scholarly journals The Global Initiative for Asthma (GINA): 25 years later

2019 ◽  
Vol 54 (2) ◽  
pp. 1900598 ◽  
Author(s):  
Louis-Philippe Boulet ◽  
Helen K. Reddel ◽  
Eric Bateman ◽  
Søren Pedersen ◽  
J. Mark FitzGerald ◽  
...  
Keyword(s):  
Point Of Care ◽  
Scientific Information ◽  
Asthma Management ◽  
Treatment Guideline ◽  
Global Strategy ◽  
World Health ◽  
Care Practice ◽  
Evidence Based ◽  
Global Initiative For Asthma ◽  
Global Initiative

The Global Initiative for Asthma (GINA) was launched in 1993 under the auspices of the National Heart, Lung, and Blood Institute, National Institutes of Health, USA, and the World Health Organization to produce a global strategy on asthma management and prevention. Now constituted as a non-profit entity, it continues to produce, on an annual basis, the most widely cited evidence-based report on the optimal management of asthma in both adults and children intended for global use. Although the GINA Report is often viewed and used as an asthma treatment guideline, it is designed to be a clinically oriented strategy document that supports the development of practice guidelines in different countries and regions.Other GINA products, including the report's pocket guides, teaching slide kits and implementation tools, are also offered free of charge for public use. The GINA Scientific Committee comprises recognised international experts from primary, secondary and tertiary centres of care who are actively involved in both the care of patients and research in asthma. The GINA Assembly is a forum for exchange of scientific information and discussions on initiatives to improve asthma care in various countries, focusing on implementation strategies. GINA plays a role in shaping research on the diagnosis and treatment of asthma and informs the development of point of care practice guides and decision support tools. GINA supports the objectives of raising awareness of asthma and improving access to therapy and quality of care for asthmatic patients, in addition to presenting and promoting continuously updated evidence-based treatment approaches for global use.

scholarly journals Assessment of Asthma Control and Severity among Children According to Global Initiative for Asthma Guidelines in Sulaimani City-Iraq

2016 ◽  
Vol 12 (3) ◽  
pp. 160
Author(s):  
Adnan M. H. Hamawandi ◽  
Kosar M Ali ◽  
Ali Z. Naji
Keyword(s):  
Asthma Control ◽  
Objective Assessment ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Global Initiative For Asthma ◽  
Severe Persistent Asthma ◽  
Global Initiative ◽  
Gina Guidelines

Background: Asthma is a common and potentially serious chronic disease that imposes a substantial burden on patients, their families and the community. Objective: Assessment of the level of asthma control and severity in asthmatic children in Sulaimani city according to the global initiative for asthma (GINA) guidelines. Methods: A cross-sectional study of 82 patients who are known cases of asthma, aged 5 – 15 years , from 1st of March 2014 to 1st of August 2014. Results: Out of 82 patients in our study, 20.8%were classified as having intermittent asthma all of them have well controlled asthma, 42.7% of those classified as having mild persistent asthma 65.7% of them have well controlled asthma, 26.8% of those classified as having moderate persistent asthma 54.5% of them have partly controlled asthma, and 9.8%of those classified as having severe persistent asthma the majority of them 87.5% have uncontrolled asthma and none of them reached to the controlled asthma level according to GINA guidelines. Regarding the peak expiratory flow (PFT) we notice that 58.8% of asthmatic children who were classified as having intermittent severity, their PEF measurements ranged between 160- 250 l/min while those with severe persistent asthma 75% of them have readings between 50-150 l/min. Conclusion: Current levels of asthma control in the Sulaimani city fall far short of the goals specified in the GINA guidelines for asthma management. Also there is a strong correlation between PEF measurements and the level of asthma severity,

scholarly journals Comparing LAMA with LABA and LTRA as add-on therapies in primary care asthma management

2020 ◽  
Vol 30 (1) ◽  
Author(s):  
Alan Kaplan ◽  
J. Mark FitzGerald ◽  
Roland Buhl ◽  
Christian Vogelberg ◽  
Eckard Hamelmann
Keyword(s):  
Primary Care ◽  
Lung Function ◽  
Inhaled Corticosteroids ◽  
Asthma Management ◽  
Global Initiative For Asthma ◽  
Control Asthma ◽  
Global Initiative ◽  
Long Acting ◽  
Randomised Controlled ◽  
Meta Analyses

