Talk:Asthma

/Archive 1

New treatments for Asthma, Bronchial Thermoplasty

Bronchial Thermoplasty is an experimental treatment for asthma where heat (149 degrees or about the temperature of a cup of coffee) created by radio frequency waves, is applied to small- and medium-sized bronchial tubes, reducing the amount of smooth muscle in that area. So far, the treatment appears promising and well-tolerated by patients. Trials appear to have dramatic benefits for those patients with the most severe asthma.(104)

loaded with references http://www.respology.com/CEUs/AsthmaPastPresentandFuture3.aspx

perhaps add this new treatment? I see patients are having results with it....

207.106.86.85 (talk) —Preceding undated comment was added at 20:16, 11 December 2008 (UTC).

I thought this was an encyclopedia

Anonywiki added a number of extremely dubious, inflammatory, and completely unsupported statements to the Buteyko section of this article, including "The mainstream medical community regards the practice as extremely dangerous and it is frowned upon hugely." I removed these, because unsubstantiated claims like that have no place in an encyclopedia.

Orangemike then reverted my deletion, saying that I should request a citation first! Well, I have seen "citation needed" tags in a number of articles, and some sit there for months without any action. In the meantime, the spurious statement is allowed to stay in the article. What nonsense. Anonywiki, if you cannot provide references to support the statements you added, then I will remove them again. Logicman1966 (talk) 12:19, 22 November 2007 (UTC)

re this thread's query, yes it is an encyclopedia and so dangerous claims must not be suggested to the readership without editorial responsibility (as per wikipedia does not give medical advice). So such a propostrous suggestion that an asthmatic in extremis should refuse oxygen, is not a dangerous one ? Hmmm just what is mechanism therefore that asthma may in extreme circumstances cause death ? I rather thought it eventually involves brain death due to a lack of circulating oxygenated blood ? As for sources - if someone were to suggest that underwater juggling is good for asthma and a newspaper reports that claim (ie a reliable source), then there is no need insist that wikipedia includes the claim just because no one in the medical community decides to waste their time giving it any serious consideration or expend the energy to write a rebutal - clearly we know the common (majority) opinion on this (PS uncontrolled asthma is an absolute contraindication for scuba diving, of which there are many published guidelines, yet none of these mention underwater juggling).David Ruben ^Talk 15:54, 22 November 2007 (UTC)

You respond to my complaint about people adding unsourced claims to articles, by providing an unsourced claim of your own (asthmatic in extremis should refuse oxygen)?? You didn't understand my point - dubious, inflammatory, or controversial comments should not be added to an article unless they are already supported by a reputable source. Otherwise, perhaps I should add my own comment to this article : "pharmaceutical companies prey on asthmatics by getting them addicted to over-priced medications that do not effectively treat the condition". Of course, I would add the "citation needed" tag....Logicman1966 (talk) 02:27, 23 November 2007 (UTC)

Gender and asthma

I am new to Wikipedia and want to follow the protocols before making any major edits. I am proposing a new heading possibly called "Gender and asthma or Women and asthma".

There are several disparities that run between adult men and women concerning asthma which have not been addressed in the entry. It states,"being female, for persistence of asthma into adulthood." A statistic from the Asthma and Allergy Foundation of America, states that more adult females will die from asthma by 65% in overall asthma deaths. The Office on Women's Health Asthma Reseacrh recognizes that," Some populations, including women,are particularly affected by asthma." They attribute this to factors including difference in hormones, factors relating to pregnancy, and varient reactions to medications. They also acknowledge as a growing concern the adult onset of asthma in women at the start of menopause. Another study from the NIEHS suggests that, "sex hormones may play a role in asthma". This study found a correlation between girls reaching puberty before the age of 12 with an increase incidence of asthma being diagnosed after puberty at nearly twice the rate than girls who experience later onset of puberty. This study remarks that as the age of girls reaching puberty continues to decline the rate of asthma continues to escalate. I can find and follow through with all the footnotes and citations at another time.

I think this would be an appropriate addition to this article. Thank you, WH701 (talk) 22:39, 20 December 2007 (UTC)WH701

I added a section on population disparities to the epidemiology section that tries to elaborate more on populations outside of the US (it was mentioned above that the epi section is very US-centric), talks about differences among various US ethnic populations, and includes what you stated about gender and asthma. Do you have the references?Aklauncher (talk) 06:21, 30 December 2007 (UTC)

Papworth method

When page unprotected, Papworth method (a breathing technique with effectiveness demonstrated in a small clinical study) should be added after the meditation mentions in the alternative therapy section —Preceding unsigned comment added by 68.165.11.209 (talk) 17:08, 22 March 2008 (UTC)

Big Tobacco still up to its "health effects are controversial" tricks

Some of the comments above are difficult to understand other than as an attempt to extend tobacco sellers' decades-old "tobacco might be healthy" controversy-tricks to Wikipedia's asthma page, and to minimize or obfusticate the causative role of tobacco smoke as a cause of asthma.

