WorldWideScience

Sample records for asthma

  1. Asthma

    Science.gov (United States)

    ... babies. Poor asthma control increases the risk of preeclampsia, a condition in which a pregnant woman develops ... other conditions that can interfere with your asthma management. Watch for Signs That Your Asthma Is Getting ...

  2. Asthma

    Science.gov (United States)

    ... their experiences with clinical research. More Information Related Health Topics Cough How the Lungs Work Oxygen Therapy Pulmonary Function Tests Other Resources NHLBI Resources "Asthma Action Plan" "Asthma and Physical Activity in the School" "At-A-Glance: Asthma" "How Asthma-Friendly Is ...

  3. Asthma

    Directory of Open Access Journals (Sweden)

    Kim Harold

    2011-11-01

    Full Text Available Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA inhalers are preferred for most adults who fail to achieve control with ICS therapy. Allergen-specific immunotherapy represents a potentially disease-modifying therapy for many patients with asthma, but should only be prescribed by physicians with appropriate training in allergy. Regular monitoring of asthma control, adherence to therapy and inhaler technique are also essential components of asthma management. This article provides a review of current literature and guidelines for the appropriate diagnosis and management of asthma.

  4. Asthma Basics

    Science.gov (United States)

    ... Giving Teens a Voice in Health Care Decisions Asthma KidsHealth > For Parents > Asthma Print A A A ... Should I Know? en español Asma What Is Asthma? Asthma is a condition that causes breathing problems. ...

  5. Asthma education

    African Journals Online (AJOL)

    2011-01-01

    ). Allergy and Asthma Clinic, Red Cross War Memorial Hospital. Mike Levin runs a secondary level asthma/ allergy clinic and does a tertiary allergy session once a week, focusing on difficult asthma and food allergies. He has ...

  6. Asthma Research

    Science.gov (United States)

    EPA is working to explore the role of common air pollutants in the development and exacerbation of asthma at different life stages as well as other environmental and genetic factors that might make a person more sensitive to developing asthma.

  7. Severe Asthma

    Science.gov (United States)

    Erzurum, Serpil C.; Bleecker, Eugene R.; Calhoun, William J.; Castro, Mario; Comhair, Suzy A. A.; Chung, Kian Fan; Curran-Everett, Douglas; Dweik, Raed A.; Fain, Sean B.; Fitzpatrick, Anne M.; Gaston, Benjamin M.; Israel, Elliot; Hastie, Annette; Hoffman, Eric A.; Holguin, Fernando; Levy, Bruce D.; Meyers, Deborah A.; Moore, Wendy C.; Peters, Stephen P.; Sorkness, Ronald L.; Teague, W. Gerald; Wenzel, Sally E.; Busse, William W.

    2012-01-01

    The National Heart, Lung, and Blood Institute Severe Asthma Research Program (SARP) has characterized over the past 10 years 1,644 patients with asthma, including 583 individuals with severe asthma. SARP collaboration has led to a rapid recruitment of subjects and efficient sharing of samples among participating sites to conduct independent mechanistic investigations of severe asthma. Enrolled SARP subjects underwent detailed clinical, physiologic, genomic, and radiological evaluations. In addition, SARP investigators developed safe procedures for bronchoscopy in participants with asthma, including those with severe disease. SARP studies revealed that severe asthma is a heterogeneous disease with varying molecular, biochemical, and cellular inflammatory features and unique structure–function abnormalities. Priorities for future studies include recruitment of a larger number of subjects with severe asthma, including children, to allow further characterization of anatomic, physiologic, biochemical, and genetic factors related to severe disease in a longitudinal assessment to identify factors that modulate the natural history of severe asthma and provide mechanistic rationale for management strategies. PMID:22095547

  8. Diagnosing Asthma

    Science.gov (United States)

    ... Ribbon Commands Skip to main content Turn off Animations Turn on Animations Our Sponsors Log in | Register Menu Log in | ... were tried and if they helped Any family history of allergies or asthma It is very important ...

  9. Occupational Asthma

    Science.gov (United States)

    ... the enzymes of the bacteria Bacillus subtilis, while bakers may develop an allergy and occupational asthma symptoms ... counts Continuing education center Find an allergist / immunologist Journals Login / My membership Search your symptoms Shop the ...

  10. Do Allergies Cause Asthma?

    Science.gov (United States)

    ... Voice in Health Care Decisions Do Allergies Cause Asthma? KidsHealth > For Parents > Do Allergies Cause Asthma? Print ... son la causa del asma? Do Allergies Cause Asthma? Allergies don't cause asthma. But kids who ...

  11. Asthma Medications and Pregnancy

    Science.gov (United States)

    ... Associated Conditions Asthma & Pregnancy Asthma & Pregnancy: Medications Asthma & Pregnancy: Medications Make an Appointment Refer a Patient Ask ... mother and child. Making Decisions about Medication During Pregnancy It is important that your asthma be controlled ...

  12. Death due to asthma

    Directory of Open Access Journals (Sweden)

    Albert L. Sheffer

    1996-01-01

    Full Text Available The prevalence and fatality rate of asthma have increased worldwide. Underdiagnosis and undertreatment of asthma are central to the occurrence of fatal asthma. Atopy is the principal risk factor associated with asthma. However, consideration of the epidemiologic, physiologic, pharmacologic, pathologic and clinical parameters of asthma assessment may provide valuable insight into death due to asthma. Psychologic and socioeconomic factors may further aggravate the asthma status. Ethnic minorities are at increased risk of asthma. The perception of dyspnea may be blunted in asthma sufferers. Slow-onset fatal asthma may be associated with submucosal eosinophilic, whereas sudden-onset may be associated with submucosal neutrophilia. Fatal asthma occurs in patients abusing regular |32-agonist therapy. Peak flow assessment often provides insight into asthma deterioration prior to signs of respiratory distress. Markers of risk of death due to asthma further identify the fatality-prone asthma patient.

  13. Death due to asthma

    OpenAIRE

    Sheffer, Albert L.

    1996-01-01

    The prevalence and fatality rate of asthma have increased worldwide. Underdiagnosis and undertreatment of asthma are central to the occurrence of fatal asthma. Atopy is the principal risk factor associated with asthma. However, consideration of the epidemiologic, physiologic, pharmacologic, pathologic and clinical parameters of asthma assessment may provide valuable insight into death due to asthma. Psychologic and socioeconomic factors may further aggravate the asthma status. Ethnic minoriti...

  14. Asthma - children

    Science.gov (United States)

    ... BS, Burks AW, et al, eds. Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 53. Lugogo N, Que LG, Gilstrap DL, Kraft M. Asthma: clinical diagnosis and management. In: Broaddus VC, Mason RJ, Ernst JD, et ...

  15. Childhood asthma

    African Journals Online (AJOL)

    atopy, night cough, exercise-induced cough and/or wheeze and seasonal variation in symptoms. Epidemiology. Asthma is on the increase in both the developed and developing countries of the world. In South Africa, its prevalence in children in Cape Town (measured by exercise challenge) was only three per cent in 1979.

  16. Childhood asthma

    African Journals Online (AJOL)

    prevalence in children in Cape Town (measured by exercise challenge) was only three per ... mortality among the five to 34-year-old age group, and fifth for asthma ... clouded by differences in terminology used by respondents, depending on ...

  17. Exercise-Induced Asthma

    Science.gov (United States)

    ... January 2014 More on this topic for: Parents Kids Teens Can Kids and Teens With Asthma Play Sports? Asthma Center When to Go to the ER if Your Child Has Asthma Kids and Exercise Asthma Triggers Word! Exercise-Induced Asthma ...

  18. Allergies, asthma, and molds

    Science.gov (United States)

    Reactive airway - mold; Bronchial asthma - mold; Triggers - mold; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. Mold is a common trigger. When your asthma or allergies become worse due to mold, you are ...

  19. Asthma Triggers: Gain Control

    Science.gov (United States)

    ... asthma. Dogs, cats, rodents (including hamsters and guinea pigs) and other warm-blooded mammals can trigger asthma ... Page Contact Us to ask a question, provide feedback, or report a problem. Asthma Indoor Air Quality ...

  20. What Is Asthma?

    Science.gov (United States)

    ... Asthma Awareness National Asthma Awards Federal and Partner Organizations Public Service Announcements & Multimedia Main menu Environmental Topics Air Bed Bugs Chemicals and Toxics Environmental ...

  1. Asthma and obesity

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ali, Zarqa; Nilas, Lisbeth

    2012-01-01

    Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma....

  2. Obesity and Asthma

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is more prevalent in obese compared with normal weight subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy.Several studies have shown that overweight and obesity is associated with more severe asthma...... and impaired quality of life compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency...... department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index (BMI) on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy with regard...

  3. Smoking and Asthma (For Teens)

    Science.gov (United States)

    ... Personal Plan Hot Topics Flu Facts Arrhythmias Abuse Smoking and Asthma KidsHealth > For Teens > Smoking and Asthma ... A en español Fumar y el asma Does Smoking Make Asthma Worse? Yes. If you have asthma, ...

  4. Asthma and obesity.

    Science.gov (United States)

    Boulet, L-P

    2013-01-01

    The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients. © 2012 Blackwell Publishing Ltd.

  5. Allergy in severe asthma.

    Science.gov (United States)

    Del Giacco, S R; Bakirtas, A; Bel, E; Custovic, A; Diamant, Z; Hamelmann, E; Heffler, E; Kalayci, Ö; Saglani, S; Sergejeva, S; Seys, S; Simpson, A; Bjermer, L

    2017-02-01

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. For Parents of Children with Asthma

    Science.gov (United States)

    ... Asthma > Managing Asthma For Parents of Children with Asthma Your Child's Asthma: A Parent's Guide to Better Breathing This step- ... health considerations you should keep in mind. Diagnosing Asthma in Young Children Most children who have asthma ...

  7. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Asthma among Persons with Current Asthma Asthma and Obesity Percentage of People with Asthma who Smoke Insurance ... Asthma Resources for Professionals National Asthma Control Program America Breathing Easier Guide for State Programs Interventions Community ...

  8. What is Asthma?

    Medline Plus

    Full Text Available ... Lung Association 104 COPD Awareness Month: Connecting with Social Support American Lung Association ... Asthma - Duration: 3:36. Nucleus Medical Media 658,979 views 3:36 What is asthma. ...

  9. Obesity, adipokines and asthma

    National Research Council Canada - National Science Library

    Jartti, T; Saarikoski, L; Jartti, L; Lisinen, I; Jula, A; Huupponen, R; Viikari, J; Raitakari, O. T

    2009-01-01

    .... Our objective was to examine whether obesity is associated with asthma in three time points of life, and whether immunomodulatory adipokines, leptin and adiponectin are linked to overweight-associated asthma. Methods...

  10. What is Asthma?

    Medline Plus

    Full Text Available ... Lung Association 139 Barbara Tie talks about Alpha 1-caused COPD American Lung Association 140 Judy Pruitt ... American Lung Association 182 Asthma - Theresa Moore PSA 1 American Lung Association 183 Asthma Walk PSA American ...

  11. Exercise-induced asthma

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000036.htm Exercise-induced asthma To use the sharing features on this page, ... such as running, basketball, or soccer. Use Your Asthma Medicine Before you Exercise Take your short-acting, ...

  12. Allergies, asthma, and pollen

    Science.gov (United States)

    Reactive airway - pollen; Bronchial asthma - pollen; Triggers - pollen; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. It is important to know your triggers because avoiding them is your first step toward feeling better. ...

  13. What is Asthma?

    Medline Plus

    Full Text Available ... Clubs American Lung Association 146 Angela Abel on exercise and COPD American Lung Association 147 American Lung ... 40 Types of Asthma - Duration: 11:38. Affinity Health Plan 6,222 views 11:38 Asthma Tech - ...

  14. Smoking and asthma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000504.htm Smoking and asthma To use the sharing features on ... your allergies or asthma worse are called triggers. Smoking is a trigger for many people who have ...

  15. Asthma - child - discharge

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000001.htm Asthma - child - discharge To use the sharing features on this ... care for your child. Take Charge of Your Child's Asthma at Home Make sure you know the ...

  16. Psychopathology in difficult asthma

    NARCIS (Netherlands)

    Prins, L.C.; van Son, M.J.M.; Keimpema, A.R.; van Ranst, D; Pommer, A; Meijer, J.W.; Pop, V.J.M.

    2015-01-01

    OBJECTIVE: Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed

  17. Obesity and asthma

    DEFF Research Database (Denmark)

    Ali, Zarqa; Ulrik, Charlotte Suppli

    2013-01-01

    Epidemiological data has established increasing adiposity as a risk factor for incident asthma. However, the mechanisms underlying the association between obesity and asthma are incompletely understood. In the present paper, we review current knowledge of possible mechanisms mediating the observed...... association between obesity and asthma....

  18. Allergy in severe asthma

    NARCIS (Netherlands)

    Del Giacco, Stefano R.; Bakirtas, A.; Bel, E.; Custovic, A.; Diamant, Z.; Hamelmann, E.; Heffler, E.; Kalayci, O.; Saglani, S.; Sergejeva, S.; Seys, S.; Simpson, A.; Bjermer, Leif

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps

  19. Clinical phenotypes of asthma

    NARCIS (Netherlands)

    Bel, Elisabeth H.

    2004-01-01

    PURPOSE OF REVIEW: Asthma is a phenotypically heterogeneous disorder and, over the years, many different clinical subtypes of asthma have been described. A precise definition of asthma phenotypes is now becoming more and more important, not only for a better understanding of pathophysiologic

  20. Epigenetic Mechanisms in Asthma.

    Science.gov (United States)

    DeVries, Avery; Vercelli, Donata

    2016-03-01

    Asthma and allergic diseases are among the most prevalent chronic noncommunicable diseases of childhood, but the underlying pathogenetic mechanisms are poorly understood. Because epigenetic mechanisms link gene regulation to environmental cues and developmental trajectories, their contribution to asthma and allergy pathogenesis is under active investigation. DNA methylation signatures associated with concurrent disease and with the development of asthma during childhood asthma have been identified, but their significance is not easily interpretable. On the other hand, the characterization of early epigenetic predictors of asthma points to a potential role of epigenetic mechanisms in regulating the inception of, and the susceptibility to, this disease.

  1. Obesity and asthma.

    Science.gov (United States)

    Gibson, Peter G

    2013-12-01

    There is a global epidemic of asthma and obesity that is concentrated in Westernized and developed countries. A causal association in some people with asthma is suggested by observations that obesity precedes the onset of asthma and that bariatric surgery for morbid obesity can resolve asthma. The obese asthma phenotype features poor asthma control, limited response to corticosteroids, and an exaggeration of the physiological effects of obesity on lung function, which includes a reduction in expiratory reserve volume and airway closure occurring during tidal breathing. Obesity has important implications for asthma treatment. Increasing corticosteroid doses based on poor asthma control, as currently recommended in guidelines, may lead to overtreatment with corticosteroids in obese asthma. Enhanced bronchodilation, particularly of the small airways, may reduce the component of airway closure due to increased bronchomotor tone and suggests that greater emphasis should be placed on long-acting bronchodilators in obese asthma. The societal implications of this are important: with increasing obesity there will be increasing asthma from obesity, and the need to identify successful individual and societal weight-control strategies becomes a key goal.

  2. Obesity and asthma

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Diamant, Zuzana; Ulrik, Charlotte Suppli

    2015-01-01

    PURPOSE OF REVIEW: Obesity has significant impact on asthma incidence and manifestations. The purpose of the review is to discuss recent observations regarding the association between obesity and asthma focusing on underlying mechanisms, clinical presentation, response to therapy and effect...... of weight reduction. RECENT FINDINGS: Clinical and epidemiological studies indicate that obese patients with asthma may represent a unique phenotype, which is more difficult to control, less responsive to asthma medications and by that may have higher healthcare utilization. A number of common comorbidities...... have been linked to both obesity and asthma, and may, therefore, contribute to the obese-asthma phenotype. Furthermore, recently published studies indicate that even a modest weight reduction can improve clinical manifestations and outcome of asthma. SUMMARY: Compared with normal-weight patients, obese...

  3. Patient's adherence in asthma.

    Science.gov (United States)

    Gillisen, Adrian

    2007-11-01

    Nonadherence in asthma treatment results in increasing mortality, morbidity, and it is associated with increasing treatment costs. In asthma, adherence rates are often below 50%. Understanding of the needs and behaviors of asthma patients as well as treatment barriers to comply with asthma guidelines is important in developing programs to promote adherence. This article presents information on common types of nonadherence in asthma patients, the causes, and it reviews the literature on interventions to overcome these factors to maximize adherence rates. Although several interventions are effective in improving medication adherence in asthma, only few significantly enhance adherence rates and clinical outcomes of these patients. An improvement in treatment adherence is a complex task, requiring asthma self-management, education programs coupled with educational reinforcements, simplifying treatment planes and applications forms. Good communications skills among clinicians and patient education are also central for improving adherence. Methods to overcoming physician barriers ensure consistency in implementing guideline recommendations in practice.

  4. Monitoring asthma in childhood

    Directory of Open Access Journals (Sweden)

    Karin C. Lødrup Carlsen

    2015-06-01

    Full Text Available The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. However, to date there is limited evidence on how to monitor patients with asthma. Childhood asthma introduces specific challenges in terms of deciding what, when, how often, by whom and in whom different assessments of asthma should be performed. The age of the child, the fluctuating course of asthma severity, variability in clinical presentation, exacerbations, comorbidities, socioeconomic and psychosocial factors, and environmental exposures may all influence disease activity and, hence, monitoring strategies. These factors will be addressed in herein. We identified large knowledge gaps in the effects of different monitoring strategies in children with asthma. Studies into monitoring strategies are urgently needed, preferably in collaborative paediatric studies across countries and healthcare systems.

  5. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

    Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients...... with asthma. Substantial evidence suggests that smoking affects asthma adversely. Exposure to environmental tobacco smoke, especially maternal smoking in children, may be a significant risk factor for asthma. Such exposure in patients with established asthma is not only associated with more severe symptoms......, but also with a poorer quality of life, reduced lung function, and increased utilisation of health care including hospital admissions. Active smoking does not appear to be a significant risk factor for asthma, but is associated with a worse outcome with regard to both longitudinal changes in lung function...

  6. Asthma in the Elderly

    Directory of Open Access Journals (Sweden)

    Domenico Lorenzo Urso

    2009-01-01

    Full Text Available Bronchial asthma is a common problem with enormous medical and economics impacts. It is an inflammatory disease of the airways associated with intermittent episodes of bronchospasm. Asthma is not uncommon in the elderly patients. Prevalence of asthma is similar in older and younger adults. Asthma in the elderly patient is underdiagnosed because of false perceptions by both patient and physician. The high incidence of comorbid conditions in the elderly patient makes the diagnosis and management more difficult. Correct diagnosis is demonstrated with spirometry. The goals of asthma treatment are to achieve and maintain control of symptoms and to prevent development of irreversible airflow limitation. Asthma drugs are preferably inhaled because this route minimizes systemic absorption and, thus, improves the ratio of the therapeutic benefit to the potential side-effects in elderly patients.

  7. Asthma and obesity

    DEFF Research Database (Denmark)

    Ulrik, Charlotte S

    2016-01-01

    PURPOSE OF REVIEW: Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. RECENT FINDINGS: Clinical studies have shown that weight...... reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness...... reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma....

  8. Late-Onset Asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli

    2017-01-01

    , to objectively confirm asthma. If necessary, a trial of oral or inhaled corticosteroid might be necessary. Asthma can be diagnosed when increased airflow variability is identified in a symptomatic patient, and if the patient does not have a history of exposure, primarily smoking, known to cause chronic...... obstructive pulmonary disease, the diagnosis is asthma even if the patient does not have fully reversible airflow obstruction. Pharmacological therapy in patients with late-onset asthma follows international guidelines, including treatment with the lowest effective dose of inhaled corticosteroid to minimize...... the risk of systemic effects. However, most recommendations are based on extrapolation from findings in younger patients. Comorbidities are very common in patients with late-onset asthma and need to be taken into account in the management of the disease. In conclusion, late-onset asthma is poorly...

  9. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... please visit this page: About CDC.gov . Asthma Learn How to Control Asthma Asthma and Severe Weather ... Working on Asthma Follow @CDCasthma on Twitter to learn more about helping people with asthma live healthier ...

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler ... MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I view ...

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler ... ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I view ...

  12. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I ...

  13. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... among Children Asthma-related Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with Current Asthma Asthma Severity among Children with Current Asthma Overuse of quick-relief medication ...

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma ... MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I ...

  15. Severe Asthma in Children.

    Science.gov (United States)

    Chipps, Bradley E; Parikh, Neil G; Maharaj, Sheena K

    2017-04-01

    The aim of this study is to characterize, diagnose, evaluate, and treat severe childhood asthma. Understanding the occurrence of the physiologic and clinical presentations of childhood severe asthma, the treatment and response may be predicted by biomarkers, but the patient's response is highly variable. The onset of severe asthma occurs early and is primarily predicted by severity of viral infection and coexistence of the atopic state.

  16. Linking obesity and asthma.

    Science.gov (United States)

    Sutherland, E Rand

    2014-04-01

    A growing body of literature suggests that obesity has a significant impact on asthma risk, phenotype, and prognosis. Epidemiological studies have clearly demonstrated that asthma is more likely to occur in obese patients, and health status is impaired in obese individuals with asthma, with obese asthmatics experiencing more symptoms, worse quality of life, increased healthcare use, and increased asthma severity. However, obesity has well-described effects on lung function and mechanics that can lead to symptoms of dyspnea without causing the pathophysiologic changes of asthma. Adding to the challenges of evaluating this association, some studies have failed to demonstrate a robust relationship between obesity and traditional biomarkers of airway inflammation in adult asthmatics, leading to the conclusion that obesity does not necessarily worsen airway inflammation in asthma. In this regard, emerging data suggest that nonatopic mechanisms may be relevant in obese asthmatics, and that these mechanisms may have a direct impact on the response of obese asthmatics to asthma therapies, most notably inhaled glucocorticoids. This article will review selected aspects of the contributions of obesity-related airway and systemic inflammation to asthma, with a focus on the impact of obesity as a modifier of risk, prognosis, and therapeutic response in asthma. © 2014 New York Academy of Sciences.

  17. Asthma in the Elderly.

    Science.gov (United States)

    Braman, Sidney S

    2017-11-01

    The older population has seen the greatest increase in the prevalence of current asthma in recent years. Asthma may begin at any age and when it occurs at an advanced as opposed to a young age, it is often nonatopic, severe, and unremitting. Unfortunately, geriatric-specific guidelines are not available for the diagnosis and treatment of asthma. However, with objective monitoring, avoidance of asthma triggers, appropriate pharmacotherapy, and patient education, the disease can be managed successfully. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Asthma among mink workers

    DEFF Research Database (Denmark)

    Grøntved, Berit; Carstensen, Ole; Petersen, Rolf

    2014-01-01

    We report two cases of asthma among mink workers. The first case is about a mink farmer who had asthma that was difficult to treat. In the medical history there was no clear relation to work, and no conclusive work relation with peak flow monitoring. He had a positive histamine release test to mink...... urine. The second case is about a mink farm worker, who had an asthma attack when handling mink furs. Peak flow monitoring showed a clear relation to this work, but there were no signs of allergy. We conclude that these two cases suggest an increased risk of asthma among mink workers....

  19. Nutrition and Asthma

    Directory of Open Access Journals (Sweden)

    Gupta K

    2007-01-01

    Full Text Available Increase in the asthma prevalence in many countries over the recent decades, highlights the need for a greater understanding of the risk factors for asthma. Be-cause asthma is the result of interaction between genetic and environmental fac-tors, increasing prevalence is certainly the result of changes in environmental fac-tors because of process of wesernization. That is the reason for higher prevalence in countries where a traditional to a westernized lifestyle occurred earlier. This increasing prevalence has affected both rural and urban communities, suggesting that local environmental factors such as exposure to allergens or industrial air pol-lutions are not the sole cause. In the last few years, nutrition has represented an important conditioning factor of many cardiovascular, gastrointestinal and chronic pulmonary diseases. So it has been hypothesized that dietary constituents influence the immune system and thus, may also be actively involved in the onset of asthma and other allergic diseases. Dietary constituents can play beneficial as well as det-rimental role in asthma. The possible role of diet in the development of asthma can be described as follows: first, a food allergen can cause asthma. Second, there is role of breast-feeding for prevention of asthma later in life. Third, a low intake of antioxidative dietary constituents might be a risk factor for asthma. Moreover, role of cations such as sodium, potassium and magnesium has been described in development of asthma. Finally, intake of fatty acids specially the role of omega-3 and omega-6 fatty acids play important role in cause of asthma.

  20. What is Asthma?

    Medline Plus

    Full Text Available ... Lung Association 104 COPD Awareness Month: Connecting with Social Support American Lung Association 105 Ohio Cares about ... 7:59 Asthma - Duration: 3:36. Nucleus Medical Media 658,979 views 3:36 What is asthma. ...

  1. Traveling and Asthma

    Science.gov (United States)

    ... Stress How Cliques Make Kids Feel Left Out Traveling and Asthma KidsHealth > For Kids > Traveling and Asthma Print A A A en español ... handy at all times. So if you're traveling by car, keep them where you can get ...

  2. Assessment of asthma control using asthma control test in chest ...

    African Journals Online (AJOL)

    ... CI 1.06-3.47) and obesity (OR 1.81; 1.01-3.27). Conclusion: Asthma remains poorly controlled in a large proportion of asthma patients under specialist care in Cameroon. Educational programs for asthma patients targeting women and based on weight loss for obese patients may help in improving the control of asthma.

  3. Advances in pediatric asthma in 2013: coordinating asthma care.

    Science.gov (United States)

    Szefler, Stanley J

    2014-03-01

    Last year's "Advances in pediatric asthma: moving toward asthma prevention" concluded that "We are well on our way to creating a pathway around wellness in asthma care and also to utilize new tools to predict the risk for asthma and take steps to not only prevent asthma exacerbations but also to prevent the early manifestations of the disease and thus prevent its evolution to severe asthma." This year's summary will focus on recent advances in pediatric asthma on prenatal and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding potential therapeutic targets for altering the course of asthma in children, as indicated in Journal of Allergy and Clinical Immunology publications in 2013 and early 2014. Recent reports continue to shed light on methods to understand factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention, as well as new immunomodulators. It will now be important to carefully assess risk factors for the development of asthma, as well as the risk for asthma exacerbations, and to improve the way we communicate this information in the health care system. This will allow parents, primary care physicians, specialists, and provider systems to more effectively intervene in altering the course of asthma and to further reduce asthma morbidity and mortality. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  4. Genetics of asthma

    DEFF Research Database (Denmark)

    Thomsen, Simon F

    2015-01-01

    Asthma runs in families, and children of asthmatic parents are at increased risk of asthma. Prediction of disease risk is pivotal for the clinician when counselling atopic families. However, this is not always an easy task bearing in mind the vast and ever-increasing knowledge about asthma genetics....... The advent of new genotyping technologies has made it possible to sequence in great detail the human genome for asthma-associated variants, and accordingly, recent decades have witnessed an explosion in the number of rare and common variants associated with disease risk. This review presents an overview...... of methods and advances in asthma genetics in an attempt to help the clinician keep track of the most important knowledge in the field....

  5. Fertility outcomes in asthma

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis; Lindenberg, Svend

    2016-01-01

    of fertility treatments, and the number of successful pregnancies differ significantly between women with unexplained infertility with and without asthma.245 women with unexplained infertility (aged 23-45 years) underwent questionnaires and asthma and allergy testing while undergoing fertility treatment. 96...... women entering the study had either a former doctor's diagnosis of asthma or were diagnosed with asthma when included. After inclusion they were followed for a minimum of 12 months in fertility treatment, until they had a successful pregnancy, stopped treatment, or the observation ended.The likelihood...... pregnancies during fertility treatment, 39.6 versus 60.4% (p=0.002). Increasing age was of negative importance for expected time to pregnancy, especially among asthmatic women (interaction between age and asthma on time to pregnancy, p=0.001). Female asthmatics had a longer time to pregnancy and less often...

  6. Advances in Pediatric Asthma in 2013: Coordinating Asthma Care

    Science.gov (United States)

    Szefler, Stanley J.

    2014-01-01

    Last year’s Advances in Pediatric Asthma: Moving Toward Asthma Prevention concluded that: “We are well on our way to creating a pathway around wellness in asthma care and also to utilize new tools to predict the risk for asthma and take steps to not only prevent asthma exacerbations but also to prevent the early manifestations of the disease and thus prevent its evolution to severe asthma.” This year’s summary will focus on recent advances in pediatric asthma on pre- and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding potential therapeutic targets for altering the course of asthma in children as indicated in Journal of Allergy and Clinical Immunology publications in 2013 and early 2014. Recent reports continue to shed light on methods to understand factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention as well as new immunomodulators. It will now be important to carefully assess risk factors for the development of asthma as well as the risk for asthma exacerbations and to improve the way we communicate this information in the health care system. This will allow parents, primary care physicians, specialists and provider systems to more effectively intervene in altering the course of asthma and to further reduce asthma morbidity and mortality. PMID:24581430

  7. The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control

    OpenAIRE

    Malin Axelsson; Linda Ekerljung; Bo Lundbäck

    2015-01-01

    Objective. The aim was to investigate adherence to asthma medication treatment, medication beliefs, and asthma control in relation to asthma follow-up consultations in asthmatics in the general population. A further aim was to describe associations between adherence, medication beliefs, and asthma control. Method. In the population-based West Sweden Asthma Study, data allowing calculation of adherence for 4.5 years based on pharmacy records were obtained from 165 adult asthmatics. Additional ...

  8. Children with Asthma and Sports

    OpenAIRE

    Selda Yuzer; Sevinc Polat

    2014-01-01

    Asthma is one of the chronic diseases which have are widely seen among the children. The disease has recently been in the increase all over the world and affects many children. In a study conducted with International Study of Asthma and Allergies in Childhood (ISAAC) method, it was found out that prevalence of childhood asthma was 17.1%. Participation in sportive activities by the children with asthma, which is today considered as a part of asthma treatment program, makes contributions to the...

  9. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

    Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients with ast......Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients...... with asthma. Substantial evidence suggests that smoking affects asthma adversely. Exposure to environmental tobacco smoke, especially maternal smoking in children, may be a significant risk factor for asthma. Such exposure in patients with established asthma is not only associated with more severe symptoms......, but also with a poorer quality of life, reduced lung function, and increased utilisation of health care including hospital admissions. Active smoking does not appear to be a significant risk factor for asthma, but is associated with a worse outcome with regard to both longitudinal changes in lung function...

  10. Asthma control in children

    DEFF Research Database (Denmark)

    Pedersen, Søren

    2016-01-01

    studies have added new information about the effects of poorly controlled asthma on a range of important, but less studied outcomes, including risk of obesity, daily physical activity, cardiovascular fitness, stress, concentration and focused attention, learning disabilities and risk of depression. From...... in whom the tests suggest good asthma control may still have poorly controlled asthma when various objective outcomes are included in the assessment. A main reason for that seems to be that none of the tests accurately detects the child's adaptation in lifestyle. If you do not exercise you have fewer...

  11. Genetics, atopy asthma

    Directory of Open Access Journals (Sweden)

    William O.C.M. Cookson

    1996-01-01

    Full Text Available Asthma is a complex disease which is due to the interaction of an unknown number of genes with strong environmental factors. Segregation analysis suggests the presence of major genes underlying asthma and atopy. Different genetic effects have been recognized which predispose to generalized atopy, or modify the atopic response to particular allergens, or enhance bronchial inflammation, or modify bronchial tone. These known genes or genetic loci do not account for all of the familial clustering of asthma and atopy. Many studies are now under way to identify the remaining genes.

  12. Exercise-Induced Asthma

    Science.gov (United States)

    ... Blood Institute. http://www.nhlbi.nih.gov/health-pro/resources/lung/naci/discover/action-plans.htm. Accessed Sept. 12, 2014. Mickleborough TD, et al. Exercise-induced asthma: Nutritional management. Current ...

  13. Reflexology and bronchial asthma

    DEFF Research Database (Denmark)

    Brygge, T; Heinig, J H; Collins, P

    2001-01-01

    Many asthma patients seek alternative or adjunctive therapies. One such modality is reflexology, whereby finger pressure is applied to certain parts of the body. The aim of the study was to examine the popular claim that reflexology treatment benefits bronchial asthma. Ten weeks of active...... or simulated (placebo) reflexology given by an experienced reflexologist, were compared in an otherwise blind, controlled trial of 20+20 outpatients with asthma. Objective lung function tests (peak flow morning and evening, and weekly spirometry at the clinic) did not change. Subjective scores (describing...... diaries was carried out. It was accompanied by a significant pattern compatible with subconscious unblinding, in that patients tended to guess which treatment they had been receiving. No evidence was found that reflexology has a specific effect on asthma beyond placebo influence....

  14. Asthma in elite athletes

    DEFF Research Database (Denmark)

    Elers, Jimmi; Pedersen, Lars; Backer, Vibeke

    2011-01-01

    Asthma is frequently found among elite athletes performing endurance sports such as swimming, rowing and cross-country skiing. Although these athletes often report symptoms while exercising, they seldom have symptoms at rest. Moreover, compared with nonathletic asthmatic individuals, elite athletes...... their physical capacity. Elite athletes should undergo comprehensive assessment to confirm an asthma diagnosis and determine its degree of severity. Treatment should be as for any other asthmatic individual, including the use of ß2-agonist, inhaled steroid as well as leukotriene-antagonist. It should, however......, be noted that daily use of ß-agonists could expose elite athletes to the risk of developing tolerance towards these drugs. Use of ß2-agonist should be replaced with daily inhaled corticosteroid treatment, the most important treatment of exercise-induced asthma. All physicians treating asthma should...

  15. Zoneterapi og asthma

    DEFF Research Database (Denmark)

    Brygge, Thor; Heinig, John Hilligsøe; Collins, Philippa

    2002-01-01

    INTRODUCTION: Many patients with asthma seek alternative or adjunctive therapies. One such modality is reflexology. Our aim was to examine the popular claim that reflexology treatment benefits bronchial asthma. MATERIAL AND METHODS: Ten weeks of either active or simulated (placebo) reflexology were...... compared in an otherwise blind, controlled trial of 40 patients with asthma. RESULTS: Objective lung function tests did not change. Subjective scores and bronchial sensitivity to histamine improved on both regimens, but no differences were found in the groups receiving active or placebo reflexology....... However, a trend in favour of reflexology became significant when a supplementary analysis of symptom diaries was carried out. At the same time a significant pattern compatible with subconscious un-blinding was found. DISCUSSION: We found no evidence that reflexology has a specific effect on asthma beyond...

  16. Asthma in elite athletes

    DEFF Research Database (Denmark)

    Elers, Jimmi; Pedersen, Lars; Backer, Vibeke

    2011-01-01

    Asthma is frequently found among elite athletes performing endurance sports such as swimming, rowing and cross-country skiing. Although these athletes often report symptoms while exercising, they seldom have symptoms at rest. Moreover, compared with nonathletic asthmatic individuals, elite athletes...... their physical capacity. Elite athletes should undergo comprehensive assessment to confirm an asthma diagnosis and determine its degree of severity. Treatment should be as for any other asthmatic individual, including the use of β2-agonist, inhaled steroid as well as leukotriene-antagonist. It should, however......, be noted that daily use of β-agonists could expose elite athletes to the risk of developing tolerance towards these drugs. Use of β2-agonist should be replaced with daily inhaled corticosteroid treatment, the most important treatment of exercise-induced asthma. All physicians treating asthma should...

  17. Vitamin D and asthma

    National Research Council Canada - National Science Library

    Brown, Sheena D; Calvert, H. Hardie; Fitzpatrick, Anne M

    2012-01-01

    .... Vitamin D is of particular interest in asthma since vitamin D concentrations decrease with increased time spent indoors, decreased exposure to sunlight, less exercise, obesity, and inadequate calcium intake...

  18. So You Have Asthma

    Science.gov (United States)

    ... get all the medicine into your lungs . The best way to learn to use these devices correctly is ... bed. • Take your asthma medicine right after you brush your teeth and keep it with your toothbrush as a ...

  19. Inflammation in Asthma

    African Journals Online (AJOL)

    Ashraf

    Systemic hypersensitivity diseases include, among others, asthma, rhinoconjunctivitis, otitis, rhinosinusitis ... hypersensitivity.13 As a medical specialty based on immunology, the allergy specialty (in some countries, called .... In certain countries (the United States, for instance), training in allergy encompasses both pediatrics.

  20. Pediatric asthma in a nutshell.

    Science.gov (United States)

    Link, Holger Werner

    2014-07-01

    On the basis of strong research evidence, asthma is a leading cause of emergency department visits and hospital admissions for children. On the basis of research evidence, implementation of asthma guidelines by medical professionals in not optimal. On the basis of research evidence, the Asthma Predictive Index supports a diagnosis of chronic asthma in children younger than 3 years. On the basis of strong research evidence, premedication with a short-acting β2-agonist is the preferred initial therapy for exercise-induced asthma. On the basis of strong research evidence, anti-inflammatory therapy with inhaled corticosteroids is an effective treatment for asthma. On the basis of research and consensus, assessment of impairment and risk followed by scheduled assessment for asthma control is recommended. On the basis of research and consensus, the establishment of a close cooperative relationship among medical professionals, patients with asthma, and their families is an important component of asthma management.

  1. Stress and asthma

    OpenAIRE

    Shoji Nagata; Masahiro Irie; Norio Mishima

    1999-01-01

    Three factors in recent medical research and treatment (advances in the field of psychoneuroimmunology, epidemiological evidence regarding important interaction between psychosocial factors and development of disease, and the recognition of the importance of patient education for self-management of asthma) have led clinicians and researchers to reconsider the role of psychosocial stress in asthma. There are many reports suggesting that stressful life events, family problems and a behavior pat...

  2. Update in asthma 2008

    National Research Council Canada - National Science Library

    Moore, Wendy C

    2009-01-01

    ... between obesity and asthma (8-10). Articles published in 2008 have advanced our understanding of the influence of genetics (11-18), factors in early life (19-21), and the environment (19, 22-24) on the development of asthma or the modification of disease severity. Basic pathobiologic studies in humans (25-35) and mice (36-46) have added to our underst...

  3. Genetics, atopy asthma

    OpenAIRE

    Cookson, William O. C. M.

    1996-01-01

    Asthma is a complex disease which is due to the interaction of an unknown number of genes with strong environmental factors. Segregation analysis suggests the presence of major genes underlying asthma and atopy. Different genetic effects have been recognized which predispose to generalized atopy, or modify the atopic response to particular allergens, or enhance bronchial inflammation, or modify bronchial tone. These known genes or genetic loci do not account for all of the familial clustering...

  4. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... to learn more about helping people with asthma live healthier lives by gaining control over their asthma. Quick Links ... to learn more about helping people with asthma live healthier lives by gaining control over their asthma. ...

  5. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Recent Asthma Data Most Recent Asthma State or Territory Data Previous Most Recent Asthma Data 2014 National Data Archive 2014 State or Territory Data Archive AsthmaStats Flu Vaccination among Adults with ...

  6. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... page: About CDC.gov . Asthma Learn How to Control Asthma Asthma and Severe Weather Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ...

  7. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking ... people with asthma live healthier lives by gaining control over their asthma. Quick Links Asthma Action Plan ...

  8. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Archive 2014 State or Territory Data Archive AsthmaStats Flu Vaccination among Adults with Current Asthma Flu Vaccination among Children with Current Asthma Asthma and Fair ...

  9. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Learn How to Control Asthma Asthma and Severe Weather Brochures Facts Triggers Indoors In the Workplace Outdoors ... CDC Publications on Asthma National Asthma Control Program America Breathing Easier Guide for State Programs Interventions Community ...

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do ...

  11. Asthma Control Essential in Pregnancy, Study Suggests

    Science.gov (United States)

    ... were born to mothers with active asthma during pregnancy. Those born to mothers who had mild controlled asthma were less likely to be diagnosed with asthma at an early age than those whose moms had mild uncontrolled asthma, ...

  12. Evolving Concepts of Asthma

    Science.gov (United States)

    Ray, Anuradha; Wenzel, Sally E.

    2015-01-01

    Our understanding of asthma has evolved over time from a singular disease to a complex of various phenotypes, with varied natural histories, physiologies, and responses to treatment. Early therapies treated most patients with asthma similarly, with bronchodilators and corticosteroids, but these therapies had varying degrees of success. Similarly, despite initial studies that identified an underlying type 2 inflammation in the airways of patients with asthma, biologic therapies targeted toward these type 2 pathways were unsuccessful in all patients. These observations led to increased interest in phenotyping asthma. Clinical approaches, both biased and later unbiased/statistical approaches to large asthma patient cohorts, identified a variety of patient characteristics, but they also consistently identified the importance of age of onset of disease and the presence of eosinophils in determining clinically relevant phenotypes. These paralleled molecular approaches to phenotyping that developed an understanding that not all patients share a type 2 inflammatory pattern. Using biomarkers to select patients with type 2 inflammation, repeated trials of biologics directed toward type 2 cytokine pathways saw newfound success, confirming the importance of phenotyping in asthma. Further research is needed to clarify additional clinical and molecular phenotypes, validate predictive biomarkers, and identify new areas for possible interventions. PMID:26161792

  13. Asthma is Different in Women

    Science.gov (United States)

    Erzurum, Serpil C.

    2015-01-01

    Gender differences in asthma incidence, prevalence and severity have been reported worldwide. After puberty, asthma becomes more prevalent and severe in women, and is highest in women with early menarche or with multiple gestations, suggesting a role for sex hormones in asthma genesis. However, the impact of sex hormones on the pathophysiology of asthma is confounded by and difficult to differentiate from age, obesity, atopy, and other gender associated environmental exposures. There are also gender discrepancies in the perception of asthma symptoms. Understanding gender differences in asthma is important to provide effective education and personalized management plans for asthmatics across the lifecourse. PMID:26141573

  14. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The obj......BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents...

  15. Physical training for asthma.

    Science.gov (United States)

    Pereira, Mônica Corso

    2014-01-01

    People with asthma may show less tolerance to exercise due to worsening asthma symptoms during exercise or other reasons such as deconditioning as a consequence of inactivity. Some may restrict activities as per medical advice or family influence and this might result in reduced physical fitness. Physical training programs aim to improve physical fitness, neuromuscular coordination and self confidence. Subjectively, many people with asthma report that they are symptomatically better when fit, but results from trials have varied and have been difficult to compare because of different designs and training protocols. Also, as exercise can induce asthma, the safety of exercise programmes needs to be considered. To gain a better understanding of the effect of physical training on the respiratory and general health of people with asthma, from randomised trials. We searched the Cochrane Airways Group Specialised Register of trials up to January 2013. We included randomised trials of people over eight years of age with asthma who were randomised to undertake physical training or not. Physical training had to be undertaken for at least 20 minutes, two times a week, over a minimum period of four weeks. Two review authors independently assessed eligibility for inclusion and undertook risk of bias assessment for the included studies. Twenty-one studies (772 participants) were included in this review with two additional 2012 studies identified as 'awaiting classification'. Physical training was well tolerated with no adverse effects reported. None of the studies mentioned worsening of asthma symptoms following physical training. Physical training showed marked improvement in cardiopulmonary fitness as measured by a statistically and clinically significant increase in maximum oxygen uptake (mean difference (MD) 4.92 mL/kg/min; 95% confidence interval (CI) 3.98 to 5.87; P physical training may have positive effects on health-related quality of life, with four of five studies

  16. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Asthma & Community Health Know How ... Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Asthma & Community Health File Formats ...

  17. Environmental pollution and asthma.

    Science.gov (United States)

    Di Giampaolo, L; Quecchia, C; Schiavone, C; Cavallucci, E; Renzetti, A; Braga, M; Di Gioacchino, M

    2011-01-01

    Clinical evidences and epidemiological studies show that allergic pathologies of the respiratory tract are increasing in the world areas with high pollution impact, demonstrating how many polluting substances favor both allergic sensitization and the bronchial inflammatory changes characteristic of asthma. It has been shown that asthma, as many other diseases, is a complex interaction between genetic predisposition and environmental stimuli that results in clinical expression of various phenotypes of asthma: allergic, intrinsic etc. Many pollutants have such a potential. Diesel exhaust particles (DEP) can favor allergic sensitization, induce acute asthma attacks and increase bronchial reactivity, acting both on allergen, on bronchial mucosa and on immune cells. In fact, DEP can favor B lymphocytes to shift to a production of IgE and T cells to produce Th2 cytokines. Asthma can be also induced by high exposure to many other substances as NO2 and first of all ozone (O3): strong oxidizing substance that is synthesized, in absence of ventilation, by photochemical reaction due to the combination of ultraviolet sun radiation on exhaust gases as NO2 and hydrocarbons. Ozone is abundant in cities with minimal concentration in the morning gradually increasing during the day until maximal levels in the afternoon and then decreasing during the night. Epidemiological studies show that the number of access to hospital for acute asthma and even the use of bronchodilator by asthmatics increase during the high level periods when Ozone constitute almost 90 percent of the total oxidants in the environment. Particulate matter of very small diameter have a crucial role in favoring asthma attacks, and smaller the substance deeper the penetration in the bronchial tree, with an inflammatory reaction in the peripheral bronchial mucosa characterized by increased vessel permeability, mucosal edema, inflammatory mediator production by damaged epithelium and inflammatory cells that determines

  18. Innate lymphoid cells and asthma.

    Science.gov (United States)

    Yu, Sanhong; Kim, Hye Young; Chang, Ya-Jen; DeKruyff, Rosemarie H; Umetsu, Dale T

    2014-04-01

    Asthma is a complex and heterogeneous disease with several phenotypes, including an allergic asthma phenotype characterized by TH2 cytokine production and associated with allergen sensitization and adaptive immunity. Asthma also includes nonallergic asthma phenotypes, such as asthma associated with exposure to air pollution, infection, or obesity, that require innate rather than adaptive immunity. These innate pathways that lead to asthma involve macrophages, neutrophils, natural killer T cells, and innate lymphoid cells, newly described cell types that produce a variety of cytokines, including IL-5 and IL-13. We review the recent data regarding innate lymphoid cells and their role in asthma. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  19. Asthma-COPD overlap syndrome

    National Research Council Canada - National Science Library

    Şen, Elif; Oğuzülgen, Kıvılcım; Bavbek, Sevim; Günen, Hakan; Kıyan, Esen; Türktaş, Haluk; Yorgancıoğlu, Arzu; Polatlı, Mehmet; Yıldız, Füsun; Çelik, Gülfem; Demir, Tunçalp; Gemicioğlu, Bilun; Mungan, Dilşad; Saryal, Sevgi; Sayıner, Abdullah; Yıldırım, Nurhayat

    2015-01-01

    .... Among patient with COPD and asthma; there is a group of patients with an overlap between clinical, functional characteristics and airway inflammation patterns, named "Asthma-COPD Overlap Syndrome" (ACOS...

