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Asthma guidelines

Eleftherios Zervas, Konstantinos Samitas, Andriana I Papaioannou, Petros Bakakos, Stelios Loukides, Mina Gaga
A small subgroup of patients with asthma suffers from severe disease that is either partially controlled or uncontrolled despite intensive, guideline-based treatment. These patients have significantly impaired quality of life and although they constitute <5% of all asthma patients, they are responsible for more than half of asthma-related healthcare costs. Here, we review a definition for severe asthma and present all therapeutic options currently available for these severe asthma patients. Moreover, we suggest a specific algorithmic treatment approach for the management of severe, difficult-to-treat asthma based on specific phenotype characteristics and biomarkers...
January 2018: ERJ Open Research
Barbara P Yawn, Peter C Wollan, Matthew A Rank, Susan L Bertram, Young Juhn, Wilson Pace
PURPOSE: The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS: We used a pragmatic cluster-randomized controlled design in 18 US family medicine and pediatric practices to compare outcomes in patients with persistent asthma aged 5 to 45 years after introduction of the Asthma APGAR tools vs usual care...
March 2018: Annals of Family Medicine
Antonio Anzueto, Marc Miravitlles
Chronic obstructive pulmonary disease (COPD) is often misdiagnosed and inappropriately treated in many patients. COPD is a distinct disease from adult-onset asthma; however, some patients with COPD may present with several forms of airway disease described as asthma-COPD overlap (ACO). Bronchodilators and inhaled corticosteroids (ICS) both have a place in standard maintenance treatment of COPD and asthma; however, recommendations for use differ widely. In patients with COPD, long-acting bronchodilators are effective initial monotherapy treatment, while ICS monotherapy is recommended as initial treatment in patients with asthma...
March 7, 2018: Chest
Osman Savran, Charlotte Suppli Ulrik
Background: Early life events may predispose to the development of chronic lung disease in adulthood. Aim: To provide an update on current knowledge of early nongenetic origins of COPD. Materials and methods: Systematic literature review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Results: A total of 16 studies, comprising 69,365 individuals, met the predefined criteria and were included in the present review...
2018: International Journal of Chronic Obstructive Pulmonary Disease
H H Shen, X F Du, S M Ying
No abstract text is available yet for this article.
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Zahra Alizadeh, Marzieh Mazinani, Esmaeil Mortaz, Mohammad Reza Fazlollahi, Ian Adcock, Mostafa Moein
Different phenotypes of asthma from mild to severe are categorized based on diverse clinical features. A guideline for the recognition and treatment of asthma has been provided by Global Initiative for Asthma (GINA). To control symptoms and prevent asthma exacerbation in most patients combinational therapy with inhaled corticosteroids (ICS) and a long acting B2-adrenreceptor agonist (LABA) are recommended. Understanding asthma phenotypes would be helpful to improve asthma diagnosis and treatment. The aim of this study was to verify glucocorticoid receptor glcococorticoid receptor (GR) nuclear translocation in CD4 T cells treated with fluticasone furoate (FF), vilanterol (V) and FF/V combination in severe asthmatic patients compare to patients with moderate asthma and healthy controls using Immunocytochemistry (ICC)...
February 2018: Iranian Journal of Allergy, Asthma, and Immunology
Lauren M Kao, Julie Wang, Olga Kagan, Anne Russell, S Shahzad Mustafa, Diane Houdek, Bridget Smith, Ruchi Gupta
BACKGROUND: Although school health care professionals are integral to the management of students with food allergy, their views on school food allergy policies have not yet been reported. OBJECTIVE: To characterize food allergy policies currently being used in schools and their utility and potential barriers to implementation from the perspective of school health care professionals. METHODS: An electronic survey was disseminated to school nurses at the 2016 National Association of School Nurses meeting and through the Allergy and Asthma Network listserv...
March 2018: Annals of Allergy, Asthma & Immunology
Kenneth Wysocki
Research and application of genomic medicine in lung disease during the past century has clarified our understanding and focus on specific phenotypes, helping clinicians tailor treatment for individual patients. Cystic fibrosis and lung cancer have been researched extensively; specific genotypes have been instrumental in precision medicine to treat these lung diseases. Asthma and chronic obstructive pulmonary disease are more complex and heterogeneous in their pathogenesis, genotypic profile, and phenotypic expression, making treatment more difficult with increasing disease severity...
2018: AACN Advanced Critical Care
Huguette Romieu, Françoise Charbonnier, Dora Janka, Aymeric Douillard, Valérie Macioce, Kathleen Lavastre, Hamouda Abassi, Marie-Catherine Renoux, Thibault Mura, Pascal Amedro
BACKGROUND: Asthma is the most common chronic disease in pediatrics. Along with the usual drug therapy using corticosteroids and bronchodilators, some interest has been shown for adjuvant therapies, such as sophrology. However, the level of evidence for non-pharmaceutical therapies in asthma remains low, especially in children. This study aimed to assess whether in children with asthma, peak expiratory flow (PEF) improved more after a sophrology session alongside standard treatment than after standard treatment alone...
