Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ASTHMA”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 847 records · Page 47Linked to original sources
PubMed2005

Perspectives in asthma: molecular use of microbial products in asthma prevention and treatment.

Asthma and atopy are characterized by T(H)2-type patterns of inflammation. The hygiene hypothesis suggests that early-life environmental exposure to microbes, other pathogens, and their products promotes innate immune responses that suppress atopy; the current epidemic of allergic disease may result from a dearth of such stimuli. Antiatopic responses engendered by these exposures include both T(H)1-type and regulatory-type patterns, the latter including mechanisms of antigen-presenting cells as well as those of lymphoid origin, and are characterized by prominent IL-10 and/or TGF-beta effects. The Toll-like receptors are an important family of innate immune response elements that have many similar structural and functional properties, but have evolved to recognize distinct ligands as well as to be expressed differentially on immune cells. An active and productive area of current research is investigating the utility of microbes and microbial products for modulation of inflammation in asthma and atopic disorders. Clinical trials have been conducted for some of these biologic compounds, such as cytosine-guanine dinucleotide DNA and Mycobacterium vaccae, whereas others remain in preclinical testing.

Anti-Asthmatic Agents↗
PubMed2003

Asthma management across the life span: the child with asthma.

Childhood asthma has an adverse impact on children, families, and society. Treatment of asthma presents special challenges related to diagnosis, ongoing symptom monitoring, and treatment when the patient is a child. To be effective, treatment needs to be medically sound and developmentally appropriate.

Adolescent↗
PubMed2003

HLA class II genotypic frequencies in atopic asthma: association of DRB1*01-DQB1*0501 genotype with Artemisia vulgaris allergic asthma.

Different human leukocyte antigen (HLA) class II alleles have been associated with the development of atopic asthma. To determine whether HLA class II alleles are associated with atopic asthma in a population from southeast Spain (Murcia region), 213 atopic asthmatic patients and 150 controls were selected for HLA typing. Significant association of the DRB1*01 and DQB1*0501 alleles was found in Artemisia vulgaris allergic patients (p(c) = 0.00052 and p(c) = 0.00023, respectively). No significant correlation was found in other atopic patients allergic to pollens (Phleum pratense, Olea europaea, and Salsola kali), house dust mites (Dermatophagoides pteronyssinus, D. farinae), molds (Alternaria alternata, Cladosporium herbarum), or animal danders (dog, cat). The results reveal that the DRB1*01-DQB1*0501 genotype is strongly associated with a positive response to Artemisia vulgaris in the population studied.

Alleles↗
PubMed1995

[The quality of life in asthma: an evaluation of the AQLQ questionnaire for its use on a Spanish population. Asthma Quality of Life Questionnaire].

The study of morbidity in asthma requires consideration not only of standard physiopathologic and function parameters, but also of the impact the disease has on the patient's life-style as he or she perceives it and evaluates it. The quantification of this factor, known as health-related quality of life (HRQL), is achieved by administering questionnaires specially designed for the purpose. We analyzed the reliability, content validity and construct validity (convergence and divergence) of one instrument, the Asthma Quality of Life Questionnaire (AQLQ) designed by Marks and colleagues. This questionnaire covers 4 dimensions (breathlessness, mood, social limitation and worrying) and gives a total score. After a process of translation and back translation the AQLQ was administered to 102 adult asthmatics living in an urban center, all of whom had been stable for at least the preceding 4 weeks. The following data were recorded: age, sex, duration of disease, FEV1, medication, dyspnea, hospital visits, nighttime symptoms and severity of disease (from the patient's own point of view and according to the scale of the International Consensus Report [ICR]). The reliability study (internal consistency with Crombach's alpha coefficient and inter-item correlation analysis) gave satisfactory results in all cases (range of r = 0.39 to 0.78; alpha = 0.78 to 0.91). Content validity (factorial analysis of the main components, oblique and orthogonal rotations) was less satisfactory, although 4 factors were found; these factors adjusted relatively well to one of the proposed sub-scales and together explained 65.2% of the total variance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2002

Asthma education tailored to individual patient needs can optimise partnerships in asthma self-management.

