Vocal cord dysfunction (VCD) is a functional respiratory tract disorder resulting from paradoxical adduction of the vocal cords, complicates the diagnosis and management of common respiratory tract problems, including asthma. The recognition of VCD in a patient with atypical or difficult-to-control asthma is critical in minimizing symptoms and potential side-effects associated with treatment of severe asthma. The symptoms of VCD are not unique to the disorder and include cough, wheeze, stridor, dyspnea, hoarseness, and choking. (more…)
With the help of well-trained and experienced pulmonary function technicians, children as young as 4 to 5 years of age should b ...
Asthma is a frightening condition. I have lived with asthma symptoms for 17 years and the thought of an allergy induced asthma atta ...
In 2004, there were 2.4 million children aged 5 to 14 years, or 5.9% of this population group, with a self-reported asthma atta ...
A history of cough, dyspnea, wheezing, chest tightness or performance problems during exercise suggests the person may have Exercis ...
How to properly make clinical diagnosis of acute severe asthma? There is little doubt of the accuracy of current asthma testing ...
More severe asthma can persist from childhood into adulthood without remission. Another important tendency in the natural history is for symptoms to remit in adolescence only to return again in adulthood. In general, the amount of wheezing in early adolescence seems to be a guide for severity in early adult years, with 73% of those with few symptoms at age 14 years continuing to have little or no asthma progression at age 28 years. Similarly 68% of those with frequent wheezing at 14 years still suffered from recurrent asthma at age 28 years. Most subjects with frequent wheezing at 21 years continued to have comparable asthma at 28 years. In addition to the importance of symptoms in childhood, childhood degree of bronchial responsiveness in combination with a low FEV-1 were also related to the outcome of asthma in adulthood. (more…)
In the Tucson CRS study, about 50% of young children experienced a period of recurrent wheezing and/or coughing in the first 6 ...
Exposure and allergic sensitization to cockroach was associated with a significantly greater risk of asthma hospitalization and ...
With the help of well-trained and experienced pulmonary function technicians, children as young as 4 to 5 years of age should b ...
Asthma is a complex syndrome rather than a single disease entity. Different phenotypes with varying prognosis and determinants have ...
It is clear from the results of large epidemiologic studies that while atopy is a major risk factor for asthma, it is usually n ...
Airway remodelling is considered to be of major importance in the pathology of asthma, with subepithelial basement membrane thickening in particular being indicative of early development of the disease and characteristic of its progression. Airway fibroblasts are central cells in the processes of remodelling: increased deposition of fibroblast-derived connective tissue proteins and differentiation of fibroblasts into contractile myofibroblasts are consistent observations in morphological studies of moderate to severe asthmatic airways. The secretory function of fibroblasts is under the control of locally produced growth factors such as vascular endothelial cell growth factor (VEGF, see below) and platelet-derived growth factor (PDGF). (more…)
Vascular Endothelial Growth Factor (VEGF), originally described as a vascular permeability factor generating tissue oedema, has be ...
Local micro environmental factors are crucial in determining both susceptibility to vascular remodeling and the extent of angio ...
Tumour Necrosis Factor is a pro-inflammatory cytokine implicated in the pathogenesis of asthmatic airway inflammation, hyper-react ...
Asthma is a continuing problem for healthcare, particularly in the industrialized world. Some 150 million people are estimated ...
Airway hyper-responsiveness in asthma may involve smooth muscle growth, a manifestation of airway remodelling. The involvement ...
Leukotrienes can be found in the airway and urine following both spontaneous exacerbations of asthma and acute exposure to bronchoconstrictor stimuli in the laboratory. This in turn indicates that they may have a role in the pathogenesis of acute episodes of bronchoconstriction. Although antileukotrienes are not currently advocated in the management of acute asthma, there are data to suggest that they might be of some potential benefit. Prior treatment with montelukast asthma has been shown in several studies to significantly shorten the time taken to recover (in terms of FEV 1 ) following exposure to a bronchoconstrictor stimulus. (more…)
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
Current internationally recognized guidelines indicate that symptomatic asthmatics using a low to medium inhaled corticosteroid ...
The prevalence of aspirin-sensitive asthma is uncertain although it may exist in up to 20% of all asthmatics patients. The char ...
Montelukast has proven efficacy in the treatment of chronic asthma and seasonal allergic rhinitis, but it has not been evaluate ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
In 2004, there were 2.4 million children aged 5 to 14 years, or 5.9% of this population group, with a self-reported asthma attack, with no decrease in prevalence since 1997 1 in spite of the much improved therapies available. In this interval, the number of physician office visits for asthma doubled, from 1.7 to 3.3 million which many leads to asthma morbidity and asthma mortality. (more…)
Negative family characteristics such as family conflict and family dysfunction discriminated children who died of asthma from c ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
Asthmatic children who also have Allergic Rhinitis seem to have higher morbidity and to use more healthcare resources. This was fur ...
