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Asthma exacerbations

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https://www.readbyqxmd.com/read/28548898/comparison-of-a-rapid-albuterol-pathway-with-a-standard-pathway-for-the-treatment-of-children-with-a-moderate-to-severe-asthma-exacerbation-in-the-emergency-department
#1
Matthew Wilkinson, Ben King, Sujit Iyer, Eric Higginbotham, Anna Wallace, Collin Hovinga, Coburn Allen
OBJECTIVE: The objective of this study was to determine if a rapid albuterol delivery pathway with a breath-enhanced nebulizer can reduce emergency department (ED) length of stay (LOS), while maintaining admission rates and side effects, when compared to a traditional asthma pathway with a standard jet nebulizer. METHODS: Children aged 3-18 presenting to a large urban pediatric ED for asthma were enrolled if they were determined by pediatric asthma score to have a moderate to severe exacerbation...
May 26, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28546381/adjunct-therapies-for-refractory-status-asthmaticus-in-children
#2
Kyle J Rehder
Asthma exacerbation is a common reason for children to present to the emergency department. If primary therapies fail to halt the progression of an asthma flare, status asthmaticus often leads to hospital, and potentially ICU, admission. Following the initial administration of inhaled β agonists and systemic corticosteroids, a wide array of adjunct medical therapies may be used to treat status asthmaticus. Unfortunately, the data supporting the use of these adjunct therapies are often unclear, conflicting, or absent...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28545978/benralizumab-for-patients-with-mild-to-moderate-persistent-asthma-bise-a-randomised-double-blind-placebo-controlled-phase-3-trial
#3
Gary T Ferguson, J Mark FitzGerald, Eugene R Bleecker, Michel Laviolette, David Bernstein, Craig LaForce, Lyndon Mansfield, Peter Barker, Yanping Wu, Maria Jison, Mitchell Goldman
BACKGROUND: Benralizumab is a humanised, anti-interleukin 5 receptor α monoclonal antibody that directly and rapidly depletes eosinophils, reduces asthma exacerbations, and improves lung function for patients with severe eosinophilic asthma. The objective of this trial was to assess the safety and efficacy of benralizumab for patients with mild to moderate, persistent asthma. METHODS: In this randomised, double-blind, placebo-controlled, phase 3 trial, we recruited patients aged 18-75 years, weighing at least 40 kg, and with a postbronchodilator reversibility in forced expiratory volume in 1 s (FEV1) of at least 12% at screening, from 52 clinical research centres in six countries...
May 22, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28545810/thymic-stromal-lymphopoietin-and-apocynin-alter-the-expression-of-airway-remodeling-factors-in-human-rhinovirus-infected-cells
#4
Joanna Wieczfinska, Rafal Pawliczak
Airway remodeling is a characteristic of bronchial asthma. The process involves the expression of many genes, such as transforming growth factor-beta (TGF-β), tissue inhibitors of metalloproteinases (TIMP-1), MMP and arginase. Human rhinovirus (HRV) is known to cause asthma exacerbations, and viral infections might be involved in the development of airway remodeling. Therefore, the aim of this study was to determine the influence of HRV on the genes involved in airway remodeling and to examine the impact of thymic stromal lymphopoietin (TSLP) and contribution of oxidative stress on airway remodeling in the context of HRV infection...
May 16, 2017: Immunobiology
https://www.readbyqxmd.com/read/28544140/investigation-of-bronchiectasis-in-severe-uncontrolled-asthma
#5
Katerina Dimakou, Anna Gousiou, Michail Toumbis, Maria Kaponi, Serafeim Chrysikos, Loukas Thanos, Christina Triantafillidou
INTRODUCTION: The presence of bronchiectasis in patients with asthma varies in different reports, while a clear etiological relation has not been precisely established. OBJECTIVES: To investigate the presence of bronchiectasis in patients with severe uncontrolled asthma and examine whether they contribute to the severity of asthma. METHODS: Patients with severe asthma were prospectively recruited. HRCT of the chest was performed to identify and grade bronchiectasis using the "Smith" radiology scale...