  20. Psychopathology in difficult asthma : Review

    NARCIS (Netherlands)

    Prins, L.C.J.; van Son, M.A.C.; van Keimpema, A.R.J.; van Ranst, D.; Antonissen-Pommer, A.M.; Meijer, J.W.G.; Pop, V.J.M.

    2015-01-01

    Objective: Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed

  1. Allergy and Asthma Health Magazine

    Science.gov (United States)

    ... Of Age Older Adults Allergy and Asthma Health Magazine Women Infant, Children and Teenagers Living With Lung ... written by Respiratory Experts Like no other health magazine, Allergy & Asthma Health Magazine is published by people ...

  2. Aspirin-Exacerbated Asthma

    Directory of Open Access Journals (Sweden)

    Varghese Mathew

    2008-06-01

    Full Text Available This review focuses on aspirin-exacerbated asthma (AEA. The review includes historical perspective of aspirin, prevalence, pathogenesis, clinical features and treatment of AEA. The pathogenesis of AEA involves the cyclooxygenase and lipooxygenase pathway. Aspirin affects both of these pathways by inhibiting the enzyme cycooxygenase-1 (COX-1. Inhibition of COX-1 leads to a decrease in prostaglandin E2 (PGE2. The decrease in PGE2 results in an increase in cysteinyl leukotrienes by the lipooxygenase pathway involving the enzyme 5-lipooxygenase (5-LO. Leukotriene C4 (LTC4 synthase is the enzyme responsible for the production of leukotriene C4, the chief cysteinyl leukotriene responsible for AEA. There have been familial occurences of AEA. An allele of the LTC4 synthase gene in AEA is known as allele C. Allele C has a higher frequency in AEA. Clinical presentation includes a history of asthma after ingestion of aspirin, nasal congestion, watery rhinorrhea and nasal polyposis. Treatment includes leukotriene receptor antagonists, leukotriene inhibitors, aspirin desinsitaztion and surgery. AEA is the most well-defined phenotype of asthma. Although AEA affects adults and children with physician-diagnosed asthma, in some cases there is no history of asthma and AEA often goes unrecognized and underdiagnosed.

  3. Allergens, germs and asthma.

    Science.gov (United States)

    Scadding, Glenis Kathleen

    2015-04-01

    To explore asthma pathogenesis using data from upper and lower airways. English-language papers on human asthma and nasal polyp subjects from 1990 onwards. High-quality studies in established journals. The recognition of its inflammatory nature led to a quantum leap in the understanding and treatment of asthma, with lives saved by inhaled corticosteroids. Further work at genetic, molecular, histological and clinical levels has shown that asthma is polymorphic and rarely involves isolated Th2 bronchial inflammation. Viral infections may act as an initiating event in children and adults, showing synergy with atopy. Chronic staphylococcal colonization of the mucosa may act as a promoter, as in atopic dermatitis. These two observations may be linked, with viruses providing an entry for bacteria into the mucosal epithelium. Most asthma begins in the nose and involves allergy and infection: both viral and bacterial. The combination of atopy and infection suggests new possibilities for therapy. © 2014 The Author. The Clinical Respiratory Journal published by John Wiley & Sons Ltd.

  4. Asthma and dental caries.

    Science.gov (United States)

    Matthews, Joseph

    2012-06-01

    Medline, government reports and conference proceedings were searched. Case-control, cohort or cross sectional studies were included if they provided relevant and applicable quantitative information on the relation between asthma and caries, had an independent study population and adequate definitions of asthma and caries and appropriate measurement of caries. Data were extracted independently by two reviewers and quality was assessed using the Newcastle-Ottawa Quality Assessment Scale. Fixed- and random-effects models were used for the analyses. Heterogeneity and publication bias were evaluated. Eighteen articles were included; 11 provided information on primary dentition and 15 on permanent dentition. Random-effects models showed a significant association between asthma and caries for both primary and permanent dentition, the odds ratios being 2.73 (95% CI: 1.61, 4.64) and 2.04 (95% CI: 1.44, 2.89), respectively. Evidence from this analysis suggests that asthma doubles the risk of caries in both primary and permanent dentition. Publication bias diagnostics and simulation suggested possible overestimation of the summary odds ratio for permanent dentition but not for primary dentition. Physicians and dentists should recommend preventive measures against caries for people with asthma.

  5. [Epigenetics, environment and asthma].

    Science.gov (United States)

    Rico-Rosillo, Guadalupe; Vega-Robledo, Gloria Bertha; Silva-García, Raúl; Oliva-Rico, Diego

    2014-01-01

    Asthma is a chronic inflammatory disease of the respiratory tract with a complex genetic background influenced by the exposition to a series of environmental factors. Genetic studies can only elucidate part of the heritability and susceptibility of asthma and even though several diseases have an evident genetic etiology, only a fraction of the genes involved in their pathogenicity have been identified. The epigenetic regulation of the latter is a fact one should bear in mind in order to explain the major triggers of diseases whose understanding is complicated, such as allergies and asthma. External stimulus such as nourishment, stress, physical activity, atmospheric pollution, tobacco smoking and alcohol drinking can induce either gene silencing or gene expression. In this regard, epigenetics can explain how these environmental factors influence our genetic inheritance. There is growing evidence that backs-up the fact that DNA methylation, histone post-translational modification and microRNA expression are influenced by the environment. This helps explaining how several of the risk factors mentioned contribute to the development and inheritance of asthma. In this review, different environmental factors and their relation with the main epigenetic regulatory mechanisms will be analyzed, as well as their possible role in the development of asthma.

  6. The pharmacotherapy of the asthma

    OpenAIRE

    BROŽOVÁ, Lenka

    2008-01-01

    Asthma bronchiale is a very common chronic disorder of airways with not fully elucidated pathology, which is not fully curable at the moment. It is estimated that 300 millions of persons suffer from asthma. About 8% of adult population and 10% of children are affected in the Czech republic. The aim of this thesis is to give an overview of contemporary modern pharmacotherapy of asthma. Firstly, this work describes asthma from pathophysiological and epidemiological point of view, among others: ...

  7. Obesity, Asthma, and the Microbiome.

    Science.gov (United States)

    Cho, Youngji; Shore, Stephanie A

    2016-03-01

    Obesity is a risk factor for asthma, but standard asthma drugs have reduced efficacy in the obese. Obesity alters the gastrointestinal microbial community structure. This change in structure contributes to some obesity-related conditions and also could be contributing to obesity-related asthma. Although currently unexplored, obesity may also be altering lung microbiota. Understanding the role of microbiota in obesity-related asthma could lead to novel treatments for these patients. ©2016 Int. Union Physiol. Sci./Am. Physiol. Soc.

  8. Obesity, Asthma, and the Microbiome

    OpenAIRE

    Cho, Youngji; Shore, Stephanie A.

    2016-01-01

    Obesity is a risk factor for asthma, but standard asthma drugs have reduced efficacy in the obese. Obesity alters the gastrointestinal microbial community structure. This change in structure contributes to some obesity-related conditions and also could be contributing to obesity-related asthma. Although currently unexplored, obesity may also be altering lung microbiota. Understanding the role of microbiota in obesity-related asthma could lead to novel treatments for these patients.

  9. Obesity, Asthma, and the Microbiome

    Science.gov (United States)

    Cho, Youngji

    2016-01-01

    Obesity is a risk factor for asthma, but standard asthma drugs have reduced efficacy in the obese. Obesity alters the gastrointestinal microbial community structure. This change in structure contributes to some obesity-related conditions and also could be contributing to obesity-related asthma. Although currently unexplored, obesity may also be altering lung microbiota. Understanding the role of microbiota in obesity-related asthma could lead to novel treatments for these patients. PMID:26889016

  10. Japanese Guideline for Adult Asthma

    Directory of Open Access Journals (Sweden)

    Ken Ohta

    2011-01-01

    Full Text Available Adult bronchial asthma (hereinafter, asthma is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause an intractable asthma. The number of patients with asthma has increased, while the number of patients who die from asthma has decreased (1.7 per 100,000 patients in 2009. The aim of asthma treatment is to enable patients with asthma to lead a healthy life without any symptoms. A partnership between physicians and patients is indispensable for appropriate treatment. Long-term management with agents and elimination of causes and risk factors are fundamental to asthma treatment. Four steps in pharmacotherapy differentiate mild to intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid (ICS, varying from low to high doses. Long-acting β2 agonists (LABA, leukotriene receptor antagonists, and theophylline sustained-release preparation are recommended as concomitant drugs, while anti-IgE antibody therapy is a new choice for the most severe and persistent asthma. Inhaled β2 agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, etc., are used as needed against acute exacerbations. Allergic rhinitis, chronic obstructive pulmonary disease (COPD, aspirin induced asthma, pregnancy, and cough variant asthma are also important factors that need to be considered.

  11. Defining asthma in genetic studies

    NARCIS (Netherlands)

    Koppelman, GH; Postma, DS; Meijer, G.

    1999-01-01

    Genetic studies have been hampered by the lack of a gold standard to diagnose asthma. The complex nature of asthma makes it more difficult to identify asthma genes. Therefore, approaches to define phenotypes, which have been successful in other genetically complex diseases, may be applied to define

  12. Rhinitis: a complication to asthma

    DEFF Research Database (Denmark)

    Hansen, J W; Thomsen, S F; Nolte, H

    2010-01-01

    Asthma and rhinitis often co-occur, and this potentially increases the disease severity and impacts negatively on the quality of life. We studied disease severity, airway responsiveness, atopy, quality of life and treatment in subjects with both asthma and rhinitis compared to patients with asthma...

  13. Flavonoids and Asthma

    Science.gov (United States)

    Tanaka, Toshio; Takahashi, Ryo

    2013-01-01

    Asthma is a chronic disease, characterized by airway inflammation, airflow limitation, hyper-reactivity and airway remodeling. It is believed that asthma is caused by the interaction between genetic and environmental factors. The prevalence of allergic diseases, including asthma, has increased worldwide during the past two decades. Although the precise reasons that have caused this increase remain unknown, dietary change is thought to be one of the environmental factors. Flavonoids, which are polyphenolic plant secondary metabolites ubiquitously present in vegetables, fruits and beverages, possess antioxidant and anti-allergic traits, as well as immune-modulating activities. Flavonoids are powerful antioxidants and anti-allergic nutrients that inhibit the release of chemical mediators, synthesis of Th2 type cytokines, such as interleukin (IL)-4 and IL-13, and CD40 ligand expression by high-affinity immunoglobulin E (IgE) receptor-expressing cells, such as mast cells and basophils. They also inhibit IL-4-induced signal transduction and affect the differentiation of naïve CD4+ T cells into effector T-cells through their inhibitory effect on the activation of the aryl hydrocarbon receptor. Various studies of flavonoids in asthmatic animal models have demonstrated their beneficial effects. The results of several epidemiological studies suggest that an increase in flavonoid intake is beneficial for asthma. Moreover, clinical trials of flavonoids have shown their ameliorative effects on symptoms related to asthma. However, these human studies are currently limited; further validation is required to clarify whether an appropriate intake of flavonoids may constitute dietary treatment and for part of a preventive strategy for asthma. PMID:23752494

  14. Obesity and asthma

    OpenAIRE

    Pranab Baruwa; Kripesh Ranjan Sarmah

    2013-01-01

    Asthma is a chronic disorder affecting millions of people worldwide. The prevalence of asthma is around 300 million and is expected to increase another 100 million by 2025. Obesity, on the other hand, also affects a large number of individuals. Overweight in adults is defined when body mass index (BMI) is between 25 to 30 kg/m 2 and obesity when the BMI >30 kg/m 2 . It has been a matter of interest for researchers to find a relation between these two conditions. This knowledge will provide a ...

  15. Management of infantile asthma.

    Science.gov (United States)

    Brasher, G W

    1977-09-01

    Infantile asthama is an important pediatric problem and may cause substantial morbidity and mortality in this age group. The pathophysiology of allergic asthma involves a type I hypersensitivity reaction that is mediated by reaginic antibodies of the IgE class. Various factors predisposing to infantile asthma have been suggested but not confirmed. The differential diagnosis of infantile wheezing is of particular importance in this very young age group. An appreciation of the natural history and clinical characteristics of the disease, and of the important causative factors (foods, environmental inhalants, and respiratory infections), will aid the physician in the management of this problem.

  16. Relvar Ellipta for asthma.

    Science.gov (United States)

    2014-08-01

    ▼Relvar Ellipta (GSK) is a dry powder inhaler that contains a corticosteroid (fluticasone furoate) and a long-acting beta2 agonist (vilanterol trifenatate). It is licensed for once-daily use as maintenance therapy for chronic obstructive pulmonary disease (COPD) and asthma. In a previous article we considered its use in the management of COPD.1 Here we review the evidence for Relvar Ellipta in the treatment of patients with asthma. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Work-related asthma

    African Journals Online (AJOL)

    grain dust, welding fumes and wood dust. (Table III).1 Exposure to animal epithelia, hairs and secretions is commonly reported among laboratory animal workers and agricultural workers. Latex allergy-related asthma appears to be less common due to the introduction of latex-free gloves in most health care settings.

  18. Treating childhood asthma

    African Journals Online (AJOL)

    played by additional factors, such as patient adherence and administration of medication technique. It is always necessary to treat the child as an individual, but some measures apply in all cases. It is important to allay anxiety about the diagnosis. This is best done by carefully explaining the nature and causes of asthma, ...

  19. Asthma Home Environment Checklist

    Science.gov (United States)

    This checklist guides home care visitors in identifying environmental asthma triggers most commonly found in homes. It includes sections on the building, home interior and room interior and provides low-cost action steps for remediation. EPA 402-F-03-030.

  20. School and Asthma

    Science.gov (United States)

    ... or dad to speak to the teacher, school nurse, or principal. Most teachers are glad to help. After all, if you can't breathe, you can't learn! What About Sports? You might think that because you have asthma ...

  1. Asthma and Hispanic Americans

    Science.gov (United States)

    ... to non-Hispanic whites. While all of the causes of asthma remain unclear, children exposed to secondhand tobacco smoke exposure are at increased risk for acute lower respiratory tract infections, such as bronchitis. Children living below or near the poverty level are more likely to have high levels ...

  2. Stress and asthma

    Directory of Open Access Journals (Sweden)

    Shoji Nagata

    1999-01-01

    Full Text Available Three factors in recent medical research and treatment (advances in the field of psychoneuroimmunology, epidemiological evidence regarding important interaction between psychosocial factors and development of disease, and the recognition of the importance of patient education for self-management of asthma have led clinicians and researchers to reconsider the role of psychosocial stress in asthma. There are many reports suggesting that stressful life events, family problems and a behavior pattern that increases psychological conflict may influence the development or relapse of asthma and influence its clinical course. Depression is known as one of the risk factors of fatal asthmatic attack. In laboratory studies, about 20% of asthmatics were considered reactors who showed an airway change after exposure to emotional stress. Studies regarding the pathway of stress effect on allergy and asthma are reviewed and discussed from the standpoint of psychoneuroimmunology; for example, the enhancement of IgE production and increased susceptibility to respiratory infection by stress, conditioned anaphylaxis and nerve/mast cell interaction, the effect of stress on various bronchial responses and the inhibition of the immediate and late asthmatic response by anterior hypothalamic lesioning.

  3. Vascular remodelling in asthma.

    Science.gov (United States)

    Walters, Eugene Haydn; Soltani, Amir; Reid, David William; Ward, Chris

    2008-02-01

    We review the recent literature, focusing on 2006 and 2007, to produce an update on the patho-biology of angiogenesis and vascular endothelial growth factor in the asthmatic airway. In terms of conceptual development in asthma research, airway inflammation and remodelling have been regarded as separate processes or perhaps as sequential, with early inflammation leading later to remodelling. Recent insights identify a central role for vascular endothelial growth factor in stimulating both inflammation and vascular remodelling coincidentally, with the full panoply of vascular endothelial growth factor mediated events being complex and wide. Both nitric oxide and matrix metalloproteinase-9 induction may be important downstream pathogenic mechanisms. Virus-mediated exacerbations are a prime manifestation of the oscillating trajectory of clinical asthma. The early stimulation of vascular endothelial growth factor production is probably a central aetiological mechanism, with secondary inflammation and angiogenesis. The time scale of the latter, especially, fits with the time scale of clinico-physiological changes after exacerbation. These vascular endothelial growth factor induced changes are potentially modifiable with therapy. Insights into the importance of vascular endothelial growth factor and angiogenesis in asthma pathogenesis now lead to potential new therapeutic possibilities and elucidate why recent advances in asthma therapeutics have been so successful.

  4. Decreasing asthma morbidity

    African Journals Online (AJOL)

    1994-12-12

    Dec 12, 1994 ... Apart from the optimal use of drugs, various supplementary methods have been tested to decrease asthma morbidity, usually in patients from reiatively affluent socio-economic backgrounds. A study of additional measures taken in a group of moderate to severe adult asthmatics from very poor socio- ...

  5. Allergy, asthma and the environment; Allergie, Asthma und Umwelt

    Energy Technology Data Exchange (ETDEWEB)

    Ring, J. [Klinik und Poliklinik fuer Dermatologie und Allergologie am Biederstein, Technische Univ. Muenchen (Germany); Gfesser, M. [Klinik und Poliklinik fuer Dermatologie und Allergologie am Biederstein, Technische Univ. Muenchen (Germany)

    1996-10-11

    Asthma is a chronic inflammatory disease of the airways. Asthma and other allergic diseases have increased in prevalence during the last decades in many industrialized countries. Among other hypotheses, the possible role of environmental pollutants has received much public and scientific attention. Some pollutants may modulate the different phases of allergic reactions. Inflammation is a critical feature in the pathogenesis of asthma and therefore, beside allergen avoidance, anti-inflammatory treatment is the first line therapy of asthma. Cysteinyl-leukotrienes are lipid mediators which appear to play a major role in the pathophysiology of asthma. Based on current data, it appears that leukotrience receptor antagonists have bronchodilative and anti-inflammatory effects and may therefore enrich the pharmacotherapeutic spectrum within the therapeutic concept of patient management in asthma. (orig.) [Deutsch] Asthma bronchiale ist eine entzuendliche Erkrankung der Atemwege. Epidemiologische Studien konnten eine deutliche Zunahme der Erkrankung in den letzten zwei Jahrzehnten aufzeigen. In der Entstehung von Allergien und Asthma bronchiale spielen Umwelteinfluesse eine grosse Rolle. Luftschadstoffe scheinen mit verschiedenen Allergie-Parametern bei der Sensibilisierung, Symptombildung und Chronifizierung zu interferieren. Da beim Asthma bronchiale neben der Bronchokonstriktion die Entzuendung der Bronchialschleimhaut eine besondere Rolle spielt, wird heute neben Allergenkarenz und prophylaktischen Massnahmen eine fruehzeitige antientzuendliche Asthmatherapie angestrebt. Cysteinyl-Leukotriene gehoeren zu den wirksamsten Entzuendungsmediatoren beim Asthma bronchiale. Leukotrien-Rezeptorantagonisten scheinen sowohl bronchodilatatorische als auch antientzuendliche Wirkungen zu haben und koennten so innerhalb eines Gesamtkonzeptes von antiallergischer und antiasthmatischer Therapie das pharmakotherapeutische Spektrum bereichern. (orig.)

  6. Physical training for asthma

    Directory of Open Access Journals (Sweden)

    Kristin V. Carson

    Full Text Available BACKGROUND: People with asthma may show less tolerance to exercise due to worsening asthma symptoms during exercise or other reasons such as deconditioning as a consequence of inactivity. Some may restrict activities as per medical advice or family influence and this might result in reduced physical fitness. Physical training programs aim to improve physical fitness, neuromuscular coordination and self confidence. Subjectively, many people with asthma report that they are symptomatically better when fit, but results from trials have varied and have been difficult to compare because of different designs and training protocols. Also, as exercise can induce asthma, the safety of exercise programmes needs to be considered.OBJECTIVE: To gain a better understanding of the effect of physical training on the respiratory and general health of people with asthma, from randomised trials.METHODS:Search methods: We searched the Cochrane Airways Group Specialised Register of trials up to January 2013. Selection criteria: We included randomised trials of people over eight years of age with asthma who were randomised to undertake physical training or not. Physical training had to be undertaken for at least 20 minutes, two times a week, over a minimum period of four weeks. Data collection and analysis:Two review authors independently assessed eligibility for inclusion and undertook risk of bias assessment for the included studies.MAIN RESULTS: Twenty-one studies (772 participants were included in this review with two additional 2012 studies identified as 'awaiting classification'. Physical training was well tolerated with no adverse effects reported. None of the studies mentioned worsening of asthma symptoms following physical training. Physical training showed marked improvement in cardiopulmonary fitness as measured by a statistically and clinically significant increase in maximum oxygen uptake (mean difference (MD 4.92 mL/kg/min; 95% confidence interval (CI 3

  7. Understanding mild persistent asthma in children

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Szefler, Stanley J

    2005-01-01

    Limitations in asthma prevalence studies and difficulties in diagnosing pediatric asthma lead to uncertainty over the full extent of mild persistent asthma in children and adolescents. Although recent surveys have reported that the majority of pediatric patients with asthma in the United States...... and Europe have symptoms consistent with mild disease, these surveys have limitations in design. Thus, the true prevalence of mild asthma remains unknown. It is unclear whether children with mild persistent asthma progress to more severe asthma, but the risk of severe asthma exacerbations seems...... into the true prevalence of mild persistent asthma in children and adolescents, and optimal treatment....

  8. Asthma outcomes: Biomarkers

    Science.gov (United States)

    Szefler, Stanley J.; Wenzel, Sally; Brown, Robert; Erzurum, Serpil C.; Fahy, John V.; Hamilton, Robert G.; Hunt, John F.; Kita, Hirohito; Liu, Andrew H.; Panettieri, Reynold A.; Schleimer, Robert P.; Minnicozzi, Michael

    2012-01-01

    Background Measurement of biomarkers has been incorporated within clinical research studies of asthma to characterize the population and associate the disease with environmental and therapeutic effects. Objective National Institutes of Health institutes and federal agencies convened an expert group to propose which biomarkers should be assessed as standardized asthma outcomes in future clinical research studies. Methods We conducted a comprehensive search of the literature to identify studies that developed and/or tested asthma biomarkers. We identified biomarkers relevant to the underlying disease process progression and response to treatment. We classified the biomarkers as either core (required in future studies), supplemental (used according to study aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an National Institutes of Health–organized workshop convened in March 2010 and finalized in September 2011. Results Ten measures were identified; only 1, multiallergen screening to define atopy, is recommended as a core asthma outcome. Complete blood counts to measure total eosinophils, fractional exhaled nitric oxide (Feno), sputum eosinophils, urinary leukotrienes, and total and allergen-specific IgE are recommended as supplemental measures. Measurement of sputum polymorphonuclear leukocytes and other analytes, cortisol measures, airway imaging, breath markers, and system-wide studies (eg, genomics, proteomics) are considered as emerging outcome measures. Conclusion The working group participants propose the use of multiallergen screening in all asthma clinical trials to characterize study populations with respect to atopic status. Blood, sputum, and urine specimens should be stored in biobanks, and standard procedures should be developed to harmonize sample collection for clinical trial biorepositories. PMID:22386512

  9. Mast cell-nerve interactions in asthma

    NARCIS (Netherlands)

    Kleij, Hanneke Paulina Maria van der

    2002-01-01

    Asthma is characterized by a chronic inflammatory reaction in the airways. Roughly, asthma can be subdivided into atopic asthma involving elevated levels of serum IgE and a less familiar form, non-atopic asthma. Non-atopic asthma is an increasing problem in the developed world. The mechanisms

  10. Do Written Asthma Action Plans Improve Outcomes?

    Science.gov (United States)

    Kelso, John M

    2016-03-01

    With appropriate management, children with asthma should expect few symptoms, no limits on activity, rare exacerbations, and normal lung function. Appropriate education of parents and other caregivers of children with asthma has clearly been shown to help achieve these goals. Although recommended in asthma guidelines, providing written asthma action plans does not improve outcomes beyond asthma education alone.

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I view different ...

  12. Mechanisms of obesity in asthma.

    Science.gov (United States)

    Rasmussen, Finn; Hancox, Robert J

    2014-02-01

    Obesity and asthma are chronic conditions affecting millions of people worldwide. The two conditions also appear to be linked with an increased risk of asthma in people who are obese. The purpose of this review is to describe mechanism(s) that may explain the association between asthma and obesity. Current evidence suggests that the association between asthma and obesity is linked by two major phenotypes and three important pathways of obesity-related asthma: one phenotype with primary (often atopic) asthma that is aggravated by obesity and a second phenotype with late-onset nonatopic asthma, which predominantly affects women and primarily seems to be associated with neutrophilic inflammation. Proposed pathways include the mechanical effects of obesity (fewer deep inspirations leading to increased airway hyperresponsiveness), an inflammatory pathway driven by obesity-related cytokines (adipokines), and finally environment and lifestyle changes that have led to an increasing prevalence of obesity over the past 50 years (including exposures in utero, physical activity, and diet) may also result in asthma in predisposed individuals. How these environmental changes influence the occurrence and expression of asthma may depend on the age of exposure and on interactions with genetic susceptibilities. Future research should be directed to shed light on the associations between obesity and asthma phenotypes, modern lifestyles and environmental exposures and genetic susceptibilities. http://links.lww.com/COAI/A6.

  13. Children with Asthma and Sports

    Directory of Open Access Journals (Sweden)

    Selda Yuzer

    2014-06-01

    Full Text Available Asthma is one of the chronic diseases which have are widely seen among the children. The disease has recently been in the increase all over the world and affects many children. In a study conducted with International Study of Asthma and Allergies in Childhood (ISAAC method, it was found out that prevalence of childhood asthma was 17.1%. Participation in sportive activities by the children with asthma, which is today considered as a part of asthma treatment program, makes contributions to their physical, mental and psychological development and increases their quality of life. The most recommended sports for the children with asthma are swimming and water sports. Sports like tennis and volleyball are too advised. Choice of sports depends on severity of asthma, child and #8217;s choice and whether or not asthma is kept under control. Nursing approaches for the children with asthma include correction of symptoms, training of children and their families, assistance with disease adaptation, continuing asthma care at home and interventions to make children lead healthy activities of daily life of children. With protective measures to be taken by families and children; children should be encourage for sportive activities. [TAF Prev Med Bull 2014; 13(3.000: 241-244

  14. Rhinoviruses, Allergic Inflammation, and Asthma

    Science.gov (United States)

    Gavala, Monica; Bertics, Paul J.; Gern, James E.

    2011-01-01

    Summary Viral infections affect wheezing and asthma in children and adults of all ages. In infancy, wheezing illnesses are usually viral in origin, and children with more severe wheezing episodes are more likely to develop recurrent episodes of asthma and to develop asthma later in childhood. Children who develop allergen-specific immunoglobulin E (allergic sensitization), and those who wheeze with rhinoviruses (HRV) are at especially high risk for asthma. In older children and adults, HRV infections generally cause relatively mild respiratory illnesses and yet contribute to acute and potentially severe exacerbations in patients with asthma. These findings underline the importance of understanding the synergistic nature of allergic sensitization and infections with HRV in infants relative to the onset of asthma and in children and adults with respect to exacerbations of asthma. This review discusses clinical and experimental evidence of virus/allergen interactions and evaluates theories which relate immunologic responses to respiratory viruses and allergens to the pathogenesis and disease activity of asthma. Greater understanding of the relationship between viral respiratory infections, allergic inflammation, and asthma is likely to suggest new strategies for the prevention and treatment of asthma. PMID:21682739

  15. AsthmaVent – Effect of Ventilation on Asthma Control

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    sensitive towards. Reducing this exposure may improve the asthma control in these children. Previous studies give conflicting information on the effect of mechanical ventilation on asthma control in children. Objectives We aim at investigating whether mechanical ventilation is capable of improving indoor...... and design of housing. Indoor environment factors that trigger the disease must be controlled as well as possible. The results of this project will be a significant contribution to the potential recommendations regarding the effect of ventilation on indoor air quality and asthma control of HDM allergic...... air quality and thereby asthma symptoms and quality of life, in children with house dust mite allergy and asthma. Materials and Methods Randomized double-blind placebo-controlled intervention study, including 80 children from 3 Danish Pediatric outpatient clinics, with: Verified asthma, requiring...

  16. Yoga for asthma

    Directory of Open Access Journals (Sweden)

    Zu-Yao Yang

    Full Text Available ABSTRACT BACKGROUND: Asthma is a common chronic inflammatory disorder affecting about 300 million people worldwide. As a holistic therapy, yoga has the potential to relieve both the physical and psychological suffering of people with asthma, and its popularity has expanded globally. A number of clinical trials have been carried out to evaluate the effects of yoga practice, with inconsistent results. OBJECTIVES: To assess the effects of yoga in people with asthma. METHODS: Search methods: We systematically searched the Cochrane Airways Group Register of Trials, which is derived from systematic searches of bibliographic databases including the Cochrane Central Register of Controlled Trials (CENTRAL, MEDLINE, EMBASE, CINAHL, AMED, and PsycINFO, and handsearching of respiratory journals and meeting abstracts. We also searched PEDro. We searched ClinicalTrials.gov and the WHO ICTRP search portal. We searched all databases from their inception to 22 July 2015, and used no restriction on language of publication. We checked the reference lists of eligible studies and relevant review articles for additional studies. We attempted to contact investigators of eligible studies and experts in the field to learn of other published and unpublished studies. Selection criteria: We included randomized controlled trials (RCTs that compared yoga with usual care (or no intervention or sham intervention in people with asthma and reported at least one of the following outcomes: quality of life, asthma symptom score, asthma control, lung function measures, asthma medication usage, and adverse events. Data collection and analysis: We extracted bibliographic information, characteristics of participants, characteristics of interventions and controls, characteristics of methodology, and results for the outcomes of our interest from eligible studies. For continuous outcomes, we used mean difference (MD with 95% confidence interval (CI to denote the treatment effects, if the

  17. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Quick Links Asthma Action Plan America Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical ... Using a metered dose inhaler with a spacer [ PDF - 377 KB] Your browser does not support iframes ...

  18. Can the Weather Affect My Child's Asthma?

    Science.gov (United States)

    ... Giving Teens a Voice in Health Care Decisions Can the Weather Affect My Child's Asthma? KidsHealth > For ... Affect My Child's Asthma? Print A A A Can the Weather Affect My Child's Asthma? Yes. Weather ...

  19. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, and Surveillance Most Recent ... Archive 2014 State or Territory Data Archive AsthmaStats Flu Vaccination among Adults with Current Asthma Flu Vaccination ...

  20. Treating Asthma in Children under 5

    Science.gov (United States)

    ... laughing Gastrointestinal reflux Changes or extremes in weather Asthma emergencies Severe asthma attacks can be life-threatening ... Changes in activity levels or sleep patterns Control asthma triggers Depending on the triggers for your child's ...

  1. Managing Asthma: Learning to Breathe Easier

    Science.gov (United States)

    ... Issues Subscribe June 2014 Print this issue Managing Asthma Learn To Breathe Easier En español Send us ... Allergy Therapy Seeking Allergy Relief Wise Choices Controlling Asthma Get regular checkups for your asthma. Make a ...

  2. Allergies and Asthma: They Often Occur Together

    Science.gov (United States)

    ... A family history of allergies is a major risk factor for allergic asthma. Having hay fever or other allergies yourself also increases your risk of getting asthma. Though allergic asthma is very common, there are other types ...

  3. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... among Adults with Current Asthma Flu Vaccination among Children with Current Asthma Asthma and Fair or Poor Health Usual Place for Medical Care among Children Number of Visits to a Health Care Provider(s) ...

  4. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... and Publications Related Articles, Publications, and Links Asthma’s Impact on the Nation Fact Sheet State Data Profiles ( ... MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma ...

  5. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Obesity Percentage of People with Asthma who Smoke Insurance coverage and barriers to care for people with ... Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals ...

  6. Asthma & Physical Activity in the School

    Science.gov (United States)

    ... of Education) How Asthma-Friendly Is Your School? (checklist in English and in Spanish) Is the Asthma ... gov/ asthma/ publications. html U.S. Department of Education Office for Civil Rights Lyndon Baines Johnson Department of ...

  7. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Messages Agencies Working on Asthma Follow @CDCasthma on Twitter to learn more about helping people with asthma ... de boca) [PDF - 276 KB] Follow @CDCasthma on Twitter to learn more about helping people with asthma ...

  8. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public ...

  9. Violence and Asthma: A Review

    Directory of Open Access Journals (Sweden)

    Takeo Fujiwara

    2008-01-01

    Full Text Available Recent research shows that exposure to community violence is, directly and indirectly, associated with asthma. This article reviews the findings on the impact of violence on asthma, and the pathways for the association of violence and asthma are suggested: 1 exposure to violence is directly associated with asthma, mainly through dysregulation of sympathetic-adrenal-medullary (SAM and hypothalamic-pituitary-adrenal (HPA axis, 2 exposure to violence is associated with the change of susceptibility of outdoor air pollution on asthma, probably through the change of an immune response, and 3 behavioral change due to exposure to violence (e.g. keeping children indoors leads to more exposure to indoor pollutants. The suggested framework may be useful to develop health policy on asthma in high-violence communities.

  10. Asthma in Children: MedlinePlus Health Topic

    Science.gov (United States)

    ... PDF School and Asthma (Nemours Foundation) Also in Spanish Teaching Your Child about Asthma (American Academy of Allergy, Asthma, and Immunology) What's an Asthma Action Plan? (Nemours Foundation) ... Also in Spanish Related Issues Asthma & Physical Activity in the School ( ...

  11. Nasal disease and asthma.

    Science.gov (United States)

    Marseglia, G L; Merli, P; Caimmi, D; Licari, A; Labó, E; Marseglia, A; Ciprandi, G; La Rosa, M

    2011-10-01

    The nose plays a primary role within the airways, working as a filter and air-conditioner, together with other important functions. Thus, it is not surprising that nasal diseases are associated with several other comorbidities, including both upper and lower airways, such as bronchial hyperresponsiveness (BHR) and asthma. Several studies have investigated the relationship existing between the upper and the lower airways and new insights are rising. Nevertheless, some uncertainties still remain, mainly because nasal disorders are quite heterogeneous, overlapping (i.e. rhinitis-rhinosinusitis-sinusitis, acute or chronic, allergic or non-allergic) and difficult to diagnose, so that, frequently, many studies don’t differentiate between the various conditions. For this reason, the purpose of this review is to systematically analyze present epidemiological, pathophysiological and clinical data on the relationship between nasal diseases and asthma, splitting up three main conditions: allergic rhinitis, chronic rhinosinusitis and nasal polyposis.

  12. Asthma management: important issues

    Directory of Open Access Journals (Sweden)

    P. Barnes

    2005-12-01

    Full Text Available Although most attention has been focused on the drugs used to control asthma, it is increasingly recognised that effective delivery of these drugs to the lungs is just as important. The most effective drugs, beta2-agonists and corticosteroids, are given by inhalation so there has been a search for more efficient inhaler devices that are easier for patients to use. A symposium at the European Respiratory Society Annual Meeting in 2005 discussed some of the important issues in inhaler therapy in adults and children. This article summarises the major points of discussion that arose out of this symposium. New more effective inhaler devices are now becoming available and are likely to have an important impact on asthma management.

  13. MANIFEST ANXIETY IN BRONCHIAL ASTHMA

    OpenAIRE

    Sreedhar, Krishna Prasad

    1989-01-01

    SUMMARY Using a vernacular adaptation of MAS 50 bronchial asthma patients were compared with 102 normals, 60 hospital general out-patients and 50 neurotics to determine the level of anxiety in asthma. The manifest anxiety scores of the bronchial asthma patients were found to be significantly high showing that their level of anxiety was abnormally higher in comparison with that of the normals and the hospital general out-patients. The bronchial asthmatics and the neurotics did not differ in an...

  14. Aspirin-Exacerbated Asthma

    OpenAIRE

    Varghese, Mathew; Lockey, Richard F

    2008-01-01

    This review focuses on aspirin-exacerbated asthma (AEA). The review includes historical perspective of aspirin, prevalence, pathogenesis, clinical features and treatment of AEA. The pathogenesis of AEA involves the cyclooxygenase and lipooxygenase pathway. Aspirin affects both of these pathways by inhibiting the enzyme cycooxygenase-1 (COX-1). Inhibition of COX-1 leads to a decrease in prostaglandin E2 (PGE2). The decrease in PGE2 results in an increase in cysteinyl leukotrienes by the lipoo...

  15. Japanese Guideline for Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Toshiyuki Nishimuta

    2011-01-01

    JAGL differs from the Global Initiative for Asthma Guideline (GINA in that the former emphasizes long-term management of childhood asthma based on asthma severity and early diagnosis and intervention at <2 years and 2–5 years of age. However, a management method, including step-up or step-down of long-term management agents based on the status of asthma symptoms, is easy to understand and thus JAGL is suitable for routine medical treatment. JAGL also introduced treatment and management using a control test for children, recommending treatment and management aimed at complete control through avoiding exacerbation factors and appropriate use of antiinflammatory agents.

  16. Acute bronchial asthma

    Directory of Open Access Journals (Sweden)

    Susanna Ramuscello

    2007-04-01

    Full Text Available Asthma is one of the main causes of morbidity worldwide. It affects some 300 million individuals and has risen over the past 20 years, especially in the paediatric population. Asthma is a chronic inflammation of the airways, subject to periodic exacerbations, characterised by coughing and progressive dyspnoea. Clinical conditions may vary greatly, ranging from moderate exacerbation with an increase in nocturnal awakening and a less than 20% reduction in the flow peak, through to severe respiratory insufficiency that requires immediate intubation of the airways. Pharmacological treatment envisages a step approach that aims to obtain and maintain control over the symptoms, taking into consideration the effectiveness of the treatment available, potential side effects and cost. β2-agonists and corticosteroids are the drugs of election for both maintenance therapy and for treating exacerbations. Other therapeutic devices may prove useful in particular cases. One fundamental key point in treatment over time is the cooperation between patient and attending doctor. The latest review of the Global Initiative for Asthma (GINA guidelines was published in 2006.

  17. [Asthma and cyclic neutropenia].

    Science.gov (United States)

    Salazar Cabrera, A N; Berrón Pérez, R; Ortega Martell, J A; Onuma Takane, E

    1996-01-01

    We report a male with history of recurrent infections (recurrent oral aphtous disease [ROAD], middle ear infections and pharyngo amigdalitis) every 3 weeks since he was 7 months old. At the age of 3 years cyclic neutropenia was diagnosed with cyclic fall in the total neutrophil count in blood smear every 21 days and prophylactic antimicrobial therapy was indicated. Episodic events every 3 weeks of acute asthma and allergic rhinitis were detected at the age of 6 years old and specific immunotherapy to Bermuda grass was given during 3 years with markedly improvement in his allergic condition but not in the ROAD. He came back until the age of 16 with episodic acute asthma and ROAD. The total neutrophil count failed to 0 every 21 days and surprisingly the total eosinophil count increased up to 2,000 at the same time, with elevation of serum IgE (412 Ul/mL). Specific immunotherapy to D.pt. and Aller.a. and therapy with timomodulin was indicated. After 3 months we observed clinical improvement in the asthmatic condition and the ROAD disappeared, but the total neutrophil count did not improve. We present this case as a rare association between 2 diseases with probably no etiological relationship but may be physiopatological that could help to understand more the pathogenesis of asthma.

  18. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Providers CDC Publications on Asthma National Asthma Control Program America Breathing Easier Guide for State Programs Interventions Community Guide—Evidence-based Potentially Effective Interventions ...

  19. The Future of Asthma Treatment

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    1995-01-01

    identification and possible correction of genetic abnormalities responsible for the tendency to develop asthma and atopy, and prevention or functional and structural airway changes. This last goal will be achieved by improved environmental control, earlier use of more powerful and safe anti-inflammatory agents, as well as an increased involvement on the part of the asthma patient in treatment.

  20. The Saudi Initiative for asthma

    Directory of Open Access Journals (Sweden)

    Al-Moamary Mohamed

    2009-01-01

    Full Text Available The Saudi Initiative for Asthma (SINA provides up-to-date guidelines for healthcare workers managing patients with asthma. SINA was developed by a panel of Saudi experts with respectable academic backgrounds and long-standing experience in the field. SINA is founded on the latest available evidence, local literature, and knowledge of the current setting in Saudi Arabia. Emphasis is placed on understanding the epidemiology, pathophysiology, medications, and clinical presentation. SINA elaborates on the development of patient-doctor partnership, self-management, and control of precipitating factors. Approaches to asthma treatment in SINA are based on disease control by the utilization of Asthma Control Test for the initiation and adjustment of asthma treatment. This guideline is established for the treatment of asthma in both children and adults, with special attention to children 5 years and younger. It is expected that the implementation of these guidelines for treating asthma will lead to better asthma control and decrease patient utilization of the health care system.

  1. How Do Asthma Medicines Work?

    Science.gov (United States)

    ... a Kid Who's Bullied? How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines Work? Print A A A en español ¿Cómo funcionan ... control medicines (also called controller or maintenance medicines) work over a long period of time by keeping ...

  2. Smoking and Asthma (For Parents)

    Science.gov (United States)

    ... Giving Teens a Voice in Health Care Decisions Smoking and Asthma KidsHealth > For Parents > Smoking and Asthma Print A A A What's in ... Antismoking Message en español Fumar y el asma Smoking is an unhealthy habit for anyone, but it's ...

  3. Adolescents and Exercise Induced Asthma

    Science.gov (United States)

    Hansen, Pamela; Bickanse, Shanna; Bogenreif, Mike; VanSickle, Kyle

    2008-01-01

    This article defines asthma and exercise induced asthma, and provides information on the triggers, signs, and symptoms of an attack. It also gives treatments for these conditions, along with prevention guidelines on how to handle an attack in the classroom or on the practice field. (Contains 2 tables and 1 figure.)

  4. Adult-onset eosinophilic asthma

    NARCIS (Netherlands)

    de Groot, J.C.

    2017-01-01

    In the last decades, it has been recognized that asthma is not a single disease, but comprises several clinical syndromes, which all share respiratory symptoms and lung function abnormalities, associated with different types of airway inflammation. These syndromes are now known as different asthma

  5. Asthma in patients with psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, A S; Skov, L; Skytthe, A

    2015-01-01

    We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan [1]. The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...

  6. Asthma in pregnancy: association between the Asthma Control Test and the Global Initiative for Asthma classification and comparisons with spirometry.

    Science.gov (United States)

    de Araujo, Georgia Véras; Leite, Débora F B; Rizzo, José A; Sarinho, Emanuel S C

    2016-08-01

    The aim of this study was to identify a possible association between the assessment of clinical asthma control using the Asthma Control Test (ACT) and the Global Initiative for Asthma (GINA) classification and to perform comparisons with values of spirometry. Through this cross-sectional study, 103 pregnant women with asthma were assessed in the period from October 2010 to October 2013 in the asthma pregnancy clinic at the Clinical Hospital of the Federal University of Pernambuco. Questionnaires concerning the level of asthma control were administered using the Global Initiative for Asthma classification, the Asthma Control Test validated for asthmatic expectant mothers and spirometry; all three methods of assessing asthma control were performed during the same visit between the twenty-first and twenty-seventh weeks of pregnancy. There was a significant association between clinical asthma control assessment using the Asthma Control Test and the Global Initiative for Asthma classification (pTest can be used for asthmatic expectant mothers to assess the clinical control of asthma, especially at the end of the second trimester, which is assumed to be the period of worsening asthma exacerbations during pregnancy. We highlight the importance of the Asthma Control Test as a subjective instrument with easy application, easy interpretation and good reproducibility that does not require spirometry to assess the level of asthma control and can be used in the primary care of asthmatic expectant mothers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Asthma symptoms in obese adults

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli

    2016-01-01

    The association between asthma and obesity is well-described, but not straightforward, and according to current guidelines asthma control is more difficult to achieve in obese patients. The currently available studies evaluating response to pharmacological asthma therapy in obese patients show...... that these patients have an altered, in general less favorable, response to both reliever and controller medication compared to normal weight patients. However, at present, the limited available evidence precludes evidence-based recommendations. The 'obesity-related asthma' phenotype has different characteristics......, including association with atopy and type of airway inflammation, compared to 'classic' asthma. Furthermore, weight loss in patients with this phenotype leads to an improvement in symptoms, lung function, and airway responsiveness, as well as a reduction in medication utilization and hospital admissions...