This paper studies the effects of patient education, tailored to individual needs of patients as part of an asthma self-management program. A tailored education program was designed which took into account individual information needs of patients by using a feedback instrument. Totally 98 steroid dependent asthmatics entered the tailored education program, 95 patients received usual care. Outcome measures were information exchanged and patient satisfaction. Study duration was 6 months. Patients in the tailored education group showed a significant reduction in information need (P=0.005). Patient satisfaction increased from 87.9 to 93.7 in this group while this did not change in the usual care group (P=0.000). Use of this tailored education program improved the GP-patient interaction within the context of a clinically effective asthma self-management program. Findings from this study may be applicable to other chronic conditions as well.

Acute Disease↗
PubMed2004

Do children with asthma and their parents agree on household ETS exposure? Implications for asthma management.

The adverse consequences of passive smoking have spurred efforts to reduce environmental tobacco smoke (ETS) exposure among children, particularly in the home. For children with asthma, teaching them to avoid tobacco smoke at home is an important element of patient self-management. This strategy assumes that children can accurately assess household smoking behaviors and the level of their own exposure in the home. This study compared child and parental assessments of household smoking behaviors in an urban, low-income and largely ethnic minority sample of asthmatic children and their parents. While there was general parent-child agreement on the smoking status of household members, there was less agreement on duration of household smoking and the child's exposure to ETS. Objective validation measures (cotinine, nicotine) suggest that parents were better able than their children to assess hours of indoor smoking. Children's assessment of the extent of exposure to ETS may be problematic, with important implications for asthma patient self-management efforts.

Adolescent↗
PubMed2001

Cost-effectiveness of inhaled corticosteroids in adults with mild-to-moderate asthma: results from the asthma policy model.

BACKGROUND: Inhaled corticosteroids remain underused among United States-based clinicians in treating mild-to-moderate adult asthma. OBJECTIVE: The purpose of this investigation was to estimate the clinical impact, health-related quality of life, cost, and cost-effectiveness of inhaled corticosteroid therapy in a population of patients aged 18 years and over with FEV(1) = 60% to 100% of predicted normal. METHODS: We performed a cost-effectiveness analysis of quick relievers (eg, short-acting beta-agonists) on an as-needed basis plus inhaled corticosteroid therapy versus quick relievers alone. A mathematical simulation model was developed to forecast symptoms, acute exacerbations, quality-adjusted life-years (QALYs), health care costs, and cost-effectiveness, measured in both dollars per QALY gained and dollars per symptom-free day gained. All evaluation outcomes were discounted at an annual rate of 3% and measured over a 10-year planning horizon. Data on the natural history of disease, drug efficacy, patient preferences, and economic costs were obtained from a variety of observational cohorts, randomized trials, and patient surveys. RESULTS: Over a 10-year period, use of inhaled corticosteroids increases total health costs from roughly $5,200 to $8,400 and improves QALYs from 6.8 to 7.0, implying an incremental cost of $13,500 per QALY gained. Costs per symptom-free day gained are $7.50. Both per-person acute exacerbations and hospitalizations are reduced by 33%. The cost-effectiveness findings are sensitive to the assumed efficacy and side-effects of inhaled corticosteroid therapy. CONCLUSIONS: Inhaled corticosteroids appear to deliver good comparative value in adults with mild-to-moderate asthma. Although more research is needed to understand their impact on preferences regarding side effects and compliance, these findings might be useful for priority-setting in limited resource situations.

Administration, Inhalation↗
PubMed2001

Improvement in health care utilization and pulmonary function with fluticasone propionate in patients with steroid-dependent asthma at a National Asthma Referral Center.

