Previous studies have linked psychological morbidity to poor control of asthma, but have not objectively measured adherence to treatment, and have linked poor adherence to depression, but have not measured asthma severity. This study assessed asthma and psychological morbidity and objectively measured adherence to medication and showed that psychological morbidity ...

BACKGROUND: Randomized clinical trials have demonstrated that fluticasone propionate (FP) has better objective as well as subjective clinical outcomes than zafirlukast (ZA) in the treatment of asthma. OBJECTIVE: The goal of this study was to determine whether the superiority of FP over ZA observed in clinical trials is supported under ...

The simplest and most natural route of drug delivery to the lungs is the inhaled one. From the historical and medical point of view, it was a Greek, Pedanus Discorides, the father of the science of pharmacy, who, during the first century prescribed inhaled fumigation. Pipes were also used to ...

OBJECTIVE: To determine the severity of asthma in the elderly compared to the younger asthmatics. DESIGN: Cross-sectional study. SETTING: University outpatient asthma clinic. SUBJECTS: Asthmatics seen over a 6 month period in 1997. RESULTS: There were 154 patients and 16% were elderly (> 65 years) asthmatics. The elderly asthmatics were ...

AIM: To determine the prevalence of bronchial asthma among Saudi Arabian schoolboys living in Al-Khobar city. METHODS: Parents of 1,482 randomly selected boys in preparatory and elementary schools included in this cross-sectional study filled out a questionnaire on asthma signs in their sons. Number of Questionnaire-Diagnosed Asthmatics was compared with ...

In a retrospective epidemiologic study of 202 patients with eczematous cheilitis attending a patch test clinic, females (182 (90%)) predominated over males (20 (10%)). The mean age of our patients was 30.9 years. There was no significant difference between the mean age of females (31 years) presenting with cheilitis compared ...

BACKGROUND: Aerosolized asthma medications with chlorofluorocarbon (CFC) propellants are being phased out because of environmental concerns about the ozone layer. Medications are being reformulated with non-ozone-depleting propellants. OBJECTIVE: To evaluate the clinical comparability of albuterol sulfate formulated in a new hydrofluoroalkane-134a (HFA) propellant (Ventolin HFA Inhalation Aerosol), and conventional CFC-containing ...

As our understanding of asthma has evolved, so have pharmaceutical strategies for managing this disorder. Once considered a disorder of airway smooth muscle, asthma now is regarded primarily as a chronic inflammatory disorder of the airways. Traditional therapy sought to suppress bronchoconstriction and other signs and symptoms of asthma when ...

In difficult-to-manage asthma, effective control depends on identification and alleviation of exacerbating factors, such as ongoing allergen exposure, chronic sinusitis, GERD, and emotional stress. Level of compliance with the prescribed medication regimen should be evaluated in all patients. Hormonal factors (i.e., menses, use of exogenous hormones by female patients, and ...

This study examines the correspondence between medical records and Medicaid claims to determine whether claims are a valid source of data for monitoring quality of asthma care. A total of 460 claims for care encounters were matched to medical records of the encounters. While most of the diagnoses and procedures ...

OBJECTIVE: To report a case of warfarin resistance associated with the use of sulfasalazine. CASE SUMMARY: A 37-year-old white woman on oral anticoagulant therapy with warfarin was being evaluated for complaints of joint pains. Her past medical history consisted of recurrent deep-vein thrombosis, asthma, and ulcerative colitis. Warfarin concentrations had ...

BACKGROUND: Cockroach allergy occurs frequently in asthmatics in urban areas, where the level of cockroach infestation is usually high. The prevalence of cockroach allergy, as well as the effect of associated factors on cockroach sensitisation in Nigeria is largely unknown. OBJECTIVE: To determine the prevalence of cockroach allergy in asthmatics ...

The therapy for chronic stable asthma and acute asthma exacerbations continues to evolve as the pathogenesis of asthma becomes better understood. Although the role of many standard therapies for asthma is well established, some carry significant side effects. The newer anti-inflammatory medications have demonstrated both therapeutic benefit as well as ...

OBJECTIVES: (1) To measure the extent of use of preventer medications (ie, inhaled corticosteroids or cromones) and possession of written asthma management plans (AMPs) among people with asthma in New South Wales in 1997. (2) To assess factors associated with underuse of preventer medications and AMPs. DESIGN AND SETTING: A ...

Asthma is the most common chronic disease in adolescents. Despite advances in the understanding of this disease and the availability of more specific treatment, the prevalence of asthma and its morbidity and mortality are increasing. This trend is especially prominent and worrisome in the age group that includes adolescents and ...

The objective of this study was to measure the knowledge of childhood asthma among medical students and paramedics. A previously validated questionnaire about childhood asthma was completed by 281 of 314, third and fifth year medical students at Universiti Kebangsaan Malaysia, Kuala Lumpur. Their knowledge of asthma was assessed during ...

1. Asthma is the third leading cause of preventable hospitalization in the United States and has accounted for more than 3 million lost workdays. 2. Understanding the stepwise approach and the medications used to control asthma can reduce exacerbations which can contribute to reduction in costly emergency department visits. 3. ...

