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https://www.readbyqxmd.com/read/29341525/-general-internal-medicine%C3%A2-2017-scientific-breakthroughs-in-ambulatory-care
#1
Alexandre Gouveia, Lionel De Alencastro, Yvonne Fierz, Lionel Koehli, Alexandre Béguelin, Olivier Pasche, Kevin Selby, Patrick Bodenmann
Bariatric surgery improves glycemic control in obese patients with diabetes type 2. Dual antiplatelet therapy can be maintained beyond 12 months after a myocardial infarction. Levothyroxine is not beneficial among patients ≥ 65 years that have subclinical hypothyroidism. Prophylactic anticoagulation in lower limb immobilisation should be reserved only for patients with a high risk of thromboembolism. A diagnosis of asthma should be initially confirmed by a spirometry if clinically suspected. A proton pump inhibitor is indicated for patients ≥ 65 years that are treated with aspirin...
January 17, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29341228/bronchoalveolar-lavage-fluid-neutrophilia-is-associated-with-the-severity-of-pulmonary-lesions-during-equine-asthma-exacerbations
#2
M Bullone, P Joubert, A Gagné, J-Pierre Lavoie, P Hélie
BACKGROUND: The severe form of equine asthma is associated with pathological changes of the peripheral airways and pulmonary parenchyma that are only partly described. Also, the relationship between these structural alterations and the percentage of neutrophils found within the airway lumen, assessed by bronchoalveolar lavage fluid (BALF) cytology, remains ill-defined. OBJECTIVE: To examine the histological lesions associated with equine asthma during disease exacerbation and remission, and their relationship with lung function and BALF neutrophilia...
January 17, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29339129/systemic-reactions-in-pediatric-patients-receiving-standardized-allergen-subcutaneous-immunotherapy-with-and-without-seasonal-dose%C3%A2-adjustment
#3
Sultan Albuhairi, Tatyana Sare, Paul Lakin, Kristel El Khoury, Elena Crestani, Lynda C Schneider, Rocco Anzaldi, Al Patterson, Rima Rachid
BACKGROUND: The 2003 Joint Task Force on Practice Parameters recommended standardizing allergen subcutaneous immunotherapy (SCIT). Data from longitudinal surveillance survey in North America reported a systemic reaction (SR) rate of 0.1% to 0.2% of injection visits. The rate of SR to standardized SCIT in pediatric patients has not been well evaluated. OBJECTIVE: The objective of this study was to evaluate the rate of SRs to standardized SCIT in pediatric patients aged 5 to 18 years in a single tertiary care center in the United States...
January 12, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29338973/asthma-copd-overlap-a-portuguese-survey
#4
E Padrão, D Araújo, A Todo Bom, C Robalo Cordeiro, J Correia de Sousa, J Cardoso, M Morais-Almeida, R Costa, F Pavão, R B Leite, A Marques
INTRODUCTION: The overlap between asthma and chronic obstructive pulmonary disease (COPD) (ACO) has been discussed for many years but clinical recommendations for this entity have been diverse. This study is intended to reach a consensus on diagnosis, treatment and patient orientation for ACO, within the Portuguese medical community. METHODS: This study was conducted by a multidisciplinary panel of experts from three distinct medical specialties (Pulmonology, Family Medicine and Immunoallergology)...
January 12, 2018: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29338960/small-airway-dysfunction-precedes-the-development-of-asthma-in-children-with-allergic-rhinitis
#5
E Skylogianni, M Triga, K Douros, K Bolis, K N Priftis, S Fouzas, M B Anthracopoulos
BACKGROUND: Epidemiological evidence suggests the existence of a direct link between allergic rhinitis (AR) and asthma. Several studies also support the presence of small-airway dysfunction (SAD) in non-asthmatic children with AR. However, it remains unknown whether SAD can predict the progression of AR to asthma. Our objective was to explore the existence of SAD in non-asthmatic children with AR and to assessed its ability to predict the development of asthma. METHODS: Seventy-three 6-year-old children with intermittent moderate-severe AR but without asthma symptoms/medication within the last two years, underwent spirometry and measurement of respiratory resistance (Rrs) and reactance (Xrs) before and after bronchodilation (BD) (300mcg salbutamol)...
