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acute exacerbations of asthma

Thais Mauad, Felipe B P do Nascimento, Marisa Dolhnikoff, Milena C M Picka, Paulo H N Saldiva
BACKGROUND: Mortality related to asthma has decreased worldwide since the introduction of inhaled corticosteroid therapy in the past decades. However, there are still some asthma fatalities identified mainly in populations with less access to regular treatment. Pulmonary interstitial emphysema due to alveolar rupture has been rarely described as a complication of an acute severe asthma attack, and its identification in pathological analysis can be difficult. Previous studies reported the association of pulmonary interstitial emphysema and bronchial ductal gland ectasia in asthma...
March 20, 2018: BMC Pulmonary Medicine
Giuseppe Brescia, Daniela Parrino, Lorenzo Nicolè, Claudia Zanotti, Cristiano Lanza, Umberto Barion, Filippo Marino, Gino Marioni
PURPOSE: The term aspirin-exacerbated respiratory disease (AERD) refers to a combination of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and acute respiratory tract reactions to nonsteroidal anti-inflammatory drugs. AERD has now been included among the CRSwNP endotypes, and is considered one of the most aggressive in terms of disease recurrence. Cortactin is a multi-domain protein with a part in several cellular mechanisms involving actin assembly and cytoskeleton arrangement...
March 5, 2018: American Journal of Otolaryngology
Christina Li-Ping Thio, Po-Yu Chi, Alan Chuan-Ying Lai, Ya-Jen Chang
BACKGROUND: Allergic asthma is characterized airway hyperreactivity (AHR) and inflammation driven by aberrant TH 2 response. Type 2 innate lymphoid cells (ILC2s) are a critical source of TH 2 cytokines IL-5 and IL-13 which promote acute asthma exacerbation. Short chain fatty acids (SCFAs) have been shown to attenuate T cell-mediated allergic airway inflammation. Their role in the regulation of ILC2-driven AHR and lung inflammation, however, remains unknown. OBJECTIVE: We investigated the immunomodulatory role of SCFAs in the regulation of ILC2-induced AHR and airway inflammation and delineated the mechanism involved...
March 6, 2018: Journal of Allergy and Clinical Immunology
Nicholas Arrotta, Jesse Hill, Cristina Villa-Roel, Elizabeth Dennett, Molly Harries, Brian H Rowe
OBJECTIVES: A variable proportion of patients presenting to the emergency department (ED) with acute asthma require admission to hospital. Previous studies have identified select factors associated with admission following ED presentation; however, no review has synthesized the evidence in this regard. This systematic review summarizes the evidence regarding factors associated with hospital admission following ED presentation. METHODS: Searches were conducted in seven electronic databases and common sources of grey literature...
March 9, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Karin Lisspers, Christer Janson, Kjell Larsson, Gunnar Johansson, Gunilla Telg, Marcus Thuresson, Björn Ställberg
BACKGROUND: Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden. OBJECTIVE: To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population. METHODS: Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers...
March 2018: Respiratory Medicine
Hao Zhang, Yue Niu, Yili Yao, Renjie Chen, Xianghong Zhou, Haidong Kan
The evidence concerning the acute effects of ambient air pollution on various respiratory diseases was limited in China, and the attributable medical expenditures were largely unknown. From 2013 to 2015, we collected data on the daily visits to the emergency- and outpatient-department for five main respiratory diseases and their medical expenditures in Shanghai, China. We used the overdispersed generalized additive model together with distributed lag models to fit the associations of criteria air pollutants with hospital visits, and used the linear models to fit the associations with medical expenditures...
February 28, 2018: International Journal of Environmental Research and Public Health
Asalim Thabet, Tyler Greenfield, Richard M Cantor
Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis...
March 2018: Pediatric Emergency Medicine Practice
Asalim Thabet, Tyler Greenfield, Richard M Cantor, Bryan Wilson
Corticosteroids have been used for over half a century to treat various inflammatory disorders; however, their use in many pediatric conditions remains controversial. This issue reviews evidence on corticosteroid treatment in acute asthma exacerbations, croup, acute pharyngitis, anaphylaxis, acute spinal injury, and bacterial meningitis. While corticosteroids are clearly indicated for management of asthma exacerbations and croup, they are not universally recommended for potential spinal cord injury. Due to insufficient data or conflicting data, corticosteroids may be considered in children with acute pharyngitis, anaphylaxis, and bacterial meningitis...
