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Diagnostic of asthma

Christina D Wells, Min J Joo
Up to one-third of patients receiving a clinical diagnosis of COPD or asthma have been shown to lack evidence of disease in subsequent lung-function studies.
March 2019: Journal of Family Practice
S Gaduzo, V McGovern, J Roberts, J E Scullion, D Singh
While single-inhaler triple therapy (SITT) devices were not available when the Global Initiative for Chronic Obstructive Lung Disease strategy and National Institute for Health and Care Excellence guidelines were developed, two devices are now available in the UK. This paper offers practical, patient-focused advice to optimize placement of SITT in the management of COPD. A survey of UK health care professionals (HCPs) identified issues around, and attitudes toward, SITT, which informed a multidisciplinary expert panel's discussions...
2019: International Journal of Chronic Obstructive Pulmonary Disease
Radoslaw Gawlik, Marcin Kurowski, Marek Kowalski, Ziemowit Ziętkowski, Andrzej Pokrywka, Hubert Krysztofiak, Jarosław Krzywański, Andrzej Bugajski, Zbigniew Bartuzi
Exercise-induced respiratory symptoms describe acute airway narrowing that occurs as a result of exercise. It includes exercise-induced bronchoconstriction (EIB) and exercise-induced asthma (EIA) issues. To provide clinicians with practical guidelines, a multidisciplinary panel of stakeholders was convened to review the pathogenesis of EIB/EIA and to develop evidence-based guidelines for the diagnosis and treatment. Recommendations for the diagnosis and treatment of EIB were developed. High-intensity exercise in polluted environment (cold air, humidity, contamination, allergens) may increase the risk of EIB and asthma symptoms in athletes...
February 2019: Postȩpy Dermatologii i Alergologii
Pierantonio Laveneziana, Antoine Beurnier
Dyspnoea is a cardinal symptom of asthma and an essential part of assessing control of the disease. Its intensity is variable for the same level of bronchial obstruction, which suggests the involvement of other mechanisms. Therefore, it is extremely important to characterize and measure dyspnoea in asthmatic patients because its profile can be quantitatively and qualitatively modified by disease control, comorbidities and anxiety. Hence the value of using additional tools to ACT and ACQ because the latter do not characterize nor measure specifically dyspnoea in asthma...
March 7, 2019: La Presse Médicale
Wadah Ibrahim, Michael Wilde, Rebecca Cordell, Dahlia Salman, Dorota Ruszkiewicz, Luke Bryant, Matthew Richardson, Robert C Free, Bo Zhao, Ahmed Yousuf, Christobelle White, Richard Russell, Sheila Jones, Bharti Patel, Asia Awal, Rachael Phillips, Graham Fowkes, Teresa McNally, Clare Foxon, Hetan Bhatt, Rosa Peltrini, Amisha Singapuri, Beverley Hargadon, Toru Suzuki, Leong L Ng, Erol Gaillard, Caroline Beardsmore, Kimuli Ryanna, Hitesh Pandya, Tim Coates, Paul S Monks, Neil Greening, Christopher E Brightling, Paul Thomas, Salman Siddiqui
INTRODUCTION: Patients presenting with acute undifferentiated breathlessness are commonly encountered in admissions units across the UK. Existing blood biomarkers have clinical utility in distinguishing patients with single organ pathologies but have poor discriminatory power in multifactorial presentations. Evaluation of volatile organic compounds (VOCs) in exhaled breath offers the potential to develop biomarkers of disease states that underpin acute cardiorespiratory breathlessness, owing to their proximity to the cardiorespiratory system...
March 8, 2019: BMJ Open
Paolo Maria Matricardi, Stephanie Dramburg, Ekaterina Potapova, Chrysanthi Skevaki, Harald Renz
The extensive use of allergen molecules in birth cohort studies revealed that atopic sensitization is a sequential IgE response to distinct non-cross-reacting molecules from the same allergenic source (ie, molecular spreading), starting with an initiator molecule. This phenomenon reaches different degrees of progression (monomolecular, oligomolecular, and polymolecular) according to the individual atopic propensity and allergen exposure, thus producing an extreme heterogeneity of IgE sensitization profiles in patient populations...
March 2019: Journal of Allergy and Clinical Immunology
Mariëlle W Pijnenburg
Asthma-like symptoms like wheezing and dyspnea affect 1 in every 3 preschool children. An easily available biomarker that predicts later asthma or unfavorable lung growth in these children may be helpful in targeting the right child with the right drugs and avoiding exposure to potentially harmful drugs in others. The fraction of exhaled nitric oxide (FeNO) has been suggested as a marker of eosinophilic inflammation. FeNO can be measured in a standardized way from the age of 4 but several methods have been developed to measure FeNO also in younger children...
