Canadian Health and Care: Diagnosis and Management of Work-Related Asthma

2015-03-18 / Asthma / 0 Comments

Clinical Course

Our patient was treated with systemic corticosteroids and had rapid resolution of the rash and pulmonary infiltrates (Fig 5). All culture findings were sterile. The patient underwent a bone marrow biopsy, and the findings were consistent with a myelodysplastic syndrome. Subsequently, a cutaneous recurrence of Sweet syndrome developed during tapering of systemic corticosteroid. Four months after the initial diagnosis, the patient underwent allogeneic stem-cell transplantation but later died of multisystem organ failure.

Clinical Pearls

1. Acute febrile neutrophilic dermatosis (Sweet syndrome) is a well-recognized clinical entity with a diverse clinical spectrum that not only includes characteristic dermatologic manifestations but also may present with extracutaneous involvement of almost any organ system. Management of Work-Related Asthma

2. Criteria have been established to aid in the diagnosis of Sweet syndrome, which include a combination of clinical, pathologic, and laboratory findings, as well as response to treatment with corticosteroids.

3. If the diagnosis of Sweet syndrome is made, it should be classified as classical (idiopathic), malignancy associated, or drug induced, and the potential for associated clinical conditions should be recognized based on this classification.

4. Extracutaneous manifestations can involve a variety of organ systems, and if pulmonary involvement is noted an underlying hematologic dyscrasia is more likely to be an associated clinical condition.

5. Due to the fact that treatment with corticosteroids typically induces rapid improvement, Sweet syndrome should be promptly recognized in order to provide timely treatment and potentially prevent clinical deterioration.

Background: A previous American College of Chest Physicians Consensus Statement on asthma in the workplace was published in 1995. The current Consensus Statement updates the previous one based on additional research that has been published since then, including findings relevant to preventive measures and work-exacerbated asthma (WEA).

Interesting canadian health blog you can read here.

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Asthma-like symptoms and the risk for BHR

2014-10-22 / Asthma / 0 Comments

Current smokers in both our samples had the largest BHR values, with an OR of 1.39 for getting an elevated slope. The tendency to an increased BR for smokers has been observed in previous studies, and it has been supported by pathological evidences of important changes in large and peripheral airways induced by smoke, which lead to different degrees of airway obstruction. Moreover, Mitsunobu and associates reported that the cumulative dose of methacholine causing a significant increase in total respiratory resistance was significantly lower in asthmatics with a smoking history than in those without it. risk for BHR

We also showed a strong relationship between chronic bronchitis-like or asthma-like symptoms and the risk for BHR (OR, 1.30 and OR, 2.65, respectively), bringing further evidence to a reappraisal of the Dutch hypothesis. Furthermore, our findings underline the association of a positive skin reactivity (OR, 1.32) or of higher total IgE values (OR, 1.61) with an enhanced BR, according to other studies.

We also confirmed the inverse relationship between airway caliber and BHR, which could be ascribed to anatomic, mechanical, and mathematical factors: the flow resistance in a tube is inversely proportional to the radius of the tube to the fourth power Cheap Viagra. This leads to a proportionally greater resistance for a narrow airway. Hence, the influence of baseline lung function must be accounted for when analyzing BHR.

BHR and Urban Residence

In our investigation, after controlling for the independent effects of gender, age, smoking habits, respiratory symptoms/diseases, and atopic status, residence in an urban area appears to be an independent risk factor for BHR (OR, 1.41; 95% confidence interval [CI], 1.13 to 1.76). Interestingly, such an OR is of the same magnitude as the one for active smoking (1.39).

Likely, there is higher outdoor air pollution in urban than in rural areas. Indeed, when we had evaluated pollutants (sulfur dioxide, total suspended particulate) from the two areas, we had found higher mean annual levels in Pisa than in Po Delta, with differences of 40 ^g/m3 for total suspended particulate (94 ^g/m3 and 54 ^g/m3, respectively) and 7 ^g/m3 for sulphur dioxide (15 ^g/mand 8 ^g/m3, respectively).

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Asthma Treatment: Gecko can’t cure Aids, asthma

2011-07-17 / Asthma / 0 Comments

Health department: Gecko can’t cure Aids, asthma

THE Department of Health (DOH) on Thursday expressed alarm over the persistent folkloric practice of using geckos or (locally called “tuko”) as cure for acquired immune deficiency syndrome (Aids) and asthma.

