The finding that pneumatic otoscopy can do as well as or better than tympanometry and acoustic reflectometry has significant practical implications. For the typical clinician, pneumatic otoscopy should be easier to use than other diagnostic methods. The important question may be what degree of training will be needed for the clinician to be as effective with pneumatic otoscopy as were the examiners in the studies reviewed in this report.

Asthma is related to school absenteeism and underperformance in elementary students. This pilot study assessed whether school nurse case management (CM) in children identified with asthma impacts academic performance and school absenteeism in one school. A validated questionnaire was used to identify children at risk for asthma and CM was provided to link these students to medical care and assure asthma action plans at school. In the 40 children with confirmed diagnosis who received CM, academic performance on standardized testing postintervention was similar to the 76 children who were low risk for asthma. Average days absent due to illness in the CM group were reduced from 5.8 to 3.7 days in the postintervention school year. School nurse screening, CM, and collaboration with a medical provider resulted in early identification, referral, and subsequent treatment of students at risk for asthma and may have contributed to reduced illness absences.

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Objective The purpose of this study was to determine the relationship of poor asthma control to bronchodilator response (BDR) phenotypes in children with normal spirometry. Methods Asthmatic children were assessed for clinical indices of poorly controlled asthma. Pre and post bronchodilator spirometry were performed and the percent BDR determined. Multivariate logistic regression assessed the relationship of the clinical indices to BDR at ≥8%, ≥10% and ≥12% BDR thresholds. Results There were 510 controller naïve, and 169 on controller medication. In the controller naïve population the mean age (± 1SD) was 9.5 (3.4), 57.1% were male, 85.7% Hispanic. Demographics were similar in both populations. In the adjusted profile, significant clinical relationships were found particularly to positive BDR phenotypes ≥10% and ≥12% versus negative responses including younger age, (odds ratios (OR) 2.0, 2.5; P <.05), atopy (OR 1.9, 2.6;P< .01), nocturnal symptoms in females (OR 3.4, 3.8;P< .01); beta2 agonist use (OR 1.7, 2.8;P< .01); and exercise limitation (OR 2.2, 2.5;P< .01) only in the controller naïve population. Conclusions The BDR phenotype ≥10% is significantly related to poor asthma control providing a potentially useful objective tool in controller naïve children even when prebronchodilator spirometry is normal.