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management of exacerbation of asthma

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https://www.readbyqxmd.com/read/28743293/assessment-of-inhaled-corticosteroids-use-and-associated-factors-among-asthmatic-patients-attending-tikur-anbessa-specialized-hospital-ethiopia
#1
Yohanes Ayele, Ephrem Engidawork, Tola Bayisa
BACKGROUND: Inhaled corticosteroids (ICSs) are cornerstone therapy for persistent asthma. However, underutilization of ICSs is common and little is known about factors contributing toward this undesirable use. METHODS: A cross-sectional study was conducted through interview and chart review among persistent asthmatic patients attending chest clinic of Tikur Anbessa Specialized Hospital from 1 May to 31 September 2014. A total of 131 eligible patients who attended the clinic during study period were included in the study...
July 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#2
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28728272/-the-level-of-asthma-control-in-china-from-a-national-asthma-control-survey
#3
J T Lin, W Q Wang, X Zhou, C Z Wang, M Huang, S X Cai, P Chen, Q C Lin, J Y Zhou, Y H Gu, Y D Yuan, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, P Jiang, J Zhang, X W Ye, H G Liu, H P Tang, R Y Liu, C T Liu, W Zhang, C P Hu, Y Q Chen, X J Liu, L M Dai, W Zhou, Y J Huang, J Y Xu
Objective: To assess the overall asthma control level in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out in 30 provinces in China (except Tibet). Asthmatic outpatients who met the inclusion criteria were recruited consecutively from 30 sub-centers from October 2015 to May 2016. Data of demographic characteristics, asthma control, asthma management, asthma exacerbations and self-management, and disease perception were collected by face-to-face interviews. Results: Totally 3 875 asthmatic outpatients were recruited...
July 12, 2017: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/28721017/targeted-therapy-in-severe-asthma-today-focus-on-immunoglobulin-e
#4
REVIEW
Girolamo Pelaia, Giorgio Walter Canonica, Andrea Matucci, Rossella Paolini, Massimo Triggiani, Pierluigi Paggiaro
Asthma is a complex chronic inflammatory disease of multifactorial etiology. International guidelines increasingly recognize that a standard "one size fits all" approach is no longer an effective approach to achieve optimal treatment outcomes, and a number of disease phenotypes have been proposed for asthma, which has the potential to guide treatment decisions. Among the many asthma phenotypes, allergic asthma represents the widest and most easily recognized asthma phenotype, present in up to two-thirds of adults with asthma...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28716529/the-pro-inflammatory-cytokines-salivary-cortisol-and-alpha-amylase-are-associated-with-generalized-anxiety-disorder-gad-in-patients-with-asthma
#5
Chang-Jiang Yang, Di Liu, Zhen-Sheng Xu, Shen-Xun Shi, Yi-Jie Du
Generalized anxiety disorder (GAD) is common in patients with asthma. High levels of GAD may lead both to exacerbation of the condition and poor management. However, the physiological mechanisms of GAD in asthma patient is unclear. This study investigated the associations between the diurnal rhythm of sputum cytokines, salivary cortisol, α-amylase and GAD in asthma patients. Patients with co-morbid GAD and asthma showed higher sputum IL-1 AUC, sputum IL-6 AUC and sAA AUC. And there were positive correlations between Hamilton anxiety scale (HAMA) scores and sputum IL-1 AUC concentrations (r=0...
July 14, 2017: Neuroscience Letters
https://www.readbyqxmd.com/read/28709967/advances-in-asthma-2016-designing-individualized-approaches-to-management
#6
William C Anderson, Andrea Apter, Cullen M Dutmer, Daniel A Searing, Stanley J Szefler
In this years Advances in Asthma review we discuss viral infections in asthma and potential therapeutic agents, the microbiome, novel genetic associations with asthma, air quality and climate effects on asthma, exposures during development and long term sequelae of childhood asthma, patient centered outcome research, and precision medicine. In addition, we discuss application of biomarkers to precision medicine, and new information on asthma medications. New evidence indicates that rhinovirus-triggered asthma exacerbations become more severe as the degree of sensitization to dust mite and mouse increase...
July 11, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28692003/comparison-of-psychological-quality-of-life-work-limitation-and-socioeconomic-status-between-patients-with-occupational-asthma-and-work-exacerbated-asthma
#7
Joshua C Lipszyc, Frances Silverman, Dorothy Linn Holness, Gary M Liss, Kim L Lavoie, Susan M Tarlo
OBJECTIVE: The aim of this study was to compare psychological status, quality of life (QoL), work limitation, and socioeconomic status between patients with occupational asthma (OA) and work-exacerbated asthma (WEA). METHODS: The following questionnaires were administered to participants: Beck anxiety and depression (II) inventories, Marks' Asthma Quality of Life Questionnaire, and Work Limitations Questionnaire. Cross-sectional analyses between OA and WEA subgroups were completed...
