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Asma

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By Roberto Garay-Cabada Pediatrics , Fellow in pediatric Pulmonology
https://www.readbyqxmd.com/read/29866794/respiratory-viruses-and-treatment-failure-in-children-with-asthma-exacerbation
#1
Joanna Merckx, Francine M Ducharme, Christine Martineau, Roger Zemek, Jocelyn Gravel, Dominic Chalut, Naveen Poonai, Caroline Quach
: media-1vid110.1542/5771275574001PEDS-VA_2017-4105 Video Abstract OBJECTIVES: Respiratory pathogens commonly trigger pediatric asthma exacerbations, but their impact on severity and treatment response remains unclear. METHODS: We performed a secondary analysis of the Determinants of Oral Corticosteroid Responsiveness in Wheezing Asthmatic Youth (DOORWAY) study, a prospective cohort study of children (aged 1-17 years) presenting to the emergency department with moderate or severe exacerbations...
June 4, 2018: Pediatrics
https://www.readbyqxmd.com/read/29790678/pediatric-pulmonology-year-in-review-2017-part-1
#2
William A Gower, David J Birnkrant, Jane B Black, Thomas Nicolai, Terry L Noah
Pediatric Pulmonology publishes original research, case reports and review articles on topics related to a wide range of children's respiratory disorders. In this article (Part 1 of a series), we summarize the past year's publications in our major topic areas, as well as selected literature in these areas from other journals. In Part 1, we review selected articles on diagnostic testing/endoscopy, respiratory complications of neuromuscular disorders, and rare lung diseases.
May 23, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29785255/feasibility-of-high-intensity-training-in-asthma
#3
L L Toennesen, E D Soerensen, M Hostrup, C Porsbjerg, J Bangsbo, V Backer
Background: High-intensity interval training is an effective and popular training regime but its feasibility in untrained adults with asthma is insufficiently described. Objective: The randomized controlled trial 'EFFORT Asthma' explored the effects of behavioural interventions including high-intensity interval training on clinical outcomes in nonobese sedentary adults with asthma. In this article we present a sub analysis of data aiming to evaluate if patients' pre-intervention levels of asthma control, FEV1, airway inflammation and airway hyperresponsiveness (AHR) predicted their training response to the high-intensity interval training program, measured as increase in maximal oxygen consumption (VO2 max)...
2018: European Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29670674/tiotropium-for-the-treatment-of-asthma-patient-selection-and-perspectives
#4
REVIEW
V Madhu Chari, Robert Andrew McIvor
Asthma is a chronic disease of airway inflammation with a large global burden. Despite established, guideline-based stepwise therapy, a significant proportion of patients remain symptomatic and poorly controlled. As such, there is a need for additional safe, effective, convenient, and cost-effective therapies that can be broadly applied across a range of asthma phenotypes. Tiotropium is a long-acting muscarinic antagonist (LAMA) that leads to bronchodilation by blocking endogenous acetylcholine receptors in the airways...
2018: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
https://www.readbyqxmd.com/read/29605203/in-vitro-and-clinical-characterization-of-the-valved-holding-chamber-aerochamber-plus-%C3%A2-flow-vu-%C3%A2-for-administrating-tiotropium-respimat-%C3%A2-in-1-5-year-old-children-with-persistent-asthmatic-symptoms
#5
Herbert Wachtel, Mark Nagel, Michael Engel, Georges El Azzi, Ashish Sharma, Jason Suggett
BACKGROUND: When characterizing inhalation products, a comprehensive assessment including in vitro, pharmacokinetic (PK), and clinical data is required. We conducted a characterization of tiotropium Respimat® when administered with AeroChamber Plus® Flow-Vu® anti-static valved holding chamber (test VHC) with face mask in 1-5-year-olds with persistent asthmatic symptoms. METHODS: In vitro tiotropium dose and particle size distribution delivered into a cascade impactor were evaluated under fixed paediatric and adult flow rates between actuation and samplings...
