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management of exacerbation of asthma

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https://www.readbyqxmd.com/read/29339126/addressing-the-impact-and-unmet-needs-of-nonadherence-in-asthma-and-chronic-obstructive-pulmonary-disease-where-do-we-go-from-here
#1
Richard Dekhuijzen, Federico Lavorini, Omar S Usmani, Job F M van Boven
Nonadherence to treatment, and its associated health and economic burden, is particularly problematic in asthma and chronic obstructive pulmonary disease management because of heterogeneous patient populations and the need for an inhaled route of drug administration. Symptom variability, comorbidities, and device switching further add to suboptimal adherence rates. As opposed to controlled clinical trials, real-life studies show consistently low inhaler adherence in daily practice, yet exact adherence rates have long been affected by disagreement on standardized definitions...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29337458/-pulmonary-diseases-asthma-copd-and-sleep-apnea-syndrome
#2
Béatrice Duxbury, Émilie Chappuis-Gisin, Salim Chucri, Jean-Paul Janssens
Among the novelties described in the management of pulmonary disorders during the year 2017, we chose to describe three. First, the indication for inhaled glucocorticosteroids (ICS) in COPD has been revisited, because of their relationship with an increased occurence of pneumonia : ICS are now recommended only in severe COPD (GOLD D) with frequent exacerbations as second line treatment. Secondly, azithromycine has shown very promising results in poorly controlled severe asthma, with a significant impact on symptoms and exacerbations...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29334861/copd-management-by-swedish-general-practitioners-baseline-results-of-the-primair-study
#3
Hanna Sandelowsky, Natalia Natalishvili, Ingvar Krakau, Sonja Modin, Björn Ställberg, Anna Nager
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a common cause of suffering and death. Evidence-based management of COPD by general practitioners (GPs) is crucial for decreasing the impact of the disease. Efficient strategies include early diagnosis, smoking cessation and multimodal treatment. AIM: To describe knowledge about and skills for managing COPD in GPs in Sweden. METHODS: Prior to COPD education (the PRIMAIR Study), GPs at primary health care centers (PHCCs) in Stockholm replied to 13 written, patient-case based, multiple choice and free-text questions about COPD...
January 15, 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29334288/targeted-anti-il-13-therapies-in-asthma-current-data-and-future-perspectives
#4
Polyxeni Ntontsi, Evgenia Papathanassiou, Stelios Loukides, Petros Bakakos, Georgios Hillas
Introduction The identification of patients with severe asthma who will benefit from a personalized management approach remains an unmet need. Interleukin-13 (IL-13) is a cytokine possessing a significant role in asthma pathogenesis and progression of disease. Humanised monoclonal antibodies against IL-13 and IL-13 and IL-4 receptors are mainly proposed as add-on therapy in patients with TH2-high inflammation with uncontrolled asthma despite maximum therapy. Areas covered The role of IL-13 in airway inflammation in severe asthma, the targeted anti-IL-13 therapies and biomarkers that predict response to anti-IL-13 treatment are discussed...
January 15, 2018: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#5
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
January 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29325304/-the-chinese-experts-consensus-on-the-evaluation-and-management-of-asthma-exacerbation
#6
(no author information available yet)
Asthma exacerbations can do a lot of harm to the patients and consume large amounts of medical resources. This consensus is based on the domestic and foreign guidelines and literatures to standardize the evaluation and management of asthma exacerbations in China. Asthma exacerbations are characterized by a progressive increase in symptoms of shortness of breath, cough, wheezing or chest tightness and progressive decrease in lung function, and usually require modification of treatment. Recognizing risk factors and triggering factors of asthma exacerbations is helpful for the prevention and long-term management...
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29325303/-standardize-the-management-of-asthma-exacerbation-and-improve-the-treatment-level-of-acute-attack
#7
(no author information available yet)
No abstract text is available yet for this article.
January 1, 2018: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/29321114/nebulized-ketamine-to-avoid-mechanical-ventilation-in-a-pediatric-patient-with-severe-asthma-exacerbation
#8
Abdelghafour Elkoundi, Aziza Bentalha, Alae El Koraichi, Salma Ech-Cherif El Kettani
Asthma is a major cause of morbidity and mortality despite advances in outpatient treatment. Sometimes, children fail to respond to standard treatment and can potentially require mechanical ventilation. We describe a case of a 26-month-old girl with a severe asthma exacerbation successfully managed by ketamine administration via nebulization route that permitted to avoid mechanical ventilation. Nebulized ketamine might be a reasonable option to avoid mechanical ventilation in children who fail to respond to standard treatment of severe asthma exacerbation...
