Latest & greatest articles for asthma

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Top results for asthma

1221. Integrated care for asthma: a clinical, social, and economic evaluation

Integrated care for asthma: a clinical, social, and economic evaluation Integrated care for asthma: a clinical, social, and economic evaluation Integrated care for asthma: a clinical, social, and economic evaluation Drummond N, Abdall M, Buckingham J K, Beattie J A, Lindsay T, Osman L M, Ross S J, Roy-Chaudhury A, Russell I, Turner M, Douglas J G, Legge J S, Friend J A, Grampian Asthma Study of Integrated Care (GRASSIC) Record Status This is a critical abstract of an economic evaluation (...) that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Integrated care for asthma between specialist chest physicians and GPs. Type of intervention Secondary prevention. Economic study type Cost-effectiveness analysis. Study population Adults (16 years and over) attending hospital outpatients' clinics

NHS Economic Evaluation Database.1994

1222. Asthma and vitamin C

Asthma and vitamin C Asthma and vitamin C Asthma and vitamin C Bielory L, Gandhi R Authors' objectives To define the role of vitamin C in the treatment of asthma. Searching MEDLINE was searched (search dates are unclear) for English language papers, and bibliographies of identified papers were examined. The search strategy is not given. Study selection Study designs of evaluations included in the review No restriction stated. Designs included: clinical trials, cross-sectional, prospective (...) and longitudinal studies, which were double-, single- or un-blinded, randomised or non-randomised, controlled or uncontrolled. Specific interventions included in the review The use of vitamin C in asthma and allergy. Participants included in the review No restrictions stated. The studies included had differing populations: adults and children with asthma, healthy adults, adults with seasonal allergic rhinitis and sailors, plus two animal studies were included. No detailed characteristics of the patients

DARE.1994

1223. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma.

Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. 8058076 1994 09 15 1994 09 15 2013 11 21 0028-4793 331 11 1994 Sep 15 The New England journal of medicine N. Engl. J. Med. Effects of reducing or discontinuing inhaled budesonide in patients with mild asthma. 700-5 In a previous study, we found that two years of treatment with an inhaled corticosteroid, budesonide, was more effective than treatment with an inhaled beta 2-agonist, terbutaline, in patients (...) with newly diagnosed, generally mild asthma. We continued this study for a third year to investigate whether the steroid dose could be reduced or discontinued and what effect crossover of patients from beta 2-agonist therapy to corticosteroid therapy would have. A total of 37 patients treated for two years with inhaled budesonide at a dose of 1200 micrograms per day were randomly assigned to treatment with 400 micrograms of budesonide per day (19 patients) or placebo (18 patients) in a double-blind

NEJM1994

1224. Reducing hospital admission through computer supported education for asthma patients. Grampian Asthma Study of Integrated Care (GRASSIC).

Reducing hospital admission through computer supported education for asthma patients. Grampian Asthma Study of Integrated Care (GRASSIC). 8093148 1994 05 06 1994 05 06 2013 09 22 0959-8138 308 6928 1994 Feb 26 BMJ (Clinical research ed.) BMJ Reducing hospital admission through computer supported education for asthma patients. Grampian Asthma Study of Integrated Care (GRASSIC). 568-71 To evaluate a personalised computer supported education programme for asthma patients. Pragmatic randomised (...) trial comparing outcomes over 12 months between patients taking part in an enhanced education programme (four personalised booklets, sent by post) and patients receiving conventional oral education at outpatient or surgery visits. Hospital outpatient clinics and general practices in north east Scotland. 801 adults attending hospital outpatient clinics, with a diagnosis of asthma confirmed by a chest physician and pulmonary function reversibility of at least 20%. Numbers of hospital admissions

BMJ1994 Full Text: Link to full Text with Trip Pro

1225. Integrated care for asthma: a clinical, social, and economic evaluation. Grampian Asthma Study of Integrated Care (GRASSIC)

