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Inhaled corticosteroids and asthma

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https://www.readbyqxmd.com/read/28212153/new-therapies-for-the-prevention-and-treatment-of-exacerbations-of-bronchiectasis
#1
Hani Abo-Leyah, James D Chalmers
PURPOSE OF REVIEW: Exacerbations of bronchiectasis have a major impact on quality of life, healthcare costs, and long-term risk of complications. Preventing exacerbations is one of the major goals of treatment. Bronchiectasis is increasingly recognized and the impact of bronchiectasis exacerbations on daily clinical practice is also increasing. RECENT FINDINGS: Preventing bronchiectasis exacerbations are dependent on appropriate risk assessment, identifying the patients at highest risk to rationally target preventive therapies...
February 16, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28208871/clinical-utility-of-fractional-exhaled-nitric-oxide-feno-as-a-biomarker-to-predict-severity-of-disease-and-response-to-inhaled-corticosteroid-ics-in-asthma-patients
#2
Revathy Neelamegan, Vinodkumar Saka, Kadhiravan Tamilarasu, Manju Rajaram, Sandhiya Selvarajan, Adithan Chandrasekaran
INTRODUCTION: Bronchial asthma is a common chronic inflammatory airway disease diagnosed and is based on symptomatic history and Pulmonary Function Tests (PFT). Fractional exhaled Nitric Oxide (FeNO) is exclusively a non-invasive biomarker of on-going eosinophilic airway inflammation which remains unpredictable only with PFTs. FeNO measurement is recommended in predicting asthma severity and Inhaled Corticosteroid (ICS) response but further research is required to understand its clinical utility and agreement with current recommendations in a specific population...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28203072/-real-life-inhaled-corticosteroid-withdrawal-in-copd-a-subgroup-analysis-of-daccord
#3
Claus Vogelmeier, Heinrich Worth, Roland Buhl, Carl-Peter Criée, Nadine S Lossi, Claudia Mailänder, Peter Kardos
Many patients with chronic obstructive pulmonary disease (COPD) receive inhaled corticosteroids (ICSs) without a clear indication, and thus, the impact of ICS withdrawal on disease control is of great interest. DACCORD is a prospective, noninterventional 2-year study in the primary and secondary care throughout Germany. A subgroup of patients were taking ICS prior to entry - 1,022 patients continued to receive ICS for 2 years; physicians withdrew ICS on entry in 236 patients. Data from these two subgroups were analyzed to evaluate the impact of ICS withdrawal...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28196638/japanese-guidelines-for-adult-asthma-2017
#4
REVIEW
Masakazu Ichinose, Hisatoshi Sugiura, Hiroyuki Nagase, Masao Yamaguchi, Hiromasa Inoue, Hironori Sagara, Jun Tamaoki, Yuji Tohda, Mitsuru Munakata, Kohei Yamauchi, Ken Ohta
Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms...
February 11, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28194189/day-time-variation-of-serum-periostin-in-asthmatic-adults-treated-with-ics-laba-and-adults-without-asthma
#5
Rachel Caswell-Smith, Terrianne Cripps, Thom Charles, Alexander Hosking, Meghana Handigol, Cecile Holweg, John Matthews, Mark Holliday, Corentin Maillot, James Fingleton, Mark Weatherall, Richard Beasley, Irene Braithwaite
BACKGROUND: We aimed to determine the effect of sampling time during the day on serum periostin levels in adult participants with and without asthma. METHODS: Serum periostin was measured at 2-h intervals from 0800 to 1800 h in 16 adult participants with stable asthma prescribed inhaled corticosteroid and long-acting beta-agonist therapy, and in 16 otherwise healthy participants without asthma. Mixed linear models were used to compare time zero (08:00 h) with subsequent measurement time for serum periostin for both groups...
2017: Allergy, Asthma, and Clinical Immunology
https://www.readbyqxmd.com/read/28192574/primary-care-asthma-management-inhaled-corticosteroids-and-other-clinical-pearls
#6
Zachary Marcus, Nanah Suk Park
Most children in the United States with intermittent, mild, and moderate persistent asthma are cared for by primary care practitioners (PCPs). Despite inhaled corticosteroids (ICS) being highly effective at controlling asthma symptoms, many PCPs are uncomfortable prescribing these medications. Cumbersome guidelines, increasing numbers of medication choices, and concerns regarding side effects are some of the barriers to prescribing ICS for children with asthma. This article serves as a quick-start guide for PCPs that (1) condenses the routine diagnosis and management of asthma into concise clinical tools for children who would benefit from ICS therapy and (2) provides clinical pearls to aid in the treatment of mild- to moderate-persistent asthma...