In a statement, Health Secretary Enrique T. Ona said geckos frenzy is now the department’s serious concern even as health officials do not recommend using lizards as cure to said ailments.

“The use of geckos as cure, which is unproven and have no scientific basis, could be dangerous because patients might not seek the proper treatment for their diseases like asthma, which could become more serious and later, require hospitalization and other more complications as well as more expensive treatment. Further, this is likely to aggravate their overall health and put them at greater risk,” Ona said.

For diseases like asthma, he said there are now very effective treatments available at affordable prices that can provide relief from this ailment.

“With regular treatment, asthmatic persons can successfully control the symptoms and live a comfortable and healthy life,” he said.

For patients infected with Human Immunodeficiency Virus (HIV), Ona said antiviral medications that can control the progress of the disease are now also available.

However, the DOH did not categorically admit that there is a cure to such deadly disease.

Melda (family name withheld), a single mother who resides in a hinterland barangay of Cagayan de Oro, said she finds hard to look for a job until she was contacted to secure live geckos weighing 300 grams for P10 million each.

Beside her house situated at a semi-forested area, Melda caged two geckos weighing 200 grams each feeding it with cockroaches, rice and monggo.

“If it can make me rich and live a decent life, why would I refuse to find geckos?” she said.

She claimed that a European national tapped a Manila man to contact her for the said “big business.”

Treatment, not medicine, helps asthma patients feel better

Inhaling albuterol helps asthmatic lungs work better, but patients who get it don’t feel much better than those treated with a placebo inhaler or phony acupuncture, according to a U.S. study.

The results, which appeared in the New England Journal of Medicine, demonstrate the importance of, literally, caring for patients and not just providing drugs, said co-author Ted Kaptchuk of Harvard Medical School.

The findings also demonstrate the impact of the so-called “placebo effect,” or the phenomenon seen in clinical trials when people given inactive, fake “treatments,” such as a sugar pill or saline, show improvements.

“My honest opinion is that a lot of medicine is the doctor-patient relationship,” Kaptchuk told Reuters Health.

“A lot of doctors don’t know that, they think it’s their drugs. Our study demonstrates that the interaction between the two is actually a very strong component of healthcare.”

All of the 39 patients, each of whom had mild-to-moderate asthma, thought the placebos were just as effective as the real therapy.

Those who got albuterol reported a 50 percent improvement in symptoms. The ones who got phony albuterol said they improved by 50 percent as well, while those getting sham acupuncture had a subjective improvement rate of 46 percent.

The only thing that didn’t work as well, according to the patients’ impressions, was no therapy at all, with the asthmatics sent home after waiting for several hours. In those cases, patients reported 21 percent improvement.

Only when the researchers measured the patients’ ability to force air from their lungs was the benefit of albuterol clear. The so-called FEV1 volume improved by 20 percent with the drug, nearly three times more than the 7 percent increase in patients getting the fake acupuncture, ersatz albuterol or no treatment.

Fake acupuncture turned out to be the most convincing treatment and was done doing needles that retract into the handle instead of going into the skin. In addition, the needles were “inserted” into the wrong acupuncture points, said Kaptchuk, who is trained in the discipline.

Eighty-five percent of the people who got it thought they were getting a real therapy, compared to 73 percent who received real albuterol and 66 percent who were getting placebo albuterol.

“Patients could not reliably detect the difference between this robust effect of the active drug and the effects of inhaled placebo and sham acupuncture,” the researchers wrote.

They also said the findings show that a patient’s self-report can be an unreliable indicator of actual improvement.

Kaptchuk said the test may help resolve the longstanding question of whether placebo treatments, because they seem to show a benefit, actually affect the physical illness.

“But changing subjective outcomes is very important for us,” he said.

Salt therapy lets asthma sufferers breathe easy

Lifestyle – Hay fever victim Judy Murphy chronicles arrival of halotherapy treatment in Galway

When you suffer from asthma and hay fever – an estimated 470,000 Irish people do – feeling under the weather is a regular occurrence.
In winter you are more likely to get chest infections. In summer, if you also suffer from hay fever, as people with asthma often do, you can face days of sniffling, sneezing and watery eyes.

