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https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#1
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29721323/inconsistencies-in-dosage-practice-in-children-with-overweight-or-obesity-a-retrospective-cohort-study
#2
Christina Gade, Hanne R Christensen, Kim P Dalhoff, Jens Christian Holm, Helle Holst
Obesity can affect the pharmacokinetics of most drugs, which may result in under- or overdosing if traditional pediatric dosing strategies are used. To investigate currently applied dosage strategies in children with overweight or obesity (overweight/obesity), in a clinical treatment facility. In particular, whether dosing guidelines were available and metrics of body size applied. A retrospective cohort study of 200 patients admitted to the Danish Children's Obesity Clinic. Data were collected from 2007 to 2015...
June 2018: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/29676072/current-management-of-moderate-to-severe-atopic-dermatitis-a-survey-of-allergists-pediatric-allergists-and-dermatologists-in-korea
#3
Hye Yung Yum, Hyun Hee Kim, Hyun Jung Kim, Woo Kyung Kim, So Yeon Lee, Kapsok Li, Dong Hun Lee
PURPOSE: There is an unmet need for the treatment of moderate-to-severe atopic dermatitis (AD), leading to variation in management strategies. To investigate distinct features and treatment modalities according to physicians' specialties, we collected data on the current treatment approach to moderate-to-severe AD among allergists, pediatric allergists and dermatologists in Korea. METHODS: This questionnaire-based study was administered to physicians from the Korean Academy of Asthma, Allergy and Clinical Immunology (KAAACI), Korean Academy of Pediatric Allergy and Respiratory Disease (KAPARD), and Korean Atopic Dermatitis Association (KADA)...
May 2018: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/29669351/bronchial-thermoplasty-in-severe-asthma-best-practice-recommendations-from-an-expert-panel
#4
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29653238/the-pediatric-asthma-yardstick-practical-recommendations-for-a-sustained-step-up-in-asthma-therapy-for-children-with-inadequately-controlled-asthma
#5
Bradley E Chipps, Leonard B Bacharier, Judith R Farrar, Daniel J Jackson, Kevin R Murphy, Wanda Phipatanakul, Stanley J Szefler, W Gerald Teague, Robert S Zeiger
Current asthma guidelines recommend a control-based approach to management involving assessment of impairment and risk followed by implementation of treatment strategies individualized according to the patient's needs and preferences. However, for children with asthma, achieving control can be elusive. While tools are available to help children (and families) track and manage day-to-day symptoms, when and how to implement a longer-term step-up in care is less clear. Furthermore, treatment is challenged by the three age groups of childhood - adolescence (12-18 years old), school age (6-11 years old), and young children (≤ 5 years old), and what works for one age group may not be the best approach for another...
April 10, 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29575948/blood-biomarkers-in-chronic-airways-diseases-and-their-role-in-diagnosis-and-management
#6
Job J M H van Bragt, Susanne J H Vijverberg, Els J M Weersink, Levi B Richards, Anne H Neerincx, Peter J Sterk, Elisabeth H D Bel, Anke H Maitland-van der Zee
The complexity and heterogeneous nature of asthma and chronic obstructive pulmonary disease (COPD) results in difficulties in diagnosing and treating patients. Biomarkers that can identify underlying mechanisms, identify patient phenotypes and to predict treatment response could be of great value for adequate treatment. Areas covered: Biomarkers play an important role for the development of novel targeted therapies in airways disease. Blood biomarkers are relatively non-invasive, easy to obtain and easy to apply in routine care...
May 2018: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29336067/treatment-of-allergic-rhinitis-using-mobile-technology-with-real-world-data-the-mask-observational-pilot-study
#7
REVIEW
J Bousquet, P Devillier, S Arnavielhe, A Bedbrook, G Alexis-Alexandre, M van Eerd, R Murray, G W Canonica, M Illario, E Menditto, G Passalacqua, C Stellato, M Triggiani, P Carreiro-Martins, J Fonseca, M Morais Almeida, L Nogueira-Silva, A M Pereira, A Todo Bom, I Bosse, D Caimmi, P Demoly, J F Fontaine, J Just, G L Onorato, M L Kowalski, P Kuna, B Samolinski, J M Anto, J Mullol, A Valero, P V Tomazic, K C Bergmann, T Keil, L Klimek, R Mösges, S Shamai, T Zuberbier, E Murphy, P McDowall, D Price, D Ryan, A Sheikh, N H Chavannes, W J Fokkens, V Kvedariene, A Valiulis, C Bachert, P W Hellings, I Kull, E Melen, M Wickman, C Bindslev-Jensen, E Eller, T Haahtela, N G Papadopoulos, I Annesi-Maesano, M Bewick, S Bosnic-Anticevich, A A Cruz, G De Vries, B Gemicioglu, D Larenas-Linnemann, D Laune, E Mathieu-Dupas, R E O'Hehir, O Pfaar, F Portejoie, V Siroux, O Spranger, E Valovirta, O VandenPlas, A Yorgancioglu
BACKGROUND: Large observational implementation studies are needed to triangulate the findings from randomized control trials as they reflect "real-world" everyday practice. In a pilot study, we attempted to provide additional and complementary insights on the real-life treatment of allergic rhinitis (AR) using mobile technology. METHODS: A mobile phone app (Allergy Diary, freely available in Google Play and Apple App stores) collects the data of daily visual analog scales (VAS) for (i) overall allergic symptoms, (ii) nasal, ocular, and asthma symptoms, (iii) work, as well as (iv) medication use using a treatment scroll list including all medications (prescribed and over the counter (OTC)) for rhinitis customized for 15 countries...
