Clinical Asthma: Theory and Practice

334 Pages·2014·14.007 MB·English

by  Jonathan A Bernstein, Mark L Levy

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Pulminary Medicine VR
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C L I N I C A L A S T H M A
T H E O R Y A N D P R A C T I C E

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Enormous progress in asthma research has been made in the past 50 years, includ- L
ing a greater understanding of its complex pathogenesis and new and more effective I
therapies. Consequently, the scientific literature has grown vast and can be difficult N
T H E O R Y A N D P R A C T I C E
to integrate. With contributions from a distinguished panel of world-renowned I
authors, Clinical Asthma: Theory and Practice presents a comprehensive study C
of both the common and the more challenging problems faced by all health care A
personnel who treat patients with asthma. L
Jonathan A. Bernstein • Mark L. Levy
EDITED BY

The book is divided into seven sections, starting with the basics of asthma and A
ending with a discussion on the approach to asthma worldwide and in the primary S
care setting. Reflecting a strong clinical emphasis, each chapter begins with a T
patient case study supported by essential background information on the basic H
science and clinical decision-making process. This is followed by a discussion of
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clinical evaluation and management.
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The multidisciplinary coverage explores a range of topics including genetics,
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inflammation, immunology, and the identification of different endotypes. Using a H
bench-to-bedside approach, the book links basic science to the clinical manage- E
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ment of asthma and explores options for improvement. The carefully selected
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authorship from experts worldwide presents a truly global outlook.
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About the editors:
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Jonathan A. Bernstein, MD, FAAAAI, FACAAI, FACP, FACCP
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Professor of Clinical Medicine, University of Cincinnati College of Medicine,
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Department of Internal Medicine, Division of Immunology/Allergy Section, A
Cincinnati, Ohio, USA C
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Mark L. Levy, MBChB (Pret) FRCGP C
General Practitioner and Senior Research Fellow Kenton Bridge, E

Medical Centre London, UK and Edinburgh University, UK
K19101
T H E O R Y A N D P R A C T I C E

T H E O R Y A N D P R A C T I C E
Edited by
Jonathan A. Bernstein
MD, FAAAAI, FACAAI, FACP, FACCP
Professor of Clinical Medicine, University of Cincinnati College of Medicine
Department of Internal Medicine, Division of Immunology/Allergy Section
Cincinnati, Ohio, USA
Mark L. Levy
MBChB (Pret) FRCG
General Practitioner and Senior Research Fellow, Kenton Bridge Medical
Centre London, UK and Edinburgh University, UK
Boca Raton London New York
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Version Date: 20131126
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Dedication
I dedicate this textbook to my father, I. Leonard Bernstein, MD, who was my role
model, mentor, and colleague. His thirst for knowledge and devotion to teaching,
research, and patient care were the qualities that inspired me to follow him into
the field of allergy and clinical immunology. It is especially significant that this
textbook focuses on asthma, as this “syndrome” was of particular interest to
him, especially as it pertained to the workplace. Through my father, I was able
to better appreciate how our understanding of the immunopathogenesis and
physiology of asthma leading to improvement in its management and treatment
has evolved dramatically over the past 60 years from a condition that was at
one time considered to be a psychiatric illness to what is now recognized as a
complex inflammatory lung disease influenced by a multitude of environmental and genetic determinants.
I. Leonard Bernstein recognized early on that the effective management of asthma required a team approach,
reflected in his early work with Dr. Tom Creer who developed the “Living with Asthma” educational model
that became the prototypic design for all subsequent behavioral modification education programs. The
selection of contributing authors for this book who trained in multiple specialties and disciplines reflects
the holistic approach to asthma care advocated by my father. Therefore, it is anticipated that this book,
which addresses the spectrum of basic and clinical issues pertaining to asthma, will be appealing to the
asthma specialist, the primary care physician, and other ancillary health-care providers that manage
asthma patients. Finally, like my father, who would not have been able to devote the amount of time to
his profession without the dedicated support of his wife and my mother Miriam, I would be remiss in not
expressing my deepest love and gratitude to my wife Lisa, who has been my greatest supporter and partner
throughout my career and has given me four fantastic children: Alison, Joshua, Rebecca, and Caren.
Jonathan A. Bernstein
For my father, Hymie Levy.
His unstinting support and the example he set inspired my career.
Mark L. Levy

