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Asthma symptoms and treatments in elderly.

Alida Benfante, Nicola Scichilone
Historically, asthma has been envisioned as a disease of younger ages. This has led to the assumption that respiratory symptoms suggestive of asthma occurring in older ages are to be attributed to conditions other than asthma, mainly COPD. Old observational reports and new epidemiological studies confirm that asthma is as frequent in older as it is in younger populations. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. The characterization of asthma in the aged suffers from the fact that there has been very little original research in this field...
2016: Asthma research and practice
Tugba Songul Tat, Aykut Cilli
BACKGROUND: Severe asthma management in elderly patients may be difficult because of increased comorbid conditions, polypharmacy, physiologic changes that occur with aging, incorrect use of inhaler devices, and poor adherence. OBJECTIVE: To evaluate the long-term safety and efficacy of the anti-IgE antibody omalizumab in elderly (aged ≥65 years) patients with uncontrolled allergic asthma. METHODS: The efficiency and adverse effects of omalizumab treatment were evaluated based on data extracted from medical records...
November 2016: Annals of Allergy, Asthma & Immunology
Hoang Kim Tu Trinh, Ga-Young Ban, Ji-Ho Lee, Hae-Sim Park
Elderly asthma (EA) is regarded as a distinct phenotype of asthma and is associated with age-related changes in airway structure and alterations in lung function and immune responses. EA is difficult to diagnose because of aging and co-morbidities, and overlaps with fixed airway obstructive disease. Novel modalities to differentiate between EA and chronic obstructive pulmonary disease (COPD) are necessary. A multifaceted approach, including clinical history, smoking habits, atopy, and measurement of lung function, is mandatory to differentiate asthma from COPD...
October 2016: Drugs & Aging
J-N Cornu, G Amarenco, F Bruyere, E Chartier-Kastler, B Fatton, P Grise, F Haab, R Bourouina
AIMS: To determine the prevalence of overactive bladder (OAB) syndrome in France and gather data about initial patient trajectories in the healthcare system. METHODS: A dedicated questionnaire (41 questions) has been sent to a 12,000 sample of people representative of the global population. The following data were investigated: social and demographic features, medical history, Urinary Symptom Profile questionnaire, bother, history of symptoms, care seeking and treatments received...
June 2016: Progrès en Urologie
Katharina Marth, Monica Spinola, Judith Kisiel, Christian Woergetter, Milos Petrovic, Wolfgang Pohl
OBJECTIVE: Scant clinical data are available on the effects of current treatments for asthma on different subgroups of patients with this disease. We conducted a prospective, noninterventional, multicenter real-life study in adult patients with persistent asthma, and we specifically analyzed the effects of treatment with extrafine beclometasone dipropionate/formoterol (BDP/F) in asthma patients categorized by phenotypes related to small airways (i.e. smoking habits, disease duration, and air trapping)...
June 2016: Therapeutic Advances in Respiratory Disease
K Sekiya, E Nakatani, Y Fukutomi, H Kaneda, M Iikura, M Yoshida, K Takahashi, K Tomii, M Nishikawa, N Kaneko, Y Sugino, M Shinkai, T Ueda, Y Tanikawa, T Shirai, M Hirabayashi, T Aoki, T Kato, K Iizuka, S Homma, M Taniguchi, H Tanaka
BACKGROUND: Severe or life-threatening asthma exacerbation is one of the worst outcomes of asthma because of the risk of death. To date, few studies have explored the potential heterogeneity of this condition. OBJECTIVES: To examine the clinical characteristics and heterogeneity of patients with severe or life-threatening asthma exacerbation. METHODS: This was a multicentre, prospective study of patients with severe or life-threatening asthma exacerbation and pulse oxygen saturation < 90% who were admitted to 17 institutions across Japan...
August 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
V V Tsukanov, E V Kasparov, E V Onuchina, A V Vasyutin, N N Butorin, O S Amelchugova, Yu L Tonkikh
AIM: To investigate the frequency of extraesophageal syndromes in elderly patients with gastroesophageal reflux disease (GERD). MATERIALS AND METHODS: This cross-sectional study was conducted to compare the clinical manifestations of GERD in 1100 patients aged 60 to 75 years and in 453 patients aged 36 to 60 years. A control group consisted of 154 elderly patients without GERD and 178 mature-aged patients without this condition. GERD was diagnosed via analysis of its symptoms, esophagogastroduodenoscopy, and 24-hour pH monitoring on the basis of the Montreal consensus guidelines...