And it’s not just people with asthma who get hayv fever – according to the Asthma Society about 15 percent of the population suffer from the condition.

It isn’t pleasant. And while the medication available to sufferers has improved hugely over the years, a lot of us who suffer wish there was a less ‘chemical’ way of clearing our respiratory systems.

Hence the growing phenomenon of halotherapy – otherwise known as salt therapy – in the Western world, with a recent addition in Galway being the Salt Spa in the city’s Radisson Hotel.

The idea of gargling salt water for sore throats or using saline nasal sprays to relieve congestion is pretty familiar, but halotherapy takes it to a new level.

My first experience of breathing salty air was during a visit to Warsaw Salt Mines a couple of years ago. Deep underground, the air was so clean you could actually feel it entering your system. The mines are a major tourist attraction in the region, both for their amazing underground cathedral and the reputed benefits their salt offers to people with respiratory disorders.

The idea that salt had health benefits was first highlighted by a Polish doctor, Felix Bochkovsky in 1843, when he was dealing with patients in salt mines in the Ukraine. His research indicated that the people working in salt mines didn’t suffer from colds and respiratory diseases despite working in harsh conditions and having poor nutrition.

Since then, the idea of using natural salt caves – speleotherapy – has spread and it has been used in Eastern Europe for generations. It is especially popular in Russia. In fact, it was in Russia, in 1987 that a system was developed using underground salt rock that had been shaped into blocks.

That technique allowed the atmosphere of the salt mines to be recreated above ground. It was further developed into halotherapy in which a saline diffuser releases salty air into a special room where the walls and floor are covered by layers of salt. The machine produces and maintains the required level of natural concentration of salt micro-particles to create similar conditions to those found in salt mines. These are small enough to penetrate deep into your lungs.
Ireland has only adopted salt therapy relatively recently, with the first cave being opened at Maynooth in early 2009 by Dr Tamas Bakonyi, a GP from Hungary involved in a practice in Leixlip.

The Radisson is one of two salt caves that opened in Galway this year and while it’s designed to offer relief from various ailments, it also comes with certain luxuries, including soft lights, music, a salt waterfall and – most impressively – stalactites hanging from the ceiling. And there’s a 15-minute ventilation period between each session to allow the room to be purified and germ free for each new group.

Ann McDonagh, the manager of the Radisson’s Spirit One Spa, explains that the salt spa was the brainchild of the hotel’s former manager, Stephen Kennedy, who first experienced these treatment rooms in Central Europe and decided to introduce the concept to Galway. But, while some of them are minimal in design, the Radisson went for more add ons.

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Asthma Treatment News: UK doctors begin pioneering asthma treatment

2011-06-21 / Asthma / 0 Comments

UK doctors begin pioneering asthma treatment

Doctors in Manchester and Glasgow have begun treating NHS asthma patients with a pioneering treatment described as “melting away” muscle in the airways.

Instead of using drugs such as steroids, a wire probe is inserted into the lungs and then heats the tissue.

Currently, the procedure – called bronchial thermoplasty – is not being used anywhere else in Europe.

The technique uses 10-second bursts of radio waves which heat the lining of the lungs to 65 degrees Celsius.

That destroys some of the muscle tissue which constricts during an asthma attack, making breathing difficult.

Dr Rob Niven, senior lecturer in Respiratory Medicine at the University Hospital of South Manchester, who led the team carrying out the procedure at Wythenshawe Hospital, said “bronchial thermoplasty is the first non-drug treatment for asthma and it may be a new option for patients with severe asthma who have symptoms despite use of drug therapies.”

“The operation went according to plan and our patient has responded well. It will be a little while before we are able to say it’s been a complete success, but I am cautiously optimistic,” he said.

Normal airway
Airway of asthma patient has thickened muscle walls restricting the opening
Bronchoscope containing small wire probe passed into lungs
Probe is expanded so it touches walls of airways
Probe is then heated, reducing thickness of muscle tissue. Process is repeated along the airway to increase capacity

The procedure follows six years of trials in the UK, Canada and South America. Patients in the United States have been receiving the treatment for some months already.

Bronchial thermoplasty will not be used on children, says Dr Niven, and its effectiveness decreases as patients age.

