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Severe Persistent Asthma

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61. Comparison of severity of asthma hospitalization between African American and Hispanic children in the Bronx. (Abstract)

more likely to have severe persistent asthma (12% vs. 7%, p = .02). They were also more likely to require magnesium sulfate (45% vs. 32%, p < .001) and admission to the ICU from the emergency department (ED) (14% vs. 8%, p = .01), which were independent of asthma severity. There was no significant difference in LOS or other characteristics of hospitalization.African American children hospitalized for asthma have more severe exacerbations compared to Hispanic children, which is independent (...) Comparison of severity of asthma hospitalization between African American and Hispanic children in the Bronx. There are racial and ethnic disparities in childhood asthma burden and outcomes. Although there have been comparisons between whites and minorities, there are few between minority groups. This study aimed to compare characteristics of asthma hospitalizations in African American and Hispanic children.A retrospective chart review was conducted to compare asthma characteristics between

2019 Journal of Asthma

62. Changes in asthma severity in the first year of school and difficulty learning to read. (Abstract)

and covariates of achievement at school entry (T1) and 12 months later (T2). Asthma severity scores at T1 and T2 showed that in 27 of 51 children with asthma, symptoms improved over the year, whereas in 24, symptoms persisted or worsened. Word and story reading were assessed at T1 and T2. We compared reading achievement at both timepoints between children with asthma and children who had no reported respiratory symptoms between birth and T2 (controls, N = 74), and between those with persistent versus (...) Changes in asthma severity in the first year of school and difficulty learning to read. Asthma is a risk factor for poor early reading in children, for reasons that are unclear. This analysis examines the relationship between changes in asthma severity during the first year of school and being in the lowest quartile of reading achievement after 1 year of school.We used previously unreported data from our cohort study. Parent interviews and teacher questionnaires enquired about asthma

2019 Journal of Asthma

63. Long-term effect of weight loss induced by bariatric surgery on asthma control and health related quality of life in asthmatic patients with severe obesity: A pilot study. Full Text available with Trip Pro

unchanged in CG. As compared with the pre-surgery values, the percentage of predicted FEV1 and FVC significantly increased at five-year follow-up from surgery in TG, while it remained unchanged in CG.In severe obese asthmatic patients, the significant improvement of asthma control test and HRQoL, observed one year after LAGB, persists five years after surgery.Copyright © 2017 Elsevier Ltd. All rights reserved. (...) Long-term effect of weight loss induced by bariatric surgery on asthma control and health related quality of life in asthmatic patients with severe obesity: A pilot study. The weight loss induced by bariatric surgery (BS) improves asthma clinical control evaluated usually after a short time. The long-term effects of weight loss attained by BS on asthma control and health related-quality of life (HRQoL) in patients affected by asthma and obesity are not known.To investigate the five-year effect

2017 Respiratory medicine

64. Maternal asthma severity and control during pregnancy and risk of offspring asthma. Full Text available with Trip Pro

were offspring early-onset transient, early-onset persistent, and late-onset asthma. We estimated prevalence ratios (PRs) of each phenotype of asthma using a log-binomial model with 95% CIs.Higher prevalence of early-onset persistent asthma was observed among children of asthmatic mothers with mild uncontrolled (PR, 1.19; 95% CI, 1.05-1.35), moderate-to-severe controlled (PR, 1.33; 95% CI, 1.09-1.63), and moderate-to-severe uncontrolled asthma (PR, 1.37; 95% CI, 1.17-1.61) compared with those (...) cohort study. Using linkage of Danish national registers, we constructed a cohort of 675,379 singletons, of which 15,014 children were born to asthmatic mothers. Among them, 7,188 children were born to mothers with active asthma during pregnancy. We categorized mothers with active asthma into 4 groups based on dispensed antiasthma prescriptions and on use of medical services: mild controlled, mild uncontrolled, moderate-to-severe controlled, and moderate-to-severe uncontrolled asthma. The outcomes

2017 Journal of Allergy and Clinical Immunology

65. Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden. Full Text available with Trip Pro

Relevance of specific IgE antibody titer to the prevalence, severity, and persistence of asthma among 19-year-olds in northern Sweden. Although sensitization to indoor allergens is strongly associated with asthma, there are questions as to how this relates to asthma symptoms.We sought to study the relevance of IgE antibodies to cat and dog allergens in an area in which (1) the climate discourages cockroach, fungal, and mite growth and (2) dander allergens are known to be present in schools (...) with the diagnosis, severity, and persistence of asthma; however, a large proportion of patients with current asthma did not live in a house with a cat or dog.Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

2016 Journal of Allergy and Clinical Immunology

66. Omalizumab therapy in a 13-year-old boy with severe persistent asthma and concomitant eosinophilic esophagitis Full Text available with Trip Pro

