Tiotropium for Adults with Inadequately Controlled Persistent Asthma

2013 ◽  
Vol 47 (1) ◽  
pp. 117-123 ◽  
Author(s):  
Katie S Adams ◽  
Denise K Lowe
Keyword(s):  
Clinical Trials ◽  
Pulmonary Function ◽  
Case Reports ◽  
Pulmonary Function Tests ◽  
Persistent Asthma ◽  
High Dose ◽  
Function Tests ◽  
Sparing Effect ◽  
Steroid Sparing

OBJECTIVE To review the literature evaluating the efficacy and steroid-sparing effect of tiotropium for inadequately controlled persistent asthma in adults. DATA SOURCES Information was obtained through a search of MEDLINE/PubMed (1966-October 2012), using the terms asthma and tiotropium. A further review of reference citations was performed to identify other relevant articles. STUDY SELECTION AND DATA EXTRACTION English-language case reports and clinical trials were reviewed. Publications evaluating the efficacy and steroid-sparing effect of tiotropium in adults with inadequately controlled persistent asthma were included in the review. One case report and 5 clinical trials met our criteria. DATA SYNTHESIS The ultimate goal for asthma management is to maintain disease control by preventing acute exacerbations while avoiding adverse medication effects. Inhaled corticosteroids (ICS) are part of all preferred maintenance regimens for persistent asthma. Unfortunately, persistent asthma remains inadequately controlled in some patients and concerns about serious adverse effects with long-term high-dose ICS treatment exist. Interest in the use of tiotropium to control asthma symptoms and reduce steroid requirements in inadequately controlled persistent asthma is emerging. Results of several trials indicate that tiotropium improves pulmonary function markers and reduces corticosteroid requirements. Moreover, the largest and longest published trial not only showed improvements in pulmonary function tests but also a reduction in corticosteroid use and an increase in the time to first exacerbation. CONCLUSIONS Although tiotropium use in treatment of persistent asthma appears to be promising, more robust clinical trials are needed to assess whether improved pulmonary function tests as well as a decrease in asthma exacerbations and corticosteroid requirements translate into improvements in quality of life. Additionally, the optimal patient population, long-term efficacy, and safety of tiotropium when delivered by various methods need to be determined before it can be recommended over current alternative asthma therapies.

scholarly journals Observational study of omeprazole for gastroesophageal reflux on pulmonary function in adult asthmatics

2017 ◽  
Vol 9 (2) ◽  
pp. 139-145
Author(s):  
Nattapong Jaimchariyatam ◽  
Phurin Haprasert ◽  
Sutep Gonchanvit ◽  
Somkiat Wongtim
Keyword(s):  
Gastroesophageal Reflux ◽  
Pulmonary Function ◽  
Asthma Control ◽  
Pulmonary Function Tests ◽  
High Dose ◽  
Uncontrolled Asthma ◽  
Act Scores ◽  
Function Tests ◽  
The Mean ◽  
Act Score

Abstract Background Asthma is a chronic inflammatory disease of airways. Gastroesophageal reflux disease (GERD) is known to be associated with worsening asthma. We hypothesized that treatment of GERD in asthmatics will improve asthma control and quality of life. We reviewed our experience of treatment of GERD in asthmatics in Thailand. Objectives To study the effects of omeprazole for treatment of GERD in patients with poorly controlled asthma on pulmonary function tests and asthma control test (ACT) scores. Methods This study was conducted at King Chulalongkorn Memorial Hospital between August 2009 and December 2010. Patients with partly controlled and uncontrolled asthma who were found to have GERD by 24 hour esophageal pH monitoring were administered omeprazole 40 mg per day for 8 weeks. Pulmonary function tests and ACT scores before and after treatment were compared at 4-weeks and 8-weeks follow up. Results Twenty four patients were included in this study. None of them had asthmatic attacks during the study. After 4 and 8 weeks of omeprazole treatment, the mean FEV1 (2.20 ± 0.64 L, 2.36 ± 0.58 L, respectively) and the mean ACT score (20.82 ± 3.30, 23.00 ± 1.69, respectively) were significantly higher than the pretreatment values (mean FEV1 1.99 ± 0.56 L and ACT score 16.36 ± 3.97) (P < 0.05). Conclusion High-dose omeprazole may improve pulmonary function and the level of asthma control in Thai patients with partly controlled or uncontrolled asthma and coexisting GERD.

