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acute exacerbations of asthma

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https://www.readbyqxmd.com/read/28430773/is-dexamethasone-as-effective-as-other-corticosteroids-for-acute-asthma-exacerbation-in-children
#1
Gonzalo A Bravo-Soto, Constanza Harismendy, Pamela Rojas, Rodrigo Silva, Pamela von Borries
Dexamethasone has been proposed as an alternative in the treatment of acute asthma exacerbation in children. It allows shortening the duration of treatment, reducing costs and adverse effects. However, it is not clear whether its efficacy is similar to the traditional steroid regimen. To answer this question, we searched in Epistemonikos database, which is maintained by screening multiple information sources. We identified six systematic reviews including 10 randomized trials. We extracted data, conducted a meta-analysis and generated a summary of findings table using the GRADE approach...
April 18, 2017: Medwave
https://www.readbyqxmd.com/read/28416251/initial-asthma-severity-assessment-tools-as-predictors-of-hospitalization
#2
Natalia Paniagua, Amaia Elosegi, Isabel Duo, Ana Fernandez, Elisa Mojica, Lorea Martinez-Indart, Santiago Mintegi, Javier Benito
BACKGROUND: Assessment tools to classify and prioritize patients, such as systems of triage, and indicators of severity, such as clinical respiratory scores, are helpful in guiding the flow of asthmatic patients in the emergency department. OBJECTIVE: Our aim was to assess the performance of the Pediatric Assessment Triangle (PAT), triage level (TL), Pulmonary Score (PS), and initial O2 saturation (O2 sat), in predicting hospitalization in pediatric acute asthma exacerbations...
April 14, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28407829/-application-of-pulmonary-function-and-fractional-exhaled-nitric-oxide-tests-in-the-standardized-management-of-bronchial-asthma-in-children
#3
Hui-Qin Zhang, Hui-Qin Zhang, Jing-Jing Zhang, Yu-Dong Liu, Yue-Lin Deng, Jian-Feng Luo, Huan-Hong Niu, Xin Sun
OBJECTIVE: To investigate the changes of pulmonary function and fractional exhaled nitric oxide (FeNO) in the standardized treatment of bronchial asthma in children. METHODS: A total of 254 children who were newly diagnosed with acute exacerbation of bronchial asthma were selected as asthma group, and they were divided into two subgroups: asthma with concurrent rhinitis and asthma without concurrent rhinitis. All patients received the standardized management and treatment for one year...
April 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/28401936/bmal1-links-the-circadian-clock-to-viral-airway-pathology-and-asthma-phenotypes
#4
A Ehlers, W Xie, E Agapov, S Brown, D Steinberg, R Tidwell, G Sajol, R Schutz, R Weaver, H Yu, M Castro, L B Bacharier, X Wang, M J Holtzman, J A Haspel
Patients with asthma experience circadian variations in their symptoms. However it remains unclear how specific aspects of this common airway disease relate to clock genes, which are critical to the generation of circadian rhythms in mammals. Here, we used a viral model of acute and chronic airway disease to examine how circadian clock disruption affects asthmatic lung phenotypes. Deletion of the core clock gene bmal1 or environmental disruption of circadian function by jet lag exacerbated acute viral bronchiolitis caused by Sendai virus (SeV) and influenza A virus in mice...
