The Journal of asthma : official journal of the Association for the Care of Asthma
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To identify patient characteristics associated with nocturnal emergency department (ED) visits for asthma. ⋯ Higher odds of nocturnal visits in men suggest the existence of gender-differences in health-seeking behavior in asthmatics. Although nocturnal visits are associated with more severe asthma, they do not lead to higher return rates.
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The hypothesis was that asthmatics might experience impaired perception of dyspnea and salbutamol-induced reversibility during unlimited airway narrowing. A total of 38 asthmatics (18 to 59 years of age) were examined. All patients underwent the methacholine challenge test. ⋯ Salbutamol-induced reversibility was significantly lower in the UAN group (81 +/- 1.4 % of baseline FEV1) compared with patients from the RP group (91 +/- 1.1% of baseline FEV1; p < 0.001). In conclusion, asthmatics during methacholine-induced unlimited airway narrowing exhibit diminished perception of dyspnea and lower bronchial reversibility to the baseline 20 minutes after inhalation of salbutamol. This suggests that more careful monitoring of the lung function for timely recognition of asthma deteriorations and adequate bronchodilatory therapy during severe acute attacks should be recommended for such patients.
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Comparative Study
Looking beyond urban/rural differences: emergency department utilization by asthmatic children.
Asthma causes pediatric morbidity throughout the US with substantial regional variability. Emergency department (ED) utilization data were studied to determine if geographic variability of pediatric asthma cases exists within a state. ⋯ While Baltimore City had the highest rates of asthma visits, adjusted odds ratios identified the wealthiest suburban county to have a higher risk of an asthma ED visit. Children from rural counties, for the most part, had fewer ED asthma visits than children from urban and suburban counties.
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Over 20 million Americans are affected with asthma. Many will require some type of surgical procedure during which their asthma management should be optimized. ⋯ The use of corticosteroids has not been shown to adversely affect wound healing or increase the rate of infections postoperatively. Preoperative systemic corticosteroids may be used safely in the majority of patients to decrease asthma-related morbidity.
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Comparative Study
Is fetal gender associated with emergency department visits for asthma during pregnancy?
To investigate if fetal gender (1) affects the risk of having an emergency department (ED) visit for asthma; and (2) is associated with adverse pregnancy outcomes among women who had at least one visit to the ED for asthma during pregnancy. ⋯ Fetal gender does not affect the risk of having an ED visit for asthma during pregnancy, and it is not associated with adverse pregnancy outcomes among women who had an asthma-related ED during pregnancy.