July 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28689842/asthma-exacerbations-pathogenesis-prevention-and-treatment
#8
Jamee R Castillo, Stephen P Peters, William W Busse
Guideline-based management of asthma focuses on disease severity and choosing the appropriate medical therapy to control symptoms and reduce the risk of exacerbations. However, irrespective of asthma severity and often despite optimal medical therapy, patients may experience acute exacerbations of symptoms and a loss of disease control. Asthma exacerbations are most commonly triggered by viral respiratory infections, particularly with human rhinovirus. Given the importance of these events to asthma morbidity and health care costs, we will review common inciting factors for asthma exacerbations and approaches to prevent and treat these events...
July 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28688465/chronic-obstructive-pulmonary-disease-phenotypes-implications-for-care
#9
REVIEW
Shireen Mirza, Roberto Benzo
Chronic obstructive pulmonary disease (COPD) phenotyping can help define clusters of patients with common characteristics that relate to clinically meaningful outcomes. In this review, we describe 7 clinically meaningful COPD phenotypes that can be identified by primary care physicians as well as specialists and that have specific management and prognostic implications: (1) asthma-COPD overlap phenotype, (2) frequent exacerbator phenotype, (3) upper lobe-predominant emphysema phenotype, (4) rapid decliner phenotype, (5) comorbid COPD phenotype, (6) physical frailty phenotype, and (7) emotional frailty phenotype...
July 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28677351/positioning-of-long-acting-muscarinic-antagonists-in-the-management-of-asthma
#10
REVIEW
René Aalbers, Hae Sim Park
Despite a range of efficacious therapies for asthma, including inhaled corticosteroids (ICS) and long-acting β₂-agonists (LABA), a significant proportion of patients have poor asthma control and retain a risk of future worsening of their symptoms. Long-acting muscarinic antagonist (LAMA) bronchodilators offer a well-tolerated, efficacious, and cost-effective add-on to a patient's treatment. Of the LAMAs currently under investigation or available for the treatment of asthma, evidence from a comprehensive clinical trial program in adults and children shows that once-daily treatment with tiotropium provides benefits for patients with uncontrolled asthma despite the use of ICS and LABAs...
September 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28671166/effects-of-oral-montelukast-on-airway-function-in-acute-asthma-a-randomized-trial
#11
Alisha Chaudhury, Gajanan S Gaude, Jyothi Hattiholi
BACKGROUND: The role of leukotriene receptor antagonist is well known in the management of chronic asthma, but their efficacy in acute exacerbation of asthma is unknown. The present study was done to evaluate the clinical efficacy of oral montelukast as an add on therapy to the usual standard therapy of acute attack of bronchial asthma. MATERIALS AND METHODS: A randomized single-blinded controlled study was conducted in a tertiary care teaching hospital. A total of 162 patients with age >18 years of acute exacerbations due to bronchial asthma were included in the study...
July 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28669892/validity-of-the-asthma-control-test-questionnaire-among-smoking-asthmatics
#12
Xavier Soler, Janet T Holbrook, Lynn B Gerald, Cristine E Berry, Joy Saams, Robert J Henderson, Elizabeth Sugar, Robert A Wise, Joe W Ramsdell
BACKGROUND: Smoking asthmatics respond worse to existing asthma therapies and have more asthma symptoms and exacerbations. OBJECTIVE: We evaluated the Asthma Control Test (ACT) for assessing asthma control among smokers. METHODS: Adults with asthma who smoked were enrolled and followed for 6 weeks. The statistical properties, validity, and responsiveness of the ACT were evaluated. Physician global assessment (GS) of asthma was the "gold standard...
June 29, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28646883/ioeasma-an-integrated-clinical-and-educational-pathway-for-managing-asthma-in-children-and-adolescents
#13
Sebastiano Guarnaccia, Gaia Pecorelli, Marina Bianchi, Massimo Cartabia, Gianluigi Casadei, Ada Pluda, Cristina Quecchia, Valeria Gretter, Maurizio Bonati
BACKGROUND: Due to the lack of real life clinical and educational studies, "Io e l'Asma" Centre performed this implementation research (IR). Evaluate long-term effectiveness on bronchial asthma control of an integrated clinical and educational pathway for asthmatic children and adolescents. METHODS: An observational retrospective pre-post intervention IR study was conducted among 262 children with asthma, ages 6-15 yrs. The intervention protocol included three clinical visits 8 weeks apart; an educational course at visit 1, post intervention consisted in two follow-up visits 6 months apart...