Big Tobacco's attempt to create the appearance of health "controversy" wherever it can seems to me to have extended to editing Wikipedia's "Tobacco" and "Smoking" pages, and to deleting mention of Big Tobacco's circumvention of its advertising agreements by product placement in movies from the Product Placement article.

Just as product placement in media such as movies is devastatingly effective advertising because it appears not to be advertising, misinformation planted in Wikipedia is devastatingly effective because those expecting to rely on it expect straight information, and do not expect it to be skewed for the profits of the tobacco sellers.

To the extent that the tobacco sellers succeed in extending the appearance of "controversy" to Wikipedia and depriving a new generation of the information needed to make a fully-informed decision about becoming a tobacco buyer, the tobacco sellers' direct and indirect profits will be huge and worldwide. It's censoring and throwing half-baked, off-topic studies to generate the appearance of "controversy" amount to subtle vandalism, and to the extent these tricky context tamperings are effective, are designed to suggest to impressionable preteens considering smoking -- tobacco seller's favorite marketing group -- that the health effects of tobacco use are, after all, in doubt.

Tampering with Wikipedia to dilute the fact that tobacco costs are far higher than the price per pack should be viewed as a call to Wikipedians familiar with the science on the issue to ensure that

(1) the science and facts needed to evaluate tobacco's risks and costs in context, and the insidious marketing strategies of tobacco sellers, are not allowed to be quietly deleted from the relevant pages,

(2) that tobacco sellers' smoke screen of off-topic implications that tobacco use might be healthy is addressed by full factual context, and

(3) that health professionals realize that there is a continuing need for vigilance in guarding the pages where potentially profitable young customers for Big Tobacco will come looking for presumably-accurate information -- that making sure that information is reliable -- not jimmied to increase sales -- is an ongoing public health issue.

CHI3L1

According to the the New England Journal of Medicine, an allele of the gene CHI3L1 doubles the risk of getting Asthma. However, the section on genetics seems to have a requirement that the effect must be found in six populations or something, I can't figure it out, perhaps somebody misunderstood a QTL study. CHI3L1 has been mentioned in the major news media, so it needs to be added to the article. Phlegm Rooster (talk) 18:00, 11 April 2008 (UTC)

perfumes as a trigger

A better link for the well-recognized role of perfumes as a trigger is http://www.lungusa.org/site/apps/s/content.asp?c=dvLUK9O0E&b=4061173&ct=5314727

Philippines, 12%

12% of Filipinos cannot breath: Asthma Insights and Reality in the Asia Pacific Region (AIRIAP) study (on the prevalence of asthma in 12 Asia Pacific countries) reported that, as of May, 2008, 10.7 million Filipinos are suffering from asthma, or 12% of the entire Philippine population. The study revealed that 4% of the patients are not being given preventive medicine, or only 963,000 asthmatics are using inhaled corticosteroids (ICS) preventive medicine, while only 23% of asthma patients are familiar with ICS.gmanews.tv/story, 10.7M Filipinos suffering from asthma - study --Florentino floro (talk) 11:58, 5 May 2008 (UTC)

Some view points and a few problems

I am not an expert in asthma or allergy myself but have several members of my family who suffer from allergy one of whom has asthma (likely allergy induced asthma, pollen and dust mite). I have a basic understanding of the literature on asthma and a fairly good understanding on certain aspects of allergy literature and treatment, having researched allergy for my own allergies and from consulting with immunologists for my own allergies. I have three problems with the article. (1) My first problem is that the article is filled up with "citation needed" throughout it with about 20 "citation needed's". Why does a featured article have 20 or more "citation's needed" throughout it? (2) Another problem is the article correctly mentions that ozone can worsen asthma but then later in the article it lists ozone producing air filters as a treatment, without mentioning that these air filtration units fill rooms with ozone which can worsen asthma! I don't think that the text about ozone producing units should be deleted as it is relevant because so many people use ozone producing filtration units. It needs a sentence beside it saying something like "However, ozone has been found to worsen asthma and such ozone filtration devices have demonstrated no clinical benefit to asthma sufferers." (3) Also there is a part where it mentions negative ion producing devices without mentioning that devices which produce negative ions all produce ozone since ozone is a by product in negative ion production by such devices. I don't mean any offense to the editors here, I am pointing out a few imperfections as I see them. Overall I think the article is a very good article and the editors have done a good job. I do think the citations needed need to be resolved. I think a featured article should not have so many "citations needed". I also think the other points that I raised are important and I would welcome comments. I will add this article talk page to my watch list.--Literaturegeek | T@1k? 13:12, 14 May 2008 (UTC)

