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Diagnostic of asthma

Nicola Ullmann, Virginia Mirra, Antonio Di Marco, Martino Pavone, Federica Porcaro, Valentina Negro, Alessandro Onofri, Renato Cutrera
Childhood asthma remains a multifactorial disease with heterogeneous clinical phenotype and complex genetic inheritance. The primary aim of asthma management is to achieve control of symptoms, in order to reduce the risk of future exacerbations and progressive loss of lung function, which results especially challenging in patients with difficult asthma. When asthma does not respond to maintenance treatment, firstly, the correct diagnosis needs to be confirmed and other diagnosis, such as cystic fibrosis, primary ciliary dyskinesia, immunodeficiency conditions or airway and vascular malformations need to be excluded...
2018: Frontiers in Pediatrics
Sigrid Platzer, Thomas Fehr, Tsogyal Latshang
CME: Mepolizumab, an Additional Therapeutic Agent for Severe Asthma Abstract. The challenging therapy of severe uncontrollable bronchial asthma aims primarily at sufficient symptom control and the minimization of the exacerbation rate. If, despite extended drug therapy, symptom control is very difficult to achieve, biologics should preferably be used instead of corticosteroid therapy. The aim of this article is to point out these different asthma therapy pathways and to describe diagnostic criteria as well as practical experiences through application in patients...
2018: Praxis
Paul Brinkman, Anke-Hilse Maitland-van der Zee, Ariane H Wagener
PURPOSE OF REVIEW: The long-term management goals of the inflammatory airway diseases asthma and chronic obstructive pulmonary disease (COPD) are similar and focus on symptom control and reduction of exacerbation frequency and severity. Treatable traits have recently been postulated as a management concept which complements the traditional diagnostic labels 'asthma' and 'COPD', thereby focusing on therapy targeted to a patients' individual disease-associated characteristics. Exhaled volatile organic compounds (VOCs) may be utilized as noninvasive biomarker for disease activity or manifestation in asthma and COPD...
October 15, 2018: Current Opinion in Pulmonary Medicine
Iliya P Amaza, Swan Lee, Rolando Sanchez
The flow-volume loop (FVL) analysis is typically helpful in establishing the diagnosis of airway obstruction caused by endobronchial lesions. In this report, we describe a patient with emphysema and tobacco abuse who presented with chronic dry cough and severe chronic obstructive pulmonary disease (COPD) refractory to standard therapy. The initial FVL showed a relatively normal forced expiratory peak flow shape followed by a smooth flattening of the expiratory curve on spirometry, a pattern consistent with distal airway obstruction as seen in severe asthma or COPD...
October 12, 2018: BMJ Case Reports
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Erikson Kaszubowski, Rosemeri Maurici
BACKGROUND: Lung ultrasound can accelerate the diagnosis of life-threatening diseases in adults with respiratory symptoms. OBJECTIVE: Systematically review the accuracy of lung ultrasonography (LUS) for emergency diagnosis of pneumonia, acute heart failure, and exacerbation of chronic obstructive pulmonary disease (COPD)/asthma in adults. METHODS: PubMed, Embase, Scopus, Web of Science, and LILACS (Literatura Latino Americana e do Caribe em Ciências da Saúde; until 2016) were searched for prospective diagnostic accuracy studies...
October 9, 2018: Journal of Emergency Medicine
Hiroyuki Sano, Katsuyuki Tomita, Akiko Sano, Shou Saeki, Yusaku Nishikawa, Osamu Nishiyama, Takashi Iwanaga, Yuji Tohda
BACKGROUND: We obtain summary estimates of the accuracy of additional objective tests for the diagnosis of adult asthma using systematic review and meta-analysis of diagnostic test accuracy studies. METHODS: Medline, Embase, and other relevant electronic databases were searched for papers published between January 1989 and December 2016. Studies were included if they evaluated the diagnostic accuracy of objective tests, including airway reversibility (AR), airway hyperresponsiveness (AHR), and fractionated exhaled nitric oxide (FeNO) for the diagnosis of adult asthma in patients with symptoms suggestive of asthma...
October 8, 2018: Allergology International: Official Journal of the Japanese Society of Allergology
Dae Jin Song, Woo Jung Song, Jae Woo Kwon, Gun Woo Kim, Mi Ae Kim, Mi Yeong Kim, Min Hye Kim, Sang Ha Kim, Sang Heon Kim, Sang Hyuck Kim, Sun Tae Kim, Sae Hoon Kim, Ja Kyoung Kim, Joo Hee Kim, Hyun Jung Kim, Hyo Bin Kim, Kyung Hee Park, Jae Kyun Yoon, Byung Jae Lee, Seung Eun Lee, Young Mok Lee, Yong Ju Lee, Kyung Hwan Lim, You Hoon Jeon, Eun Jung Jo, Young Koo Jee, Hyun Jung Jin, Sun Hee Choi, Gyu Young Hur, Sang Heon Cho, Sang Hoon Kim, Dae Hyun Lim
Chronic cough is common in the community and causes significant morbidity. Several factors may underlie this problem, but comorbid conditions located at sensory nerve endings that regulate the cough reflex, including rhinitis, rhinosinusitis, asthma, eosinophilic bronchitis, and gastroesophageal reflux disease, are considered important. However, chronic cough is frequently non-specific and accompanied by not easily identifiable causes during the initial evaluation. Therefore, there are unmet needs for developing empirical treatment and practical diagnostic approaches that can be applied in primary clinics...
