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Emergency treatment asthma

Matteo Bonini
PURPOSE OF REVIEW: Asthma is the most prevalent chronic respiratory disease and represents a relevant socioeconomic burden. e-Health has the potential to improve disease control and adherence to treatment in asthmatic patients. Available data are, however, scarce and inconsistent limiting the use of e-health in clinical practice. This article aims to provide a systematic review of the literature published in the last year regarding the real place and impact of e-health in the management of asthma...
October 18, 2016: Current Opinion in Pulmonary Medicine
Justin C Chia, P Régine Mydlarski
PURPOSE: Omalizumab is a recombinant humanized monoclonal antibody that inhibits the binding of IgE to the high-affinity IgE receptor (FceRI) on the surface of mast cells and basophils. Omalizumab has been approved for use in asthma, and new reports show promise in a variety of dermatologic diseases. Herein, we review the literature on omalizumab in dermatology and discuss the safety, efficacy and mechanisms of action for this emerging therapy. MATERIALS AND METHODS: PubMED, MEDLINE, and Embase databases were searched for the period January 1, 1990, to September 1, 2016...
October 19, 2016: Journal of Dermatological Treatment
Engi F Attia, Robert F Miller, Rashida A Ferrand
PURPOSE OF REVIEW: The incidence of pulmonary infections has declined dramatically with improved access to antiretroviral therapy (ART) and cotrimoxazole prophylaxis, but chronic lung disease (CLD) is an increasingly recognized but poorly understood complication in adolescents with perinatally acquired HIV. RECENT FINDINGS: There is a high prevalence of chronic respiratory symptoms, abnormal spirometry and chest radiographic abnormalities among HIV-infected adolescents in sub-Saharan Africa, wherein 90% of the world's HIV-infected children live...
October 7, 2016: Current Opinion in Infectious Diseases
Gennaro D'Amato, Carolina Vitale, Antonio Molino, Anna Stanziola, Alessandro Sanduzzi, Alessandro Vatrella, Mauro Mormile, Maurizia Lanza, Giovanna Calabrese, Leonardo Antonicelli, Maria D'Amato
Despite major advances in the treatment of asthma and the development of several asthma guidelines, people still die of asthma currently. According to WHO estimates, approximately 250,000 people die prematurely each year from asthma. Trends of asthma mortality rates vary very widely across countries, age and ethnic groups. Several risk factors have been associated with asthma mortality, including a history of near-fatal asthma requiring intubation and mechanical ventilation, hospitalization or emergency care visit for asthma in the past year, currently using or having recently stopped using oral corticosteroids (a marker of event severity), not currently using inhaled corticosteroids, a history of psychiatric disease or psychosocial problems, poor adherence with asthma medications and/or poor adherence with (or lack of) a written asthma action plan, food allergy in a patient with asthma...
2016: Multidisciplinary Respiratory Medicine
Bo Chen, Shuai Feng, Xiao-Wen Yin
OBJECTIVE: To study the effect of obesity on the treatment outcome of asthma predictive index (API)-positive infants and young children with wheezing. METHODS: A total of 208 API-positive infants and young children with wheezing were enrolled. According to the Kaup index, the patients were divided into an obese group (n=93) and a non-obese group (n=115). The patients were given multimodality therapy in an acute episode of wheezing and aerosol inhalation of inhaled corticosteroid (ICS) budesonide suspension in the remission stage...
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Gary P Anderson
In recent years, thousands of publications on chronic obstructive pulmonary disease (COPD) and its related biology have entered the world literature, reflecting the increasing scientific and medical interest in this devastating condition. This article is a selective review of several important emerging themes that offer the hope of creating new classes of COPD medicines. Whereas basic science is parsing molecular pathways in COPD, its comorbidities, and asthma COPD overlap syndrome (ACOS) with unprecedented sophistication, clinical translation is disappointingly slow...
2016: F1000Research
Andrew O'Keefe, Ann Clarke, Yvan St Pierre, Jennifer Mill, Yuka Asai, Harley Eisman, Sebastien La Vieille, Reza Alizadehfar, Lawrence Joseph, Judy Morris, Jocelyn Graveli, Moshe Ben-Shoshan
OBJECTIVES: To determine the recurrence rate of anaphylaxis in children medically attended in an emergency department (ED), we performed a prospective cohort study to evaluate prehospital and ED management of children with recurrent anaphylaxis and to assess factors associated with recurrent anaphylaxis. STUDY DESIGN: As part of the Cross-Canada Anaphylaxis Registry, parents of children with anaphylaxis identified prospectively in 3 EDs and through an emergency medical response service were contacted annually after presentation and queried on subsequent reactions...
