The “Things We Do for No Reason” (TWDFNR) series reviews practices which have become common parts of hospital care but which may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent “black and white” conclusions or clinical practice standards, but are meant as a starting place for research and active discussions among hospitalists and patients. We invit...

Uric acid levels in serum were observed to fall precipitously in a group of 20 hospitalized asthmatic patients receiving azlocillin, bronchodilators, and steroids. None of the 20 hospitalized controls receiving the antiasthma therapy without azlocillin showed any decline in their uric acid levels. The levels for the azlocillin-treated group fell from a mean of 6.4 mg/dl to mean of 2.3 mg/dl, wh...

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...

Case 1 A 70-year old female came to our clinic complaining uncontrolled asthma for 10 years. Spirometry showed obstructive lesion (FEV1=94.9%, FEV1/FVC =71.08%) with 5% bronchodilator (BD) response. PC20 of methacholine was 3.8 mg/ml. Chest CT showed diffuse bronchial wall thickening with tree in bud sign. Treated with clarithromycin for 1 month, FEV1was improved from 64.9% to 84.2% without ast...

This study aimed to investigate the association between daily air pollution levels and the occurrence of acute respiratory signs and symptoms among people with asthma or asthma-like problems. Thirty eight subjects in the southern Swedish city of Landskrona kept a daily diary for 10 weeks. The daily prevalence of symptoms, supplementary bronchodilator use and peak flow deviations were compared w...

Asthma guidelines should be followed closely to ensure improvement and consistency of outcome. In order to measure compliance with local acute asthma protocols, we reviewed notes of children presenting to our ED with acute asthma. We noted clinical assessment of severity of asthma exacerbation, compared management of cases with local protocols, noted time to first nebulisation, discharge advice...

BACKGROUND In 2 prior uncontrolled studies, nebulized lidocaine reduced oral glucocorticoid use in patients with severe glucocorticoid-dependent asthma. OBJECTIVE We tested the safety and efficacy of nebulized lidocaine in a randomized, placebo-controlled study in patients with mild-to-moderate asthma. METHODS We recruited 50 subjects (25 receiving lidocaine and 25 receiving placebo); all h...

BACKGROUND Acute wheezers for the first time in life are an important target group for efforts aimed at reducing unnecessary antibiotic use. OBJECTIVE To evaluate the effect of clinical, laboratory and radiological data on the decision to prescribe antibiotics to paediatric patients with first time wheezing as well as to seek criteria that would justify antibiotic use. METHODS A prospective...

BACKGROUND The management of asthma attacks by general practitioners in 1992/93 was compared with 1991/92 in relation to recommended guidelines. METHODS The findings from a postal survey of 299 UK general practitioners who managed 2332 patients with an asthma attack in 1992/93 were compared with those from 218 practitioners who managed 1805 attacks in 1991/92. Management by a subgroup of prac...