scholarly journals Review of Single Centre Experience with Bronchial Thermoplasty in Obesity

2021 ◽  
Author(s):  
EKAMJEET RANDHAWA ◽  
Kartik Shenoy
Keyword(s):  
Severe Asthma ◽  
Average Weight ◽  
Loss Reduction ◽  
Hospitalization Rates ◽  
Post Procedure ◽  
Single Centre Experience ◽  
Before And After ◽  
Asthma Patients ◽  
Oral Steroids ◽  
Predominantly Female

Abstract BackgroundBronchial thermoplasty (BT) is a bronchoscopic procedure that aims to reduce symptoms in patients with severe asthma by delivering controlled radiofrequency activations to reduce airway smooth muscle mass who are uncontrolled despite adequate therapy.ObjectiveTo evaluate response and outcomes of BT in asthma patients with obesity.MethodsA retrospective review of patients who had BT for severe asthma performed at our institution. We examined baseline differences in eosinophil, IgE levels, controller agent uses before and after BT, symptomatology and exacerbation rates post-procedure. A comparative analysis was done using t-test for unequal variables for those reported to have benefitted from the procedure against those who did not.ResultsIn total 23 patients were studied, 18 (78%) noted benefit from BT. Patients were predominantly female, 21/23 (91%) with average BMI of 37.9 and 35.3 kg/m2 in improved and not improved groups. Patients with improvement following completion of all three BT procedures were likely to be weaned off chronic oral steroids or biologicals, reduced albuterol uses, report a subjective improvement in symptoms or reduced exacerbations within 1 year following completion of procedures. There was a statistically significant average weight loss reduction in the improved group compared to not benefitted of 6.4kg versus a gain of 2.5kg; hospitalization rates for exacerbations were higher than those reported in the AIR2 and PAS2 studies at 43%.ConclusionBT can be beneficial for obese patients with a potential decrease in exacerbations and reduced oral corticosteroid dosage and an anticipated increased rate of post-procedure exacerbation hospitalization.

scholarly journals Impact on hospitalization rates as a result of the implementation of a care programme for severe asthma patients in Espirito Santo, Brazil

2015 ◽  
Vol 8 ◽  
pp. A224
Author(s):  
Lyvia Barbosa Alves ◽  
Maria José Sartório ◽  
Faradiba Serpa ◽  
Rayane Fontoura Koch ◽  
Braga Neto ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Care Programme ◽  
Espírito Santo ◽  
Hospitalization Rates ◽  
Asthma Patients ◽  
Espirito Santo

scholarly journals Comparing Patient Characteristics, Clinical Outcomes, and Biomarkers of Severe Asthma Patients in Taiwan

Biomedicines ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 764
Author(s):  
Shih-Lung Cheng ◽  
Kuo-Chin Chiu ◽  
Hsin-Kuo Ko ◽  
Diahn-Warng Perng ◽  
Hao-Chien Wang ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Clinical Characteristics ◽  
Linear Models ◽  
Patient Characteristics ◽  
Emergency Department Visits ◽  
Receiver Operating Characteristic Curves ◽  
Increased Risk ◽  
Significant Difference ◽  
Asthma Patients ◽  
Patients At Risk

Purpose: To understand the association between biomarkers and exacerbations of severe asthma in adult patients in Taiwan. Materials and Methods: Demographic, clinical characteristics and biomarkers were retrospectively collected from the medical charts of severe asthma patients in six hospitals in Taiwan. Exacerbations were defined as those requiring asthma-specific emergency department visits/hospitalizations, or systemic steroids. Enrolled patients were divided into: (1) those with no exacerbations (non-exacerbators) and (2) those with one or more exacerbations (exacerbators). Receiver operating characteristic curves were used to determine the optimal cut-off value for biomarkers. Generalized linear models evaluated the association between exacerbation and biomarkers. Results: 132 patients were enrolled in the study with 80 non-exacerbators and 52 exacerbators. There was no significant difference in demographic and clinical characteristics between the two groups. Exacerbators had significantly higher eosinophils (EOS) counts (367.8 ± 357.18 vs. 210.05 ± 175.24, p = 0.0043) compared to non-exacerbators. The optimal cut-off values were 292 for EOS counts and 19 for the Fractional exhaled Nitric Oxide (FeNO) measure. Patients with an EOS count ≥ 300 (RR = 1.88; 95% CI, 1.26–2.81; p = 0.002) or FeNO measure ≥ 20 (RR = 2.10; 95% CI, 1.05–4.18; p = 0.0356) had a significantly higher risk of exacerbation. Moreover, patients with both an EOS count ≥ 300 and FeNO measure ≥ 20 had a significantly higher risk of exacerbation than those with lower EOS count or lower FeNO measure (RR = 2.16; 95% CI, 1.47–3.18; p = < 0.0001). Conclusions: Higher EOS counts and FeNO measures were associated with increased risk of exacerbation. These biomarkers may help physicians identify patients at risk of exacerbations and personalize treatment for asthma patients.

