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Emergency treatment asthma

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https://www.readbyqxmd.com/read/28208047/targeted-therapy-for-chronic-respiratory-disease-a-new-paradigm
#1
Peter G Gibson, Matthew J Peters, Claire E Wainwright
Targeted therapy has emerged as a highly effective treatment approach for chronic respiratory diseases. Many of these conditions have dismal outcomes; however, targeted therapy shows great results for the subgroup who respond. This represents a new way to approach these conditions and offers great promise as a future treatment direction. In severe eosinophilic asthma, therapy that targets the interleukin-5 pathway with monoclonal antibodies leads to a 50% reduction in asthma exacerbations in previously refractory disease...
February 20, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28160338/h1-antihistamine-refractory-chronic-spontaneous-urticaria-it-s-worse-than-we-thought-first-results-of-the-multicenter-real-life-aware-study
#2
Marcus Maurer, Petra Staubach, Ulrike Raap, Grit Richter-Huhn, Andrea Bauer, Franziska Ruëff, Thilo Jakob, Amir S Yazdi, Vera Mahler, Nicola Wagner, Undine Lippert, Uwe Hillen, Andreas Schwinn, Mario Pawlak, Norbert Behnke, Kamel Chaouche, Nadine Chapman-Rothe
BACKGROUND: Most data on chronic spontaneous urticaria (CSU) originate from highly selected patient populations treated at specialized centers. Little is known about CSU patient characteristics and the burden of CSU in routine clinical practice. AWARE (A World-wide Antihistamine-Refractory chronic urticaria patient Evaluation) is an ongoing global study designed to assess chronic urticaria in the real-life setting. OBJECTIVE: To describe the baseline characteristics of the first 1,539 German AWARE patients with H1-antihistamine-refractory CSU...
February 4, 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28160290/regulatory-t-cells-and-type-2-innate-lymphoid-cell-dependent-asthma
#3
REVIEW
Jennifer L Aron, Omid Akbari
Group two innate lymphoid cells (ILC2s) are a recently identified group of cells with the potent capability to produce Th2-type cytokines such as interleukin (IL)-5 and IL-13. Several studies suggest that ILC2s play an important role in the development of allergic diseases and asthma. Activation of pulmonary ILC2s in murine models lacking T and B cells induces eosinophilia and airway hyperreactivity (AHR), which are cardinal features of asthma. More importantly, numerous recent studies have highlighted the role of ILC2s in asthma persistence and exacerbation among human subjects and thus, regulation of pulmonary ILC2s is a major area of investigation aimed at curbing allergic lung inflammation and exacerbation...
February 4, 2017: Allergy
https://www.readbyqxmd.com/read/28153353/the-effect-of-nebulised-magnesium-sulphate-in-the-management-of-childhood-moderate-asthma-exacerbations-as-adjuvant-treatment
#4
S Turker, M Dogru, F Yildiz, S Bozkaya Yilmaz
BACKGROUND: After the bronchodilator effect of magnesium was shown, the use of magnesium in treatment of asthma exacerbations became common. With the results of recent studies, the use of intravenous magnesium in severe asthma exacerbations took its place. We aimed to examine the effects of adding isotonic magnesium sulphate instead of isotonic saline into nebulised salbutamol on the Modified Pulmonary Index Score (MPIS) and the hospitalisation rate in moderate asthma exacerbations. METHODS: Our study population included 100 children age between 3 and 15 years with asthma admitted to emergency department due to moderate asthma exacerbations...
