scholarly journals Discharge Considerations for Adult Asthmatic Patients Treated in Emergency Departments

1996 ◽  
Vol 3 (5) ◽  
pp. 322-327 ◽  
Author(s):  
Anton F Grunfeld ◽  
J Mark FitzGerald
Keyword(s):  
Risk Factors ◽  
Emergency Department ◽  
Emergency Departments ◽  
English Language ◽  
Acute Asthma ◽  
Airflow Obstruction ◽  
Response To Therapy ◽  
Medline Search ◽  
Asthmatic Patients ◽  
Adult Asthmatic

OBJECTIVE:To review the medical literature on outcome of treatment of acute asthma in the emergency department and issue recommendations regarding patient admission or discharge.DATA SOURCES:A MEDLINE search was done for articles in the English language on acute asthma and treatment in the emergency department for the years 1975 to 1993. In addition, references in pertinent review articles were reviewed.STUDY SELECTION:Studies addressing treatment of acute asthma in emergency departments were selected by consensus.DATA SYNTHESIS:Three major areas have been shown to affect outcome and the decision to admit or discharge a patient following treatment in the emergency department: first, the severity of the attack and the response to therapy; second, historical risk factors; and third, care following discharge from the emergency department. This paper reviews the literature on outcome of acute asthma attacks and issues recommendations regarding objective airflow measurements and co-existing risk factors to be assessed before discharging patients. The role of anti-inflammatory therapy in emergency department treatment and in postdischarge treatment of these patients is also reviewed.CONCLUSION:Evaluation for discharge following treatment of acute asthma should integrate objective measures of airflow obstruction with historical high risk factors. The use of systemic corticosteroids in the emergency department and following discharge, with careful follow-up, may help control the attack and reduce relapse of asthma.

Medication Bezoars: A Literature Review and Report of a Case

1998 ◽  
Vol 32 (9) ◽  
pp. 940-946 ◽  
Author(s):  
James R Taylor ◽  
Daniel S Streetman ◽  
Sharon S Castle
Keyword(s):  
Risk Factors ◽  
English Language ◽  
Case Reports ◽  
Relevant Literature ◽  
Significant Risk ◽  
Signs And Symptoms ◽  
The Body ◽  
Surgical Removal ◽  
Diagnostic Challenge ◽  
Medline Search

OBJECTIVE: To describe a case of a medication bezoar and to review the clinical presentation, diagnosis, risk factors, pathogenesis, complications, and treatment of medication bezoars. DATA SOURCES AND STUDY SELECTION: A MEDLINE search (January 1966–December 1997) of the English-language literature pertaining to bezoars was performed. These articles were scanned, and literature specifically discussing medication bezoars was selected. Additionally, the reference sections of pertinent review and case reports were scanned for additional relevant literature. DATA SYNTHESIS: Bezoars are concretions of foreign material within the body. In the case of medication bezoars, these concretions occur within the digestive tract and are composed of medications and/or medication vehicles. Rarely, however, is bezoar formation solely due to a medication. In nearly all reported cases the patient had one or more significant risk factors that contributed to bezoar formation. The exact method by which medication bezoars form is dependent on the particular type or combination of medications involved. Bezoar formation may be associated with significant complications for the patient due to the presence of the bezoar and because of the effects of the medication within the bezoar. Treatment of medication bezoars depends largely on the location and the cause of the bezoar. CONCLUSIONS: Medication bezoars are a rare but potentially serious complication of medication use in certain patients. These patients often present with signs and symptoms consistent with an obstruction of the gastrointestinal tract and represent an even greater diagnostic challenge due to the rarity of this complication. These patients also face significant complications from both the bezoar and the medication within the bezoar. To date, treatment of medication bezoars involves mainly physical manipulation of the bezoar through lavage, endoscopic removal, or, in most cases, surgical removal.

Risk Factors for Intubation of Adult Asthmatic Patients

1995 ◽  
Vol 32 (2) ◽  
pp. 97-104 ◽  
Author(s):  
Sean Leson ◽  
M. Eric Gershwin
Keyword(s):  
Risk Factors ◽  
Asthmatic Patients ◽  
Adult Asthmatic

scholarly journals Retrospective Cohort Study of Leukotriene Receptor Antagonist Therapy for Preventing Upper Respiratory Infection-Induced Acute Asthma Exacerbations