April 12, 2017: Mucosal Immunology
https://www.readbyqxmd.com/read/28400693/ludwig-s-angina-a-nightmare-worsened-by-adverse-drug-reaction-to-antibiotics
#5
Mohamed Hisham, Mundilipalayam N Sivakumar, R S Senthil Kumar, P Nandakumar
A 52-year-old obese gentleman presented to the hospital with complaints of fever and shortness of breath for 10 days. He was admitted in the ward and treated for acute exacerbation of asthma. He was shifted to the Intensive Care Unit (ICU) for persistent fever, neck swelling, airway obstruction and desaturation. Ludwig's angina was suspected and computed tomography of neck confirmed it. A difficult airway was anticipated and preceded with surgical tracheostomy. The patient had hypersensitivity reactions to piperacillin/tazobactam; hence, he was treated with clindamycin and metronidazole...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28388779/aerobic-exercise-decreases-lung-inflammation-by-ige-decrement-in-an-ova-mice-model
#6
Deborah Camargo Hizume-Kunzler, Flavia R Greiffo, Bárbara Fortkamp, Gabriel Ribeiro Freitas, Juliana Keller Nascimento, Thayse Regina Bruggemann, Leonardo Melo Avila, Adenir Perini, Franciane Bobinski, Morgana Duarte Silva, Fernanda Rocha Lapa, Rodolfo Paula Vieira, Verônica Vargas Horewicz, Adair Roberto Soares Dos Santos, Kelly Cattelan Bonorino
Aerobic exercise (AE) reduces lung function decline and risk of exacerbations in asthmatic patients. However, the inflammatory lung response involved in exercise during the sensitization remains unclear. Therefore, we evaluated the effects of exercise for 2 weeks in an experimental model of sensitization and single ovalbumin-challenge. Mice were divided into 4 groups: mice non-sensitized and not submitted to exercise (Sedentary, n=10); mice non-sensitized and submitted to exercise (Exercise, n=10); mice sensitized and exposed to ovalbumin (OVA, n=10); and mice sensitized, submitted to exercise and exposed to OVA (OVA+Exercise, n=10)...
April 7, 2017: International Journal of Sports Medicine
https://www.readbyqxmd.com/read/28383629/ip-10-in-occupational-asthma-review-of-the-literature-and-case-control-study
#7
F Ragusa, P Fallahi
OBJECTIVES: T-helper (Th)2 cytokines are thought to mediate most of the allergic inflammatory responses associated with atopic asthma. But the Th1-related chemokine, interferon (IFN)-γ-induced protein 10 (IP-10)/chemokine (C-X-C motif) ligand (CXCL)10, was the predominant chemokine measured during human allergic pulmonary late-phase reaction. Viral infection and allergens can exacerbate asthma by inducing the accumulation of these chemokines and inflammatory cells in the airway. Short-acting β2-adrenoreceptor agonists, budesonide and formoterol (all important relievers in asthma exacerbation), such as vitamin D3, vitamin C, have been shown to inhibit airway cells inflammatory responses by modulating these chemokines...
March 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28372712/outpatient-management-for-acute-exacerbations-of-obstructive-lung-diseases
#8
REVIEW
Brenda Marsh, Matthew G Drake
Primary care providers tasked with treating acute exacerbations of asthma and chronic obstructive pulmonary disease must be able to recognize exacerbation of symptoms and triage patients based on exacerbation severity to the appropriate level of care. Early treatment with bronchodilators and corticosteroids should be followed by repeated assessments of treatment efficacy. Primary care providers should also provide symptom-guided action plans to empower patients to manage their disease.
May 2017: Medical Clinics of North America
https://www.readbyqxmd.com/read/28362676/behavioral-interventions-to-improve-asthma-outcomes-a-systematic-review-of-recent-publications
#9
Giselle S Mosnaim, Esra Akkoyun, Joshua Eng, Madeleine U Shalowitz
PURPOSE OF REVIEW: Asthma outcomes are influenced by factors at multiple ecological levels: the individual and his/her family, home, medical care, and community. This systematic review describes recently published single-level and multilevel behavioral interventions to improve asthma outcomes. RECENT FINDINGS: Of the 23 total title/abstracts reviewed in the original systematic search of PubMed, Ovid, Scopus, PsychINFO, and CIHAHL reference review databases, six met inclusion criteria...
March 30, 2017: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/28349590/benzalkonium-chloride-a-bronchoconstricting-preservative-in-continuous-albuterol-nebulizer-solutions
#10
Sreekala Prabhakaran, Mutasim Abu-Hasan, Leslie Hendeles
BACKGROUND: For convenience, many pediatric hospitals are preparing solutions for continuous nebulized albuterol (CNA) using the 0.5% 20 mL multi-dose albuterol dropper bottle. This product contains benzalkonium chloride (BAC) which, by itself, produces bronchospasm that is dose-dependent and cumulative. The bronchoconstrictive effects of BA are greater in patients with more severe airway obstruction and increased airway responsiveness. CONCERNS: Use of BAC-containing albuterol during severe acute asthma exacerbations may antagonize the bronchodilator response to albuterol, prolong treatment, and increase the risk of albuterol-related systemic adverse effects...
