scholarly journals Asthma and COVID-19: Emphasis on Adequate Asthma Control

2021 ◽  
Vol 2021 ◽  
pp. 1-12
Author(s):  
David D. Nassoro ◽  
Leodegard Mujwahuzi ◽  
Issakwisa Habakkuk Mwakyula ◽  
Mwajabu K. Possi ◽  
Sylvester L. Lyantagaye
Keyword(s):  
Asthma Control ◽  
Seasonal Influenza ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Cell Mediated Immunity ◽  
Level Of Evidence ◽  
Increased Risk ◽  
Wide Availability ◽  
The Relationship ◽  
Increased Susceptibility

Asthmatics are at an increased risk of developing exacerbations after being infected by respiratory viruses such as influenza virus, parainfluenza virus, and human and severe acute respiratory syndrome coronaviruses (SARS-CoV). Asthma, especially when poorly controlled, is an independent risk factor for developing pneumonia. A subset of asthmatics can have significant defects in their innate, humoral, and cell-mediated immunity arms, which may explain the increased susceptibility to infections. Adequate asthma control is associated with a significant decrease in episodes of exacerbation. Because of their wide availability and potency to promote adequate asthma control, glucocorticoids, especially inhaled ones, are the cornerstone of asthma management. The current COVID-19 pandemic affects millions of people worldwide and possesses mortality several times that of seasonal influenza; therefore, it is necessary to revisit this subject. The pathogenesis of SARS-CoV-2, the virus that causes COVID-19, can potentiate the development of acute asthmatic exacerbation with the potential to worsen the state of chronic airway inflammation. The relationship is evident from several studies that show asthmatics experiencing a more adverse clinical course of SARS-CoV-2 infection than nonasthmatics. Recent studies show that dexamethasone, a potent glucocorticoid, and other inhaled corticosteroids significantly reduce morbidity and mortality among hospitalized COVID-19 patients. Hence, while we are waiting for more studies with higher level of evidence that further narrate the association between COVID-19 and asthma, we advise clinicians to try to achieve adequate disease control in asthmatics as it may reduce incidences and severity of exacerbations especially from SARS-CoV-2 infection.

scholarly journals Higher Omega-3 Index Is Associated with Better Asthma Control and Lower Medication Dose: A Cross-Sectional Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 74 ◽  
Author(s):  
Isobel Stoodley ◽  
Manohar Garg ◽  
Hayley Scott ◽  
Lesley Macdonald-Wicks ◽  
Bronwyn Berthon ◽  
...  
Keyword(s):  
Fatty Acids ◽  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Airway Disease ◽  
Cross Sectional Study ◽  
Erythrocyte Membranes ◽  
Omega 3 ◽  
Asthma Control Questionnaire ◽  
Cross Sectional

Asthma is a chronic inflammatory airway disease, associated with systemic inflammation. Omega-3 polyunsaturated fatty acids (n-3 PUFA) have established anti-inflammatory effects, thus having potential as an adjunct therapy in asthma. This study aimed to compare erythrocyte n-3 PUFA in adults with (n = 255) and without (n = 137) asthma and determine the relationship between erythrocyte n-3 PUFA and clinical asthma outcomes. Subjects had blood collected, lung function measured and Juniper Asthma Control Questionnaire (ACQ) score calculated. Fatty acids were measured in erythrocyte membranes by gas chromatography, and the omega-3 index (O3I) was calculated (% eicosapentaenoic acid + % docosahexaenoic acid). O3I was similar in subjects with and without asthma (p = 0.089). A higher O3I was observed in subjects with controlled or partially controlled asthma (ACQ < 1.5) compared to subjects with uncontrolled asthma (ACQ ≥ 1.5) (6.0% (5.4–7.2) versus 5.6% (4.6–6.4) p = 0.033). Subjects with a high O3I (≥8%) had a lower maintenance dose of inhaled corticosteroids (ICS) compared to those with a low O3I (<8%) (1000 μg (400–1000) versus 1000 μg (500–2000) p = 0.019). This study demonstrates that a higher O3I is associated with better asthma control and with lower ICS dose, suggesting that a higher erythrocyte n-3 PUFA level may have a role in asthma management.

scholarly journals Vitamin D Deficiency in Children with Chronic Renal Disease

2021 ◽  
Vol 9 (B) ◽  
pp. 1751-1757
Author(s):  
S. B. Dyussenova ◽  
M. Y. Gordiyenko ◽  
G. B. Serikova ◽  
S. A. Turlybekova ◽  
A. A. Issayeva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Growth ◽  
Chronic Renal Disease ◽  
Immune Disorders ◽  
Increased Risk ◽  
The Relationship ◽  
Increased Susceptibility

