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Latest & greatest articles for asthma
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Effect of a short course of prednisone in the prevention of early relapse after the emergency room treatment of acute asthma. 1997850 1991 04 02 1991 04 02 2013 11 21 0028-4793 324 12 1991 Mar 21 The New England journal of medicine N. Engl. J. Med. Effect of a short course of prednisone in the prevention of early relapse after the emergency room treatment of acute asthma. 788-94 Relapse after the treatment of acute asthma in the emergency room is common (occurring in 25 to 30 percent of cases (...) ) and is not accurately predicted by any available measurements. We studied the usefulness of prednisone in reducing this high rate of relapse. One hundred twenty-two patients treated in the emergency room for acute exacerbations of asthma were assigned in a randomized, double-blind fashion to receive at discharge either prednisone for eight days (the dose being tapered from 40 to 0 mg per day) or matching placebo. Ninety-three were subsequently discharged from the emergency room and participated in the trial
Comparison of a beta 2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma. 2062329 1991 08 08 1991 08 08 2015 11 19 0028-4793 325 6 1991 Aug 08 The New England journal of medicine N. Engl. J. Med. Comparison of a beta 2-agonist, terbutaline, with an inhaled corticosteroid, budesonide, in newly detected asthma. 388-92 The presence of airway inflammation even in mild asthma points to the potential value of antiinflammatory therapy. We compared the effect (...) of an inhaled corticosteroid, budesonide, with that of an inhaled beta 2-agonist, terbutaline, in the long-term treatment of newly detected asthma. We studied 103 patients (29 male and 74 female patients 15 to 64 years old) in whom asthma had appeared within the previous year. The patients were randomly assigned in blinded fashion to two treatment groups: one to receive 600 micrograms of inhaled budesonide twice a day, and the other to receive 375 micrograms of inhaled terbutaline twice a day. The study
Can morbidity associated with untreated asthma in primary school children be reduced?: a controlled intervention study. 1747614 1992 01 21 1992 01 21 2015 11 19 0959-8138 303 6811 1991 Nov 09 BMJ (Clinical research ed.) BMJ Can morbidity associated with untreated asthma in primary school children be reduced?: a controlled intervention study. 1169-74 To determine whether an intervention programme based on existing school and community resources can reduce school absence and improve participation (...) in games lessons and sport in children with unrecognised or undertreated asthma. Parallel group controlled intervention study. 102 primary schools in Nottingham: 49 were randomised to receive the intervention and 53 to be control schools. All children aged 5 to 10 years with parent reported absence from school because of wheezing in the previous year and taking no treatment or beta agonists only. Children with asthma were referred to their general practitioner for assessment of symptoms and treatment
Bronchodilator treatment in moderate asthma or chronic bronchitis: continuous or on demand? A randomised controlled study. 1837744 1992 03 04 1992 03 04 2013 11 21 0959-8138 303 6815 1991 Dec 07 BMJ (Clinical research ed.) BMJ Bronchodilator treatment in moderate asthma or chronic bronchitis: continuous or on demand? A randomised controlled study. 1426-31 To examine the effect of bronchodilator treatment given continuously versus on demand on the progression of asthma and chronic bronchitis (...) and to compare the long term effects of a beta 2 adrenergic drug (salbutamol) and an anticholinergic drug (ipratropium bromide). Two year randomised controlled prospective 'crossover' study in which patients were assigned to one of two parallel treatment groups receiving continuous treatment or treatment on demand. 29 general practices in the catchment area of the University of Nijmegen. 223 patients aged greater than or equal to 30 with moderate airway obstruction due to asthma or chronic bronchitis
Lung function improvement in asthma with a cysteinyl-leukotriene receptor antagonist. 1673495 1991 05 28 1991 05 28 2016 11 23 0140-6736 337 8749 1991 May 04 Lancet (London, England) Lancet Lung function improvement in asthma with a cysteinyl-leukotriene receptor antagonist. 1062-3 In a double-blind study ten asthmatic patients with impaired lung function received the cysteinyl-leukotriene receptor antagonist ICI 204,219 (40 mg by mouth) and placebo in random order on 2 days at least 1 week (...) apart. The increase in forced expiratory volume in 1 s (FEV1) above baseline was significantly greater after ICI 204,219 than after placebo. This effect persisted after nebulised salbutamol. These findings suggest that cysteinyl-leukotrienes are one of the causes of persistent bronchoconstriction in chronic asthma. Hui K P KP Department of Thoracic Medicine, London Chest Hospital, UK. Barnes N C NC eng Clinical Trial Comparative Study Journal Article Randomized Controlled Trial Research Support, Non
