The overall goal of the Severe Asthma Research Program (SARP) is to develop a new paradigm for the understanding of severe asthma and its sub-phenotypes, in chi...

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Data & statistics on Current Asthma Status by Health Care Utilization Colorado Adults BRFSS: Current Asthma Status by Health Care Utilization: Colorado Adults, BRFSS 2000, To the right breaks down the prevalence of COPD among Colorado adults by age, race/ethnicity, sex, employment status, education level, income, marital status, smoking status, and asthma history., Urgent care visits: Percent of adults currently with asthma who had at least one urgent care visit for asthma with their provider in the past 12 months by State, District of Columbia and U.S. Territory, 2003...

The Asthma USA survey showed that uncontrolled asthma had significant medical consequences. Adults with uncontrolled asthma were more prone to need treatment with oral corticosteroids, visit the emergency room, or be hospitalized, compared with patients with well-controlled asthma.. Children with uncontrolled asthma also were in the same situation. Earlier studies have shown that uncontrolled asthma can put patients at risk for increased asthma symptoms, sudden asthma attacks, hospitalization, and even death.. The survey included >81,500 households that were assessed using the Asthma Control Test (ACT). Of the >10,000 adults with self-reported asthma taking the ACT, 41% had a score of 19 or less, which indicates uncontrolled asthma. The survey also examined scores from the Childhood Asthma Control Test and ACT in >3000 children respondents between the ages of 4 and 17. The results indicated that 31% of the children with asthma between the ages of 4 and 11 and 25% of those between the ages of 12 ...

TABLE1 - Estimated percent of current and former asthma status among adults ever diagnosed with asthma by state/territory.. TABLE2 - Estimated percent of active and inactive asthma status among adults ever diagnosed with asthma by state/territory.. TABLE3a - Estimated percent for time since first diagnosis among adults with current asthma by state/territory.. TABLE3b - Estimated percent for time since first diagnosis among adults with active asthma by state/territory.. TABLE4a - Estimated percent reporting an asthma attack or episode in the past year among adults with current asthma by state/territory.. TABLE4b - Estimated percent reporting an asthma attack or episode in the past year among adults with active asthma by state/territory. TABLE5a - Estimated percent reporting routine doctor visits in the past year among adults with current asthma by state/territory.. TABLE5b - Estimated percent reporting routine doctor visits in the past year among adults with active asthma by ...

TY - JOUR. T1 - Classification of childhood asthma phenotypes and long-term clinical responses to inhaled anti-inflammatory medications. AU - Howrylak, Judie A.. AU - Fuhlbrigge, Anne L.. AU - Strunk, Robert C.. AU - Zeiger, Robert S.. AU - Weiss, Scott T.. AU - Raby, Benjamin A.. N1 - Funding Information: Heterogeneity of severe asthma in childhood: confirmation by cluster analysis of children in the National Institutes of Health/National Heart, Lung, and Blood Institute Severe Asthma Research Program. PY - 2014/5. Y1 - 2014/5. N2 - Background Although recent studies have identified the presence of phenotypic clusters in asthmatic patients, the clinical significance and temporal stability of these clusters have not been explored. Objective Our aim was to examine the clinical relevance and temporal stability of phenotypic clusters in children with asthma. Methods We applied spectral clustering to clinical data from 1041 children with asthma participating in the Childhood Asthma Management ...

Updated guidelines and new treatments for asthma have become available since the last major survey of asthma management in the United States was completed ∼11 years ago. The Asthma Insight and Management (AIM) survey was conducted to assess the current status of asthma burden in the United States. A geographically stratified screening of 60,682 households provided a national sample of 2500 patients with current asthma (2186 adults aged ≥18 years; 314 adolescents aged 12‐17 years). A national sample of 1004 adults without current asthma was interviewed for comparison with the adult asthma population, and 309 asthma health care providers were surveyed for their opinions about the burden of asthma. Asthma prevalence in the United States was estimated at 8%. Twice as many adult asthma patients rated their health as only fair, poor, or very poor, or experienced limitations in activity because of health problems, compared with the general population. Asthma also frequently caused negative ...

What is an asthma action plan?. An asthma action plan is a written plan, customised for every asthmatic patient. The action plan is developed and designed by the doctor to help asthmatic patients to control their asthma. Action plans may differ from patient to patient depending on severity.. The asthma action plan may need to be reviewed and updated from time to time so that any changes in asthma medication is recorded according to the asthma control.. What is in the plan?. The asthma action plan will tell the patient what to do during asthma attacks. It contains specific written instructions on:. ...

Asthma is a prevalent chronic respiratory disease and major cause of morbidity in the United States (1). However, with appropriate medication, medical care, and self-management, most asthma symptoms are preventable (2). Recent evidence indicates that asthma self-management education is effective in improving outcomes of chronic asthma (3). Guidelines issued by the National Asthma Education and Prevention Program (NAEPP) specify essential components of asthma management, including patient education, objective monitoring of symptoms, and avoiding asthma triggers (3). Healthy People 2010 objectives include increasing the proportion of persons with asthma who receive formal patient education from 8% to 30% (objective 24-6) and who receive care according to NAEPP guidelines (objective 24-7) (4,5). The National Health Interview Survey (NHIS) routinely includes questions that assess asthma status. In 2003, the survey included a series of questions designed to reflect clinical best practices for asthma ...

TY - JOUR. T1 - The Role of the Six-minute Walk Test, Pulmonary Function Test, and Asthma Control Test in Asthmatic Patients-a Preliminary Report. AU - Chen, Shiau-Yee. AU - Hsu, Han Lin. AU - Lin, Jiu Jenq. AU - 余, 明治(Ming-Chi Yu). AU - 江, 玲玲(Ling-Ling Chiang). AU - 李, 俊年(Chun-Nie Lee). PY - 2010. Y1 - 2010. N2 - Purpose: Asthma control is the main concern for related professionals when approaching asthmatic patients. In this study, we selected three different tools to understand asthma control status in patients with asthma.Methods: Twenty-six patients with asthma were recruited in the study. These patients underwent pulmonary function testing with spirometry and the six-minute walk test, and completed an asthma control questionnaire (Asthma Control Test, ACT). In statistical analysis, the Spearman rank correlation and Pearson correlation coefficient were used for correlation between measured variables. For explanation, potential prediction variables were entered into a ...

The phenotypic features of asthma differ by severity and with advancing age. With advancing age, patients with severe asthma are more obese, have greater airflow limitation, less allergen sensitization, and variable type 2 inflammation. Novel mechanisms besides type 2 inflammatory pathways may infor …

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BACKGROUND: Asthma is a common chronic disease affecting patients health status and quality of life. Although recent guidelines focus on asthma control, asthma remains poorly controlled in many patients even under specialist care. Asthma Control Test™ (ACT) is a short, simple, patient-based tool that provides consistent assessment of asthma.OBJECTIVE: The aim of this study was to estimate the relationship of ACT with objective measures of lung function and inflammation such as forced expiratory volume in 1st second (FEV(1)) and exhaled nitric oxide (FeNO) in outpatients admitted for initial diagnosis of asthma and at follow-up.METHODS: One hundred and sixty (104 women and 56 men, mean age 39.7 ± 16.6 years) asthmatic patients with newly diagnosed asthma were included in the study. Patients completed the ACT questionnaire and underwent a detailed clinical examination, FeNO measurement, and prebronchodilator spirometry before (visit 1) and 4-12 weeks after initiation of treatment (visit ...

By Jaclyn Chasse N.D.. Over 22 million Americans have asthma and it is one of the most common pediatric chronic diseases, affecting about 6 million children. Asthma is a condition characterized by cough, difficulty breathing, wheezing and chest tightness. Asthma has several underlying pathological mechanisms including bronchoconstriction, bronchial hyperreactivity, and underlying inflammation and airway edema.. The National Asthma Education and Prevention Program (NAEPP) first published guidelines for care in 1991 and published the most recent update in 2007. One of the key clinical activities recommended by the NAEPP is the development of a written asthma action plan in partnership with the patient. An asthma action plan is a written tool which outlines appropriate care for an asthma patient. The stoplight tool is on example of a written asthma action plan that categorizes severity of asthma into a red, yellow, or green zone. Each zone corresponds with a different stage of asthma and outlines ...

