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achieving asthma control

Audrey Tilly-Gratton, Alexandrine Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
BACKGROUND: Asthma control remains suboptimal in Canada. Expansion of pharmacist's professional activities offers the opportunity to improve the interdisciplinary management of patients with asthma. OBJECTIVE: The aim of this study was to determine the level of agreement of physicians regarding the expansion of pharmacists' professional activities in the management of asthma patients. METHODS: We conducted a survey of randomly selected Quebec physicians in family medicine, paediatrics and emergency medicine...
October 24, 2016: International Journal of Pharmacy Practice
John Nixon, Paul Newbold, Tomas Mustelin, Gary P Anderson, Roland Kolbeck
Eosinophils have been linked with asthma for more than a century, but their role has been unclear. This review discusses the roles of eosinophils in asthma and chronic obstructive pulmonary disease (COPD) and describes therapeutic antibodies that affect eosinophilia. The aims of pharmacologic treatments for pulmonary conditions are to reduce symptoms, slow decline or improve lung function, and reduce the frequency and severity of exacerbations. Inhaled corticosteroids (ICS) are important in managing symptoms and exacerbations in asthma and COPD...
October 20, 2016: Pharmacology & Therapeutics
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
Patricia D Freitas, Palmira G Ferreira, Aline G Silva, Rafael Stelmach, Regina M Carvalho-Pinto, Frederico L A Fernandes, Marcio C Mancini, Maria N Sato, Milton A Martins, Celso R F Carvalho
RATIONALE: Clinical control is difficult to achieve in obese patients with asthma. Bariatric surgery has been recommended for weight-loss and to improve asthma control; however, the benefits of nonsurgical interventions have been poorly investigated. OBJECTIVE: To examine the effect of exercise training in a weight-loss program on asthma control, quality of life, inflammatory biomarkers and lung function. METHODS: Fifty-five obese patients with asthma were randomly assigned to either a weight-loss program + exercise (WL+E group, n=28) or a weight-loss program + sham (WL+S group, n=27) group, where the weight-loss program included nutrition (caloric restriction) and psychological therapies...
July 19, 2016: American Journal of Respiratory and Critical Care Medicine
Marieke Verkleij, Anita Beelen, Bart E van Ewijk, Rinie Geenen
OBJECTIVE: For children with problematic severe asthma, achieving adequate control of asthma is difficult. The aim of this prospective observational study was to evaluate the effects of intensive multidisciplinary inpatient treatment on multiple outcome variables in children with problematic severe asthma. METHODS: Participants were 89 children with problematic severe asthma (mean age 13.6 ± 2.5 years) treated in tertiary care clinics at high altitude (Switzerland) or sea level (Netherlands) and their parents (85 mothers, 55 fathers)...
October 13, 2016: Pediatric Pulmonology
David B Price, Gene Colice, Elliot Israel, Nicolas Roche, Dirkje S Postma, Theresa W Guilbert, Willem M C van Aalderen, Jonathan Grigg, Elizabeth V Hillyer, Victoria Thomas, Richard J Martin
Asthma management guidelines recommend adding a long-acting β2-agonist (LABA) or increasing the dose of inhaled corticosteroid (ICS) as step-up therapy for patients with uncontrolled asthma on ICS monotherapy. However, it is uncertain which option works best, which ICS particle size is most effective, and whether LABA should be administered by separate or combination inhalers. This historical, matched cohort study compared asthma-related outcomes for patients (aged 12-80 years) prescribed step-up therapy as a ≥50% extrafine ICS dose increase or add-on LABA, via either a separate inhaler or a fine-particle ICS/LABA fixed-dose combination (FDC) inhaler...
April 2016: ERJ Open Research
Hoang Kim Tu Trinh, Ga-Young Ban, Ji-Ho Lee, Hae-Sim Park
Elderly asthma (EA) is regarded as a distinct phenotype of asthma and is associated with age-related changes in airway structure and alterations in lung function and immune responses. EA is difficult to diagnose because of aging and co-morbidities, and overlaps with fixed airway obstructive disease. Novel modalities to differentiate between EA and chronic obstructive pulmonary disease (COPD) are necessary. A multifaceted approach, including clinical history, smoking habits, atopy, and measurement of lung function, is mandatory to differentiate asthma from COPD...