January 12, 2018: Allergologia et Immunopathologia
https://www.readbyqxmd.com/read/29337458/-pulmonary-diseases-asthma-copd-and-sleep-apnea-syndrome
#6
Béatrice Duxbury, Émilie Chappuis-Gisin, Salim Chucri, Jean-Paul Janssens
Among the novelties described in the management of pulmonary disorders during the year 2017, we chose to describe three. First, the indication for inhaled glucocorticosteroids (ICS) in COPD has been revisited, because of their relationship with an increased occurence of pneumonia : ICS are now recommended only in severe COPD (GOLD D) with frequent exacerbations as second line treatment. Secondly, azithromycine has shown very promising results in poorly controlled severe asthma, with a significant impact on symptoms and exacerbations...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29337379/interleukin-17a-and-vascular-remodeling-in-severe-asthma-lack-of-evidence-for-a-direct-role
#7
Alice Panariti, Carolyn J Baglole, Veronica Sanchez, David H Eidelman, Sabah Hussain, Ron Olivenstein, James G Martin, Qutayba Hamid
BACKGROUND: Bronchial vascular remodeling may contribute to the severity of airway narrowing through mucosal congestion. Interleukin (IL)-17A is associated with the most severe asthmatic phenotype but whether it might contribute to vascular remodeling is uncertain. OBJECTIVE: To assess vascular remodeling in severe asthma and whether IL-17A directly or indirectly may cause endothelial cell activation and angiogenesis. METHODS: Bronchial vascularization was quantified in asthmatic subjects, COPD and healthy subjects together with the number of IL-17A+ cells as well as the concentration of angiogenic factors in the sputum...
January 16, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29336706/family-caregivers-reported-nonadherence-to-the-controller-medication-of-asthma-in-children-in-casablanca-morocco-extent-and-associated-factors
#8
Sandra Ménard, Jalila Jbilou, Sophie Lauzier
OBJECTIVE: Recent statistics show a relatively high prevalence of asthma among Moroccan children and a weak control over their symptoms. To our knowledge, no research has been carried out to document adherence to the controller treatment in this population. This study aims 1) to assess the extent of children's nonadherence to the controller treatment of asthma in an urban region of Morocco as reported by a family caregiver, and 2) to identify the associated factors. METHODS: We conducted a cross-sectional study among caregivers of asthmatic children (2-12 years old) in different health and education facilities of Casablanca-Settat...
January 16, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29336633/the-relationship-between-asthma-and-depression-in-a-community-based-sample
#9
Mahima Akula, Alexandra Kulikova, David A Khan, E Sherwood Brown
OBJECTIVE: Asthma is an increasingly prevalent disease that is associated with substantial physical and financial burdens. Additionally, asthma is linked to psychiatric disorders. This study examines the relationship between asthma diagnosis, current depressive symptoms, and lifetime psychiatric disorder history in a large, community-based sample. METHODS: We analyzed data from 2168 participants in the Dallas Heart Study, a large, diverse, community-based sample of people designed to be representative of the Dallas County population...
January 16, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29334723/methacholine-bronchial-provocation-test-in-patients-with-asthma-serial-measurements-and-clinical-significance
#10
Hyun-Jung Seo, Pureun-Haneul Lee, Byeong-Gon Kim, Sun-Hye Lee, Jong-Sook Park, Junehyuck Lee, Sung-Woo Park, Do-Jin Kim, Choon-Sik Park, An-Soo Jang
Background/Aims: The methacholine bronchial provocation test (MBPT) is used to detect and quantify airway hyper-responsiveness (AHR). Since improvements in the severity of asthma are associated with improvements in AHR, clinical studies of asthma therapies routinely use the change of airway responsiveness as an objective outcome. The aim of this study was to assess the relationship between serial MBPT and clinical profiles in patients with asthma. Methods: A total of 323 asthma patients were included in this study...