Tens of thousands of patients across the UK with the most severe forms of asthma stand to benefit most from the treatment.
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Symptoms can worsen to begin with, as the heat also causes damage to the sensitive lung lining. But once this is repaired doctors say asthmatics can be helped for up to five years.

However, cost is a potential problem – it costs around £10,000 per patient, although savings could be made in the longer term through fewer hospital admissions and reductions in the costs of medicines.

It will be up to the local NHS bodies, which buy care for patients, to decide on whether to fund it, possibly on a case-by-case basis.

According to the campaign group Asthma UK, 5.4 million people in the UK have asthma and around 250,000 of these have severe asthma.

The group’s Chief Medical Adviser, Professor Ian Pavord, said of bronchial thermoplasty: “In some people with severe asthma, the symptoms of their asthma have been improved and the risk of them having an asthma attack has been reduced, so it is encouraging to see that the technique has now been carried out outside of clinical trials.”

“However, this kind of procedure will not work for everyone so we would encourage people with asthma to discuss various treatment options with their GP to find the best way for them to keep their asthma managed and under control.”

Anthropology of Asthma

Citing a study he conducted in India — in which he showed doctors video footage of people with typical asthma symptoms — Van Sickle notes that in some cultures, physicians are hesitant to diagnose patients with asthma because of social stigma.

“A diagnosis of chronic disease can impair a woman’s marital chances, and a physician is unlikely to make an unpopular diagnosis because a patient can always go down the street and get a different physician,” Van Sickle says of the study performed in India. After performing the same experiment in Wisconsin, he found that doctors were considerably more likely to associate the symptoms with asthma.

Van Sickle suggests that the additional study of lifestyle factors should reveal a better understanding of potential causes of the disease and help physicians treat and eventually prevent asthma.

Indians Eat Live Sardines to Cure Asthma

Indians Eat Live Sardines to Cure Asthma– In an effort to cure asthma, hundreds of Indians gather for an annual ‘fish medicine festival’ where live sardines are consumed. Despite efforts to battle the respiratory affliction, this somewhat bizarre tradition has garnered negative attention from human right campaigners around the world.

The festival takes place every June on a day determined by astrological means. The ‘treatment’ of eating live sardines is administered by members of the Goud family in southern India. According to the Goud family, they have been administering this treatment to those afflicted with asthma for 166 years.
Indians Eat Live Sardines to Cure Asthma

Millions of people suffer from asthma and other respiratory diseases in India. The treatment the Goud family administers is taking a live sardine and smearing it with ‘secret’ spices. According to legend, this recipe of ‘secret’ spices was given to them by a Hindu Saint who said they could never profit from it. For that reason the hundreds of thousands of people over the years who have come to the Goud family have received their sardines for free.

There is no evidence that this is effective in any way. Human rights organizations are protesting about children’s participation in the event. They think that their lack of consent and the questionable hygienic practices are in violation of basic human rights.

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Asthma Treatment News: Metabolomics brings diagnosis a step closer

2011-06-03 / Asthma / 0 Comments

Allergic asthma on the breath: Metabolomics brings diagnosis a step closer

Allergic asthma, a sub-type of asthma, is a growing health problem affecting all age groups. The symptoms do not differ between the allergic and non-allergic condition, although the causes do.

The allergens responsible are encountered commonly everyday. They include house dust mites, mould spores, airborne pollen, faeces of the cockroach and dust mite, and food or food preservatives.

They trigger allergic asthma by entering the airways, causing the immune system to overreact. The airways become inflamed and filled with mucus, bringing on coughing, wheezing, shortness of breath and tightening of the chest. The effects range from mild to serious and can result in hospitalisation.

Currently, it has been estimated that 90% of children with asthma have allergies, compared with 50% of adults. They are diagnosed via their symptoms and, in some cases, by measuring biomarkers such as immunoglobulin E. Unfortunately, these markers are non-specific, so moves are taking place in research centres around the world to devise more sensitive and specific diagnoses.

A team of researchers based in Portugal has taken the view that the exhaled breath of a patient is a good place to start, since the disease affects the airways directly. It is also a non-invasive sampling method which children find easy to perform without discomfort.

