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Emergency treatment asthma

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https://www.readbyqxmd.com/read/27912982/should-recommendations-about-starting-inhaled-corticosteroid-treatment-for-mild-asthma-be-based-on-symptom-frequency-a-post-hoc-efficacy-analysis-of-the-start-study
#1
Helen K Reddel, William W Busse, Søren Pedersen, Wan C Tan, Yu-Zhi Chen, Carin Jorup, Dan Lythgoe, Paul M O'Byrne
BACKGROUND: Low-dose inhaled corticosteroids (ICS) are highly effective for reducing asthma exacerbations and mortality. Conventionally, ICS treatment is recommended for patients with symptoms on more than 2 days per week, but this criterion has scant evidence. We aimed to assess the validity of the previous symptom-based cutoff for starting ICS by establishing whether there was a differential response to budesonide versus placebo for severe asthma exacerbations, lung function, and asthma symptom control across subgroups identified by baseline asthma symptom frequency...
November 29, 2016: Lancet
https://www.readbyqxmd.com/read/27912950/a-randomized-placebo-controlled-trial-of-traditional-chinese-medicine-as-an-add-on-therapy-to-oral-montelukast-in-the-treatment-of-mild-persistent-asthma-in-children
#2
Pak-Hong Chan, Ching-Yee To, Eric Yat-Tung Chan, Handong Li, Xiuxia Zhang, Pok-Yu Chow, Po-Ling Liu, Shuk-Yu Leung, Chung-Hong Chan, Ka-Yan Chan, Johnny Yick-Chun Chan, Jonathan Pak-Heng Ng, Daniel Kwok-Keung Ng
OBJECTIVES: Traditional Chinese medicine are commonly used for treatment of asthma. However, there are only very limited data about its efficacy in children. Therefore, we aimed to determine the efficacy of augmented Yu Ping Feng San (aYPFS) as an add-on to oral montelukast compared with montelukast alone for treatment of mild persistent asthma in children. DESIGN: A single centre, placebo-controlled, double-blinded, randomized control trial was carried out. Participants with age 6-18 years who had mild persistent asthma were randomized according to random number list to receive either aYPFS plus montelukast for 24 weeks or placebo plus montelukast for 24 weeks...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27905828/procedural-and-short-term-safety-of-bronchial-thermoplasty-in-clinical-practice-evidence-from-a-national-registry-and-hospital-episode-statistics
#3
Julie Burn, Andrew J Sims, Kim Keltie, Hannah Patrick, Sally A Welham, Liam G Heaney, Robert Niven
OBJECTIVE: Bronchial thermoplasty (BT) is a novel treatment for severe asthma. Its mode of action and ideal target patient group remain poorly defined, though clinical trials provided some evidence on efficacy and safety. This study presents procedural and short-term safety evidence from routine UK clinical practice. METHODS: Patient characteristics and safety outcomes (procedural complications, 30-day readmission and A&E attendance, length of stay) were assessed using two independent data sources, the British Thoracic Society UK Difficult Asthma Registry (DAR) and Hospital Episodes Statistics (HES) database...
December 1, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27905186/severe-asthma-current-management-targeted-therapies-and-future-directions-a-roundtable-report
#4
REVIEW
Vanessa M McDonald, Steven Maltby, Helen K Reddel, Gregory G King, Peter A B Wark, Lorraine Smith, John W Upham, Alan L James, Guy B Marks, Peter G Gibson
Asthma is a chronic respiratory disease characterized by respiratory symptoms, airway inflammation, airway obstruction and airway hyper-responsiveness. Asthma is common and directly affects 10% of Australians, 1-5% of adults in Asia and 300 million people worldwide. It is a heterogeneous disorder with many clinical, molecular, biological and pathophysiological phenotypes. Current management strategies successfully treat the majority of patients with asthma who have access to them. However, there is a subset of an estimated 5-10% of patients with asthma who have severe disease and are disproportionately impacted by symptoms, exacerbations and overall illness burden...