March 1, 2018: Pediatric Emergency Medicine Practice
Koen B Pouwels, F Christiaan K Dolk, David R M Smith, Julie V Robotham, Timo Smieszek
Objectives: Previous work based on guidelines and expert opinion identified 'ideal' prescribing proportions-the overall proportion of consultations that should result in an antibiotic prescription-for common infectious conditions. Here, actual condition-specific prescribing proportions in primary care in England were compared with ideal prescribing proportions identified by experts. Methods: All recorded consultations for common infectious conditions (cough, bronchitis, exacerbations of asthma or chronic obstructive pulmonary disease, sore throat, rhinosinusitis, otitis media, lower respiratory tract infection, upper respiratory tract infection, influenza-like illness, urinary tract infection, impetigo, acne, gastroenteritis) for 2013-15 were extracted from The Health Improvement Network (THIN) database...
February 1, 2018: Journal of Antimicrobial Chemotherapy
Jose L Gomez, Maria P Diaz, Gustavo Nino, Clemente J Britto
BACKGROUND: Asthma exacerbations are an important cause of morbidity in asthma. Respiratory infections are often involved in asthma exacerbations in both children and adults. Some individuals with asthma have increased susceptibility to viral infections and as a result increased rates of asthma exacerbations. We sought to identify a transcriptomic signature in the blood associated with asthma exacerbations triggered by respiratory infections (AETRI) and determine its association with increased risk for asthma exacerbations...
February 27, 2018: BMC Medical Genomics
Neale Smith, Anne Smith, Alice Wang, Kaitlyn Shaw, Gabriella Groeneweg, Ran D Goldman, Bryan Wilkinson, Ricardo Jimenez, Leah Mwai, Bruce Carleton
Objectives: Administration of oral corticosteroids at the onset of an upper respiratory tract infection (URTI) can be effective in the management of acute asthma exacerbations in children. This study was designed to identify barriers to parent-initiated implementation of clinical practice guideline-recommended use of oral corticosteroids for prophylaxis against severe asthma exacerbations in children. Methods: Twenty-seven children who presented to BC Children's Hospital with URTI-induced asthma exacerbations were recruited...
July 2017: Paediatrics & Child Health
Rihuang Qiu, Jiaxing Xie, Kian Fan Chung, Naijian Li, Zhaowei Yang, Mengzhang He, Jing Li, Rongchang Chen, Nanshan Zhong, Qingling Zhang
BACKGROUND: Asthma is a heterogeneous disease with diverse clinical manifestations and inflammatory pathologies that is punctuated by exacerbations. OBJECTIVES: To describe the clinical and inflammatory characteristics of asthma patients treated in hospital for an acute exacerbation. METHODS: Data from 320 adult patients receiving treatment for an acute exacerbation of asthma were obtained. In 218 with complete data , we used Ward's hierarchical clustering to obtain clusters...
February 22, 2018: Journal of Allergy and Clinical Immunology in Practice
Yee Vern Yong, Asrul Akmal Shafie
BACKGROUND: Patients with asthma need long-term management to maintain optimal control. In addition to routine maintenance, urgent visits and hospitalizations may be required, as these patients are prone to acute exacerbations. The aim of this study was to estimate the costs of maintenance and acute exacerbation managements in patients with asthma in a suburban public hospital in Malaysia. METHODS: An activity-based microcosting approach was applied to estimate the unit cost of events from the hospital's perspective...
June 21, 2017: Value in Health Regional Issues
Win Sen Kuan, Simon Craig, Anne-Maree Kelly, Gerben Keijzers, Sharon Klim, Colin A Graham, Peter Jones, Anna Holdgate, Charles Lawoko, Said Laribi
INTRODUCTION: Shortness of breath is a common presenting symptom to the emergency department (ED) that can arise from a myriad of possible diagnoses. Asthma is one of the major causes. OBJECTIVE: To describe the demographic features, clinical characteristics, management and outcomes of adults with an emergency department (ED) diagnosis of asthma who presented to an ED in the Asia Pacific region with a principal symptom of dyspnea. METHODS: Planned sub-study of patients with an ED diagnosis of asthma identified in the Asia, Australia and New Zealand Dyspnoea in Emergency Departments (AANZDEM) study...
