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Search Results: 1 - 10 of 2075 matches for " asthma "
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Nitric oxide paradox in asthma
Keller, Alexandre Castro;Rodriguez, Dunia;Russo, Momtchilo;
Memórias do Instituto Oswaldo Cruz , 2005, DOI: 10.1590/S0074-02762005000900005
Abstract: asthma results from allergen-driven intrapulmonary th2 response, and is characterized by intermittent airway obstruction, airway hyperreactivity (ahr), and airway inflammation. accumulating evidence indicates that inflammatory diseases of the respiratory tract are commonly associated with elevated production of nitric oxide (no). it has been shown that exhaled no may be derived from constitutive no synthase (nos) such as endothelial (nos 3) and neural (nos 1) in normal airways, while increased levels of no in asthma appear to be derived from inducible nos2 expressed in the inflamed airways. nevertheless, the functional role of no and nos isoforms in the regulation of ahr and airway inflammation in human or experimental models of asthma is still highly controversial. in the present commentary we will discuss the role of lipopolysaccharides contamination of allergens as key element in the controversy related to the regulation of nos2 activity in experimental asthma.
Gastroesophageal Reflux in Children with Refractory Asthma
Alaa S. Deeb,Amal Al-Hakeem,Ghazal S. Dib
Oman Medical Journal , 2010,
Abstract: Objectives: To investigate the association between clinical and macroscopic findings of GER and severity of refractory asthma (statistical study).Methods: A prospective study in a university-based practice of 75 children who were diagnosed with refractory asthma because they exhibited no satisfactory response for at least three months of treatment. Medical history, physical examination, spirometrical measurements and prick skin test were conducted on all patients. Endoscopic and macroscopic evaluations for esophagitis were performed on all patients regardless of the presence of GER symptoms.Results: Endoscopy was done for 75 children with refractory asthma. GER was symptomatic in 65% of all patients with no statistical significance (p>0.05) and the most frequent symptom was abdominal pain (67%). The frequency of these symptoms was 50% in mild asthma, 58% in moderate asthma and 72% in severe asthma with no statistical significance (p>0.05). The frequency of macroscopic esophagitis was 71%, distributed in three asthmatic groups as in order of 75% in mild asthma, 58.3% in moderate asthma and 76.6% in severe asthma (p>0.05). Regarding the relationship between GER and nocturnal attacks or spasmodic cough, the frequency of the latest was 66.7%. The differences have no statistical significance regarding GER symptoms (p>0.05), but they are statistically significant regarding the reflux esophagitis (p<0.05). Also endoscopic reflux was as frequent as76.3% in non allergic patients, and this result is statistically significant (p<0.05).Conclusion: In spite of the fact that there was no relationship between the severity of asthma and the symptoms of GER, or its endoscopic findings, the frequency of GER in asthmatic children was higher than its frequency in other children.
The role of eosinophils in asthma  [PDF]
Faris Q. Alenzi, Fahad G. B. Alanazi, Abdulaziz D. Al-Faim, Mohamed W. Al-Rabea, Waleed Tamimi, Bassel Tarakji, Omar Kujan, Ali Al-Jabri, Richard K. H. Wyse
Health (Health) , 2013, DOI: 10.4236/health.2013.52A045
Abstract: Asthma is a chronic inflammatory disorder of the airways characterized by recurring episodes of reversible airway obstruction, hyper-responsiveness, wheezing, breathlessness and coughing. Clinical diagnosis of asthma is based on the pattern of clinical symptoms and pulmonary fuction tests. Asthma affectes 5% - 10% of the population and the number of worldwide cases is approximately 300 milliones. The incidence of this disease is increasing particulry in western countries [1]. It is the cause of a huge economic burden to national healthcare services. In a minority of cases, asthma is potentially fatal. After a period when fatalities appeared to be increasing [2], in recent years asthma-related mortality has progressively declined due to the develop- ment of specific asthma disease management programs, as well as the extensive use of in- haled corticosteroids [3]. Inflammation of the airways is a central component in asthma. In- flammation is associated with infliltration of the airway wall with eosinophiles and or neutron- philes mast cell degranulation and T cell active- tion. Other pathological features include, sub- basement membrane thickening, loss of epithet- lial cell integrity, goblet cells hyperplasia In- crease in airway smooth muscle mass. Eosino- phils are thought to be vital in the development of airway hyperreactivity, with the eosinophil cationic protein playing a crucial role [4]. The fact that treatment of asthma with corticos-teroids reduces eosinophils numbers and decreases airway reactivity further supports this hypothesis.
