Asthma is a complex disease of airway inflammation, which results in airway remodeling and hyper-responsiveness.1 Because asthma-related symptoms are not specific to asthma, diagnosis requires objective data from pulmonary function tests (PFT). Bronchodilator responsiveness and airway responsiveness to provocational stimuli (eg, methacholine, dry-gas hyperpnea) help establish the diagnosis of a...

Asthma is a common inflammatory condition affecting the airways. Many people with it fail to achieve a satisfactory level of control and, consequently, have recurrent acute exacerbations. These can occur due to allergen exposure, viral infections or for no identifiable reason. Guidelines categorise exacerbations into three categories, from moderate to life threatening. Prompt assessment and tre...

Rapid-acting bronchodilators, systemic corticosteroids, and antibiotics are among the keys to managing exacerbations of chronic obstructive pulmonary disease. Preventing exacerbations should also be a component of therapy for the disease.

BACKGROUND Few studies have compared the effects of immunotherapy and inhaled steroids. The main limitation of such studies is the long duration required to fully appreciate the effects of immunotherapy. OBJECTIVE To compare the effects of inhaled budesonide and sublingual immunotherapy (SLIT) in mild persistent asthma for up to 5 years. METHODS Patients with mild persistent asthma and rhin...

A BONFIRE OF THE EVIDENCE The American Academy of Pediatrics (AAP) 2014 Bronchiolitis guidelines (the guidelines) were recently published in the official journal of the AAP, Pediatrics.1 The committee that wrote the guidelines anticipates that these will form the basis of bronchiolitis treatment throughout the house of medicine, not just in pediatricians’ offices. Emergency physicians may well ...

OBJECTIVE Current debates on the bronchodilator response in COPD patients and whether the variation in FEV1 can be considered as an indicator of complete reversibility in such patients motivated us to conduct this study. The objective of the study was to determine the effect of albuterol on the resistive and reactive properties of the respiratory system in COPD patients. METHODS We evaluated ...

Tiotropium is a long-acting muscarinic antagonist (LAMA) that exerts its bronchodilatory effect by blocking endogenous acetylcholine receptors in the airways. Its safety and efficacy are well established for the treatment of COPD, and it is now being recognized for its role in improving lung function and control in asthma. This review discusses the evolving role of tiotropium delivered by the R...

OBJECTIVE To analyze pulmonary function parameters and pharmacodynamic response to a bronchodilator, as well as the prescription of bronchodilators, in cystic fibrosis (CF) patients. METHODS This was a retrospective cohort study involving patients 6-18 years of age, diagnosed with CF, and followed at a referral center between 2008 and 2010. We evaluated only those patients who were able to pe...

Pulmonary function test results of individuals with the acquired immunodeficiency syndrome (AIDS) were analyzed to determine the prevalence of abnormally low forced expiratory flow rates and bronchial hyperreactivity. Of 99 individuals with AIDS, a total of 44 (44 percent) had either low forced expiratory flow rates or a significant response to inhaled bronchodilator. Thirty-one (31 percent) in...

• Objective: To review the diagnosis and treatment of acute exacerbations of chronic bronchitis (AECB). • Methods: Qualitative assessment of the literature. • Results: The physician must first make an accurate determination of the cause of the AECB. Antibiotics are appropriate only for patients proven or suspected of having a bacterial infection. Patients with purulent sputum and multisymptom e...