A conundrum of modern times that's still unresolved.
نویسنده
چکیده
In recent decades, there has been an abundance of publications about wheezing illnesses and asthma, although none have had the capability to sufficiently define this object of curiosity and concern. Confidence has been lost in traditional approaches, such as locking up key people until one ultimate and final decision has been reached, indicated by white fumes emanating from grave chimneys. Moreover, trust in accepting and following such truths has also been lost. Yet, many will argue that these semantic discussions are purely intellectual and aimed at satisfying the scientific flock, but that a clinician, thanks to his or her intuitive skills, will easily recognise the condition. After all, humanity has successfully dealt with other comparable problems: myriads of poets, literates, psychologists and neurobiologists failed to identify love, yet everybody knows what love is [1]. However, love is probably as faceted and complex as living systems are and its presence is not always recognised. The full-embracing approach towards this mysterious phenomenon is through the arts, bundling all sensual, intuitive and intellectual forces at everyone9s disposition. Clinical work is an art too, even in these modern days of computer algorithms, globalised treatment guidelines and ever-increasing scientific knowledge. As with every artist, some talent is needed, but more importantly, constant practice and improvements in digesting and incorporating novel aspects identified in clinical, basic and epidemiological research are required. The paper by YEATTS et al. [2] in the current issue of the European Respiratory Journal (ERJ) highlights unambiguously the still-existing weaknesses of current clinical abilities, i.e. there is a substantial proportion of children in the community reporting asthma-like symptoms without a proper diagnosis of asthma. Even more importantly, these children suffer more illness-related limitations of daily activities and sleep than children with proper management. Although the findings are likely to reflect the local structure and function of the national healthcare system in the USA, with more limited access to healthcare for some population groups, Europe cannot sit back. The ERJ has repeatedly published work showing that a significant underdiagnosis of asthma still occurs in Europe [3–5]. These reports have been based on epidemiological surveys with inherent limitations due to potential misclassification. However, all of these studies came to very comparable conclusions, showing that underdiagnosis is not just an intellectual dilemma, but results in undertreatment and increased morbidity of affected children. These surveys are, furthermore, much more likely to reflect true patient compliance and conduct …
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عنوان ژورنال:
- The European respiratory journal
دوره 22 5 شماره
صفحات -
تاریخ انتشار 2003