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Biomedical subjects

Sitesh R Roy

Publications and source records attributed to Sitesh R Roy.

6 recordsLinked to original sources
PubMed2003

Managing outpatient asthma exacerbations.

Asthma is a chronic inflammatory disease that renders individuals prone to acute exacerbations. Several allergic and nonallergic triggers can incite an asthma exacerbation. The goals of managing an asthma exacerbation are prompt recognition, rapid reversal of airflow obstruction, prevention of relapses, and forestalling future episodes. A written asthma home-management plan is essential to minimize the severity of exacerbations. Short-acting b-agonists, oxygen, and corticosteroids are fundamental to early intervention in acute asthma exacerbation. Anticholinergics and magnesium sulfate can help nonresponders. Newer agents such as levalbuterol and long-acting b-agonists might be future additions to our armamentarium of drugs to treat acute exacerbations. Initiation or intensification of long-term controller therapy, treatment of co-morbid conditions, and avoidance of possible triggers along with prompt follow-up can help prevent relapses. Listening to patient preferences and concerns to enhance adherence and regular follow-up care can help prevent future episodes.

Acute Disease↗
PubMed2003

Bacterial DNA in house and farm barn dust.

BACKGROUND: Early in life, natural exposure to microbial components (eg, endotoxin) may mitigate allergy and asthma development in childhood. Bacterial DNA is a potent stimulus for the innate immune system; its immune stimulatory potential in dust is unknown. OBJECTIVES: We sought to quantify bacterial DNA and endotoxin content in dust from urban homes, rural homes, farm homes, and farm barns and to determine if dust DNA is immune-stimulatory. METHODS: Total DNA, bacterial DNA, and endotoxin were measured in 32 dust samples. To measure bacterial DNA content, a quantitative polymerase chain reaction assay specific for bacterial ribosomal DNA was developed. Peripheral blood mononuclear cells from 5 adults were stimulated with endotoxin-free dust DNA with/without lipopolysaccharide (LPS) from selected dust samples. IL-12p40, IL-10, and tumor necrosis factor-alpha were measured in cell supernatants by enzyme-linked immunosorbent assay. RESULTS: Bacterial DNA in dust correlated with endotoxin (r = 0.56, P <.001) and total DNA content (r = 0.51, P =.003). The highest bacterial DNA levels were measured in farm barns (mean, 22.1 microg/g dust; range, 1.3 to 56.2), followed by rural homes (6.3 microg/g; 0.2 to 20), farm homes (2.2 microg/g; 0.1 to 9.1), and urban homes (0.6 microg/g; 0.1 to 1.2). Farm barn DNA significantly potentiated (P < or =.05) LPS-induced IL-10 and IL-12 p40 but not tumor necrosis factor-alpha release (13-fold, 3-fold, and 1.5-fold increases, respectively). DNA from 6 urban homes did not demonstrate this LPS-potentiating effect. CONCLUSIONS: Endotoxin is a marker for bacterial DNA, which is also higher in locales of lower asthma and allergy prevalence. DNA from farm barn dust augments the immune modulatory effects of endotoxin and may combine with exposure to other such naturally occurring microbial components to mitigate allergy and asthma development.

Adult↗
PubMed2003

Management of the acute exacerbation of asthma.

All patients with asthma are at risk of having asthma exacerbations characterized by worsening symptoms, airflow obstruction, and an increased requirement for rescue bronchodilators. The goals of managing an asthma exacerbation are prompt recognition and rapid reversal of airflow obstruction to avert relapses and future episodes. Short-acting beta-agonists, oxygen, and corticosteroids form the basis of management of acute asthma exacerbation, but a role is emerging for anticholinergics and newer agents such as levalbuterol and formoterol. Initiation or intensification of long-term controller therapy, treatment of comorbid conditions, avoidance of likely triggers, and timely follow-up care prevent setbacks. Acceptance of current treatment guidelines by physicians and adherence to the recommended clinical regimens by patients are essential for effective management of asthma. The physician should strive to establish a constructive relationship with the patient by addressing the patient's concerns, reaching agreement on the goals of therapy, and developing a written action plan for patient self-management.

Acute Disease↗
PubMed2003

Asthma.

This article is a comprehensive review of asthma that discusses risk factors, diagnosis, and management. Guidelines for choosing appropriate asthma therapy are discussed. Key aspects of patient education are described. Reasons for the failure of asthma therapy with potential remedies are presented. Regular follow-up for good asthma care is emphasized.

Adrenergic beta-Agonists↗
PubMed2002

Endotoxin, atopy and asthma.

Endotoxin is infamous for its ability to exacerbate existing allergy and asthma symptoms. Current research supports this phenomenon, demonstrating its significance in the home, as well as in the workplace. At the same time, evidence is emerging that exposure to endotoxin may drive immune development away from the T-helper lymphocyte type 2-mediated allergy and asthma profile. This fits in nicely with the 'hygiene hypothesis', which attributes the past century's rise in allergy and asthma to a reduction in microbial burden. Indeed, infections have been associated with less atopy and asthma. Recent investigations have suggested that naturally-occurring non-infectious exposure to microbial components such as endotoxin might mitigate atopy and asthma as well.

Air Pollution, Indoor↗