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management of exacerbation of asthma

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https://www.readbyqxmd.com/read/29137905/emergency-department-chest-radiography-for-children-with-asthma-exacerbation-is-infrequently-associated-with-change-of-management
#1
Evan H Allie, Henry E Dingle, William N Johnson, Jeffrey R Birnbaum, Melissa A Hilmes, Sudha P Singh, Donald H Arnold
BACKGROUND: Acute asthma exacerbations (AAE) account for many Pediatric Emergency Department (PED) visits. Chest radiography (CXR) is often performed in these patients to identify practice-changing findings such as pneumonia (PNA). Limited knowledge exists to balance the cost and radiation dose of CXR with expected yield of clinically meaningful information. OBJECTIVE: To determine in children with AAE with CXR, whether patient characteristics are associated with radiographic PNA; and significant practice change by initiation of antibiotic...
October 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29119851/clinical-characteristics-of-children-infected-with-enterovirus-d68-in-an-outpatient-clinic-and-the-association-with-bronchial-asthma
#2
Tsutomu Itagaki, Yoko Aoki, Yohei Matoba, Shizuka Tanaka, Tatsuya Ikeda, Katsumi Mizuta, Yoko Matsuzaki
BACKGROUND: All reports of increases in severe respiratory disease associated with human enterovirus D68 (EV-D68) are from hospital settings. However, there are few reports describing clinical characteristics in less severely affected populations. METHODS: We conducted a retrospective observational study from January 2010 to December 2015 in Yamagata, Japan. Using regional passive surveillance, 5794 respiratory specimens were collected from children who initially presented to an outpatient clinic with acute respiratory symptoms...
November 9, 2017: Infectious Diseases
https://www.readbyqxmd.com/read/29117796/effects-of-varenicline-therapy-in-combination-with-advanced-behavioral-support-on-smoking-cessation-and-quality-of-life-in-inpatients-with-acute-exacerbation-of-copd-bronchial-asthma-or-community-acquired-pneumonia-a-prospective-open-label-preference-based
#3
Alexios Politis, Vasileios Ioannidis, Konstantinos I Gourgoulianis, Zoe Daniil, Chrissi Hatzoglou
Quitting smoking is the most important element in the therapeutic management of chronic respiratory diseases. Combining pharmacotherapy with behavioral support increases smoking cessation success rates. In addition, hospitalized smokers have increased motivation to quit. We investigated the efficacy on smoking cessation, of varenicline in combination with behavioral support, in smokers hospitalized due to (a) acute exacerbation of chronic obstructive pulmonary disease (COPD), or (b) bronchial asthma attack, or (c) community-acquired pneumonia (CAP)...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/29105786/influenza-burden-prevention-and-treatment-in-asthma-a-scoping-review-by-the-eaaci-influenza-in-asthma-task-force
#4
REVIEW
Jürgen Schwarze, Peter Openshaw, Akhilesh Jha, Stefano R Del Giacco, Davide Firinu, Olympia Tsilochristou, Graham Roberts, Anna Selby, Cezmi Akdis, Ioana Agache, Adnan Custovic, Enrico Heffler, Georgia Pinna, Musa Khaitov, Alexandra Nikonova, Nikolaos Papadopoulos, Ather Akhlaq, Ulugbek Nurmatov, Harald Renz, Aziz Sheikh, Chrysanthi Skevaki
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma...
