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Biomedical subjects

David M Lang

Publications and source records attributed to David M Lang.

10 recordsLinked to original sources
PubMed2006

The controversy over long-acting beta agonists: examining the evidence.

In the Salmeterol Multicenter Asthma Research Trial (SMART), patients receiving the long-acting beta agonist salmeterol--particularly African Americans--had a statistically significantly higher risk of fatal or potentially fatal asthma episodes. As a result, medications that contain salmeterol (Serevent, Advair) or formoterol (Foradil) carry a "black box warning." However, the benefits of these drugs continue to outweigh the risks, if they are used appropriately.

Administration, Inhalation↗
PubMed2006

Evaluating and managing hypogammaglobulinemia.

If a patient has frequent or recurrent bronchopulmonary or sinus infections, they may be due to low levels of immunoglobulins. This article describes common primary (idiopathic) and secondary forms of hypogammaglobulinemia and how to evaluate and manage them.

Agammaglobulinemia↗
PubMed2005

Asthma deaths and the athlete.

Asthma has recently become more prevalent, more severe, and more deadly. Approximately 4500 individuals die from asthma annually in the United States, an unacceptable number for a condition that can be managed effectively. Sudden death with exercise may result from a variety of causes, including previously unrecognized cardiac conditions. Asthma has also been recognized as a cause of death in association with sports. Recent data indicate those who suffer from mild to moderate asthma are also at risk for asthma fatality. The absolute magnitude of the increase in risk of death from asthma during sports, however, is very small. For this reason, individuals with asthma should not be discouraged from active participation in sports. Rather, this should reinforce the message that asthma is a condition that may be potentially serious, but can, and should be, well controlled with proper management.

Adolescent↗
PubMed2004

Physical activity in urban school-aged children with asthma.

OBJECTIVES: To compare the physical activity levels of children with and without asthma and evaluate predictors of activity level in children with asthma. METHODS: Parents of 137 children with asthma and 106 controls 6 to 12 years old who attended an urban primary care pediatric clinic were interviewed by telephone. A structured survey evaluated 1 day's total activity and the number of days active in a typical week; asthma characteristics and treatment; physician advice; opportunities for physical activity; and caregiver beliefs about physical activity. The activity levels of children with and without asthma were compared. Predictors of activity level of children with asthma were evaluated. RESULTS: Children with asthma were less active than their peers. The mean amount of daily activity differed by group: 116 (asthma) vs 146 (nonasthma) minutes; 21% (asthma) vs 9% (nonasthma) were active <30 minutes/day; and 23% (asthma) vs 11% (nonasthma) were active <3 days/week. Among children with asthma, disease severity and parental beliefs regarding exercise and asthma predicted activity level. Children with moderate or severe persistent asthma were more likely to be active <30 minutes/day (odds ratio: 3.0; confidence interval: 1.2-7.5), and children whose parents believed exercise could improve asthma were more likely to be highly active > or = 120 minutes/day (odds ratio: 2.5; confidence interval: 1.2-5.4). CONCLUSIONS: Disease severity and parental health beliefs contribute to the lower activity level of children with asthma. Pediatricians should evaluate exercise level as an indicator of disease control and address exercise and its benefits with patients and caregivers to help achieve the goal of normal physical activity in children with asthma.

Asthma↗
PubMed2004

Omalizumab: where does it fit into current asthma management?

Omalizumab (Xolair), a monoclonal antibody, is a new agent that blocks the allergic cascade at its primary step. This drug offers substantial promise for patients with moderate-to-severe, persistent allergic asthma that is not well controlled. But due to the cost of the drug, limitations on dosage, and available clinical trial data, it is not a first-line therapy. This review discusses how this drug works, which patients will be candidates for it, and the practical aspects of using it.

Algorithms↗
PubMedDate not supplied

Feasibility of a national fatal asthma registry: more evidence of IRB variation in evaluation of a standard protocol.

PURPOSE: Approximately 4,500 Americans die from asthma each year. Our objective was to determine the feasibility of creating a national fatal asthma registry to better understand this problem.Methods. Using a standard questionnaire, 18 state vital statistics departments and 22 medical examiners offices were contacted in 2001 to assess availability of fatal asthma data. Funding was obtained in 2002 to implement a fatal asthma registry. During 2003, the project was put on hold due to uncertainty about the impact of the Health Insurance Portability and Accountability Act (HIPAA). The project was revived in 2004 when a standard protocol was submitted to Institutional Review Boards (IRBs) in four different states. RESULTS: All vital statistics departments reported that they were able to identify the decedent's name and demographic characteristics. Contact information for a relative or doctor was available in all states. Demographic characteristics and autopsy findings were available from 100% of the medical examiners offices. However, IRBs at the four institutions required major protocol modifications, including language and approach for contacting next of kin. CONCLUSION: Availability of demographic and clinical data across states is consistent. The creation of a national fatal asthma registry appears feasible, but different IRB interpretations of what is permissible preclude a standard approach across states.

Asthma↗