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Guidelines For Bronchial Asthma

Graham M Donovan, John G Elliot, Stacey R Boser, Francis H Y Green, Alan L James, Peter B Noble
Bronchial thermoplasty is a recent treatment for asthma in which ablative thermal energy is delivered to specific large airways according to clinical guidelines. Current practice is therefore effectively 'blind' as it is not informed by patient-specific data. The present study seeks to establish whether a patient-specific approach based on structural or functional patient data can improve outcomes and/or reduce the number of procedures required for clinical efficacy. We employed a combination of extensive human lung specimens and novel computational methods to predict bronchial thermoplasty outcomes guided by structural or functional data, compared with current clinical practice...
January 24, 2019: Journal of Applied Physiology
Xianru Peng, Minyu Huang, Wenqu Zhao, Yafei Yuan, Bohou Li, Yanmei Ye, Jianpeng Liang, Shunfang Zhu, Laiyu Liu, Shaoxi Cai, Haijin Zhao
OBJECTIVE: To investigate the association of the time of initial diagnosis with the severity of chronic obstructive pulmonary disease (COPD). METHODS: A total of 803 patients who were diagnosed to have COPD for the first time in our hospital between May 2015 to February 2018 were enrolled in this study.The diagnoses of COPD and asthma COPD overlap (ACO) were made according GOLD guidelines and european consensus definition.Lung function of the patients was graded according to the GOLD guidelines...
December 30, 2018: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Khalid M Salah, Hadeel M Abd-Elrahman, Ahmed E Fakhr, Mohamed I Marghany
Bronchial asthma is one of the most prevailed non-communicable diseases among Egyptian children. Genetic-environmental interaction can influence the nature of asthma and β2 agonists are the most commonly prescribed bronchodilators for relieving asthma symptoms. This study was conducted to investigate the possible relationship between Gln27/Glu polymorphism of ADRβ2 and bronchial asthma susceptibility, severity and responsiveness to Albuterol in Egyptian children. A case control study of one hundred Egyptian children, where all contributors were genotyped using allele-specific Polymerase chain reaction (AS-PCR)...
June 2018: Egyptian Journal of Immunology
Mona Z Nasser, Dina A Ezzat
Genetic polymorphism of Tumor necrosis factor alpha (TNF-α)-308 G/A is one of the potential markers involved in bronchial asthma pathogenesis. This highly polymorphic gene can influence TNF-α serum levels which has major biological effects on airway inflammation, remodeling, and hyper responsiveness. This study was designed to evaluate the association between TNF-α-308 G/A polymorphism, serum levels of TNF-α and the susceptibility to bronchial asthma in children. The study included 102 pediatric patients with bronchial asthma recruited from Pediatric Allergy and Pulmonology Clinic, Specialized Pediatric Beni Suef University Hospital...
June 2018: Egyptian Journal of Immunology
Shahieda Adams, Andreas L Lopata, Cornelius M Smuts, Roslynn Baatjies, Mohamed F Jeebhay
Recent studies have highlighted the potential protective role of omega-3 polyunsaturated fatty acids (n-3 PUFA) in asthma. This study aimed at determining the association between seafood intake, serum PUFA composition and clinical endpoints of asthma in adults. A cross-sectional study of 642 subjects used the European Committee Respiratory Health Survey (ECRHS) questionnaire, skin prick tests, spirometry and methacholine challenge tests following ATS guidelines. Sera was analysed for n-3 and n-6 PUFA composition...
December 25, 2018: International Journal of Environmental Research and Public Health
Pedro H Berenguer, Irene C Camacho, Rita Câmara, Susana Oliveira, José S Câmara
Leukotrienes and prostaglandins are arachidonic acid bioactive derived eicosanoids and key mediators of bronchial inflammation and response modulation in the airways contributing to the pathophysiology of asthma. An easy-to-use ultra-high pressure liquid chromatography (UHPLC)-based strategy was developed to characterize biomarkers of lipid peroxidation: leukotrienes E (LTE4 ) and B4 (LTB4 ) and 11β-prostaglandin F2α (11βPGF2α ), present in urine of asthmatic patients (N = 27) and healthy individuals (N = 17)...