Alternative to Meds

The person above who dismisses Buteyko to be included in the asthma page has obviously not read the Russian, British and Australian research. My ex-girlfriend was on Advair and other meds, until I sent her to a Buteyko class. Afterwards, under doctor's supervision, she stopped the Advair and cut her other meds by 50%, and improved her sports performance. If she were not so lazy about her breathing exercises I think that she could cut them more. I was not asthmatic, but Buteyko has improved my sports performance and free diving time. Although many physicians in school have heard of the Bohr effect of overbreathing (more CO2= more O2 released by hemoglobin to tissues; less CO2= less O2 being released by hemoglobin to tissues), which results in asthma and other hypoxia symptoms, most medical schools in the US have been slow to accept Buteyko Breathing Therapy, which has been helping people for 50 years, reportedly because most research was done in Russia and Australia (also by an asthmatic Glaxo ex-employee) and the pharmacology companies that fund US medical schools do not seem to acknowledge it for some reason... This is why slowed yoga breathing (as real yogis do) seems to reduce asthma problems, while huffing and puffing yoga and pilates routines aggravate asthma symptoms. Perhaps my comments will not be appreciated because the person who disclosed the problems on another wiki page with meds had his comments removed. 68.106.184.122 (talk) 06:45, 6 June 2008 (UTC)

First, if you make further insinuations about the editors of this article, you will be blocked. Second, wikipedia articles require verification by reliable sources. We also do not give undue weight to fringe therapies. Just because your girlfriend improved in health, a random occurrence, it does not indicate anything except maybe your girlfriend improved in health. OrangeMarlin ^{Talk• Contributions} 07:57, 6 June 2008 (UTC)

1. I'm sorry that you threatened to block me from discussion- I don't believe my words are an attack on anyone. An asthmatic ex-marketing manager at GlaxoSmithKline made such comments after his condition improved using Buteyko enough to discontinue his years of medication. Wasn't acupuncture considered "fringe" therapy until recently? but now it is covered by health insurance although there is less theoretical physiologic basis for it than for Buteyko. I am skeptical of new ideas myself, but have noticed consistent results with only beneficial side-effects.
2. Buteyko Therapy is based of the Bohr effect, which is measurable. Research has now shown that Buteyko significantly reduces medication needs in 85% of patients (probably the ones who are diligent.) Anyone familiar with medical literature will recognize some of the following sources, which I hope you consider reliable:

• www.ncbi.nlm.nih.gov which published several studies, such as the 2000 paper "A clinical trial of the Buteyko Breathing Technique in asthma as taught by a video" (yes, just a home video) stating "Our results demonstrated a significant improvement in quality of life among those assigned to the BBT compared with placebo (p = 0.043), as well as a significant reduction in inhaled bronchodilator intake (p = 0.008). We conclude that the BBT may be effective in improving the quality of life and reducing the intake of inhaled reliever medication in patients with asthma. These results warrant further investigation."

• www.unboundmedicine.com/medline Bowler SD, Green A, Mitchell CA Buteyko breathing techniques in asthma: a blinded randomised controlled trial. [Clinical Trial, Journal Article, Randomized Controlled Trial] Med J Aust 1998 Dec 7-21; 169(11-12):575-8.

• Behavioral Interventions in Asthma- Breathing Training. Thomas Ritz, University of Hamburg, Thomas.ritz@uni-hamburg.de, Walton T. Roth, Stanford University and VA Palo Alto Health Care System

• American College of Chest Physicians- Hypocapnia and Asthma, A Mechanism for Breathing Retraining? Anne Bruton, PhD and Stephen T. Holgate, DSc. From the University of Southampton, Highfield, Southampton, UK.

• 2003 BMJ Publishing Group & British Thoracic Society ASTHMA Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. S Cooper, J Oborne, S Newton, V Harrison, J Thompson Coon, S Lewis, A Tattersfield, Division of Respiratory Medicine, City Hospital, Nottingham NG5 1PB, UK (Buteyko was found beneficial.)

• Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Med J Australia 1998; 169: 575-578[Medline]. A medical trial run in 1994 at the Mater Hospital, Brisbane, Australia, clearly showed that asthma patients derive great benefits from learning the Buteyko breathing techniques. For example, usage of reliever medication in the Buteyko group was reduced by an average of 90% after six weeks, and usage of steroid preventer medication was reduced by an average of 49% after three months (with no significant changes in medication usage in the control group).

• Even the Quackwatch link had: "In conclusion, we found that those practising BBT reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without changes in objective measures of airway calibre." (Yes, I'm a skeptic! but the research supports Buteyko.)

