New Article From Asthma Research and Practice: Clinical characteristics and comorbidities of elderly asthmatics who attend allergy clinics

Juan Carlos Ivancevich Monday, 23 April 2018 18:06
 
Anahí YáñezMarcela SoriaSusana De BarayazarraNancy RecueroFrancisco RoviraEdgardo JaresAna María StokSergio Nemirovsky and
Carlos Bueno

Abstract

Background

To date, few studies have focused on the clinical and allergic characteristics of asthma in the elderly, defined as asthma in people aged 60 or over. Thus, we propose to identify and study the clinical and allergic characteristics and comorbidities of patients with asthma among the elderly.

Methods

A retrospective, observational, descriptive study was developed in five clinics and hospitals in Argentina. Allergy Physicians analyzed their patients’ medical records in 2014 and included those adults over the age of 60, who had been diagnosed with asthma according to the GINA guidelines. Clinical and allergic characteristics were analyzed.

Results

A total of 152 patients diagnosed with asthma, of whom 73% were women and 11% ex-smokers, were included in this study, with a mean age of 66 years. Only 10.5% of the participants had onset asthma past the age of 60. Regarding asthma severity, 74.3% were diagnosed with moderate persistent asthma, and 7.2% with severe persistent asthma. Eighty-four percent of the patients were treated with an inhaled corticosteroid (ICS) along with a long-acting β 2-adrenergic agent (LABA). More than half of the patients had two or more comorbidities simultaneously. Allergic comorbidities were the most frequent comorbidities, followed by arterial hypertension. Among allergic comorbidities, most patients presented allergies at the nasal level. There were no significant differences between the subpopulations of patients with late-onset asthma (LOA) and asthma with onset before the age of 60, i.e. early onset asthma (EOA) in most of their clinical characteristics. However, it was observed that EOA accounted for a higher percentage of patients with nasal allergies as compared to LOA (71% vs 46%, p <  0.05).It is worth mentioning that almost half of the patients with LOA had allergies at the nasal level.

Conclusion

These results may provide a better understanding of the clinical characteristics of asthma in the elderly in Argentina, thus, enabling the development of future therapeutic strategies and a better quality of life for our elderly asthma patients.

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WCA 2018 - Abstract Submission

Juan Carlos Ivancevich Monday, 09 April 2018 12:10

Submission Deadline June 08, 2018

Abstract Guidelines

Specifications:

Rationale: A brief statement of purpose of the study and the hypothesis to be tested.

Methods: Summarize the predictors and outcomes analyzed, as well as the methods used.

For abstracts reporting clinical research, a sentence or phrase presenting the most important selection criteria for subjects should be included.

Results: Provide a summary of the results including quantitative data, presented in sufficient

detail with statistical analysis when possible to support the conclusions.

Conclusions: Summarize the impact and significance of the findings. It is not sufficient to

state, “The results will be discussed,” or “other data will be  presented,” etc.

Be sure to use the words “Rationale, Methods, Results and Conclusions” in the body of your abstract to indicate the start of each new section. See the Sample Abstract included in this document. Author information should not be included in the body of the abstract.

Abstract Length

The maximum length of an abstract submitted is 250 words. Use of the words “Rationale, Methods, Results and Conclusions” as described above will not count towards the 250 word total.

Title

Capitalize only the first letter of each word of the title.

Abbreviations

The use of standard abbreviations is desirable (i.e., rbc, kg, mg). A special or unusual abbreviation should be placed in parentheses after the first appearance of the full word which it represents. Do not use periods after abbreviations or initials. Numerals rather than words should indicate numbers, except to begin sentences.

Drug Names

Non-proprietary (generic) names are preferred and should be used in the title of the abstract. Generic drug names are not capitalized in the body of the abstract. If a proprietary drug name is used in the body of the abstract, the first letter is capitalized.

Format

You may use your word processor’s capabilities for bold, underline, italic, subscript and superscript, or use the tools provided when entering your abstract. Bold the words Rationale, Methods, Results and Conclusions used to separate one section of the abstract from another. Text that will be in italics in published form (e.g., genus, species) may be formatted as italics.

