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Latest & greatest articles for asthma
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Trends in international asthma mortality: analysis of data from the WHO Mortality Database from 46 countries (1993-2012). International time trends in asthma mortality have been strongly affected by changes in management and in particular drug treatments. However, little is known about how asthma mortality has changed over the past decade. In this study, we assessed these international trends.We collated age-standardised country-specific asthma mortality rates in the 5-34 year age group from (...) the online WHO Mortality Database for 46 countries. To be included in the analysis, we specified that a country must have 10 years of complete data in the WHO Mortality Database between 1993 and 2012. In the absence of consistent and accurate asthma prevalence and prescribing data, we chose to use a locally weighted scatter plot smoother (LOESS) curve, weighted by the individual country population in the 5-34-year age group to show the global trends in asthma mortality rates with time.Of the 46 countries
Omega-3 fatty acids during pregnancy and asthma prevention. Are we talking here about more than just a suspect involved? Ácidos grasos omega-3 durante el embarazo y prevención del asma, ¿algo más que un presunto implicado? - Evidencias en pediatría Buscando, por favor espere. Mostrar menú Gestión de biblioteca Aún no ha añadido ningún artículo a su biblioteca. | Buscar Toma de decisiones clínicas basadas en pruebas científicas Toma de decisiones clínicas basadas en pruebas científicas Mostrar (...) embarazo para realizar el ensayo clínico. Los hijos de estas mujeres forman parte de la cohorte de Copenhagen Prospective Studies on Asthma in Chilhood 2010 (COPSAC2010). Las mujeres rellenaron un cuestionario de frecuencias de consumo de alimentos y se midieron sus niveles de ácido eicosapentaenoico (EPA) y docosahexaenoico (DHA) antes de la aleatorización y una semana después del parto. Tras el parto, la cohorte se formó con 695 niños, de los que el 95,5% completaron el periodo de tres años de
Reslizumab (severe eosinophilic asthma) ? Benefit assessment according to § 35a Social Code Book V Extract 1 Translation of Sections 2.1 to 2.6 of the dossier assessment Reslizumab (Asthma) – Nutzenbewertung gemäß § 35a SGB V (Version 1.0; Status: 11 April 2017). Please note: This translation is provided as a service by IQWiG to English-language readers. However, solely the German original text is absolutely authoritative and legally binding. IQWiG Reports – Commission No. A17-02 Reslizumab (...) (asthma) – Benefit assessment according to §35a Social Code Book V 1 Extract of dossier assessment A17-02 Version 1.0 Reslizumab (asthma) 11 April 2017 Institute for Quality and Efficiency in Health Care (IQWiG) - i - Publishing details Publisher: Institute for Quality and Efficiency in Health Care Topic: Reslizumab (asthma) – Benefit assessment according to §35a Social Code Book V Commissioning agency: Federal Joint Committee Commission awarded on: 16 January 2017 Internal Commission No.: A17-02
Preventing Severe Asthma Exacerbations in Children. A Randomized Trial of Mite-Impermeable Bedcovers Allergen exposure in sensitized individuals with asthma interacts with viruses to increase the risk of asthma exacerbation.To evaluate the use of house dust mite-impermeable bedding and its impact on severe asthma exacerbations in children.We randomized mite-sensitized children with asthma (ages 3-17 yr) after an emergency hospital attendance with an asthma exacerbation to receive mite (...) -impermeable (active group) or control (placebo group) bed encasings.Over a 12-month intervention period, the occurrence of severe asthma exacerbations was investigated. Of 434 children with asthma who consented, 286 (mean age, 7.7 yr; male sex, 65.8%) were mite sensitized, and 284 were randomized (146 to the active group and 138 to the placebo group). At 12 months, significantly fewer children in the active group than in the placebo group had attended the hospital with an exacerbation (36 [29.3%] of 123