After 20 years on constant meds, and then after a few hours of Buteyko self-therapy, my friend improved the same day. She also notices that whenever she follows the exercises, she improves within hours- quite a coincidence if random. I know that the exercises have helped my free diving and other athletic performance significantly, and helped my friends avoid post-event, (exercise-induced) asthma. Should we not explore alternatives that are being researched by Stanford and in other countries to help asthma symptoms and reduce medications? So that I do not offend you, I will not speculate why such research is not on the front page of newspapers. I'm sorry that I am not wiki-fluent; I rarely write here, but I am dismayed that such current research is not publicized for such an important and popular "disease". 68.106.184.122 (talk) 00:04, 10 June 2008 (UTC) Psnack (talk) 00:46, 10 June 2008 (UTC)

OrangeMarlin - please don't threaten people with administrative action for making what amounts (at worst) to snide insinuations. it's unnecessary and overreactive. a simple 'please don't say stuff like that' would be enough.

that being said, I am disturbed by the number of times I have seen (on various pages) wp:fringe used to silence comments concerning alternative medicine, so I'm going to butt in and start looking around. if anyone knows an example of this, please leave me a link to the page and appropriate diffs, here: User:Ludwigs2/AltMed. --Ludwigs2 00:32, 10 June 2008 (UTC)

P.s. spread the word around... ;-) --Ludwigs2 00:47, 10 June 2008 (UTC)

New BTS Guideline recommends Buteyko

Personal views/experiences aside, Buteyko should probably get a mention in this article since the British Thoracic Society (who make the British Guideline on the Management of Asthma and are mentioned several times in this article) have now recommended Buteyko in the Guideline.

This actually gives permission for GPs and doctors in Britain to recommend it to their patients.

Here's some recent news coverage from the Prince's Foundation for Integrated Health: http://www.fih.org.uk/news/buteyko_technique.html

And here's a quote from the above article:

"Up until now conventional medicine took the stance that that there was insufficient evidence to recommend Buteyko Technique. However in May 2008 the updated British Guidelines for the Management of Asthma endorsed Buteyko Technique so that GPs and asthma nurses can now recommend it. The new guidelines grade the research on Buteyko as a 'B' classification - indicating that there are high quality clinical trials supporting the efficacy of the therapy in reducing both asthma symptoms and bronchiodilator usage. No other complementary therapy has been endorsed by this body for the treatment of asthma."

Yes, I noticed that they spelled 'bronchodilator' wrong so this might need to be taken with a pinch of salt. However, quite a glowing report from a well-respected organisation.

Here's a link to the latest BTS guidelines: http://www.brit-thoracic.org.uk/Portals/0/Clinical%20Information/Asthma/Guidelines/asthma_final2008.pdf

The bit on Buteyko is on page 35, section 3.5.3. They quote 5 clinical trials I think.

I plan on updating the Buteyko Method page with some of this information and would appreciate any help tidying it up as I am more a reader of wikipedia than an editor! Spathi (talk) 15:26, 10 July 2008 (UTC)

Peer review

Hi all, For those of you who don't know this article has been peer reviewed recently. You can check it Wikipedia:Peer_review/Asthma/archive2#BirgitteSB.

Anyways, one suggestion was to explain what is meant by replication, in the causes section. e.g As with other complex diseases, many environmental and genetic factors have been suggested as causes of asthma, but not all of them have been replicated.

However, even among this list of highly replicated genes associated with asthma, the results have not been consistent among all of the populations that have been tested ...

However, this is beyond my scope of knowledge so I would appreaciate it if someone else could help.

Thanks!

Ziphon (^ALL_ears) 11:51, 15 July 2008 (UTC)

No mention of NO

To my surprise, exhaled nitric oxide isn't mentioned in our featured article, in fact it is completely absent from Wikipedia! Ouch... --Steven Fruitsmaak (Reply) 18:14, 21 July 2008 (UTC)

Started the article few days ago. --Steven Fruitsmaak (Reply) 08:24, 26 July 2008 (UTC)

Asthma Cure

I have recently found, browsing on the web, that Cuban doctors have found an effective vaccine against Asthma, that works by suppresing reactions caused by stimuli. Which only allows the brain to exercise control, any response that is carried by a trigger is suppressed by neurological modification. Which make the airways inmobile unless the normal breathing instinct acts. This has proven to be successful in more than 75% of cases, the other percent require a second vaccination. I, however, think this may become an answer to Asthma. The vaccine, named Valergem, is manufactured in Cuba and investigations are being carried out for a children's version. Eventually, only internal control exercised by the brain original functions are allowed lung function control. I cannot search it because of short time but I would want someone to seek it on the web. 200.75.250.59 (talk) 01:52, 26 July 2008 (UTC)

There are several sources online based on a newswire article, but none with sufficient information to judge the vaccine and certainly no scientific articles have been published in the international literature. This prevents inclusion in the article for now. --Steven Fruitsmaak (Reply) 08:24, 26 July 2008 (UTC)

I have also heard that some traditional doctors in Hyderabad, India, use some medicine where they have you swallow a complete fish, any Idea about that Swapnils2106^T 12:29, 25 May 2009 (UTC)

Afferent vs Efferent mixup?

