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Diagnostic of asthma

Jorge Sanchez, Andres Sánchez, Ricardo Cardona
Background: Epidemiological studies have shown that children who grow up on traditional farms are protected from allergic diseases. However, less is known about if the environment influences the pharmacotherapy in these patients. Objective: To compare the treatment of asthmatic and rhinitis children from urban and rural areas in Medellín, Colombia. Methods: During one year, we follow up a group of children (6 to 14 years) with diagnostic of asthma or rhinitis living for more than five years in urban or rural area...
June 30, 2018: Colombia Médica: CM
Angel San Miguel-Rodríguez, Alicia Armentia, Sara Martín-Armentia, Blanca Martín-Armentia, Alfredo Corell, Mª Carmen Lozano Estevan, Irene Iglesias Peinado
Component resolved diagnosis (CRD) is a microarray-based diagnostic solution capable of simultaneously analysing specific IgE antibodies against 112 allergenic components, providing sensitivity patterns for multi-sensitised or complex patients. The CRD is indicated for these patients, especially those with concomitant respiratory and food allergies. This study reivews the method, its utility, limitations, and our experience in allergic diseases with difficult etiologic diagnosis (eosinophilic esophagitis, occupational asthma and drug allergy)...
August 7, 2018: Clinica Chimica Acta; International Journal of Clinical Chemistry
Ruben J Colman, Neal Bryan S Rosario, Analydia Gutierrez Bonilla, Gabriela Benavidez Alvarez, Joel Benavidez Alvarez, Vincent P Uy, Paulo R Pina, David H Rubin
AIM: Functional gastrointestinal disorders (such as functional abdominal pain, irritable bowel syndrome and functional dyspepsia) are a common cause of chronic GI symptoms in children. Prior studies demonstrated a high comorbidity of functional GI disorders (FGIDs) among patients with asthma. However, data exploring specific disease characteristics within the US populations are scarce. This study aimed to assess the prevalence and comorbidities of FGIDs among pediatric asthma patients at a university-affiliated urban community hospital...
August 9, 2018: Journal of Digestive Diseases
Valentina Ferraro, Silvia Carraro, Sara Bozzetto, Stefania Zanconato, Eugenio Baraldi
Background: Asthma is a chronic condition usually characterized by underlying inflammation. The study of asthmatic inflammation is of the utmost importance for both diagnostic and monitoring purposes. The gold standard for investigating airway inflammation is bronchoscopy, with bronchoalveolar lavage and bronchial biopsy, but the invasiveness of such procedures limits their use in children. For this reason, in the last decades there has been a growing interest for the development of noninvasive methods...
2018: Asthma Research and Practice
Ayobami T Akenroye, Abayomi Ajala, Elham Azimi-Nekoo, Gabriele S de Vos
BACKGROUND: In asthmatics, making a diagnosis of anaphylaxis could be challenging as respiratory symptoms are a common feature of both conditions. Identifying anaphylaxis is important to providing appropriate care. A prior study showed that anaphylaxis is sometimes misdiagnosed as acute asthma in children. We sought to identify the percentage of adults admitted to the intensive care unit (ICU) with asthma exacerbations who met criteria for anaphylaxis. METHODS: Retrospective chart review of adults admitted with acute asthma to the ICU at Jacobi Medical Center, a Level 1 trauma centre in Bronx, New York...
August 9, 2018: Emergency Medicine Journal: EMJ
Keiji Oishi, Kazuto Matsunaga
INTRODUCTION: Recently, several new biological therapies targeted IgE and IL-5 in severe asthma have been developed and approved. In the last few years, there have been some reports on the therapeutic algorithms for severe asthmatic subjects screened by biomarkers. However, these algorithms have one problem. In atopic/eosinophilic overlapping asthmatic subjects, there is no effective answer to the question: "which is the optimal choice between Anti-IgE and anti-IL-5?" METHODS: We propose a new three-step algorithm for biological therapy in severe asthma...
August 7, 2018: Immunity, Inflammation and Disease
Tina Heyder, Emil Wiklundh, Anders Eklund, Anna James, Johan Grunewald, Roman A Zubarev, Susanna L Lundström
Characterising chronic lung diseases is challenging. New, less invasive diagnostics are needed to decipher disease pathologies and subphenotypes. Fc galactosylation is known to affect IgG function, and is altered in autoimmune disorders and under other pathological conditions. We tested how well Fc glycans in IgG from bronchoalveolar lavage fluid (BALF) and serum correlated, and if the Fc glycan profile could reveal pulmonary inflammation. A shotgun proteomics approach was used to profile Fc glycans in serum and BALF of controls (n=12) and sarcoidosis phenotypes (Löfgren's syndrome (LS), n=11; and non-LS, n=12)...