April 2018: Respiratory Medicine
https://www.readbyqxmd.com/read/29693459/evaluating-the-effectiveness-of-systemic-corticosteroids-to-mitigate-relapse-in-children-assessed-and-treated-for-acute-asthma-a-network-meta-analysis
#6
Scott W Kirkland, Ben Vandermeer, Sandy Campbell, Cristina Villa-Roel, Amanda Newton, Francine M Ducharme, Brian H Rowe
OBJECTIVE: The objective of this systematic review was to explore the effectiveness of various systemic corticosteroid (SCS) regimens to mitigate relapse in children with asthma discharged from an acute care setting. DATA SOURCES: Medline, EMBASE, Global Health, International Pharmaceutical Abstracts, EMB ALL, CINAHL, SCOPUS, Proquest Dissertations and Theses Global, and LILACS were searched using controlled vocabulary and key words. Additional citations were searched via clinical trial registries, Google Scholar, bibliographies, a SCOPUS forward search of a sentinel paper, and hand searching conference abstracts...
April 25, 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/29650006/beclomethasone-dipropionate-and-formoterol-fumarate-synergistically-interact-in-hyperresponsive-medium-bronchi-and-small-airways
#7
Luigino Calzetta, Maria Gabriella Matera, Francesco Facciolo, Mario Cazzola, Paola Rogliani
BACKGROUND: Corticosteroids increase the expression of β2 -adrenoceptors (β2 -ARs) and protect them against down-regulation. Conversely, β2 -AR agonists improve the anti-inflammatory action of corticosteroids. Nevertheless, it is still uncertain whether adding a long-acting β2 -AR agonist (LABA) to an inhaled corticosteroid (ICS) results in an additive effect, or there is true synergy. Therefore, the aim of this study was to pharmacologically characterize the interaction between the ICS beclomethasone diproprionate (BDP) and the LABA formoterol fumarate (FF) in a validated human ex vivo model of bronchial asthma...
April 12, 2018: Respiratory Research
https://www.readbyqxmd.com/read/29625664/challenges-in-the-treatment-of-asthma-in-children-and-adolescents
#8
REVIEW
Stanley J Szefler, Bradley Chipps
OBJECTIVE: Despite the availability of effective treatments, asthma control in children and adolescents remains inadequate and rates of health care use are high. This follow-up to a recent review (O'Byrne et al, Eur Respir J. 2017;50[3]) examines a number of challenges in current pediatric asthma management compared with that of an adult perspective and discusses possible alternative strategies that might improve pediatric asthma management and control. DATA SOURCES: The evidence base for this review is limited because, historically, much of the research has been performed in adults...
April 2018: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/29302790/optimizing-the-dosing-of-intravenous-theophylline-in-acute-severe-asthma-in-children
#9
Gemma L Saint, Malcolm G Semple, Ian Sinha, Daniel B Hawcutt
Optimizing the management of children presenting with acute severe asthma is of utmost importance to minimize hospital stays, morbidity, and mortality. Intravenous medications, including theophyllines, are used as second-line treatments for children experiencing a life-threatening exacerbation. For intravenous theophylline (aminophylline), guidelines and formularies recommend a target therapeutic range between 10 and 20 mg/l, with the commonest regimen being a loading dose of 5 mg/kg followed by an infusion calculated by age and weight...
January 5, 2018: Paediatric Drugs
https://www.readbyqxmd.com/read/29301922/budesonide-formoterol-maintenance-and-reliever-therapy-in-adolescent-patients-with-asthma
#10
Carin Jorup, Dan Lythgoe, Hans Bisgaard
Asthma control is often suboptimal in adolescents, but few studies have evaluated asthma treatments in this population.This post hoc analysis assessed the efficacy and safety of budesonide/formoterol (BUD/FORM) maintenance and reliever therapy (MART) for treatment of persistent asthma in adolescent (age 12-17 years) subgroups within six randomised, double-blind trials. The primary end-point was time to first severe exacerbation. Secondary end-points included number of severe exacerbations, asthma-related symptoms, night-time awakenings, morning peak expiratory flow, forced expiratory volume in 1 s, as-needed medication use and five-item asthma control questionnaire scores...