February 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28190974/avoiding-misdiagnosis-in-patients-with-dyspnea-and-wheezing-a-case-report-illustrating-the-clinical-implications-of-fixation-error
#7
Fabiano Di Marco, Giuseppe Francesco Sferrazza Papa, Dejan Radovanovic, Pierachille Santus
BACKGROUND: Bronchial asthma is a heterogeneous respiratory condition which can be mimicked by a wide range of pathologies including upper airways stenosis. The accurate diagnosis of asthma, as with other conditions, may be influenced by fixation errors, which are common in medicine and occur when a physician concentrates on only one element of a clinical case without considering other relevant aspects. Here we report a challenging case characterized by the contemporaneous presence of a common disease, asthma, together with a rare respiratory disease, idiopathic tracheal stenosis...
2017: Clinical and Molecular Allergy: CMA
https://www.readbyqxmd.com/read/28176972/factors-associated-with-relapse-in-adult-patients-discharged-from-the-emergency-department-following-acute-asthma-a-systematic-review
#8
Jesse Hill, Nicholas Arrotta, Cristina Villa-Roel, Liz Dennett, Brian H Rowe
A significant proportion of patients discharged from the emergency department (ED) with asthma exacerbations will relapse within 4 weeks. This systematic review summarises the evidence regarding relapses and factors associated with relapse in adult patients discharged from EDs after being treated for acute asthma. Following a registered protocol, comprehensive literature searches were conducted. Studies tracking outcomes for adults after ED management and discharge were included if they involved adjusted analyses...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28173781/effect-of-inhaled-corticosteroid-particle-size-on-asthma-efficacy-and-safety-outcomes-a-systematic-literature-review-and-meta-analysis
#9
Céline El Baou, Rachael L Di Santostefano, Rafael Alfonso-Cristancho, Elizabeth A Suarez, David Stempel, Mark L Everard, Neil Barnes
BACKGROUND: Inhaled corticosteroids (ICS) are the primary treatment for persistent asthma. Currently available ICS have differing particle size due to both formulation and propellant, and it has been postulated that this may impact patient outcomes. This structured literature review and meta-analysis compared the effect of small and standard particle size ICS on lung function, symptoms, rescue use (when available) and safety in patients with asthma as assessed in head-to-head randomized controlled trials (RCTs)...
February 7, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28164255/late-onset-asthma-a-diagnostic-and-management-challenge
#10
Charlotte Suppli Ulrik
Late-onset asthma is common, associated with poor outcome, underdiagnosed and undertreated, possibly due to the modifying effect of ageing on disease expression. Although the diagnostic work-up in elderly individuals suspected of having asthma follows the same steps as in younger individuals (case history and spirometry), it is important to acknowledge that elderly individuals are likely to have diminished bronchodilator reversibility and some degree of fixed airflow obstruction. Elderly individuals, therefore, often require further objective tests, including bronchial challenge testing, to objectively confirm asthma...
February 6, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/28160287/association-between-migraine-and-atopic-diseases-in-childhood-a-potential-protective-role-of-anti-allergic-drugs
#11
Camille Aupiais, Stephanie Wanin, Silvia Romanello, Daniele Spiri, Raffaella Moretti, Priscilla Boizeau, Davide Massano, Gian Vincenzo Zuccotti, Giovanni Crichiutti, Lakshmi Kanagarajah, Veronique Houdouin, Corinne Alberti, Luigi Titomanlio
BACKGROUND: Migraine is a common cause of headache in childhood. Several studies have investigated the association between migraine and atopic diseases, mostly in the adult population. OBJECTIVE: This study aimed to investigate this association in children. METHODS: A case-control study was conducted across 3 European tertiary care hospitals between June 2014 and August 2014. Cases (n = 229) were children aged 6-18 years consulting for a migraine episode...
February 4, 2017: Headache
https://www.readbyqxmd.com/read/28157474/factors-impacting-asthma-control-in-children-in-a-low-to-middle-income-country-setting-a-retrospective-study
#12
K A Monene, R Masekela
OBJECTIVES: 1) To assess asthma control and its evolution over time among children in a low-to-middle-income country, and 2) to explore whether demographics, type of asthma medication, comorbidities or exacerbations impact asthma control. METHODS: In a retrospective study in children with asthma aged 6-18 years conducted between 2005 and 2010, we collected clinical and demographic data and used Global Initiative for Asthma (GINA) criteria to assess asthma control...
January 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28148459/exploring-factors-associated-with-asthma-related-emergency-department-visits-among-adults-a-path-analysis-approach
#13
Maithili Deshpande, Kevin A Look
BACKGROUND: Asthma is an expensive chronic lung disease that affects 7% of U.S. adults and results in as many as 1.8 million emergency department (ED) visits each year. Pharmacists play an important role in managing asthma, including assessing control and monitoring disease progression, educating the patient about the disease and associated treatments, and ensuring safe and cost-effective medication use. However, comprehensive studies that account for the complex relationships between factors impacting asthma-related ED visits are lacking in the adult asthma population...