May 24, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28543086/allergen-immunotherapy-for-allergic-asthma-a-systematic-review-and-meta-analysis
#6
REVIEW
Sangeeta Dhami, Artemisia Kakourou, Felix Asamoah, Ioana Agache, Susanne Lau, Jutel Marek, Antonella Muraro, Graham Roberts, Cezmi A Akdis, Matteo Bonini, Ozlem Cavkaytar, Breda Flood, Pawel Gajdanowicz, Kenji Izuhara, Ömer Kalayci, Ralph Mosges, Oscar Palomares, Oliver Pfaar, Sylwia Smolinska, Milena Sokolowska, Miqdad Asaria, Gopal Netuveli, Hader Zaman, Ather Akhlaq, Aziz Sheikh
BACKGROUND: To inform the development of the European Academy of Allergy and Clinical Immunonology's (EAACI) Guidelines on Allergen Immunotherapy (AIT) for allergic asthma, we assessed the evidence on the effectiveness, cost-effectiveness and safety of AIT. METHODS: We performed a systematic review, which involved searching nine databases. Studies were screened against pre-defined eligibility criteria and critically appraised using established instruments. Data were synthesized using random-effects meta-analyses...
May 19, 2017: Allergy
https://www.readbyqxmd.com/read/28540844/a-6-month-safety-and-efficacy-study-of-fluticasone-propionate-and-fluticasone-propionate-salmeterol-multidose-dry-powder-inhalers-in-persistent-asthma
#7
L Mansfield, G Yiu, A Sakov, S Liu, C Caracta
BACKGROUND: A novel multidose dry powder inhaler (MDPI) that is breath actuated, easy, and intuitive to use has beendeveloped for administering fluticasone propionate (Fp) and Fp/salmeterol (FS). OBJECTIVE: To assess the safety and efficacy of Fp MDPI versus Fp hydrofluoroalkane (HFA) and FS MDPI versus FS dry-powder inhaler (DPI). METHODS: This phase III, 26-week, open-label, active drug-controlled study enrolled subjects 12 years old with persistentasthma...
May 24, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28539203/the-interplay-between-neuroendocrine-activity-and-psychological-stress-induced-exacerbation-of-allergic-asthma
#8
REVIEW
Tomomitsu Miyasaka, Kaori Dobashi-Okuyama, Tomoko Takahashi, Motoaki Takayanagi, Isao Ohno
Psychological stress is recognized as a key factor in the exacerbation of allergic asthma, whereby brain responses to stress act as immunomodulators for asthma. In particular, stress-induced enhanced type 2 T-helper (Th2)-type lung inflammation is strongly associated with asthma pathogenesis. Psychological stress leads to eosinophilic airway inflammation through activation of the hypothalamic-pituitary-adrenal pathway and autonomic nervous system. This is followed by the secretion of stress hormones into the blood, including glucocorticoids, epinephrine, and norepinephrine, which enhance Th2 and type 17 T-helper (Th17)-type asthma profiles in humans and rodents...
May 20, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28535964/income-is-an-independent-risk-factor-for-worse-asthma-outcomes
#9
Juan Carlos Cardet, Margee Louisias, Tonya S King, Mario Castro, Christopher D Codispoti, Ryan Dunn, Linda Engle, B Louise Giles, Fernando Holguin, John J Lima, Dayna Long, Njira Lugogo, Sharmilee Nyenhuis, Victor E Ortega, Sima Ramratnam, Michael E Wechsler, Elliot Israel, Wanda Phipatanakul
BACKGROUND: Socioeconomic status (SES) is associated with asthma morbidity in observational studies but the factors underlying this association are uncertain. OBJECTIVE: We investigated whether three SES correlates-low income, low education, and high perceived stress- were independent risk factors for treatment failure and asthma exacerbations in the context of a randomized controlled trial (RCT). METHODS: The effect of low SES [household income (defined as <$50,000/year), household educational level (defined as less than a bachelor's degree) and high perceived stress (defined as a score of >20 on a perceived stress scale)] on asthma morbidity was analyzed in 381 participants utilizing Poisson regression models...
