Local adverse effects associated with the use of inhaled corticosteroids in patients with moderate or severe asthma

OBJECTIVE: To describe and characterize local adverse effects (in the oral cavity, pharynx, and larynx) associated with the use of inhaled corticosteroids (ICSs) in patients with moderate or severe asthma. METHODS: This was a cross-sectional study involving a convenience sample of 200 asthma patients followed in the Department of Pharmaceutical Care of the Bahia State Asthma and Allergic Rhinitis Control Program Referral Center, located in the city of Salvador, Brazil. The patients were ≥ 18 years of age and had been using ICSs regularly for at least 6 months. Local adverse effects (irritation, pain, dry throat, throat clearing, hoarseness, reduced vocal intensity, loss of voice, sensation of thirst, cough during ICS use, altered sense of taste, and presence of oral candidiasis) were assessed using a 30-day recall questionnaire. RESULTS: Of the 200 patients studied, 159 (79.5%) were women. The mean age was 50.7 ± 14.4 years. In this sample, 55 patients (27.5%) were using high doses of ICS, with a median treatment duration of 38 months. Regarding the symptoms, 163 patients (81.5%) reported at least one adverse effect, and 131 (65.5%) had a daily perception of at least one symptom. Vocal and pharyngeal symptoms were identified in 57 (28.5%) and 154 (77.0%) of the patients, respectively. The most commonly reported adverse effects were dry throat, throat clearing, sensation of thirst, and hoarseness. CONCLUSIONS: Self-reported adverse effects related to ICS use were common among the asthma patients evaluated here.

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The Identification and Description of Severe Asthma Patients in a Cross-Sectional Study —the Ideal Study

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2015.12.462 ◽

2016 ◽

Vol 137 (2) ◽

pp. AB103 ◽

Cited By ~ 2

Author(s):

Robert Y. Suruki ◽

Necdet Gunsoy ◽

Ji-Yeon Shin ◽

Jonas Daugherty ◽

Linda Nelsen ◽

...

Keyword(s):

Severe Asthma ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Asthma Patients ◽

Ideal Study ◽

The Ideal

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Systemic adverse events from inhaled corticosteroids self-reported by asthma patients: A “real-life” cross sectional study

Revista Portuguesa de Pneumologia (English Edition) ◽

10.1016/j.rppnen.2016.02.006 ◽

2016 ◽

Vol 22 (4) ◽

pp. 243-245

Author(s):

C.R. Pinto ◽

A.C.M. Lemos ◽

A.T. de Alcantara ◽

P.M.C. de Oliveira ◽

A.C.T. do Vale ◽

...

Keyword(s):

Adverse Events ◽

Inhaled Corticosteroids ◽

Real Life ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Asthma Patients

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Respiratory Adherence Care Enhancer Questionnaire: Identifying Self-Management Barriers of Inhalation Corticosteroids in Asthma

Frontiers in Pharmacology ◽

10.3389/fphar.2021.767092 ◽

2021 ◽

Vol 12 ◽

Author(s):

Claire D. Visser ◽

Jip M. Linthorst ◽

Esther Kuipers ◽

Jacob K. Sont ◽

Joyca P. W. Lacroix ◽

...

Keyword(s):

