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https://www.readbyqxmd.com/read/29764909/ohio-pediatric-asthma-repository-opportunities-to-revise-care-practices-to-decrease-time-to-physiologic-readiness-for-discharge
#1
Jeffrey M Simmons, Jocelyn M Biagini Myers, Lisa J Martin, Carolyn M Kercsmar, Christine L Schuler, Valentina V Pilipenko, John W Kroner, Hua He, Stephen R Austin, Huyen-Tran Nguyen, Kristie R Ross, Karen S McCoy, Sherman J Alter, Samantha M Gunkelman, Pierre A Vauthy, Gurjit K Khurana Hershey
BACKGROUND: Large-scale, multisite studies in which researchers evaluate patient- and systems-level factors associated with pediatric asthma exacerbation outcomes are lacking. We sought to investigate patient-level risks and system-level practices related to physiologic readiness for discharge (PRD) in the prospective Ohio Pediatric Asthma Repository. METHODS: Participants were children ages 2 to 17 years admitted to an Ohio Pediatric Asthma Repository hospital for asthma exacerbation...
May 15, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29760843/multicenter-study-of-albuterol-use-among-infants-hospitalized-with-bronchiolitis
#2
Anna Condella, Jonathan M Mansbach, Kohei Hasegawa, Peter S Dayan, Ashley F Sullivan, Janice A Espinola, Carlos A Camargo
Introduction: Although bronchiolitis is a common reason for infant hospitalization, significant heterogeneity persists in its management. The American Academy of Pediatrics currently recommends that inhaled albuterol not be used in routine care of children with bronchiolitis. Our objective was to identify factors associated with pre-admission (e.g., emergency department or primary care) use of albuterol among infants hospitalized for bronchiolitis. Methods: We analyzed data from a 17-center observational study of 1,016 infants (age <1 year) hospitalized with bronchiolitis between 2011-2014...
May 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29733738/case-study-a-combination-of-mepolizumab-and-omaluzimab-injections-for-severe-asthma
#3
Rejmon Dedaj, Lindie Unsel
A Combination of Mepolizumab and Omaluzimab injections for severe asthma. INTRODUCTION: Patients with severe persistent asthma account for a large proportion of asthma morbidity and health care expenditures. In this case report we describe the use of a combination of omalizumab and mepolizumab in severe asthma with elevated IgE levels and eosinophilic phenotype. CASE STUDY: We are treating a 55 year old woman with severe persistent eosinophilic asthma and elevated IgE levels...
May 7, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29718720/mixing-of-low-dose-cohesive-drug-and-overcoming-of-pre-blending-step-using-a-new-gentle-wing-high-shear-mixer-granulator
#4
Bader B Alsulays, Mohamed H Fayed, Ahmed Alalaiwe, Saad M Alshahrani, Abdullah S Alshetaili, Sultan M Alshehri, Fars K Alanazi
The objective of this study was to examine the influence of drug amount and mixing time on the homogeneity and content uniformity of a low-dose drug formulation during the dry mixing step using a new gentle-wing high shear mixer. Moreover, the study investigated the influence of drug incorporation mode on the content uniformity of tablets manufactured by different methods. Albuterol sulphate was selected as a model drug and was blended with the other excipients at two different levels, 1% w/w and 5% w/w at impeller speed of 300 rpm and chopper speed of 3000 rpm up to 30 minutes...
May 2, 2018: Drug Development and Industrial Pharmacy
https://www.readbyqxmd.com/read/29716881/mini-review-chronic-obstructive-pulmonary-disease-its-new-drug-treatments-and-strategies-a-review
#5
Muhammad Hanif, Junaid Qureshi, Hira Ijaz, Muhammad Iqbal Mustafa, Akhtar Rasul, Naeem Amir, Basma Aftab, Ahad Fayyaz
COPD is a complicated disease. Current available treatments are just for symptomatic relief and they cannot reverse the damages to lungs tissues due to alveolar destruction in COPD. Research is being conducted to evaluate new treatments and strategies to find specific treatments to minimize the symptoms of COPD. A new mixture of herbal medicine i.e AKL1 has emerged and thought to cure COPD symptoms especially cough related quality of life of COPD patients. Although, the results have showed no significant difference as compared to placebo but researchers recommend further evaluation in a large population (COPD Patients) group...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29716819/a-randomized-trial-comparing-metered-dose-inhalers-and-breath-actuated-nebulizers
#6
Mark A Snider, Jim Y Wan, Jonathan Jacobs, Rudy Kink, Barry Gilmore, Sandra R Arnold
BACKGROUND: Despite little evidence for its effectiveness, the breath-actuated nebulizer (BAN) is the default albuterol delivery method in our pediatric emergency department. OBJECTIVE: We compared the clinical efficacy of BAN and the metered-dose inhaler (MDI) in treating subjects patients 2 to 17 years of age who presented with mild to moderate asthma exacerbations. METHODS: This is a randomized, nonblinded, noninferiority study conducted at a single pediatric tertiary care emergency department...
