10-16 00:00:00

eissn

0003-9888

issn

1468-2044

pii

archdischild-2020-318971

pub_type

杂志文章
  • Prevalence and management of gastrointestinal manifestations in Silver-Russell syndrome.

    abstract:OBJECTIVES:Silver-Russell syndrome (SRS) is an imprinted disorder characterised by intrauterine growth retardation, relative macrocephaly, failure to thrive, typical facial phenotype and frequent body asymmetry. Feeding difficulties are frequently noted, but no study described evolution of gastrointestinal signs during...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/archdischild-2013-305864

    authors: Marsaud C,Rossignol S,Tounian P,Netchine I,Dubern B

    更新日期:2015-04-01 00:00:00

  • Family implications of neonatal Gorlin's syndrome.

    abstract::Two very preterm infants (born at 29 and 25 weeks, respectively) were found to have abnormal ribs. Though this was thought unimportant at the time, it was subsequently shown to indicate that some members of their families had a dominantly inherited risk of developing skin cancer and other serious problems. ...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.66.10_spec_no.1162

    authors: Evans DG,Sims DG,Donnai D

    更新日期:1991-10-01 00:00:00

  • Faecal excretion of oligosaccharides and other carbohydrates in normal neonates.

    abstract::Chromatographic analysis of sugars in the stools of 40 normal newborn infants has shown the presence of an oligosaccharide in 85% of samples. The oligosaccharide has been shown to contain fucose (6-deoxygalactose), glucose, and galactose and is present in normal breast milk. In addition fucose has also been found in t...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.53.11.913

    authors: Whyte RK,Homer R,Pennock CA

    更新日期:1978-11-01 00:00:00

  • Amino acid and protein requirements in a preterm infant with classic phenylketonuria.

    abstract::A preterm infant with classic phenylketonuria required rather less than 90 mg/kg of phenylalanine and between 270 and 290 mg/kg tyrosine daily to achieve a rate of weight gain of around 20 g/kg per day. Using Lofenalac as the low phenylalanine food, the intake of tyrosine, an essential amino acid for patients with phe...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.60.3.263

    authors: Shortland D,Smith I,Francis DE,Ersser R,Wolff OH

    更新日期:1985-03-01 00:00:00

  • Distinguishing infant prolonged crying from sleep-waking problems.

    abstract:OBJECTIVE:Infants who cry a lot, or are unsettled in the night, are common sources of concern for parents and costly problems for health services. The two types of problems have been linked together and attributed to a general disturbance of infant regulation. Yet the infant behaviours involved present differently, at ...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.2010.200204

    authors: St James-Roberts I,Peachey E

    更新日期:2011-04-01 00:00:00

  • Hydrocephalus and primary ciliary dyskinesia.

    abstract::Primary ciliary dyskinesia was shown in a 12 year old boy with bronchiectasis who had developed hydrocephalus in the neonatal period. The possible relevance of his ciliary abnormality is discussed. ...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.59.5.481

    authors: Greenstone MA,Jones RW,Dewar A,Neville BG,Cole PJ

    更新日期:1984-05-01 00:00:00

  • Clinical longitudinal standards for height, weight, height velocity, weight velocity, and stages of puberty.

    abstract::New charts for height, weight, height velocity, and weight velocity are presented for clinical (as opposed to population survey) use. They are based on longitudinal-type growth curves, using the same data as in the British 1965 growth standards. In the velocity standards centiles are given for children who are early- ...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.51.3.170

    authors: Tanner JM,Whitehouse RH

    更新日期:1976-03-01 00:00:00

  • Health needs of preschool children.

    abstract::An epidemiological study of disease in a geographically identified population of 250 children is reported. 22% had not seen their general practitioner (GP) at all in the past year, while 20% had seen him four times or more. The vast majority of these visits were because of an infective illness; and developmental and b...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.51.11.848

    authors: Bax M,Hart H

    更新日期:1976-11-01 00:00:00

  • Pathogenesis of liver damage during parenteral nutrition: is lipofuscin a clue?