"Whenever these afferent nerve endings are stimulated (for example, by dust, cold air or fumes) impulses travel to the brain-stem vagal center, then down the vagal afferent pathway to again reach the bronchus. Acetylcholine is released from the afferent nerve endings. This acetylcholine results in the excessive formation of cyclic Guanine Mono phosphate (GMP)."

I think it should read: ...then down the vagal EFFERENT pathway to again reach the bronchus. Acetylcholine is released from the EFFERENT nerve endings. Horus (talk) 01:12, 26 October 2008 (UTC)

Early asthma treatments and their long term consequences

Is there a scientificly proven link between the the use of asthma drugs predominantly used in the 1950,s 1960,s and 1970,s (before Ventolin was available on the market) and mental issues for example OCD ,Schizophrenia & memory loss.Is there any statistical research done on early asthma sufferers and their mental conditions when they are now in ther forties and fifties. —Preceding unsigned comment added by 115.166.1.117 (talk) 08:58, 1 November 2008 (UTC)

Please take that to the reference desk. This is the first time I have ever heard of such a suggestion. JFW | T@lk 08:31, 2 November 2008 (UTC)

Firstly which medications were you thinking of ?

For search of PubMed for "asthma schizophrenia" some issues can be considered (but needs a secondary source to rely upon and not just be WP:SYNTHESIS) - In principle difficult as what might be the cause of any observation? Certainly those with chronic mental illness may be less well reviewed or managed in their non-psychiatric illness (see PMID 17062587 "Physical health care of patients with schizophrenia in primary care: a comparative study")

If even begin to understand the simplification of the abstract of PMID 15045582 "Quasi-linkage: a confounding factor in linkage analysis of complex diseases?" (where "A number of individual markers showing linkage to schizophrenia, asthma, multiple sclerosis, inflammatory bowel disease and type-1 diabetes were tested for") then some genetic predispositions for asthma and schizophrenia might sit near each other on the same chromosomes, and so tend to be co-inherited even though no direct link between the genes or the diseases.

Whilst searching PubMed one can find suggestion of a direct common pathway for asthma and affect disorders eg PMID 12692775 "Substance P and Substance P receptor antagonists in the pathogenesis and treatment of affective disorders." which notes suggestion that "SP has been proposed to play a role in the aetiopathology of asthma, inflammatory bowel disease, emesis, psoriasis, as well as neuropsychiatric disorders including pain syndromes (e.g. migraine and fibromyalgia) and affective disorders, anxiety disorders, schizophrenia and Alzheimer's disease." - unfortunately full review not available online to find out their conclusions on this.

Of course if asthma/schizophrenia coexisted as PMID 6456295 "Concordance of atopic and affective disorders" implies, then if not just coincidence then nature/nuture would need be looked at - i.e. if they do not form by direct genetic/metabolic common pathway, then might asthma by being a miserable chronic disease, make people more depressed or mentally ill ? (PMID 10802131 "Prevalence of DSM IV anxiety and affective disorders in a pediatric population of asthmatic children and adolescents" and also PMID 8742538 are small studies - but at least show people have looked).

Finally to consider historical question of effect prior to modern treatment - but was this researched as well as current studies in in the same manner to allow a metanalysis ? Were criteria for asthma or schizophrenia the same then as now, after the introduction of modern treatments ? Asthma#History implies asthma previously thought to be partly psychosomatic (or look at PMID 3511492 's PDF link for 1986 psychoanalytical idea that asthma a response to smells and in part a learnt behaviour, PMID 7062299 suggests not learnt)

Search of "salbutamol schizophrenia" gives one hit of PMID 8748438 "Exacerbation of psychosis associated with inhaled albuterol" but that really does not answer your question

So again comes back to which previous treatments were you thinking of ? David Ruben ^Talk 20:46, 3 November 2008 (UTC)

reply to David Ruben 3rd.Nov.2008 on " Early asthma treatments and their long term consequences" I am researching our state library archives for medications that were prevalent during the period 1950 to 1980 as i will present names of drugs long forgotten.However for a start here are some ALUPENT (common) TEDRAL (common) THEODUR (theophyline i think) suppositories (aminophyline)there was a yellow tablet which was put under the tongue ( researching )and preventative (supposedly long acting)series of injections ( researching).I am really interested in feedback from sufferers from what i call the "experimental era" before the inhalers and corticosteriod preparations were made available.Ifthere is some common thread i think it would be an advantage for the wikipedia asthma article to be extended regarding the psychological and psychiatric consequences of these powerful drugs acting intensely on the human nervous system many of which were in there infancy of drug research.Breatheasy (talk) 08:48, 9 November 2008 (UTC)

Just to help with above (and thanks for signing up as a registered user) - INNs of above brands are:

• Alupent = Orciprenaline
• Theodur = theophylline is still in the British National Formulary (also see aminophylline which being more water soluble is/was used iv in status asthmaticus, see Status Asthmaticus~Treatment at eMedicine, as well as a slow release tablet Phyllocontin Continus used in routine control of asthma and COPD#Other medication)
• Tedral = combination of Theophylline/Ephedrine/Phenobarbital (see [1]).