November 2018: Allergy, Asthma & Immunology Research
Rimon Sobhi Azzam
BACKGROUND: Gastroesophageal reflux disease (GERD) is a clinical condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Transient lower esophageal sphincter relaxation is the main pathophysiological mechanism of GERD. Symptoms and complications can be related to the reflux of gastric contents into the esophagus, oral cavity, larynx and/or the lung. Symptoms and other possible manifestations of GERD are heartburn, regurgitation, dysphagia, non-cardiac chest pain, chronic cough, chronic laryngitis, asthma and dental erosions...
October 4, 2018: Arquivos de Gastroenterologia
Ji-Yeon Shin, Kyoung-Hee Sohn, Ji Eun Shin, Mira Park, Jiseun Lim, Jin Yong Lee, Min-Suk Yang
This study was conducted to assess the changes in the annual incidence of adult asthma in Korea where the prevalence of asthma had increased steadily in recent decades. A population-based cohort study was conducted using the National Health Insurance Service-National Sample Cohort (NHIS-NSC), which consisted of 746,816 adults aged >20 years between 2004 and 2012. Asthma was defined by two or more physician claims on the basis of a primary diagnostic code for asthma and administration of asthma medications within 1 year...
October 9, 2018: Scientific Reports
Ilja Geraets, Tjard Schermer, Janwillem W H Kocks, Reinier Akkermans, Erik Bischoff, Lisette van den Bemt
To prevent unnecessary use of inhaled corticosteroids (ICS), ICS treatment should only be started when the diagnostic process of asthma and COPD is completed. Little is known about the chronological order between these diagnoses and the start of ICS. We performed a retrospective cohort study, based on electronic medical records of 178 Dutch general practices, to explore the temporal relations between starting continuous use of ICS and receiving a diagnosis of asthma and/or COPD. The database included information of patients who were registered with a diagnosis of asthma and/or COPD in one of the practices during January 1, 2012 and December 31, 2013...
October 9, 2018: NPJ Primary Care Respiratory Medicine
Ceyda Oksel, Sadia Haider, Sara Fontanella, Clement Frainay, Adnan Custovic
Advances in big data analytics have created an opportunity for a step change in unraveling mechanisms underlying the development of complex diseases such as asthma, providing valuable insights that drive better diagnostic decision-making in clinical practice, and opening up paths to individualized treatment plans. However, translating findings from data-driven analyses into meaningful insights and actionable solutions requires approaches and tools which move beyond mining and patterning longitudinal data. The purpose of this review is to summarize recent advances in phenotyping of asthma, to discuss key hurdles currently hampering the translation of phenotypic variation into mechanistic insights and clinical setting, and to suggest potential solutions that may address these limitations and accelerate moving discoveries into practice...
2018: Frontiers in Pediatrics
Brooks W Morgan, Matthew R Grigsby, Trishul Siddharthan, Muhammad Chowdhury, Adolfo Rubinstein, Laura Gutierrez, Vilma Irazola, J Jaime Miranda, Antonio Bernabe-Ortiz, Dewan Alam, Robert A Wise, William Checkley
BACKGROUND: Asthma-COPD Overlap (ACO) represents the confluence of bronchial airway hyper reactivity and chronic airflow limitation and has been described as leading to worse lung function and quality of life than found with either singular disease process. OBJECTIVE: We aimed to describe the prevalence and risk factors for ACO among adults across six low- and middle-income countries (LMICs). METHODS: We compiled cross-sectional data for 11,923 participants aged 35-92 years from four population-based studies in 12 settings...
October 3, 2018: Journal of Allergy and Clinical Immunology
Sandeep Kapur, Wade Watson, Stuart Carr
Atopic dermatitis (AD) is a common, chronic skin disorder that can significantly impact the quality of life of affected individuals as well as their families. Although the pathogenesis of the disorder is not completely understood, it appears to result from the complex interplay between defects in skin barrier function, environmental and infectious agents, and immune dysregulation. There are no diagnostic tests for AD; therefore, the diagnosis is based on specific clinical criteria that take into account the patient's history and clinical manifestations...