February 22, 2018: Clinical Respiratory Journal
Roxana Khalili, Scott M Bartell, Xuefei Hu, Yang Liu, Howard H Chang, Candice Belanoff, Matthew J Strickland, Verónica M Vieira
BACKGROUND: Associations between ambient particulate matter < 2.5 μm (PM2.5 ) and asthma morbidity have been suggested in previous epidemiologic studies but results are inconsistent for areas with lower PM2.5 levels. We estimated the associations between early-life short-term PM2.5 exposure and the risk of asthma or wheeze clinical encounters among Massachusetts children in the innovative Pregnancy to Early Life Longitudinal (PELL) cohort data linkage system. METHODS: We used a semi-bidirectional case-crossover study design with short-term exposure lags for asthma exacerbation using data from the PELL system...
February 21, 2018: Environmental Health: a Global Access Science Source
Sarah Kyuragi Luthe, Atsushi Hirayama, Tadahiro Goto, Mohammad Kamal Faridi, Carlos A Camargo, Kohei Hasegawa
BACKGROUND: Although studies have demonstrated relations between obesity and incident asthma, little is known about the association of obesity with acute severity in adults hospitalized for asthma exacerbation. OBJECTIVES: To investigate the association of obesity with acute severity of asthma exacerbation. METHODS: This is a retrospective cohort study using population-based data of 8 geographically diverse US states from 2010 through 2013...
February 13, 2018: Journal of Allergy and Clinical Immunology in Practice
Jose A Romero-Espinoza, Yazmin Moreno-Valencia, Rodrigo H Coronel-Tellez, Manuel Castillejos-Lopez, Andres Hernandez, Aaron Dominguez, Angel Miliar-Garcia, Arturo Barbachano-Guerrero, Rogelio Perez-Padilla, Alejandro Alejandre-Garcia, Joel A Vazquez-Perez
BACKGROUND: Acute asthma exacerbations and pneumonia are important causes of morbidity and mortality in children and may coexist in the same children, although symptom overlap may lead to difficulties in diagnosis. Microbial and viral diversity and differential abundance of either may play an important role in infection susceptibility and the development of acute and chronic respiratory diseases. OBJECTIVES: To describe the virome and bacteriome present in the upper respiratory tract of hospitalized children with a clinical diagnosis of asthma and pneumonia during an acute exacerbation and an acute respiratory illness ARI episode respectively...
2018: PloS One
Kathleen T Unroe, Jennifer L Carnahan, Susan E Hickman, Greg A Sachs, Zachary Hass, Greg Arling
OBJECTIVES: To describe the relationship between nursing facility resident risk conditions and signs and symptoms at time of acute transfer and diagnosis of conditions associated with potentially avoidable acute transfers (pneumonia, urinary tract infection, congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) or asthma, dehydration, pressure sores). DESIGN: As part of a demonstration project to reduce potentially avoidable hospital transfers, Optimizing Patient Transfers, Impacting Medical Quality, Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project clinical staff collected data on residents who transferred to the emergency department (ED) or hospital...
February 13, 2018: Journal of the American Geriatrics Society
Vincent Yi-Fong Su, Kuang-Yao Yang, Yao-Hsu Yang, Ying-Huang Tsai, Diahn-Warng Perng, Wei-Juin Su, Kun-Ta Chou, Kang-Cheng Su, Yung-Feng Yen, Pau-Chung Chen
BACKGROUND: Based on current guidelines, more research is urgently needed to guide appropriate treatment for patients with asthma-chronic obstructive pulmonary disease (COPD) overlap. OBJECTIVE: The objective of this study was to investigate medication effects on acute exacerbation in patients with coexistent COPD and asthma. METHODS: Using Taiwan's National Health Insurance Research Database, we conducted a nationwide population-based study to evaluate medication effects in patients with COPD and asthma...
February 10, 2018: Journal of Allergy and Clinical Immunology in Practice
Peter Korošec, Bernhard F Gibbs, Matija Rijavec PhD, Adnan Custovic, Paul J Turner
IgE-mediated allergic reactions involve the activation of effector cells, predominantly through the high-affinity IgE receptor (FcεRI) on mast cells and basophils. Although the mast cell is considered the major effector cell during acute allergic reactions, more recent studies indicate a potentially important and specific role for basophils and their migration which occurs rapidly upon allergen challenge in humans undergoing anaphylaxis. We review the evidence for a role of basophils in contributing to clinical symptoms of anaphylaxis, and discuss the possibility that basophil trafficking during anaphylaxis might be a pathogenic (to target organs) or protective (preventing degranulation in circulation) response...
February 12, 2018: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
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