Abstract The Global Initiative for Asthma recommends a stepwise approach to adjust asthma treatment to the needs of individual patients; inhaled corticosteroids (ICS) remain the core pharmacological treatment. However, many patients remain poorly controlled, and evidence-based algorithms to decide on the best order and rationale for add-on therapies are lacking. We explore the challenges of asthma management in primary care and review outcomes from randomised controlled trials and meta-analyses comparing the long-acting muscarinic antagonist (LAMA) tiotropium with long-acting β2-agonists (LABAs) or leukotriene receptor antagonists (LTRAs) as add-on to ICS in patients with asthma. In adults, LAMAs and LABAs provide a greater improvement in lung function than LTRAs as add-on to ICS. In children, results were positive and comparable between therapies, but data are scarce. This information could aid decision-making in primary care, supporting the use of add-on therapy to ICS to help improve lung function, control asthma symptoms and prevent exacerbations.

scholarly journals Effective Asthma Management: Is It Time to Let the AIR out of SABA?

2020 ◽  
Vol 9 (4) ◽  
pp. 921
Author(s):  
Alan Kaplan ◽  
Patrick D. Mitchell ◽  
Andrew J. Cave ◽  
Remi Gagnon ◽  
Vanessa Foran ◽  
...  
Keyword(s):  
Asthma Management ◽  
Beta Agonist ◽  
Inhaled Corticosteroid ◽  
Short Acting ◽  
Asthma Symptoms ◽  
Beta Agonists ◽  
Global Initiative For Asthma ◽  
Global Initiative ◽  
Poor Outcomes ◽  
Fast Acting

For years, standard asthma treatment has included short acting beta agonists (SABA), including as monotherapy in patients with mild asthma symptoms. In the Global Initiative for Asthma 2019 strategy for the management of asthma, the authors recommended a significant departure from the traditional treatments. Short acting beta agonists (SABAs) are no longer recommended as the preferred reliever for patients when they are symptomatic and should not be used at all as monotherapy because of significant safety concerns and poor outcomes. Instead, the more appropriate course is the use of a combined inhaled corticosteroid–fast acting beta agonist as a reliever. This paper discusses the issues associated with the use of SABA, the reasons that patients over-use SABA, difficulties that can be expected in overcoming SABA over-reliance in patients, and our evolving understanding of the use of “anti-inflammatory relievers” in our patients with asthma.

scholarly journals Inflammatory Mechanism and Clinical Implication of Asthma in COVID-19

2021 ◽  
Vol 15 ◽  
pp. 117954842110427
Author(s):  
Vasa Adi Wisnu Wardana ◽  
Alfian Nur Rosyid
Keyword(s):  
Viral Infections ◽  
Public Health Problem ◽  
Chronic Inflammatory Disease ◽  
World Health ◽  
Inflammatory Mechanism ◽  
Global Initiative For Asthma ◽  
Asthma Patients ◽  
Control And Prevention ◽  
Global Initiative ◽  
Health Organization

Asthma is a chronic inflammatory disease of the respiratory tract that has become a public health problem in various countries. Referring to the Global Initiative for Asthma, the prevalence of asthma continues to increase especially in children. Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) that has declared a pandemic by the world health organization on March 2020. For many years, it has been known that people with asthma have a worse impact on respiratory viral infections. Asthma has been listed by the centers for disease control and prevention as one of the risk factors for COVID-19, although several studies have different results. SARS-CoV-2 utilizes angiotensin-converting enzyme 2 (ACE2) as its cellular receptor, and it has been known that the expression of the ACE2 receptor is reduced in asthma patients. This reduced expression could also be accounted from the therapy of asthma. This paper aims to discuss the pathophysiology of asthma and COVID-19 and the susceptibility of asthma patients in contracting COVID-19.

scholarly journals National Asthma Education and Prevention Program 2020 Guidelines: What’s Important for Primary Care

2021 ◽  
Vol 70 (6 Supplement) ◽  
Author(s):  
Murphy
Keyword(s):  
Primary Care ◽  
Prevention Program ◽  
Expert Panel ◽  
Asthma Management ◽  
Persistent Asthma ◽  
Asthma Severity ◽  
Asthma Education ◽  
Global Initiative For Asthma ◽  
Primary Care Clinicians ◽  
Global Initiative