January 30, 2017: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/28151877/impact-of-standardized-patients-on-the-training-of-medical-students-to-manage-emergencies
#5
Frank Herbstreit, Stefanie Merse, Rainer Schnell, Marcel Noack, Daniel Dirkmann, Anna Besuch, Jürgen Peters
BACKGROUND: Teaching emergency management should educate medical students not only for facts and treatment algorithms but also for time effective physical examination, technical skills, and team interaction. We tested the hypothesis, that using standardized emergency patients would be more effective in transmitting knowledge and skills compared with a more traditional teaching approach. METHODS: Medical students (n = 242) in their fourth (second clinical) year were randomized to receive either training on standardized patients simulating 3 emergency settings ("acute chest pain," "stroke," and "acute dyspnea/asthma") or traditional small group seminars...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28148730/a-multicenter-collaborative-to-improve-care-of-community-acquired-pneumonia-in-hospitalized-children
#6
Kavita Parikh, Eric Biondi, Joanne Nazif, Faiza Wasif, Derek J Williams, Elizabeth Nichols, Shawn Ralston
BACKGROUND AND OBJECTIVES: The Value in Inpatient Pediatrics Network sponsored the Improving Care in Community Acquired Pneumonia collaborative with the goal of increasing evidence-based management of children hospitalized with community acquired pneumonia (CAP). Project aims included: increasing use of narrow-spectrum antibiotics, decreasing use of macrolides, and decreasing concurrent treatment of pneumonia and asthma. METHODS: Data were collected through chart review across emergency department (ED), inpatient, and discharge settings...
February 1, 2017: Pediatrics
https://www.readbyqxmd.com/read/28148459/exploring-factors-associated-with-asthma-related-emergency-department-visits-among-adults-a-path-analysis-approach
#7
Maithili Deshpande, Kevin A Look
BACKGROUND: Asthma is an expensive chronic lung disease that affects 7% of U.S. adults and results in as many as 1.8 million emergency department (ED) visits each year. Pharmacists play an important role in managing asthma, including assessing control and monitoring disease progression, educating the patient about the disease and associated treatments, and ensuring safe and cost-effective medication use. However, comprehensive studies that account for the complex relationships between factors impacting asthma-related ED visits are lacking in the adult asthma population...
January 23, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28146297/development-of-a-patient-centered-outcome-measure-for-emergency-department-asthma-patients
#8
Margaret E Samuels-Kalow, Karin V Rhodes, Mira Henien, Emily Hardy, Thomas Moore, Felicia Wong, Carlos A Camargo, Carolyn T Rizzo, Cynthia Mollen
BACKGROUND: Measuring outcomes of emergency care is of key importance, but current metrics, such as 72-hour return visit rates, are subject to ascertainment bias, incentivize over-testing and over-treatment at initial visit, and do not reflect the full burden of disease and morbidity experienced at home following ED care. There is increasing emphasis on including patient-reported outcomes, but the existing patient-reported measures have limited applicability to emergency care. OBJECTIVE: To identify concepts for inclusion in a patient-reported outcome measure for ED care, and assess differences in potential concepts by health literacy...
February 1, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28134501/the-current-and-future-role-of-biomarkers-in-type-2-cytokine-mediated-asthma-management
#9
REVIEW
I D Pavord, S Afzalnia, A Menzies-Gow, L G Heaney
Assessment and management of asthma is complicated by the heterogeneous pathophysiological mechanisms that underlie its clinical presentation, which are not necessarily reflected in standardized management paradigms and which necessitate an individualized approach to treatment. This is particularly important with the emerging availability of a variety of targeted forms of therapy that may only be appropriate for use in particular patient subgroups. The identification of biomarkers can potentially aid diagnosis and inform prognosis, help guide treatment decisions and allow clinicians to predict and monitor response to treatment...
February 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28128966/assessing-patient-and-provider-perceptions-of-factors-associated-with-patient-engagement-in-asthma-care
#10
Tamar Sapir, Kathleen F Moreo, Laurence S Greene, Laura C Simone, Jeffrey D Carter, James J L Mateka, Nicola A Hanania
RATIONALE: National quality improvement initiatives emphasize building partnerships between patients and providers by promoting patient engagement through communication, shared decision-making, and self-care skills. Efforts to promote patient engagement are especially important for people with asthma. To cultivate effective partnerships in asthma care, patients and providers may benefit from understanding each other's values and perceptions regarding treatment goals, shared decision-making, and barriers to optimal care and outcomes...
