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Asthma: School-Based Self-Management Interventions for Children and Adolescents with AsthmaAsthma: School-Based Self-Management | The Community Guide Welcome to The Community Guide! Let us know what you think of the website by completing this . Open Navigation or Search form Search Search The Community Guide You are here » Systematic Review Topic Recommended (strong evidence) July 2019 Audience Adolescents and Young Adults Children/Infants Setting School Strategy Case Management Counseling (...) Health Education Organizational Changes This webpage summarizes information available in the CPSTF Finding and Rationale Statement. Asthma: School-Based Self-Management Interventions for Children and Adolescents with Asthma Tabs Snapshot Summary of CPSTF Finding The school-based asthma self-management interventions to reduce hospitalizations and emergency room visits among children and adolescents with asthma. Evidence shows interventions are effective when delivered by trained school staff, nurses
Does maintenance azithromycin reduce asthma exacerbations? An individual participant data meta-analysis Preventing exacerbations is an important goal of asthma treatment. Long-term treatment with azithromycin may help achieve this. Our aim was to conduct a systematic review and individual participant data (IPD) meta-analysis to examine the efficacy of azithromycin in reducing exacerbations in asthma, and in the subphenotypes of noneosinophilic asthma, eosinophilic asthma and severe asthma.We (...) were undertaken in duplicate. We conducted an IPD meta-analysis on the primary outcome of exacerbations and a random effects meta-analysis for secondary outcomes.Three studies were identified (n=604). In the IPD meta-analysis, treatment with azithromycin was associated with a reduced rate of exacerbations (oral corticosteroid course due to worsening asthma, antibiotic use for lower respiratory tract infection, hospitalisation and/or emergency department visits) in asthma as well
Using Inhaled Steroids in Asthma durIng the COVID-19 Outbreak Inhaled Steroids in Asthma durIng the COVID-19 Outbreak - CEBM CEBM The Centre for Evidence-Based Medicine develops, promotes and disseminates better evidence for healthcare. Navigate this website Inhaled Steroids in Asthma durIng the COVID-19 Outbreak Jamie Hartmann-Boyce, Richard Hobbs Are inhaled steroids in asthma OK to use or should you discontinue them? Verdict : There is no evidence of a relationship between the use of inhaled (...) corticosteroids and COVID-19 infection at present. Inhaled corticosteroids are generally considered a for controlling asthma symptoms. Evidence from a of seven randomized controlled trials found that discontinuing inhaled corticosteroids in people with stable asthma more than doubled the risk of asthma exacerbation (RR 2.35, 95% CI 1.88 to 2.92, mean follow-up 27 weeks). Inhaled corticosteroids, when taken as prescribed, would reduce the risk of an asthma attack being triggered by a respiratory virus
Are the 2019 Global Initiative for Asthma (GINA) strategy recommendations applicable to the Canadian context? Full Terms & Conditions of access and use can be found at https://www.tandfonline.com/action/journalInformation?journalCode=ucts20 Canadian Journal of Respiratory, Critical Care, and Sleep Medicine Revue canadienne des soins respiratoires et critiques et de la médecine du sommeil ISSN: 2474-5332 (Print) 2474-5340 (Online) Journal homepage: https://www.tandfonline.com/loi/ucts20 (...) Are the 2019 Global Initiative for Asthma (GINA) strategy recommendations applicable to the Canadian context? Christopher Licskai, Connie L. Yang, Catherine Lemiere, Francine M. Ducharme, M. Diane Lougheed, Dhenuka Radhakrishnan, Delanya Podgers, Clare Ramsey, Tania Samanta, Andréanne Côté, Cristina Villa-Roel, Anne Van Dam & Helen Reddel To cite this article: Christopher Licskai, Connie L. Yang, Catherine Lemiere, Francine M. Ducharme, M. Diane Lougheed, Dhenuka Radhakrishnan, Delanya Podgers, Clare