January 6, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29306991/asthma-and-medicines-long-term-side-effects-monitoring-and-dose-titration
#9
REVIEW
Satnam Kaur, Varinder Singh
Asthma is a major pediatric respiratory morbidity requiring long-term management. A thorough knowledge of long-term medication side-effects in children is, thus, essential for every physician dealing with childhood asthma. Establishing diagnosis and initiating treatment is just a beginning of the journey. Ongoing monitoring is an essential component of comprehensive asthma management programme. Monitoring includes not only assessment of asthma control but also checking for adherence to treatment, technique of inhaler device use, associated co-morbities, if any, and potential environmental exposure...
January 6, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29302790/optimizing-the-dosing-of-intravenous-theophylline-in-acute-severe-asthma-in-children
#10
Gemma L Saint, Malcolm G Semple, Ian Sinha, Daniel B Hawcutt
Optimizing the management of children presenting with acute severe asthma is of utmost importance to minimize hospital stays, morbidity, and mortality. Intravenous medications, including theophyllines, are used as second-line treatments for children experiencing a life-threatening exacerbation. For intravenous theophylline (aminophylline), guidelines and formularies recommend a target therapeutic range between 10 and 20 mg/l, with the commonest regimen being a loading dose of 5 mg/kg followed by an infusion calculated by age and weight...
January 5, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29278745/strategies-towards-improving-pharmacological-management-of-asthma-during-pregnancy
#11
REVIEW
Luke E Grzeskowiak, Jessica A Grieger, Vicki L Clifton
Maternal asthma represents a significant burden to individuals and the healthcare system, affecting 1 in 10 pregnancies worldwide. Approximately 50% of asthmatic women experience a deterioration of asthma control at some stage during pregnancy, with a number requiring use of oral corticosteroids for the management of acute exacerbations. The presence of maternal asthma and exacerbations during pregnancy is a noted risk factor for a range of adverse perinatal outcomes including preterm birth, small-for-gestational age, pre-eclampsia, and gestational diabetes...
December 23, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29273246/asthma
#12
REVIEW
Alberto Papi, Christopher Brightling, Søren E Pedersen, Helen K Reddel
Asthma-one of the most common chronic, non-communicable diseases in children and adults-is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control-ie, to minimise symptom burden and risk of exacerbations. Anti-inflammatory and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach...
December 19, 2017: Lancet
https://www.readbyqxmd.com/read/29249187/an-update-on-the-management-of-aspirin-exacerbated-respiratory-disease
#13
Ji-Ho Lee, Chang-Gyu Jung, Hae-Sim Park
Clinical features of aspirin-exacerbated respiratory disease (AERD) consist of moderate to severe asthma associated with chronic rhinosinusitis (CRS), which are derived from overproduction of cysteinyl leukotrienes along with chronic type 2 mediated inflammation in the upper and lower airway mucosa. Area covered: This review provides recent up-to-date information regarding phenotypes of AERD and encompasses comprehensive diagnostic methods and treatment options. To confirm the diagnosis of AERD, provocation testing via nasal, inhalation or the oral route of aspirin remains the gold standard; in vitro diagnostic methods are still not available...
December 18, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29247229/salford-lung-study-in-chronic-obstructive-pulmonary-disease-sls-copd-follow-up-interviews-on-patient-centred-outcomes
#14
Lynda Doward, Henrik Svedsater, Diane Whalley, Rebecca Crawford, David Leather, James Lay-Flurrie, Nick Bosanquet
This study investigated patient perceptions, experiences and management of COPD throughout the SLS COPD study. Follow-up interviews were conducted with 400 patients who completed SLS COPD; a mixed-methods approach was used to collect quantitative and qualitative information. Structured interviews using closed-ended questions were conducted with 360 patients, detailing aspects of background/lifestyle information and COPD. Extended interviews containing open-ended questions on perceptions of COPD and quality of life (QoL) in addition to the closed-ended questions were completed by 40 further patients...
December 15, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/29238240/the-effect-of-dpp-4-inhibitors-on-asthma-control-an-administrative-database-study-to-evaluate-a-potential-pathophysiological-relationship
#15
Gene Colice, David Price, Maria Gerhardsson de Verdier, Karma Rabon-Stith, Christopher Ambrose, Katherine Cappell, Debra E Irwin, Paul Juneau, Anna Vlahiotis
Rationale: DPP-4 may regulate immunological pathways implicated in asthma. Assessing whether DPP-4 inhibitor (DPP-4i) use might affect asthma control is clinically important because DPP-4i use in type 2 diabetes mellitus management (T2DM) is increasing. This study evaluated associations between DPP-4i use and asthma control. Methods: This was a retrospective, observational, matched cohort study using administrative claims in the MarketScan® Commercial Claims and Encounters (Commercial) and Medicare Supplemental and Coordination of Benefits (Medicare Supplemental) databases...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29238123/epidemiology-triggers-and-severity-of-childhood-asthma-in-ilesa-nigeria-implications-for-management-and-control
#16
Bankole Peter Kuti, Kehinde Oluyori Omole
Background: Knowledge about childhood asthma in a locality will assist clinicians to adequately manage the condition. This study set out to report the epidemiology, triggers of exacerbation, comorbid conditions, and severity of childhood asthma at a tertiary health facility in Nigeria and the implication of these, in management and symptoms control. Methods: Over a 15-month study period, children (aged <15 years) with physician-diagnosed asthma were consecutively recruited at the pediatric chest clinic of the hospital...