June 24, 2017: Italian Journal of Pediatrics
https://www.readbyqxmd.com/read/28645995/mepolizumab-for-the-treatment-of-severe-eosinophilic-asthma
#14
REVIEW
Mara N Poulakos, Shawna M Cargill, Melissa F Waineo, Allen L Wolford
PURPOSE: Published data on the pharmacology, pharmacokinetics and pharmacodynamics, and clinical efficacy and safety of the interleukin-5 antagonist mepolizumab are reviewed. SUMMARY: Asthma of the eosinophilic phenotype is characterized by persistent eosinophilic airway inflammation promoted primarily by T-helper type 2 cytokines, the key regulator of eosinophils. Patients with severe eosinophilic asthma are burdened by the need to administer high doses of corticosteroids to help manage their symptoms...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28636411/asthma-and-influenza-vaccination-in-elderly-hospitalized-patients-matched-case-control-study-in-spain
#15
María Morales Suárez-Varela, Agustin Llopis, Estrella Fernandez-Fabrellas, Francisco Sanz, M Jose Perez-Lozano, Vicente Martin, Jenaro Astray, Jesús Castilla, Mikel Egurrola, Luis Force, Diana Toledo, Àngela Domínguez
OBJECTIVES: Influenza infection is an exacerbating factor for asthma, and its prevention is critical in managing asthmatic patients. We investigated the effect of influenza vaccination on asthmatic and non-asthmatic patients hospitalized with laboratory-confirmed influenza in Spain. METHODS: We made a matched case-control study to assess the frequency of hospitalization for influenza in people aged ≥65 years. Hospitalized patients with unplanned hospital admissions were recruited from 20 hospitals representing seven Spanish regions...
June 21, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28635549/a-missed-primary-care-appointment-correlates-with-a-subsequent-emergency-department-visit-among-children-with-asthma
#16
Colleen Marie McGovern, Margaret Redmond, Kimberly Arcoleo, David R Stukus
OBJECTIVE: Since the Affordable Care Act's implementation, emergency department (ED) visits have increased. Poor asthma control increases the risk of acute exacerbations and preventable ED visits. The Centers for Medicare and Medicaid Services support the reduction of preventable ED visits to reduce healthcare spending. Implementation of interventions to avoid preventable ED visits has become a priority for many healthcare systems yet little data exist examining children's missed asthma management primary care (PC) appointments and subsequent ED visits...
March 2, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28633665/optimizing-bronchodilation-in-the-prevention-of-copd-exacerbations
#17
REVIEW
Marc Miravitlles, Antonio Anzueto, José R Jardim
The natural disease course of chronic obstructive pulmonary disease (COPD) is often punctuated by exacerbations: acute events of symptom worsening associated with significant morbidity and healthcare resource utilization; reduced quality of life; and increased risk of hospitalization and death. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommend that patients at risk of exacerbations (GOLD Groups C and D) receive a long-acting muscarinic antagonist (LAMA) or a long-acting β2-agonist (LABA)/LAMA combination, respectively, as preferred initial treatments...
June 20, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28631599/efficacy-and-safety-of-omalizumab-in-children-and-adolescents-with-moderate-to-severe-asthma-a-systematic-literature-review
#18
Jonathan Corren, Abhishek Kavati, Benjamin Ortiz, Jennifer A Colby, Kimberly Ruiz, Brett A Maiese, Sarah M Cadarette, Reynold A Panettieri
BACKGROUND: There are limited pediatric data about the use of omalizumab, especially the effectiveness and safety of omalizumab in the real-world management of allergic asthma. OBJECTIVE: The objective of this study was to summarize the safety and efficacy of omalizumab in both randomized clinical trials (RCT) used for U.S. Food and Drug Administration registration and real-world studies (RWS) based on clinical care of children with moderate-to-severe asthma. METHODS: Studies that evaluated omalizumab use in patients <18 years old and with asthma, published between January 2003 and October 2016, were retrieved from medical literature data bases...
July 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28619649/the-school-inner-city-asthma-intervention-study-design-rationale-methods-and-lessons-learned
#19
Wanda Phipatanakul, Petros Koutrakis, Brent A Coull, Choong-Min Kang, Jack M Wolfson, Stephen T Ferguson, Carter R Petty, Mihail Samnaliev, Amparito Cunningham, William J Sheehan, Jonathan M Gaffin, Sachin N Baxi, Peggy S Lai, Perdita Permaul, Liming Liang, Peter S Thorne, Gary Adamkiewicz, Kasey J Brennan, Andrea A Baccarelli, Diane R Gold
Asthma is the most common chronic disease of childhood in the United States, causes significant morbidity, particularly in the inner-city, and accounts for billions of dollars in health care utilization. Home environments are established sources of exposure that exacerbate symptoms and home-based interventions are effective. However, elementary school children spend 7 to 12h a day in school, primarily in one classroom. From the observational School Inner-City Asthma Study we learned that student classroom-specific exposures are associated with worsening asthma symptoms and decline in lung function...
June 12, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28590992/montelukast-treatment-of-acute-asthma-exacerbations-in-children-aged-2-to-5-years-a-randomized-double-blind-placebo-controlled-trial
#20
Xiuping Wang, Jinfang Zhou, Xin Zhao, Xiongxiong Yi
BACKGROUND: Although montelukast has an established role in the management of chronic asthma in children, its efficacy in acute asthma exacerbations (AAEs) in children aged 2 to 5 years is not fully known. This study aimed to evaluate the effectiveness and safety of montelukast for treating AAE in children aged 2 to 5 years in China. METHODS: In total, 120 Chinese children with AAE, aged 2 to 5 years, were randomly divided into 2 groups, each with 60 patients. All patients received either montelukast or placebo along with standard therapy for acute asthma between January 2011 and December 2015...
June 6, 2017: Pediatric Emergency Care
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