The impact of switching from other inhaled corticosteroids to fluticasone propionate was studied in patients with severe oral-steroid-dependent asthma over a 1-year period. In this open-label prospective study, patients on maintenance doses of oral and inhaled steroids were referred to a national asthma treatment center and were switchedfrom their previous inhaled corticosteroid to fluticasone propionate 880 microg BID. Compared with data collected from the year prior to enrollment, treatment with fluticasone propionate resulted in significant improvements in pulmonary function, oral steroid requirements, and health resource utilization. In addition, five patients were completely weaned off oral steroids.

Administration, Inhalation↗
PubMed2006

Animal models of allergen-induced tolerance in asthma: are T-regulatory-1 cells (Tr-1) the solution for T-helper-2 cells (Th-2) in asthma?

Non-specific anti-inflammatory medication is actually the treatment of choice for controlling the T-helper type 2 (Th-2) cell-driven airway inflammation in asthma. The induction of counterbalancing Th-1 cell clones, long considered a promising approach for immunotherapy, has failed to fulfil its promise because of potentially detrimental side-effects. This is therefore probably not a valid option for the treatment of asthma. With the increasing awareness that active immune mechanisms exist to control inflammatory responses, interest rises to investigate whether these can be exploited to control allergen-induced airway disease. The induction of antigen-specific T cells with suppressive characteristics (regulatory T cells) is therefore a potentially interesting approach. These regulatory T cells mediate tolerance in healthy, non-atopic individuals and have the potential of becoming an effective means of preventing allergen-induced airway inflammation and possibly of suppressing ongoing allergic immune responses. Here we review the available knowledge about allergen-induced suppressive immunity obtained from animal models taking into account the different developmental stages of allergic airway disease.

Adoptive Transfer↗
PubMed1989

Leukotriene C4 in children with atopic asthma. I. Plasma levels in acute asthma.

The leukotrienes C4, D4 and E4 are potent biologic mediators, and are thought to play an important role in obstructive airways disease such as asthma. In this study, plasma immunoreactive LTC4 (iLTC4) levels in asthmatic children were measured using radioimmunoassay after Sep-pak extraction in order to determine whether LTC4 is released in vivo during an asthmatic attack. In 10 non-atopic children, the mean +/- SEM of plasma iLTC4 level was 0.031 +/- 0.013 pmol/ml. Significantly higher plasma iLTC4 levels were recognized at all stages in asthmatic children, both in remission (p less than 0.01) and during an attack (p less than 0.01). PaO2 levels during an attack were significantly lower in the high iLTC4 group. In 15 asthmatic children, the plasma iLTC4 levels during an attack (0.134 +/- 0.017 pmol/ml) significantly decreased during recovery (0.078 +/- 0.012 pmol/ml) (p less than 0.05). Plasma iLTC4 levels correlated closely with lung function (p less than 0.01). The high iLTC4 levels in plasma in asthmatic children suggest a role for LTC4 in the pathophysiology of asthma.

Acute Disease↗
PubMed1997

Walking around in circles--the life situation of patients with asthma-like symptoms but negative asthma tests.

In-depth interviews were conducted with fourteen women with asthma-like symptoms but negative asthma tests. In collecting and analysing data the method of grounded theory was used. A core category emerged, Walking around in circles, and three main categories, Subjective Hyperreactivity, Social Limitations and Non Confirmation which elucidated the life situation and psychosocial processes involved in having the breathing disorder. The findings were characterised by numerous self-reinforcing vicious circles. The symptoms were especially associated with subjective hyperreactivity with strong sensitivity to odours, impaired ability to perform physical activities and mental stress, which in turn impose social limitations. These restrictions arouse feelings of social isolation and distress, which implies mental stress and thereby increased attention and sensitivity to adverse stimuli. The fact that the medical experts cannot offer diagnosis and treatment engenders feelings of confusion, non-confirmation and thereby anxiety which further aggravate the vicious circles described. Most informants considered that they had few coping strategies. Some stated that they had changed their strategies from being passive, taking no responsibility, to become more active, not caring about the reactions of others and taking the risk of being ill, favouring social contacts and thus minimising the impact of the disorder.

