Clinicians' Guide to Asthma
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Clinicians' Guide to Asthma Kian Fan Chung MD DSc FRCP Professor of Respiratory Medicine National Heart & Lung Institute Imperial College School of Medicine and Honorary Consultant Physician Royal Brompton and Harefield NHS Trust London With a contribution by: Andrew Bush MB BS (Hons) MA MD FRCP FRCPCH Reader in Paediatric Respirology National Heart & Lung Institute Imperial College School of Medicine and Honorary Consultant Paediatric Chest Physician Royal Brompton and Harefield NHS Trust London
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First published in Great Britain in 2002 by Arnold, a member of the Hodder Headline Group, 338 Euston Road, London NW1 3BH http://www.arnoldpublishers.com Distributed in the United States of America by Oxford University Press Inc., 198 Madison Avenue, New York, NY 10016 Oxford is a registered trademark of Oxford University Press © 2002 Arnold All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronically or mechanically, including photocopying, recording or any information storage or retrieval system, without either prior permission in writing from the publisher or a licence permitting restricted copying. In the United Kingdom such licences are issued by the Copyright Licensing Agency: 90 Tottenham Court Road, London W1T 4LP. Whilst the advice and information in this book are believed to be true and accurate at the date of going to press, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. In particular (but without limiting the generality of the preceding disclaimer) every effort has been made to check drug dosages; however, it is still possible that errors have been missed. Furthermore, dosage schedules are constantly being revised and new side-effects recognized. For these reasons the reader is strongly urged to consult the drug companies' printed instructions before administering any of the drugs recommended in this book. British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book is available from the Library of Congress ISBN 0 340 76287 X 1 2 3 4 5 6 7 8 9 10 Commissioning Editor: Joanna Koster Production Editor: Wendy Rooke Production Controller: Iain McWilliams Cover Designer: Terry Griffiths Typeset in 11 on 13 pt Garamond by Charon Tec Pvt. Ltd, Chennai, India Printed and bound in Malta by Gutenberg Press Ltd
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Preface There is no doubt that asthma is one of the most common afflictions of industrialized countries and it is worrying that its prevalence is truly on the increase. Asthma also has a toll of morbidity and mortality. Some patients (thankfully only a minority) experience constant severe disruption to their lives, with recurrent exacerbations that can be life-threatening, and often with daily symptoms despite taking large amounts of medications. One of the