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Severe persistent asthma

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https://www.readbyqxmd.com/read/28721017/targeted-therapy-in-severe-asthma-today-focus-on-immunoglobulin-e
#1
REVIEW
Girolamo Pelaia, Giorgio Walter Canonica, Andrea Matucci, Rossella Paolini, Massimo Triggiani, Pierluigi Paggiaro
Asthma is a complex chronic inflammatory disease of multifactorial etiology. International guidelines increasingly recognize that a standard "one size fits all" approach is no longer an effective approach to achieve optimal treatment outcomes, and a number of disease phenotypes have been proposed for asthma, which has the potential to guide treatment decisions. Among the many asthma phenotypes, allergic asthma represents the widest and most easily recognized asthma phenotype, present in up to two-thirds of adults with asthma...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28719697/diagnosis-and-management-of-asthma-in-adults-a-review
#2
Jennifer L McCracken, Sreenivas P Veeranki, Bill T Ameredes, William J Calhoun
Importance: Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma. Observations: Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway obstruction using spirometry...
July 18, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28718252/use-of-complementary-and-alternative-medicine-among-asthmatic-patients
#3
Fawad Ahmed, Ayaz Ayub, Hamid Hussain
BACKGROUND: The prevalence of complementary and alternative medicine (CAM) use in some developed countries is on the rise as surveys conducted on large scale vouch for. This study was conducted with the aim to determine the frequency of complementary and alternative medicine (CAM) use among asthmatic patients at outpatient department of tertiary care hospitals in Peshawar, Khyber Pakhtunkhwa, Pakistan. METHODS: This cross-sectional study was conducted in outpatient department of two tertiary care hospitals...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28712803/maternal-asthma-severity-and-control-during-pregnancy-and-risk-of-offspring-asthma
#4
Xiaoqin Liu, Esben Agerbo, Vivi Schlünssen, Rosalind J Wright, Jiong Li, Trine Munk-Olsen
BACKGROUND: Severe and uncontrolled asthma during pregnancy has been linked to several unfavorable perinatal outcomes. However, current knowledge on the association between the severity and control of maternal asthma and offspring asthma is sparse. OBJECTIVE: We sought to investigate the extent to which offspring asthma is influenced by maternal asthma severity and control during pregnancy. METHODS: We performed a prospective population-based cohort study...
June 27, 2017: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28696802/correlation-of-induced-sputum-eosinophil-levels-with-clinical-parameters-in-mild-and-moderate-persistent-asthma-in-children-aged-7-18%C3%A2-years
#5
Prachi Kansal, Devki Nandan, Sheetal Agarwal, Neha Patharia, Narendra Arya
BACKGROUND: Treatment decisions in asthma are currently based on clinical assessment and spirometry. Sputum eosinophil, being a marker of airway inflammation, can serve as a tool for assessing severity and response to treatment in asthma patients. OBJECTIVES: To measure eosinophil percentage in induced sputum in children with asthma and correlate it with clinical asthma parameters. METHODS: A prospective observational study was performed at tertiary care hospital on 91 children aged 7-18 years with newly diagnosed mild or moderate persistent asthma...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28693328/eliminating-disparities-in-asthma-care-identifying-broad-challenges-in-quality-improvement
#6
Joseph P Anarella, Victoria L Wagner, Susan G McCauley, Jennifer B Mane, Patricia A Waniewski
Racial disparities in asthma care persist in New York State's Medicaid Program. African Americans with asthma experience higher rates of emergency department visits and inpatient hospitalizations, coupled with lower rates of long-term control medication use compared to other racial/ethnic groups. Within this context, and with funding from the Centers for Disease Control and Prevention, the New York State Department of Health designed and implemented the Eliminating Disparities in Asthma Care (EDAC) Collaborative to improve the quality of asthma care delivered in 7 provider sites located in Central Brooklyn, New York...
