The Journal of asthma : official journal of the Association for the Care of Asthma
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Management of asthma in emergency departments (ED) has been well documented to be deficient over many years, despite national and international guidelines. This review summarizes the effect of ED protocols aimed at improving the assessment and treatment of asthma in the ED. ⋯ A small number of protocols with the specific aims of reducing the length of stay in the ED as well as rates of hospital admission and return visits were effective. Persistent education of ED staff regarding protocols based on current management guidelines and adoption of easy-to-use forms can facilitate improved care of patients with asthma in the ED.
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This study investigated whether self-reported damage, dust, and odors in homes near the World Trade Center (WTC) after September 11, 2001, were related to increased rates of respiratory symptoms among residents and if multiple sources of exposure were associated with greater health risk. We mailed questionnaires to homes within 1.5 km of the WTC site (affected area) and in upper Manhattan (control area). Surveys asked about respiratory symptoms, unplanned medical visits, physician diagnoses, medication use, and conditions in the home after 9/11. ⋯ Residents reporting longer duration of dust/odors or multiple sources of exposure had greater risk for symptoms compared to those reporting shorter duration and fewer sources. These data suggest that WTC-related contamination in the home after 9/11 was associated with new and persistent respiratory symptoms among residents living near the site. While we cannot eliminate potential biases related to self-reported data, we took strategies to minimize their impact, and the observed effects are biologically plausible.
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We compared asthma prevalence among New York City Hispanics-Puerto Rican, Dominican, and other Hispanics-in relation to nativity, socioeconomic status, and asthma risk factors. ⋯ Puerto Ricans, both mainland- and native-born, report the highest rates of adult asthma. Non-US-born Hispanics report lower rates. Acculturation and patterns of residential settlement may account for this variation.