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management of exacerbation of asthma

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https://www.readbyqxmd.com/read/27906698/ige-and-eosinophils-as-therapeutic-targets-in-asthma
#1
Tanvi R Patel, Sanjiv Sur
PURPOSE OF REVIEW: Asthma is a chronic inflammatory disorder characterized by reversible airflow obstruction, which is being more widely recognized as a broad-spectrum disease that encompasses multiple patient characteristics and pathophysiologic mechanisms. Suboptimal asthma control leads to increasing burden of healthcare costs and loss of productivity to society. Biologic therapies targeted at IgE and eosinophils can be used in poorly controlled allergic and eosinophilic asthma, respectively...
November 30, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27905186/severe-asthma-current-management-targeted-therapies-and-future-directions-a-roundtable-report
#2
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/27896984/methods-for-clustering-time-series-data-acquired-from-mobile-health-apps
#3
Nicole Tignor, Pei Wang, Nicholas Genes, Linda Rogers, Steven G Hershman, Erick R Scott, Micol Zweig, Yu-Feng Yvonne Chan, Eric E Schadt
In our recent Asthma Mobile Health Study (AMHS), thousands of asthma patients across the country contributed medical data through the iPhone Asthma Health App on a daily basis for an extended period of time. The collected data included daily self-reported asthma symptoms, symptom triggers, and real time geographic location information. The AMHS is just one of many studies occurring in the context of now many thousands of mobile health apps aimed at improving wellness and better managing chronic disease conditions, leveraging the passive and active collection of data from mobile, handheld smart devices...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27889330/use-of-biologics-to-treat-acute-exacerbations-and-manage-disease-in-asthma-copd-and-ipf
#4
REVIEW
Lynne A Murray, Chris Grainge, Peter A Wark, Darryl A Knight
A common feature of chronic respiratory disease is the progressive decline in lung function. The decline can be indolent, or it can be accelerated by acute exacerbations, whereby the patient experiences a pronounced worsening of disease symptoms. Moreover, acute exacerbations may also be a marker of insufficient disease management. The underlying cause of an acute exacerbation can be due to insults such as pathogens or environmental pollutants, or the cause can be unknown. For each acute exacerbation, the patient may require medical intervention such as rescue medication, or in more severe cases, hospitalization and ventilation and have an increased risk of death...
November 24, 2016: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/27887807/the-role-of-the-pharmacy-in-the-management-of-bronchial-asthma-a-literature-based-evaluation
#5
REVIEW
Gianenrico Senna, Marco Caminati, Clara Bovo, Giorgio Walter Canonica, Giovanni Passalacqua
OBJECTIVE: Pharmacists play a relevant role in the real-life management of asthma because they are a first-line referral for patients. In fact, the role of pharmacies has been underlined and evidenced also in guidelines. Nonetheless, the true effect of pharmacy-based management of asthma has been assessed in only a few studies. We review the available literature on asthma management in a territorial pharmacy setting. DATA SOURCES: The literature was searched for the keywords pharmacy, bronchial asthma, control, and management...
November 22, 2016: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/27878470/%C3%AE-2-agonists
#6
Charlotte K Billington, Raymond B Penn, Ian P Hall
History suggests β agonists, the cognate ligand of the β2 adrenoceptor, have been used as bronchodilators for around 5,000 years, and β agonists remain today the frontline treatment for asthma and chronic obstructive pulmonary disease (COPD). The β agonists used clinically today are the products of significant expenditure and over 100 year's intensive research aimed at minimizing side effects and enhancing therapeutic usefulness. The respiratory physician now has a therapeutic toolbox of long acting β agonists to prophylactically manage bronchoconstriction, and short acting β agonists to relieve acute exacerbations...
November 23, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27875341/occupational-asthma-diagnostic-challenges-and-management-dilemmas
#7
Vrinda Trivedi, Dinesh R Apala, Vivek N Iyer
PURPOSE OF REVIEW: Work-related asthma encompasses both sensitizer-induced and irritant-induced occupational asthma as well as work-exacerbated asthma. This review summarizes current diagnostic and management strategies for occupational asthma. RECENT FINDINGS: Occupational asthma is the most common occupational lung disease in the industrialized world. Over 400 agents have been described to cause occupational asthma. Specific inhalation challenge is often considered the reference method for diagnosis of occupational asthma but specific inhalation challenge as well as other diagnostic tests all generate false positive or false negative results...
