scholarly journals FEATURES OF BRONCHIAL ASTHMA CONTROL AND COURSE IN CHILDREN WITH AN ALTERNATIVE ONSET OF THE DISEASE

2020 ◽  
Vol 8 (4) ◽  
pp. 383-392
Author(s):  
О.К. Koloskova ◽  
Т.М. Bilous ◽  
N.O. Shevchenko ◽  
V.V. Bilous

Despite the large number of studies on the diagnosis and treatment of asthma and the constant updating of recommendations for the provision of medical care to patients with asthma, this disease still has a significant impact on the quality of life of patients and their families and significant economic losses. However, the peculiarities of bronchial asthma and the diagnosis of certain phenotypes of the disease in children, depending on biomarkers of inflammatory activity in the airways, require greater use of non-invasive diagnostic procedures and optimization of individualized treatment depending on the nature and intensity of inflammation in the respiratory tract.

2021 ◽  
Vol 8 (4) ◽  
pp. 21-32
Author(s):  
T.V. Shestakova ◽  
I.A. Kirshchina

RELEVANCE. Bronchial asthma, along with cardiovascular and oncological diseases, is one of the three most common chronic non- communicable diseases. For the most part, anti-asthmatic drugs (LP) are presented in the form of aerosols, powders, solutions for inhalation and other dosage forms intended for administration directly into the human respiratory tract. It is obvious that misunderstanding of the method of application and / or insufficient effectiveness of LP due to improper use can lead to a decrease in patients’ adherence to the prescribed therapy. In this regard, the availability of pharmaceutical information in the instructions becomes important, i.e. the more accessible the information in the instructions is to the patient, the higher the probability of proper use of the drug, maintaining patient compliance and preserving the patient’s quality of life. PURPOSE. The aim of the study was to analyze the completeness of pharmaceutical information provided in the instructions for the medical use of anti-asthmatic drugs (LP) and on the websites of manufacturing companies, from the standpoint of patients’ compliance with the rules for the use of LP. The main objectives of the analysis were: identification of the proportion of anti- asthmatic drugs that have a detailed scheme of use in the instructions; analysis of the instructions of anti-asthmatic drugs from the position of having indications of additional features of the use / use of drugs; analysis of instructions for anti-asthmatic drugs, the use of which is possible for groups of patients with physical or cognitive disabilities; identification of the share of companies producing anti-asthmatic drugs that support patients by conducting a specialized consulting service on the use of drugs. METHODS. The assessment of the quality of pharmaceutical information for patients was carried out on the basis of an analysis of 165 instructions for the medical use of pharmacotherapeutic groups of drugs designated in GINA-2021 (Global Initiative for Asthma-2021) and Federal Clinical Guidelines for the Treatment of Bronchial Asthma of the Russian Respiratory Society (2019) as anti-asthmatic drugs. The analysis was also carried out in relation to the information content of the websites of anti-asthmatic LP manufacturers, additionally, by creating a direct search query, the presence of a private page on the Internet for specific LP was determined. In the course of the research, methods of logical, comparative analysis, as well as generalization and grouping were used. To process the results obtained, the Excel computer program of the Microsoft Office 10 package was used. RESULTS. As a result of the analysis, it was revealed that the vast majority of anti-asthmatic drugs of all the studied pharmacotherapeutic groups are intended for administration directly into the respiratory tract, the article presents the results of a study on the ratio of inhaled and non-inhaled dosage forms in the context of the analyzed pharmacotherapeutic groups. The article presents data on the proportion of anti-asthmatic drugs that have a detailed description in the instructions in addition to the standard method of application (figure, diagram, pictogram) the method of introduction / use of LP. The fact of the absence of a detailed method of application in the instructions of various pharmacotherapeutic groups has been established. The results of the analysis of the number of instructions with the additional properties of LP indicated in them, allowing the use of LP data in patients with physical or cognitive characteristics (limitations), are presented. The number of companies producing anti-asthmatic drugs that have posted detailed information for consumers regarding the use of these drugs on their websites, as well as the number of drugs that have their own website, has been revealed. CONCLUSION. The information in the instructions for the medical use of anti-asthmatic drugs and on the official websites of the manufacturing companies (holders of registration certificates) of the studied drugs is not always exhaustive in terms of the use of inhaled dosage forms, which does not fully ensure the safe and effective receipt of anti-asthmatic pharmacotherapy. According to the authors, improving the quality of information for patients about the rules of using drugs for the treatment of bronchial asthma will simplify the use of dosage forms specific for its therapy, increase patients’ adherence to prescribed pharmacotherapy, reduce the risks from insufficient effectiveness of anti-asthmatic pharmacotherapy and preserve the quality of life of patients associated with the disease.