    abstract::Lipofuscin develops in cells when peroxidation damage occurs. Its development in the liver of patients receiving prolonged parenteral nutrition suggests that peroxidation damage by free radicals has occurred. Deficiencies in antioxidants such as vitamin E may be an important contributing factor. ...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.60.8.774

    authors: Berger HM,Den Ouden AL,Calame JJ

    更新日期:1985-08-01 00:00:00

  • Hypocitraturia in patients with urolithiasis.

    abstract::The urinary citrate/creatinine ratio was evaluated in 25 children with idiopathic calcium urolithiasis and 24 controls. The mean (SD) urinary citrate/creatinine ratio in controls and patients was 0.510 (0.205) and 0.181 (0.076), respectively, a statistically significant difference. In neither group was there a relatio...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.74.4.350

    authors: Akçay T,Konukoğlu D,Celik C

    更新日期:1996-04-01 00:00:00

  • Prune belly syndrome--report of 47 cases.

    abstract::Forty-seven cases of prune belly syndrome in children born between 1948 and 1977 are described. They have been classified into three groups according to the state of the urinary tract in the neonatal period. The results achieved in these cases form the basis of our present management. In group I, the most severely aff...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.57.11.856

    authors: Woodhouse CR,Ransley PG,Innes-Williams D

    更新日期:1982-11-01 00:00:00

  • Effect of tracheobronchial suction on respiratory resistance in intubated preterm babies.

    abstract::Measurements of the resistance, time constant, and compliance of the respiratory system were made in 25 mechanically ventilated, preterm babies on 32 occasions, using the single breath technique. Patients were classified according to the level of respiratory resistance by reference to a population of 36 babies studied...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.61.12.1178

    authors: Prendiville A,Thomson A,Silverman M

    更新日期:1986-12-01 00:00:00

  • Photopheresis at onset of type 1 diabetes: a randomised, double blind, placebo controlled trial.

    abstract:BACKGROUND:In recent years photopheresis, an extracorporeal form of photochemotherapy using psoralen and ultraviolet A irradiation of leucocytes, has been claimed to be an effective form of immunomodulation. AIM:To evaluate its effect in type 1 diabetes we performed a double blind, controlled study using placebo table...

    journal_title:Archives of disease in childhood

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/adc.85.2.149

    authors: Ludvigsson J,Samuelsson U,Ernerudh J,Johansson C,Stenhammar L,Berlin G

    更新日期:2001-08-01 00:00:00

  • Pelvic ultrasonography in premenarcheal girls: relation to puberty and sex hormone concentrations.

    abstract::Real time ultrasonography of the pelvic organs was performed on 114 normal premenarcheal girls aged between 2 years and 13 years 11 months. Values were obtained for total uterine length, anteroposterior diameters of the corpus and cervix, corpus/cervix ratio, and uterine and ovarian volumes and the resultant data were...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.60.2.120

    authors: Salardi S,Orsini LF,Cacciari E,Bovicelli L,Tassoni P,Reggiani A

    更新日期:1985-02-01 00:00:00

  • An assessment of a new breath actuated inhaler device in acutely wheezy children.

    abstract::A randomised double blind, two period cross over study was designed to compare the ability of 51 hospitalised asthmatics with acute exacerbations to use each of two inhalers. The inhalers compared were a new breath actuated metered dose inhaler, the Autohaler inhalation device, and a dry powder device, the Rotahaler. ...

    journal_title:Archives of disease in childhood

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/adc.68.4.477

    authors: Ruggins NR,Milner AD,Swarbrick A

    更新日期:1993-04-01 00:00:00

  • The Royal College of Paediatrics and Child Health programme for subspecialty training.

    abstract::The National Grid is a training scheme that represents a unique partnership between Deaneries and the Royal College of Paediatrics and Child Health (RCPCH) in offering through national competition, equitable access to high quality subspecialty training. Paediatrics is unusual in that within the umbrella Certificate of...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章,评审

    doi:10.1136/adc.2004.066688

    authors: McGraw M,Ng G

    更新日期:2006-01-01 00:00:00

  • Features of transient hypogammaglobulinaemia in infants screened for immunological abnormalities.