2016: Terapevticheskiĭ Arkhiv
Li Zuo, Benjamin K Pannell, Zewen Liu
Asthma is a chronic disease characterized by reversible airflow limitation, coughing, bronchial constriction, and an inflammatory immune response. While asthma has frequently been categorized as emerging in childhood, evidence has begun to reveal that the elderly population is certainly susceptible to late-onset, or even long-standing asthma. Non-atopic asthma, most commonly found in elderly patients is associated with elevated levels of serum and sputum neutrophils and may be more detrimental than atopic asthma...
May 3, 2016: Oncotarget
C Maradey-Romero, R Prakash, S Lewis, A Perzynski, R Fass
BACKGROUND: Eosinophilic oesophagitis (EoE) is primarily diagnosed by clinicians. There are less than a handful of epidemiological studies in EoE that have included elderly patients (>65 years). AIM: To determine the prevalence of elderly subjects among EoE patients and compare their clinical presentation, associated conditions and treatment modalities with adult and paediatric EoE patients. METHODS: A large nationwide database (Explorys) between January 2011 and January 2014 was used...
May 2015: Alimentary Pharmacology & Therapeutics
Nydia Arjona
Asthma affects the elderly as often as other age groups; however, it more often becomes fatal in the elderly. Unfortunately, asthma is often unmanaged or underdiagnosed in the older population. It is important for health care providers to recognize risk factors in the elderly and properly treat them before asthma becomes fatal. This article describes near-fatal asthma and identifies risk factors specifically for the elderly. Symptoms of asthma are reviewed as well as assessments and diagnostic tests to identify asthma severity and complications...
January 2015: Dimensions of Critical Care Nursing: DCCN
Heung-Woo Park, Woo-Jung Song, Sae-Hoon Kim, Hye-Kyung Park, Sang-Heon Kim, Yong Eun Kwon, Hyouk-Soo Kwon, Tae-Bum Kim, Yoon-Seok Chang, You-Sook Cho, Byung-Jae Lee, Young-Koo Jee, An-Soo Jang, Dong-Ho Nahm, Jung-Won Park, Ho Joo Yoon, Young-Joo Cho, Byoung Whui Choi, Hee-Bom Moon, Sang-Heon Cho
BACKGROUND: No attempt has yet been made to classify asthma phenotypes in the elderly population. It is essential to clearly identify clinical phenotypes to achieve optimal treatment of elderly patients with asthma. OBJECTIVES: To classify elderly patients with asthma by cluster analysis and developed a way to use the resulting cluster in practice. METHODS: We applied k-means cluster to 872 elderly patients with asthma (aged ≥ 65 years) in a prospective, observational, and multicentered cohort...
January 2015: Annals of Allergy, Asthma & Immunology
Claudio F Donner, Alberto Visconti
BACKGROUND: The management of patients with complex forms of bronchial asthma and COPD is not usually addressed in the major international guidelines and management documents which exclusively address pure forms. AIMAR thus undertook a survey to obtain information about: a) the perceived frequency of complex forms of asthma/COPD in adult patients and in the elderly; b) patient management regarding the complex forms (focus on therapeutic goals and consequent treatment); c) the management problems perceived in diagnosis, management, monitoring, indices of appropriateness in pharmacological treatment and adherence to treatment...
2014: Multidisciplinary Respiratory Medicine
Michael J Abramson, Jennifer L Perret, Shyamali C Dharmage, Vanessa M McDonald, Christine F McDonald
Adult-onset asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. This review presents a comprehensive synopsis of their epidemiology, pathophysiology, and clinical presentations; describes how they can be distinguished; and considers both established and proposed new approaches to their management. Both adult-onset asthma and COPD are complex diseases arising from gene-environment interactions. Early life exposures such as childhood infections, smoke, obesity, and allergy influence adult-onset asthma...
2014: International Journal of Chronic Obstructive Pulmonary Disease
Andrzej Bozek, Krzysztof Kolodziejczyk, Barbara Warkocka-Szoltysek, Jerzy Jarzab
BACKGROUND: This study evaluates the safety and efficacy of specific sublingual immunotherapy (SLIT) against grass pollen allergens in patients >60 years of age with seasonal allergic rhinitis (SAR) and/or asthma. This study sought to assess nasal symptoms during the grass pollen season, reduce medication use, and monitor adverse reactions during immunotherapy. METHODS: Seventy-eight 60- to 70-year-old patients with SAR and a confirmed grass pollen allergy according to skin-prick tests, nasal provocation, and measurement of serum IgE were included in the study...