Salmeterol in nocturnal asthma: a double blind, placebo controlled trial of a long acting inhaled beta 2 agonist. 1980220 1991 02 28 1991 02 28 2015 11 19 0959-8138 301 6765 1990 Dec 15 BMJ (Clinical research ed.) BMJ Salmeterol in nocturnal asthma: a double blind, placebo controlled trial of a long acting inhaled beta 2 agonist. 1365-8 To determine whether inhaled salmeterol, a new long acting inhaled beta adrenergic agonist, reduces nocturnal bronchoconstriction and improves sleep quality (...) in patients with nocturnal asthma. Randomised, double blind, placebo controlled crossover study. Hospital outpatient clinics in Edinburgh. Twenty clinically stable patients (13 women, seven men) with nocturnal asthma, median age 39 (range 18-60) years. Salmeterol 50 micrograms and 100 micrograms and placebo taken each morning and evening by metered dose inhaler. Rescue salbutamol inhalers were provided throughout the run in and study periods. Improvement in nocturnal asthma as measured by peak expiratory
Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. 2148702 1991 02 28 1991 02 28 2013 11 21 0959-8138 301 6765 1990 Dec 15 BMJ (Clinical research ed.) BMJ Evaluation of peak flow and symptoms only self management plans for control of asthma in general practice. 1355-9 To compare a peak flow self management plan for asthma with a symptoms only plan. Randomisation to one of the self management plans and follow up for a year. Four partner (...) , rural training practice in Norfolk. 115 Patients (46 children and 69 adults) with asthma who were having prophylactic treatment for asthma and attending a nurse run asthma clinic. The number of doctor consultations, courses of oral steroids, and short term nebulised salbutamol treatments and the number of patients who required doctor consultations, courses of oral steroids, and short term nebulised salbutamol. Both self management plans produced significant reductions in the outcome measures
The effects of a 5-lipoxygenase inhibitor on asthma induced by cold, dry air. 2247106 1991 01 07 1991 01 07 2016 11 23 0028-4793 323 25 1990 Dec 20 The New England journal of medicine N. Engl. J. Med. The effects of a 5-lipoxygenase inhibitor on asthma induced by cold, dry air. 1740-4 The enzyme 5-lipoxygenase catalyzes the metabolism of arachidonic acid to form products that have been implicated in the airway obstruction of asthma. We hypothesized that if products of the 5-lipoxygenase pathway (...) are important in mediating this obstruction, then prevention of their formation should decrease the severity of an induced asthmatic response. In a randomized, double-blind, placebo-controlled, crossover study, we examined the effect of A-64077, a 5-lipoxygenase inhibitor, on the bronchoconstriction induced by hyperventilation of cold, dry air in 13 patients with asthma. The completeness of 5-lipoxygenase inhibition was confirmed by examining the profile of eicosanoids produced in whole blood ex vivo after
Adrenaline and nocturnal asthma. 2207401 1990 11 06 1990 11 06 2013 11 21 0959-8138 301 6750 1990 Sep 08 BMJ (Clinical research ed.) BMJ Adrenaline and nocturnal asthma. 473-6 To determine whether the nocturnal fall in plasma adrenaline is a cause of nocturnal asthma. Double blind placebo controlled cross-over study. In the first experiment the nocturnal fall in plasma adrenaline at 4 am was corrected in 10 asthmatic subjects with an infusion of adrenaline after parasympathetic blockade with 30 (...) micrograms/kg intravenous atropine. In the second experiment 11 asthmatic subjects showing similar variations in peak expiratory flow rate had the nocturnal fall in plasma adrenaline corrected by infusion before atropine was given. Asthmatic subjects with a diurnal variation in home peak expiratory flow rate of greater than 20% for at least 75% of the time in the two weeks before the study. Peak expiratory flow rate and plasma adrenaline. Correction of the nocturnal fall in plasma adrenaline at 4 am
Regular inhaled beta-agonist treatment in bronchial asthma. 1978871 1991 01 10 1991 01 10 2015 06 16 0140-6736 336 8728 1990 Dec 08 Lancet (London, England) Lancet Regular inhaled beta-agonist treatment in bronchial asthma. 1391-6 89 subjects with stable asthma took part in a double-blind, placebo-controlled, randomized, crossover study of the effects of regular versus on-demand inhaled bronchodilator therapy. The subjects inhaled fenoterol or placebo by a dry powder delivery system for 24 (...) weeks. Control of asthma was judged by daily morning and evening peak expiratory flow rates, symptom diaries, use of additional inhaled bronchodilator, and requirement for short courses of prednisone. Of 64 subjects who completed the trial, 57 showed a clear difference in degree of control of asthma between the fenoterol and placebo periods: in 17 (30% [95% confidence interval 18.4-43.4%]) asthma was better controlled during regular inhaled bronchodilator treatment, whereas in 40 (70% [56.6-81.6
Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma. 1978872 1991 01 10 1991 01 10 2015 06 16 0140-6736 336 8728 1990 Dec 08 Lancet (London, England) Lancet Bronchodilator, cardiovascular, and hypokalaemic effects of fenoterol, salbutamol, and terbutaline in asthma. 1396-9 The airway response and cardiovascular and hypokalaemic effects of fenoterol, salbutamol, and terbutaline given in multiples of standard doses from metered-dose (...) inhalers were studied in ten patients with mild asthma. In a double-blind, crossover, placebo-controlled study the subjects received 2, 6, and 18 puffs of each drug with intervals of 90 min, and forced expiratory volume in 1 s, heart rate, QTc interval, plasma potassium concentration, tremor, and bronchial reactivity to histamine were measured. All three drugs produced similar bronchodilatation. However, the rises in heart rate, QTc interval, and tremor and the fall in plasma potassium were greater
Effect of yoga breathing exercises (pranayama) on airway reactivity in subjects with asthma. 1971670 1990 07 05 1990 07 05 2015 06 16 0140-6736 335 8702 1990 Jun 09 Lancet (London, England) Lancet Effect of yoga breathing exercises (pranayama) on airway reactivity in subjects with asthma. 1381-3 The effects of two pranayama yoga breathing exercises on airway reactivity, airway calibre, symptom scores, and medication use in patients with mild asthma were assessed in a randomised, double-blind (...) , placebo-controlled, crossover trial. After baseline assessment over 1 week, 18 patients with mild asthma practised slow deep breathing for 15 min twice a day for two consecutive 2-week periods. During the active period, subjects were asked to breathe through a Pink City lung (PCL) exerciser--a device which imposes slowing of breathing and a 1:2 inspiration:expiration duration ratio equivalent to pranayama breathing methods; during the control period, subjects breathed through a matched placebo device
Attenuation of nocturnal asthma by cromakalim. 1975334 1990 10 03 1990 10 03 2015 06 16 0140-6736 336 8711 1990 Aug 11 Lancet (London, England) Lancet Attenuation of nocturnal asthma by cromakalim. 334-6 In a randomised, double-blind, crossover study, single oral doses of cromakalim, a potassium-channel activator, or placebo were given to 23 patients with nocturnal asthma. There was a significant reduction (p less than 0.005) in the early morning fall in forced expiratory volume in 1 s (FEV1 (...) ) after 0.5 mg cromakalim (fall 9.8% [SEM 3.2%]) compared with placebo (18.5 [2.8]%). In a repeat dosing study, administration of 0.25 mg and 0.5 mg cromakalim on 5 consecutive nights to a further group of 8 asthmatic subjects significantly reduced the early morning fall in FEV1 from 28.7 (6.5)% after placebo to 19 (4.2)% after 0.25 mg and 14.9 (6.5)% after 0.5 mg. Potassium-channel activators may be useful in the treatment of asthma, especially for nocturnal symptoms. Williams A J AJ Department
Randomised, double-blind, placebo-controlled trial of methotrexate in steroid-dependent asthma. 1973472 1990 08 20 1990 08 20 2015 06 16 0140-6736 336 8708 1990 Jul 21 Lancet (London, England) Lancet Randomised, double-blind, placebo-controlled trial of methotrexate in steroid-dependent asthma. 137-40 69 patients with steroid-dependent asthma (mean daily prednisolone dose 14.2 [SD 6.1] mg) took part in a randomised, double-blind, placebo-controlled study of 24 weeks' treatment with methotrexate (...) . There were substantial abnormalities in liver function tests in 5 of the 38 patients taking methotrexate. Shiner R J RJ Brompton Hospital, London, UK. Nunn A J AJ Chung K F KF Geddes D M DM eng Clinical Trial Journal Article Randomized Controlled Trial Research Support, Non-U.S. Gov't England Lancet 2985213R 0140-6736 VB0R961HZT Prednisone YL5FZ2Y5U1 Methotrexate AIM IM Administration, Oral Adult Aged Asthma blood drug therapy physiopathology Double-Blind Method Drug Administration Schedule Drug
Protection against allergen-induced asthma by salmeterol. 1978163 1990 12 26 1990 12 26 2015 11 19 0140-6736 336 8727 1990 Dec 01 Lancet (London, England) Lancet Protection against allergen-induced asthma by salmeterol. 1338-42 The effects of the long-acting beta 2-agonist salmeterol on early and late phase airways events provoked by inhaled allergen were assessed in a group of atopic asthmatic patients. In a placebo-controlled study, salmeterol 50 micrograms inhaled before allergen challenge (...) ablated both the early and late phase of allergen-induced bronchoconstriction over a 34 h time period. Salmeterol also completely inhibited the allergen-induced rise in non-specific bronchial responsiveness over the same time period. These effects were shown to be unrelated to prolonged bronchodilatation or functional antagonism. These data suggest novel actions for topically active long-acting beta 2-agonists in asthma that extend beyond their protective action on airways smooth muscle. Twentyman O P