January 23, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28146601/stepping-down-the-dose-of-inhaled-corticosteroids-for-adults-with-asthma
#14
REVIEW
Iain Crossingham, David Jw Evans, Nathan R Halcovitch, Paul A Marsden
BACKGROUND: Asthma is a condition of the airways affecting more than 300 million adults and children worldwide. National and international guidelines recommend titrating up the dose of inhaled corticosteroids (ICS) to gain symptom control at the lowest possible dose because long-term use of higher doses of ICS carries a risk of systemic adverse events. For patients whose asthma symptoms are controlled on moderate or higher doses of ICS, it may be possible to reduce the dose of ICS without compromising symptom control...
February 1, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28145647/relationship-between-fractional-exhaled-nitric-oxide-level-and-efficacy-of-inhaled-corticosteroid-in-asthma-copd-overlap-syndrome-patients-with-different-disease-severity
#15
Jia Xi Feng, Yun Lin, Jian Lin, Su Su He, Mei Fang Chen, Xiao Mai Wu, You Zu Xu
This study explored the relationship between the fractional exhaled nitric oxide (FeNO) level and the efficacy of inhaled corticosteroid (ICS) in asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) patients with different disease severity. A total of 127 ACOS patients with ACOS (case group) and 131 healthy people (control group) were enrolled in this study. Based on the severity of COPD, the ACOS patients were divided into: mild ACOS; moderate ACOS; severe ACOS; and extremely severe ACOS groups...
March 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/28144054/current-trends-of-management-of-respiratory-diseases-by-pulmonologists-results-of-national-conference-of-pulmonary-disease-2015-survey
#16
Sheetu Singh, Nishtha Singh
CONTEXT: Respiratory diseases are a common problem in our country and these are associated with significant morbidity and mortality. AIMS: The aim of the paper was to analyze the pattern of diagnostic tests used and treatment prescribed for common respiratory diseases. SETTINGS AND DESIGN: A total of 1028 pulmonologists, either member of Indian Chest Society or delegate attending the National Conference of Pulmonary Diseases (NAPCON) 2015, participated in the online survey...
January 2017: Lung India: Official Organ of Indian Chest Society
https://www.readbyqxmd.com/read/28137490/comparative-effectiveness-of-mepolizumab-and-omalizumab-in-severe-asthma-an-indirect-treatment-comparison
#17
Sarah M Cockle, Gillian Stynes, Necdet B Gunsoy, Daniel Parks, Rafael Alfonso-Cristancho, Jaro Wex, Eric S Bradford, Frank C Albers, Jenny Willson
BACKGROUND: Severe asthma is a heterogeneous disease. Patients with both eosinophilic and allergic asthma phenotypes may be eligible for treatment with mepolizumab and omalizumab. Evidence on the relative effectiveness of these treatments in this 'overlap' population would be informative for clinical and payer decision making. METHODS: A systematic literature review and indirect treatment comparison (Bayesian framework) were performed to assess the comparative effectiveness and tolerability of mepolizumab and omalizumab, as add-ons to standard of care...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28137226/management-of-status-asthmaticus-in-children
#18
Kam-Lun E Hon, Alexander K C Leung
BACKGROUND: Status asthmaticus is an acute exacerbation of asthma that is persistent and intractable and remains unresponsive to initial treatment with bronchodilators and systemic corticosteroids and that can result in hypoxemia, hypercarbia, and secondary respiratory failure. METHOD: We reviewed treatment and recent patents on management of status asthmaticus. CONCLUSIONS: Supplemental oxygen should be given to maintain an oxygen saturation of ≥92% in room air...
30, 2017: Recent Patents on Inflammation & Allergy Drug Discovery
https://www.readbyqxmd.com/read/28134501/the-current-and-future-role-of-biomarkers-in-type-2-cytokine-mediated-asthma-management
#19
REVIEW
I D Pavord, S Afzalnia, A Menzies-Gow, L G Heaney
Assessment and management of asthma is complicated by the heterogeneous pathophysiological mechanisms that underlie its clinical presentation, which are not necessarily reflected in standardized management paradigms and which necessitate an individualized approach to treatment. This is particularly important with the emerging availability of a variety of targeted forms of therapy that may only be appropriate for use in particular patient subgroups. The identification of biomarkers can potentially aid diagnosis and inform prognosis, help guide treatment decisions and allow clinicians to predict and monitor response to treatment...
February 2017: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28134228/knowledge-on-bronchial-asthma-among-teachers-and-educators-preliminary-results-of-a-pilot-study
#20
Andrzej Witusik, Łukasz Mokros, Tadeusz Pietras
: One of the elements contributing to development of health-promoting behaviors is knowledge transmitted by teachers. AIM: The aim of the research was to assess the teachers' and educators' knowledge on bronchial asthma. MATERIALS AND METHODS: The survey consisting of closed multiple choice questions concerning bronchial asthma was conducted among 106 teachers. The questionnaire contained 12 questions selected by competent judges. To verify statistical hypotheses, we used Pearson Chi2 test with Benjamini-Hochberg correction...
January 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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