Theophylline and Phenobarbital articles mention CNS side effects (confusion being most important). As for psychiatric side effects - see PMID 6427078 (abstract fails mention which antiepileptic considered) and PMID 16377138 in talking about newer anti-epileptics points out problem of cause/effect/co-incidence in neurological/psychiatric areas. PMID 6221 indicates that phenobarbitone was used in the psychiatric treatment of elderly, so quite what psychiatric effects phenobarbitone might have on a mentally-well asthmatic has to be wondered at (I quite agree dangerous to assume nothing as clearly a psychoactive medication). PMID 13641514 title looks interesting, but no online abstract.

Final point to bear in mind is that these older medications proved less effective for the control of asthma (and to some extent had problems of narrow therapeutic index of safety) and chronic disease states, in themselves, reduce the mental (as well as physical) well being of patients, so difficult to assess a potential problem of an older drug from the poorer asthmatic control (especially as severe asthma would not be treated with just one drug, but rather usually several drugs co-administered) - anyway I await outcome of your further historical research into this :-) David Ruben ^Talk 03:00, 17 November 2008 (UTC)

Metabolic acidosis

PMID 2118447 is an older paper that addresses a question that's puzzled me for some time: why do some asthmatics have a lactic acidosis? Unsure if we need to touch on this, and we'd need a better source, but the concept exists. Alternatively, I understand that some bronchodilators can cause lactic acidosis in high doses. JFW | T@lk 08:31, 2 November 2008 (UTC)

Agree many hits for PubMed search of "asthma acidosis" 247hits and more selective "asthma lactic acidoisis" 40 hits. But I'm not sure how great the issue is in terms of notability (ie how rare) and appropriate weight.

From this summer: PMID 18715850 (with full link) "Metabolic acidosis secondary to lactic acidosis may occur in acute, severe asthma and its presence suggests that respiratory muscle fatigue and tissue hypoxia play a major part in the pathogenesis. Non-anion gap metabolic acidosis (NAG acidosis) has also been reported in acute asthma but its impact on the clinical outcome has not been evaluated."

Case report from April 2008 PMID 18471314 (with full link) "Acidosis promptly reversed on discontinuation of inhaled beta-agonists.", and abstract-only of further Feb 2007 reports PMID 17198331 and a discussion from Nov'07 PMID 17906597

Abstract without direct access to full article of PMID 18410827 'An under-recognized complication of treatment of acute severe asthma' "This patient had lactic acidosis as a direct effect of administration of salbutamol."

So seems researchers in part suggest salbutamol and in part from the respiratory distress of the attack itself - would need be careful summarising the research without risk of WP:SYN.

BNF only warns of hypokalaemia for high use of salbutamol particularly in conjunction with theophylines, corticosteroids, diuretics and hypoxia. David Ruben ^Talk 14:55, 3 November 2008 (UTC)

Metabolic acidosis in asthmatics can have many etiologies: In the article Metabolic acidosis in severe asthma: Is it the disease or is it the doctor? in Pediatric Critical Care Medicine - Volume 8, Issue 6 (November 2007), it's pointed out that 1) respiratory muscle fatigue, 2) high dose beta agonists (for example as tocolysis) 3) other therapies such as steroids, epinephrine, and other drugs used in status asthmaticus have the effect of causing hyperglycemia and an increase in pyruvate > lactate formation, and 4) tissue hypoxia will all produce lactic acidosis, though the method of action in each case is different. It's suggested that the aggressiveness of initial treatment, especially in children, may correlate to the degree of metabolic acidosis. A metabolic acidosis will of course contribute to feelings of shortness of breath, and will actually increase breathlessness in a person in exacerbation. 216.174.136.2 (talk) 03:05, 10 March 2009 (UTC)

Azma.com

Over the past month, three named accounts and three IPs have repeatedly inserted links to http://www.azma.com. The method of insertion has varied from simple addition as an external link to the insertion of three paragraphs of 'content' describing that site's services. These additions have been reverted thirteen times. Discussions have ensued here and here. The promoters of the link (clearly most, if not all, are employees of that company, if not all the same person as well) argue that the site provides valuable 'asthma trend statistics'. I feel this amounts to air quality (pollution and pollen) forecasting that is available from any weather forecasting service. Concerns about copyright issues and COI (company contracts with pharmaceutical and homeopathic product manufacturers) were brought up as well. Further opinions requested. Maralia (talk) 16:13, 26 November 2008 (UTC)