  8. Influence of asthma definition on the asthma-obesity relationship

    Science.gov (United States)

    2012-01-01

    Background Epidemiological studies suggest an association between obesity and asthma in adults and children. Asthma diagnosis criteria are different among studies. The aim of this study was to test the influence of asthma definition on the asthma-obesity relationship. Methods In a cross-sectional analysis of 1922 men and women, subjects completed a translated questionnaire from the European Community Respiratory Health Survey and underwent spirometry and a bronchial challenge test. Weight, height and waist circumference were measured. Multiple logistic regression analysis was carried out to assess the association of variables related to obesity and asthma. Asthma was defined either by the presence of symptoms with bronchial hyperresponsiveness (BHR) or by a self-report of a physician-made diagnosis. The following variables were separately tested for associations with asthma: socioeconomic characteristics, schooling, physical activity, smoking status, anthropometry and spirometry. Results No association was detected between asthma confirmed by BHR and obesity indicators, odds ratio (OR) = 1.08 (95% confidence interval: 0.69 - 1.68) for obesity assessed by body mass index ≥ 30 kg/m2; OR = 1.02 (0.74 - 1.40) for obesity assessed by abnormal waist-to-height ratio; and, OR = 0.96 (0.69 - 1.33) for abnormal waist circumference. On the contrary, a previous diagnosis of asthma was associated with obesity, OR = 1.48 (1.01 - 2.16) for body mass index ≥ 30 kg/m2; OR = 1.48 (1.13 - 1.93) for abnormal waist-to-height ratio; and, OR = 1.32 (1.00 – 1.75) for abnormal waist circumference. Female gender, schooling ≥ 12 years and smoking were associated with BHR-confirmed asthma. Physically inactive subjects were associated with a previous diagnosis of asthma. Conclusions Our findings indicate that the relationship between asthma and obesity in epidemiological studies depends on the definition adopted. Certain components of asthma, for instance, symptoms may be more prone to

  9. [Asthma drugs and doping].

    Science.gov (United States)

    Pillard, F; Rolland, Y; Rivière, D

    1999-11-01

    Some drugs regularly used in the treatment of asthma (beta-agonists and corticosteroids) are registered on the list of drugs forbidden in sport, because they have a doping action. To avoid penalizing asthmatic sportsmen, some beta-agonists (Salbutamol, Salmeterol, Terbutaline) and corticosteroids are allowed only in inhaled form, with written notification from the prescribing physician, a pneumologist or the team doctor. Considering the increase of doping with increasing involvement of physicians, good and up to date notions about the current rules of prescription in asthmatic sportsmen are needed.

  10. Manual therapy for asthma.

    Science.gov (United States)

    Hondras, M A; Linde, K; Jones, A P

    2002-01-01

    A variety of manual therapies with similar postulated biologic mechanisms of action are commonly used to treat patients with asthma. Manual therapy practitioners are also varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic physicians. A systematic review across disciplines is warranted. To evaluate the evidence for the effects of manual therapies for treatment of patients with bronchial asthma. Trials were searched in computerized general (EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane Rehabilitation Field, ICL, and MANTIS). In addition, bibliographies from included studies were assessed, and authors of known studies were contacted for additional information about published and unpublished trials. Date of most recent search: February 2002. Trials were included if they: (1) were randomised; (2) included asthmatic children or adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes. All three reviewers independently extracted data and assessed trial quality using a standard form. From 393 unique citations, 59 full text articles were retrieved and evaluated, which resulted in nine citations to five RCTs (290 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. Quality of the remaining three trials was poor. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data have yet to be confirmed. One small trial compared chest

  11. Manual therapy for asthma.

    Science.gov (United States)

    Hondras, M A; Linde, K; Jones, A P

    2005-04-18

    A variety of manual therapies with similar postulated biologic mechanisms of action are commonly used to treat patients with asthma. Manual therapy practitioners are also varied, including physiotherapists, respiratory therapists, chiropractic and osteopathic physicians. A systematic review across disciplines is warranted. To evaluate the evidence for the effects of manual therapies for treatment of patients with bronchial asthma. We searched for trials in computerized general (EMBASE, CINAHL and MEDLINE) and specialized databases (Cochrane Complementary Medicine Field, Cochrane Rehabilitation Field, Index to Chiropractic Literature (ICL), and Manual, Alternative and Natural Therapy (MANTIS)). In addition, we assessed bibliographies from included studies, and contacted authors of known studies for additional information about published and unpublished trials. Date of most recent search: August 2004. Trials were included if they: (1) were randomised; (2) included asthmatic children or adults; (3) examined one or more types of manual therapy; and (4) included clinical outcomes with observation periods of at least two weeks. All three reviewers independently extracted data and assessed trial quality using a standard form. From 473 unique citations, 68 full text articles were retrieved and evaluated, which resulted in nine citations to three RCTs (156 patients) suitable for inclusion. Trials could not be pooled statistically because studies that addressed similar interventions used disparate patient groups or outcomes. The methodological quality of one of two trials examining chiropractic manipulation was good and neither trial found significant differences between chiropractic spinal manipulation and a sham manoeuvre on any of the outcomes measured. One small trial compared massage therapy with a relaxation control group and found significant differences in many of the lung function measures obtained. However, this trial had poor reporting characteristics and the data

  12. Early risk factors for pubertal asthma.

    Science.gov (United States)

    Hovland, V; Riiser, A; Mowinckel, P; Carlsen, K-H; Lødrup Carlsen, K C

    2015-01-01

    Early life risk factors are previously described for childhood asthma, but less is known related to asthma in adolescence. We aimed to investigate early risk factors (before 2 years) for pubertal asthma and secondarily for pubertal asthma phenotypes based upon allergic comorbidities. Based on data from 550 adolescents in the prospective birth cohort 'Environment and Childhood Asthma' study, subjects were categorized by recurrent bronchial obstruction (rBO) 0-2 years, asthma 2-10 years, and pubertal asthma from 10 to 16 years including incident asthma in puberty and asthma in remission from 10 to 16 years or as never rBO/asthma 0-16 years. Asthma in puberty was further classified based on the comorbidities atopic dermatitis and allergic rhinitis (AR) from 10 to 16 years. Twenty-three common asthma risk factors identified by 2 years of age, including frequency and persistence of bronchial obstruction (severity score), were analysed by weighted logistic regression for each phenotype. In adjusted models, the risk of pubertal asthma increased significantly with higher severity score, parental rhinitis, being the firstborn child, and familial stress around birth. Pubertal asthma in remission was significantly associated with severity score and number of lower respiratory tract infections and inversely associated with breastfeeding beyond 4 months. Pubertal incident asthma was more common among firstborn children. All asthma phenotypes with allergic diseases were significantly associated with severity score, whereas familial perinatal stress increased the risk of asthma only. Asthma combined with AR was associated with parental asthma and being firstborn, whereas the risk of asthma with both atopic dermatitis and AR increased with higher paternal education, atopic dermatitis, being firstborn, and familial perinatal stress. Important early risk factors for pubertal asthma were early airways obstruction, parental rhinitis, being the firstborn child, and perinatal familial

  13. Global Asthma Network survey suggests more national asthma strategies could reduce burden of asthma.

    Science.gov (United States)

    Asher, I; Haahtela, T; Selroos, O; Ellwood, P; Ellwood, E

    Several countries or regions within countries have an effective national asthma strategy resulting in a reduction of the large burden of asthma to individuals and society. There has been no systematic appraisal of the extent of national asthma strategies in the world. The Global Asthma Network (GAN) undertook an email survey of 276 Principal Investigators of GAN centres in 120 countries, in 2013-2014. One of the questions was: "Has a national asthma strategy been developed in your country for the next five years? For children? For adults?". Investigators in 112 (93.3%) countries answered this question. Of these, 26 (23.2%) reported having a national asthma strategy for children and 24 (21.4%) for adults; 22 (19.6%) countries had a strategy for both children and adults; 28 (25%) had a strategy for at least one age group. In countries with a high prevalence of current wheeze, strategies were significantly more common than in low prevalence countries (11/13 (85%) and 7/31 (22.6%) respectively, pasthma strategy was reported. A large reduction in the global burden of asthma could be potentially achieved if more countries had an effective asthma strategy. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to ... PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: ...

  15. Exploring the obesity-asthma link

    DEFF Research Database (Denmark)

    Fenger, R V; Gonzalez-Quintela, A; Vidal, C

    2012-01-01

    Obesity and risk of asthma are linked. Different distributions of adiposity, such as visceral, subcutaneous or ectopic adiposity, may affect asthma risk differently.......Obesity and risk of asthma are linked. Different distributions of adiposity, such as visceral, subcutaneous or ectopic adiposity, may affect asthma risk differently....

  16. What's an Asthma Flare-Up?

    Science.gov (United States)

    ... Pregnancy Healthy Food Shopping Healthy Drinks for Kids Asthma Flare-Ups KidsHealth > For Parents > Asthma Flare-Ups ... español ¿Qué es una crisis asmática? What Are Asthma Flare-Ups? Keeping asthma under control helps kids ...

  17. American Academy of Allergy, Asthma, and Immunology

    Science.gov (United States)

    ... Allergy, Asthma & Immunology Life Spectrum of Asthma Meeting School-based Asthma Management Program – (SAMPRO TM ) This central resource focuses on ... AAAAI is proud to endorse HR 2285, the School-Based Respiratory Health Management Act Read Practice Matters! Allergy, Asthma & Immunology Quality ...

  18. Developing and emerging clinical asthma phenotypes

    NARCIS (Netherlands)

    Hekking, Pieter-Paul W.; Bel, Elisabeth H.

    2014-01-01

    For more than a century, clinicians have attempted to subdivide asthma into different phenotypes based on triggers that cause asthma attacks, the course of the disease, or the prognosis. The first phenotypes that were described included allergic asthma, intrinsic or nonallergic asthma, infectious

  19. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking your medicine exactly as your doctor or other medical professional ...

  20. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... with asthma Tables and Graphs Asthma Call-back Survey Technical Information Prevalence Tables BRFSS Prevalence Data NHIS ... Profiles (2011) Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare ...

  1. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know ... Breathing Easier [PDF – 1.1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File ...

  2. Eicosanoids in asthma.

    Science.gov (United States)

    Wan, Kong-Sang; Wu, Wei-Fong

    2007-01-01

    Eicosanoids belong to a diverse family of bioactive fatty acids that play important roles in regulating airway inflammation and reactivity. They are the key mediators of the pathobiology of asthma. Among the eicosanoids, lipoxins (LXs) were the first agents to be identified and recognized as potential anti-inflammatory endogenous lipid mediators. Lipoxins are biosynthesized in vivo at inflammation sites. They result mainly from the interaction between 5 and 15-lipoxygenases (LOs), which are distinct from leukotrienes (LTs) and prostaglandins (PGs) in structure and function. Leukotrienes are potent proinflammatory mediators and directly and indirectly stimulate fibroblast chemotaxis, proliferation, and collagen synthesis. Prostaglandins have both bronchoconstrictive and bronchoprotective effects and the bronchoconstriction mediated by PGD2 and PGF2alpha is only occurred in asthmatic patients but not in healthy subjects. Lipoxins counter-regulate the proinflammatory actions of LTs and activate resolution of the inflammatory response. At least two classes of receptors, CysLT1 receptors and Asprin-triggered lipoxin A4 (ALX) receptors, can interact with lipoxin A4 (LXA4) and LXA4 analogs to mediate their biologic actions. Allergen challenge initiates airway biosynthesis of LXA4 and increases expression of its receptor. In addition, LXA4 affects the release of interleukin-8 by blood mononuclear cells, and ALX affects calcium influx into epithelial cells. Therefore, the pivotal role of LXs is mediating airway homeostasis, and LXs may be part of a novel, multipronged approach for treating human asthma.

  3. Evaluation of quality of life according to asthma control and asthma severity in children and adolescents.

    Science.gov (United States)

    Matsunaga, Natasha Yumi; Ribeiro, Maria Angela Gonçalves de Oliveira; Saad, Ivete Alonso Bredda; Morcillo, André Moreno; Ribeiro, José Dirceu; Toro, Adyléia Aparecida Dalbo Contrera

    2015-01-01

    To evaluate quality of life according to the level of asthma control and degree of asthma severity in children and adolescents. We selected children and adolescents with asthma (7-17 years of age) from the Pediatric Pulmonology Outpatient Clinic of the State University of Campinas Hospital de Clínicas, located in the city of Campinas, Brazil. Asthma control and asthma severity were assessed by the Asthma Control Test and by the questionnaire based on the Global Initiative for Asthma, respectively. The patients also completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), validated for use in Brazil, in order to evaluate their quality of life. The mean age of the patients was 11.22 ± 2.91 years, with a median of 11.20 (7.00-17.60) years. We selected 100 patients, of whom 27, 33, and 40 were classified as having controlled asthma (CA), partially controlled asthma (PCA), and uncontrolled asthma (UA), respectively. As for asthma severity, 34, 19, and 47 were classified as having mild asthma (MiA), moderate asthma (MoA), and severe asthma (SA), respectively. The CA and the PCA groups, when compared with the NCA group, showed higher values for the overall PAQLQ score and all PAQLQ domains (activity limitation, symptoms, and emotional function; p Quality of life appears to be directly related to asthma control and asthma severity in children and adolescents, being better when asthma is well controlled and asthma severity is lower.

  4. Gastroesophageal reflux disease and asthma in children.

    Science.gov (United States)

    Khoshoo, Vikram; Haydel, Robert; Saturno, Emilio

    2006-06-01

    Gastroesophageal reflux disease (GERD) occurs in about two thirds of children with asthma. It may simply represent a concomitant unrelated finding or it may be responsible for provoking or worsening asthma. GERD could also be a byproduct of asthma itself. In any case, aggressive treatment of GERD seems to improve asthma outcomes. GERD should be suspected in asthma patients who do not have any known risk factors or those who are becoming difficult to treat.

  5. Guidelines for severe uncontrolled asthma.

    Science.gov (United States)

    Cisneros Serrano, Carolina; Melero Moreno, Carlos; Almonacid Sánchez, Carlos; Perpiñá Tordera, Miguel; Picado Valles, César; Martínez Moragón, Eva; Pérez de Llano, Luis; Soto Campos, José Gregorio; Urrutia Landa, Isabel; García Hernández, Gloria

    2015-05-01

    Since the publication, 9 years ago, of the latest SEPAR (Spanish Society of Pulmonology and Thoracic Surgery) Guidelines on Difficult-to-Control Asthma (DCA), much progress has been made in the understanding of asthmatic disease. These new data need to be reviewed, analyzed and incorporated into the guidelines according to their level of evidence and recommendation. Recently, consensus documents and clinical practice guidelines (CPG) addressing this issue have been published. In these guidelines, specific mention will be made of what the previous DCA guidelines defined as "true difficult-to-control asthma". This is asthma that remains uncontrolled after diagnosis and a systematic evaluation to rule out factors unrelated to the disease itself that lead to poor control ("false difficult-to-control asthma"), and despite an appropriate treatment strategy (Spanish Guidelines for the Management of Asthma [GEMA] steps 5 and 6): severe uncontrolled asthma. In this respect, the guidelines propose a revised definition, an attempt to classify the various manifestations of this type of asthma, a proposal for a stepwise diagnostic procedure, and phenotype-targeted treatment. A specific section has also been included on DCA in childhood, aimed at assisting healthcare professionals to improve the care of these patients. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  6. Prevalence of asthma-like symptoms, asthma and its treatment in elite athletes

    DEFF Research Database (Denmark)

    Lund, T; Pedersen, L; Larsson, B

    2008-01-01

    The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006. All elite athletes (N=418) financially supported by the national...... organization of elite athletes comprised the study group; 329 (79%) completed the questionnaire concerning their sport, asthma-like symptoms, asthma and use of asthma medication. Asthma-like symptoms at rest were reported by 41% of respondents; 55% reported asthma-like symptoms at rest or at exercise....... Physician-diagnosed asthma was present in 16% and 14% had current asthma. Asthma medication was taken by 7% of the athletes, of whom 79% used inhaled corticosteroids and 21% used inhaled beta(2)-agonists only. Athletes participating in endurance sports had higher prevalences of current asthma (24%) and use...

  7. Acute asthma exacerbations: an overview

    Directory of Open Access Journals (Sweden)

    Domenico Lorenzo Urso

    2014-07-01

    Full Text Available Asthma is a chronic inflammatory disease of the airways. All patient with asthma are at risk of having exacerbations characterized by worsening symptoms, airflow obstruction, and an increased requirement for rescue bronchodilators. Asthma exacerbations can be classified as mild, moderate, severe, or life threatening. The goals of treatment are correction of severe hypoxemia, rapid reversal of airflow obstruction, and reduction of the risk of relapse.http://dx.doi.org/10.7175/rhc.v5i3.932

  8. Occupational asthma in maritime environments

    DEFF Research Database (Denmark)

    Lucas, David; Loddé, Brice; Jepsen, Jørgen Riis

    2016-01-01

    In 2006 we published our first review based on the available literature on occupational asthma in maritime environments in the “International Maritime Health” journal. Since then, we have obtained a great deal of new knowledge on asthma in seafood workers and fishermen and on the impact...... of exposures from sulphites preservatives, container fumigants etc. in maritime workers. This review aims to provide an update of the current knowledge base about occupational asthma in a maritime context and to provide recommendations regarding medical surveillance of workers at risk....

  9. Biomarkers in Asthma: A Real Hope to Better Manage Asthma

    Science.gov (United States)

    Erzurum, Serpil C.; Gaston, Benjamin M.

    2012-01-01

    SYNOPSIS Diagnosis and treatment of asthma are currently based on assessment of patient symptoms and physiologic tests of airway reactivity. The morbidities and costs associated with the over and/or under treatment of this common disease, as well as the growing numbers of biologically-specific targeted strategies for therapy, provide a rationale for development of biomarkers to evaluate the presence and type of inflammation in individuals with asthma in order to optimize treatment plans. Research over the past decade has identified an array of biochemical and cellular biomarkers, which reflect the heterogeneous and multiple mechanistic pathways that may lead to asthma. These mechanistic biomarkers offer hope for optimal design of therapies targeting the specific pathways that lead to inflammation. This article provides an overview of blood, urine and airway biomarkers, summarizes the pathologic pathways that they signify, and begins to describe the utility of biomarkers in the future care of patients with asthma. PMID:22929095

  10. Role of Obesity in Asthma Control, the Obesity-Asthma Phenotype

    OpenAIRE

    Shannon Novosad; Supriya Khan; Bruce Wolfe; Akram Khan

    2013-01-01

    Asthma is a disease with distinct phenotypes that have implications for both prognosis and therapy. Epidemiologic studies have demonstrated an association between asthma and obesity. Further studies have shown that obese asthmatics have poor asthma control and more severe asthma. This obese-asthma group may represent a unique phenotype. The mechanisms behind poor asthma control in obese subjects remain unclear, but recent research has focused on adipokines and their effects on the airways as ...

  11. Psychological aspects in asthma: do psychological factors affect asthma management?

    OpenAIRE

    Baiardini, Ilaria; Sicuro, Francesca; Balbi, Francesco; Canonica, Giorgio Walter; Braido, Fulvio

    2015-01-01

    Despite the regular treatment with inhaled corticosteroids (ICS) or ICS plus long-acting beta2-agonists, permits to control de majority of asthmatics, a significant proportion of patients does not respond to this treatment. This review was aimed to explore the role of psychological factors associated to the unsuccessful fulfilment of optimal levels of asthma control, especially in patients suffering from severe asthma. The results of a Medline search were 5510 articles addressed to different ...

  12. Emerging molecular phenotypes of asthma

    Science.gov (United States)

    Ray, Anuradha; Oriss, Timothy B.

    2014-01-01

    Although asthma has long been considered a heterogeneous disease, attempts to define subgroups of asthma have been limited. In recent years, both clinical and statistical approaches have been utilized to better merge clinical characteristics, biology, and genetics. These combined characteristics have been used to define phenotypes of asthma, the observable characteristics of a patient determined by the interaction of genes and environment. Identification of consistent clinical phenotypes has now been reported across studies. Now the addition of various 'omics and identification of specific molecular pathways have moved the concept of clinical phenotypes toward the concept of molecular phenotypes. The importance of these molecular phenotypes is being confirmed through the integration of molecularly targeted biological therapies. Thus the global term asthma is poised to become obsolete, being replaced by terms that more specifically identify the pathology associated with the disease. PMID:25326577

  13. Stay away from asthma triggers

    Science.gov (United States)

    ... BS, Burks AW, et al, eds. Middleton's Allergy Principles and Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 86. Durrani SR, Busse WW. Management of asthma in adolescents and adults. In: Adkinson ...

  14. Mediterranean diet and childhood asthma

    National Research Council Canada - National Science Library

    Calatayud-Sáez, F M; Calatayud Moscoso Del Prado, B; Gallego Fernández-Pacheco, J G; González-Martín, C; Alguacil Merino, L F

    .... The objective of the present study was to assess the effects of a traditional Mediterranean diet on patients diagnosed with childhood asthma and determine if there is a beneficial effect from this dietary intervention...

  15. Obesity, asthma, and oxidative stress

    National Research Council Canada - National Science Library

    Fernando Holguin; Anne Fitzpatrick

    2010-01-01

    .... Contrary to what has previously been thought, the combination of obesity and asthma, both chronic inflammatory diseases, does not necessarily result in a synergistic effect, leading to even greater oxidative stress...

  16. Allergy and asthma prevention 2014

    DEFF Research Database (Denmark)

    Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht

    2014-01-01

    Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy....... This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas...... that antiviral vaccines could be useful in the future. Allergen-specific immunotherapy is effective for the treatment of allergic patients with symptoms; the study of its value for primary and secondary prevention of asthma and allergy is in its very preliminary phases. The lack of success in the prevention...

  17. Asthma in Children - Multiple Languages

    Science.gov (United States)

    ... Supplements Videos & Tools You Are Here: Home → Multiple Languages → All Health Topics → Asthma in Children URL of this page: https://medlineplus.gov/languages/asthmainchildren.html Other topics A-Z Expand Section ...

  18. Genetics Home Reference: allergic asthma

    Science.gov (United States)

    ... have another allergic disorder, such as hay fever (allergic rhinitis) or food allergies. Asthma is sometimes part of a series of allergic disorders, referred to as the atopic march. Development ...

  19. The poorly explored impact of uncontrolled asthma

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Søren; Schatz, Michael

    2013-01-01

    The goal of asthma management is to achieve disease control; however, despite the availability of effective and safe medications, for many patients asthma remains uncontrolled. One reason for this is the fear of long-term side effects from the regular use of inhaled corticosteroids (ICSs). Adverse...... effects of poorly controlled asthma (for example, obesity, pneumonia, and risks to the fetus) can be perceived as side effects of ICSs. Poorly controlled asthma adversely affects children's cardiovascular fitness, while children with well-controlled asthma perform at the same level as their peers....... Children with uncontrolled asthma also have a higher frequency of obesity than children with controlled asthma. Stress can affect asthma control, and children with poorly controlled asthma are more likely to have learning disabilities compared with those with good control. In adults, focused attention...

  20. Coexistence of asthma and polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Zierau, Louise; Gade, Elisabeth Juul; Lindenberg, Svend

    2016-01-01

    Asthma may be associated with polycystic ovary syndrome (PCOS), and possibly patients with PCOS have a more severe type of asthma. The purpose of this systematic literature review is to summarize evidence of a coexistense of PCOS and asthma using the available literature. The search was completed...... on 01.01.2016. English language articles were retrieved using the search terms 'Asthma' AND 'PCOS', 'Asthma' AND 'systemic inflammation', 'Asthma' AND 'metabolic syndrome', 'asthma' AND 'gynaecology', 'PCOS' AND 'systemic inflammation', 'PCOS' AND 'metabolic syndrome', 'PCOS' AND 'allergy'. Five papers...... meeting prespecified search criteria were found of which two were registry studies of relevance. The current literature supports a coexistense of PCOS and asthma and gives us an indication of the causes for the possible link between PCOS and asthma. Further research in the area must be conducted...

  1. Japanese Guideline for Adult Asthma 2014

    Directory of Open Access Journals (Sweden)

    Ken Ohta

    2014-01-01

    Full Text Available Adult bronchial asthma (hereinafter, asthma is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause intractable asthma. The number of patients with asthma has increased, and that of patients who die from asthma has decreased (1.5 per 100,000 patients in 2012. The aim of asthma treatment is to enable patients with asthma to lead a normal life without any symptoms. A good relationship between physicians and patients is indispensable for appropriate treatment. Long-term management with antiasthmatic agents and elimination of the causes and risk factors of asthma are fundamental to its treatment. Four steps in pharmacotherapy differentiate between mild and intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid, varying from low to high. Long-acting 02-agonists, leukotriene receptor antagonists, and sustained-release theophylline are recommended as concomitant drugs, while anti-immunoglobulin E antibody therapy has been recently developed for the most severe and persistent asthma involving allergic reactions. Inhaled 02-agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, and others are used as needed in acute exacerbations by choosing treatment steps for asthma exacerbations depending on the severity of attacks. Allergic rhinitis, chronic obstructive pulmonary disease, aspirin-induced asthma, pregnancy, asthma in athletes, and coughvariant asthma are also important issues that need to be considered.

  2. Tartrazine exclusion for allergic asthma.

    Science.gov (United States)

    Ardern, K D; Ram, F S

    2001-01-01

    Tartrazine is the best known and one of the most commonly used food additives. Food colorants are also used in many medications as well as foods. There has been conflicting evidence as to whether tartrazine causes exacerbations of asthma with some studies finding a positive association especially in individuals with cross-sensitivity to aspirin. To assess the overall effect of tartrazine (exclusion or challenge) in the management of asthma. A search was carried out using the Cochrane Airways Group specialised register. Bibliographies of each RCT was searched for additional papers. Authors of identified RCTs were contacted for further information for their trials and details of other studies. RCTs of oral administration of tartrazine (as a challenge) versus placebo or dietary avoidance of tartrazine versus normal diet were considered. Studies which focused upon allergic asthma, were also included. Studies of tartrazine exclusion for other allergic conditions such as hay fever, allergic rhinitis and eczema were only considered if the results for subjects with asthma were separately identified. Trials could be in either adults or children with asthma or allergic asthma (e.g. sensitivity to aspirin or food items known to contain tartrazine). Study quality was assessed and data abstracted by two reviewers independently. Outcomes were analysed using RevMan 4.1.1. Ninety abstracts were found, of which 18 were potentially relevant. Six met the inclusion criteria, but only three presented results in a format that permitted analysis and none could be combined in a meta-analysis. In none of the studies did tartrazine challenge or avoidance in diet significantly alter asthma outcomes. Due to the paucity of available evidence, it is not possible to provide firm conclusions as to the effects of tartrazine on asthma control. However, the six RCTs that could be included in this review all arrived at the same conclusion. Routine tartrazine exclusion may not benefit most patients

  3. Exacerbations of asthma during pregnancy

    DEFF Research Database (Denmark)

    Ali, Z; Hansen, A V; Ulrik, C S

    2016-01-01

    that asthma exacerbations during pregnancy increase the risk of pre-eclampsia, gestational diabetes, placental abruption and placenta praevia. Furthermore, these women also have higher risk for breech presentation, haemorrhage, pulmonary embolism, caesarean delivery, maternal admission to the intensive care...... to these outcomes. In conclusion, asthma exacerbations during pregnancy are associated with complications of pregnancy, labour and delivery. Prevention of exacerbations is essential to reduce the risk of complications and poor outcome....

  4. Childhood Asthma: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Wim M. van Aalderen

    2012-01-01

    Full Text Available Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  5. Indoor Air Quality and Asthma

    Directory of Open Access Journals (Sweden)

    Robert Golden

    2017-02-01

    Full Text Available Numerous contaminants in indoor air and their potential to cause or exacerbate asthma continue to be a subject of public health concern. Many agents are causally associated with or can exacerbate asthma, particularly in children. For formaldehyde, an established respiratory irritant based on numerous studies, the evidence for an association with asthma is still considered only limited or suggestive. However, there is no evidence that indicates increased sensitivity to sensory irritation to formaldehyde in people often regarded as susceptible such as asthmatics. Acrolein, but not formaldehyde, was significantly associated with asthma in a large cohort of children. This prompted an evaluation of this highly irritating chemical that had never previously been considered in the context of the indoor air/childhood asthma issue. Because acrolein is more potent than formaldehyde as a respiratory irritant and ubiquitous in indoor air, it is plausible that previous studies on potential risk factors and childhood asthma may be confounded by formaldehyde acting as an unrecognized proxy for acrolein.

  6. Building school health partnerships to improve pediatric asthma care: the School-based Asthma Management Program.

    Science.gov (United States)

    Kakumanu, Sujani; Antos, Nicholas; Szefler, Stanley J; Lemanske, Robert F

    2017-04-01

    Children with asthma require care that is seamlessly coordinated so that asthma symptoms are recognized and managed at home and at school. The purpose of this review is to discuss recent consensus recommendations in school-based asthma care. The School-based Asthma Management Program (SAMPRO) provides a widely endorsed framework to coordinate care with schools and consists of four components: establishing a circle of support around the child with asthma; facilitating bidirectional communication between clinicians and schools; comprehensive asthma education for schools; and assessment and remediation of environmental asthma triggers at school. SAMPRO standardizes recommendations for school-based asthma care coordination and provides a toolkit with websites and resources useful for the care of children with asthma in the school setting. The review will discuss the need for coordinated school asthma partnerships, the inception and development of SAMPRO, and its vision to improve pediatric asthma care coordination within the circle of support, comprising clinicians, school nurses, families, and communities.

  7. [Warning symptoms of asthma attack and asthma self-management: a national asthma control survey from China].

    Science.gov (United States)

    Lin, J T; Wang, W Q; Zhou, X; Wang, C Z; Huang, M; Cai, S X; Chen, P; Lin, Q C; Zhou, J Y; Gu, Y H; Yuan, Y D; Sun, D J; Yang, X H; Yang, L; Huo, J M; Chen, Z C; Jiang, P; Zhang, J; Ye, X W; Liu, H G; Tang, H P; Liu, R Y; Liu, C T; Zhang, W; Hu, C P; Chen, Y Q; Liu, X J; Dai, L M; Zhou, W; Huang, Y J; Xu, J Y

    2017-08-08

    Objective: To investigate warning symptoms of asthma attack and evaluate asthma self-management status of asthma patients in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out from 30 general hospitals dispersed in 30 provinces of mainland China (except for Tibet) during Oct 2015 to May 2016. Information of frequency and warning symptoms of asthma attack, the time from warning symptoms to asthma attack, the impact of asthma attack and asthma self-management were collected from asthma patients of outpatient department. Results: Altogether 3 875 asthmatic outpatients were recruited. 78.1% (3 026/3 875) of the patients reported restriction of exercise and daily activities during asthma exacerbation. 82.5% (3 160/3 829) of the patients had warning symptoms before asthma attack, the most common warning symptoms were cough, chest tightness and shortness of breath. The median time from warning symptoms to asthma attack was 2 h, the mean time was 90 h. Only 4.4% (167/3 829) of the patients had definite confidence to control asthma when symptoms deteriorated. 76.7% (2 937/3 828) of the patients used medications to control asthma when asthma symptoms deteriorated. Medication choice: inhaled corticosteroid (ICS) + formoterol 45.8% (1 776/3 875), short-acting beta-agonist (SABA) 23.9% (927/3 875). Conclusions: Most asthma patients have warning symptoms before asthma attack, the most common symptoms are cough, chest tightness and shortness of breath. The proportion of patients conducting effective asthma self-management remains low.

  8. The relation between paracetamol use and asthma

    DEFF Research Database (Denmark)

    Shaheen, S; Potts, J; Gnatiuc, L

    2008-01-01

    with adult asthma across Europe. The network compared 521 cases with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 507 controls with no diagnosis of asthma and no asthmatic symptoms in the last 12 months across 12 European centres. All cases and controls were selected from.......002. There was no evidence for heterogeneity across centres. No association was seen between use of other analgesics and asthma.These data add to the increasing and consistent epidemiological evidence implicating frequent paracetamol use in asthma in diverse populations...

  9. Relevance of Allergy in Adult Asthma

    Science.gov (United States)

    Mathur, Sameer K.; Viswanathan, Ravi K.

    2014-01-01

    Recent studies on asthma have demonstrated multiple phenotypes of asthma, based on the clinical characteristics of the disease. With the current interest in personalized medicine, the question arises whether the presence of allergic sensitization has any relevance for these phenotypes and the management of asthma. This review will examine the current knowledge of asthma phenotypes and the impact of atopy on asthma diagnosis and severity in adults. In addition, this review will address whether therapies targeted at the atopic axis help improve asthma outcomes, including lung function indices and exacerbations. PMID:24643812

  10. Environmental issues in managing asthma.

    Science.gov (United States)

    Diette, Gregory B; McCormack, Meredith C; Hansel, Nadia N; Breysse, Patrick N; Matsui, Elizabeth C

    2008-05-01

    Management of asthma requires attention to environmental exposures both indoors and outdoors. Americans spend most of their time indoors, where they have a greater ability to modify their environment. The indoor environment contains both pollutants (eg, particulate matter, nitrogen dioxide, secondhand smoke, and ozone) and allergens from furred pets, dust mites, cockroaches, rodents, and molds. Indoor particulate matter consists of particles generated from indoor sources such as cooking and cleaning activities, and particles that penetrate from the outdoors. Nitrogen dioxide sources include gas stoves, furnaces, and fireplaces. Indoor particulate matter and nitrogen dioxide are linked to asthma morbidity. The indoor ozone concentration is mainly influenced by the outdoor ozone concentration. The health effects of indoor ozone exposure have not been well studied. In contrast, there is substantial evidence of detrimental health effects from secondhand smoke. Guideline recommendations are not specific for optimizing indoor air quality. The 2007 National Asthma Education and Prevention Program asthma guidelines recommend eliminating indoor smoking and improving the ventilation. Though the guidelines state that there is insufficient evidence to recommend air cleaners, air cleaners and reducing activities that generate indoor pollutants may be sound practical approaches for improving the health of individuals with asthma. The guidelines are more specific about allergen avoidance; they recommend identifying allergens to which the individual is immunoglobin E sensitized and employing a multifaceted, comprehensive strategy to reduce exposure. Outdoor air pollutants that impact asthma include particulate matter, ozone, nitrogen dioxide, and sulfur dioxide, and guidelines recommend that individuals with asthma avoid exertion outdoors when these pollutants are elevated. Outdoor allergens include tree, grass, and weed pollens, which vary in concentration by season

  11. Future biologic therapies in asthma.

    Science.gov (United States)

    Quirce, Santiago; Bobolea, Irina; Domínguez-Ortega, Javier; Barranco, Pilar

    2014-08-01

    Despite the administration of appropriate treatment, a high number of patients with asthma remain uncontrolled. This suggests the need for alternative treatments that are effective, safe and selective for the established asthma phenotypes, especially in patients with uncontrolled severe asthma. The most promising options among the new asthma treatments in development are biological therapies, particularly those monoclonal antibodies directed at selective targets. It should be noted that the different drugs, and especially the new biologics, act on very specific pathogenic pathways. Therefore, determination of the individual profile of predominant pathophysiological alterations of each patient will be increasingly important for prescribing the most appropriate treatment in each case. The treatment of severe allergic asthma with anti-IgE monoclonal antibody (omalizumab) has been shown to be effective in a large number of patients, and new anti-IgE antibodies with improved pharmacodynamic properties are being investigated. Among developing therapies, biologics designed to block certain pro-inflammatory cytokines, such as IL-5 (mepolizumab) and IL-13 (lebrikizumab), have a greater chance of being used in the clinic. Perhaps blocking more than one cytokine pathway (such as IL-4 and IL-13 with dulipumab) might confer increased efficacy of treatment, along with acceptable safety. Stratification of asthma based on the predominant pathogenic mechanisms of each patient (phenoendotypes) is slowly, but probably irreversibly, emerging as a tailored medical approach to asthma, and is becoming a key factor in the development of drugs for this complex respiratory syndrome. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

  12. Asthma exacerbation prediction: recent insights.

    Science.gov (United States)

    Fleming, Louise

    2018-04-01

    Asthma attacks are frequent in children with asthma and can lead to significant adverse outcomes including time off school, hospital admission and death. Identifying children at risk of an asthma attack affords the opportunity to prevent attacks and improve outcomes. Clinical features, patient behaviours and characteristics, physiological factors, environmental data and biomarkers are all associated with asthma attacks and can be used in asthma exacerbation prediction models. Recent studies have better characterized children at risk of an attack: history of a severe exacerbation in the previous 12 months, poor adherence and current poor control are important features which should alert healthcare professionals to the need for remedial action. There is increasing interest in the use of biomarkers. A number of novel biomarkers, including patterns of volatile organic compounds in exhaled breath, show promise. Biomarkers are likely to be of greatest utility if measured frequently and combined with other measures. To date, most prediction models are based on epidemiological data and population-based risk. The use of digital technology affords the opportunity to collect large amounts of real-time data, including clinical and physiological measurements and combine these with environmental data to develop personal risk scores. These developments need to be matched by changes in clinical guidelines away from a focus on current asthma control and stepwise escalation in drug therapy towards inclusion of personal risk scores and tailored management strategies including nonpharmacological approaches. There have been significant steps towards personalized prediction models of asthma attacks. The utility of such models needs to be tested in the ability not only to predict attacks but also to reduce them.

  13. The role of trait mindfulness in quality of life and asthma control among adolescents with asthma

    NARCIS (Netherlands)

    Cillessen, L.J.G.; Ven, M.O.M. van de; Karremans, J.C.T.M.

    2017-01-01

    Objective: The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients. Furthermore, potential underlying mechanisms (general and asthma-specific stress) of this relationship were investigated. Methods: In this

  14. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma…

  15. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... physicians’ office Health care providers – Other Parents – Home Case Studies Open Airways for Schools Asthma Care Training ...

  16. Asthma mortality in the Danish child population

    DEFF Research Database (Denmark)

    Jørgensen, Inger Merete; Jensen, V B; Bülow, S

    2003-01-01

    Child death due to asthma is a rare and potentially preventable event. We investigated possible risk factors for death due to asthma in children and adolescents, as a step towards preventing or minimizing asthma death in this age group, and improving asthma management and care. We reviewed all 108...... cases of asthma death in 1-19-year-olds in Denmark, 1973-1994. Copies of death certificates, hospital records, information from general practitioners, and autopsy records were obtained. The information was assessed with particular reference to: features and duration of asthma before death; severity...... of asthma; time and place of death; long-term and ongoing medical treatment; quality of medical care; circumstances of final illness; and medical treatment during the final episode of asthma. Age groups of 1-4 years, 5-14 years, and 15-19 years were analyzed separately and in aggregate. Death occurred...

  17. Obesity-related asthma in adults.

    Science.gov (United States)

    Bhatt, Nikunj A; Lazarus, Angeline

    2016-08-01

    Obesity as a risk factor for asthma has been identified in previous studies. Additionally, a disproportionate number of patients with severe or difficult-to-control asthma are obese. Patients with obesity-related asthma tend to have worse asthma control and quality of life disproportionate to their pulmonary function tests, are less responsive to corticosteroid therapy, and are more likely to have obesity-related comorbidities such as obstructive sleep apnea and gastroesophageal disease that complicate asthma treatment. With the increasing prevalence of obesity, the prevalence of asthma is anticipated to grow proportionally. Addressing weight loss and encouraging activity is essential in the management of obesity-related asthma. This article briefly overviews the epidemiology, unique distinguishing features, potential mechanisms, and approach to management of patients with obesity-related asthma in adults.

  18. National Environmental Leadership Award in Asthma Management

    Science.gov (United States)

    The National Asthma Awards recognizes health plans, healthcare providers and communities in action that demonstrate an environmental component to address asthma triggers, collaborate with others and save healthcare dollars with their programming.

  19. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... CDCasthma on Twitter to learn more about helping people with asthma live healthier lives by gaining control over their asthma. Quick Links ... Formats Help: How do I view different file formats (PDF, ...

  20. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... physicians’ office Health care providers – Other Parents – Home Case Studies Open Airways for Schools Asthma Care Training ... Informs Design Other Evaluation Resources Multimedia Messages Agencies Working on Asthma Follow @CDCasthma on Twitter to learn ...

  1. New Asthma Guidelines What You Should Know

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section New Asthma Guidelines: What You Should Know Past Issues / Fall ... on. If you or a relative suffers from asthma, it is important to know that quality care ...

  2. Asthma Research: The NIH–NJRC Connection

    Science.gov (United States)

    ... Bar Home Current Issue Past Issues Special Section Asthma Research: The NIH–NJRC Connection Past Issues / Fall ... the many ways that NIH supports and promotes asthma research is through its strong relationship with National ...

  3. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking your medicine ...

  4. Asthma and COPD: Differences and Similarities

    Science.gov (United States)

    ... and COPD: differences and similarities Share | Asthma and COPD: Differences and Similarities This article has been reviewed ... or you could have Chronic Obstructive Pulmonary Disease (COPD) , such as emphysema or chronic bronchitis. Because asthma ...

  5. Sleep Problems in Asthma and COPD

    Science.gov (United States)

    ... Mini Series #5 Sleep Problems in Asthma and COPD NORMAL AIRWAY Good quality sleep is important for ... with asthma and/or Chronic Obstructive Pulmonary Disease (COPD) may have sleep issues that can lead to ...

  6. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Territory Data AsthmaStats Asthma and Fair or Poor Health Usual Place for Medical Care among Children Number of Visits to a Health Care Provider(s) among Children Health Care Coverage among ...

  7. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook ... Guidelines Air Pollution & Respiratory Health File Formats Help: How do I view different file formats (PDF, DOC, ...

  8. Asthma Medication Ratio Predicts Emergency Depart...

    Data.gov (United States)

    U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

  9. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack ...

  10. Co-morbidities in severe asthma

    DEFF Research Database (Denmark)

    Porsbjerg, Celeste; Menzies-Gow, Andrew

    2017-01-01

    Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma...... to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma. This review provides the clinician with an overview of the prevalence and clinical...... impact of the most common co-morbidities in severe asthma, including chronic rhinosinusitis, nasal polyposis, allergic rhinitis, dysfunctional breathing, vocal cord dysfunction, anxiety and depression, obesity, obstructive sleep apnoea syndrome (OSAS), gastroesophageal reflux disease (GERD...

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma YES WE CAN Bibliography Breathing Easier Success Stories State Contacts and Programs Evaluation Evaluation Guide Evaluation Webinars 1. Avoiding Evaluation ...

  12. Near-fatal asthma in the elderly.

    Science.gov (United States)

    Arjona, Nydia

    2015-01-01

    Asthma affects the elderly as often as other age groups; however, it more often becomes fatal in the elderly. Unfortunately, asthma is often unmanaged or underdiagnosed in the older population. It is important for health care providers to recognize risk factors in the elderly and properly treat them before asthma becomes fatal. This article describes near-fatal asthma and identifies risk factors specifically for the elderly. Symptoms of asthma are reviewed as well as assessments and diagnostic tests to identify asthma severity and complications. Proper management needs to be urgently initiated to prevent worsening respiratory distress; this includes fast-acting drug treatments appropriate for elderly patients. Decompensated acute respiratory failure, secondary to severe asthma, requires the skills of an experienced anesthesiologist because these patients may rapidly deteriorate during induction and intubation. Ventilator management must include strategies to prevent worsening hyperinflation of the lungs. Elderly asthma patients have a higher mortality risk related to ventilator complications and other comorbidities.

  13. Vitamin D and asthma: current perspectives.

    Science.gov (United States)

    Jiao, Junfang; Castro, Mario

    2015-08-01

    To review the current evidence on the relationship between vitamin D and asthma. The rising morbidity and tremendous socioeconomic burden of asthma have prompted efforts to seek modifiable environmental and nutritional factors that contribute to the asthma epidemic. The association between low levels of vitamin D and asthma has been supported by many, but not all observational and epidemiologic studies. Recently, several controlled clinical trials have been undertaken to explore the effect of vitamin D supplementation on asthma control and respiratory tract infections. While some trials support the beneficial role of vitamin D supplementation in reducing asthma severity in children, several trials have found no beneficial role in adults. Given the high prevalence of vitamin D insufficiency in children and adults worldwide and recent randomized controlled trials of vitamin D in asthma, supplementation with vitamin D cannot be recommended as adjunctive therapy for asthma.

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... with Current Asthma Asthma and Fair or Poor Health Usual Place for Medical Care among Children Number of Visits to a Health Care Provider(s) among Children Health Care Coverage among ...

  15. Recent developments regarding periostin in bronchial asthma

    National Research Council Canada - National Science Library

    Izuhara, Kenji; Matsumoto, Hisako; Ohta, Shoichiro; Ono, Junya; Arima, Kazuhiko; Ogawa, Masahiro

    2015-01-01

    Although it is currently recognized that bronchial asthma is not a single disease but a syndrome, we have not yet made use of our new understanding of this heterogeneity as we treat asthma patients...