scholarly journals Long-Term Pulmonary Function in Survivors of Childhood Cancer

2015 ◽  
Vol 33 (14) ◽  
pp. 1592-1600 ◽  
Author(s):  
Saro H. Armenian ◽  
Wendy Landier ◽  
Liton Francisco ◽  
Claudia Herrera ◽  
George Mills ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Cancer Survivors ◽  
Childhood Cancer ◽  
Comprehensive Evaluation ◽  
Pulmonary Function Tests ◽  
Childhood Cancer Survivors ◽  
High Dose ◽  
Healthy Controls ◽  
Function Tests ◽  
Over Time

Purpose This study was undertaken to determine the magnitude of pulmonary dysfunction in childhood cancer survivors when compared with healthy controls and the extent (and predictors) of decline over time. Patients and Methods Survivors underwent baseline (t1) pulmonary function tests, followed by a second comprehensive evaluation (t2) after a median of 5 years (range, 1.0 to 10.3 years). Survivors were also compared with age- and sex-matched healthy controls at t2. Results Median age at cancer diagnosis was 16.5 years (range, 0.2 to 21.9 years), and time from diagnosis to t2 was 17.1 years (range, 6.3 to 40.1 years). Compared with odds for healthy controls, the odds of restrictive defects were increased 6.5-fold (odds ratio [OR], 6.5; 95% CI, 1.5 to 28.4; P < .01), and the odds of diffusion abnormalities were increased 5.2-fold (OR, 5.2; 95% CI, 1.8 to 15.5; P < .01). Among survivors, age younger than 16 years at diagnosis (OR, 3.0; 95% CI, 1.2 to 7.8; P = .02) and exposure to more than 20 Gy chest radiation (OR, 5.6; 95% CI, 1.5 to 21.0; P = .02, referent, no chest radiation) were associated with restrictive defects. Female sex (OR, 3.9; 95% CI, 1.7 to 9.5; P < .01) and chest radiation dose (referent: no chest radiation; ≤ 20 Gy: OR, 6.4; 95% CI, 1.7 to 24.4; P < .01; > 20 Gy: OR, 11.3; 95% CI, 2.6 to 49.5; P < .01) were associated with diffusion abnormalities. Among survivors with normal pulmonary function tests at t1, females and survivors treated with more than 20 Gy chest radiation demonstrated decline in diffusion function over time. Conclusion Childhood cancer survivors exposed to pulmonary-toxic therapy are significantly more likely to have restrictive and diffusion defects when compared with healthy controls. Diffusion capacity declines with time after exposure to pulmonary-toxic therapy, particularly among females and survivors treated with high-dose chest radiation. These individuals could benefit from subsequent monitoring.

scholarly journals Effect of police training during the confinement period on some cardiopulmonary and hematological parameters in Khartoum, Sudan

2018 ◽  
Vol 6 (5) ◽  
pp. 1639
Author(s):  
Ahmed O. Ahmed ◽  
Isam M. Abdallah ◽  
Ibrahim A. Ali ◽  
Omer A. Musa
Keyword(s):  
Blood Pressure ◽  
Pulmonary Function ◽  
Police Officers ◽  
Pulmonary Function Tests ◽  
Hematological Parameters ◽  
Health Assessment ◽  
Police Training ◽  
Function Tests ◽  
History Of

Background: Pulmonary function tests (PFT) serve as a tool of health assessment and as a predictor of occupational fitness. Police officers must develop and maintain high levels of physical fitness for physical demanding tasks they perform. The training program starts with confinement of five to eight weeks according to the trainee. Previously it has been shown that the police students have better lung functions values compared to their civilian colleagues. In this study the effect of the confinement training on pulmonary function tests was investigated.Methods: Eighty one policemen trainee were randomly selected from a new batch in the faculty of police sciences and Law, the National Ribat University, Khartoum, Sudan at their starting confinement period. Subjects were medically fit with no history of Diabetes, Hypertension, Asthma or use of any long term medications. Pulmonary function tests (FVC, FEV1 and PEFR) were performed using a micro-plus spirometer. Blood pressure, pulse rate, and hemoglobin were measured. All these were repeated at the end of the confinement.Results: The age of participants ranged from 24 to 26 years. FVC, FEV1 and PEFR significantly increased after the confinement period. The blood pressure and the pulse significantly decreased. The weight of the participants decreased after the confinement but Hb significantly slightly increased.Conclusions: Regular police training during the confinement improved the pulmonary and cardiovascular reserve function.

scholarly journals Effect of Yoga (Pranayama) in Improving Pulmonary Function Tests In Pediatric Age Group: a One Year Prospective Study

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
A. R. Somashekar ◽  
B. C. Arun ◽  
Arpitha Pandurang ◽  
Dharmapuri Vidyasagar ◽  
Shivaraj Nallur Somanna ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Prospective Study ◽  
School Teacher ◽  
Pulmonary Function Tests ◽  
Final Visit ◽  
Age Group ◽  
Moderate Asthma ◽  
Function Tests ◽  
Better Than