Silvia Maria da Rocha and colleagues from the University of Aveiro, the University of Madeira and the Children’s Hospital D. Pedro, Aveiro, developed a method using GC/MS to analyse the volatile compounds in breath.

Asthma volatiles identified

Breath samples were collected in gas sampling bags for 22 children with allergic asthma and a further 13 children with the combination of allergic asthma and allergic rhinitis. The allergens of 26 were known to be dust mite (19 patients), dust mite plus cat fur (3), dust mite plus grass pollen (3) and dust mite plus cat fur plus grass pollen (1). Breath from healthy children was also collected as controls for comparison.

The compounds in the breath were sampled by headspace solid-phase microextraction using a divinylbenzene-carboxen-polydimethylsiloxane fibre in an optimised procedure. The fibre was inserted into the injection port of the gas chromatograph and the trapped compounds were thermally desorbed onto a high-polarity nitroterephthalic acid-modified polyethylene glycol column.

The eluting compounds were analysed by electron ionisation in full-scan mode and identified from their retention times and by comparing the mass spectra with those from the NIST mass spectral library.

A total of 44 compounds were identified, the vast majority being straight-chain and branched alkanes. Other classes included terpenoids, aldehydes, ketones, fatty acids and aromatic hydrocarbons. Many of these had been identified in earlier studies of exhaled breath.

The relative amounts of each compound were quantified from their GC peak areas. An analysis of variance (ANOVA) revealed no significant intra-individual variations throughout each day or between days. However, a partial least squares-discriminant analysis (PLA-DA) uncovered some variations that were attributed to the effects of diet and circadian rhythm.

Products of oxidative stress characterise allergic asthma

A subset of 28 volatiles was selected for multivariate analysis, ruling out any compounds which were not present on the breath of all the children and those which are known solvents or airborne contaminants. The 28 were not unique to children with allergic asthma but were observed to greater or lesser degrees in healthy children too.

The PLA-DA procedure was used to identify those compounds that best distinguished between healthy children and those with allergic asthma. A successful classification rate of 88% was achieved, the most indicative compounds being those linked to oxidative stress, such as aldehydes and alkanes. So, lipid peroxidation appears to be an important feature in allergic asthma.

The PLA-DA plots also largely discriminated between children with allergic asthma alone and those with allergic asthma and allergic rhinitis. The volatile composition was altered because allergic rhinitis is concentrated in the nose, producing a different profile.

The areas in the plots associated with allergic rhinitis were also positively correlated with cases that had shown positive prick tests.

The volatile profiles also displayed some correlation with the type of treatment received by the patients. Those given corticosteroids and leukotriene receptor agonists to treat the disease were distinguished from those receiving corticosteroids with antihistamines or corticosteroids with bronchodilators.

The results from this study are promising but the researchers acknowledge that the sample size is small. They are now extending the process to a larger number of healthy and allergic asthmatic children to see if the method really can provide a rapid and non-invasive diagnostic tool.

If successful, it will “provide a novel methodological approach to characterise allergic asthma as a function of its metabolomics patterns, which will open new strategies to early diagnosis, therapy monitoring and understanding the asthma pathogenesis that affects millions around the world.”

Asthma Treatment Can Lead to Osteoporosis

If you have asthma, you may be at increased risk of developing the bone disease osteoporosis. Asthma is a chronic condition that makes breathing difficult. During an asthma attack, tissues inside the airways swell and produce extra mucus, which clogs the airways. At the same time, the muscles surrounding the airways can clamp down and make airways even smaller. These things combine to make it hard for the air to move into and out of the lungs.
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There is no cure for asthma, but many asthma symptoms can be controlled using a variety of medications. Some of the most effective medications are corticosteroids or glucocorticoids, which can be taken as a pill or can be inhaled. Unfortunately, these medications can also cause damage to your bones and lead to osteoporosis.

Osteoporosis is a condition that makes bones brittle and weak. Healthy bone is a combination of bone and small holes that looks similar to a honeycomb. Bone with osteoporosis has larger than normal holes with weak, brittle bone in between. The mineral calcium is a building block for bone. In a healthy person, new bone is constantly being grown to replace old bone. But when the body is low on calcium, bone growth slows as the mineral is pulled out of bones. This can leave bones weak and more likely to break.