KEY TAKEAWAYS • The 2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group provides updated recommendations for 6 topics related to the management of individuals with asthma. • The classification of asthma severity and asthma control, as well as the concept of utilizing a stepwise approach to pharmacologic treatment, were not updated from the Expert Panel Report 3, released in 2007. • However, important updates in preferred therapies for intermittent and persistent asthma at treatment steps 1 through 5 were suggested. • Recommendations regarding biologic therapy were not included in the 2020 update, as only evidence and US Food and Drug Administration approvals through October 2018 were considered. • The most recent 2021 Global Initiative for Asthma guidelines are not included in this review but can be used in a complementary manner to assist primary care clinicians to optimize decisions regarding the care of patients with asthma.

“Aspirin - resistance”? A few critical considerations on definition, terminology, diagnosis, clinical value, natural course of atherosclerotic disease, and therapeutic consequences

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 429-438 ◽  
Author(s):  
Berent ◽  
Sinzinger
Keyword(s):  
Platelet Function ◽  
Point Of Care ◽  
Aspirin Resistance ◽  
Point Of View ◽  
Evidence Based ◽  
Platelet Function Tests ◽  
Clinical Value ◽  
Vascular Events ◽  
Therapeutic Consequences ◽  
Function Tests

Based upon various platelet function tests and the fact that patients experience vascular events despite taking acetylsalicylic acid (ASA or aspirin), it has been suggested that patients may become resistant to the action of this pharmacological compound. However, the term “aspirin resistance” was created almost two decades ago but is still not defined. Platelet function tests are not standardized, providing conflicting information and cut-off values are arbitrarily set. Intertest comparison reveals low agreement. Even point of care tests have been introduced before appropriate validation. Inflammation may activate platelets, co-medication(s) may interfere significantly with aspirin action on platelets. Platelet function and Cox-inhibition are only some of the effects of aspirin on haemostatic regulation. One single test is not reliable to identify an altered response. Therefore, it may be more appropriate to speak about “treatment failure” to aspirin therapy than using the term “aspirin resistance”. There is no evidence based justification from either the laboratory or the clinical point of view for platelet function testing in patients taking aspirin as well as from an economic standpoint. Until evidence based data from controlled studies will be available the term “aspirin resistance” should not be further used. A more robust monitoring of factors resulting in cardiovascular events such as inflammation is recommended.

Determination of Antioxidant Activities and Bioactive Components of Foeniculum vulgare Mill. (Samonsabar)

2019 ◽  
Vol 30 (3) ◽  
pp. 16-22
Keyword(s):  
Antioxidant Activities ◽  
Biological Activities ◽  
Scientific Information ◽  
Ethanolic Extract ◽  
The Body ◽  
World Health ◽  
Gas Chromatography Mass Spectrometry ◽  
Molecular Formula ◽  
Bioactive Components ◽  
Foeniculum Vulgare

World Health Organization (WHO) estimated that 80% of the population of developing countries use traditional medicines, mostly natural plant products, for their primary health care needs. In the past few decades, the medicinal value of plants has been assumed more important dimension owing largely to the discovery that extracts from plants contain not only primary metabolites but also a diverse array of secondary metabolites with antioxidant potential. Medicinal plants are potential sources of natural compounds with biological activities and therefore attract the attention of researchers worldwide. Antioxidants are vital substances which possess ability to protect the body from damage due to free radical-induced oxidative stress. The purpose of current study was to determine the antioxidant activities and bioactive components of Foeniculum vulgare (fennel) (Samonsabar) seeds by using UV Visible Spectrophotometer (UV-Vis) and Gas Chromatography-Mass Spectrometry (GC-MS). Aqueous extract of fennel seeds showed more antioxidant activity (IC50: 0.28 ug/ml) than ethanolic extract (IC50: 0.83 ug/ml) and comparable to standard antioxidant, ascorbic acid (IC50: 0.59 ug/ml). GC-MS analysis was fruitful in identification of compounds based on peak area, retention time, molecular formula, molecular weight, MS Fragmentions and pharmacological actions. Ten bioactive phytochemical compounds from aqueous extracts and 11 from ethanolic extract of fennel seeds were identified. These findings indicated that fennel seeds are potential to provide preventive properties against oxidative damage. These results will give scientific information for quality control of indigenous drug to herbal medicine users and local practitioners using fennel for different types of ailments

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