  16. Neurotrophins in bronchial asthma

    Directory of Open Access Journals (Sweden)

    Renz Harald

    2001-07-01

    Full Text Available Abstract Allergic bronchial asthma (BA is characterized by chronic airway inflammation, development of airway hyperreactivity and recurrent reversible airway obstruction. T-helper 2 cells and their products have been shown to play an important role in this process. In contrast, the mechanisms by which immune cells interact with the cells residing in lung and airways, such as neurons, epithelial or smooth muscle cells, still remains uncertain. Sensory and motor neurons innervating the lung exhibit a great degree of functional plasticity in BA defined as 'neuronal plasticity'. These neurons control development of airway hyperresponsiveness and acute inflammatory responses, resulting in the concept of 'neurogenic inflammation'. Such quantitative and/or qualitative changes in neuronal functions are mediated to a great extent by a family of cytokines, the neurotrophins, which in turn are produced by activated immune cells, among others in BA. We have therefore developed the concept that neurotrophins such as nerve growth factor and brain-derived neurotrophic factor link pathogenic events in BA to dysfunctions of the immune and nervous system.

  17. [Laboratory animal; allergy; asthma].

    Science.gov (United States)

    Corradi, M; Romano, C; Mutti, A

    2011-01-01

    Laboratory animal allergy (LAA) may develop when susceptible persons are exposed to allergens produced by laboratory animals. LAA is associated with exposure to urine, fur, and salivae of rats, guinea pigs, dogs and rabbits. Approximately 30% of persons who are exposed to laboratory animals may develop LAA and some will also develop asthma. LAA is most likely to occur in persons with previously known allergies, especially to domestic pets. The majority of LAA sufferers experience symptoms within six months their first exposure to laboratory animals; almost all develop symptoms within three years. The most common symptoms are watery eyes and an itchy, runny nose, although skin symptoms and lower respiratory tract symptoms may also occur. Feeding and handling laboratory animals or cleaning their cages generates ten times the amount of allergens compared with undisturbed conditions. Prevention of animal allergy depends on control of allergenic material in the work environment and on organizational and individual protection measures. Pre-placement evaluation and periodic medical surveillance of workers are important pieces of the overall occupational health programme. The emphasis of these medical evaluations should be on counselling and early disease detection.

  18. Svær asthma bronchiale

    DEFF Research Database (Denmark)

    von Bülow, Anna; Backer, Vibeke; Porsbjerg, Celeste

    2015-01-01

    Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health......-care resources. The clinical assessment of severe asthma must include verification of the correct diagnosis, adherence to medication, excluding differential diagnosis and identification and treatment of aggravating co-morbidities and trigger factors....

  19. Role of inflammation in nocturnal asthma.

    OpenAIRE

    MacKay, T. W.; Wallace, W A; Howie, S. E.; Brown, P. H.; Greening, A P; Church, M. K.; Douglas, N. J.

    1994-01-01

    BACKGROUND--Nocturnal airway narrowing is a common problem for patients with asthma but the role of inflammation in its pathogenesis is unclear. Overnight changes in airway inflammatory cell populations were studied in patients with nocturnal asthma and in control normal subjects. METHODS--Bronchoscopies were performed at 0400 hours and 1600 hours in eight healthy subjects and in 10 patients with nocturnal asthma (> 15% overnight fall in peak flow plus at least one awakening/week with asthma)...

  20. Obesity and Asthma: Microbiome–Metabolome Interactions

    OpenAIRE

    Shore, Stephanie A.; Cho, Youngji

    2016-01-01

    Obesity is a risk factor for asthma, but obese subjects with asthma respond poorly to standard asthma drugs. Obesity also alters gut bacterial community structure. Obesity-related changes in gut bacteria contribute to weight gain and other obesity-related conditions, including insulin resistance and systemic inflammation. Here, we review the rationale for the hypothesis that obesity-related changes in gut bacteria may also play a role in obesity-related asthma. The metabolomes of the liver, s...

  1. "Association between Asthma Severity and Obesity in Two Asthma Clinics in Tehran "

    OpenAIRE

    Sanaz Tavasoli; Hassan Heidarnazhad; Anooshirvan Kazemnejad; Sara Miri

    2005-01-01

    The prevalence of both obesity and asthma has increased in recent years. Thus we decided to investigate the relation between obesity and asthma severity. We undertook a cross-sectional study in outpatient asthma clinics of 2 tertiary hospitals in Tehran. Obesity was defined as a body mass index greater than 30. Asthma severity was defined by using the Guide for Asthma Management and Prevention 2004 guidelines, according to patients’ clinical and/or spirometerical parameters. Active cigare...

  2. Risk of asthma exacerbation associated with nonsteroidal anti-inflammatory drugs in childhood asthma

    OpenAIRE

    Lo, Pei-Chia; Tsai, Yueh-Ting; Lin,Shun-Ku; Lai, Jung-Nien

    2016-01-01

    Abstract Patients allergic to aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) who develop respiratory reactions such as bronchospasm or asthma exacerbation have aspirin-induced asthma or NSAIDs-exacerbated respiratory disease. However, large-scale studies have not been conducted to investigate the risk of aspirin/NSAIDs exposure in children with asthma. Therefore, this study evaluated the relationship between aspirin/NSAIDs and the risk of asthma exacerbation in children with asthma....

  3. Asthma control questionnaires in the management of asthma in children: A review.

    Science.gov (United States)

    Voorend-van Bergen, S; Vaessen-Verberne, A A; de Jongste, J C; Pijnenburg, M W

    2015-02-01

    Several self-administered questionnaires have been developed to assess childhood asthma control in a simple and standardized way. This review discusses the most commonly used questionnaires and explores their usefulness in asthma management in children. We conclude that the use of asthma control questionnaires in daily practice and in research contributes to the standardized evaluation of children with asthma and helps to track asthma symptoms, but validation studies in a wider range of settings are needed. © 2014 Wiley Periodicals, Inc.

  4. Genetics of Asthma Susceptibility and Severity

    NARCIS (Netherlands)

    Slager, Rebecca E.; Hawkins, Gregory A.; Li, Xingnan; Postma, Dirkje S.; Meyers, Deborah A.; Bleecker, Eugene R.

    This article summarizes major findings in genome-wide studies of asthma susceptibility and severity. Two large meta-analyses identified four chromosomal regions which were consistently associated with development of asthma. Genes that are associated with asthma subphenotypes such as lung function,

  5. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Children aged 5–17 Years Asthma Severity among Adults with Current Asthma Asthma Severity among Children with ... Effective Interventions Background Methodology Results Community-Based Interventions Adults – Home Adults – Hospital Emergency Departments Adults – Hospital Inpatients ...

  6. New developments in work-related asthma.

    Science.gov (United States)

    Quirce, Santiago; Campo, Paloma; Domínguez-Ortega, Javier; Fernández-Nieto, Mar; Gómez-Torrijos, Elisa; Martínez-Arcediano, Ana; Mur, Pilar; Delgado, Julio

    2017-03-01

    Work-related asthma includes two subtypes: occupational asthma or asthma caused by specific agents (sensitizers or irritants) in the workplace, and work-exacerbated asthma or pre-existing asthma worsened by workplace exposures. Areas covered: This review provides an update on the definitions and the clinical features of the different work-related asthma subtypes as well as new insights into their etiology and the pathophysiological mechanisms involved. The diagnosis of work-related asthma should be made on objective basis using a constellation of clinical, physiologic and allergologic tests. Specific inhalation challenge with the suspected occupational agent(s) remains as the reference standard for diagnosis. A literature search was performed using the following terms: work-related asthma, occupational asthma, work-exacerbated asthma, irritant-induced asthma and etiological agents. Expert commentary: Studies focusing on the biological effects and mechanisms of environmental exposures in the development of sensitizer-induced or irritant-induced asthma in various workplace settings are of greatest interest. An integrative approach that combines clinical parameters with component-resolved diagnosis as well as inflammatory biomarkers appears to be very promising. Occupational allergy provides a good opportunity to understand the complex relationships between exposure to allergens in the workplace, interaction with genes and the co-exposures to other factors in the working environment.

  7. The importance of genetic influences in asthma

    NARCIS (Netherlands)

    Los, H; Koppelman, GH; Postma, DS

    1999-01-01

    Asthma is a complex genetic disorder in which the mode of inheritance is not known. Many segregation studies suggest that a major gene could be involved in asthma, but until now different genetic models have been obtained, Twin studies, too, have shown evidence for genetic influences in asthma, but

  8. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet ... boca) [PDF - 276 KB] Follow @CDCasthma on Twitter to learn more about helping people with asthma live healthier lives by gaining ... Formats Help: How do I view different file formats (PDF, DOC, ...

  9. School-based asthma disease management.

    Science.gov (United States)

    Tinkelman, David; Schwartz, Abby

    2004-06-01

    Asthma is the most common chronic childhood illness and the leading cause of missed school days. School is a potential location for establishing an asthma education program for children and their parents/caregivers designed to improve disease management. To determine whether a comprehensive, school-based asthma management program, in addition to a conventional disease management program, can reduce measures of asthma control, student absenteeism, and caregiver lost workdays. School nurses recruited parents/caregivers of students with asthma from three urban elementary and middle schools. Children were identified as having asthma by a previous diagnosis from their personal physician. Parents were invited to attend educational sessions about the program. Students received peak flow meters and training in their use and had access to an interactive asthma diary to record symptoms, peak flow, and medicine usage. They received monthly asthma education at school and had access to an online asthma education program and additional handouts. Parents received several educational calls regarding asthma and had a 24-hour, 7-days-a-week emergency number to call if problems arose. At 6 months, missed school days and unscheduled doctor visits were reduced by two thirds (n = 41; pschool-based asthma management program can successfully improve asthma control and reduce absenteeism in elementary and middle school students and caregiver lost workdays.

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... on this page will be unavailable. For more information about this message, please visit this page: About CDC.gov . Asthma Learn How to Control Asthma Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ...

  11. Epidemiology of bronchial asthma among preparatory school ...

    African Journals Online (AJOL)

    Background: The prevalence of asthma and allergies is increasing in both Western and developing countries. Few studies evaluated asthma prevalence in Egypt . Objectives: Determination of the prevalence and risk factors of asthma among preparatory school children in Assiut district, in Upper Egypt. Methods: A cross ...

  12. The dissemination and implementation of national asthma ...

    African Journals Online (AJOL)

    Asthma is an important chronic inflammatory disorder with significant morbidity and mortality in South Africa. The development of national asthma guidelines by the South African Thoracic Society and National Asthma Education Programme has been one approach to try and improve the quality of care. The impact of ...

  13. Socioeconomic factors associated with asthma prevalence and ...

    African Journals Online (AJOL)

    studies corroborate a 'stress hypothesis' for asthma, whereby greater life stress increases the likelihood of asthma onset and frequent exacerbations. No studies have tested this type of socioeconomic risk model for childhood asthma in southern Africa, however, despite high rates of violence, poverty and psychological ...

  14. Milestones in asthma management | Ekweani | Port Harcourt ...

    African Journals Online (AJOL)

    Methods: A review of the literature regarding the history of asthma and the evolution of its management was undertaken with the aid of textbooks, journal publications and the Internet via Google Pubmed. The history of asthma and the evolution of the management of asthma was surveyed with emphasis on major and ...

  15. Adult Asthma Consensus Guidelines Update 2003

    Directory of Open Access Journals (Sweden)

    Catherine Lemière

    2004-01-01

    Full Text Available BACKGROUND: Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.

  16. Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

    NARCIS (Netherlands)

    Koolen, B.B.; Pijnenburg, M.W.; Brackel, H.J.; Landstra, A.M.; Berg, N.J. van den; Merkus, P.J.F.M.; Hop, W.C.J.; Vaessen-Verberne, A.A.

    2011-01-01

    Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children. 145 children with

  17. Asthma education for school staff.

    Science.gov (United States)

    Kew, Kayleigh M; Carr, Robin; Donovan, Tim; Gordon, Morris

    2017-04-12

    Teachers and school staff should be competent in managing asthma in schools. Demonstrated low levels of asthma knowledge mean that staff may not know how best to protect a child with asthma in their care, or may fail to take appropriate action in the event of a serious attack. Education about asthma could help to improve this knowledge and lead to better asthma outcomes for children. To assess the effectiveness and safety of asthma education programmes for school staff, and to identify content and attributes underpinning them. We conducted the most recent searches on 29 November 2016. We included randomised controlled trials comparing an intervention to educate school staff about asthma versus a control group. We included studies reported as full text, those published as abstract only and unpublished data. At least two review authors screened the searches, extracted outcome data and intervention characteristics from included studies and assessed risk of bias. Primary outcomes for the quantitative synthesis were emergency department (ED) or hospital visits, mortality and asthma control; we graded the main results and presented evidence in a 'Summary of findings' table. We planned a qualitative synthesis of intervention characteristics, but study authors were unable to provide the necessary information.We analysed dichotomous data as odds ratios, and continuous data as mean differences or standardised mean differences, all with a random-effects model. We assessed clinical, methodological and statistical heterogeneity when performing meta-analyses, and we narratively described skewed data. Five cluster-RCTs of 111 schools met the review eligibility criteria. Investigators measured outcomes in participating staff and often in children or parents, most often at between 1 and 12 months.All interventions were educational programmes but duration, content and delivery varied; some involved elements of training for pupils or primary care providers. We noted risk of selection

  18. Exploring asthma in the workplace: A triangulation of perspectives from management, employees and people with asthma.

    Science.gov (United States)

    Zhao, Denise H; Cheung, Janet M Y; Smith, Lorraine; Saini, Bandana

    2017-08-31

    People with asthma spend a significant amount of time in the workplace but little is known about the current state of disease management in such contexts. The aim of the current study is to explore the experiences, attitudes and perceptions of asthma across different stakeholders in the workplace to help inform potential recommendations for workplace asthma policies. Using purposive and convenience sampling methods, in-depth semi-structured interviews were conducted in Australia with 5 human resource personnel, 10 employees with asthma and 10 employees without asthma. Interviews were guided by a schedule of questions focusing on attitudes and experiences of people with asthma in the workplace, which were audio recorded, transcribed verbatim and thematically analysed. Analysis of the qualitative dataset revealed three key themes: Beliefs and Attitudes about Asthma, Asthma Solutions in the Workplace and Workplace Obstacles. Findings suggest that employees with asthma experience problems managing their asthma at work and there is a lack of workplace support in relation to asthma emergency management. Key recommendations for workplace asthma policies have been made to provide better support for employees with asthma. However, further investigation into the experience of managing asthma is required in a wider variety of occupations and work experiences to inform the development of a workplace asthma policy.

  19. The role of trait mindfulness in quality of life and asthma control among adolescents with asthma.

    Science.gov (United States)

    Cillessen, Linda; van de Ven, Monique O; Karremans, Johan C

    2017-08-01

    The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients. Furthermore, potential underlying mechanisms (general and asthma-specific stress) of this relationship were investigated. In this cross-sectional study, questionnaire data of 94 adolescents with asthma that were prescribed daily asthma medication were included. Two Structural Equation Models (SEMs), a direct model and an indirect model, were tested. We found that trait mindfulness was directly related to asthma-related QoL, but not to asthma control. The relationship between trait mindfulness and asthma-related QoL was explained by asthma-specific, but not by general stress. Furthermore, an indirect relation from mindfulness to asthma control via asthma-specific stress was found. Cross-sectional evidence for a relation between mindfulness and asthma-related QoL is found. These findings may point to the possibility that an intervention aimed at increasing mindfulness could be a promising tool to improve asthma-related QoL in adolescents via a decrease in asthma-specific stress. Copyright © 2017. Published by Elsevier Inc.

  20. Perception of asthma as a factor in career choice among young adults with asthma.

    Science.gov (United States)

    Bhinder, Sacha; Cicutto, Lisa; Abdel-Qadir, Husam M; Tarlo, Susan M

    2009-01-01

    Asthma is a common chronic condition that can be aggravated by workplace exposures. Young adults with asthma should know how their future occupation might affect their asthma, and potentially, their quality of life. The aim of the present study was to assess the awareness of young adults to occupational risks for asthma and high-risk occupations, as well as their perception of the role of asthma in career choice. Young adults 16 to 22 years of age with reported physician-diagnosed asthma were recruited to complete a questionnaire eliciting information regarding asthma control, career choice and awareness of occupational exposure risks. A small majority of the study cohort (56.4%) could identify occupations that cause or exacerbate asthma, and 34.7% indicated that asthma was an important factor in their career plans. Family physicians were most responsible for asthma management (80.2%), but young adults were more likely to discuss asthma and career plans with their parents (43.6%) or friends (29.7%) than with their family physician (13.9%; PFamily physicians most commonly provide asthma care to these young adults. However, few young adults are talking to their family physicians about career choices and asthma. This observation represents an area of asthma care that needs to be explored in young adults with asthma.

  1. Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma

    Directory of Open Access Journals (Sweden)

    Bouchard Anne

    2009-12-01

    Full Text Available Abstract Background Low socioeconomic status (SES has been linked to higher morbidity in patients with chronic diseases, but may be particularly relevant to asthma, as asthmatics of lower SES may have higher exposures to indoor (e.g., cockroaches, tobacco smoke and outdoor (e.g., urban pollution allergens, thus increasing risk for exacerbations. Methods This study assessed associations between adult SES (measured according to educational level and asthma morbidity, including asthma control; asthma-related emergency health service use; asthma self-efficacy, and asthma-related quality of life, in a Canadian cohort of 781 adult asthmatics. All patients underwent a sociodemographic and medical history interview and pulmonary function testing on the day of their asthma clinic visit, and completed a battery of questionnaires (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire, and Asthma Self-Efficacy Scale. General Linear Models assessed associations between SES and each morbidity measure. Results Lower SES was associated with worse asthma control (F = 11.63, p Conclusions Results suggest that lower SES (measured according to education level, is associated with several indices of worse asthma morbidity, particularly worse asthma control, in adult asthmatics independent of disease severity. Results are consistent with previous studies linking lower SES to worse asthma in children, and add asthma to the list of chronic diseases affected by individual-level SES.

  2. [Asthma-COPD overlap syndrome].

    Science.gov (United States)

    Odler, Balázs; Müller, Veronika

    2016-08-01

    Obstructive lung diseases represent a major health problem worldwide due to their high prevalence associated with elevated socioeconomic costs. Bronchial asthma and chronic obstructive pulmonary disease are chronic obstructive ventilatory disorders with airway inflammation, however they are separate nosological entities based on thedifferent development, diagnostic and therapeutic approaches, and prognostic features. However, these diseases may coexist and can be defined as the coexistence of increased variability of airflow in a patient with incompletely reversible airway obstruction. This phenotype is called asthma - chronic obstructive pulmonary disease overlap syndrome. The syndrome is a clinical and scientific challenge as the majority of these patients have been excluded from the clinical and pharmacological trials, thus well-defined clinical characteristics and therapeutic approaches are lacking. The aim of this review is to summarize the currently available literature focusing on pathophysiological and clinical features, and discuss possible therapeutic approaches of patients with asthma - chronic obstructive pulmonary disease overlap syndrome. Orv. Hetil., 2016, 157(33), 1304-1313.

  3. Asthma Outcomes: Quality of Life

    Science.gov (United States)

    Wilson, Sandra R.; Rand, Cynthia S.; Cabana, Michael D.; Foggs, Michael B.; Halterman, Jill S.; Olson, Lynn; Vollmer, William M.; Wright, Rosalind J.; Taggart, Virginia

    2014-01-01

    Background “Asthma-related quality of life” refers to the perceived impact that asthma has on the patient’s quality of life. Objective National Institutes of Health (NIH) institutes and other federal agencies convened an expert group to recommend standardized measures of the impact of asthma on quality of life for use in future asthma clinical research. Methods We reviewed published documentation regarding the development and psychometric evaluation; clinical research use since 2000; and extent to which the content of each existing quality of life instrument provides a unique, reliable, and valid assessment of the intended construct. We classified instruments as core (required in future studies), supplemental (used according to the study’s aims and standardized), or emerging (requiring validation and standardization). This work was discussed at an NIH-organized workshop convened in March 2010 and finalized in September 2011. Results Eleven instruments for adults and 6 for children were identified for review. None qualified as core instruments because they predominantly measured indicators of asthma control (symptoms and/or functional status); failed to provide a distinct, reliable score measuring all key dimensions of the intended construct; and/or lacked adequate psychometric data. Conclusions In the absence of existing instruments that meet the stated criteria, currently available instruments are classified as either supplemental or emerging. Research is strongly recommended to develop and evaluate instruments that provide a distinct, reliable measure of the patient’s perception of the impact of asthma on all of the key dimensions of quality of life, an important outcome that is not captured in other outcome measures. PMID:22386511

  4. [From atopic dermatitis to asthma].

    Science.gov (United States)

    Businco, L; Marziali, M; Furcolo, G; Meglio, P

    1997-10-01

    Atopic dermatitis (AD) is the most common chronic skin disorder in infancy and childhood and is the main hallmark of atopic constitution. The disease is multifactorial, and although genetic predisposition is certainly a prerequisite, a number of environmental factors modulate the phenotypic expression of AD. The majority of affected children shows IgE sensitisation towards a large variety of foods and aeroallergens. Since at least 1600, it has been recognized that patients with AD have a high predisposition to develop asthma. Recent epidemiological studies show that AD is commonly seen in individuals from families with a history of asthma. In addition, in population where asthma is uncommon, AD is also uncommon. The sex distribution of AD and asthma is the same, with boys affected significantly more often by these two atopic diseases and in similar proportions. The ETAC project (Early Treatment of the Atopic Child) is a large multicenter, multi-national, double blind, placebo controlled, randomised trial. The main objective of the study is to stop the progression from AD to asthma in young children with AD using early therapeutic intervention with Cetirizine and the second objective is to investigate the main risk factors for the onset of asthma. The results of this study indicate that exposure to potent allergens such as cat or mite significantly increased the risk of sensitisation to these allergens. Prolonged breast feeding was associated with a lowest sensitisation rate to cow milk proteins and to egg. Therefore environmental factors seem to play a crucial role in IgE sensitisation in children with AD.

  5. Evaluation of quality of life according to asthma control and asthma severity in children and adolescents

    Science.gov (United States)

    Matsunaga, Natasha Yumi; Ribeiro, Maria Angela Gonçalves de Oliveira; Saad, Ivete Alonso Bredda; Morcillo, André Moreno; Ribeiro, José Dirceu; Toro, Adyléia Aparecida Dalbo Contrera

    2015-01-01

    ABSTRACT OBJECTIVE: To evaluate quality of life according to the level of asthma control and degree of asthma severity in children and adolescents. METHODS: We selected children and adolescents with asthma (7-17 years of age) from the Pediatric Pulmonology Outpatient Clinic of the State University of Campinas Hospital de Clínicas, located in the city of Campinas, Brazil. Asthma control and asthma severity were assessed by the Asthma Control Test and by the questionnaire based on the Global Initiative for Asthma, respectively. The patients also completed the Paediatric Asthma Quality of Life Questionnaire (PAQLQ), validated for use in Brazil, in order to evaluate their quality of life. RESULTS: The mean age of the patients was 11.22 ± 2.91 years, with a median of 11.20 (7.00-17.60) years. We selected 100 patients, of whom 27, 33, and 40 were classified as having controlled asthma (CA), partially controlled asthma (PCA), and uncontrolled asthma (UA), respectively. As for asthma severity, 34, 19, and 47 were classified as having mild asthma (MiA), moderate asthma (MoA), and severe asthma (SA), respectively. The CA and the PCA groups, when compared with the NCA group, showed higher values for the overall PAQLQ score and all PAQLQ domains (activity limitation, symptoms, and emotional function; p < 0.001 for all). The MiA group showed higher scores for all of the PAQLQ components than did the MoA and SA groups. CONCLUSIONS: Quality of life appears to be directly related to asthma control and asthma severity in children and adolescents, being better when asthma is well controlled and asthma severity is lower. PMID:26785958

  6. Asthma affects time to pregnancy and fertility

    DEFF Research Database (Denmark)

    Gade, Elisabeth J; Thomsen, Simon F; Lindenberg, Svend

    2014-01-01

    including questions about the presence of asthma and fertility. Differences in time to pregnancy and pregnancy outcome were analysed in subjects with asthma, allergy and in healthy individuals using multiple regression analysis. Asthma was associated with an increased time to pregnancy, the percentage...... tended to have a shorter time to pregnancy than untreated asthmatics (OR 1.40; p=0.134). Asthma prolongs time to pregnancy. The negative effect of asthma on fertility increases with age and with disease intensity, indicating that a systemic disease characterised by systemic inflammation also can involve...

  7. Pharmacotherapy options to treat asthma during pregnancy.

    Science.gov (United States)

    Namazy, Jennifer A; Schatz, Michael

    2015-01-01

    Pregnancy may be complicated by new onset or pre-existing asthma. This article reviews the recognition and management of asthma during pregnancy, paying close attention to the general principles of asthma medication use during pregnancy. Asthma is one of the most common potentially serious medical problems to complicate pregnancy, and asthma may adversely affect both maternal quality of life and perinatal outcomes. Therefore, optimal management of asthma during pregnancy is important for both mother and baby. This article reviews asthma pharmacotherapy during pregnancy, with an emphasis on gestational safety of commonly used medications. In this review of asthma pharmacotherapy during pregnancy, the most pertinent recent publications are reported. Electronic databases such as PubMed were searched for terms pregnan* or perinat* or obstet* and asthma or wheeze and treatment. Although retrospective data have been reassuring, since pregnant women are generally excluded from clinical trials, there is a lack of adequate safety information for most medications taken during pregnancy. One of the most important needs for the future is the availability of further safety information for asthma medications used during pregnancy that can also account for asthma control.

  8. Is influenza vaccination in asthma helpful?

    Science.gov (United States)

    Bueving, Herman J; Thomas, Siep; Wouden, Johannes C van der

    2005-02-01

    Influenza infections are frequently involved in asthma exacerbations. During influenza epidemics substantial excess morbidity due to respiratory tract complications is reported in all age categories as well as excess mortality among the elderly. Vaccines are available for protection against influenza. Worldwide, vaccination is advised and considered a quality point for asthma care. However, the protective effect of influenza vaccination in patients with asthma is still disputed. In order to establish the current state of affairs we reviewed the recent literature on the protective effect of influenza vaccination and its usefulness in patients with asthma. Several studies were found addressing influenza and the protective aspects of vaccination. They discussed the incidence, the adverse effects of vaccination, the coverage of influenza vaccination among patients with asthma and the effectiveness of the vaccine. Influenza vaccination can safely be used in patients with asthma. Allegations that vaccination could provoke asthma exacerbations are convincingly invalidated by previous and recent research. Although patients with asthma are one of the major target groups for immunization, vaccine coverage in all age categories remains low. So far, no unequivocal beneficial effect of influenza vaccination in patients with asthma was found in observational and experimental studies in the sense of reduction of asthma exacerbations and other complications. Recent studies confirm these negative findings. More long-term randomized, placebo-controlled studies, focusing on influenza- proven illness in patients with asthma, are needed to address the question of how helpful influenza vaccination is in these patients.

  9. Role of Obesity in Asthma Control, the Obesity-Asthma Phenotype

    Directory of Open Access Journals (Sweden)

    Shannon Novosad

    2013-01-01

    Full Text Available Asthma is a disease with distinct phenotypes that have implications for both prognosis and therapy. Epidemiologic studies have demonstrated an association between asthma and obesity. Further studies have shown that obese asthmatics have poor asthma control and more severe asthma. This obese-asthma group may represent a unique phenotype. The mechanisms behind poor asthma control in obese subjects remain unclear, but recent research has focused on adipokines and their effects on the airways as well as the role of oxidative stress. Both surgical and nonsurgical weight loss therapy have shown promising results with improvements in asthma control and decreased asthma severity. Comorbid conditions such as gastroesophageal reflux disease and obstructive sleep apnea may also have a role in poor asthma control in obese asthmatics. Further research is needed to define the mechanisms behind this phenotype which will guide the development of targeted therapies.

  10. Mismatch between asthma symptoms and spirometry: implications for managing asthma in children.

    Science.gov (United States)

    Schifano, Elizabeth D; Hollenbach, Jessica P; Cloutier, Michelle M

    2014-11-01

    To examine the concordance between spirometry and asthma symptoms in assessing asthma severity and beginning therapy by the general pediatrician. 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. Thirty percent of participants had clinically determined intermittent asthma; 32%, 33%, and 5% had mild, moderate, and severe, persistent asthma, respectively. Increasing disease severity was associated with decreases in the forced expiratory volume in 1 second/forced vital capacity (FVC) ratio (P spirometry-determined severity. Concordance was 0.16 (95% CI 0.10, 0.23), and when adjusted for bias and prevalence, was 0.20 (95% CI 0.17, 0.23). When accounting for age, sex, exposure to smoke, and insurance type, only spirometry-determined asthma severity was a significant predictor of agreement (P spirometry-determined severity increased. Concordance between spirometry and asthma symptoms in determining asthma severity is low even when guideline-based clinical assessment tools are used. Because appropriate therapy reduces asthma morbidity and is guided by disease severity, results from spirometry testing could better guide pediatricians in determining appropriate therapy for their patients with asthma. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Atopy, but not obesity is associated with asthma severity among children with persistent asthma.

    Science.gov (United States)

    Lu, Kim D; Phipatanakul, Wanda; Perzanowski, Matthew S; Balcer-Whaley, Susan; Matsui, Elizabeth C

    2016-12-01

    Obesity is associated with an increased risk of asthma in children. Atopic sensitization is a major risk factor for asthma including severe asthma in children. It is unclear if obesity is associated with worse asthma control or severity in children and how its effects compare to atopy. We sought to examine relationships of weight status and atopy to asthma control and severity among a population of predominantly low income, minority children and adolescents with persistent asthma. A cross-sectional analysis of 832 children and adolescents, age range 5-17 years, with persistent asthma was performed. Clinical assessments included asthma questionnaires of symptoms, asthma severity score, health care utilization and medication treatment step, lung function testing, and skin prick testing as well as measures of adiposity. Data were collected between December 2010 and August 2014 from Johns Hopkins Hospital in Baltimore, MD and Children's Hospital of Boston, MA. Obesity was not associated with worse asthma control or severity in this group of predominantly low income, minority children and adolescents with persistent asthma. However, a greater degree of atopy was associated with lower lung function, higher asthma severity score, and higher medication treatment step. Atopy may be a more important risk factor for asthma severity than obesity among low-income minority children and adolescents with persistent asthma living in Northeastern cities in the United States.

  12. Obesity in asthma: approaches to treatment.

    Science.gov (United States)

    Pradeepan, Shyamala; Garrison, Garth; Dixon, Anne E

    2013-10-01

    There is mounting evidence that obesity is associated with asthma, both of which are seeing a dramatic increase in prevalence. Not only is obesity a risk factor for the development of asthma but it is also associated with poor asthma control. Asthma phenotypes associated with obesity include early-onset allergic asthma and late-onset non-allergic asthma. The pathogenesis of the linkage is complex; obesity causes a variety of mechanical, metabolic, and immunological changes that can affect the airways. The treatment of asthma in obesity can be challenging, as obesity is associated with poor response to standard controller medications. A tailored approach that involves combining pharmacologic and non-pharmacologic therapies including weight loss, dietary interventions, and exercise, along with identification and treatment of obstructive sleep apnea, should therefore be considered in this population.

  13. Diet and Asthma: Vitamins and Methyl Donors

    Science.gov (United States)

    Han, Yueh-Ying; Blatter, Josh; Brehm, John M.; Forno, Erick; Litonjua, Augusto A; Celedón, Juan C.

    2014-01-01

    SUMMARY Dietary changes may partly explain the high burden of asthma in industrialized nations. Experimental studies have motivated a significant number of observational studies of the relation between vitamins (A, C, D, and E) or nutrients acting as methyl donors (folate, vitamin B12, and choline) and asthma. Because observational studies are susceptible to several sources of bias, well-conducted randomized controlled trials (RCTs) remain the “gold standard” to determine whether a vitamin or nutrient has an effect on asthma. Evidence from observational studies and/or relatively few RCTs most strongly justify ongoing and future RCTs of: 1) vitamin D to prevent or treat asthma, 2) choline supplementation as adjuvant treatment for asthma, and 3) vitamin E to prevent the detrimental effects of air pollution in subjects with asthma. At this time, there is insufficient evidence to recommend supplementation with any vitamin or nutrient acting as a methyl donor to prevent or treat asthma. PMID:24461761

  14. Carboxyhemoglobin and methemoglobin in asthma.

    Science.gov (United States)

    Naples, Robert; Laskowski, Dan; McCarthy, Kevin; Mattox, Emmea; Comhair, Suzy A A; Erzurum, Serpil C

    2015-04-01

    Nitric oxide (NO) and carbon monoxide (CO) are synthesized at high levels in asthmatic airways. NO can oxidize hemoglobin (Hb) to methemoglobin (MetHb). CO binds to heme to produce carboxyhemoglobin (COHb). We hypothesized that MetHb and COHb may be increased in asthma. COHb, MetHb, and Hb were measured in venous blood of healthy controls (n = 32) and asthmatics (n = 31). Arterial COHb and oxyhemoglobin were measured by pulse CO-oximeter. Hb, oxyhemoglobin, and deoxyhemoglobin were similar among groups, but arterial COHb was higher in asthmatics than controls (p = 0.04). Venous COHb was similar among groups, and thus, arteriovenous COHb (a-v COHb) concentration difference was greater in asthma compared with controls. Venous MetHb was lower in asthma compared to controls (p = 0.01) and correlated to venous NO (p = 0.009). The greater a-v COHb in asthma suggests CO offloading to tissues, but lower than normal MetHb suggests countermeasures to avoid adverse effects of high NO on gas transfer.

  15. Approach to asthma in adults

    African Journals Online (AJOL)

    During an acute asthma attack, patients can experience anxiety, severe dyspnoea, tightness of the chest, or a burning ... Nutritional and exercise-related factors. • Obesity. • Vitamin D insufficiency in children ... breathing, recurrent chest tightness, symptoms occurring or worsening at night or with exercise, a viral infection, ...

  16. Carboxyhemoglobin and Methemoglobin in Asthma

    Science.gov (United States)

    Naples, Robert; Laskowski, Dan; McCarthy, Kevin; Mattox, Emmea; Comhair, Suzy A. A.; Erzurum, Serpil C.

    2015-01-01

    Nitric oxide (NO) and carbon monoxide (CO) are synthesized at high levels in asthmatic airways. NO can oxidize hemoglobin (Hb) to methemoglobin (MetHb). CO binds to heme to produce carboxyhemoglobin (COHb). We hypothesized that MetHb and COHb may be increased in asthma. COHb, MetHb, and Hb were measured in venous blood of healthy controls (n=32) and asthmatics (n=31). Arterial COHb and oxyhemoglobin were measured by pulse CO-oximeter. Hb, oxyhemoglobin, and deoxyhemoglobin were similar among groups, but arterial COHb was higher in asthmatics than controls (p=0.04). Venous COHb was similar among groups, and thus arteriovenous COHb (a-v COHb) concentration difference was greater in asthma compared with controls. Venous MetHb was lower in asthma compared to controls (p=0.01) and correlated to venous NO (p=0.009). The greater a-v COHb in asthma suggests CO offloading to tissues, but lower than normal MetHb suggests countermeasures to avoid adverse effects of high NO on gas transfer. PMID:25680415

  17. Helicobacter, Hygiene, Atopy, and Asthma.

    Science.gov (United States)

    Miftahussurur, Muhammad; Nusi, Iswan A; Graham, David Y; Yamaoka, Yoshio

    2017-01-01

    The hygiene hypothesis links environmental and microbial exposures in early life to the prevalence of atopy, allergy, and asthma. Helicobacter pylori infection is typically acquired in childhood and acquisition of the infection is associated with poor household hygiene. Some population surveys have shown an inverse association between H. pylori infection and atopy, allergy, and asthma leading to the suggestion that H. pylori infection may be protective against disease; others consider it simply a biomarker for poor household hygiene. We review the relevant surveys, cohort studies, meta-analyses, and studies testing the protective hypothesis. Overall, the results of surveys and cohort studies are inconsistent, whereas meta-analyses show a significant but weak inverse correlation. In contrast, studies directly testing the protection hypothesis in relation to asthma in populations with poor hygiene and low H. pylori prevalence failed to confirm a protective effect. H. pylori is a major cause of human disease including chronic gastritis, peptic ulcer, and gastric malignancies. H. pylori infections most likely serve as a biomarker for poor hygienic conditions in childhood. We conclude that while synergistic interactions between environmental factors in childhood are important determinants of the pathogenesis of atopy, allergy, and asthma; H. pylori is inversely related to good hygiene and thus it's presence serves as a biomarker rather than for a specific prevention role for H. pylori or H. pylori antigens.

  18. Helicobacter, Hygiene, Atopy, and Asthma

    Directory of Open Access Journals (Sweden)

    Muhammad Miftahussurur

    2017-06-01

    Full Text Available The hygiene hypothesis links environmental and microbial exposures in early life to the prevalence of atopy, allergy, and asthma. Helicobacter pylori infection is typically acquired in childhood and acquisition of the infection is associated with poor household hygiene. Some population surveys have shown an inverse association between H. pylori infection and atopy, allergy, and asthma leading to the suggestion that H. pylori infection may be protective against disease; others consider it simply a biomarker for poor household hygiene. We review the relevant surveys, cohort studies, meta-analyses, and studies testing the protective hypothesis. Overall, the results of surveys and cohort studies are inconsistent, whereas meta-analyses show a significant but weak inverse correlation. In contrast, studies directly testing the protection hypothesis in relation to asthma in populations with poor hygiene and low H. pylori prevalence failed to confirm a protective effect. H. pylori is a major cause of human disease including chronic gastritis, peptic ulcer, and gastric malignancies. H. pylori infections most likely serve as a biomarker for poor hygienic conditions in childhood. We conclude that while synergistic interactions between environmental factors in childhood are important determinants of the pathogenesis of atopy, allergy, and asthma; H. pylori is inversely related to good hygiene and thus it's presence serves as a biomarker rather than for a specific prevention role for H. pylori or H. pylori antigens.

  19. Adult asthma: Diagnosis and treatment.

    Science.gov (United States)

    Durham, Catherine O; Fowler, Terri; Smith, Whitney; Sterrett, James

    2017-11-16

    Adult asthma is a prevalent chronic medical condition that is associated with high morbidity, mortality, and cost. Early identification, evidence-based diagnosis, and step-wise management can lead to improvements in patient outcomes, decrease exacerbations, and eliminate respiratory function decline as the patient ages.

  20. Alexander technique for chronic asthma.

    Science.gov (United States)

    Dennis, Jane A; Cates, Christopher J

    2012-09-12

    'The Alexander technique' is a taught form of physical therapy involving a series of movements designed to correct posture and bring the body into natural alignment with the object of helping it to function efficiently, and is reported to aid relaxation. Some practitioners claim benefits for those who desire greater ease and efficiency of breathing, including asthmatics. The objective of this review was to evaluate the efficacy of the Alexander technique in people with chronic, stable asthma. We searched the Cochrane Airways Group Specialised Register, the Cochrane Complementary Medicine Field trials register and the bibliographies of relevant articles. The most recent search was run in June 2012. Randomised controlled trials of Alexander technique (AT) for the improvement of the symptoms of chronic, stable asthma, comparing the treatment with either another intervention or no intervention. No trials were found that met the selection criteria. No meta-analysis could be performed. Robust, well-designed randomised controlled trials are required in order to test claims by practitioners that AT can have a positive effect on the symptoms of chronic asthma and thereby help people with asthma to reduce medication.

  1. [Asthma mortality trends in Mexico].

    Science.gov (United States)

    Salas Ramírez, M; Segura Méndez, N H; Martínez-Cairo Cueto, S

    1994-04-01

    The objective of this cross-sectional study was to estimate mortality and morbidity from asthma in Mexico by federative entity (state) of residence, age, and sex during the period between 1960 and 1988. Statistics published by the National Institute of Statistics, Geography, and Information Science were reviewed, as were vital statistics and information from other sources. Data were selected on mortality, hospital admissions, and outpatient visits, as well as population by federative entity, age, and sex. Mortality and morbidity rates were adjusted for age using the direct method. From 1960 to 1987, mortality decreased for both sexes. The groups with the highest asthma mortality were those under 4 years of age and those over 50. From 1960 to the present, the state with the highest mortality was Tlaxcala. Hospitalizations increased from 10 to 140 per 100,000 population for the country as a whole. When both outpatient visits and hospitalizations were considered, the morbidity rates rose from 180 to 203.4 per 100,000 between 1960 and 1970. In 1970, hospital morbidity was higher among males than females. From 1960 up to the 1990s, the highest rates of hospitalization and outpatient visits were registered among those under 4 and those over 60. The states with the highest asthma hospitalization rates were Morelos, Baja California Sur, Nuevo León, Durango, and Tamaulipas. It is concluded that asthma mortality in Mexico is showing a downward trend, while morbidity is increasing considerably, especially among adolescents.

  2. Occupational asthma caused by palladium

    Energy Technology Data Exchange (ETDEWEB)

    Daenen, M.; Rochette, F.; Demedts, M.; Nemery, B. [K.U. Leuven, Pneumology (Belgium); Rogiers, P. [A.Z. St-Lucas, Brugge (Belgium); Walle, C. Van de [Siemens, Oostkamp (Belgium)

    1999-01-01

    Occupational exposure to complex platinum salts is a well-known cause of occupational asthma. Although there is evidence that platinum refinery workers may also be sensitized to other precious metals, such as palladium or rhodium, no instances of occupational asthma due to an isolated sensitization to palladium have been reported. A case is reported of occupational rhinoconjunctivitis and asthma in a previously healthy worker exposed to the fumes of an electroplating bath containing palladium. There was no exposure to platinum. Sensitization to palladium was documented by skin-prick tests. The skin-prick test was positive with Pd(NH{sub 3}){sub 4}Cl{sub 2}, but not with (NH{sub 4}){sub 2}PdCl{sub 4}. Corresponding salts of platinum were all negative. A bronchial provocation test with Pd(NH{sub 34})Cl{sub 2} (0.0001 % for a total of 315 s, followed by 0.001 % for a total of 210 s) led to an early decrease in forced expiratory volume in one second (-35%). A similar exposure (0.001 % for a total of 16 min) in an unrelated asthmatic gave no reaction. This case shows that an isolated sensitization to palladium can occur and that respiratory exposure to palladium is a novel cause of metal-induced occupational asthma. (au) 24 refs.

  3. Allergic asthma and bronchial hyperreactivity

    NARCIS (Netherlands)

    Santing, Rudolf Eduard

    1993-01-01

    Asthma may effect 5-10% of the population in Western countries and is probably underdiagnosed (Mortagy et al., 1986). Despite improved possibilities for therapy and increased drug use morbidity and mortality are still increasing (Page, 1993). The social and financial burden of the disease is

  4. Asthma in Adults Fact Sheet

    Science.gov (United States)

    ... to the factors that may trigger asthma, including: respiratory infections and colds cigarette smoke allergic reactions to such allergens as pollen, ... Tumor Testing Treatment Palliative Care Clinical Trials Support System Summary '; var arrows3 = ... Effects Emotional Challenges Life Planning Summary '; if (window.location. ...

  5. Obesity and Asthma: Physiological Perspective

    Directory of Open Access Journals (Sweden)

    Bill Brashier

    2013-01-01

    Full Text Available Obesity induces some pertinent physiological changes which are conducive to either development of asthma or cause of poorly controlled asthma state. Obesity related mechanical stress forces induced by abdominal and thoracic fat generate stiffening of the lungs and diaphragmatic movements to result in reduction of resting lung volumes such as functional residual capacity (FRC. Reduced FRC is primarily an outcome of decreased expiratory reserve volume, which pushes the tidal breathing more towards smaller high resistance airways, and consequentially results in expiratory flow limitation during normal breathing in obesity. Reduced FRC also induces plastic alteration in the small collapsible airways, which may generate smooth muscle contraction resulting in increased small airway resistance, which, however, is not picked up by spirometric lung volumes. There is also a possibility that chronically reduced FRC may generate permanent adaptation in the very small airways; therefore, the airway calibres may not change despite weight reduction. Obesity may also induce bronchodilator reversibility and diurnal lung functional variability. Obesity is also associated with airway hyperresponsiveness; however, the mechanism of this is not clear. Thus, obesity has effects on lung function that can generate respiratory distress similar to asthma and may also exaggerate the effects of preexisting asthma.

