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Asthma management

Sébastien Chanoine, Margaux Sanchez, Isabelle Pin, Sofia Temam, Nicole Le Moual, Agnès Fournier, Christophe Pison, Jean Bousquet, Pierrick Bedouch, Marie-Christine Boutron-Ruault, Raphaëlle Varraso, Valérie Siroux
Multi-medication related to multimorbidity is common in the elderly with asthma. We aimed at comprehensively characterizing medications used by elderly women, and assessing how multi-medication impacts on asthma prognosis.We performed network-based analyses on drug administrative databases to visualize the prevalence of drug classes and their interconnections among 17,458 elderly women from the Asthma-E3N study, including 4,328 women with asthma. Asthma groups sharing similar medication profiles were identified by clustering method relying on all medications and were studied in association with adverse asthma events (uncontrolled asthma, attacks/exacerbations, and poor asthma-related quality of life)...
March 15, 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Elizabeth Ruvalcaba, Shang-En Chung, Cynthia Rand, Kristin A Riekert, Michelle Eakin
OBJECTIVE: Asthma disproportionately affects minority groups, low income populations, and young children under 5. Head Start (HS) programs predominantly serve this high-risk population, yet staff are not trained on asthma management. The objective of this study was to assess a 5-year, multicomponent HS staff asthma education program in Baltimore City HS programs. METHODS: All HS programs were offered annual staff asthma education by a medical research team that included didactic lectures and hands-on training...
March 15, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Melissa H Bellin, Angelica Newsome, Cassie Lewis-Land, Joan Kub, Shawna S Mudd, Rachel Margolis, Arlene M Butz
INTRODUCTION: Low-income caregiver perspectives on asthma management are understudied but may illuminate strategies to improve care delivery and child outcomes. METHOD: Purposive sampling methods were used to recruit 15 caregivers of children with frequent asthma emergency department visits. Interviews explored how poverty and stress affect asthma management. Grounded theory coding techniques were used to analyze the data. RESULTS: Participants were the biological mother (100%) and were poor (75% had mean annual income ≤ $30,000)...
March 12, 2018: Journal of Pediatric Health Care
Sean A McGhee
PURPOSE OF REVIEW: Although biologic therapies can provide outstanding efficacy in the management of lung disease, especially asthma, most of these agents have been approved only for adults. Recent findings provide new strategies for using these agents in children. RECENT FINDINGS: Extensive evidence has consistently demonstrated the efficacy and safety of biologic therapy for asthma. In addition, some studies have documented potentially important secondary effects, such as improving response to respiratory virus infection in asthmatic patients...
March 13, 2018: Current Opinion in Pediatrics
Yuan Cao, Shi-Hua Lin, Ding Zhu, Feng Xu, Zhi-Hua Chen, Hua-Hao Shen, Wen Li
BACKGROUND WeChat is a convenient and popular social medium, and it seems to be an appropriate platform for education and management of patients. This study sought to identify usefulness in clinical control of cough-variant asthma (CVA). MATERIAL AND METHODS A randomized controlled trial was conducted among 80 CVA patients. After being assigned to either the traditional group (TG) or the WeChat group (WG), they received the same inhalation therapy, but patients in WG received additional education and instruction via our public account on the WeChat application...
March 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Celeste Porsbjerg, Charlotte Ulrik, Tina Skjold, Vibeke Backer, Birger Laerum, Sverre Lehman, Crister Janson, Thomas Sandstrøm, Leif Bjermer, Barbro Dahlen, Bo Lundbäck, Dora Ludviksdottir, Unnur Björnsdóttir, Alan Altraja, Lauri Lehtimäki, Paula Kauppi, Jussi Karjalainen, Hannu Kankaanranta
Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma ('difficult asthma') should undergo systematic assessment, in order to differentiate between true severe asthma, and 'difficult-to-treat' patients, in whom poor control is related to factors such as poor adherence or co-morbidities...
2018: European Clinical Respiratory Journal
Xiaolin Xu, Gita D Mishra, Annette J Dobson, Mark Jones
BACKGROUND: The prevalence of diabetes, heart disease, and stroke multimorbidity (co-occurrence of two or three of these conditions) has increased rapidly. Little is known about how the three conditions progress from one to another sequentially through the life course. We aimed to delineate this progression in middle-aged women and to determine the roles of common risk factors in the accumulation of diabetes, heart disease, and stroke multimorbidity. METHODS AND FINDINGS: We used data from 13,714 women aged 45-50 years without a history of any of the three conditions...