2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Samiaa Hamdy Sadek ◽  
Maha Mohamed El-kholy ◽  
Fareda Ahmed Mohammed ◽  
Reham Mohammed El-Morshedy

Abstract Background Poorly controlled bronchial asthma limits patients’ quality of life (QOL), the condition which may potentiate the development of psychiatric disorders. The aim of this study was the assessment of anxiety and depression in bronchial asthma patients, and their interrelation with both level of asthma control and quality of life in our society. Results This study included 102 bronchial asthma patients, and 50 healthy control individuals. Patients had poorer QOL, and higher anxiety and depression scores compared to healthy control, moreover these scores were higher in uncontrolled asthma patients compared to controlled group. Poor QOL, frequent hospital admissions, and poor asthma control were the predictors for psychiatric disorders. Conclusion Depression and anxiety are frequently encountered in patients with bronchial asthma in our society; poor symptom control, poor QOL, and frequent hospital admissions are the main predictors for these psychiatric disorders.


2021 ◽  
Vol 2021 (4) ◽  
pp. 14-20
Author(s):  
Yu. I. Feshchenko ◽  
◽  
L. A. Iashyna ◽  
G. L. Gumeniuk ◽  
V. I. Ignatieva ◽  
...  

THE EFFICACY OF COMBINED THERAPY IN PATIENTS WITH NEUTROPHILIC BRONCHIAL ASTHMA Yu. I. Feshchenko, L. A. Iashyna, G. L. Gumeniuk, V. I. Ignatieva, M. A. Polianska, S. G. Opimakh, I. V. Zvol, S. M. Moskalenko, N. A. Vlasova, L. A. Halai State organization «F. G. Yanovsky National institute of phthisiology and pulmonology National Academy of medical sciences of Ukraine» , Kyiv, Ukraine Abstract. Background: Issues of neutrophilic bronchial asthma remain unresolved and the investigations of the pathogenesis and treatment of this disease endotype are currently continuing. The aim of the study: This study aimed to develop the technology of the treatment of the neutrophilic asthma with the use of available drugs in Ukraine. Methods. The study involved 30 patients with neutrophilic asthma. The first (control) group consisted of 15 patients who received standard therapy with a combination of budesonide and formoterol. The second (main) group consisted of 15 patients who received the treatment according the technology (ultrafine beclomethasone dipropionate, formoterol, tiotropium bromide and additionally for the first 10 days — inhalation of 10.0 % acetylcysteine solution through a nebulizer). All patients were surveyed with the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ). The quality of life of patients was assessed by a St. George’s Respiratory Questionnaire. All patients underwent spirometry and a 6-minute walking test (6MWT). Results: In the prescription of complex therapy to patients with neutrophilic asthma clinical and functional efficacy was achieved in 93.3 % of patients. There were observed statistically significant increase in the ACT from (14.3 ± 1.3) to (20.3 ± 0.8) points (p < 0.05), a decrease in the ACQ from (2.3 ± 0.2) ) to (1.1 ± 0.1) points (p < 0.05), clinically significant reduction in the number of symptoms from (71.4 ± 5.6) points to (51.3  5.0) points, p < 0.05 according to the results of the St. George’s Respiratory Questionnaire, and a statistically significant increase in MEF50 from (28.9 ± 4.5) % to (41.6 ± 4.2) %, p < 0.05, MEF25 — from (19.1 ± 2.9) % to (27.6 ± 2.6) %, p < 0.05 and FEV1 /FVC from (67.2 ± 3.5) % to (76.1 ± 2.3) %, p < 0.05 after 3 months of complex treatment, as well as a statistically significant increase in the number of meters passed in the 6MWT from (266.3 ± 16.2) m to (312.0 ± 14.4) m, p < 0.05, reduction of shortness of breath on the Borg scale before test from (2.5  0.3) points to (1.5 ± 0.1) points, p < 0.05 and after the test — from (4.1 ± 0.3) points to (3.1 ± 0.3) points, p < 0.05. Conclusions: The technology of treatment of patients with neutrophilic asthma allows to improve the control of the asthma symptoms and quality of life of the patients, bronchial patency at the small airways and reduce fixed bronchial obstruction, as well as increase exercise tolerance. Key words: bronchial asthma, neutrophilic inflammation, combined therapy.


