bronchiolitis

Summary

Summary: Inflammation of the BRONCHIOLES.

Top Publications

  1. Arora B, Mahajan P, Zidan M, Sethuraman U. Nasopharyngeal airway pressures in bronchiolitis patients treated with high-flow nasal cannula oxygen therapy. Pediatr Emerg Care. 2012;28:1179-84 pubmed publisher
    ..There are no data on airway pressures generated and efficacy in bronchiolitis. The objective of this study was to determine nasopharyngeal (NP) pressures generated with HHHFNC therapy in ..
  2. Gomes E, Postiaux G, Medeiros D, Monteiro K, Sampaio L, Costa D. Chest physical therapy is effective in reducing the clinical score in bronchiolitis: randomized controlled trial. Rev Bras Fisioter. 2012;16:241-7 pubmed
    ..the effectiveness of chest physical therapy (CP) in reducing the clinical score in infants with acute viral bronchiolitis (AVB). Randomized controlled trial of 30 previously healthy infants (mean age 4.08 SD 3...
  3. Scagnolari C, Midulla F, Riva E, Monteleone K, Solimini A, Bonci E, et al. Evaluation of interleukin 28B single nucleotide polymorphisms in infants suffering from bronchiolitis. Virus Res. 2012;165:236-40 pubmed publisher
    The genetic diversity of the host is believed to be the key of the diversity in the clinical presentation of bronchiolitis. The aim of this study was to determine whether the known rs12979860 and rs8099917 single nucleotide polymorphisms ..
  4. Akenroye A, Baskin M, Samnaliev M, Stack A. Impact of a bronchiolitis guideline on ED resource use and cost: a segmented time-series analysis. Pediatrics. 2014;133:e227-34 pubmed publisher
    b>Bronchiolitis is a major cause of infant morbidity and contributes to millions of dollars in health care costs. Care guidelines may cut costs by reducing unnecessary resource utilization...
  5. Lewin A, Buteau S, Brand A, Kosatsky T, Smargiassi A. Short-term risk of hospitalization for asthma or bronchiolitis in children living near an aluminum smelter. J Expo Sci Environ Epidemiol. 2013;23:474-80 pubmed publisher
    ..Here we estimate the risk of hospitalization for asthma and bronchiolitis in young children associated with their recent exposure to emissions from an aluminum smelter...
  6. McCallum G, Morris P, Chang A. Antibiotics for persistent cough or wheeze following acute bronchiolitis in children. Cochrane Database Syst Rev. 2012;12:CD009834 pubmed publisher
    b>Bronchiolitis is a common acute respiratory infectious condition, with a high prevalence worldwide. It is a clinically diagnosed syndrome, manifested by tachypnoea (rapid breathing), with crackles or wheeze in young children...
  7. Morgan D, Jokinen M, Price H, Gwinn W, Palmer S, Flake G. Bronchial and bronchiolar fibrosis in rats exposed to 2,3-pentanedione vapors: implications for bronchiolitis obliterans in humans. Toxicol Pathol. 2012;40:448-65 pubmed publisher
    ..The use of PD is increasing since diacetyl, a major butter flavorant, was associated with bronchiolitis obliterans (BO) in workers and has been removed from many products...
  8. Mansbach J, Piedra P, Laham F, McAdam A, Clark S, Sullivan A, et al. Nasopharyngeal lactate dehydrogenase concentrations predict bronchiolitis severity in a prospective multicenter emergency department study. Pediatr Infect Dis J. 2012;31:767-9 pubmed publisher
    ..between values of nasopharyngeal lactate dehydrogenase, a marker of the innate immune response, and bronchiolitis severity...
  9. Esposito S, Salice P, Bosis S, Ghiglia S, Tremolati E, Tagliabue C, et al. Altered cardiac rhythm in infants with bronchiolitis and respiratory syncytial virus infection. BMC Infect Dis. 2010;10:305 pubmed publisher
    ..virus (RSV) infection involve the cardiovascular system, no data regarding heart function in infants with bronchiolitis associated with RSV infection have yet been systematically collected...

More Information

Publications62

  1. Jones L, Hashim A, McKeever T, Cook D, Britton J, Leonardi Bee J. Parental and household smoking and the increased risk of bronchitis, bronchiolitis and other lower respiratory infections in infancy: systematic review and meta-analysis. Respir Res. 2011;12:5 pubmed publisher
    ..of studies of the association between passive smoking and LRI, and with diagnostic subcategories including bronchiolitis, in infants aged two years and under...
