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Asthma: ParuchMD

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14 papers 0 to 25 followers
By John Paruch Combined training in Internal Medicine-Psychiatry with holistic, evidence-based, preventive approach to implementation and promotion of wellness.
Mario Cazzola, Clive P Page, Luigino Calzetta, M Gabriella Matera
Bronchodilators are central in the treatment of of airways disorders. They are the mainstay of the current management of chronic obstructive pulmonary disease (COPD) and are critical in the symptomatic management of asthma, although controversies around the use of these drugs remain. Bronchodilators work through their direct relaxation effect on airway smooth muscle cells. at present, three major classes of bronchodilators, β(2)-adrenoceptor (AR) agonists, muscarinic receptor antagonists, and xanthines are available and can be used individually or in combination...
July 2012: Pharmacological Reviews
Jodie L Simpson, Heather Powell, Michael J Boyle, Rodney J Scott, Peter G Gibson
RATIONALE: Patients with refractory asthma have persistent symptoms despite maximal treatment with inhaled corticosteroids and long-acting bronchodilators. The availability of add-on therapies is limited, and effective add-on therapies that target noneosinophilic airway inflammation are needed. Macrolide antibiotics, such as clarithromycin, have in vitro efficacy against IL-8 and neutrophils, key inflammatory mediators in noneosinophilic asthma. OBJECTIVES: To determine the efficacy of clarithromycin in patients with severe refractory asthma and specifically in a subgroup of patients with noneosinophilic asthma...
January 15, 2008: American Journal of Respiratory and Critical Care Medicine
E Daviskas, S D Anderson, I Gonda, S Eberl, S Meikle, J P Seale, G Bautovich
Hyperosmolarity of the airway surface liquid (ASL) has been proposed as the stimulus for hyperpnoea-induced asthma. We found previously that mucociliary clearance (MCC) was increased after isocapnic hyperventilation (ISH) with dry air, and we proposed that the increase related to transient hyperosmolarity of the ASL. We investigated the effect of increasing the osmolarity of the ASL on MCC, by administering an aerosol of concentrated salt solution. MCC was measured using 99mTc-sulphur colloid, gamma camera and computer analysis in 12 asthmatic and 10 healthy subjects on three separate days, involving administration of each of the following: 1) ultrasonically nebulized 14...
April 1996: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
Elizabeth D Schifano, Jessica P Hollenbach, Michelle M Cloutier
OBJECTIVES: To examine the concordance between spirometry and asthma symptoms in assessing asthma severity and beginning therapy by the general pediatrician. STUDY DESIGN: Between 2008 and 2012, spirometry testing was satisfactorily performed in 894 children (ages 5-19 years) whose asthma severity had been determined by their pediatrician using asthma guideline-based clinical criteria. Spirometry-determined asthma severity using national asthma guidelines and clinician-determined asthma severity were compared for concordance using weighted Kappa coefficients...
November 2014: Journal of Pediatrics
M L Moy, E Israel, S T Weiss, E F Juniper, L Dubé, J M Drazen
The National Asthma Education and Prevention Program guidelines define asthma severity before treatment by lung function and symptoms. It has been assumed, but not demonstrated, that improvement in these measures would translate into improvement in health-related quality of life (HRQL). Because HRQL is an important outcome in asthma management, we asked what are the determinants of HRQL? To address this question, we retrospectively analyzed HRQL data, as measured by the Juniper Asthma Quality of Life Questionnaire, in subjects with mild versus moderate-severe asthma from two clinical trials...
March 2001: American Journal of Respiratory and Critical Care Medicine
Homer A Boushey, Christine A Sorkness, Tonya S King, Sean D Sullivan, John V Fahy, Stephen C Lazarus, Vernon M Chinchilli, Timothy J Craig, Emily A Dimango, Aaron Deykin, Joanne K Fagan, James E Fish, Jean G Ford, Monica Kraft, Robert F Lemanske, Frank T Leone, Richard J Martin, Elizabeth A Mauger, Gene R Pesola, Stephen P Peters, Nancy J Rollings, Stanley J Szefler, Michael E Wechsler, Elliot Israel
BACKGROUND: Although guidelines recommend daily therapy for patients with mild persistent asthma, prescription patterns suggest that most such patients use these so-called controller therapies intermittently. In patients with mild persistent asthma, we evaluated the efficacy of intermittent short-course corticosteroid treatment guided by a symptom-based action plan alone or in addition to daily treatment with either inhaled budesonide or oral zafirlukast over a one-year period. METHODS: In a double-blind trial, 225 adults underwent randomization...
April 14, 2005: New England Journal of Medicine
Christian E Sandrock, Andrew Norris
In chronic persistent asthma and severe acute exacerbations of bronchial asthma, infectious agents are the predominant triggers that drive disease and airway pathobiology. In acute exacerbations of bronchial asthma (AEBA) including near fatal and fatal asthma, viral agents, particularly human rhinovirus-C, respiratory syncytial virus and influenza A appear to be the more prevalent and recurring threats. Both viral, and to a lesser extent bacterial agents, can play a role, and co-infection may also be present and worsen prognosis in hospitalized patients, placing a portion at risk for critical asthma syndrome...
