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At least 829 records · Page 46Linked to original sources
PubMed1990

[Neopterin in phases of exacerbation of bronchial asthma and in experimental asthma conditions].

In conditions associated with stimulation of cellular immunity and enhanced macrophage activity, for example, in viral infections, neopterin is elevated. Acute exacerbations of bronchial asthma--in particular in the case of intrinsic asthma--are frequently precipitated by viral infections of the upper airways. In both extrinsic and intrinsic asthma, neopterin is normal in the stable phases. In the exacerbation phase with signs of infection of the upper airways, however, neopterin in significantly elevated both in the serum and in the urine. In contrast, during and following positive inhalative provocation testing with histamine, allergens and aspirin, no increase in neopterin is to be observed.

Asthma↗
PubMed1987

[Glucocorticosteroid therapy in bronchial asthma with special reference to the prevention of life-threatening bronchial obstruction in high-risk asthma].

The treatment of bronchial asthma with glucocorticosteroids requires consideration of unequivocal principles which include strong indication, considering the individual risk-benefit-relation. Glucocorticosteroids should be fitted in a medicamentous-therapeutic hierarchy. Inhalable glucocorticosteroids hardly cause systemic side effects, so they are very suitable for the continuous treatment, if the need in glucocorticosteroids is low. The indication for systemic application of glucocorticosteroid, their side effects, relative contraindications and pharmacological interactions are given. Careful analyses of cases of death, caused by bronchial asthma in accordance show that an inadequate glucocorticosteroid-therapy was the most important avoidable factor. The attention of the clinicians must be directed on a small group of patients characterised by high risk of death ("high-risk-asthma"). These patients, having certain clinical signs, need not only special intensive care, but also experienced, early and sufficient treatment with glucocorticosteroids to prevent life threatening situations.

Administration, Inhalation↗
PubMed1995

[Psychological profiles of patients with bronchial asthma (II). Analysis according to the modes of attack in severe asthmatics and in those with fatal asthma].

When the rise of asthma death became a world-wide problem, background factors proposed were the poor patient education and compliance with psychological factors which hindered these accomplishments. Analysis were made on the psychological test scales recorded by the severe asthmatics and found that the result for the acute type resembled the controls, while those with chronic attacks had depressive/neurotic tendencies with decreased activity. Result of those with acute on chronic attacks show more active attitude in life. Fatal asthmatics had high level for thinking extroversion signifying more optimistic attitude which may have lead them to their under-estimation of asthma. Other scales in fatal asthma suggest problems in their life styles and maladaptation.

Acute Disease↗
PubMed1993

[Bronchial asthma--airway inflammation and asthma--role of airway epithelium].

The importance of airway inflammation in the pathophysiology of bronchial asthma has been recognized recently. This inflammation is organized by the interaction between inflammatory cells and the cells which compose airway structures. We studied the role of airway epithelium in airway hyperresponsiveness and airway inflammation, which are the major characteristics of bronchial asthma, and demonstrated a close relationship between them. On the bases of these data and the data reported by many other researchers, and from the point of view of airway inflammation, we discussed the possible roles of airway epithelium in bronchial asthma.

Animals↗
PubMed1996

Fluticasone propionate aerosol: efficacy in patients with mild to moderate asthma. Fluticasone Propionate Asthma Study Group.

BACKGROUND: This double-blind, randomized, parallel-group, placebo-controlled study investigated the efficacy and tolerability of fluticasone propionate aerosol (25, 50, or 100 mg bid for 12 weeks) administered as primary maintenance therapy to patients whose mild to moderate asthma was inadequately controlled by as-needed use of an inhaled beta-agonist. RESULTS: At all clinic visits, fluticasone propionate compared with placebo was associated with significant (P<.05) improvement in pulmonary function indexed by forced expiratory volume in 1 second (FEV1) as well as fewer night awakenings and less use of rescue albuterol. Values for patient-measured morning peak expiratory flow rates (PEFR) were significantly (P<.05) higher and the use of rescue albuterol was significantly (P<.05) lower beginning 3 to 5 days after initiation of therapy in the groups treated with fluticasone propionate, compared with the placebo group. Maximal improvement in FEV1 was achieved during the second week of treatment and maintained throughout the course of therapy. Differences among the three fluticasone propionate dosing groups for these efficacy measures were not statistically significant. The incidence of adverse events was similar across groups. CONCLUSIONS: These data indicate that fluticasone propionate aerosol is an effective and well-tolerated treatment for asthma and significantly improves pulmonary function within days of initiation of treatment in patients whose asthma is inadequately controlled with as-needed beta-agonists.