January 2017: Nigerian Medical Journal: Journal of the Nigeria Medical Association
https://www.readbyqxmd.com/read/29229090/health-related-quality-of-life-in-asthma-patients-a-comparison-of-two-cohorts-from-2005-and-2015
#17
Josefin Sundh, Philip Wireklint, Mikael Hasselgren, Scott Montgomery, Björn Ställberg, Karin Lisspers, Christer Janson
INTRODUCTION: The aim was to investigate temporal variation in Health-Related Quality of Life (HRQL) and factors influencing low HRQL, in patients with asthma. MATERIAL AND METHODS: Questionnaire data on patient characteristics and the mini-Asthma Quality of Life Questionnaire (mini-AQLQ) scores from two separate cohorts of randomly selected Swedish primary and secondary care asthma patients, in 2005 (n = 1034) and 2015 (n = 1126). Student's t-test and analysis of covariance with adjustment for confounders compared mini-AQLQ total and domain scores in 2005 and 2015...
November 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29221328/uncontrolled-and-under-diagnosed-asthma-in-a-damascus-shelter-during-the-syrian-crisis
#18
Yousser Mohammad, Shaaban Rafea, Youssef Latifeh, Ali Khaddam, Bisher Sawaf, Mhd Ismael Zakaria, Mohammad Sadek Al Masalmeh, Yaser Fawaz, Abdoulraouf Allaham, Imad Almani, Hiba El-Tarcheh, Ayham Ghazal, Ali Zaher, Hala Rifai, Hamed Joumah, S Dresden Glockler-Lauf, Teresa To
Background: Studies have shown that poor shelter or dwelling conditions may lead to deteriorations in health. Those with asthma may be more susceptible to compromised living conditions and stress leading to a higher risk of asthma exacerbations. To describe the asthma control and quality of life of individuals with diagnosed asthma living in a shelter in Damascus, Syria and estimate the prevalence of respiratory symptoms in shelter dwellers without diagnosed asthma. Methods: In this cross-sectional study, all individuals 5 years and older living in Al-Herjalleh shelter with diagnosed asthma were recruited to complete a questionnaire, which included items related to their respiratory symptoms, asthma exacerbations, exposure to asthma triggers, medication use, and health-related quality of life before and since entering the shelter...
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29213221/omalizumab-in-children-with-severe-allergic-asthma-the-italian-real-life-experience
#19
Amelia Licari, Riccardo Castagnoli, Chiara Denicolò, Linda Rossini, Manuela Seminara, Lucia Sacchi, Giorgia Testa, Mara De Amici, Gian Luigi Marseglia
Background: Anti-IgE treatment represents a major breakthrough in the therapeutic management of severe allergic asthma. To date, omalizumab is the only biological drug currently licensed as add-on therapy in children aged > 6 years with moderate-to-severe and severe allergic asthma uncontrolled after treatment with high dose of inhaled corticosteroids plus long-acting inhaled beta2-agonist. The clinical efficacy and safety of omalizumab treatment in the pediatric population has been extensively documented in specific trials and consistently expanded from real-life studies...
March 2017: Current Respiratory Medicine Reviews
https://www.readbyqxmd.com/read/29207999/corticosteroid-plus-%C3%AE-2-agonist-in-a-single-inhaler-as-reliever-therapy-in-intermittent-and-mild-asthma-a-proof-of-concept-systematic-review-and-meta-analysis
#20
REVIEW
Gang Wang, Xin Zhang, Hong Ping Zhang, Lei Wang, De Ying Kang, Peter J Barnes, Gang Wang
BACKGROUND: Current guidelines recommend a single inhaler maintenance and reliever therapy (SMART) regimen for moderate to severe asthma. However, evidence for the inhaled corticosteroid plus fast-onset-acting β2-agonist (ICS/FABA) as reliever therapy in management of intermittent and mild asthma patients is lacking. OBJECTIVE: To systematically explore efficacy and safety of the proof-of-concept of the ICS plus FABA regimen in a single inhaler as reliever therapy across children and adults with intermittent and mild persistent asthma...
December 6, 2017: Respiratory Research
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