March 28, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28306629/management-of-acute-asthma-exacerbations
#11
Erin K Stenson, Michael J Tchou, Derek S Wheeler
PURPOSE OF REVIEW: Herein, we review the current guidelines for the management of children with an acute asthma exacerbation. We focus on management in the emergency department, inpatient, and ICU settings. RECENT FINDINGS: The most recent statistics show that the prevalence of asthma during childhood has decreased in certain demographic subgroups and plateaued in other subgroups. However, acute asthma accounts for significant healthcare expenditures. Although there are few, if any, newer therapeutic agents available for management of acute asthma exacerbations, several reports leveraging quality improvement science have shown significant reductions in costs of care as well as improvements in outcome...
March 16, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28293932/effect-of-tio%C3%A2-nanoparticles-on-inflammasome-mediated-airway-inflammation-and-responsiveness
#12
Byeong Gon Kim, Pureun Haneul Lee, Sun Hye Lee, Moo Kyun Park, An Soo Jang
PURPOSE: Nanoparticles (NPs) may cause cell and tissue damage, leading to local and systemic inflammatory responses and adverse effects on health due to the inhalation of particulate matter. The inflammasome is a major regulator of inflammation through its activation of pro-caspase-1, which cleaves pro-interleukin-1β (pro-IL-1β) into its mature form and may induce acute and chronic immune responses to NPs. However, little is known about the response of the inflammasome to NP exposure via the airways in asthma...
May 2017: Allergy, Asthma & Immunology Research
https://www.readbyqxmd.com/read/28292797/acetaminophen-use-and-asthma-in-children
#13
REVIEW
Teeranai Sakulchit, Ran D Goldman
Question A child with a history of asthma came to my clinic with acute fever. I have heard that acetaminophen might be associated with exacerbation of asthma. Is it safe if I recommend acetaminophen for this child? Answer Most studies suggest an association between acetaminophen use in children and development of asthma later in childhood. However, several confounding factors in study design might contribute to this positive correlation, and without a prospective controlled trial, confirming this finding is challenging...
March 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28284473/positive-expiratory-pressure-for-the-treatment-of-acute-asthma-exacerbations-a-randomized-controlled-trial
#14
Nidhya Navanandan, Monica Federico, Rakesh D Mistry
OBJECTIVES: To evaluate the efficacy of brief, single administration of positive expiratory pressure (PEP) therapy in reducing clinical severity and need for additional second-line therapies and hospitalization in children presenting to the emergency department (ED) with acute asthma. STUDY DESIGN: This was a prospective randomized controlled trial of children 2-18 years of age presenting to a tertiary-care academic pediatric ED with moderate-to-severe asthma exacerbations from December 2014 to June 2016...
March 8, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28284319/longterm-clinical-outcomes-of-omalizumab-therapy-in-severe-allergic-asthma-study-of-efficacy-and-safety
#15
Adel H Mansur, Sapna Srivastava, Verity Mitchell, Julie Sullivan, Ismail Kasujee
Omalizumab has been shown to be an effective add-on therapy for patients with uncontrolled severe persistent allergic asthma. There has been a steady accumulation of evidence on the long-term effectiveness of omalizumab; however, data on real-life outcomes beyond one year of treatment is limited. In this study, we report on long-term outcomes of omalizumab treatment. We collected data from our severe asthma registry on hospitalisations, exacerbations, corticosteroid sparing, asthma control, lung function, biomarkers and side effects, to determine if the benefit was sustained and treatment was safe on the long term...