A recent review revealed that a lot needs to be done to improve asthma control in Australian children (www.aihw.gov.au).. Asthma affects 1 in 5 children. The good news is that there has been a 25% drop in the number of kids with asthma since 2001.. Poor asthma control is common. The study found that many children have poorly controlled asthma. Poor control leads to more severe symptoms, more flareups, days off school and hospital admissions.. Management plans. Most asthmatic children have not had an Asthma Cycle of Care, a full asthma assessment and treatment plan from their GP.. Half of Australian children with asthma do not have a written Asthma Action Plan which helps recognise and treat any deterioration. Action Plans improve asthma control.. Incorrect use of medication. Many children use their short-acting relievers too often, instead of taking a daily preventer such as an inhaled corticosteroid. Preventers should be taken on a regular once- or twice-daily basis, but are most often used ...

BackgroundMany patients and healthcare professionals believe that work-related psychosocial stress, such as job strain, can make asthma worse, but this is not corroborated by empirical evidence. We investigated the associations between job strain and the incidence of severe asthma exacerbations in working-age European men and women. MethodsWe analysed individual-level data, collected between 1985 and 2010, from 102 175 working-age men and women in 11 prospective European studies. Job strain (a combination of high demands and low control at work) was self-reported at baseline. Incident severe asthma exacerbations were ascertained from national hospitalization and death registries. Associations between job strain and asthma exacerbations were modelled using Cox regression and the study-specific findings combined using random-effects meta-analyses. ResultsDuring a median follow-up of 10years, 1 109 individuals experienced a severe asthma exacerbation (430 with asthma as the primary diagnostic ...

TY - JOUR. T1 - Quantifying asthma symptoms in adults. T2 - The Lara Asthma Symptom Scale. AU - Wood, Pamela Runge. AU - Smith, Brad. AU - ODonnell, Louise. AU - Galbreath, Autumn Dawn. AU - Lara, Marielena. AU - Forkner, Emma. AU - Peters, Jay I.. PY - 2007/12/1. Y1 - 2007/12/1. N2 - Background: Accurate assessment of asthma symptoms is critical in research and clinical settings. A multidimensional asthma control questionnaire could provide more accurate information about asthma symptoms than global assessments, which often overestimate asthma control. Objective: We sought to evaluate the efficacy of the Lara Asthma Symptom Scale (LASS) in adults with persistent asthma. Methods: Participants were 18 to 64 years of age with persistent asthma. Data were collected at baseline, 6 months, and 12 months. We described the construct and predictive validity of the LASS by comparing it with measures of pulmonary function (FEV1), asthma-specific quality of life (Junipers Asthma Quality of Life ...

As co-Editors in Chief (and Professor Canonica as President of Interasma), it is our pleasure to welcome our colleagues to this first issue of the journal Asthma Research and Practice (ARP) [1]. This will be an open-access online journal, and thus easily accessible to a large audience. The aims and scope of ARP will be to publish original research articles and state of the art reviews focusing on risk factors, diagnosis and management of asthma at all ages. Since asthma is a disease that comprises diverse endotypes and is often accompanied by co-morbidities, we expect and welcome manuscripts on topics such as obese asthma, exercise-induced asthma, asthma-COPD overlap syndrome, occupational asthma, and others [2, 3]. Although existing journals in fields as diverse as paediatrics, internal medicine, allergy and pulmonology include articles on asthma, we believe that a journal entirely dedicated to asthma is both valuable and necessary. Moreover, we are committed to have a section devoted ...

with mild intermittent asthma: *you have symptoms fewer than three times a week, and nighttime symptoms fewer than two times a month. *lung function tests are greater than 80% of predicted values ba

We have previously shown that atopic mechanisms may account for, at most, only 40% of cases of asthma in the general population.4 Interestingly, in this review we have shown that, at most, only 50% of all asthma cases are attributable to eosinophilic airway inflammation. Thus, evidence from studies of eosinophilia and asthma is consistent with that from studies of atopy and asthma: in both instances, at most about 50% of asthma cases appear to be due to allergic mechanisms (whether these are defined in terms of atopy or in terms of eosinophilia). This further adds to the evidence that allergic mechanisms may not be the only and/or necessarily the most important underlying mechanism for asthma. Non-eosinophilic asthma is associated with neutrophilic responses not only in severe asthmatics but also in those with moderate and mild asthma, and we thus hypothesise that a major proportion of asthma is based on neutrophilic airway inflammation. Environmental exposure to bacterial endotoxin, ...

Dr. Wei Wu is an Associate Research Professor at the Lane Center for Computational Biology at Carnegie Mellon University. Her research focuses on understanding complex human diseases by undertaking integrative approaches, which combine biology, computational and statistical learning, bioinformatics, and genomics. Dr. Wu received a Ph.D. in Computational Molecular Biology from Rutgers University. She also received a M.S. in Computer Science from the University of California at Santa Cruz, where she worked on the construction of the Human Genome Browser with Professor David Haussler. She later did a postdoctoral training at Lawrence Berkeley National Lab with Dr. Mina Bissell. Her current work involves: i) subphenotyping asthma patients using computational approaches; and ii) understanding breast cancer mechanisms using dynamic network learning approaches. Her paper on developing a tree-varying network learning approach for analyzing a breast cancer progression series of cells has won the Best ...

Mild and Severe Asthma May Be 2 Diseases The authors of a study reported recently in the European Respiratory Journal have concluded that severe asthma and mild asthma may be different conditions with different inflammatory processes. The study, conducted by scientists across Europe, evaluated 321 patients, 158 with mild-to-moderate asthma and 163 with severe asthma. The results of the study showed that both groups had very different levels of key chemicals in their blood. Also, whereas more men suffered from asthma, women were 4 times as likely to suffer from severe asthma. Individuals with mild-to-moderate asthma were able to control their symptoms with low doses of inhaled corticosteroids. Very few with severe asthma, however, were able to have their symptoms treated despite being treated with heavier doses of drugs. ...

The Particulars: Research shows that chronic asthma and cardiovascular disease (CVD) share a common inflammatory pathophysiology. However, few studies have explored the potential association between persistent asthma-defined as requiring daily controller medications-and an increased risk of CVD.. Data Breakdown: Researchers compared the rates of CVD over 9 years among patients with persistent asthma, intermittent asthma, or no asthma for a study. Among those with persistent asthma, 84.1% were alive and free from CVD, compared with a 91.1% rate for those with intermittent asthma and a 90.2% rate for those without asthma. Patients with persistent asthma had about a 60.0% higher risk of CVD events that those without asthma.. Take Home Pearl: There appears to be a strong association between persistent asthma and risk for CVD. ...

Asthma or bronchial asthma is a disease which is characterized by airways narrowing. It happens because of some agents provoke the airways making them inflamed. This disorder gains more and more scope nowadays making asthma one of the most widespread disorder nowadays. The evidence has proved that the amount of asthma sufferers grows rapidly.. Asthma may be manifested differently with short and long attacks. Some people feel light attack of dyspnea and cough but other cannot bare the severe attack of these symptoms. Asthma is an unpredictable disorder. It is a known fact that asthma is a chronic disease but there is opportunities to control your asthma attacks due to Asthma Inhalers Online ordered via the Internet. Everything is possible if you have such an inhaler within a reach.. There is also one more type of asthma known as exercise-induced asthma. This type of asthma may be caused by excessive physical trainings when lungs are pressed so much that you do not have any oxygen for breathing. ...