  2. Atzei A, Atzori L, Moretti C, Barberini L, Noto A, Ottonello G, et al. Metabolomics in paediatric respiratory diseases and bronchiolitis. J Matern Fetal Neonatal Med. 2011;24 Suppl 2:59-62 pubmed publisher
    ..the application of clinical metabolomics in three different areas of respiratory diseases in pediatrics: asthma, pneumonia and bronchiolitis. Comparison between two 1H-NMR urine spectra by two bronchiolitis patients are also presented.
  3. Johnston C, de Carvalho W, Piva J, Garcia P, Fonseca M. Risk factors for extubation failure in infants with severe acute bronchiolitis. Respir Care. 2010;55:328-33 pubmed
    ..blood gas values, and ventilatory indexes as predictors of extubation failure in infants with severe acute bronchiolitis. We conducted a prospective observational study from March 2004 to September 2005 with consecutive infants (..
  4. Roqué I Figuls M, Gine Garriga M, Granados Rugeles C, Perrotta C. Chest physiotherapy for acute bronchiolitis in paediatric patients between 0 and 24 months old. Cochrane Database Syst Rev. 2012;:CD004873 pubmed publisher
    This is an update of the original Cochrane review published in 2005 and updated in 2007. Acute bronchiolitis is the leading cause of medical emergencies during winter in children younger than two years of age...
  5. Nuolivirta K, Hurme M, Halkosalo A, Koponen P, Korppi M, Vesikari T, et al. Gene polymorphism of IFNG +874 T/A and TLR4 +896 A/G and recurrent infections and wheezing in toddlers with history of bronchiolitis. Pediatr Infect Dis J. 2009;28:1121-3 pubmed publisher
    ..and TLR4 polymorphisms and their association with the infection history of 129 children hospitalized for bronchiolitis during the first 6 months of life were analyzed...
  6. Houben M, Rovers M, Wilbrink B, Belderbos M, Bloemen Carlier E, Visser G, et al. High concentrations of amniotic fluid proinflammatory cytokines in healthy neonates are associated with low risk of respiratory syncytial virus bronchiolitis. Pediatr Infect Dis J. 2012;31:931-4 pubmed publisher
    The burden of respiratory syncytial virus (RSV) bronchiolitis in individual children and their families, the medical system and society is considerable. Mechanisms underlying RSV bronchiolitis in healthy term infants are largely unknown...
  7. Nuolivirta K, He Q, Vuononvirta J, Koponen P, Helminen M, Korppi M. Toll-like receptor 3 L412F polymorphisms in infants with bronchiolitis and postbronchiolitis wheezing. Pediatr Infect Dis J. 2012;31:920-3 pubmed publisher
    ..L412F polymorphism and viral findings, clinical characteristics and subsequent wheezing in young infants with bronchiolitis. In all, 129 full-term infants hospitalized for bronchiolitis at age <6 months have been followed-up until ..
  8. Faber T, Groen H, Welfing M, Jansen K, Bont L. Specific increase in local IL-17 production during recovery from primary RSV bronchiolitis. J Med Virol. 2012;84:1084-8 pubmed publisher
    Although Respiratory syncytial virus (RSV) bronchiolitis is the most important cause of hospital admission for infants during the winter season, the pathogenesis is largely unknown...
  9. Gupta N, Puliyel A, Manchanda A, Puliyel J. Nebulized hypertonic-saline vs epinephrine for bronchiolitis; proof of concept study of cumulative sum (CUSUM) analysis. Indian Pediatr. 2012;49:543-7 pubmed
    To apply cumulative sum (CUSUM) to monitor a drug trial of nebulized hypertonic-saline in bronchiolitis. To test if monitoring with CUSUM control lines is practical and useful as a prompt to stop the drug trial early, if the study drug ..
  10. Scagnolari C, Midulla F, Pierangeli A, Moretti C, Bonci E, Berardi R, et al. Gene expression of nucleic acid-sensing pattern recognition receptors in children hospitalized for respiratory syncytial virus-associated acute bronchiolitis. Clin Vaccine Immunol. 2009;16:816-23 pubmed publisher
    ..with respiratory syncytial virus (RSV) infection might explain the broad clinical spectrum of RSV-associated bronchiolitis in infants...
