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https://www.readbyqxmd.com/read/29316003/pathophysiology-of-severe-asthma-we-ve-only-just-started
#1
REVIEW
Gregory G King, Alan James, Louise Harkness, Peter A B Wark
Severe asthma is defined by the high treatment requirements to partly or fully control the clinical manifestations of disease. It remains a problem worldwide with a large burden for individuals and health services. The key to improving targeted treatments, reducing disease burden and improving patient outcomes is a better understanding of the pathophysiology and mechanisms of severe disease. The heterogeneity, complexity and difficulties in undertaking clinical studies in severe asthma remain challenges to achieving better understanding and better outcomes...
January 9, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29315966/new-and-emerging-drug-treatments-for-severe-asthma
#2
S Diver, R J Russell, C Brightling
Asthma is a common chronic inflammatory condition of the airways affecting over 300 million people worldwide. In 5-10% of cases it is severe, with disproportionate healthcare resource utilisation including costs associated with frequent exacerbations and the long-term health effects of systemic steroids. Characterisation of inflammatory pathways in severe asthma has led to development of targeted biological and small molecule therapies which aim to achieve disease control whilst minimising corticosteroid-associated morbidity...
January 8, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29313309/air-pollution-and-allergic-airway-diseases-social-determinantsand-sustainability-in-the-control-and-prevention
#3
REVIEW
H Paramesh
Air pollution, global warming and climate change are the major contributing factors in causing the increase prevalence of allergic airway diseases like asthma and allergic rhinitis and they will be the defining issues for health system in the twenty-first century. Asthma is an early onset non-communicable environmental disease with global epidemic and contributes a greatest psycho socio economic burden. Nearly 8 million global deaths are from air pollution. Over one billion population are the sufferers during 2015 and will increase to 4 billion by 2050...
January 9, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29306991/asthma-and-medicines-long-term-side-effects-monitoring-and-dose-titration
#4
REVIEW
Satnam Kaur, Varinder Singh
Asthma is a major pediatric respiratory morbidity requiring long-term management. A thorough knowledge of long-term medication side-effects in children is, thus, essential for every physician dealing with childhood asthma. Establishing diagnosis and initiating treatment is just a beginning of the journey. Ongoing monitoring is an essential component of comprehensive asthma management programme. Monitoring includes not only assessment of asthma control but also checking for adherence to treatment, technique of inhaler device use, associated co-morbities, if any, and potential environmental exposure...
January 6, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29274305/treatment-adherence-and-level-of-control-in-moderate-persistent-asthma-in-children-and-adolescents-treated-with-fluticasone-and-salmeterol
#5
Nulma S Jentzsch, Gabriela C G Silva, Guilherme M S Mendes, Paul L P Brand, Paulo Camargos
OBJECTIVE: There is a scarcity of studies that assessed the association between adherence to combination therapy and asthma control in pediatric patients. The authors investigated the association between adherence to fluticasone propionate/salmeterol xinafoate combination-metered aerosol and the level of asthma control in children. METHODS: This was a prospective observational study of 84 patients aged 5-16 years with moderate persistent asthma, who remained uncontrolled despite the use of 1000μg/day of inhaled nonextrafine-hydrofluoric alkane-beclomethasone dipropionate in the three months prior to study enrollment...
December 20, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/29273246/asthma
#6
REVIEW
Alberto Papi, Christopher Brightling, Søren E Pedersen, Helen K Reddel
Asthma-one of the most common chronic, non-communicable diseases in children and adults-is characterised by variable respiratory symptoms and variable airflow limitation. Asthma is a consequence of complex gene-environment interactions, with heterogeneity in clinical presentation and the type and intensity of airway inflammation and remodelling. The goal of asthma treatment is to achieve good asthma control-ie, to minimise symptom burden and risk of exacerbations. Anti-inflammatory and bronchodilator treatments are the mainstay of asthma therapy and are used in a stepwise approach...
December 19, 2017: Lancet
https://www.readbyqxmd.com/read/29259760/lung-function-in-severe-pediatric-asthma-a-longitudinal-study-in-children-and-adolescents-in-brazil
#7
Mônica Versiani Nunes Pinheiro de Queiroz, Cristina Gonçalves Alvim, Álvaro A Cruz, Laura Maria de Lima Belizário Facury Lasmar
Background: In severe asthma, high doses of inhaled corticosteroids (ICS) are used in order to achieve clinical and functional control. This study aimed to evaluate lung function in outpatients (children and adolescents) with severe asthma in Brazil, all of whom were treated with high doses of ICS. We evaluated all spirometry tests together and by ICS dose: 800 and > 800 µg/day. Methods: This was a 3-year longitudinal study in which we analyzed 384 spirometry tests in 65 severe asthma patients (6-18 years of age), divided into two groups by the dose of ICS (budesonide or equivalent): 800 and > 800 µg/day...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29248433/physiotherapy-breathing-retraining-for-asthma-a-randomised-controlled-trial
#8
Anne Bruton, Amanda Lee, Lucy Yardley, James Raftery, Emily Arden-Close, Sarah Kirby, Shihua Zhu, Manimekalai Thiruvothiyur, Frances Webley, Lyn Taylor, Denise Gibson, Guiqing Yao, Mark Stafford-Watson, Jenny Versnel, Michael Moore, Steve George, Paul Little, Ratko Djukanovic, David Price, Ian D Pavord, Stephen T Holgate, Mike Thomas
BACKGROUND: Despite effective pharmacotherapy, asthma continues to impair quality of life for most patients. Non-pharmacological approaches, including breathing retraining, are therefore of great interest to patients. However, clinicians rarely advocate breathing retraining and access to this intervention is restricted for most patients due to the limited availability of suitable physiotherapists and poor integration of breathing retraining into standard care. We aimed to assess the effectiveness of a digital self-guided breathing retraining intervention...