Severe asthma is typically characterized by chronic airway inflammation that is refractory to corticosteroids and associated with excess morbidity. Patients were recruited into the National Heart, Lung, and Blood Institute-sponsored Severe Asthma Research Program and comprehensively phenotyped by bronchoscopy. Bronchoalveolar lavage (BAL) cells were analyzed by flow cytometry. Compared with healthy individuals (n = 21), patients with asthma (n = 53) had fewer BAL natural killer (NK) cells. Patients with severe asthma (n = 29) had a marked increase in the ratios of CD4+ T cells to NK cells and neutrophils to NK cells. BAL NK cells in severe asthma were skewed toward the cytotoxic CD56dim subset, with significantly increased BAL fluid levels of the cytotoxic mediator granzyme A. The numbers of BAL CD56dim NK cells and CCR6−CCR4− T helper 1-enriched CD4+ T cells correlated inversely with lung function [forced expiratory volume in 1 s (FEV1) % predicted] in asthma. Relative to cells from healthy ...

A stranger would never guess my friend Catrina has asthma. She plays three varsity sports, sings along to entire musicals without losing her breath, and overall leads an active, nonstop life. Because of the incredible advancements in asthma treatment, Catrina seems practically indistinguishable from someone without asthma. Even I have never seen her reach for her inhaler. It is only because of our close friendship that I know she takes medicine to control her asthma and frequently visits an allergist. How has asthma treatment come so far? The use of animals in asthma research has lead to many groundbreaking discoveries that have benefited asthma sufferers like Catrina. Early asthma studies relied on animal research, and so does the current research that develops the kind of new medicines that Catrina uses today.. Asthma is defined by the National Institutes of Health as a chronic lung disease that inflames and narrows the airways, with symptoms of recurring periods of wheezing, tightness, ...

TY - JOUR. T1 - Management of asthma exacerbations. AU - Chestnutt, Mark. PY - 2002/1/1. Y1 - 2002/1/1. N2 - The 1997 Expert Panel Report 2 from the National Asthma Education and Prevention Program* details principles and goals for managing asthma exacerbations, based on scientific literature and the opinion of the panel. The panels recommendations are summarized here, along with approaches to the evaluation and management of patients with asthma exacerbations. Methods to assess and classify the severity of asthma exacerbations are discussed, and treatment objectives for mild, moderate, and severe exacerbations are presented, along with a discussion of postinfectious acute airway hyperresponsiveness. A review of pharmacologic agents used in the treatment of asthma exacerbations is also included. Key points in the management of asthma exacerbations include the notion that early treatment is the best strategy for management. Important elements of early treatment include recognition of early signs ...

Community Asthma Program. The Community Asthma Program provides free asthma self-management education and support for children and young people with asthma and their families.. The program is aimed at people who frequently attend an Emergency Department for help with asthma, are at risk of attending or have complex psychosocial needs impacting on their ability to self-manage their asthma.. Families entering the program receive one-on-one help and support from a qualified health professional with advanced skills in asthma and respiratory education.. Click on the links below for further information: ...

Accordingly, the new update of the Global Initiative for Asthma (GINA) guidelines 2006 is based on the control of the disease and attempts to quantify and graduate the level of control by using a classification of asthmatic subjects into controlled,partly controlled and uncontrolled groups.. Achieving and maintaining optimal asthma control is a major goal of asthma management. Although the results of clinical trials advocate that asthma control can be reached in most patients, there is evidence that many subjects with asthma have poorly controlled disease and that there is a significant gap between the treatment goals and the current level of asthma control achieved in the general population.. The aim of this study is to assess the prevalence of uncontrolled and partly controlled asthma in Italy using a patient-based tool such as Asthma Control Test. ...

TY - JOUR. T1 - Comparison of asthma knowledge, management, and psychological burden among parents of asthmatic children from rural and Urban neighborhoods in India. AU - Rastogi, D.. AU - Gupta, S.. AU - Kapoor, R.. PY - 2009/11/5. Y1 - 2009/11/5. N2 - Introduction: Asthma prevalence is increasing in developing countries such as India. Little is known on parental knowledge of asthma severity, management and psychosocial impact, particularly among rural dwellers. Further, it is not known whether the female asthmatic child is particularly vulnerable. Objective: To evaluate parental asthma knowledge and psychological impact of having an asthmatic child. Methods: 134 consecutive caregivers were surveyed at the visit for their childs asthma exacerbation at an urban hospital in Kanpur, India between 3/20073/2008. Results: The childs age range was 5.7Â ± 2.7 years. 76 were urban city dwellers with significantly higher number having a college degree. 23 children had moderate to severe persistent ...

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Asthma Surveillance Abstract: Asthma Surveillance (Asthma GIS Maps) The Burden of Asthma in Connecticut 2012 Surveillance Report Asthma is a chronic disease of the respiratory system that is characterized by reversible obstruction of the airways and airway hyper-responsiveness to a variety of stimuli. Left uncontrolled or poorly-managed, asthma can lead to emergency department visits, hospitalization, or death. In 2010, 18.7 million adults and 7 million children in the United States had asthma. Asthma prevalence in Connecticut adults and children has been higher than national prevalence rates since the year 2000. In Connecticut, the populations disproportionately affected by asthma are: children, females, Hispanics, non-Hispanic Blacks, and residents of CTs five largest cities.Custom Download Select specific sections of The Burden of Asthma in ConnecticutFull Version Download the complete version of The Burden of Asthma in Connecticut Updated Report Tables (2016): Table F-1: Asthma Hospitalization

Results. A total of 4.8% of children had atopic asthma, 1.9% had nonatopic asthma, 3.4% had resolved asthma, and 4.3% had frequent respiratory symptoms. Mean BMI was higher among children with nonatopic asthma, whereas prenatal maternal smoking was a risk factor for resolved asthma. Atopic and nonatopic asthma were similar for most measures of asthma severity (eg, medication use and lung function), and relatively few children in either group were receiving inhaled corticosteroids (5%-10%). Patients with resolved asthma had fewer symptoms but lung-function impairment similar to that seen with current asthma, whereas children with frequent respiratory symptoms but no asthma diagnosis had normal lung function. ...

If you or your child has asthma that requires daily treatment, it is important to have an asthma action plan. An asthma action plan is a written plan that tells you what asthma medicine to take every day and how to treat an asthma attack. It can help you make quick decisions in case you are not able to think clearly during an attack.. An asthma action plan usually includes:. ...

A year ago, we told you about the 5 best asthma treatments.. Today, well tell you how to avoid asthma attacks and get more sleep.. Today were all about breathing.. But first, we have some tips for when you have a problem with asthma and want to know whats best for you.. How to Avoid Asthma Attacks for Asthma sufferers How to prevent asthma attacks: 1.. Dont put yourself in a situation where youre tempted to take an asthma medication.. People often get sicker after taking asthma medications, especially if they have a history of asthma.. This is true for everyone, but especially if youre using a medication that is already being taken for another ailment.. Even if you dont take asthma medications regularly, you should be careful not to overdo it.. If youve already had an asthma reaction, the next time you use an asthma inhaler, be sure to take a short break.. This may make it harder to breathe.2.. Do not smoke.. Smoking can cause asthma attacks.. Smoking is dangerous for you and your ...