Contents
Foreword ......................................................................................................................................................................................xi
Editors ........................................................................................................................................................................................xiii
Contributors ................................................................................................................................................................................xv
Section i the Basics of Asthma
Chapter 1 Epidemiology of Asthma: A Worldwide Perspective ..............................................................................................3
Colin R. Simpson and Aziz Sheikh
Chapter 2 Immunopathogenesis .............................................................................................................................................13
Chris J. Corrigan
Chapter 3 Genetics and Asthma ............................................................................................................................................21
Rebecca E. Slager, Xingnan Li, Deborah A. Meyers, and Eugene R. Bleecker
Chapter 4 Endotypes and Asthma .........................................................................................................................................29
Pranabashis Haldar and Rachid Berair
Section ii Diagnosis of Asthma
Chapter 5 Guidelines in Asthma ............................................................................................................................................47
Louis-Philippe Boulet
Chapter 6 Diagnosis of Asthma in Preschool-Age Children .................................................................................................57
Chris Cleveland, Lora Stewart, Bradley Chipps, and Joseph D. Spahn
Chapter 7 Diagnosis of Asthma in Older Children and Adults .............................................................................................65
Paul M. O’Byrne
Chapter 8 United Airways: Managing Patients with Allergic Rhinitis and Asthma .............................................................71
Glenis K. Scadding and Guy Scadding
Section iii Asthma triggers
Chapter 9 Viral Infections in Asthma ....................................................................................................................................83
Joy Hsu and Pedro C. Avila
Chapter 10 Asthma and Allergens ...........................................................................................................................................93
James L. Friedlander, Sachin Baxi, and Wanda Phipatanakul
vii
viii Contents
Chapter 11 Air Pollutants .......................................................................................................................................................101
Neil E. Alexis and Chris Carlsten
Chapter 12 Exercise-Induced Bronchoconstriction ................................................................................................................111
Christopher Randolph and John M. Weiler
Section iV Asthma education and outcomes
Chapter 13 Asthma Education ...............................................................................................................................................127
Vanessa M. McDonald and Peter G. Gibson
Chapter 14 Adherence and Outcomes ...................................................................................................................................139
Andrew G. Weinstein
Chapter 15 Inhaler Devices....................................................................................................................................................151
Federico Lavorini, Mark L. Levy, and Giovanni A. Fontana
Chapter 16 Assessment of Asthma Control in Adults ...........................................................................................................163
Claude S. Farah and Helen K. Reddel
Section V Asthma Management and treatments
Chapter 17 Management of Pediatric Asthma .......................................................................................................................177
Leonard B. Bacharier
Chapter 18 Management of Adolescent Asthma ...................................................................................................................187
Gina T. Cosia, Beverley J. Sheares, and Jean-Marie Bruzzese
Chapter 19 Management of Adult Asthma ............................................................................................................................197
Pallavi Bellamkonda and Thomas B. Casale
Chapter 20 Management of Asthma in Older Adults ............................................................................................................207
Tolly G. Epstein
Chapter 21 Severe Acute and Life-Threatening Asthma in Children.....................................................................................217
Annabelle Quizon and Erick Forno
Chapter 22 Severe Acute and Life-Threatening Asthma in Adults .......................................................................................227
Brian H. Rowe
Contents ix
Section Vi Asthma and Special Populations
Chapter 23 Asthma and Obesity: Clinical Implications ........................................................................................................241
Fernando Holguin
Chapter 24 Occupational Asthma ..........................................................................................................................................247
Jonathan A. Bernstein
Chapter 25 Asthma in Pregnancy ..........................................................................................................................................259
Paul A. Greenberger
Chapter 26 Anxiety and Depression and Asthma ..................................................................................................................265
Alison C. McLeish, Kimberly M. Avallone, and Kristen M. Kraemer
Section Vii Approach to Asthma Worldwide and in the Primary care Setting
Chapter 27 Managing Asthma and Allergy: A Countrywide Approach to Integrating Care ...............................................277
Tari Haahtela
Chapter 28 Primary Care Setting and Integrating Care across Primary/Secondary Care Interface ....................................287
Barbara P. Yawn
Chapter 29 Preventing Asthma Death: Primary Care Setting ...............................................................................................299
Mark L. Levy