Browsing by Subject "Respiratory Research"

Now showing 1 - 3 of 3
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    Open Access
    Budesonide/formoterol and formoterol provide similar rapid relief in patients with acute asthma showing refractoriness to salbutamol
    (BioMed Central Ltd, 2006) Bateman, ED; Fairall, L; Lombardi, DM; English, R
    BACKGROUND:To compare the efficacy and safety of budesonide/formoterol (Symbicort(R)) with formoterol (Oxis(R)) in the treatment of patients with acute asthma who showed evidence of refractoriness to short-acting beta2-agonist therapy. METHODS: In a 3 hour, randomized, double-blind study, a total of 115 patients with acute asthma (mean FEV1 40% of predicted normal) and a refractory response to salbutamol (mean reversibility 2% of predicted normal after inhalation of 400 mug), were randomized to receive either budesonide/formoterol (320/9 mug, 2 inhalations at t = -5 minutes and 2 inhalations at 0 minutes [total dose 1280/36 mug]) or formoterol (9 mug, 2 inhalations at t = -5 minutes and 2 inhalations at 0 minutes [total dose 36 mug]). The primary efficacy variable was the average FEV1 from the first intake of study medication to the measurement at 90 minutes. Secondary endpoints included changes in FEV1 at other timepoints and change in respiratory rate at 180 minutes. Treatment success, treatment failure and patient assessment of the effectiveness of the study medication were also measured. RESULTS: FEV1 increased after administration of the study medication in both treatment groups. No statistically significant difference between the treatment groups was apparent for the primary outcome variable, or for any of the other efficacy endpoints. There were no statistically significant between-group differences for treatment success, treatment failure or patient assessment of medication effectiveness. Both treatments were well tolerated. CONCLUSION: Budesonide/formoterol and formoterol provided similarly rapid relief of acute bronchoconstriction in patients with asthma who showed evidence of refractoriness to a short-acting beta2-agonist.
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    Diagnostic accuracy of an integrated respiratory guideline in identifying patients with respiratory symptoms requiring screening for pulmonary tuberculosis: a cross-sectional study
    (BioMed Central Ltd, 2006) English, Rene; Bachmann, Max; Bateman, Eric; Zwarenstein, Merrick; Fairall, Lara; Bheekie, Angeni; Majara, Bosielo; Lombard, Carl; Scherpbier, Robert; Ottomani, Salah
    BACKGROUND:To evaluate the diagnostic accuracy of the integrated Practical Approach to Lung Health in South Africa (PALSA) guideline in identifying patients requiring bacteriological screening for tuberculosis (TB), and to determine which clinical features best predict suspected and bacteriologically-confirmed tuberculosis among patients with respiratory symptoms. METHODS: A prospective, cross-sectional study in which 1392 adult patients with cough and/or difficult breathing, attending a primary care facility in Cape Town, South Africa, were evaluated by a nurse using the guideline. The accuracy of a nurse using the guideline to identify TB suspects was compared to that of primary care physicians' diagnoses of (1) suspected TB, and (2) proven TB supported by clinical information and chest radiographs. RESULTS: The nurse using the guideline identified 516 patients as TB suspects compared with 365 by the primary care physicians, representing a sensitivity of 76% (95% confidence interval (CI) 71%-79%), specificity of 77% (95% CI 74%-79%), positive predictive value of 53% (95% CI 49%-58%), negative predictive value of 90% (95% CI 88%-92%), and area under the receiver operating characteristic curve (ARUC) of 0.76 (95% CI 0.74-0.79). Sputum results were obtained in 320 of the 365 primary care physicians TB suspects (88%); 40 (13%) of these were positive for TB. Only 4 cases were not identified by the nurse using the guideline. The primary care physicians diagnostic accuracy in diagnosing bacteriologically-confirmed TB (n = 320) was as follows: sensitivity 90% (95% CI 76%-97%), specificity 65% (95% CI 63%-68%), negative predictive value 7% (95% CI 5%-10%), positive predictive value 99.5% (95% CI 98.8%-99.8%), and ARUC 0.78 (95% CI 0.73-0.82). Weight loss, pleuritic pain, and night sweats were independently associated with the diagnosis of bacteriologically-confirmed tuberculosis (positive likelihood ratio if all three present = 16.7, 95% CI 5.9-29.4). CONCLUSION: The PALSA guideline is an effective screening tool for identifying patients requiring bacteriological screening for pulmonary tuberculosis in this primary care setting. This supports the randomized trial finding that use of the guideline increased TB case detection.
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    Lung function in healthy South African adult females
    (2015) Smith, Emilee; Myer, Landon; Zar, Heather
    Background: Accurate and appropriate spirometry reference values allow for early detection of respiratory illness and perform an important role in monitoring lung health. There is, in general, a scarcity of data from Africa, and the Global Lung Initiative (GLI) has published global reference equations but models did not include data from African studies. The aim of this study was to investigate lung function in a group of healthy South African females and the applicability of the GLI reference equations. Methodology: Maternal lung function testing was undertaken at 6 to 10 weeks post-partum as part of a birth cohort study, the Drakenstein Child Health Study. Pre- and post-bronchodilator spirometry was performed according to a standardised protocol and correlated with clinical information. Bronchodilator response was assessed by repeating spirometry 15 minutes after administration of inhaled 400mcg salbutamol. Results: A total of 462 women were included, mean age 17 years (range 18- 42 years). The GLI reference equations fitted the observed lung function results well for the group of mothers who did not self-report smoking or asthma. There were 64 (14%) mothers with an abnormal Forced Expiratory Volume in 1 Second (FEV 1) result, 60 (13%) mothers with an abnormal Forced Vital Capacity (FVC), and 35 (8%) mothers with an abnormal FEV 1 /FVC ratio. There were 22 (5%) mothers who had reversible FEV 1; the rate of undiagnosed reversibility was 4% of the cohort. High body mass index was associated with a higher risk for poor FVC and FEV 1 /FVC lung function, OR 1.40 (CI: 1.01, 1.65) and OR 1.25 (CI 1.10, 1.95) respectively. Mothers with a higher socio-economic status had better FEV 1 with the adjusted SES OR 0.65 (CI 0.36, 1.08). Conclusions: There was a high prevalence of abnormal lung function in this cohort of South African adult females and a number of cases of undiagnosed reversibility. Spirometry testing is important to diagnose lung disease in South African communities. The GLI's reference equations were appropriate and applicable for a cohort of South African adult women.