November 30, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27903593/respiratory-syncytial-virus-infection-detection-and-new-options-for-prevention-and-treatment
#5
REVIEW
Cameron Griffiths, Steven J Drews, David J Marchant
Respiratory syncytial virus (RSV) infection is a significant cause of hospitalization of children in North America and one of the leading causes of death of infants less than 1 year of age worldwide, second only to malaria. Despite its global impact on human health, there are relatively few therapeutic options available to prevent or treat RSV infection. Paradoxically, there is a very large volume of information that is constantly being refined on RSV replication, the mechanisms of RSV-induced pathology, and community transmission...
January 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/27885827/a-mathematical-modeling-approach-to-understanding-the-effect-of-anti-interleukin-therapy-on-eosinophils
#6
T Karelina, V Voronova, O Demin, G Colice, B M Agoram
Emerging T-helper type 2 (Th2 ) cytokine-based asthma therapies, such as tralokinumab, lebrikizumab (anti-interleukin (IL)-13), and mepolizumab (anti-IL-5), have shown differences in their blood eosinophil (EOS) response. To better understand these effects, we developed a mathematical model of EOS dynamics. For the anti-IL-13 therapies, lebrikizumab and tralokinumab, the model predicted an increase of 30% and 10% in total and activated EOS in the blood, respectively, and a decrease in the total and activated EOS in the airways...
November 2016: CPT: Pharmacometrics & Systems Pharmacology
https://www.readbyqxmd.com/read/27880053/disparities-in-emergency-department-visits-in-american-children-with-asthma-2006-2010
#7
Qi Zhang, Rajan Lamichhane, Leigh Diggs
OBJECTIVE: To examine the trends in emergency department (ED) visits for asthma among American children in 2006-2010 across socio-demographic factors, parental smoking status, and children's body weight status. METHODS: We analyzed 5,535 children aged 2-17 with current asthma in the Asthma Call-Back Survey in 2006-2010. Multivariate log binomial regression was used to examine the disparities of ED visits by demographics, socioeconomic status, parental smoking status, children's body weight status, and the level of asthma control...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27869955/progress-with-the-strategic-action-plan-for-tackling-chronic-non-communicable-diseases-in-brazil-2011-2015
#8
Deborah Carvalho Malta, Taís Porto Oliveira, Maria Aline Siqueira Santos, Silvânia Suely Caribé de Araújo Andrade, Marta Maria Alves da Silva
OBJECTIVE: to describe the actions undertaken by the Strategic Action Plan for Tackling Chronic Non-Communicable Diseases (NCDs) in Brazil, from 2011 to 2015. METHODS: the actions were identified through sectorial and interministerial meetings, annual forums, as well as document reviews of publications and laws on government websites. RESULTS: the actions found were: national surveys and monitoring of mortality and risk factor reduction targets; encouragement of physical activity, adequate nutrition and health promotion through the creation of the Health Gym Program (Programa Academia da Saúde); the publication of legislation on tobacco-free environments; free of charge drugs for hypertension, diabetes, and asthma; organization of the emergency service network for cardiovascular diseases; and expanding access to diagnosis and treatment of cancer patients...
April 2016: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/27864676/anti-ige-and-biologic-approaches-for-the-treatment-of-asthma
#9
Patrick D Mitchell, Amani I El-Gammal, Paul M O'Byrne
Current asthma treatments are effective for the majority of patients with mild-to-moderate disease. However, in those with more severe refractory asthma, agents other than inhaled corticosteroids and beta-agonists are needed both to better manage this group of patients and to avoid the side effects of high-dose corticosteroids and the social and personal hardship endured. Several biological pathways have been targeted over the last 20 years, and this research has resulted in pharmacological approaches to attempt to better treat patients with severe refractory asthma...
November 19, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27852427/monitoring-the-hospital-management-of-acute-asthma-the-italian-pediatric-network-experience
#10
A G Martelli, R Bianchi, B Boldrighini, M Bosoni, A De Vuono, A Flores D'Arcais, G Gargantini, R Longhi, M T Ortisi, E Racchi, L Parola
BACKGROUND: The Study Group on Accreditation and Quality Improvement of the Italian Society of Pediatrics has developed an observational study about the hospital management of pediatric patients affected by severe asthma, in order to evaluate how the Guidelines for severe asthma in childhood are applied in the daily practice. METHODS: This study included patients between 2 and 17 years, hospitalized or under short intensive observation for acute asthma. The data collection was carried out through the compilation of on-line forms...
