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asthma crises

Alexis Leonard, Nihal Godiwala, Nicole Herrera, Robert McCarter, Matthew Sharron, Emily Riehm Meier
Acute chest syndrome (ACS) is a leading cause of mortality in patients with sickle cell disease (SCD). Systemic corticosteroids decrease ACS severity, but the risk of readmission for vaso-occlusive crises (VOC) has limited their use. The efficacy of inhaled corticosteroids (ICS) as a safer alternative is currently unknown. An observational, historic cohort study compared patients with SCD with ACS who received ICS at admission (ICS) to those who did not (non-ICS). Outcome measures included rates of transfusion, oxygen requirement, BiPAP initiation, PICU transfer, intubation, readmission, hospital cost, and length of stay...
July 2018: Blood Cells, Molecules & Diseases
Shilpa Jain, Nitya Bakshi, Lakshmanan Krishnamurti
Acute chest syndrome (ACS) is a frequent cause of acute lung disease in children with sickle cell disease (SCD). Patients may present with ACS or may develop this complication during the course of a hospitalization for acute vaso-occlusive crises (VOC). ACS is associated with prolonged hospitalization, increased risk of respiratory failure, and the potential for developing chronic lung disease. ACS in SCD is defined as the presence of fever and/or new respiratory symptoms accompanied by the presence of a new pulmonary infiltrate on chest X-ray...
December 1, 2017: Pediatric Allergy, Immunology, and Pulmonology
Andrea E Cassidy-Bushrow, Alexandra R Sitarik, Suzanne Havstad, Sung Kyun Park, Lawrence F Bielak, Christine Austin, Christine Cole Johnson, Manish Arora
BACKGROUND: Recent public health lead crises in urban areas emphasize the need to better understand exposure to environmental toxicants, particularly in higher risk groups. Although African-American children have the highest prevalence of elevated blood lead levels in the United States, little is known about when this trajectory of disproportionate burden of lead exposure first emerges. OBJECTIVES: Using tooth-matrix biomarkers that directly measure fetal and early childhood metal levels, the primary goal of this study was to determine if there were racial disparities in lead levels during fetal development and early childhood...
November 2017: Environment International
Pascale Amberger
The paradoxical vocal fold motion (PVFM) is a temporary total inability to breathe, which is important to rule out from other more or less important breathing difficulties encountered in asthma. Overtreatment for asthma instead of treatment for PVFM can lead to iatrogenic complications which can be averted by early and correct diagnosis. This article presents a list of symptoms and related disorders, enabling to more easily diagnose PVFM, as well as its specifics treatments and a « Block-unblock maneuver » not yet described in the literature, allowing the patient to respond to the crisis and to prevent future crises...
August 9, 2017: Revue Médicale Suisse
Htoo Htoo Kyaw Soe, Adinegara Bl Abas, Nan Nitra Than, Han Ni, Jaspal Singh, Abdul Razzak Bin Mohd Said, Ifeyinwa Osunkwo
BACKGROUND: Sickle cell disease is a genetic chronic haemolytic and pro-inflammatory disorder. The clinical manifestations of sickle cell disease result from the presence of mutations on the beta globin genes that generate an abnormal haemoglobin product (called haemoglobin S) within the red blood cell. Sickle cell disease can lead to many complications such as acute chest syndrome, stroke, acute and chronic bone complications (including painful vaso-occlusive crisis, osteomyelitis, osteonecrosis and osteoporosis)...
January 20, 2017: Cochrane Database of Systematic Reviews
Brennan C Kahan
BACKGROUND: Patient recruitment in clinical trials is often challenging, and as a result, many trials are stopped early due to insufficient recruitment. The re-randomization design allows patients to be re-enrolled and re-randomized for each new treatment episode that they experience. Because it allows multiple enrollments for each patient, this design has been proposed as a way to increase the recruitment rate in clinical trials. However, it is unknown to what extent recruitment could be increased in practice...
December 13, 2016: Trials
Zeina A Salman, Meaad K Hassan
Objectives. Despite improvements in the management of sickle cell disease (SCD), many patients still experience disease-related complications requiring hospitalizations. The objectives of this study were to identify causes of hospitalization among these patients and factors associated with the length of hospital stay (LOS) and readmission. Methods. Data from 160 patients (<14 years old) with SCD who were admitted to the Basra Maternity and Children's Hospital from the first of January 2012 through July 2012 were analyzed...