Omalizumab therapy in a 13-year-old boy with severe persistent asthma and concomitant eosinophilic esophagitis Eosinophilic esophagitis (EoE) has been defined as "asthma of the esophagus" for the large number of similarities between the two diseases. Omalizumab is an anti-Immunoglobulin E (IgE) antibody currently approved only in allergic IgE-mediated severe persistent uncontrolled asthma and in chronic spontaneous urticaria unresponsive to antihistamines, but it has been tried in other (...) steroid-dependent. Currently, he continues both treatments: omalizumab for asthma and topical steroid for EoE.This case report confirms that omalizumab is an effective treatment in patients with severe persistent, uncontrolled asthma. On the other hand, in our patient it did not produce persistent improvement neither on symptoms nor on biopsy findings of EoE. The outcome of this case might indicate different pathogenic mechanism(s) of the two diseases.

2016 Italian journal of pediatrics

67. Economic analysis of temperature-controlled laminar airflow (TLA) for the treatment of patients with severe persistent allergic asthma. Full Text available with Trip Pro

Economic analysis of temperature-controlled laminar airflow (TLA) for the treatment of patients with severe persistent allergic asthma. Chronic asthma is a significant burden for individual sufferers, adversely impacting their quality of working and social life, as well as being a major cost to the National Health Service (NHS). Temperature-controlled laminar airflow (TLA) therapy provides asthma patients at BTS/SIGN step 4/5 an add-on treatment option that is non-invasive and has been shown (...) by the National Institute for Health and Care Excellence (NICE). Sensitivity analysis indicates that ICER values range from £18 883/QALY for the least severe patients through to TLA being dominant, that is, cost saving as well as improving quality of life, for individuals with the most severe and poorly controlled asthma.Based on our results, Airsonett TLA is a cost-effective addition to treatment options for stage 4/5 patients. For high-risk individuals with more severe and less well controlled asthma

2016 BMJ open respiratory research Controlled trial quality: uncertain

68. Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: a pilot, triple-blind, randomized clinical trial. (Abstract)

Squill Oxymel, a traditional formulation from Drimia Maritima (L.) Stearn, as an add-on treatment in patients with moderate to severe persistent asthma: a pilot, triple-blind, randomized clinical trial. In Traditional Iranian Medicine (TIM), Squill (Drimia maritima (L.) Stearn) Oxymel was utilized in the treatment of asthma. Squill has been reported to exert anti-inflammatory, anti-oxidant, anti-cholinergic, and mucus secretion modulating effects.This study aimed to make a preliminary (...) evaluation of the efficacy and safety of an add-on Squill Oxymel treatment in patients with moderate to severe persistent asthma.In a 6-week, triple-blind, randomized, placebo-controlled trial, 60 patients with stable moderate to severe persistent asthma were randomly allocated to receive either 10ml syrup of Squill Oxymel, simple oxymel, or a placebo 2 times a day, as an add-on to their routine treatment (inhaled corticosteroids and β2 agonists). Spirometry and plethysmography were performed on patients

2016 Journal of Ethnopharmacology Controlled trial quality: predicted high

69. Bronchial thermoplasty for treatment of inadequately controlled severe asthma

thermoplasty for treatment of inadequately controlled severe asthma . Chicago: BlueCross BlueShield Association (BCBS). TEC Assessment 29(12). 2014 Authors' objectives To determine whether relevant evidence demonstrates that BT improves the net health outcome — including asthma control, exacerbations, quality of life, medication use, lung function, and adverse events — in patients with inadequately controlled severe persistent asthma compared with best medical care. Authors' conclusions There is a sizeable (...) population with severe persistent asthma that could be considered for BT. Evidence from the 3 trials of BT applicable to individuals with severe persistent and inadequately controlled asthma—a single trial incorporated a sham control—is accompanied by uncertainty concerning the net health outcome. For FDA approval, superiority with respect to the primary outcomes (albeit changed in AIR2) must be considered together with safety. To judge impact on the net health outcome requires considering a set

2014 Health Technology Assessment (HTA) Database.

70. Adult Asthma Care: Promoting Control of Asthma

a BACKGROUND Adult Asthma Care: Promoting Control of Asthma — Second Edition For optimal effectiveness, recommendations in these three areas should be implemented together. The scope of this Guideline includes effective assessment and management interventions for adults (defined as persons aged 18 and older) who have a diagnosis of asthma. Several populations and conditions are beyond the scope of this Guideline. These include: ? Assessment and management recommendations specific to children (...) ? Oxygen to maintain O2 saturation =92% WORSENING30 REGISTERED NURSES’ ASSOCIATION OF ONTARIO RECOMMENDATIONS Adult Asthma Care: Promoting Control of Asthma — Second Edition RECOMMENDATION 1.3: At every encounter, assess the person’s risk of future asthma exacerbations according to the following criteria: ? Current control of asthma, ? Severe exacerbations experienced, ? Exacerbations requiring systemic corticosteroids, and ? Use of emergency care or hospitalizations for asthma. Level of Evidence = V

