Asthma

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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)

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

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.

CHICAGO -- Medicare patients who couldn't read a physician's instructions, or who didn't understand what they read had a higher mortality rate than patients with adequate reading skills.

BOSTON -- A lack of fruit and fish in teenagers' diets may keep them from attaining full lung capacity and set them up for later respiratory problems, researchers here said.

The risks of occupational asthma have been established in a number of groups, such as farmers and workers who are exposed to certain chemicals, such as isocyanates. The results of a study conducted by Delclos and associates provide insight into the risks of asthma in healthcare workers. The bottom line: the risk of asthma is increased about 2-fold in persons whose tasks involve instrument cleaning and disinfection, use of general cleaning products, and administration of aerosolized medications.

LONDON -- A program of breathing and relaxation exercises known as the Papworth method eases the symptoms of asthma significantly -- largely without change in underlying lung function, researchers here said.

SAINT-MAX, France -- Steroids and other performance-enhancing agents appear to be creeping into use by ever-younger populations -- even junior high students, researchers found.