January 27, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28122115/precision-medicine-in-allergic-disease-food-allergy-drug-allergy-and-anaphylaxis-practall-document-of-the-european-academy-of-allergy-and-clinical-immunology-and-the-american-academy-of-allergy-asthma-immunology
#11
REVIEW
Antonella Muraro, Robert F Lemanske, Mariana Castells, Maria J Torres, David Khan, Hans-Uwe Simon, Carsten Bindslev-Jensen, Wesley Burks, Lars K Poulsen, Hugh A Sampson, Margitta Worm, Kari C Nadeau
This consensus document summarizes the current knowledge on the potential for precision medicine in food allergy, drug allergy and anaphylaxis under the auspices of the PRACTALL collaboration platform. PRACTALL is a joint effort of the European Academy of Allergy and Clinical Immunology (EAACI) and the American Academy of Allergy, Asthma and Immunology (AAAAI), which aims to synchronize the European and American approaches to allergy care. Precision medicine is an emerging approach for disease treatment based on disease endotypes, which are phenotypic subclasses associated with specific mechanisms underlying the disease...
January 25, 2017: Allergy
https://www.readbyqxmd.com/read/28110896/efficacy-and-safety-of-mepolizumab-in-japanese-patients-with-severe-eosinophilic-asthma
#12
Terufumi Shimoda, Hiroshi Odajima, Arisa Okamasa, Minako Kawase, Masaki Komatsubara, Bhabita Mayer, Steven Yancey, Hector Ortega
BACKGROUND: The MENSA trial assessed the efficacy and safety of mepolizumab in patients with severe eosinophilic asthma. This report describes the efficacy and safety of mepolizumab in Japanese patients from MENSA. METHODS: A post hoc analysis of the Japanese subgroup from the randomized, double-blind, placebo-controlled, double-dummy, Phase III MENSA trial (NCT01691521). Patients ≥12 years with severe eosinophilic asthma received mepolizumab 75 mg intravenously (IV), 100 mg subcutaneously (SC), or placebo, every 4 weeks for 32 weeks...
January 16, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28110335/personalised-medicine-for-asthma-and-chronic-obstructive-pulmonary-disease
#13
Liam G Heaney, Lorcan P A McGarvey
Asthma and chronic obstructive pulmonary disease (COPD) are prevalent conditions, and despite recent advances and multiple available therapies and interventions, there remains a significant unmet clinical need. In recent years, it has become clear that there is both significant heterogeneity within each of these conditions and additionally significant overlap in many of the clinical and inflammatory features. In parallel, useful clinical and immunological biomarkers which inform about prognosis and response to therapy have emerged in both asthma and COPD...
2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28106744/oligonucleotide-therapy-for-obstructive-and-restrictive-respiratory-diseases
#14
REVIEW
Wupeng Liao, Jinrui Dong, Hong Yong Peh, Lay Hong Tan, Kah Suan Lim, Li Li, Wai-Shiu Fred Wong
Inhaled oligonucleotide is an emerging therapeutic modality for various common respiratory diseases, including obstructive airway diseases like asthma and chronic obstructive pulmonary disease (COPD) and restrictive airway diseases like idiopathic pulmonary fibrosis (IPF). The advantage of direct accessibility for oligonucleotide molecules to the lung target sites, bypassing systemic administration, makes this therapeutic approach promising with minimized potential systemic side effects. Asthma, COPD, and IPF are common chronic respiratory diseases, characterized by persistent airway inflammation and dysregulated tissue repair and remodeling, although each individual disease has its unique etiology...
