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Latest & greatest articles for asthma
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on asthma or other clinical topics then use Trip today.
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Does early onset asthma increase childhood obesity risk? A pooled analysis of 16 European cohorts The parallel epidemics of childhood asthma and obesity over the past few decades have spurred research into obesity as a risk factor for asthma. However, little is known regarding the role of asthma in obesity incidence. We examined whether early-onset asthma and related phenotypes are associated with the risk of developing obesity in childhood.This study includes 21 130 children born from 1990 (...) to 2008 in Denmark, France, Germany, Greece, Italy, The Netherlands, Spain, Sweden and the UK. We followed non-obese children at 3-4 years of age for incident obesity up to 8 years of age. Physician-diagnosed asthma, wheezing and allergic rhinitis were assessed up to 3-4 years of age.Children with physician-diagnosed asthma had a higher risk for incident obesity than those without asthma (adjusted hazard ratio (aHR) 1.66, 95% CI 1.18-2.33). Children with active asthma (wheeze in the last 12 months
Comprehensive Community-Based Intervention and Asthma Outcomes in African American Adolescents : media-1vid110.1542/5804911922001PEDS-VA_2017-3737Video Abstract BACKGROUND: African American adolescents appear to be the most at risk for asthma morbidity and mortality even compared with other minority groups, yet there are few successful interventions for this population that are used to target poorly controlled asthma.African American adolescents (age 12-16 years) with moderate-to-severe (...) persistent asthma and ≥1 inpatient hospitalization or ≥2 emergency department visits in 12 months were randomly assigned to Multisystemic Therapy-Health Care or an attention control group (N = 167). Multisystemic Therapy-Health Care is a 6-month home- and community-based treatment that has been shown to improve illness management and health outcomes in high-risk adolescents by addressing the unique barriers for each individual family with cognitive behavioral interventions. The attention control
). 80 asthmatic patients were included in a double-blinded, parallel, randomised controlled trial with follow-up visits after 8, 24 and 36 weeks. Treatment was tailored using either a FeNO or Asthma Control Questionnaire (ACQ) based algorithm. Inclusion criteria were asthma symptoms and a provocative dose causing a 15% fall in forced expiratory volume in 1 s <635 mg mannitol. At each visit AHR, FeNO, ACQ and blood tests were performed. No differences between the two groups were found at inclusion (...) FeNO-based asthma management results in faster improvement of airway hyperresponsiveness Asthma is characterised by inflammation and respiratory symptoms. Current asthma treatment is based on severity of asthma symptoms only. Exhaled nitric oxide fraction (FeNO) is not recommended by the Global Initiative for Asthma guidelines. The aim was to compare the usefulness of a FeNO guided versus symptom-based treatment in achieving improved asthma control assessed by airway hyperresponsiveness (AHR
may decrease asthma exacerbations in individuals 18 years of age and over with severe asthma independent of their in?ammatory pro?le; 4) Children aged 6 years and older and adults who are sensitized to at least one relevant perennial allergen and who remain poorly controlled asthmatics despite high dose ICS and a second controller can bene?tfrom the addition of anti-IgE therapy to reduce asthma exacerbations; due to the known risk of side effects associated with high-dose ICS in children (...) . Limited experi- ence in individuals with very severe asthma have shown that some individuals do improve clinically but the 214 J.M. FITZGERALD ETAL.procedure carries increased short-term risks such as over- night hospitalization. 134 Several studies have attempted to better identify the BT responder phenotype. The predictive value of imaging techni- ques, biomarkers and airway histology for BT response is cur- rently under investigation. Asthmatics with signi?cant AHR and apauci-granulocyticendotype
that this study was systematic, consistent and had low bias. Perspective: This analysis does provide significant evidence that asthma impacts caries experience in primary and permanent dentitions. The inclusion criteria for this study reflects the asthmatic population that general, pediatric and orthodontic practices will include, further supporting the relevance of this critical appraisal. Applicability This evidence can be used in clinical practice to provide applicable oral health care instruction (...) to patients being treated for asthma and parents of children and adolescents with asthma. Additionally, this information can inform practitioners of the increase in caries risk for asthmatic patients so that they can include prevention measures in treatment planning. Specialty/Discipline (Public Health) (General Dentistry) (Orthodontics) (Pediatric Dentistry) (Periodontics) Keywords asthma, caries, physician; patient education; preventive; prevention ID# 3328 Date of submission: 10/09/2018 E-mail pagek
Occupational asthma Occupational asthma - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Occupational asthma Last reviewed: February 2019 Last updated: September 2018 Summary Should be suspected in all adult patients with asthma. An occupational history should be taken to identify work-related causes. Details of work exposures should be obtained from material safety data sheets and other material available (...) to the patient from their workplace. Objective evidence of asthma should be obtained from spirometry, a bronchodilator response, and/or a methacholine challenge. Tests should be performed when the patient is symptomatic and/or within days of having exposure to a suspected aetiological agent. If sensitiser-induced occupational asthma is suspected, additional testing of asthma should be done, preferably while the patient is still working. Whenever possible an immunological response to a suspected work
Understanding asthma phenotypes: the World Asthma Phenotypes (WASP) international collaboration The World Asthma Phenotypes (WASP) study started in 2016 and has been conducted in five centres, in the UK, New Zealand, Brazil, Ecuador and Uganda. The objectives of this study are to combine detailed biomarker and clinical information in order to 1) better understand and characterise asthma phenotypes in high-income countries (HICs) and low and middle-income countries (LMICs), and in high and low (...) of asthma phenotypes. The findings of this study will help elucidate the aetiological mechanisms of asthma and might potentially identify new causes and guide the development of new treatments, thereby enabling better management and prevention of asthma in both HICs and LMICs.