December 13, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29246162/use-of-a-baseline-risk-score-to-identify-the-risk-of-serious-infectious-events-in-patients-with-rheumatoid-arthritis-during-certolizumab-pegol-treatment
#9
Jeffrey R Curtis, Kevin Winthrop, Cathy O'Brien, Matladi N Ndlovu, Marc de Longueville, Boulos Haraoui
BACKGROUND: The risk of serious infectious events (SIEs) is increased in patients with rheumatoid arthritis (RA). The aim of this study was to develop an age-adjusted comorbidity index (AACI) to predict, using baseline characteristics, the SIE risk in patients with RA treated with certolizumab pegol (CZP). METHODS: Data of CZP-treated patients with RA were pooled from the RAPID1/RAPID2 randomized controlled trials (RCT CZP) and their open-label extensions (All CZP)...
December 15, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/29238240/the-effect-of-dpp-4-inhibitors-on-asthma-control-an-administrative-database-study-to-evaluate-a-potential-pathophysiological-relationship
#10
Gene Colice, David Price, Maria Gerhardsson de Verdier, Karma Rabon-Stith, Christopher Ambrose, Katherine Cappell, Debra E Irwin, Paul Juneau, Anna Vlahiotis
Rationale: DPP-4 may regulate immunological pathways implicated in asthma. Assessing whether DPP-4 inhibitor (DPP-4i) use might affect asthma control is clinically important because DPP-4i use in type 2 diabetes mellitus management (T2DM) is increasing. This study evaluated associations between DPP-4i use and asthma control. Methods: This was a retrospective, observational, matched cohort study using administrative claims in the MarketScan® Commercial Claims and Encounters (Commercial) and Medicare Supplemental and Coordination of Benefits (Medicare Supplemental) databases...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/29237390/chronopharmacokinetic-evaluation-of-budesonide-multiparticulate-systems
#11
Sowjanya Battu, Prasanna Raju Yalavarthi, G V Subbareddy, Uma Maheswara Rao, Jyothshna Devi Katamreddy, Harini Cowdary Vadlamudi
Poor oral absorption of budesonide limits design of its solid oral dosage form. With this context, multiparticulate pulsatile system of budesonide for chronotherapy of nocturnal asthma was aimed in this study. Initially, solid dispersions of budesonide (BD) using sodium starch glycolate (SSG) and guar gum (GG) were developed and characterized. Uniform sized non-pariel seeds (~400 µm) were coated with solid dispersions to obtain immediate (BMP) and controlled release pellets by solution layering technique. Pulsatile drug release pellets (BMPP) were obtained by coating the controlled release pellets with Eudragit L100 and RS 100...
December 12, 2017: Recent Patents on Drug Delivery & Formulation
https://www.readbyqxmd.com/read/29231431/-micro-invasive-embedding-combined-with-montelukast-sodium-for-children-cough-variant-asthma-a-randomized-controlled-trial
#12
Xiaoyan Wang, Baoqin Liu, Bin Lu, Yanmei Zhang, Liran Wang, Haijin Li, Xue Han, Dan Ding
OBJECTIVE: To observe the effects of micro-invasive embedding combined with montelukast sodium and simple montelukast sodium for children cough variant asthma (CVA). METHODS: A total of 240 patients were randomly assigned into an observation group and a control group, 120 cases in each one. Considering of cases dropping, 101 patients in the observation group and 105 cases in the control group were included. Montelukast sodium chewable tablets were applied before sleep for 3 months in the control group, 5 mg a time, once a day...
March 12, 2017: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29222627/pediatric-asthma-management-in-china-current-and-future-challenges
#13
Xiaojian Zhou, Jianguo Hong
The purpose of this report was to review the state of asthma diagnosis and treatment in China and to examine challenges in achieving earlier diagnosis and treatment. The prevalence of asthma in children in China has increased over past decades, and data published in 2013 indicated a prevalence of 3.0% in children aged 0-14 years. Although this prevalence has increased, the percentage of children with acute asthma attacks decreased from 86% in 2000 to 77% in 2010, and the frequency of hospitalizations for asthma attacks decreased from 54...