Asthma is one of the most common diseases amongst children. Blood eosinophil count and neutrophil-lymphocyte ratio (NLR) are known as markers for phenotyping asthma. This study was performed to investigate blood eosinophil count and NLR as predictors of hospitalization in pediatric asthma exacerbations. In this cross-sectional study, children admitted to hospital ward for more severe asthma exacerbation were compared with non-hospitalized children with moderate to severe asthma exacerbation whose asthma exacerbation was managed in emergency department or outpatient clinic. We investigated patients characteristic and factors associated with hospitalization. A total of 211 children with moderate to severe asthma exacerbation (mean age $$5.76 \pm 3.28$$ years old) were enrolled in the study including 91 hospitalized patients and 120 non-hospitalized patients. For the prediction of

TY - JOUR. T1 - Measures of asthma control. AU - Bime, Christian. AU - Nguyen, Jessica. AU - Wise, Robert A.. PY - 2012/1/1. Y1 - 2012/1/1. N2 - Purpose of Review: Over the past decade, the concept of asthma control as distinct from asthma severity has been clearly defined. Well controlled asthma is the goal of therapy in all asthma patients. This review is a comprehensive description of the tools currently available for a methodical assessment of different aspects of asthma control in clinical practice and research. Recent Findings: Several questionnaires for assessing asthma control have been extensively validated in adults. In children, validation data are less extensive. Considerable overlap exists between asthma control measures and measures of asthma-specific quality of life. Asthma-specific quality-of-life questionnaires have been used as primary outcome measures in major clinical trials evaluating asthma therapy. Biomarkers that reflect eosinophilic inflammation of the airways are used ...

About Severe Asthma. Asthma affects 315 million individuals worldwide, and up to 10% of asthma patients have severe asthma, which may be uncontrolled despite high doses of standard-of-care asthma controller medicines and can require the use of chronic oral corticosteroids (OCS).. Severe, uncontrolled asthma is debilitating and potentially fatal with patients experiencing frequent exacerbations and significant limitations on lung function and quality of life. Severe, uncontrolled asthma has an eight times higher risk of mortality than severe asthma.. Severe, uncontrolled asthma can lead to a dependence on OCS, with systemic steroid exposure potentially leading to serious short- and long-term adverse effects, including weight gain, diabetes, osteoporosis, glaucoma, anxiety, depression, cardiovascular disease and immunosuppression. There is also a significant physical and socio-economic burden of severe, uncontrolled asthma with these patients accounting for 50% of asthma-related costs.. About the ...

KLING, S et al. Guideline for the management of acute asthma in children: 2013 update - Part 3: March 2013. SAMJ, S. Afr. med. j. [online]. 2013, vol.103, n.3, pp.199-207. ISSN 2078-5135.. BACKGROUND: Acute asthma exacerbations remain a common cause of hospitalisation and healthcare utilisation in South African children. AIM: To update the South African paediatric acute asthma guidelines according to current evidence, and produce separate recommendations for children above and below 2 years of age. METHODS: A working group of the South African Childhood Asthma Group was established to review the published literature on acute asthma in children from 2000 to 2012, and to revise the South African guidelines accordingly. RECOMMENDATIONS: Short-acting inhaled bronchodilators remain the first-line treatment of acute asthma. A metered dose inhaler with spacer is preferable to nebulisation for bronchodilator therapy to treat mild to moderate asthma. Two to four puffs of a short-acting bronchodilator ...

Asthma symptoms were recorded by the patient each morning and evening in the asthma daily diary. Symptoms were recorded using a scale of 0-3, where 0 indicates no asthma symptoms. The daily asthma symptom total score was calculated by taking the sum of the daytime score recorded in the evening and the nighttime score recorded the following morning. The weekly total asthma score was averaged from the daily scores over a 7 day period, with score ranging from 0 to 6, where 0 indicates no asthma symptoms. The changes from baseline of weekly total asthma score are compared between benralizumab 30 mg Q4W and placebo by using the mixed-effect model repeated measures (MMRM) with baseline blood eosinophil count (≥300 cells/μL or ,300 cells/μL), protocol specified visit, region (Europe or North America) and treatment*visit interaction as fixed effects and baseline total asthma score as a covariate.. Changes at Week 12 were calculated based on patients with both baseline and Week 12. ...

Background: Racial and ethnic minority youth have poorer asthma status than white youth, even after controlling for socioeconomic variables. Proper use of asthma controller medications is critical in reducing asthma mortality and morbidity. The clinical consequences of poor asthma management include increased illness complications, excessive functional morbidity, and fatal asthma attacks. There are significant limitations in research on interventions to improve asthma management in racial minority populations, particularly minority adolescents and young adults, although illness management tends to deteriorate after adolescence during emerging adulthood, the unique developmental period beyond adolescence but before adulthood. Objective: The objective of the pilot study was to test the feasibility, acceptability, and signals of efficacy of an intervention targeting adherence to controller medication in African American youth (ages 18-29) with asthma. All elements of the protocol were piloted in a National

Based on the modified GINA criteria, of the 397 children in the sample, 143 (36%) had intermittent asthma; 160 (40%) had mild persistent asthma; 51 (12.8%) had moderate persistent asthma; and 43 (10.8%) had severe persistent asthma. In 60 children, occasional limitation of daily activities was the indicator of greatest severity. Taking into account that responses to the remaining questions were not related to more severe asthma, a decision for more conservative categorization was made, and these children were classified as having mild persistent asthma. Based on the ISAAC questionnaire, 90 of the 397 children (22.3%) provided positive responses to questions assessing symptom severity, whereas 307 (77.3%) replied in the negative.. Comparison of both asthma severity criteria according to data from the second survey (Table 2) shows that, the greater the severity of the disease according to GINA criteria, the greater the proportion of children with more severe symptoms as assessed by ISAAC. No ...

The University of Sydney in Australia is currently performing asthma research and is trying to stop the destructive cells responsible for the inflammatory response from being produced. These cells are stimulated by chemical messengers called cytokines and current medications, for example steroids which help to reduce the concentration of cytokines and stop the inflammatory response.. Steroids also have an effect on a number of other tissues in the body and are known to produce side effects. Asthma research at the university is undergoing on how the cytokines are produced and how they can stop production and also inflammatory response.. Woolcock Institute of Medical Research is conducting an asthma research on the long-term effects of asthmatic episodes on the lining of the airways and how the inflammatory response can affect and how current medications work.. They are trying to develop a non-invasive method that will allow them to determine the degree of scarring and how this affects the ...

Lung function test: Lung function test is an asthma test used to determine if there is any progress in your breathing following the inhalation of a bronchodilator. If there is fifteen percent improvement, then asthma is a possible diagnosis.. Spirometry: Spirometry is the lung function test that can be carried at asthma clinic. It is used to measure how much and how quickly you can move air out of your lungs. You have to inhale and exhale deeply and seal your lips around the mouthpiece and blow forcefully as long as possible. The information is collected by the spirometer and can be printed out on a chart called spirogram.. Skin prick test: Skin prick test is an asthma test used to identify any allergens which you may be sensitive and which may trigger asthma attack. Some small amounts of allergens are injected into your skin of the forearm and the area is monitored for a reaction.. After monitoring for fifteen minutes, if there is no visible swelling, then it may that you dont have asthma or ...

Investigators from multiple institutions in Michigan and Georgia sought to determine whether using Puff City,1 a web-based asthma intervention developed by the authors and aimed at African American teenagers, improves asthma outcomes. Students in grades 9 through 12 were recruited from 6 public high schools for the study if they had a diagnosis of asthma made by a health care provider, current symptoms, and use of asthma medications. Students without a formal asthma diagnosis were also included if they had symptoms consistent with a diagnosis of intermittent asthma or more severe asthma (based on the International Survey of Asthma and Allergies in Childhood questionnaire). ...

Though exercise-induced bronchoconstriction is common among asthmatics, physical activity (PA) seems important in asthma management. Still, various studies point at avoidance of sports and certain daily life activities like walking stairs, even by patients with mild symptoms. We aimed to compare physical activity levels between healthy subjects and asthmatics with controlled and uncontrolled disease. Data on asthma and PA were drawn from the Portuguese National Asthma Survey. The short telephone version of the International Physical Activity Questionnaire (IPAQ) was used to measure PA levels. Current asthma was defined as self-reported asthma and at least one of these criteria: one or more asthma symptoms in the last twelve months, currently taking asthma medication or an asthma medical appointment in the previous twelve months. Controlled asthma was defined as a CARAT global score | 24 or a CARAT second factor score ≤ 16. Healthy subjects were defined as individuals without atopy, heart disease or

Asthma Action Plan. You and your doctor write an Asthma Action Plan together. It is a written plan that will help you stay away from triggers and take medicine to control your asthma symptoms. Learn more about an Asthma Action Plan. Always keep a copy with you.. Asthma Control Test:. The Asthma Control Test (ACT) has questions for a person with asthma. Take the ACT and see if your asthma is under control. Share the results with your doctor. Page Updated: 12/7/2017 ...