October 12, 2016: Journal of Pediatrics
Anne Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Simon Craig, Win Sen Kuan, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
OBJECTIVES: To describe the epidemiology of dyspnoea presenting to emergency departments (EDs) in the Asia-Pacific region, to understand how it is investigated and treated and its outcome. METHODS: Prospectiveinterrupted time series cohort study conducted at three time points in EDs in Australia, New Zealand, Singapore, Hong Kong and Malaysia of adult patients presenting to the ED with dyspnoea as a main symptom. Data were collected over three 72-hour periods and included demographics, co-morbidities, mode of arrival, usual medications, pre-hospital treatment, initial assessment, ED investigations, treatment in the ED, ED diagnosis, disposition from ED, in-hospital outcome and final hospital diagnosis...
October 15, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Jillian M Cavallari, Tara S Jawaro, Nadia I Awad, Patrick J Bridgeman
Glucagon, a hormone secreted by pancreatic alpha cells, causes bronchial smooth muscle relaxation by activating the synthesis of cyclic adenosine monophosphate. It was studied in the 1980s and 1990s as a treatment option for the management of asthma but has since not been evaluated. Data to support its use are limited, but it may serve as a last-line agent for refractory asthma exacerbation. Here we describe 4 cases in which intravenous glucagon was used to manage severe, refractory asthma exacerbation in the emergency department...
September 30, 2016: American Journal of Emergency Medicine
Amy H Y Chan, Alistair W Stewart, Juliet M Foster, Edwin A Mitchell, Carlos A Camargo, Jeff Harrison
Adherence to preventive asthma treatment is poor, particularly in children, yet the factors associated with adherence in this age group are not well understood. Adherence was monitored electronically over 6 months in school-aged children who attended a regional emergency department in New Zealand for an asthma exacerbation and were prescribed twice-daily inhaled corticosteroids. Participants completed questionnaires including assessment of family demographics, asthma responsibility and learning style. Multivariable analysis of factors associated with adherence was conducted...
January 2016: ERJ Open Research
E Gómez Torrijos, P Sánchez Miranda, P Donado Palencia, A Castro Jimenez, J Rodriguez Sánchez, Y Mendez Díaz, L Moreno Lozano, R García Rodríguez
BACKGROUND: Eosinophilic esophagitis (EoE) is a chronic inflammatory emerging disease of the oesophagus with immunoallergic aetiology. Until now, few studies about this disease in children and adolescents have been published Objectives: To study the demographic, clinical, serologic, endoscopic-histological and allergologic characteristics of the patients and their atopic and digestive comorbidities. METHODOLOGY: It is an prospective observacional study in children and adolescents (<16 years) assessed in a multidisciplinary specialized eosinpophilic esopahgitis unit in a tertiary referral centre in the central region of Spain carried out between 2011-2015...
October 10, 2016: Journal of Investigational Allergology & Clinical Immunology
Steven W Yancey, Hector G Ortega, Oliver N Keene, Bhabita Mayer, Necdet B Gunsoy, Christopher E Brightling, Eugene R Bleecker, Pranabashis Haldar, Ian D Pavord
BACKGROUND: Studies show that mepolizumab can reduce the frequency of clinically significant exacerbations in patients with severe eosinophilic asthma, compared with placebo. However, important events such as hospitalizations and emergency room visits are rare and difficult to characterize in single studies. OBJECTIVE: We sought to compare hospitalization or hospitalization and/or emergency room visit rates in patients with severe eosinophilic asthma treated with mepolizumab or placebo in addition to standard of care for at least 24 weeks...
October 4, 2016: Journal of Allergy and Clinical Immunology
Vibe Maria Laden Nielsen, Jacob Madsen, Anette Aasen, Anne Pernille Toft-Petersen, Kenneth Lübcke, Bodil Steen Rasmussen, Erika Frischknecht Christensen
BACKGROUND: Patients with acute respiratory failure are at risk of deterioration during prehospital transport. Ventilatory support with continuous positive airway pressure (CPAP) can be initiated in the prehospital setting. The objective of the study is to evaluate adherence to treatment and effectiveness of CPAP as an addition to standard care. METHODS: In North Denmark Region, patients with acute respiratory failure, whom paramedics assessed as suffering from acute cardiopulmonary oedema, acute exacerbation of chronic obstructive pulmonary disease or asthma were treated with CPAP using 100 % O2 from 1 March 2014 to 3 May 2015...