scholarly journals Trends in oral corticosteroids use in severe asthma: a 14-year population-based study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Mohsen Sadatsafavi ◽  
Amir Khakban ◽  
Hamid Tavakoli ◽  
Solmaz Ehteshami-Afshar ◽  
Larry D. Lynd ◽  
...  
Keyword(s):  
Severe Asthma ◽  
Poisson Regression ◽  
Population Based ◽  
Population Based Study ◽  
Factors Associated ◽  
Asthma Patients ◽  
Oral Corticosteroids ◽  
Administrative Health Databases ◽  
Time Since Diagnosis

Abstract Background Oral corticosteroids are important components of pharmacotherapy in severe asthma. Our objective was to describe the extent, trends, and factors associated with exposure to oral corticosteroids (OCS) in a severe asthma cohort. Methods We used administrative health databases of British Columbia, Canada (2000–2014) and validated algorithms to retrospectively create a cohort of severe asthma patients. Exposure to OCS within each year of follow-up was measured in two ways: maintenance use as receiving on average ≥ 2.5 mg/day (prednisone-equivalent) OCS, and episodic use as the number of distinct episodes of OCS exposure for up to 14 days. Trends and factors associated with exposure on three time axes (calendar year, age, and time since diagnosis) were evaluated using Poisson regression. Results 21,144 patients (55.4% female; mean entry age 28.7) contributed 40,803 follow-up years, in 8.2% of which OCS was used as maintenance therapy. Maintenance OCS use declined by 3.8%/calendar year (p < 0.001). The average number of episodes of OCS use was 0.89/year, which increased by 1.1%/calendar year (p < 0.001). Trends remained significant for both exposure types in adjusted analyses. Both maintenance and episodic use increased by age and time since diagnosis. Conclusions This population-based study documented a secular downward trend in maintenance OCS use in a period before widespread use of biologics. This might have been responsible for a higher rate of exacerbations that required episodic OCS therapy. Such trends in OCS use might be due to changes in the epidemiology of severe asthma, or changes in patient and provider preferences over time.

scholarly journals Clinical equivalency of Beclasone Eco Easi Breathe and Flixotide via MDI in asthma patients

2007 ◽  
pp. 74-81
Author(s):  
A. A. Visel ◽  
V. N. Seliverstov ◽  
I. Yu. Visel ◽  
V. A. Sergeev ◽  
N. M. Rakhmatullina
Keyword(s):  
Severe Asthma ◽  
Comparative Trial ◽  
Similar Efficacy ◽  
Heart Beat ◽  
Inhaled Steroids ◽  
Russian Version ◽  
Asthma Patients ◽  
Heart Beat Rate ◽  
Physical Findings

It is well known that efficacy of asthma treatment depends on a choice of a basic medication as well as on a delivery system. The aim of this study was a comparison of clinical efficacy of equal doses of beclomethasone dipropionate (Beclasone Eco Easi Breathe) and fluticasone propionate (Flixotide) via MDI. The study was designed as a randomized open prospective comparative trial. Findings of 26 patients with moderate and severe asthma of > 18 yrs old were analyzed, such as medical history, physical findings, spirometric and bronchodilating test results, heart beat rate and blood pressure, quality of life (QoL) using Russian version of AQLQ questionnaire. After the run-in period the patients randomly received Beclasone Eco Easi Breathe 500 to 1000 μg daily or Flixotide at the same doses for 4 weeks followed the cross-over change of the drugs for the next 4 weeks. After 1 month of the treatment, significant improvements in airflow parameters, need in short-acting β2 -agonists and QoL have been reported. After changing the drugs these effects have been maintained with no further reliable improvement. Thus, the study demonstrated similar efficacy and safety of these inhaled steroids that could be considered as being clinically equal in treatment of moderate and severe asthma.

scholarly journals Features of pulmonary haemodynamics and endothelium function in children with asthma

2007 ◽  
pp. 56-59
Author(s):  
E. A. Starovoytova ◽  
S. N. Ivanov ◽  
L. M. Ogorodova
Keyword(s):  
Right Ventricle ◽  
Severe Asthma ◽  
Systolic Pressure ◽  
Pulmonary Artery Systolic Pressure ◽  
Control Group ◽  
Pulmonary Hemodynamics ◽  
Vasomotor Function ◽  
Ultrasound Evaluation ◽  
Endothelium Function ◽  
Asthma Patients

Asthma patients (n = 79, 7 to 17 years of age) were divided into 3 groups according to asthma severity: mild (n = 23), moderate (n = 24), and severe asthma (n = 32). Asthma was diagnosed according to GINA (2002). Echocardiography, ultrasound evaluation of endothelium vasomotor function and measurement of nitrite anion concentration in exhaled breathe condensate (EBC) were performed in the all patients. Right ventricle dilatation and increase in the total pulmonary vascular resistance were revealed only in patients with severe asthma compared to the control group. Increase in pulmonary artery systolic pressure was significantly higher in the severe asthma patients compared both to the control group and mild asthma patients. Increased right ventricle pressure was accompanied by endothelium dysfunction in 48.1 % (38 patients). High EBC nitrite anion concentration (12.11 ± 1.72 μmol/L) was revealed in asthmatic children compared to control group (3,34 ± 1,58 μmol/L). The results suggest that childhood asthma is associated with morphological and functional abnormalities of pulmonary hemodynamics and endothelium function depending on severity of the disease.

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