Inhaled Corticosteroids ◽

Theoretical Domains Framework ◽

Cross Sectional Study ◽

Individual Variability ◽

Self Management ◽

Expert Assessment ◽

Cross Sectional ◽

Asthma Patients ◽

Golden Standard ◽

Behavioral Barriers

Introduction: Suboptimal self-management of inhaled corticosteroids (ICS) in asthma patients is frequently observed in clinical practice and associated with poor asthma control. Driving factors for suboptimal self-management are complex and consist of a range of behavioral barriers (cognitive, affective and practical) with a considerable inter-individual variability. Identification of individual barriers facilitates the use of corresponding behavior change techniques and tailored care to improve asthma treatment outcomes.Objective: This study describes the development and validation of the ‘Respiratory Adherence Care Enhancer’ (RACE) questionnaire to identify individual barriers to self-management of ICS therapy in asthma patients.Methods: The development included: 1) an inventory of self-management barriers based on a literature review, 2) expert assessment on relevance and completeness of this set, linking these barriers to behavioral domains of the Theoretical Domains Framework (TDF) and 3) the formulation of corresponding questions assessing each of the barriers. A cross-sectional study was performed for validation. Primary care asthma patients were invited to fill out the RACE-questionnaire prior to a semi-structured telephonic interview as golden standard. Barriers detected from the questionnaire were compared to those mentioned in the interview.Results: The developed questionnaire is made up of 6 TDF-domains, covering 10 self-management barriers with 23 questions. For the validation 64 patients completed the questionnaire, of whom 61 patients were interviewed. Cronbach’s alpha for the consistency of questions within the barriers ranged from 0.58 to 0.90. Optimal cut-off values for the presence of barriers were determined at a specificity between 67 and 92% with a sensitivity between 41 and 83%. Significant Areas Under the Receiver Operating Curves values were observed for 9 barriers with values between 0.69 and 0.86 (p-value <0.05), except for ‘Knowledge of ICS medication’ with an insignificant value of 0.53.Conclusion: The RACE-questionnaire yields adequate psychometric characteristics to identify individual barriers to self-management of ICS therapy in asthma patients, facilitating tailored care.

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Prevalence and Severity of Adolescent Asthma in Yazd, Iran: Based on the 2020 Global Asthma Network (GAN) Survey

Iranian Journal of Allergy Asthma and Immunology ◽

10.18502/ijaai.v20i1.5410 ◽

2021 ◽

Author(s):

Nasrin Behniafard ◽

Zahra Nafei ◽

Mohsen Mirzaei ◽

Mehran Karimi ◽

Mahmood Vakili

Keyword(s):

Severe Asthma ◽

Inhaled Corticosteroids ◽

Cross Sectional Study ◽

Cluster Sampling ◽

Cross Sectional ◽

Common Chronic Disease ◽

Male Predominance ◽

The Past ◽

Yazd City ◽

Long Acting

Asthma, as the most common chronic disease in children, encompasses substantial health and socioeconomic burden worldwide. This study aimed to evaluate the prevalence, severity, and management of asthma in adolescents aged 13-14 years. This cross-sectional study, which was part of the Global Asthma Network (GAN) 2020 survey, was conducted in early 2020 in Yazd, Iran. A total of 48 schools in Yazd city were selected by cluster sampling. In this study, 5141 students, including 3069 (59.7%) females and 2072 (40.3%) males participated. Prevalence of ever and current wheezing was 19% and 9% respectively. The former was significantly higher in males than females (p<0.001). About 2% of the participants, which was 22.1% of students with current wheezing, had severe asthma. The prevalence of severe asthma was significantly higher in males (p=0.026). Our results showed that 4.8% of students had confirmed asthma by a doctor, significantly predominant in males (p<0.001). The prevalence of using inhaled medicines in the past 12 months was 3.8%, which was significantly higher in males than females (p<0.001). The prevalence of using short-acting β-agonists (SABA) and long-acting β-agonists (LABA) was 2.3% and 1.4% among the students, respectively, with a male predominance (p=0.019). About 1.2% and 0.8% of participants were using inhaled corticosteroids (ICS) and the combination of ICS and LABA, respectively, which was significantly higher in male participants (p<0.001). According to our findings and in comparison to the previous ISAAC study in Yazd, the prevalence of severe asthma has decreased which indicates better management of asthma during the past two decades.

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EFFICACY OF TREATMENT OF H.PYLORI EARDICATION WITH STANDARD TRIPLE THERAPY IN PEPTIC ULCER PATIENTS

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2011.3.17 ◽

2011 ◽

pp. 122-129

Author(s):

Quang Di Bui ◽

Phuoc Lam Nguyen

Keyword(s):

