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In a US multicentre trial (New England Journal of Medicine 2011;365;1990–2001) daily low dose inhaled budesonide has been compared with intermittent high-dose inhaled budesonide for the treatment of preschool children with recurrent wheezing and predicted increased risk of asthma. A total of 278 children aged 12–53 months were randomised to daily (0.5 mg every night) or intermittent (1.0 mg twice daily at the onset of respiratory illness) inhaled budesonide for 1 year. The rate of exacerbations of wheezing treated with oral steroid (after consulting a doctor) was similar in the two groups (daily therapy, 0.97 exacerbations per patient-year; intermittent therapy, 0.95 per patient-year). The mean cumulative dose of inhaled budesonide during the study was significantly greater with the daily regimen (150 mg vs 46 mg). There were no significant differences between the groups for several other outcome measures. The intermittent regimen was not inferior to the daily regimen and resulted in less budesonide being taken.

Epidermolysis bullosa (EB) is classified into four types: simplex, junctional, dystrophic and mixed (Kindler syndrome). At least 14 gene mutations have been identified in the various …

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