    abstract::The incidence of transient hypogammaglobulinaemia of infancy (THI) detected in a major paediatric centre over a 10 year period was examined. A total of 2468 subjects less than 2 years of age had an IgG measurement taken between July 1979 and March 1990. Subjects with known immunodeficiencies were excluded. Fifteen pat...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.70.3.183

    authors: Walker AM,Kemp AS,Hill DJ,Shelton MJ

    更新日期:1994-03-01 00:00:00

  • Asthma drug adherence in a long term clinical trial.

    abstract:AIM:To measure drug adherence in children with mild asthma receiving long term prophylactic treatment. METHODS:Double blind randomised placebo controlled trial. Patients received inhaled budesonide 100 microg or 200 microg daily, or placebo for 27 months. All participants were asked to inhale medication or placebo fro...

    journal_title:Archives of disease in childhood

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1136/adc.83.4.330

    authors: Jónasson G,Carlsen KH,Mowinckel P

    更新日期:2000-10-01 00:00:00

  • Hospitalisation for gastroenteritis in Western Australia.

    abstract:AIMS:To document gastroenteritis hospitalisations of the 1995-96 cohort of infants born in Western Australia to mid-2002, and to assess factors associated with their hospitalisations and readmissions. METHODS:Retrospective analysis of the State's hospitalisation data, Midwives' Notification of Births data, the Austral...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.2003.037531

    authors: Gracey M,Lee AH,Yau KK

    更新日期:2004-08-01 00:00:00

  • Fat absorption by small babies fed two filled milk formulae.

    abstract::In 3-day fat balances, 7 of 8 infants had appreciably more steatorrhoea when they were fed Cow and Gate V formula than when they were fed SMA. The mean fat excretion (+/- SEM) expressed as a percentage of the amount ingested on Cow and Gate V was 28-1 +/- 3-9 compared with 10-5 +/- 2-3 on SMA. Gas-liquid chromatograph...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.50.8.654

    authors: Milner RD,Deodhar Y,Chard CR,Grout RM

    更新日期:1975-08-01 00:00:00

  • Neonatal urological ultrasound: diagnostic inaccuracies and pitfalls.

    abstract::Ninety one patients with urinary tract abnormalities diagnosed before birth were reviewed. Diagnoses based on prenatal and postnatal ultrasound scans alone were compared with the final diagnoses after full urological investigations, with operative or necropsy confirmation in 79 cases. The results confirmed that ultras...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.64.4.578

    authors: Clarke NW,Gough DC,Cohen SJ

    更新日期:1989-04-01 00:00:00

  • Chlamydia trachomatis as a cause of neonatal conjunctivitis.

    abstract::Chlamydia trachomatis was identified in 37 of 73 consecutive neonates with purulent conjunctivitis, including four delivered by caesarean section with intact membranes. Most (28/37) presented in the first week. Infection was significantly associated with referral from the community. Genital C. trachomatis infection wa...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.61.8.797

    authors: Barry WC,Teare EL,Uttley AH,Wilson SA,McManus TJ,Lim KS,Gamsu H,Price JF

    更新日期:1986-08-01 00:00:00

  • Tuberculosis in the United Kingdom and Republic of Ireland.

    abstract:AIMS:To describe the clinical features, diagnosis and management of children with tuberculosis in the United Kingdom and Republic of Ireland. METHODS:Cases of culture-confirmed and clinically diagnosed tuberculosis were reported to the British Paediatric Surveillance Unit from December 2003 to January 2005. RESULTS:3...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章,多中心研究

    doi:10.1136/adc.2007.133645

    authors: Teo SS,Riordan A,Alfaham M,Clark J,Evans MR,Sharland M,Novelli V,Watson JM,Sonnenberg P,Hayward A,Moore-Gillon J,Shingadia D,British Paediatric Surveillance Unit Childhood Tuberculosis Study Group.