2017 Registered Nurses' Association of Ontario

71. Altered Epithelial Gene Expression in Peripheral Airways of Severe Asthma. Full Text available with Trip Pro

asthma and were targeted for global epithelial gene expression profiling in this study. Differences between central and peripheral airways were evaluated using transcriptomic analysis (Affymetrix HG U133 plus 2.0 GeneChips) of epithelial brushings obtained from severe asthma patients (N = 17) and healthy volunteers (N = 23). Results were validated in an independent cohort (N = 10) by real-time quantitative PCR. The IL-13 disease signature that is associated with an asthmatic phenotype was upregulated (...) of disease in severe asthma unadressed by current therapies. A transcriptomic approach to understand epithelial activation in severe asthma has thus highlighted the need for better-targeted therapy to the peripheral airways in severe asthma, where the IL-13 disease signature persists despite treatment with currently available therapy.

2017 PLoS ONE

72. Clinical Issues in Severe Asthma: Debates and Discussions About Personalizing Patient Management. Full Text available with Trip Pro

and other clinical parameters related to asthma severity and persistence. In many cases, the patient's medical history, clinical presentation, and results from biomarker testing can help classify severe asthma phenotypically. Increasingly, this approach can allow health-care providers to personalize maintenance regimens using targeted therapies for the identified endotypes; that is, asthma phenotypes linked to specific underlying disease mechanisms and proinflammatory signaling cascades. Several (...) Clinical Issues in Severe Asthma: Debates and Discussions About Personalizing Patient Management. An outsized proportion of asthma-related morbidity and mortality is borne by the 5% to 15% of affected patients who have severe forms of the disease. These patients experience poorly controlled symptoms and frequent exacerbations despite daily treatment with high-dose inhaled corticosteroids and other long-acting controller medications. Ongoing research has elucidated key pathophysiologic processes

2018 Chest

73. Clinical, Inflammatory and Functional Evaluation of a Population of Severe and Obese Asthmatics: Follow up

. According to the refractoriness of the response to treatment, severe asthma may be phenotype in some distinct groups.Other prospective study found a large proportion of severe asthmatics with persistent airway obstruction, despite optimized treatment and systematic follow-up. Small airway involvement and remodelling, characterized by bronchial muscle thickening, appear to be the main culprits for asthma severity and persistent obstruction in this population.A point of interest in the severe asthmatics (...) . The stability and natural history of the phenotypes is poorly understood, postulating that the inflammatory activation of the severe asma is multifactorial and may resemble that described in the oncology literature.To date, there are no markers that allow prediction of lung evolution of most patients with severe asthma, and which patients are at greater risk of developing persistent or accelerated loss airflow or lung function, factors determining the severity of asthma. It is also unclear whether and how

2018 Clinical Trials

74. What is the role of bronchial thermoplasty in the management of severe asthma? Full Text available with Trip Pro

What is the role of bronchial thermoplasty in the management of severe asthma? Asthma is a common chronic inflammatory condition of the airways. Conventional therapy comprises inhaled corticosteroid and bronchodilators as well as trigger avoidance and management of comorbid conditions. A small group remain symptomatic despite these strategies and novel therapies have been developed. Bronchial thermoplasty is a nonpharmacological therapy which targets airway smooth muscle to improve asthma (...) control. Clinical trials to date have shown the efficacy and safety of bronchial thermoplasty with a persistent effect on extended follow up. Questions remain regarding the exact mechanism of action of bronchial thermoplasty, the cost effectiveness of the procedure and the ideal criteria for patient selection.

2018 Therapeutic advances in respiratory disease

75. Sputum Eosinophilia and MRI Ventilation Heterogeneity in Severe Asthma. (Abstract)

response. In those patients in whom sputum eosinophilia was uncontrolled, greater VDP persisted postsalbutamol (P = 0.004). Postsalbutamol VDP correlated with sputum eosinophils (r = 0.63; P = 0.005).In patients with severe asthma, MRI regionally identifies the inflammatory and noninflammatory components of airway disease. Ventilation heterogeneity persists postsalbutamol in patients with uncontrolled eosinophilic bronchitis, which may be the functional consequence of airway inflammation. (...) Sputum Eosinophilia and MRI Ventilation Heterogeneity in Severe Asthma. Inflammation and smooth muscle dysfunction are integral components of severe asthma that contribute to luminal obstruction causing airflow limitation, ventilation heterogeneity, and symptoms. This is important for guiding treatment decisions directed at the inflammatory (e.g., anti-T-helper cell type 2 monoclonal antibodies) and noninflammatory, smooth muscle-mediated (e.g., bronchial thermoplasty) components of severe

