Beta-blocker use is an independent risk factor for thunderstorm asthma.

OBJECTIVE: To identify risk factors for thunderstorm asthma (TA) in subjects ≥15 years of age from information available in routine clinical records. METHODS: Retrospective and hospital-based case-control study of various clinical factors in all TA cases (n = 53) who presented to a single-site ED in November 2016 (TA16) and in a control group of patients (n = 156) who presented to the same ED with asthma during the pollen season over eight non-TA years. Bivariate analysis and multivariable logistic regression modelling was performed to calculate the odds of TA asthma in the presence of potential risk factors. RESULTS: A logistic regression model revealed that the odds of TA were lower for age (odds ratio [OR] 0.97, 95% confidence interval [CI] 0.95-0.99), higher for Asian country of birth (OR 4.09, 95% CI 1.40-11.95) and higher for oral beta-blocker use (OR 6.43, 95% CI 1.58-26.33) compared to controls. No difference was found between TA16 cases and controls for allergies (to medication, grass pollen, animal), hayfever, smoking, oral non-steroidal anti-inflammatory drugs, or aspirin. Newly diagnosed asthma was higher in TA16 cases versus controls (32.1% vs 12.2%, P = 0.001). CONCLUSIONS: Oral beta-blocker medications, younger age and Asian-born heritage are risk factors for TA. Further study is required to explore the potential association between beta-blockers and TA.

NexTemp thermometer can be used interchangeably with tympanic or mercury thermometers for emergency department use.

OBJECTIVES: To determine the agreement between the chemical dot NexTemp thermometer with mercury and tympanic thermometers and the repeatability of measurements using these devices. METHODS: A prospective study involving a convenience sample of 194 consenting adult patients presenting to the ED, Freemasons Hospital, East Melbourne, Victoria, Australia. A survey of emergency medical staff was conducted to determine what they considered an acceptable level of agreement and repeatability for a putative new thermometer. The NexTemp thermometer's performance was judged against this. For each thermometer, a set of two temperature measurements was made in every patient. The sequence of the set of readings (and hence device) was random between patients and the staff member performing one set was blinded to the results of the other two sets of readings in each patient. The method of Bland and Altman was used for assessing agreement and repeatability. RESULTS: Clinicians considered that a new thermometer should exhibit repeatability of +/- 0.3 degrees C and agree with existing devices within +/- 0.5 degrees C. The tympanic thermometer had 95% limits of repeatability of -0.8-0.5 degrees C compared with the NexTemp (-0.3-0.4 degrees C) and mercury thermometers (-0.3-0.4 degrees C). The NexTemp thermometer agreed with mercury thermometer within -0.6-0.5 degrees C. The tympanic thermometer agreed with the mercury thermometer within -1.0-1.1 degrees C. CONCLUSION: Based on temperature measurement only, the NexTemp thermometer can be used interchangeably with current mercury and tympanic thermometers.