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Doubling of steroids before severe asthma attacks ineffective (p 271)
January 21, 2004Recommendations to double inhaled steroids at the start of asthma attacks are challenged by research findings in this week's issue of THE LANCET.
Doubling the dose of inhaled corticosteroid when asthma control deteriorates is widely advocated but is of unproven value. Tim Harrison from the department of respiratory medicine, Nottingham City Hospital, UK, and colleagues studied 390 asthma patients, deemed to be at risk of an asthma exacerbation. Patients monitored their asthma for up to one year and were instructed to add an extra inhaler (either steroid or placebo) for two weeks when their asthma control deteriorated.
There was no statistically significant difference in the proportion of people requiring oral steroids (the main study outcome) between the active and placebo groups (around 12% of patients in both groups).
Tim Harrison comments: "Our findings provide little support for the recommendation that patients taking an inhaled corticosteroid should double the dose when asthma control is deteriorating. Whether a larger increase in inhaled corticosteroid dose would be effective needs to be established. Until more data are available patients should continue to take a short course of oral steroids for asthma exacerbations"
Lancet
Asthma News and Current Asthma Events RSSInfection Blocks Lung's Protective Response Against Tobacco Smoke
An infection that often goes undetected can block the lung's natural protective response against tobacco smoke, according to researchers at National Jewish Health.
Many U.S. Public Schools in 'Air Pollution Danger Zone'
One in three U.S. public schools are in the "air pollution danger zone," according to new research from the University of Cincinnati (UC).
Asthma in boys may be just a phase, but for girls it may be there to stay
Boys may be more apt than girls to have childhood asthma, but, when compared to girls, they are also more likely to grow out of it in adolescence and have a decreased incidence of asthma in the post-pubertal years. This indicates that there may be a buried mechanism in asthma development, according to a prospective study that analyzed airway responsiveness (AR) in more than 1,000 children with mild to moderate asthma over a period of about nine years.
White blood cell uses DNA 'catapult' to fight infection
U.S. and Swiss scientists have made a breakthrough in understanding how a type of white blood cell called the eosinophil may help the body to fight bacterial infections in the digestive tract, according to research published online this week in Nature Medicine.
Tiny molecule helps control blood-vessel development, researchers find
The development and repair of heart tissue and blood vessels is intimately tied to a tiny piece of ribonucleic acid (RNA) that is found nowhere else in the body, researchers at UT Southwestern Medical Center have found.
Asthma, outdoor air quality and the Olympic Games
As we come close to the Beijing Olympic Games, a review article in CMAJ (Canadian Medical Association Journal) reminds us that the heat and humidity in the Beijing region will present a formidable challenge to all athletes. Moreover, poor quality of air can also affect all athletes, especially those with asthma.
Students with food allergies often not prepared
College students with food allergies aren't avoiding the foods they know they shouldn't eat. Students of all ages are not treated with potentially life-saving epinephrine as often as they should be. And instructors, roommates and friends often are not aware of what to do if a food-allergic student has a reaction.
Most generalists reluctant to provide primary care for young adults with chronic illness
The majority of general internists and pediatricians in the United States are not comfortable serving as primary care providers for young adults with complex chronic illnesses that originate during childhood, according to findings from a new national survey.
New research on pre-eclampsia in mice may have important implications for humans
In a new March of Dimes-funded study of pre-eclampsia, a serious and potentially deadly disorder that affects about 5 percent of pregnancies, researchers have found results in mice that may have important implications for diagnosis and treatment in humans.
Scientists identify how gastric reflux may trigger asthma
Researchers at Duke University Medical Center appear to have solved at least a piece of a puzzle that has mystified physicians for years: why so many patients with asthma also suffer from GERD, or gastroesophageal reflux disease.
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