a provisional diagnosis of COPD is first made on presentation to the ED, but more commonly these patients have already been diagnosed with chronic bronchitis or emphysema through pulmonary function testing. Most patients will have visited the ED before. The initial management of these patients is similar to the management of patients with asthma, but these patients are more likely to require antibiotic treatment for an acute exacerbation. 1 In both these patients and asthmatics, the clinician must (...) . On the other hand, intubation is delayed as long as possible for asthmatic patients. 3 Aspiration in children or the elderly or those with developmental delay: Inhalation of a foreign body, secretions, or a mucous plug is of particular concern in children, the elderly, and patients with cognitive deficits or developmental delay. The wheeze of aspiration can often by differentiated from asthmatic wheeze by its nature; the wheeze of asthma is bilateral and usually end-expiratory, whereas foreign body wheeze
Diagnosis and Management of Asthma in Adults: A Review. Asthma affects about 7.5% of the adult population. Evidence-based diagnosis, monitoring, and treatment can improve functioning and quality of life in adult patients with asthma.Asthma is a heterogeneous clinical syndrome primarily affecting the lower respiratory tract, characterized by episodic or persistent symptoms of wheezing, dyspnea, and cough. The diagnosis of asthma requires these symptoms and demonstration of reversible airway (...) obstruction using spirometry. Identifying clinically important allergen sensitivities is useful. Inhaled short-acting β2-agonists provide rapid relief of acute symptoms, but maintenance with daily inhaled corticosteroids is the standard of care for persistent asthma. Combination therapy, including inhaled corticosteroids and long-acting β2-agonists, is effective in patients for whom inhaled corticosteroids alone are insufficient. The use of inhaled long-acting β2-agonists alone is not appropriate. Other
Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed (...) to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female
Effect of azithromycin on asthma exacerbations and quality of life in adults with persistent uncontrolled asthma (AMAZES): a randomised, double-blind, placebo-controlled trial. Exacerbations of asthma cause a substantial global illness burden. Adults with uncontrolled persistent asthma despite maintenance treatment require additional therapy. Since macrolide antibiotics can be used to treat persistent asthma, we aimed to assess the efficacy and safety of oral azithromycin as add-on therapy (...) in patients with uncontrolled persistent asthma on medium-to-high dose inhaled corticosteroids plus a long-acting bronchodilator.We did a randomised, double-blind, placebo controlled parallel group trial to determine whether oral azithromycin decreases the frequency of asthma exacerbations in adults (≥18 years) with symptomatic asthma despite current use of inhaled corticosteroid and long-acting bronchodilator, and who had no hearing impairment or abnormal prolongation of the corrected QT interval
2017LancetControlled trial quality: predicted high
Variations in the prevalence of childhood asthma and wheeze in MeDALL cohorts in Europe While there is evidence for variations in prevalence rates of childhood wheeze and asthma between countries, longitudinal, individual-level data are needed to understand these differences. The aim of this study was to examine variations in prevalence rates of childhood asthma, wheeze and wheeze with asthma in Europe. We analysed datasets from 10 MeDALL (Mechanisms of the Development of ALLergy) cohorts (...) in eight countries, representing 26 663 children, to calculate prevalence rates of wheeze and asthma by child age and wheeze with asthma at age 4 years. Harmonised variables included outcomes parent-reported wheeze and parent-reported doctor-diagnosed asthma, and covariates maternal education, parental smoking, pets, parental asthma, doctor-diagnosed allergic rhinitis, doctor-diagnosed eczema and wheeze severity. At age 4 years, asthma prevalence varied from 1.72% in Germany to 13.48% in England
[Fractional exhaled nitric oxide measurement in patients with asthma and chronic cough] [Fractional exhaled nitric oxide measurement in patients with asthma and chronic cough] [Fractional exhaled nitric oxide measurement in patients with asthma and chronic cough] Virgilio S, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation (...) of the quality of this assessment has been made for the HTA database. Citation Virgilio S, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A. [Fractional exhaled nitric oxide measurement in patients with asthma and chronic cough] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rapida No 536. 2017 Authors' conclusions Moderate quality evidence suggests that fractional exhaled