2018: Allergy, Asthma, and Clinical Immunology
Slavomír Perečinský, Lenka Murínová, Peter Kalanin, Andrea Jančová, Ľubomír Legáth
INTRODUCTION: Occupational asthma (OA) is the most common occupational lung disease in industrialized countries; however, in Western Europe, a decline in the prevalence of OA and changes in etiological factors has been recorded. Data from Central Europe, where in the past healthcare and economy sectors were different, are rare. OBJECTIVE: The aim of this study was to discover the changes related to OA during a four decade long period in the Slovak Republic. MATERIAL AND METHODS: The study included patients whom OA was reported during 1980-2016...
September 25, 2018: Annals of Agricultural and Environmental Medicine: AAEM
Marina Lampalo, Irena Jukić, Jasna Bingulac-Popović, Hana Safić, Nikola Ferara, Sanja Popović-Grle
Asthma is a chronic inflammatory disease that is characterized by reversible obstruction of airways, bronchial hyper-reactivity and airway remodeling. The etiology of asthma is multifactorial, with inheritance playing an important role. The aim of our study was to investigate the importance of biomarkers of asthma and the role of plasminogen activator inhibitor-1 (PAI-1) gene as a genetic factor that could be involved in the pathogenesis of asthma. The research was conducted at Jordanovac University Department for Lung Diseases and Croatian Institute of Transfusion Medicine...
March 2018: Acta Clinica Croatica
Francis Nissen, Daniel R Morales, Hana Mullerova, Liam Smeeth, Ian J Douglas, Jennifer K Quint
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) share many characteristics and symptoms, and the differential diagnosis between the two diseases can be difficult in primary care. This study explored potential overlap between both diseases in a primary care environment. AIM: To quantify how commonly patients with COPD have a concomitant diagnosis of asthma, and how commonly patients with asthma have a concomitant diagnosis of COPD in UK primary care...
September 24, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Salma Hussain Abu-Grain, Sanaa Sadiq Alsaad, Dalia Yahia El Kheir
Background: Being the first in-line care providers, primary health-care (PHC) physicians may encounter all forms of emergencies, ranging from minor complaints to life-threatening events. This wide variation of cases challenges the physicians to be competent in emergency medicine. Informative literature describing and assessing the factors affecting PHC physicians' emergency medical services (EMS)-related practice is deficient (nationally and internationally). The aim of this study is to assess PHC physicians' practice related to EMS, the factors affecting it, as well as their learning needs and preferred methods of continuous training in emergency medicine...
July 2018: Journal of Family Medicine and Primary Care
Rolf Kramer, Marina Sabatier, Thierry Wirth, Maxime Pichon, Bruno Lina, Isabelle Schuffenecker, Laurence Josset
BackgroundUnderstanding enterovirus D68 (EV-D68) circulation patterns as well as risk factors for severe respiratory and neurological illness is important for developing preventive strategies. Methods : Between 2010 and 2016, 11,132 respiratory specimens from hospitalised patients in Lyon, France, were screened for EV-D68 by PCR. Phylogenetic relationships of the viral-protein-1 sequences were reconstructed using maximum-likelihood and Bayesian-Markov-Chain-Monte-Carlo approaches. Results: Overall, 171 infections with a biennial pattern were detected, including seven, one, 55, none, 42, one and 65 cases annually during 2010-16...
September 2018: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
Marek L Kowalski, Ioana Agache, Sevim Bavbek, Arzu Bakirtas, Miguel Blanca, Grażyna Bochenek, Matteo Bonini, Enrico Heffler, Ludger Klimek, Tanya M Laidlaw, Joaquim Mullol, Ewa Niżankowska-Mogilnicka, Hae-Sim Park, Marek Sanak, Mario Sanchez-Borges, Silvia Sanchez-Garcia, Glenis Scadding, Masami Taniguchi, Maria J Torres, Andrew A White, Aleksandra Wardzyńska
NSAID-exacerbated respiratory disease (N-ERD) is a chronic eosinophilic, inflammatory disorder of the respiratory tract occurring in patients with asthma and/or chronic rhinosinusitis with nasal polyps (CRSwNP), symptoms of which are exacerbated by NSAIDs, including aspirin. Despite some progress in understanding of the pathophysiology of the syndrome, which affects 1/10 of patients with asthma and rhinosinusitis, it remains a diagnostic and therapeutic challenge. In order to provide evidence-based recommendations for the diagnosis and management of N-ERD, a panel of international experts was called by the EAACI Asthma Section...
September 14, 2018: Allergy
Michiel A G E Bannier, Kim D G van de Kant, Quirijn Jöbsis, Edward Dompeling
The measurement of volatile organic compounds (VOCs) in exhaled breath is a promising tool for diagnosing and monitoring various lung diseases in children. Gas chromatography mass spectrometry (GC-MS) analysis is a frequently used standard technique for VOCs analysis. However, as GC-MS is an expensive and time-consuming technique, hand-held devices or electronic noses (eNoses) have been developed. Recently, the Aeonose was introduced as an easy-to-use handheld eNose capable of point-of-care testing. Although first results using this eNose in adults are promising, studies in children are lacking...
September 14, 2018: Journal of Breath Research
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