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management of exacerbation of asthma adult

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https://www.readbyqxmd.com/read/28583260/the-case-for-impulse-oscillometry-in-the-management-of-asthma-in-children-and-adults
#1
REVIEW
Stanley P Galant, Hirsh D Komarow, Hye-Won Shin, Salman Siddiqui, Brian J Lipworth
OBJECTIVE: To provide a clinical rationale for including impulse oscillometry (IOS) as a part of standard office-based asthma assessment. DATA SOURCES: PubMed and Google search, limited to English language and human disease, with the keywords IOS and asthma. STUDY SELECTIONS: Articles included in this review were based on the expert opinion and previous publications by the authors. RESULTS: In children, IOS was more useful than spirometry in identifying asthma and uncontrolled asthma and predicting loss of control and exacerbations...
June 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28530840/oral-glucocorticoid-sparing-effect-of-benralizumab-in-severe-asthma
#2
Parameswaran Nair, Sally Wenzel, Klaus F Rabe, Arnaud Bourdin, Njira L Lugogo, Piotr Kuna, Peter Barker, Stephanie Sproule, Sandhia Ponnarambil, Mitchell Goldman
Background Many patients with severe asthma rely on oral glucocorticoids to manage their disease. We investigated whether benralizumab, a monoclonal antibody directed against the alpha subunit of the interleukin-5 receptor that significantly reduces the incidence of asthma exacerbations, was also effective as an oral glucocorticoid-sparing therapy in patients relying on oral glucocorticoids to manage severe asthma associated with eosinophilia. Methods In a 28-week randomized, controlled trial, we assessed the effects of benralizumab (at a dose of 30 mg administered subcutaneously either every 4 weeks or every 8 weeks [with the first three doses administered every 4 weeks]) versus placebo on the reduction in the oral glucocorticoid dose while asthma control was maintained in adult patients with severe asthma...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28526665/the-sensor-study-protocol-for-a-mixed-methods-study-of-self-management-checks-to-predict-exacerbations-of-pseudomonas-aeruginosa-in-patients-with-long-term-respiratory-conditions
#3
Claire Roberts, Thomas L Jones, Samal Gunatilake, Will Storrar, Scott Elliott, Sharon Glaysher, Ben Green, Steven Rule, Carole Fogg, Ann Dewey, Kevin A Auton, Anoop J Chauhan
BACKGROUND: There are an estimated three million people in the United Kingdom with chronic obstructive pulmonary disease (COPD), and the incidence of bronchiectasis is estimated at around 0.1% but is more common in COPD and severe asthma. Both COPD and bronchiectasis are characterized by exacerbations in which bacteria play a central role. Pseudomonas aeruginosa is isolated from sputum samples from 4% to 15% of adults with COPD and is more likely to be isolated from patients with severe disease...
May 19, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28487836/allergic-conjunctivitis-in-asia
#4
REVIEW
Bernard Yu-Hor Thong
Allergic conjunctivitis (AC), which may be acute or chronic, is associated with rhinitis in 30%-70% of affected individuals, hence the term allergic rhinoconjunctivitis (AR/C). Seasonal and perennial AC is generally milder than the more chronic and persistent atopic and vernal keratoconjunctivitis. Natural allergens like house dust mites (HDM), temperate and subtropical grass and tree pollen are important triggers that drive allergic inflammation in AC in the Asia-Pacific region. Climate change, environmental tobacco smoke, pollutants derived from fuel combustion, Asian dust storms originating from central/north Asia and phthalates may also exacerbate AR/C...