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MicroRNAs are small non-coding RNAs that regulate gene expression at the post-transcriptional level. While they have been implicated in various diseases, the profile changes in allergen inhalation challenge are not clarified in human. We aimed to evaluate changes in the microRNA profiles in the peripheral blood of asthmatic subjects undergoing allergen inhalation challenge. Seven mild asthmatic subjects participated in the allergen inhalation challenge. In addition, four healthy control subjects (HCs) were recruited. MicroRNA profiles in peripheral blood samples (pre-challenge and 2 hours post-challenge) were measured by the NanoString nCounter assay to determine changes in miRNA levels as these asthmatic subjects underwent an allergen inhalation challenge. One common miRNA, miR-192, was significantly expressed in both comparisons; HCs vs. pre-challenge and pre- vs. post-challenge, showing that miR-192 was significantly under-expressed in asthmatics compared to HCs and decreased in post-challenge at an

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ABSTRACT. Purpose. To review the characteristics of difficult-to-treat asthma and describe patients who may benefit from therapy with the recently approved humanized monoclonal anti-immunoglobulin E (IgE) antibody, omalizumab.. Principal findings. Up to 20 percent of patients have difficult-to-treat asthma. These patients consume a disproportionate share of asthma care resources. Clinical and economic outcomes can be improved via improved self-management, increased adherence to prescribed therapy, and better compliance to national asthma treatment guidelines. These patients also may benefit from therapies that directly target mechanisms responsible for persistent airway inflammation and elicit favorable clinical responses.. Conclusions. Effective asthma control remains difficult in a small cohort of patients with persistent, severe airway inflammation. Management strategies that improve asthma control and reduce exacerbations can improve clinical outcomes and minimize health care resource ...

The effect of weather on asthma symptoms isnt fully understood, but clearly there is a link. Numerous studies have shown a variety of connections, such as increases in asthma-related emergency department visits when certain weather conditions are present. Some people find that their asthma symptoms get worse at specific times of year. For others, a severe storm or sudden weather change may trigger an attack.. Exposure to cold, dry air is a common asthma trigger and can quickly cause severe symptoms. People with exercise-induced asthma who participate in winter sports are especially susceptible. Dry, windy weather can stir up pollen and mold in the air, leading to problems for some people.. Hot, humid air also can trigger asthma symptoms, and wet weather encourages the growth of mold spores, another asthma trigger. In certain areas, heat and sunlight combine with pollutants to create ground-level ozone, which is also an asthma trigger.. Studies have shown that thunderstorms can trigger asthma ...

INTRODUCTION: asthma is a chronic inflammatory and a heterogeneous condition of respiratory system whose pathogenesis is linked with variable structural changes. The clinical manifestation of asthma includes attacks of breathlessness, cough, chest tightness and wheezing. Provision of basic equipment and test for asthma diagnosis and access to essential medicines by asthmatic patients reduces morbidity and mortality rates. Significant progress has been made in the diagnosis and management of asthma in other countries but not in the health care delivery system in Zimbabwe. Therefore, the aim of this study was to develop algorithm for asthma diagnosis and management for Zimbabwe. METHODS: a two stage Delphi model was used to collect data in order to develop an algorithm of asthma diagnosis and management. A baseline interview with 44 doctors was done to understand their experiences and knowledge regarding asthma diagnosis and management. We collected data using the KoBo Collect Toolbox installed on Android

Millions of children with asthma heading back to classrooms this fall will be greeted by an increasing number of school-based asthma education initiatives, and adult patients around the U.S. are getting more access to these types of patient education programs, as well. Now, the new asthma care guidelines from the National Asthma Education and Prevention Program (NAEPP) at the National Institutes of Health (NIH), has made patient education a major priority in their new guidelines.. It is well-known that patient education is the cornerstone of quality care and outcomes for asthma patients, as it is for other diseases, says Mary Brasler, MSN, EdD, Director of Programs for the Asthma and Allergy Foundation of America (AAFA), the leading national asthma patient advocacy group and a member of the NAEPP schools committee. Simply put, if people are taught asthma self-management skills, they are more likely to adhere to their treatment plans and their health improves.. Public health experts agree ...

National Heart, Lung, and Blood Institute - So You Have Asthma: A Guide for Patients and Their Families This booklet offers the latest information on asthma management. In an easy-to-read format, it provides information about asthma symptoms, the latest treatments, and ways to monitor and keep your asthma under control. This site also includes the Clinical Guidelines for the Diagnosis and Management of Asthma and What Is Asthma?. The American Lung Associations (ALA) Asthma Basics The Asthma Basics course is a free, one-hour interactive online learning module designed to help people learn more about asthma. This course is ideal for frontline healthcare professionals like nurses or community health care workers, as well as individuals who have asthma. Asthma Basics also includes comprehensive resources like asthma medication devices, and demonstration videos and downloads. This course is also available in Spanish.. Living with Asthma - National Jewish Health. National Jewish Health website ...

According to the California Work-Related Asthma Prevention Program, part of the Occupational Health Branch of California Department of Public Health, cleaning products used in workplaces can cause or trigger work-related asthma. To prevent harsh affects of cleaning products, employers should make sure the safest products and practices are used in the workplace. The program has found that nearly 10 percent of all work-related asthma cases were caused by exposure to cleaning products. Most of these cases had new asthma that started only after they began work - the exposures caused their asthma. About one in five people (almost 20 percent) used cleaning products directly, such as janitors. The other 80 percent of workers attributed their asthma symptoms to cleaning products used nearby. Many workplaces, like schools, hospitals, and restaurants are places where everyone, including children, can be affected by cleaning products. How can asthma from cleaning products be prevented? ...

Stanbrook and Kaplan have previously suggested that physicians who do not use spirometry for their asthma patients should not be managing asthma.1 They have put forth the notion that asthma management without spirometry testing would be considered failing to maintain an adequate standard of care, and that most primary care physicians need to make testing available in their own offices.1 They developed this theme based on a study by Aaron et al,2 whose results actually revealed that asthma diagnosis was confirmed in 16% and 72% of patients studied, by spirometry and methacholine challenge testing, respectively. Building a case for office spirometry based on these results seems counterintuitive.3 Further, Stanbrook and Kaplan did not cite a single reference in their article that described how widespread use of office spirometry in primary care might influence asthma outcomes in patients not previously diagnosed with asthma.1. Spirometry can provide important information about lung function and ...

In the 1990s, healthcare professionals and community advocates recognized an alarming rise in uncontrolled asthma, especially in low-income communities and communities of color. Between 1988 and 1995, hospitalizations for asthma in low-income communities in Seattle and South King County more than doubled, and were twice the rate of the general King County population.. Growing evidence showed that indoor asthma triggers such as dust mites, smoke, mold, and roaches were major contributors to poor asthma control. Local data demonstrated that in King County, low-income people were more likely to live in substandard housing, exposing them to these triggers.. A new approach to asthma care. Alarmed by this rise in asthma, a coalition of clinicians, public health officials, the American Lung Association, and community health advocates designed a pilot project to help low-income families manage asthma triggers in their homes.. While the cause [of the rise] was not clear, it was clear that people with ...

