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PubMedDate not supplied

An increasing number of your pediatric patients may have asthma: the demographics of asthma.

In light of the growing prevalence of children with asthma, dental practitioners should increase their awareness of the demographic characteristics of the disease and the associated use of health services. A review is provided of 1) the distribution of the disease in the pediatric and general populations, 2) the number of physician visits, 3) emergency room and hospital usage, and 4) mortality patterns.

Adolescent↗
PubMedDate not supplied

[Effectiveness of short courses of fasting in pre-asthma and asthma patients].

In patients with preasthma and bronchial asthma, short-term courses of fasting dietotherapy (FDT) with a 7-day fasting period proved to be effective, as evidenced by clinical-and-functional and laboratory investigations. The incidence rate of viral infections was much lower with short-term courses compared to long-term courses. Too low an effect, if any, with FDT short-term courses can be explained by excess of the patient's body weight. Short-term FDT courses with a 3-day fasting period have been found out to result in a significant decrease in the level of anxiety, as measured by Spilberger Anxiety Inventory.

Adult↗
PubMed2003

[Asthma attack out of control--what to do? Therapy of acute asthma exacerbation depends on severity].

Treatment of acute asthma exacerbation is determined by the severity of the attack, making it necessary to grade the latter using objective parameters such as clinical symptoms, respiratory rate, heart rate, oxygen saturation and FEV1 or PEF. Severity grading is also essential for the further management--need for early hospitalization--in particular in the case of risk patients. Apart from the treatment of hypoxia, first-line treatment comprises bronchodilation with beta-2-agonists. Anti-inflammatory measures applying corticosteroids are indicated, in particular in moderate to severe exacerbation, while inhalative anticholinergics and theophyline are available in addition when primary treatment fails, and in the case of severe exacerbations.

Acute Disease↗
PubMed2002

[Study of cellular inflammatory response with bronchoalveolar lavage in allergic asthma, aspirin asthma and in extrinsic infiltrating alveolitis].

The asthmatic inflammatory responses present different type of cells involved in this process, such as: Lymphocytes and Eosinophils. In experienced hands the bronchoalveolar lavage (BAL) is a well-tolerated and valuable tool for investigation of basic mechanisms in asthma and other immunological respiratory diseases. The purpose of this work was to study the different cells involved in asthmatic inflammatory responses in allergic and aspirin sensitivity patients and compared with Extrinsic Allergic Alveolitis patients (EAA) by BAL procedure. We studied 27 asthmatic patients. This group was divided by etiological conditions in: allergic asthmatic patients (a) (n: 19), (9 male and 10 female) demonstrated by reversible fall of FEV 1 (3) 20% and 2 or more positive skin test for common aeroallergens. The aspirin asthmatic patients (b) (n: 8) (5 male and 3 female) demonstrated by progressive challenge with aspirin and fall of FEV 1 (3) 20%. The third group with compatible symptoms and signs of EAA, demonstrated by lung biopsy, (n: 9) (8 male and 1 female) (c). We determined in all patients: Total IgE serum level by ELISA test. BAL was performed by standard procedure in all patients. The cells count were performed in BAL and were separated in Eosinophils, T lymphocytes defined by monoclonal anti CD 3 antibody, Lymphocytes CD 4 and CD 8 by monoclonal anti CD 4 and CD 8 antibodies respectively. The B lymphocytes defined by surface immunoglobulin isotypes IgG, IgM, IgA and IgE. The IgE level was in (a) 630 +/- 350 kU/L, in (b) it was 85 +/- 62 kU/L and in EAA (c) 55 +/- 23 kU/L, p < .0005. Eosinophil percentage in (a) was 25 +/- 13% of cells, in (b) was 28 +/- 15% of cells, NS, and 0 in (c), p < .0005. Lymphocytes T level was 43 +/- 15% of cells in (a), it was 32 +/- 15% of cells in (b) and it was 54 +/- 19% of cells in (c), NS. Lymphocytes CD 4 (+) level was 30 +/- 10% of cells in (a), it was 24 +/- 11% of cells in (b) and it was 8 +/- 6% of cells in (c), p < .005. Lymphocytes CD8 level was 8 +/- 6% of cells in (a), it was 7 +/- 4% of cells in (b) and it was 44 +/- 15% of cells in EAA (c), p < .005. Lymphocytes B level was 8 +/- 4% cells in (a), it was 2.9 +/- 2.5% cells in (b) and it was 3 +/- 2.7% of cells in (c), p < .025. The features described here suggest the importance of the Eosinophils and CD 4 +/- Lymphocytes in asthmatic response of allergic asthmatic patients as well as in aspirin sensitivity asthmatic patients. The LBA cellular profile of E.AA patients presented eosinophilia and CE8+ Lymphocite predominance when compared with both asthmatic cellular profile.

Adult↗
PubMed1978

Discriminant analysis of bronchial asthma by linear discriminant function with parameters of flow-volumes: discriminant analysis of bronchial asthma in young male non-smokers.

