Methotrexate and asthma.

population, 1)0th b()dV habitus and degree of effort expended in PEFR measurement var widely among patients. \Ve have found that percent predicted PEFRs are much more useful for the individual patient, both in assessing progress of therapy and in objectively comparing severity of respirator)’ distress with that on previous ED visits. Indeed, even the primary supporting study cited by the authors, that by Nowak et al,2 cautioned that patients with a body habitus falling outside the norm ma)’ benefit from percent predicted PEFR calculation. In summar ; the article 1w McNamara and Cionni, while suggesting an interesting use ofobjective data (PEFR), suffers somewhat from its lack of emphasis on other useful information that ma)’ he expeditiously obtained in the ED o)n patients in respirator)’ distress, namely, clinical and radiographic data. Patients with features of both CHF and CLD ma)’ he initially managed without a clear differentiatiom between the two. In addition, we have had good success with the routine use of percent predicted PEFRs in our ED, and we recommend their use in this setting.