2013 ◽  
Vol 4 (3) ◽  
pp. ar.2013.4.0062 ◽  
Author(s):  
Hiroto Matsuse ◽  
Tomoko Tsuchida ◽  
Susumu Fukahori ◽  
Tetsuya Kawano ◽  
Shinya Tomari ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Acute Asthma ◽  
Leukotriene Receptor Antagonist ◽  
Asthmatic Patients ◽  
Asthma Exacerbations ◽  
Adult Asthmatic ◽  
Acute Asthma Exacerbation ◽  
Leukotriene Receptor ◽  
Upper Respiratory ◽  
Acute Asthma Exacerbations

Upper respiratory tract infections (URIs) represent the most frequent cause of acute asthma exacerbations. It has yet to be determined whether leukotriene receptor antagonist (LTRA) treatment prevents URI-induced acute asthma exacerbations in adults. The objective of the present study was to evaluate the preventive effects of LTRA treatment on URI-induced acute asthma exacerbations. The incidences of URI alone, acute asthma exacerbation without URI, and URI-induced acute asthma exacerbation were determined retrospectively by analyzing diary and medical records of 321 adult asthmatic patients (mean age, 56.3 ± 17.2 years; male/female ratio, 117:204) over 1 year. Results were compared between patients who had been taking an LTRA (n = 137) and those who had never taken any LTRA (n = 184) during the study periods. Significantly fewer URIs alone and acute asthma exacerbations without URI occurred in patients with than in those without prophylactic daily use of LTRA. LTRA treatment significantly reduced the durations of URIs alone and of total acute asthma exacerbations, as well as the incidence of mild exacerbations of asthma. In contrast, in patients with URI-induced acute asthma exacerbations, LTRA treatment failed to significantly reduce the interval between URI onset and acute asthma exacerbation, as well as the duration and severity of both URIs and acute asthma exacerbations. Use of an LTRA for adult asthmatic patients appears to reduce the incidences of URIs alone and acute asthma exacerbations without URI, but it failed to prevent URI-induced acute asthma exacerbations once a URI occurred.

scholarly journals The Interpretation of Dyspnea in the Patient with Asthma

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Marc H. Lavietes
Keyword(s):  
Lung Function ◽  
Panic Disorder ◽  
Acute Asthma ◽  
Initial Response ◽  
Response To Therapy ◽  
The Self ◽  
Self Report ◽  
Borg Scale ◽  
Behavioral Traits ◽  
Asthmatic Patients

Physicians have noted dyspnea in severely ill asthmatic patients to be associated with fright or panic; in more stable patients dyspnea may reflect characteristics including lung function, personality and behavioral traits. This study evaluates the symptom of dyspnea in 32 asthmatic patients twice: first when acutely ill and again after an initial response to therapy. Spirometry was performed, dyspnea quantified (Borg scale), and panic assessed with a specialized measure of acute panic (the acute panic inventory (API)) in the 32 patients before and again after treatment. After treatment, questionnaires to evaluate somatization and panic disorder were also administered. When acutely ill, both the API and all spirometric measures (PEFR; FEV1; IC) correlated with dyspnea. Multiple linear regression showed that measures of the API, the peak expiratory flow rate, and female sex taken together accounted for 41% of dyspnea in acute asthma. After treatment, the API again predicted dyspnea while spirometric data did not. Those subjects who described themselves as having chronic panic disorder reported high grades of dyspnea after treatment also. We conclude that interpretations of the self-report of asthma differ between acutely ill and stable asthmatic patients.

scholarly journals Determinants of Acute Asthma Attack among adult asthmatic patients visiting hospitals of Tigray, Ethiopia, 2019: case control study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Melaku Negash ◽  
Hagos Tsegabrhan ◽  
Teklit Meles ◽  
Degena Bahrey Tadesse ◽  
Gebreamlak Gidey ◽  
...  
Keyword(s):  
Case Control Study ◽  
Acute Asthma ◽  
Case Control ◽  
Asthmatic Patients ◽  
Asthma Attack ◽  
Adult Asthmatic ◽  
Control Study

Stereoselective Pharmacokinetics and Pharmacodynamics of Anti-Asthma Agents

2002 ◽  
Vol 36 (4) ◽  
pp. 693-701 ◽  
Author(s):  
Majid Vakily ◽  
Reza Mehvar ◽  
Dion Brocks
Keyword(s):  
English Language ◽  
Data Extraction ◽  
Plasma Concentrations ◽  
Volume Of Distribution ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Chiral Drugs ◽  
Medline Search ◽  
Secondary Sources ◽  
Asthmatic Patients ◽  
Stereoselective Pharmacokinetics