Review

Abstracts will be graded by several reviewers on the following criteria; Clinical or basic science significance, Methodology and as an Overall submission. Reviewers are also asked to flag abstracts that involve research on human or animal subjects if the corresponding approvals are missing.

http://wca-2018.com/abstracts/

World Congress of Asthma 2018 - Scientific Program Committee's Message

Juan Carlos Ivancevich Monday, 09 April 2018 11:40

Significant achievements have been accomplished in the last few years to better understanding what asthma is, how it should be assessed in regards to control and severity and what its optimal therapy is. Unfortunately, these improvements in our understanding of the disease have not always translated into better asthma management.

The 2018 World Congress on Asthma in Tokyo will review the key findings from recent research on both adult and pediatric Asthma and how knowledge translation methods have evolved to better integrate research findings into care.

The origins and determinants of Asthma, triggers and inducers, the new insight gained on the role of allergy, environmental and biodiversity changes, workplace hazards, respiratory infections and various aspects of assessment of the disease are among the topics that will be addressed by world experts. The role of phenotyping/endotyping Asthma, particularly when severe, and new therapeutic current and future advances will be covered.

A significant part of the meeting will be devoted to practical workshops on asthma testing and treatment delivery, as well as the integration of practice tools into day-to-day care. Sessions will discuss how to optimize the multidisciplinary approach to asthma management.

We and the members of the scientific advisory board are confident that the impressive program of WCA-2018 will be of interest to all those involved in research and care of asthma.

G. Walter Canonica       Lawrence DuBuske       Louis-Philippe Boulet       Fulvio Braido

http://wca-2018.com/

New article published in Asthma Research and Practice: Single nucleotide polymorphisms in asthma candidate genes TBXA2R, ADAM33 FCER1B and ORMDL3 in Pakistani asthmatics a case control study

Juan Carlos Ivancevich Friday, 23 March 2018 13:03

RESEARCH

Single nucleotide polymorphisms in asthma candidate genes TBXA2R, ADAM33 FCER1B and ORMDL3 in Pakistani asthmatics a case control study

Asthma Research and Practice 2018, 4:4 | Published on: 22 March 2018

Abstract

Background

Genetic variations in different loci and genes are important in asthma pathogenesis. There is much importance of various immunological pathways in the IgE secretion regulation. Alterations in any main part of these pathways can increase the risk of asthma development. Polymorphisms in these genetic markers can effect certain pathways which predict the asthma susceptibility. In the present study, SNPs directly or indirectly affecting the immunological process pathways are selected.

Methods

This study was conducted to determine association of 16 SNPs in 10 candidate genes with asthma in Pakistani population in 333 asthmatic cases and 220 healthy controls. Genotyping was performed using the Sequenom Mass ARRAY iPLEX platform (14 SNPs) and TaqMan assay (2 SNPs).

Results

The minor allele at two of the SNPs showed association with protection from asthma, rs1131882 in TBXA2R gene (OR 0.73, 95% CI 0.52–1.01, P = 0.05) and rs2280091 in the ADAM33 gene (OR 0.69, 95% CI 0.50–0.97, P = 0.03). For FCER1B gene, rs2583476 the asthmatic male gender had higher TT genotype counts as compared to controls (OR = 1.86, 95% CI = 1.09–3.17, p = 0.01). In rs11650680 of ORMDL3 gene the CT genotype is more prevalent in female asthma cases in comparison with female controls (OR = 1.99, 95% CI = 1.02–3.89, p = 0.03).

Conclusions

This data suggests that variations at TBXA2R and ADAM33 genes are found to be associated with asthma susceptibility in Pakistan. FCER1B gene is associated with male and ORMDL3 in female asthmatics. These genetic markers can be important source of asthma risk in Pakistani population.

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New Article From Asthma Research and Practice: Inhalation of hydrogen gas attenuates airway inflammation and oxidative stress in allergic asthmatic mice

Juan Carlos Ivancevich Saturday, 17 March 2018 00:17

Inhalation of hydrogen gas attenuates airway inflammation and oxidative stress in allergic asthmatic mice

Ning Zhang, Changwen Deng, Xingxing ZhangJingxi Zhang Email author and Chong Bai

Abstract

Background

Asthma is a worldwide common chronic airway disease that cannot be cured and results in the huge burden in public health. Oxidative stress was considered an important mechanism in the pathogenesis of asthma. Hydrogen gas been demonstrated to function as a novel antioxidant and exert therapeutic antioxidant activity in a number of diseases and the function of this nontoxic gas in asthma was unclear. The purpose of the study aims to examine the effect of inhalation hydrogen gas on the pathophysiology of a mouse model of asthma.