Asthma and Injury Risk: A Large Scale Population-Based Study  [PDF]
Wenbin Liang, Tanya Chikritzhs
International Journal of Clinical Medicine (IJCM) , 2012, DOI: 10.4236/ijcm.2012.35074
Abstract: Purpose: Clinical data suggest that asthma impairs sleep quality and further impairs cognitive performance during the daytime, while there is a causal relationship between impaired sleep quality and injuries. Therefore asthma patients may have increased risk of injury, and this is supported by our recent population-based studies conducted in Australia. This study is to investigate the effect of asthma on the risk of injury at the population level using data from the U.S. National Health Interview Survey collected in 2008, 2009, and 2010. Method: Data from the 2008, 2009 and 2010 National Health Interview Surveys were combined and analyzed together. Results: U.S. adults with current or previous asthma had significantly greater risk of injury compared to those without asthma. The risk of injury was also significantly higher among children with current asthma. Conclusion: This population-based study provided further evidence on the positive association between asthma and risk of injury among both adults and children. The increased risk of injury among asthma patients is at least partly due to impaired sleep quality and quantity caused by asthma symptoms and asthma medications.
Allergies in Children: What’s New?—A Cross-Sectional Descriptive Study  [PDF]
Daniela Simoncini, Anna Peirolo, Alberto Macchi, Stefania Porcu, Daniela Graziani, Luigi Nespoli
Open Journal of Pediatrics (OJPed) , 2015, DOI: 10.4236/ojped.2015.54045
Abstract: Background: The prevalence of respiratory allergies is increasing worldwide, with important consequences especially for little children. Objective: The aim of this study was to assess the prevalence of respiratory allergies, such as rhinitis and asthma, and to point out the risk factors and their relationship with allergic diseases in a specific area of Northern Italy. Methods: 110 children, male and female, from our outpatient service for allergic children, between 3 and 17 years old, were examined. After a skin prick test and a nasal cytology, the written questionnaire of the International Study of Asthma and Allergies in Childhood was filled by parents together with their children. Results: 110 children were examined. 74% of children had rhinitis and 71% asthma. 88 patients were allergic, grass pollen and house dust mite was the most frequent allergens. A family history of atopy, family background, geographic area, active and passive smoking and home pets were associated to allergies. Older children (6 - 15 years old) had more often rhinitis associated with asthma and conjunctivitis as compared to younger. 21 Children were also affected by non allergic rhinitis. Conclusions: Respiratory allergies are widespread and associated to a low quality of life among little children. Sensitization to Ragweed is increasing with important consequences. Rhinitis precedes the onset of asthmatic symptoms. Moreover non allergic rhinitis is increasing and frequently underdiagnosed.
The Impact of Microbiological Pollutants on School Indoor Air Quality  [PDF]
Peter Fsadni, Bezzina Frank, Claudia Fsadni, Stephen Montefort
Journal of Geoscience and Environment Protection (GEP) , 2017, DOI: 10.4236/gep.2017.55004
Abstract: Asthma is common in children with allergens and mould influencing the development of the disease. Since children spend most of their time outside their homes within the school environment, school indoor air quality can directly influence their respiratory health. This study aims to identify microbiological contaminants in Maltese schools. The association between contaminants, respiratory health and school characteristics has been analysed. Five primary schools were selected with 9 to 11 years old students participating. Standardised health questionnaires, lung function tests, and school characterisation were performed. Dust samples were analysed for fungi, bacteria and allergens were performed. Penicillium/Aspergillus/Paecilomyces/Variotii (PenAsp) group had the highest median indoor concentration followed by Mycobacterial and Streptomyces species. There was a significant negative correlation between PenAsp and Mycobacterium spp levels in all the participating schools (r = ?0.42; p = 0.03). Cat allergen in classroom dust correlated positively with the number of cat owners (r = 0.43; p = 0.041). High exposure to fungi, bacteria and allergens was significantly associated with upper and lower airway atopy. School/classroom characteristics and cleaning protocols were significantly associated with exposure to these pollutants. In conclusion, fungi, bacteria, endotoxin, cat and dog allergens have been found to have a direct influence on school indoor air quality in the Maltese Islands. A significant association was observed between these contaminants and upper and lower airway atopy. Specific school, classroom, cleaning and maintenance characteristics have been identified as having a direct impact on indoor air quality.
Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity
Mark D Eisner, Patricia P Katz, Edward H Yelin, Stephen C Shiboski, Paul D Blanc
Respiratory Research , 2000, DOI: 10.1186/rr37
Abstract: In adults with health care access, we prospectively studied 242 with asthma, aged 18–50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization.Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1–8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9–1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7–6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1–33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0–9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02–1.4).In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.Asthma is a common condition in general medical practice, accounting for about 1% of all ambulatory visits in the USA [1]. The mortality rate from asthma has risen sharply since the late 1970s, which may reflect increasing disease severity [2]. The hospitalization rate, another population-level marker of asthma severity, remains substantial [2], generating nearly one-half of all US health care costs for asthma [3]. Hospitalization rates for asthma have actually increased in some demographic subgroups, such as young adults [2] and the urban poor [4], desp
Severe Asthma: Definitions, risk factors and phenotype characterization
Penny Moraitaki,Despina Papamichail,Niki Georgatou
Pneumon , 2010,
Abstract: SUMMARY. The correct diagnosis of asthma is usually made easily and most patients with asthma respond to therapy. Approximately 5-10% of patients with asthma, however, have disease that is difficult to control despite administration of maximal doses of inhaled medications. It appears that asthma is a heterogeneous disorder which presents not as a single disease but rather as a complex of multiple, separate syndromes that overlap. Although the various different phenotypes of asthma have been long recognized, they are still poorly characterized. Improved phenotypical characterization and understanding of the underlying pathobiology are necessary for linkage of specific genotypes with clinical disease manifestations, for possible development of biomarkers and for devising advanced, phenotype-targeted asthma treatment. This review reports on the asthma phenotypes that have been best described and analyses the methods used to define them. Pneumon 2010, 23(3):260-292.
Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity
Eisner Mark,Katz Patricia,Yelin Edward,Shiboski Stephen
Respiratory Research , 2001,
Abstract: Background The morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial. Methods In adults with health care access, we prospectively studied 242 with asthma, aged 18–50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization. Results Thirty-nine subjects (16%) reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1–8.8) and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9–1.3) were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7–6.8) and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1–33.4) were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0–9.8). In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02–1.4). Conclusion In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.
The effect of budesonide/formoterol maintenance and reliever therapy on the risk of severe asthma exacerbations following episodes of high reliever use: an exploratory analysis of two randomised, controlled studies with comparisons to standard therapy
Buhl Roland,Kuna Piotr,Peters Matthew J,Andersson Tomas LG
Respiratory Research , 2012, DOI: 10.1186/1465-9921-13-59
Abstract: Background Divergent strategies have emerged for the management of severe asthma. One strategy utilises high and fixed doses of maintenance treatment, usually inhaled corticosteroid/long-acting β2-agonist (ICS/LABA), supplemented by a short-acting β2-agonist (SABA) as needed. Alternatively, budesonide/formoterol is used as both maintenance and reliever therapy. The latter is superior to fixed-dose treatment in reducing severe exacerbations while achieving similar or better asthma control in other regards. Exacerbations may be reduced by the use of budesonide/formoterol as reliever medication during periods of unstable asthma. We examined the risk of a severe exacerbation in the period after a single day with high reliever use. Methods Episodes of high reliever use were quantified and exacerbations occurring post-index day with these episodes were examined post hoc in two double-blind studies comparing the efficacy and safety of budesonide/formoterol maintenance and reliever therapy (Symbicort SMART , Turbuhaler ) 160/4.5 μg twice daily plus as needed with similar or higher maintenance doses of ICS/LABA plus SABA or formoterol. Results Budesonide/formoterol maintenance and reliever therapy significantly reduced the risk of episodes of high reliever use (>6 inhalations/day) vs. all alternative ICS/LABA regimens. With conventional fixed-dose treatment the need for exacerbation treatment within 21 days ranged from 6.0–10.1% of days post-index for all regimens compared with 2.5–3.4% of days with budesonide/formoterol maintenance and reliever therapy. Conclusions Budesonide/formoterol maintenance and reliever therapy reduces the incidence of high reliever episodes and the exacerbation burden immediately following these episodes vs. alternative ICS/LABA plus SABA regimens at up to double the maintenance dose of ICS. Trial registration These studies do not have registration numbers as they were conducted before clinical trial registration was required
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