Guidelines for the Diagnosis and Management of Asthma. William W. Busse, M.D. ... Gail Shapiro, M.D.. Northwest Asthma and Allergy Center. Seattle, WA. Stuart Stoloff, M.D.
Reviews the evidence for and against hundreds of preventive health services, recommending tests, and counseling interventions when evidence exists that it is effective.
Guidelines from the National Asthma Education and Prevention Program: Expert Panel Report 3. ... The goal of this asthma care quick reference guide is to help clinicians provide quality care to people who have asthma.
A 6-month-old boy has a 1-week history of dry cough that worsens at night. He has been wheezing intermittently for the past month. A 2-year-old girl has had severe nighttime cough, congestion, and fever for 2 days. She recently recovered from a respiratory illness of 1 month's duration. Chest radiographs of both patients are shown… Read More
If your bedroom or other rooms in your home look a lot like the one here, you may be living in an asthma "nightmare"—an environment full of potential causes of asthma attacks. Many people with asthma have allergies that make their asthma worse… Read More
Patients with asthma may be reluctant to exercise for fear of triggering an attack. You can reassure them that adequate control can allow them to participate in almost any physical activity they wish. Recommendations from the NIH offer guidance on prevention of exercise-induced bronchospasm… Read More
In the United States, asthma affects approximately 1.4 million children younger than 5 years and causes frequent activity limitations and hospitalizations. Unfortunately, a substantial number of children in this age-group have suboptimal asthma control, demonstrated by the higher rates of ER visits and hospitalizations in preschool-aged children than in older children … Read More
A number of inflammatory diseases have been associated with an increased risk of atherosclerosis. Knoflach and colleagues report findings that support a link between allergic diseases, such as allergic rhinitis and asthma, and atherosclerosis. Their findings came from 2 studies: the Bruneck study,... More »
A 45-year-old man was referred to our pulmonary clinic for progressive dyspnea and worsening asthma. His shortness of breath had been worsening over the past 2 years. He denied fever, weight loss, and other systemic complaints. More »
Although the National Asthma Education and Prevention Program's (NAEPP) guidelines for managing asthma have been widely disseminated, compliance has been less than impressive. Results of a study by Grant and associates in the Chicago area reveal a considerable discrepancy between the NAEPP's... More »
The use of analgesics, specifically acetaminophen, has been proposed as one of the mechanisms for the rise in asthma prevalence in the last 30 to 40 years.1 Acetaminophen, approved by the FDA in 1951, is one of the most commonly used analgesics in adults and children. The association between asthma... More »
Under what circumstances would asthma or chronic obstructive pulmonary disease (COPD) be a contraindication to scuba diving? What precautions should patients with either asthma or COPD take if they are determined to go diving? More »
Abstract: Although controller therapies are currently recommended for patients who have persistent asthma, a number of studies indicate that these therapies do not adequately control asthma in a substantial number of these patients. This observation, combined with the potential risk of adverse... More »
Abstract: There is convincing evidence that controller therapies, such as inhaled corticosteroids and leukotriene receptor antagonists, provide many benefits to patients with asthma. These benefits include decreased symptoms, improved lung function, reduced frequency of exacerbations, and improved... More »
Abstract: Pulmonary function tests, such as the measurement of forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF), provide an objective, standardized, and quantifiable method of patient assessment and can be essential in the evaluation of asthma. However, FEV1 and PEF are... More »
Asthma is one of the most common chronic diseases worldwide, and its prevalence--particularly among children--is increasing in many countries.1,2 In 1997, an estimated 9.6% of persons in the United States had asthma (Table 1).3 More »
Dr Storms: Given that a patient's asthma varies quite a bit from day to day, and that controller therapies can prevent exacerbations, is there any role for using a controller medication as-needed rather than using it regularly? Could exacerbations be prevented if the patient has been educated to... More »
Commentary on: Bergroth E, Remes S, Pekkanen J, et al. Respiratory tract illnesses during the first year of life: effect of dog and cat contacts. Pediatrics 2012;130:211–20.
Implications for practice and research
Early dog contacts are associated with fewer respiratory infections in infants, especially otitis, but not wheezing after adjustment for possible confounders.