September 2014: American Journal of Rhinology & Allergy
Mitsuhiro Tada, Takashige Kuraki, Yasuyuki Taooka, Hiroshi Fuchita, Fumi Karino, Kiyotaka Miura, Shunichi Hamaguchi, Miki Ohe, Akihisa Sutani, Takeshi Isobe
BACKGROUND: Asthmatic death in the elderly is a serious problem worldwide. Differences in clinical skill between respiratory specialists (RS) and general practitioners (GP) are important in asthma control. The aim of this study was to compare asthma management between RS and GP. METHODS: A cross-sectional survey was carried out in Shimane, Japan, in February 2009 using a questionnaire about patient background, treatment, asthma control test (ACT) and adherence to treatment...
March 2015: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Hiroshi Kimura, Kazuyoshi Imaizumi
The management and therapy of miliary tuberculosis: Nobuharu OHSHIMA (Asthma and Allergy Center, National Hospital Organization Tokyo National Hospital). Treatment and management of severe pulmonary tuberculosis: Yuta HAYASHI, Kenji OGAWA (Department of Respiratory Medicine, National Hospital Organization Higashi Nagoya National Hospital). Death of a young (non-elderly) patient may become a large psychological burden not only for patient's family but also for medical staff. We analyzed non-elderly cases with severe pulmonary tuberculosis by comparing 13 patients who died of tuberculosis in the hospital (death group) and 31 patients who survived and were discharged from hospital (survivor group)...
May 2014: Kekkaku: [Tuberculosis]
Gary Linkov, Elina Toskala
PURPOSE OF REVIEW: To review the recent European studies on sublingual immunotherapy (SLIT). SLIT is currently widely used in Europe and is gaining popularity in the United States. RECENT FINDINGS: Longer treatment with SLIT compared with subcutaneous immunotherapy (SCIT) is needed to reduce the rhinitis symptoms in house dust mite (HDM) allergic children. SLIT appears to be well tolerated and effective for treating rhinitis and asthma in children, adults, and the elderly...
June 2014: Current Opinion in Otolaryngology & Head and Neck Surgery
Marianne Frieri
Current literature related to asthma diagnosis, epidemiology, pathogenesis, and treatment linked with rhinosinusitis is important. Asthma is very heterogeneous; new theories and treatments are emerging. It is a growing epidemic among children and adults in the United States and the severity of asthma is caused by many factors such as lack of education, poor early recognition, decreased symptom awareness, improper medications, and phenotypic changes. Genetic variation, innate immune genes, those involved in tissue remodeling and arachidonic acid metabolism, and inflammatory mediators might contribute to the pathogenesis of chronic rhinosinusitis (CRS) linked with asthma...
March 2014: Allergy & Rhinology
Heung-Woo Park, Jae-Woo Jung, Kyung-Mook Kim, Tae-Wan Kim, So-Hee Lee, Chang Hyun Lee, Jin Mo Goo, Kyung-Up Min, Sang-Heon Cho
BACKGROUND AND OBJECTIVE: Xenon ventilation computed tomography (CT) has shown potential in assessing the regional ventilation status in subjects with asthma. The purpose of this study was to evaluate the usefulness of xenon ventilation CT in the management of asthma in the elderly. METHODS: Treatment-naïve asthmatics aged 65 years or older were recruited. Before initiation of medication, spirometry with bronchodilator (BD) reversibility, questionnaires to assess the severity of symptoms including a visual analogue scale (VAS), tests to evaluate cognitive function and mood, and xenon ventilation CT were performed...
April 2014: Respirology: Official Journal of the Asian Pacific Society of Respirology
Henry Milgrom, Hua Huang
This review focuses on 3 allergic disorders of persons coming up against venerable age: asthma, allergic rhinitis, and atopic dermatitis. The prevalence of allergic diseases in the elderly ranges from 5 to 10% and appears to be rising. A gradual decline in immune function, termed immunosenescence, and age-related changes in tissue structure influence the development of these disorders. Common complications are comorbidities, polypharmacy, and adverse effects of drugs. The elderly have difficulty mounting protective immune responses against newly encountered antigens...
2014: Gerontology
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