Asthma Top results for asthma - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for asthma The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted
Asthma Evidence Maps - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4) Loading
Combined Analysis of Asthma Safety Trials of Long-Acting β2-Agonists. Safety concerns regarding long-acting β2-agonists (LABAs) in asthma management were initially identified in a large postmarketing trial in which the risk of death was increased. In 2010, the Food and Drug Administration (FDA) mandated that the four companies marketing LABAs for asthma perform prospective, randomized, controlled trials comparing the safety of combination therapy with a LABA plus an inhaled (...) outcome was a composite of asthma-related intubation or death. Post hoc secondary outcomes included serious asthma-related events and asthma exacerbations.Among the 36,010 patients in the intention-to-treat study, there were three asthma-related intubations (two in the inhaled-glucocorticoid group and one in the combination-therapy group) and two asthma-related deaths (both in the combination-therapy group) in 4 patients. In the secondary analysis of serious asthma-related events (a composite
Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study: rationale and methods Despite a considerable number of international reports on allergic diseases among children, information about the prevalence and risk factors of asthma and allergy-related diseases among Indian adolescents is relatively sparse. The Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study has been conceived to study (...) the aetiology of asthma and allergic diseases including rhinoconjunctivitis, atopic eczema and food allergies among adolescents in West Bengal, India, using standardised methods and collaborations. The aims of the study are: 1) to estimate the prevalence and risk factors of asthma and allergic diseases among the adolescents residing in rural, suburban and urban areas of West Bengal; 2) to obtain information about the possible role of lifestyle factors (smoking, diet and physical activity) on the disease
version 20, using descriptive statistics and Chi-square test. A p-value of 0.05 or less was considered, statistically significant.Among the 511 students, the prevalence of physician-diagnosed asthma was 11.4%. The prevalence of lifetime wheeze, and exercise-induced wheeze were 30.3% and 19% respectively. The prevalence of night cough and wheezing attack in the past 12 months were 17% and 16.8% respectively. A total of 51.8% of asthmatic students have poor asthma control.The prevalence of asthma (...) and associated symptoms in 16 to18-year-old students is high in the Northern Borders Region. Uncontrolled asthma was observed in half of asthmatic students.
Fluticasone/formoterol (flutiform k-haler) - for the regular treatment of asthma Abbreviated Submission fluticasone propionate/ formoterol fumarate 50microgram/5microgram, 125microgram/5microgram pressurised inhalation, suspension (Flutiform k-haler ® ) SMC2016 Napp Pharmaceuticals Ltd 4 May 2018 The Scottish Medicines Consortium (SMC) has completed its assessment of the above product and advises NHS Boards and Area Drug and Therapeutic Committees (ADTCs) on its use in NHS Scotland. The advice (...) is summarised as follows: ADVICE: following an abbreviated submission fluticasone propionate/ formoterol fumarate (Flutiform k-haler ® ) is accepted for use within NHS Scotland. Indication under review: for the regular treatment of asthma where the use of a combination product [an inhaled corticosteroid (ICS) and a long-acting ß 2-agonist (LABA)] is appropriate: • For patients not adequately controlled with ICS as ‘as required’ inhaled short-acting ß2- agonist or • For patients already adequately controlled
Dupilumab Efficacy and Safety in Moderate-to-Severe Uncontrolled Asthma. Dupilumab is a fully human anti-interleukin-4 receptor α monoclonal antibody that blocks both interleukin-4 and interleukin-13 signaling. We assessed its efficacy and safety in patients with uncontrolled asthma.We randomly assigned 1902 patients 12 years of age or older with uncontrolled asthma in a 2:2:1:1 ratio to receive add-on subcutaneous dupilumab at a dose of 200 or 300 mg every 2 weeks or matched-volume placebos (...) for 52 weeks. The primary end points were the annualized rate of severe asthma exacerbations and the absolute change from baseline to week 12 in the forced expiratory volume in 1 second (FEV1) before bronchodilator use in the overall trial population. Secondary end points included the exacerbation rate and FEV1 in patients with a blood eosinophil count of 300 or more per cubic millimeter. Asthma control and dupilumab safety were also assessed.The annualized rate of severe asthma exacerbations
Efficacy and Safety of Dupilumab in Glucocorticoid-Dependent Severe Asthma. Dupilumab is a fully human anti-interleukin-4 receptor α monoclonal antibody that blocks both interleukin-4 and interleukin-13 signaling. Its effectiveness in reducing oral glucocorticoid use in patients with severe asthma while maintaining asthma control is unknown.We randomly assigned 210 patients with oral glucocorticoid-treated asthma to receive add-on dupilumab (at a dose of 300 mg) or placebo every 2 weeks for 24 (...) with glucocorticoid-dependent severe asthma, dupilumab treatment reduced oral glucocorticoid use while decreasing the rate of severe exacerbations and increasing the FEV1. Transient eosinophilia was observed in approximately 1 in 7 dupilumab-treated patients. (Funded by Sanofi and Regeneron Pharmaceuticals; LIBERTY ASTHMA VENTURE ClinicalTrials.gov number, NCT02528214 .).