Over the last 20 years, the understanding of the pathogenesis of asthma has changed dramatically. Asthma is now seen as a disease of chronic airway inflammation. Consequently, the paradigm of management has expanded from "as-needed bronchodilators" to include maintenance therapy with antiinflammatory medications and action plans. Health care professionals are ...

Severe persistent asthma accounts for a small percentage, probably less than 5% of all patients with asthma, but is responsible for the major portion of health care costs associated with the illness. According to the National Institutes of Health (National Asthma Education and Prevention Program) guidelines for the management of ...

In the past decade the use of proton pump inhibitors on the one hand, and an aggressive surgical approach on the other hand have revolutionised the treatment of gastro-oesophageal reflux disease (GORD). Many studies have suggested that the successful management of GORD results in improvement of the symptoms of asthma ...

BACKGROUND: About one of every 5 athletes who participated in the 1996 Summer Olympic Games in Atlanta had a past history of asthma, had symptoms that suggested asthma, or took asthma medications. No previous study has determined the prevalence of asthma in all US athletes who participated in an Olympic ...

In 1976-1992 245 new cases of asthma induced by diisocyanates were diagnosed, caused by hexamethylene diisocyanate (HDI) in 39%, diphenylmethane diisocyanate (MDI) in 39%, and toluene diisocyanate (TDI) in 17% of the cases. Our aim was to study the clinical outcome of diisocyanate-induced asthma. A questionnaire was sent to the ...

The aerosol route is attractive for the delivery of mucoactive medications. Mucoactive medications include mucolytics, which depolymerize polymers of mucin (classic mucolytics) or DNA/actin (peptide mucolytics), mucokinetic agents, which increase cough clearance, mucoregulatory medications, which decrease abnormal mucus secretion, and expectorants and ion channel modifiers. Despite the widespread use of ...

BACKGROUND: Sevoflurane is an inhaled anesthetic agent with ideal properties for achieving deep sedation during pediatric outpatient gastrointestinal endoscopy. This is a comparison of experience with this gas and other sedation methods used in the authors' hospital. METHODS: Retrospective chart review and statistical analysis of data from children receiving inhaled ...

OBJECTIVE: To compare ambulatory visit patterns, rates of medication use, and emergency department and hospital utilization for children with asthma covered under Medicaid and commercial payers within the same health maintenance organization (HMO). DESIGN: Retrospective cohort study. SETTING: Eleven staff-model pediatric departments of an HMO. PATIENTS: A total of 1928 ...

Nonadherence with asthma medications is a significant problem associated with unnecessary functional limitations. The development of measures to assess psychological factors important to adherence with medication regimens among adult patients with asthma is described in the present report. The results indicated that the reliability and validity of the newly designed ...

RATIONALE: Noncompliance with asthma treatments is a common cause of hospitalization. Currently, physicians in the emergency department can only diagnose noncompliance with asthma therapy by asking patients if they have taken their medication (i.e., the HONOR SYSTEM). Patients frequently "overstate" their compliance and subsequently receive unnecessary supplemental medication (p.o. corticosteroid) ...

Recent changes in health care have been characterized by an increased demand for empirically supported treatments in medicine. Presently, there is moderate support for the integration of hypnotic techniques in the treatment of a number of medical problems. This critical review of the research literature focuses on the empirical research ...

BACKGROUND: Non-compliance with prescribed anti-asthma medication is considered to be a major problem. The reasons why adolescents may fail to comply with their regimen are poorly understood. OBJECTIVES:This study set out to understand better the reasons for non-compliance in adolescents with asthma. METHODS:In-depth interviews were conducted with a sample of ...

Inhalant abuse is a major public health problem that has been associated with numerous acute and chronic medical problems. Inhalants are defined as volatile organic substances and are found in common household and commercial products that are easily accessible, inexpensive, and legally obtained. We discuss a rare case of mothball ...

Large white/landrace piglets (mass 11 to 21 kg) were exposed to aerosolized alkaline glycine diluent (n = 2) or inhaled aerosolized prostacyclin (n = 2) for five to eight hours. Pigs receiving these aerosols developed mild acute sterile tracheitis, involving the superficial layers of the trachea, shown histologically and ultrastructurally. ...

Asthma is one of the most common chronic medical conditions. The usual treatment includes quick relief bronchodilator medications of the sympathomimetic class and controller medications that may include the long-acting inhaled bronchodilator salmeterol. Mild adverse cardiac and central nervous system effects are common with these medications, requiring modifications in dose ...

BACKGROUND: Optimal treatment for persistent asthma requires multiple classes of medication, including antiinflammatory agents and bronchodilators. Inhaled corticosteroids are the most effective antiinflammatory agents available and are recommended by recent guidelines as first-line treatment. Salmeterol, a long-acting inhaled bronchodilator, is recommended as adjunctive therapy to inhaled corticosteroids. Non-adherence to prescribed ...

