Biomedical subjects

Teal S Hallstrand

Publications and source records attributed to Teal S Hallstrand.

3 recordsLinked to original sources

PubMed2002

Leukotriene modifiers.

Leukotrienes (LTs) are 5-lipoxygenase products formed from arachidonic acid metabolism. There is compelling evidence that LTs play an important role in the pathogenesis of asthma. LTs affect vascular permeability, mucus production, and smooth muscle constriction, and may contribute to airway remodeling. In mild-to-moderate asthma, LT modifiers improve measures of airflow limitation and quality of life and reduce the frequency of asthma exacerbations and the need for short-acting bronchodilator therapy. In moderate-to-severe asthma, an LT modifier in combination with an inhaled corticosteroid results in improvements in lung function and asthma control over that achieved with an inhaled corticosteroid alone. LT modifiers are effective in the treatment of exercise-induced bronchoconstriction and aspirin-induced asthma. There are few adverse effects of LT modifiers.

Asthma↗

PubMed2002

Effectiveness of screening examinations to detect unrecognized exercise-induced bronchoconstriction.

OBJECTIVE: To determine if a physician-administered physical examination and screening questionnaire accurately detects exercise-induced bronchoconstriction (EIB) in adolescent athletes. STUDY DESIGN: Cross-sectional study of 256 adolescents participating in organized sports from 3 suburban high schools. The number of persons screened positive for EIB by physical examination and questionnaire was compared with the number of persons with EIB diagnosed by a "gold standard" test that consisted of a 7-minute exercise challenge followed by serial spirometry. RESULTS: We diagnosed EIB in 9.4% of adolescent athletes. The screening history identified persons with symptoms or a previous diagnosis suggestive of EIB in 39.5% of the participants, but only 12.9% of these persons actually had EIB. Among adolescents with a negative review of symptoms of asthma or EIB, 7.8% had EIB. Among adolescents with no previous diagnosis of asthma, allergic rhinitis, or EIB, 7.2% had EIB diagnosed by exercise challenge. Persons who screened negative on all questions about symptoms or history of asthma, EIB, and allergic rhinitis accounted for 45.8% of the adolescents with EIB. CONCLUSIONS: EIB occurs frequently in adolescent athletes, and screening by physical examination and medical history does not accurately detect it.

Adolescent↗

PubMed2002

Practical management of acute asthma in adults.

All asthma patients are at risk for acute asthma exacerbations. Moderate to severe exacerbations account for many emergency department visits and subsequent hospitalizations each year. Recent studies have advanced our understanding of the pathogenesis and treatment of acute asthma. The purpose of this review is to provide practical guidance in the assessment and treatment of adults with acute asthma in the hospital setting. Managing patients with acute asthma involves assessing the severity of the exacerbation, implementing measures to rapidly reverse airflow limitation, and instituting therapies that limit the progression of airway inflammation. Some patients may benefit from other supportive measures such as heliox and noninvasive ventilation. If the patient continues to deteriorate and requires mechanical ventilation, then ventilator settings that minimize the risk of hyperinflation should be chosen. After an episode of acute asthma, long-term preventive medications, especially inhaled corticosteroids, should be prescribed and education should be provided to prevent future episodes.

Acute Disease↗