Integrated care for asthma: a clinical, social, and economic evaluation. Grampian Asthma Study of Integrated Care (GRASSIC) 8148678 1994 05 06 1994 05 06 2013 09 19 0959-8138 308 6928 1994 Feb 26 BMJ (Clinical research ed.) BMJ Integrated care for asthma: a clinical, social, and economic evaluation. Grampian Asthma Study of Integrated Care (GRASSIC) 559-64 To evaluate integrated care for asthma in clinical, social, and economic terms. Pragmatic randomised trial. Hospital outpatient clinics (...) and general practices throughout the north east of Scotland. 712 adults attending hospital outpatient clinics with a diagnosis of asthma confirmed by a chest physician and pulmonary function reversibility of at least 20%. Use of bronchodilators and inhaled and oral steroids; number of general practice consultations and hospital admissions for asthma; sleep disturbance and other restrictions on normal activity; psychological aspects of health including perceived asthma control; patient satisfaction

BMJ1994 Full Text: Link to full Text with Trip Pro

1226. Effectiveness of routine self monitoring of peak flow in patients with asthma. Grampian Asthma Study of Integrated Care (GRASSIC).

Effectiveness of routine self monitoring of peak flow in patients with asthma. Grampian Asthma Study of Integrated Care (GRASSIC). 8148679 1994 05 06 1994 05 06 2013 09 19 0959-8138 308 6928 1994 Feb 26 BMJ (Clinical research ed.) BMJ Effectiveness of routine self monitoring of peak flow in patients with asthma. Grampian Asthma Study of Integrated Care (GRASSIC). 564-7 To evaluate the effectiveness of routine self monitoring of peak flow for asthma outpatients. Pragmatic randomised trial (...) . Hospital outpatient clinics and general practices in north east Scotland. Use of bronchodilators and inhaled and oral steroids; number of general practice consultations and hospital admissions for asthma; sleep disturbance and other restrictions on normal activity; psychological aspects of health including perceived control of asthma. After one year there were no significant differences between patients randomised between self monitoring of peak flow and conventional monitoring. However, those given

BMJ1994 Full Text: Link to full Text with Trip Pro

1227. Salmeterol xinafoate as maintenance therapy compared with albuterol in patients with asthma.

Salmeterol xinafoate as maintenance therapy compared with albuterol in patients with asthma. 7909853 1994 06 06 1994 06 06 2016 10 17 0098-7484 271 18 1994 May 11 JAMA JAMA Salmeterol xinafoate as maintenance therapy compared with albuterol in patients with asthma. 1412-6 To compare the efficacy and safety of inhaled salmeterol xinafoate, a long-acting beta 2-adrenoceptor agonist, with that of albuterol, a short-acting inhaled beta 2-agonist, in the treatment of asthma. Randomized, double-blind (...) , placebo-controlled, parallel-group study. Eleven outpatient clinical centers. A total of 322 male and female patients at least 12 years of age with chronic symptomatic asthma requiring daily therapy. Patients were treated with salmeterol xinafoate (42 micrograms inhaled twice daily), albuterol (180 micrograms inhaled four times daily), or placebo (four times a day) for 12 weeks; patients in all three groups could use inhaled albuterol as backup medication for breakthrough symptoms. Serial 12-hour

JAMA1994

1228. Regular vs as-needed inhaled salbutamol in asthma control.

Regular vs as-needed inhaled salbutamol in asthma control. 7910880 1994 06 28 1994 06 28 2015 06 16 0140-6736 343 8910 1994 Jun 04 Lancet (London, England) Lancet Regular vs as-needed inhaled salbutamol in asthma control. 1379-82 Recent studies have suggested that regular use of inhaled beta 2 agonists cause loss of asthma control as measured by worsening peak-flow rates, increased asthma symptoms, and more frequent need for supplementary bronchodilators. However, the magnitude of this effect (...) and the reliability of investigator-originated definitions of control is unknown. We studied 341 people with asthma in a four-week, randomised, crossover trial of regular salbutamol (2 puffs--200 micrograms--four times daily) for two weeks and as needed for two weeks. There were no significant differences in morning and evening peak-flow rates between treatments but asthma symptoms and supplementary bronchodilator use were significantly less frequent when salbutamol was given regularly. Asthma episodes occurred

Lancet1994

1229. Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group.

Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group. 7913155 1994 08 11 1994 08 11 2015 11 19 0140-6736 344 8917 1994 Jul 23 Lancet (London, England) Lancet Added salmeterol versus higher-dose corticosteroid in asthma patients with symptoms on existing inhaled corticosteroid. Allen & Hanburys Limited UK Study Group. 219-24 Guidelines on asthma management recommend that in patients who (...) still have symptoms on treatment with low-dose inhaled corticosteroids the first step should be an increase in inhaled corticosteroid dose. The addition of long-acting inhaled beta 2-adrenoceptor agonists is another option. We have compared these two strategies in a randomised, double-blind, parallel-group trial. We studied 429 adult asthmatic patients who still had symptoms despite maintenance treatment with 200 micrograms twice daily inhaled beclomethasone dipropionate (BDP). 3 did not provide

Lancet1994

1230. Anti-inflammatory effects of low-dose oral theophylline in atopic asthma.

Anti-inflammatory effects of low-dose oral theophylline in atopic asthma. 7909049 1994 05 19 1994 05 19 2015 06 16 0140-6736 343 8904 1994 Apr 23 Lancet (London, England) Lancet Anti-inflammatory effects of low-dose oral theophylline in atopic asthma. 1006-8 Theophylline, in addition to its bronchodilator effect, may attenuate inflammation in asthma. We did a double-blind placebo-controlled study of the effect of oral theophylline on the inflammatory response of the bronchial mucosa (...) to inhalation of allergen in 19 atopic asthmatic subjects. Bronchoscopy and bronchial biopsy were done 24 hours after allergen inhalation before and after six weeks of treatment with oral slow-release theophylline, 200 mg 12 hourly. The mean serum concentration was 36.6 mumol/L, which is below the currently-accepted therapeutic range. After treatment with theophylline there was a significant reduction in the number of EG2-positive activated eosinophils (5.9 before and 2.1 after treatment, Wilcoxon signed

Lancet1994

1231. Comparison of oral-steroid sparing by high-dose and low-dose inhaled steroid in maintenance treatment of severe asthma.

Comparison of oral-steroid sparing by high-dose and low-dose inhaled steroid in maintenance treatment of severe asthma. 1361594 1993 01 25 1993 01 25 2015 06 16 0140-6736 340 8834-8835 1992 Dec 19-26 Lancet (London, England) Lancet Comparison of oral-steroid sparing by high-dose and low-dose inhaled steroid in maintenance treatment of severe asthma. 1483-7 It is not clear whether high doses of inhaled steroids have a greater sparing effect than low doses on the requirement for systemic steroids (...) . In a randomised, double-blind, multicentre study, we compared the effects of high-dose (1500 micrograms/day) and low-dose (300 micrograms/day) inhaled beclomethasone dipropionate (BDP) in patients with severe asthma requiring a daily oral prednisolone dose of 10-40 mg. During a 3-month run-in period, we tried to achieve optimum asthma control by means of oral steroid and inhaled BDP 300 micrograms/day. The patients were then allocated to high-dose (n = 71) or low-dose (n = 72) treatment by an independent

Lancet1993

1232. Cost-effectiveness of a structured treatment and teaching programme on asthma

Cost-effectiveness of a structured treatment and teaching programme on asthma Cost-effectiveness of a structured treatment and teaching programme on asthma Cost-effectiveness of a structured treatment and teaching programme on asthma Trautner C, Richter B, Berger M Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical (...) assessment on the reliability of the study and the conclusions drawn. Health technology Structured treatment and teaching programme for asthma sufferers (ATTP). Type of intervention Prevention and treatment. Economic study type Cost-benefit analysis. Study population Adult patients with moderate to severe asthma. The mean age was 40 (range: 16-75) years and the median duration of asthma was 12 (range: 1-56) years.57% of the study population were employed. Setting University hospital. The economic study

