Thorax
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Randomized Controlled Trial Clinical Trial
Large volume spacer devices and the influence of high dose beclomethasone dipropionate on hypothalamo-pituitary-adrenal axis function.
The systemic effects of the inhaled corticosteroid beclomethasone dipropionate are reduced if the drug is inhaled through a large volume spacer. Use of spacers may therefore permit higher doses to be given without causing hypothalamo-pituitary-adrenal suppression. ⋯ There is wide interindividual variation in the dose of beclomethasone dipropionate causing hypothalamo-pituitary-adrenal suppression. Whether or not a spacer is used, doses higher than the currently accepted maximum of 2 mg/day can be taken by many adults with asthma without causing subnormal function of the hypothalamo-pituitary-adrenal axis. Whether these higher doses are more effective in controlling asthma remains to be established.
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Overnight polysomnography is expensive and time consuming. An approach based on a logistic regression model and overnight pulse oximetry has been developed to determine which of the snorers referred to our sleep laboratory need polysomnography. ⋯ It is concluded that snorers with negative results from oximetry classified as not having obstructive sleep apnoea according to this model do not need polysomnography.