OBJECTIVE: To review the previously published studies on pharmacokinetics and pharmacodynamics of chiral drugs used in the treatment of asthma. DATA SOURCES: Primary and review articles were identified with a MEDLINE search (1980–May 2001) and through secondary sources. STUDY SELECTION AND DATA EXTRACTION: All English-language studies and reviews obtained from the MEDLINE search pertaining to stereoselective pharmacokinetics and pharmacodynamics of chiral anti-asthma drugs were assessed. DATA SYNTHESIS: Several anti-asthma drugs (e.g., β2-adrenergic agonists, leukotriene modifiers) are chiral and marketed as racemates, which consist of equal proportions of 2 enantiomers. Significant stereoselectivity has also been reported in pharmacodynamics and pharmacokinetics of the β2-agonists. The enantiomers of β2-agonists in the R configuration are primarily responsible for the bronchodilating effects of the racemate. The plasma concentrations of the enantiomers of anti-asthma drugs may differ as a reflection of stereoselectivity in clearance, volume of distribution, and route of administration. CONCLUSIONS: Stereoselectivity in the pharmacokinetics of anti-asthma drugs may complicate the relationship between dose and/or plasma concentration of racemic drug versus effect relationship. An appreciation of the stereoselective pharmacokinetics and pharmacodynamics of chiral anti-asthma drugs may optimize the use of these agents in asthmatic patients.

scholarly journals The problem of obstructive sleep apnea syndrome in asthmatic patients

2017 ◽  
Vol 89 (1) ◽  
pp. 107-111
Author(s):  
E G Sheludko ◽  
D E Naumov ◽  
Yu M Perelman ◽  
V P Kolosov
Keyword(s):  
Risk Factors ◽  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Obstructive Sleep Apnea Syndrome ◽  
Sleep Apnea Syndrome ◽  
Response To Therapy ◽  
Cpap Therapy ◽  
Asthmatic Patients ◽  
Obstructive Sleep ◽  
Apnea Syndrome

Asthma and obstructive sleep apnea syndrome (OSAS) are one of the most common chronic respiratory diseases. These have common risk factors that include obesity, gastroesophageal reflux disease (GERD) and impaired nasal breathing (allergic rhinitis, sinusitis). At the same time, experimental evidence demonstrates common pathophysiological mechanisms of these diseases, such as involvement in the process of the respiratory tract, a systemic inflammatory response, and implementation of neuromechanical reflexes. Thus, there is an obvious synergism between these conditions, which affects symptoms, response to therapy, and prognosis. The available data allow discussion on whether there is a need to identify and treat OSAS in asthmatic patients. By keeping in mind the high incidence of OSAS in patients with severe asthma, it may be suggested that treatment for OSAS can reduce the number of exacerbations, improve the quality of life, and decline the number of obstinate asthma cases. It is very important for general practitioners to assess risk factors, such as body weight, nasal stuffiness, and GERD, and to utilize screening tools for more efficient use of healthcare resources. Considering the known positive effects of CPAP therapy in short-term studies, future investigations should focus on the impact of CPAP therapy on asthma symptoms in the long-term, as well as on the effects of asthma drugs on the course of OSAS.

The epidemiology and natural history of anal human papillomavirus infection in men who have sex with men

Sexual Health ◽  
2012 ◽  
Vol 9 (6) ◽  
pp. 527 ◽  
Author(s):  
Dorothy A. Machalek ◽  
Andrew E. Grulich ◽  
Fengyi Jin ◽  
David J. Templeton ◽  
I. Mary Poynten
Keyword(s):  
Risk Factors ◽  
Human Papillomavirus ◽  
Natural History ◽  
English Language ◽  
Epidemiological Data ◽  
Hpv Infection ◽  
Medline Search ◽  
Infection Dynamics ◽  
History Of ◽  
Sex With Men

Studies on the epidemiology and natural history of anal human papillomavirus (HPV) infection are essential to understand the significance of this virus in the aetiology of anal cancer in men who have sex with men (MSM). This paper presents a review of studies on anal HPV in MSM. For this review, a Medline search was performed to identify English-language articles published in peer-reviewed journals on the epidemiology, natural history and risk factors for anal HPV infection in MSM. Anal HPV prevalence is high in MSM and infection with multiple HPV types is common. The available prospective data suggest detection of new anal HPV infections may also be common. However, with limited epidemiological data available on infection dynamics and associated behavioural risk factors, it is difficult to draw conclusions on how persistent anal HPV infection is in this population.

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