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
Abstract: The coexistence of asthma and obstructive sleep apnea (OSA) in a given patient presents a number of diagnostic and treatment challenges. Although the relationship between these 2 diseases is complex, it is clear that risk factors such as obesity, rhinosinusitis, and gastroesophageal reflux... More »
Studies have indicated that depression occurs more frequently in adults with asthma than in the general population; however, few studies have investigated the relationship between depression and asthma outcomes. A recent study by Eisner and associates revealed noteworthy findings: depressive... More »
A 51-year-old man with a 20-year history of asthma and seasonal allergies presented with low-grade fever, progressive dyspnea on exertion, and wheezing that had persisted for 2 weeks. Four days earlier, he had been seen by his primary care physician and had started levofloxacin therapy. However, his... More »
As the incidence of asthma continues to increase worldwide, current studies have indicated that the most prevalent challenge to the alleviation of asthma symptoms is undertreatment. Results of a controlled study in Denmark suggest that a physician-managed Internet-based asthma monitoring system can... More »
Abstract: All children with asthma should have periodic office visits, usually every 3 to 6 months, in which asthma action plans are updated. Periodic assessment of lung function by peak expiratory flow or office spirometry can help determine the appropriate treatment strategy. Low daily doses of... More »
Abstract: ß-Agonists, administered by metered-dose inhaler
or nebulizer, are still the mainstay of therapy for asthma exacerbations.
A trial of a subcutaneous ß-agonist should be
considered in patients who fail to respond to inhaled medications.
Levalbuterol may play a role in managing refractory... More »
ABSTRACT: Asthma is a very serious yet very controllable illness. In acute exacerbations, bronchospasm can be reversed with nebulized albuterol (2.5 to 5 mg); give 2 additional treatments at 20-minute intervals and then every hour for the first few hours until wheezing resolves. Subcutaneous... More »
Abstract: In most patients, a life-threatening exacerbation of asthma is preceded by a gradual worsening of symptoms. However, some patients have a sudden onset of worsening symptoms, and these patients are at increased risk for respiratory failure and death. Risk factors for near-fatal asthma... More »
The prevalence of asthma in the United States is estimated to be 5% to 8%. Asthma is responsible for approximately 5000 deaths annually in this country. It is a leading cause of emergency department visits, hospitalizations, and school and work absenteeism. The total estimated direct cost of the... 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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