Methods

A murine model of ovalbumin (OVA)-induced allergic airway inflammation was used in this study. Briefly, Mice were sensitized to ovalbumin and received inhalation of 67% high concentration of hydrogen gas for 60 min once a day for 7 consecutive days after OVA or PBS challenge respectively. Lung function was assessed in the apparatus with 4 channels of biological signal system. Morphology and goblet cell hyperplasia were stained by H/E and Periodic acid-Schiff staining. Cytologic classification in the bronchial alveolar lavage fluid (BALF) was analyzed by Wright Giemsa staining. Serum, BALF and lung tissue were collected for biochemical assay. One-way analysis of variance (ANOVA) was used to determine statistical significance between groups. Multiple comparisons were made by Bonferroni’s Multiple Comparison Test by using GraphPad Prism 5 software.

Results

Inhalation of hydrogen gas abrogated ovalbumin-induced the increase in lung resistance. Concomitantly, the asthmatic mice showed severe inflammatory infiltration and goblet cell hyperplasia which were reversed by hydrogen gas inhalation. Hydrogen gas inhalation reduced significantly the number of total cells, eosinophils and lymphocytes in BALF. Increased level of IL-4, IL-13, TNF-α and CXCL15 in the BALF and IL-4 in the serum were decreased significantly after inhalation. Hydrogen gas inhalation markedly upregulated the activity of decreased superoxide dismutase and significantly attenuated the increased level of malondialdehyde and myeloperoxidase.

Conclusions

Hydrogen gas inhalation improves lung function and protects established airway inflammation in the allergic asthmatic mice model which may be associated with the inhibition of oxidative stress process. This study provides a potential alternative therapeutic opportunity for the clinical management of asthma.

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Assessment of knowledge and education relating to asthma during pregnancy among women of childbearing age

Juan Carlos Ivancevich Saturday, 20 January 2018 12:16

Mohammed O. Al Ghobain, Mohammed AlNemer and Mohammad Khan

Abstract

Background

Misconceptions about medications’ safety can lead pregnant women with asthma to stop their medications, resulting in asthma-related neonatal morbidity and mortality. Our aim was to assess the level of pregnancy-related asthma knowledge and education about asthma medications’ safety, among women of childbearing age with a history of bronchial asthma.

Methods

A cross-sectional survey of convenience sample of outpatient clinic attendees of Pulmonary, Family Medicine and Obstetrics & Gynecology among women of childbearing age with history of asthma at King Abdulaziz Medical City, Riyadh, Saudi Arabia. Participants (n = 171) completed a questionnaire to determine levels of education and knowledge, as well as attitudes and practice relating to asthma treatment.

Results

Among participants, 77.1% were pregnant at the time of the survey, 77.8% had used asthma medications during current or previous pregnancy, 70.8% of all respondents who ever been pregnant believed in the safety of asthma medications during pregnancy, 49.1% had received education about asthma, and 46.8% had been educated about the safety of asthma medications during pregnancy. Responses indicated that 46.8% had stopped (or expressed the desire to stop) asthma medications during pregnancy, and 48% believed asthma medications would harm them and their babies more than asthma itself, but 92.4% expressed that they would be willing to use asthma medications during pregnancy if their safety was confirmed by a physician. Education level and employment status were both associated with an increased likelihood of having received asthma education (p values <0.001 and <0.001 respectively), and with awareness of the safety of the medications during pregnancy (p values <0.001 and <0.003 respectively).

Conclusion

Further efforts is to be taken to develop a program where female asthmatic patients are taught about asthma and its medications’ safety during pregnancy.

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New Article From Asthma Research and Practice

Juan Carlos Ivancevich Saturday, 06 January 2018 12:33

Microbiome and asthma

Milena SokolowskaRemo FreiNonhlanhla LunjaniCezmi A. Akdis and Liam O’Mahony

Abstract

The mucosal immune system is in constant communication with the vast diversity of microbes present on body surfaces. The discovery of novel molecular mechanisms, which mediate host-microbe communication, have highlighted the important roles played by microbes in influencing mucosal immune responses. Dendritic cells, epithelial cells, ILCs, T regulatory cells, effector lymphocytes, NKT cells and B cells can all be influenced by the microbiome. Many of the mechanisms being described are bacterial strain- or metabolite-specific. Microbial dysbiosis in the gut and the lung is increasingly being associated with the incidence and severity of asthma. More accurate endotyping of patients with asthma may be assisted by further analysis of the composition and metabolic activity of an individual’s microbiome. In addition, the efficacy of specific therapeutics may be influenced by the microbiome and novel bacterial-based therapeutics should be considered in future clinical studies.

