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https://www.readbyqxmd.com/read/29720013/general-practitioners-experiences-of-asthma-management-in-culturally-and-linguistically-diverse-populations
#1
Reem Alzaye, Betty Bouad Chaar, Iman A Basheti, Bandana Saini
OBJECTIVE:  The purpose of this study was to explore General Practitioners' experiences and perspectives about asthma management of culturally and linguistically diverse (CALD) people with asthma, particularly with reference to Arabic speaking patients with low English proficiency (LEP). METHODS:  Semi-structured interviews guided by an interview protocol were conducted with general practitioners who deal with CALD patients with asthma. Participants were recruited from medical practices in Melbourne, Australia...
May 3, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29700091/diagnosis-and-treatment-of-severe-asthma-a-phenotype-based-approach
#2
Thomas L Jones, Daniel M Neville, Anoop J Chauhan
Severe asthma is a heterogeneous and often difficult to treat condition that results in a disproportionate cost to healthcare systems. Appropriate diagnosis and management of severe asthma is critical, as most asthma deaths have been retrospectively identified as having poorly recognised severe asthma. With multiple biologic agents becoming available, it is crucial to correctly phenotype patients in order to identify those that will respond to these high-cost treatments. We provide an overview of the assessment, phenotyping and management of severe asthma in primary and secondary care...
April 1, 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29584459/perimenstrual-asthma-report-of-a-case-with-therapeutic-intervention-of-oral-prednisone
#3
Zhang Lei, Deng Yanhan, Wang Yi, Xiong Shengdao, Xiong Weining
INTRODUCTION: Many asthmatic women of childbearing age experience cyclical aggravation of asthmatic symptoms during the perimenstrual period, or perimenstrual asthma (PMA). PMA is considered to be a difficult-to-treat asthma phenotype; conventional asthma therapies are not always effective against PMA. CASE STUDY: We report a case of a 27-year-old female with PMA who had received standard asthma treatment since 2013. RESULT: The patient showed a dramatic response to therapeutic intervention of oral prednisone, taken for 7 days prior to menstruation each month, in a dose-dependent manner...
March 27, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29554826/reslizumab-in-the-treatment-of-severe-eosinophilic-asthma-an-update
#4
Garry M Walsh
A marked heterogeneity is exhibited by asthma both clinically and at the molecular level with different phenotypes driven by diverse mechanistic pathways that require specifically targeted treatments. Biologics aimed at IL-4/13, IL-5 or IgE are proven or potentially effective treatments for patients with difficult to treat eosinophilic asthma. Importantly, it is now widely accepted that biologic-based therapies give significant clinical improvements in those patient populations where asthma phenotypes are taken into account...
March 20, 2018: Immunotherapy
https://www.readbyqxmd.com/read/29553094/role-of-regulatory-t-cells-in-airway-inflammation-in-asthma
#5
Tomotaka Kawayama, Takashi Kinoshita, Kazuko Matsunaga, Yoshiko Naito, Jun Sasaki, Yoshikazu Tominaga, Tomoaki Hoshino
Asthma is an allergic disease characterized by chronic airway inflammation, airway hyperresponsiveness (AHR), reversibility and remodeling. Inhaled corticosteroids (ICS) are effective in many patients with asthma. However, ICS are a controlling, but not but curative treatment, and there are still many patients with refractory and difficult-to-treat asthma. The evaluation of airway inflammation by induced sputum, non-specific AHR by methacholine, and asthmatic reactions by specific allergen challenge techniques are useful not only to investigate the pathogenesis of asthma but also to help develop new drugs for asthma management...
March 16, 2018: Kurume Medical Journal
https://www.readbyqxmd.com/read/29535852/nordic-consensus-statement-on-the-systematic-assessment-and-management-of-possible-severe-asthma-in-adults
#6
REVIEW
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
https://www.readbyqxmd.com/read/29531957/an-algorithmic-approach-for-the-treatment-of-severe-uncontrolled-asthma
#7
REVIEW
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
https://www.readbyqxmd.com/read/29496715/lung-disease-and-genomics
#8
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
https://www.readbyqxmd.com/read/29484869/-diagnosis-and-treatment-of-bronchiectasis-position-paper-of-the-israeli-pulmonology-society-and-the-israeli-pediatric-pulmonology-society
#9
Michal Shteinberg, Emilia Hardak, Matthew Koslow, Dario Prais, Malena Cohen-Cymberkno, David Shoseyov, Adi Dagan, Yochai Adir, David Shitrit
Bronchiectasis is anatomically defined by irreversible distortion of the bronchi. Clinically, its manifestations are cough with sputum production and a predisposition to pulmonary infections. Unlike asthma and COPD, where ample clinical data are present regarding the course and effective treatment, knowledge of bronchiectasis has yet to evolve. Lately, bronchiectasis is gaining renewed attention among the medical community, with growing basic and clinical research-based data. In Israel, no registered treatments exist for bronchiectasis, which makes it difficult to treat these patients...