February 2015: Clinical Reviews in Allergy & Immunology
David Hodgson, John Anderson, Catherine Reynolds, Janet Oborne, Garry Meakin, Helen Bailey, Dominick Shaw, Kevin Mortimer, Tim Harrison
BACKGROUND: Chronic cough is a common clinical problem worldwide. Although many patients have underlying precipitating conditions such as asthma, gastroesophageal reflux, or rhinitis, many remain symptomatic despite treating these conditions. New approaches are needed for the treatment of this group of patients. METHODS: We conducted a randomized, double-blind, placebo-controlled trial to determine whether 250 g of azithromycin three times a week for 8 weeks would affect the Leicester Cough Questionnaire (LCQ) score in 44 patients with treatment-resistant cough...
April 2016: Chest
Michael J Parnham, Vesna Erakovic Haber, Evangelos J Giamarellos-Bourboulis, Gianpaolo Perletti, Geert M Verleden, Robin Vos
Azithromycin is a macrolide antibiotic which inhibits bacterial protein synthesis, quorum-sensing and reduces the formation of biofilm. Accumulating effectively in cells, particularly phagocytes, it is delivered in high concentrations to sites of infection, as reflected in rapid plasma clearance and extensive tissue distribution. Azithromycin is indicated for respiratory, urogenital, dermal and other bacterial infections, and exerts immunomodulatory effects in chronic inflammatory disorders, including diffuse panbronchiolitis, post-transplant bronchiolitis and rosacea...
August 2014: Pharmacology & Therapeutics
Semiha Bahceci Erdem, Hikmet Tekin Nacaroglu, Canan Sule Unsal Karkiner, Ilker Gunay, Demet Can
BACKGROUND: Leukotriene receptor antagonists (LTRAs) are drugs which have been widely used more than ten years. As the use of LTRAs increases, our knowledge with respect to their side effects increases as well. OBJECTIVES: The objective of our study was to evaluat the observed side effects of LTRAs used in patients with astma. PATIENTS AND METHODS: 1024 patients treated only with LTRAs owing to asthma or early wheezing were included in the study for a five-year period...
October 2015: Iranian Journal of Pediatrics
Monil Bharat Shah, Jayendra Gohil, Swati Khapekar, Jigna Dave
OBJECTIVES: To compare the efficacy of oral Montelukast and inhaled Budesonide as a first line preventive therapy in mild persistent asthma in age group 2-18 y. METHODS: This prospective randomized controlled clinical study was conducted for 12 wk. Sixty patients of mild persistent asthma aged 2 to 18 y were randomly allocated to either oral Montelukast (n = 60) or inhaled Budesonide (n = 60) group. Outcomes measured were improvement in peak expiratory flow rate (PEFR), forced expiratory volume 1 s/forced vital capacity (FEV1/FVC), day time and night time symptoms and frequency of exacerbations and need to change medications...
July 2014: Indian Journal of Pediatrics
Dejan Dokic, Bozidar Poposki, Dimitar Karkinski
Chronic C. pneumoniae infection has been suggested as a cause for adult onset of asthma. There are data to suggest that infectious organisms, particularly the atypical bacteria C. pneumoniae, may be involved in asthma pathogenesis. The significance of these organisms is as yet unclear. It is not known whether this organism was allowed to persist after an infection, or was present prior to the development of asthma. The purpose of this study was to determine whether anti-chlamydial treatment with azithromycin will improve asthma symptoms and lung function in asthmatic patients positive for C...
2013: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
W S Tunnicliffe, M F Hilton, R M Harrison, J G Ayres
Sulphur dioxide (SO2) is an important air pollutant and causes bronchoconstriction in normal and asthmatic adults. This paper has explored the autonomic consequences of SO2 exposure using the spectral analysis of heart rate variability. Electrocardiogram recordings were made in 12 normal and 12 asthmatic adults undergoing pollutant exposures. Exposures were of a 1 h duration, double blind, in random order, > or = 2 weeks apart and included air and 200 parts per billion SO2. Spectral analysis of R-R intervals was performed...
April 2001: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
B J Freedman
Sulphur dioxide is widely used in the food and drinks industries for its properties as a preservative and antioxidant. Whilst harmless to healthy persons when used in recommended concentrations, it can induce asthma when inhaled or ingested by sensitive subjects, even in high dilution. About one in nine asthmatics gives a history of asthma worsened by drinking 'soft drinks' containing sulphur dioxide. They are comparatively young and their asthma is predominantly extrinsic. The amount of sulphur dioxide in foods is limited by regulation in the UK, by directive in the EEC, and by recommendations to 'good manufacturing practice' in the USA...
April 1980: British Journal of Diseases of the Chest
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