March 1, 2018: Pediatric Pulmonology
Koen B Pouwels, F Christiaan K Dolk, David R M Smith, Julie V Robotham, Timo Smieszek
Objectives: Previous work based on guidelines and expert opinion identified 'ideal' prescribing proportions-the overall proportion of consultations that should result in an antibiotic prescription-for common infectious conditions. Here, actual condition-specific prescribing proportions in primary care in England were compared with ideal prescribing proportions identified by experts. Methods: All recorded consultations for common infectious conditions (cough, bronchitis, exacerbations of asthma or chronic obstructive pulmonary disease, sore throat, rhinosinusitis, otitis media, lower respiratory tract infection, upper respiratory tract infection, influenza-like illness, urinary tract infection, impetigo, acne, gastroenteritis) for 2013-15 were extracted from The Health Improvement Network (THIN) database...
February 1, 2018: Journal of Antimicrobial Chemotherapy
L Yang Connie
No abstract text is available yet for this article.
November 2017: Paediatrics & Child Health
Neale Smith, Anne Smith, Alice Wang, Kaitlyn Shaw, Gabriella Groeneweg, Ran D Goldman, Bryan Wilkinson, Ricardo Jimenez, Leah Mwai, Bruce Carleton
Objectives: Administration of oral corticosteroids at the onset of an upper respiratory tract infection (URTI) can be effective in the management of acute asthma exacerbations in children. This study was designed to identify barriers to parent-initiated implementation of clinical practice guideline-recommended use of oral corticosteroids for prophylaxis against severe asthma exacerbations in children. Methods: Twenty-seven children who presented to BC Children's Hospital with URTI-induced asthma exacerbations were recruited...
July 2017: Paediatrics & Child Health
Israel Amirav, Michael T Newhouse
No abstract text is available yet for this article.
May 2017: Paediatrics & Child Health
James D Chalmers, Sanjay H Chotirmall
European Respiratory Society guidelines for the management of adult bronchiectasis highlight the paucity of treatment options available for patients with this disorder. No treatments have been licensed by regulatory agencies worldwide, and most therapies used in clinical practice are based on very little evidence. Development of new treatments is needed urgently. We did a systematic review of scientific literature and clinical trial registries to identify agents in early-to-late clinical development for bronchiectasis in adults...
February 22, 2018: Lancet Respiratory Medicine
Karen McLaughlin, Maralyn Foureur, Megan E Jensen, Vanessa E Murphy
BACKGROUND: Asthma affects 12.7% of pregnancies in Australia. Poorly controlled asthma is associated with increased maternal and infant morbidity and mortality. Optimal antenatal management of asthma during pregnancy has the potential to reduce complications relating to asthma. Evidence-based clinical practice guidelines help to translate health research findings into practice and when implemented can improve health outcomes. National and International guidelines currently provide recommendations for optimal asthma care in pregnancy...
February 21, 2018: Women and Birth: Journal of the Australian College of Midwives
Debora Lee Oh, Petra Jerman, Sara Silvério Marques, Kadiatou Koita, Sukhdip Kaur Purewal Boparai, Nadine Burke Harris, Monica Bucci
BACKGROUND: Early detection of and intervention in childhood adversity has powerful potential to improve the health and well-being of children. A systematic review was conducted to better understand the pediatric health outcomes associated with childhood adversity. METHODS: PubMed, PsycArticles, and CINAHL were searched for relevant articles. Longitudinal studies examining various adverse childhood experiences and biological health outcomes occurring prior to age 20 were selected...
February 23, 2018: BMC Pediatrics
Win Sen Kuan, Simon Craig, Anne-Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
INTRODUCTION: Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes. OBJECTIVE: To describe the demographic features, clinical characteristics, management and outcomes of adults with an emergency department (ED) diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea. METHODS: Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study...
February 22, 2018: Clinical Respiratory Journal
Ashley Woodcock, Isabelle Boucot, David A Leather, Jodie Crawford, Susan Collier, Nawar Diar Bakerly, Emma Hilton, Jørgen Vestbo
Guidelines for chronic obstructive pulmonary disease (COPD) management are based largely on results from double-blind randomised controlled trials (RCTs) of efficacy. These trials have high internal validity and test whether a drug is efficacious, but they are conducted in highly selected populations that may differ significantly from patients with COPD seen in routine practice.We compared the baseline characteristics, healthcare use and outcomes between the Salford Lung Study (SLS), an open-label effectiveness RCT, with six recent large-scale efficacy RCTs...
February 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Akira Akasawa, Hiroko Watanabe, Mayumi Furukawa, Mari Sasaki, Koichi Yoshida, Hiroshi Odajima, Motohiro Ebisawa, Takao Fujisawa
BACKGROUND: The use of asthma control guidelines and anti-inflammatory drugs have significantly decreased the number of severe asthma cases including death from asthma. However, there are few prospective cohort studies among pediatric asthma patients in Japan describing the course of asthma symptoms with the treatment taken into consideration. METHOD: We recruited a total of 851 children diagnosed with asthma through 90 hospitals and clinics in 2004 to 2006. Questionnaires were posted annually to collect data on their asthma symptoms, treatment and environmental exposures...
2018: Arerugī, [Allergy]
Joaquin Sastre, Astrid Crespo, Toni Fernandez-Sanchez, Manuel Rial, Vicente Plaza
BACKGROUND: It has been documented that anxiety and depression are prevalent in patients with asthma and are associated with greater frequency of exacerbations, increased use of health-care resources, and poor asthma control. OBJECTIVES: Our study examined not only the association of asthma diagnosis with symptoms of depression/anxiety and asthma control at baseline, but also over a 6-month period of specialist supervision. METHODS: We enrolled 3,182 patients with moderate-severe asthma...
February 14, 2018: Journal of Allergy and Clinical Immunology in Practice
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