Conclusion : Aspirin‐intolerant asthma identified in the general population was associated with a high burden of symptoms, uncontrolled disease and a high morbidity. Increasing body mass index increased the risk of aspirin‐intolerant asthma in a dose‐response manner.

A number of risk factors, including obesity and current smoking, were considerably stronger for aspirin‐intolerant asthma than for aspirin‐tolerant asthma.

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On 17 June 2014, the National IHR Focal Point of Saudi Arabia notified WHO of 2 additional laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV).

Details of the cases

• A 42 year old resident of Jeddah city, Mecca Region. He was admitted to a hospital in Jeddah for a medical condition on 26 May and was discharged on 4 June. The patient visited his physician as follow up in the same hospital on 11 June. On 13 June, he developed respiratory symptoms, was diagnosed with pneumonia and was re-admitted to the hospital. He was laboratory-confirmed with MERS-CoV on 16 June. His condition deteriorated and he died on 18 June. The patient is reported not to have had contact with a laboratory-confirmed case with MERS-CoV. He neither had a history of recent travel nor a history of contact with animals. Preliminary investigations indicate that none of the personnel working in the ward where the patient was initially admitted had illnesses that fit the case definition for MERS-CoV.
• A 58 year old resident of Riyadh city, Riyadh Region. He became ill on 4 June and was admitted to a hospital on 12 June. He was laboratory-confirmed with MERS-CoV on 15 June. The patient is currently in a stable condition. ...

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Related Articles

STUDY OBJECTIVE: Noninvasive positive-pressure ventilation (NIPPV) is increasingly being used by emergency medical services (EMS) for treatment of patients in respiratory distress. The primary objective of this systematic review is to determine whether out-of-hospital NIPPV for treatment of adults with severe respiratory distress reduces inhospital mortality compared with "standard" therapy. Secondary objectives are to examine the need for invasive ventilation, hospital and ICU length of stay, and complications.

METHODS: Electronic searches of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature were conducted and reference lists of relevant articles hand searched. Randomized controlled trials comparing out-of-hospital NIPPV with standard therapy in adults (aged ≥16 years) with severe respiratory distress published in English were included. Two reviewers independently screened abstracts, assessed quality of the studies, and extracted data. Data were pooled with random-effects models and reported as risk ratios (RRs) with 95% confidence intervals (CIs) and number needed to treat (NNT).

RESULTS: Seven randomized controlled trials were included, with a combined total of 632 patients; 313 in the standard therapy group and 319 in the NIPPV group. In patients treated with NIPPV, the pooled estimate showed a reduction in both inhospital mortality (RR 0.58; 95% CI 0.35 to 0.95; NNT=18) and need for invasive ventilation (RR 0.37; 95% CI 0.24 to 0.58; NNT=8). There was no difference in ICU or hospital length of stay.

CONCLUSION: Out-of-hospital administration of NIPPV appears to be an effective therapy for adult patients with severe respiratory distress.

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