Clinical effect on uncontrolled asthma using a novel digital automated self-management solution: a physician-blinded randomised controlled crossover trial AsthmaTuner is a novel self-management system consisting of a patient app, a cloud-based storage solution and a healthcare interface. Patients use Bluetooth spirometers to measure lung function (forced expiratory volume in 1 s) and can register symptoms. They then receive immediate feedback on asthma control and an image of the correct (...) inhaler(s) to use and the dose. The aim of this pilot study was to evaluate the effect of AsthmaTuner on symptom control and adherence compared with conventional treatment.This multicentre physician-blinded crossover trial randomised patients in two groups that started with 8 weeks of AsthmaTuner or conventional treatment using a personalised printed treatment plan, with 2 weeks of washout between the crossover treatments. Participants in a primary or paediatric care setting in Sweden with asthma
Traditional medicines for asthma in children and adults: A systematic review of placebo-controlled studies Traditional medicines (TMs) adjunctive to conventional medications are widely used for asthma in east-Asia and have gained popularity in western countries.To assess the efficacy and safety of TMs for asthma in children and adults based on placebo-controlled trials in order to inform physicians and assist them in discussions with patients.Seventeen electronic databases were searched (...) . Participants had acute or chronic asthma. Interventions included orally administered traditional medicines used in east-Asia. Outcomes included lung function, symptoms, quality of life, exacerbations, medication use and safety. RevMan 5.3 (random effect model) was used for meta-analysis. Baseline values were assessed for balance and asthma severity. Within-group changes were calculated to assess minimal clinically important difference (MCID).Eighteen studies (2080 participants) were included. All combined
ASCIA Position Statement - Unorthodox Techniques for the Diagnosis and Treatment of Allergy, Asthma and Immune Disorders Unorthodox Testing and Treatment - Australasian Society of Clinical Immunology and Allergy (ASCIA) | | Unorthodox Testing and Treatment Use of unproven “allergy tests” is common in Australia Despite advances in scientific knowledge about allergic disorders, 50-70 per cent of adults and children with allergic disease consult alternative practitioners yearly for diagnosis (...) detect or treat so many different problems? Further Reading Evidence based Medicine Cochrane Reviews Medline/PubMed database of published medical articles Quackwatch References Becker EL. Elements of the history of our present concepts of anaphylaxis, hay fever and asthma. Clin Exp Allergy 1999; 29: 875-895. Chinen J, Shearer WT. Advances in Asthma, Allergy and Immunology Series 2004: Basic and clinical immunology. J Allergy Clin Immunol 2004; 114: 398-405. MacLennan AH, Wilson DH, Taylor AW
Workplace interventions for treatment of occupational asthma. The impact of workplace interventions on the outcome of occupational asthma is not well understood.To evaluate the effectiveness of workplace interventions on occupational asthma.We searched the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (PubMed); EMBASE(Ovid); NIOSHTIC-2; and CISILO (CCOHS) up to July 31, 2019.We included all eligible randomized controlled trials, controlled before and after studies (...) from exposure to continued exposure. Removal may increase the likelihood of reporting absence of asthma symptoms, with risk ratio (RR) 4.80 (95% confidence interval (CI) 1.67 to 13.86), and it may improve asthma symptoms, with RR 2.47 (95% CI 1.26 to 4.84), compared to continued exposure. Change in FEV1 % may be better with removal from exposure, with a mean difference (MD) of 4.23 % (95% CI 1.14 to 7.31) compared to continued exposure. NSBH may improve with removal from exposure, with standardized
Asthma. This review provides an evidence-based guide for the diagnosis, evaluation, and treatment of patients with asthma. It addresses typical questions that arise in the clinic-based care of patients with asthma and provides a basic and comprehensive resource for asthma care.