When corticosteroids used to treat asthma are taken by mouth, they interfere with the body’s ability to absorb calcium from foods. They also cause the kidneys to flush more calcium out of the body and limit the amount of bone that is produced. Corticosteroids used as inhalers are safer, but can still cause damage to bones.

In addition to the use of medications, other factors can also make someone with asthma more prone to osteoporosis. Some people with asthma believe milk and other dairy products can trigger an asthma attack. As a result, they avoid calcium rich foods that could help protect their bones. Research has shown that dairy is not a risk for most people with asthma, unless they are allergic to dairy products. Children in particular need calcium because strong bones early in life add some protection against osteoporosis later in life.

How to Treat Asthma with Aromatherapy

This sounds like irony, since generally asthmatics have difficulty with smells and such. But aromatherapy is being utilized to aid those with this type of breathing problem to surmount it.

Asthma is a severe condition that bears upon the breathing of the individual. When an asthma attack is set off, the bronchial passages become inflamed. This inflammation causes them to swell, leaving only a narrow space for air to travel through.

An asthmatic might feel like they can not catch their breath. Wheezing is frequently a characteristic as they try harder and harder to move air. Another consequence of an asthma attack is the smaller passageways in the lungs called bronchioles are likewise congested.

The lungs produce mucus to help engulf the irritant and push it out of the lungs. Only, the inflammation makes it difficult for the mucus to pass.

Asthma is set off by many of the same things that can cause allergic reactions to become unbearable. It may be food, nerve-wracking situations, allergens (dust, pollen, grass) or different causes. Either way, histamine is triggered off in the body and it leads to particular reactions like constriction of the airways. Add to that the inflammation and an asthmatic may scarcely move air.

One way that asthma attacks are being addressed is naturally with aromatherapy. Aromatherapy is a complementary medicine that utilizes different aromatic oils to give rise to positive effects inside the body.

Before beginning any aromatherapy treatment, confer with your physician. If you experience asthma, you’re likely being treated with inhalers and different medicine already. Make certain that none of the complementary treatments will interfere with your medicines. In the event of an asthma attack, always turn to your rescue meds for treatment.

Aromatherapy is one way to help relax the lungs while no attack is in progress or close at hand. If you would like to give this technique an attempt, that’s the finest time. Tell your aromatherapist if any type of aroma is an actual trigger for your asthma attacks.

These oils may be utilized in much the same way as medicines only without the side effects. Here is a good example. Lavender is well-known to relax the mind and alleviate stress. For the asthmatic, it may likewise be used to relax breathing passages, reducing spasms that cause the lungs to contract during an attack. Adding lavender essential oil to a humidifier or vaporizer may promote freer breathing. The results are faster if it’s added to hot water and the steam is inhaled.

Peppermint oil is likewise good for opening the lungs. Make a chest rub with a couple of drops of it to promote deeper breathing at nighttime. Including lavender will likewise steady your nerves.

Have you ever inhaled eucalyptus? You likely thought a freight train could run through your nose after that. It’s a potent oil that has to be used judiciously to relax the bronchioles and permit air to pass.

Aromatherapy may be utilized to help asthmatics savor freer respiration between asthma attacks. Several can even assist in shortening an attack, only that decision is best left up to your physician.

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UK doctors begin pioneering asthma treatment

Doctors in Manchester and Glasgow have begun treating NHS asthma patients with a pioneering treatment described as “melting away” muscle in the airways.

Instead of using drugs such as steroids, a wire probe is inserted into the lungs and then heats the tissue.

Currently, the procedure – called bronchial thermoplasty – is not being used anywhere else in Europe.

The technique uses 10-second bursts of radio waves which heat the lining of the lungs to 65 degrees Celsius.

That destroys some of the muscle tissue which constricts during an asthma attack, making breathing difficult.

Dr Rob Niven, senior lecturer in Respiratory Medicine at the University Hospital of South Manchester, who led the team carrying out the procedure at Wythenshawe Hospital, said “bronchial thermoplasty is the first non-drug treatment for asthma and it may be a new option for patients with severe asthma who have symptoms despite use of drug therapies.”

“The operation went according to plan and our patient has responded well. It will be a little while before we are able to say it’s been a complete success, but I am cautiously optimistic,” he said.

