Respiratory Diseases

A clinical nurse consultant demonstrates best practices for inhalers and puffers, with an emphasis on pediatric asthma patients.

Prof. Dominic Fitzgerald, a pediatric respiratory and sleep physician, reviews the basics about spirometry, and explains its use in children.

Recent studies have interesting implications for selecting medication and modifying asthma management. Clinician and researcher Barabara Yawn, MD, MSc provides a review-and offers insights on practical implications for primary care.

A 56-year-old was seen in the ED after 4 days of hemoptysis and intermittent left chest pain. He also complained of exertional dyspnea and arthralgias. He had been treated for “pneumonia” twice during the past month. Histories were unremarkable.

A 43-year-old African American woman presented to the emergency department with severe dyspnea, wheeze, and cough productive of white sputum. Three years earlier, she had been given a diagnosis of asthma based on symptoms of wheeze and cough; her treatment regimen included intermittent use of albuterol.

A 61-year-old man with arthritis and an 80-pack-year smoking history presented with fever, dyspnea, and productive cough of a week’s duration that did not respond to outpatient treatment with levofloxacin.

Are persons with asthma at risk for other proinflammatory disorders? Yes, say researchers from the Mayo Clinic and Olmsted Medical Center in Rochester, Minn, who found that asthma is associated with the development of diabetes mellitus and coronary artery disease. However, there was no association between asthma and rheumatoid arthritis or inflammatory bowel disease.

Patients who have more confidence in the effectiveness of their medications tend to be more likely to adhere to their therapeutic regimen. A recent study, which appears online in the Journal of Allergy and Clinical Immunology, examined whether actively promoting the benefits of a therapy can increase adherence.

Patients with asthma may be reluctant to exercise for fear of triggering an attack. You can reassure them that adequate control can allow them to participate in almost any physical activity they wish. Recommendations from the NIH offer guidance on prevention of exercise-induced bronchospasm.

When counseling patients about why they should receive the influenza vaccine, I remind them that each year the disease kills 250,000 to 500,000 persons worldwide and more than 37,000 persons in the United States. This means that influenza kills more people per year than auto accidents.

Patients who followed a written action plan for exacerbations of chronic obstructive pulmonary disease (COPD) had shorter recovery times, reported Canadian researchers.

This year's influenza season is approaching fast. Although the World Health Organization officially declared an end to the 2009 H1N1 influenza pandemic in August, the H1N1 virus is still circulating and is likely to continue to cause serious disease in infants, young children, pregnant women, and other high-risk groups.

This year’s influenza season is approaching fast. Although the World Health Organization officially declared an end to the 2009 H1N1 influenza pandemic in August, the H1N1 virus is still circulating and is likely to continue to cause serious disease in infants, young children, pregnant women, and other high-risk groups.

Instruct patients with chronic obstructive pulmonary disease and asthma to discard their rescue albuterol inhalers 2 to 3 months after opening.

In adults who present with persistent cough following an upper respiratory tract infection but who have no history of asthma or chronic obstructive pulmonary disease, lung findings are usually “normal” on auscultation.

Avoidance of guidelines because they are “cookbook” is no longer an adequate excuse-especially when we are doing things incorrectly and expensively, while adding to potential complications

A universal vaccine that protects against all strains of influenza virus may eventually replace yearly seasonal flu shots. This vaccine has been shown to be effective in animals, report investigators from the National Institute of Allergy and Infectious Diseases (NIAID).

Nitrofurantoin has been widely used for the treatment and prevention of recurrent urinary tract infections since its introduction into clinical practice in 1953. Although it continues to be an effective antibiotic, nitrofurantoin is associated with several adverse effects, including pulmonary toxicity.

Many pharmacological options exist for allergic rhinitis. Intranasal corticosteroids are the most effective medication class for patients with moderate to severe symptoms; those with milder intermittent symptoms can be treated with a second-generation oral or intranasal antihistamine.

Diabetes mellitus is a group of disorders characterized by hyperglycemia and the resulting macrovascular and microvascular complications.

H1N1 influenza has paid an unwelcome visit to a number of nursing homes, reports the CDC.

Malignant thymoma is an indolent tumor arising from the thymic epithelial cells located in the anterior mediastinum. These tumor cells spread via regional metastasis or invade surrounding structures, including the pleural space.

Endobronchial schwannomas are rare and often benign neoplasms that develop from the nerve sheath of the peripheral nervous system.

A 31-year-old Bangladeshi man presented with dull, aching abdominal pain primarily in the right flank. The pain began a week after he underwent exploratory laparotomy for a perforated duodenal ulcer. He had been taking oxycodone/acetaminophen, docusate sodium, and omeprazole since the surgery.

Although the prevalence of tuberculosis (TB) in the United States continues to decline (from 2006 to 2007, the total number of TB cases declined 4.2%, from 13,779 cases to 13,293), the rate of decline has slowed in recent years.1 The rate in foreignborn persons is much higher than in US-born persons and appears to be increasing.1

Both seasonal and H1N1 influenza pose a greater risk of severe illness and complications in patients with diabetes-and these infections can also wreak havoc with blood glucose levels.

Imaging experts are lining up to caution physicians not to read too much into study findings suggesting that chest CT is better than general radiography for examining A-H1N1 flu patients.

Lung disease was the most common underlying condition in a British study of 192 patients who had been admitted to the hospital because of complications related to H1N1 influenza.