May 20, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28535631/-a-multi-center-study-for-the-association-between-the-perception-and-control-of-disease-among-asthmatic-patients-in-chinese-urban-areas
#10
Y Nong, J T Lin, W Q Wang, X Zhou, C Z Wang, M Huang, S X Cai, P Chen, Q C Lin, J Y Zhou, Y H Gu, Y D Yuan, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, P Jiang, J Zhang, X W Ye, H G Liu, H P Tang, R Y Liu, C T Liu, W Zhang, C P Hu, Y Q Chen, X J Liu, L M Dai, W Zhou, Y J Huang, J Y Xu
Objective: To investigate the current perception of disease among asthmatic patients in Chinese urban areas, and to address its association with asthma control. Methods: This was a nationwide, multi-center, cross-sectional study covering 30 third-level, grade A hospitals in 30 provinces, municipalities and autonomous regions (not including Tibet) across Chinese mainland. The survey was carried out from October 2015 to May 2016. Asthmatic outpatients were selected to receive face-to-face questionnaire survey on asthma control including Asthma Control Test (ACT) score, classification of asthma control level[according to the Global Initiative for Asthma (GINA) 2015 classification system, as assessed by the physician completing the survey], perception of asthma (including question 1: nature of asthma as a disease; question 2: selection of first-line therapeutic agents to be regularly used daily for asthma; question 3: appropriate timing of the use of short-acting aerosols of β(2) receptor agonists; and question 4: therapeutic goals for asthma)...
May 16, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28533230/deletion-of-pikfyve-alters-alveolar-macrophage-populations-and-exacerbates-allergic-inflammation-in-mice
#11
Takumi Kawasaki, Kosuke Ito, Haruhiko Miyata, Shizuo Akira, Taro Kawai
Alveolar macrophages (AMs) are specialized tissue-resident macrophages that orchestrate the immune responses to inhaled pathogens and maintain organ homeostasis of the lung. Dysregulation of AMs is associated with allergic inflammation and asthma. Here, we examined the role of a phosphoinositide kinase PIKfyve in AM development and function. Mice with conditionally deleted PIKfyve in macrophages have altered AM populations. PIKfyve deficiency results in a loss of AKT activation in response to GM-CSF, a cytokine critical for AM development...
May 22, 2017: EMBO Journal
https://www.readbyqxmd.com/read/28533080/influenza-vaccination-for-patients-with-chronic-obstructive-pulmonary-disease-implications-for-pharmacists
#12
Rasha M Arabyat, Dennis W Raisch, Ludmila Bakhireva
BACKGROUND: Influenza virus is responsible for substantial morbidity and mortality. Specific populations are at higher risk for exacerbations from influenza virus, such as patients with chronic obstructive pulmonary disease (COPD). Influenza vaccination coverage among COPD patients is low. Pharmacists can improve influenza vaccination among COPD patients by recognizing factors that influence vaccination and addressing these factors. OBJECTIVES: To (1) determine the recent influenza vaccination coverage among patients with COPD, (2) identify factors that were associated with immunization, and (3) interpret the results based upon Andersen's healthcare utilization model...
February 24, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28532657/mechanistic-link-between-diesel-exhaust-particles-and-respiratory-reflexes
#13
Ryan K Robinson, Mark A Birrell, John J Adcock, Michael A Wortley, Eric D Dubuis, Shu Chen, Catriona M McGilvery, Sheng Hu, Milo Sp Shaffer, Sara J Bonvini, Sarah A Maher, Ian S Mudway, Alexandra E Porter, Chris Carlsten, Teresa D Tetley, Maria G Belvisi
BACKGROUND: Diesel exhaust particles (DEP) are a major component of particulate matter in Europe's largest cities and epidemiological evidence links exposure with respiratory symptoms and asthma exacerbations. Respiratory reflexes are responsible for symptoms and are regulated by vagal afferent nerves which innervate the airway. It is not known how DEP exposure activates airway afferents to elicit symptoms such as cough and bronchospasm. OBJECTIVE: To identify the mechanisms involved in the activation of airway sensory afferents by DEPs...
