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Asthma patients that depend on emergency department (ED) services are generally considered to have extremely poor disease control and prognosis. It is important to identify characteristics related to poor disease control and frequent visits to the ED to apply appropriate clinical management. This study comprised a cross-sectional survey of consecutive patients with asthma exacerbation (age > or = 12 years) presenting at the adult ED of a large, tertiary care, university-affiliated hospital over a 2-month period. The frequent visitors (FV) were defined by > or = 3 visits to the ED in the preceding year, and the occasional visitors (OV) by < or = 2 visits. Eighty-six patients (61 females and 25 males) were included in the study (mean age 38 +/- 18 years). Of these patients, 51.2% were FV and 48.8% were OV. Sixty-nine percent had annual income lower than A dollar 3000 and 66.3% had < or = 8 years of the formal education. Only 18.6% had used inhaled corticosteroids, 79.1% identified the asthma attack severity, 70.9% increased or initiated inhaled beta-agonist, 20.9% increased or initiated steroid therapy, and 55.8% had an asthma action plan for attack. The number of hospital admissions in past year (OR 4.3, P = .02), use of home nebulizer (OR 3.6, P = .05) and the lack of a written asthma action plan (OR 3.3, P = .03) were independently associated with frequent visits to the ED. We conclude that a substantial proportion of the patients that visit the ED are FV. These patients are more likely to have hospital admission in the past year, to use a home nebulizer, and to lack a written asthma action plan. They should be considered the most important target for asthma education.

Early identification of patients who need hospitalization or patients who should be discharged would be helpful for the management of acute asthma in the emergency room. The objective of the present study was to examine the clinical and pulmonary functional measures used during the first hour of assessment of acute asthma in the emergency room in order to predict the outcome. We evaluated 88 patients. The inclusion criteria were age between 12 and 55 years, forced expiratory volume in the first second below 50% of predicted value, and no history of chronic disease or pregnancy. After baseline evaluation, all patients were treated with 2.5 mg albuterol delivered by nebulization every 20 min in the first hour and 60 mg of intravenous methylprednisolone. Patients were reevaluated after 60 min of treatment. Sixty-five patients (73.9%) were successfully treated and discharged from the emergency room (good responders), and 23 (26.1%) were hospitalized or were treated and discharged with relapse within 10 days (poor responders). A predictive index was developed: peak expiratory flow rates after 1 h £0% of predicted values and accessory muscle use after 1 h. The index ranged from 0 to 2. An index of 1 or higher presented a sensitivity of 74.0, a specificity of 69.0, a positive predictive value of 46.0, and a negative predictive value of 88.0. It was possible to predict outcome in the first hour of management of acute asthma in the emergency room when the index score was 0 or 2.

Background: In face of variable definitions and sampling criteria, the real prevalence of resistant hypertension in a clinical setting is unknown.

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Definition Berufsverband, der die Interessen von 4 Berufsgruppen der biomedizinischen Analytik (MTLA, MTRA, MTAF, VMTA) vertritt und deren Aus-und Weiterbildung regelt. Beschreibung Im April 2016 erfolgten Änderungen von Satzung und Geschäftsordnung, verbunden mit einer Namensänderung, des seit 1969 bis dahin gültigen berufsständischen Verbandes ("Deutscher Verband Technischer Assistenteninnen und Assistenten in der Medizin e.V."), die eine bessere Wahrnehmung der Anliegen und Interessen dieses Berufsverbandes ermöglichen sollen. Im DVTA sind vertreten: Medizinisch-technische Laboratoriumsassistenten/-innen (MTLA), Medizinisch-technische Radiologieassistenten/-innen (MTRA), Veterinärmedizinischtechnische Assistenten/-innen (VMTA) und Medizinischtechnische Assistenten/-innen der Funktionsdiagnostik (MTAF). Detaillierte Angaben zu Aus-und Fortbildung sowie Weiterqualifikationen (z. B. Bachelor) und Spezialisierungen sind zu erhalten beim Deutschen Institut zur Weiterbildung für Technologen/-innen und Analytiker/-innen in der Medizin e.V.