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Comparison of asthma control criteria: importance of spirometry.

AIMS: To compare the measurements of asthma control using Canadian Thoracic Society (CTS) Asthma Management Consensus Summary and Global Initiative for Asthma (GINA) guidelines composite indices with and without spirometry.

METHODS: Asthma control parameters were extracted from electronic medical records (EMRs) of patients ≥6 years old at two primary care sites. Asthma control ratings calculated according to CTS and GINA criteria were compared.

RESULTS: Data were available from 113 visits by 93 patients, aged 6-85 years (38.7 ± 24.8; mean ± SD). The proportion of visits at which individuals' asthma was completely controlled was 22.1% for CTS symptoms only and 9.7% for CTS with spirometry (p < .01); and 17.7% versus 14.1% for GINA symptoms only versus symptoms with spirometry (p = .125).

CONCLUSIONS: Asthma control ratings using GINA and CTS criteria are discordant in more than half of the patients deemed "in control" by at least one scale. Differences in the spirometry criterion threshold are primarily responsible for this discordance. Failure to include spirometry as part of the control index consistently overestimates asthma control and may underestimate future risk of exacerbations.

Relationship between exercise-induced bronchospasm (EIB) and asthma control test (ACT) in asthmatic children.

OBJECTIVE: Evaluate the relationship between Asthma Control Test™ (ACT) and exercise-induced bronchospasm (EIB) in 81 asthmatic children.

METHODS: EIB was assessed in every patient by Balke protocol and asthma control was evaluated by ACT. Patients were divided into three groups: Group A (30 patients) with complete asthma control (ACT score = 25), Group B (37 patients) with partial asthma control (ACT score = 21-24), and Group C (14 patients) with poor asthma control (ACT score < 20).

RESULTS: About 36% (11/30) of patients in Group A (with complete asthma control) tested positive for EIB, whereas 21% (8/37) in Group B (with partial asthma control) and 28% (4/14) in Group C (with poor asthma control) exhibited EIB. The percentage of positive EIB was very similar between the three groups with no differences between controlled, partially controlled, and uncontrolled asthma. Statistical evaluation by χ(2)-test between complete (ACT score = 25) and not complete asthma control (ACT score < 24) confirmed a statistically significant difference (p < .01) between the obtained data.

CONCLUSIONS: It must be stated that ACT alone is not sufficient to evaluate asthma control in children correctly because it fails to detect EIB in a significant percentage of subjects.

Gastroesophageal Reflux Disease (GERD)

Title: Gastroesophageal Reflux Disease (GERD)Category: Diseases and ConditionsCreated: 12/31/1997Last Editorial Review: 12/23/2011 (Source: MedicineNet Asthma General)

The association of low bone mineral density with systemic inflammation in clinically stable COPD

Chronic obstructive pulmonary disease (COPD) is known to be a systemic inflammatory disease which affects the function of many organs, and the low bone mineral density (BMD) may be the result of systemic inflammation.

The aim of the present study was to explore the association of BMD with systemic inflammation in patients with clinically stable COPD. BMD and inflammatory markers, including C-reactive protein, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6), were determined in all the recruited patients with clinically stable COPD. The patients were classified according to T scores, and the relationship between BMD with markers of systemic inflammation and that with other osteoporosis risk factors was assessed. There were no differences in age, femal...

How I Use It: iGoogle, RSS feeds and aggregators

GraphicWould not it be useful if you could pull relevant information of interest to you from the Internet rather than being bombarded with a wide variety of material, varying in usefulness? RSS (RDF Site Summary also known as Really Simple Syndication or Rich Site Summary) allows you to tailor the display of up-to-date web-based content to your needs on one site. This allows you to become much more efficient in harnessing the Internet rather than visiting separate sites to review new information.

Many different sites syndicate their content as an RSS feed and this can be displayed using an RSS reader or aggregator. Once you have set-up a reader, all you then need to do is identify sites that syndicate their content. This is often indicated by the symbol below. Although this can take a little time to set up, it does save significant amounts of time later and allows you to regularly check for updates on your favourite sites very quickly. If you then want more detailed information, you can click on the headline displayed in the RSS feed to take you to the page from which the feed is generated.

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