March 2018: PLoS Medicine
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
Ahmed Abushahin, Abdulla Zarroug, Magda Wagdi, Ibrahim Janahi
Wheezing and cough are common case scenarios that pediatricians encountered in their office practices. Although a bronchogenic cyst is an uncommon condition, it is essential to be considered in the differential diagnosis of a chronic cough and wheezing among young children who fail to respond to appropriate medical treatment. A 28-month-old girl was referred to our pediatric pulmonology clinic with persistent symptoms of a cough and wheeze unresponsive to standard asthma therapy. This presentation prompted us to undertake a detailed diagnostic evaluation...
2018: Case Reports in Pediatrics
Matthew Morten, Adam Collison, Vanessa E Murphy, Daniel Barker, Christopher Oldmeadow, John Attia, Joseph Meredith, Heather Powell, Paul D Robinson, Peter D Sly, Peter G Gibson, Joerg Mattes
BACKGROUND: The single-centre double-blind, randomised controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FeNO) in combination with asthma symptoms (FeNO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (ANZ Clinical Trials Registry, number 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FeNO group...
March 7, 2018: Journal of Allergy and Clinical Immunology
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
Maria Michelle Papamichael, Som Kumar Shrestha, Catherine Itsiopoulos, Bircan Erbas
BACKGROUND: The evidence is mixed on the use of long chain omega 3 fatty acids in the prevention and management of childhood asthma. METHODS: We conducted a systematic search and meta-analysis investigating the role of fish intake, the main dietary source of long chain omega-3 fatty acids, on asthma in children. RESULTS: A total of 1,119 publications were identified. Twenty-three studies on fish intake in association with childhood asthma were included in the final review...
March 9, 2018: Pediatric Allergy and Immunology
Umakanth Katwa, Estefania Rivera
Asthma is the most common chronic pediatric condition. Effective asthma management requires a proactive and inclusive approach that controls the patient's symptoms and prevents recurrence of exacerbations. Clinicians should encourage patients to become involved in their management since self-management approaches have proven to be an effective means for chronic illness treatment. Novel forms of self-monitoring and management are technological interventions. In the last decade, novel technology has been developed and used to improve asthma control since it is a powerful agent that addresses a variety of challenges in chronic disease management such as education, communication and adherence...
March 10, 2018: Indian Journal of Pediatrics
Fred H Brennan, Jeffrey Alent, Michael J Ross
Exercise-induced asthma (EIA) and exercise-induced bronchospasm (EIB)/bronchoconstriction (EIC) describes two clinical entities by which exercise triggers bronchial hyperresponsiveness. Exercise is a common trigger of bronchospasm in the asthmatic (EIA), as well as athletes without the underlying inflammation associated with asthma (EIC/EIB). Approximately 10% to 20% of the general population have EIA or EIB (). The approach to the diagnosis and subsequent management relies on the clinician's ability to recognize clinical signs and symptoms, then selecting the correct diagnostic test...
March 2018: Current Sports Medicine Reports
Vinh Nhu Nguyen, Thuong Thi Hoai Huynh, Niels H Chavannes
Background: Most asthma patients in Vietnam have poorly controlled asthma. Besides reasons related to the health care system and health care providers, knowledge on the self-management of patients has also contributed to this situation. Purpose: To assess knowledge on asthma self-management among adult asthma patients in Ho Chi Minh City. Patients and methods: A cross-sectional study with convenience sampling was conducted among 322 ambulatory patients using questionnaires filled in via a face-to-face interview...
2018: International Journal of General Medicine
J T Lin, W Q Wang, X Zhou, K S Yin, C T Liu, C Z Wang, M Huang, P Chen, Y D Yuan, S X Cai, C G Wu, J Li, Q C Lin, J Y Zhou, H G Liu, Y H Gu, X G Huang, D J Sun, X H Yang, L Yang, J M Huo, Z C Chen, W Zhou, P Jiang, H P Tang, R Y Liu, W Zhang, Y Q Chen, Y J Huang, X J Liu, L M Dai, X W Ye, C P Hu, J Zhang, J Y Xu
Objective: To evaluate the changes of asthma control, disease management and perception in recent years in China. Methods: We conducted 2 multi-center, cross-sectional surveys. Outpatient asthmatic patients from 10 cities in mainland China (2007-2008) and 30 central cities from 30 provinces in China (except Tibet)(2015-2016) were recruited respectively. Data of asthma control, disease management and perception from the 2 surveys were compared for 10 cities which took part in both of the 2 surveys. Chi-square test was used for comparison between groups...
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
C T Liu
No abstract text is available yet for this article.
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
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
J T Lin
No abstract text is available yet for this article.
March 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
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