December 1, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/28691616/assessment-of-northern-jordanian-adolescents-knowledge-and-attitudes-towards-asthma
#7
Abdullah Alkhawaldeh, Mohammed ALBashtawy, Omar Al Omari, Dianne Wynaden, Fadwa Alhalaiqa, Shereen Hamadneh, Khalid Aljohani, Khetam Al-Awamreh, Moawiah Khatatbeh
Background Asthma is a chronic illness of the airways that can cause a persistent cough. The illness affects a significant population of young people worldwide and can affect their ongoing quality of life. Aim To explore Jordanian adolescents' knowledge and attitudes to asthma. Method A cross-sectional research design was used with a convenience sample of 302 adolescents from six schools in northern Jordan, who completed a self-reported knowledge and attitude survey. Results Although the adolescents had an adequate knowledge level about asthma, several areas of knowledge deficit were identified and some negative attitudes were demonstrated...
July 10, 2017: Nursing Children and Young People
https://www.readbyqxmd.com/read/28689843/nonpharmacologic-therapy-for-severe-persistent-asthma
#8
Chase Hall, Linda Nici, Shweta Sood, Richard ZuWallack, Mario Castro
The treatment of asthma largely depends on guideline-based pharmacologic therapies. However, nonpharmacologic therapies for asthma such as pulmonary rehabilitation, focused breathing techniques, and bronchial thermoplasty have an important, yet underappreciated, role. Structured pulmonary rehabilitation programs can reduce dyspnea and increase cardiopulmonary fitness. The educational component of these programs can ensure that therapies are being used appropriately, increase compliance, and decrease health care utilization...
July 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28687413/effect-of-azithromycin-on-asthma-exacerbations-and-quality-of-life-in-adults-with-persistent-uncontrolled-asthma-amazes-a-randomised-double-blind-placebo-controlled-trial
#9
Peter G Gibson, Ian A Yang, John W Upham, Paul N Reynolds, Sandra Hodge, Alan L James, Christine Jenkins, Matthew J Peters, Guy B Marks, Melissa Baraket, Heather Powell, Steven L Taylor, Lex E X Leong, Geraint B Rogers, Jodie L Simpson
BACKGROUND: Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require additional therapy. Since macrolide antibiotics can be used to treat persistent asthma, we aimed to assess the efficacy and safety of oral azithromycin as add-on therapy in patients with uncontrolled persistent asthma on medium-to-high dose inhaled corticosteroids plus a long-acting bronchodilator. METHODS: We did a randomised, double-blind, placebo controlled parallel group trial to determine whether oral azithromycin decreases the frequency of asthma exacerbations in adults (≥18 years) with symptomatic asthma despite current use of inhaled corticosteroid and long-acting bronchodilator, and who had no hearing impairment or abnormal prolongation of the corrected QT interval...
July 4, 2017: Lancet
https://www.readbyqxmd.com/read/28679952/severe-asthma-in-humans-and-mouse-model-suggests-a-cxcl10-signature-underlies-corticosteroid-resistant-th1-bias
#10
Marc Gauthier, Krishnendu Chakraborty, Timothy B Oriss, Mahesh Raundhal, Sudipta Das, Jie Chen, Rachael Huff, Ayan Sinha, Merritt Fajt, Prabir Ray, Sally E Wenzel, Anuradha Ray
We previously showed that Th1/type 1 inflammation marked by increased IFN-γ levels in the airways can be appreciated in 50% of patients with severe asthma, despite high dose corticosteroid (CS) treatment. We hypothesized that a downstream target of IFN-γ, CXCL10, which recruits Th1 cells via the cognate receptor CXCR3, is an important contributor to Th1high asthma and CS unresponsiveness. We show high levels of CXCL10 mRNA closely associated with IFNG levels in the BAL cells of 50% of severe asthmatics and also in the airways of mice subjected to a severe asthma model, both in the context of high-dose CS treatment...