TY - JOUR. T1 - Different seasonal effect on asthma trajectories. T2 - A population-based birth cohort study. AU - Wu, Tsung Ju. AU - Pan, Shih Chun. AU - Chen, Bing Yu. AU - Chin, Wei Shan. AU - Guo, Yue Leon. PY - 2018/12/1. Y1 - 2018/12/1. KW - adolescence. KW - asthma phenotype. KW - atopic disease. KW - children. KW - group-based trajectory model. KW - season. KW - urbanization. KW - adolescence. KW - asthma phenotype. KW - atopic disease. KW - children. KW - group-based trajectory model. KW - season. KW - urbanization. UR - http://www.scopus.com/inward/record.url?scp=85054172925&partnerID=8YFLogxK. UR - http://www.scopus.com/inward/citedby.url?scp=85054172925&partnerID=8YFLogxK. U2 - 10.1111/pai.12973. DO - 10.1111/pai.12973. M3 - Letter. C2 - 30144172. AN - SCOPUS:85054172925. VL - 29. SP - 873. EP - 877. JO - Pediatric Allergy and Immunology. JF - Pediatric Allergy and Immunology. SN - 0905-6157. IS - 8. ER - ...

Over-proliferation of airway smooth muscle cell (ASMC) is one of the important contributors to airway remodeling in asthma. The aim of this study was to investigate the effect of Shenmai injection (SMI) on the proliferation of the rat ASMC in asthma. Rats were randomly divided into three groups: the control group, the asthma group, and the SMI treatment group. Reverse transcription-polymerase chain reaction (RT-PCR) and immunocytochemistry staining were used to detect the mRNA and protein expression of transient receptor potential vanilloid 1 (TRPV1) and proliferating cell nuclear antigen (PCNA) in rat ASMC respectively. Intracellular Ca2+ concentration ( [Ca2+]i ) in rat ASMC were measured with Fluo-3/AM by confocal microscopy. The proliferation was detected by MTT assay. Compared with the control group, the asthma group showed an increased expression of TRPV1 and [Ca2+]i in rat ASMC. The expression of PCNA and absorbance of MTT assay in asthma rat ASMC was also significantly increased. SMI could

Children whose parents perceived their lives as unpredictable, uncontrollable, or overwhelming had increased risk of new onset asthma associated with TRP and maternal smoking during pregnancy. Furthermore, susceptibility to TRP attributable to parental education was markedly attenuated after accounting for the susceptibility attributable to parental stress. While parental stress may influence the development of asthma in a child due to biological and behavioral pathways other than psychological stress in children (26), the observed pattern of susceptibility to air pollution based on stress was not explained by potentially relevant history of illness and a range of behavioral, socioeconomic, and environmental risk factors for asthma. Although there were relatively few children with a history of in utero tobacco smoke exposure, significantly larger effects were observed both among children with low parental education and with high parental stress. Thus, common biological pathways may underlie the ...

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There is increasing evidence that neutrophils are involved in acute asthma exacerbation. Prominent neutrophilic inflammation has been demonstrated during exacerbated asthma inadult patients 2-8. Recently, inflammatory profiles of asthmatic airways in children have been assessed by analysing sputum and/or BAL fluid 9-11. These studies proposed that neutrophil-mediated inflammation was also involved in the pathophysiology of exacerbation of childhood asthma. However, the nature of airway inflammation in childhood asthma and its severity have not been adequately evaluated because bronchoscopic studies or BAL fluid analysis can be too invasive for children.. There are several lines of evidence that activation of NE is involved in asthma exacerbation and results in hypersecretion by mucous-producing cells 8, 12, 13. In BAL fluid of asthmatic subjects, excessive secretion of proteinases, including NE and MMPs, has been observed during acute asthma exacerbation 12, 19. However, it is hard to detect ...

The original authors main conclusions are taken from Abstract, Results and Discussion. They are decided upon by the authors of the BOHRF occupational asthma guidelines and form part of the guidelines.. Objective criteria for interpretation of peak expiratory flow rate readings were assessed in 50 patients evaluated for suspected occupational asthma who had at least two weeks of PEFR readings and an objective diagnosis based on other investigations. The prevalence of occupational asthma was 36 percent. Peak flows were interpreted by two observers blinded to other results. Criteria for a PEFR interpretation of occupational asthma were as follow: diurnal variation greater than or equal to 20 percent relatively more frequently or with greater variation on working days than days off work. With the objective diagnoses as the gold standard, the sensitivity of the PEFR interpretations was 72 percent for OA; specificity for no asthma was 53 percent. Excluding those with greater than or equal to 20 ...

Theres a tremendous disparity there, said Wendy Brunner an epidemiologist for the Minnesota Department of Health Asthma Program.. The program tracks a number of asthma measures, among them emergency department visits, smoking rates, second-hand smoke exposure by people with asthma, rates of flu and pneumonia vaccinations for asthma sufferers and asthma deaths.. Brunner said where people live can explain much of the racial disparity in asthma rates. Like Jackson and her son, many low-income people turn to rentals where they may have less control over their living conditions.. We know in Minnesota that African Americans have the lowest home ownership rate in the state and that has implications for somebody with asthma, Brunner said.. Rental housing can have old, dirty carpets -a big asthma trigger. Tobacco smoke from nearby apartments may seep into the units where people with asthma live. In many cases, theres nothing a renter can do about these problems. Landlords may prevent them from ...

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In the present study, the relationship between airway inflammation and infection with C. pneumoniae in acute asthma was examined. It was found that over one-third of adults presenting with acute severe asthma showed a rise in C. pneumoniae-specific antibodies consistent with acute infection, reinfection or reactivation of latent infection with C. pneumoniae. These subjects exhibited a more intense inflammatory response during the acute exacerbation, with an increase in sputum TCC, neutrophil count and ECP level compared to subjects with acute asthma who did not show an increase in C. pneumoniae antibody levels.. Subjects were recruited from patients presenting to the emergency department with acute asthma, who had at least moderate airflow obstruction, representing a group with more severe acute asthma. This group was selected for study based on previous work linking C. pneumoniae infection with asthma exacerbations and severe asthma 6, 7, 14. The sputum induction time tended to be shorter at ...

Boston, Mass.-May 2, 2012) The Connecticut Childrens Medical Center is one of four winners nationwide of the 2012 National Environmental Leadership Award in Asthma Management for its Easy Breathing Program, which includes patient education and environmental interventions. The program is implemented across the state of Connecticut helping ensure that comprehensive asthma care is available to the 105,000 children with asthma now enrolled in the program. The Easy Breathing Program is designed to aid primary care clinicians in making a diagnosis of asthma and treating individuals using a systematic, standardized, approach which adheres to the National Asthma Education and Prevention Program (NAEPP) guidelines. It was the first large scale program in the country to demonstrate that clinicians can use NAEPP guidelines and that its effective use can result in improved quality of asthma care. One of the distinguishing features of this program is the creation of a robust database which is used for ...

The inter-relationship between the perception of bronchoconstriction, bronchial hyper-responsiveness and temporal adaptation in asthma is still a matter of debate. In a total of 52 stable asthmatic patients, 32 without airway obstruction [forced expiratory volume in 1 s (FEV1)/vital capacity (VC) 84.1% (S.D. 7.9%)], and 20 with airway obstruction [FEV1/VC 60% (4%)], we assessed the perception of bronchoconstriction during methacholine inhalation by using: (i) the slope and intercept of the Borg and VAS (Visual Analog Scale) scores against the decrease in FEV1, expressed as a percentage of the predicted value; and (ii) the Borg and VAS scores at a 20% decrease in FEV1 from the lowest post-saline level (PB20). Bronchial hyper-responsiveness was assessed as the provocative concentration of methacholine causing a 20% fall in FEV1 (PC20FEV1). The reduction in FEV1 was significantly related to the Borg and VAS scores, with values for the group mean slope and intercept of this relationship of 0.13 ...