Peptic Ulcer ◽

Adverse Effects ◽

Triple Therapy ◽

Cross Sectional Study ◽

Cross Sectional ◽

Duodenal Ulcers ◽

Ulcer Disease ◽

Intention To Treat ◽

Standard Triple Therapy

Objectives: The aim of study is to evaluate the efficacy, tolerability and adverse effects of a standard triple therapy including Rabeprazole, Clarithromycin and Amoxicilline at Sai gon Hoan My hospital in order to consider treatment H.pylori for patients who have not yet eradicated before or need to be undertaked by alternative regimens. Methods: By descriptive cross-sectional study, the authors have examined 116 patients sufferring from peptic ulcer received 10-day therapy including Rabe (20mg b.d) plus Clari(500mg b.d) plus Amoxi(1g b.d). Eradication is confirmed with endoscopy after 4 weeks from completing of treatment. Results and Discussion: 100% of patients were initially included and noboby was dropped out of the follow-up satges. The mean age was 49 in which 62% was male, 73(62,9%) presented duodenal ulcer, 28(24,1%) gastric ulcer and 15(13%) simultaneous gastric and duodenal ulcers. All patients took medications correctly. Per-protocol and intention to treat eradication rates were both 75%(95% CI=73,4-78,3). Additionally, 62(53,4%) patients had at least one risky factor for peptic ulcer disease, smoking being the most common one 44(37,9%).The adverse effects were reported overall in 67% of the patients, mainly including changed taste, very bitter, tired 49%, trouble sleeping 12% and diarrhea 5%. Conclusion: this ten-day standard triple therapy used in this study is ineffective with high adverse effects.The first line eradication with new regimens should be alternative.

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Does COVID-19 change dietary habits and lifestyle behaviours in Kuwait: a community-based cross-sectional study

Environmental Health and Preventive Medicine ◽

10.1186/s12199-020-00901-5 ◽

2020 ◽

Vol 25 (1) ◽

Cited By ~ 3

Author(s):

Wafaa Husain ◽

Fatemah Ashkanani

Keyword(s):

Physical Activity ◽

Fast Food ◽

Dietary Habits ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Convenience Sample ◽

Lifestyle Behaviours ◽

Late Night ◽

Main Meal

Abstract Background The coronavirus pandemic has transformed and continues to transform and affect the daily lives of communities worldwide, particularly due to the lockdown restrictions. Therefore, this study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak. Methods A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults living in Kuwait (age range 18–73 years). Results The rate of skipping breakfast remained consistent, with a slight increase during the pandemic. Lunch remained the main reported meal before and during COVID-19. Compared to before COVID-19, people were much more likely have a late-night snack or meal during COVID-19 (OR = 3.57 (95% CI 1.79–7.26), p < 0.001). Moreover, there was a drastic decrease in the frequency of fast-food consumption during COVID-19, up to 82% reported not consuming fast food (p < 0.001). There was a significant increase in the percentage of participants who had their main meal freshly made (OR = 59.18 (95% CI 6.55–1400.76), p = 0.001). Regarding food group patterns, no significant differences were found before and during the pandemic in terms of the weekly frequency of consumption, except in the case of fish and seafood. There were no remarkable changes in beverage consumption habits among participants before and during the pandemic, except for Americano coffee and fresh juice. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants. Conclusion In general, this study indicates some changes in daily life, including changes in some eating practices, physical activity and sleeping habits during the pandemic. It is important that the government considers the need for nutrition education programmes and campaigns, particularly during this critical period of the pandemic in Kuwait.

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The usefulness of competitive PCR: airway gene expression of IL-5, IL-4, IL-4δ2, IL-2, and IFNγ in asthma

Thorax ◽

10.1136/thx.56.7.541 ◽

2001 ◽

Vol 56 (7) ◽

pp. 541-548

Author(s):

E M Glare ◽

M Divjak ◽

M J Bailey ◽

E H Walters

Keyword(s):