  6. Premenstrual asthma and atopy markers.

    Science.gov (United States)

    Pereira-Vega, Antonio; Sánchez, José L; Maldonado, José A; Borrero, Fátima; Rico, Ignacio Vázquez; Vázquez, Rosa; Alvarez, Francisco; Ignacio, José M; Romero, Pedro; Gil, Francisco L

    2010-09-01

    The frequency of atopy in women with premenstrual asthma (PMA) and its possible effect on the premenstrual exacerbation of asthma are unknown. To analyze the relation between atopy markers (total IgE, Phadiatop, and specific IgE) and PMA. Asthmatic women of reproductive age completed a questionnaire about respiratory symptoms and recorded peak flow during an entire menstrual cycle to be classified as asthmatic patients with or without PMA. Their asthma severity was graded according to the 2005 Global Initiative for Asthma scale. PMA was defined as a clinical or functional exacerbation (>or=20%) in the premenstrual phase compared with the preovulatory phase. Blood tests for several atopy markers were conducted for: total IgE and screening for aeroallergens (Phadiatop) and specific IgE. Blood determinations were performed in 59 asthmatic women, of whom 31 (53%) had PMA. Twenty-six patients with PMA (84%) and 12 without PMA (43%) had total IgE values greater than 100 kU/L (P=.001). Twenty-one patients with PMA (68%) and 14 without PMA (50%) tested positive for Phadiatop (P=.17). Those who were positive for Phadiatop were also tested for specific IgE. No relation was found between specific IgE and PMA; values for ryegrass (63%), olive (60%), and Dermatophagoides pteronyssinus (54%) exceeded 0.35 kU/L. PMA seems to be closely linked to total IgE levels but not to specific allergens. The atopy affects the clinical manifestations of PMA in women of reproductive age. Copyright © 2010 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  7. Sleep duration, asthma and obesity.

    Science.gov (United States)

    Teodorescu, Mihaela; Polomis, David A; Gangnon, Ronald E; Consens, Flavia B; Chervin, Ronald D; Teodorescu, Mihai C

    2013-11-01

    Obesity is more prevalent in asthmatics. Sleep duration is a novel risk factor for obesity in general populations. We tested the association of sleep duration and asthma characteristics with obesity. Adults at tertiary clinics were surveyed on asthma symptoms and habitual sleep duration. Medical records were used to assess asthma severity step (1-4), extract height and weight, current medications and diagnosed comorbid conditions. BMI ≥30 kg/m(2) defined obesity. Habitual sleep was categorized as 8 to ≤9 h (long) and >9 h (very long). Inhaled corticosteroid doses were categorized as low, moderate and high. Among 611 participants (mean BMI 30 ± 8), 249 (41%) were obese. After adjustment for covariates, obesity was associated with short and very long sleep: as compared to normal sleepers, the odds of being obese were on an average 66% higher ([95% CI: 1.07-2.57], p = 0.02) among short and 124% higher ([1.08-1.65], p = 0.03) among very long sleepers, and the association with very short sleep approached significance (1.74 [0.96-3.14], p = 0.06). Obesity was also significantly related to highest asthma step (1.87 [1.09-3.21], p = 0.02) and psychopathology (1.64 [1.08-2.48], p = 0.02), and a trend was seen with high-dose inhaled corticosteroids (1.82 [0.93-3.56], p = 0.08). Obesity in asthmatics is associated with shorter and very long sleep duration, worse asthma severity, psychopathology and high-dose inhaled corticosteroids. Although this cross-sectional study cannot prove causality, we speculate that further investigation of sleep may provide new opportunities to reduce the rising prevalence of obesity among asthmatics.

  8. Asthma and Adolescents: Review of Strategies to Improve Control

    Science.gov (United States)

    Hennessy-Harstad, Ellen

    2013-01-01

    One of every 10 adolescents in the United States has asthma. Adolescents who lack asthma control are at increased risk for severe asthma episodes and death. The National Heart, Lung, and Blood Institute 2007 asthma guidelines and research studies indicated that school nurses are instrumental in assisting adolescents to monitor their asthma, learn…

  9. Children with problematic severe asthma: A biopsychosocial perspective

    NARCIS (Netherlands)

    Verkleij, M.

    2016-01-01

    This thesis focuses on problematic severe asthma in children and its treatment from a biopsychosocial perspective. Asthma is a chronic inflammatory disease of the airways. In children with problematic severe asthma, asthma is not under control despite optimal medical treatment. Asthma control is the

  10. Asthma control - Practical suggestions for practicing doctors in family ...

    African Journals Online (AJOL)

    ... the 'Goals of asthma management' as set out in the Global Initiative for Asthma (GINA) guidelines. Despite the availability of useful asthma therapies and treatment strategies, the morbidity from asthma has remained significant. This review includes practical suggestions on optimal asthma control for the family practitioner.

  11. Long-term control medication use and asthma control status among children and adults with asthma.

    Science.gov (United States)

    Zahran, Hatice S; Bailey, Cathy M; Qin, Xiaoting; Johnson, Carol

    2017-12-01

    Uncontrolled asthma decreases quality of life and increases health care use. Most people with asthma need daily use of long-term control (LTC) medications for asthma symptoms and to prevent asthma attacks. Ongoing assessment of a person's level of asthma control and medication use is important in determining the effectiveness of current treatment to decrease the frequency and intensity of symptoms and functional limitations. To assess the use of LTC medication among children and adults with current asthma and identify contributing factors for LTC medication use. We used the 2006-2010 Behavioral Risk Factor Surveillance System (BRFSS) child and adult Asthma Call-back Survey (ACBS) data to assess the level of asthma control and LTC medication use. Asthma control was classified as well controlled and uncontrolled using guideline-based measures. We used multivariable logistic regression models to identify contributing factors for LTC medication use and having uncontrolled asthma. Among persons with current asthma, 46.0% of children and 41.5% of adults were taking LTC medications and 38.4% of children and 50.0% of adults had uncontrolled asthma. Among children who had uncontrolled asthma (38.4%), 24.1% were taking LTC medications and 14.3% were not taking LTC medications. Among adults who had uncontrolled asthma (50.0%), 26.7% were taking LTC medications and 23.3% were not taking LTC medications. Using BRFSS ACBS data to assess the level of asthma control and LTC medication use can identify subpopulations of persons with asthma who receive suboptimal treatment, for which better asthma-related medical treatment and management are needed.

  12. Asthma and obesity: does weight loss improve asthma control? a systematic review

    Directory of Open Access Journals (Sweden)

    Juel CTB

    2012-06-01

    Full Text Available Caroline Trunk-Black Juel,1 Zarqa Ali,1 Lisbeth Nilas,2 Charlotte Suppli Ulrik11Respiratory Section, Internal Medicine Unit, 2Department of Obstetrics and Gynaecology, Hvidovre Hospital and University of Copenhagen, Hvidovre, DenmarkAim and methods: Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma.Results: Weight loss in obese individuals with doctor-diagnosed asthma is associated with a 48%–100% remission of asthma symptoms and use of asthma medication. Published studies, furthermore, reveal that weight loss in obese asthmatics improves asthma control, and that especially surgically induced weight loss results in significant improvements in asthma severity, use of asthma medication, dyspnoea, exercise tolerance, and acute exacerbations, including hospitalizations due to asthma. Furthermore, weight loss in obese asthmatics is associated with improvements in level of lung function and airway responsiveness to inhaled methacholine, whereas no significant improvements have been observed in exhaled nitric oxide or other markers of eosinophilic airway inflammation.Conclusion: Overweight and obese adults with asthma experience a high symptomatic remission rate and significant improvements in asthma control, including objective measures of disease activity, after weight loss. Although these positive effects of weight loss on asthma-related health outcomes seem not to be accompanied by remission or improvements in markers of eosinophilic airway inflammation, it has potentially important implications for the future burden of asthma.Keywords: asthma, weight loss, diet, bariatric surgery, asthma control

  13. Asthma in Hispanics. An 8-Year Update

    Science.gov (United States)

    Rosser, Franziska J.; Forno, Erick; Cooper, Philip J.

    2014-01-01

    This review provides an update on asthma in Hispanics, a diverse group tracing their ancestry to countries previously under Spanish rule. A marked variability in the prevalence and morbidity from asthma remains among Hispanic subgroups in the United States and Hispanic America. In the United States, Puerto Ricans and Mexican Americans have high and low burdens of asthma, respectively (the “Hispanic Paradox”). This wide divergence in asthma morbidity among Hispanic subgroups is multifactorial, likely reflecting the effects of known (secondhand tobacco smoke, air pollution, psychosocial stress, obesity, inadequate treatment) and potential (genetic variants, urbanization, vitamin D insufficiency, and eradication of parasitic infections) risk factors. Barriers to adequate asthma management in Hispanics include economic and educational disadvantages, lack of health insurance, and no access to or poor adherence with controller medications such as inhaled corticosteroids. Although considerable progress has been made in our understanding of asthma in Hispanic subgroups, many questions remain. Studies of asthma in Hispanic America should focus on environmental or lifestyle factors that are more relevant to asthma in this region (e.g., urbanization, air pollution, parasitism, and stress). In the United States, research studies should focus on risk factors that are known to or may diverge among Hispanic subgroups, including but not limited to epigenetic variation, prematurity, vitamin D level, diet, and stress. Clinical trials of culturally appropriate interventions that address multiple aspects of asthma management in Hispanic subgroups should be prioritized for funding. Ensuring high-quality healthcare for all remains a pillar of eliminating asthma disparities. PMID:24881937

  14. Mitochondrial Dysfunction in Metabolic Syndrome and Asthma

    Directory of Open Access Journals (Sweden)

    Ulaganathan Mabalirajan

    2013-01-01

    Full Text Available Though severe or refractory asthma merely affects less than 10% of asthma population, it consumes significant health resources and contributes significant morbidity and mortality. Severe asthma does not fell in the routine definition of asthma and requires alternative treatment strategies. It has been observed that asthma severity increases with higher body mass index. The obese-asthmatics, in general, have the features of metabolic syndrome and are progressively causing a significant burden for both developed and developing countries thanks to the westernization of the world. As most of the features of metabolic syndrome seem to be originated from central obesity, the underlying mechanisms for metabolic syndrome could help us to understand the pathobiology of obese-asthma condition. While mitochondrial dysfunction is the common factor for most of the risk factors of metabolic syndrome, such as central obesity, dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, the involvement of mitochondria in obese-asthma pathogenesis seems to be important as mitochondrial dysfunction has recently been shown to be involved in airway epithelial injury and asthma pathogenesis. This review discusses current understanding of the overlapping features between metabolic syndrome and asthma in relation to mitochondrial structural and functional alterations with an aim to uncover mechanisms for obese-asthma.

  15. The impact of food allergy on asthma

    Directory of Open Access Journals (Sweden)

    Anupama Kewalramani

    2010-07-01

    Full Text Available Anupama Kewalramani, Mary E BollingerDepartment of Pediatrics, Division of Pediatric Allergy/Pulmonology, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Food allergy is a potentially severe immune response to a food or food additive. Although a majority of children will outgrow their food allergies, some may have lifelong issues. Food allergies and other atopic conditions, such as asthma, are increasing in prevalence in Western countries. As such, it is not uncommon to note the co-existence of food allergy and asthma in the same patient. As part of the atopic march, many food allergic patients may develop asthma later in life. Each can adversely affect the other. Food allergic patients with asthma have a higher risk of developing life-threatening food-induced reactions. Although food allergy is not typically an etiology of asthma, an asthmatic patient with food allergy may have higher rates of morbidity and mortality associated with the asthma. Asthma is rarely a manifestation of food allergy alone, but the symptoms can be seen with allergic reactions to foods. There may be evidence to suggest that early childhood environmental factors, such as the mother’s and child’s diets, factor in the development of asthma; however, the evidence continues to be conflicting. All food allergic patients and their families should be counseled on the management of food allergy and the risk of developing co-morbid asthma.Keywords: food allergy, diagnosis, treatment, asthma

  16. Rural school nurses' asthma education needs.

    Science.gov (United States)

    Huss, K; Winkelstein, M; Calabrese, B; Nanda, J; Quartey, R; Butz, A; Resto, M; Huss, R; Rand, C S

    2001-05-01

    School nurses play an important role in identifying children with asthma and providing care during school hours. Educational programs designed to improve nurses' asthma knowledge and practices have concentrated on urban settings. The purpose of this investigation was to determine asthma-related practices and educational needs of rural school nurses. A survey about asthma was mailed to school nurses in all counties of the state of Maryland and in Washington, D.C. Responses were compared between rural Maryland counties and counties from the remainder of Maryland and Washington, D.C. The survey addressed attitudes and beliefs, function and roles, medication administration, and educational needs about asthma. We found that rural nurses used peak flow meters less often to assess and monitor asthma, requested fewer referrals for asthma, had fewer interactions with health room assistants, and had reduced access to asthma educational resources. Also, they provided less asthma education in the schools than other school nurses. These results suggest a need for comprehensive asthma educational programs in rural areas that are based on national guidelines, and that address the unique needs of rural school nurses. These programs should also emphasize the need for open communication between rural school nurses, health room assistants, primary care providers, and parents/caregivers.

  17. Recent developments regarding periostin in bronchial asthma.

    Science.gov (United States)

    Izuhara, Kenji; Matsumoto, Hisako; Ohta, Shoichiro; Ono, Junya; Arima, Kazuhiko; Ogawa, Masahiro

    2015-09-01

    Although it is currently recognized that bronchial asthma is not a single disease but a syndrome, we have not yet made use of our new understanding of this heterogeneity as we treat asthma patients. To increase the efficacy of anti-asthma drugs and to decrease costs, it is important to stratify asthma patients into subgroups and to develop therapeutic strategies for each subgroup. Periostin has recently emerged as a biomarker for bronchial asthma, unique in that it is useful not in diagnosis but in categorizing asthma patients. We first found that periostin is a novel component of subepithelial fibrosis in bronchial asthma downstream of IL-13 signals. Thereafter, it was shown that periostin can be a surrogate biomarker of type 2 immune responses, the basis of the notion that a detection system of serum periostin is potentially a companion diagnostic for type 2 antagonists. Furthermore, we have recently shown that serum periostin can predict resistance or hyporesponsiveness to inhaled corticosteroids, based on its contribution to tissue remodeling or fibrosis in bronchial asthma. Thus, serum periostin has two characteristics as a biomarker for bronchial asthma: it is both a surrogate biomarker of type 2 immune responses and a biomarker reflecting tissue remodeling or fibrosis. We can take advantage of these characteristics to develop stratified medicine in bronchial asthma. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  18. Japanese guidelines for adult asthma 2017

    Directory of Open Access Journals (Sweden)

    Masakazu Ichinose

    2017-04-01

    Full Text Available Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015. The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms. A good relationship between physicians and patients is indispensable for appropriate treatment. Long-term management by therapeutic agents and elimination of the causes and risk factors of asthma are fundamental to its treatment. Four steps in pharmacotherapy differentiate between mild and intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid, varying from low to high levels. Long-acting β2-agonists, leukotriene receptor antagonists, sustained-release theophylline, and long-acting muscarinic antagonist are recommended as add-on drugs, while anti-immunoglobulin E antibody and oral steroids are considered for the most severe and persistent asthma related to allergic reactions. Bronchial thermoplasty has recently been developed for severe, persistent asthma, but its long-term efficacy is not known. Inhaled β2-agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, and other approaches are used as needed during acute exacerbations, by choosing treatment steps for asthma in accordance with the severity of exacerbations. Allergic rhinitis, eosinophilic chronic rhinosinusitis, eosinophilic otitis, chronic obstructive pulmonary disease, aspirin-induced asthma, and pregnancy are also important issues that need to be considered in asthma therapy.

  19. 2003 Canadian Asthma Consensus Guidelines Executive Summary

    Directory of Open Access Journals (Sweden)

    Becker Allan

    2006-03-01

    Full Text Available Abstract Background Guidelines for the diagnosis and management of asthma have been published over the last 15 years; however, there has been little focus on issues relating to asthma in childhood. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies, particularly in children, have highlighted the need to incorporate new information into the asthma guidelines. The objectives of this article are to review the literature on asthma published between January 2000 and June 2003 and to evaluate the influence of new evidence on the recommendations made in the 1999 Canadian Asthma Consensus Report and its 2001 update, with a major focus on pediatric issues. Methods The diagnosis of asthma in young children and prevention strategies, pharmacotherapy, inhalation devices, immunotherapy, and asthma education were selected for review by small expert resource groups. The reviews were discussed in June 2003 at a meeting under the auspices of the Canadian Network For Asthma Care and the Canadian Thoracic Society. Data published through December 2004 were subsequently reviewed by the individual expert resource groups. Results This report evaluates early-life prevention strategies and focuses on treatment of asthma in children, emphasizing the importance of early diagnosis and preventive therapy, the benefits of additional therapy, and the essential role of asthma education. Conclusion We generally support previous recommendations and focus on new issues, particularly those relevant to children and their families. This document is a guide for asthma management based on the best available published data and the opinion of health care professionals, including asthma experts and educators.

  20. Asthma in elite athletes: how do we manage asthma-like symptoms and asthma in elite athletes?

    DEFF Research Database (Denmark)

    Lund, Thomas Kromann

    2009-01-01

    INTRODUCTION: Asthma is frequent in elite athletes and the high prevalence of asthma might be associated with specific types of sport. It has been suggested that chronic endurance training might increase the number of neutrophils in the airways, and this may reflect airway injury. The use of anti......-asthmatic medication in elite athletes is also currently under scrutiny in order to reduce the risk of under-treatment or over treatment. OBJECTIVES: Determine the use of anti-asthmatic medication and the prevalence of asthma-like symptoms and asthma in Danish elite athletes. Further, to determine whether elite...... athletes with asthma-like symptoms have asthma and investigate the airway inflammation and airway reactivity to mannitol. MATERIALS AND METHODS: Three cross-sectional studies: (i) Applications for Abbreviated Therapeutic Use Exemption (ATUE) certificates in 2005 were studied (N = 694); (ii) a questionnaire...

  1. Asthma Endotypes and an Overview of Targeted Therapy for Asthma

    Directory of Open Access Journals (Sweden)

    Sarah Svenningsen

    2017-09-01

    Full Text Available Guidelines for the management of severe asthma do not emphasize the measurement of the inflammatory component of airway disease to indicate appropriate treatments or to monitor response to treatment. Inflammation is a central component of asthma and contributes to symptoms, physiological, and structural abnormalities. It can be assessed by a number of endotyping strategies based on “omics” technology such as proteomics, transcriptomics, and metabolomics. It can also be assessed using simple cellular responses by quantitative cytometry in sputum. Bronchitis may be eosinophilic, neutrophilic, mixed-granulocytic, or paucigranulocytic (eosinophils and neutrophils not elevated. Eosinophilic bronchitis is usually a Type 2 (T2-driven process and therefore a sputum eosinophilia of greater than 3% usually indicates a response to treatment with corticosteroids or novel therapies directed against T2 cytokines such as IL-4, IL-5, and IL-13. Neutrophilic bronchitis represents a non-T2-driven disease, which is generally a predictor of response to antibiotics and may be a predictor to therapies targeted at pathways that lead to neutrophil recruitment such as TNF, IL-1, IL-6, IL-8, IL-23, and IL-17. Paucigranulocytic disease may not warrant anti-inflammatory therapy. These patients, whose symptoms may be driven largely by airway hyper-responsiveness may benefit from smooth muscle-directed therapies such as bronchial thermoplasty or mast-cell directed therapies. This review will briefly summarize the current knowledge regarding “omics-based signatures” and cellular endotyping of severe asthma and give an overview of segmentation of asthma therapeutics guided by the endotype.

  2. Are asthma-like symptoms in elite athletes associated with classical features of asthma?

    DEFF Research Database (Denmark)

    Lund, T.K.; Pedersen, L.; Anderson, S.D.

    2009-01-01

    Background: Asthma is frequent in elite athletes and clinical studies in athletes have found increased airway inflammation. Objective: To investigate asthma-like symptoms, airway inflammation, airway reactivity (AR) to mannitol and use of asthma medication in Danish elite athletes. Methods......: The study group consisted of 54 elite athletes (19 with doctor-diagnosed asthma), 22 non-athletes with doctor-diagnosed asthma (steroid naive for 4 weeks before the examination) and 35 non-athletes without asthma; all aged 18-35 years. Examinations (1 day): questionnaires, exhaled nitric oxide (e......-diagnosed asthma had less AR (response dose ratio 0.02 (0.004) vs 0.08 (0.018) pathletes with doctor-diagnosed asthma. Use of inhaled corticosteroids was similar in the two groups (not significant). In all, 42 elite athletes had...

  3. Efffect of Aeroallergen Sensitization on Asthma Control in African-American Teens with Persistent Asthma

    Science.gov (United States)

    In African-American adolescents with persistent asthma, allergic profile predicted the likelihood of having poorly controlled asthma despite guidelines-directed therapies. Our results suggest that tree and weed pollen sensitization are independent risk factors for poorly controll...

  4. Perceived Stress, Severity of Asthma, and Quality of Life in Young Adults with Asthma

    Directory of Open Access Journals (Sweden)

    Tomoaki Kimura

    2009-01-01

    Conclusions: A major variable related to the disease-specific quality of life was perceived stress, followed by the severity of asthma. Stress management of patients with asthma may improve their quality of life.

  5. Effect of asthma severity on symptom perception in childhood asthma

    Directory of Open Access Journals (Sweden)

    A.L.B. Cabral

    2002-03-01

    Full Text Available Individual ability to perceive airway obstruction varies substantially. The factors influencing the perception of asthma are probably numerous and not well established in children. The present study was designed to examine the influence of asthma severity, use of preventive medication, age and gender on the association between respiratory symptoms (RS and peak expiratory flow (PEF rates in asthmatic children. We followed 92 asthmatic children, aged 6 to 16 years, for five months. Symptom scores were recorded daily and PEF was measured twice a day. The correlations among variables at the within-person level over time were analyzed for each child and for the pooled data by multivariate analysis. After pooling the data, there was a significant (P<0.05 correlation between each symptom and PEF; 60% of the children were accurate perceivers (defined by a statistically significant correlation between symptoms and PEF across time for diurnal symptoms and 37% for nocturnal symptoms. The accuracy of perception was independent of asthma severity, age, gender or the use of preventive medication. Symptom perception is inaccurate in a substantial number of asthmatic children, independently of clinical severity, age, gender or use of preventive medication. It is not clear why some asthmatic patients are capable of accurately perceiving the severity of airway obstruction while others are not.

  6. [Updating the concept of asthma. Is asthma a syndrome?].

    Science.gov (United States)

    Muñoz-López, Francisco

    2015-01-01

    Several symptoms are common to different processes that affect the respiratory system and their precise assessment is key to a correct diagnosis. Amongst those symptoms, mostly dyspnoea oriented toward the possible diagnosis of asthma. Nevertheless, the concept of asthma has changed in recent times, as inflammation of the bronchial tree is valued as the pathogenic base of the process, although it can not be ignored that the bronchial hyperresponsiveness is still the basis of dyspnoea crisis. In the last years, several variants have been established, being defined as phenotypes and endotypes that can identify diverse asthmatic or pseudo-asthmatic processes, and there for it is questioned if asthma is not the only process, but a syndrome. In any case, it cannot be ignored that dyspnoea episodes can be based on bronchial hyperresponsiveness of genetic origin or due to inflammation because of unfavourable environmental conditions, as well as physical exercise or the ingestión of aspirin, processes in which other mechanisms are involved.

  7. Asthma Yardstick: Practical recommendations for a sustained step-up in asthma therapy for poorly controlled asthma.

    Science.gov (United States)

    Chipps, Bradley E; Corren, Jonathan; Israel, Elliot; Katial, Rohit; Lang, David M; Panettieri, Reynold A; Peters, Stephen P; Farrar, Judith R

    2017-02-01

    Current asthma guidelines recommend a control-based approach to management that involves assessment of impairment and risk followed by implementation of treatment strategies individualized according to the patient's needs and preferences. The fact that many patients still experience severe symptoms that negatively affect quality of life suggests that asthma control remains an objective to be achieved. Tools are available to help patients (and families) manage the day-to-day and short-term variability in asthma symptoms; however, when and how to implement a sustained step-up in therapy is less clear. The Asthma Yardstick is a comprehensive update on how to conduct a sustained step-up in asthma therapy for the patient with not well-controlled or poorly controlled asthma. Patient profiles and step-up strategies are based on current guidelines, newer data, and the authors' combined clinical experience and are intended to provide a practical and clinically meaningful guide toward the goal of well-controlled asthma for every patient. The development of this tool comes in response to the continued need to proactively address the sustained loss of asthma control at all levels of severity. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Indicators of asthma control among students in a rural, school-based asthma management program.

    Science.gov (United States)

    Rasberry, Catherine N; Cheung, Karen; Buckley, Rebekah; Dunville, Richard; Daniels, Brandy; Cook, Deborah; Robin, Leah; Dean, Blair

    2014-10-01

    The evaluation sought to determine if a comprehensive, school-based asthma management program in a small, rural school district helped students improve asthma control. To determine if students in the asthma program demonstrated better asthma control than students in a comparison school district, the evaluation team used a quasi-experimental, cross-sectional design and administered questionnaires assessing asthma control (which included FEV1 measurement) to 456 students with asthma in the intervention and comparison districts. Data were analyzed for differences in asthma control between students in the two districts. To determine if students in the intervention experienced increased asthma control between baseline and follow-up, the evaluation team used a one-group retrospective design. Program records for 323 students were analyzed for differences in percent of predicted forced expiratory volume in one second (FEV1) between baseline and follow-up. Students with asthma in the intervention district exhibited significantly better asthma control than students with asthma in the comparison district. Percent of predicted FEV1 did not change significantly between baseline and follow-up for the intervention participants; however, post hoc analyses revealed students with poorly controlled asthma at baseline had significantly higher FEV1 scores at follow-up, and students with well-controlled asthma at baseline had significantly lower FEV1 scores at follow-up. Findings suggest that the comprehensive school-based program led to improvements in asthma control for students with poorly controlled asthma at baseline, and school-based programs need mechanisms for tracking students with initially well-controlled asthma to ensure they maintain control.

  9. Better Asthma Management with Advanced Technology: Creation of an Asthma Utilization Rx Analyzer (AURA) Tool.

    Science.gov (United States)

    Jackson, James H; Gutierrez, Benjamin; Lunacsek, Orsolya E; Ramachandran, Sulabha

    2009-02-01

    With nearly 23 million people affected by asthma each year, optimizing care among patients with persistent disease is a constant challenge for health care providers. The Asthma Utilization Rx Analyzer (AURA) tool enables health plan managers to evaluate quality and resource utilization for its members with asthma by analyzing medical and pharmacy claims. Customizable quality measures allow users of the tool to generate results from specific plans in order to optimize asthma disease management.

  10. 534 Clinical Characteristics of Eosinophilic Asthma Compared to Noneosinophilic Asthma in Children

    OpenAIRE

    Lee, Yong Ju; Kim, Kyung Won; Choi, Bong Seok; Sohn, Myung Hyun; Kim, Kyu-Earn

    2012-01-01

    Background Asthma is a heterogeneous and complex chronic inflammatory disease of the airways. Asthma can be classified as eosinophilic asthma (EA) or noneosinophilic asthma (NEA). We investigated whether children with EA and NEA manifest different clinical characteristics. Methods A total of 158 children with EA and 89 children with NEA were enrolled in this study. We performed pulmonary function and methacholine challenge tests, and measured blood eosinophil count, total serum immunoglobulin...

  11. Lungtropolis: Where Kids with Asthma Learn to Play

    Science.gov (United States)

    ... Asthma > Finding Support Lungtropolis: Where Kids with Asthma Learn to Play The American Lung Association and ORCAS, Inc. bring you Lungtropolis®: Where Kids with Asthma Learn to Play. This is an interactive website designed ...

  12. Spirometry for Asthma - When You Need It and Why

    Science.gov (United States)

    ... Patient Resources Adult , Geriatric , Pediatric Spirometry for Asthma Spirometry for Asthma When you need the test—and ... from the treatment for pneumonia or heart disease. Spirometry helps diagnose and manage asthma. A spirometry test ...

  13. If My Child Has Asthma, Can We Keep Our Pet?

    Science.gov (United States)

    ... Allergies Allergy Shots Managing Asthma Dealing With Triggers: Mold Dealing With Triggers: Pollen Dealing With Triggers: Irritants Dealing With Triggers: Cockroaches Your House: How to Make It Asthma-Safe Asthma Center ...

  14. Treating Asthma in Children Ages 5 to 11

    Science.gov (United States)

    ... triggers such as cigarette smoke or seasonal allergies. Asthma emergencies Severe asthma attacks can be life-threatening ... devices. Immunotherapy or injectable medication for allergy-induced asthma Allergy-desensitization shots (immunotherapy) may help if your ...

  15. Asthma and Schools | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Breathing Easier Asthma and Schools Past Issues / Fall 2013 Table of ... of America 800–727–8462 www.aafa.org Asthma and Physical Activity Exercise-induced asthma is triggered ...

  16. Imaging diagnosis of bronchial asthma and related diseases

    Energy Technology Data Exchange (ETDEWEB)

    Sakai, Fumikazu; Fujimura, Mikihiko; Kimura, Fumiko; Fujimura, Kaori; Hayano, Toshio; Nishii, Noriko; Machida, Haruhiko; Toda, Jo; Saito, Naoko [Tokyo Women' s Medical Coll. (Japan)

    2002-12-01

    We describe imaging features of bronchial asthma and related diseases. The practical roles of imaging diagnosis are the evaluation of severity and complications of bronchial asthma and differential diagnosis of diseases showing asthmatic symptoms other than bronchial asthma. (author)

  17. Characteristics of phenotypes of elderly patients with asthma

    Directory of Open Access Journals (Sweden)

    Hiroyuki Sano

    2016-04-01

    Conclusions: Half of elderly patients with asthma are characterized by asthma-emphysema overlap. Our results showed that elderly patients with asthma who are smokers and have moderate or severe OAD are also likely to have emphysema.

  18. Asthma, GERD and Obesity: Triangle of Inflammation.

    Science.gov (United States)

    Gupta, Samriti; Lodha, Rakesh; Kabra, S K

    2017-11-11

    There is increasing prevalence of both asthma and obesity in children globally in recent years. Various epidemiological studies link obesity as a risk factor for asthma and suggest a possible causal association. Obesity asthma phenotype is considered as distinct in view of greater severity and poor asthma control. Various mechanisms underlying this phenotype have been suggested including mechanical effects of obesity and systemic inflammation, but still the exact mechanism is unclear. Also, the comorbidities like gastroesophageal reflux disease (GERD) and sleep disordered breathing (SDB) lead to inflammation in airways and contribute to asthma obesity association. A better understanding of mechanisms by which obesity and GERD lead to inflammation in airways and increase the risk of asthma may provide insight towards targeted treatment approach of these patients.

  19. Asthma and oral health: a review.

    Science.gov (United States)

    Thomas, M S; Parolia, A; Kundabala, M; Vikram, M

    2010-06-01

    Asthma is a chronic inflammatory condition that causes the airways to constrict and produce excess mucus, making breathing difficult. It is characterized by the obstruction of airflow which is variable over a short period of time. This condition is reversible, either spontaneously or can be controlled with the help of drugs. Asthma medication comprises bronchodilators, corticosteroids and anticholinergic drugs. Most of these drugs are inhaled using various forms of inhalers or nebulizers. The effect of these drugs on oral health is the subject of debate among dental practitioners. Patients taking asthma medication may be at risk of dental caries, dental erosion, periodontal diseases and oral candidiasis. Hence, patients with bronchial asthma on medication should receive special prophylactic attention. This article reviews the correlation between asthma and oral health, and suggests various measures to counter possible oral health problems related to asthma.

  20. The Danish National Register for Asthma

    DEFF Research Database (Denmark)

    Backer, Vibeke; Lykkegaard, Jesper; Bodtger, Uffe

    2016-01-01

    year, the inclusion criteria are a second purchase of asthma prescription medicine within a 2-year period (National Prescription Registry) or a diagnosis of asthma (National Patient Register). Patients with chronic obstructive pulmonary disease are excluded, but smokers are not excluded. DESCRIPTIVE......AIM OF THE DATABASE: Asthma is the most prevalent chronic disease in children, adolescents, and young adults. In Denmark (with a population of 5.6 million citizens), >400,000 persons are prescribed antiasthmatic medication annually. However, undiagnosed cases, dubious diagnoses, and poor asthma...... DATA: A total of 366,471 prevalent patients with asthma have been identified (year 2014 - as a preliminary test search). This number is in agreement with the estimates of ~400,000 inhabitants that are available for patients with possible asthma in Denmark. Data encompass the following quality...

  1. [The asthma-COPD overlap syndrome].

    Science.gov (United States)

    Garelli, V; Petitpierre, N; Nicod, L P

    2015-11-18

    Asthma and COPD are often considered mutually exclusive diseases, mainly because of the inclusion of only typical cases of asthma or COPD in therapeutic clinical trials. However, clinicians are unable to distinguish between both conditions in a substantial number of patients, a situation that may be called the "asthma-COPD overlap syndrome". It is important to recognize this entity, as patients suffering from an asthma-COPD overlap syndrome are more symptomatic, have a poorer quality of life and suffer more exacerbations than patients with asthma or COPD alone. In the absence of studies specifically designed to assess the treatment modalities for these patients, it appears wise to prescribe inhaled corticosteroids early in the course of the disease, considering their established efficacy in asthma.

  2. Phenotype-Driven Therapeutics in Severe Asthma.

    Science.gov (United States)

    Opina, Maria Theresa D; Moore, Wendy C

    2017-02-01

    Inhaled corticosteroids are the mainstay of asthma treatment using a step-up approach with incremental dosing and additional controller medications in order to achieve symptom control and prevent exacerbations. While most patients respond well to this treatment approach, some patients remain refractory despite high doses of inhaled corticosteroids and a long-acting β-agonist. The problem lies in the heterogeneity of severe asthma, which is further supported by the emergence of severe asthma phenotypes. This heterogeneity contributes to the variability in treatment response. Randomized controlled trials involving add-on therapies in poorly controlled asthma have challenged the idea of a "one size fits all" approach targeting specific phenotypes in their subject selection. This review discusses severe asthma phenotypes from unbiased clustering approaches and the most recent scientific evidence on novel treatments to provide a guide in personalizing severe asthma treatment.

  3. Importance of mold allergy in asthma.

    Science.gov (United States)

    Portnoy, Jay M; Barnes, Charles S; Kennedy, Kevin

    2008-03-01

    Fungal exposure is hypothesized (controversially) to contribute to asthma development and to trigger symptoms in patients with asthma. The ubiquity of environmental fungal exposure makes a careful review of evidence essential. Evidence that exposure to high concentrations of fungal spores, antigens, or metabolites is associated with asthma development is limited. However, because mechanisms of asthma genesis are poorly understood, so too are the mechanisms of this potential association. This association is not proof of causality. Stronger evidence supports the hypothesis that fungal exposure triggers symptoms in asthmatic individuals. Proposed mechanisms have been tested and correlations between exposure and symptoms demonstrated. Though some correlations remain speculative, controlled studies could test such hypotheses. Because asthma is common and fungal exposure is ubiquitous, it is surprising that asthmatics don't have more symptoms when exposed to fungi. Fortunately, symptoms are dose dependent, creating an opportunity to develop clinically effective interventions. Given the right guidance, even patients with severe asthma can create healthy indoor environments.

  4. [Anesthetic management in bronchial asthma].

    Science.gov (United States)

    Kozian, Alf; Schilling, Thomas; Hachenberg, Thomas

    2016-06-01

    In daily practice, acute and chronic pulmonary diseases are common issues presenting to the anesthetist. Respiratory physiology in general is affected by both general and regional anesthesia, which results in an increased number of perioperative complications in pulmonary risk patients. Therefore, anesthetic management of patients with bronchial asthma needs to address different clinical topics: the physical appearance of pulmonary disease, type and extent of surgical intervention as well as effects of therapeutic drugs, anesthetics and mechanical ventilation on respiratory function. The present work describes important precautions in preoperative scheduling of the asthmatic patient. In the operative course, airway manipulation and a number of anesthetics are able to trigger intraoperative bronchial spasm with possibly fatal outcome. It is essential to avoid these substances to prevent asthma attack. If asthmatic status occurs, appropriate procedures according to therapeutic standards have to be applied to the patient. Postoperatively, sufficient pain therapy avoids pulmonary complications and improves outcome. © Georg Thieme Verlag Stuttgart · New York.

  5. Physiotherapy in patients with bronchial asthma

    OpenAIRE

    Pichová, Jiřina

    2014-01-01

    Author: Jiřina Pichová Institution: Department of rehabilitation medicine of teaching hospital in Hradec Králové Topic of the thesis: Physiotherapy in patients with bronchial asthma Supervisor: Mgr. Zuzana Hamarová Number of pages: 69 Year of defences: 2014 Keywords: bronchial asthma, respiratory physiotherapy, risk factors Topic of this bachelor thesis is Physiotherapy of patients with bronchial asthma and it is divided into theoretical and practical part. The theoretical part deals with dan...

  6. Creating an Asthma-Friendly School

    Centers for Disease Control (CDC) Podcasts

    2007-11-08

    This podcast features real-life success stories of students with asthma who, thanks to their schools' implementation of asthma-friendly policies and programs, now have their asthma under control.  Created: 11/8/2007 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (DASH).   Date Released: 5/20/2008.

  7. The Future of Asthma Research and Development

    DEFF Research Database (Denmark)

    Masefield, Sarah; Edwards, Jessica; Hansen, Kjeld S.

    2017-01-01

    questions addressed, asthma outcomes would be transformed and avoidable use of healthcare systems eradicated, resulting in significant financial savings. The realisation of this vision through coordinated efforts at a European level is the only way to achieve the change needed to reduce asthma deaths...... and hospitalisations and improve productivity and quality of life for people with asthma. Integral to this is maintaining and growing the networks established through EARIP professional societies, patient organisations and EU-funded programmes....

  8. Bronchial Smooth Muscle Remodeling in Nonsevere Asthma.

    Science.gov (United States)

    Girodet, Pierre-Olivier; Allard, Benoit; Thumerel, Matthieu; Begueret, Hugues; Dupin, Isabelle; Ousova, Olga; Lassalle, Régis; Maurat, Elise; Ozier, Annaig; Trian, Thomas; Marthan, Roger; Berger, Patrick

    2016-03-15

    Increased bronchial smooth muscle (BSM) mass is a key feature of airway remodeling that classically distinguishes severe from nonsevere asthma. Proliferation of BSM cells involves a specific mitochondria-dependent pathway in individuals with severe asthma. However, BSM remodeling and mitochondrial biogenesis have not been examined in nonsevere asthma. We aimed to assess whether an increase in BSM mass was also implicated in nonsevere asthma and its relationship with mitochondria and clinical outcomes. We enrolled 34 never-smoker subjects with nonsevere asthma. In addition, we recruited 56 subjects with nonsevere asthma and 19 subjects with severe asthma as comparative groups (COBRA cohort [Cohorte Obstruction Bronchique et Asthme; Bronchial Obstruction and Asthma Cohort; sponsored by the French National Institute of Health and Medical Research, INSERM]). A phenotypic characterization was performed using questionnaires, atopy and pulmonary function testing, exhaled nitric oxide measurement, and blood collection. Bronchial biopsy specimens were processed for immunohistochemistry and electron microscopy analysis. After BSM remodeling assessment, subjects were monitored over a 12-month period. We identified characteristic features of remodeling (BSM area >26.6%) and increased mitochondrial number within BSM in a subgroup of subjects with nonsevere asthma. The number of BSM mitochondria was positively correlated with BSM area (r = 0.78; P asthma with high BSM had worse asthma control and a higher rate of exacerbations per year compared with subjects with low BSM. This study reveals that BSM remodeling and mitochondrial biogenesis may play a critical role in the natural history of nonsevere asthma (Mitasthme study). Clinical trial registered with www.clinicaltrials.gov (NCT00808730).

  9. Challenges of Asthma Management for School Nurses in Districts with High Asthma Hospitalization Rates

    Science.gov (United States)

    Liberatos, Penny; Leone, Jennifer; Craig, Ann Marie; Frei, Elizabeth Mary; Fuentes, Natalie; Harris, India Marie

    2013-01-01

    Background: School nurses play a central role in assisting elementary school children in managing their asthma, especially those in higher-risk school districts that are at increased risk of uncontrolled asthma. Study purposes are to (1) identify barriers to asthma management by school nurses in higher-risk school districts; and (2) assess the…

  10. Overlap of obstructive sleep apnea and bronchial asthma: Effect on asthma control

    Directory of Open Access Journals (Sweden)

    Mohamed Zidan

    2015-04-01

    Conclusion: A high index of suspicion is warranted for the overlap of OSA and asthma, particularly in the presence of obesity, GERD, and in patients with severe asthma. Individualized therapy addressing these moderating factors is warranted for optimal health outcomes. Recognition and treatment of OSA in asthmatics is an important element in improving asthma control.

  11. Scheduled asthma management in general practice generally improve asthma control in those who attend

    DEFF Research Database (Denmark)

    Backer, Vibeke; Bornemann, Maja; Knudsen, Anja Dorte Brandt

    2012-01-01

    Successful asthma management involves guideline-based treatment and regular follow-up. We aimed to study the level of disease control in asthmatic individuals managed by their GP and a dedicated nurse when using a systematic asthma consultation guide based on Global Initiative of Asthma guidelines...

  12. Monitoring childhood asthma: Web-based diaries and the asthma control test

    NARCIS (Netherlands)

    Voorend-van Bergen, S.; Vaessen-Verberne, A.A.; Landstra, A.M.; Brackel, H.J.; Berg, N.J. van den; Caudri, D.; Jongste, J.C. de; Merkus, P.J.F.M.; Pijnenburg, M.W.

    2014-01-01

    BACKGROUND: Data from asthma diaries are frequently used as an end point in asthma studies; however, data on the validity of Web-based diaries are scarce. OBJECTIVES: First, we examined the validity of a Web-based diary in assessing asthma control. Second, we determined the cutoff points for

  13. Causes of death in patients with asthma and asthma-chronic obstructive pulmonary disease overlap syndrome.

    Science.gov (United States)

    Harada, Tomoya; Yamasaki, Akira; Fukushima, Takehito; Hashimoto, Kiyoshi; Takata, Miki; Kodani, Masahiro; Okazaki, Ryota; Takeda, Kenichi; Watanabe, Masanari; Kurai, Jun; Shimizu, Eiji

    2015-01-01

    The administration of inhaled corticosteroids and worldwide usage of several asthma guidelines have improved asthma mortality. Elderly patients with asthma show high mortality rates, and may have several comorbidities, including overlap with chronic obstructive pulmonary disease (COPD). Among patients showing asthma overlapped with COPD (asthma-COPD overlap syndrome; ACOS), mortality is worse than for asthma alone. Therefore, we investigated comorbidities, malignancies, and causes of death in patients with asthma and ACOS. This was a retrospective study. From January 2000 to March 2012, 650 patients were followed up at Tottori University Hospital. Medical records were reviewed to collect data regarding patient characteristics and comorbidities, and causes of death were recorded for patients who died during the study period. Eighty-seven patients died during the study period. The most frequent cause of death was malignancy. The proportion of malignant disease was 21.7% in all patients, 19.4% in patients with asthma alone, and 32.4% in patients with ACOS. One patient died from an asthma attack during this period. The most frequent cause of death in patients with asthma and ACOS was malignant disease. It is necessary to control not only asthma but also comorbidities in patients with asthma, especially in those with ACOS.

  14. Allergic rhinitis is associated with poor asthma control in children with asthma

    NARCIS (Netherlands)

    de Groot, Eric P.; Nijkamp, Anke; Duiverman, Eric J.; Brand, Paul L. P.

    Background Asthma and allergic rhinitis are the two most common chronic disorders in childhood and adolescence. To date, no study has examined the impact of comorbid allergic rhinitis on asthma control in children. Objective To examine the prevalence of allergic rhinitis in children with asthma, and

  15. Predicting asthma in preschool children with asthma symptoms: study rationale and design

    NARCIS (Netherlands)

    E.H.D. Hafkamp-De Groen (Esther); H.F. Lingsma (Hester); D. Caudri (Daan); A.H. Wijga (Alet); V.W.V. Jaddoe (Vincent); E.W. Steyerberg (Ewout); J.C. de Jongste (Johan); H. Raat (Hein)

    2012-01-01

    textabstractBackground: In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) Risk Score has been proposed as an instrument that predicts

  16. Asthma Risk Profiles of Children Participating in an Asthma Education and Management Program

    Science.gov (United States)

    Wilson, Candice; Rapp, Kristi Isaac; Jack, Leonard, Jr.; Hayes, Sandra; Post, Robert; Malveaux, Floyd

    2015-01-01

    Background: Focused risk assessment is essential in the effective management of asthma. Purpose: This study identified and examined correlations among areas of pediatric asthma risk and determined associations between these risks and demographic characteristics. Methods: This exploratory study identified risk factors that affect asthma management…

  17. A Reliable and Valid Asthma General Knowledge Questionnaire Useful in the Training of Asthma Educators.

    Science.gov (United States)

    Allen, Rae M.; Abdulwadud, Omar A.; Jones, Michael P.; Abramson, Michael; Walters, Haydn

    2000-01-01

    Using the responses of 115 adults attending an asthma educator training course, the Asthma General Knowledge Questionnaire for Adults (AGKQA) was found to be an acceptably valid and reliable measure for assessing knowledge related to the management of asthma by adults. (Author/MKA)

  18. Can the Asthma Control Questionnaire be used to differentiate between patients with controlled and uncontrolled asthma symptoms? A pilot study

    NARCIS (Netherlands)

    van den Nieuwenhof, Lotte; Schermer, Tjard; Eysink, Petra; Halet, Eric; van Weel, Chris; Bindels, Patrick; Bottema, Ben

    2006-01-01

    BACKGROUND: A substantial number of adult patients with asthma are inadequately controlled despite the availability of effective asthma treatment. Patients and physicians seem to overestimate the level of asthma control. OBJECTIVE: The current study explores whether valid differentiation is possible

  19. Can the Asthma Control Questionnaire be used to differentiate between patients with controlled and uncontrolled asthma symptoms? A pilot study.

