Asthma

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Increased exposure to polycyclic aromatic hydrocarbons in air pollution is associated with certain immune system effects and asthma diagnosis, according to research reported the 2013 Annual Meeting of the American Academy of Allergy, Asthma & Immunology.

In many parts of the country-and for people of all ages-a turn of the calendar to the winter months means more time spent indoors. For patients with asthma, however, an evening spent in front of a crackling fire may simply serve as a trigger for an attack.

Following on the heels of the obesity epidemic, a second epidemic has become apparent-sleep-disordered breathing and its effect on esophageal conditions, primarily gastroesophageal reflux disease (GERD). Many, many primary care providers have heard the following complaint: “I gained 10 pounds and now I have heartburn/cough/worsening asthma” (take your pick). What’s going on?

A 43-year-old African American woman presented to the emergency department with severe dyspnea, wheeze, and cough productive of white sputum. Three years earlier, she had been given a diagnosis of asthma based on symptoms of wheeze and cough; her treatment regimen included intermittent use of albuterol.

Are persons with asthma at risk for other proinflammatory disorders? Yes, say researchers from the Mayo Clinic and Olmsted Medical Center in Rochester, Minn, who found that asthma is associated with the development of diabetes mellitus and coronary artery disease. However, there was no association between asthma and rheumatoid arthritis or inflammatory bowel disease.

Successful long-term management of asthma requires identification and control of environmental factors that increase asthma symptoms and/or precipitate exacerbations. Highlights of guidelines from the Expert Panel of the National Asthma Education and Prevention Program are presented here.

Patients who have more confidence in the effectiveness of their medications tend to be more likely to adhere to their therapeutic regimen. A recent study, which appears online in the Journal of Allergy and Clinical Immunology, examined whether actively promoting the benefits of a therapy can increase adherence.

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.

Primary care is demanding for a host of reasons, not the least of which is the daunting breadth of issues practitioners grapple with. One issue is evaluating the risk of suicide. Two recent studies provide some intriguing data that may change the way we practice.