January 15, 2018: Allergy
https://www.readbyqxmd.com/read/29146015/tablet-based-sublingual-immunotherapy-for-respiratory-allergy
#8
REVIEW
L Prieto
Allergic respiratory disease represents a significant and expanding health problem worldwide. The gold standard of therapeutic intervention is still grucocorticosteroids, although they are not effective in all patients and may cause side effects. Allergen Immunotherapy has been administrated as subcutaneous injections for treatment of allergic rhinoconjunctivitis and asthma and has been practiced for the past century. Sublingual immunotherapy (SLIT) tablets are now available for grass- or ragweed-induced rhinoconjunctivitis and will be available in Spain for house dust mite (HDM)-induced rhinoconjunctivitis and asthma in the next months...
December 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29051276/precision-medicine-in-airway-diseases-moving-to-clinical-practice
#9
Alvar Agustí, Mona Bafadhel, Richard Beasley, Elisabeth H Bel, Rosa Faner, Peter G Gibson, Renaud Louis, Vanessa M McDonald, Peter J Sterk, Mike Thomas, Claus Vogelmeier, Ian D Pavord
On February 21, 2017, a European Respiratory Society research seminar held in Barcelona discussed how to best apply precision medicine to chronic airway diseases such as asthma and chronic obstructive pulmonary disease. It is now clear that both are complex and heterogeneous diseases, that often overlap and that both require individualised assessment and treatment. This paper summarises the presentations and discussions that took place during the seminar. Specifically, we discussed the need for a new taxonomy of human diseases, the role of different players in this scenario (exposome, genes, endotypes, phenotypes, biomarkers and treatable traits) and a number of unanswered key questions in the field...
October 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28986071/severe-asthma-and-the-primary-care-provider-identifying-patients-and-coordinating-multidisciplinary-care
#10
Barbara P Yawn, Michael E Wechsler
Without proper care, patients with severe forms of asthma face substantial medical risks, marked reductions in quality of life, and other significant disease-related burdens. Therefore, it is essential that primary care clinicians and other healthcare providers are adept at identifying cases of severe asthma on the basis of symptom control, exacerbation risks, and the need for relatively aggressive treatment regimens (eg, high-dose inhaled corticosteroids with long-acting controller medications or frequent oral corticosteroid use)...
December 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28962626/efficacy-and-usability-of-a-novel-nebulizer-targeting-both-upper-and-lower-airways
#11
Daniela Posa, Antonio Pizzulli, Petra Wagner, Serena Perna, Stephanie Hofmaier, Paolo Maria Matricardi, Susanne Lau
BACKGROUND: Upper and lower airways diseases share in part their pathogenic mechanisms and frequently occur simultaneously as "United Airway Disease." Local treatment with nebulizers delivers anti-symptomatic drugs in either the upper or the lower airways, according to the particle size generated by the nebulizer. To our knowledge, no nebulizer combines both application ways. The aim of this study is to test the efficacy and usability of a new nebulizer (OMRON A3 complete), generating aerosols with particles diameters of 2-4...
September 29, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28879503/asthma-phenotypes-and-endotypes-implications-for-personalised-therapy
#12
Katrina Dean, Robert Niven
Asthma is increasingly recognised as a heterogeneous group of diseases with similar clinical presentations rather than a singular disease entity. Asthma was historically categorised by clinical symptoms; however, newer methods of subgrouping, describing and categorising the disease have sub-defined asthma. These sub-definitions are intermittently called phenotypes or endotypes, but the real meanings of these words are poorly understood. Novel treatments are currently and increasingly available, partly in the monoclonal antibody environment, and also some physical therapies (bronchial thermoplasty), but additionally small molecules are not far away from clinical practice...
October 2017: BioDrugs: Clinical Immunotherapeutics, Biopharmaceuticals and Gene Therapy
https://www.readbyqxmd.com/read/28872683/phytochemistry-and-pharmacological-potential-of-cassia-absus-a-review
#13
REVIEW
Saeed Ahmad, Ayesha Hassan, Waheed Mumtaz Abbasi, Tayyeba Rehman
OBJECTIVES: Cassia absus is a plant of the family fabaceae with Ayurvedic ethnomedical records. It is used in traditional medicine for the treatment of bronchitis, asthma, cough, conjunctivitis, leucoderma, renal and hepatic diseases, constipation, tumors, venereal ulcer, headache, hemorrhoids and wound healing. Preliminary in vitro and in vivo studies have provided valuable scientific evidence for its use. This review aims to summarize reported pharmacognosy, traditional uses, phytochemistry and pharmacological potential of C...
