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Emergency treatment asthma

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https://www.readbyqxmd.com/read/28725844/teaching-about-better-family-clinician-partnerships-in-high-risk-pediatric-asthma-care
#1
Georgia Michalopoulou, Sherylyn Briller, Stephanie Myers-Schim, Kaitlin C Muklewicz, Kimberly Compton Katzer, Elizabeth Secord, Beverly Crider, Julia Wasiluk
Family-clinician partnership including communication, trust, respect, and power leveling is essential in pediatrics. Our case study illustrates elements supporting/hindering partnership in a high-risk urban pediatric asthma clinic. Data from observation of a 100-minute visit were qualitatively analyzed by applying codes to themes, using family-centered principles. Three key categories emerged from examining interactions and their sequencing: (1) partnership supported, (2) partnership missed, and (3) partnership hindered...
September 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28708944/indirect-comparison-of-bronchial-thermoplasty-versus-omalizumab-for-uncontrolled-severe-asthma
#2
Robert M Niven, Michael R Simmonds, Michael J Cangelosi, Dominic P Tilden, Suzanne Cottrell, Narinder S Shargill
OBJECTIVE: Bronchial thermoplasty (BT) as an add-on therapy for uncontrolled severe asthma is an alternative to biologic therapies like omalizumab (OM). We conducted an indirect treatment comparison (ITC) to appraise comparative effectiveness of BT and OM. METHODS: A systematic literature review identified relevant randomized controlled trials. The ITC followed accepted methodology. RESULTS: The ITC comprised a sham-controlled trial of BT (AIR2) and two placebo-controlled trials of OM (INNOVATE; EXTRA)...
July 14, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28696802/correlation-of-induced-sputum-eosinophil-levels-with-clinical-parameters-in-mild-and-moderate-persistent-asthma-in-children-aged-7-18%C3%A2-years
#3
Prachi Kansal, Devki Nandan, Sheetal Agarwal, Neha Patharia, Narendra Arya
BACKGROUND: Treatment decisions in asthma are currently based on clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients. OBJECTIVES: To measure eosinophil percentage in induced sputum in children with asthma and correlate it with clinical asthma parameters. METHODS: A prospective observational study was performed at tertiary care hospital on 91 children aged 7-18 years with newly diagnosed mild or moderate persistent asthma...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28689841/biologic-therapy-and-novel-molecular-targets-of-severe-asthma
#4
Amber N Pepper, Harald Renz, Thomas B Casale, Holger Garn
Treatment options for severe or uncontrolled asthma are increasing, especially pertaining to novel biologic therapies. The 2 primary asthma endotypes, T2 high and T2 low, are defined by the level of type 2 T helper and innate lymphoid cell activity and mediators. Most therapies for severe asthma target T2 high asthma, including the 3 biologics approved for use in the United States and Europe: omalizumb, mepolizumb, and reslizumab. Other biologics, with various molecular targets, are under investigation. Unfortunately, treatment options for T2 low asthma are limited...
July 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28689839/severe-asthma-in-children
#5
Sima K Ramratnam, Leonard B Bacharier, Theresa W Guilbert
Severe asthma in children is associated with significant morbidity and is a highly heterogeneous disorder with multiple clinical phenotypes. Cluster analyses have been performed in several groups to explain some of the heterogeneity of pediatric severe asthma, which is reviewed in this article. The evaluation of a child with severe asthma includes a detailed diagnostic assessment and excluding other possible diagnoses and addressing poor control due to comorbidities, lack of adherence to asthma controller medications, poor technique, and other psychological and environmental factors...
July 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28676053/bronchial-thermoplasty-activations-predict-response
#6
David Langton, Joy Sha, Alvin Ing, David Fielding, Francis Thien, Virginia Plummer
BACKGROUND: Bronchial thermoplasty (BT) is an emerging bronchoscopic intervention for the treatment of severe asthma. The predictive factors for clinical response to BT are unknown. We examined the relationship between the number of radiofrequency activations applied and the treatment response observed. METHODS: Data were collected from 24 consecutive cases treated at three Australian centres from June 2014 to March 2016. The baseline characteristics were collated along with the activations delivered...
July 4, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28668237/point-of-care-blood-eosinophil-count-in-a-severe-asthma-clinic-setting
#7
Enrico Heffler, Giovanni Terranova, Carlo Chessari, Valentina Frazzetto, Claudia Crimi, Silvia Fichera, Giuseppe Picardi, Giuliana Nicolosi, Morena Porto, Rossella Intravaia, Nunzio Crimi
BACKGROUND: One of the main severe asthma phenotypes is severe eosinophilic or eosinophilic refractory asthma for which novel biologic agents are emerging as therapeutic options. In this context, blood eosinophil counts are one of the most reliable biomarkers. OBJECTIVE: To evaluate the performance of a point-of-care peripheral blood counter in a patients with severe asthma. METHODS: The blood eosinophil counts of 76 patients with severe asthma were evaluated by point-of-care and standard analyzers...
