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Spirometry for adults with a diagnosis of asthma or COPD

 

Abstract (provisional)
Background
Objective measurement of airflow obstruction by spirometry is an essential part of the diagnosis of asthma or COPD. During exacerbations, the feasibility and utility of spirometry to confirm the diagnosis of asthma or chronic obstructive pulmonary disease (COPD) are unclear. Addressing these gaps in knowledge may help define the need for confirmatory testing in clinical care and quality improvement efforts. This study was designed to determine the feasibility of spirometry and to determine its utility to confirm the diagnosis in patients hospitalized with a physician diagnosis of asthma or COPD exacerbation.
 
Methods
Multi-center study of four academic healthcare institutions. Spirometry was performed in 113 adults admitted to general medicine wards with a physician diagnosis of asthma or COPD exacerbation. Two board-certified pulmonologists evaluated the spirometry tracings to determine the proportion of patients able to produce adequate quality spirometry data. Findings were interpreted to evaluate the utility of spirometry to confirm the presence of obstructive lung disease, according to the 2005 European Respiratory Society/American Thoracic Society recommendations.
 
For more on this, read the article here.
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Urban pollution contribute to children's asthma

 

California's effort to reverse urban sprawl and encourage denser development may mean more children will live closer to polluted high-traffic areas. A new study estimates that near-road air pollution is at least partially responsible for 8 percent of childhood asthma cases in Los Angeles County. The authors reported that their findings "suggest that there are large and previously unappreciated public health consequences of air pollution" in metropolitan areas and that "compact urban development strategies should be coupled with policies to reduce near-roadway pollution exposure."
 
Read more about the connection between pollution and the asthma connection here.
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Advair: How Safe is it?

 

The 2001 product launch of the asthma drug Advair (fluticasone/salmeterol) was a lavish, Las Vegas affair.

Using images of a slot machine to illustrate their message, top GlaxoSmithKline executives took the stage in front of thousands of assembled sales reps. "There are people in this room who are going to make an ungodly sum of money selling Advair," one executive told the group.

He was right.

The Serious Business of Asthma

Millions of people with asthma, including many children, have gone on the drug and, according to data from IMS, Advair sales have exceeded $4 billion every year since 2007.

Yet even as profits mounted evidence began to emerge from independent medical studies and court records suggesting that the drug can be dangerous, especially to children and that overuse of the drug exacerbated the danger.

Asthma is not a benign condition.

To continue reading about this condition, visit the article here on Medpage.

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Children With Allergies and Steroid Use

Drug experts have warned parents and healthcare professionals to double-check if children with allergic conditions such as asthma and hayfever are being over-prescribed corticosteroids. The warning follows research unveiled at the British Pharmaceutical Conference (BPC) in Manchester revealing that many children with multiple allergic conditions such as asthma, eczema and hayfever may be exposed to high, cumulative doses of corticosteroids through co-prescribing of steroid preparations for different conditions.

Asthma and hayfever are common conditions in children for which long-term inhaled or nasal corticosteroids may be prescribed. Some children with severe conditions may receive both, resulting in high doses of steroids and increased risk of adverse effects.
 
Read more about this topic on Respiratory Scholar.
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Our New eCommerce Website for Doctors and Their Practice

LEWISTON, ME – 11-13-2012 — MD Spiro a Micro Direct company proudly announces the launch of their new spirometry eCommerce website platform for doctors and their practice.  MD Spiro specializes in the sale and support of pulmonary diagnostic medical device products and can now sell direct to a doctor’s practice any time of the day.  The website is designed to help doctors understand the importance of incorporating spirometry into their practice to help diagnose and treat patients that may suffer from Chronic Obstructive Pulmonary Disease (COPD), asthma, and other chronic conditions that affect breathing.

Spirometry may also be used periodically to check how well your lungs are working once the patient has been treated for a chronic lung condition.  The importance of being able to measure how a patient’s lungs are functioning is crucial in the care of patients with breathing conditions and allergies.

Pulmonary lung function testing has grown as an industry in sports medicine and general practice across the world.  It is good medicine to correctly diagnose and treat patients more accurately and effectively in the convenience of a doctor’s office.  MD Spiro sells easy-to-use desktop, handheld, and pocket spirometers, peak flow meters, calibration equipment, and the disposable products that support the equipment.