February 2018: Harefuah
https://www.readbyqxmd.com/read/29484838/efficacy-cost-effectiveness-and-sustainability-of-a-pediatric-high-risk-asthma-clinic
#10
Nadia L Krupp, Andrea Weist, Cindy D Fiscus, James Slaven, Andrew Harner, Gregory S Montgomery, Michelle S Howenstine
AIM: At our institution, a pediatric High Risk Asthma clinic has been in operation for over 15 years, targeting children with poorly controlled, and difficult to treat asthma. This study evaluates the outcomes and cost-effectiveness of the High Risk Asthma clinic from 2000 through 2014. METHODS: A retrospective chart review was performed on all patients entering High Risk Asthma clinic from 2000-2014, and total hospitalizations and Emergency Department visits were tallied for the year prior to entering clinic and the year after...
May 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29466963/pediatric-severe-asthma-a-case-series-report-and-perspectives-on-anti-ige-treatment
#11
Virginia Mirra, Silvia Montella, Francesca Santamaria
BACKGROUND: The primary goal of asthma management is to achieve disease control for reducing the risk of future exacerbations and progressive loss of lung function. Asthma not responding to treatment may result in significant morbidity. In many children with uncontrolled symptoms, the diagnosis of asthma may be wrong or adherence to treatment may be poor. It is then crucial to distinguish these cases from the truly "severe therapy-resistant" asthmatics by a proper filtering process...
February 21, 2018: BMC Pediatrics
https://www.readbyqxmd.com/read/29427989/diagnosis-and-management-of-severe-asthma
#12
Kian Fan Chung
Severe therapy-resistant asthma has been defined as "asthma which requires treatment with high dose inhaled corticosteroids (ICSs) plus a second controller (and/or systemic corticosteroids) to prevent it from becoming 'uncontrolled' or which remains 'uncontrolled' despite this therapy". Patients who usually present with 'difficult-to-treat asthma' should first be assessed to determine whether he/she has asthma with the exclusion of other diagnoses and if so, whether the asthma can be classified as severe therapy-resistant...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29427984/controlling-the-risk-domain-in-pediatric-asthma-through-personalized-care
#13
William C Anderson, Stanley J Szefler
Strategies to control the risk domain of NHLBI EPR-3 (National Heart, Lung, and Blood Institute Expert Panel Report-3) asthma guidelines, which includes exacerbations requiring systemic corticosteroids, reduction in lung growth, and progressive loss of lung function, and treatment-related adverse effects, are evolving in children and adolescents. Increasing evidence demonstrates that children and adolescents with asthma are at risk of a reduction in lung growth, leading to lower lung function and potentially chronic obstructive pulmonary disease as adults...
February 2018: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29414651/high-fat-diet-induces-airway-hyperresponsiveness-partly-through-activating-cd38-signaling-pathway
#14
Lei Chong, Weixi Zhang, Gang Yu, Hailin Zhang, Lili Zhu, Haiyan Li, Youyou Shao, Changchong Li
CD38 is a plasma membrane bound multifunctional enzyme. It can be activated by inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-13, inducing calcium responses to agonist in airway smooth muscle cells (ASMC). Previous studies have found that high-fat-diet (HFD) induced obesity exhibited innate airway hyperresponsiveness (AHR). This study aimed to detect the effect of CD38 signaling pathway on the AHR of overweight/obese mice. The HFD-fed mice exhibited a significantly higher baseline airway resistance (Rn), and the increasing rates of Rn responded to increasing doses of methacholine compared with the LFD-fed mice...
March 2018: International Immunopharmacology
https://www.readbyqxmd.com/read/29401500/mobile-direct-observation-of-therapy-mdot-a-rapid-systematic-review-and-pilot-study-in-children-with-asthma
#15
REVIEW
Michael D Shields, Fahad ALQahtani, Michael P Rivey, James C McElnay
We describe, for the first time, the use of a mobile device platform for remote direct observation of inhaler use and technique. The research programme commenced with a rapid systematic review of mobile device (or videophone) use for direct observation of therapy (MDOT). Ten studies (mainly pilots) were identified involving patients with tuberculosis, sickle cell disease and Alzheimer's disease. New studies are ongoing (ClinicalTrials.gov website) in TB, stroke, sickle cell disease, HIV and opioid dependence...