NHS Economic Evaluation Database.1993

1233. Interaction and dose equivalence of salbutamol and salmeterol in patients with asthma.

Interaction and dose equivalence of salbutamol and salmeterol in patients with asthma. 8096416 1993 05 05 1993 05 05 2015 11 19 0959-8138 306 6877 1993 Feb 27 BMJ (Clinical research ed.) BMJ Interaction and dose equivalence of salbutamol and salmeterol in patients with asthma. 543-5 To examine the pharmacological interaction of salmeterol and salbutamol and to derive an estimate of dose equivalence of salmeterol for airway and systemic effects in patients with asthma. Randomised double blind (...) crossover study. 12 patients with mild asthma. Placebo or salmeterol 50, 100, 200 micrograms given on separate days followed two hours later by inhaled salbutamol in cumulative doses up to 3600 micrograms. Change in forced expiratory volume in one second (FEV1), heart rate, plasma potassium concentration, QTc interval, tremor amplitude, and creatine kinase myocardial isoenzyme concentration. Compared with placebo, the mean (95% confidence interval) changes in FEV1 and heart rate after salmeterol 200

BMJ1993 Full Text: Link to full Text with Trip Pro

1234. Preventing bronchoconstriction in exercise-induced asthma with inhaled heparin.

Preventing bronchoconstriction in exercise-induced asthma with inhaled heparin. 8510708 1993 07 15 1993 07 15 2015 11 19 0028-4793 329 2 1993 Jul 08 The New England journal of medicine N. Engl. J. Med. Preventing bronchoconstriction in exercise-induced asthma with inhaled heparin. 90-5 We have previously reported that inhaled heparin prevents allergic bronchoconstriction in sheep and inhibits the anti-IgE-mediated release of histamine from mast cells in vitro. Since the release (...) of such mediators has been implicated in exercise-induced asthma, we investigated whether inhaled heparin could also attenuate the bronchoconstrictor response in this disease. On five days we studied 12 subjects with a history of exercise-induced asthma. On day 1 they underwent a standardized exercise challenge on a treadmill to document the presence of exercise-induced asthma. Minute ventilation was estimated with a calibrated respiratory inductive plethysmograph. The workload was increased until the heart

NEJM1993

1235. Double-blind trial of steroid tapering in acute asthma.

Double-blind trial of steroid tapering in acute asthma. 8094111 1993 03 10 1993 03 10 2015 06 16 0140-6736 341 8841 1993 Feb 06 Lancet (London, England) Lancet Double-blind trial of steroid tapering in acute asthma. 324-7 It is customary to tail off the dose of oral steroids after treatment of an acute exacerbation of asthma; the main reason for this practice is to avoid rebound asthma. We have carried out a randomised double-blind study to find out whether a tapering course of oral (...) prednisolone has any advantage over an abruptly terminated course of prednisolone for an episode of acute asthma requiring hospital admission. We studied 35 patients admitted to hospital with acute asthma; their mean peak expiratory flow rate (PEFR) on admission was 173 L/min and their mean age was 32 years (range 18-55); all were using inhaled steroids on discharge (mean dose 908 micrograms daily). Each patient received 40 mg enteric-coated prednisolone daily for 10 days followed by a tapering course

Lancet1993

1236. A comparison of salmeterol with albuterol in the treatment of mild-to-moderate asthma.

A comparison of salmeterol with albuterol in the treatment of mild-to-moderate asthma. 1357554 1992 11 23 1992 11 23 2015 11 19 0028-4793 327 20 1992 Nov 12 The New England journal of medicine N. Engl. J. Med. A comparison of salmeterol with albuterol in the treatment of mild-to-moderate asthma. 1420-5 An effective, long-acting bronchodilator could benefit patients with asthma who have symptoms not controlled by antiinflammatory drugs. We compared a new long-acting, inhaled beta 2-adrenoceptor (...) agonist, salmeterol, with a short-acting beta 2-agonist, albuterol, in the treatment of mild-to-moderate asthma. We randomly assigned 234 patients (150 male and 84 female patients 12 to 73 years old) to one of three treatment groups: one group received 42 micrograms of salmeterol twice daily, one received 180 micrograms of albuterol four times daily, and one received placebo. Treatment was assigned in a double-blind fashion, and all patients could use supplemental inhaled albuterol as needed during

NEJM1992

1237. Long-term effects of a long-acting beta 2-adrenoceptor agonist, salmeterol, on airway hyperresponsiveness in patients with mild asthma.