  11. Rosychuk R, Klassen T, Voaklander D, Senthilselvan A, Rowe B. Presentations of infants to emergency departments in Alberta, Canada, for bronchiolitis: a large population-based study. Pediatr Emerg Care. 2011;27:189-95 pubmed publisher
    b>Bronchiolitis is the most common lower respiratory tract disease among infants and results in 35 admissions per 1000 infants in Canada...
  12. Mikalsen I, Halvorsen T, Øymar K. The outcome after severe bronchiolitis is related to gender and virus. Pediatr Allergy Immunol. 2012;23:391-8 pubmed publisher
    The association between bronchiolitis in the first year of life and subsequent asthma, atopy, airway obstruction and bronchial hyper-responsiveness (BHR) is unsettled...
  13. Huguenin A, Moutte L, Renois F, Leveque N, Talmud D, Abely M, et al. Broad respiratory virus detection in infants hospitalized for bronchiolitis by use of a multiplex RT-PCR DNA microarray system. J Med Virol. 2012;84:979-85 pubmed publisher
    ..RT-PCR DNA microarray in diagnosis and epidemiological survey of viral infections in infants hospitalized for bronchiolitis was assessed...
  14. Miron D, Srugo I, Kra Oz Z, Keness Y, Wolf D, Amirav I, et al. Sole pathogen in acute bronchiolitis: is there a role for other organisms apart from respiratory syncytial virus?. Pediatr Infect Dis J. 2010;29:e7-e10 pubmed publisher
    Acute bronchiolitis (AB) is a common disease of young children with peak incidence during the winter season...
  15. Chang A, Chang C, O Grady K, Torzillo P. Lower respiratory tract infections. Pediatr Clin North Am. 2009;56:1303-21 pubmed publisher
    ..b>Bronchiolitis and pneumonia account for the majority of the ALRI burden...
  16. Zorc J, Hall C. Bronchiolitis: recent evidence on diagnosis and management. Pediatrics. 2010;125:342-9 pubmed publisher
    Viral bronchiolitis is a leading cause of acute illness and hospitalization of young children...
  17. Kim C, Callaway Z, Koh Y, Kim S, Fujisawa T. Airway IFN-? production during RSV bronchiolitis is associated with eosinophilic inflammation. Lung. 2012;190:183-8 pubmed publisher
    ..the possible role of IFN-? in eosinophil degranulation that occurs during respiratory syncytial virus (RSV) bronchiolitis. Sixty-seven infants, 2-24 months old and hospitalized with their first episode of acute RSV bronchiolitis, ..
  18. Hosakote Y, Jantzi P, Esham D, Spratt H, Kurosky A, Casola A, et al. Viral-mediated inhibition of antioxidant enzymes contributes to the pathogenesis of severe respiratory syncytial virus bronchiolitis. Am J Respir Crit Care Med. 2011;183:1550-60 pubmed publisher
    ..S-transferase, and glutathione peroxidase in murine lungs and in the airways of children with severe bronchiolitis. Markers of oxidative damage correlated with severity of clinical illness in RSV-infected infants...
  19. Da Dalt L, Bressan S, Martinolli F, Perilongo G, Baraldi E. Treatment of bronchiolitis: state of the art. Early Hum Dev. 2013;89 Suppl 1:S31-6 pubmed publisher
    b>Bronchiolitis is a leading cause of acute illness and hospitalization for infants and young children worldwide...
  20. Papoff P, Moretti C, Cangiano G, Bonci E, Roggini M, Pierangeli A, et al. Incidence and predisposing factors for severe disease in previously healthy term infants experiencing their first episode of bronchiolitis. Acta Paediatr. 2011;100:e17-23 pubmed publisher
    To determine the incidence and predisposing factors for severe bronchiolitis in previously healthy term infants <12?months of age experiencing their first episode of bronchiolitis...
  21. Gajdos V, Katsahian S, Beydon N, Abadie V, de Pontual L, Larrar S, et al. Effectiveness of chest physiotherapy in infants hospitalized with acute bronchiolitis: a multicenter, randomized, controlled trial. PLoS Med. 2010;7:e1000345 pubmed publisher
    Acute bronchiolitis treatment in children and infants is largely supportive, but chest physiotherapy is routinely performed in some countries...