July 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28657816/retrospective-evaluation-of-risk-factors-for-pediatric-secondary-transport
#8
Jennifer N Fishe, Kevin J Psoter, Bruce L Klein, Jennifer F Anders
OBJECTIVE: Emergency medical services (EMS) typically transports patients to the nearest emergency department (ED). After initial presentation, children who require specialized care must undergo secondary transport, exposing them to additional risks and delaying definitive treatment. EMS direct transport protocols exist for major trauma and certain adult medical conditions, however the same cannot be said for pediatric medical conditions or injuries that do not meet trauma center criteria ('minor trauma')...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28651793/rapid-vs-maintenance-vitamin-d-supplementation-in-deficient-asthmatic-children-to-prevent-exacerbations
#9
Khalid Alansari, Bruce L Davidson, Khalid Ibrahim Yousef, Abdel Nasser H Mohamed, Imad Alattar
BACKGROUND: Whether vitamin D reduces clinically important exacerbations of childhood asthma remains uncertain. We compared rapid to maintenance vitamin D repletion analyzed by baseline vitamin D level. METHODS: Children presenting to the emergency department with moderate-severe asthma exacerbations and vitamin D levels <25ng/mL underwent masked randomization, then open dosing to either: IM+oral , the latter daily, therapy; or daily oral-only therapy, and were followed for 12 months...
June 23, 2017: Chest
https://www.readbyqxmd.com/read/28649417/pilot-study-of-a-randomized-trial-to-evaluate-a-web-based-intervention-targeting-adolescents-presenting-to-the-emergency-department-with-acute-asthma
#10
Christine L M Joseph, Prashant Mahajan, Stephanie Stokes-Buzzelli, Dayna A Johnson, Elizabeth Duffy, Renee Williams, Talan Zhang, Dennis R Ownby, Shannon Considine, Mei Lu
BACKGROUND: Low-income African-American adolescents use preventive medical services less frequently than their White counterparts, indicating a need for effective interventions targeting this group. Puff City is a Web-based, asthma management program for urban adolescents that has been evaluated in high school settings with promising results. The objective of this pilot was to assess the feasibility of initiating Puff City (treatment) in an emergency department setting, thereby informing the conduct of an individual randomized trial to evaluate its effectiveness compared to a generic, Web-based program (control) in preventing subsequent emergency department (ED) visits...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28633906/respiratory-syncytial-virus-rsv-in-adult-emergency-department-patients-do-emergency-providers-consider-rsv-as-an-admission-diagnosis-a-retrospective-observational-study-carried-out-at-massachusetts-general-hospital-boston-ma
#11
William Binder, Jill Thorsen, Pierre Borczuk
BACKGROUND: Respiratory Syncytial Virus (RSV) has been recognized for over half a century as a cause of morbidity in infants and children. Over the past 20years, data has emerged linking RSV as a cause of illness in adults resulting in 177,000 annual hospitalizations and up to 14,000 deaths among older adults. OBJECTIVE: Characterize clinical variables in a cohort of adult RSV patients. We hypothesize that emergency physicians do not routinely consider RSV in the differential diagnosis (DDx) of influenza like illness...
June 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28629672/the-safety-profile-of-subcutaneous-allergen-immunotherapy-in-children-with-asthma-in-hangzhou-east-china
#12
J-L Liu, W-X Ning, S-X Li, Y-C Xu, L Wu, Y-S Wang, X-F Xu, Y Jiang, Y-J Sheng, Y-L Zhou, J-H Wang, L-F Tang, Z-M Chen
BACKGROUND: The aim of the current study is to evaluate the prevalence, severity and possible risk factors of systemic reactions (SRs) to subcutaneous allergen immunotherapy (SCIT) in children and adolescents with asthma in Hangzhou, east China's Zhejiang province. METHODS: From January 2011 to December 2016, this survey analysed the SCIT-related SRs involving 429 patients (265 children and 134 adolescents) affected by allergic asthma. Recorded data included demographics, diagnosis, patient statuses, pulmonary function testing results before and after each injection, allergen dosage, and details of SRs...
June 16, 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/28590244/tralokinumab-pharmacokinetics-and-tolerability-when-administered-by-different-subcutaneous-injection-methods-and-rates%C3%A2
#13
Meena Jain, Diane Doughty, Corbin Clawson, Xiaobai Li, Nicholas White, Balaji Agoram, René van der Merwe
OBJECTIVE: Tralokinumab, administered as two 1-mL subcutaneous injections every 2 weeks, at the target dose 300 mg, has been shown to improve lung function in patients with asthma. This study evaluated the pharmacokinetic (PK) and tolerability profile of tralokinumab 300 mg when administered by different rates of subcutaneous injection, as part of a pilot investigation of new injection regimens. METHODS: This phase I study randomized 60 healthy adults to receive 300 mg tralokinumab, as two 1-mL subcutaneous injections, each delivered over 10 seconds, or one 2-mL injection delivered over 10 seconds (12 mL/min), 1 minute (2 mL/min), or 12 minutes (0...