2020 ◽  
Vol 15 (6) ◽  
pp. 831-839
Author(s):  
G. F. Andreeva ◽  
M. I. Smirnova ◽  
V. M. Gorbunov ◽  
A. S. Kurekhyan ◽  
Ya. N. Koshelyaevskaya

Aim. To study the seasonal indicators of quality of life and control of bronchial asthma in hypertensive patients with bronchial asthma, observed by a cardiologist of the state outpatient institution.Material and methods. Data from a prospective cohort study of hypertensive patients, some of which had bronchial asthma without exacerbation, were analyzed. Patients who were observed by a cardiologist at a state outpatient clinic took part in the study. There were other concomitant diseases that occurred in the participants, in addition to hypertension and bronchial asthma. Two groups of patients were formed: the control group (n=85) included patients with hypertension only, the main group (n=40) included hypertension and bronchial asthma. Patients had 3 visits: initial one, and after 6 and 12 months and then data on outcomes (30.1Ѓ}7.6 months of follow-up) were collected. The first and third visits included clinical measurements of blood pressure (BP), 24-hour BP monitoring, spirometry, clinical and biochemical blood tests, a standard survey, survey with questionnaires evaluating the control of bronchial asthma (Asthma Control Questionnaire; ACQ) and the patients quality of life (General Well-Being Questionnaire; GWBQ). The second visit included clinical BP and ACQ and GWBQ questionnaires. A comparison of the average indicators from the total number of observations carried out in winter, spring, summer and autumn periods has been performed.Results. Hypertensive patients with/without bronchial asthma (n=125; 28 men, 97 women, average age 62.6Ѓ}8.8 years, duration of hypertension – 11.6Ѓ}8.6, duration of bronchial asthma – 9.3Ѓ}11.9 years) took part in the study. Outpatient BP levels throughout the study period were maintained at target values in both groups. It was shown that seasonal BP levels do not differ in the compared groups, except for winter indicators: winter daytime systolic BP levels were higher in the main group (p=0.03). Seasonal fluctuations in BP were not detected in the control group, however, they were present in the patients of the main group: winter daytime levels of diastolic BP and average daily levels of diastolic BP and systolic BP were higher than summer ones, and winter daytime systolic BP values (p<0.05) and clinical diastolic BP (p=0.004) – higher than autumn levels. Seasonal quality of life indicators in the main group were worse than in the control group in all seasons. Significant seasonal dynamics of quality of life indicators in patients in two groups was not detected. The ACQ questionnaire showed that asthma control changed in different seasons in accordance with the ACQ total score: in winter and spring – uncontrolled bronchial asthma (total score >1.5), in summer and autumn – partially controlled (total score ≤1.5). During the analysis of various factors associated with the combined primary endpoint (death, transient ischemic attack, angina pectoris, cardiac arrhythmias, arterial revascularization), relationships with quality of life indicators were revealed: negative connections – with indicators characterizing positive psychological health, mood at visit, positive correlations – with psychological abilities.Conclusion: Seasonal fluctuations in ambulatory BP levels were not found in the control group and were found in the main group. The quality of life indicators for patients of the main group were significantly worse than in the control group for all components in all seasons. The control of asthma changed in different seasons in accordance with the ACQ total score: uncontrolled bronchial asthma occurred in winter and spring, partially controlled – in summer and autumn. Correlations of the combined primary endpoint with quality of life indicators were found after analyzing various factors.


Pathologia ◽  
2018 ◽  
Vol 0 (2) ◽  
Author(s):  
O. V. Herasymova ◽  
T. L. Protsiuk ◽  
L. O. Protsiuk ◽  
N. M. Surkova ◽  
L. D. Kotsur ◽  
...  

2021 ◽  
Author(s):  
Eniola Awolola Oladejo ◽  
Sonill Maharaj Sooknunan

AbstractBackgroundInterferential therapy (IFT) is the application of two medium frequency currents to the skin to stimulate and activate different systems in the body using specific frequencies and frequency ranges. IFT aims to reduce myalgia in the chest and upper back, reduce muscular fatigue and induce mucus expectoration. This study is designed to compare the efficacy of IFT on asthma control and quality of life of asthma patients pre-and post-administration of bronchodilators and determine the most influential body position in its application.MethodsForty-eight (48) patients aged 18 years and above with bronchial Asthma attending the respiratory clinic at the Lagos State University Teaching Hospital, Ikeja (LASUTH) will be assessed for the study eligibility. The study design will be a double-blinded, randomized control trial with four intervention groups and four parallel placebo control groups. IFT will be administered as an intervention to patients on short and long-acting bronchodilators in an assigned fundamental body position for 20 minutes. Six continuous outcome variables at different points will be utilized as an outcome measure. Baseline Pulmonary Function Test (PFT) will be assessed on entry into the study, Quality of life and asthma control will be evaluated every two (2) weeks of the study. Data obtained will be analyzed using descriptive and inferential statistics of repeated ANOVA; P<0.05.DiscussionThe study outcome will compare the efficacy of IFT on Bronchial Asthma, identify its effect in different body positions, and compare the relationship between its application and the bronchodilator medication frequently used by the patients.Trial Registrationhttps://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=10942:PACTR202005807526130