Status asthmaticus is the most common medical emergency in children today and is responsible for nearly half a million hospital admissions annually. Despite evidence that asthma hospitalizations are decreasing, asthma mortality is not. In order to gain a better understanding of status asthmaticus, its treatment, and its overall outcomes, each PICU research team within the Collaborative Pediatric Critical Care Research Network (CPCCRN) examined its admissions records in detail for children aged from 1 year up to the 18th birthday over the last 5 years for any instances of deaths resulting from a diagnosis of asthma (fatal asthma). Post-mortem data was reviewed where available. In addition, the medical records for children intubated and mechanically ventilated for asthma (near-fatal asthma) were analyzed. This review and abstraction has enabled CPCCRN investigators to quantify the current variability of critical asthma treatment and has helped us to identify additional medical problems, such as ...

Twenty-five patients with severe childhood asthma were treated with beclomethasone dipropionate. 21 of these children were receiving oral corticosteroid therapy in addition to disodium cromoglycate.. Of the total treated, 21 children improved or maintained their asthma status on this treatment over an average period of 4 months, and were able to reduce and stop their regular oral corticosteroid dosage, but 4 children had to revert to their original therapy.. No systemic or local toxic effects were experienced by any of the children.. Beclomethasone dipropionate appears to be an effective drug in the treatment of severe childhood asthma in those patients who need corticosteroid therapy in addition to disodium cromoglycate.. ...

Telehealth has the potential to improve asthma management through regular monitoring of lung function and/or asthma symptoms by health professionals in conjunction with feedback to patients. Although the benefits of telehealth for improving asthma management have been extensively studied, the feasibility of telehealth for supporting asthma management in pregnant women has not been investigated. This study aims to evaluate the use of telehealth for remotely monitoring lung function and optimising asthma control during pregnancy. A randomised controlled trial comparing usual care with a telehealth program (MASTERY©) has been conducted. The intervention comprised a mobile application - Breathe-easy © supported by a Bluetooth-enabled handheld device (COPD-6®), which was used for self-monitoring of lung function (FEV1, FEV6) twice daily, and recording asthma symptoms and medication usage weekly; and a written asthma action plan (WAAP). The primary outcome measure is

TY - JOUR. T1 - Death due to asthma at workplace in a diphenylmethane diisocyanate-sensitized subject. AU - Carino, Mauro. AU - Aliani, Maria. AU - Licitra, Carmelo. AU - Sarno, Nicola. AU - Ioli, Francesco. PY - 1997/1. Y1 - 1997/1. N2 - Total cases of fatal asthma in the occupational setting reported in the literature are reviewed and the case of a 39-year-old foundry worker who died at work is described. A diagnosis of occupational asthma induced by diphenylmethane diisocyanate (MDI) had been assessed 5 years in advance through a 0.005 ppm exposure inhalation challenge. Postmortem microscopic examination of the lung showed epithelial desquamation, eosinophilic/neutrophilic infiltration of the mucosa, dilatation of bronchial vessels, edema, hypertrophy and disarray of smooth muscle. Fatal asthma attack in a MDI-sensitized individual, to our knowledge, has not been previously described.. AB - Total cases of fatal asthma in the occupational setting reported in the literature are reviewed and the ...

In the second part of this respiratory health special report, Bernard Garbe looks at how serial peak expiratory flow can be used to identify occupational asthma.. The first part of the report explores the 2010 BOHRF Occupational Asthma Guidance on sensitiser-induced occupational asthma.. In occupational health, lung disease is the most common form of disease encountered after skin problems. Occupational lung diseases include byssinosis (typically cotton dust), allergic rhinitis, farmers lung, asbestosis, pneumoconiosis (most commonly coal dust), silicosis and chronic obstructive pulmonary disease (COPD). While COPD has the greatest mortality rate, occupational asthma (OA) has by far the greater incidence. OA, by definition, is a lung disease caused by occupational exposures and is the cause of about 15% of adult-onset asthma. Occupational asthma often results in skilled and experienced people having to end their careers, in many cases without a confirmed diagnosis. In nearly half the diagnosed ...

Asthma is a chronic and heterogenic respiratory tract disorder with a high global prevalence. The underlying chronic inflammatory process and airway remodeling (AR) contribute to the symptomatology of the disease. The most severely ill asthma patients may now be treated using a variety of monoclonal antibodies aiming key inflammatory cytokines involved in asthma pathogenesis. Although clinical data shows much beneficial effects of biological therapies in terms of reduction of exacerbation rates, improvement of lung functions, asthma control and patients quality of life, little is known on the effects of these monoclonal antibodies on AR-a key clinical trait of long-term asthma management. In this review, the authors summarize the data on the proven effects of monoclonal antibodies in asthma on AR. To date, in terms of reversing AR, the mostly studied was omalizumab. However, some studies also addressed this clinical issue in context of other severe asthma biological therapies (mepolizumab, benralizumab

This study is being performed to help patients and their health care team work together to make decisions about managing their asthma. A new class of medicines for asthma called asthma biologics, which target very specific immunological pathways responsible for asthma, were developed. The first such medicine, omalizumab, first became available in 2003 and 2 additional medicines, mepolizumab and reslizumab, became available in 2015 and 2016, respectively. These medicines are currently intended for those who have moderate or severe asthma and who havent responded to other asthma medicines like inhaled corticosteroids. Patients receiving asthma biologics usually have the highest burden of asthma disease. Asthma biologic medicines are very expensive and may not work for everyone. Sometimes, patients and their doctors need to make decisions about stopping asthma biologics. Right now, we do not have very good information about what happens to patients after they stop these medicines. It is important ...

Nitrogen dioxide (NO2) can enhance both early and late airway narrowing after inhaled antigen in allergic asthmatic subjects. We hypothesized that NO2 may also increase airway inflammation during the late response. Nitrogen dioxide has been shown to cause airway inflammation in healthy subjects without asthma. We also hypothesized that individuals with asthma may have increased non-allergic airway inflammation after exposure to NO2. To test these hypotheses, we designed two experiments with the following specific aims: Experiment 1) To determine the effect of a single exposure to NO2 on allergen-induced airway inflammation. Experiment Two: To determine the effect of NO2 exposure on non-allergic airway inflammation. Experiment One: 15 house dust mite (HDM)-sensitive asthmatic subjects were exposed for 3 hours to filtered air or 0.4 ppm NO2 followed immediately by inhalation of HDM allergen. Lung function was measured before and after each exposure and after allergen challenge, hourly for 6 hours. Sputum

Asthma is a chronic respiratory disease that affects over half a million children and adults living in Indiana. Asthma can be controlled but not cured. In a person with asthma, airways can swell and tighten making it hard to breathe. When an asthma attack happens, the inside of the airways swell and fill with mucus. The muscles around the airways tighten. This makes the airways smaller. Some of the most common symptoms of asthma include wheezing, shortness of breath, tightness in the chest, and coughing.. People with asthma can help control their symptoms by managing triggers in their environment. Triggers include anything that brings on asthma symptoms, and they differ for each person with asthma. Some triggers include dust mites, cigarette smoke, perfumes and fragrances, mold, pet dander, cockroaches, and stressful or emotional situations.. People with asthma should talk to their doctor about developing an asthma action plan. Asthma action plans help people with asthma to manage their ...

Essentially, airway remodeling is the result of chronic inflammation in the airways that goes untreated long-term. This is added evidence that asthma should be treated aggressively with inhaled corticosteroids early on in the course of the disease to prevent permanent airway damage and worsening asthma ...

It wasnt easy getting to this point, though. This can work as a natural anti-inflammatory agent. I agree with the change to a corticosteroid inhaler minus the long acting bronchodilater. Make a wire mould similar in size and shape to the mouthpiece of the MDI [metered-dose inhaler]. Depending on where your asthma control falls on the chart, you may need to make adjustments to your medications. Why do inhalers make me feel better if I dont have asthma? Tools for asthma control. Your written asthma action plan will let you know exactly when and how to make adjustments. Thats why ginger tea is a great alternative to stop asthma naturally. While asthma causes symptoms that challenge breathing, you can participate in any activity as long as you manage your asthma symptoms, notes the American Lung Association. The Buteyko method teaches you to breathe slowly and calmly through your nose instead of your mouth. Before embarking on any home remedy, it is important to speak with your doctor to ensure ...

