Nikolina Icitovic.


Boushey, M.D., William J. Calhoun, M.D., Mario Castro, M.D., Reuben M. Cherniack, M.D., Timothy Craig, D.O., Loren Denlinger, M.D., Ph.D., Linda L. Engle, B.S., Emily A. DiMango, M.D., John V. Fahy, M.D., Elliot Israel, M.D., Nizar Jarjour, M.D., Shamsah D. Kazani, M.D., Monica Kraft, M.D., Stephen C. Lazarus, M.D., Robert F. Lemanske, Jr., M.D., Njira Lugogo, M.D., Richard J. Martin, M.D., Deborah A. Meyers, Ph.D., Joe Ramsdell, M.D., Christine A. Sorkness, Pharm.D., E. Rand Sutherland, M.D., Stanley J. Szefler, M.D., Stephen I. Wasserman, M.D., Michael J. Walter, M.D., Michael E. Wechsler, M.D., Vernon M. Chinchilli, Ph.D., and Eugene R. Bleecker, M.D. For the National Heart, Lung, and Blood Institute Asthma Clinical Research Network: Tiotropium Bromide Step-Up Therapy for Adults with Uncontrolled Asthma Many adults with asthma have inadequate control of symptoms when receiving a low-to-medium dose of an inhaled glucocorticoid.1,2 Treatment options include the addition of a leukotriene modifier,2 the addition of a long-acting beta-agonist ,2-4 or an increased dose of an inhaled glucocorticoid.2 Current guidelines of the National Asthma Education and Prevention Plan favor the last two options.2 In recent communications, however, the Food and Drug Administration 5 and asthma professionals6,7 have questioned the protection of LABA therapy and suggested strategies to minimize the use of these drugs.Disease fighting capability naturally protects your body from foreign objects, calcifies the fetus dies themAfter, the mother’s immune system goes to function protecting her very own body from the fetus that is deemed by your body to be a ‘foreign object.’ In this full case, the mother’s body have been encasing and calcifying a fetus for over 40 years! ‘When you get previous cartilage in the knee, it calcifies,’ Garcsi explains. The calcification of the mom is safeguarded by the tissue from infection, but does mean the ‘stone’ baby can stay in the stomach undetected for many years.