Meeta Prasad Kerlin, MD, MSCE
CME Objective: To review current evidence for diagnosis, treatment, and practice improvement of asthma.
Funding Source: American College of Physicians.
Disclosures: Dr. Kerlin, ACP Contributing Author, has disclosed no conflicts of interest. Disclosures can also be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-0862.
Editors' Disclosures: Christine Laine, MD, MPH, Editor in Chief, reports that she has no financial relationships or interests to disclose. Darren B. Taichman, MD, PhD, Executive Deputy Editor, reports that he has no financial relationships or interests to disclose. Cynthia D. Mulrow, MD, MSc, Senior Deputy Editor, reports that she has no relationships or interests to disclose. Deborah Cotton, MD, MPH, Deputy Editor, reports that she has no financial relationships or interest to disclose. Jaya K. Rao, MD, MHS, Deputy Editor, reports that she has stock holdings/options in Eli Lilly and Pfizer. Sankey V. Williams, MD, Deputy Editor, reports that he has no financial relationships or interests to disclose. Catharine B. Stack, PhD, MS, Deputy Editor for Statistics, reports that she has stock holdings in Pfizer.
With the assistance of additional physician writers, Annals of Internal Medicine editors develop In the Clinic using resources of the American College of Physicians, including ACP Smart Medicine and MKSAP (Medical Knowledge and Self-Assessment Program).
Prasad Kerlin M. Asthma. Ann Intern Med. 2014;160:ITC3-1. doi: 10.7326/0003-4819-160-5-201403040-01003
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Published: Ann Intern Med. 2014;160(5):ITC3-1.
Asthma is a common respiratory illness characterized by airway hyperresponsiveness and inflammation. It affects over 300 million people globally (1), including 22 million adults in the United States alone. Although asthma mortality in the United States has declined, the morbidity and costs remain substantial. In certain groups of Americans, such as persons of lower socioeconomic status and minority ethnicity, asthma morbidity and mortality are disproportionately high. Such trends are surprising, given the improvement in air quality in the United States and the availability of effective therapies.
Symptoms that should prompt clinicians to consider asthma are episodic wheezing, dyspnea, cough, difficulty taking a deep breath, and chest tightness (2, 3). A careful history to elicit the nature and timing of symptoms is paramount in diagnosing asthma. Characteristically, asthma symptoms are intermittent and may remit spontaneously or with use of short-acting bronchodilators. Symptoms often vary seasonally or are associated with specific triggers, such as cold, exercise, animal dander, pollen, occupational exposures, certain foods, and aspirin or nonsteroidal anti-inflammatory drugs. Clinicians should also consider asthma in patients with chronic cough, especially if it is nocturnal, seasonal, or related to the workplace or a specific activity.
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Pulmonary/Critical Care, Asthma.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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