The Net Guide: Bronchitis & Asthma

MDNG Hospital Medicine, October 2010, Volume 4, Issue 5

The Educated PatientHelp Your Child Gain Control over Asthma

Along with providing useful information for parents of children with asthma, this educational tool from the Environmental Protection Agency can also be printed out and shared with physicians to help develop a plan to control a child’s asthma. Here, parents and other family members of children with asthma can learn how to stop attacks before they get worse, access an asthma warning signs checklist, learn to identify emergency warning signs, and obtain information about potential asthma triggers inside and outside of the home.

Pulmonary Function Testing in Children

Parents whose children have to undergo pulmonary function testing can print out this educational resource from the American Thoracic Society, which provides answers to questions such as: “What is spirometry?” “What is a post bronchodilator or bronchodilator response test?” “Why shouldn’t I give my child some of their breathing medications before the test?” and “What are airway resistance tests?” Also included is a list of steps parents can take to make breathing tests less stressful for them and for their children.

Medical WebsitesDiagnosis and Management of Acute Bronchitis

Acute bronchitis is one of the most common conditions for which patients seek care, write authors Doug Knutson, MD, and Chad Braun, MD, of Ohio State University, in this paper, which “examines the diagnosis and treatment of acute bronchitis in otherwise healthy, non-smoking patients, with a focus on symptomatic therapy and the role of antibiotics in treatment.” Originally published in American Family Physician, the report provides a detailed description of the pathophysiology and etiology, signs and symptoms, physical examination, and treatment of acute bronchitis, with treatment further divided into sections addressing protrusive and antitrussive therapy, bronchodilators, and antibiotics.

Practice Guidelines

At this site, the American Academy of Allergy Asthma & Immunology (AAAI) provides dozens of guidelines for clinicians as well as patients and other health care professionals. Among the categories covered are Pediatric Asthma, Adult Asthma, Prevention of Allergies and Asthma, Anaphylaxis, Sinusitis, and more. In addition practice parameters, clinicians can download AAAI position statements, teaching slides, and advocacy statements.

Online CMESevere AsthmaCredits: 0.50

Fee: None

Expires: May 7, 2012

Multimedia: None

This program presents “an evidence-based review of research on more severe asthma disease and analyze treatment options for these patients.” Through a series of three articles, the activity will describe advances in diagnostic procedures for differentiating severity classifications of asthma; compare and contrast the safety and efficacy of therapeutic options for asthma; and report results from clinical trials investigating experimental therapies for asthma and discuss their potential roles in management strategies.

Should Patients with Mild Asthma Use Inhaled Steroids?Credits: 1.00

Fee: None

Expires: May 31, 2011

Multimedia: None

To earn credit for this activity, participants must read an article published in the Cleveland Clinic Journal of Medicine in which Susan R. Abouhassan, MD, discusses the use of inhaled corticosteroids in patients with mild persistent asthma. The article also explores the classification of asthma severity, goals of asthma management, the benefits of inhaled corticosteroids in mild persistent asthma, alternative treatments, whether steroids slow loss of lung function, and whether inhaled corticosteroids stunt children’s growth.

Clinical TrialsImpact of Oximetry on Hospitalization in Acute BronchiolitisStudy Type: Interventional

Age/Gender Requirements: 6 weeks-12 months (male/female)

Sponsor: The Hospital for Sick Children

Purpose: Researchers seek to determine whether “children with oxygen saturations above or in the vicinity of the threshold recommended for initiation of oxygen therapy by the AAP can be safely discharged based on their clinical appearance rather than to have their hospitalization dictated by a locally defined number.” The study looks to provide “much needed evidence” necessary to help clinicians interpret the oximetry results in a way that can lead to fewer hospitalizations, shorter length of stay and lower costs.

Improving the Quality of Asthma Care Using the InternetStudy Type: Interventional

Age/Gender Requirements: 21-60 years (male/female)

Sponsor: National Heart, Lung, and Blood Institute

Purpose: This 12-month study will evaluate the impact of an interactive website on asthma control and other aspects of managing the condition. The site will provide tailored feedback and information to asthma patients that can help them learn to ask specific questions about their care.

eAbstractsDuration of Illness in Infants with Bronchiolitis Evaluated in the Emergency DepartmentJournal: Pediatrics (August 2010)

Authors: Petruzella F, Gorelick M

Purpose: Researchers conducted a cohort study of infants younger than 12 months who presented to a tertiary care children’s hospital emergency department (ED) with a first episode of bronchiolitis to determine the duration of illness and to assess the burden of the illness on caregivers and families.

Results: The median duration of symptoms was 15 days; however, 25% of the infants remained symptomatic after 21 days. It was found that “symptom duration may be influenced by a propensity toward atopy.” The disease course is often prolonged, they wrote, “with substantial burden to the family.” Clinicians may use this information for counseling families.

Use of Lung Function Tests in Asthmatic Children is Associated with Lower Risk of Hospitalization. A Danish Population-based Follow-up StudyJournal: Journal of Asthma (October 12, 2011)

Authors: Moth G, Schiotz P, Parner E, Vedsted P

Purpose: To assess whether adherence to guidelines concerning use of lung function tests at time of diagnosis and during the first year after the start of medical treatment is associated with risk of hospitalization.

Results: Analyses of data from five nationwide registries showed that administering a lung function test at the start of treatment was associated with a lower risk of hospitalization than giving the test during the first 6 months of treatment. Researchers also found that a medication ratio of controller-to-total medication of at least 0.5 was linked to a lower risk of hospitalization.

Pharma Focus

Xolair (Omalizumab)

Clinical TrialsIdentifying Responders to Xolair (Omalizumab) Using Eosinophilic Esophagitis as a Disease ModelStudy Type: Interventional

Age/Gender Requirements: 12-76 years (male/female)

Sponsor: O & O Alpan LLC

Purpose: Using Eosinophilic esophagitis as a disease model, this open label, study seeks to determine mucosal markers that will predict responders to omalizumab, “a recently developed anti-IgE antibody that has been shown to decrease the use of inhaled and oral corticosteroids and improve asthma related symptoms in patients with allergic asthma.”

eAbstractsEffectiveness of Omalizumab in Patients 50 Years and Older with Severe Persistent Allergic AsthmaJournal: Journal of Asthma (October 12, 2011)

Authors: Korn S, Schumann C, Kropf C, et al

Purpose: To compare the efficacy of omalizumab therapy in patients 50 years or older with patients younger than age 50 over a period of four months.

Results: Compared with pretrial regimens, omalizumab treatment reduced the rate of severe exacerbations in patients 50 years or older by 68.9%, and by 75.4% in patients younger than 50 years. After four months, daily asthma symptoms and nocturnal awakenings were reduced by 67.8% and 72.6% in the older group and by 79.3% and 82.5% in the younger patients, respectively, and lung function improved in 60% of patients 50 years or older versus 69% of patients younger than 50 years.