2018: PloS One
https://www.readbyqxmd.com/read/29374455/how-patient-participation-was-used-to-develop-a-questionnaire-that-is-fit-for-purpose-for-assessing-quality-of-life-in-severe-asthma
#16
Michael E Hyland, Joseph W Lanario, Jill Pooler, Matthew Masoli, Rupert C Jones
BACKGROUND: Previous research shows that existing asthma quality of life questionnaires fail to measure the burden of oral corticosteroids that can be used to treat severe asthma, and are therefore not fit for purpose for severe asthma according to the USA's Federal Drug Authority's (FDA) criteria for content validity. Patient input and documentation of that input is key to achieving content validity according to FDA guidelines. This paper describes the process of constructing a new questionnaire to measure the burden of asthma symptoms and burden of treatment in severe asthma, using criteria specified by the FDA...
January 27, 2018: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29227721/chinese-guidelines-for-childhood-asthma-2016-major-updates-recommendations-and-key-regional-data
#17
Jianguo Hong, Yixiao Bao, Aihuan Chen, Changchong Li, Li Xiang, Chuanhe Liu, Zhimin Chen, Deyu Zhao, Zhou Fu, Yunxiao Shang
OBJECTIVE: With increased industrialization and urbanization in China, pediatric asthma is becoming more prevalent. Despite a growing body of evidence, there remains a significant unmet need for adequate management of childhood asthma. The Subspecialty Group of Respiratory Diseases of the Society of Pediatrics, the Chinese Medical Association, and the editorial board of the Chinese Journal of Pediatrics have recently updated the "Guidelines for diagnosis and optimal management of asthma in children," first published in 2008...
December 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29220200/a-practical-approach-to-severe-asthma-in-children
#18
Emily E Barsky, Lauren M Giancola, Sachin N Baxi, Jonathan M Gaffin
Severe asthma accounts for only a small proportion of the children with asthma but a disproportionately high amount of resource utilization and morbidity. It is a heterogeneous entity and requires a step-wise, evidence-based approach to evaluation and management by pediatric subspecialists. The first step is to confirm the diagnosis by eliciting confirmatory history and objective evidence of asthma and excluding possible masquerading diagnoses. The next step is to differentiate difficult-to-treat asthma, asthma that can be controlled with appropriate management, from asthma that requires the highest level of therapy to maintain control or remains uncontrolled despite management optimization...
April 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29206634/long-term-real-life-safety-of-omalizumab-in-patients-with-severe-uncontrolled-asthma-a-nine-year-study
#19
Danilo Di Bona, Irene Fiorino, Marialuisa Taurino, Flavia Frisenda, Elena Minenna, Carlo Pasculli, Georgios Kourtis, Anna Simona Rucco, Andrea Nico, Marcello Albanesi, Lucia Giliberti, Luciana D'Elia, Maria Filomena Caiaffa, Luigi Macchia
BACKGROUND: Randomized Controlled Trials showed that omalizumab exhibited a good safety and tolerability profile in patients with moderate-to-severe asthma. However, safety data of long-term treatment with omalizumab are scarce. Our aim was to assess the safety of omalizumab in patients under long-term treatment in a real-life setting. METHODS: Difficult-to-control asthmatic patients treated with omalizumab up to 9 years were retrospectively evaluated. Mild to severe adverse events any and reasons for discontinuation were recorded...
September 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/29182799/inhaled-magnesium-sulfate-in-the-treatment-of-acute-asthma
#20
REVIEW
Rachel Knightly, Stephen J Milan, Rodney Hughes, Jennifer A Knopp-Sihota, Brian H Rowe, Rebecca Normansell, Colin Powell
BACKGROUND: Asthma exacerbations can be frequent and range in severity from mild to life-threatening. The use of magnesium sulfate (MgSO₄) is one of numerous treatment options available during acute exacerbations. While the efficacy of intravenous MgSO₄ has been demonstrated, the role of inhaled MgSO₄ is less clear. OBJECTIVES: To determine the efficacy and safety of inhaled MgSO₄ administered in acute asthma. SPECIFIC AIMS: to quantify the effects of inhaled MgSO₄ I) in addition to combination treatment with inhaled β₂-agonist and ipratropium bromide; ii) in addition to inhaled β₂-agonist; and iii) in comparison to inhaled β₂-agonist...
November 28, 2017: Cochrane Database of Systematic Reviews
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