2015: Anemia
Vishnu Sannarangappa, Ryan Jalleh
Inhaled corticosteroids (ICS) have been used as first line treatment of asthma for many decades. ICS are a form of exogenous glucocorticosteroids that can suppress the endogenous production of glucocorticosteroids, a condition known as adrenal suppression (AS). As a result, cessation, decreasing the dose or changing the type of ICS may trigger features of adrenal insufficiency (AI). AI may cause a spectrum of presentations varying from vague symptoms of fatigue to potentially life threatening acute adrenal crises...
2014: Open Respiratory Medicine Journal
Julia B Nath, Renee Y Hsia
OBJECTIVES: Although the emergency department (ED) provides essential care for severely ill or injured children, past research has shown that children often visit the ED for potentially preventable illnesses, including asthma. We sought to determine how children's rate of ED visits for asthma has changed over the last decade and to analyze what factors are associated with a child's potentially preventable ED visit for asthma. METHODS: We retrospectively analyzed ED visits by children aged 2 to 17 from 2001 to 2010 using data from the National Hospital Ambulatory Medical Care Survey...
March 2015: Academic Pediatrics
F C Werhmeister, B P Nunes, C Loret de Mola, N Gómez-Cofré, P D de Oliveira, P L Marco, M C F Assunção, H Gonçalves, B L Horta, A M B Menezes
Previous studies have suggested an association between maternal smoking during pregnancy and asthma symptoms such as wheezing during childhood. However, few have evaluated this association in adolescence, especially in populations with high prevalence of wheezing as in Brazil. Using the 1993 Pelotas birth cohort, a longitudinal study set in southern Brazil of 5249 urban live births, we aimed to evaluate the association between maternal and the partner's smoking during pregnancy and wheezing at 11 and 15 years of age...
June 2015: Journal of Developmental Origins of Health and Disease
Amanda Pinter Carvalheiro da Silva, Valdir Tercioti-Junior, Luiz Roberto Lopes, João de Souza Coelho-Neto, Laura Bertanha, Paulo Rodrigo de Faria Rodrigues, Nelson Adami Andreollo
BACKGROUND: Asthma, laryngitis and chronic cough are atypical symptoms of the gastroesophageal reflux disease. AIM: To analyze the efficacy of laparoscopic surgery in the remission of extra-esophageal symptoms in patients with gastroesophageal reflux, related to asthma. METHODS: Were reviewed the medical records of 400 patients with gastroesophageal reflux disease submitted to laparoscopic Nissen fundoplication from 1994 to 2006, and identified 30 patients with extra-esophageal symptoms related to asthma...
April 2014: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
V Julian, B Pereira, A Labbé, F Amat
INTRODUCTION: The frequency of emergency department visits for asthma is a major public health problem in pediatrics. The aim of this study is to establish the characteristics of children visiting pediatric emergency departments for acute asthma and to assess their therapeutic management prior to admission. METHODS: A prospective clinical study performed during 3 months at the pediatric emergency department of the university teaching hospital of Clermont-Ferrand, of children aged 1 to 16 years admitted to the department with a clinical diagnosis of asthma exacerbation...
January 2014: Revue des Maladies Respiratoires
Esteban Gomez, Claudia R Morris
Asthma is a common comorbid factor in sickle cell disease (SCD). However, the incidence of asthma in SCD is much higher than expected compared to rates in the general population. Whether "asthma" in SCD is purely related to genetic and environmental factors or rather is the consequence of the underlying hemolytic and inflammatory state is a topic of recent debate. Regardless of the etiology, hypoxemia induced by bronchoconstriction and inflammation associated with asthma exacerbations will contribute to a cycle of sickling and subsequent complications of SCD...
2013: BioMed Research International
Gimol Benzaquen Perosa, Isabel de Andrade Amato, Ligia Maria S S Rugolo, Giesela Fleisher Ferrari, Maria Carolina F A de Oliveira
OBJECTIVE: To evaluate the quality of life of asthmatic children and adolescents, its relation with sociodemographic and clinical variables, and maternal coping strategies. METHODS: Cross-sectional study in which children and adolescents with asthma answered a quality of life questionnaire, and their mothers did the same with a coping scale. RESULTS: Out of the 42 children and adolescents investigated, 74% were classified as having mild/severe persistent asthma; 19%, mild persistent asthma; and 7%, intermittent asthma...
June 2013: Revista Paulista de Pediatria: Orgão Oficial da Sociedade de Pediatria de São Paulo
Maria Theodoratou-Bekou, Ourania Andreopoulou, Panoraia Andriopoulou, Beatrice Wood
This paper applies the Biobehavioral Family Model (BBFM) of stress- related illness to the study and treatment of an adolescent with intractable asthma. The model is described, along with supportive research findings. Then a case study is presented, demonstrating how the model is clinically applied. We tell the story of an asthmatic adolescent presenting for therapy due to her intense asthmatic crises, and the case is presented to exemplify how the BBFM can help understand the family-psychobiological contribution to exacerbation of disease activity, and therefore guide treatment towards the amelioration of severe physical symptoms...