=0.32) and decreased in both groups (mean difference: for asthmatic subjects 0.160 L; p=0.02; for COPD subjects 0.164 L; p<0.0001). However, changes in IC were significantly associated with changes in the Borg score in the COPD group (r2=0.17; p=0.006), but not in the asthma group (r2=0.06; p=0.20). In severe asthmatic subjects, IC significantly drops during the 6MWT to the same extent as COPD subjects with a similar degree of lung impairment, indicating the development of dynamic hyperinflation (...) Dynamic hyperinflation during the 6-min walk test in severely asthmatic subjects We tested the hypothesis that dynamic hyperinflation develops in severe asthmatic subjects during exercise. Changes in inspiratory capacity (IC) were measured during the 6-min walk test (6MWT) in severe asthmatic subjects compared with chronic obstructive pulmonary disease (COPD) subjects with a similar degree of bronchial obstruction. We assessed whether changes in IC were associated with changes in dyspnoea
As-Needed Budesonide-Formoterol versus Maintenance Budesonide in Mild Asthma. Patients with mild asthma often rely on inhaled short-acting β2-agonists for symptom relief and have poor adherence to maintenance therapy. Another approach might be for patients to receive a fast-acting reliever plus an inhaled glucocorticoid component on an as-needed basis to address symptoms and exacerbation risk.We conducted a 52-week, double-blind, multicenter trial involving patients 12 years of age or older who (...) had mild asthma and were eligible for treatment with regular inhaled glucocorticoids. Patients were randomly assigned to receive twice-daily placebo plus budesonide-formoterol (200 μg of budesonide and 6 μg of formoterol) used as needed or budesonide maintenance therapy with twice-daily budesonide (200 μg) plus terbutaline (0.5 mg) used as needed. The primary analysis compared budesonide-formoterol used as needed with budesonide maintenance therapy with regard to the annualized rate of severe
Inhaled Combined Budesonide-Formoterol as Needed in Mild Asthma. In patients with mild asthma, as-needed use of an inhaled glucocorticoid plus a fast-acting β2-agonist may be an alternative to conventional treatment strategies.We conducted a 52-week, double-blind trial involving patients 12 years of age or older with mild asthma. Patients were randomly assigned to one of three regimens: twice-daily placebo plus terbutaline (0.5 mg) used as needed (terbutaline group), twice-daily placebo plus (...) in the budesonide-formoterol group, and 1282 in the budesonide maintenance group) were included in the full analysis and safety data sets. With respect to the mean percentage of weeks with well-controlled asthma per patient, budesonide-formoterol was superior to terbutaline (34.4% vs. 31.1% of weeks; odds ratio, 1.14; 95% confidence interval [CI], 1.00 to 1.30; P=0.046) but inferior to budesonide maintenance therapy (34.4% and 44.4%, respectively; odds ratio, 0.64; 95% CI, 0.57 to 0.73). The annual rate
Intermittent Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists for Asthma Comparative Effectiveness Review Number 194 Intermittent Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists for Asthma e Comparative Effectiveness Review Number 194 Intermittent Inhaled Corticosteroids and Long-Acting Muscarinic Antagonists for Asthma Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 5600 Fishers Lane Rockville, MD 20857 (...) of intermittent inhaled corticosteroids in different populations of patients with asthma and to assess whether adding long-acting muscarinic antagonists improves outcomes for patients with uncontrolled, persistent asthma. Key Messages • In children less than 5 years old with recurrent wheezing, intermittent use of inhaled corticosteroids during an upper respiratory tract infection decreases asthma exacerbations • In patients 12 years and older with persistent asthma: o using inhaled corticosteroids
A Randomized Trial of Itraconazole vs Prednisolone in Acute-Stage Allergic Bronchopulmonary Aspergillosis Complicating Asthma Whether itraconazole monotherapy is effective in the acute stage of allergic bronchopulmonary aspergillosis (ABPA) remains unknown. The goal of this study was to compare the efficacy and safety of itraconazole and prednisolone monotherapy in ABPA.Treatment-naive subjects with ABPA complicating asthma (January 2012 to December 2013) were randomized to receive either oral