Asthma is a common chronic condition composed of numerous different phenotypes. One clinically relevant phenotype is that of aspirinsensitive respiratory disease (ASRD) which is more frequently seen in patients with difficult asthma. Reliance on a history of previous reaction to non-steroidal anti-inflammatory drugs (NSAIDs) in order to diagnose ASRD may give false reassurance. We describe the case of a 58-year old man with late onset asthma who was suspected to have ASRD on the basis of associated clinical features despite having taken aspirin safely in the past. The diagnosis of ASRD was subsequently confirmed by an inadvertent aspirin challenge which led to a serious adverse asthma outcome.
patients, a belief that night attire will prevent patients absconding from ward areas. The last of these reasons is not supported by evidence from literature reviews. 5 There is a belief that patients who abscond are easier to identify if they are wearing certain clothing. Searches of relevant databases (eg CINAHL) illustrate that nursing and other non-medical specialties fair no better concerning research, and evidence in this area is limited. One recent study of psychiatric inpatients did, however, highlight a disparity between beliefs of nurses and patients, particularly when the latter were being detained under the Mental Health Act. 6 The same research did, however, highlight the importance of day clothing in patients' quest for 'normality'. Effective care of older people is often complex and challenging, but frequently comes down to addressing 'straightforward' issues in an attempt to maximise patients' functional abilities. Above and beyond medicine, all who care for older patients (regardless of clinical specialty) have a role in promoting dignity, independence and choice for patients. In a time of high-tech solutions, simple improvements in overall clinical care can be overlooked. Wearing day clothes is not supported by trials or meta-analyses, and yet this does not devalue the process, and allows patients to become people once more. Patients are people and clothes maketh the man or woman.
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