November 13, 2012: Annals of General Psychiatry
J Christian Virchow
Asthma is a chronic inflammatory condition affecting up to 10% of all women of child-bearing age. In most patients asthma can be safely treated during pregnancy. However, asthma crises or exacerbations during pregnancy can be life threatening to both the mother and the child. Uncontrolled asthma has been associated with adverse pregnancy outcomes and adverse effects to the fetus (eg, prematurity, low birth weight, increased risk of congenital malformations). Impaired oxygenation during asthma crisis in pregnancy is a major concern...
December 2012: Seminars in Respiratory and Critical Care Medicine
Christopher J Bean, Sheree L Boulet, Dorothy Ellingsen, Meredith E Pyle, Emily A Barron-Casella, James F Casella, Amanda B Payne, Jennifer Driggers, Heidi A Trau, Genyan Yang, Kimberly Jones, Solomon F Ofori-Acquah, W Craig Hooper, Michael R DeBaun
Sickle cell disease is a common hemolytic disorder with a broad range of complications, including vaso-occlusive episodes, acute chest syndrome (ACS), pain, and stroke. Heme oxygenase-1 (gene HMOX1; protein HO-1) is the inducible, rate-limiting enzyme in the catabolism of heme and might attenuate the severity of outcomes from vaso-occlusive and hemolytic crises. A (GT)(n) dinucleotide repeat located in the promoter region of the HMOX1 gene is highly polymorphic, with long repeat lengths linked to decreased activity and inducibility...
November 1, 2012: Blood
Valdecir C Galindo-Filho, Daniella C Brandão, Rita de Cássia S Ferreira, Maria José C Menezes, Paulo Almeida-Filho, Verônica F Parreira, Tayse N Silva, Maria da Glória Rodrigues-Machado, Elizabeth Dean, Armèle Dornelas de Andrade
BACKGROUND: Despite the clinical improvements attributed to noninvasive ventilation (NIV) during asthma crises, and the well established effects of nebulization, there are few studies on the effects of these interventions together. We hypothesized that nebulization coupled to NIV should raise radio-aerosol pulmonary deposition in asthmatics. The aims of this study were to assess the effects of coupling β-agonist nebulization and NIV during asthma exacerbations on radio-aerosol pulmonary deposition, using scintigraphy and cardiopulmonary parameters, to correlate pulmonary function with radio-aerosol deposition index, radio-aerosol penetration index, and pulmonary clearance...
February 2013: Respiratory Care
Irina Bobolea, Daiana Guillén, Pilar Barranco, Cristina Alvarez-Escola, Santiago Quirce
We report on a 24-year-old male, with exercise-induced asthma and intermittent abdominal pain since puberty, who suffered from recurrent anaphylactic reactions. He also complained of occasional headaches. After extensive studies he was eventually diagnosed with idiopathic anaphylaxis, once the following diagnoses had been excluded: allergic origin [foods (including ω5-gliadin), latex and drugs], hydatidosis, carcinoid syndrome, systemic mastocytosis, autonomic epilepsy, hereditary angioedema, pheocromocitoma, Meckel diverticle, medullar thyroid carcinoma, leukemia, hyper-IgE and hypereosinophilic syndromes...
2012: International Archives of Allergy and Immunology
E Kathryn Miller, Johanna Zea Hernandez, Vera Wimmenauer, Bryan E Shepherd, Diego Hijano, Romina Libster, M Elina Serra, Niranjan Bhat, Juan P Batalle, Yassir Mohamed, Andrea Reynaldi, Andrea Rodriguez, Monica Otello, Nestor Pisapia, Jimena Bugna, Miguel Bellabarba, David Kraft, Silvina Coviello, F Martin Ferolla, Aaron Chen, Stephanie J London, George K Siberry, John V Williams, Fernando P Polack
RATIONALE: Human rhinoviruses (HRV) are the leading cause of upper respiratory infections and have been postulated to trigger asthma exacerbations. However, whether HRV are detected during crises because upper respiratory infections often accompany asthma attacks, or because they specifically elicit exacerbations, is unclear. Moreover, although several hypotheses have been advanced to explain virus-induced exacerbations, their mechanism remains unclear. OBJECTIVES: To determine the role of HRV in pediatric asthma exacerbations and the mechanisms mediating wheezing...
March 1, 2012: American Journal of Respiratory and Critical Care Medicine
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