  22. Petruzella F, Gorelick M. Duration of illness in infants with bronchiolitis evaluated in the emergency department. Pediatrics. 2010;126:285-90 pubmed publisher
    To describe the duration of illness in infants with first-time bronchiolitis who present to an emergency department (ED) and assess the burden of the illness on caregivers and families...
  23. Bailey E, Maclennan C, Morris P, Kruske S, Brown N, Chang A. Risks of severity and readmission of Indigenous and non-Indigenous children hospitalised for bronchiolitis. J Paediatr Child Health. 2009;45:593-7 pubmed publisher
    To describe the characteristics of children admitted to Royal Darwin Hospital with bronchiolitis, and to compare the severity of illness and incidence of subsequent readmission in Indigenous and non-Indigenous children...
  24. Miller E, Gebretsadik T, Carroll K, Dupont W, Mohamed Y, Morin L, et al. Viral etiologies of infant bronchiolitis, croup and upper respiratory illness during 4 consecutive years. Pediatr Infect Dis J. 2013;32:950-5 pubmed publisher
    Prospective data on viral etiology and clinical characteristics of bronchiolitis and upper respiratory illness (URI) in infants are limited...
  25. Abu Raya B, Bamberger E, Kassis I, Kugelman A, Srugo I, Miron D. Bordetella pertussis infection attenuates clinical course of acute bronchiolitis. Pediatr Infect Dis J. 2013;32:619-21 pubmed publisher
    ..The aim of this study was to assess clinical characteristics of BP infection, and its effect on disease severity in young children hospitalized with acute bronchiolitis.
  26. Caiulo V, Gargani L, Caiulo S, Fisicaro A, Moramarco F, Latini G, et al. Lung ultrasound in bronchiolitis: comparison with chest X-ray. Eur J Pediatr. 2011;170:1427-33 pubmed publisher
    The diagnosis of bronchiolitis is based mainly on the patient's medical history and physical examination. However, in severe cases, a further evaluation including chest X-ray (CXR) may be necessary...
  27. Plint A, Johnson D, Patel H, Wiebe N, Correll R, Brant R, et al. Epinephrine and dexamethasone in children with bronchiolitis. N Engl J Med. 2009;360:2079-89 pubmed publisher
    ..have explored the benefit of using nebulized epinephrine or corticosteroids alone to treat infants with bronchiolitis, the effectiveness of combining these medications is not well established...
  28. Tinsa F, Ben Rhouma A, Ghaffari H, Boussetta K, Zouari B, Brini I, et al. A randomized, controlled trial of nebulized terbutaline for the first acute bronchiolitis in infants less than 12-months-old. Tunis Med. 2009;87:200-3 pubmed
    Despite the common clinical practice, the available evidence on the efficacy of bronchodilators therapy for bronchiolitis is conflicting...
  29. Pezzotti P, Mantovani J, Benincori N, Mucchino E, Di Lallo D. Incidence and risk factors of hospitalization for bronchiolitis in preterm children: a retrospective longitudinal study in Italy. BMC Pediatr. 2009;9:56 pubmed publisher
    b>Bronchiolitis is a distressing, potentially life-threatening respiratory condition that affects infants. We evaluated the incidence and risk factors of hospitalization for broncholitis in preterm infants (i.e...
  30. Carraro S, Zanconato S, Baraldi E. Bronchiolitis: from empiricism to scientific evidence. Minerva Pediatr. 2009;61:217-25 pubmed
    b>Bronchiolitis is the most common viral infection of the lower respiratory tract in infants in their first year of life, with an incidence peak between 3 and 9 months of age...
  31. Fitzgerald D. Preventing RSV bronchiolitis in vulnerable infants: the role of palivizumab. Paediatr Respir Rev. 2009;10:143-7 pubmed publisher
  32. Pupin M, Riccetto A, Ribeiro J, Baracat E. Comparison of the effects that two different respiratory physical therapy techniques have on cardiorespiratory parameters in infants with acute viral bronchiolitis. J Bras Pneumol. 2009;35:860-7 pubmed
    ..in terms of their effects on the heart rate (HR), respiratory rate (RR) and SpO(2) of infants with acute viral bronchiolitis (AVB). Infants with clinical and radiological diagnosis of AVB were analyzed...