April 28, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29682796/phase-2a-randomized-double-blind-placebo-controlled-multicenter-parallel-group-study-of-an-h-4-r-antagonist-jnj-39758979-in-adults-with-uncontrolled-asthma
#7
Alexa P Kollmeier, Andrew Greenspan, Xie L Xu, Philip E Silkoff, Elliot Barnathan, Matthew J Loza, Jingzhi Jiang, Bei Zhou, Bin Chen, Robin L Thurmond
BACKGROUND: The effects of H4 R antagonists in preclinical asthma models support the study of antagonists of the H4 R in the treatment of asthma in humans. JNJ-39758979 is a potent and highly-selective oral H4 R antagonist. OBJECTIVE: We sought to evaluate the safety and efficacy of the H4 R-antagonist JNJ-39758979 in adult patients with uncontrolled asthma. METHODS: One hundred and fifteen eligible patients were randomly assigned to JNJ-39758979 300 mg or placebo once daily for 12 weeks in this phase 2a, double-blind, multicenter, placebo-controlled study...
April 23, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29676619/cysteinyl-leukotriene-receptor-1-and-health-effects-of-particulate-exposure-in-asthma
#8
Nathan Rabinovitch, Meaghan J Jones, Anna Faino, Matthew Strand, Alexander M Morin, Julia MacIsaac, Paul R Reynolds, Amrit Singh, Michael S Kobor, Erwin W Gelfand, Christopher Carlsten
RATIONALE: Acute exposure to ambient particle matter is associated with increased levels of the cysteinyl leukotriene (CysLT) biomarker, urinary leukotriene E4 (uLTE4 ), in subjects with asthma. OBJECTIVES: The role of CysLTs in mediating asthma worsening after particulate matter exposures was explored. METHODS: Daily concentrations of particulate matter of 2.5 μm and smaller diameter (PM2.5 ) and repeated measurements of albuterol use over a 5-month period were collected in 44 urban school children with persistent asthma...
April 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29664873/effects-of-a-picu-status-asthmaticus-de-escalation-pathway-on-length-of-stay-and-albuterol-use
#9
Steven Brennan, Lia Lowrie, Jamie Wooldridge
OBJECTIVES: Evaluate the effects of an asthma de-escalation clinical pathway on selected outcomes for patients admitted to a PICU with status asthmaticus. DESIGN: Time series quality improvement trial. SETTING: PICU in a tertiary care children's hospital. PATIENTS: Children age 2-18 years old with a known diagnosis of asthma presenting with status asthmaticus. INTERVENTION: One-hundred five admissions to a PICU for status asthmaticus were treated according to a new de-escalation pathway between August 15, 2015, and August 30, 2016...
April 16, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29661658/is-transcellular-potassium-shifting-with-insulin-albuterol-or-sodium-bicarbonate-in-emergency-department-patients-with-hyperkalemia-associated-with-recurrent-hyperkalemia-after-dialysis
#10
Brian E Driver, Lauren R Klein, Chaitanya Chittineni, Ellen K Cales, Nathaniel Scott
BACKGROUND: Emergency department (ED) treatment of hyperkalemia often involves shifting potassium into the intracellular space. There is uncertainty whether transcellular shifting causes insufficient potassium removal during hemodialysis, resulting in a subsequent need for further medical therapy or multiple sessions of hemodialysis. OBJECTIVE: We sought to determine whether transcellular potassium shifting in ED patients with hyperkalemia who undergo hemodialysis is associated with recurrent hyperkalemia with or without repeat hemodialysis within 24 h...
April 13, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29660840/the-effectiveness-of-magnesium-sulfate-for-status-asthmaticus-outside-the-intensive-care-setting
#11
Ryan L DeSanti, Nisha Agasthya, Krystal Hunter, Mohammed J Hussain
AIM: Magnesium is an adjunctive therapy used in patients with status asthmaticus who do not respond to conventional therapy. The optimal time from initiation of therapy, to determination of response and administration of magnesium has not yet been resolved. Our objective was to determine if magnesium administered in the non-intensive care setting can decrease duration of continuous albuterol and hospital length of stay. METHODS: We performed a retrospective cohort analysis of children ages 2-18 years admitted to the pediatric unit on continuous albuterol between January 2014 and December 2015 in a tertiary care children's hospital...