    NARCIS (Netherlands)

    Nieuwenhof, L.J.L. van den; Schermer, T.R.J.; Eysink, P.; Halet, E.; Weel, C. van; Bindels, P.P.J.M.; Bottema, B.J.A.M.

    2006-01-01

    BACKGROUND: A substantial number of adult patients with asthma are inadequately controlled despite the availability of effective asthma treatment. Patients and physicians seem to overestimate the level of asthma control. OBJECTIVE: The current study explores whether valid differentiation is possible

  20. Parental Perceptions and Practices toward Childhood Asthma.

    Science.gov (United States)

    Abu-Shaheen, Amani K; Nofal, Abdullah; Heena, Humariya

    2016-01-01

    Introduction . Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective. To investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods . Using a self-administered questionnaire, a two-stage cross-sectional survey of parents of children aged between 3 and 15 years, was conducted from schools located in Riyadh province in central Saudi Arabia. Results . During the study interval, 2000 parents were asked to participate in the study; 1450 parents responded, of whom 600 (41.4%) reported that their children had asthma, dyspnea, or chest allergy (recurrent wheezing or coughing), while 478 (32.9%) of the parents reported that their children were diagnosed earlier with asthma by a physician. Therefore, the final statistical analyses were performed with 600 participants. Furthermore, 321 (53.5%) respondents believed that asthma is solely a hereditary disease. Interestingly, 361 (60.3%) were concerned about side effects of inhaled corticosteroids and 192 (32%) about the development of dependency on asthma medications. Almost 76% of parents had previously visited a pediatric emergency department during an asthma attack. Conclusions . Parents had misperceptions regarding asthma and exhibited ineffective practices in its management. Therefore, improving asthma care and compliance requires added parental education.

  1. Pediatric asthma and development of atopy.

    Science.gov (United States)

    Custovic, Adnan; Lazic, Nevena; Simpson, Angela

    2013-04-01

    There is ongoing controversy about the relationship between atopy and asthma. In clinical practice, specific IgE and skin test results should not be reported as 'positive' or 'negative', but as the level of IgE and the size of skin test wheal diameter. In assessment of children with severe asthma, these tests are not mutually exclusive but complementary, and both should be carried out and quantified. In the near future, their diagnostic accuracy in children with wheezing may be improved by the measurement of allergen-specific IgG. It is becoming increasingly clear that asthma is not a single disease, but a collection of several diseases with similar/same symptoms. These distinct disease entities (endotypes) may share similar observable characteristics (phenotypes), but arise via different pathophysiological mechanisms. Observable phenotypic features (e.g. sputum inflammatory phenotypes) are not stable in children with asthma. The discovery of novel, latent endotypes of asthma will require integration of a time component to take into account the phenotype instability and longitudinal changes. Not only asthma, but also 'atopy' encompasses a number of different endotypes which differ in their association with asthma. Novel endotypes of atopy and asthma which better reflect the unique pathophysiological processes underlying different diseases in the atopy and asthma syndromes can be defined through the fusion of computational thinking and novel mathematical approaches with biomedical science. These novel endotypes may be more relevant for epidemiological, genetic and therapeutic studies.

  2. Japanese guidelines for childhood asthma 2017

    Directory of Open Access Journals (Sweden)

    Hirokazu Arakawa

    2017-04-01

    Full Text Available The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2017 (JAGL 2017 includes a minor revision of the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012 by the Japanese Society of Pediatric Allergy and Clinical Immunology. The section on child asthma in JAGL 2017 provides information on how to diagnose asthma between infancy and adolescence (0–15 years of age. It makes recommendations for best practices in the management of childhood asthma, including management of acute exacerbations and non-pharmacological and pharmacological management. This guideline will be of interest to non-specialist physicians involved in the care of children with asthma. JAGL differs from the Global Initiative for Asthma Guideline in that JAGL emphasizes diagnosis and early intervention of children with asthma at <2 years or 2–5 years of age. The first choice of treatment depends on the severity and frequency of symptoms. Pharmacological management, including step-up or step-down of drugs used for long-term management based on the status of asthma control levels, is easy to understand; thus, this guideline is suitable for the routine medical care of children with asthma. JAGL also recommends using a control test in children, so that the physician aims for complete control by avoiding exacerbating factors and appropriately using anti-inflammatory drugs (for example, inhaled corticosteroids and leukotriene receptor antagonists.

  3. Vitamin D deficiency and adult asthma exacerbations.

    Science.gov (United States)

    Salas, Natalie Mariam; Luo, Li; Harkins, Michelle S

    2014-11-01

    There is growing evidence indicating a connection between vitamin D deficiency and the severity of asthma exacerbations. This study seeks to assess the relationship between vitamin D deficiency and the number and severity of asthma exacerbation in adults. A retrospective analysis was conducted in 92 patients being treated for asthma at the University of New Mexico Adult Asthma Clinic. Serum 25-hydroxyvitamin D3 levels were analyzed in adults with mild to severe persistent asthma. Using multi-variant modeling, the relationship was examined between serum vitamin D levels and the odds of asthma exacerbations ranging in severity from moderate to severe over the span of five years. This study demonstrates that vitamin D sufficiency was significantly associated with a decreased total number of asthma exacerbations (incidence rate ratio [IRR]: 0.61, 95% confidence interval [CI]: 0.44-0.84, p = 0.002), decreased total severe asthma exacerbations (IRR: 0.41, 95% CI: 0.24-0.72, p = 0.002) and decreased emergency room visits (IRR: 0.42, 95% CI: 0.20-0.88, p = 0.023). Vitamin D deficiency may be linked to the risk of severe asthma exacerbations in adults.

  4. Indoor air pollution and asthma in children.

    Science.gov (United States)

    Breysse, Patrick N; Diette, Gregory B; Matsui, Elizabeth C; Butz, Arlene M; Hansel, Nadia N; McCormack, Meredith C

    2010-05-01

    The purpose of this article is to review indoor air pollution factors that can modify asthma severity, particularly in inner-city environments. While there is a large literature linking ambient air pollution and asthma morbidity, less is known about the impact of indoor air pollution on asthma. Concentrating on the indoor environments is particularly important for children, since they can spend as much as 90% of their time indoors. This review focuses on studies conducted by the Johns Hopkins Center for Childhood Asthma in the Urban Environment as well as other relevant epidemiologic studies. Analysis of exposure outcome relationships in the published literature demonstrates the importance of evaluating indoor home environmental air pollution sources as risk factors for asthma morbidity. Important indoor air pollution determinants of asthma morbidity in urban environments include particulate matter (particularly the coarse fraction), nitrogen dioxide, and airborne mouse allergen exposure. Avoidance of harmful environmental exposures is a key component of national and international guideline recommendations for management of asthma. This literature suggests that modifying the indoor environment to reduce particulate matter, NO(2), and mouse allergen may be an important asthma management strategy. More research documenting effectiveness of interventions to reduce those exposures and improve asthma outcomes is needed.

  5. Angiogenesis and lymphangiogenesis in bronchial asthma

    National Research Council Canada - National Science Library

    Detoraki, A; Granata, F; Staibano, S; Rossi, F. W; Marone, G; Genovese, A

    2010-01-01

    ... A. Angiogenesis and lymphangiogenesis in bronchial asthma. Allergy 2010; 65: 946-958. Neovascularization plays a prominent role in inflammation and tissue remodeling in several chronic inflammatory disorders...

  6. Pediatric Asthma and Viral Infection.

    Science.gov (United States)

    Garcia-Garcia, M Luz; Calvo Rey, Cristina; Del Rosal Rabes, Teresa

    2016-05-01

    Respiratory viral infections, particularly respiratory syncytial virus (RSV) and rhinovirus, are the most importance risk factors for the onset of wheezing in infants and small children. Bronchiolitis is the most common acute respiratory infection in children under 1year of age, and the most common cause of hospitalization in this age group. RSV accounts for approximately 70% of all these cases, followed by rhinovirus, adenovirus, metapneumovirus and bocavirus. The association between bronchiolitis caused by RSV and the development of recurrent wheezing and/or asthma was first described more than 40years ago, but it is still unclear whether bronchiolitis causes chronic respiratory symptoms, or if it is a marker for children with a genetic predisposition for developing asthma in the medium or long term. In any case, sufficient evidence is available to corroborate the existence of this association, which is particularly strong when the causative agent of bronchiolitis is rhinovirus. The pathogenic role of respiratory viruses as triggers for exacerbations in asthmatic patients has not been fully characterized. However, it is clear that respiratory viruses, and in particular rhinovirus, are the most common causes of exacerbation in children, and some type of respiratory virus has been identified in over 90% of children hospitalized for an episode of wheezing. Changes in the immune response to viral infections in genetically predisposed individuals are very likely to be the main factors involved in the association between viral infection and asthma. Copyright © 2016 SEPAR. Published by Elsevier Espana. All rights reserved.

  7. Social networks and bronchial asthma.

    Science.gov (United States)

    D'Amato, Gennaro; Cecchi, Lorenzo; Liccardi, Gennaro; D'Amato, Maria; Stanghellini, Giovanni

    2013-02-01

    To focus on both positive and negative aspects of the interaction between asthmatic patients and the social networks, and to highlight the need of a psychological approach in some individuals to integrate pharmacological treatment is the purpose of review. There is evidence that in some asthmatic patients, the excessive use of social networks can induce depression and stress triggering bronchial obstruction, whereas in others their rational use can induce beneficial effects in terms of asthma management. The increasing asthma prevalence in developed countries seen at the end of last century has raised concern for the considerable burden of this disease on society as well as individuals. Bronchial asthma is a disease in which psychological implications play a role in increasing or in reducing the severity of bronchial obstruction. Internet and, in particular, social media are increasingly a part of daily life of both young and adult people, thus allowing virtual relationships with peers sharing similar interests and goals. Although social network users often disclose more about themselves online than they do in person, there might be a risk for adolescents and for sensitive individuals, who can be negatively influenced by an incorrect use. However, although some studies show an increased risk of depression, other observations suggest beneficial effects of social networks by enhancing communication, social connection and self-esteem.

  8. Interleukin 18 receptor 1 gene polymorphisms are associated with asthma

    DEFF Research Database (Denmark)

    Zhu, Guohua; Whyte, Moira K B; Vestbo, Jørgen

    2008-01-01

    The interleukin 18 receptor (IL18R1) gene is a strong candidate gene for asthma. It has been implicated in the pathophysiology of asthma and maps to an asthma susceptibility locus on chromosome 2q12. The possibility of association between polymorphisms in IL18R1 and asthma was examined by genotyp......The interleukin 18 receptor (IL18R1) gene is a strong candidate gene for asthma. It has been implicated in the pathophysiology of asthma and maps to an asthma susceptibility locus on chromosome 2q12. The possibility of association between polymorphisms in IL18R1 and asthma was examined...

  9. Sibship Characteristics and Risk of Allergic Rhinitis and Asthma

    DEFF Research Database (Denmark)

    Westergaard, Tine; Rostgaard, Klaus; Wohlfahrt, Jan

    2005-01-01

    asthma; birth order; hypersensitivity; rhinitis; allergic; perennial; rhinitis; allergic; seasonal; risk factors; siblings......asthma; birth order; hypersensitivity; rhinitis; allergic; perennial; rhinitis; allergic; seasonal; risk factors; siblings...

  10. Comprehensive multiplexed protein quantitation delineates eosinophilic and neutrophilic experimental asthma

    National Research Council Canada - National Science Library

    Bergquist, M; Jonasson, S; Hjoberg, J; Hedenstierna, G; Hanrieder, Jörg

    2014-01-01

    ...; eosinophilic and neutrophilic asthma, will be reflected in the lung protein expression profile of murine asthma models and can be delineated using proteomics of bronchoalveolar lavage (BAL). Methods...

  11. Obesity and asthma, an association modified by age of asthma onset

    Science.gov (United States)

    Holguin, Fernando; Bleecker, Eugene R.; Busse, William W.; Calhoun, William J.; Castro, Mario; Erzurum, Serpil C.; Fitzpatrick, Anne M.; Gaston, Benjamin; Israel, Elliot; Jarjour, Nizar N.; Moore, Wendy C.; Peters, Stephen P.; Yonas, Michael; Teague, W. Gerald; Wenzel, Sally E.

    2011-01-01

    Background Studies of asthma phenotypes have identified obesity as a component of a group characterized by a high proportion of adult-onset asthmatics. However, whether age of asthma onset modifies the association between obesity and asthma is unknown. Methods From the Severe Asthma Project (SARP), we defined age of asthma onset as early (before 12 years of age) and late-onset (12 and higher). Comparisons of body mass index (BMI) categories were done within age of onset groups and obesity was also compared across these groups. Multivariable logistic regression analysis was done to evaluate the association between BMI categories with healthcare utilization and respiratory symptoms and multivariable linear regression for the association between duration of asthma and weight gain (BMI change/yr). An interaction between obesity and age of asthma onset was included in the multivariable analyses. Results The study population consisted on 1,049 subjects of which the median age for asthma onset was 10 years (IQR 4 – 25); 48% were late-onset (≥ 12) and 52% were early-onset (obese asthmatics, early-onset obese asthmatics had more airway obstruction, bronchial hyperresponsiveness, and higher OR of ever having 3 or more oral steroid tapers preceding/year or ICU admissions for asthma/preceding year (Interactions between obesity and age of asthma onset were respectively p=0.055 and p=0.02). In early-onset, but not in late-onset asthmatics, there was a significant association between increasing BMI and duration of asthma, after adjusting for confounders. The interaction between asthma duration and age of asthma onset was p obesity, based on whether they developed asthma early (obesity as a comorbidity that affects specific clinical phenotypes and not all asthma subjects alike. PMID:21624618

  12. Maternal asthma, asthma medication use, and the risk of congenital heart defects.

    Science.gov (United States)

    Lin, Shao; Herdt-Losavio, Michele; Gensburg, Lenore; Marshall, Elizabeth; Druschel, Charlotte

    2009-02-01

    Asthma is a common problem that complicates pregnancy. Several drugs are considered acceptable for use during pregnancy, although none have been classified as safe. Few studies have assessed the health impact of maternal asthma/medication use on the fetus. A population-based case-control study was conducted in New York State to determine if cardiac congenital malformations in offspring were associated with maternal use of asthma medication and/or maternal asthma. Cases were cardiac anomalies in the New York State Congenital Malformations Registry. Controls were live births without any major birth defects randomly selected from birth certificates and frequency matched by year of birth. Data were collected through a 30 min telephone interview. Exposure was maternal asthma/medication use, maternal asthma/no medication use, no asthma/medication use, and no asthma/no medication use (reference). A total of 502 (59.4%) cases and 1,066 (53.8%) controls participated. A positive association was seen between any heart defect and women with asthma who used medication (OR 2.38; 95% CI: 1.18, 4.82). No significant associations were observed between heart defects and either women with asthma who did not use medication or women without asthma who used asthma medications. When considering types of medication used, offspring of women with asthma who used bronchodilators had an increased risk of any heart defect (OR 2.20; 95%CI: 1.05, 4.61). These results suggest that both maternal asthma status (controlled vs. uncontrolled; severe vs. mild) and asthma medication use, particularly bronchodilators, may play a role in cardiac malformations in offspring. (c) 2008 Wiley-Liss, Inc.

  13. Comparing the Asthma APGAR system and the Asthma Control Test™ in a multicenter primary care sample.

    Science.gov (United States)

    Rank, Matthew A; Bertram, Susan; Wollan, Peter; Yawn, Roy A; Yawn, Barbara P

    2014-07-01

    To compare asthma control assessment using the Asthma APGAR system, a tool developed by primary care clinicians, in a multicenter primary care sample with the Asthma Control Test (ACT™)/Childhood Asthma Control Test (CACT™), a tool developed by asthma specialists. This is a substudy of a multicenter, randomized, controlled pragmatic trial that tests the effectiveness of the Asthma APGAR system in primary care practices. As part of the study, enrolled patients completed both the ACT™/CACT™ and the Asthma APGAR system between March 1, 2011, and December 31, 2011. Kappa and McNemar statistics were used to compare the results of questionnaires. Of the 468 patients in our sample, 306 (65%) were classified as not controlled by the ACT™/CACT™ or the Asthma APGAR system. The overall agreement was 84.4%, with a kappa value of .68 (substantial agreement) and a McNemar test P value of .35 (suggesting no significant difference in the direction of disagreement). Of those with poor control as defined by the Asthma APGAR system, 23.8% (73) had no controller medications and 76.5% (234) were seldom or sometimes able to avoid identified triggers for their asthma. Of those who stated that they had been prescribed controller medications, 116 of 332 (35%) stated that they did not use the controller medication on a daily basis. The Asthma APGAR system and the ACT™/CACT™ similarly assess asthma control in a multicenter primary care-based sample. The Asthma APGAR system identified an "actionable item" in more than 75% (234) of the individuals with poor asthma control, thus linking an assessment of poor asthma control with a management strategy. Copyright © 2014 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  14. Obese individuals experience wheezing without asthma but not asthma without wheezing

    DEFF Research Database (Denmark)

    Çolak, Yunus; Shoaib, Afzal; Lange, Peter

    2016-01-01

    BACKGROUND: Observational studies suggest that obesity is associated with increased risk of asthma. However, it is unknown whether this could be explained by wheezing. We tested the hypothesis that high body mass index (BMI) observationally and genetically is associated with high risk of wheezing...... individuals experienced wheezing and 5406 had asthma. Wheezing was self-reported, and asthma was ascertained through self-report, hospital contacts with asthma, and/or receiving medication for asthma. BMI was calculated as measured weight divided by measured height squared (kg/m(2)). RESULTS: In observational...

  15. Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma

    DEFF Research Database (Denmark)

    Prescott, E; Lange, P; Vestbo, J

    1997-01-01

    . RESULTS: At baseline 315 subjects (2.3%) reported asthma, 2.2% of women and 2.5% of men. During follow up 160 subjects were admitted to hospital for asthma. After controlling for self-reported asthma and smoking, women had a higher risk of being admitted to hospital than men (relative risk 1.7, 95......% confidence interval 1.2 to 2.4). This increased risk was not due to misclassification of chronic obstructive pulmonary disease (COPD) as asthma. CONCLUSIONS: These findings indicate gender-related differences in either the severity, perception, or management of asthma....

  16. Outcomes of the Montana Asthma Home Visiting Program: A home-based asthma education program.

    Science.gov (United States)

    Fernandes, Jessie C; Biskupiak, William W; Brokaw, Sarah M; Carpenedo, Dorota; Loveland, Katie M; Tysk, Sonja; Vogl, Shea

    2018-02-09

    Asthma is a common disease in children. Home-based, multi-trigger, multi-component interventions with an environmental focus have been shown to be effective to address asthma in children. The objective of this study was to assess the outcomes and feasibility of implementing a specific asthma home visiting (HV) program in a rural area. Children aged 0-17 years with uncontrolled asthma were enrolled in an asthma HV program that included six contacts over a 12-month period delivered by a registered nurse specifically trained in asthma education and trigger removal in eleven counties in the rural state of Montana. Between June 2010 and December 2016, data on asthma symptoms and asthma self-management skills were collected at baseline and throughout the program. In June 2017, they were analyzed to assess changes in asthma control and quality of life over time among participants completing all six contacts. Since June 2010, 152 of 338 enrolled children completed all six contacts outlined in the program (45%). Participants who completed the program reported significant improvements in asthma control test scores, self-management skills, and self-efficacy related to asthma management. These results improved the longer participants remained in the program. These findings suggest that it is feasible to implement a 12-month HV program using local public health resources in a rural area as outcomes improved over this time period.

  17. The Brussels Declaration: the need for change in asthma management

    DEFF Research Database (Denmark)

    Holgate, S.; Bisgaard, H.; Bjermer, L.

    2008-01-01

    Asthma is a highly prevalent condition across Europe and numerous guidelines have been developed to optimise management. However, asthma can be neither cured nor prevented, treatment choices are limited and many patients have poorly controlled or uncontrolled asthma. The Brussels Declaration on A...... reviews the evidence supporting the need for change in asthma management and summarises the ten key points contained in the Brussels Declaration Udgivelsesdato: 2008/12......Asthma is a highly prevalent condition across Europe and numerous guidelines have been developed to optimise management. However, asthma can be neither cured nor prevented, treatment choices are limited and many patients have poorly controlled or uncontrolled asthma. The Brussels Declaration...... on Asthma, sponsored by The Asthma, Allergy and Inflammation Research Charity, was developed to call attention to the shortfalls in asthma management and to urge European policy makers to recognise that asthma is a public health problem that should be a political priority. The Declaration urges recognition...

  18. Impact of asthma education received from health care providers on parental illness representation in childhood asthma.

    Science.gov (United States)

    Peterson-Sweeney, Kathleen; McMullen, Ann; Yoos, H Lorrie; Kitzmann, Harriet; Halterman, Jill S; Arcoleo, Kimberly Sidora; Anson, Elizabeth

    2007-04-01

    The burden of asthma has increased dramatically despite increased understanding of asthma and new medication regimens. Data reported here are part of a larger study investigating factors that influence parental asthma illness representation and the impact of this representation on treatment outcomes, including the parent/health care provider relationship. We investigated the influence of asthma related education provided by health care providers on these outcomes. After interviewing 228 parents of children with asthma, we found that asthma education received from the child's health care providers positively influenced parental belief systems, especially attitudes towards anti-inflammatory medications and facts about asthma. Parents who reported receiving more education also reported stronger partnerships with their child's health care provider. (c) 2007 Wiley Periodicals, Inc.

  19. Predicting asthma in preschool children with asthma symptoms: study rationale and design

    Directory of Open Access Journals (Sweden)

    Hafkamp-de Groen Esther

    2012-10-01

    Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

  20. Predicting asthma in preschool children with asthma symptoms: study rationale and design.

    Science.gov (United States)

    Hafkamp-de Groen, Esther; Lingsma, Hester F; Caudri, Daan; Wijga, Alet; Jaddoe, Vincent Wv; Steyerberg, Ewout W; de Jongste, Johan C; Raat, Hein

    2012-10-16

    In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy) Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1) to externally validate and update the PIAMA Risk Score, 2) to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of) preschool children with asthma symptoms and 3) to test implementation of the Asthma Risk Appraisal Tool in well-child care. The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index) and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth). The (updated) PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear.This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups of) preschool children, who present with asthma symptoms at well

  1. Indoor allergen exposure and asthma outcomes

    Science.gov (United States)

    Sheehan, William J.; Phipatanakul, Wanda

    2016-01-01

    Purpose of review The aim of the present review is to discuss updates on research regarding the relationship between indoor allergen exposure and childhood asthma with a focus on clinical effects, locations of exposure, and novel treatments. Recent findings Recent data continue to demonstrate that early life sensitization to indoor allergens is a predictor of asthma development later in life. Furthermore, avoidance of exposure to these allergens continues to be important especially given that the vast majority of children with asthma are sensitized to at least one indoor allergen. New research suggests that mouse allergen, more so than cockroach allergen, may be the most relevant urban allergen. Recent evidence reminds us that children are exposed to clinically important levels of indoor allergens in locations away from their home, such as schools and daycare centers. Exposure to increased levels of indoor mold in childhood has been associated with asthma development and exacerbation of current asthma; however, emerging evidence suggests that early exposure to higher fungal diversity may actually be protective for asthma development. Novel treatments have been developed that target TH2 pathways thus decreasing asthmatic responses to allergens. These therapies show promise for the treatment of severe allergic asthma refractory to avoidance strategies and standard therapies. Summary Understanding the relationship between indoor allergens and asthma outcomes is a constantly evolving study of timing, location, and amount of exposure. PMID:27653703

  2. What defines airflow obstruction in asthma?

    NARCIS (Netherlands)

    Cerveri, I.; Corsico, A. G.; Accordini, S.; Cervio, G.; Ansaldo, E.; Grosso, A.; Niniano, R.; Tegomo, E. Tsana; Anto, J. M.; Kuenzli, N.; Janson, C.; Sunyer, J.; Svanes, C.; Heinrich, J.; Schouten, J. P.; Wjst, M.; Pozzi, E.; de Marco, R.

    Asthma guidelines from the Global Initiative for Asthma (GINA) and from the National Heart, Lung, and Blood Institute provide conflicting definitions of airflow obstruction, suggesting a fixed forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) cut-off point and the lower limit of

  3. Fetal and infant origins of asthma

    NARCIS (Netherlands)

    L. Duijts (Liesbeth)

    2012-01-01

    textabstractPrevious studies have suggested that asthma, like other common diseases, has at least part of its origin early in life. Low birth weight has been shown to be associated with increased risks of asthma, chronic obstructive airway disease, and impaired lung function in adults, and increased

  4. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health ... as your doctor or other medical professional tells you to do and by avoiding things that can cause an attack. Watch a video to follow along ...

  5. [Obesity and the severity of asthma crisis].

    Science.gov (United States)

    Boussoffara, L; Boudawara, N; Touil, I; El Fahem, N; Sakka, M; Knani, J

    2014-09-01

    Obesity is associated with inflammatory processes, which could influence the airway inflammation that is found in patients with asthma. Obesity may thus have a role in the development of asthma. However, the role of obesity in the severity of acute asthma has not been well described. We performed a retrospective study, which included 77 patients hospitalized for acute asthma. Two groups of patients were formed according to their body mass index (BMI): group 1 consisting of 59 patients with a BMI inferior to 30 kg/m(2) and group 2 consisting of 18 patients with a BMI superior or equal to 30 kg/m(2). These two groups were compared according to demographic factors, clinical features and the spirometric severity of asthma. The mean age was 43 ± 17.4 years with a sex-ratio 0.57 (28 men/49 women). Thirty-one percent of these patients had a severe asthma attack requiring hospitalization in intensive care in four patients with the use of mechanical ventilation in two patients. The comparison between obese and non-obese patients did not show a significant difference in the severity of asthma. Although a contribution of obesity to the manifestation and severity of asthma is commonly recognized, the present data to not confirm the impact of obesity on the severity of acute attacks. Copyright © 2013 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  6. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... the Nation Fact Sheet State Data Profiles (2011) Work-related Asthma NCHS Asthma FastStats Survey Questions Resources ... physicians’ office Adults – Pharmacies Adults – Worksite Adults – Other Children – Home Children – Hospital emergency departments Children – Hospital inpatients ...

  7. Asthma control in London secondary school children.

    Science.gov (United States)

    Harris, Katherine; Mosler, Gioia; Williams, Samson A; Whitehouse, Abigail; Raine, Rosalind; Grigg, Jonathan

    2017-12-01

    The asthma control test (ACT) is a validated tool for assessing control in asthmatic children aged 12 years and older. Using the ACT, we sought to assess asthma control and knowledge in London secondary school children. Secondary schools in London, UK, participated in this study. Children with doctor-diagnosed asthma were invited to complete an online questionnaire that included the ACT and questions about asthma. Suboptimal asthma control was defined as an ACT score of ≤ 19 out of a maximum score of 25. Data are summarised as median and interquartile range (IQR), and were analysed by either Mann-Whitney test, or chi-square test. A p value of asthma control was reported by 49.6% of students. Over a third (42.4%) of students prescribed a short-acting β2-agonist inhaler felt uncomfortable using it at school, and 29.2% (n = 173) reported not using this inhaler when wheezy. 56.4% (n = 220) of those with regular inhaled corticosteroids did not take them as prescribed, and 41.7% did not know what this inhaler was for. Suboptimal control was associated with a greater proportion of students reporting that they were 'somewhat', 'hardly' or 'not at all' comfortable using inhalers at school (52.7% vs 29.1%, p asthma control and poor asthma knowledge are common in London schoolchildren.

  8. Obesity and Asthma: A Missing Link

    Science.gov (United States)

    Gomez-Llorente, Mª Amelia; Romero, Raquel; Chueca, Natalia; Martinez-Cañavate, Ana

    2017-01-01

    Obesity and asthma are two chronic conditions that affect millions of people. Genetic and lifestyle factors such as diet, physical activity, and early exposure to micro-organisms are important factors that may contribute to the escalating prevalence of both conditions. The prevalence of asthma is higher in obese individuals. Recently, two major phenotypes of asthma with obesity have been described: one phenotype of early-onset asthma that is aggravated by obesity, and a second phenotype of later-onset asthma that predominantly affects women. Systemic inflammation and mechanical effect, both due to the expansion of the adipose tissue, have been proposed as the main reasons for the association between obesity and asthma. However, the mechanisms involved are not yet fully understood. Moreover, it has also been suggested that insulin resistance syndrome can have a role in the association between these conditions. The intestinal microbiota is an important factor in the development of the immune system, and can be considered a link between obesity and asthma. In the obese state, higher lipopolysaccharide (LPS) serum levels as a consequence of a microbiota dysbiosis have been found. In addition, changes in microbiota composition result in a modification of carbohydrate fermentation capacity, therefore modifying short chain fatty acid (SCFA) levels. The main objective of this review is to summarize the principal findings that link obesity and asthma. PMID:28696379

  9. Cleaning and asthma characteristics in women.

    NARCIS (Netherlands)

    Dumas, O.; Siroux, V.; Luu, F.; Nadif, R.; Zock, J.P.; Kauffmann, F.; Moual, N. le

    2014-01-01

    Background We aimed to assess the associations between occupational exposure to cleaning products, a gender-related exposure, and asthma characteristics, considering clinical, mmunological and inflammatory aspects. Methods Analyses were conducted in 391 women (73 with adult-onset asthma) from the

  10. [Delayed asthma bronchiale due to epoxy resin].

    Science.gov (United States)

    Authried, Georg; Al-Asadi, Haifaa; Møller, Ulla; Sherson, David Lee

    2013-10-28

    Epoxy resin is a low molecular weight agent, which can cause both acute and delayed allergic reactions. However, it is known causing skin reactions with direct or airborne contact. Rarely it can cause airway reactions like asthma bronchiale. We describe a case of a windmill worker who developed delayed asthma bronchiale due to airborne contact with epoxy resin.

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... the Nation Fact Sheet State Data Profiles (2011) Work-related Asthma NCHS Asthma FastStats Survey Questions Resources ... clinics/physicians’ office Mixed Age Groups – Pharmacies Pregnant Women – Home Pregnant Women – Medical clinics/physicians’ office Health ...

  12. Associations between asthma and bronchial hyperresponsiveness ...

    African Journals Online (AJOL)

    Objectives. To determine asthma and allergy phenotypes in unselected urban black teenagers and to associate bronchial hyperresponsiveness (BHR) with asthma, other atopic diseases and allergen sensitisation. Methods. This was a cross-sectional study of 211 urban highschool black children of Xhosa ethnicity. Modified ...

  13. Helicobacter pylori Seropositivity in Children With Asthma

    OpenAIRE

    Yousefichaijan; Mosayebi; Sharafkhah; Kahbazi; Heydarbagi; Rafiei

    2016-01-01

    Background Some studies have reported an association between Helicobacter pylori (H. pylori) colonization and the occurrence of asthma or other allergies. However, data are inconsistent, and few studies have been performed in children. Objectives The current study aimed to investigate H. pylori seropositivity in children with and without asthma. Patients and Methods This cross-sect...

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Asthma-related Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with Current ... Prevalence Data NHIS Prevalence Data 2015 Data Table 1-1 Table 1-2 Table 2-1 Table ...

  15. Management of an acute asthma attack.

    Science.gov (United States)

    Barnard, Amanda

    2005-07-01

    Despite a more proactive approach to asthma management, which includes an increased range of drugs, wide dissemination of guidelines, and the use of asthma action plans, an acute severe asthma attack is one of the most common emergencies a general practitioner will encounter. This article discusses the management of an acute asthma attack in the general practice setting. Assessment of severity is vital and can be ascertained quite quickly with a brief history and rapid physical examination. It is important to remember that wheeze is an unreliable indicator of the severity of attack and may be absent in severe asthma. The cornerstones of treatment are oxygen and inhaled beta 2 agonists. Beta 2 agonists can be given continuously in severe life threatening asthma. Early administration of systemic steroids is important. Patients discharged to home after treatment of an asthma attack require close follow up including beta 2 agonists for symptom control, review of medications including a consideration of a short course of oral steroids, a written asthma action plan and detailed advice about what to do in case of deterioration in the next 24 hours. They should be reviewed in 24-48 hours.

  16. Deciphering Asthma Biomarkers with Protein Profiling Technology

    Directory of Open Access Journals (Sweden)

    Zhizhou Kuang

    2015-01-01

    Full Text Available Asthma is a chronic inflammatory disease of the airways, resulting in bronchial hyperresponsiveness with every allergen exposure. It is now clear that asthma is not a single disease, but rather a multifaceted syndrome that results from a variety of biologic mechanisms. Asthma is further problematic given that the disease consists of many variants, each with its own etiologic and pathophysiologic factors, including different cellular responses and inflammatory phenotypes. These facets make the rapid and accurate diagnosis (not to mention treatments of asthma extremely difficult. Protein biomarkers can serve as powerful detection tools in both clinical and basic research applications. Recent endeavors from biomedical researchers have developed technical platforms, such as cytokine antibody arrays, that have been employed and used to further the global analysis of asthma biomarker studies. In this review, we discuss potential asthma biomarkers involved in the pathophysiologic process and eventual pathogenesis of asthma, how these biomarkers are being utilized, and how further testing methods might help improve the diagnosis and treatment strain that current asthma patients suffer.

  17. Epidemiological Pattern and Management of Pediatric Asthma ...

    African Journals Online (AJOL)

    Epidemiological Pattern and Management of Pediatric Asthma Review of Ain Shams Pediatric Hospital Chest Clinic Data Cairo, Egypt 1995-2004. ... Egyptian Journal of Pediatric Allergy and Immunology (The) ... Conclusion & recommendations: Asthma constitutes a main problem in the Pediatric Chest Clinic. Respiratory ...

  18. Nedocromil sodium and exercise induced asthma.

    OpenAIRE

    Chudry, N; Correa, F; Silverman, M.

    1987-01-01

    Serial exercise tests were carried out by 12 children with asthma on two study days. After a control exercise test either nedocromil sodium 4 mg or placebo were given double blind by metered dose inhaler. Highly significant inhibition of exercise induced asthma occurred after nedocromil, lasting for over two hours.

  19. Identifying novel genes contributing to asthma pathogenesis

    NARCIS (Netherlands)

    Holloway, John W.; Koppelman, Gerard H.

    Purpose of review To illustrate recent examples of novel asthma genes such as those encoding G-protein-coupled receptor for asthma susceptibility, filaggrin and tenascin-C, and to describe the process that is needed to translate these findings to the clinic. Recent findings Many hundreds of studies

  20. Bronchial asthma, allergic rhinitis and cholecystectomy: An ...

    African Journals Online (AJOL)

    Background: Gallbladder has not been associated with any allergic condition what so ever. However, certain patients with bronchial asthma and cholelithiasis have reported to the author improvement in their asthmatic attack after cholecystectomy. Methods: This was an observational study on 22 bronchial asthma or allergic ...

  1. Childhood asthma | Levin | South African Family Practice

    African Journals Online (AJOL)

    Asthma is the most common chronic disease of South African children, affecting growth and development and quality of life. Features supporting the diagnosis are a family or personal history of atopy, night cough, exercise-induced cough and/or wheeze and seasonal variation in symptoms. Asthma is on the increase in both ...

  2. Management of asthma in primary care

    NARCIS (Netherlands)

    Honkoop, Pieter Jacob

    2016-01-01

    Asthma is a common non-communicable respiratory disease. In this thesis we analysed three different management strategies for adult patients with asthma in primary care. In the first, we targeted the currently recommended aim of ‘Controlled asthma’, which means patients experience hardly any

  3. Epidemiological study of school performance and asthma ...

    African Journals Online (AJOL)

    Background: Childhood asthma is a major health problem in Egypt and worldwide. Barriers to reducing the burden of asthma include symptom-based rather than disease-based approaches, tendency of care to be ''acute'' rather than “regular” and cultural attitudes towards drugs and drug delivery systems. Objective: To ...

  4. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... clinics/physicians’ office Health care providers – Other Parents – Home Case Studies Open Airways for Schools Asthma Care Training Wee Wheezers Adventures of Puff Inner City Asthma YES WE CAN Bibliography Breathing Easier Success Stories State Contacts and Programs Evaluation Evaluation Guide ...

  5. Nasobronchial interaction in allergic rhinitis and asthma

    NARCIS (Netherlands)

    G.J. Braunstahl (Gert-Jan)

    2001-01-01

    textabstractThe key to the diagnosis lies in taking a good medical history. This rule especially applies to allergic rhinitis and asthma. Both diseases have in common that they are often underdiagnosedl and lack proper treatment. Allergic rhinitis and asthma frequently occur together. Almost 40 % of

  6. Environmental control for asthma: recent evidence.

    Science.gov (United States)

    Matsui, Elizabeth C

    2013-08-01

    To review and interpret recent literature related to the role of environmental control in prevention and treatment of asthma. Environmental control has a clearly established role in the management of asthma, but its role as a primary prevention tool is not supported by recent clinical trials. Although some of the interventions tested in these trials reduced the risk of asthma, the interventions often included dietary modification and those trials intervening only on environmental exposures were largely negative. Environmental interventions that target multiple asthma triggers, such as a laminar airflow device and relocation to high altitude, continue to demonstrate efficacy in asthma. Several studies highlight the efficacy of portable HEPA purifiers in reduction of indoor particulate matter and improving asthma outcomes. Several recently published practice parameters provide evidence-based recommendations for environmental control practices targeting furry pet, rodent, and cockroach allergens. Emerging work highlights the potential impact of spatial-temporal aspects of exposure and the shape of the dose-response relationships on the indoor allergen exposure-asthma relationship. Environmental interventions likely have no effect on the risk of developing atopic disease, but multifaceted interventions are generally of benefit in the management of asthma, particularly in children.

  7. Anti-leukotriene therapy in asthma

    NARCIS (Netherlands)

    Diamant, Z.; Bel, E. H.; Dekhuijzen, P. N.

    1998-01-01

    There is ample evidence that leukotrienes are important inflammatory mediators of asthma. Anti-leukotriene therapy is a novel, specific anti-asthma strategy providing both reliever and controller effects. Currently, two types of anti-leukotriene drugs are being registered in several countries:

  8. Insights into disease severity in adult asthma

    NARCIS (Netherlands)

    Amelink, M.

    2014-01-01

    In this thesis we investigated and associated several new insights into disease severity in adult asthma. First we identified several clusters of adult-onset asthma and in addition to this we showed that severe disease is mostly associated with persistent eosinophilia and ENT disease. Also we showed

  9. Asthma and cystic fibrosis: A tangled web.

    LENUS (Irish Health Repository)

    Kent, Brian D

    2014-03-01

    Successfully diagnosing concomitant asthma in people with cystic fibrosis (CF) is a challenging proposition, and the utility of conventional diagnostic criteria of asthma in CF populations remains uncertain. Nonetheless, the accurate identification of individuals with CF and asthma allows appropriate tailoring of therapy, and should reduce the unnecessary use of asthma medication in broader CF cohorts. In this review, we discuss the diagnostic challenge posed by asthma in CF, both in terms of clinical evaluation, and of interpretation of pulmonary function testing and non-invasive markers of airway inflammation. We also examine how the role of cross-sectional thoracic imaging in CF and asthma can assist in the diagnosis of asthma in these patients. Finally, we critically appraise the evidence base behind the use of asthma medications in CF populations, with a particular focus on the use of inhaled corticosteroids and bronchodilators. As shall be discussed, the gaps in the current literature make further high-quality research in this field imperative. Pediatr Pulmonol. 2014; 49:205-213. © 2014 Wiley Periodicals, Inc.

  10. Asthma medication delivery : Mists and myths

    NARCIS (Netherlands)

    Rottier, Bart L.; Rubin, Bruce K.

    Asthma is usually treated with inhaled corticosteroids (ICS) and bronchodilators generated from pressurized metered dose inhalers (pMDI), dry powder inhalers (DPI), or nebulizers. The target areas for ICS and beta 2-agonists in the treatment of asthma are explained. Drug deposition not only depends

  11. [Inhalation therapy in children with asthma].

    Science.gov (United States)

    de Jongste, J C; van Essen-Zandvliet, E E; Brackel, H J; Kerrebijn, K F

    1990-02-01

    Inhalation therapy for childhood asthma is safe and effective. It has the advantages of a low dose, a rapid effect and a wide therapeutic range. For the majority of children the available medications make it possible now to treat asthma optimally, provided that special care is taken to select the appropriate inhalation devices, and repeated practical instructions are given.

  12. Evaluation of monitoring strategies for childhood asthma.

    Science.gov (United States)

    Brouwer, M L; Wijngaart, L S van den; Hugen, C A C; Gerrits, G P J M; Roukema, J; Merkus, P J F M

    2016-10-05

    The goal of monitoring pediatric asthma is to obtain and maintain asthma control, which is defined as minimizing asthma symptoms, restrictions to daily activities and the use of rescue medication. Long term goals include reducing the risk of fixed airflow limitation, and preventing asthma exacerbations and side effects of treatment. Several monitoring tools are available but no consensus exists on how to monitor patients in the most optimal way. Areas covered: In this review, we provide an overview of different tools and address general considerations on monitoring childhood asthma. Asthma care should be tailored to the individual patient. The health care professional should decide which monitoring strategy and frequency is optimal for the individual patient. Expert commentary: Personalized medicine should be the key issue in monitoring asthma in children. It is crucial to monitor disease activity and deterioration but there is no monitoring strategy that is clearly superior compared to others: The optimal strategy and frequency will vary between patients. Actually, both treatment and monitoring of pediatric asthma probably benefit from a personalized approach.

  13. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Health Care Coverage among Children Asthma-related Missed School Days among Children aged 5–17 Years Asthma ... FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School and Childcare ...

  14. Oxidant-antioxidant balance in childhood asthma

    African Journals Online (AJOL)

    EL-HAKIM

    Conclusion: Acute asthma leads to a considerable oxidative stress that is indicated by the high level of malondialdehyde and low level of antioxidant enzymes. Keywords: bronchial asthma, superoxide dismutases (SOD), glutathione peroxidases (Gpx), malondialdehyde (MDA), antioxidants. Dina M. Shokry,. Shereen A. El-.

  15. Exhaled nitric oxide and asthma in childhood

    NARCIS (Netherlands)

    R.J.P. van der Valk (Ralf)

    2013-01-01

    textabstractAsthma was first described in the medical literature of Greek antiquity. It is difficult to determine whether by referring to “asthma”, Hippocrates and his school (460-360 B.C.) meant an autonomous clinical entity or a symptom. The clinical presentation of asthma nowadays has probably

  16. Chiropractic care in asthma and allergy.

    Science.gov (United States)

    Balon, Jeffrey W; Mior, Silvano A

    2004-08-01

    To provide a brief overview of the current state of evidence for chiropractic care, specifically in the management of asthma and to a lesser extent allergy. A search of MEDLINE for English-language articles published between January 1966 and July 2002 was conducted using the keywords asthma, allergy, manual therapy, physical therapy techniques, chiropractic, physical therapy (specialty), physiotherapy, massage, and massage therapy. A hand search of the primary chiropractic and osteopathic literature on the treatment of asthma was performed, and proceedings from a recent research symposium on spinal manipulation were included. Clinical controlled studies and systematic reviews on spinal manipulative therapy (SMT) and asthma were selected. There were no primary clinical trials on SMT and allergy found. Many of the claims of chiropractic success in asthma have been primarily based on anecdotal evidence or uncontrolled case studies. Three recently reported randomized controlled studies showed benefit in subjective measures, such as quality of life, symptoms, and bronchodilator use; however, the differences were not statistically significant between controls and treated groups. There were no significant changes in any objective lung function measures. The clinical issues emanating from these trials are discussed. There is currently no evidence to support the use of chiropractic SMT as a primary treatment for asthma or allergy. Based on reported subjective improvement in patients receiving chiropractic care, certain clinical circumstances may warrant a therapeutic trial in patients with asthma. Further properly designed, collaborative research is needed to determine if there is a role for chiropractic SMT in the care of asthma or allergy.

  17. Assessing and Treating Work-Related Asthma

    Directory of Open Access Journals (Sweden)

    Stoughton Tracy

    2008-12-01

    Full Text Available Work-related asthma is asthma that is caused or exacerbated by exposures at work. It is the most common form of occupational lung disease in developed countries. It has important impacts on the health and well-being of the affected individual, as well as consequences for society because of unemployment issues and workers' compensation claims. With ongoing exposure, occupational asthma can result in persistent airway hyperresponsiveness and, possibly, permanent disability for the individual. Thus, it is important for the clinician to be able to diagnose this disorder as quickly and accurately as possible. The evaluation of a patient with work-related asthma can be extensive. It includes obtaining a consistent history, identifying the cause in the workplace, and confirming the diagnosis with objective tests. After a diagnosis has been made, treatment must sometimes go beyond the medications used for nonoccupational asthma and include interventions to minimize or completely remove the individual from exposure to the causal agent if he or she has sensitizer-induced occupational asthma. In addition, once an individual has been identified with occupational asthma, steps should be taken to prevent the development of this disorder in other workers. The purpose of this article is to review the current literature and provide the clinician with a stepwise approach to the diagnosis and management of a patient with work-related asthma.

  18. Epidemiology of bronchial asthma among preparatory school ...

    African Journals Online (AJOL)

    EL-HAKIM

    analysis: a positive family history of allergy and the presence of other one or more allergic diseases were significantly associated risk factors for asthma. Exposure to dust, cigarette smoke, playing and physical activity, common cold attacks, and special food or drinks were the most common triggering factors for asthma ...