BACKGROUND: Vitamin D is essential for children and adults for healthy bone growth. Lack of this vitamin in children can cause rickets, and in adults, softening of the bones and an increased risk of fractures. Vitamin D deficiency can cause immune disorders, increased susceptibility to infections, the development of certain types of cancer, diabetes mellitus, and cardiovascular diseases. AIM: The article presents the literature data and the results of our own research on the analysis of the relationship between chronic kidney disease (CKD) and Vitamin D provision in children from 1 to 17 years old. The aim of the study was to establish the level of Vitamin D in children with different stages of CKD. METHODS: Between January 2020 and September 2020, we examined 40 children (16 boys and 24 girls). The patients’ age ranged from 1 to 17 years inclusive. RESULTS: Vitamin D deficiency was found in 62.5% of children with CKD. Vitamin D deficiency was noted in 25% of cases. The prevalence of Vitamin D deficiency correlates with a decrease in glomerular filtration rate. CONCLUSION: Determination of Vitamin D level in children with CKD is important for timely correction and prevention of further progression of CKD. Timely substitution therapy will improve the quality of life of a child with CKD and prevent the development of complications.

Considerations for asthma management and viral transmission in the era of COVID-19

2021 ◽  
Vol 42 (1) ◽  
pp. 93-96 ◽  
Author(s):  
Mitchell M. Pitlick ◽  
Avni Y. Joshi
Keyword(s):  
Inhaled Corticosteroids ◽  
Pediatric Population ◽  
Asthma Management ◽  
Viral Transmission ◽  
Subsequent Investigation ◽  
Conflicting Evidence ◽  
Increased Risk ◽  
Recent Position ◽  
Continued Use ◽  
Inhaled Glucocorticoids

Background: As the global COVID-19 pandemic has unfolded, there has been much debate surrounding the optimal management of patients with asthma who are at risk of or contract COVID-19, whether asthma and steroids are risk factors for severe COVID-19, and how transmissible the virus is among children. Objective: The objective of this study is to provide allergists and other clinicians with pearls pertaining to the management of patients with asthma in the setting of the COVID-19 pandemic and to provide some information regarding the risk of transmission among the pediatric population. Methods: Utilizing the case of one of our own patients with asthma who developed COVID-19 as context, we review the recent literature discussing the risk of COVID-19 in patients with asthma, the management of asthma medications in the time of the pandemic, and the risk of viral transmission. Results: Despite initial reports that asthma was a risk factor for developing severe COVID-19, subsequent investigation has shown that this is likely not true. Additionally, the use of systemic or inhaled glucocorticoids does not appear to increase the risk of severe COVID-19, but there is no evidence guiding the use of biologic therapy. There is conflicting evidence regarding the ability of children to transmit the virus. Conclusion: We provide pearls that asthma does not appear to be associated with an increased risk of COVID-19 and continued use of inhaled corticosteroids appears to be safe. While there is no evidence guiding the use of biologic therapies, a recent position paper suggests that they should be continued unless a patient contracts COVID-19, at which point they should be held until clinical recovery occurs.

scholarly journals The genetic variants of LINC-PINT are related to head and neck squamous cell carcinoma susceptibility in Chinese population

2021 ◽  
Author(s):  
Jincai Xue ◽  
Fang Dong ◽  
Tianchang Wang ◽  
Qinjiang Liu ◽  
Jun Wang ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Case Control Study ◽  
Neck Squamous Cell Carcinoma ◽  
Increased Risk ◽  
The Relationship ◽  
Control Study ◽  
Increased Susceptibility

Abstract Background: Head and neck squamous cell carcinoma (HNSCC) is the most leading incident tumor worldwide. Genetic factors act crucial role in the HNSCC progression. Our study is intent to explore the correlation of LINC-PINT polymorphism with the risk of HNSCC in Chinese population.Methods: The case-control study (including 537 HNSCC cases and 533 controls) was performed to determine the relationship between LINC-PINT polymorphisms and HNSCC susceptibility. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the associations.Results: The current study indicated that rs157916 and rs7781295 in the LINC-PINT gene have a strong significant correlation with HNSCC risk (OR 1.32, p = 0.042; OR 1.31, p = 0.016). Stratification analyses showed that rs157916 is related to the increased risk of HNSCC in age ≤ 46 years (OR 1.56, p = 0.029). Rs157916, rs16873842, rs7801029, and rs7781295 exhibited an enhanced risk of HNSCC in men (OR 1.82, p = 0.004; OR 1.61, p = 0.028; OR 1.53, p = 0.047; OR 1.62, p = 0.021). Besides, we found that rs16873842 significantly increased the risk of Nasopharyngeal SCC (OR 4.04, p = 0.015). Rs157916 (OR 1.39, p = 0.028) and rs7781295 (OR 1.30, p = 0.028) had a high susceptibility to Thyroid SCC.Conclusions: This research indicated that polymorphisms in the LINC-PINT gene are significantly associated with an increased susceptibility to HNSCC, which suggest that LINC-PINT polymorphisms have a significant role in prevention and diagnosis of HNSCC.