November 22, 2018: Journal of Chromatography. A
Filip Raciborski, Bolesław Samoliński, Edyta Krzych-Fałta, Aleksandra Grąbczewska, Filip Furman, Michał Bieszczad, Paweł Morkisz, Patrycja Witkowska, Jean Bousquet, Mariusz Gujski
Background: In 2006, the Global Alliance against Chronic Respiratory Diseases (GARD) was established. The GARD strategy is based mainly on activities aimed at implementing preventive tasks at a local and global level. In Poland, the National Health Program (NHP) is the strategic document describing the tasks of governmental and local administration in the field of public health. One of the activities under the NHP is a project to carry out mass allergy screening (of children and adolescents at school age) and to organize an information and education campaign...
September 2018: Journal of Thoracic Disease
Faria Nasim, Vivek N Iyer
Bronchial Thermoplasty is a procedure that involves the delivery of radiofrequency energy during bronchoscopy to airways in order to selectively ablate airway smooth muscles. Bronchial Thermoplasty was approved by the FDA in 2010 and remains the only device based non-pharmacological treatment approach for severe asthma. We appraise the trials leading to the approval of Bronchial Thermoplasty in light of the FDA approval process. Current international guidelines regarding use of Bronchial Thermoplasty and emering pharmacological options for severe asthma are reviewed...
October 2018: Annals of Thoracic Medicine
Suhasini Donthi, Venkata Sanjeev Kumar Neela, Sumanlatha Gaddam, Hidayath Hussain Mohammed, Soheb Sadath Ansari, Vijaya Lakshmi Valluri, Krovvidi S R Sivasai
Background & objectives: High expression of arginase gene and its elevated level in serum and bronchial lavage reported in animal models indicated an association with the pathogenesis of asthma. This study was undertaken to assess the serum arginase activity in symptomatic asthma patients and healthy controls and to correlate it with cytokine levels [interleukin (IL)-4 and IL-13] and arginase I (ARG1) gene polymorphism. Methods: Asthma was confirmed by lung function test according to the GINA guidelines in patients attending Allergy and Pulmonology Clinic, Bhagwan Mahavir Hospital and Research Centre, Hyderabad, India, a tertiary care centre, during 2013-2015...
August 2018: Indian Journal of Medical Research
Jana Graf, Rudolf A Jörres, Tanja Lucke, Dennis Nowak, Claus F Vogelmeier, Joachim H Ficker
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is common around the world and carries a high morbidity and mortality. Symptom- and risk-oriented drug treatment is recommended, both in Germany and in other countries. It is not yet known to what extent the treatment that is actually delivered in Germany corresponds to the current recommendations in the guidelines. METHODS: As recommended by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2017, 2281 patients of the national COPD cohort COSYCONET (COPD and Systemic Consequences-Comorbidities Network) were classified into Gold classes A-D on the basis of disease-specific manifestations and the frequency of exacerbations...
September 14, 2018: Deutsches Ärzteblatt International
Marina Lampalo, Irena Jukić, Jasna Bingulac-Popović, Hana Safić, Nikola Ferara, Sanja Popović-Grle
Asthma is a chronic inflammatory disease that is characterized by reversible obstruction of airways, bronchial hyper-reactivity and airway remodeling. The etiology of asthma is multifactorial, with inheritance playing an important role. The aim of our study was to investigate the importance of biomarkers of asthma and the role of plasminogen activator inhibitor-1 (PAI-1) gene as a genetic factor that could be involved in the pathogenesis of asthma. The research was conducted at Jordanovac University Department for Lung Diseases and Croatian Institute of Transfusion Medicine...
March 2018: Acta Clinica Croatica
J Borak, R Y Lefkowitz, B Linde
Background: Bronchial hyper-responsiveness (BHR) is often regarded as a 'hallmark' of asthma, and bronchoprovocation testing is frequently performed to support a diagnosis of asthma. The European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently updated their technical standards and guidelines for performing methacholine challenge testing (MCT), the most commonly performed clinical test of BHR. Aims: To review the updated guidelines and discuss the various changes and their potential impact on clinicians...
November 16, 2018: Occupational Medicine
Shadwa Hassan, Anthony Gonzalez, Seleshi Demissie, Kashun Morawakkoralage, Pushpom James
Nebulized normal saline is frequently prescribed for the treatment of bronchiolitis or bronchial asthma exacerbations. We aimed to reinforce guidelines care by educating providers on the futility of saline administration. Frequency and indications for nebulized normal saline prescription were documented from November 1, 2014, to April 1, 2015, and then again, after dissemination of educational material to providers, from November 1, 2016, to April 1, 2017. A total of 263 patients had bronchiolitis and 470 had asthma...