Trichophyton asthma: sensitisation of bronchi and upper airways to dermatophyte antigen. 2564948 1989 05 24 1989 05 24 2015 06 16 0140-6736 1 8643 1989 Apr 22 Lancet (London, England) Lancet Trichophyton asthma: sensitisation of bronchi and upper airways to dermatophyte antigen. 859-62 12 adult patients with perennial asthma and chronic skin infection were found to have immediate hypersensitivity to Trichophyton spp. 10 patients were tested by bronchial provocation and gave immediate bronchial (...) reactions to an extract of T tonsurans. Double-blind, placebo-controlled nasal challenge of 8 patients demonstrated that the upper airways of these patients were also sensitive to this dermatophyte antigen. In addition to perennial asthma most of the patients had persistent eosinophilia and chronic rhinosinusitis. The results suggest that absorption of fungal antigen can give rise to IgE antibody production, sensitisation of the airways, and symptomatic asthma and rhinosinusitis. Several patients had
Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. 2761061 1989 09 19 1989 09 19 2016 10 17 0098-7484 262 9 1989 Sep 01 JAMA JAMA Intravenous magnesium sulfate for the treatment of acute asthma in the emergency department. 1210-3 Conventional nebulized beta-agonist therapy has met with disappointing results in an increasing number of moderate to severe asthmatics who may be characterized as "poor responders." Thirty-eight patients suffering from acute (...) exacerbations of moderate to severe asthma were treated in an emergency department with an intravenous infusion of saline placebo or 1.2 g of magnesium sulfate after conventional beta-agonist therapy failed to produce significant improvement in peak expiratory flow rate. Nineteen patients were randomized into each of two groups in a placebo-controlled, double-blind clinical trial. The treatment group demonstrated an increase in peak expiratory flow rate from 225 to 297 L/min as compared with 208 to 216 L
Effect of peak flow information on patterns of self-care in adult asthma. 3417465 1988 10 27 1988 10 27 2013 11 21 0147-9563 17 5 1988 Sep Heart & lung : the journal of critical care Heart Lung Effect of peak flow information on patterns of self-care in adult asthma. 543-9 Self-care is an important issue in the management of adults with asthma. Little is known about the specific strategies used by people with asthma to control symptoms and abort asthma attacks. The purpose of this study (...) was to identify self-care strategies used to control asthma symptoms and to determine the effect of peak expiratory flow rate (PEFR) information on selection of self-care strategies. Thirty adult subjects with asthma were randomly assigned to either a control or an experimental group; 28 completed the study. All subjects recorded episodes of dyspnea, wheezing, and chest tightness and self-care actions in an asthma symptom diary. The experimental group recorded PEFR at the beginning and end of each symptom
Controlled trial of budesonide given by the nebuhaler in preschool children with asthma. 3044506 1988 10 05 1988 10 05 2013 10 01 0959-8138 297 6642 1988 Jul 16 BMJ (Clinical research ed.) BMJ Controlled trial of budesonide given by the nebuhaler in preschool children with asthma. 163-6 To determine whether the inhaled corticosteroid budesonide, given by a Nebuhaler spacing device, was effective in prophylaxis of asthma in preschool children. Double blind, placebo controlled, random order (...) crossover trial with two week practice run in period. Outpatient clinic referrals in secondary referral centre. 39 children aged 2-6 years selected for the following: able to use Nebuhaler; parents able to complete record card; poorly controlled asthma (defined); not already on systemic or inhaled steroids. Eleven withdrew for various reasons not connected with intolerance to budesonide. Age, sex, other atopies, and symptoms during run in period were similar in the 28 children who completed the trial
Intravenous beta agonist in severe acute asthma. 3139138 1988 11 17 1988 11 17 2015 10 26 0959-8138 297 6646 1988 Aug 13 BMJ (Clinical research ed.) BMJ Intravenous beta agonist in severe acute asthma. 448-50 To determine whether salbutamol is more effective in treating severe asthma when given intravenously or by inhalation. Randomised trial of short term response to intravenous versus nebulised salbutamol in acute severe asthma. District general hospital (secondary care centre). 76 patients (...) aged 16-70 admitted to hospital with acute severe asthma (peak expiratory flow rate less than 50% of predicted) during study period. Five withdrawn because of adverse effects of treatment or non-response. Of remaining 71, 34 allocated to nebuliser group and 37 to intravenous treatment group. Patients with history of cardiovascular disease or recent corticosteroid or intravenous bronchodilator treatment excluded. Admission characteristics similar in the two groups. All patients given 5 mg nebulised