January 2018: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29197105/upper-and-lower-airway-remodelling-mechanisms-in-asthma-allergic-rhinitis-and-chronic-rhinosinusitis-the-one-airway-concept-revisited
#11
REVIEW
K Samitas, A Carter, H H Kariyawasam, G Xanthou
Allergic rhinitis (AR), chronic rhinosinusitis (CRS) and asthma often co-exist. The one airway model proposes that disease mechanisms occurring in the upper airway may mirror lower airway events. Airway remodelling is the term used to describe tissue structural changes that occur in a disease setting and reflect the dynamic process of tissue restructuring during wound repair. Remodelling has been long identified in the lower airways in asthma and is characterized by epithelial shedding, goblet cell hyperplasia, basement membrane thickening, subepithelial fibrosis, airway smooth muscle hyperplasia and increased angiogenesis...
December 1, 2017: Allergy
https://www.readbyqxmd.com/read/29105786/influenza-burden-prevention-and-treatment-in-asthma-a-scoping-review-by-the-eaaci-influenza-in-asthma-task-force
#12
REVIEW
J Schwarze, P Openshaw, A Jha, S R Del Giacco, D Firinu, O Tsilochristou, G Roberts, A Selby, C Akdis, I Agache, A Custovic, E Heffler, G Pinna, M Khaitov, A Nikonova, N Papadopoulos, A Akhlaq, U Nurmatov, H Renz, A Sheikh, C Skevaki
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma...
November 6, 2017: Allergy
https://www.readbyqxmd.com/read/29079610/duration-of-the-efficacy-of-omalizumab-after-treatment-discontinuation-in-real-life-severe-asthma
#13
Maria Del Carmen Vennera, Carlos Sabadell, Cesar Picado
Efficacy of omalizumab in severe asthma is well documented; however, the optimal duration of the treatment remains unclear. In an open prospective study, we sought to assess the persistence of response in subjects withdrawing from omalizumab treatment. We evaluated 49 patients who voluntarily accepted to discontinue omalizumab treatment after 6 years of therapy. Asthma relapse was defined as any severe asthma exacerbation associated with loss of asthma control. Twelve patients relapsed in the first year of follow-up, and 7 within 13 and 48 months...
October 27, 2017: Thorax
https://www.readbyqxmd.com/read/29064265/pregnancy-complications-and-wheezing-and-asthma-in-childhood
#14
Franca Rusconi, Luigi Gagliardi
No abstract text is available yet for this article.
March 1, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29053714/atopic-asthmatic-immune-phenotypes-associated-with-airway-microbiota-and-airway-obstruction
#15
Benjamin A Turturice, Halvor S McGee, Brian Oliver, Melissa Baraket, Brian T Nguyen, Christian Ascoli, Ravi Ranjan, Asha Rani, David L Perkins, Patricia W Finn
BACKGROUND: Differences in asthma severity may be related to inflammation in the airways. The lower airway microbiota has been associated with clinical features such as airway obstruction, symptom control, and response to corticosteroids. OBJECTIVE: To assess the relationship between local airway inflammation, severity of disease, and the lower airway microbiota in atopic asthmatics. METHODS: A cohort of young adult, atopic asthmatics with intermittent or mild/moderate persistent symptoms (n = 13) were assessed via bronchoscopy, lavage, and spirometry...