Gene Expression ◽

Inhaled Corticosteroids ◽

In Situ Hybridisation ◽

Housekeeping Gene ◽

Cross Sectional Study ◽

Mrna Levels ◽

Competitive Pcr ◽

Cross Sectional ◽

Steroid Use ◽

Biopsy Specimens

BACKGROUNDAsthma has been described as an eosinophilic bronchitis driven by interleukin(IL)-4 and IL-5. The quantification of cytokine mRNA levels in airway samples has been confounded by housekeeping gene expression which differs between and within asthmatics and controls.METHODSThe usefulness of competitive reverse transcriptase-polymerase chain reaction (RT-PCR) that is independent of housekeeping gene expression for quantitating the mRNA for interferon (IFN)γ, IL-2, IL-5, IL-4 and its receptor antagonist encoding splicing variant IL-4δ2 was determined in a cross sectional study of 45 normal control subjects and 111 with asthma.RESULTSAtopic controls and atopic asthmatic subjects expressed more IL-5 than non-atopic controls (p<0.02) in bronchoalveolar lavage (BAL) cells, but not in biopsy specimens. IL-5 mRNA expression in BAL cells from asthmatic subjects using inhaled corticosteroids (ICS) was significantly lower than those not receiving ICS (p=0.04). IL-2 mRNA levels differed with steroid use in biopsy specimens but not in BAL cells. IFNγ, IL-4, and IL-4δ2 mRNA levels did not differ between any groups and were not affected by steroid use. IL-4 and IL-4δ2 mRNA levels were positively correlated (p<0.0001), suggesting coordinated transcription.CONCLUSIONSWhile the signal differentiation of competitive PCR in asthma may rival that of in situ hybridisation and immunohistochemistry, the method is expensive and wasteful of material.

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From Stress to Psychopathology: Relationship with Self-Reassurance and Self-Criticism in Czech University Students

International Journal of Mental Health and Addiction ◽

10.1007/s11469-021-00516-z ◽

2021 ◽

Author(s):

Yasuhiro Kotera ◽

Jaroslava Dosedlova ◽

Denise Andrzejewski ◽

Greta Kaluzeviciute ◽

Makoto Sakai

Keyword(s):

Mental Health ◽

University Students ◽

Mental Health Problems ◽

Cross Sectional Study ◽

Health Problems ◽

Transactional Model ◽

Cross Sectional ◽

Convenience Sample ◽

Path Analyses ◽

As Stress

AbstractPsychological stress has become a major concern, potentially leading to diverse health problems including psychopathology such as depression and anxiety. Transactional Model of Stress and Coping is an established model, conceptualizing stressful experiences via person–environment relationship. This cross-sectional study aimed to explore the pathway from stress to depression/anxiety, with a focus on self-criticism (inadequate-self and hated-self) and self-reassurance (reassured-self) in Czech students who suffered from high prevalence of mental health problems. Convenience sample of 119 undergraduates completed the Depression Anxiety and Stress Scale-21 and the Forms of the Self-Criticizing/Attacking & Self-Reassuring Scale. Correlation and path analyses were conducted. The Strengthening the Reporting of Observational Studies in Epidemiology guidelines were used to aid an accurate and complete report of the study. Depression, anxiety, and stress were positively associated with inadequate-self and hated-self while negatively associated with reassured-self. Both inadequate-self and hated-self partially mediated the stress–depression and stress–anxiety relationships, whereas reassured-self only partially mediated the stress–depression relationship. Inadequate-self had greater impact on the stress–depression/anxiety pathways than hated-self and reassured-self. Findings indicate that clinical treatment may benefit from targeting the feelings of inadequacy to prevent stress progressing to psychopathology. This is particularly relevant as stress levels are rising globally. Our findings offer developments to the Transactional Model, and help practitioners and educators identify solutions to protect mental health of Czech university students.

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Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-11239-0 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Julien Fakhoury ◽

Claudine Burton-Jeangros ◽

Idris Guessous ◽

Liala Consoli ◽

Aline Duvoisin ◽

...

Keyword(s):