November 2016: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27852079/propofol-and-remifentanil-sedation-for-bronchial-thermoplasty-a-prospective-cohort-trial
#11
Julia N S d'Hooghe, Susanne Eberl, Jouke T Annema, Peter I Bonta
BACKGROUND: Bronchial thermoplasty (BT) is a rapidly emerging bronchoscopic treatment for patients with moderate-to-severe asthma. Different sedation strategies are currently used, ranging from mild midazolam sedation to general anesthesia requiring tracheal intubation. OBJECTIVES: The aim of this study was to assess the feasibility, safety, and both patients' and bronchoscopists' satisfaction with propofol and remifentanil sedation administered by specialized sedation anesthesiology nurses during BT in severe asthma patients...
November 17, 2016: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/27842581/impact-of-occupational-exposures-on-exacerbation-of-asthma-a-population-based-asthma-cohort-study
#12
Jeong-Lim Kim, Paul K Henneberger, Susanna Lohman, Anna-Carin Olin, Anna Dahlman-Höglund, Eva Andersson, Kjell Torén, Mathias Holm
BACKGROUND: Asthma is a prevalent chronic disease and occupation contributes to approximately 15 % of cases among adults. However, there are still few studies on risk factors for work-exacerbated asthma. The current study investigated the association between asthma exacerbations and occupational exposures. METHODS: The study comprised all currently working adults (n = 1356) who reported ever asthma in prior population-based cohorts. All subjects completed a questionnaire about exposures, occupations and exacerbations of asthma...
November 15, 2016: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/27836164/-anaphylaxis-in-children-what-pediatricians-should-know
#13
G Pouessel, A Deschildre
Anaphylaxis is a severe potentially life-threatening allergic emergency that has been increasing over the last two decades, especially in young children. Anaphylaxis deaths remain rare, in particular in children, and their frequency is stable during this period. Food is the main anaphylaxis trigger in children, notably to cow's milk, peanuts, and tree nuts. In infants, the recognition of anaphylaxis may be difficult. Vomiting, urticaria, and laryngeal edema are more frequent at this age. Cardiovascular involvement is rare, most often encountered in adolescence...
November 8, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27831833/direct-concurrent-comparison-of-multiple-pediatric-acute-asthma-scoring-instruments
#14
Michael D Johnson, Flory L Nkoy, Xiaoming Sheng, Tom Greene, Bryan L Stone, Jennifer Garvin
OBJECTIVE: Appropriate delivery of Emergency Department (ED) treatment to children with acute asthma requires clinician assessment of acute asthma severity. Various clinical scoring instruments exist to standardize assessment of acute asthma severity in the ED, but their selection remains arbitrary due to few published direct comparisons of their properties. Our objective was to test the feasibility of directly comparing properties of multiple scoring instruments in a pediatric ED. METHODS: Using a novel approach supported by a composite data collection form, clinicians categorized elements of 5 scoring instruments before and after initial treatment for 48 patients 2-18 years of age with acute asthma seen at the emergency department of a tertiary care pediatric hospital ED from August to December 2014...
