Asthma

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.

SALT LAKE CITY -- Corticosteroids appear to be ineffective against first episode bronchiolitis in infants, despite frequent emergency room use, researchers said.

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.

LONDON, July 2 -- Cats may trigger an asthmatic airway response even in patients not specifically allergic to cat dander, researchers found.

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.

Unilateral cystic lung anomalies are uncommon. We report a case of placental transmogrification of the lung in an adult, a condition with a peculiar histological pattern characterized by formation of placental, villus-like structures in the lung parenchyma.

Clinical Images to Help You Hone Your Diagnoses

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.

DUNEDIN, New Zealand -- Widespread systemic inflammation may be the missing link that explains why reduced lung function leads to heart disease, 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.

WINNIPEG, Manitoba -- Children who are given antibiotics during the first year of life may be at significantly greater risk of developing asthma, researchers here found.

abstract: In the treatment of certain allergies, sublingual immunotherapy (SLIT) may represent an attractive alternative to subcutaneous immunotherapy (SCIT) because of its lower risk of systemic reactions. The most common adverse reactions are local symptoms, such as oral "itchiness." GI complaints, rhinoconjunctivitis, urticaria, and asthma are uncommon reactions to this therapy, and no fatalities have been reported. In contrast to SCIT, accelerated induction schedules for SLIT do not appear to be associated with an increased risk of systemic reactions. SLIT may present an opportunity for broadening the use of immunotherapy by extending it to patients who are not candidates for SCIT because they dislike injections, find the frequent visits to the physician's office inconvenient, or are concerned with the safety of SCIT. The optimal effective dose and dosing schedule need to be established before a cost-benefit analysis can be performed. (J Respir Dis. 2007;28(6):237-243)

Bronchial thermoplasty is a procedure designed to reduce airway smooth muscle mass and, as a result, reduce bronchoconstriction in persons with asthma. In this procedure, radiofrequency current is applied to the walls of the central airways during a series of bronchoscopies. The results of a randomized controlled study conducted in 11 centers in 4 countries suggest that this intervention is beneficial.

SAN FRANCISCO -- The electronic nose, already proficient at sniffing out bombs and optimizing coffee roasting, may become a one-stop diagnostic tool for asthma.