Archive for March, 2010

Management of Asthma Based on Exhaled Nitric Oxide in Addition to Guideline-Based Treatment for Inner-City Adolescents and Young Adults: A Randomised Controlled Trial
Niya H. Wanich, MD, Michael S. Kaplan, MD
Los Angeles, CA

Szefler SJ, Mitchell H, Sorkness CA, et al. Lancet. 2008;372(9643):1065–1072

PURPOSE OF THE STUDY. To determine whether the use of exhaled nitric oxide (NO) measurements to modify asthma treatment regimens improves asthma control when used as an adjunct to management based on national asthma care guidelines.

STUDY POPULATION. A randomized, double-blind, parallel-group trial at 10 centers in the United States monitored a total of 546 inner-city subjects, 12 to 20 years of age, with poorly controlled asthma.

METHODS. Physician assessment was performed every 6 to 8 weeks for 46 weeks, during which patients were evaluated for asthma symptoms, pulmonary function, and exhaled NO, a marker of airway inflammation. At each visit, treatment was stepped up or down on the basis of the National Asthma Education and Prevention Program (NAEPP) asthma care guidelines for the control group or the NAEPP guidelines plus measurements of fraction of exhaled NO (FeNO) for the NO group.

RESULTS. There was no difference between the control group and the NO group with respect to asthma symptoms, pulmonary function, or asthma exacerbations. By the end of the study, patients in the NO group were receiving higher doses of inhaled corticosteroids (difference in fluticasone doses: 119 µg; P = .001) than were those in the control group, with a greater number receiving long-acting ?2-adrenergic receptor agonists. Adverse events did not differ between the treatment groups.

CONCLUSIONS. The addition of FeNO as an indicator of asthma control resulted in higher doses of inhaled corticosteroids, without clinically important improvements in symptomatic asthma control.

REVIEWERS COMMENTS. Because asthma symptoms and exacerbations are linked to underlying airway inflammation, it seems that using measurements of biomarkers that are indicators of airway inflammation (FeNO) to direct asthma management would improve asthma control. However, this study showed that use of current NAEPP guidelines for asthma treatment alone provided good asthma control for inner-city adolescents and young adults. The addition of FeNO measurements resulted in higher doses of inhaled corticosteroids and long-acting ?2-adrenergic receptor agonists, without producing additional improvements in asthma symptoms, lung function, or need for health care.

3 Sites to Get Your Medical Questions Answered by Experts for Free: ”

Going to the doctor can be expensive, especially if you don’t have a health plan. What’s annoying is discovering you could have gotten his or her advice for free within the comfort and privacy of your own home by having your medical questions answered free from professionals online.

Often, diagnosing illnesses and symptoms can be extremely simple. Learning more about the condition that you have educates you, so you can make an informed decision on whether or not you should then seek medical attention or deal with it yourself.
Of course, medical advice is something you want from a trusted source. And the Internet is often presumed to be a bad source for health apps and information. However, there are quite a few websites out there owned and run by healthcare professional providing free medical advice and answers to readers questions. Here are three great sites where you can have your medical questions answered for free.

Editor’s note: MakeUseOf is in no way advocating self-diagnosis and/or treatment. This is merely a source of information. If you require medical attention, do not hesitate to visit a healthcare professional.

Medical Questions Answered Free – Ask Medical Doctor

This is a simple site with thousands of answered questions already in its database. It’s really simple to use and is held in a very high esteem by its users. Along the top of the site there are various categories and links to the doctors’ profiles and recent questions. There is also a ticker tape running across the top of the screen with numerous conditions including everything from Autism to Cancer and STIs.

medical questions answered free

The homepage consists mainly of this question form which you enter your medical query into. The response time varies much in the same way replies to comments on a blog vary. Whenever there is a doctor on call, then your questions should be answered. 24 hours would be the maximum you’ll be waiting.

However, you may not need to even ‘ask’ your question. As I mentioned above, there are thousands already answered so performing a search or sifting through one of the categories along the top of the site may be quicker.

Med Help

MedHelp is a form of medical social network with over 9 million visitors per month. The community is made up of users and experts (experts are clearly marked). Registration is required to partake in the community. I think this is to keep you coming back and hopefully spread your own knowledge.

medical questions answered free

What I liked most about this site was that the community answers questions as well as experts. Obviously, the community could only answer general knowledge questions from their own experience. But with such a large amount of users there is bound to be someone there who went through it before you did. There is also user forums and dictionaries to look up medical jargon (this is very useful) and profiles of various health centres and treatments.

medical questions answered free

The community on MedHelp are supportive, mature and above all else, backed up by experts in their fields who keep the conversation accurate and dole out excellent advice to those who need it.

The site also offers numerous tools and web apps to help you keep fit and track recovery data. Ryan profiled those here a few months back.

MD Advice

This website is also great for having your medical questions answered. When you first log onto the site, click ‘Ask and Expert’ in the left-hand column. This will bring you to the a page where you can submit your question to the doctor and receive a reply via email.

There is also a vast library of previously answered questions, like the sites above. They also have loads of articles and information on the website such as ‘Drug Information’ and the ‘Health Library’.

The Health Library is the reason I chose MD Advice. It’s packed with loads of common injuries and illnesses such as sports injuries and pregnancy along with health advice and nutrition. Furthermore, there is a community message board and also live chat rooms for both the expert and the members.

mdadvice

Always remember though, information found on the Internet should only be secondary to that of a doctor who you can meet in person and have checks done. For medical emergencies and extreme cases with a sense of urgency, it’s best to visit your doctor.

So there you go. Before you rush off to the doctors next time, check to see if your symptoms are something which can be treated at home. Which online medical services do you use?

(Via MakeUseOf.com.)

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