November 6, 2017: Allergy
https://www.readbyqxmd.com/read/29101938/practical-considerations-for-the-diagnosis-and-management-of-asthma-in-older-adults
#5
REVIEW
Barbara P Yawn, MeiLan K Han
Although often considered a disease of childhood, the prevalence of asthma in US adults aged 65 years or older is similar to that in children, with the number of older patients needing care for asthma likely to continue to increase. As with most chronic diseases, there are challenges associated with the diagnosis and management of asthma in an older population. This review discusses these challenges, suggesting practical management strategies for primary care physicians and their teams. Asthma comprises a spectrum of phenotypes, some associated with adult onset...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29083972/inhaled-corticosteroid-containing-treatment-escalation-and-outcomes-for-patients-with-asthma-in-a-u-s-health-care-organization
#6
Lindsay G S Bengtson, Yanni Yu, Weijia Wang, Feng Cao, Erin M Hulbert, Ryan Wolbeck, Caitlin A Elliott, Ami R Buikema
BACKGROUND: Asthma is a common disorder that affects approximately 8% of the U.S. POPULATION: Treatment guidelines indicate inhaled corticosteroids (ICS) as the mainstay treatment, yet poor asthma control is common among ICS-treated patients. Treatment escalation (ICS dose increase and other controller therapy add-ons) is used to manage symptoms. Real-world studies of postescalation outcomes may inform treatment decisions. OBJECTIVES: To (a) describe characteristics and treatment patterns among asthma patients who escalated treatment and (b) assess outcomes (exacerbations, uncontrolled asthma, and health care resource utilization [HCRU]) after escalation...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29082361/investigation-of-an-indoor-air-quality-sensor-for-asthma-management-in-children
#7
Utkarshani Jaimini, Tanvi Banerjee, William Romine, Krishnaprasad Thirunarayan, Amit Sheth, Maninder Kalra
Monitoring indoor air quality is critical because Americans spend 93% of their life indoors, and around 6.3 million children suffer from asthma. We want to passively and unobtrusively monitor the asthma patient's environment to detect the presence of two asthma-exacerbating activities: smoking and cooking using the Foobot sensor. We propose a data-driven approach to develop a continuous monitoring-activity detection system aimed at understanding and improving indoor air quality in asthma management. In this study, we were successfully able to detect a high concentration of particulate matter, volatile organic compounds, and carbon dioxide during cooking and smoking activities...
April 2017: IEEE Sens Lett
https://www.readbyqxmd.com/read/29080708/classification-of-cough-as-a-symptom-in-adults-and-management-algorithms-chest-guideline-and-expert-panel-report
#8
Richard S Irwin, Cynthia L French, Anne B Chang, Kenneth W Altman
BACKGROUND: We performed systematic reviews using the population, intervention, comparison, outcome (PICO) format to answer the following key clinical question: Are the CHEST 2006 classifications of acute, subacute and chronic cough and associated management algorithms in adults that were based on durations of cough useful? METHODS: We used the CHEST Expert Cough Panel's protocol for the systematic reviews and the American College of Chest Physicians (CHEST) methodological guidelines and Grading of Recommendations Assessment, Development, and Evaluation framework...
November 9, 2017: Chest
https://www.readbyqxmd.com/read/29075362/psychological-and-lifestyle-risk-factors-for-asthma-exacerbations-and-morbidity-in-children
#9
REVIEW
Alyssa A Oland, Genery D Booster, Bruce G Bender
Asthma is the most common childhood illness and disproportionately affects low-income, minority children who live in urban areas. A range of risk factors are associated with asthma morbidity and mortality, such as treatment non-adherence, exposure to environmental triggers, low-income households, exposure to chronic stress, child psychological problems, parental stress, family functioning, obesity, physical inactivity, and unhealthy diets. These risk factors often have complex interactions and inter-relationships...
2017: World Allergy Organization Journal
https://www.readbyqxmd.com/read/29072882/rita-the-italian-severe-uncontrolled-asthma-registry
#10
Sara Maio, Sandra Baldacci, Megon Bresciani, Marzia Simoni, Manuela Latorre, Nicola Murgia, Fabrizio Spinozzi, Mariachiara Braschi, Leonardo Antonicelli, Barbara Brunetto, Patrizia Iacovacci, Paolo Roazzi, Carlo Pini, Mario Pata, Lidia La Grasta, Pierluigi Paggiaro, Giovanni Viegi
BACKGROUND: The Italian severe/uncontrolled asthma (SUA) web-based registry encompasses demographic, clinical, functional, inflammatory data; it aims to raise SUA awareness, identifying specific phenotypes and promoting optimal care. METHODS: 493 adult patients from 27 Italian centres (recruited in 2011-2014) were analyzed. RESULTS: Mean age was 53.8yrs. SUA patients were more frequently female (60.6%), with allergic asthma (83.1%). About 30% showed late onset of asthma diagnosis/symptoms (>40yrs); the mean age for asthma symptoms onset was 30...