scholarly journals Association between Asthma Control and Exposure to Greenness and Other Outdoor and Indoor Environmental Factors: A Longitudinal Study on a Cohort of Asthmatic Children

2022 ◽  
Vol 19 (1) ◽  
pp. 512
Author(s):  
Giovanna Cilluffo ◽  
Giuliana Ferrante ◽  
Salvatore Fasola ◽  
Velia Malizia ◽  
Laura Montalbano ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Environmental Factors ◽  
Asthma Control ◽  
Vegetation Index ◽  
Normalized Difference Vegetation Index ◽  
Asthma Management ◽  
Asthmatic Children ◽  
Increased Risk ◽  
Passive Smoke ◽  
Unit Increase

Achieving and maintaining asthma control (AC) is the main goal of asthma management. Indoor and outdoor environmental factors may play an important role on AC. The aim of this longitudinal study was to evaluate the association between AC and exposure to greenness and other outdoor or indoor environmental factors in a cohort of asthmatic children. This study involved 179 asthmatic children (5–16 years). Parents were interviewed through a modified version of the SIDRIA questionnaire. AC was assessed at each visit. Exposure to greenness was measured using the normalized difference vegetation index (NDVI). A logistic regression model was applied for assessing risk factors for uncontrolled asthma (UA). Low NDVI exposure was a risk factor for UA (OR: 2.662, 95% CI (1.043–6.799)); children exposed to passive smoke during pregnancy had a higher risk of UA than those non-exposed to passive smoke during pregnancy (OR: 3.816, 95% CI (1.114–13.064)); and a unit increase in the crowding index was associated with an increased risk of UA (OR: 3.376, 95% CI (1.294–8.808)). In conclusion, the current study provided a comprehensive assessment of urban-related environmental exposures on asthma control in children, using multiple indicators of greenness and other outdoor or indoor environmental factors.

scholarly journals What Is New Since the Last (1999) Canadian Asthma Consensus Guidelines?

2001 ◽  
Vol 8 (suppl a) ◽  
pp. 5A-27A ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Tony R Bai ◽  
Allan Becker ◽  
Denis Bérubé ◽  
Robert Beveridge ◽  
...  
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Environmental Control ◽  
Treatment Plan ◽  
Airflow Obstruction ◽  
Asthma Management ◽  
Consensus Guidelines ◽  
Number Of Patients ◽  
The Impact

The objective of the present document is to review the impact of new information on the recommendations made in the last (1999) Canadian Asthma Consensus Guidelines. It includes relevant published studies and observations or comments regarding what are considered to be the main issues in asthma management in children and adults in office, emergency department, hospital and clinical settings. Asthma is still insufficiently controlled in a large number of patients, and practice guidelines need to be integrated better with current care. This report re-emphasises the need for the following: objective measures of airflow obstruction to confirm the diagnosis of asthma suggested by the clinical evaluation; identification of contributing factors; and the establishment of a treatment plan to rapidly obtain and maintain optimal asthma control according to specific criteria. Recent publications support the essential role of asthma education and environmental control in asthma management. They further support the role of inhaled corticosteroids as the mainstay of anti-inflammatory therapy of asthma, and of both long acting beta2-agonists and leukotriene antagonists as effective means to improve asthma control when inhaled corticosteroids are insufficient. New developments, such as combination therapy, and recent major trials, such as the Children’s Asthma Management Project (CAMP) study, are discussed.

scholarly journals Management of Asthma with ICS and LABAs: Different treatment strategies

2009 ◽  
Vol 1 ◽  
pp. CMT.S2283
Author(s):  
M Van Den Berge ◽  
NHT Ten Hacken ◽  
HAM Kerstjens ◽  
DS Postma
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Treatment Strategies ◽  
Rapid Onset ◽  
Onset Of Action ◽  
Persistent Symptoms ◽  
Patient Symptom ◽  
Asthma Patients ◽  
Long Acting

In recent years considerable insight has been gained in the optimal management of adult asthma. In asthma patients who have persistent symptoms despite the daily use of (a low dose) inhaled corticosteroids (ICS), adding a long-acting β2-agonist to ICS improves asthma control and decreases the number of exacerbations. Currently two different LABAs are available, ie formoterol and salmeterol. The most important difference between both LABAs is a more rapid onset of action of formoterol (2-5 minutes) when compared to salmeterol (15-30 minutes). Partly based on these pharmacological differences, two major different approaches have been put forward to asthma management. The first approach (Gaining Optimal Asthma Control) is promoted by the producers of fluticasone/salmeterol and recommends to step up ICS to the dose needed to achieve optimal asthma control in order to keep the patient symptom free and to prevent exacerbations. The second approach is promoted by the producers of budesonide/formoterol and recommends a low maintenance dose which can be adjusted up or down according to the clinical control of asthma. Initially, a treatment strategy with Adjustable Maintenance Dosing with budesonide/formoterol was introduced. At a later time, this concept was changed to the Symbicort Maintenance And Reliever Therapy (SMART) approach. The aim of this manuscript is to review the current literature on the management of asthma with ICS and LABAs and to discuss the different treatment strategies.