January 2018: Journal of Pharmacy and Pharmacology
https://www.readbyqxmd.com/read/28800866/five-year-trends-of-critical-care-practice-and-outcomes
#14
Craig M Lilly, Sunil Swami, Xinggang Liu, Richard R Riker, Omar Badawi
BACKGROUND: Longitudinal analyses of large, detailed adult critical care datasets provide insights into practice trends and generate useful outcome and process benchmarks. METHODS: Data representing 991,571 consecutive critical care visits to 160 US adult ICUs from 2009 to 2013 from the eICU Research Institute clinical practice database were used to quantitate patient characteristics, APACHE IV-based acuity predictions, treatments, and outcomes. Analyses for changes over time were performed for patient characteristics, entry and discharge locations, primary admission diagnosis, treatments, adherence to consensus ICU best practices, length of stay (LOS), and inpatient mortality...
October 2017: Chest
https://www.readbyqxmd.com/read/28794646/bronchial-thermoplasty-implementing-best-practice-in-the-era-of-cost-containment
#15
Laren D Tan, Nicholas Kenyon, Ken Y Yoneda, Samuel Louie
Increasing dependence on advanced technologies in the 21st century has created a dilemma between the practice and business of medicine. From information technology to robotic surgery, new technologies have expanded treatment possibilities and have potentially improved patient outcomes and safety. Simultaneously, their escalating costs limit access for certain patients and health care facilities. Nevertheless, medical decisions should not simply be based on cost. Input from physicians and other health care specialists as well as adherence to best practice position statements, are vital to implementing truly cost-effective strategies in medicine...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28712576/comparing-effectiveness-and-outcomes-in-asthma-and-cystic-fibrosis
#16
REVIEW
Michael S Schechter
As technology yields new treatments, pediatric pulmonologists need determine how best to use them and how to decide which ones are best for any specific group or individual patient. Physicians have always customized therapies based upon patient response, but the new concept of "Personalized (or precision) medicine" focuses attention to a greater degree on the individual needs of patients based on their genetic, biomarker, phenotypic, or psychosocial characteristics. The newly developed biologics for treatment of asthma and CFTR modulators for treatment of cystic fibrosis (CF) highlight this newer approach...
September 2017: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/28634371/factors-related-to-good-asthma-control-using-different-medical-adherence-scales-in-latvian-asthma-patients-an-observational-study
#17
Dins Smits, Girts Brigis, Jana Pavare, Baiba Maurina, Noël Christopher Barengo
One of the main challenges in asthma control is adherence to pharmaceutical treatment. The aim of this study was to test the association between adherence to asthma medication, control and medical beliefs, cognitive and emotional perceptions using three different validated questionnaires. Beliefs about asthma medicine, cognitive and emotional factors were determined in a cross-sectional survey of patients attending outpatient pulmonologist practices in Latvia (n = 352). The validated Beliefs about Medicines Questionnaire and the Brief Illness Perception Questionnaire were used...
June 20, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28592704/the-added-value-of-exhaled-breath-temperature-in-respiratory-medicine
#18
Todor A Popov, Tanya Kralimarkova, Marina Labor, Davor Plavec
Recognition of the huge economic burden chronic respiratory diseases pose for society motivated fundamental and clinical research leading to insight into the role of airway inflammation in various disease entities and their phenotypes. However, no easy, cheap and patient-friendly methods to assess it have found a place in routine clinical practice. Measurement of exhaled breath temperature (EBT) has been suggested as a non-invasive method to detect inflammatory processes in the airways as a result of increased blood flow within the airway walls...
June 8, 2017: Journal of Breath Research
https://www.readbyqxmd.com/read/28364118/enablers-and-determinants-of-the-provision-of-written-action-plans-to-patients-with-asthma-a-stratified-survey-of-canadian-physicians
#19
Fabienne Djandji, Alexandrine J Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
Despite national recommendations, most patients with asthma are not given a written action plan . The objectives were to ascertain physicians' endorsement of potential enablers to providing a written action plan, and the determinants and proportion, of physician-reported use of a written action plan. We surveyed 838 family physicians, paediatricians, and emergency physicians in Quebec. The mailed questionnaire comprised 102 questions on asthma management, 11 of which pertained to written action plan and promising enablers...
March 31, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28348726/targeting-patients-with-asthma-for-omalizumab-therapy-choosing-the-right-patient-to-get-the-best-value-for-money
#20
REVIEW
Abir Al Said, Breda Cushen, Richard W Costello
The asthma syndrome has many manifestations, termed phenotypes, that arise by specific cellular and molecular mechanisms, termed endotypes. Understanding an individual's asthma phenotype helps clinicians make rational therapeutic decisions while the understanding of endotypes has led to the development of specific precision medications. Allergic asthma is an example of an asthma phenotype and omalizumab, a monoclonal antibody that neutralizes serum immunoglobulin (Ig)E, is a specific targeted treatment which was developed as a result of an understanding of the endotype of allergic asthma...
February 2017: Therapeutic Advances in Chronic Disease
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