[Reslizumab (severe eosinophilic asthma) - Benefit assessment according to õ 35a Social Code Book V] Reslizumab (Asthma): Nutzenbewertung gemäß § 35a SGB V; Dossierbewertung; Auftrag A17-02 [Reslizumab (severe eosinophilic asthma) – Benefit assessment according to § 35a Social Code Book V] Reslizumab (Asthma): Nutzenbewertung gemäß § 35a SGB V; Dossierbewertung; Auftrag A17-02 [Reslizumab (severe eosinophilic asthma) – Benefit assessment according to § 35a Social Code Book V] Institut für (...) Qualität und Wirtschaftlichkeit im Gesundheitswesen Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen. Reslizumab (Asthma): Nutzenbewertung gemäß § 35a SGB V; Dossierbewertung; Auftrag A17-02. [Reslizumab (severe eosinophilic asthma) – Benefit assessment according to § 35a Social Code
An evidence-based, point-of-care tool to guide completion of asthma action plans in practice Asthma action plans (AAPs) reduce healthcare utilisation, improve quality of life and are recommended across guidelines. However, fewer than 25% of patients receive an AAP, partly due to prescribers' inability to complete "yellow zone" instructions (how to intensify therapy for acute loss of control). We sought to review best evidence to develop a practical, evidence-based tool to facilitate yellow zone (...) guidance in adults.We reviewed recent asthma guidelines and adult studies addressing acute loss of asthma control (January 2010 to March 2016). We developed evidence-based rules for yellow zone therapy and operational guidelines to maximise adherence and minimise errors.We reviewed three guidelines and 11 manuscripts (2486 abstracts screened). Recommendations were comparable but some areas lacked guidance. For 15/43 asthma regimens, the commonly recommended four- to five-fold yellow zone inhaled
A pharmacy management service for adults with asthma: a cluster randomised controlled trial Although clinical guidelines are available for the management of asthma, this health condition is still poorly managed in many countries.To assess the effects of a Pharmacy Management Service (PharMS) on asthma control of adult patients.This study comprised of a cluster randomised controlled trial (RCT) that was conducted from April 2014 to July 2015 at four government health clinics. The control (...) participants received usual pharmacy service, while the intervention participants were recruited into the PharMS. Each participant was monitored for 6 months, and the outcome measures included asthma control using the Asthma Control Test (ACT), inhaler technique using a checklist and medication adherence using the Malaysian Medication Adherence Scale.A total of 157 participants were recruited: 77 in the control and 80 in the intervention group. At the end of the study, 90% of the intervention participants
Oral Glucocorticoid-Sparing Effect of Benralizumab in Severe Asthma. Many patients with severe asthma rely on oral glucocorticoids to manage their disease. We investigated whether benralizumab, a monoclonal antibody directed against the alpha subunit of the interleukin-5 receptor that significantly reduces the incidence of asthma exacerbations, was also effective as an oral glucocorticoid-sparing therapy in patients relying on oral glucocorticoids to manage severe asthma associated (...) with eosinophilia.In a 28-week randomized, controlled trial, we assessed the effects of benralizumab (at a dose of 30 mg administered subcutaneously either every 4 weeks or every 8 weeks [with the first three doses administered every 4 weeks]) versus placebo on the reduction in the oral glucocorticoid dose while asthma control was maintained in adult patients with severe asthma. The primary end point was the percentage change in the oral glucocorticoid dose from baseline to week 28. Annual asthma exacerbation
KIT Inhibition by Imatinib in Patients with Severe Refractory Asthma. Mast cells are present in the airways of patients who have severe asthma despite glucocorticoid treatment; these cells are associated with disease characteristics including poor quality of life and inadequate asthma control. Stem cell factor and its receptor, KIT, are central to mast-cell homeostasis. We conducted a proof-of-principle trial to evaluate the effect of imatinib, a KIT inhibitor, on airway hyperresponsiveness (...) , a physiological marker of severe asthma, as well as on airway mast-cell numbers and activation in patients with severe asthma.We conducted a randomized, double-blind, placebo-controlled, 24-week trial of imatinib in patients with poorly controlled severe asthma who had airway hyperresponsiveness despite receiving maximal medical therapy. The primary end point was the change in airway hyperresponsiveness, measured as the concentration of methacholine required to decrease the forced expiratory volume in 1