2020 ◽  
Vol 8 (2) ◽  
pp. 16-22
Author(s):  
Shalini Verma ◽  
Shally Awasthi ◽  
Sarika Gupta

Background: To assess the association of self-reported quality of life (QOL) by using mini- pediatric asthma quality of life questionnaire (mini-PAQLQ) in children aged between 7-15 years with a level of asthma control. Subjects and Methods: Prospective observational study conducted in the asthma clinic in the outpatient department from September 2016 to August 2017. All the cases of asthma, as defined by GINA guidelines, aged between 7-15 years with parental consent were recruited. The level of control was also assessed according to GINA guidelines. Excluded were clinically suspected cases of chronic lung diseases except for bronchial asthma and any other chronic medical condition. QOL was assessed by using mini-PAQLQ which had three domains i.e. Symptoms, emotions and limitation of activity. Each domain had questions and their responses coded on a visual scale with 7 options. Results: From September 2016 to August 2017, total enrolled were 85 of which 51 (60%) were partly controlled and 34(40%) were well controlled. Mean mini-PAQOL score in patients with partly control was low (3.59 0.93) as compared to those with well-controlled asthma (5.83 1.21) (p=0.0001). Conclusion: Self-reported QOL of children with partly controlled asthma was found to be impaired in all the domains as compared to those with well-controlled asthma.


QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Laila M Abdel Ghaffar Hegazy ◽  
Ahmad Mostafa Allam ◽  
Marwa Salah Helmy

Abstract Background Obstructive sleep apnea (OSA) and asthma are common inflammatory respiratory diseases of childhood. The similarities between and the parallel rise of both diseases raise the question of whether OSA is indeed more common in asthmatic children. Objectives The present study is cross section study conducted on fifty children with bronchial asthma the aim of study was to evaluate the frequency of obstructive sleep apnea in asthmatic patients, and impact of OSA on asthma control. Patients and Methods The present work is a Cross-sectional study conducted on fifty Children (27 females and 23 males) aging 5 to 18 years diagnosed as bronchial asthma following up in pulmonology clinic or admitted to pulmonology department in Pediatric Hospital- Ain Shams University. Patients were excluded from presence of any other chronic chest diseases, any congenital malformation in upper respiratory, any genetic disease or inborn error of metabolism, morbid obesity and other medical co morbidities that might interfere with sleep quality. All patients were subjected to full history taking, meticulous general and local chest examination, pulmonary function tests and exposed questionnaire: Asthma control questionnaire (ACQ) and OSA-18 quality of life questionnaire. Children were positive OSA with OSA-18 quality of life questionnaire referred to sleep study. Results 54 % of cases were females and 46% were males. There mean age=10.1, mean of OSA score =75.6. 20% diagnosed OSA according to questionnaire. OSA score increased in patients with history of PICU and hospital admission. OSA score was highly correlated with severity and degree of control of bronchial asthma. 10% of children were positive OSA with OSA-18 quality of life questionnaire suggestive have obstructive sleep apnea according to polysomnogram. Conclusion OSA has a direct and significant impact on asthma severity and control. Asthma and OSA are common disorders, and the concomitant presence of both conditions can be detrimental. Due to the bidirectional association of both conditions, we as clinicians should be aware of it.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
T. I. Eliseeva ◽  
S. V. Krasilnikova ◽  
N. A. Geppe ◽  
S. Yu. Babaev ◽  
E. V. Tush ◽  
...  

Allergic rhinitis (AR) and allergic rhinosinusitis (ARS) are typical upper airway pathologies (UAP) in children with bronchial asthma (BA) frequently accompanied with nasal obstructive diseases (NOD). In order to establish the effect of NOD on correlations between nasal and synonasal symptoms with clinical assessments of asthma control, 82 children, 9.8 [8.9; 10.7] years old, with atopic BA were assessed using ACQ-5 for the BA control level, TNSS for nasal symptoms, and SNOT-20 for synonasal quality of life in combination with rhinovideoendoscopy for NOD. All patients had AR/ARS; in 76.3% (63/82) of children, UAP had a multimorbid character with the presence of NOD. Significant correlations were found between ACQ-5 and TNSS (R=0.40,  p<0.0001) and ACQ-5 and SNOT-20 (R=0.42,  p<0.0001). Correlations between TNSS/ACQ-5 and SNOT-20/ACQ-5 were higher in patients who do not have a combination of AR/ARS with NOD (R=0.67,  p=0.0012; R=0.50,  p=0.022, resp.) than in patients who have AR/ARS combined with NOD (R=0.30,  p=0.015;  R=0.26,  p=0.04, resp.). Thus, the association of BA control level with the expression of nasal and synonasal symptoms is higher in children who do not have multimorbid UAP.


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