April 16, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29655864/comparison-of-the-severity-of-respiratory-disease-in-children-testing-positive-for-enterovirus-d68-and-human-rhinovirus
#12
Esra Caylan, Ezra Weinblatt, John Welter, Allen Dozor, Guiqing Wang, Sheila M Nolan
OBJECTIVE: To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV). STUDY DESIGN: A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species...
April 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29559773/use-of-clinical-characteristics-to-predict-spirometric-classification-of-obstructive-lung-disease
#13
Steven J Pascoe, Wei Wu, Kathryn A Collison, Linda M Nelsen, Keele E Wurst, Laurie A Lee
Background: There is no consensus on how to define patients with symptoms of asthma and chronic obstructive pulmonary disease (COPD). A diagnosis of asthma-COPD overlap (ACO) syndrome has been proposed, but its value is debated. This study (GSK Study 201703 [NCT02302417]) investigated the ability of statistical modeling approaches to define distinct disease groups in patients with obstructive lung disease (OLD) using medical history and spirometric data. Methods: Patients aged ≥18 years with diagnoses of asthma and/or COPD were categorized into three groups: 1) asthma (nonobstructive; reversible), 2) ACO (obstructive; reversible), and 3) COPD (obstructive; nonreversible)...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29515802/on-demand-intermittent-beclomethasone-is-effective-for-mild-asthma-in-brazil
#14
Paulo Camargos, Alessandra Affonso, Geralda Calazans, Lidiana Ramalho, Marisa L Ribeiro, Nulma Jentzsch, Simone Senna, Renato T Stein
Background: Daily inhaled corticosteroids are widely recommended for mild persistent asthma. This study aimed to assess the efficacy of the intermittent use of beclomethasone as an alternative treatment for mild persistent asthma. Methods: In this 16-week trial, children aged 6-18 years were evaluated. Subjects in the continuous treatment arm of the study received 500 μg/day of beclomethasone, whereas the intermittent ones were given 1000 μg/day (250 μg every 6 h) in combination with albuterol for 7 days upon exacerbations or worsening of symptoms...
2018: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29509491/whole-genome-sequencing-of-pharmacogenetic-drug-response-in-racially-diverse-children-with-asthma
#15
Angel Cy Mak, Marquitta J White, Walter L Eckalbar, Zachary A Szpiech, Sam S Oh, Maria Pino-Yanes, Donglei Hu, Pagé Goddard, Scott Huntsman, Joshua Galanter, Ann Chen Wu, Blanca E Himes, Soren Germer, Julia M Vogel, Karen L Bunting, Celeste Eng, Sandra Salazar, Kevin L Keys, Jennifer Liberto, Thomas J Nuckton, Thomas A Nguyen, Dara G Torgerson, Pui-Yan Kwok, Albert M Levin, Juan C Celedón, Erick Forno, Hakon Hakonarson, Patrick M Sleiman, Amber Dahlin, Kelan G Tantisira, Scott T Weiss, Denise Serebrisky, Emerita Brigino-Buenaventura, Harold J Farber, Kelley Meade, Michael A Lenoir, Pedro C Avila, Saunak Sen, Shannon M Thyne, William Rodriguez-Cintron, Cheryl A Winkler, Andrés Moreno-Estrada, Karla Sandoval, Jose R Rodriguez-Santana, Rajesh Kumar, L Keoki Williams, Nadav Ahituv, Elad Ziv, Max A Seibold, Robert B Darnell, Noah Zaitlen, Ryan D Hernandez, Esteban G Burchard
Rationale Albuterol, a bronchodilator medication, is the first-line therapy for asthma worldwide. There are significant racial/ethnic differences in albuterol drug response. Objective To identify genetic variants important for bronchodilator drug response (BDR) in racially diverse children. Methods We performed the first whole genome sequencing (WGS) pharmacogenetics study from 1,441 children with asthma from the tails of the BDR distribution to identify genetic association with BDR. Measurements and Main Results We identified population-specific and shared genetic variants associated with BDR, including genome-wide significant (p < 3...
