All that Wheezes is not Asthma or Bronchiolitis.

Wheezing is a common finding across patients of all age groups presenting to the emergency department and being hospitalized for respiratory distress, with most patients responding to standard therapeutics and having readily apparent diagnoses of asthma or bronchiolitis. We describe several clinical entities that may present with wheezing and respiratory distress, calling attention to the broad differential that may masquerade as asthma or bronchiolitis, and potentially lead to misdiagnosis, delayed diagnosis, or inappropriate treatment.

Assessment and feedback methods in competency-based medical education.

Graduate and continuing medical education programs have transitioned to a competency-based medical education model, in which abilities necessary for the practice of medicine, called competencies, are defined as learning outcomes. Each competency contains milestones that describe stages of development from novice to master and provide criteria for assessing learners along this continuum. Assessments in competency-based medical education are formative and are intended to assist learners in achieving the next stage in mastery rather than render a final evaluation.

The effects of beta-lactam allergy relabeling on antibiotic prescribing practices.

Background: Beta-lactam antibiotic allergy labels are highly prevalent but rarely indicate an allergic intolerance. These patient-reported allergies lead to broad-spectrum antibiotic use, conferred resistance, increased expense, and adverse effects.

Objective: To implement and assess the impact of a history-based clinical guideline that directs antibiotic management and beta-lactam allergy relabeling for patients reporting beta-lactam allergies.

Nasal airway obstruction: allergy and otolaryngology perspectives.

Background: Diagnostic test preferences and management strategies for nasal airway obstruction (NAO) may vary depending on medical specialty.

Objective: To discern current attitudes and practices of different medical specialties regarding diagnostic and management strategies for patients with NAO.

Methods: Cross-sectional survey of all practicing otolaryngologists and medical allergists in Wisconsin and parts of northern Illinois (N = 268).

Anaphylaxis: drug allergy, insect stings, and latex.

The highest rates of anaphylaxis in humans occur in early childhood associated with food allergy. Latex allergy, pharmaceutical drugs, and stinging insect reactions are important later in childhood, with drug allergy peaking in adult populations. Knowledge about diagnosis and therapy of anaphylaxis is critical, because a large percentage of subjects are not previously known to be at risk at the time of initial reactions.

Latex hypersensitivity in Department of Veterans Affairs health care workers: glove use, symptoms, and sensitization.

Background: This report of the prevalence of latex glove allergy in 3 Department of Veterans Affairs (VA) medical centers was a collaboration of the VA, the Centers for Disease Control and Prevention, and the National Institute for Occupational Safety and Health.

Objective: To enroll and evaluate personnel from across the entire hospital workforce for latex hypersensitivity and to determine the type and extent of latex glove use.

Methods: A questionnaire was administered that covered demographics, job category, latex glove use, and current latex glove allergic symptoms.

The treatment of allergic bronchopulmonary aspergillosis.

Allergic bronchopulmonary aspergillosis (ABPA) is a disease characterized by asthma, peripheral eosinophilia, pulmonary infiltrates, hypersensitivity to Aspergillus fumigatus and bronchiectasis. The treatment of ABPA depends on the stage of the disease, and includes following clinical symptoms, serum IgE levels, pulmonary function tests, and chest radiographs. This review covers the current treatment options for ABPA.