Social Support ◽

Social Networks ◽

Cross Sectional Study ◽

Future Research ◽

Undocumented Migrants ◽

Long Term Effects ◽

Residence Permit ◽

Cross Sectional ◽

Convenience Sample ◽

Self Rated Health

Abstract Background In Europe, knowledge about the social determinants of health among undocumented migrants is scarce. The canton of Geneva, Switzerland, implemented in 2017–2018 a pilot public policy aiming at regularizing undocumented migrants. We sought to test for associations between self-rated health, proven eligibility for residence status regularization and social and economic integration. Methods This paper reports data from the first wave of the Parchemins Study, a prospective study whose aim is to investigate the effect of residence status regularization on undocumented migrants’ living conditions and health. The convenience sample included undocumented migrants living in Geneva for at least 3 years. We categorized them into those who were in the process of receiving or had just been granted a residence permit (eligible or newly regularized) and those who had not applied or were ineligible for regularization (undocumented). We conducted multivariate regression analyses to determine factors associated with better self-rated health, i.e., with excellent/very good vs. good/fair/poor self-rated health. Among these factors, measures of integration, social support and economic resources were included. Results Of the 437 participants, 202 (46%) belonged to the eligible or newly regularized group. This group reported better health more frequently than the undocumented group (44.6% versus 28.9%, p-value < .001), but the association was no longer significant after adjustment for social support and economic factors (odds ratio (OR): 1.12; 95% confidence interval (CI): 0.67–1.87). Overall, better health was associated with larger social networks (OR: 1.66; 95% CI: 1.04–2.64). This association remained significant even after adjusting for health-related variables. Conclusion At the onset of the regularization program, access to regularization was not associated with better self-rated health. Policies aiming at favouring undocumented migrants’ inclusion and engagement in social networks may promote better health. Future research should investigate long-term effects of residence status regularization on self-rated health.

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Awareness and outcomes of the fruits and veggies (FNV) campaign to promote fruit and vegetable consumption among targeted audiences in California and Virginia: a cross-sectional study

BMC Public Health ◽

10.1186/s12889-021-11055-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tessa R. Englund ◽

Valisa E. Hedrick ◽

Sofía Rincón-Gallardo Patiño ◽

Lauren E. Kennedy ◽

Kathryn W. Hosig ◽

...

Keyword(s):

Fruits And Vegetables ◽

Vegetable Intake ◽

Behavioral Outcomes ◽

Cross Sectional Study ◽

Fruit And Vegetable Intake ◽

Brand Awareness ◽

Sectional Study ◽

Fruit And Vegetable ◽

Cross Sectional ◽

Convenience Sample

Abstract Background In 2015, the Partnership for a Healthier America launched the branded Fruits & Veggies (FNV) Campaign to apply a unique industry-inspired marketing approach to promote fruit and vegetable sales and intake to moms and teens in two US pilot markets: Fresno, California and Hampton Roads, Virginia. The aims of this cross-sectional study were to: 1) assess brand awareness and fruit- and vegetable-related outcomes among FNV Campaign target audiences in the California and Virginia market locations; and 2) examine whether reported awareness of the FNV Campaign was associated with differences in fruit- and vegetable-related cognitive and behavioral outcomes. Methods Data for this cross-sectional study were collected using an online survey administered to a non-probability convenience sample (n = 1604; February–July 2017) of youth aged 14–20 years (n = 744) and moms aged 21–36 years (n = 860) in the two pilot markets. Descriptive statistics were computed and outcomes compared between unaware and aware respondents, controlling for sociodemographic covariates. Multivariate analysis of covariance (MANCOVA) was conducted to assess whether fruit- and vegetable-related attitude, belief, and encouragement outcomes differed by FNV Campaign awareness; logistic regression was used to examine associations between FNV brand awareness and dichotomous variables (fruit- and vegetable-related behavioral intentions, trying new fruits and vegetables); and ANCOVA was used to assess associations with daily fruit and vegetable intake frequency. Results Approximately 20% (n = 315/1604) of respondents reported awareness of the FNV Campaign. Youth that reported awareness of the FNV Campaign (n = 167, 22.4%) had higher intentions to buy (p = 0.003) and eat (p = 0.009) fruits and vegetables than unaware respondents. Mothers that reported awareness of the FNV Campaign (n = 148, 17.2%) reported greater encouragement for friends and family to eat fruits and vegetables (p = 0.013) and were approximately 1.5 times more likely to report trying a new fruit or vegetable (p = 0.04) than mothers unaware of the Campaign. Daily fruit and vegetable intake frequency did not differ by Campaign awareness. Conclusions FNV Campaign awareness was associated with limited but positive short- and intermediate-term cognitive and behavioral outcomes among target audience respondents. These findings can inform future research to enhance understanding and improve the FNV Campaign as it is expanded to new markets nationwide.

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