Commentary on: SilversKM, Frampton CM, Wickens K, et al.. New Zealand Asthma and Allergy Cohort Study Group. Breastfeeding protects against current asthma up to 6 years of age. <I>J Pediatr</I>2012;160:991–6.
Commentary on: Chandratilleke MG, Carson KV, Picot J, et al. Physical training for asthma. Cochrane Database Syst Rev 2012;5:CD001116.
Implications for practice and research
Regular physical activity (PA) should be recommended to those with well-controlled asthma as it leads to improvements in aerobic capacity, quality of life (QOL) and asthma symptoms.
Regular PA is safe for those with well-controlled ast
The fraction of exhaled nitric oxide (FeNO) has gained interest as a non-invasive tool to measure airway inflammation in asthma since it reflects allergic inflammation. Recent controlled clinical studies have, however, questioned its role in the management of asthma in children. To assess the clinical value of FeNO in paediatric asthma management, a meta-analysis was performed on the controlled studies of childhood asthma management guided by repeated FeNO measurements, and relevant publications on the confounders of FeNO were reviewed. The data suggests that utilising FeNO to tailor the dose of inhaled corticosteroids in children cannot be recommended for routine clinical practice since there is a danger of excessive inhaled corticosteroid doses in children without meaningful changes in clinical outcomes. Many disease and non-disease related factors (most importantly atopy, height/age and infection) affect FeNO levels which can easily confound the interpretation.
Laser acupuncture has often been recommended as a treatment of asthma. The technique is noninvasive, and seems particularly suitable for children. However, the results from several clinical trials are contradictory. The objective of this review was to assess the effectiveness of laser acupuncture in the treatment of childhood asthma.|Literature searches of electronic database were conducted in The Cochrane Library, Medline, EMBASE, AMED, CINAHL, and two Chinese literature databases (CNKI and VIP) up to February 2012. Randomized controlled trials (RCTs) testing laser acupuncture for asthma in children were included. No language restrictions were applied. Three authors independently selected articles, extracted data, and assessed trial quality.|Our searches identified 13 potential eligible studies, of which three with a total number of 176 patients met our inclusion criteria. The quality of included RCTs were low. One RCT with a parallel group design showed positive results, while two
23311283 2013 01 14 2013 02 12 1474-9114 22 5 2012 Sep-Oct J Fam Health Care 16-20 Yeovil District Hospital, Yeovil, Somerset. Paul Siba Prosad SP O'Keeffe Paul P Sanjeevaiah Manjunath K MK Brettle Elizabeth E eng Journal Article England J Fam
23299596 2013 01 09 2013 01 10 1538-3598 309 2 Jan 9 JAMA 135-6 10.1001/jama.2012.73379 Sterk Peter J PJ Sont Jacob K JK eng Comment Letter United States JAMA 7501160 0098-7484 0 Adrenal Cortex Hormones 0 Biological Markers AIM IM JAMA. 2013 Jan 9;
T BT Asthma Clinical Research Network BASALT Trial Investigators eng Comment Letter United States JAMA 7501160 0098-7484 0 Adrenal Cortex Hormones 0 Biological Markers AIM IM JAMA.
23085559 2012 12 18 2013 02 13 1470-7926 70 1 Jan Occup Environ Med 70 10.1136/oemed-2012-101189 Pralong Jacques Andr JA Seed Martin J MJ Yasri Ranya R Agius Raymond M RM Cartier Andr A Labrecque Manon M eng Letter 2012 10 19 England Occup
23260313 2012 12 24 2013 02 19 1097-6833 162 1 Jan J. Pediatr. 127 10.1016/j.jpeds.2012.07.064 S0022-3476( 12) 00889-X Center for Evidence-Based Practice, Tecnologico de Monterrey School of Medicine and Health Sciences, Instituto de Pediatra
Guidelines for the Diagnosis and Management of Asthma. William W. Busse, M.D. ... Gail Shapiro, M.D.. Northwest Asthma and Allergy Center. Seattle, WA. Stuart Stoloff, M.D.
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