Spontaneous tonsillar hemorrhage.
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Biomedical subjects
Publications and source records attributed to V Kumra.
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Asthma continues to be a challenging disease to treat in both the inpatient and outpatient settings. The growing database on therapeutic interventions at the time of transition from the acute to chronic phase of this disease is encouraging. Glucocorticoids and inhaled beta-agonists clearly reduce readmission and relapse. Other medications and educational interventions also appear effective. Still, no true discharge guidelines have been established. Multiple statements by consensus panels have recommended using FEV1 or PEFR as indicators of readiness for discharge, but this has not been prospectively validated from either the emergency department or inpatient setting. In contrast, some studies argue that pulmonary functions do not accurately predict relapse and readmission, so the usefulness of these discharge recommendations is debatable. Large studies, especially in the adult asthmatic population, are needed to validate these recommendation.
Numerous epidemiological studies have linked tobacco use with a wide variety of diseases. Strong government-supported anti-smoking campaigns have decreased the prevalence of smoking in many developed countries, including the United States. However, it remains a major public health pariah. In developing countries, such as China, cigarette smoking and other forms of tobacco use continue to increase. If unchecked this will eventually lead to 10 million deaths per year worldwide. Even in the United States, the prevalence of smoking is rising in crucial population groups such as adolescents. Recent advances have made physicians more able to help patients quit smoking, but organized campaigns must be further strengthened to prevent the initiation of tobacco use, especially in the young.