The Journal of asthma : official journal of the Association for the Care of Asthma
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The last half-century has seen substantial changes in asthma treatment and care. We investigated whether arterial blood gas parameters in acute and non-acute asthma have changed historically. ⋯ In studies of habitual-state asthma, mean reported P(aO2) and P(aCO2) levels were found to have increased since 1967. In acute asthma studies, mean P(aO2) and P(aCO2) were associated with mean FEV1% but not with either publication year or patient age.
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To examine the association between numbers of primary care provider (PCP) visits for asthma monitoring (AM) over time and acute asthma visits in the emergency department (ED) and at the PCP for Medicaid-insured children. ⋯ Asthma monitoring visits and documented controller medication for these urban Medicaid-insured children occurred infrequently over 3 years, and having more asthma monitoring visits was not associated with fewer ED or PCP acute asthma visits.
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Inhaled corticosteroids (ICS) are underutilized among persistent asthmatics. Because of low outpatient follow-up rates after Emergency Department (ED) visits, children are unlikely to be prescribed ICS by their primary care physician after an acute exacerbation. ED physicians have the opportunity to contribute to the delivery of preventive care in the acute care setting. Our objective was to evaluate if quality improvement (QI) methods could improve the rate of ICS initiation at ED discharge. ⋯ This study demonstrates that QI methods can be used to increase inhaled corticosteroid initiation rate at the time of ED discharge and, thus, improve the delivery of preventive asthma care in the acute care setting.
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The goals of this study are to identify factors associated with ordering of chest radiographs (CXR's) in children hospitalized with acute asthma exacerbations and determine the overall clinical impact of these CXR's. ⋯ The majority of CXR's ordered in pediatric inpatients with asthma exacerbation do not provide clinically relevant information.
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Increases in asthma and obesity over the past three decades have led to speculation about a causal link between the two diseases. However, investigations of the relationship between body mass index (BMI) and fractional exhaled nitric oxide (FeNO) - a marker of eosinophilic airway inflammation - have produced mixed results. The purpose of this study was to evaluate the relationship between body mass index (BMI), asthma and FeNO in a sample of U.S. adults using data from the National Health and Nutrition Examination Surveys (NHANES) for 2007-2010. ⋯ Our results suggest that in the U.S. adult population, BMI is not associated with eosinophilic airway inflammation.