November 21, 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/27870665/near-fatal-asthma-a-heterogeneous-clinical-entity
#8
José Serrano-Pariente, Vicente Plaza
PURPOSE OF REVIEW: The aims of the present review were to describe the heterogeneous nature of near-fatal asthma (NFA) and to summarize the distinctive phenotypes identified in this subtype of asthma. RECENT FINDINGS: Clinical, physiological, and histological studies have shown a large number of triggers, pathological mechanisms, and risk factors associated with NFA. Based on the demographic and clinical characteristics of the patients, the circumstances surrounding the asthma exacerbation and some distinctive features of the disease, several clinical profiles of asthma patients with NFA have been described...
November 18, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27862645/association-between-asthma-control-and-asthma-cost-results-from-a-longitudinal-study-in-a-primary-care-setting
#9
Hai V Nguyen, Nivedita V Nadkarni, Usha Sankari, Shweta Mital, Weng K Lye, Ngiap C Tan
BACKGROUND AND OBJECTIVE: Asthma control can be assessed with the Asthma Control Test (ACT) and a score of 20 or higher indicates good asthma control. Patients pay for their consultation and treatment in the fee-for-service primary healthcare system in Singapore. We hypothesized that achieving asthma control would result in lower asthma costs through reduced acute exacerbations, fewer physician consultations and lower lost productivity. The study compared the healthcare costs of patients who achieved asthma control and those with suboptimal asthma control based on ACT scores...
November 10, 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/27859832/comparison-of-anti-interleukin-5-therapies-in-patients-with-severe-asthma-global-and-indirect-meta-analyses-of-randomized-placebo-controlled-trials
#10
Yann Cabon, Nicolas Molinari, Gregory Marin, Isabelle Vachier, Anne Sophie Gamez, Pascal Chanez, Arnaud Bourdin
BACKGROUND: Inconsistent results have been reported regarding IL-5 blockade treatment in asthma. There were no direct between-treatment comparisons. Only differences between each drug and placebo were studied. METHODS: We identified all RCTs with anti-IL5 treatments for asthma patients over the 1990-September 2015 period. RCT were searched on Medline, Cochrane and Embase. At least 50 patients were enrolled in each study. Outcomes considered were: exacerbation rate reduction, FEV1 changes, ACQ-5 improvement, adverse events and serious adverse events...
November 10, 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27852249/assessment-of-work-related-asthma-prevalence-control-and-severity-protocol-of-a-field-study
#11
Hermine Mével, Valérie Demange, Emmanuelle Penven, Christian Trontin, Pascal Wild, Christophe Paris
BACKGROUND: There are still uncertainties regarding the respective prevalence, diagnosis and management of occupational asthma (OA) and work-exacerbated asthma (WEA). There is as yet no standardized methodology to differentiate their diagnosis. A proper management of both OA and WEA requires tools for a good phenotyping in terms of control, severity and quality of life in order to propose case-specific therapeutical and preventive measures. Moreover, there is a lack of knowledge concerning their actual costs...
November 16, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#12
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27836376/-new-drugs-for-severe-asthma
#13
Caroline Sattler, Roxane Malrin, Gilles Garcia, Marc Humbert
Asthma is a very frequent disease with complex and heterogenous immunological and clinical features. Daily inhaled steroids are the cornerstone of the current therapeutics sometimes associated with long-acting β2-agonist. This controller treatment is effective and allows to control asthma symptoms for the vast majority of the patients. Severe asthma is characterized by a poor level of control of symptoms, with recurrent exacerbations or a chronic airflow limitation despite an optimal management. Severe asthma remains a difficult diagnosis but we have now studies proving the clinical efficacy or promising data about monoclonal antibodies targeting IgE, IL-5, IL-4 or IL-13...
November 8, 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27834496/improving-childcare-staff-management-of-acute-asthma-exacerbation-an-australian-pilot-study
#14
Yien Yien Soo, Kate Helen FitzGerald, Bandana Saini, Vicky Kritikos, John D Brannan, Rebekah Jane Moles
OBJECTIVE This study aimed to evaluate the effectiveness of an asthma first-aid training tool for childcare staff in Australia. The effects of training on both asthma knowledge and skills were assessed. METHODS A pre/post study design was utilised to assess changes in asthma knowledge and asthma first-aid skills in childcare staff before and after an educational intervention. Asthma first-aid skills were assessed from the participant's response to two scenarios in which a child was having a severe exacerbation of asthma...