October 10, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
M Engelkes, H M Janssens, M A J de Ridder, M C J M Sturkenboom, J C de Jongste, K M C Verhamme
Real-life data on the incidence rates (IR) and risk factors of severe asthma exacerbations in children are sparse. We aimed to assess IR and risk factors of severe asthma exacerbations in children in real life. We conducted a population-based cohort study using a Dutch GP database containing complete medical records of >1 million patients. All records of children with physician-diagnosed asthma aged 5-18 years between 2000 and 2012 were examined for exacerbations, defined as either hospitalization, emergency department visit or need of systemic steroids for asthma...
October 2016: Respiratory Medicine
Brian H Rowe, Scott W Kirkland, Ben Vandermeer, Sandy Campbell, Amanda Newton, Francine M Ducharme, Cristina Villa-Roel
OBJECTIVES: While systemic corticosteroids (SCS) are widely used to prevent relapse in adults with acute asthma discharged from the emergency department, the most effective route of administration is unclear. The objective of this review was to examine the effectiveness of SCS in adults and to identify the most effective route of SCS to preventing relapse. METHODS: A search was conducted to identify randomized controlled trials comparing the effectiveness of intramuscular, oral short-course or long-course corticosteroids to prevent relapse in adults with acute asthma...
September 24, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas-Alises, José Francisco Pascual, Albert Roger, Diego Vargas, Adi Bijedic
OBJECTIVE: To assess the economic impact of the introduction of DuoResp(®) Spiromax(®) by focusing on a potential improvement in the inhalation technique to strengthen medication adherence for the treatment of moderate to severe asthmatics in Spain and five Spanish regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the period 2015-2018 from the Spanish Healthcare System perspective. Budesonide-formoterol fixed-dose combination delivered by Turbuhaler(®) was considered to be the most appropriate comparator for assessing the budget impact with the introduction of DuoResp(®) Spiromax(®)...
2016: ClinicoEconomics and Outcomes Research: CEOR
Zhaoe Liu, Bo Han, Xing Chen, Qiaoling Wu, Lijun Wang, Gang Li
Pycnogenol(®) (PYC) is utilized in the treatment of various diseases ranging from chronic inflammation to circulatory diseases, but its efficacy and functional mechanism in pediatric asthma continue to remain obscure. Therefore, the purpose of this study was to investigate the effectiveness and molecular mechanism of PYC on regulation of asthmatic airway inflammation. We found that PYC with tail intravenous injection of 50 mg/kg or intragastric administration of 100 mg/kg all reduced ovalbumin (OVA)-induced airway injury...
September 19, 2016: DNA and Cell Biology
E W de Roos, J C C M In 't Veen, G-J Braunstahl, L Lahousse, G G O Brusselle
Severe asthma in the elderly places a high burden on affected individuals and society. Emerging therapies target specific phenotypes of the asthma disease spectrum, and can be beneficial for older asthmatics, albeit their response might be altered due to age-related characteristics. Paradoxically, these characteristics are often ground for exclusion from clinical trials. The question thus arises how the senior asthmatic population can successfully enter the era of targeted therapy. Therefore, we highlight characteristics of this population relevant to effective treatment, and review the evidence for targeted therapy in elderly patients...
September 2016: Drugs & Aging
Rajkala S Ramteke, Panchakshari D Patil, Anup B Thakar
For emergency conditions, Ayurveda has never been given importance in recent times. However, there are certain emergency conditions where biomedicine has limitations but, Ayurveda can provide solution. Classics have many references regarding management of acute conditions like syncope, coma, episodic conditions of bronchial asthma, epilepsy, etc., In the present study, a 61 year female patient had a two year history of hypertension and was suffering with coma. She was treated with an Ayurvedic treatment modality...
April 2016: Ancient Science of Life
Nicola A Hanania, Phillip Korenblat, Kenneth R Chapman, Eric D Bateman, Petr Kopecky, Pierluigi Paggiaro, Akihito Yokoyama, Julie Olsson, Sarah Gray, Cecile T J Holweg, Mark Eisner, Charles Asare, Saloumeh K Fischer, Kun Peng, Wendy S Putnam, John G Matthews
BACKGROUND: In phase 2 trials, lebrikizumab, an anti-interleukin-13 monoclonal antibody, reduced exacerbation rates and improved FEV1 in patients with uncontrolled asthma, particularly in those with high concentrations of type 2 biomarkers (eg, periostin or blood eosinophils). We undertook replicate phase 3 studies to assess the efficacy and safety of lebrikizumab in patients with uncontrolled asthma despite inhaled corticosteroids and at least one second controller medication. METHODS: Adult patients with uncontrolled asthma, pre-bronchodilator FEV1 40-80% predicted, and stable background therapy were randomly assigned (1:1:1) with an interactive voice-web-based response system to receive lebrikizumab 37·5 mg or 125 mg, or placebo subcutaneously, once every 4 weeks...
October 2016: Lancet Respiratory Medicine
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