OBJECTIVE: Video Intervention/Prevention Assessment (VIA) was developed to determine whether medical information gathering might be augmented by video diaries created by patients to show clinicians the realities of managing chronic disease in the contexts of their lives. DESIGN: Children and adolescents who met National Heart, Lung, and Blood Institute criteria ...

Status asthmaticus is the most common diagnosis leading to hospital admission in childhood. Most of these patients respond well to oxygen, steroids, beta-agonists, anticholinergics, and other medications. The few patients who develop respiratory failure from severe status asthmaticus pose many challenges to those supporting them in the intensive care unit. ...

Acid aspiration syndrome at the induction of anesthesia is still a potentially life-threatening complication. Its severity is affected by both pH and volume of the gastric juice that is aspirated. We compared the effects of rabeprazole (a new proton pump inhibitor), lansoprazole, and ranitidine on gastric fluid properties in a ...

BACKGROUND AND OBJECTIVE: The reported effects of asthma on gastroesophageal reflux (GER), effects of GER on asthma and the effects of antireflux therapy on asthma are conflicting. The purpose of this paper is to review the evidence for a relationship between the two conditions. DESIGN: A search of the MEDLINE ...

A variety of chemicals are used in medical imaging as developer and fixer ingredients, germicides, and cleaning agents. Glutaraldehyde, a potent sensitizer, may cause occupational skin and respiratory diseases in exposed individuals. Poor ventilation, unsafe practices, and lack of hazard recognition may contribute to occupational asthma and other respiratory disease ...

BACKGROUND: Asthma mortality rates (AMRs) during the last several decades increased in many countries with developed medical services, including Israel. The reasons for this trend were never established. Recent data suggested that this trend is changing. OBJECTIVES: We sought to compare the AMR in Israel during 1991-1995 with that of ...

INTRODUCTION: A number of traditional systems of medicine exist in India of which Ayurveda is the most popular. Despite being in use for more than 3000 years, few properly designed trials have scientifically examined the clinical potential of Ayurvedic and other medications. METHODS: We reviewed the MEDLINE database to identify ...

OBJECTIVES: We sought to test whether tetrahydrobiopterin (BH4) supplementation improves nitric oxide (NO) bioactivity in smokers. BACKGROUND: In smokers, endothelium-derived NO bioactivity is impaired. BH4 is an essential cofactor of NO synthase, and its deficiency decreases NO bioactivity. METHODS: Sapropterin hydrochloride, an active analogue of BH4 (2 mg/kg body weight), ...

The new leukotriene (LT) modifiers have been shown to be effective, safe and convenient 'controller' medications in patients with asthma. However, their use in asthma is recommended only in the most recent US guidelines, and then only as alternative long term controllers in patients with mild persistent asthma. In fact, ...

Introduced in the 1950s, metered dose inhalers (MDIs) became a revolutionary way to deliver medication directly to the lungs of patients with asthma and chronic obstructive pulmonary disease. Since their initial introduction, MDIs have used chlorofluorocarbons to propel the medication out of the canister into a patient's lungs. This article ...

This study relates the impact of various medical conditions to clinically important forced expiratory volume in 1 second (FEV1) declines in a cohort of steelworkers evaluated cross-sectionally and longitudinally. Medical records of 1171 randomly chosen steelworkers were obtained from the medical department of a steel company. We reviewed the medical ...

Inhaled, short-acting, beta-agonist medications are widely used in the treatment of asthma. It is recommended in current asthma management guidelines that these medications should only be used "as required" for relief of asthma symptoms. Despite this, there are still a number of asthmatic patients who are using excessive amounts. In ...

OBJECTIVE: The goals of this article include the reporting of the epidemiology, economic and medical impact of allergic rhinitis. In addition, the pharmacology and clinical profile of the therapeutic agent cetirizine are reviewed. DATA SOURCES: A detailed literature search was conducted. References are limited to the English language and human ...

Multiple medications are available to treat asthma and other allergic diseases, making it difficult to determine which medications to use. The decision should be based on efficacy, cost, and other advantages and disadvantages. Comparative tables can help for rapid selection and can be used as a tool for enhancing prescribing ...

We compared the ability of definitions/symptoms of asthma to identify urban, elementary schoolchildren with physician-diagnosed asthma and bronchial hyperresponsiveness (BHR) post-exercise challenge. Definitions of asthma from the literature were compared, including American Thoracic Society (ATS) and British Medical Research Council (BMRC) definitions. Modified ATS had the highest sensitivity (77%), whereas ...

Diisocyanates are a group of low molecular weight aromatic and aliphatic compounds, widely used in the manufacture of polyurethanes. The most commonly used of these compounds are toluene diisocyanate (TDI), methylene diphenyl diisocyanate (MDI), and hexamethylene diisocyanate (HDI). This article presents a brief summary of the use of diisocyanates in ...

OBJECTIVES: To explore the sources of patients' knowledge about the potential side-effects of oral steroids prescribed to treat asthma. METHODS: Seventeen in-depth interviews were conducted with patients taking prescribed oral steroid medication (prednisolone) for asthma. The interviews were transcribed verbatim and the data organized according to common themes. RESULTS: All ...