December 8, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/29220200/a-practical-approach-to-severe-asthma-in-children
#14
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 which can be controlled with appropriate management, from asthma which requires the highest level of therapy to maintain control or remains uncontrolled despite management optimization...
December 8, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29161088/mechanistic-basis-for-obesity-related-increases-in-ozone-induced-airway-hyperresponsiveness-in-mice
#15
Stephanie A Shore
Obesity is a risk factor for asthma, especially nonallergic asthma. Ozone, a common air pollutant, is a nonallergic asthma trigger. Importantly, ozone-induced decrements in lung function are greater in obese and overweight human subjects than in lean individuals. Obese mice also exhibit exaggerated pulmonary responses to ozone. Ozone causes greater increases in pulmonary resistance, in bronchoalveolar lavage neutrophils, and in airway hyperresponsiveness in obese than in lean mice. Our data indicate that IL-33 plays a role in mediating these events...
November 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29152167/differences-in-medication-adherence-are-associated-with-beliefs-about-medicines-in-asthma-and-copd
#16
Susanne Brandstetter, Tamara Finger, Wiebke Fischer, Magdalena Brandl, Merle Böhmer, Michael Pfeifer, Christian Apfelbacher
Adherence to medication is crucial for achieving treatment control in chronic obstructive lung diseases. This study refers to the "necessity-concerns framework" and examines the associations between beliefs about medicines and self-reported medication adherence in people with chronic obstructive lung disease. 402 patients (196 with asthma, 206 with COPD) participated in the study and completed a questionnaire comprising the "Beliefs about Medicines-Questionnaire" (BMQ) and the "Medication Adherence Report Scale" (MARS)...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/29113525/biological-mechanisms-underlying-the-clinical-effects-of-allergen-specific-immunotherapy-in-asthmatic-children
#17
Corrado Pelaia, Alessandro Vatrella, Nicola Lombardo, Rosa Terracciano, Paolo Navalesi, Rocco Savino, Girolamo Pelaia
Allergen-specific immunotherapy (AIT) is indicated for patients with allergic asthma and/or allergic rhinitis, and can be implemented by either subcutaneous injection (SCIT) or sublingual administration (SLIT). AIT reduces asthma symptoms, lowers the use of pharmacologic controller therapy, and decreases the need for rescue medications. SLIT appears to be safer than SCIT, but SCIT seems to be more efficacious and acts earlier in allergic asthmatic children. Areas covered: This review looks at the pathobiology of allergic asthma as well as the role of regulatory T and B cells in allergen tolerance...
November 8, 2017: Expert Opinion on Biological Therapy
https://www.readbyqxmd.com/read/29107955/the-impact-of-financial-incentives-on-the-implementation-of-asthma-or-diabetes-self-management-a-systematic-review
#18
Tracy Jackson, Michael D Shields, Liam G Heaney, Marilyn Kendall, Christina J Pearce, Chi Yan Hui, Hilary Pinnock
INTRODUCTION: Financial incentives are utilised in healthcare systems in a number of countries to improve quality of care delivered to patients by rewarding practices or practitioners for achieving set targets. OBJECTIVES: To systematically review the evidence investigating the impact of financial incentives for implementation of supported self-management on quality of care including: organisational process outcomes, individual behavioural outcomes, and health outcomes for individuals with asthma or diabetes; both conditions with an extensive evidence base for self-management...
2017: PloS One
https://www.readbyqxmd.com/read/29104649/small-interfering-rna-directed-against-microrna-155-delivered-by-a-lentiviral-vector-attenuates-asthmatic-features-in-a-mouse-model-of-allergic-asthma
#19
Huilong Chen, Xiangqin Xu, Sheng Cheng, Yuzhu Xu, Qi Xuefei, Yong Cao, Jungang Xie, Cong-Yi Wang, Yongjian Xu, Weining Xiong
Asthma is a chronic T helper type 2 (Th2) cell-mediated inflammatory disease characterized by airway hyperresponsiveness (AHR) and airway inflammation. Although the majority of patients with asthma can achieve a good level of control with existing treatments, asthma runs a chronic course and the effectiveness of current treatment is not satisfactory for certain patients. MicroRNAs (miRNAs) are short noncoding RNAs that suppress gene expression at the post-transcriptional level; their role in regulating allergic inflammation remains largely unknown...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29083219/smokers-who-are-unmotivated-to-quit-and-have-a-child-with-asthma-are-more-likely-to-quit-with-intensive-motivational-interviewing-and-repeated-biomarker-feedback
#20
Belinda Borrelli, Romano Endrighi, S Katharine Hammond, Shira Dunsiger
OBJECTIVE: Smokers who are not motivated to quit are an important group for intervention, particularly if they have children with asthma. Research indicates that unmotivated smokers are less responsive to intensive interventions, although motivation-by-treatment interactions have not been tested. This study examines whether motivation to quit moderates the effect of a cessation induction intervention. METHOD: Parents had an asthmatic child requiring urgent care, and did not have to want to quit smoking to be eligible for the study...
November 2017: Journal of Consulting and Clinical Psychology
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