Adolescent↗
PubMedDate not supplied

[Epidemiologic aspects of childhood asthma in Mexico. Asthma in the Child Study Group].

Asthma is one of the most frequent chronic diseases in children. Its epidemiological tendency is of great importance. In this study, we evaluated the statistical information available from 1987 to 1994 on childhood asthma from several medical institutions in Mexico. We found that: 1) the frequency of medical care provided to asthmatic children under the age of 15 in outpatient, emergency and within hospital settings, expressed as a percentage of the total care provided for each category, has remained unchanged in almost all of the institutions reviewed, whereas the national mortality rate due to asthma has decreased from 3.5/100,000 inhabitants in 1987 to 2.9 in 1993, 2) the frequency of healthcare provided to asthmatics decreases between the ages of 15 to 24; 3) the disease occurs more frequently among males under 15 and in females over that age, 4) from August to November there was a significant rise in care provided for asthmatics in outpatient, emergency and hospital settings in Mexico City and almost every state studied; and 5) the frequency of care for asthmatics increases according to an increase in geographical altitude levels.

Adolescent↗
PubMed1997

Utilization of anti-asthma medications in two Quebec populations of anti-asthma medication users: a prescription database analysis.

This study describes the utilization of anti-asthma medications in two groups of users of such medications in the province of Quebec, Canada, during the year from June 1, 1990, to May 31, 1991. It is based on a secondary analysis of existing data banks recording the medications reimbursed by two government-funded ambulatory drug reimbursement programs that cover individuals aged 65 and over (seniors) and income security (welfare) recipients (ISRs). The study analyzed the use of the anti-asthma medications included in the list of medications eligible for reimbursement for program beneficiaries. Use was studied in two random samples of individuals who had at least one prescription filled for an anti-asthma medication (2566 seniors and 3695 ISRs). The most commonly used medication in both groups was inhaled salbutamol 100 mcg. Various forms of theophylline tablets were also used by a high proportion of the sample studied. Over 75% of the seniors and 68% of the ISR group used at least one form of theophylline during the course of the year. Inhaled corticosteroids were used by 43% of the seniors and by 36% of the ISR group, and sympathomimetics (beta 2-agonists), by 63% of seniors and 68% of ISRs.

Adolescent↗
PubMed2006

Concerns about intranasal corticosteroids for over-the-counter use: position statement of the Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology.

The Joint Task Force for the American Academy of Allergy, Asthma and Immunology and the American College of Allergy, Asthma and Immunology was charged with formulating a position paper regarding the potential release of intranasal corticosteroids for over-the-counter use. We took the position that safety issues regarding this proposal would be our sole concern. We reviewed the literature to evaluate the frequency and severity of potential adverse events related to the administration of intranasal corticosteroids. We limited this review to 5 areas: (1) effects on growth, (2) ocular effects, (3) effects on bone, (4) effects on the hypothalamic-pituitary-adrenal axis, and (5) local adverse effects. After review of the available data, we concluded that intranasal corticosteroids should remain prescription-only drugs. Patients receiving an intranasal corticosteroid should be instructed in its use and that use should be monitored by a physician or an appropriately trained medical provider (eg, nurse practitioner or physician assistant) under the direct supervision of a physician. This conclusion was reached based on the evidence that corticosteroids administered by any route, including the intranasal route, have the potential to cause adverse effects in all the areas noted herein. Our conclusion was strengthened by the fact that these adverse effects can be insidious and therefore not evident for many years; there is the potential for overuse; patients could also have access to other forms of topically administered corticosteroids, thus increasing their total dose; and individuals vary in their susceptibility to corticosteroid-induced adverse effects. We were also influenced to take this position knowing that generally reassuring data regarding the use of respiratory tract-administered corticosteroids are based on mean data and that all such studies have shown outliers in whom adverse effects were evident. Thus, as stated, we recommend that intranasal corticosteroids remain prescription-only drugs.