July 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28589122/the-future-of-bronchopulmonary-dysplasia-emerging-pathophysiological-concepts-and-potential-new-avenues-of-treatment
#14
REVIEW
Jennifer J P Collins, Dick Tibboel, Ismé M de Kleer, Irwin K M Reiss, Robbert J Rottier
Yearly more than 15 million babies are born premature (<37 weeks gestational age), accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD), one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28567280/solar-powered-oxygen-systems-in-remote-health-centers-in-papua-new-guinea-a-large-scale-implementation-effectiveness-trial
#15
Trevor Duke, Ilomo Hwaihwanje, Magdalynn Kaupa, Jonah Karubi, Doreen Panauwe, Martin Sa'avu, Francis Pulsan, Peter Prasad, Freddy Maru, Henry Tenambo, Ambrose Kwaramb, Eleanor Neal, Hamish Graham, Rasa Izadnegahdar
BACKGROUND: Pneumonia is the largest cause of child deaths in Papua New Guinea (PNG), and hypoxaemia is the major complication causing death in childhood pneumonia, and hypoxaemia is a major factor in deaths from many other common conditions, including bronchiolitis, asthma, sepsis, malaria, trauma, perinatal problems, and obstetric emergencies. A reliable source of oxygen therapy can reduce mortality from pneumonia by up to 35%. However, in low and middle income countries throughout the world, improved oxygen systems have not been implemented at large scale in remote, difficult to access health care settings, and oxygen is often unavailable at smaller rural hospitals or district health centers which serve as the first point of referral for childhood illnesses...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28560041/severe-acute-asthma-caused-by-chlamydophila-pneumoniae-infection
#16
Yoshinari Endo, Toshihiro Shirai, Mika Saigusa, Eisuke Mochizuki
Asthma exacerbation is associated with respiratory infections, including those by viruses and atypical bacteria. We herein report a case of severe acute asthma in an adult caused by Chlamydophila pneumoniae (C. pneumoniae) infection. A 39-year-old woman without a history of asthma reported to the emergency department with progressive worsening of cough, shortness of breath, and wheezing with low oxygen saturation. A computed tomography (CT) scan revealed patchy ground-glass opacity and bronchial wall thickening...
July 2017: Respirology Case Reports
https://www.readbyqxmd.com/read/28557753/oral-corticosteroid-prescribing-for-children-with-asthma-in-a-medicaid-managed-care-program
#17
Harold J Farber, Edwin A Silveira, Douglas R Vicere, Viral D Kothari, Angelo P Giardino
BACKGROUND AND OBJECTIVE: Short courses of oral corticosteroid (OCS) medication are recommended for treatment of moderate to severe asthma exacerbations. Concern has been raised about OCS overuse. Our objective is to describe rates of OCS dispensing among children with asthma and factors associated with variation in OCS dispensing. METHODS: Claims data for children 1 to <18 years of age with an asthma diagnosis between January 2011 and January 2016 were extracted from the computerized databases of Texas Children's Health Plan...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28553015/interluekin-35-in-asthma-and-its-potential-as-an-effective-therapeutic-agent
#18
REVIEW
Peng Gao, Zhenzhong Su, Xuejiao Lv, Jie Zhang
Interleukin- (IL-) 35 is a member of the IL-12 cytokine family and a heterodimeric protein formed by Epstein-Barr-induced gene 3 (EBI3) and IL-12p35. Emerging evidence shows that IL-35 is a key player in the regulation of cellular communication, differentiation, and inflammation. Altered IL-35 expression has been found in disease conditions such as cancer, rheumatoid arthritis, and, more recently, asthma. In cancer, IL-35 is involved in the regulation of tumorigenesis, cancer progression, and metastasis. In rheumatoid arthritis, IL-35 acts as a negative regulator of inflammation...
2017: Mediators of Inflammation
https://www.readbyqxmd.com/read/28552257/-allergic-bronchopulmonary-aspergillosis-evaluation-of-a-maintenance-therapy-with-nebulized-ambisome-%C3%A2
#19
C Godet, F Couturaud, S Ragot, F Laurent, A L Brun, A Bergeron, J Cadranel
BACKGROUND: Allergic bronchopulmonary aspergillosis (ABPA) affects 3-13% of patients with asthma. Its natural history includes possibly life-threatening exacerbations and evolution towards fixed obstructive ventilatory disorders or even irreversible lung fibrosis lesions. ABPA prognosis is directly associated with exacerbation control and the main objective of the treatment is to decrease their frequency and duration. Recommendations regarding dosage and duration of treatment are not very precise...
May 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28548898/comparison-of-a-rapid-albuterol-pathway-with-a-standard-pathway-for-the-treatment-of-children-with-a-moderate-to-severe-asthma-exacerbation-in-the-emergency-department
#20
Matthew Wilkinson, Ben King, Sujit Iyer, Eric Higginbotham, Anna Wallace, Collin Hovinga, Coburn Allen
OBJECTIVE: The objective of this study was to determine if a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce emergency department (ED) length of stay (LOS), while maintaining admission rates and side effects, when compared to a traditional asthma pathway with a standard jet nebulizer. METHODS: Children aged 3-18 presenting to a large urban pediatric ED for asthma were enrolled if they were determined by pediatric asthma score to have a moderate to severe exacerbation...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
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