October 6, 2016: Drugs & Aging
Ola A Dabbous, Mona M Soliman, Nagwa H Mohamed, Magda Y Elseify, Mai S Elsheikh, Asmaa A A Alsharkawy, Manal M Abd Al Aziz
Variable therapy of asthma is not sufficient yet to achieve good asthma control. Therapy decision requires serial investigations. Low-level laser acupuncture is a suitable non-invasive modality of complementary medicine. The exhaled breath condensate (EBC) is easy and useful to evaluate the efficacy of drugs or novel therapy. This study aimed to evaluate the effectiveness of low-level laser biostimulation of acupuncture points on asthma improvement in children. Forty-eight asthmatic children were subdivided into case (laser) group, which received 12 direct contact low-power laser acupuncture sessions (three sessions/week) on specific traditional Chinese acupuncture points for bronchial asthma, and control asthmatic group, which received sham laser acupuncture on the same acupoints and number of sessions of the case (laser) group...
October 5, 2016: Lasers in Medical Science
Lia Jahedi, Sue R Downie, Bandana Saini, Hak-Kim Chan, Sinthia Bosnic-Anticevich
BACKGROUND: Correct inhaler technique can increase medication efficacy, reducing both dose and side effects. Patient preference for inhaler device has not been fully explored, and we hypothesized that if patients have a preference and can choose their inhaler, they might be more likely to use it correctly. Our aim was to determine the preferences, attitudes, and perceptions of patients with asthma toward their inhalers, and to evaluate whether any of these factors were related to inhalation technique...
September 27, 2016: Journal of Aerosol Medicine and Pulmonary Drug Delivery
Mandeep Singh, Nitesh Gupta, Raj Kumar
INTRODUCTION: The study aimed to compare the effect of obesity with and without metabolic syndrome on asthma severity, quality of life, sleep quality, sleep disordered breathing and inflammatory markers as compared to non-obese asthma patients. MATERIAL AND METHODS: 60 asthma patients recruited for the study were divided equally into non-obese (NOA), obese without metabolic syndrome (OANMS) and obese with metabolic syndrome (OAMS) groups. Study cohorts were assessed for severity of asthma, quality of life and quality of sleep using questionnaires and inflammatory markers (FENO, hs-CRP, IL-5, IL-6 and leptin)...
2016: Pneumonologia i Alergologia Polska
Pierre Le Cann, Hélène Paulus, Philippe Glorennec, Barbara Le Bot, Sophie Frain, Jean Pierre Gangneux
Home health care workers interventions have been implemented in western countries to improve health status of patients with respiratory diseases especially asthma and allergic illnesses. Twenty-six controlled studies dealing with prevention and control of these diseases through home environmental interventions were reviewed. After a comprehensive description of the characteristics of these studies, the effectiveness of each intervention was then evaluated in terms of participants' compliance with the intervention program, improvement of quality of the indoor environment, and finally improvement of health outcomes, in detailed tables...
September 21, 2016: Journal of Allergy and Clinical Immunology in Practice
Anne M Fitzpatrick, Susan T Stephenson, Milton R Brown, Khristopher Nguyen, Shaneka Douglas, Lou Ann S Brown
BACKGROUND: Severe asthma in children is a heterogeneous disorder associated with variable responses to corticosteroid treatment. Criterion standards for corticosteroid responsiveness assessment in children are lacking. OBJECTIVE: This study sought to characterize systemic corticosteroid responses in children with severe asthma after treatment with intramuscular triamcinolone and to identify phenotypic and molecular predictors of an intramuscular triamcinolone response...
September 21, 2016: Journal of Allergy and Clinical Immunology in Practice
Mariel G Slater, Ian D Pavord, Dominick E Shaw
Many people with asthma do not achieve disease control, despite bronchodilators and inhaled corticosteroid therapy. People with uncontrolled asthma are at higher risk of an asthma attack and death, with mortality rates estimated at 1000 deaths/year in England and Wales. The recent National Review of Asthma Deaths (NRAD) report, 'Why asthma still kills', recommended that patients at step 4 or 5 of the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN) guidance must be referred to a specialist asthma service...