May 19, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28532191/cost-effectiveness-of-omalizumab-add-on-to-standard-of-care-therapy-in-patients-with-uncontrolled-severe-allergic-asthma-in-a-brazilian-healthcare-setting
#14
Cibele Suzuki, Nilceia Lopes da Silva, Praveen Kumar, Purnima Pathak, Siew Hwa Ong
OBJECTIVE: Omalizumab add-on to standard-of-care therapy has proven to be efficacious in severe asthma patients for whom exacerbations cannot be controlled otherwise. Moreover, evidence from different healthcare settings suggests reduced healthcare resource utilization with omalizumab. Based on these findings, we aimed to assess the cost effectiveness of the addition of omalizumab to standard-of-care therapy in patients with uncontrolled severe allergic asthma in a Brazilian healthcare setting...
May 22, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28530840/oral-glucocorticoid-sparing-effect-of-benralizumab-in-severe-asthma
#15
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...
May 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
#16
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/28526598/breathe-easy-5-steps-to-better-breathing-with-your-metered-dose-inhaler-mdi
#17
Evan H Allie, Ellen B O'Kelley, Katie H Fischesser, Lawrence B Stack, Donald H Arnold
Proper use of the metered-dose inhaler (MDI) is essential for medications to prevent and treat acute asthma exacerbations. This training video teaches children and clinicians correct technique for MDI use.
May 13, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28526210/early-control-treatment-with-montelukast-in-preschool-children-with-asthma-a-randomized-controlled-trial
#18
Mizuho Nagao, Masanori Ikeda, Norimasa Fukuda, Chizu Habukawa, Tetsuro Kitamura, Toshio Katsunuma, Takao Fujisawa
BACKGROUND: While Japanese guideline recommends initial control treatment for preschool children with asthma symptoms more than once a month, Western guidelines do not. To determine whether control treatment with montelukast was more effective than as-needed β2-agonists in this population, we conducted a randomized controlled trial. METHODS: Eligible patients were children aged 1-5 years who had asthma symptoms more than once a month but less than once a week. Patients were randomly assigned in a 1:1 ratio to receive montelukast 4 mg daily for 48 weeks or as-needed β2-agonists...
May 16, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28526018/infection-mediated-asthma-etiology-mechanisms-and-treatment-options-with-focus-on-chlamydia-pneumoniae-and-macrolides
#19
REVIEW
Wilmore C Webley, David L Hahn
Asthma is a chronic respiratory disease characterized by reversible airway obstruction and airway hyperresponsiveness to non-specific bronchoconstriction agonists as the primary underlying pathophysiology. The worldwide incidence of asthma has increased dramatically in the last 40 years. According to World Health Organization (WHO) estimates, over 300 million children and adults worldwide currently suffer from this incurable disease and 255,000 die from the disease each year. It is now well accepted that asthma is a heterogeneous syndrome and many clinical subtypes have been described...
May 19, 2017: Respiratory Research
https://www.readbyqxmd.com/read/28523172/roles-of-roflumilast-a-selective-phosphodiesterase-4-inhibitor-in-airway-diseases
#20
REVIEW
Theerasuk Kawamatawong
Asthma and chronic obstructive pulmonary disease (COPD) are common chronic respiratory diseases. Both diseases have incompletely distinct pathophysiology, clinical manifestation, and treatment responsiveness. Pulmonary and systemic inflammations are the hallmarks of COPD. Most asthma responds to inhaled corticosteroid (ICS) treatment. In contrast, COPD is a corticosteroid-resistant disease. Bronchodilators are a preferred treatment method of COPD, with the aim of improving symptoms and preventing exacerbation...
April 2017: Journal of Thoracic Disease
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