Administration, Inhalation↗
PubMed1981

Do exercise- and antigen-induced asthma utilize the same pathways? Antigen provocation in patients rendered refractory to exercise-induced asthma.

Twelve asthmatics (ages 8 to 33 yr) with proven exercise-induced asthma (EIA) and allergen-induced asthma (AIA) were investigated in an attempt to elucidate the pathways through which each type of attack develops. All patients were rendered refractory to EIA by repeated exercise at short intervals and were then immediately challenged by inhalation with an allergen known to evoke AIA. After an average of three runs all subjects were rendered refractory to EIA (post-exercise fall in FEV1 of 7 +/- 8% SEM compared with the control postexercise fall of 32 +/- 14%). In this refractory state six patients failed to respond to antigen challenge (6 +/- 4% SEM fall in FEV1 compared with the 30 +/- 3% fall in control study, p less than 0.001), suggesting a common pathway for EIA and AIA, such as the exhaustion of stored chemical mediators. Six other patients developed attacks of AIA while refractory to EIA, which were at least as severe as those in their control study (34 +/- 7% SEM fall in FEV1 compared with 29 +/- 3%). The fact that AIA could develop while EIA was blocked in this group requires an alternate pathway or mechanism for their AIA. The only significant difference between the AIA "blocked" and AIA "nonblocked" groups was a lower baseline level of lung function in all tests in the nonblocked group.

Adolescent↗
PubMedDate not supplied

The National Asthma Campaign Manchester Asthma and Allergy Study.

The NACManchester Asthma and Allergy Study is a prospective study of the development of asthma and allergies in childhood. The subjects (995 children at age 3 years) were recruited in utero by screening parents in the antenatal clinic using skin prick testing and a questionnaire regarding allergic diseases. Children were assigned to risk groups according to parental atopic status (high risk, both parents atopic; medium risk, one parent atopic; low risk, neither parent atopic). A subgroup of those at high risk (with no pets in the home) was randomized to stringent environmental control (allergen impermeable covers for the parental and infant bed, hot washing of bedding weekly, HEPA vacuum cleaner, hard floor for the nursery), and the remainder followed a normal regime. The children have been followed prospectively. The environmental influences are very clearly defined. Measurements of environmental exposures include levels of house dust mite; cat and dog allergens during pregnancy and early life; pet ownership and exposure; childcare arrangements; number of siblings; vaccination uptake; thorough dietary questionnaire; and endotoxin exposure. Further unique objective outcome in the cohort is the assessment of lung function in preschool children using specific airways resistance, which at age 3 years clearly reflects both genetic and environmental influences.

Asthma↗
PubMed2004

Progression of asthma measured by lung function in the childhood asthma management program.

From the Childhood Asthma Management Program cohort, which was randomly assigned to receive budesonide, nedocromil, or placebo for 4-6 years, we determined the prevalence of and factors associated with at least 1% per year loss in postbronchodilator FEV(1)% predicted. Participants who had a significant reduction in postbronchodilator FEV(1)% predicted (SRP), comprised 25.7% of the cohort (n = 990). Using logistic regression, predictors of SRP at baseline were younger age (p = 0.0005), male sex (p < 0.0001), clinic (p = 0.02), and higher postbronchodilator FEV(1)% predicted (p = 0.02). Examination of the SRPs indicated that the effect of baseline lung function was such that the higher the lung function, the less steep the reduction in postbronchodilator FEV(1)% predicted (p < 0.0001). A similar proportion of SRPs was found in each treatment group. Among the SRPs, the rate of reduction in postbronchodilator FEV(1)% predicted was similar in all treatment groups. At a single site where biomarker assessment was performed, SRPs also had more prominent eosinophilic inflammation during the washout period. The course and mechanisms of lung function reduction or slow lung growth velocity in children with asthma must be defined.

Administration, Inhalation↗
PubMed1989

[Effect of the syndrome of asthma of effort on work fitness of bronchial asthma patients].

