Posts Tagged ‘asthma’

Mild Asthma

Posted by Sara Fazio • August 9th, 2013

Mild, persistent asthma is common but underdiagnosed and often undertreated. Regular controller treatment with lowdose inhaled glucocorticoids and rescue treatment with short-acting beta2-agonists as needed is recommended initially. Treatment is adjusted on the basis of the response within 3 to 4 months. The latest article in our Clinical Practice series comes from Dr. Elisabeth H…. Read More…

Another Bench-to-Bedside Story in the Treatment of Asthma

Posted by Rachel Wolfson • June 26th, 2013

In the early 20th century, the physician’s toolbox for asthma included adrenergic stimulants and belladonna alkaloids derived from the thorn-apple plant. Fifty years later, corticosteroids were added to the repertoire. (See the NEJM 200th anniversary review article on asthma.) But the next 50 years witnessed much more accelerated changes as basic science advances inspired the… Read More…

Tiotropium and the ancient datura plant: Revisiting the role of antimuscarinic therapy in asthma

Posted by Jamie Colbert • September 6th, 2012

For centuries the datura plant has been used for treatment of respiratory disease. The plant, also known as jimson weed or devil’s trumpet, is a potent member of the alkaloid family with antimuscarinic properties. American physicians in the 19th century would commonly recommend patients to smoke datura leaves for relief of asthma and obstructive airway… Read More…

Whistling in the Dark

Posted by Sara Fazio • May 4th, 2012

In a new Clinical Problem-Solving article, shortness of breath, fever, and cough productive of yellow sputum developed in a 38-year-old woman soon after the birth of her third child. Although her symptoms initially resolved with antibiotics, an intermittent nonproductive cough, wheezing, and shortness of breath soon followed. It is important to consider a broad differential… Read More…

Constrictive Bronchiolitis

Posted by Daniela Lamas • July 20th, 2011

A soldier returns from deployment in Iraq. A non-smoker without a history of asthma or other lung disease, he begins to notice that he’s no longer able to complete the army exercise regimen without becoming short of breath. The onset is insidious, but the impairment real: he isn’t even able to meet the fitness standard… Read More…

Breathing Easy

Posted by Rena Xu • July 13th, 2011

If a treatment for asthma makes an asthma patient feel better, did it work?  It’s hard to say, according to an article by Wechsler et al published this week in NEJM.  The authors report the results of a randomized double-blind crossover pilot study comparing the effectiveness of four interventions: an active albuterol inhaler, a placebo… Read More…

A Trial of Leukotriene Receptor Antagonists in the ‘Real World’ of Asthma Treatment

Posted by John Staples • May 4th, 2011

“Asthma’s been bugging me again, Doc,” intones the 72-year-old woman in front of you, “Saw this ad in a magazine and I think it might help.” As Mrs. Jackson fishes the crumpled advert from her purse, you look at your clinic notes. Multiple co-morbidities, medication intolerances, and confessions of previous treatment non-adherence seem to stare… Read More…

Omalizumab for Asthma

Posted by Graham McMahon • March 18th, 2011

In the Original Article, Randomized Trial of Omalizumab (Anti-IgE) for Asthma in Inner-City Children, Busse et al. found the introduction of guidelines-based therapy in all children decreased the number of days per fortnight that children had asthma symptoms. Treatment with omalizumab resulted in fewer days with asthma symptoms than placebo. Studies of inner-city children, adolescents,… Read More…

Emergency Treatment of Asthma

Posted by Graham McMahon • August 20th, 2010

Our latest article in the Clinical Practice series, Emergency Treatment of Asthma, comes from Stephen C. Lazarus, M.D., at the University of California, San Francisco. Asthma is one of the most common diseases in developing countries and has a worldwide prevalence of 7 to 10%. It is also a common cause of urgent care and… Read More…

Step-up Therapy for Children with Uncontrolled Asthma Receiving Inhaled Corticosteroids

Posted by Karen Buckley • March 17th, 2010

Evidence to guide step-up therapy for children whose asthma is poorly controlled by low-dose inhaled corticosteroids (ICS) has been lacking. In a crossover study of 182 children, Lemanske et al. attempt to determine which step-up therapy is best, and whether it can be predicted which therapy will induce a better response in a particular child…. Read More…