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Severe asthma: looking beyond the amount of medication
The Lancet Respiratory Medicine ( IF 38.7 ) Pub Date : 2017-10-11 , DOI: 10.1016/s2213-2600(17)30379-x
Andrew Bush 1 , Sejal Saglani 1 , Louise Fleming 1
Affiliation  

In 20081 we proposed the concept of problematic severe asthma as an umbrella term for children referred to a specialist service who are not responding to high-dose asthma medications.2 Problematic severe asthma comprised non-asthma-related conditions (ie, wrong diagnosis) and asthma-plus comorbidities (eg, obesity, rhinosinusitis, food allergies, and dysfunctional breathing; excluding gastro-oesophageal reflux).3 After confirming the diagnosis, all children with problematic severe asthma referred to our severe asthma clinic undergo a detailed nurse-led assessment,4 which considers airway disease in the context of comorbidities, and social and environmental factors,5 before even considering assessment of airway pathology using bronchoscopy.

中文翻译:

重度哮喘:超越药物剂量

2008 年1我们提出了问题性严重哮喘的概念,将其作为对高剂量哮喘药物无反应的专科服务儿童的总称。2有问题的重度哮喘包括非哮喘相关病症(即错误诊断)和哮喘合并症(例如肥胖、鼻鼻窦炎、食物过敏和呼吸功能障碍;不包括胃食管反流)。3在确认诊断后,所有转诊到我们严重哮喘门诊的有问题的严重哮喘儿童都会接受由护士主导的详细评估,4考虑合并症背景下的气道疾病以及社会和环境因素,5甚至在考虑使用支气管镜检查评估气道病理学之前。
更新日期:2017-10-12
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