Hurdles on the way to the diagnosis of asthma and successful therapy.

There are many potential hurdles, obviously at the forefront of patient care which may impede the correct and early diagnosis of asthma, as well as successful, appropriate treatment. Although the illness is often accompanied by many typical signs which may enable a rapid diagnosis, these are often overlooked or misinterpreted. Symptoms may not be recognised or confused with others, such as respiratory infections, and inappropriate diagnostic tests used.

Comparative evaluation of the immunogenicity of combined hepatitis A and B vaccine by a prospective and retrospective trial.

In the past, immunogenicity of hepatitis A and B vaccines needed to be questioned in persons of advanced age, especially in those of 40 years and older. We performed a comparative multicenter prospective and retrospective study with the combined hepatitis A and B vaccine Twinrix to identify factors influencing the results of the vaccination in a population of all age groups. Out of 489 subjects enrolled, 241 were vaccinated in a prospective study (group 1) and 248 subjects in a retrospective study (group 2) in 17 German centers with median age of 40.

International Primary Care Respiratory Group (IPCRG) Guidelines: diagnosis of respiratory diseases in primary care.

This Diagnosis paper constitutes the second of the IPCRG Guideline papers on the management of chronic respiratory diseases in primary care. Primary care health professionals are usually the first point of contact for patients who can present a wide range of initial symptoms which may or may not constitute their first presentation of a chronic disease such as asthma, COPD, or rhinitis. This paper is focussed upon the early identification and diagnosis of chronic respiratory diseases in primary care.

Symptom-based questionnaire for identifying COPD in smokers.

Background: Symptom-based questionnaires may enhance chronic obstructive pulmonary disease (COPD) screening in primary care.

Objectives: We prospectively tested questions to help identify COPD among smokers without prior history of lung disease.

Methods: Subjects were recruited via random mailing to primary care practices in Aberdeen, UK, and Denver, Colo.

Symptom-based questionnaire for differentiating COPD and asthma.

Background: Many patients with obstructive lung disease (OLD) carry an inaccurate diagnostic label. Symptom-based questionnaires could identify persons likely to need spirometry.

Objectives: We prospectively tested questions derived from a comprehensive literature review and an international Delphi panel to help identify chronic OLD (COPD) in persons with prior evidence of OLD.