Long-term effects of a long-acting beta 2-adrenoceptor agonist, salmeterol, on airway hyperresponsiveness in patients with mild asthma. 1357550 1992 10 26 1992 10 26 2015 11 19 0028-4793 327 17 1992 Oct 22 The New England journal of medicine N. Engl. J. Med. Long-term effects of a long-acting beta 2-adrenoceptor agonist, salmeterol, on airway hyperresponsiveness in patients with mild asthma. 1198-203 Asthma is characterized by hyperresponsiveness of the airways to bronchoconstrictive stimuli (...) . Long-acting beta 2-adrenoceptor agonists have been introduced as a new therapeutic approach, but there is growing concern about whether control of asthma may deteriorate with the regular use of these agents. We investigated the long-term effects of the beta 2 agonist salmeterol on bronchodilation and on airway hyperresponsiveness to the bronchoconstrictive agent methacholine in mild asthma. In a parallel, double-blind study, 24 patients with mild asthma were randomly assigned to treatment

NEJM1992

1238. Tolerance to the nonbronchodilator effects of inhaled beta 2-agonists in asthma.

Tolerance to the nonbronchodilator effects of inhaled beta 2-agonists in asthma. 1357551 1992 10 26 1992 10 26 2013 11 21 0028-4793 327 17 1992 Oct 22 The New England journal of medicine N. Engl. J. Med. Tolerance to the nonbronchodilator effects of inhaled beta 2-agonists in asthma. 1204-8 Tolerance to the direct bronchodilator effects of beta 2-agonists does not appear to occur in asthma. However, it is not known whether this is true for the nonbronchodilator effects of these agents, which (...) protect the airways against bronchoconstrictive stimuli. We investigated whether tolerance develops to the protective effect of inhaled terbutaline on airway responsiveness to the bronchoconstrictors methacholine (which acts directly on airway smooth muscle) and AMP (which acts indirectly by stimulating the release of mediators from mast cells) during sustained treatment with terbutaline. In a randomized, double-blind, crossover study, 12 patients with mild asthma each inhaled a single dose

NEJM1992

1239. Trial of cyclosporin in corticosteroid-dependent chronic severe asthma.

Trial of cyclosporin in corticosteroid-dependent chronic severe asthma. 1346410 1992 03 03 1992 03 03 2015 06 16 0140-6736 339 8789 1992 Feb 08 Lancet (London, England) Lancet Trial of cyclosporin in corticosteroid-dependent chronic severe asthma. 324-8 The treatment of chronic severe asthma is unsatisfactory for many patients. In a randomised, double-blind, placebo-controlled, crossover trial we have tested whether cyclosporin, which is thought to act primarily by inhibition of T lymphocyte (...) activation, improves lung function in corticosteroid-dependent asthmatics. After a 4-week run-in period, 33 patients with longstanding asthma (mean duration 27 years), and who had required continuous oral corticosteroids for a mean of 9.3 years, were randomised to receive either cyclosporin (initial dose 5 mg/kg per day) or placebo for 12 weeks, crossing over after a 2-week washout period. Mean baseline forced expiratory volume in 1 s (FEV1) was 60.1% of the predicted value. 2 patients failed to complete

Lancet1992

1240. High-dose intramuscular triamcinolone in severe, chronic, life-threatening asthma.

High-dose intramuscular triamcinolone in severe, chronic, life-threatening asthma. 2021388 1991 03 11 1991 03 11 2013 11 21 0028-4793 324 9 1991 Feb 28 The New England journal of medicine N. Engl. J. Med. High-dose intramuscular triamcinolone in severe, chronic, life-threatening asthma. 585-9 Despite oral corticosteroid therapy, some patients with asthma have frequent exacerbations requiring emergency room visits, hospitalization, and occasionally, mechanical ventilation. We compared (...) the effects of high-dose intramuscular triamcinolone with oral prednisone in patients with severe chronic asthma. In a double-blind, placebo-controlled, cross-over study that spanned all seasons, we treated 12 patients with high-dose intramuscular triamcinolone (360 mg over the first three days of the treatment period) or low-dose oral prednisone (median dose, 12.5 mg per day throughout the period; range 0 to 30). The two three-month treatment periods were separated by a three-month washout period. During

NEJM1991