The goal of new National Institutes of Health guidelines is a reduction in
the number of asthma attacks and hospitalizations nationwide.
Asthma affects 22 million Americans including 6.5 million children. More
than 500,000 people are hospitalized each year. Attacks often occur
after a patient is exposed to the common cold, which can trigger an
The NIH stresses the need to monitor and
assess patients for long-term risks by testing for declines in lung
function. It also recommends short checklists for patients and doctors
that ask about medication use, frequency of attacks, and whether sleep
has been impaired by coughing or shortness of breath.
Guidelines call for a low-dose inhaled corticosteroid, which is
particularly effective in children, plus a rescue medication to manage
In patients 12 and older whose asthma is not
controlled by corticosteroids, there are long-lasting beta-agonists such
as Serevent from GlaxoSmithKline and Foradil by Schering-Plough.
Drugs such as GlaxoSmithKline's Advair and AstraZeneca's Symbicort
contain both a long-acting beta-agonist and a corticosteroid.
Last year, the Food and Drug Administration required all long-lasting
beta-agonists to include a warning label saying the drugs could cause
severe or fatal attacks in some patients.
guidelines also approve Genentech's Zolair to treat asthma-related
allergies not controlled by inhaled steroids.
TB treatment time shortened
A Johns Hopkins University report indicates that
adding the antibiotic moxifloxacin to the usual TB drugs shortens the
treatment time needed to cure TB from six months to four.
The Bill and Melinda Gates Foundation announced $280 million in grants
to develop TB vaccines, tests, and drugs.
announcements were made at the recent American Society for Microbiology
Breakfast health benefit
Eating a whole-grain breakfast seven times a week has
been associated with a 28 percent lower risk of heart failure, according
to statistics from the Physicians Health Study. Researchers analyzed
data from 1982 through 2006 on 21,410 male physicians at an average age
of 53.7 years.
Eating whole-grain cereal less often
also had heart-health benefits. The risk of heart failure decreased by
22 percent in those who ate it two to six times per week and by 14
percent in those who ate whole grain cereal once per week.
Technology aids diagnoses
To make a diagnosis, doctors match a patient's
symptoms against the patterns of several likely diseases, narrowing down
the list as they go, according to Lawrence Weed, professor emeritus of
medicine at the University of Vermont. He says the process involves
juggling a great deal of information and relying on memory to come to a
Weed developed Problem Knowledge Couplers,
a technology that couples symptoms with relevant medical literature.
Patients can enter their symptoms and walk through the diagnosis with
the doctor. About 50 private employers provide access to Couplers.
A web-based program called "Isabel" ($750) allows doctors at hospitals
to enter symptoms in complicated cases. The American Medical Informatics
Association reports growing interest in such programs.
Suspect a heart attack?
Call an ambulance! Only half of all people having a
heart attack call 911, says the American Heart Association.
Going to the hospital by car can be a fatal mistake.
About 5 percent of heart attack victims suffer cardiac arrest en route
to a hospital. If not revived within minutes, survival is unlikely.
Ambulances are equipped with gear to spark the heart
back into rhythm. Call your doctor later. Dial 911 first.