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Imaging Case of the Week 157

The following chest x-ray is from an adolescent who has been intubated following a critical asthma presentation. What radiological sign can be seen? It is very subtle.  
emergucate.com
about 5 years ago
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What is the evidence for stopping long-acting beta2-agonists for adults with stable asthma using combination therapy? | Cochrane

Stopping long-acting beta2-agonists (LABA) for adults whose asthma is stable with LABA and inhaled corticosteroid (ICS) treatment may increase the number of asthma attacks that require treatment with extra corticosteroids, but this remains uncertain. Stopping LABA may also slightly reduce quality of life and asthma control. We could not tell whether stopping LABA changed serious side effects or the likelihood of having to go to the hospital for an asthma attack.  
cochrane.org
about 5 years ago
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Magnesium for Asthma

Thanks to Dr. Kim for the writeup of this post Case A 36-year-old female with a history of asthma presents with wheezing, tachypnea, and a room air O2  
jeffem.org
about 5 years ago
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Can taking inhaled corticosteroids when needed for symptoms help people with mild asthma from becoming more unwell? | Cochrane

Daily inhaled corticosteroids (ICS) are the mainstay of medications prescribed for people with asthma who have ongoing difficulty with their breathing. However, for those with a milder form of the condition, it is hard to predict when their asthma will get worse and so many people do not use their inhaler regularly. In this review, we compared the use of ICS used intermittently at the start of an asthma episode with placebo treatment in children and adults with mild asthma (two trials representing 385 participants) and in preschool children deemed to be at risk of developing asthma symptoms in the future (four trials representing 490 participants).  
cochrane.org
about 5 years ago
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For people with uncontrolled asthma on inhaled steroids, is it better to increase the dose or add a long-acting muscarinic antagonist? | Cochrane

We don't yet know whether adding LAMA to ICS is better or worse than increasing the dose of ICS. It is important that future studies include a treatment group for people given a double dose of ICS, because this is an option for doctors treating people with asthma.  
cochrane.org
about 5 years ago
Www.bmj
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Self management for a man with asthma

A 35 year old man with a history of asthma attended the practice asthma clinic a few weeks after an acute exacerbation. He was a non-smoker who had asthma as a child but “grew out of” the more troublesome symptoms in his teens. He regards his asthma as well controlled, although his computer record suggested that he has had six short acting bronchodilator inhalers in the past year. He is more troubled by hay fever, which he manages with antihistamines that he buys from the pharmacy. He has a sedentary lifestyle so avoids exercise induced symptoms. He has a repeat prescription for an inhaled steroid (which he takes “when he needs it”) and carries a salbutamol inhaler with him in case he experiences any chest tightness. Despite annual invitations to the asthma clinic he last attended six years ago.  
feeds.bmj.com
about 5 years ago
Www.bmj
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Antibiotics in fetal and early life and subsequent childhood asthma: nationwide population based study with sibling analysis

Objective To investigate the association between exposure to antibiotics in fetal and early life and asthma in childhood, with adjustment for confounding factors.  
feeds.bmj.com
about 5 years ago
Static.www.bmj
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Adenotonsillectomy reduces acute asthma exacerbations in children, study shows

Children who undergo adenotonsillectomy have a 30% reduction in acute exacerbations of asthma in the year after their surgery compared with the year before, a large US study has shown.1  
feeds.bmj.com
about 5 years ago
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Mepolizumab as opposed to placebo for asthma | Cochrane

Asthma is an inflammatory lung condition characterised by the narrowing of the airways, breathlessness, a tight chest and reduced quality of life. By the year 2025, there may be up to 400 million people with asthma worldwide. Mepolizumab is one treatment that may help to reduce the symptoms.  
cochrane.org
about 5 years ago
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Severe Asthma Exacerbation

This week's case is written by Dr. Andrew Hall. He is an Assistant Professor in the Department of Emergency Medicine at Queen’s University where he is a Simulation-based Resuscitation Rounds Instructor and runs the Simulation-based OSCE Assessment Program for EM residents. He's also one of the advisory board members here at EMSimCases. Why it Matters…  
emsimcases.com
about 5 years ago
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31

Asthma UK | Occupational asthma and work aggravated asthma

Every year many people in the UK develop asthma because they are exposed to dangerous substances at work. This is called occupational asthma.  
asthma.org.uk
almost 5 years ago
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Management of Mild to Moderate Asthma Exacerbations - R.E.B.E.L. EM - Emergency Medicine Blog

This post accompanies the REBEL Cast episode on The Crashing Asthmatic from June 2015 and about management of the mild to moderate asthma exacerbation  
rebelem.com
almost 5 years ago
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Does adding a long-acting muscarinic antagonist (LAMA) to an inhaled steroid help people with uncontrolled asthma more than an inhaled steroid alone? | Cochrane

Main point: People with poorly controlled asthma are less likely to have an asthma attack needing treatment with oral steroids if they take a LAMA on top of their inhaled steroid. LAMA also improve lung function compared with inhaled steroids alone, but their benefit is uncertain for hospital admissions, serious adverse events, quality of life and asthma control.  
cochrane.org
almost 5 years ago
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Sublingual immunotherapy for asthma | Cochrane

We assessed the evidence on the use of sublingual immunotherapy (SLIT) for people with asthma compared with placebo or with normal treatment for asthma. We focused on whether SLIT is a good treatment for asthma and whether it is safe.  
cochrane.org
almost 5 years ago
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Beta2-agonist drugs for treating cough or a clinical diagnosis of acute bronchitis | Cochrane

Acute bronchitis is a chest infection, with cough and sometimes sputum production, chest pain and fever. People affected feel unwell and for those who do not have asthma or chronic lung disease there is no clear treatment. Viruses cause most cases of bronchitis, so antibiotics usually do not help. Beta2-agonists (such as albuterol or salbutamol) are drugs that relieve asthma by relaxing muscles that cause narrowing in the passages to the lungs. They are sometimes used to relieve the cough in acute bronchitis, even in people who do not have asthma.  
cochrane.org
almost 5 years ago
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The Wide-Ranging Role of the Microbiome

What goes in your stomach can influence countless disorders, from cancer to asthma. Dr David Johnson surveys the latest data underlining the ever-increasing importance of a low-fat, high-fiber diet.  
medscape.com
almost 5 years ago
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Tiotropium (Spiriva Respimat) Gets Asthma Indication in US

The FDA approved a once-daily dose, delivered in two puffs, for long-term maintenance treatment of asthma in people aged 12 years and older.  
medscape.com
almost 5 years ago
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Should macrolides be used for chronic asthma? | Cochrane

Main point: Studies do not show that macrolides are better than placebo for most outcomes. There may be a benefit on lung function but it depends on how this is measured. The evidence was very low quality so we can't rule out the possibility of other benefits or harms.  
cochrane.org
almost 5 years ago
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Asthma Diary Helpful for Monitoring Exacerbations in Preschoolers

An asthma flare-up diary may help assess the severity of asthma exacerbation in young children, according to a Canadian study.  
medscape.com
almost 5 years ago
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Asthma, COPD Therapies Raise Curtain at Conference

Targeted therapies, epigenetics, and the subtyping of chronic airway diseases will be among the issues addressed at this year's European Respiratory Society Congress.  
medscape.com
almost 5 years ago