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Clinical practice guidelines for pediatric asthma case

post in: Health Date:15 Nov 2017, 04:55 views:1473

Clinical practice guidelines for pediatric asthma case

Dust Mite Intervention, article Citation(s Halken S, Host A, Niklassen U, Hansen LG, Nielson F, Pedersen S, Osterballe O, Veggerby C, Poulsen. Effect of mattress and asthma pillow encasings on children with asthma and house dust mite high allergy. Journal of Allergy and Clinical Immunology.

Intervention Setting: Participants homes, target Population: Children aged 615 years with well managed asthma and house dust mite (HDM) allergy.

Program Description: This investigation aimed to determine whether use of mattress and pillow encasings resulted in effective long-term control of HDM allergen levels, thereby reducing the need for asthma medication in the children. Children were randomized to either an active treatment treatment group that was provided mattress and pillow encasings coated with semipermeable polyurethane or a control group that received specially constructed cotton placebo mattress and pillow covers that resembled the active treatment covers.

All encasings were delivered directly from the manufacturer to the patients. During the study, the encasings were to remain unwashed, and changes in the childs mattress, bed and bedroom, as well as structural changes in the residence, were not allowed. Three children in the active group and four children in the placebo group were excluded during the study when their families could not comply with these controls or when the child did not take the medications as prescribed.

A clinical evaluation with lung function measurement, adjustment of the pharmacologic treatment, and dust sampling from the childs mattress occurred at baseline and every 3 months during the 12-month study period.

At inclusion and during baseline and treatment periods, asthma medication was titrated to the lowest effective dose of inhaled steroids and B2-agonists on the basis of symptoms, need for B2-agonists, and peak flow recorded in diaries. Lung function measurements were determined using spirometry. Diaries were used to record morning and evening peak expiratory flow symptoms (symptom scores of 03 with 0 being no symptoms and 3 being worst case) during night and day.

The number of doses of B2-agonist used on demand were recorded for 2 weeks before the visits. Forty of the 47 children using inhaled steroids used the same product during the entire study period. All children used short-acting B2-agonist as needed during the study period.

 

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