RESUMEN
OBJECTIVE: To audit the use of home nebulisers in children with asthma. DESIGN: Postal questionnaire. SETTING: Two Health Board Areas in Central Scotland--one large industrialised city, one mixed urban and rural. SUBJECTS: 297 children with asthma. MEASURES EVALUATED: Initial supply and technical support for the compressor. EDUCATION: Pattern of drug usage. SYMPTOM CONTROL: Monitoring and treatment of acute attacks. RESULTS: The full burden of the home nebulised therapy is not being met by the NHS. Supply and servicing arrangements for home nebuliser therapy were poorly organised. Chronic asthma symptoms did not appear to be optimally controlled on present medication, with 61% reporting sleep disturbance in the previous three months. About 20% of parents admitted that they would give nebulised bronchodilator therapy more frequently than the recommended 3 to 4 hourly. CONCLUSION: Re-organisation of resources and arrangements could improve the service and bring it in line with recognised standards of care.
Asunto(s)
Asma/tratamiento farmacológico , Servicios de Atención de Salud a Domicilio/normas , Nebulizadores y Vaporizadores/estadística & datos numéricos , Terapia Respiratoria/instrumentación , Enfermedad Aguda , Broncodilatadores/uso terapéutico , Niño , Preescolar , Enfermedad Crónica , Humanos , Auditoría Médica , Educación del Paciente como Asunto , Terapia Respiratoria/educación , Escocia , Encuestas y CuestionariosAsunto(s)
Consumo de Bebidas Alcohólicas/fisiopatología , Feto/efectos de los fármacos , Complicaciones del Embarazo/fisiopatología , Alcoholismo/complicaciones , Etanol/efectos adversos , Padre , Femenino , Trastornos del Espectro Alcohólico Fetal/fisiopatología , Humanos , Masculino , Intercambio Materno-Fetal , EmbarazoRESUMEN
The world literature contains few reports of infants born while intoxicated by alcohol. I describe the clinical course of such a child who had a high blood alcohol concentration on delivery, and exhibited features of acute alcohol withdrawal in the days after birth. He later demonstrated features consistent with a partial alcohol foetopathy (foetal alcohol effects).
Asunto(s)
Intoxicación Alcohólica/etiología , Intercambio Materno-Fetal , Etanol/efectos adversos , Femenino , Humanos , Recién Nacido , Masculino , Embarazo , Síndrome de Abstinencia a Sustancias/etiologíaRESUMEN
The circumstances of ingestion, clinical course, and long term sequelae were examined retrospectively in 143 children (108 boys, 35 girls) admitted with acute alcohol intoxication in Glasgow and Nottingham over the 12 years 1973-84. Fifty three of the children were aged less than 7 years and 90 were aged 7-14. Twelve of the children were hypoglycaemic on arrival at hospital. Trauma related to intoxication occurred in 14 cases, and nine boys became drunk under duress, which in four cases was associated with sexual abuse.
Asunto(s)
Intoxicación Alcohólica/epidemiología , Factores de Edad , Intoxicación Alcohólica/sangre , Glucemia/análisis , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino , Estudios Retrospectivos , Reino UnidoRESUMEN
Forty children with the fetal alcohol syndrome were identified in the west of Scotland. All were growth retarded and had abnormal facial features, and all those who were tested were found to have neurological or developmental abnormalities. Two children died of associated physical defects. Most of the mothers were socially deprived, and all had drunk heavily while pregnant. Three women had subsequently died. These findings provide clear evidence that in the west of Scotland maternal alcohol abuse during pregnancy is a significant cause of morbidity and mortality in children.