What is the biggest obstacle you face in communicating the impact of environmental tobacco smoke?

The main treatment of asthma is inhaled corticosteroids. However adherence to these medications in asthma is often poor, with low adherence associated with excessive health care costs and an increased risk of emergency room visits and mortality. Although various methods are used to indirectly assess adherence, all have significant limitations whether used in clinical or research practice. The recent development of electronic monitoring devices (EMDs) for use with inhalers presents an exciting opportunity to easily and accurately measure inhaler adherence.

Cough is the most common complaint for which patients seek medical attention. Cough variant asthma (CVA) is a form of asthma, which presents solely with cough. CVA is one of the most common causes of chronic cough. More importantly, 30 to 40% of adult patients with CVA, unless adequately treated, may progress to classic asthma. CVA shares a number of pathophysiological features with classic asthma such as atopy, airway hyper-responsiveness, eosinophilic airway inflammation and various features of airway remodeling.

Asthma is a pathophysiological condition associated with eosinophilia and heightened inflammatory reactions, epithelial desquamation, hyper responsiveness, recurring episodes of reversible broncho-constriction, and mucus hyper secretion from the respiratory organs. Asthma interludes can be triggered by a variety of factors most notably allergens, infectious agents, pollutants, and nonspecific stimuli such as exercise, nutritional factors and emotional stress. Certain genes and their polymorphism may also have effects in the initiation and progression of asthma.

Thickening of the basement membrane zone (BMZ) is a characteristic feature of airway remodeling in the lungs of asthmatics. However the significance of a thickened BMZ in the pathology of the asthmatic airway is not known. In this review we show that the columnar epithelium is linked to the reticular BMZ through the supracellular anchoring network. We discuss the evidence that changes in the width of the BMZ in control airways are part of a supracellular anchoring mechanism for increasing the strength of attachment between the airway epithelium and the extracellular matrix (ECM).

Hi All,

I work with the Clean Air for Kids program at the Tacoma-Pierce County Health Department in the State of Washington. The majority of our work is done utilizing home visits and our database is not quite up to snuff. We are starting to shop around for other databases and thought we would check and see what other programs are using. If you are willing, it would be helpful if you could share: what database you are using, how much it cost, what fields you can fill in, can it be used on a laptop/tablet, what are the pros and cons.

Many thanks in advance!

What level of attrition do you typically experience? For example, if you were to successfully enroll 100 families and they received your initial visit, how many would "graduate" through the entire program?