Like others, I have deleted this link, and some text from the same source, a couple of times over the last week or so. I did so because it seemed a clear case of spam. Reading the discussions you refer to above (which I had not previously seen), I am quite convinced that I was right to delete on sight. It seems clear that the anon editor is concerned mainly to promote his/her company and its service. No doubt it is a fine company. No doubt it does a good job. But Wikipedia is not an advertising site. SNALWIBMA ( talk - contribs ) 16:36, 26 November 2008 (UTC)

I also agree that this link should not be included. I've requested that it be added to User:XLinkBot's list. This would give us automatic reversals from IP spammers, which should significantly reduce the load on this article's editors. WhatamIdoing (talk) 18:03, 26 November 2008 (UTC)

I think azma.com will help Asthma patients deal with this chronic condition, I hope we can get mentioned someday on wikipedia Asthma Page

We make a unique US daily map and have a database of trends by zip code there is no other site doing this for just Asthma related air quality. azma.com is very unique and the only site of its kind, we get constant good feedback from users. SDI Health is affiliated with the Asthma and Allergy Foundation of America and listed on their front page. I had hoped listing azma.com on Asthma Wikipedia page would be helpful, sorry if too self serving for this Article. http://www.sdihealth.com/ http://www.azma.com/ 207.106.86.85 (talk) 19:20, 26 November 2008 (UTC)

Thanks for your understanding note. A link to azma.com does not appear to be in compliance with our guidelines for external links. Additionally, since you're part of the company, then you shouldn't add your own links to anything, because it's a conflict of interest. If it seems relevant to a particular article, then you could leave a note on the talk page to explain why you think it's a good idea. WhatamIdoing (talk) 19:25, 26 November 2008 (UTC)

Asthma not one disease

This article starts from the premise that asthma is a single disease. In contrast, PMID 14980251 argues that asthma is several diseases that share a cluster of signs and symptoms, and hence that effective treatment depends on distinguishing which underlying disease is responsible. Is there enough evidence for this view to merit rewriting this article? I expect such a rewrite to involve a lot of reorganization, but rather little new content otherwise. --Una Smith (talk) 04:19, 6 December 2008 (UTC)

Perhaps you are confusing asthma with COPD. Asthma is not a disease but a medical contition, as is the condition of not being an asthmatic. The use of the word ASTHMA before the condition was discovered about five decades ago was for a symptom of what i think you would now call COPD or pneumoconiosis —Preceding unsigned comment added by 87.80.103.44 (talk) 18:52, 7 May 2009 (UTC)

WHAT HAPPENED TO the "Cough Variant Asthma" page !?!?!?

I have found general articles on Asthma to be useless to me. After 14-ish years of a chronic, re-occurring cough, I was finally diagnosed as having Cough Variant Asthma. Immediately after the diagnosis, upon my return home I _THOUGHT_ that I had wiki-ed 'Cough Variant Asthma', and read a very useful article. It's now gone. Is my memory wrong? If not, and it's been merged into the main Asthma article, then I CONSIDER THIS TO BE NOTHING LESS THAN VANDALISM. Please restore the 'Cough Variant Asthma' article, or correct my memory. LP-mn (talk) 16:37, 14 December 2008 (UTC)

The cough-variant asthma article existed for 30 minutes somewhere in October before someone redirected it. As it clearly deserves its own article, I restored it as a stub; feel free to improve this stub! --Steven Fruitsmaak (Reply) 17:18, 14 December 2008 (UTC)

Hmmmm... Maybe I was wrong. I clearly remember a MUCH longer article. Huh. I'd be willing to swear that I looked at Wikipedia first. 67.220.13.180 (talk) 21:15, 14 December 2008 (UTC)

Adding information about new device to "asthma" topic

Hello, I am from Russia, and I was trying to edit the article about asthma by adding there information to the "non-medical treatments" subsection; the information was about Frolov's device, which is about another respiratory training technique, like Buteyko method, which also originates from Russia and is already mentioned. After a few minutes the information was deleted as possibly promotional. Please help me post the information because I believe that it is no more promotional than the information about Buteyko. A lot of people in Russia do get better after using the device, it sells in almost every Russian chemist shop, and I am sure that in Russia more people know Frolovs than Buteyko (if you need evidences on this, please let me know which, and I will work towards submiting them). This is why I believe that it deserves being mentioned.

Folki (talk) 05:25, 15 December 2008 (UTC)

Hi,

After searching PubMed and Google Scholar, I found no reputable international scientific journals reviewing this method (contrary to the Buteyko method). Therefore, I don't think we should include it in the article. See WP:MEDRS for more information.

--Steven Fruitsmaak (Reply) 19:09, 15 December 2008 (UTC)

Cut short medical subsection

The details of Long acting Beta agonists is long.It may be cut short.