November 11, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27834175/severe-asthma-anti-ige-or-anti-il-5
#15
REVIEW
Evgenia Papathanassiou, Stelios Loukides, Petros Bakakos
Severe asthma is a discrete clinical entity characterised by recurrent exacerbations, reduced quality of life and poor asthma control as ordinary treatment regimens remain inadequate. Difficulty in managing severe asthma derives partly from the multiple existing phenotypes and our inability to recognise them. Though the exact pathogenetic pathway of severe allergic asthma remains unclear, it is known that numerous inflammatory cells and cytokines are involved, and eosinophils represent a key inflammatory cell mediator...
2016: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27826703/leukotriene-receptor-antagonists-and-antiallergy-drugs
#16
Tsutomu Tamada, Masakazu Ichinose
As one of the candidates of the therapeutic strategy for asthma in addition to inhaled corticosteroids (ICS), leukotriene receptor antagonists (LTRAs) are known to be useful for long-term management of asthma patients complicated by allergic rhinitis (AR) or exercise-induced asthma (EIA). Currently available LTRAs are pranlukast hydrate, zafirlukast, and montelukast. These LTRAs have a bronchodilator action and inhibit airway inflammation, resulting in a significant improvement of asthma symptoms, respiratory function, inhalation frequency of as-needed inhaled β2-agonist, airway inflammation, airway hyperresponsiveness, dosage of ICSs, asthma exacerbations, and patients' QOL...
November 9, 2016: Handbook of Experimental Pharmacology
https://www.readbyqxmd.com/read/27825614/impulse-oscillometry-in-the-assessment-of-asthmatic-children-and-adolescents-from-a-narrative-to-a-systematic-review
#17
REVIEW
Karoliny Dos Santos, Lílian L Fausto, Paulo A M Camargos, Maicon R Kviecinski, Jane da Silva
Diagnosis and management of asthma often relies mostly on symptoms because spirometry is not always reliable in some age groups, such as preschoolers. It is unclear whether impulse oscillometry (IOS) can supplement or replace spirometry. Available reports suggest that IOS has been applied with success in asthmatic children and adolescents to assess exacerbations, level of control, severity and response to treatment in the short and long term. Very few studies using adequate sample sizes and methods have been performed comparing the accuracy of IOS to spirometry for the diagnosis of asthma...
September 28, 2016: Paediatric Respiratory Reviews
https://www.readbyqxmd.com/read/27825189/exhaled-nitric-oxide-levels-to-guide-treatment-for-children-with-asthma
#18
REVIEW
Helen L Petsky, Kayleigh M Kew, Anne B Chang
BACKGROUND: Asthma guidelines aim to guide health practitioners to optimise treatment for patients to minimise symptoms, improve or maintain good lung function, and prevent acute exacerbations. The principle of asthma guidelines is based on a step-up or step-down regimen of asthma medications to maximise health using minimum doses. Fractional exhaled nitric oxide (FeNO) is a marker of eosinophilic inflammation and tailoring asthma medications in accordance to airway eosinophilic levels may improve asthma outcomes such as indices of control or reduce exacerbations, or both...
November 9, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27822136/predicting-and-reducing-risk-of-exacerbations-in-children-with-asthma-in-the-primary-care-setting-current-perspectives
#19
REVIEW
Steve Turner
Childhood asthma is a very common condition in western countries and is becoming more prevalent worldwide. Asthma attacks (or exacerbations) affect the quality of life for child and parent, can rarely result in death, and also come at a cost for health care providers and the economy. The aims of this review were to 1) describe the burden of asthma exacerbations, 2) describe factors that might predict a child at increased risk of having an asthma attack, and 3) explore what interventions might be delivered in primary care to reduce the risk of a child having an asthma attack...
2016: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/27822075/health-care-resource-use-and-costs-associated-with-possible-side-effects-of-high-oral-corticosteroid-use-in-asthma-a-claims-based-analysis
#20
Allan T Luskin, Evgeniya N Antonova, Michael S Broder, Eunice Y Chang, Theodore A Omachi, Dennis K Ledford
BACKGROUND: The objective of this study was to estimate the prevalence of possible oral corticosteroid (OCS)-related side effects and health care resource use and costs in patients with asthma. METHODS: This was a cross-sectional, matched-cohort, retrospective study using a commercial claims database. Adults with asthma diagnosis codes and evidence of asthma medication use were studied. Patients with high OCS use (≥30 days of OCS annually) were divided into those who did versus those who did not experience OCS-related possible side effects...
2016: ClinicoEconomics and Outcomes Research: CEOR
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