Update in Pulmonary Medicine
- Michael S. Niederman, MD; and
- Stephen P. Peters, MD
- From State University of New York at Stony Brook, Stony Brook, New York, and Jefferson Medical College, Philadelphia, Pennsylvania. Requests for Reprints: Michael S. Niederman, MD, Pulmonary and Critical Care Medicine, Winthrop-University Hospital, 222 Station Plaza North, Suite 400, Mineola, NY 11501. Current Author Addresses: Dr. Niederman: Pulmonary and Critical Care Medicine, Winthrop-University Hospital, 222 Station Plaza North, Suite 400, Mineola, NY 11501.
Asthma and pneumonia received much attention in clinical research published in 1996. Asthma studies focused on the optimal use of β-adrenergic agents, inhaled steroids, and leukotriene-inhibiting drugs. Studies of chronic obstructive pulmonary disease focused on the mechanisms of benefit from lung volume reduction surgery. Systematic reviews and large population studies provided more insight into community-acquired pneumonia. Finally, carefully developed guidelines for the management of hospital-acquired pneumonia were published.
Asthma
Asthma affects about 5% to 7% of Americans. Research on this common illness is aimed at finding the optimal treatment regimen for mild asthma and for determining the best approach to treating patients who show a less than ideal response to inhaled steroid therapy.
As-Needed Albuterol Was Effective in Mild Asthma
Drazen JM, Israel E, Boushey HA, Chinchilli VM, Fahy JV, Fish JE, et al. Comparison of regularly scheduled with as-needed use of albuterol in mild asthma. Asthma Clinical Research Network. N Engl J Med. 1996; 335:841-7.
About 70% of patients with asthma have a relatively mild form of the disease, but they often have chronic symptoms as well. Should such patients be treated only with inhaled β-agonist drugs, or should they also receive anti-inflammatory therapy? Studies of this question are in progress in the Childhood Asthma Management Project, a trial supported by the National Institutes of Health. However, if β-agonist monotherapy is favored, the next question is whether it should be used regularly or only as needed to relieve symptoms. This question is important because several studies have suggested that regular use of β-agonists may be associated with adverse asthma control [1].
The Asthma Clinical Research Network is a six-center research group set up by the National Heart, Lung, and Blood Institute to investigate important questions in asthma. In the first study done by this group, Drazen and colleagues compared the effects of regularly scheduled inhaled albuterol …
This 100-word excerpt has been provided in the absence of an abstract.
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