With the parameters of a flow-volume and a volume-time curve, the discriminant analysis of bronchial asthma is described. The subjects were classified into three groups (healthy adults, mild asthmatic patients and moderates ones). The difference of the mean vectors of the parameters of the three groups was made clear by the selection methods of the discriminant analysis between any two of the groups both with 6 parameters (%FVC, FEV1.0%, peak flow rate (PF), flow rate at 50% of FVC (V50), flow rate at 25% of FVC (V25), and V50/V25) and with 8 (6 parameters mentioned above and V75, V10). Forced expiratory volume in 1 second percent (FEV1.0%) or V50 was selected at the first step with 6 parameters, and V75 was selected at the first step with 8 parameters. Probabilities of misclassification with 8 parameters were lower than those with 6 ones and the probability of misclassification at the discriminant analysis between healthy adults and mild asthmatic patients with 8 parameters was 15.75% at the final step.

Adult↗
PubMed1992

[Lung function of adult patients with bronchial asthma or chronic obstructive lung disease prior to and following a 3-month-stay in the Dutch Asthma Center in Davos].

The effect of a multidisciplinary treatment for obstructive airway disease at high altitude has not been well established for adult patients. One hundred and fifty patients with obstructive airway disease were examined at admission and at discharge after a 3-month hospitalization period in an Alpine clinic. Body plethysmographic data were collected at admission and at discharge as was medication use. Patients were subdivided into three groups, one group (n = 34) with bronchial asthma, one group (n = 97) with moderately severe chronic obstructive pulmonary disease (COPD) and one group (n = 19) with severe COPD. The greatest improvement in lung function data occurred in the moderately severe COPD group (at discharge before salbutamol administration there was an increase in FEV1 of 6%, after salbutamol administration there was an increase in FEV1 of 7%). When we divided the patient groups into atopic and non-atopic, it appeared that the non-atopic moderately severe COPD group showed the greatest improvement in lung function variables. The histamine threshold (expressed in 10logPC20) improved only in the moderately severe COPD group. There was a reduction from mean 7.5 mg per day in oral corticosteroids use to mean 5.0 mg per day in the moderately severe COPD group. We conclude that after 3 months' multidisciplinary treatment in the Alpine climate there is an improvement in lung function and a reduction in medication use in patients with airflow limitation.

Albuterol↗
PubMed2004

[Exploring the knowledge of asthma, attitude and self-management behaviors of school age children with asthma in the Ping-Tung area].

The present correlational research was aimed at: exploring asthmatic children's knowledge of their disease, their attitude towards it, and their self-management behavior. Convenient sampling was used to recruit subjects. One hundred and sixty eight asthmatic children from 7 to 12 years old were recruited from 14 elementary schools in the Pintung area, Taiwan. The results showed: (1) a moderate-leveled standardized score of 57.26 for knowledge of the disease; a positive-leveled standardized score of 86.27 for attitude toward the disease; a moderate high-leveled standardized score of 69.34 for self-management behaviors; (2) no significant relationship between demographic information and self-management behavior; (3) a significant correlation between asthmatic knowledge and self-management behavior; (4) a significant correlation between attitude towards asthma and self-management behavior; and (5) knowledge of the disease and attitude towards the disease as important predictors of self-management behavior, together accounting for 23.9% of the total variance. Results of the present study could serve as a basis for future studies.

Asthma↗
PubMed1991

T cells and asthma. II. Regulation of the eosinophilia of asthma by T cell cytokines.

Peripheral blood eosinophilia of both allergic and nonallergic asthmatics was found to correlate with blood T cell activation and lymphokine production. A close correlation was shown between the increase of IL-2 receptor expressing T cells and the number of eosinophils. These in vivo activated T cells spontaneously released factors that prolonged eosinophil survival in vitro. The T cell derived lymphokines IL-5, GM-CSF and IL-3 were demonstrated to be responsible for prolonged eosinophil survival in vitro, and were identified in T cell supernatants and sera from asthmatics. In summary, T cell derived cytokines play an important regulatory function towards eosinophils in asthma.

Asthma↗
PubMed1989

[Biologically active substance levels in exhaled air from patients with pre-asthma and bronchial asthma].

Acetylcholine, serotonin, and histamine levels have been measured in exhaled air humor condensate in 65 patients aged 18 to 60, 44 ones with bronchial asthma and 21 with preasthma. Nonuniform release of biogenic amines and acetylcholine in pulmonologic patients depended on the severity of the inflammatory process in the bronchi, hypoxemia, bronchial obstruction, and reactivity of the bronchi examined during cold air breathing.

Acetylcholine↗
PubMed1975

Menaquinone (vitamin K2) therapy for bronchial asthma. II. Clinical effect of menaquinone on bronchial asthma.

A series of 191 patients with bronchial asthma were treated with menaquinone for not less than one year to investigate the clinical effects of the drug. The clinical effect may be summarized as follows: 1) The therapy with menaquinone only gave an effective rate oo 90.9% (a markedly effective rate of 42.4%) in mild patients, an effective rate of 86.7% (a markedly effective rate of 30.0%) in moderate patients, and effective rate of 72.7% (a markedly effective rate of 27.3%) in severe patients; namely, considerably a high effective rate was attained by the therapy in the respective patients. 2) The therapy with menaquinone, in conjunction with hyposensitization therapy, gave an effective rate of 100% (a markedly effective rate of 33.3%). 3) The double blind study of the clinical effects of menaquinone revealed that placebo used in the study was effective on only 16.7% of the patients treated with it, and that the incidence of recurrence due to withdrawal of meaquinone therapy tended to be low in the patients treated with the drug for a long period of time.

