Lung Function Decline in Adult Asthmatics—A 10-Year Follow-Up Retrospective and Prospective Study

Asthma may have an impact on lung function decline but conflicting results are reported in forced expiratory volume in one second (FEV1) decline. We aimed to describe the changes in FEV1 in lifelong non-smoking adult asthmatic outpatients during a 10-year follow-up comparing years 1–5 (1st period) with years 6–10 (2nd period) to assess factors affecting these changes. A total of 100 outpatients performed spirometry every 3 months during a 10-year survey. FEV1/Ht3 slope values of the 2nd period reduced significantly respect to the 1st period (p < 0.0001). FEV1 slopes of years 1–5 and 6–10 were inversely associated with FEV1 at enrolment (p = 0.02, p = 0.01, respectively). Reversibility and variability FEV1 showed a significant effect on the 1st period slopes (p = 0.01 and p < 0.04, respectively). Frequent exacerbators in the 1st year had steeper FEV1/Ht3 slopes in the 1st period (p = 0.01). The number of subjects using higher doses of ICS was significantly lower at the 10th years respect to the 5th and the 1st year (p < 0.001, p = 0.003, respectively). This study shows that FEV1 decline in treated adult asthmatics non-smokers, over 10-year follow-up, is not constant. In particular, it slows down over time, and is influenced by FEV1 at enrolment, reversibility, variability FEV1 and exacerbation score in the 1st year.

In vitro delivery efficiencies of nebulizers for different breathing patterns

Background Nebulizers are medical devices that deliver aerosolized medication directly to lungs to treat a variety of respiratory diseases. However, breathing patterns, respiration rates, airway diameters, and amounts of drugs delivered by nebulizers may be respiratory disease dependent. Method In this study, we developed a respiratory simulator consisting of an airway model, an artificial lung, a flow sensor, and an aerosol collecting filter. Various breathing patterns were generated using a linear actuator and an air cylinder. We tested six home nebulizers (jet (2), static (2), and vibrating mesh nebulizers (2)). Nebulizers were evaluated under two conditions, that is, for the duration of nebulization and at a constant output 1.3 mL using four breathing patterns, namely, the breathing pattern specified in ISO 27427:2013, normal adult, asthmatic, and COPD. Results One of the vibrating mesh nebulizers had the highest dose delivery efficiency. The drug delivery efficiencies of nebulizers were found to depend on breathing patterns. Conclusion We suggest a quantitative drug delivery efficiency evaluation method and calculation parameters that include considerations of constant outputs and residual volumes. The study shows output rates and breathing patterns should be considered when the drug delivery efficiencies of nebulizers are evaluated.

Association study between asthma and single nucleotide polymorphisms of ORMDL3, GSDMB, and IL1RL1 genes in an Algerian population

Background Genetic variation has a key role in the development of asthma, but genetic influences may vary between different populations. In this study, we looked for evidence of association of key asthma SNPs, namely, rs1420101 and rs10192157 within the IL1RL1 gene, rs2305480 in GSDMB gene, and the rs3744246 polymorphism in the ORMDL3 gene, in the Algerian population. We included 266 unrelated subjects of an Algerian population in a case-control study, with 125 adult asthmatic and 141 healthy controls. DNA was extracted and genotypes determined by the Taqman PCR technique for characterization of the different genetic variants. Results The results show that there were no significant differences in allele frequencies for 3 of the chosen SNPs in the ORMDL3, GSDMB, and IL1RL1 genes between the asthmatic and control groups with respective P values of 0.922, 0.331, and 0.937. However the T allele of rs10192157 of the IL1RL1gene was associated with protection from asthma (P value=0.010). Conclusion These results indicate that there is no marked effect of rs3744246, rs2305480, and rs1420101 polymorphisms of the ORMDL3, GSDMB, and IL1RL1 genes on asthma risk in the Algerian population. However, a protective effect of the rs10192157 polymorphism of the IL1RL1 gene was found.

Self-care practice and associated factors among adult asthmatic patients on follow-up care at Northwest Amhara referral hospitals, Northwest Ethiopia 2020

Background Self-care practice of asthma is the strategy for asthma symptom control and future reduction of exacerbation, but it is poorly implemented in clinical settings due to the patients, professionals, and organizational related factors. Therefore, the study aimed to assess the self-care practice and associated factors among adult asthmatic patients at Northwest Amhara referral hospitals. Methods Institution-based cross-sectional study was conducted among asthmatic patients on follow-up care at Northwest Amhara Regional State referral hospitals from February 1st, 2020 to March 30, 2020. Data were collected through an interviewer-administered technique. Asthma self-care practice tool was used to measure the outcome. Data were entered into EPI info version 7 and exported to SPSS version 22 for analysis. A binary logistic regression analysis was used. In multivariable logistic regression analysis, those independent variables having p value < 0.05 were considered as statistically significant with poor self-care practice of asthma. Results A total of 470 participants enrolled in the study with a response rate of 100%. The proportion of good self-care practice among asthmatic patients was found to be 42.3%. The study revealed that; age group ≥ 55 years, having a co-morbid illness and borderline anxiety, having no social support, and drinking alcohol were significantly associated with poor asthma self-care practice. Conclusions Poor-self care practice in this study was high. Efforts need to be implemented for asthmatic patients with older age, having co-morbid illness and borderline anxiety, having no social support, and drinking alcohol.