March 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28283855/the-role-of-human-parainfluenza-virus-infections-in-the-immunopathology-of-the-respiratory-tract
#16
REVIEW
Malgorzata Pawełczyk, Marek Leszek Kowalski
Viral infections are leading causes of both upper and lower airway acute illness in all age groups of healthy persons, and have also been implicated in the acute exacerbations of chronic respiratory disorders like asthma and COPD. Human rhinovirus, respiratory syncytial virus, influenza virus and coronavirus have been considered as the most important respiratory pathogens and relatively little attention has been paid to the role of parainfluenza viruses (hPIVs). Human parainfluenza viruses are single-stranded RNA viruses belonging to the paramyxovirus family that may evoke lower respiratory infections in infants, children and immunocompromised individuals...
March 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28269105/changes-in-inhaler-inhalation-acoustic-features-during-induced-bronchoconstriction-a-pilot-study
#17
Thomas A McCartan, Terence E Taylor, Imran Sulaiman, Richard W Costello, Richard B Reilly
Asthma is a chronic respiratory disease affecting millions of people worldwide, and is consequently a major issue for global health. Exacerbations are acute events involving the worsening of asthma's primary respiratory symptoms and are a major cause of morbidity in asthma patients, largely due to the unpredictability of their onset. This study aimed to investigate the relationship between changes in acoustic features of inhaler inhalations and changes in forced expiratory volume in one second (FEV1) that occur during a simulated exacerbation, a bronchial challenge test (BCT)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28245238/impacts-of-allergic-airway-inflammation-on-lung-pathology-in-a-mouse-model-of-influenza-a-virus-infection
#18
Akira Kawaguchi, Tadaki Suzuki, Yuki Ohara, Kenta Takahashi, Yuko Sato, Akira Ainai, Noriyo Nagata, Masato Tashiro, Hideki Hasegawa
Influenza A virus is the respiratory pathogen responsible for influenza. Infection by the 2009 pandemic influenza A (H1N1) virus caused severe lower airway inflammation and pneumonia. Asthma is a chronic inflammatory disorder of the airways that affects the entire brachial tree, and was one of the commonest underlying medical conditions among patients hospitalized with the 2009 pandemic influenza virus infection. Although respiratory virus infections are the major causes of asthma exacerbation, the mechanism by which influenza exacerbates asthma is poorly understood...
2017: PloS One
https://www.readbyqxmd.com/read/28227330/changes-in-inhaler-inhalation-acoustic-features-during-induced-bronchoconstriction-a-pilot-study
#19
Thomas A McCartan, Terence E Taylor, Imran Sulaiman, Richard W Costello, Richard B Reilly, Thomas A McCartan, Terence E Taylor, Imran Sulaiman, Richard W Costello, Richard B Reilly, Richard B Reilly, Thomas A McCartan, Terence E Taylor, Imran Sulaiman, Richard W Costello
Asthma is a chronic respiratory disease affecting millions of people worldwide, and is consequently a major issue for global health. Exacerbations are acute events involving the worsening of asthma's primary respiratory symptoms and are a major cause of morbidity in asthma patients, largely due to the unpredictability of their onset. This study aimed to investigate the relationship between changes in acoustic features of inhaler inhalations and changes in forced expiratory volume in one second (FEV1) that occur during a simulated exacerbation, a bronchial challenge test (BCT)...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28216104/high-flow-nasal-cannula-therapy-versus-non-invasive-ventilation-in-children-with-severe-acute-asthma-exacerbation-an-observational-cohort-study
#20
J Pilar, V Modesto I Alapont, Y M Lopez-Fernandez, O Lopez-Macias, D Garcia-Urabayen, I Amores-Hernandez
INTRODUCTION: The present study describes our experience with the high-flow humidified nasal cannula (HFNC) versus non-invasive ventilation (NIV) in children with severe acute asthma exacerbation (SA). METHODS: An observational study of a retrospective cohort of 42 children with SA admitted to a Pediatric Intensive Care Unit (PICU) for non-invasive respiratory support was made. The primary outcome measure was failure of initial respiratory support (need to escalate from HFNC to NIV or from NIV to invasive ventilation)...
February 16, 2017: Medicina Intensiva
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