March 6, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29504498/quintupling-inhaled-glucocorticoids-to-prevent-childhood-asthma-exacerbations
#16
RANDOMIZED CONTROLLED TRIAL
Daniel J Jackson, Leonard B Bacharier, David T Mauger, Susan Boehmer, Avraham Beigelman, James F Chmiel, Anne M Fitzpatrick, Jonathan M Gaffin, Wayne J Morgan, Stephen P Peters, Wanda Phipatanakul, William J Sheehan, Michael D Cabana, Fernando Holguin, Fernando D Martinez, Jacqueline A Pongracic, Sachin N Baxi, Mindy Benson, Kathryn Blake, Ronina Covar, Deborah A Gentile, Elliot Israel, Jerry A Krishnan, Harsha V Kumar, Jason E Lang, Stephen C Lazarus, John J Lima, Dayna Long, Ngoc Ly, Jyothi Marbin, James N Moy, Ross E Myers, J Tod Olin, Hengameh H Raissy, Rachel G Robison, Kristie Ross, Christine A Sorkness, Robert F Lemanske
BACKGROUND: Asthma exacerbations occur frequently despite the regular use of asthma-controller therapies, such as inhaled glucocorticoids. Clinicians commonly increase the doses of inhaled glucocorticoids at early signs of loss of asthma control. However, data on the safety and efficacy of this strategy in children are limited. METHODS: We studied 254 children, 5 to 11 years of age, who had mild-to-moderate persistent asthma and had had at least one asthma exacerbation treated with systemic glucocorticoids in the previous year...
March 8, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29498483/enterovirus-d-68-in-children-presenting-for-acute-care-in-the-hospital-setting
#17
Timothy J Savage, Jane Kuypers, Helen Y Chu, Miranda C Bradford, Anne Marie Buccat, Xuan Qin, Eileen J Klein, Keith R Jerome, Janet A Englund, Alpana Waghmare
BACKGROUND: Severe respiratory disease associated with enterovirus D68 (EV-D68) has been reported in hospitalized pediatric patients. Virologic and clinical characteristics of EV-D68 infections exclusively in patients presenting to a hospital Emergency Department (ED) or urgent care have not been well defined. METHODS: Mid-nasal swabs from pediatric patients with respiratory symptoms presenting to the ED or urgent care were evaluated using a commercial multiplex PCR platform...
March 2, 2018: Influenza and Other Respiratory Viruses
https://www.readbyqxmd.com/read/29467332/chronic-%C3%AE-2ar-stimulation-limits-cftr-activation-in-human-airway-epithelia
#18
John J Brewington, Jessica Backstrom, Amanda Feldman, Elizabeth L Kramer, Jessica D Moncivaiz, Alicia J Ostmann, Xiaoting Zhu, L Jason Lu, John P Clancy
Traditional pulmonary therapies for cystic fibrosis (CF) target the downstream effects of CF transmembrane conductance regulator (CFTR) dysfunction (the cause of CF). Use of one such therapy, β-adrenergic bronchodilators (such as albuterol), is nearly universal for airway clearance. Conversely, novel modulator therapies restore function to select mutant CFTR proteins, offering a disease-modifying treatment. Recent trials of modulators targeting F508del-CFTR, the most common CFTR mutation, suggest that chronic β-agonist use may undermine clinical modulator benefits...
February 22, 2018: JCI Insight
https://www.readbyqxmd.com/read/29441694/presynaptic-congenital-myasthenic-syndrome-with-altered-synaptic-vesicle-homeostasis-linked-to-compound-heterozygous-sequence-variants-in-rph3a
#19
Ricardo A Maselli, Jessica Vázquez, Leah Schrumpf, Juan Arredondo, Marian Lara, Jonathan B Strober, Peter Pytel, Robert L Wollmann, Michael Ferns
BACKGROUND: Monogenic defects of synaptic vesicle (SV) homeostasis have been implicated in many neurologic diseases, including autism, epilepsy, and movement disorders. In addition, abnormal vesicle exocytosis has been associated with several endocrine dysfunctions. METHODS: We report an 11 year old girl with learning disabilities, tremors, ataxia, transient hyperglycemia, and muscle fatigability responsive to albuterol sulfate. Failure of neuromuscular transmission was confirmed by single fiber electromyography...
February 14, 2018: Molecular Genetics & Genomic Medicine
https://www.readbyqxmd.com/read/29432139/crossover-evaluation-of-compressors-and-nebulizers-typically-used-by-cystic-fibrosis-patients
#20
Samah M Awad, Ariel Berlinski
BACKGROUND: Compressor/nebulizer units are used to deliver inhaled medications to patients with cystic fibrosis. Practitioners and parents frequently replace either the compressor or the nebulizer with a similar component from a different brand. We hypothesized that these changes could affect the compressor/nebulizer flow-pressure and aerosol characteristics. METHODS: The following compressors were studied: Pari Vios, Pulmo-Aide model 5650D, and Inspiration Elite model HS456...
March 2018: Respiratory Care
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