Normal airway
Airway of asthma patient has thickened muscle walls restricting the opening
Bronchoscope containing small wire probe passed into lungs
Probe is expanded so it touches walls of airways
Probe is then heated, reducing thickness of muscle tissue. Process is repeated along the airway to increase capacity

The procedure follows six years of trials in the UK, Canada and South America. Patients in the United States have been receiving the treatment for some months already.

Bronchial thermoplasty will not be used on children, says Dr Niven, and its effectiveness decreases as patients age.

Tens of thousands of patients across the UK with the most severe forms of asthma stand to benefit most from the treatment.

Symptoms can worsen to begin with, as the heat also causes damage to the sensitive lung lining. But once this is repaired doctors say asthmatics can be helped for up to five years.

However, cost is a potential problem – it costs around £10,000 per patient, although savings could be made in the longer term through fewer hospital admissions and reductions in the costs of medicines.

It will be up to the local NHS bodies, which buy care for patients, to decide on whether to fund it, possibly on a case-by-case basis.

According to the campaign group Asthma UK, 5.4 million people in the UK have asthma and around 250,000 of these have severe asthma.

The group’s Chief Medical Adviser, Professor Ian Pavord, said of bronchial thermoplasty: “In some people with severe asthma, the symptoms of their asthma have been improved and the risk of them having an asthma attack has been reduced, so it is encouraging to see that the technique has now been carried out outside of clinical trials.”

“However, this kind of procedure will not work for everyone so we would encourage people with asthma to discuss various treatment options with their GP to find the best way for them to keep their asthma managed and under control.”

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Asthma Treatment Today

2011-05-25 / Asthma / 0 Comments

Asthma Patients Are Over-Prescribed Antibiotics

Asthma treatment often results in unnecessary antibiotics being prescribed to children, says a new study.

One in six children with asthma are prescribed roughly 1 million unnecessary antibiotics to US children with asthma. Another study published in the same issue of the journal Pediatrics noted the similarities between the United States’ over-medication and Belgium, where children with asthma were found to be nearly twice as likely as other children to receive an antibiotic.

“You must have a good reason to prescribe both an asthma drug and an antibiotic,” study author Dr. Kris De Boeck of the University Hospital of Leuven told Reuters Health.

The “overuse” and “incorrect use” of antibiotics will “put pressure on bacteria and drive them to develop survival strategies,” which could prompt new drug-resistant bacteria to emerge, added De Boeck.

For the study, Dr. Ian M. Paul at Penn State Colelge of Medicine and his team examined information collected as part of national surveys about US doctor’s visits. They looked at more than 60 million visits involving children with asthma that had no symptoms presenting suggesting the use of an antibiotic. In one in six of those visits, the children received a prescription for an antibiotic.

De Boeck’s study involved a database from the insurer that covers over 40 percent of the Belgian population and found that 75 percent of children who received asthma drugs also got an antibiotic, which occurred in less than 40 percent of kids who were not given any drugs to treat asthma.

Many doctors are likely offering antibiotics “out of fear, out of habit,” wrote De Boeck in an email to Reuters Health.

“Some physicians state that parents do not want to leave the consultation room before they get a medicine.”

Bacteria May Have Role in Asthma

People with severe asthma are more likely to have antibodies against the disease-causing bacteria Chlamydia pneumoniae than the general population and in some cases antibiotic treatment can greatly improve symptoms according to research presented today at the 111th General Meeting of the American Society for Microbiology.

“We conclude that a subset of severe asthmatics harbor infectious C. pneumoniae in their lungs, resulting in antibody production and increased asthma severity,” says Eduard Drizik of the University of Massachusetts, Amherst, who presented the study.

Asthma is a chronic respiratory disease, whose causes are not completely understood, affecting over 300 million people worldwide, including almost 24 million American children and adults. There is no cure for asthma and the disease is managed by controlling disease symptoms. The recognition that asthma pathogenesis involves chronic inflammation has led to a flurry of studies exploring the prevalence of various infectious organisms in the asthmatic condition.

Having previously demonstrated an increased prevalence of C. pneumoniae in the lungs of children and adults with asthma, the researchers conducted a study designed to determine if the presence of Chlamydia-specific antibodies could predict asthma severity and if these antibody-positive patients would benefit from treatment with antibiotics.