“Without the proper equipment in your doctor’s office, you cannot correctly and effectively treat your patient.  We feel that it is crucial for our products to be in every doctor’s office and to teach doctors and patients alike about the importance of spirometry in medical practice,” said David Staszak, Owner and CEO of MD Spiro and Micro Direct.

For more information about MD Spiro and their parent organization, Micro Direct, please visit their website at www.mdspiro.com.

About MD Spiro

MD Spiro was established in 1993.  MD Spiro offers medical devices from the pulmonary diagnostic field that helps to evaluate and diagnose the patients they treat. Their sales and support staff have over 100 years of combined experience in the medical equipment industry.  The staff is ready to advise customers on the best products for their practice.  They pride themselves on being available for their customers after the sale to provide technical support on equipment operation, proper patient testing techniques and third party insurance billing. 

 

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Spirometry in Primary Care: Airway Obstruction in Smokers

BACKGROUND:

Diagnosis of chronic obstructive pulmonary disease (COPD) and its severity determination is based on spirometry. The quality of spirometry is crucial.

OBJECTIVES:

Our aim was to assess the quality of spirometry performed using a spirometer with automated feedback and quality control in a general practice setting in Switzerland and to determine the prevalence of airflow limitation in smokers aged > or =40 years.

METHOD:

Current smokers > or =40 years of age were consecutively recruited for spirometry testing by general practitioners. General practitioners received spirometry training and were provided with an EasyOne spirometer. Spirometry tests were assigned a quality grade from A to D and F, based on the criteria of the National Lung Health Education Program. Only spirometry tests graded A-C (reproducible measurements) were included in the analysis of airflow limitation.

RESULTS:

A total of 29,817 spirometries were analyzed. Quality grades A-D and F were assigned to 33.9, 7.1, 19.4, 27.8 and 11.8% of spirometries, respectively. 95% required < or =5 trials to achieve spirometries assigned grade A. The prevalence of mild, moderate, severe and very severe airway obstruction in individuals with spirometries graded A-C was 6, 15, 5 and 1%, respectively.

CONCLUSION:

Spirometries in general practice are of acceptable quality with reproducible spirometry in 60% of measurements. Airway obstruction was found in 27% of current smokers aged > or =40 years. Office spirometry provides a simple and quick means of detecting airflow limitation, allowing earlier diagnosis and intervention in many patients with early COPD.

 

http://www.ceb-institute.org/fileadmin/upload/refman/Respiration_2009_1_Leuppi.pdf

Respiration. 2010;79(6):469-74. Epub 2009 Sep 26.

Quality of spirometry in primary care for case finding of airway obstruction in smokers.

Leuppi JD, Miedinger D, Chhajed PN, Buess C, Schafroth S, Bucher HC, Tamm M.

Source:

Clinic for Pneumology, University Hospital, Basel, Switzerland

 

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Push for a spirometer in every doctor's office?

Professional societies have encouraged primary care providers to conduct spirometry testing for the detection of chronic obstructive pulmonary disease (COPD). In spite of this effort, the success rate is unacceptably low. Simple flow-sensing spirometers have technical flaws that can cause misreadings, and they are rarely checked for accuracy. When spirometry is performed by an experienced technologist, and when payment is made on the criterion of quality, the success rate for adults and school-aged children can be as high as 90%. But testing remains a challenge for younger children and the elderly. Regular feedback for the technologist about their testing results is essential. Even with an accurate spirometer, an able patient, and a skilled technologist, the ordering physician may wrongly interpret the data. Use of spirometry in primary care will continue to be problematic unless high quality testing is tied to reimbursement. Using FEV(1) or peak flow measurements to rule out airway abnormality in the majority of patients, followed by referral for more sophisticated studies in those remaining, may be the best approach. Respiratory therapists should engage in this effort.

http://www.ncbi.nlm.nih.gov/pubmed/22222133   PMID:   22222133   [PubMed - indexed for MEDLINE]  
Respiratory Science Center, College of Medicine, University of Arizona, Tucson, USA

 

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