July 2018: ERJ Open Research
Almir Badnjevic, Lejla Gurbeta, Eddie Custovic
Respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD), are affecting a huge percentage of the world's population with mortality rates exceeding those of lung cancer and breast cancer combined. The major challenge is the number of patients who are incorrectly diagnosed. To address this, we developed an expert diagnostic system that can differentiate among patients with asthma, COPD or a normal lung function based on measurements of lung function and information about patient's symptoms...
August 3, 2018: Scientific Reports
Maria Jose Abadias Medrano, Oriol Yuguero Torres, Ignasi Bardés Robles, Luis Fernando Casas-Méndez, Ferran Barbé, Jordi de Batlle
To describe the characteristics of patients visiting a Hospital Emergency Department (HED) due to chronic obstructive pulmonary disease (COPD) exacerbation (AECOPD) and to evaluate their management.A cross-sectional study of the first 219 patients with AECOPD visiting the HED of the University Hospital Arnau de Vilanova, Lleida, Spain, was performed from January to May 2016. The data collected included the following: main patient characteristics, diagnostic tests, applied treatments, response times, discharge destination, need for hospital admission, and re-admissions and deaths at 90 days...
August 2018: Medicine (Baltimore)
Maria Teresa Río Ramírez, María Antonia Juretschke Moragues, Rocío Fernández González, Virginia Álvarez Rodríguez, Elena Aznar Andrés, Juan Pedro Zabaleta Camino, Rodolfo Romero Pareja, Andrés Esteban de la Torre
The aim of this study was to analyze whether FeNO levels in acute exacerbation of COPD (AECOPD) with hospital admission have better diagnostic value than eosinophilia in blood, and to evaluate its usefulness in predicting a better clinical response. An observational prospective study of patients with AECOPD was carried out. FeNO determinations were made on arrival at the emergency room (ER), at discharge and during stability 3-6 months after discharge. Co-morbidities, bronchodilators, inhaled (IGC) and systemic (SGC) glucocorticoids, eosinophils, systemic inflammation markers (procalcitonin, C-reactive protein), eosinophil cationic protein, and total IgE were collected...
July 31, 2018: COPD
Luana Vieira Mukamal, Celso Tavares Sodré, Lara Beatriz Prata, Fernanda Nakasato, Tullia Cuzzi, Marcia Ramos-E-Silva
The authors present a classic case of Churg-Strauss syndrome with an exuberant clinical picture in a 34-year-old woman. She showed the following diagnostic criteria: asthma, polyneuropathy, rhinopathy, marked eosinophilia, positive p-ANCA with a perinuclear pattern, and skin histopathology results suggestive of vasculitis with eosinophils. There was a good response to prednisone, dexamethasone pulse therapy, and cyclophosphamide.
May 2018: Case Reports in Dermatology
Agnieszka Kowalczyk, Aneta Krogulska
Nitric oxide is produced by enzymes called nitric oxide synthases. It fulfills many important functions in the human body, but produced in excess amount has a proinflammatory activity. Fractional exhaled nitric oxide measurements are used in the diagnosis and monitoring of eosinophilic inflammation in the lower airways, but should not be used as an independent parameter to make a diagnosis of asthma or for the monitoring of asthma treatment. Evaluation of fractional exhaled nitric oxide concentrations is also used to determine the pathogenesis of symptoms in patients with rhinitis...
2018: Developmental Period Medicine
Hanneke Coumou, Guus A Westerhof, Selma B de Nijs, Marijke Amelink, Elisabeth H Bel
BACKGROUND: Eosinophilic asthma is characterized by persistently elevated blood eosinophils, adult-onset asthma and corticosteroid resistance. For stratified medicine purposes one single measurement of blood eosinophils or exhaled nitric oxide (FeNO) is commonly used. The aim of this study was to investigate in patients with new-onset asthma whether persistent blood eosinophilia can be predicted with one single measurement of these biomarkers. METHODS: Blood eosinophils and exhaled nitric oxide levels were measured at yearly intervals over 5 years in 114 adults with new-onset asthma on inhaled corticosteroid treatment...
