Acute effect of nebulized budesonide in asthmatic children.

The acute anti-inflammatory effects of inhaled steroids at high doses and their use at home and as emergency treatment of acute asthma attacks in children have been evaluated in many clinical studies. However very little is known about their additional bronchodilator response to systemic steroids plus nebulized salbutamol in the early management in children. Asthmatic patients aged between 5-15 years were investigated in a double-blind, placebo-controlled fashion. Both the study group (Group I) and the control group (Group II) received three consecutive doses of nebulized salbutamol (0.15 mg/kg/dose) and one dose of parenteral methylprednisolone (1 mg/kg/dose, intramuscularly). After this treatment, nebulized budesonide (1 mg/dose) was administered to patients in the study group and placebo (nebulized saline) was administered to patients in the control group. Pulmonary index scoring and peak flow meter was performed to both groups before and after the treatment. There were twelve patients in Group I (mean age: 7.90 +/- 2.34 years) and fourteen patients in Group II (mean age: 9.36 +/- 2.55 years). There was no difference between the two groups with respect to age (p = 0.1421), gender (p = 1.000) and inhaled steroid prophylaxis rate (p = 0.2177). No statistically significant difference was detected between the two groups with respect to the pulmonary index score (p = 0.3528). Yet, there was a statistically significant difference between the two groups with respect to the increase in PEFR (p = 0.0155). The positive acute effect of nebulized budesonide in addition to systemic steroids and nebulized salbutamol in improving the spirometric indices in asthmatic children is an encouraging finding for further investigations of its routine use in the pediatric emergency department.

The association between delayed type hypersensitivity reaction to Mycobacterium tuberculosis and atopy in asthmatic children.

BACKGROUND: It has been postulated that there is an inverse association between mycobacterium tuberculosis infection and atopy. We aimed to investigate if there is a similar relation in our study group, consisting 252 asthmatic children. METHODS: In tuberculin testing indurations greater than or equal to 5 mm were accepted as positive. The most common aeroallergens were used in skin prick testing and reactions > or = 3 mm were accepted as positive. RESULTS: In 139 patients PPD was negative, where as in 113 patients PPD was positive. Among the PPD (-) patients skin prick test was positive in 64 % (n = 89). Among the PPD (+) patients skin prick test was positive in 71 % (n = 80). As the two groups were compared for having positive skin prick test reactions no statistically significant difference was detected between them (p = 0.283). CONCLUSIONS: Tuberculin reactivity is not inversely associated with atopy in asthmatic children.