Adaptation, Psychological↗
PubMed1997

The effects of combined intravenous and inhaled steroids (beclomethasone dipropionate) for the emergency treatment of acute asthma. The Asthma ED Study Group.

OBJECTIVE: To compare the efficacy of high-dose inhaled steroids in conjunction with IV steroids with that of IV steroids alone in the emergency treatment for acute asthma. METHODS: A double-blind, placebo-controlled, randomized trial was conducted on 60 ED patients presenting with acute asthma. All patients received nebulized salbutamol, and IV methylprednisolone, 80 mg at baseline and 40 mg at 6 hours. In addition to the above therapy, the experimental group received beclomethasone dipropionate (BDP) 7 mg over 8 hours via a metered-dose inhaler (MDI) attached to a holding chamber, while the control group received a placebo administered in the same fashion. Patients were treated on the protocol for 12 hours with the primary outcome measure being the change in % predicted FEV1. RESULTS: Of 60 patients, 30 were randomized to BDP (age: 42 +/- 16 years; FEV1: 0.97 +/- 0.42 L) and 30 were randomized to placebo (age: 37 +/- 18 years; FEV1: 0.98 +/- 0.35 L). Spirometry and dyspnea measured by the Borg Scale improved significantly in both groups compared with baseline (p < 0.001). Changes in spirometry measures, dyspnea, and vital signs did not differ between treatment groups over the 12 hours of study (p > 0.05). CONCLUSION: Inhaled BDP added to the standard regimen of IV methylprednisolone, and beta-agonist did not further improve flow rates or dyspnea scores measured for up to 12 hours after presentation to the ED.

Administration, Inhalation↗
PubMed1976

Bacterial precipitins and their immunoglobulin class in atopic asthma, non-atopic asthma, and chronic bronchitis.

In a study of groups of patients with atopic (extrinsic) asthma, non-atopic (intrinsic) asthma, and chronic bronchitis, no difference could be detected in the numbers having precipitating antibodies against species specific antigens from Staphylococcus aureus or Streptococcus pneumoniae compared to suitably matched control subjects. Precipitating antibodies against species specific antigens from Haemophilus influenzae, demonstrated in this investigation by double diffusion in agar gel, were found much more frequently in patients with chronic mucopurulent or obstructive bronchitis (50%) than in either asthmatic subjects (6%) or normal controls (6%) (P = less than 0.0005). While the precipitating antibody demonstrated in these patients against the extracts of Str. pneumoniae and Staph. aureus was in the IgG class alone, IgM and IgA antibody were detected against the species specific but not the non-species specific antigens of H. influenzae. These results underline the importance of H. influenzae as an infecting agent in chronic bronchitis and suggest that the finding of precipitins against the species specific H1 and H2 antigens of this bacterium denotes infection either concurrently or in the recent past. There is no evidence to suggest from this study that infection with Staph. aureus, Str. pneumoniae or H. influenzae is any more common in asthmatics as a group compared to controls or between patients with the non-atopic (intrinsic) and atopic (extrinsic) form of the disease.

Adolescent↗
PubMed1992

Occupational asthma due to polyethylene shrink wrapping (paper wrapper's asthma).

Occupational asthma due to the pyrolysis products of polyvinyl chloride (PVC) produced by shrink wrapping processes has previously been reported. The first case of occupational asthma in a shrink wrap worker using a different plastic, polyethylene, is reported; the association was confirmed by specific bronchial provocation testing.

Adolescent↗
PubMedDate not supplied

Prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema in 6- to 7-year-old Nigerian primary school children: the international study of asthma and allergies in childhood.