August 2018: Respiratory Medicine
James T Good, Donald R Rollins, Christena A Kolakowski, Allen D Stevens, Joshua L Denson, Richard J Martin
BACKGROUND: Chronic Refractory Cough (CRC) is a common condition that significantly impairs patients' quality of life. Unfortunately, in many situations patients continue to experience CRC in spite of following published guidelines for diagnosis and treatment. METHODS: 99 patients were referred to National Jewish Health (NJH), a specialty respiratory center for evaluation of CRC (cough ≥ 8 weeks duration). Study duration occurred over 18 months. Intake evaluation for all patients included history, physical examination, spirometry and fiberoptic laryngoscopy...
August 2018: Respiratory Medicine
Wei-Jie Guan, Yang Peng, Xiao-Xue Zi, Kai Sen Tan, Ting-Ting He, Nan-Shan Zhong, De Yun Wang
PURPOSE OF REVIEW: Impaired mucociliary clearance has been implicated in chronic upper and lower airway inflammatory diseases (i.e., allergic and non-allergic rhinitis, chronic rhinosinusitis with or without nasal polyps and asthma). How motile ciliary disorders (impaired ciliogenesis, ciliary beating and ultrastructural defects) are implicated in chronic airway inflammatory diseases is not fully understood. Elaboration of the role of motile ciliary disorders may serve as therapeutic targets for improving mucociliary clearance, thereby complementing contemporary disease management...
July 26, 2018: Current Allergy and Asthma Reports
Man Tian, Ying Zhou, Haoyuan Jia, Xuming Zhu, Yubao Cui
This study assessed the changes and clinical significance of microRNA-1 (miR-1) and inflammatory factors in the peripheral blood of children with acute-stage asthma. 100 children with acute-stage asthma (study group) and 100 healthy children (control group) were enrolled. For all enrolled children, the peripheral blood levels of miR-1, interleukin-4 (IL-4), IL-5, IL-8, tumor necrosis factor-alpha (TNF- α ), and interferon- γ (IFN- γ ) were measured. The relative expression levels of miR-1 and IFN- γ in the peripheral blood of children in the study group were significantly lower than those in the control group, whereas expression levels of IL-4, IL-5, IL-8, and TNF- α were significantly higher...
2018: BioMed Research International
Henriëtte E van der Horst
In recent years disease-specific outpatient clinics have gained a foothold in the Netherlands. In some instances, this is warranted. An example would be an outpatient clinic for early-onset Alzheimer's disease to ensure that patients get optimal diagnostic procedures and receive state-of-the-art treatment. However, the initiation of outpatient clinics for common diseases predominantly treated in primary care, such as a one-stop-shop for the diagnosis of asthma, is a more questionable development. It may lead to patients assuming that such a referral is always necessary for the diagnosis, patients seeking a second opinion in case the diagnosis is not confirmed, and to the exhaustion of available clinical capacity to the detriment of other patients...
June 21, 2018: Nederlands Tijdschrift Voor Geneeskunde
Ruby M E Gillis, Walter van Litsenburg, Roland H H van Balkom, Jean W Muris, Frank W J M Smeenk
OBJECTIVE: Previous studies showed that general practitioners (GPs) have problems in diagnosing asthma accurately, resulting in both under and overdiagnosis. To support GPs in their diagnostic process an asthma diagnostic consultation service (ADCS) was set up. DESIGN: We evaluated the performance of this ADCS by analysing the (dis)concordance between the GPs working hypotheses and the ADCS diagnoses and possible consequences this had on the patients' pharmacotherapy...
June 21, 2018: Nederlands Tijdschrift Voor Geneeskunde
Agnes S Sundaresan, Gargi Schneider, Joy Reynolds, H Lester Kirchner
BACKGROUND:  Asthma exacerbation leading to emergency department (ED) visit is prevalent, an indicator of poor control of asthma, and is a potentially preventable clinical outcome. OBJECTIVE:  We propose to utilize multiple data elements available in electronic medical records (EMRs) and claims database to create separate algorithms with high validity for clinical and research purposes to identify asthma exacerbation-related ED visit among the general population...
July 2018: Applied Clinical Informatics
Piero Marco Fisichella, Francisco Schlottmann, Marco G Patti
Patients with gastroesophageal reflux disease (GERD) may present with a variety of symptoms, including heartburn, regurgitation, dysphagia, chronic cough, laryngitis, or even asthma. Therefore, the clinical presentation of GERD varies among individuals and conversely symptoms not always correspond to the presence of actual reflux. For that reason, the diagnosis poses certain challenges to the physician. To overcome these challenges, a thorough clinical examination followed by objective functional testing could improve diagnostic accuracy...
July 23, 2018: Updates in Surgery
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