Despite intense attention over the past 10–20 years, asthma still offers many potential new targets and approaches for improved treatment. Bronchospasm is the most obvious target, which is amenable to treatment that relaxes airway smooth muscle. Inflammation is the most emphasized aspect of the disease and is used to direct maintenance therapy at the underlying facets of asthma. However, emergi...

Bilateral subconjunctival haemorrhage was observed on 5 separate occasions in 4 patients presenting a fulminant form of acute severe asthma. Four of these episodes required ventilatory support. All patients recovered from their asthma attack after treatment with bronchodilators, corticosteroids, and oxygen. The incidence of this previously unreported finding represents 5% of the total number of...

Many patients with cystic fibrosis have symptoms of dyspnoea and wheeze which are responsive to treatment with bronchodilators. An adolescent woman with cystic fibrosis is described who presented with inspiratory stridor and in whom the classical features of paradoxical vocal cord adduction were found.

OBJECTIVE To evaluate the efficacy of beta2-agonists in bronchiolitis. DESIGN Critical review and meta-analysis of randomized controlled trials of inhaled beta2-agonists. RESULTS Three inpatient and five outpatient studies were identified. Inpatient studies (82 patients) were characterized by wide variability in therapeutic regimens and measurement of outcomes. Several problems were identif...

Viral bronchiolitis is the most common reason for infants to be admitted to hospital,1,2 yet we seem powerless to do much about it. Physicians who have been in practice for 30 years or more have ridden the rollercoaster of optimism following the publication of randomized controlled trials (RCTs) on bronchiolitis showing the efficacy of bronchodilators, steroids, hypertonic saline and so on, onl...

BACKGROUND We studied the effects of access to point-of-care medical evidence in a computerised physician order entry system (CPOE) on management and clinical outcome of children with bronchiolitis. METHODS This was a before-after study that took place in a Canadian tertiary care paediatric teaching hospital. The intervention was a clinical evidence module (CEM) for bronchiolitis management, ...

BACKGROUND The purpose of this study was to examine socioeconomic variations in the use of prescription medicines among elderly subjects with COPD. METHODS Data from the Danish national administrative registers were used. The study population included 1,365 individuals >60 y old residing in the Municipality of Copenhagen and diagnosed with COPD in a hospital setting in 2007. Logistic regressi...

Combination therapy with anticholinergics and β2-agonists should be used in COPD patients after failure of previous monotherapy with one of these drugs. Synergistic effect of both mechanisms of bronchodilation can maximize the efficacy of separately administered drugs. The effectiveness of the combination of LABA and LAMA is already confirmed, nevertheless the question about the safety profile ...

Bronchial Asthma is one of the major public health problems for the developed and developing countries. Worldwide, it is estimated that 300 million people are affected with bronchial asthma. India has an estimated 15‐20 million asthmatics with a prevalence of about 10% and 15% in 5‐11 year old children1. Asthma prevalence is increasing despite the recent advances in its management including und...

BACKGROUND Bronchiolitis causes nearly 20% of all acute care hospitalizations for young children in the United States. Unnecessary testing and medication for infants with bronchiolitis contribute to cost without improving outcomes. OBJECTIVES The goal of this study was to systematically review the quality improvement (QI) literature on inpatient bronchiolitis and to propose benchmarks for red...