There was only one problem. As more data came in, they failed to tell the same story as the hygiene hypothesis. Children in Latin America with high rates of supposedly protective infection have even higher rates of asthma than children in western Europe. Inner-city children in Chicago and New York have quite high rates of asthma, despite unhygienic living. And the rates of asthma varied among countries with very similar histories of cleanliness-indicating that there was more to it than tidiness. For example, by 2004 Swedens asthma cases had increased to 10 percent, according to one international study, while the number of cases in the U.K. had soared to 20 percent.. In addition, research showed that the relation between asthma and allergy is not at all straightforward. Some cases of asthma are indeed triggered by allergies, although the consensus among researchers over the past decade is that the connection is probably not as clear-cut as the hygiene hypothesis would suggest. Still other layers ...

TY - JOUR. T1 - Choosing Wisely. T2 - Adherence by Physicians to Recommended Use of Spirometry in the Diagnosis and Management of Adult Asthma. AU - Sokol, Kristin C.. AU - Sharma, Gulshan. AU - Lin, Yu Li. AU - Goldblum, Randall M.. PY - 2015/5/1. Y1 - 2015/5/1. N2 - Purpose: The National Asthma Education and Prevention Program (NAEPP) and the American Thoracic Society provide guidelines stating that physicians should use spirometry in the diagnosis and management of asthma. The aim of this study was to evaluate the trends, over a 10-year period, in the utilization of spirometry in patients newly diagnosed with asthma. We hypothesized that spirometry use would increase in physicians who care for asthma patients, especially since 2007, when the revised NAEPP guidelines were published. Methods: This retrospective cohort analysis of spirometry use in subjects newly diagnosed with asthma used a privately insured adult population for the years 2002-2011. Our primary outcome of interest was ...

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Asthma is a chronic inflammatory airway disease induced by many environmental factors. The inhalation of allergens and pollutants promote the reactive oxygen species (ROS) production leading to airway inflammation, hyper-responsiveness and remodeling in allergic asthma. The effects of asthma medications on ROS production are unclear. The present study investigated the anti-ROS effects of current asthma medications including inhaled corticosteroid (ICS; budesonide and fluticasone), leukotriene receptor antagonist (LTRA; montelukast), long acting β2 agonists (LABAs; salmeterol and formoterol) and a new extra-LABA (indacaterol). The human monocyte cell line THP-1 cells were pre-treated with different concentrations of the asthma medications at different time-points after hydrogen peroxide (H2O2) stimulation. H2O2 production was measured with DCFH-DA by flow cytometry. Montelukast, fluticasone and salmeterol suppressed H2O2-induced ROS production. Indacaterol enhanced H2O2-induced ROS production.

The Adult Asthma Program at Boston Medical Center provides a multidisciplinary diagnostic evaluation and tailored therapeutic plan for patients with asthma and related allergic lung disease, including allergic bronchopulmonary aspergillosis (ABPA) and hypersensitivity pneumonitis. Our mission is to improve the lives of patients living with asthma and allergic lung disease by providing state-of-the-art patient care.. The staff includes physicians who are double board-certified in Pulmonary Diseases (ABIM) and the American Board of Allergy and Immunology. As a result, testing/treatment for allergy to possible environmental triggers is ordered and interpreted in the clinic as part of our comprehensive care including allergy skin testing, allergy immunotherapy (allergy shots), anti-IgE therapy, and other more recently approved biologics. In addition, the team includes nurse practitioners who specialize in asthma disease management and training to provide targeted asthma education.. Our patient ...

Supporting self-management behaviours is recommended guidance for people with asthma. Preliminary work suggests that a brief, intensive, patient-centred intervention may be successful in supporting people with asthma to participate in life roles and activities they value. We seek to assess the feasibility of undertaking a cluster-randomised controlled trial (cRCT) of a brief, goal-setting intervention delivered in the context of an asthma review consultation. A two armed, single-blinded, multi-centre, cluster-randomised controlled feasibility trial will be conducted in UK primary care. Randomisation will take place at the practice level. We aim to recruit a total of 80 primary care patients with active asthma from at least eight practices across two health boards in Scotland (10 patients per practice resulting in ~40 in each arm). Patients in the intervention arm will be asked to complete a novel goal-setting tool immediately prior to an asthma review consultation. This will be used to underpin a

TY - CHAP. T1 - Eosinophils. AU - Lee, Nancy A.. AU - Dahl, Mark V.. AU - Jacobsen, Elizabeth A.. AU - Ochkur, Sergei I.. PY - 2011/7/27. Y1 - 2011/7/27. KW - Allergic, nonatopic asthma - allergic asthma, observed in atopic patients. KW - Asthma in humans, three groups - nonatopic allergic asthma, asthma associated with allergies and atopic asthma. KW - Eosinophil numbers, increasing in presence - of allergic disease, as asthma, AD and hay fever. KW - Eosinophil presence, in airway allergic disease - and inflammation in respiratory tract. KW - Eosinophils and T cells - cooperating in asthmatic inflammation. KW - Eosinophils and asthma - disease of lungs and airways, pathologies outside lungs, as well. KW - Eosinophils, classical view of eosinophils - as destructive effector cells, killing cells or tissues indiscriminately. KW - Nonallergic asthma, not often responsive - to prednisone treatment. KW - T cells, and eosinophils - key immune modulators and remodeling agents in asthma. KW - T cells, ...

p,Asthma is a chronic respiratory disease which is characterized by reversible bronchoconstriction, airway hyperresponsiveness, and airway inflammation. Allergen inhalation by sensitized atopic asthmatics enhances airway hyperresponsiveness and inflammation, providing a model to study mild asthma exacerbation. Airway inflammation can be measured non-invasively from airway secretions by sputum induction. Prior to starting this thesis, information on allergen-induced inflammation measured from sputum was limited. Furthermore, the pro- or anti-inflammatory effects of asthma therapies had not been investigated using this model of allergen-induced airway inflammation. The aim of this thesis was to first characterize the allergen-induced changes in sputum inflammatory cells and determine the repeatability of measurements of sputum inflammatory cells following allergen inhalation challenge. In addition, this thesis was aimed to investigate the pro- or anti-inflammatory effects of asthma therapies on ...

In this historical cohort study, we found that infants of asthmatic women, as compared with nonasthmatic control women, were more likely to exhibit transient tachypnea of the newborn. We also observed that the association between maternal asthma and transient tachypnea of the newborn was more pronounced in term births as opposed to preterm births and in infants of male sex as opposed to infants of female sex.. Strengths of the present study included: 1) large sample size; 2) historical cohort design; 3) extensive control for potentially confounding variables; 4) stratified analysis by gestational age and sex.. Several limitations of our study must be kept in mind. Administrative databases are prone to some degree of coding errors.26Because the analyses reported here depend on the patient data recorded at the time of obstetrical delivery, it is possible that only mothers with severe or active asthma would have been identified as such and mothers with less severe or inactive asthma may have been ...

Bermuda Hospitals Board (BHB) invites the public to an Asthma Day Open House on Thursday 6 May from 8:30am to 2:30pm in the hospital lobby. Asthma and allergy education and free spacer devices will be provided to anyone suffering with asthma or other breathing difficulties. Adult lung screening will also be offered to smokers and ex-smokers over the age of 40.. Asthma is one of the most common chronic diseases in the world, affecting more than 300 million people worldwide. It is characterized by recurrent breathing problems and symptoms such as breathlessness, wheezing, chest tightness and coughing.. Asthma affects approximately 12% of our community, explains Debbie Barboza, Asthma Nurse Educator for the Asthma Education Centre at KEMH. Thousands of people suffer unnecessarily every day because of poorly controlled asthma. Yet people can control their disease and minimize incidents with proper diagnoses, education and treatment.. While hospital admissions from asthma-related incidents are ...