November 10, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27827333/quality-improvement-project-to-improve-timeliness-between-bronchodilator-treatments-from-emergency-department-to-medical-wards
#15
Jennifer R Cockerham, Gary R Lowe, Randy Willis, Ryan M Stecks, Ariel Berlinski
BACKGROUND: Quality improvement methodology was applied to study sporadic reports that patients with asthma were not given bronchodilator treatments or assessed within an appropriate time frame when they were admitted from the emergency department to the medical ward. The goal was to increase the number of patients who had an interval between emergency department assessment/bronchodilator treatment and medical ward assessment/treatment of <120 min. METHODS: A flow chart diagram, a fishbone diagram, data collection, intervention implementation, and data monitoring and analysis were used in this study...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27827332/a-preventative-respiratory-protocol-to-identify-trauma-subjects-at-risk-for-respiratory-compromise-on-a-general-in-patient-ward
#16
Bethany A Nyland, Sarah K Spilman, Meghan E Halub, Keith D Lamb, Julie A Jackson, Trevor W Oetting, Sheryl M Sahr
BACKGROUND: Patients are at risk for respiratory complications after sustaining blunt chest trauma, yet contradictory evidence exists about the utility of prophylactic respiratory therapy to reduce respiratory complications in this population. This study assessed the effectiveness of a proactive respiratory protocol on an in-patient ward to identify trauma patients at risk for pulmonary complications, administer appropriate therapies, and prevent deterioration requiring transfer to the ICU...
December 2016: Respiratory Care
https://www.readbyqxmd.com/read/27820746/role-of-biologics-targeting-type-2-airway-inflammation-in-asthma-what-have-we-learned-so-far
#17
Amit D Parulekar, Zuzana Diamant, Nicola A Hanania
PURPOSE OF REVIEW: Severe asthma is a heterogeneous syndrome that can be classified into distinct phenotypes and endotypes. In the type 2 (T2)-high endotype, multiple cytokines are produced that lead to eosinophilic inflammation. These cytokines and their receptors are targets for biologic therapies in patients with severe asthma who do not respond well to standard therapy with inhaled corticosteroids. RECENT FINDINGS: In the last decade, an increasing number of biologic therapies have been developed targeting T2 inflammation...
January 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27806533/epidemiologic-correlates-of-chronic-respiratory-infections-in-adults-an-urban-slum-of-bhubaneswar-odisha-india
#18
Sonali Kar, Ipsa Mohapatra, Amrita Konar
INTRODUCTION: Urbanization is marked by emergence of slum areas, wherein migrants from the nearby villages stay in temporary establishments for seeking avenues of employment. These dwellings lack most of the essential living conditions like safe water, healthy living conditions and access to health services. This population is also vulnerable to social evils like alcohol and tobacco addiction. KIMS, a medical college in Bhubaneswar, Odisha, India has an Urban Health Training Centre (UHTC) that caters to a slum population of nearly 12,000 population for their primary health needs...
August 4, 2016: Global Journal of Health Science
https://www.readbyqxmd.com/read/27793836/educating-professionals-to-support-self-management-in-people-with-asthma-or-diabetes-protocol-for-a-systematic-review-and-scoping-exercise
#19
Nicola McCleary, Amanda Andrews, Susan Morrow, Sharon Wiener-Ogilvie, Monica Fletcher, Liz Steed, Stephanie J C Taylor, Hilary Pinnock
INTRODUCTION: Supported self-management for asthma helps people adjust their treatment in response to symptom changes. This improves day-to-day control and reduces the risk of asthma attacks and the need for emergency healthcare. However, implementation remains poor in routine clinical practice. This systematic review is part of a programme of work developing an intervention to help primary care practice teams embed self-management support into routine asthma care. The aim of the review is to synthesise the evidence regarding the effectiveness of educational interventions for professionals supporting self-management in people with asthma or diabetes (type 1 and type 2)...
October 28, 2016: BMJ Open
https://www.readbyqxmd.com/read/27776827/intranasal-dexmedetomidine-sedation-as-adjuvant-therapy-in-acute-asthma-exacerbation-with-marked-anxiety-and-agitation
#20
Giorgio Cozzi, Sara Lega, Rita Giorgi, Egidio Barbi
We describe 2 patients with acute asthma exacerbation who were admitted to the emergency department (ED) with severe agitation and restlessness as a prominent finding, for which bedside asthma treatment sedation with intranasal dexmedetomidine was performed. In both cases, dexmedetomidine allowed the patients to rest and improved tolerance to treatment. Dexmedetomidine is a unique sedative with an excellent safety profile and minimal effect on respiratory function. These properties render it particularly promising for the management of severe agitation in children admitted to the ED with acute asthma exacerbation...
October 5, 2016: Annals of Emergency Medicine
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