October 26, 2017: Allergy
https://www.readbyqxmd.com/read/29071080/description-of-the-protocol-for-the-practical-study-a-randomised-controlled-trial-of-the-efficacy-and-safety-of-ics-laba-reliever-therapy-in-asthma
#11
James Fingleton, Jo Hardy, Christina Baggott, Janine Pilcher, Andrew Corin, Robert J Hancox, Matire Harwood, Mark Holliday, Helen K Reddel, Philippa Shirtcliffe, Suzanne Snively, Mark Weatherall, Richard Beasley
INTRODUCTION: In adult asthma, combination inhaled corticosteroid (ICS)/fast-onset long-acting beta agonist (LABA) used solely as reliever therapy may represent an effective and safe alternative to ICS maintenance and short-acting beta agonist (SABA) reliever therapy. OBJECTIVE: To compare the efficacy and safety of ICS/fast-onset LABA reliever therapy with ICS maintenance and SABA reliever therapy in adults with asthma. METHODS AND ANALYSIS: A 52-week, open-label, parallel group, multicentre, phase III randomised controlled trial with 1:1 randomisation to either budesonide/formoterol Turbuhaler 200/6 µg, one actuation as required for symptom relief, or budesonide Turbuhaler 200 µg, one actuation twice daily and terbutaline Turbuhaler 250 µg, two actuations as required for symptom relief...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29038166/why-and-how-to-step-down-chronic-asthma-drugs
#12
REVIEW
Michael R Gionfriddo, John B Hagan, Matthew A Rank
Asthma is a common chronic airways disease. The goal of asthma management is to control symptoms while minimizing the side effects of treatment. Following a period of stable asthma, clinicians should consider stepping down treatment. This approach is recommended by current guidelines. Step-down has been studied for several types of asthma drug regimens, and certain approaches may have lower risk than others. Systematic reviews of multiple trials support the following specific step-down approaches: optimizing inhaled corticosteroid dosing when stepping down oral corticosteroid, reducing inhaled corticosteroid from a higher dose, lowering inhaled corticosteroid-long acting bronchodilator (ICS-LABA) dose while adding ICS-LABA on-demand, adding leukotriene receptor antagonist (LTRA) while lowering inhaled corticosteroid dose, and using allergen immunotherapy when reducing inhaled corticosteroid from a higher dose...
October 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29034999/home-supply-of-emergency-oral-steroids-and-reduction-in-asthma-healthcare-utilization
#13
Lisa M Sarzynski, Tiffany Turner, David R Stukus, Elizabeth Allen
OBJECTIVE: To determine if children with moderate-to-severe persistent asthma have decreased healthcare utilization after receiving a prescription and instructions to use an at home emergency supply of oral steroids during asthma exacerbations. METHODS: A quasi-experimental design study with a historical control from retrospective chart review was performed for patients aged 2-18 years seen in a tertiary care pediatric pulmonary clinic for moderate to severe persistent asthma...
