synopsisIn a controlled population study 111 families of children with asthma and wheezy bronchitis were screened. The mothers of asthmatics suffered more depressive illness than controls. This correlates with the severity of the child's asthma. There was no difference in immunological status between depressive and non-depressive mothers of asthmatics.
The relationship between atopy and wheeze was examined in children, together with the possible influence on these conditions of parental atopy and family size. Children with a repeated history of wheezing were selected from an urban general practice population. The children, their first degree relatives, and a control group were examined for atopic status, atopy being defined as more than one positive immediate skin prick test response. The prevalence of wheeze in boys was 15'5%, in girls 7-6%, and of atopy in boys 19-7% and in girls 8-1%. Of 110 atopic children 70% had no atopic parent, 27% had one atopic parent, and in 3% both parents were atopic. The presence of parental atopy was associated with an increased prevalence of wheeze in boys but not in girls, 12'0% of boys having a history of wheezing if neither parent was atopic and 27-5% if either or both parents were atopic (p<0 05). The presence of parental atopy was associated with an increased prevalence of atopy in girls but not in boys, 6-1 % of girls having atopy if neither parent was atopic and 18-9% if either or both parents were atopic (p
Twice as many boys,as girls are prone to wheeze (15-3% compared with 7%). This study examines the possible immunological basis for this phenomenon. There were 1064 children in this survey. The family of each wheezy child was indexed, and a control sampleof families was selected. At least 85% of the study population were skin tested for Type I allergic reactions. An interval survey of values for FEV,, FVC and PEFR against height was completed.Of 118 wheezy subjects there were 83/542 boys and 35/522 girls. Single and multiple sensitivity, the capacity to react to two or more major allergens, is examined. Of the child asthmatics, significani differences from controls emerge for pollens, foods and the house dust mite. These difTerences are borne out with multiple sensitivity. (/*>OOOI.) Ofthe brothers and sisters of asthmalics, only the sisters show differences from controls. This is true for grass pollen, cow's milk and the house dust mile, and also to a highly significant degree for multiple sensitivity (/'>0001). When the incidence of multiple sensitivity is expressed for all children in the asthma group, that is, cases and their siblings, the sex difference is not demonstrable. The mothers (A'>005) and fathers (P>O-Ol), of asthmatics also differ from control parents in respect of skin sensitivity.If multiple sensitivity Is equated with atopy, it may not be the main determinant of the capacity to wheeze, and thus of the sex difference.The mean curve for interval PEFR for asthmatic children was significantly lower than that of control children and ofthe brothers and sisters of asthmatics.
Decubitus ulcers are most commonly seen in debilitated and malnourished animals as well as those with long-term bandaging or hospitalization. Identifying risk factors is key to preventing the condition developing. Implementing a good nursing care plan will ensure continuity of care and will help minimize the occurence and progression of decubitus ulcers. If treatment for an existing ulcer is required, there are a number of nursing interventions that can be implemented to help avoid a prolonged painful and debilitating recovery.
OBJECTIVES Patient morbidity and mortality associated with contaminated and improperly prepared sterile products has captured national attention. In response, both the United States Pharmacopeia (USP) and Centers for Disease Control (CDC) have published recommendations in an effort to minimize the risk of infection. While the CDC recommends that administration sets are not changed more frequently than every 72 hours, the USP recommends a maximum beyond use date of 48 hours. Neither organization provides specific guidance on expiration dating once the intravenous drug is dispensed. Likewise, neither addresses the length of time that a bag containing medication for continuous infusion may hang once administration to the patient has begun. We evaluated the sterility of medications that are commonly administered by continuous infusion to pediatric patients. Because frequent manipulation of infusion and administration sets may predispose the patient to adverse events, we evaluated sterility for extended beyond use dating up to 72 hours. METHODS Thirty-five common intravenous (IV) continuous infusions using 94 standard concentrations and diluents were identified. IV solutions were mixed using sterile technique in the laminar flow hood in accordance with USP guidelines. Medications were excluded for short stability, short durations of use or high cost. A sample from each solution was tested for contamination or bacterial growth at 72 hours. Any visible discoloration suggesting physical instability was also evaluated. RESULTS None of the syringes or chambers resulted in contamination, bacterial growth or discoloration after 72 hours. CONCLUSIONS This study provides sufficient data that these compounded sterile products may be stored using a beyond use date up to 72 hours for a number of commonly used continuous IV infusions in pediatric patients. In our institution, this allows for a more convenient and consistent change of both administration sets and continuous infusions at 72 hours to potentially minimize adverse events, workload and cost.
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