2016: BMJ Open Respiratory Research
Wei-Jei Lee
Obesity is a pan-endemic health problem in both developed and developing countries, in both western and eastern countries. It increases risk for many common diseases, including type 2 diabetes, dyslipidemia, hypertension, obstructive sleep apnea, heart disease, stroke, asthma, osteoarthritis, cancers and depression etc.. Although the incidence of obesity in Asia is relatively low, Asian patients tend to have similar incidence of obesity related metabolic syndrome at lower BMI level comparing to Caucasians because of central obesity...
September 2016: Journal of Hypertension
Nathan P Falk, Scott W Hughes, Blake C Rodgers
Chronic asthma is a major health concern for children and adults worldwide. The goal of treatment is to prevent symptoms by reducing airway inflammation and hyperreactivity. Step-up therapy for symptom control involves initiation with low-dose treatment and increasing intensity at subsequent visits if control is not achieved. Step-down therapy starts with a high-dose regimen, reducing intensity as control is achieved. Multiple randomized controlled trials have shown that inhaled corticosteroids are the most effective monotherapy...
September 15, 2016: American Family Physician
Jai Bharat Mullerpattan, Zarah Zarir Udwadia, Sushil S Kathar, Hardik D Shah, Sarthak Ashok Rastogi, Kamlesh V Pandey, Zarir Farokh Udwadia
INTRODUCTION: The proper use of inhalers is essential for ensuring proper control of the disease. Various studies have shown high levels of improper use and lack of knowledge of the correct technique among patients with asthma. However, less data are available on how health care workers (HCW's) use inhalers. MATERIALS AND METHODS: The study was conducted at a Tertiary Care Hospital in Mumbai. We evaluated the pMDI technique in 141 consecutive adult asthmatics and 100 HCW's...
September 2016: Lung India: Official Organ of Indian Chest Society
Jay M Portnoy, Morgan Waller, Stephen De Lurgio, Chitra Dinakar
BACKGROUND: Access to asthma specialists is a problem, particularly in rural areas, thus presenting an opportunity for management using telemedicine. OBJECTIVE: To compare asthma outcomes during 6 months in children managed by telemedicine vs in-person visits. METHODS: Children with asthma residing in 2 remote locations were offered the choice of an in-person visit or a telemedicine session at a local clinic. The telemedicine process involved real-time use of a Remote Presence Solution (RPS) equipped with a digital stethoscope, otoscope, and high-resolution camera...
September 2016: Annals of Allergy, Asthma & Immunology
Feride Taşkın Yılmaz, Sezgi Çınar, Adnan Yılmaz, Azime Karakoç Kumsar
BACKGROUND: Asthma is a chronic disease which is prevalent throughout the world. Physical problems such as deterioration in oral health, which may occur due to the triggering factors of asthma as well as the ineffective use of asthma medicine, seem to affect the daily lives of asthma patients. Therefore, it is important to protect oral health and promote positive behavior changes in asthma patients in order to achieve effective treatment and asthma control. AIMS: The present study aimed to determine the effects of a training program provided for asthma patients on oral health, inhaler use skills, and behavior change...
July 2016: Balkan Medical Journal
Laurent Laforest, Manon Belhassen, Gilles Devouassoux, Alain Didier, Marine Ginoux, Eric Van Ganse
BACKGROUND: Although the use of inhaled corticosteroids (ICS) in asthma is known to be overall erratic, the long-term use of ICS by patients selected during an episode of regular use is poorly documented. OBJECTIVE: In a cohort of patients with asthma regularly acquiring ICS therapy over several months, we verified whether these patients remained treated in the following 12 months. The correlates of regular ICS use over this period were investigated. METHODS: A historical cohort of patients with asthma was identified from the Echantillon généraliste de bénéficiaires national French health care reimbursement data (2007-2012)...
September 2016: Journal of Allergy and Clinical Immunology in Practice
Miguel Tortajada-Girbés, Miriam Moreno-Prat, David Ainsa-Laguna, Silvia Mas
BACKGROUND: Spontaneous pneumomediastinum (SPM) is an uncommon disorder. It is rarely reported in paediatric patients and may be accompanied by subcutaneous emphysema. It is usually benign and self-limiting, with only supportive therapy being needed, but severe cases may require invasive measures. Asthma exacerbations have classically been described as a cause of SPM. However, detailed descriptions in asthmatic children are scarce. We aimed at improving the current understanding of the features of SPM and subcutaneous emphysema, and outcomes, by means of a case report and a systematic review...
October 2016: Therapeutic Advances in Respiratory Disease
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