  33. Mittal V, Shah A. Situs inversus totalis: the association of Kartagener's syndrome with diffuse bronchiolitis and azoospermia. Arch Bronconeumol. 2012;48:179-82 pubmed publisher
    ..Association of diffuse bronchiolitis (DB) with KS has been documented from Japan only...
  34. O Donnell D, Parslow R, Draper E. Deprivation, ethnicity and prematurity in infant respiratory failure in PICU in the UK. Acta Paediatr. 2010;99:1186-91 pubmed publisher
    ..epidemiology of infants admitted to Paediatric Intensive Care (PIC) with acute respiratory failure including bronchiolitis. Data from all consecutive admissions from 2004 to 2007 in all 29 designated Paediatric Intensive Care Units (..
  35. Franz A, Adams O, Willems R, Bonzel L, Neuhausen N, Schweizer Krantz S, et al. Correlation of viral load of respiratory pathogens and co-infections with disease severity in children hospitalized for lower respiratory tract infection. J Clin Virol. 2010;48:239-45 pubmed publisher
    ..The clinical significance of viral load and co-infections in children with respiratory infections is not clear...
  36. Laham F, Trott A, Bennett B, Kozinetz C, Jewell A, Garofalo R, et al. LDH concentration in nasal-wash fluid as a biochemical predictor of bronchiolitis severity. Pediatrics. 2010;125:e225-33 pubmed publisher
    Because the decision to hospitalize an infant with bronchiolitis is often supported by subjective criteria and objective indicators of bronchiolitis severity are lacking, we tested the hypothesis that lactate dehydrogenase (LDH), which ..
  37. Nuolivirta K, He Q, Gröndahl Yli Hannuksela K, Koponen P, Korppi M, Helminen M. Mannose-binding lectin gene polymorphisms in infants with bronchiolitis and post-bronchiolitis wheezing. Allergol Int. 2012;61:305-9 pubmed publisher
    ..of the MBL2 gene and viral findings, clinical characteristics and subsequent wheezing in young infants with bronchiolitis. In all, 129 full-term infants hospitalized for bronchiolitis at age less than 6 months have been followed-up ..
  38. Vissing N, Chawes B, Bisgaard H. Increased risk of pneumonia and bronchiolitis after bacterial colonization of the airways as neonates. Am J Respir Crit Care Med. 2013;188:1246-52 pubmed publisher
    The frequency of pneumonia and bronchiolitis exhibits considerable variation in otherwise healthy children, and suspected risk factors explain only a minor proportion of the variation...
  39. Trow T, Morris D, Miller C, Homer R. Granulomatous bronchiolitis of Crohn's disease successfully treated with inhaled budesonide. Thorax. 2009;64:546-7 pubmed publisher
    ..white woman with longstanding Crohn's disease presented with the rare complication of granulomatous bronchiolitis. Rapid resolution after inhaled budesonide is highlighted, as this is the first case described in the ..
  40. McKiernan C, Chua L, Visintainer P, Allen H. High flow nasal cannulae therapy in infants with bronchiolitis. J Pediatr. 2010;156:634-8 pubmed publisher
    ..cannulae (HFNC) therapy was associated with decreased rates of intubation for infants <24 months old with bronchiolitis admitted to a pediatric intensive care unit (PICU)...
  41. Brand H, De Groot R, Galama J, Brouwer M, Teuwen K, Hermans P, et al. Infection with multiple viruses is not associated with increased disease severity in children with bronchiolitis. Pediatr Pulmonol. 2012;47:393-400 pubmed publisher
    ..This study evaluated the association between the detection of multiple viruses by RT-PCR and disease severity in children with bronchiolitis.
  42. Bressan S, Balzani M, Krauss B, Pettenazzo A, Zanconato S, Baraldi E. High-flow nasal cannula oxygen for bronchiolitis in a pediatric ward: a pilot study. Eur J Pediatr. 2013;172:1649-56 pubmed publisher
    High-flow nasal cannula (HFNC) is a widely used ventilatory support in children with bronchiolitis in the intensive care setting. No data is available on HFNC use in the general pediatric ward...
  43. Verleden S, Vos R, Vandermeulen E, Ruttens D, Vaneylen A, Dupont L, et al. Involvement of interleukin-17 during lymphocytic bronchiolitis in lung transplant patients. J Heart Lung Transplant. 2013;32:447-53 pubmed publisher
    ..on biopsies of LTx patients with either chronic rejection, acute A-grade rejection (A > 2B0), lymphocytic bronchiolitis (LB), infection, and stable patients...