Nishanthb (talk) 07:22, 15 February 2009 (UTC)

Pregnancy

Is this sentence really necessary? "Some women also experience a worsening of their asthma during pregnancy whereas others find no significant changes, and in other women their asthma improves during their pregnancy." Some women are affected, some aren't, and some are affected the other way. Surely this doesn't need spelling out. Merpin (talk) 22:19, 4 March 2009 (UTC)

I'd actually vote to keep it in the article. Some asthmatics can go from being in the intensive care unit with status asthmaticus every three months to completely symptom free while pregnant. On the other hand, some asthamtics haven't had symptoms since they were kids and suddenly need ICU stays while pregnant. The dizzying change the disease can undergo while one is pregnant deserves mentioning; sometimes it gets worse, sometimes it gets better, and sometimes it stays the same. This may seem self-explanitory but in reality it can mean some serious asthmatics can go off of some of their medications while pregnant whereas some mild asthmatics may have to re-start medications they haven't used in years. I think it's worth mentioning that previously stable asthma can change drastically in the face of pregnancy. IIRC the statistics are about 1/3:1/3:1/3 (worsen:stay the same:improve) Wrin (talk) 03:11, 10 March 2009 (UTC)

Does this article merit a rewrite?

I find this article to be lacking in several ways. First, it does not have a clear 'flow', with several subheadings devoting time to tangentially explaining things which are covered in other subheadings. These subheadings should be reorganized to reflect their titles so that the article has a clear and understandable train of thought.

Second, I find this article to be very vague at differentiating between asthma in a steady-state (which is after all a chronic disease unto itself even in the absence of acute exacerbations) and asthma in the acute state. Symptoms are different for each state, with even acute exacerbations being classifiable into mild/moderate/severe/near death categories. I feel there's too much confusion between 'mild' asthma and a 'mild' exacerbation or 'severe' asthma and a 'severe' exacerbation.

I've already made some edits to the page. I removed a couple of mentions of stridor as a symptom of asthma, since asthma is an obstruction of the lower respiratory tract (lungs) and stridor is a sign of an upper respiratory tract infection. Additionally, some diseases such as vocal cord dysfunction sometimes present with stridor but are easily confused with asthma in those inexperienced at differentiating the polyphonic noise of a wheeze and the very monophonic noise of inspiratory stridor. I also removed reference to the 'blue bloater' as this is a phrase that's colloquially used to describe polycythemic COPD patients, not asthmatics.

I tried to rewrite the introduction to flow a little better, but then found repetition lower down in the page. As the peer review indicated, repetition is a problem on this page. Perhaps the introduction should be limited to a definition of asthma, cited from literature, and the rest of the text should be allowed to stand on its own to explain what is only briefly glossed over in the present incarnation of the introduction. Wrin (talk) 23:46, 10 March 2009 (UTC)

Freud and ashtma

About the freudian "explanation" for ashtma, the article is too short.Agre22 (talk) 17:33, 12 March 2009 (UTC)agre22

Why can I not print this article after page 16?

My sister in law was just taken to the hospital with an asthma attack and I'm trying to learn about this condition. I wished to print out the full Wikipedia article on "Asthma" (except for the ending source listing).

However, there are some pages that will not print. I can't print pages 14, 17 and 18! Page 13 ends with the title "Treatment" and Page 16 ends with the title "Non-medical treatments". I am unable to print the one, and two, respectively, following pages. If I was into conspiracies, I would suspect some vague "medical establishment coverup"!!!

Even "print preview" shows up blank for these three pages. Is there somewhere other than this discussion page where I should bring this up? It is odd, to say the least. —Preceding unsigned comment added by FTWillie (talk • contribs) 17:13, 16 March 2009 (UTC)

I don't have this problem in Firefox, but I am able to reproduce it in Internet Explorer. Looking into it now. Maralia (talk) 17:27, 16 March 2009 (UTC)

I copied the Treatments subsection into another page and tested print preview in IE again. It repeats the behavior—some blank pages—but at entirely different points in the text, which tends to point to IE as the problem, rather than some anomaly in the article formatting. Short of changing browsers, a workaround would be to go to the article and click the 'PDF version' link (in the left sidebar, under the heading 'toolbox') to create a downloadable PDF version of the article. The PDF should print properly, and will probably look much better to boot. Maralia (talk) 17:40, 16 March 2009 (UTC)

Thank you - PDF worked great and I should have thought of that! FTWillie (talk) 17:48, 16 March 2009 (UTC)FT Willie

The use of the word ASTHMA

I think i have found a couple of instances in the text of the article of the word being used to mean ASTHMA ATTACK. There is already much confusion about the use of the word ASTHMA and dropping the word ATTACK from the term ASTHMA ATTACK can only add to it. The word ATTACK should be replaced wherever it is missing. —Preceding unsigned comment added by 87.80.103.44 (talk) 19:09, 7 May 2009 (UTC)