January 17, 2018: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/29334526/airborne-particulate-matter-human-exposure-health-effects
#11
Jonathan E Thompson
OBJECTIVE: Exposure to airborne particulate matter (PM) is estimated to cause millions of premature deaths annually. This work conveys known routes of exposure to PM and resultant health effects. METHODS: Review of available literature. RESULTS: Estimates for daily PM exposure are provided. Known mechanisms by which insoluble particles are transported and removed from the body are discussed. Biological effects of PM, including immune response, cytotoxicity, and mutagenicity are reported...
January 12, 2018: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29334288/targeted-anti-il-13-therapies-in-asthma-current-data-and-future-perspectives
#12
Polyxeni Ntontsi, Evgenia Papathanassiou, Stelios Loukides, Petros Bakakos, Georgios Hillas
Introduction The identification of patients with severe asthma who will benefit from a personalized management approach remains an unmet need. Interleukin-13 (IL-13) is a cytokine possessing a significant role in asthma pathogenesis and progression of disease. Humanised monoclonal antibodies against IL-13 and IL-13 and IL-4 receptors are mainly proposed as add-on therapy in patients with TH2-high inflammation with uncontrolled asthma despite maximum therapy. Areas covered The role of IL-13 in airway inflammation in severe asthma, the targeted anti-IL-13 therapies and biomarkers that predict response to anti-IL-13 treatment are discussed...
January 15, 2018: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/29333826/vitamin-d-deficiency-in-pediatric-clinical-practice
#13
Gustavo Cediel, Johanna Pacheco-Acosta, Carlos CastiUo-Durdn
INTRODUCTION: Vitamin D research suggests it has a role in disorders other than bone metabolism. OBJECTIVE: To update the information on vitamin D deficiency (VDD) in pediatric clinical disorders. METHODS: Search in virtual libraries, giving priority to clinical and longitudinal studies and meta-analyses on VDD in the pediatric age group published in the past 20 years. The terms "vitamin D deficiency", "children and adolescents" (both in Spanish and English) were used as search descriptors...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29332634/reports-of-wheezing-and-of-diagnosed-asthma-are-associated-with-impaired-social-functioning-secondary-analysis-of-the-cross-sectional-world-health-survey-data
#14
Adrian Loerbroks, Jos A Bosch, Aziz Sheikh, Shelby Yamamoto, Raphael M Herr
OBJECTIVE: We sought to investigate whether there are associations between asthma and social functioning in adults from Western and non-Western countries. METHODS: We analyzed data on individuals (94% aged 20+, 52% female) from 50 countries participating in the cross-sectional World Health Survey. We used information on self-reports of wheezing and an asthma diagnosis. Social functioning was defined by reports of severe or extreme difficulties related to personal relationships or participation in the community...
February 2018: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/29331328/pilot-clinical-trial-of-high-flow-oxygen-therapy-in-children-with-asthma-in-the-emergency-service
#15
Yolanda Ballestero, Jimena De Pedro, Nancy Portillo, Otilia Martinez-Mugica, Eunate Arana-Arri, Javier Benito
OBJECTIVES: To assess the efficacy of high-flow nasal cannula (HFNC) oxygen therapy and safety in children with asthma and moderate respiratory failure in the emergency department (ED). STUDY DESIGN: This was a prospective randomized pilot trial of children (aged 1-14 years) presenting to a tertiary academic pediatric ED with moderate-to-severe asthma exacerbations between September 2012 and December 2015. Patients with a pulmonary score (PS) ≥6 or oxygen saturation <94% with a face mask despite initial treatment (salbutamol/ipratropium bromide and corticosteroids) were randomized to HFNC or to conventional oxygen therapy...
