Proton pump inhibitor therapy in adults with asthma results in a small, statistically significant improvement in morning PEF rate. The magnitude of this improvement, however, is unlikely to be of meaningful clinical significance. There is insufficient evidence to recommend empirical use of PPIs for routine treatment of asthma.

The prevalence of low-trauma fracture in CP patients is comparable with or higher than that of "high-risk" GI illnesses, for which osteoporosis screening guidelines exist.

(i) Early readmission is a common occurrence in AP. (ii) Risk factors for early readmission included moderate to heavy alcohol use, persistent symptoms, and diet at the time of discharge.

The initial retrospective surveys performed in New Zealand" in the early 1980s to examine the possible causes of the epidemic of asthma deaths which began to occur in the late 1970s proved useful in generating a number of hypotheses. These included: (1) an increase in the prevalence of asthma,56 (2) an increase in the severity of asthma,7 (3) changes in the provision of, and access to, primary health care,"'0 (4) direct drug toxicity, due either to individual drugs or a combination of drugs,"1 The more recent literature relating to the New Zealand epidemic has included case control studies,'14-8 retrospective dynamic cohort studies,'920 and randomised clinical trials2' and has refocused interest back on inhaled agonists as the potential cause of the epidemic. However, a closer scrutiny of the trends in both asthma mortality and morbidity from the late 1970s through to the early 1990s suggests that there were likely to have been other factors which not only contributed to the epidemic, but also to the subsequent decline in asthma mortality and morbidity. These factors will be reviewed in this paper.

No abstract