    更新日期:2009-04-01 00:00:00

  • AN AUDIT TO ASSESS THE TIMINGS OF TTAS AND INPATIENT ORDERS IN PAEDIATRICS; FROM WRITING, TO SCREENING, TO DISPENSING, AND TO LEAVING DISPENSARY.

    abstract:AIM:To assess the time it takes for paediatric TTA and inpatient orders to be dispensed and sent to ward. This is to establish if the Trust is meeting an operational Key Performance Indicator (KPI). STANDARDS KPIS:▸ 85% of urgent items (TTAs) dispensed within 1 hour.▸ 85% of non-urgent items (most inpatient orders) di...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/archdischild-2016-311535.67

    authors: Hale A,Christiansen N,Calvert H

    更新日期:2016-09-01 00:00:00

  • Maternal mental health and childhood injury: evidence from the UK Millennium Cohort Study.

    abstract:OBJECTIVE:We assessed whether maternal mental health problems increased rates for child injury during the preschool years and mid-childhood, and the extent to which associations could be accounted for by a range of potential explanatory factors. DESIGN:We analysed the UK Millennium Cohort Study, a nationally represent...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/archdischild-2017-313809

    authors: Hope S,Deighton J,Micali N,Law C

    更新日期:2019-03-01 00:00:00

  • USE OF PILL GLIDE TO ENCOURAGE TRANSITION FROM LIQUID TO SOLID DOSAGE FORMULATIONS.

    abstract:SITUATION:Patient I is a 15 year old female with ornithine transcarbamylase deficiency prescribed L-arginine 1.5 g three times daily and sodium benzoate 4.2 g three times daily. By taking her medication and controlling her diet she is able to lead a normal life and does well at school. However she struggles with the pa...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/archdischild-2016-311535.8

    authors: Gaskell C

    更新日期:2016-09-01 00:00:00

  • Reduced incidence of tuberculosis by prophylactic chemotherapy in subjects showing strong reactions to tuberculin testing.

    abstract::The introduction of chemoprophylaxis with rifampicin and isoniazid in 1981 significantly reduced the incidence of tuberculosis. Between 1978 and 1981 children accounted for 136 of 642 notified cases, and this was reduced to 55 of 418 between 1982 and 1986. This effect was most obvious among children from the Indian su...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.62.10.1005

    authors: Ormerod LP

    更新日期:1987-10-01 00:00:00

  • Childhood and adolescent mental health of NICU graduates: an observational study.

    abstract:OBJECTIVE:To investigate the mental health of children and adolescents admitted to neonatal intensive/special care units (NICUs) in infancy. METHODS:This cross-sectional study used a provincially representative cohort from the 2014 Ontario Child Health Study. Parents provided data on psychiatric disorders using the MI...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/archdischild-2019-318284

    authors: Chiorean A,Savoy C,Beattie K,El Helou S,Silmi M,Van Lieshout RJ

    更新日期:2020-07-01 00:00:00

  • Vitamin B12 neuropathy in a 6 year old.

    abstract::Gross neuropathy consequent upon selective malabsorption of vitamin B12 was diagnosed in a 6 year old Bangladeshi girl brought to Great Britain for further investigation of an unexplained illness of three years' duration. The initial peripheral blood count was normal. Treatment with vitamin B12 has led to substantial ...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.59.6.575

    authors: Conway SP,Gillies DR,Littlewood JM

    更新日期:1984-06-01 00:00:00

  • External hydrocephalus and subdural bleeding in infancy associated with transplacental anti-Ro antibodies.

    abstract:BACKGROUND:The isolated finding of an unexplained chronic subdural haematoma in an infant may suggest non-accidental head injury (NAHI). The authors report a previously undescribed cause of multifocal chronic subdural haematoma in infancy which could result in a misdiagnosis of previous NAHI. METHODS:Two infants, aged...

    journal_title:Archives of disease in childhood

    pub_type: 杂志文章

    doi:10.1136/adc.2010.194746

    authors: Edwards RJ,Allport TD,Stoodley NG,O'Callaghan F,Lock RJ,Carter MR,Ramanan AV

    更新日期:2012-04-01 00:00:00