2019: Frontiers in Pediatrics
Y R Dai, X T Ge
No abstract text is available yet for this article.
March 12, 2019: Chinese Journal of Tuberculosis and Respiratory Diseases
Lisa M Walter, Knarik Tamanyan, Lauren Nisbet, Aidan J Weichard, Margot J Davey, Gillian M Nixon, Rosemary S C Horne
PURPOSE: Allergic rhinitis (AR) is a common risk factor for sleep disordered breathing (SDB) in children. Allergy to pollen is a trigger for allergic rhinitis, causing nasal inflammation, upper airway congestion and obstruction. We aimed to determine if the pollen count on the day of diagnostic polysomnography for SDB affected the result. METHODS: Children (3-18 years; n = 90) who participated in research studies between 1 October and 31 December, when daily regional pollen counts were available, in the years 2005-2016 were eligible for inclusion...
March 5, 2019: Sleep & Breathing
T Hermange, S Le Corre, C Bizon, E A Richard, A Couroucé
Cytology of bronchoalveolar lavage fluid (BALF) from one lung may not predict findings in the contralateral lung of the same horse. The aim of this study was to determine whether a pooled BALF from both lungs was representative of corresponding individual samples. Fifty-one horses referred for poor performance and/or respiratory signs and for which a BALF was collected from both lungs, were included in the study. Cytology of pooled and individual BALF samples were performed using a masked protocol. Based on clinical signs and individual BALF cytologies, horses were classified as control (CTL), mild equine asthma (mEA), severe equine asthma (sEA) and/or exercise-induced pulmonary haemorrhage (EIPH)...
February 2019: Veterinary Journal
Christine Jenkins, J Mark FitzGerald, Fernando J Martinez, Dirkje S Postma, Stephen Rennard, Thys van der Molen, Asparuh Gardev, Eduardo Genofre, Peter Calverley
INTRODUCTION: Asthma-chronic obstructive pulmonary disease (COPD) overlap (ACO) is a heterogenous condition with clinical features shared by both asthma and COPD. OBJECTIVES: This online global survey of respiratory/allergy specialists and primary care practitioners (PCPs) was performed to understand current clinical approaches to the differential diagnosis and management of asthma, COPD and ACO. METHODS: Respondents were recruited through: (1) a global online physician respondent community (49,980 PCPs and 7205 specialists); (2) market research agents; (3) experts; (4) professional societies; (5) colleague invitation...
March 2, 2019: Clinical Respiratory Journal
Burak Bekgoz, Isa Kilicaslan, Fikret Bildik, Ayfer Keles, Ahmet Demircan, Onur Hakoglu, Gulhan Coskun, Huseyin Avni Demir
OBJECTIVE: Dyspnea is a common Emergency Department (ED) symptom requiring prompt diagnosis and treatment. The bedside lung ultrasonography in emergency (BLUE) protocol is defined as a bedside diagnostic tool in intensive care units. The aim of this study was to investigate the test performance characteristics of the BLUE-protocol ultrasonography in ED patients presenting with acute dyspnea. METHOD: This study was performed as a prospective observational study at the ED of a tertiary care university hospital over a 3-month period...
February 20, 2019: American Journal of Emergency Medicine
Stefania Arasi, Federica Porcaro, Renato Cutrera, Alessandro G Fiocchi
Severe asthma in children is associated with significant morbidity and lung function decline. It represents a highly heterogeneous disorder with multiple clinical phenotypes. As its management is demanding, the social and economic burden are impressive. Several co-morbidities may contribute to worsen asthma control and complicate diagnostic and therapeutic management of severe asthmatic patients. Allergen sensitization and/or allergy symptoms may predict asthma onset and severity. A better framing of "allergen sensitization" and understanding of mechanisms underlying progression of atopic march could improve the management and the long-term outcomes of pediatric severe asthma...
2019: Frontiers in Pediatrics
M Neuville, C Vinclair, R Cally, L Bouadma
INTRODUCTION: The management of acute lower respiratory tract infections and, in particular, the decision whether or not to commence antibiotic therapy, still remains difficult in the absence of reliable clinical or radiological criteria allowing confident distinction between bacterial and viral infections. Numerous biomarkers have been developed to help the clinician in his/her diagnostic and therapeutic approach, but the role and significance of each has not been clearly defined. BACKGROUND: Though procalcitonin (PCT) or C-reactive protein (CRP) seem equal in helping the clinician to decide whether to commence antibiotic therapy or not during the course of an exacerbation of asthma or chronic obstructive pulmonary disease (COPD), PCT is currently the most useful biomarker to distinguish sepsis from other causes of inflammation and to determine the bacterial or viral origin of a pneumonia...