2017: PloS One
https://www.readbyqxmd.com/read/28837382/national-estimates-of-30-day-readmissions-among-children-hospitalized-for-asthma-in-the-united-states
#16
Sreenivas P Veeranki, Michael U Ohabughiro, Jacob Moran, Hemalkumar B Mehta, Bill T Ameredes, Yong-Fang Kuo, William J Calhoun
OBJECTIVE: Previous single-center studies have reported that up to 40% of children hospitalized for asthma will be readmitted. The study objectives are to investigate the prevalence and timing of 30-day readmissions in children hospitalized with asthma, and to identify factors associated with 30-day readmissions. METHODS: Data (n = 12,842) for children aged 6-18 years hospitalized for asthma were obtained from the 2013 Nationwide Readmission Database (NRD). The primary study outcome was time to readmission within 30 days after discharge attributable to any cause...
August 24, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28600901/influences-of-environmental-bacteria-and-their-metabolites-on-allergies-asthma-and-host-microbiota
#17
REVIEW
G Jatzlauk, S Bartel, H Heine, M Schloter, S Krauss-Etschmann
The prevalence of allergic diseases and asthma has dramatically increased over the last decades, resulting in a high burden for patients and healthcare systems. Thus, there is an unmet need to develop preventative strategies for these diseases. Epidemiological studies show that reduced exposure to environmental bacteria in early life (eg, birth by cesarean section, being formula-fed, growing up in an urban environment or with less contact to various persons) is associated with an increased risk to develop allergies and asthma later in life...
December 2017: Allergy
https://www.readbyqxmd.com/read/28548868/inhaled-corticosteroid-prescribing-in-a-pediatric-emergency-department-sustained-success-and-prescription-filling-rates
#18
Sarah Nicole Adams, Mary Abel, Dustin Fowler, Jennifer Braden, Myla D Ebeling, Annie N Simpson, M Olivia Titus, Annie Lintzenich Andrews
OBJECTIVE: To determine if improvement in Inhaled Corticosteroid (ICS) prescribing in the pediatric emergency department (PED) can be sustained after transition from intense intervention to low-intervention phase, and to determine ICS fill rates. METHODS: A Quality Improvement (QI) project began in Aug 2012. Results through Feb 2014 were previously published. In Feb 2014 interventions were scaled back to determine the sustainability of QI success. Eligible patients included children aged 2-17 seen in the PED for asthma between Feb 2014 and Sept 2016...
March 2018: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28484598/the-evidence-on-tiotropium-bromide-in-asthma-from-the-rationale-to-the-bedside
#19
REVIEW
Dejan Radovanovic, Pierachille Santus, Francesco Blasi, Marco Mantero
Severe and poorly controlled asthma still accounts for a great portion of the patients affected. Disease control and future risk management have been identified by international guidelines as the main goals in patients with asthma. The need for new treatment approaches has led to reconsider anticholinergic drugs as an option for asthma treatment. Tiotropium is the first anticholinergic drug that has been approved for children and adults with poorly controlled asthma and is currently considered as an option for steps 4 and 5 of the Global Initiative for Asthma...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/28363401/neutrophilic-steroid-refractory-recurrent-wheeze-and-eosinophilic-steroid-refractory-asthma-in-children
#20
Tamazoust Guiddir, Philippe Saint-Pierre, Elsa Purenne-Denis, Nathalie Lambert, Yacine Laoudi, Rémy Couderc, Rahelé Gouvis-Echraghi, Flore Amat, Jocelyne Just
BACKGROUND: Little is known about inflammatory pathways of severe recurrent wheeze in preschool children and severe asthma in children. OBJECTIVES: The aim of the Severe Asthma Molecular Phenotype cohort was to characterize phenotypes of severe recurrent wheeze and severe asthma during childhood in terms of triggers (allergic or not), involved cells (eosinophil or neutrophil), and corticoid responsiveness. METHODS: Children with moderate-to-severe asthma and preschool children with moderate-to-severe recurrent wheeze were enrolled prospectively...
September 2017: Journal of Allergy and Clinical Immunology in Practice
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