November 2018: Clinical Pediatrics
Simone K Visser, Peter Bye, Lucy Morgan
Once neglected in research and underappreciated in practice, there is renewed interest in bronchiectasis unrelated to cystic fibrosis. Bronchiectasis is a chronic lung disease characterised by chronic cough, sputum production and recurrent pulmonary exacerbations. It is diagnosed radiologically on high resolution computed tomography chest scan by bronchial dilatation (wider than the accompanying artery). The causes of bronchiectasis are diverse and include previous respiratory tract infections, chronic obstructive pulmonary disease, asthma, immunodeficiency and connective tissue diseases...
August 20, 2018: Medical Journal of Australia
L Plantier, N Beydon, A Chambellan, B Degano, C Delclaux, J-D Dewitte, A T Dinh-Xuan, G Garcia, C Kauffmann, C Paris, T Perez, M Poussel, B Wuyam, F Zerah-Lancner, B Chenuel
Bronchial challenge with the direct bronchoconstrictor agent methacholine is commonly used for the diagnosis of asthma. The "Lung Function" thematic group of the French Pulmonology Society (SPLF) elaborated a series of guidelines for the performance and the interpretation of methacholine challenge testing, based on French clinical guideline methodology. Specifically, guidelines are provided with regard to the choice of judgment criteria, the management of deep inspirations, and the role of methacholine bronchial challenge in the care of asthma, exercise-induced asthma, and professional asthma...
September 2018: Revue des Maladies Respiratoires
Carla Galeone, Chiara Scelfo, Francesca Bertolini, Marco Caminati, Patrizia Ruggiero, Nicola Facciolongo, Francesco Menzella
According to the current guidelines, severe asthma still represents a controversial topic in terms of definition and management. The introduction of novel biological therapies as a treatment option for severe asthmatic patients paved the way to a personalized approach, which aims at matching the appropriate therapy with the different asthma phenotypes. Traditional asthma phenotypes have been decomposing by an increasing number of asthma subclasses based on functional and physiopathological mechanisms. This is possible thanks to the development and application of different omics technologies...
2018: BioMed Research International
Adam M Chaker
Sinunasale Erkrankungen zählen mit zu den häufigsten chronischen Erkrankungen und führen zu einer erheblichen Störung der Lebensqualität, ein komorbides Asthma ist häufig. Trotz leitliniengerechter Therapie ist anzunehmen, dass mind. 20% der Patienten ihre Erkrankungssymptome nicht adäquat kontrollieren können. Neben den etablierten chirurgischen und konservativen Therapieoptionen finden sich nun vielversprechende Therapieansätze, die bspw. mittels therapeutischer Antikörper mechanistisch gezielt in die Pathophysiologie der Erkrankungen eingreifen können...
March 2018: Laryngo- Rhino- Otologie
Umesh Chandra Ojha, Devesh Pratap Singh, Omkar Kalidasrao Choudhari, Dipti Gothi, Shweta Singh
Introduction: There is a growing clinical awareness about the influence of gut-lung axis on lung injury and coexisting manifestations of disease processes in both the intestine and lungs. Patients of chronic lung diseases such as chronic obstructive pulmonary disease (COPD) and asthma very often present with coexistent gut symptoms. In the present study, we have tried to establish the correlation of severity of pulmonary pathology of COPD and asthma patients with functional gastrointestinal (GI) symptoms of the patients...
April 2018: International Journal of Applied and Basic Medical Research
Peter I Bonta, Pascal Chanez, Jouke T Annema, Pallav L Shah, Robert Niven
Bronchial thermoplasty (BT) is a bronchoscopic treatment for patients with severe asthma who remain symptomatic despite optimal medical therapy. In this "expert best practice" paper, the background and practical aspects of BT are highlighted. Randomized, controlled clinical trials have shown BT to be safe and effective in reducing severe exacerbations, improving quality of life, and decreasing emergency department visits. Five-year follow-up studies have provided evidence of the functional stability of BT-treated patients with persistence of a clinical benefit...
2018: Respiration; International Review of Thoracic Diseases
Michael Koennecke, Ludger Klimek, Joaquim Mullol, Philippe Gevaert, Barbara Wollenberg
Background: Chronic rhinosinusitis (CRS) is a heterogeneous, multifactorial inflammatory disease of the nasal and paranasal mucosa. It has not been possible to date to develop an internationally standardized, uniform classification for this disorder. A phenotype classification according to CRS with (CRSwNP) and without polyposis (CRSsNP) is usually made. However, a large number of studies have shown that there are also different endotypes of CRS within these phenotypes, with different pathophysiologies of chronic inflammation of the nasal mucosa...
2018: Allergo Journal International
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