February 22, 2019: Revue des Maladies Respiratoires
Rahat Ullah, Saranjam Khan, Fizah Farman, Muhammad Bilal, Christoph Krafft, Shaheen Shahzad
Medical biophotonic tools provide new sources of diagnostic information regarding the state of human health that are used in managing patient care. In our current study, Raman spectroscopy, together with the chemometric technique, has successfully been demonstrated for the screening of asthma disease. Raman spectra of sera samples from asthmatic patients as well as healthy (control) volunteers have been recorded at 532 nm excitation. In healthy sera, three highly reproducible Raman peaks assigned to β-carotene have been detected...
February 1, 2019: Biomedical Optics Express
Gian Luca Salvagno, Davide Demonte, Giuseppe Lippi
A 51-year old male patient was admitted to the hospital with acute dyspnea and history of chronic asthma. Venous blood was drawn into a 3.0 mL heparinized syringe and delivered to the laboratory for blood gas analysis (GEM Premier 4000, Instrumentation Laboratory), which revealed high potassium value (5.2 mmol/L; reference range on whole blood, 3.5-4.5 mmol/L). This result was unexpected, so that a second venous blood sample was immediately drawn by direct venipuncture into a 3.5 mL lithium-heparin blood tube, and delivered to the laboratory for repeating potassium testing on Cobas 8000 (Roche Diagnostics)...
February 15, 2019: Biochemia Medica: časopis Hrvatskoga Društva Medicinskih Biokemičara
Guy Gut, Keren Armoni Domany, Efraim Sadot, Ruth Soferman, Elizabeth Fireman, Yakov Sivan
OBJECTIVE: Increased eosinophil level in bronchoalveolar lavage fluid (BALF) characterizes asthma in school-age children and adults and has been suggested as a marker for disease severity and response to treatment. We aimed to investigate the occurrence and yield of BALF eosinophil cell count in preschool children with recurrent wheezing and its possible relation to future diagnosis of asthma. METHODS: BALF was retrospectively studied in young wheezy children and its relation to asthma at age 6 years was evaluated...
February 22, 2019: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Alexa Nuñez, Mikel Sarasate, Eduardo Loeb, Cristina Esquinas, Marc Miravitlles, Miriam Barrecheguren
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality around the world. COPD is characterised by a heterogeneous clinical presentation and prognosis which may vary according to the clinical phenotype. One of the phenotypes of COPD most frequently studied is the asthma-COPD overlap (ACO), however, there are no universally accepted diagnostic criteria for ACO. It is recognised that the term ACO includes patients with clinical features of both asthma and COPD, such as more intense eosinophilic bronchial inflammation, more severe respiratory symptoms and more frequent exacerbations, but in contrast, it is associated with a better prognosis compared to COPD...
February 21, 2019: COPD
Nicole M Robertson, Emily M Nagourney, Suzanne L Pollard, Trishul Siddharthan, Robert Kalyesubula, Pamela J Surkan, John R Hurst, William Checkley, Bruce J Kirenga
Introduction: Almost 90% of chronic obstructive pulmonary disease (COPD) deaths occur in low- and middle-income countries (LMICs), where there are large rural populations and access to health care for COPD is poor. The purpose of this study was to compare urban-rural provider experiences regarding systemic facilitators and barriers to COPD management and treatment access. Methods: We conducted a qualitative study using direct observations and in-depth semi-structured interviews with 16 and 10 health care providers in urban Kampala and rural Nakaseke, Uganda, respectively...
January 4, 2019: Chronic Obstructive Pulmonary Diseases: Journal of the COPD Foundation
Lei Zhang, Wen-Jie Fang, Ke-Ming Zhang, Wei-Wei Jiang, Min Chen, Wan-Qing Liao, Wei-Hua Pan
AIMS: LncRNAs play a vital role in the pathological and physiological process. This study aimed to explore the involvement of lncRNAs in cryptococcal meningitis. METHODS: Microarray was performed in cryptococcal meningitis patients, and then, GO and KEGG pathways were analyzed. Coexpression relationship between lncRNA and mRNA was explored. The expressions of the lncRNAs and mRNAs, and their changes after treatment were detected by PCR. RESULTS: A total of 325 mRNAs (201 upregulated and 124 downregulated) and 497 lncRNAs (263 upregulated and 234 downregulated) were identified...
February 14, 2019: CNS Neuroscience & Therapeutics
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