Aim: The aim of the study is to find out the effect of pranayama in improving the values of pulmonary function tests, in school going children (of adolescent age group between 12 years to 15 years) having mild to moderate asthma and also not being on any long term medication for the same. Method: After taking a written informed consent from the school teacher in charge, the parents and the children group from a government high school in Bengaluru, the screening of the children for asthma was done. Initial pulmonary function tests were done after inhaling a bronchodilator for the diagnosis of mild and moderate asthma. The diagnosed children were not put on any long term medication. They were educated about pranayama and were also taught the methodology of performing pranayama and other yoga asanas. They were made to perform pranayama every day for 20-30 minutes, for a period of 1 year (during June 2017 – June 2018) under the teacher’s guidance and during this period they were examined periodically(every 3 months) for the improvement in their pulmonary function tests. Results: FEV% deteriorated in 16 children in the second visit and 20 children in the last visit. This could be explained by the disproportionate increase of FVC compared to FEV1.FEV% improved better than FVC in 40% (20)  of the children while the rest 60% (29) children’s improvement in FVC was better than FEV%. In the final visit around 11 children had no change in the PEFR values, which was significantly high when other lung functions were considered. Conclusion:  FEV1 has increased from first visit to fourth visit, but at each visit the increase was not significant. This suggests the beneficial effect of pranayama in improving FEV1 when it is practised regularly for prolonged duration. Thus our prospective study confirms that Pranayama could be one of the better alternative therapies that should be considered in adolescent asthma.  

scholarly journals Correlation of Height Parameter and Pulmonary Function Test with Grade of Allergic Rhinitis and Asthma in Children

2020 ◽  
Vol 5 (08) ◽  
pp. 349-352
Author(s):  
Sadaf Choudhary ◽  
Keya Rani Lahiri ◽  
Fehmida Najmuddin
Keyword(s):  
Allergic Rhinitis ◽  
Pulmonary Function ◽  
Pulmonary Function Test ◽  
Pulmonary Function Tests ◽  
Persistent Asthma ◽  
P Value ◽  
Function Tests ◽  
Function Test

Introduction: Allergic Rhinitis and Asthma adversely affects height in children and it could be considered as an objective tool to assess severity, compliance and lung functions in children. We studied the correlation between height and pulmonary function tests with classification of allergic rhinitis and asthma. Aims & Objectives: 1) To study the height parameter with the grade of asthma and allergic rhinitis 2) To evaluate the pulmonary function test with the severity of asthma and allergic rhinitis 3) To correlate height and pulmonary function test with the classification of asthma and allergic rhinitis. Material and Methods: A prospective study including 30 patients in the age group of 5-12 years diagnosed with allergic rhinitis (AR) and bronchial asthma was conducted in a private tertiary care hospital in Navi Mumbai. History was entered in a pre-designed proforma and height was measured using a calibrated stadiometer along with pulmonary function tests recorded at the initial and two visits, 3 months apart. Results: Height increased significantly in patients without AR (p-value<0.01), with mild intermittent (p-value=0.02) and mild persistent AR (p-value<0.01) on subsequent visits. Patients with intermittent, mild persistent and moderate persistent asthma showed a statistically significant increase in height (p-value<0.01) with subsequent assessments. No significant increase in height was noted in patients with moderate persistent AR (p-value=0.14) and severe persistent asthma (p-value=0.16). At baseline, the height correlated significantly with FEV1 (p value<0.01), FVC (p value<0.01), Pre and Post-PEFR (p value<0.01, each). This trend continued at the first follow up. At the second follow-up, height correlated significantly with all parameters of pulmonary function tests (p value<0.01 for FEV1, FVC, FEV1/FVC ratio and PEFR). Conclusion: Height correlation with classification of AR and Asthma along with pulmonary function test has emerged as a simple, safe, cost-effective method in assessing control and monitoring the disease.

scholarly journals Pulmonary function impairment measured by pulmonary function tests in long-term survivors of childhood cancer

Thorax ◽  
2011 ◽  
Vol 66 (12) ◽  
pp. 1065-1071 ◽  
Author(s):  
R. L. Mulder ◽  
N. M. Thonissen ◽  
H. J. H. van der Pal ◽  
P. Bresser ◽  
W. Hanselaar ◽  
...  
Keyword(s):  
Pulmonary Function ◽  
Childhood Cancer ◽  
Pulmonary Function Tests ◽  
Function Tests ◽  
Function Impairment ◽  
Survivors Of Childhood Cancer ◽  
Long Term Survivors
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