Childhood asthma. Balancing efficacy and adherence for optimum management.

In the United States, asthma is the most common cause of school absences due to chronic illness, and its incidence in the pediatric population is increasing. Although most cases of childhood asthma can be controlled with recently available medications, there is often a gap between the goal of optimal control and the actual persistence of symptoms. In this article, Dr Sveum explores one approach to the most advantageous management of childhood asthma-an approach that weighs the advantage of a higher rate of medication adherence in practice against greater medication efficacy in clinical trials.

Validation of an asthma symptom diary for interventional studies.

Objective: The Pediatric Asthma Diary was developed and validated to assess efficacy of interventions in children with asthma.

Design, Patients, And Setting: Diary validation was performed in a three week, prospective study of 106 children aged 6-14 years with asthma. Children were classified at baseline as either stable (requiring no additional asthma treatment) or new onset/worse (requiring either addition of or increase in anti-inflammatory treatment).

Urticaria. The diagnostic challenge of hives.

Hives pose a diagnostic challenge to physicians. With an acute episode, a careful look for possible triggers and relief of symptoms with H1 antihistamines are usually sufficient. For both urticaria and angioedema, the most helpful diagnostic tool may be a carefully taken medical history, including a family history.

Evaluation of the Autohaler actuator: the effect of written patient instructions on correct use.

The Autohaler actuator is a breath-actuated device designed by 3M Pharmaceuticals. The objective of this study was to measure and improve the effectiveness of the device's package insert instructions (PII). Using only the PII for guidance, 5 of 20 (25%) subjects failed to trigger the device.