April 2017: Asia Pacific Allergy
https://www.readbyqxmd.com/read/28484598/the-evidence-on-tiotropium-bromide-in-asthma-from-the-rationale-to-the-bedside
#5
REVIEW
Dejan Radovanovic, Pierachille Santus, Francesco Blasi, Marco Mantero
Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28424767/direct-and-indirect-costs-of-asthma-management-in-greece-an-expert-panel-approach
#6
Kyriakos Souliotis, Hara Kousoulakou, Georgios Hillas, Petros Bakakos, Michalis Toumbis, Stelios Loukides, Theodoros Vassilakopoulos
OBJECTIVE: Asthma is a major cause of morbidity and mortality and is associated with significant economic burden worldwide. The objectives of this study were to map current resource use associated with the disease management and to estimate the annual direct and indirect costs per adult patient with asthma. METHODS: A Delphi panel with seven leading pulmonologists was conducted. A semistructured questionnaire was developed to elicit data on resource use and treatment patterns...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28394084/personalised-asthma-action-plans-for-adults-with-asthma
#7
REVIEW
Timothy L Gatheral, Alison Rushton, David Jw Evans, Caroline A Mulvaney, Nathan R Halcovitch, Gemma Whiteley, Fiona Jr Eccles, Sally Spencer
BACKGROUND: A key aim of asthma care is to empower each person to take control of his or her own condition. A personalised asthma action plan (PAAP), also known as a written action plan, an individualised action plan, or a self-management action plan, contributes to this endeavour. A PAAP includes individualised self-management instructions devised collaboratively with the patient to help maintain asthma control and regain control in the event of an exacerbation. A PAAP includes baseline characteristics (such as lung function), maintenance medication and instructions on how to respond to increasing symptoms and when to seek medical help...
April 10, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28318883/predicting-future-risk-of-exacerbations-in-japanese-patients-with-adult-asthma-a-prospective-1-year-follow-up-study
#8
Akihiko Tanaka, Tomoki Uno, Haruna Sato, Megumi Jinno, Kuniaki Hirai, Yoshito Miyata, Munehiro Yamaguchi, Shin Ohta, Tetsuya Homma, Mayumi Yamamoto, Shintaro Suzuki, Takuya Yokoe, Hironori Sagara
BACKGROUND: To avoid future risk is a definitive goal of long-term asthma management. Exacerbations are considered to be the most relevant future risk in real life asthma management. Few comparative studies have evaluated the risk factors associated with exacerbations in Japanese patients with asthma. METHODS: We performed the prospective 1-year follow up study in Japanese patients with adult asthma. A total of 189 patients with asthma were enrolled and followed up for 1 year...
March 16, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28301050/addition-of-anti-leukotriene-agents-to-inhaled-corticosteroids-for-adults-and-adolescents-with-persistent-asthma
#9
REVIEW
Bhupendrasinh F Chauhan, Maya M Jeyaraman, Amrinder Singh Mann, Justin Lys, Ahmed M Abou-Setta, Ryan Zarychanski, Francine M Ducharme
BACKGROUND: Asthma management guidelines recommend low-dose inhaled corticosteroids (ICS) as first-line therapy for adults and adolescents with persistent asthma. The addition of anti-leukotriene agents to ICS offers a therapeutic option in cases of suboptimal control with daily ICS. OBJECTIVES: To assess the efficacy and safety of anti-leukotriene agents added to ICS compared with the same dose, an increased dose or a tapering dose of ICS (in both arms) for adults and adolescents 12 years of age and older with persistent asthma...
March 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28286157/inhaler-errors-in-the-critikal-study-type-frequency-and-association-with-asthma-outcomes
#10
David B Price, Miguel Román-Rodríguez, R Brett McQueen, Sinthia Bosnic-Anticevich, Victoria Carter, Kevin Gruffydd-Jones, John Haughney, Svein Henrichsen, Catherine Hutton, Antonio Infantino, Federico Lavorini, Lisa M Law, Karin Lisspers, Alberto Papi, Dermot Ryan, Björn Ställberg, Thys van der Molen, Henry Chrystyn
BACKGROUND: Poor inhaler technique has been linked to poor asthma outcomes. Training can reduce the number of inhaler errors, but it is unknown which errors have the greatest impact on asthma outcomes. OBJECTIVE: The CRITical Inhaler mistaKes and Asthma controL study investigated the association between specific inhaler errors and asthma outcomes. METHODS: This analysis used data from the iHARP asthma review service-a multicenter cross-sectional study of adults with asthma...
March 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28270656/raising-awareness-of-bronchiectasis-in-primary-care-overview-of-diagnosis-and-management-strategies-in-adults
#11
James D Chalmers, Sanjay Sethi
Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine...
December 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28215604/burden-of-chronic-oral-corticosteroid-use-by-adults-with-persistent-asthma
#12
Robert S Zeiger, Michael Schatz, Qiaowu Li, Wansu Chen, Deepak B Khatry, Trung N Tran
BACKGROUND: Chronic oral corticosteroid (C-OCS) use in asthma is an indicator of disease severity, but its risk factors are largely unknown. OBJECTIVE: To describe patient characteristics and disease burden associated with C-OCS use by adults with persistent asthma. METHODS: We identified 9546 patients aged 18 to 64 years in a large managed care organization who met the Healthcare Effectiveness Data and Information Set 2-year criteria (2009-2010) for persistent asthma...
