Asthma

One way to determine whether a patient's asthma is well controlled is to inquire about the frequency of rescue treatments with an albuterol metered-dose inhaler.

A 14-year-old boy presents with frequent severe headaches characterized by sharp, throbbing pain behind his left eye and left temple.

Parents of young children know that colds are extremely common, especially from fall until spring. Colds account for a large number of pediatric office visits and telephone calls-particularly during "cold season."

In the vast majority of nonsmokers who are not receiving angiotensin converting-enzyme inhibitors and who have no evidence of active disease on chest radiographs, chronic cough is caused by postnasal drip syndrome (recently renamed upper airway cough syndrome [UACS]), asthma, non-asthmatic eosinophilic bronchitis, or gastroesophageal reflux disease (GERD), alone or in combination.

An obese 61-year-old man with a history of heroin abuse was brought to the hospital after he had fallen onto his buttocks on a sidewalk. He was able to stand initially, but weakness and numb-ness in his legs rendered him suddenly unable to walk or prevent himself from voiding. He denied abdominal or back pain. His medical history included asthma, chronic obstructive pulmonary disease, and hypertension.

PHILADELPHIA -- Patients taking beta-adrenergic receptor agonists were less likely to develop non-healing venous leg ulcers than those not taking the drugs, according to a large epidemiological study.

BARCELONA, Spain -- Using common household cleaning sprays and air fresheners at least once a week may increase the user's asthma risk, European researchers reported.

SAN DIEGO -- Rushing the decision to treat suspected pneumonia with antibiotics may lead to unnecessary treatment in a majority of cases, according to a small study reported here.

PITTSBURGH -- There is strong evidence suggesting -- but not proving -- the existence of a causal link between psychological stress and chronic conditions such as depression, cardiovascular disease, and HIV/AIDS, asserted researchers here.

COPENHAGEN -- If bacteria colonize the throat of a one-month-old infant, the risk of later persistent wheezing and asthma is sharply increased, researchers here found.

NEUHERBERG, Germany -- Babies taken swimming in public pools in the first year of life have an increased risk of diarrhea, researchers here said.

SAN DIEGO -- Eradication of Helicobacter pylori may have had the unintended consequence of unleashing an asthma threat even as the risk of gastric ulcer and cancer declined, results of a study reported here suggest.

ATLANTA -- Influenza vaccination rates have not rebounded after widespread vaccine shortages in the 2004-2005 flu season, CDC investigators said.

ANN ARBOR, Mich. -- Differences in self-management and socioeconomic factors account only in part for the disparities in glycemic control and asthma outcomes between minority and white patients with diabetes and asthma, investigators in two studies found.

NEW YORK -- Inpatients cared for by full-time hospitalists were likely to be discharged almost a day sooner than those in the care of nonhospitalists, but there was no significant difference in readmission rates or mortality, researchers found.

BRUSSELS, Belgium -- New guidelines offer a more conservative -- and pricey -- take on formula choices for infants who have an allergy to cow's milk.

ROCKVILLE, Md. -- The FDA has expanded the indications for FluMist, a nasal influenza vaccine, to include children ages two to five.

Dermclinic

ULM, Germany -- Childhood asthma symptoms are more likely to be allergy related in affluent countries than in less developed ones, researchers found.

GENEVA, Switzerland -- No individual chronic disease - not angina, not arthritis, not asthma, not diabetes -- is more disabling than depression, according to a World Health Organization study.

COLUMBUS, Ohio -- Nearly 40% of varsity athletes may be susceptible to exercise-induced bronchospasm, researchers here said.

A 43-year-old woman presented to the emergency department with complaints of severe dyspnea, wheezing, and cough productive of white sputum. She had received a diagnosis of asthma 3 years earlier, based on symptoms of wheezing and cough. Since then, her drug regimen has included intermittent use of albuterol.

**One of the most common illnesses in general pediatrics is asthma--often in children who have not yet entered their teen years. While we ask the parents what symptoms they have noticed in their child, we do not always ask younger children directly. How reliable are their answers?

abstract: Common causes of poorly controlled asthma include nonadherence to long-term inhaler therapy; environmental exposures; and uncontrolled comorbidities, such as allergic rhinitis. Adherence can be limited by many factors, including inadequate patient education, medication cost, prior failed treatment, poor physician-patient relationship, unrealistic expectations for therapy, and depression. For patients who have a poor perception of their symptoms, emphasizing the "disconnect" between symptoms and pulmonary function can help motivate them to monitor themselves with a peak flow meter and to adjust their medication accordingly. For patients with allergic triggers, instituting allergen-specific environmental controls can decrease symptoms and urgent care visits for asthma. Chronic rhinosinusitis and gastroesophageal reflux disease can also contribute to difficult-to-control asthma, and treatment of these comorbidities can help reduce asthma symptoms. (J Respir Dis. 2007;28(9):365-369)

TUCSON, Ariz. -- For many adults with poor airway function or COPD, the genesis of the problem may have been in the womb, researchers reported.

UTRECHT, The Netherlands -- Four cases of bronchiolitis obliterans among chemical plant workers shed new light on possible causes of "popcorn lung," researchers here said.

BETHESDA, Md. -- Emphasizing that asthma affects different patients in different ways, the National Asthma Education and Prevention Program has issued new evidence-based guidelines on the disease.

COLUMBUS, Ohio -- Spirometry can help emergency departments distinguish between the wheezing of acute asthma in adolescents and vocal cord dysfunction, found investigators here.

LOS ANGELES -- Traffic-related air pollution increases asthma risk among children with genetic variants that affect the lungs' ability to clear toxins, researchers found.

BARCELONA, Spain -- Nurses develop occupational asthma at a rate that is more than double that of the general population, investigators in a multinational study have found.