A total of 133 patients aged 35 to 55 years with bronchial asthma (BA) were examined. Of these 85 patients showed an infection-dependent and 48 a steroid-dependent clinico-pathogenetic disease pattern. Physical performance was studied with regard to the character of occupation, the degree of respiratory function impairment and the effects of intal and orciprenaline sulfate on the reproducibility of asthma of effort (AE) and performance of that category of patients. The development of AE was found to lead to a further decrease of work fitness of BA patients irrespective of the clinico-pathogenetic disease pattern, the degree of external respiratory function impairment and the character of occupation, resulting in the limitation of physical work possibilities of BA patients. The data are also presented concerning the effects produced by intal and orciprenaline sulfate on AE reproducibility and work fitness of this group of patients and on the relationship between tracheobronchial hyper-reactivity and physical stimulus in the development of AE. Intal action was more pronounced as compared to orciprenaline sulfate. The data thus obtained can promote the improvement of the activity of the medical expert commission for evaluation of working capacity as well as of the standards of work recommendations in BA patients.

Adult↗
PubMedDate not supplied

Should corticosteroids be used in the treatment of acute, severe asthma? I. A case for the use of corticosteroids in acute, severe asthma.

Corticosteroids have been used for over 3 decades in the treatment of asthma. There are theoretic reasons and long-standing clinical support for their use, but little in the way of good objective data on their efficacy. I have reviewed this information and concluded that notwithstanding rare side effects, corticosteroids should be used in acute asthma, and objective data exist to support this premise.

Adrenal Cortex Hormones↗
PubMed1999

Leukotrienes, leukotriene receptor antagonists and leukotriene synthesis inhibitors in asthma: an update. Part II: clinical studies with leukotriene receptor antagonists and leukotriene synthesis inhibitors in asthma.

The demonstration that leukotrienes, mainly cysteinyl leukotrienes, have biological properties relevant to the pathogenesis of asthma has stimulated the development of many therapeutic compounds to block these deleterious effects. Two main classes of leukotriene modulators have been developed: CysLT1 receptor antagonists and leukotriene synthesis inhibitors. This article reviews the pharmacodynamics, the effects on baseline airway function, the protective effects in airway challenges as well as the results in chronic asthma of the different leukotriene modulators. In addition, the complementary anti-inflammatory effect of leukotriene modulators to that of corticosteroids and H1-histamine receptor antagonists is reviewed. Finally, a concise overview of the clinical responsiveness to this new class of drug, the safety and the drug interactions as well as the place in the strategies of treatment for asthmatic patients of the leukotriene modulators is also provided.

Anti-Asthmatic Agents↗
PubMed1994

Relaxation and music therapies for asthma among patients prestabilized on asthma medication.

One hundred six asthmatic subjects were medically prestabilized, then assigned to eight sessions of progressive relaxation, music, or a waiting-list. Seventy-two subjects completed treatment, of which 37 were evaluated in the laboratory with measures of forced expiratory flow. Relaxation-group subjects reported feeling the most deeply relaxed and produced the greatest improvement in forced expiratory flow during the last presession assessment period. All groups evidenced decreases in asthma symptoms. All groups showed decreases in pulmonary function immediately after relaxation sessions. None of the changes in pulmonary function reached levels that are accepted in drug trials to be of clinical significance, and the therapeutic changes occurred only in the situation where training was rendered. Listening to music produced greater decreases in peaks of tension than progressive relaxation, and it produced greater compliance with relaxation practice, but it did not produce any specific therapeutic effects on asthma.

Adolescent↗
PubMed1989

Guidelines for the clinical evaluation of occupational asthma due to high molecular weight (HMW) allergens. Report of the Subcommittee on the Clinical Evaluation of Occupational Asthma due to HMW Allergens.

Sensitization to HMW allergens is a relatively common immunopathogenic factor in occupational asthma. The mechanism of sensitization is an IgE-mediated, type I reaction. High molecular weight allergen refers to proteins and polymers of organic compounds over 5 kd and usually in the 20 to 50 kd range. In most cases diagnosis requires: 1. A high index of suspicion of job-related asthma. 2. Exposure to HMW compounds and clinical findings associated with such an exposure. 3. Confirmation of sensitization by appropriate in vitro or in vivo tests. 4. Confirmation of a pathogenic role by physiologic measurements in either a natural setting or during laboratory-controlled challenges.

Allergens↗