July 6, 2017: JCI Insight
https://www.readbyqxmd.com/read/28671769/chronic-coffee-consumption-and-respiratory-disease-a-systematic-review
#11
Tiago M Alfaro, Rita A Monteiro, Rodrigo A Cunha, Carlos Robalo Cordeiro
PURPOSE: The widespread consumption of coffee means that any biological effects from its use can lead to significant public health consequences. Chronic pulmonary diseases are extremely prevalent and responsible for one of every six deaths on a global level. METHODS: We searched major medical databases for studies reporting on the effects of coffee or caffeine consumption on a wide range of non-malignant respiratory outcomes, including incidence, prevalence, evolution or severity of respiratory disease in adults...
July 3, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28647305/impact-of-asthma-on-the-sexual-functioning-of-patients-a-case-control-study
#12
José Gregorio Soto Campos, Josefa Rojas Villegas, Alicia Padilla Galo, Nuria Marina Malanda, Juan Luis Garcia Rivero, Celia Pinedo Sierra, Mercedes Garcia Salmones, Carmen Cabrera Galán, Esperanza Segura Molina, Vicente Plaza
INTRODUCTION: Sexual limitations play an important role in the quality of life of patients with chronic diseases. Very limited information is available on the impact of asthma on the sexual functioning of these individuals. MATERIALS AND METHODS: Cross-sectional, observational, multicenter study. Asthma patients and healthy individuals were recruited. All subjects participated in an interview in which demographic and clinical data were recorded, and completed the Goldberg Anxiety-Depression Scale (GADS) to evaluate the presence of concomitant psychiatric disease...
June 21, 2017: Archivos de Bronconeumología
https://www.readbyqxmd.com/read/28645995/mepolizumab-for-the-treatment-of-severe-eosinophilic-asthma
#13
REVIEW
Mara N Poulakos, Shawna M Cargill, Melissa F Waineo, Allen L Wolford
PURPOSE: Published data on the pharmacology, pharmacokinetics and pharmacodynamics, and clinical efficacy and safety of the interleukin-5 antagonist mepolizumab are reviewed. SUMMARY: Asthma of the eosinophilic phenotype is characterized by persistent eosinophilic airway inflammation promoted primarily by T-helper type 2 cytokines, the key regulator of eosinophils. Patients with severe eosinophilic asthma are burdened by the need to administer high doses of corticosteroids to help manage their symptoms...
July 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28633732/to-err-is-human-can-american-medicine-learn-from-past-mistakes
#14
Jeffrey B Ritterman
The history of medicine includes many errors. Some persisted for decades and caused great harm. Several are highlighted in this article, including the mythical thymic diseases: thymic asthma and status thymicolymphaticus. Some medical mistakes, such as the diet-heart hypothesis of Ancel Keys, continue to cause harm. To avoid future errors and their associated harm, I suggest a cultural shift encouraging professional humility and greater questioning of medical dogma. Medical education focused on teaching students this history may help with this cultural shift...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28631599/efficacy-and-safety-of-omalizumab-in-children-and-adolescents-with-moderate-to-severe-asthma-a-systematic-literature-review
#15
Jonathan Corren, Abhishek Kavati, Benjamin Ortiz, Jennifer A Colby, Kimberly Ruiz, Brett A Maiese, Sarah M Cadarette, Reynold A Panettieri
BACKGROUND: There are limited pediatric data about the use of omalizumab, especially the effectiveness and safety of omalizumab in the real-world management of allergic asthma. OBJECTIVE: The objective of this study was to summarize the safety and efficacy of omalizumab in both randomized clinical trials (RCT) used for U.S. Food and Drug Administration registration and real-world studies (RWS) based on clinical care of children with moderate-to-severe asthma. METHODS: Studies that evaluated omalizumab use in patients <18 years old and with asthma, published between January 2003 and October 2016, were retrieved from medical literature data bases...