The Impact of Racism on Asthma in Minority Pediatric Populations "The Impact of Racism on Asthma in Minority Pediatric Populations" by Ashley Amick > > > > > Title Author Date of Graduation Summer 8-10-2019 Degree Type Capstone Project Degree Name Master of Science in Physician Assistant Studies Rights . Abstract Background: Asthma is one of the most common chronic diseases diagnosed in children today, and some minority populations constitute a much higher incidence of asthma than others. Many (...) factors are known to play into the development of asthma, including genetics, smoking history, and psychosocial stress. Experiencing childhood racism may be one type of stressor that contributes to the development of asthma and poor asthma outcomes. This study aims to identify the effect of experienced racism on asthma outcomes in minority children. Methods: An exhaustive search of available medical literature was conducted using the databases MEDLINE – PubMed, CINAHL, and Web of Science. An age
BTS/SIGN British Guideline on the Management of Asthma SIGN158 British guideline on the management of asthma A national clinical guideline First published 2003 Revised edition published July 2019Key to evidence statements and recommendations Levels of evidence 1 ++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 – Meta-analyses, systematic reviews, or RCTs (...) (www.sign.ac.uk/sign-50). More information on accreditation can be viewed at www.evidence.nhs.ukBritish guideline on the management of asthma A national clinical guideline First published 2003 Revised edition published July 2019 Scottish Intercollegiate Guidelines Network British Thoracic Society 978-1-909103-70-2 First published 2003 Revised edition published July 2019 Scottish Intercollegiate Guidelines Network Gyle Square, 1 South Gyle Crescent Edinburgh EH12 9EB www.sign.ac.uk British Thoracic Society 17
Single inhaler extrafine triple therapy in uncontrolled asthma (TRIMARAN and TRIGGER): two double-blind, parallel-group, randomised, controlled phase 3 trials. To date, no studies have assessed the efficacy of single-inhaler triple therapy in asthma. Here we report on two studies that compared the single-inhaler extrafine combination of beclometasone dipropionate (BDP; inhaled corticosteroid), formoterol fumarate (FF; long-acting β2 agonist), and glycopyrronium (G; long-acting muscarinic (...) antagonist) with the combination of BDP with FF.Two parallel-group, double-blind, randomised, active-controlled, phase 3 trials (Triple in Asthma With Uncontrolled Patients on Medium Strength of ICS + LABA [TRIMARAN] and Triple in Asthma High Strength Versus ICS/LABA HS and Tiotropium [TRIGGER]) recruited patients from 171 sites across 16 countries (TRIMARAN), and from 221 sites across 17 countries (TRIGGER). The sites were a mixture of secondary and tertiary care centres and specialised investigation
Step-Up Therapy in Black Children and Adults with Poorly Controlled Asthma. Morbidity from asthma is disproportionately higher among black patients than among white patients, and black patients constitute the minority of participants in trials informing treatment. Data indicate that patients with inadequately controlled asthma benefit more from addition of a long-acting beta-agonist (LABA) than from increased glucocorticoids; however, these data may not be informative for treatment in black (...) patients.We conducted two prospective, randomized, double-blind trials: one involving children and the other involving adolescents and adults. In both trials, the patients had at least one grandparent who identified as black and had asthma that was inadequately controlled with low-dose inhaled glucocorticoids. We compared combinations of therapy, which included the addition of a LABA (salmeterol) to an inhaled glucocorticoid (fluticasone propionate), a step-up to double to quintuple the dose
Inhaled steroids with and without regular formoterol for asthma: serious adverse events. Epidemiological evidence has suggested a link between beta2-agonists and increases in asthma mortality. There has been much debate about whether regular (daily) long-acting beta2-agonists (LABA) are safe when used in combination with inhaled corticosteroids (ICS). This updated Cochrane Review includes results from two large trials that recruited 23,422 adolescents and adults mandated by the US Food and Drug (...) Administration (FDA).To assess the risk of mortality and non-fatal serious adverse events (SAEs) in trials that randomly assign participants with chronic asthma to regular formoterol and inhaled corticosteroids versus the same dose of inhaled corticosteroid alone.We identified randomised trials using the Cochrane Airways Group Specialised Register of trials. We checked websites of clinical trial registers for unpublished trial data as well as FDA submissions in relation to formoterol. The date of the most