February 10, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28214106/multicenter-study-of-cigarette-smoking-among-adults-with-asthma-exacerbations-in-the-emergency-department-2011-2012
#13
Robert A Silverman, Kohei Hasegawa, Daniel J Egan, Kirk A Stiffler, Ashley F Sullivan, Carlos A Camargo
INTRODUCTION: Previous studies demonstrated a high prevalence of cigarette smoking in patients presenting to the emergency department (ED) with acute asthma. Despite the clinical and public health importance, there have been no recent multicenter efforts to characterize this patient population. We aimed to update the prevalence of cigarette smoking among ED patients with asthma exacerbations. METHODS: Multicenter chart review study of 48 EDs across 23 US states...
February 7, 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28196638/japanese-guidelines-for-adult-asthma-2017
#14
REVIEW
Masakazu Ichinose, Hisatoshi Sugiura, Hiroyuki Nagase, Masao Yamaguchi, Hiromasa Inoue, Hironori Sagara, Jun Tamaoki, Yuji Tohda, Mitsuru Munakata, Kohei Yamauchi, Ken Ohta
Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms...
April 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28196623/health-care-utilization-and-direct-costs-in-mild-moderate-and-severe-adult-asthma-a-descriptive-study-using-the-2014-south-korean-health-insurance-database
#15
Yoo Ju Lee, Sun-Hong Kwon, Sung-Hyun Hong, Jin Hyun Nam, Hyun Jin Song, Jong Seop Lee, Eui-Kyung Lee, Ju-Young Shin
PURPOSE: Although asthma exacerbation comprises a large burden of the total asthma-related costs, few studies have examined the frequency and cost of acute exacerbation according to asthma severity. This study investigated asthma-related health care utilization and costs according to the severity of asthma. METHODS: We conducted a descriptive study using the national health insurance claims database between January 1 and December 31, 2014. We included adult patients with asthma (18 years of age and older) who had ≥2 claims with for an asthma diagnosis and were prescribed ≥1 asthma medications...
February 16, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28176972/factors-associated-with-relapse-in-adult-patients-discharged-from-the-emergency-department-following-acute-asthma-a-systematic-review
#16
Jesse Hill, Nicholas Arrotta, Cristina Villa-Roel, Liz Dennett, Brian H Rowe
A significant proportion of patients discharged from the emergency department (ED) with asthma exacerbations will relapse within 4 weeks. This systematic review summarises the evidence regarding relapses and factors associated with relapse in adult patients discharged from EDs after being treated for acute asthma. Following a registered protocol, comprehensive literature searches were conducted. Studies tracking outcomes for adults after ED management and discharge were included if they involved adjusted analyses...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28092287/current-and-future-management-of-the-young-child-with-early-onset-wheezing
#17
Allison J Burbank, Stanley J Szefler
PURPOSE OF REVIEW: In this review, we discuss current thinking in relation to available guidelines for the care of preschool-aged children with recurrent wheezing, while highlighting the gaps in our knowledge and discussing changes that could occur over the next 5 years. RECENT FINDINGS: The Asthma Predictive Index as well as allergen-specific IgE, peripheral eosinophil count and exhaled nitric oxide are perhaps underutilized sources of information that can assist in predicting progression to asthma and response to therapies...
April 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28076656/combined-inhaled-beta-agonist-and-anticholinergic-agents-for-emergency-management-in-adults-with-asthma
#18
REVIEW
Scott W Kirkland, Christine Vandenberghe, Britt Voaklander, Taylor Nikel, Sandra Campbell, Brian H Rowe
BACKGROUND: Inhaled short-acting anticholinergics (SAAC) and short-acting beta₂-agonists (SABA) are effective therapies for adult patients with acute asthma who present to the emergency department (ED). It is unclear, however, whether the combination of SAAC and SABA treatment is more effective in reducing hospitalisations compared to treatment with SABA alone. OBJECTIVES: To conduct an up-to-date systematic search and meta-analysis on the effectiveness of combined inhaled therapy (SAAC + SABA agents) vs...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27905186/severe-asthma-current-management-targeted-therapies-and-future-directions-a-roundtable-report
#19
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...
January 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
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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