October 16, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29026294/comparison-of-the-peripheral-blood-eosinophil-count-using-near-patient-testing-and-standard-automated-laboratory-measurement-in-healthy-asthmatic-and-copd-subjects
#14
Kirsty Hambleton, Clare M Connolly, Catherine Borg, Joanne H Davies, Helen P Jeffers, Richard Ek Russell, Mona Bafadhel
Near-patient testing (NPT) allows clinical decisions to be made in a rapid and convenient manner and is often cost effective. In COPD the peripheral blood eosinophil count has been demonstrated to have utility in providing prognostic information and predicting response to treatment during an acute exacerbation. For this potential to be achieved having a reliable NPT of blood eosinophil count would be extremely useful. Therefore, we investigated the use of the HemoCue(®) WBC Diff System and evaluated its sensitivity and specificity in healthy, asthmatic and COPD subjects...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29023163/asthma-exacerbations-and-socio-economic-status-in-french-adults-with-persistent-asthma-a-prospective-cohort-study
#15
Katia Mazalovic, Flore Jacoud, Alexandra L Dima, Eric Van Ganse, Maeva Nolin, Didier C, Claire Zaba, The Astro-Lab Group
INTRODUCTION: Adults disadvantaged by poor socio-economic status (SES) are more severely affected by asthma compared to those with better SES. We aimed to determine whether the frequency of asthma exacerbations (AEx), as well as aspects related to AEx management, differed based on SES in patients treated with daily treatments. METHODS: This study, part of the prospective observational cohort ASTRO-LAB, included French adult patients with persistent asthma. Patients were considered as low SES if they benefited from publicly funded special health insurance and/or were perceived as low SES by their general practitioner...
October 12, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29016232/algorithm-for-the-management-of-asthma-in-pregnant-women-a-protocol-to-optimize-processes-in-healthcare
#16
Eva Martinez-Moragón, Auxiliadora Romero-Falcón, Juan Luis García-Rivero
Asthma is the most common chronic disease in pregnant women. Its evolution during pregnancy could improve, stay the same or worsen, especially in cases where there is a loss of clinical control. This can lead to maternal and fetal hypoxia with serious adverse perinatal outcomes. Areas covered: This article reviews physiological modifications in pregnancy, effects of pregnancy on asthma, and possible consequences on fetus development. Furthermore, it reviews evidence on assessment and both pharmacological and non-pharmacological management of asthma in pregnant and breastfeeding women as well as in acute exacerbations...
October 23, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28986071/severe-asthma-and-the-primary-care-provider-identifying-patients-and-coordinating-multidisciplinary-care
#17
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)...
October 3, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28981368/the-national-burden-of-poorly-controlled-asthma-school-absence-and-parental-work-loss-among-school-aged-children-in-the-united-states
#18
P W Sullivan, V Ghushchyan, P Navaratnam, H S Friedman, A Kavati, B Ortiz, B Lanier
OBJECTIVE: The degree of poorly controlled asthma and its association with missed school days and parental missed work days is not well understood. METHODS: This was a retrospective analysis of missed school days and missed work days for school-aged children (SAC; aged 6-17) and their caregivers in the nationally representative 2007-2013 Medical Expenditure Panel Survey (MEPS). Indicators of poor asthma control included: exacerbation in previous 12 months; use of >3 canisters of short-acting beta agonist (SABA) in 3 months; and annual asthma-specific (AS) Emergency Department (ED) or inpatient (IP) visits...
October 5, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28978210/clinical-updates-on-the-management-of-asthma
#19
Suzanne Bollmeier
Asthma is a complex airway disorder that involves multiple inflammatory cells and cellular elements. Genetic and environmental factors result in recurrent episodes of the symptoms of asthma: coughing, wheezing, breathlessness, and chest tightness. Left untreated, these initial symptoms can transform into exacerbations ranging from spontaneous reversible airflow obstruction and airway remodeling to death. As a result, the need for novel therapeutic options for the treatment and long-term management of asthma has become increasingly vital...
February 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28976216/how-should-treatment-approaches-differ-depending-on-the-severity-of-asthma
#20
Maciej Kupczyk, Piotr Kuna
Asthma is nowadays regarded as a syndrome of various overlapping phenotypes with defined clinical characteristics, different underlying inflammatory mechanisms, identifiable genetic background, environmental risk factors and possible biomarkers. There are no doubts that due to the diversity of asthma, a 'one size fits all' management of the disease is no longer valid. Areas covered: Nowadays asthma management is based on the control of the disease, and the goals of asthma treatment are defined as good symptom control, decreased future risk of exacerbations, fixed airflow limitation, and side-effects of treatment...
October 16, 2017: Expert Review of Respiratory Medicine
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