Over the years there has been great interest in treatment of patients with moderate to severe asthma presenting to the emergency department. To make a dent in these exacerbations, clinicians have modified label recommendations for short-acting bronchodilators with innovative delivery techniques, devices, doses, and frequencies of administration. Since 1935 the use of helium-oxygen mixtures (hel...

QUESTION In my office, I frequently encounter children with wheezing. When I prescribe inhaled bronchodilators for preschool children, what is the recommended method of delivery--a nebulizer or a spacer? ANSWER The pressurized metered-dose inhaler with a spacer is an effective method of delivering inhaled drugs to young children. Children younger than 5 years of age will require the additiona...

BACKGROUND Exacerbation of asthma during travel to remote regions may lead to devastating consequences. The course of asthma in travelers and the risk factors for disease exacerbation during travel have not been studied. METHODS We screened 5835 consecutive travelers and identified 203 patients with asthma. Before travel, all enrollees were assessed for presumed risk factors for asthma exacer...

Objective: To investigate the incidence of asthma symptoms in young amateur swimmers, and to describe the clinical treatment of the children with asthma in a private sports club in the city of São Paulo, Brazil. Methods: The study included 171 amateur swimmers, ranging from 6 to14 years of age. All of the participants or their legal guardians were asked to complete the International Study of As...

BACKGROUND Asthmatics treated with long-acting beta-agonists have a reduced bronchodilator response to moderate doses of inhaled short acting beta-agonists during acute bronchoconstriction. It is not known if the response to higher doses of nebulised beta-agonists or other bronchodilators is impaired. We assessed the effect of long-acting beta-agonist treatment on the response to 5 mg nebulised...

Copies of death certificates were provided by the Registrar General for all deaths attributed to asthma in persons aged 5 to 34 years which were registered in England and Wales in the last quarter of 1966 and the first quarter of 1967. Information was obtained from the relevant general practitioners about 177 of the 184 subjects, and necropsy data were obtained for 113 of the 124 cases in which...

OBJECTIVE Standardization of evidence-based care, resource utilization, and cost efficiency are commonly used metrics to measure inpatient clinical care delivery. The aim of our project was to evaluate the effect of pediatric respiratory order sets and an asthma pathway on the efficiency and quality measures of pediatric patients treated with respiratory illnesses in an adult community hospital...

BACKGROUND A publication bias exists towards positive results in studies funded by pharmaceutical companies. OBJECTIVES To determine whether drug studies in the pulmonary/allergy literature also demonstrate a publication bias towards more favorable results when a pharmaceutical company funds the study. METHODS We reviewed all original articles published in seven pulmonary and allergy journa...

Pulmonary function studies were performed before and after one-time administration of an inhaled bronchodilator to ascertain the relative diagnostic value of using FVC, FEF25-75%, static lung volumes, Raw, and/or sGaw measurements, in addition to the FEV1, to assess the reversibility of chronic airways obstruction in nonasthmatic patients. A total of 517 patients underwent 686 spirometric tests...

The aim of the present study was to assess the management of children with asthma in the community. Community-based random samples of children aged 5-7 and 9-11 yrs in Dresden and Munich, Germany, were studied in 1995-1996 using the phase II protocol of the International Study of Asthma and Allergies in Childhood. Detailed information on the use of antiasthma drugs and accessory treatment in th...