July 1, 2017: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/28616286/severe-and-uncontrolled-asthma-in-china-a-cross-sectional-survey-from-the-australasian-severe-asthma-network
#16
Gang Wang, Fang Wang, Peter G Gibson, Michael Guo, Wei-Jie Zhang, Peng Gao, Hong-Ping Zhang, Erin S Harvey, Hui Li, Jie Zhang
BACKGROUND: Severe asthma is largely unexplored in the Chinese population. Patients with asthma underwent systematic evaluation, by investigating the characteristics of uncontrolled asthma and of asthma treated with three different controller therapies. METHODS: This multi-centre, real-world study was conducted from March 2014 to September 2015. Adults with stable asthma underwent assessment of medication use, asthma control, quality of life, psychological symptoms, work productivity and activity impairment, bronchodilator response and sputum induction...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28607943/poor-adherence-with-medication-refill-and-medical-supplies-maintenance-as-risk-factors-for-inpatient-asthma-admission-in-children
#17
Pavadee Poowuttikul, Benjamin Hart, Ronald Thomas, Elizabeth Secord
Background. Asthma results in significant pediatric hospitalizations in the inner city. Many asthmatic children were admitted to our hospital as a result of lack of medications or medical supplies that had been previously prescribed ("ran out," "broken," or "lost"). Objective. To identify the incidence of children admitted for asthma because of lack of prescribed medications/supplies and to assess risk factors for poor adherence between groups. Methods. This was a prospective chart review of 200 asthmatic children admitted to Children's Hospital of Michigan, Detroit...
2017: Global Pediatric Health
https://www.readbyqxmd.com/read/28599074/beyond-epithelial-to-mesenchymal-transition-common-suppression-of-differentiation-programs-underlies-epithelial-barrier-dysfunction-in-mild-moderate-and-severe-asthma
#18
Lucas F Loffredo, Hiam Abdala-Valencia, Kishore R Anekalla, Lyda Cuervo-Pardo, Cara J Gottardi, Sergejs Berdnikovs
BACKGROUND: Epithelial barrier dysfunction is a central feature in the pathogenesis of allergic disease. Epithelial-to-mesenchymal transition (EMT) has been proposed as one mechanism afflicting barrier in asthma. However, genes and pathways involved in aberrant epithelial-mesenchymal signaling, and their relationship to asthma severity, are poorly understood. METHODS: We used unbiased gene network analysis to evaluate functional convergence in epithelial gene expression signatures across multiple public access transcriptomics datasets of human asthma, followed by text mining to evaluate functional marker relevance of discovered genes...
June 9, 2017: Allergy
https://www.readbyqxmd.com/read/28594249/a-pilot-randomized-trial-of-school-based-administration-of-inhaled-corticosteroids-for-at-risk-children-with-asthma
#19
Cherise B Harrington, Eric Langhans, Deborah Q Shelef, Molly Savitz, Colleen Whitmore, Stephen J Teach
OBJECTIVE: To investigate whether high adherence to inhaled corticosteroids (ICS) among disadvantaged urban public school children on public insurance with persistent asthma is achievable by having school nurses administer morning doses on each day that school is in session. DESIGN/METHODS: This was a pilot prospective randomized clinical trial of home versus school nurse-administered ICS among children on Medicaid enrolled in grades K-8. The primary outcome was the proportion of expected morning doses of ICS given to the intervention group in school over the 60-day treatment period...
June 8, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28579376/a-new-measure-to-assess-asthma-s-effect-on-quality-of-life-from-the-patient-s-perspective
#20
Sandra R Wilson, Michael J Mulligan, Estela Ayala, Alan Chausow, Qiwen Huang, Sarah B Knowles, Santosh Gummidipundi, Mario Castro, Robert A Wise
BACKGROUND: The Asthma Impact on Quality of Life Scale (A-IQOLS) assesses the negative effect of asthma on quality of life (QoL) from the patient's perspective by using dimensions of Flanagan's Quality of Life Scale (QOLS), a measure of current QoL. OBJECTIVES: We sought to determine and compare the psychometric properties of the A-IQOLS and QOLS, including their sensitivities to differences and change in asthma status. METHODS: In a test-retest design (3- to 5-week interval) adults with persistent asthma underwent spirometry and were administered the A-IQOLS, other asthma outcome measures (Asthma Control Test, Asthma Symptom Utility Index, and the Marks and Juniper Asthma Quality of Life Questionnaires), and the QOLS...
June 1, 2017: Journal of Allergy and Clinical Immunology
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