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Season Greetings from GAA-Interasma

Juan Carlos Ivancevich Saturday, 23 December 2017 00:03

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Identifying the hidden burden of allergic rhinitis (AR) in community pharmacy: a global phenomenon

Juan Carlos Ivancevich Wednesday, 22 November 2017 14:33
 
Rachel Tan, Biljana Cvetkovski, Vicky Kritikos, David Price, Kwok Yan, Pete Smith and Sinthia Bosnic-Anticevich
Asthma Research and Practice 2017 3:8

https://doi.org/10.1186/s40733-017-0036-z

Abstract

Background

Patients with allergic rhinitis often trivialise their condition, self-manage inappropriately, and would benefit from health care intervention. The primary point of health care contact for these self-managing allergic rhinitis patients is the community pharmacy. With the majority of allergic rhinitis treatments being available for purchase over the counter, without health care professional contact, we know little about how the patients self-manage. This study aims to identify the burden of allergic rhinitis in the community pharmacy and to identify key opportunity for intervention.

Methods

Pharmacy customers, who purchased nasal treatment in a community pharmacy, were approached with a research-administered questionnaire that collected data on medical history, symptoms and products purchased for the treatment of nasal symptoms.

Results

Of the 296 participants, 69.9% self-managed with over-the-counter medications; with 68% experiencing allergic rhinitis symptoms and only 44.3% of this subgroup had a doctor’s diagnosis. Nasal congestion (73.6%) was most commonly experienced and oral antihistamines were most commonly purchased (44.3%), indicating a pattern of suboptimal management. A third of participants (36.5%) experienced moderate-severe symptoms, persistently, which impacted on their daily living. Medication selection was mainly based on pharmacy customers’ perceptions of medication effectiveness (47.6%).

Conclusion

A majority of participants that self-selected over-the-counter medications have symptoms consistent with allergic rhinitis, with almost half not having received a diagnosis. Medication purchasing patterns suggest that sub-optimal therapeutic decisions made by participants, even when they are experiencing significant symptoms. This study uncovers the hidden burden of allergic rhinitis in the community pharmacy and a missed opportunity to intervene and refer if necessary. Patients need to be guided through appropriate treatment as this study showed that many should be referred to a medical practitioner.

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Non adherence to inhalational medications and associated factors among patients with asthma in a referral hospital in Ethiopia, using validated tool TAI

Super User Tuesday, 10 October 2017 03:56
Asthma Research and Practice 2017 3:7
 

https://doi.org/10.1186/s40733-017-0035-0

Abstract

Background

Asthma is a chronic inflammatory condition of the airways that affects roughly 358 million people globally. It is a serious global health problem with an increasing prevalence worldwide. Most people affected are in low- and middle-income countries including Ethiopia. The association between non -adherence and poor disease control is clearly stated in different literatures. The main objective of the present study was to assess self-reported non- adherence level and to identify the potential factors associated with non-adherence.

Methods

An institution based cross-sectional study was conducted in university of Gondar teaching and referral hospital. The data was collected using a validated tool called Test of Adherence to Inhalers (TAI).

Result

Among the total of study participants, higher proportions of patients were female (57.3%). Large number of the respondents (59.1%) were Unable to read and write. 18.3% of inhalational user asthmatic patients were not adherent to inhalational medications. According to this study only 49.4% of the respondents were adherent to inhalations and 32.3% of them were intermediate adherent to inhalational anti asthmatics medications. Lack of education about the Proper use of inhalational anti-asthmatics medications, poly pharmacy and co-morbidities were statistically significant factors associated with non-adherence.

Conclusion

The rate of non-adherence to inhalational anti asthmatics is high. Therefore, promoting optimal medication adherences through education, proper patient consultation is essential to optimize the benefits of treatment. Measurement of the degree of non-adherence to inhaled treatment in each individual patient is important in early interventional practice.

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Editor: Juan C. Ivancevich, MD

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