  19. Asthma in children : origins and outcomes

    NARCIS (Netherlands)

    Zomer - Kooijker, K.

    2014-01-01

    Asthma is one of the most common chronic diseases in the world. At school age, 4-7% of all children is experiencing asthmatic symptoms. Improvement of asthma control and health related quality of life (HRQOL) may lower the huge burden of this disease. This requires insight into the determinants of

  20. Food consumption and risk of childhood asthma.

    Science.gov (United States)

    Lumia, Mirka; Takkinen, Hanna-Mari; Luukkainen, Päivi; Kaila, Minna; Lehtinen-Jacks, Susanna; Nwaru, Bright I; Tuokkola, Jetta; Niemelä, Onni; Haapala, Anna-Maija; Ilonen, Jorma; Simell, Olli; Knip, Mikael; Veijola, Riitta; Virtanen, Suvi M

    2015-12-01

    The consumption of foods rich in n-3 polyunsaturated fatty acids has been proposed to protect against childhood asthma. This study explores the association of food consumption (including cow's milk (CM)-free diet) in early life and the risk of atopic and non-atopic asthma. Food intake of 182 children with asthma and 728 matched controls was measured using 3-day food records, within the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) Nutrition Study cohort. The diagnoses of food allergies came both from the written questionnaire and from the registers of the Social Insurance Institution. Conditional logistic regression with generalized estimating equations framework was used in the analyses. The diagnosis of cow's milk allergy (CMA) led to multiple dietary restrictions still evident at 4 yr of age. Even after adjusting for CMA, higher consumption of CM products was inversely associated with the risk of atopic asthma and higher consumption of breast milk and oats inversely with the risk of non-atopic asthma. Early consumption of fish was associated with a decreased risk of all asthma. Dietary intake in early life combined with atopy history has a clear impact on the risk of developing asthma. Our results indicate that CM restriction due to CMA significantly increases and mediates the association between food consumption and childhood asthma risk. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. The many faces of asthma in obesity.

    Science.gov (United States)

    Sideleva, O; Dixon, A E

    2014-03-01

    Obesity is a major risk factor for the development of asthma, and causes severe, uncontrolled disease that responds poorly to therapy. The obese state alters early onset allergic asthma, and leads to the development of a novel form of late onset asthma secondary to obesity. The presentation of early onset allergic asthma is altered through effects on immune function. Factors such as mechanical loading, effects of adipokines on airways, altered diet, insulin resistance and altered metabolism of nitric oxide likely all contribute to increased airway reactivity in obesity, causing late onset asthma in obesity. Obesity also alters responses to environmental factors such as ozone and particulate matter. Focused studies to understand the importance of these factors in the pathogenesis of airway disease in obesity will be essential to develop therapies to intervene in this new epidemic of airway disease. © 2013 Wiley Periodicals, Inc.

  2. Mechanisms by which obesity impacts upon asthma.

    Science.gov (United States)

    Umetsu, Dale T

    2017-02-01

    Asthma, an inflammatory disease of the airways, is a common condition, currently affecting about 9% of adults. Obesity is another disease with high prevalence in adults, and asthma that develops in obese individuals appears to be distinct from other forms of asthma, in being particularly severe and difficult to control even with oral corticosteroids. Moreover, recent studies suggest that obesity may have a causal relationship with asthma. In this review, we discuss possible obesity-driven metabolic and immunological pathways that might lead to asthma that is associated with obesity. Our understanding of the mechanisms that underlie this association will likely lead in the future to improved treatments for this significant unmet medical need. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  3. Role of antileukotrienes in acute asthma exacerbations

    Directory of Open Access Journals (Sweden)

    Domenico Lorenzo Urso

    2012-04-01

    Full Text Available Acute asthma exacerbations are one of the most frequent reasons to visit the emergency department or general practitioner. Although current standard treatments for acute asthma – including supplemental oxygen, short-acting β2-agonists, systemic corticosteroids and anticholinergics – are quite effective in most patients, they are inadequate for rapid and sustained improvement in a significant proportion. The antileukotrienes, a relatively new class of drugs, have a role in the treatment of chronic asthma. Their relatively rapid onset of action after endovenous or oral administration and their additive effect to β2-agonists led to the hypothesis that they might be of benefit in acute asthma. This review examines the efficacy of antileukotrienes in the treatment of acute asthma.

  4. Asthma and dehydroepiandrosterone (DHEA): facts and hypotheses.

    Science.gov (United States)

    Kasperska-Zajac, Alicja

    2010-10-01

    Dehydroepiandrosterone (DHEA) is considered as an important immunomodulating and anti-inflammatory hormone. Despite the continuing interest in DHEA replacement therapy, our knowledge of its effects upon asthma is very limited. DHEA is able to reverse cytokine imbalances associated with asthma, may prevent and attenuate allergic inflammation in airways, and does not possess the undesirable side effects of glucocorticoids; therefore, it may be potentially applied in the treatment of asthma. The steroid-sparing effect observed with DHEA clinically could appear especially favorable in asthmatic patients receiving oral treatment and those inhaling high doses of glucocorticoids. In addition, DHEA and its analogs might prove useful in reversing relative glucocorticoids insensitivity in patients with corticosteroid-resistant asthma. In this review we have focused specifically on DHEA's role in asthma.

  5. Assessment of problematic severe asthma in children

    DEFF Research Database (Denmark)

    Carlsen, K. C. L.; Hedlin, G.; Bush, A.

    2011-01-01

    Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi-disciplinary assessm......Assessment of problematic severe asthma in children should be performed in a stepwise manner to ensure an optimal approach. A four-step assessment scheme is proposed. First, a full diagnostic work-up is performed to exclude other diseases which mimic asthma. Secondly, a multi...... in our current knowledge in all these steps are highlighted, and recommendations for current clinical practice and future research are made. The lack of good data and the heterogeneity of problematic severe asthma still limit our ability to optimise the management on an individual basis in this small...

  6. Genetic and environmental influence on asthma

    DEFF Research Database (Denmark)

    Skadhauge, L.R.; Christensen, Kaare; Kyvik, Kirsten Ohm

    1999-01-01

    The aim of this study was to estimate the relative influence of genetic and environmental factors on the aetiology of asthma. The classic twin study design was used to analyse data on self-reported asthma obtained by a questionnaire mailed to 34,076 individuals, aged 12-41 yrs and originating from...... the Danish Twin Register. The cumulative incidence of asthma was 6.2% in the pooled sample. The data showed a decreasing cumulative incidence with age for males, but no sex or zygosity difference was observed. Substantially higher concordance rates, odds ratios and correlations for asthma were estimated...... in the monozygotic than in the dizygotic twins. Using biometric modelling, a model including additive genetic and nonshared environmental effects provided the best overall fit to the data. According to this model, 73% of the variation in liability to asthma was explained by genetic factors. No sex difference or age...

  7. The Danish National Database for Asthma

    DEFF Research Database (Denmark)

    Hansen, Susanne; Hoffmann-Petersen, Benjamin; Sverrild, Asger

    2016-01-01

    Asthma is one of the most common chronic diseases worldwide affecting more than 300 million people. Symptoms are often non-specific and include coughing, wheezing, chest tightness, and shortness of breath. Asthma may be highly variable within the same individual over time. Although asthma results...... in death only in extreme cases, the disease is associated with significant morbidity, reduced quality of life, increased absenteeism, and large costs for society. Asthma can be diagnosed based on report of characteristic symptoms and/or the use of several different diagnostic tests. However......, there is currently no gold standard for making a diagnosis, and some degree of misclassification and inter-observer variation can be expected. This may lead to local and regional differences in the treatment, monitoring, and follow-up of the patients. The Danish National Database for Asthma (DNDA) is slated...

  8. Role of leukotrienes in asthma pathophysiology

    DEFF Research Database (Denmark)

    Bisgaard, H

    2000-01-01

    Inflammation is an essential component of asthma pathophysiology. While beta(2)-agonists are often used for short-term relief of acute bronchospasm, anti-inflammatory agents are required for the long-term management of chronic inflammation in this disease. Corticosteroids have emerged as the first......-line anti-inflammatory therapy for asthma management. However, in some patients, especially children, the high doses of corticosteroids that may be required to control features of hyperresponsiveness, including exercise-induced asthma, raise safety concerns. Thus, there is a need for complementary anti......-inflammatory, steroid-sparing agents in asthma therapy. Several inflammatory mediators have been targeted in an attempt to thwart this inflammatory process, but so far with little success. The cysteinyl leukotrienes (CysLT), LTC(4), LTD(4), and LTE(4), have been shown to be essential mediators in asthma, making them...

  9. Blood Coagulation and Asthma Exacerbation in Children.

    Science.gov (United States)

    Manuyakorn, Wiparat; Mairiang, Dara; Sirachainan, Nongnuch; Kadegasem, Praguywan; Kamchaisatian, Wasu; Benjaponpitak, Suwat; Chuansumrit, Ampaiwan

    2016-01-01

    Recent studies have demonstrated the activation of coagulation pathways in asthmatic airways. This study aimed to determine systemic blood coagulation during asthma exacerbation compared with the stable state in children. Pediatric patients (aged between 5 and 15 years) suffering from asthma exacerbation were enrolled. von Willebrand factor (vWF), plasminogen activator inhibitor type-1 (PAI-1), protein C, D-dimer, prothrombin fragment 1 + 2 (F1 + 2), thrombin-antithrombin complex (TAT), and C-reactive protein (CRP) levels were measured during asthma exacerbation and stable state. A total of 22 patients were enrolled. The median vWF, PAI-1, and CRP during asthma exacerbation were significantly higher than those of the stable state: 147.5% (interquartile range, IQR: 111.05-196.57) versus 94% (IQR: 69.72-109.62, p coagulation in asthma exacerbation. © 2016 S. Karger AG, Basel.

  10. Acetaminophen use and asthma in children.

    Science.gov (United States)

    Sakulchit, Teeranai; Goldman, Ran D

    2017-03-01

    Question A child with a history of asthma came to my clinic with acute fever. I have heard that acetaminophen might be associated with exacerbation of asthma. Is it safe if I recommend acetaminophen for this child? Answer Most studies suggest an association between acetaminophen use in children and development of asthma later in childhood. However, several confounding factors in study design might contribute to this positive correlation, and without a prospective controlled trial, confirming this finding is challenging. If children have a known history of asthma, it is likely safe to administer a single dose of acetaminophen without concern of precipitating adverse respiratory symptoms. Regular use of acetaminophen to relieve fever or pain does not seem to exacerbate asthma in children more than ibuprofen does. Copyright© the College of Family Physicians of Canada.

  11. Epigenome-modifying tools in asthma

    Science.gov (United States)

    Brook, Peter O; Perry, Mark M; Adcock, Ian M; Durham, Andrew L

    2015-01-01

    Asthma is a chronic disease which causes recurrent breathlessness affecting 300 million people worldwide of whom 250,000 die annually. The epigenome is a set of heritable modifications and tags that affect the genome without changing the intrinsic DNA sequence. These marks include DNA methylation, modifications to histone proteins around which DNA is wrapped and expression of noncoding RNA. Alterations in all of these processes have been reported in patients with asthma. In some cases these differences are linked to disease severity and susceptibility and may account for the limited value of genetic studies in asthma. Animal models of asthma suggest that epigenetic modifications and processes are linked to asthma and may be tractable targets for therapeutic intervention. PMID:26479310

  12. Childhood asthma in low income countries

    DEFF Research Database (Denmark)

    Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K

    2012-01-01

    that untreated asthma may contribute to respiratory mortality since respiratory syncytial virus (RSV) is an important cause of respiratory death in childhood, and asthma in under-5s is often exacerbated by viral infections, including RSV. Furthermore, acute respiratory treatment failures were predominantly seen......Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts...... and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing...

  13. [Update on treatment of asthma].

    Science.gov (United States)

    Battistini, A

    1996-01-01

    Treatment of asthma, in particular long-term therapy, has continued to evolve both for the perfectioning of single classes of drugs and for a better addressed long-term treatment, although physicians have not disposed of new drugs for over 30 years. Only with regard to chromones expectations have been disappointing, as the new nedocromil showed substantially the same efficacy as the old chromoglycate. The recent availability, in paediatrics, of long-acting beta 2 agonists, especially salmeterol, represents a big advantage with regard to compliance in therapies which last months, while the most recent corticosteroid, available in Italy as a spray, fluticasone, would have very few side effects. Principally this is due to the scarce intestinal absorption which is nearly non-existent. An old drug, such as theophylline, has been rediscovered because of the recent evidence of an antiinflammatory action. This is confirmed by the good results obtained when it is used for very long periods instead of inhaled corticosteroids. The therapeutical schemes of asthma have been modified since asthma has been demonstrated to be characterized more by phlogosis of the bronchial mucosa which persists after an acute episode rather than by broncho-constriction. This necessarily requires long-term therapies with antiinflammatory drugs which must be stepwise. In fact, the absence of an ideal drug determines the use of the drug with the fewest side effects in the less severe forms, i.e. chromones although less active, and of inhaled corticosteroids at increasing doses up to steroids per os in the more severe forms. Classical protocols suggest the combination with a beta 2-agonist (when necessary up to 3-4 times per day) to use corticosteroids as little as possible. However, recently short beta 2 agonists are being substituted by long-acting preparation which must be regularly administrated in the morning and evening.

  14. What's new in asthma pathophysiology and immunopathology?

    Science.gov (United States)

    Orihara, Kanami; Dil, Nyla; Anaparti, Vidyanand; Moqbel, Redwan

    2010-10-01

    Research on asthma pathophysiology over the past decade has expanded the complex repertoire involved in the pathophysiology of asthma to include inflammatory, immune and structural cells, as well as a wide range of mediators. Studies have identified a role for connective and other mesenchymal tissues involved in airway remodeling. Recent findings have implicated the innate immune response in asthma and have revealed interesting patterns of interaction between the innate and adaptive immune response and the associated complex chronic inflammatory reaction. New immune cell populations have also been added to this repertoire, including Tregs, natural killer T cells and Th17 cells. The role of the eosinophil, a prominent pathological feature in most asthma phenotypes, has also been expanding to include roles such as tissue modifiers and immune regulators via a number of fascinating and hitherto unexplored mechanistic pathways. In addition, new and significant roles have been proposed for airway smooth muscle cells, fibroblasts, epithelial and endothelial cells. Tissue remodeling is now considered an integral element of asthma pathophysiology. Finally, an intricate network of mediators, released from both immune and inflammatory cells, including thymus stromal lymphopoietin and matrix metalloproteinases, have added to the complex milieu of asthma immunity and inflammation. These findings have implications for therapy and the search for novel strategies towards better disease management. Sadly, and perhaps due to the complex nature of asthma, advances in therapeutic discoveries and developments have been limited. Thus, understanding the precise roles played by the numerous dramatis personae in this odyssey, both individually and collectively within the context of asthma pathophysiology, continues to pose new challenges. It is clear that the next stage in this saga is to embark on studies that transcend reductionist approaches to involve system analysis of the complex and

  15. Carboxyhemoglobin and Methemoglobin in Asthma

    OpenAIRE

    Naples, Robert; Laskowski, Dan; McCarthy, Kevin; Mattox, Emmea; Comhair, Suzy A.A.; Erzurum, Serpil C.

    2015-01-01

    Nitric oxide (NO) and carbon monoxide (CO) are synthesized at high levels in asthmatic airways. NO can oxidize hemoglobin (Hb) to methemoglobin (MetHb). CO binds to heme to produce carboxyhemoglobin (COHb). We hypothesized that MetHb and COHb may be increased in asthma. COHb, MetHb, and Hb were measured in venous blood of healthy controls (n=32) and asthmatics (n=31). Arterial COHb and oxyhemoglobin were measured by pulse CO-oximeter. Hb, oxyhemoglobin, and deoxyhemoglobin were similar among ...

  16. [Asthma bronchiale - Emergency medical treatment].

    Science.gov (United States)

    Hansen, Michael; Hachenberg, Thomas

    2016-06-01

    Treatment of patients with acute severe or life-threatening asthma in the emergency department or in rescue services is a challenge for the physician. The decision on which therapy is needed depends on the clinical assessment of severity. Early administration of bronchodilators, ipratropium bromide and oral or intravenous corticosteroids is the cornerstone of treatment. If these treatments fail, systemic administration of bronchodilators, MgSO4 and theophylline should be carried in order to avoid intubation. Patients with incomplete or poor response should stay in hospital. © Georg Thieme Verlag Stuttgart · New York.

  17. Interaction between asthma and lung function growth in early life

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Jensen, Signe Marie; Bønnelykke, Klaus

    2012-01-01

    The causal direction between asthma and lung function deficit is unknown, but important for the focus of preventive measures and research into the origins of asthma.......The causal direction between asthma and lung function deficit is unknown, but important for the focus of preventive measures and research into the origins of asthma....

  18. Asthma and Environment Fact Sheet for Parents and Schools. Revised

    Science.gov (United States)

    Healthy Schools Network, Inc., 2012

    2012-01-01

    Important facts about asthma and the environment include: (1) Asthma has reached epidemic proportions in the United States, affecting about 25 million people of all ages and races, including about 7 million children; (2) Nearly one in 10 school-aged children has asthma, and the percentage of children with asthma is rising more rapidly in…

  19. Knowledge of primary school teachers about asthma: a cross ...

    African Journals Online (AJOL)

    0.176, respectively). Areas of particular concern included knowledge regarding the signs and symptoms of a severe acute asthma attack, asthma medication and management, and asthma and sports. Conclusion: This study demonstrates deficiencies in teachers' knowledge of asthma, which will need to be addressed if they ...

  20. Quality of life in children with undiagnosed and diagnosed asthma

    NARCIS (Netherlands)

    van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

    This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

  1. Barriers to Asthma Management as Identified by School Nurses

    Science.gov (United States)

    Quaranta, Judith E.; Spencer, Gale A.

    2016-01-01

    Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors,…

  2. Genetic influence on the age at onset of asthma

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Duffy, David Lorenzo; Kyvik, Kirsten Ohm

    2010-01-01

    Although the genetics of asthma susceptibility have been frequently explored, little is known about genetic factors that influence the age at onset of asthma.......Although the genetics of asthma susceptibility have been frequently explored, little is known about genetic factors that influence the age at onset of asthma....

  3. Clinical significance of asthma clusters by longitudinal analysis in Korean asthma cohort.

    Directory of Open Access Journals (Sweden)

    So Young Park

    Full Text Available BACKGROUND: We have previously identified four distinct groups of asthma patients in KOREAN cohorts using cluster analysis: (A smoking asthma, (B severe obstructive asthma, (C early-onset atopic asthma, and (D late-onset mild asthma. METHODS AND RESULTS: A longitudinal analysis of each cluster in a Korean adult asthma cohort was performed to investigate the clinical significance of asthma clusters over 12 months. Cluster A showed relatively high asthma control test (ACT scores but relatively low FEV1 scores, despite a high percentage of systemic corticosteroid use. Cluster B had the lowest mean FEV1, ACT, and the quality of life questionnaire for adult Korean asthmatics (QLQAKA scores throughout the year, even though the percentage of systemic corticosteroid use was the highest among the four clusters. Cluster C was ranked second in terms of FEV1, with the second lowest percentage of systemic corticosteroid use, and showed a marked improvement in subjective symptoms over time. Cluster D consistently showed the highest FEV1, the lowest systemic corticosteroid use, and had high ACT and QLQAKA scores. CONCLUSION: Our asthma clusters had clinical significance with consistency among clusters over 12 months. These distinctive phenotypes may be useful in classifying asthma in real practice.

  4. Vitamin D, asthma prevalence and asthma exacerbations: a large adult population-based study.

    Science.gov (United States)

    Confino-Cohen, R; Brufman, I; Goldberg, A; Feldman, B S

    2014-12-01

    The impact of low vitamin D status on asthma, asthma morbidity and control is unclear. We aimed to investigate in adults the associations between serum 25-hydroxyvitamin D level and prevalent asthma as well as asthma exacerbations. A cohort of Israeli adults aged 22-50 years with documented vitamin D status were extracted from Clalit Health Services (HMO) between July 1, 2008 and July 1, 2012. Among this population, those with physician-diagnosed asthma and asthma exacerbations were identified. Asthma exacerbations were defined as any of the following: prescription for oral corticosteroids, >5 prescriptions for short acting beta agonists and more than four visits to a physician for asthma. Logistic regression models assessed the associations between vitamin D and both asthma and asthma exacerbations. Approximately 308 000 members with at least one vitamin D measurement were included in the cohort. Among them, 6.9% (21 237) had physician-diagnosed asthma vs 5.7% in the general population. Serum 25-OHD levels across both groups were similar. However, among those with vitamin D deficiency, the odds of having an exacerbation were 25% greater compared to those with levels in the normal range. This association remained significant after controlling for known confounders. While there was no significant association between vitamin D status and physician-diagnosed asthma, there was a strong association with asthma exacerbations. The presented evidence supports vitamin D screening in the subgroup of asthmatics that are uncontrolled and experience recurrent exacerbations. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. The mechanisms of intractable asthma

    Directory of Open Access Journals (Sweden)

    Stephen T Holgate

    1996-01-01

    Full Text Available Overwhelming evidence now points to asthma as a chronic inflammatory disease involving the airways. The T lymphocyte takes primacy in driving the inflammatory response through upregulation of cytokines, specifically those encoded in the IL-4 gene cluster: IL-4 and IL-13 (IgE isotype switching; IL-3, IL-5 and GM-CSF (eosinophil and basophil recruitment; and IL-9 (mast cell maturation. Additional cytokines of importance include TNFa and a range of related C-x-C and C-C cytokines. Although allergens are involved in initiating the Th-2 T-cell response, other factors are likely to operate that expand and maintain the inflammatory reaction. These include a potential role for superantigens and autoimmune mechanisms as well as the recruitment of accessory cytokine producing cells, especially mast cells and eosinophils. Leucocytes recruited from the microvasculature through interactions with specific adhesion molecules release an array of mediators, which in addition to causing bronchoconstriction also lead to damage to the epithelium and underlying structures. Neutral proteases from mast cells, metalloproteases from eosinophils and an array of mediators from the formed elements of the airway all contribute to the tissue destruction remodelling process. It was concluded that asthma is a dynamic disease process involving an interplay between inflammation and repair processes and that the differing proportions of these could account for the various disease phenotypes associated with severity and progression.

  6. Routine asthma control, other factors and trend of perception on controlled asthma among asthma patient in a hospital in Jakarta

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2016-01-01

    Full Text Available AbstrakLatar belakang: Asma merupakan masalah kesehatan yang penting di berbagai negara di dunia. Penelitianini bertujuan untuk mengidentifikasi faktor-faktor yang dominan berhubungan dengan penilaian diriterhadap keadaan asma pada penderita asma.Metode: Subjek pada studi potong lintang ini terdiri dari pasien asma yang berobat di poliklinik RumahSakit Persahabatan Jakarta pada tahun 2011. Wawancara dilakukan dengan menggunakan kuesioneryang berisi pertanyaan tentang data demografi (umur, jenis kelamin, pekerjaan, rutin kontrol asma,penggunaan dosis obat asma, cara menggunakan obat inhalasi, dan sumber pembiayaan. KuesionerAsthma Control Test (ACT juga digunakan untuk mendapatkan data tentang keterbatasan aktifitas karenaasma, frekuensi mengalami sesak napas, frekuensi mengalami gejala asma pada malam hari, frekuensipemakaian obat inhalasi, dan penilaian diri terhadap kontrol asma. Analisis regresi linear digunakanuntuk menganalisis faktor-faktor yang berhubungan dengan penilaian diri terhadap kontrol asma.Hasil: Pada studi terdapat 132 subjek. Rata-rata penilaian diri terhadap kontrol asma adalah 3.11±1.30.Faktor-faktor yang dominan yang berhubungan dengan penilaian diri terhadap asma terkontrol, keterbatasanaktifitas karena asma yang jarang, pemakaian obat inhalasi yang jarang, dan lebih sering kontrol asma.Kesimpulan: Berkurangnya hambatan terhadap aktifitas karena asma, pemakaian obat inhalasi yang jarang danyang lebih sering rutin kontrol asma lebih mempunyai penilaian diri yang lebih baik terhadap kontrol asma.(Health Science Journal of Indonesia 2015;6:52-6Kata kunci: kontrol, penderita, asma AbstractBackground: Asthma remains an important health problem across the globe. This study aimed toinvestigate the dominant risk factors that related to perception on controlled asthma.Methods: Methods: Subjects in this cross-sectional study consisted of patients with asthma who seektreatment at the clinic of Persahabatan Hospital Jakarta in 2011

  7. Exercise-induced bronchospasm, asthma control, and obesity.

    Science.gov (United States)

    Ostrom, Nancy K; Parsons, Jonathan P; Eid, Nemr S; Craig, Timothy J; Stoloff, Stuart; Hayden, Mary Lou; Colice, Gene L

    2013-01-01

    Exercise-induced bronchospasm (EIB) commonly affects patients with asthma. However, the relationship between EIB and asthma control remains unclear. Exercise limitation due to asthma might lead to reduced physical activity, but little information is available regarding obesity and EIB in asthma. A recent survey evaluated the frequency of EIB and exercise-related respiratory symptoms in a large number of patients with asthma. The survey results were reanalyzed to address any relationship between EIB and asthma control and obesity. A nationwide random sample of children aged 4-12 years (n = 250), adolescents aged 13-17 years (n = 266), and adults aged ≥18 years (n = 1001) with asthma were interviewed by telephone. Questions in the survey addressed asthma symptoms in general, medication use, and height and weight. Asthma control was categorized using established methods in the Expert Panel Report 3. Body mass index (BMI) was calculated using standard nomograms and obesity was defined as a BMI ≥ 30 kg/m(2). Most children (77.6%), adolescents (71.1%), and adults (83.1%) had either "not well" or "very poorly" controlled asthma. Children with "not well" controlled asthma reported a history of EIB significantly more often than those with "well" controlled" asthma. Asthma patients of all ages who had "not well" and "very poorly" controlled asthma described multiple (four or more) exercise-related respiratory symptoms significantly more often than those with "well-controlled" asthma. Obesity was significantly more common in adolescents with "not well" and "very poorly" controlled asthma and adults with "very poorly" controlled asthma. Children, adolescents, and adults with asthma infrequently have well-controlled disease. A history of EIB and exercise-related respiratory symptoms occur more commonly in patients with not well and very poorly controlled asthma. Obesity was found more often in adolescents and adults, but not children, with asthma, which was not well and

  8. Academic Performance of Primary School Children with Asthma

    OpenAIRE

    Nduagubam OC; Oguonu TA; Ojinnaka N; Ibekwe RC

    2017-01-01

    The academic performance of children with asthma may differ from that of their non-asthmatic colleagues. Reports on the academic performance of children with asthma are limited and the findings are inconsistent. The academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with asthma aged 5 and ndash;11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age-, sex...

  9. Characteristics of Late-onset Asthma in Elderly Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Hirotaka Yasuba

    2005-01-01

    Conclusions: Asthma in elderly patients may be divided into early-onset persistent asthma and late-onset asthma with short duration. Late-onset asthma is less IgE-mediated, less severe, and has a better prognosis after appropriate treatment with inhaled fluticasone, and patients are more likely to drop out. For elderly patients with asthma, early detection, repetitive patient education and early intervention with inhaled corticosteroid therapy are important.

  10. Vitamin E and D regulation of allergic asthma immunopathogenesis

    OpenAIRE

    Cook-Mills, Joan M.; Avila, Pedro C

    2014-01-01

    Asthma occurs as complex interactions of the environmental and genetics. Clinical studies and animal models of asthma indicate dietary factors such as vitamin E and vitamin D as protective for asthma risk. In this review, we discuss opposing regulatory functions of tocopherol isoforms of vitamin E and regulatory functions of vitamin D in asthma and how the variation in global prevalence of asthma may be explained, at least in part, by these dietary components.

  11. Vitamin D and markers of airway inflammation in asthma

    OpenAIRE

    Samaha, Hala Mohamed Shalaby; Elsaid, Amany Ragab; NasrEldin, Eman

    2015-01-01

    Background: Vitamin D plays a role in the pathogenesis of asthma as it has a potent immunomodulatory effect acting on the cells of innate immunity. In asthmatic children low vitamin D levels are associated with poor asthma control, reduced lung function, increased medication intake, and exacerbations. Little is known about vitamin D in adult asthma patients or its association with asthma control and inflammatory markers of asthma. Objective: To establish the relationship between vitamin D ...

  12. Update on asthma and cleaning agents.

    Science.gov (United States)

    Folletti, Ilenia; Siracusa, Andrea; Paolocci, Giulia

    2017-04-01

    Asthma due to cleaning products has been known for 20 years, and the interest in this topic is still large because of the number of cleaning workers with respiratory problems. In this review, we sought to highlight the most recent findings on the relationship between exposure to cleaning products and asthma and to summarize the specific literature published between 2013 and 2016. Women are confirmed as most of workers exposed to cleaning products and have a higher frequency than men of work-related respiratory symptoms and diseases. Many cases of asthma due to cleaning products occur in healthcare occupations. The increased risk of asthma has been shown to be related to the number of years in the job and to early life disadvantage. Recent evidence suggests that predisposition to adult-onset asthma may be related to interaction between genes and occupational exposure to low-molecular weight agents/irritants. There is some evidence that an irritant mechanism is more common, although several case reports showed animmunologic mechanism (e.g. disinfectants, amine compounds, aldehydes and fragrances). The review updated recent findings on epidemiology, cleaning agents and their mechanism, and prevention of asthma due to cleaning agents. This article provides new information on the level of exposure, which is still high in professional cleaners and even more in domestic cleaners, and on the frequency of asthma in professional and domestic cleaners. An irritant mechanism is more common, although an immunological mechanism is possible, especially in healthcare workers exposed to disinfectants.

  13. Cardiac arrhythmias in adult patients with asthma

    DEFF Research Database (Denmark)

    Warnier, Miriam J; Rutten, Frans H; Kors, Jan A

    2012-01-01

    OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias and electrocardio......OBJECTIVE: The pathogenesis of cardiac arrhythmias in asthma patients has not been fully elucidated. Adverse drug effects, particularly those of β2-mimetics, may play a role. The aim of this study was to determine whether asthma is associated with the risk of cardiac arrhythmias...... and electrocardiographic characteristics of arrhythmogenicity (ECG) and to explore the role of β2-mimetics. METHODS: A cross-sectional study was conducted among 158 adult patients with a diagnosis of asthma and 6303 participants without asthma from the cohort of the Utrecht Health Project-an ongoing, longitudinal, primary...... or flutter). Secondary outcomes were tachycardia, bradycardia, PVC, atrial fibrillation or flutter, mean heart rate, mean corrected QT (QTc) interval length, and prolonged QTc interval. RESULTS: Tachycardia and PVCs were more prevalent in patients with asthma (3% and 4%, respectively) than those without...

  14. Virus vaccines and children with asthma.

    Science.gov (United States)

    Anderson, Mark; Carroll, Will

    2009-02-01

    To describe what is currently known about the role of virus vaccines in the pathogenesis of asthma and atopy and summarize their role in the prevention of morbidity due to childhood asthma. The development of virus vaccines and their incorporation into infant and childhood immunization programmes over the last few decades of the twentieth century have been accompanied by a striking concomitant rise in the incidence of asthma and atopy. However, a causal relationship is not supported by the majority of observational studies. The role of childhood immunization against respiratory viruses in the reduction of morbidity from asthma is another important public health issue. Recent findings suggest that influenza is not strongly associated with exacerbations of asthma in children, despite recommendations that this group should be immunized against it. Current evidence suggests that virus vaccination is well tolerated and does not lead to an increased incidence of asthma or atopy in children receiving vaccines. Debate continues regarding the place of respiratory virus vaccination in the therapeutic armamentarium for children with asthma. In the case of influenza, there appears to be an absence of harm, but benefit seems to be limited to younger children.

  15. Vitamin D deficiency and severe asthma.

    Science.gov (United States)

    Poon, Audrey H; Mahboub, Bassam; Hamid, Qutayba

    2013-11-01

    Vitamin D has received tremendous amount of attention recently due to the ever-increasing reports of association between vitamin D deficiency and a wide range of conditions, from cancer to fertility to longevity. The fascination of disease association with vitamin D deficiency comes from the relatively easy solution to overcome such a risk factor, that is, either by increase in sun exposure and/or diet supplementation. Many reviews have been written on a protective role of vitamin D in asthma and related morbidities; here, we will summarize the epidemiological evidence supporting a role of vitamin D against hallmark features of severe asthma, such as airway remodeling and asthma exacerbations. Furthermore, we discuss data from in vitro and in vivo studies which provide insights on the potential mechanisms of how vitamin D may protect against severe asthma pathogenesis and how vitamin D deficiency may lead to the development of severe asthma. Approximately 5-15% of asthmatic individuals suffer from the more severe forms of disease in spite of aggressive therapies and they are more likely to have irreversible airflow obstruction associated with airway remodeling. At present drugs commonly used to control asthma symptoms, such as corticosteroids, do not significantly reverse or reduce remodeling in the airways. Hence, if vitamin D plays a protective role against the development of severe asthma, then the most effective therapy may simply be a healthy dose of sunshine. Copyright © 2013 Elsevier Inc. All rights reserved.

  16. Managing asthma patients: which outcomes matter?

    Directory of Open Access Journals (Sweden)

    A. P. Greening

    2008-06-01

    Full Text Available Within the respiratory specialist community, there is growing recognition that classification of asthma based on severity of symptoms alone may not accurately reflect the clinical status of a patient. It follows, therefore, that treatment decisions based on this classification can lead to suboptimal management of asthma. The concept of assessing patients by their level of asthma control is gaining wide acceptance and is a major component of the new 2006 Global Initiative for Asthma guidelines. Questions remain, however, on how best to achieve and maintain asthma control. Randomised controlled trials have shown that very good asthma control is achievable in the majority of patients. There is a need for a tool to accurately assess a patient's level of control in the clinical setting if such results are to be replicated in practice. A symposium at the European Respiratory Society Annual Congress in 2006 discussed the important issues that are currently facing asthma clinicians. The current article summarises the main points arising from that symposium.

  17. Asthma in Rhinosinusitis: A Survey from Iran

    Directory of Open Access Journals (Sweden)

    Mehdi Bakhshaee

    2016-05-01

    Full Text Available Introduction: The coexistence of asthma and chronic rhinosinusitis (CRS is more common than expected given their individual prevalence in the general population and may affect patient’s quality of life. The aim of this study was to evaluate the prevalence of asthma in chronic rhinosinusitis in Mashhad, Northeast Iran.  Materials and Methods: This study was performed in two university hospital from November 2012 for 12 months. In total, 153 patients with chronic rhinosinusitis were enrolled and referred to a particular pulmonologist for asthma evaluation.  Results: The mean age of participants was 40.54±13.11 years, and 41.8% were male. In total, 63.4% of patients had the polypoid form of CRS. The proportion of patients in this study with asthma was 41.8%, compared with a general asthma prevalence in this region of 13.5%.  Conclusion: There is a high prevalence of asthma among patients with CRS, but it often remains undiagnosed. Asthma in CRS patients should be diagnosed and treated in order to improve patient’s quality of life. We recommend an evaluation of the lower airways in all of these patients as well as further studies in this field.

  18. Asthma and obesity: is weight reduction the key to achieve asthma control?

    Science.gov (United States)

    Ulrik, Charlotte S

    2016-01-01

    Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. Clinical studies have shown that weight reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness, and more recently it has been shown that weight reduction following bariatric surgery has positive impact on small airway function, systemic inflammation and bronchial inflammation in this group of patients, which may explain the observed improvements in symptom control and lung function. Weight reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma.

  19. Ways of coping with asthma in everyday life: validation of the Asthma Specific Coping Scale

    DEFF Research Database (Denmark)

    Aalto, Anna-Mari; Härkäpää, Kristiina; Aro, Arja R

    2002-01-01

    ]. Data were collected by questionnaires. RESULTS: The expected structure of the six subscales (restricted lifestyle, hiding asthma, positive reappraisal, information seeking, ignoring asthma, and asthma worry) was supported. The Cronbach's alpha reliabilities of the subscales ranged from .63 to .84......OBJECTIVE: This study examines the validity of the Asthma Specific Coping Scale. METHODS: Study samples were comprised of persons with drug-treated asthma (n=3464) drawn from the Drug Reimbursement Registry and asthma rehabilitation participants [brief (n=278) and comprehensive (n=316) intervention...... also showed sensitivity to change after rehabilitation. CONCLUSION: Though further longitudinal studies are needed, this scale seems to be a promising instrument to be used in surveys and outcome studies....

  20. Can we predict fall asthma exacerbations? Validation of the seasonal asthma exacerbation index.

    Science.gov (United States)

    Hoch, Heather E; Calatroni, Agustin; West, Joseph B; Liu, Andrew H; Gergen, Peter J; Gruchalla, Rebecca S; Khurana Hershey, Gurjit K; Kercsmar, Carolyn M; Kim, Haejin; Lamm, Carin I; Makhija, Melanie M; Mitchell, Herman E; Teach, Stephen J; Wildfire, Jeremy J; Busse, William W; Szefler, Stanley J

    2017-10-01

    A Seasonal Asthma Exacerbation Predictive Index (saEPI) was previously reported based on 2 prior National Institute of Allergy and Infectious Diseases Inner City Asthma Consortium trials. This study sought to validate the saEPI in a separate trial designed to prevent fall exacerbations with omalizumab therapy. The saEPI and its components were analyzed to characterize those who had an asthma exacerbation during the Preventative Omalizumab or Step-Up Therapy for Fall Exacerbations (PROSE) study. We characterized those inner-city children with and without asthma exacerbations in the fall period treated with guidelines-based therapy (GBT) in the absence and presence of omalizumab. A higher saEPI was associated with an exacerbation in both the GBT alone (P asthma exacerbation in both groups. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  1. [Asthma clinical practice guidelines: advantages and pitfalls].

    Science.gov (United States)

    Plaza, Vicente; Bellido-Casado, Jesús; Alonso-Coello, Pablo; Rodrigo, Gustavo

    2009-01-01

    The Clinical Practice Guidelines on asthma have contributed towards unifying concepts and reaching a consensus on performances between different professional groups. However, they have failed in the overall improvement in the management of asthma, the final objective that they are meant to achieve. Today, almost 20 years after they appeared, the majority of asthmatic patients are still inadequately controlled, partly due to lack of follow up by doctors and the rest of health care staff who have to look after them. This lack of follow up of these recommendations is probably associated with a lack of well structured planning in their circulation and implementation. Also, although the recommendations of these guidelines agree in what is essential, they differ in other aspects, which in turn could be determining factors in clinical practice. The purpose of this article has been to establish the main differences in the recommendations that the principal clinical practice guidelines on the disease propose on the diagnosis, classification and treatment of asthma. To do this we have compared, The British Guideline on the Management of Asthma 2007, The Global Strategy for Asthma Management and Prevention/Global Initiative for Asthma 2006 (GINA), the National Prevention program for Education on Asthma (Programa Nacional de Prevención para la Educación del Asma) (NAEPP), the Spanish Guide for the Management of Asthma (Guía Española para el Manejo del Asma 2003) (GEMA) and the ALAT y SEPAR guides, Latin-America and Spain. Recommendations for the Prevention and Treatment of Asthma Exacerbation (América Latina y España. Recomendaciones para la Prevención y el Tratamiento de la Exacerbación Asmática 2008) (ALERTA).

  2. Obesity, Nutrition, and Asthma in Children

    Science.gov (United States)

    2012-01-01

    Obesity rates have increased dramatically among children in many parts of the world, especially in North America and several other English-speaking countries. The impact of obesity on pediatric health has become a major prevention initiative by the Obama administration and several public health organizations. Children with obesity are at increased risk for developing asthma, which is already one of the most common chronic diseases among children. The cause underlying obesity's impact on asthma risk is unknown. Commonly cited potential etiologies include airway smooth muscle dysfunction from thoracic restriction, obesity-related circulating inflammation priming the lung, and obesity-related comorbidities mediating asthma symptom development. Each of these theories does not fit precisely with all of the data that have accumulated over the last decade. In this review, I will explore other possible causes including: (1) dietary characteristics common in Westernized countries that might lead to both obesity and asthma; (2) reductions in physical activity; and (3) genetic alterations that increase the propensity to both obesity and asthma together. Next, I will review the current data on how obesity affects common characteristics of asthma such as airway inflammation, lung function, risk of exacerbation, atopy, and response to treatment. Obesity in children with asthma appears to be associated with greater airflow obstruction and a mildly diminished response to inhaled corticosteroids. Little objective evidence in children suggests that obesity significantly heightens the risk of exacerbation or worsens disease stability in children. Lastly, I will discuss the current literature that suggests that obese children with asthma generally should receive the same guidelines-based management as lean children. However, interventions that encourage daily physical activity, weight-loss, normalization of nutrient levels, and monitoring of common obesity-related sequelae should be

  3. Respiratory infections precede adult-onset asthma.

    Directory of Open Access Journals (Sweden)

    Aino Rantala

    Full Text Available BACKGROUND: Respiratory infections in early life are associated with an increased risk of developing asthma but there is little evidence on the role of infections for onset of asthma in adults. The objective of this study was to assess the relation of the occurrence of respiratory infections in the past 12 months to adult-onset asthma in a population-based incident case-control study of adults 21-63 years of age. METHODS/PRINCIPAL FINDINGS: We recruited all new clinically diagnosed cases of asthma (n = 521 during a 2.5-year study period and randomly selected controls (n = 932 in a geographically defined area in South Finland. Information on respiratory infections was collected by a self-administered questionnaire. The diagnosis of asthma was based on symptoms and reversible airflow obstruction in lung function measurements. The risk of asthma onset was strongly increased in subjects who had experienced in the preceding 12 months lower respiratory tract infections (including acute bronchitis and pneumonia with an adjusted odds ratio (OR 7.18 (95% confidence interval [CI] 5.16-9.99, or upper respiratory tract infections (including common cold, sinusitis, tonsillitis, and otitis media with an adjusted OR 2.26 (95% CI 1.72-2.97. Individuals with personal atopy and/or parental atopy were more susceptible to the effects of respiratory infections on asthma onset than non-atopic persons. CONCLUSIONS/SIGNIFICANCE: This study provides new evidence that recently experienced respiratory infections are a strong determinant for adult-onset asthma. Reducing such infections might prevent onset of asthma in adulthood, especially in individuals with atopy or hereditary propensity to it.

  4. Asthma in the elderly: a different disease?

    Directory of Open Access Journals (Sweden)

    Salvatore Battaglia

    2016-03-01

    Asthma is a chronic airway disease that affects all ages, but does this definition also include the elderly? Traditionally, asthma has been considered a disease of younger age, but epidemiological studies and clinical experience support the concept that asthma is as prevalent in older age as it is in the young. With the ever-increasing elderly population worldwide, the detection and proper management of the disease in old age may have a great impact from the public health perspective. Whether asthma in the elderly maintains the same characteristics as in young populations is an interesting matter. The diagnostic process in older individuals with suspected asthma follows the same steps, namely a detailed history supported by clinical examination and laboratory investigations; however, it should be recognised that elderly patients may partially lose reversibility of airway obstruction. The correct interpretation of spirometric curves in the elderly should take into account the physiological changes in the respiratory system. Several factors contribute to delaying the diagnosis of asthma in the elderly, including the age-related impairment in perception of breathlessness. The management of asthma in advanced age is complicated by the comorbidities and polypharmacotherapy, which advocate for a comprehensive approach with a multidimensional assessment. It should be emphasised that older age frequently represents an exclusion criterion for eligibility in clinical trials, and current asthma medications have rarely been tested in elderly asthmatics. Ageing is associated with pharmacokinetic changes of the medications. As a consequence, absorption, distribution, metabolism and excretion of antiasthmatic medications can be variably affected. Similarly, drug-to-drug interactions may reduce the effectiveness of inhaled medications and increase the risk of side-effects. For this reason, we propose the term “geriatric asthma” be preferred to the more generic “asthma in the

  5. Improving Asthma during Pregnancy with Dietary Antioxidants: The Current Evidence

    Science.gov (United States)

    Grieger, Jessica A.; Wood, Lisa G.; Clifton, Vicki L.

    2013-01-01

    The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS). Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i) review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii) provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health. PMID:23948757

  6. Asthma control and need for future asthma controller therapy among inner-city Hispanic asthmatic children engaged in a pediatric asthma disease management program (the Breathmobile program, Mobile Asthma Care for Kids Network).

    Science.gov (United States)

    Scott, Lyne; Li, Marilyn; Thobani, Salima; Nichols, Breck; Morphew, Tricia; Kwong, Kenny Yat-Choi

    2016-08-01

    To determine whether significant numbers of asthmatic children with initially rated intermittent asthma later suffer poor asthma control and require the addition of controller medications. Inner-city Hispanic children were followed prospectively in an asthma-specific disease management system (Breathmobile) for a period of 2 years. Clinical asthma symptoms, morbidity treatment, and demographic data were collected at each visit. Treatment was based upon National Heart, Lung, and Blood Institute (NHLBI) Expert Panel Report 3 asthma guidelines. Primary outcome was percentage of patients with intermittent asthma who had not well or poorly controlled asthma during subsequent visits and required controller agents. Secondary outcomes were factors associated with the maintenance of asthma control. About 30.9% of the patients with initial rating of intermittent asthma had not well controlled and poorly controlled asthma during subsequent visits and required the addition of controller agents. Factors associated with good asthma control were compliance, no previous emergency room visits and previous visit during spring season. Asthmatic children with intermittent asthma often lose asthma control and require controller therapy. This justifies asthma guideline recommendations to assess asthma control at follow-up visits and adjust therapy accordingly.