January 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29331046/prevalence-severity-and-risk-factors-for-acute-exacerbations-of-nasal-and-sinus-symptoms-by-chronic-rhinosinusitis-status
#16
Jordan R Kuiper, Annemarie G Hirsch, Karen Bandeen-Roche, Agnes S Sundaresan, Bruce K Tan, Robert P Schleimer, Robert C Kern, Walter F Stewart, Brian S Schwartz
BACKGROUND: Nasal and sinus symptoms (NSS) are common to many health conditions, including chronic rhinosinusitis (CRS). Few studies have investigated the occurrence and severity of, and risk factors for, acute exacerbations of NSS (AENSS) by CRS status (current, past, or never met European Position Paper on Rhinosinusitis [EPOS] criteria for CRS). METHODS: Four seasonal questionnaires were mailed to a stratified random sample of Geisinger primary care patients...
January 13, 2018: Allergy
https://www.readbyqxmd.com/read/29331026/the-asthma-rhinitis-multimorbidity-is-associated-with-ige-polysensitization-in-adolescents-and-adults
#17
Valérie Siroux, Natalia Ballardini, Marion Soler, Christian Lupinek, Anne Boudier, Isabelle Pin, Jocelyne Just, Rachel Nadif, Josep M Anto, Erik Melen, Rudolf Valenta, Magnus Wickman, Jean Bousquet
BACKGROUND: Children with multimorbid asthma and rhinitis show IgE polysensitization to several allergen sources. This association remain poorly studied in adolescents and adults using defined allergen molecules. We investigated IgE sensitization patterns towards a broad panel of aeroallergen components in adults and adolescents with a focus on individuals with asthma and rhinitis multimorbidity. METHODS: IgE reactivity to 64 microarrayed aeroallergen molecules was determined with the MeDALL-chip in samples from the French EGEA study (n=840, age=40...
January 13, 2018: Allergy
https://www.readbyqxmd.com/read/29330038/asthmatic-wheezing-phenotypes-in-preschool-children-influential-factors-health-care-and-urban-rural-differences
#18
Susanne Kutzora, Alisa Weber, Stefanie Heinze, Lana Hendrowarsito, Uta Nennstiel-Ratzel, Erika von Mutius, Nina Fuchs, Caroline Herr
BACKGROUND: Different wheezing and asthmatic phenotypes turned out to indicate differences in etiology, risk factors and health care. We examined influential factors and urban-rural differences for different phenotypes. METHODS: Parents of 4732 children filled out a questionnaire concerning children's health and environmental factors administered within the Health Monitoring Units (GME) in a cross-sectional study in Bavaria, Germany (2014/2015). To classify respiratory symptoms, five phenotype groups were built: episodic, unremitting and frequent wheeze, ISAAC (International Study of Asthma and Allergies in Children) - asthma and physician-diagnosed asthma (neither of the groups are mutually exclusive)...
December 24, 2017: International Journal of Hygiene and Environmental Health
https://www.readbyqxmd.com/read/29328889/respiratory-phenotypes-for-preterm-infants-children-and-adults-bronchopulmonary-dysplasia-and-more
#19
Joseph M Collaco, Sharon A McGrath-Morrow
Ongoing advancements in neonatal care since the late 1980's have led to increased numbers of premature infants surviving well beyond the neonatal period. As a result of increased survival, many individuals born preterm manifest chronic respiratory symptoms throughout infancy, childhood and adult life. The archetypical respiratory disease of prematurity, bronchopulmonary dysplasia (BPD), is the second most common chronic pediatric respiratory disease after asthma. However, there are several commonly held misconceptions...
January 12, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29328030/modern-approaches-to-fractional-exhaled-nitric-oxide-as-a-useful-biomarker-for-allergic-asthma-phenotyping-and-management
#20
N Mgaloblishvili, M Gotua
Asthma is a pathologically heterogeneous disease, consisting of several phenotypes. Different types of airway inflammation are the cornerstone feature of this condition. Fraction of nitric oxide in exhaled air (FENO) has been proposed as a noninvasive, specific biomarker for eosinophilic airway inflammation and has been shown to be elevated in patients with allergic asthma phenotype. More recent studies indicate that FeNO identifies T-helper cell type 2 (Th2)-mediated airway inflammation with a high predictive value for identifying inhaled corticosteroid (ICS) responsive airway inflammation...
December 2017: Georgian Medical News
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