Budesonide-formoterol reliever therapy versus maintenance budesonide plus terbutaline reliever therapy in adults with mild to moderate asthma (PRACTICAL): a 52-week, open-label, multicentre, superiority, randomised controlled trial. In adults with mild asthma, a combination of an inhaled corticosteroid with a fast-onset long-acting β-agonist (LABA) used as reliever monotherapy reduces severe exacerbations compared with short-acting β-agonist (SABA) reliever therapy. We investigated the efficacy (...) of combination budesonide-formoterol reliever therapy compared with maintenance budesonide plus as-needed terbutaline.We did a 52-week, open-label, parallel-group, multicentre, superiority, randomised controlled trial at 15 primary care or hospital-based clinical trials units and primary care practices in New Zealand. Participants were adults aged 18-75 years with a self-reported doctor's diagnosis of asthma who were using SABA for symptom relief with or without maintenance low to moderate doses of inhaled
2019LancetControlled trial quality: predicted high
myAsthma for the management of asthma in adults and adolescents myAsthma app - Health Technology Wales > myAsthma app myAsthma app Topic Status Complete myAsthma for the management of asthma in adults and adolescents. Summary Health Technology Wales researchers searched for evidence on the effectiveness of myAsthma as a self-management tool for people with asthma. HTW’s Assessment Group concluded not to progress this topic further, because there is very limited evidence on the use
British guideline on the management of asthma SIGN158 British guideline on the management of asthma A national clinical guideline First published 2003 Revised edition published July 2019Key to evidence statements and recommendations Levels of evidence 1 ++ High-quality meta-analyses, systematic reviews of RCTs, or RCTs with a very low risk of bias 1 + Well-conducted meta-analyses, systematic reviews, or RCTs with a low risk of bias 1 – Meta-analyses, systematic reviews, or RCTs with a high risk (...) (www.sign.ac.uk/sign-50). More information on accreditation can be viewed at www.evidence.nhs.ukBritish guideline on the management of asthma A national clinical guideline First published 2003 Revised edition published July 2019 Scottish Intercollegiate Guidelines Network British Thoracic Society 978-1-909103-70-2 First published 2003 Revised edition published July 2019 Scottish Intercollegiate Guidelines Network Gyle Square, 1 South Gyle Crescent Edinburgh EH12 9EB www.sign.ac.uk British Thoracic Society 17
One or Two Dose Steroid Regimens for Adult Asthma Exacerbation One of Two Dose Steroid Regimens for Adult Asthma Exacerbation | Emergency Medicine | Washington University in St. Louis Open Menu Back Close Menu Search for: Loading... Welcome Our Team Sections Education Alumni Research ECRC Journal Club Events Jermyn Lectures Open Search Vignette It’s a cold, blustery winter day in the local community emergency department where you’ve been moonlighting. You’ve seen half a dozen patients with Flu (...) A and just as many viral upper respiratory infections in the three hours you’ve been on shift. Your next patients is Mr. Z, a thirty-year-old with a history of asthma, who presents with a runny nose, nonproductive cough, and increased wheezing over the last 2 days. He has had some mild relief with his home albuterol MDI and is on no other meds. On exam, he has diffuse expiratory wheezes with an oxygen saturation of 97% on room air. He is no distress, is speaking in full sentences, and has an otherwise
Prevalence, risk factors, and management of asthma in China: a national cross-sectional study. Asthma is a common chronic airway disease worldwide. Despite its large population size, China has had no comprehensive study of the national prevalence, risk factors, and management of asthma. We therefore aimed to estimate the national prevalence of asthma in a representative sample of the Chinese population.A representative sample of 57 779 adults aged 20 years or older was recruited (...) . Asthma was determined on the basis of a self-reported history of diagnosis by a physician or by wheezing symptoms in the preceding 12 months. All participants were assessed with a standard asthma questionnaire and were classed as having or not having airflow limitation through pulmonary function tests before and after the use of a bronchodilator (400 μg of salbutamol). Risk factors for asthma were examined by multivariable-adjusted analyses done in all participants for whom data on the variables
Inhaled corticosteroids in children with persistent asthma: effects of different drugs and delivery devices on growth. Inhaled corticosteroids (ICS) are the most effective treatment for children with persistent asthma. Although treatment with ICS is generally considered to be safe in children, the potential adverse effects of these drugs on growth remains a matter of concern for parents and physicians.To assess the impact of different inhaled corticosteroid drugs and delivery devices (...) included trials.We included six randomized trials involving 1199 children aged from 4 to 12 years (per-protocol population: 1008), with mild-to-moderate persistent asthma. Two trials were from single hospitals, and the remaining four trials were multicentre studies. The duration of trials varied from six to 20 months.One trial with 23 participants compared fluticasone with beclomethasone, and showed that fluticasone given at an equivalent dose was associated with a significant greater linear growth