scholarly journals Clinical utility of fractional exhaled nitric oxide in severe asthma management

2020 ◽  
Vol 55 (3) ◽  
pp. 1901633 ◽  
Author(s):  
Andrew Menzies-Gow ◽  
Adel H. Mansur ◽  
Christopher E. Brightling
Keyword(s):  
Nitric Oxide ◽  
Severe Asthma ◽  
Inhaled Corticosteroids ◽  
Healthcare Providers ◽  
Asthma Management ◽  
Cost Effective ◽  
Chronic Inflammatory Disease ◽  
Initial Diagnosis ◽  
Increased Risk ◽  
The Usa

Asthma is a chronic inflammatory disease of the airways, affecting over 350 million people worldwide and placing a significant burden on healthcare providers and wider society. Approximately 5–10% of asthma patients are diagnosed with severe asthma and typically are associated with increased risk of hospitalisation from exacerbations, increased morbidity, mortality and higher asthma-associated healthcare costs. Nitric oxide (NO) is an important regulator of immune responses and is a product of inflammation in the airways that is over-produced in asthma. Fractional exhaled NO (FeNO) is predominantly used as a predictor of response to inhaled corticosteroids (ICSs), to monitor adherence and as a diagnostic tool in ICS-naïve patients. In the UK, the National Institute for Health and Care Excellence (NICE) guidelines recommend the use of FeNO for the initial diagnosis of patients with suspected asthma. In the USA, American Thoracic Society (ATS) guidelines recommend FeNO as part of the initial diagnosis of asthma and for monitoring of airway inflammation. FeNO has also been shown to be a predictive factor for asthma exacerbations, with higher levels being associated with a greater number of exacerbations. In addition, higher levels of FeNO have been shown to be associated with a decline in lung function. FeNO testing is a cost-effective procedure and has been shown to improve patient management when combined with standard assessment methods. Recent evidence suggests that FeNO may also be useful as a surrogate biomarker for the assessment and management of severe asthma and to predict responsiveness to some biological therapies.

scholarly journals Does adherence to inhaled corticosteroids predict asthma-related outcomes over time? A cohort study

2019 ◽  
Vol 54 (6) ◽  
pp. 1900901 ◽  
Author(s):  
Alexandra L. Dima ◽  
Eric van Ganse ◽  
Gertraud Stadler ◽  
Marijn de Bruin
Keyword(s):  
Asthma Control ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Text Messages ◽  
Current Evidence ◽  
Computer Assisted ◽  
Longitudinal Models ◽  
The Impact ◽  
Over Time

Inhaled corticosteroids (ICS) adherence is important for asthma management. Current evidence on the impact of ICS adherence on outcomes is mostly based on correlational analyses of between-person data. Although it is widely acknowledged that asthma outcomes fluctuate over time, evidence on predictors of within-person change is scarce. We aimed to quantify these fluctuations and the longitudinal relationships between ICS adherence and outcomes at both between- and within-person levels.A prospective cohort of persistent asthma patients in France and the UK (n=847, age 6−40 years) provided 3756 reports over up to 2 years via computer-assisted telephone interviews and text messages on ICS adherence, asthma control, reliever medication use and exacerbations. We examined adherence−outcome relationships via longitudinal models, controlling for confounders, including severity.Considerable within-person variability was found for exacerbations (91%), asthma control (59%) and reliever use (52%); 431 (11.5%) reports signalled exacerbations and 2046 (54.5%) poor control. At between-person level, patients with higher average adherence were more likely to report asthma control (OR 1.25, 95% CI 1.06−1.47), but not asthma exacerbations (OR 0.99, 95% CI 0.87−1.12) or lower reliever use (b −0.0004, 95% CI −0.089−0.088). At within-person level, higher-than-usual adherence was associated with higher concomitant reliever use (b 0.092, 95% CI 0.053−0.131) and lower subsequent reliever use (b −0.047, 95% CI −0.005− −0.088); it was unrelated to asthma control (OR 0.93, 95% CI 0.84−1.02) or exacerbations (OR 1.04, 95% CI 0.94−1.16).Patients maintaining high ICS adherence over time have better asthma control. Temporarily increasing ICS adherence tends to be simultaneous to higher reliever use and reduces reliever use later on. Causes of within-person variation in outcomes require more investigation.

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