January 17, 2017: Molecules: a Journal of Synthetic Chemistry and Natural Product Chemistry
https://www.readbyqxmd.com/read/28102970/microbiomes-in-respiratory-health-and-disease-an-asia-pacific-perspective
#15
REVIEW
Sanjay H Chotirmall, Shaan L Gellatly, Kurtis F Budden, Micheál Mac Aogain, Shakti D Shukla, David L A Wood, Philip Hugenholtz, Kevin Pethe, Philip M Hansbro
There is currently enormous interest in studying the role of the microbiome in health and disease. Microbiome's role is increasingly being applied to respiratory diseases, in particular COPD, asthma, cystic fibrosis and bronchiectasis. The changes in respiratory microbiomes that occur in these diseases and how they are modified by environmental challenges such as cigarette smoke, air pollution and infection are being elucidated. There is also emerging evidence that gut microbiomes play a role in lung diseases through the modulation of systemic immune responses and can be modified by diet and antibiotic treatment...
February 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28093429/paediatric-ed-bipap-continuous-quality-improvement-programme-with-patient-analysis-2005-2013
#16
Thomas Abramo, Abby Williams, Samaiya Mushtaq, Mark Meredith, Rawle Sepaule, Kristen Crossman, Cheryl Burney Jones, Suzanne Godbold, Zhuopei Hu, Todd Nick
OBJECTIVE: In paediatric moderate-to-severe asthmatics, there is significant bronchospasm, airway obstruction, air trapping causing severe hyperinflation with more positive intraplural pressure preventing passive air movement. These effects cause an increased respiratory rate (RR), less airflow and shortened inspiratory breath time. In certain asthmatics, aerosols are ineffective due to their inadequate ventilation. Bilevel positive airway pressure (BiPAP) in acute paediatric asthmatics can be an effective treatment...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28089059/management-of-hospitalized-asthmatic-children-before-transport
#17
Brande Mazzeo, Rami Bzeih, Robert Schultz, Melissa Tavolieri, Alicia Fraser, Sabrina M Heidemann
Asthmatic children are at risk for respiratory failure and should be appropriately treated before transport. The objectives were to find out if the Pediatric Advanced Life Support guidelines for asthma treatment were followed in the emergency department (ED); to determine if additional treatment during transport or within the first 2 hours of admission was needed; and to compare the management of intubated asthmatics by the ED, transport team, and the intensive care unit (ICU) physician. The records for children diagnosed with acute asthma over 7 years who were transported by the intensive care transport team were reviewed...
January 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#18
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28042927/obstructive-sleep-apnea-and-asthma
#19
Megat Razeem Abdul Razak, Naricha Chirakalwasan
Both asthma and obstructive sleep apnea (OSA) are common conditions involving the adults and children population, and have significant impact on the healthcare system. For the last few decades a lot of data emerged in terms of the prevalence between asthma and OSA. The prevalence ranges from 38% up to as high as 70%. Based on the current concepts of bidirectional relationship of OSA and asthma, it is sensible to assume that treating one disorder will result in the other's better control and vice versa. This review will look into the pathogenesis of concomitant OSA and asthma and whether the first line OSA therapy will result in better control of asthma in patients with concomitant OSA...
December 2016: Asian Pacific Journal of Allergy and Immunology
https://www.readbyqxmd.com/read/28036144/revisiting-type-2-high-and-type-2-low-airway-inflammation-in-asthma-current-knowledge-and-therapeutic-implications
#20
REVIEW
D Robinson, M Humbert, R Buhl, A A Cruz, H Inoue, S Korom, N A Hanania, P Nair
Asthma is a complex respiratory disorder characterized by marked heterogeneity in individual patient disease triggers and response to therapy. Several asthma phenotypes have now been identified, each defined by a unique interaction between genetic and environmental factors, including inflammatory, clinical and trigger-related phenotypes. Endotypes further describe the functional or pathophysiologic mechanisms underlying the patient's disease. type 2-driven asthma is an emerging nomenclature for a common subtype of asthma and is characterized by the release of signature cytokines IL-4, IL-5 and IL-13 from cells of both the innate and adaptive immune systems...
February 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
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