  7. [Occupational asthma in a structure nail maker].

    Science.gov (United States)

    Hannu, Timo; Tuppurainen, Matti; Kauppi, Paula; Alanko, Kristina; Henriks-Eckerman, Maj-Len; Sauni, Riitta

    2009-01-01

    Chemicals that may cause allergy are being used in structure nails. In this case report two structure nail makers are described, who were diagnosed with occupational asthma in clinical studies. The studies included an inhalational exposure simulating the work. The causative agents of occupational asthma are apparently the acrylate compounds contained in the chemicals; use of these compounds has previously been linked with allergic contact dermatitis and asthma. Since the making of structure nails involves health risks, such work requires appropriate premises and personal protection.

  8. Pediatric asthma for the primary care practitioner.

    Science.gov (United States)

    VanGarsse, Anne; Magie, Richard D; Bruhnding, Aubree

    2015-03-01

    Asthma is a complex disease, involving many different allergic, inflammatory, and environmental components. It is a disease for which patient and family education and a team-based approach are paramount for successful management. Guidelines have been put forth by the National Heart, Lung and Blood Institute, which provide a helpful framework in which to begin to manage patients and to navigate the many medication choices available. It is only through diligent attention to control of asthma symptoms that improved quality of life and prevention of long-term sequelae are possible for the pediatric patient with asthma. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. [Epigenetics in allergic diseases and asthma].

    Science.gov (United States)

    Castro-Rodríguez, José A; Krause, Bernardo J; Uauy, Ricardo; Casanello, Paola

    2016-01-01

    Allergic diseases and asthma are the result of complex interactions between genetic predisposition and environmental factors. Asthma is one of the most prevalent chronic disease among children. In this article we review some environmental factors like: allergen exposition, tobacco, bacteria, microbial components, diet, obesity and stress, which influences during intrauterine and infancy life in the epigenetic regulation of asthma and allergic diseases. The review has been done in three models: in-vitro, animal and human. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. "Dangerous relationships": asthma and substance abuse.

    Science.gov (United States)

    Caponnetto, Pasquale; Auditore, Roberta; Russo, Cristina; Alamo, Angela; Campagna, Davide; Demma, Shirin; Polosa, Riccardo

    2013-01-01

    Commonly abused drug are cocaine, marijuana, cigarettes, heroin, and alcohol. The review emphasizes the importance for clinicians to be alert to the possibility of this substance as a precipitating factor for acute asthma. Substance use disorders to characterize illnesses associated with drug use. The use of drugs of abuse increases risk of developing more severe symptoms, higher frequency of exacerbations and having and significant effect on care resources due to clinicians visits and frequent hospital admissions. Abused drug has been shown to accelerate the decline in lung function and to increase numbers of life-threatening asthma attacks, and greater asthma mortality.

  11. The Danish National Register for Asthma

    Directory of Open Access Journals (Sweden)

    Backer V

    2016-10-01

    Full Text Available Vibeke Backer,1 Jesper Lykkegaard,2 Uffe Bodtger,3,4 Lone Agertoft,5 Lene Korshoej,6 Elvira Vaclavik Braüner7,8 1Department of Respiratory Medicine L, Bispebjerg Frederiskberg University Hospital, Copenhagen, 2Research Unit of General Practice, Institute of Public Health, University of Southern Denmark, Odense, 3Department of Respiratory Medicine, Næstved Hospital, Næstved, 4Institute of Regional Health Research, University of Southern Denmark, 5Hans Christian Andersen Children's Hospital, Odense University Hospital, Odense, 6Competence Centre for Clinical Quality and Information Technology West (KCKS West, Aarhus, 7Research Center for Prevention and Health, Center for Health, Glostrup Hospital, Capital Region of Denmark, Glostrup, 8Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Capital Region of Denmark, Copenhagen, Denmark Aim of the database: Asthma is the most prevalent chronic disease in children, adolescents, and young adults. In Denmark (with a population of 5.6 million citizens, >400,000 persons are prescribed antiasthmatic medication annually. However, undiagnosed cases, dubious diagnoses, and poor asthma management are probably common. The Danish National Database for Asthma (DNDA was established in 2015. The aim of the DNDA was to collect the data on all patients treated for asthma in Denmark and to monitor asthma occurrence, the quality of diagnosis, and management. Study population: Persons above the age of 6 years, with a specific focus on 6–44 years, are included. The DNDA links three existing nationwide registries of administrative records in the Danish health care system: the National Patient Register, the National Health Insurance Services Register, and the National Prescription Registry. For each year, the inclusion criteria are a second purchase of asthma prescription medicine within a 2-year period (National Prescription Registry or a diagnosis of asthma (National Patient

  12. Asthma and obesity: does weight loss improve asthma control? a systematic review

    OpenAIRE

    Juel CTB; Ali Z; Nilas L; Ulrik CS

    2012-01-01

    Caroline Trunk-Black Juel,1 Zarqa Ali,1 Lisbeth Nilas,2 Charlotte Suppli Ulrik11Respiratory Section, Internal Medicine Unit, 2Department of Obstetrics and Gynaecology, Hvidovre Hospital and University of Copenhagen, Hvidovre, DenmarkAim and methods: Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight ...

  13. METABOLIC ASTHMA: IS THERE A LINK BETWEEN OBESITY, DIABETES AND ASTHMA?

    Science.gov (United States)

    Perez, Miriam K.; Piedimonte, Giovanni

    2014-01-01

    SYNOPSIS Childhood asthma and obesity have reached epidemic proportions worldwide, and the latter is also contributing to increasing rates of related metabolic disorders like diabetes. Yet, the relationship between asthma, obesity, and abnormal metabolism is not well understood, nor has it been adequately explored in children. This article discusses the concept of “metabolic asthma” and the recent hypothesis that early derangement in lipid and glucose metabolism is independently associated to increased risk for asthma. PMID:25282290

  14. Obesity-asthma phenotype: Effect of weight gain on asthma control in adults.

    Science.gov (United States)

    Çelebi Sözener, Zeynep; Aydın, Ömür; Mungan, Dilşad; Mısırlıgil, Zeynep

    2016-07-01

    The obesity-asthma phenotype has become an increasingly common situation in our clinical practice. The mechanisms behind poor asthma control in subjects who are obese remain unclear. We aimed to determine the effect of obesity on asthma control in a group of adult patients Method: Subjects who had been diagnosed as having asthma and who were admitted to our clinic were included to this study. Body mass index (BMI) and asthma control status of the patients were evaluated. BMI values at the time of diagnosis were also collected from the patient files, and the difference between basal and current BMI values were calculated. The effect of obesity and weight gain on asthma control was investigated. The study population was composed of 218 patients (29 men, 189 women), with a mean (standard deviation) age of 52.01 ± 11.6 years. Fifty-four percent of the patients were obese, 27.5% were overweight, and 18.3% were of normal weight. The baseline and current BMI values were higher in women than in the men. BMI increased with the increase in age or disease duration. Asthma control was poor in the patients who were obese and overweight despite optimal treatment. Moreover, asthma control was worse in patients who gained weight during the follow-up period. In our study, we found a significant relationship between obesity and asthma control. In addition, weight gain and being nonatopic also was found to worsen asthma control. In light of our finding that weight gain led to a decrease in asthma control, we suggest that weight loss may improve the course of asthma.

  15. Monitoring childhood asthma: web-based diaries and the asthma control test.

    Science.gov (United States)

    Voorend-van Bergen, Sandra; Vaessen-Verberne, Anja A; Landstra, Anneke M; Brackel, Hein J; van den Berg, Norbert J; Caudri, Daan; de Jongste, Johan C; Merkus, Peter J; Pijnenburg, Mariëlle W

    2014-06-01

    Data from asthma diaries are frequently used as an end point in asthma studies; however, data on the validity of Web-based diaries are scarce. First, we examined the validity of a Web-based diary in assessing asthma control. Second, we determined the cutoff points for well-controlled asthma of the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT), and calculated the minimal important difference for both tests. Children with asthma, ages 4-18 years (n = 228) completed a 4-week Web-based diary, C-ACT, ACT, and an asthma-related quality-of-life questionnaire at baseline and after 1-year follow-up. The completion rate of the Web-based diaries was 89%. The diary scores correlated strongly with C-ACT and ACT scores (r = -0.73, P < .01; r = -0.64, P < .01, respectively) and the changes in diary scores correlated well with changes in C-ACT and ACT scores. The best cutoff points for well-controlled asthma were C-ACT ≥ 22 and ACT ≥ 23. The minimal important differences were 1.9 (95% CI, 1.3-2.5) for ACT and 1.6 (95% CI, 1.1-2.1) for C-ACT, and -0.7 points/d (95% CI, -1.1 to -0.4) for the Web-based diary. Our Web-based diary was valid for recording asthma symptoms. Cutoff points of ≥22 (C-ACT) and ≥23 (ACT) define well-controlled asthma. We recommend a 2 C-ACT and ACT points difference as minimally important. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  16. The integrated care of asthma in Switzerland (INCAS)-study: Patients' perspective of received asthma care and their interest in asthma education.

    Science.gov (United States)

    Dürr, Selina; Hersberger, Kurt E; Zeller, Andreas; Scheuzger, Jonas; Miedinger, David; Gregoriano, Claudia; Leuppi, Jörg D; Steurer-Stey, Claudia

    2016-11-01

    For successful long-term asthma care, self-management education is a cornerstone. Little is known about associations between patients' interest in education, asthma control and care delivery. We compared patients' characteristics, asthma control and patients' perspective about asthma care in subjects with and without interest in asthma education. Moreover, we assessed reasons, why patients denied participating in asthma education. Baseline data of 223 patients with asthma (age 43 ± 12 years, 38% male, 58% non-smokers, 13% current smokers), who participated in a multicentre longitudinal controlled study, are reported. At baseline, patients completed the Asthma Control Test (ACT), the Patient Assessment Chronic Illness Care questionnaire (PACIC 5A) and stated their interest in an asthma education programme. Overall, 34% of all participants showed uncontrolled asthma. One hundred and twenty-five (56%) patients were interested in education. Compared to patients without interest, they were characterised by male gender (p = 0.013), worse asthma control (p < 0.001), and perception of lower quality of chronic asthma care delivery, in particular lower self-management support (p < 0.001). Main reasons for rejecting asthma education were having sufficient asthma knowledge, having only mild asthma, receiving adequate medical support and lack of time. More than half of the patients were interested in asthma education. Interest was associated with worse asthma control and lower receipt of care according to the Chronic Care Model. Considering these aspects, this approach may help to improve care quality and allow targeting interventions to those patients who are interested in becoming active participants in their care and who might benefit most.

  17. [Diagnostic values of fractional exhaled nitric oxide for typical bronchial asthma and cough variant asthma in children].

    Science.gov (United States)

    Wang, Tian-Yue; Shang, Yun-Xiao; Zhang, Han

    2015-08-01

    To study the diagnostic values of fractional exhaled nitric oxide (FeNO) for typical bronchial asthma and cough variant asthma in children, and to explore whether FeNO can be applied to differentiate typical bronchial asthma from cough variant asthma in children. A total of 150 children who were newly diagnosed with typical bronchial asthma between June 2012 and June 2014, as well as 120 children who were newly diagnosed with cough variant asthma during the same period, were selected as subjects. FeNO measurement, spirometry, and methacholine provocation test were performed for both groups. Meanwhile, 150 healthy children were selected as the control group, and their FeNO was measured. The diagnostic values of FeNO for typical bronchial asthma and cough variant asthma were analyzed using the receiver operating characteristic curve. The FeNO values in the typical bronchial asthma and cough variant asthma groups were significantly higher than in the control group (Pbronchial asthma group was significantly higher than in the cough variant asthma group (Pbronchial asthma group than in the cough variant asthma group (Pbronchial asthma, with a sensitivity of 83.3% and a specificity of 86.7%; the optimal cut-off value of FeNO was 15.5 ppb for the diagnosis of cough variant asthma, with a sensitivity of 67.5% and a specificity of 78.0%; the optimal cut-off value of FeNO was 28.5 ppb for the differentiation between typical bronchial asthma and cough variant asthma, with a sensitivity of 60.7% and a specificity of 82.5%. Measurenment of FeNO may be useful in the diagnosis and differential diagnosis of typical bronchial asthma and cough variant asthma.

  18. Parents' asthma information needs and preferences for school-based asthma support.

    Science.gov (United States)

    Al Aloola, Noha Abdullah; Nissen, Lisa; Alewairdhi, Huda Abdullaziz; Al Faryan, Nawaf; Saini, Bandana

    2017-11-01

    This study sought to investigate parents' needs and preferences for school-based asthma support in Saudi Arabian primary schools. Semi-structured qualitative interviews were conducted in the period between November 2015 and February 2016, with a convenience sample that comprised Saudi parents and carers of children with asthma. Recruitment of participants was primarily driven through Saudi primary schools; passive snowballing and social networks were used to boost participation rates further. Interviews were audio-recorded, transcribed verbatim, translated and data were thematically organised using a latent content analysis approach. Twenty interviews were conducted. Six themes emerged from the interviews and were grouped into three major categories: (1) general asthma management issues; (2) school-based asthma management issues; and (3) communication dissatisfaction. Participants expressed concern at schools' social and physical environments and a lack of confidence in the ability of schools to manage their child's asthma, especially when their child was ill. Most of the participants advocated for staff training and school community engagement to improve the management of asthma in Saudi primary schools. This research clearly describes a need for school-based asthma support, including asthma-related policies, procedures and education on asthma and first aid in Saudi primary schools.

  19. Asthma during pregnancy: the experiences, concerns and views of pregnant women with asthma.

    Science.gov (United States)

    Lim, Angelina S; Stewart, Kay; Abramson, Michael J; Ryan, Kath; George, Johnson

    2012-06-01

    To investigate how pregnant women manage their asthma during pregnancy and factors influencing their behavior. In-depth interviews (telephone or face-to-face) with a purposive sample of 23 asthmatic women at various stages of pregnancy and with varying severity of asthma. Five major themes were discerned relating to health behavior of pregnant women with asthma. Many of the participants decreased or discontinued their asthma medications themselves and refrained from taking doses when necessary during pregnancy without consulting their doctors. Reasons behind their decisions revolved around lack of support and information about what to do, concerns about the safety of the medications, past experiences, and desire for an "all natural" pregnancy. Asthma monitoring during pregnancy was seen as a low priority for some women and their doctors. Communication between pregnant women and health professionals regarding asthma management was poor. The health behavior of pregnant women with asthma could be explained using the Health Beliefs Model. Pregnant women are not well supported in managing asthma during pregnancy, despite being concerned about outcomes. Interventions, education, and more support are warranted and wanted by pregnant women with asthma to optimize pregnancy and neonatal outcomes.

  20. Mechanisms of Asthma in Obesity. Pleiotropic Aspects of Obesity Produce Distinct Asthma Phenotypes.

    Science.gov (United States)

    Dixon, Anne E; Poynter, Matthew E

    2016-05-01

    The majority of patients with severe or difficult-to-control asthma in the United States are obese. Epidemiological studies have clearly established that obese patients tend to have worse asthma control and increased hospitalizations and do not respond to standard controller therapy as well as lean patients with asthma. Less clear are the mechanistic underpinnings for the striking clinical differences between lean and obese patients with asthma. Because obesity is principally a disorder of metabolism and energy regulation, processes fundamental to the function of every cell and system within the body, it is not surprising that it affects the respiratory system; it is perhaps surprising that it has taken so long to appreciate how dysfunctional metabolism and energy regulation lead to severe airway disease. Although early investigations focused on identifying a common factor in obesity that could promote airway disease, an appreciation has emerged that the asthma of obesity is a manifestation of multiple anomalies related to obesity affecting all the different pathways that cause asthma, and likely also to de novo airway dysfunction. Consequently, all the phenotypes of asthma currently recognized in lean patients (which are profoundly modified by obesity), as well as those unique to one's obesity endotype, likely contribute to obese asthma in a particular individual. This perspective reviews what we have learned from clinical studies and animal models about the phenotypes of asthma in obesity, which show how specific aspects of obesity and altered metabolism might lead to de novo airway disease and profoundly modify existing airway disease.

  1. Comparative Clinical, Physiological, and Inflammatory Characteristics of Elderly Subjects With or Without Asthma and Young Subjects With Asthma.

    Science.gov (United States)

    Boulet, Louis-Philippe; Robitaille, Catherine; Deschesnes, Francine; Villeneuve, Hélène; Boulay, Marie-Ève

    2017-12-01

    Asthma seems to present in the elderly as a specific phenotype that remains to be further described. In this prospective observational study, we aimed to assess the multidimensional aspects of asthma in the elderly. In young (18 to 35 years old) subjects with mild to moderate asthma and elderly subjects (aged ≥60 years) either with or without mild to moderate asthma, we compared asthma control, health care and medication use, lung function, markers of airway and systemic inflammation, and adherence to therapy. Fifty subjects were recruited in each group. Elderly people with asthma showed more marked airway obstruction compared with young people with asthma and elderly people without asthma. They also had poorer asthma control, mainly associated with a lower FEV1, compared with young people with asthma, although airway responsiveness, health care use, prescribed doses of inhaled corticosteroids, and adherence to treatment were similar in both groups. Elderly subjects had an increase in some markers of systemic inflammation and bronchial epithelial dysfunction compared with young people with asthma. Blood eosinophils were higher in both asthma groups, particularly in elderly people with asthma. Sputum neutrophils were increased in both groups of elderly subjects and sputum eosinophils were increased in elderly people with asthma compared with the other two groups. Asthma in the elderly presents as a specific phenotype associated with increased airway obstruction and mixed airway inflammation in addition to signs of systemic inflammation. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  2. Asthma

    Science.gov (United States)

    ... family history of allergies , such as hay fever ( allergic rhinitis ) or eczema . Others have no history of allergies. ... more than twice as long as breathing in Breathing temporarily stops Chest pain Tightness in the chest

  3. Echocardiograph alterations in asthma patients

    Directory of Open Access Journals (Sweden)

    André Luís Mancini

    2008-05-01

    Full Text Available Introduction: Asthma is a chronic inflammatory disease which has increased during the last 20 years, putting a strain on medical resources, particularly severe forms of the disease. Treatment in such cases is inhaled corticosteroids and beta agonist drugs that can produce a range of side effects. The aim of this study is to identify echocardiograph abnormalities and correlate them with severity of disease. Methodology: Eight-seven outpatients were selected at the asthma unit of the Gaffree Guinle University Hospital (HUGG. Each patient underwent spirometry, electrocardiogram (ECG and echocardiogram (ECO during the trial within a month maximum. Echocardiograph abnormalities found related to degree of asthma. Statistical analysis was made by nonparametric tests. Results: We found significant differences (p ≤ 0.05 for age, disease duration and haemoglobin saturation (SaO2 between the moderate and severe groups. In the sample a high prevalence of tricuspid insufficiency (41.4% was identified. Conclusions: ECO identified a series of abnormalities that were not always dependent on severity of disease. ECO can identify pulmonary hypertension through calculation of mean pressure of the pulmonary artery. Resumo: Introdução: A asma é uma doença inflamatória crónica cuja prevalência vem aumentando nos últimos 20 anos. Demanda grande utilização de recursos, principalmente no grupo grave. Neste, há consumo crónico de corticóides inalatórios e de β2-agonistas, que podem produzir uma série de problemas. O objectivo deste trabalho é o de rastrear as alterações electro e ecocardiográficas e relacioná-las ao grau da asma. Metodologia: Selecionámos 87 doentes do ambulatório de asma do HUGG, que, por rotina, possuem uma espirografia, um eletrocardiograma (ECG e um ecocardiograma (ECO feitos com um intervalo máximo de um mês. As alterações ecocardiográficas encontradas

  4. Nonprescription racemic epinephrine for asthma.

    Science.gov (United States)

    Mondal, Pritish; Kandala, Bhargava; Ahrens, Richard; Chesrown, Sarah E; Hendeles, Leslie

    2014-01-01

    Inhaled racepinephrine (RE) (Asthmanefrin) became available in September 2012 as a nonprescription treatment for bronchospasm based on a 1986 US Food and Drug Administration rule. It contains 11.25 mg RE in 0.5 mL and is delivered by a handheld electronic nebulizer. In 2001, we conducted a pilot study that was never published. Now that the product is promoted as a replacement for epinephrine chlorofluorocarbon metered-dose inhaler (Primatene), we provide the results of that study. Methacholine challenge was used as a bioassay. To determine the dose of RE that is equivalent to nebulized albuterol. Four subjects, 18 to 45 years old, with mild stable asthma completed the pilot study. Methacholine challenge was performed on the first screening day, without pretreatment, and then on different days, 15 minutes after 1.25 mg albuterol and 2.5, 5, 10, and 20 mg RE delivered by a Pari LC Plus nebulizer. The end point was the provocative concentration of methacholine that caused a 20% decrease in FEV1. Data were log transformed and analyzed by an ANOVA for repeated measures. There was a significant dose response for RE. The geometric mean provocative concentration of methacholine that caused a 20% decrease in FEV1 was 44 mg/mL (95% CI, 23-85 mg/mL) after albuterol, and 10.2 mg/mL (95% CI, 3.5-30 mg/mL) after the 10-mg dose of RE (approximate nonprescription dose) (P = .001). There were no adverse effects. RE provides less bronchoprotection from methacholine than does albuterol and may be less effective in treating acute bronchospasm. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  5. The asthma patient and dental management.

    Science.gov (United States)

    Coke, John M; Karaki, Donald T

    2002-01-01

    Asthma is increasing worldwide at a dramatic rate. The way the medical community defines asthma is changing, from considering it solely a respiratory disease to recognizing it as a more complex inflammatory disease process. This means that the treatment of asthma is becoming multifocal, depending upon the varied symptoms displayed. Reflecting this change is a shift to the use of corticosteroids in addition to the more traditional pulmonary medications. Dentists should be aware of the newer classifications and treatment modalities. There needs to be an understanding of the role these pharmaceutical agents play in the needs and treatment of our dental patients. Recent trends in the diagnosis and management of asthma are examined and recommendations for managing the asthmatic patient are provided.

  6. Role of leukotrienes in asthma pathophysiology

    DEFF Research Database (Denmark)

    Bisgaard, H

    2000-01-01

    obvious targets for therapy. These cysteinyl leukotrienes, previously known as the slow-reacting substance of anaphylaxis (SRS-A), mediate many of the features of asthma, including bronchial constriction, bronchial hyperreactivity, edema, and eosinophilia. Data show that selective cysteinyl leukotriene......Inflammation is an essential component of asthma pathophysiology. While beta(2)-agonists are often used for short-term relief of acute bronchospasm, anti-inflammatory agents are required for the long-term management of chronic inflammation in this disease. Corticosteroids have emerged as the first......-line anti-inflammatory therapy for asthma management. However, in some patients, especially children, the high doses of corticosteroids that may be required to control features of hyperresponsiveness, including exercise-induced asthma, raise safety concerns. Thus, there is a need for complementary anti...

  7. Foreign body aspiration masquerading as difficult asthma

    Directory of Open Access Journals (Sweden)

    Rai S

    2007-01-01

    Full Text Available It is important to assess patients of difficult/therapy resistant asthma carefully in order to identify whether there are any correctable factors that may contribute to their poor control. It is critical to make a diagnosis of asthma and to exclude other airway diseases. A 65-years-old lady presented with repeated acute episodes of dyspnoea and wheezing. She was on regular medication for bronchial asthma for 18 years. There was no history of foreign body aspiration or loss of consciousness. Her chest radiograph was normal. She showed poor response to corticosteroids and bronchodilators. Fibreoptic bronchoscopy (FOB showed intracordal cyst of the left vocal cord and 1cm size irregular piece of betel nut in right main bronchus, which was removed endoscopically with the help of dormia basket, following which her condition improved and asthma was controlled on inhaled bronchodilators.

  8. Inhaled Corticosteroid Therapy Does Not Control Asthma

    Directory of Open Access Journals (Sweden)

    Robert L Cowie

    2004-01-01

    Full Text Available BACKGROUND: Randomized clinical trials demonstrate efficacy and show that inhaled corticosteroid therapy can control asthma, but details concerning their effectiveness in achieving this goal in the community are lacking.

  9. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Poor Health Usual Place for Medical Care among Children Number of Visits to a Health Care Provider(s) among Children Health Care Coverage among Children Asthma-related Missed ...

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share ... to follow along with the correct way to use your metered dose inhaler. Print the step-by- ...

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by ... you to do and by avoiding things that can cause an attack. Watch a video to follow ...

  12. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School and Childcare Providers More Asthma ... Email CDC-INFO U.S. Department of Health & Human Services HHS/Open USA.gov Top

  13. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... asthma and avoid an attack by taking your medicine exactly as your doctor or other medical professional ... Page last reviewed: May 6, 2013 Page last updated: November 19, 2014 Content source: National Center for ...

  14. Know How to Use Your Asthma Inhaler

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    Full Text Available ... City Asthma YES WE CAN Bibliography Breathing Easier Success Stories State Contacts and Programs Evaluation Evaluation Guide ... CDC Jobs Funding LEGAL Policies Privacy FOIA No Fear Act OIG 1600 Clifton Road Atlanta , GA 30329- ...

  15. Asthma Medicines: Long-Term Control

    Science.gov (United States)

    ... this site from a secured browser on the server. Please enable scripts and reload this page. Turn ... prescribed for asthma, mainly because it requires careful monitoring of blood levels to avoid side effects and ...

  16. Know How to Use Your Asthma Inhaler

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    Full Text Available ... 3-2 Table 4-1 Table 4-2 Reports and Publications Asthma Surveillance Summaries MMWR Publications NCHS Reports and Publications Related Articles, Publications, and Links Asthma’s ...

  17. Atypical Bacteria and Macrolides in Asthma

    Directory of Open Access Journals (Sweden)

    Xepapadaki Paraskevi

    2008-09-01

    Full Text Available Chlamydophila pneumoniae and Mycoplasma pneumoniae are common pathogens causing acute illness in both the upper and lower airways. Several observations are supportive of a possible causative role of these pathogens in asthma; however, more evidence is required before this becomes meaningful in clinical practice. Atypical bacteria can enhance airway hyperresponsiveness and inflammation, both of which have been associated with exacerbations in patients with preexisting asthma. It is less clear whether the above mechanisms might also be responsible for the development of asthma. Difficulties in accurately diagnosing these infections contribute to such uncertainty. In the present report, evidence of the involvement of Chlamydophila and Mycoplasma infection in the development and the progression of asthma are reviewed.

  18. Know How to Use Your Asthma Inhaler

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    Full Text Available ... on this page will be unavailable. For more information about this message, please visit this page: About ... Tables and Graphs Asthma Call-back Survey Technical Information Prevalence Tables BRFSS Prevalence Data NHIS Prevalence Data ...

  19. House dust mite control measures for asthma

    DEFF Research Database (Denmark)

    Gøtzsche, Peter C.; Johansen, Helle Krogh

    2008-01-01

    BACKGROUND: The major allergen in house dust comes from mites. Chemical, physical and combined methods of reducing mite allergen levels are intended to reduce asthma symptoms in people who are sensitive to house dust mites. OBJECTIVES: To assess the effects of reducing exposure to house dust mite...... antigens in the homes of people with mite-sensitive asthma. SEARCH STRATEGY: PubMed and The Cochrane Library (last searches Nov 2007), reference lists. SELECTION CRITERIA: Randomised trials of mite control measures vs placebo or no treatment in people with asthma known to be sensitive to house dust mites......), the standardised mean difference was 0.00 (95% confidence interval (CI) -0.10 to 0.10). There were no statistically significant differences either in number of patients improved (relative risk 1.01, 95% CI 0.80 to 1.27), asthma symptom scores (standardised mean difference -0.04, 95% CI -0.15 to 0...

  20. Novel monoclonal treatments in severe asthma

    DEFF Research Database (Denmark)

    Meteran, Howraman; Meteran, Hanieh; Porsbjerg, Celeste

    2017-01-01

    AIM: To provide a general overview of the current biological treatments and discuss their potential anti-asthmatic effects. DATA SOURCES: We reviewed articles in PubMed found using the search words "Asthma/therapy AND antibodies, monoclonal/therapeutic use AND cytokines." STUDY SELECTIONS: Only...... articles published in English since 2000 were considered. The search identified 29 studies; 8 additional studies were found by hand search, generating 37 studies. RESULTS: Of the 37 studies investigating biological treatments of asthma, 5 were on the effects of anti-IgE (omalizumab); 12 on anti-IL-5; 8...... TSLP, IL-9, and TNF-α lacked convincing effectiveness. CONCLUSION: Research on the biological treatment of asthma shows promising results. While anti-IgE (omalizumab) has been used in the treatment of asthma for some years, anti-IL-5 has recently been approved for use. The efficacy of results of other...

  1. Age at menarche and risk of asthma

    DEFF Research Database (Denmark)

    Lieberoth, Sofie; Gade, Elisabeth Juul; Brok, Jesper

    2014-01-01

    BACKGROUND: Several studies have suggested a relationship between the age at menarche and risk of asthma development. OBJECTIVE: To conduct a systematic review and meta-analysis of the relationship between the age at menarche and the risk of asthma. METHODS: This systematic review and meta...... articles, with a total of 22,859 subjects, matched the inclusion criteria for the meta-analysis. Pooling of the seven studies showed that girls with early menarche (asthma relative to girls with late menarche; random effects odds ratio = 1.37 (1.15-1.64), (p = 0.......0005). Substantial heterogeneity was revealed (I(2) = 55%). Sensitivity analysis showed that the risk estimate was not markedly changed when excluding any of the studies. The funnel plot did not indicate publication bias. CONCLUSIONS: Early menarche appears to be associated with increased risk of asthma. Hormonal...

  2. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Brochures Facts Triggers Indoors In the Workplace Outdoors Management Asthma Action Plan Flu Shots Inhalers Data, Statistics, ... Mixed Methods 5. Purpose Informs Design Other Evaluation Resources Multimedia ... USA.gov Top

  3. Lung Disease Including Asthma and Adult Vaccination

    Science.gov (United States)

    ... Diseases Resources Lung Disease including Asthma and Adult Vaccination Language: English (US) Español (Spanish) Recommend on Facebook ... more about health insurance options. Learn about adult vaccination and other health conditions Asplenia Diabetes Heart Disease, ...

  4. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Share Compartir You can control your asthma and avoid an attack by taking your medicine exactly as ... to do and by avoiding things that can cause an attack. Watch a video to follow along ...

  5. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... avoid an attack by taking your medicine exactly as your doctor or other medical professional tells you ... keep them with your Asthma Action Plan. Using a metered dose inhaler with a spacer Your browser ...

  6. How Can I Deal with My Asthma?

    Science.gov (United States)

    ... had trouble with it and why. Use asthma management tools. Even if you're feeling absolutely fine, don't abandon tools like daily long-term control medicines (also called "controller" or "maintenance" medicines) if ...

  7. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma Inhaler Recommend on Facebook Tweet ... your doctor or other medical professional tells you to do and by avoiding things that can cause ...

  8. Asthma as a disruption in iron homeostasis

    Science.gov (United States)

    Over several decades, asthma has evolved from being recognized as a single disease to include a diverse group of phenotypes with dissimilar natural histories, pathophysiologies, responses to treatment, and distinctive molecular pathways. With the application of Occam’s raz...

  9. Leukotriene modifiers in pediatric asthma management

    DEFF Research Database (Denmark)

    Bisgaard, H

    2001-01-01

    Cysteinyl leukotrienes (Cys-LTs) are mediators released in asthma and virus-induced wheezing. Corticosteroids appear to have little or no effect on this release in vivo. Cys-LTs are both direct bronchoconstrictors and proinflammatory substances that mediate several steps in the pathophysiology...... of chronic asthma, including inflammatory cell recruitment, vascular leakage, and possibly airway remodeling. Blocking studies show that Cys-LTs are pivotal mediators in the pathophysiology of asthma. Cys-LTs are key components in the early and late allergic airway response and also contribute to bronchial...... obstruction after exercise and hyperventilation of cold, dry air in asthmatics. LT modifiers reduce airway eosinophil numbers and exhaled nitric oxide levels. Together these findings support an important role for the Cys-LTs in the asthma airway inflammation. Cys-LT receptor antagonists (Cys...

  10. Optimizing inhalation therapy in childhood asthma

    NARCIS (Netherlands)

    Visser, Reina

    2016-01-01

    Childhood asthma is a common chronic disease, featured by inflammation of the airways and episodic bronchoconstriction. Exercise is an important trigger for bronchoconstriction in asthmatic children. They experience this symptom, limiting participation in play and sports, as the most bothersome

  11. Asthma and Allergy Foundation of America

    Science.gov (United States)

    ... Triggers Allergens and Allergic Asthma Tobacco Smoke Air Pollution Indoor Air Quality Respiratory Infections Pneumococcal Disease Flu ( ... State Honor Roll Alabama Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Alaska Maine Maryland ...

  12. Prevention of Allergies and Asthma in Children

    Science.gov (United States)

    ... has allergic conditions are at risk for developing food allergy, especially if they already exhibit allergic symptoms of atopic dermatitis, allergic rhinitis or asthma. Restricting a mother's diet of specific ...

  13. Nitrosative events in atopic asthma pathogenesis

    Directory of Open Access Journals (Sweden)

    Parilova O. O.

    2015-12-01

    Full Text Available The correlation between high exhaled nitric oxide levels and eosinophilic-mediated airway inflammation in patients with atopic asthma has been well documented. This generates prerequisites that a regulatory feedback mechanism exists between them. Therefore, the paper briefly describes evidence implementing biosynthesis, enzyme structural features, expression regulation of its isoforms and effects of nitric oxide, which have helped elucidate molecular mechanisms by which nitric oxide selectively promotes asthma exacerbation. In previous study we have demonstrated that airway infiltrate of immune cells contributes to NO synthesis in the respiratory tract during allergic inflammation under guinea pig model of acute asthma with multiple challenges. On the basis of these findings the authors posits that nitric oxide represents an additional signal of the induction of Th2 subset response and be considerably involved in the complex network of immune regulation distinctive for atopic asthma phenotype.

  14. The impact of asthma medication guidelines on asthma controller use and on asthma exacerbation rates comparing 1997-1998 and 2004-2005.

    Science.gov (United States)

    Rank, Matthew A; Liesinger, Juliette T; Ziegenfuss, Jeanette Y; Branda, Megan E; Lim, Kaiser G; Yawn, Barbara P; Shah, Nilay D

    2012-01-01

    The relationship between asthma controller medication use and exacerbation rates over time is unclear at the population level. To estimate the change in asthma controller medication use between 2 time periods as measured by the controller-to-total asthma medication ratio and its association with changes in asthma exacerbation rates between 1997-1998 and 2004-2005. The study design was a cross-sectional population-level comparison between individuals from 1997-1998 and 2004-2005. Study participants were individuals aged 5 to 56 years identified as having asthma in the Medical Expenditure Panel Survey (MEPS). The main outcome measures were a controller-to-total asthma medication ratio greater than 0.5 and asthma exacerbation rates (dispensing of systemic corticosteroid or emergency department visit/hospitalization for asthma) in 1997-1998 compared with 2004-2005. The proportion of individuals with a controller-to-total asthma medication ratio greater than 0.5, when adjusted for other demographic factors, has improved by 16.1% (95% CI: 10.8%, 21.3%) for all individuals from 1997-1998 to 2004-2005. Annual asthma exacerbation rates did not change significantly in any group from 1997-1998 to 2004-2005 (0.27/year to 0.23/year). African American and Hispanic individuals with asthma had higher asthma exacerbation rates and a lower proportion with a controller-to-total asthma medication ratio greater than 0.5 than whites in both 1997-1998 and 2004-2005; however, these differences were not statistically significant. An increase in asthma controller-to-total medication ratio in a sample reflective of the US population was not associated with a decreased asthma exacerbation rate comparing 1997-1998 and 2004-2005. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  15. The Integrated Care of Asthma in Switzerland (INCAS) Study: Changes in Asthma Control and Perception of Health Care through Asthma Education.

    Science.gov (United States)

    Dürr, Selina; Hersberger, Kurt E; Zeller, Andreas; Scheuzger, Jonas; Miedinger, David; Gregoriano, Claudia; Joos Zellweger, Ladina; Steurer-Stey, Claudia; Leuppi, Jörg Daniel

    2017-01-01

    Despite great efforts in establishing optimal asthma management, asthma may remain uncontrolled. To effectively manage chronic diseases, such as asthma, it is important to train patients in self-management skills. The aim of this study was to assess the potential benefit of standardised asthma education in Switzerland for asthma control and patients' perception of received asthma care and of self-management support. For this multicentre longitudinal controlled study, asthma patients were recruited in Switzerland. The Asthma Control Test (ACT) was used to assess asthma control. The Patient Assessment of Chronic Illness Care questionnaire (PACIC 5A) was applied to evaluate received health-care services and self-management support. Patients were offered the possibility to attend asthma education sessions conducted by the Swiss Lung League and Swiss Allergy Centre. After 1 year, attenders and non-attenders completed the questionnaires again. Changes in ACT and PACIC 5A scores were analysed using dependent t tests. Overall, 223 patients with asthma were investigated (mean age 43 ± 12 years, 38% male, 13% current smokers, 29% ex-smokers). Sixty-one (27%) patients attended education sessions. Both groups had improved asthma control at follow-up (attenders: t(56) = -3.2, r = 0.4 [medium effect size], p = 0.002; non-attenders: t(141) = -2.6, r = 0.2 [small effect size], p = 0.010). Attenders improved in PACIC and 5A sum scores (t(50) = -3.6, r = 0.5 [medium effect size], p = 0.001). A comprehensive self-management asthma education programme in Switzerland improved asthma control and patients' perception of received asthma care and of self-management support. Professionals should motivate patients to attend asthma education in order to become active partners in managing their disease. © 2017 S. Karger AG, Basel.

  16. [Pathogenetic and clinical aspects of diisocyanate asthma].

    Science.gov (United States)

    Swierczyńska-Machura, Dominika; Pałczyński, Cezary

    2012-01-01

    Diisocyanates are currently the most common cause of occupational asthma in industrialized countries, where its prevalence ranges from less than 5% to 15%. They are mainly used in the production of polyurethane foam, plastic packagings, laminates and polyurethane paints. The diagnosis of diisocyanate asthma is often problematic due to the lack of simple diagnostic or screening tests, uncertainty of underlying mechanisms, and a multitude of other potential occupational and environmental causes of asthma. At present, only a specific standardized challenge test with diisocyanates in concentrations not exceeding the adopted hygiene standards has been found to show a real diagnostic value. The diisocyanate-inducedsensitization, is associated with the recruitment of CD4 T lymphocytes to the lungs and the production of Th2-type cytokines, including IL-4, IL-5 and IL-13. However, clinical studies have suggested that an immunological response to diisocyanates may involve both Th1 and Th2 cells. The development of animal models has been instrumental in furthering the understanding of the pathogenesis of many diseases, including bronchial asthma. Murine models of diisocyanate-induced asthma have proved to be the most useful. Mouse models offer distinct advantages of a better-defined genome than that of guinea pigs or rats and the availability of antibody reagents and transgenic strains to investigate detailed mechanistic pathways. A better understanding of the immunopathogenesis of diisocyanate asthma will hopefully lead to early markers of sensitization and asthma, as well as to a profound comprehension of exposure and host risk factors, both of them should greatly facilitate the development of much-needed diagnostic and preventive strategies for diisocyanate asthma.

  17. Molds, parental atopy and pediatric incident asthma.

    Science.gov (United States)

    Hwang, B-F; Liu, I-P; Huang, T-P

    2011-12-01

    To assess the independent and joint effects of parental atopy and exposure to molds on the development of asthma in childhood, the authors conducted a cohort-based, incident case-control study in 2008. The case group consisted of 188 children with new asthma, and the control group (n=376) was matched one to two for age and sex. The outcome of interest was the development of asthma during the study period. The studied determinants were parental atopy and three indicators of exposure including histories of water damage, presence of visible molds, and perceived mold odor in the home at baseline in 2002. In conditional logistic regression adjusting for confounding, parental atopy [adjusted odds ratio (aOR) 3.29, 95% CI 2.19-4.94] and the presence of mold odor (aOR 2.09, 95% CI 1.30-3.37) and visible mold (aOR 1.76, 95% CI 1.18-2.62) were independent determinants of incident asthma, and apparent interaction in additive scale was observed. Our finding suggests that the interaction between parental atopy and molds may play a role in the development of asthma in children. Our study strengthens the evidence for the roles of indoor dampness problem and parental atopy as determinants of asthma in children. Furthermore, the interaction between parental atopy and exposure to molds suggests a role for the development of childhood asthma, i.e., the children whose parents had atopic disease and molds exposure are more susceptible to develop asthma. © 2011 John Wiley & Sons A/S.

  18. Occupational Asthma in a Cable Manufacturing Company

    Science.gov (United States)

    Attarchi, Mirsaeed; Dehghan, Faezeh; Yazdanparast, Taraneh; Mohammadi, Saber; Golchin, Mahdie; Sadeghi, Zargham; Moafi, Masoud; Seyed Mehdi, Seyed Mohammad

    2014-01-01

    Background: During the past decade, incidence of asthma has increased, which might have been due to environmental exposures. Objectives: Considering the expansion of cable manufacturing industry in Iran, the present study was conducted to evaluate the prevalence of occupational asthma in a cable manufacturing company in Iran as well as its related factors. Patients and Methods: This study was conducted on employees of a cable manufacturing company in Yazd, Iran, in 2012. The workers were divided into two groups of exposure (to toluene diisocyanate, polyvinyl chloride, polyethylene or polypropylene) and without exposure. Diagnosis of occupational asthma was made based on the subjects’ medical history, spirometry and peak flowmetry, and its frequency was compared between the two groups. Results: The overall prevalence of occupational asthma was 9.7%. This rate was 13.8% in the exposed group. Logistic regression analysis showed that even after adjustment for confounding factors, a significant correlation existed between the frequency of occupational asthma and exposure to the produced dust particles (P < 0.05). In addition, age, work experience, body mass index, cigarette smoking and shift work had significant correlations with the prevalence of occupational asthma (P < 0.05). Conclusions: Considering the high prevalence of occupational asthma among cable manufacturing company workers in Iran, this issue needs to be addressed immediately in addition to reduction of exposure among subjects. Reduction in work shift duration, implementation of tobacco control and cessation programs for the personnel, and performing spirometry tests and respiratory examinations in shorter periods may be among effective measures for reducing the incidence of occupational asthma in this industry. PMID:25558389

  19. Helicobacter pylori infection and pediatric asthma

    OpenAIRE

    Abdullah Karimi; Koroush Fakhimi Derakhshan; Farid Imanzadeh; Mohamad Rezaei; Zahra Cavoshzadeh; Saeid Maham

    2013-01-01

    Objective Childhood infectious diseases are one of the most known environmental pathogenic causes of childhood asthma. The high prevalence of both Helicobacter pylori infection and asthma in our country prompted us to assess anyprobable association between them in childhood. Methods This cross-sectional study recruited 196 children aged 6 to 12 years old comprising 98 asthmatic (case group) and 98 healthy (control group) individuals. Urea breath test was performed for all of the children and ...

  20. Cluster Analysis and Clinical Asthma Phenotypes

    Science.gov (United States)

    Shaw, Dominic E.; Berry, Michael A.; Thomas, Michael; Brightling, Christopher E.; Wardlaw, Andrew J.

    2014-01-01

    Rationale Heterogeneity in asthma expression is multidimensional, including variability in clinical, physiologic, and pathologic parameters. Classification requires consideration of these disparate domains in a unified model. Objectives To explore the application of a multivariate mathematical technique, k-means cluster analysis, for identifying distinct phenotypic groups. Methods We performed k-means cluster analysis in three independent asthma populations. Clusters of a population managed in primary care (n = 184) with predominantly mild to moderate disease, were compared with a refractory asthma population managed in secondary care (n = 187). We then compared differences in asthma outcomes (exacerbation frequency and change in corticosteroid dose at 12 mo) between clusters in a third population of 68 subjects with predominantly refractory asthma, clustered at entry into a randomized trial comparing a strategy of minimizing eosinophilic inflammation (inflammation-guided strategy) with standard care. Measurements and Main Results Two clusters (early-onset atopic and obese, noneosinophilic) were common to both asthma populations. Two clusters characterized by marked discordance between symptom expression and eosinophilic airway inflammation (early-onset symptom predominant and late-onset inflammation predominant) were specific to refractory asthma. Inflammation-guided management was superior for both discordant subgroups leading to a reduction in exacerbation frequency in the inflammation-predominant cluster (3.53 [SD, 1.18] vs. 0.38 [SD, 0.13] exacerbation/patient/yr, P = 0.002) and a dose reduction of inhaled corticosteroid in the symptom-predominant cluster (mean difference, 1,829 μg beclomethasone equivalent/d [95% confidence interval, 307–3,349 μg]; P = 0.02). Conclusions Cluster analysis offers a novel multidimensional approach for identifying asthma phenotypes that exhibit differences in clinical response to treatment algorithms. PMID:18480428