2018 American Journal of Respiratory and Critical Care Medicine

76. Case study: A Combination of Mepolizumab and Omaluzimab injections for severe asthma. (Abstract)

Case study: A Combination of Mepolizumab and Omaluzimab injections for severe asthma. A Combination of Mepolizumab and Omaluzimab injections for severe asthma.Patients with severe persistent asthma account for a large proportion of asthma morbidity and health care expenditures. In this case report we describe the use of a combination of omalizumab and mepolizumab in severe asthma with elevated IgE levels and eosinophilic phenotype.We are treating a 55 year old woman with severe persistent (...) status allows.Combination of omalizumab and mepolizumab could become the gold standard for severe asthma patients that have elevated IgE levels and an eosinophilic phenotype.A Combination of Mepolizumab and Omaluzimab injections for severe asthma.

2018 Journal of Asthma

77. Nerve ablation after bronchial thermoplasty and sustained improvement in severe asthma. Full Text available with Trip Pro

Nerve ablation after bronchial thermoplasty and sustained improvement in severe asthma. Bronchial thermoplasty (BT) is a non-pharmacological intervention for severe asthma whose mechanism of action is not completely explained by a reduction of airway smooth muscle (ASM). In this study we analyzed the effect of BT on nerve fibers and inflammatory components in the bronchial mucosa at 1 year.Endobronchial biopsies were obtained from 12 subjects (mean age 47 ± 11.3 years, 50% male) with severe (...) to T0. Among inflammatory cells, only CD68 showed significant changes at all time points. Improvement of all clinical outcomes was documented and persisted at the end of follow up.A reduction of nerve fibers in epithelium and in ASM occurs earlier and persists at one year after BT. We propose that nerve ablation may contribute to mediate the beneficial effects of BT in severe asthma.Registered on April 2, 2013 at ClinicalTrials.gov Identifier: NCT01839591 .

2018 BMC pulmonary medicine

78. Baseline serum CXCL10 and IL-12 levels may predict severe asthmatics' responsiveness to omalizumab. Full Text available with Trip Pro

Baseline serum CXCL10 and IL-12 levels may predict severe asthmatics' responsiveness to omalizumab. Omalizumab, a humanized anti-IgE monoclonal antibody, is the first molecularly targeted drug for severe asthmatics. However, responses to omalizumab vary widely among patients.This study aimed to assess the potential of baseline serum cytokine levels as predictors of responsiveness to omalizumab.Thirty-one patients with severe, persistent asthma were enrolled in this study and administered (...) omalizumab for at least 1 year. Response to omalizumab was assessed based on the physician's global evaluation of treatment effectiveness (GETE) at 48 weeks of treatment. Blood samples were collected at baseline and 16 and 32 weeks after starting omalizumab and measured for 30 cytokines by Luminex 200 and ELISA. Exhaled nitric oxide (FeNO) levels, peripheral blood eosinophil counts, pre-bronchodilator pulmonary functions and Asthma Quality of Life Questionnaire scores were determined at baseline and 16

2018 Respiratory medicine

79. Repeat Dose Study of GSK3772847 in Participants With Moderate to Severe Asthma With Allergic Fungal Airway Disease (AFAD)

Repeat Dose Study of GSK3772847 in Participants With Moderate to Severe Asthma With Allergic Fungal Airway Disease (AFAD) Repeat Dose Study of GSK3772847 in Participants With Moderate to Severe Asthma With Allergic Fungal Airway Disease (AFAD) - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum (...) number of saved studies (100). Please remove one or more studies before adding more. Repeat Dose Study of GSK3772847 in Participants With Moderate to Severe Asthma With Allergic Fungal Airway Disease (AFAD) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. of clinical studies and talk to your health care provider before participating. Read our for details

2018 Clinical Trials

80. Appropriate use of oral corticosteroids for severe asthma. (Abstract)

or insensitivity to corticosteroids is a feature of severe asthma, with persistent type 2 inflammation often occurring despite regular use of OCS. OCS remain the only accepted, effective treatment for acute asthma, and also continue to play an important role in the long term management of severe asthma, in spite of their significant side effect profile. Even with the availability of the new biological therapies against IgE and interleukin-5, it is likely that a large proportion of patients will continue (...) Appropriate use of oral corticosteroids for severe asthma. Severe asthma represents a significant burden of disease, particularly in high income nations; oral corticosteroids (OCS) remain an important part of the management toolkit for these patients. Corticosteroids are effective at targeting numerous elements of the type 2/eosinophilic inflammatory pathway and lead to both rapid reduction in eosinophilic inflammation and longer term reduction in airway hyper-responsiveness. Resistance

2018 Medical Journal of Australia

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