What is Flu? Influenza, commonly known as “the flu,” is a contagious disease caused by a virus. It can cause mild to severe ...
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and symptom relief (Symbicort Single Inhaler Therapy) – compared with a higher maintenance dose of budesonide in patients with moderate to severe asthma. (more…)
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require relie ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly toleranc ...
Two long-acting ß 2 -adrenergic agonists (LABAs), salmeterol and formoterol, have been demonstrated to be safe and effective ag ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
Some features seem to be common to severe asthma and Chronic Obstructive Pulmonary Disease with reversibility of airflow limitation. The neutrophil chemoattractant leukotriene B 4 (LTB 4) may play a role in Chronic Obstructive Pulmonary Disease and in some forms of asthma. In this study, 55 smokers with no disease, Chronic Obstructive Pulmonary Disease (with or without bronchodilator reversibility of airflow limitation) or asthma underwent measurement of LTB 4 in sputum supernatants and exhaled breath condensate asthma (EBC). Both Chronic Obstructive Pulmonary Disease and asthma patients had higher levels of LTB 4 than control subjects; patients with asthma or reversible Chronic Obstructive Pulmonary Disease exhibited significantly higher levels of LTB 4 than those with irreversible Chronic Obstructive Pulmonary Disease. (more…)
Leukotrienes are present in increased amounts in exhaled breath condensate (EBC) in patients with asthma. So far, no data have ...
The cysteinyl leukotrienes (LTC 4 , LTD 4 and LTE 4 ) are lipid mediators produced from an arachidonic acid precursor following ...
A role for Leukotriene B4 in the induction of airway hyper-responsiveness was explored through the use of transgenic mice defic ...
Adjusting the inhaled glucocorticoid dose based on indices of airway inflammation has been proposed as a means of achieving more ef ...
With the help of well-trained and experienced pulmonary function technicians, children as young as 4 to 5 years of age should b ...
Asthma control is improved by combining inhaled corticosteroids with long acting beta-agonists but patients still require reliever medication for breakthrough symptoms. Periodic fluctuations in symptoms and airway inflammation are characteristics of asthma, which means that treatment requirements, especially reliever use, can vary over time. (more…)
This study evaluated budesonide formoterol efficacy and safety of a novel asthma management strategy for both maintenance and s ...
This study was similar to the study of Harrison and colleagues, which looked at doubling the dose of inhaled corticosteroid dur ...
Two long-acting ß 2 -adrenergic agonists (LABAs), salmeterol and formoterol, have been demonstrated to be safe and effective ag ...
Regular use of ß-agonists has been known to lead to tolerance to their bronchodilator effects. It is not known how quickly toleranc ...
The guidelines for asthma management recommend the use of regular inhaled corticosteroid in patients with mild persistent asthma, b ...
Adjusting the inhaled glucocorticoid dose based on indices of airway inflammation has been proposed as a means of achieving more effective control of asthma than the conventional approach of adjusting steroid dose based on symptoms, lung function and rescue medication use. In a single-blind, placebo-controlled trial, 97 asthmatic patients received fluticasone doses adjusted on the basis either of conventional guidelines or of exhaled nitric oxide fraction (FE NO ). (more…)
For most patients, asthma is not controlled as defined by guidelines; whether this is achievable has not been prospectively stu ...
The new corticosteroid ciclesonide has been evaluated in various studies to assess its efficacy and adverse effect profile in a ...
Despite optimum drug delivery and good compliance with inhaled corticosteroids, many patients experience symptoms and exacerbat ...
The management of asthma in the community involves patient education to avoid the triggers, doubling the dose of inhaled steroi ...
Treating allergic rhinitis may have a downstream effect on concomitant asthma and this may be due to attenuation of the underlying ...
IgE plays an important role in allergic asthma. Reducing IgE in the airway mucosa should reduce airway inflammation. Omalizumab has significant anti-inflammatory effect and reduces serum and airway IgE, but IgE or eosinophils may not be causally linked to airway bronchial hyperresponsiveness to methacholine in mild to moderate asthma. (more…)
Treatment with omalizumab has been shown to reduce serum free IgE concentrations and to have beneficial effects on allergic airway ...
Anti-IgE therapy could be particularly beneficial for patients with concomitant asthma and rhinitis as it targets a common fact ...
Patients with severe persistent asthma who are inadequately controlled despite Global Initiative for Asthma (GINA) 2002 step 4 ther ...
Tumour Necrosis Factor is a pro-inflammatory cytokine implicated in the pathogenesis of asthmatic airway inflammation, hyper-react ...
Tumour necrosis factor alpha (TNF-a) is a major therapeutic target in a range of chronic inflammatory disorders involving neutr ...