Do Inhaled Anticholinergic Agents in Addition to ß-Agonists Improve Outcomes in Acute Asthma Exacerbations? TAKE-HOME MESSAGE The addition of inhaled anticholinergic agents to b-2 agonists reduced hospitalization and improved pulmonary function testing, but was also associated with increased rates of mild adverse events. Do Inhaled Anticholinergic Agents in Addition to b-Agonists Improve Outcomes in Acute Asthma Exacerbations? EBEM Commentators Michael Gottlieb, MD Matthew J. Kuhns, MD (...) 2017 Annals of Emergency Medicine 421exacerbations (relative risk 0.56; 95% con?dence interval 0.43 to 0.72), with no signi?cant difference noted in mild (relative risk 1.88; 95% con?dence interval 0.37 to 9.54) or moderate (relative risk 0.88; 95% con?dence interval 0.69 to 1.11) exacerbations. Commentary Asthma is a common disease, affectingmorethan17.7million adults in the United States. 2 Asthma exacerbations result in 1.8 million annual ED visits in the United States, with 11.9
Positive Expiratory Pressure for the Treatment of Acute Asthma Exacerbations: A Randomized Controlled Trial To evaluate the efficacy of brief, single administration of positive expiratory pressure (PEP) therapy in reducing clinical severity and need for additional second-line therapies and hospitalization in children presenting to the emergency department (ED) with acute asthma.This was a prospective randomized controlled trial of children 2-18 years of age presenting to a tertiary-care (...) academic pediatric ED with moderate-to-severe asthma exacerbations from December 2014 to June 2016. Children who continued to have moderate asthma severity after completion of initial therapies (albuterol/ipratropium bromide and corticosteroids) were randomized to receive PEP therapy or standard of care. The primary outcome was change in pulmonary asthma score before and after intervention, as assessed by a blinded physician. Secondary outcomes included need for additional therapies, ED length of stay
with beta agonists. Only recommended to maintain people on it if they are on it in the community Empiric antibiotics – you guessed it. With signs of overt infection (eg lobular pneumonia) not helpful. Possible that high procalcitonin levels may reflect bacterial infection Nebulized furosemide – thought to help exercised induced asthma, but no data to support its use  Discuss a ventilation strategy for the critically-ill asthmatic patient Induction agent: Ketamine/Propofol/Etomidate. No benefit (...) CRACKCast E073 – Asthma CRACKCast E073 - Asthma - CanadiEM CRACKCast E073 – Asthma In , by Adam Thomas April 27, 2017 This episode of CRACKCast covers Rosen’s Chapter 73, Asthma. Not just for kids! This disease process is satisfying to treat when patients respond well to therapy, but recognition of critically-ill patients is an important first step in management. Shownotes – Rosens in Perspective Basic Principles: Reverse Obstruction Treat Hypoxia Treat Inflammation Basic definition : A chronic
Asthma education for school staff. 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
Can we use the combination formoterol-budesonide in teenagers with moderate or severe asthma? Can we use the combination formoterol-budesonide in teenagers with moderate or severe asthma? - Evidencias en pediatría Searching, please wait Show menu Library Management You did not add any article to your library yet. | Search Evidence-Based decision making Evidence-Based decision making Show menu Library Management You did not add any article to your library yet. × User Password Log in × Reset (...) password If you need to reset your password please enter your email and click the Send button. You will receive an email to complete the process. Email Send × Library Management × March 2017. Volume 13. Number 1 Can we use the combination formoterol-budesonide in teenagers with moderate or severe asthma? Rating: 0 (0 Votes) Reviewers: , . | Newsletter Free Subscription Regularly recieve most recent articles by e-mail Subscribe × Newsletter subscription: Email Confirm email I accept the journal’s