  44. Stein R. Long-term airway morbidity following viral LRTI in early infancy: recurrent wheezing or asthma?. Paediatr Respir Rev. 2009;10 Suppl 1:29-31 pubmed publisher
    ..Respiratory syncytial virus (RSV) is an agent especially associated with severe cases of bronchiolitis affecting young infants in winter months and has a typical seasonal pattern...
  45. Nuolivirta K, Koponen P, He Q, Halkosalo A, Korppi M, Vesikari T, et al. Bordetella pertussis infection is common in nonvaccinated infants admitted for bronchiolitis. Pediatr Infect Dis J. 2010;29:1013-5 pubmed
    ..Preliminary evidence suggests that viral-pertussis coinfections are common in nonvaccinated infants...
  46. Al Ansari K, Sakran M, Davidson B, El Sayyed R, Mahjoub H, Ibrahim K. Nebulized 5% or 3% hypertonic or 0.9% saline for treating acute bronchiolitis in infants. J Pediatr. 2010;157:630-4, 634.e1 pubmed publisher
    To compare the efficacy and safety of 5%, 3%, and 0.9% saline solution for treating acute bronchiolitis in the prehospital setting...
  47. Frey U, von Mutius E. The challenge of managing wheezing in infants. N Engl J Med. 2009;360:2130-3 pubmed publisher
  48. Chen J, Deng Y, Zhao J, Luo Z, Peng W, Yang J, et al. The polymorphism of IL-17 G-152A was associated with childhood asthma and bacterial colonization of the hypopharynx in bronchiolitis. J Clin Immunol. 2010;30:539-45 pubmed publisher
    ..We investigated the association between single-nucleotide polymorphism (SNP) of IL-17 (rs2275913, IL-17 G-152A) and asthma-related traits. Its effect on IL-17 production was also attractive...
  49. Ali S, Hirschfeld A, Mayer M, Fortuno E, Corbett N, Kaplan M, et al. Functional genetic variation in NFKBIA and susceptibility to childhood asthma, bronchiolitis, and bronchopulmonary dysplasia. J Immunol. 2013;190:3949-58 pubmed publisher
    ..relevant genetic variation in the promoter of NFKBIA is associated with differential susceptibility to severe bronchiolitis following infection with respiratory syncytial virus, airway hyperresponsiveness, and severe bronchopulmonary ..
  50. Zhang L, Sanguebsche L. [The safety of nebulization with 3 to 5 ml of adrenaline (1:1000) in children: an evidence based review]. J Pediatr (Rio J). 2005;81:193-7 pubmed
    ..criteria for this review were: 1) randomized clinical trial; 2) Patients (up to 12 yrs) with diagnosis of bronchiolitis or laryngotracheobronchitis; 3) use of adrenaline (1:1000) by nebulization...
  51. Wegner S, Vann J, Liu G, Byrns P, Cypra C, Campbell W, et al. Direct cost analyses of palivizumab treatment in a cohort of at-risk children: evidence from the North Carolina Medicaid Program. Pediatrics. 2004;114:1612-9 pubmed
    ..The primary difference in cost between the groups was attributable to the palivizumab prophylaxis. ..
  52. Muething S, Schoettker P, Gerhardt W, Atherton H, Britto M, Kotagal U. Decreasing overuse of therapies in the treatment of bronchiolitis by incorporating evidence at the point of care. J Pediatr. 2004;144:703-10 pubmed
    ..point-of-care algorithms and rules, based on guideline recommendations, on the overuse of therapies for bronchiolitis. Study design Pre-postintervention for infants <1 year of age admitted with a first-time episode of ..
  53. Langley J, Smith M, LeBlanc J, Joudrey H, Ojah C, Pianosi P. Racemic epinephrine compared to salbutamol in hospitalized young children with bronchiolitis; a randomized controlled clinical trial [ISRCTN46561076]. BMC Pediatr. 2005;5:7 pubmed
    b>Bronchiolitis is the most common cause of lower respiratory tract illness in infancy, and hospital admission rates appear to be increasing in Canada and the United States. Inhaled beta agonists offer only modest short-term improvement...