OBJECTIVE: To determine the prevalence and severity of symptoms of asthma, allergic rhinoconjunctivitis and eczema in Nigerian children aged 6-7 years. SUBJECTS AND METHODS: A cross-sectional study of selected children in primary schools in Ibadan, Nigeria was conducted using phase I of the International Study of Asthma and Allergies in Childhood (ISAAC) format. Standardized questionnaires were distributed to parents and guardians of 2,325 children aged 6-7 years in 31 primary schools randomly selected among 272 in Ibadan. RESULTS: Data was collected from 1,704 children (797 boys and 907 girls; M:F ratio 1:1.14), giving a participation rate of 73.3%. Both recent rhinoconjunctivitis and wheeze were reported by 5.1%, and itchy flexural rash in the past 12 months was reported by 8.5%. The cumulative prevalences of reported symptoms of wheezing, rhinitis and eczema were 7.2, 11.3 and 10.1%, respectively. These symptoms were basically the same among the boys and girls (rhinitis 11.4 vs. 11.2%; eczema 10.7 vs. 9.5%), except for wheezing, which was higher in boys (9.0%) than girls (5.6%), p = 0.015. Current symptoms of rhinitis and atopic eczema were associated with current wheeze and severe wheezing, whereas current symptoms of allergic rhinoconjunctivitis were only associated with severe wheezing attacks. One or more current symptoms occurred in 13.2% of the children, and all three symptoms were reported by 0.5%. CONCLUSION: The study demonstrates a high prevalence of atopic conditions among children 6-7 years old in Ibadan, Nigeria, with more than three fifths of the children who had current wheezing also showing symptoms of other atopic diseases. Children with allergic rhinoconjunctivitis were more likely to have severe wheezing attacks if they had developed atopic eczema before 2 years of age.

Asthma↗
PubMed1975

Arterial and muscle oxygen tension in experimental models of asthma. Experimental models of asthma.

The immediate-type airway response in anesthetized dogs and rhesus monkeys to two antigens (ascaris and keyhole limpet hemocyanin) and pharmacologic agents (histamine, methacholine and prostaglandin F2alpha) were studied. The pulmonary function abnormalities demonstrated by changes in breathing frequency, peak expiratory flow rate, pulmonary resistance, expiratory-inspiratory time ratio, tidal volume, and dynamic compliance were compared with simultaneous determinations of arterial pO2, muscle pO2 or both, using indwelling electrodes. The results demonstrate that the O2 determinations provide an additional parameter of study of these experimental models of asthma, and that it may be one of the more sensitive indicators of an induced airway response of the immediate-type. The hypoxia parallels the degree of severity of the respiratory response and demonstrates a further similarity of this model to human asthma.

Animals↗
PubMed1991

Mucosal nerves in endobronchial biopsies in asthma and non-asthma.

To investigate neural events within the airways in asthma, endobronchial biopsies were obtained by fibre-optic bronchoscopy from 8 atopic asthmatic subjects and 8 non-atopic healthy controls. The biopsies were immediately fixed on sampling and subsequently analysed for nerves using specific indirect immunofluorescence with antisera to the neural marker PGP 9.5 and to the neuropeptides vasoactive intestinal peptide (VIP), substance P (SP) and calcitonin gene-related peptide (CGRP). Nerves were present in all the biopsies from both subject groups, with no significant difference between the asthmatic and non-asthmatics. VIP-immunoreactive nerves were equally present in both subject groups, being localized to smooth muscle and glandular sites. No immunoreactive nerves to SP or CGRP could be identified in any biopsy at any location. These in vivo findings do not identify an anatomical neuronal imbalance in asthma.

Adult↗
PubMedDate not supplied

Does asthma education equal asthma intervention?

The complex, multifactorial problem of increasing asthma morbidity, especially in minority communities, will not be solved by unidimensional approaches. Appropriately targeted multidimensional intervention programs are needed to control the rising burden of asthma.

Asthma↗