Asthma↗
PubMed1983

Mast cells and asthma. The role of mast cell mediators in the pathogenesis of allergic asthma.

Upon a specific allergic reaction mediators released from mast cells found free in the bronchial lumen or in the epithelial surface loosen the interepithelial cell tight-junctions allowing the entrance of more allergen to deeper mast cells. The primary and secondary mediators thereby generated induce further increased vascular permeability which leads to the entrance of plasma proteins and platelets. The other immediate responses induced by mediator release are smooth muscle constriction, mucus secretion and leukocyte chemoattraction. Vagal afferent and reflex efferent stimulation are induced by histamine and probably other mediators which might contribute both to the bronchospasm as well as mucous gland secretion. Subacute responses include increased cellular infiltrates, mucosal edema, desquamation, basement membrane thickening, goblet cell hyperplasia and mucus secretion. These responses may occur because of the continued release of primary and secondary mediators as well as effects caused by the mast cell granule matrix-derived factors. It can thus be seen that many of the pathologic features of asthma may be attributed to mast cell degranulation.

Airway Obstruction↗
PubMed1994

Oxidant and acid aerosol exposure in healthy subjects and subjects with asthma. Part II: Effects of sequential sulfuric acid and ozone exposures on the pulmonary function of healthy subjects and subjects with asthma.

These studies were undertaken to evaluate pulmonary responses of humans sequentially exposed to acidic aerosols and ozone at levels that could reasonably be encountered in actual environmental exposures. Subjects first were exposed to sulfuric acid (H2SO4) aerosol to sensitize the airways to ozone. The exposure protocols were designed to provide more quantitative information about the threshold levels of ozone that produce adverse biological effects and to provide exposure-response data on ozone. Two groups of 30 nonsmoking volunteers of both sexes, between the ages of 18 and 45 years, were recruited. The healthy study population comprised 16 men and 14 women with an average age of 28 years and no airway hyperreactivity. The second group comprised 10 men and 20 women comparable in age to the control group, but with allergic asthma and positive skin tests. The study examined an exposure-response relationship using three levels of ozone ranging from below the current standard to one and one-half times the ambient air quality standard (0.08, 0.12, and 0.18 ppm* [parts per million]) with preexposure 24 hours earlier to H2SO4 (100 micrograms/m3) or sodium chloride (NaCl) (control) aerosol in a 45-m3 environmental chamber. The study used an incomplete block design in which each subject was exposed to four of the six paired experimental atmospheres. Both the selection of paired exposures and the order in which they were presented were randomized. The exposure protocol required nine days: Day 1, training and baseline preexposure measurements; Day 2, the first of the three-hour particle (H2SO4 or NaCl) exposures; Day 3 (24 hours after Day 2), ozone exposure at 0.08, 0.12, or 0.18 ppm for three hours; Day 4 (two to four weeks later), exposure to the same ozone concentration as on Day 4. After at least another two weeks, Days 6, 7, 8, and 9 repeated Days 2, 3, 4, and 5 using a second ozone concentration. All three-hour exposures included several predetermined periods of exercise and pulmonary function measurements. To examine for delayed effects, pulmonary function tests were measured two and four hours after exposure on the ozone days. Data were analyzed over the time course of exposure and by exposure level of ozone at each time point to reveal dose-response relationships more closely. The main findings of the study are as follows. No significant symptomatic or physiologic effects of exposure to either aerosol or ozone on lung function were found for the healthy group.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed1995

[Nasal smear cytology in bronchial asthma: correlation of appearance and numbers of nasal smear mast cells, eosinophils or basophils and serum IgE antibodies to house dust mite in patients with bronchial asthma].

Nasal smear cytology was studied in pediatric patients with bronchial asthma with special reference with IgE RAST to house dust mite, Dermatophagoides pteronyssinus (Dp). Results obtained were as follows: (1) Numbers of eosinophils on the nasal smear correlated well with Dp RAST score, (2) mast cells were detected before Dp RAST becoming positive and appearance of eosinophils, (3) basophils appeared after detection of eosinophils and only in patients with nasal smear eosinophils. These results suggest that mast cells are the early marker for allergic inflammation and basophils and eosinophils appear in association with overt sensitization with house dust mite in house dust mite-sensitized asthmatic patients.

Adolescent↗
PubMed2003

5-Step asthma approach: managing acute asthma in 5 steps or less.

Asthma requires immediate and expert care. Definitive therapy can begin in the field with most patients, who will significantly improve by the time they arrive at the ED. Paramedics become expert caregivers when they provide oxygen, administer combined continuous nebulization of beta agonists and anticholinergics, and consider magnesium and epinephrine for asthmatics with severe symptoms.

Acute Disease↗