“The data revealed a statistically significant link between Chlamydia-specific IgE antibody production and the severity of asthma,” says Drizik. “Of the asthma patients analyzed, 55% had Chlamydia-specific IgE antibodies in their lungs compared to 12% of blood donor controls.”

Moreover, patients who were treated on the basis of asthma severity with antibiotics had significant improvements in asthma symptoms and some even experienced a complete abolition of these symptoms.

“Physicians should therefore fully explore the involvement of microbes in difficult to treat asthma cases, since there might be a cure for some types of asthma after all,” says Drizik.

Medical Advances in the Treatment for Asthma

Medical Advances in the Treatment for Asthma, have advanced so positively in the last 10 to 15 years. The treatment is now so effective that some of the world’s top sports star play sport at the highest level, but at the same time need to take preventive medication to suppress and stop any chance of an Asthma attack.

Some of the current inhalers are so beneficial all one does is take a micro dose inhalation maybe one – two or three times a day, that’s it you get on my life and work and exercise with no side effects.

Plus once you know your prescription as prescribed by a bona fide medical practitioner and/or doctor you now have the option to buy the Asthma medication you need online. Some remedies for the treatment of Asthma are – Homeopathic Spray – Respitrol Oral Drops – Asthma Home Remedies.

One of our work colleagues suffers from Asthma and they tried out the Homeopathic Spray and they found the treatment very effective, the explained the results to their doctor and he concurred no they just use the Homeopathic Spray.

Medical Advances in the Treatment for Asthma are so intrusive and effective now in 2011.

Rise in mercury, dust can trigger asthma attacks

GURGAON: Frequent fluctuation in temperature, dust storms and exposure to grain dust can trigger asthma attack especially during this time of the year. City doctors said that the frequency of asthma attack can go up by 25-30%.

Experts warned that asthma is often wrongly diagnosed as a seasonal cough or cold. This, in turn, leads to a large percentage of patients missing out on proper treatment that can result in a full blown asthma attack.

According to Dr Sushil Upadhyay, Sr Consultant Pulmonology at Artemis Health Institute, “With a change in season, there is a 50% rise in the number of patients who come with asthma or allergy symptoms. Every year, around 10-15% of new asthma cases are reported around this time period.”

As per the doctors, these symptoms may vary with time and also from individual to individual. Doctors also advise that one should look out for warning signals for first timers to prevent an attack. “Patients might experience breathlessness, wheezing and tightness in the chest. A few people may experience episodic coughing which is severe during early morning and late night,” added Dr Upadhyay.

Doctors also advise that patients who have a history of asthmatic attacks must take preventive measures to stay in good health. “People with asthmatic tendencies should avoid a sudden change in temperature like directly stepping into the sun from an air conditioned room or vice versa. One should stand in the shade for some time after coming out of a cool place into the sun and/or switch off the car air conditioner a couple of minutes before reaching office, so that the temperature change is gradual,” said Dr Vivek Singh, consultant pulmonologist at Colombia Asia hospital.

The other seasonal problems at this time of the year include those like allergic rhinitis, allergic conjunctivitis and allergic asthma. “These differ from patient to patient. While some have a runny nose, others have red, watery, itchy eyes coupled with breathing problems,” said Dr Nevin Kishor, senior consultant, Pulmonology, Max Hospital, Gurgaon.

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Asthma Treatment News

2011-04-08 / Asthma / 0 Comments

Researchers Aims to Develop a Vaccine to Cure Asthma Completely\

“Monash University researchers are working on a vaccine that could completely cure asthma brought on by house dust mite allergies. If successful, the vaccine would have the potential to cure sufferers in two to three doses. Allergies to house dust mites is a leading cause of asthma and the respiratory condition affects more than 2 million Australians and costs more than $600 million in health expenditure each year.”

Now, people are allergic to dust mites and must frequently clean their environment in order to remove the microscopic creatures that cause allergic attacks. There were some medications that bring relief to the problem, but the medication must be taken regularly. Others reported that they have responded less well to the medications.

Professor El Mauseen believes that a vaccine for people who have allergy in house dust mite will have a series of health and financial benefits for the patient as well as to the government. Professor Mauseen is working with Professor Robyn O’Hehir, both from the Faculty of Medicine, Nursing and Health Services. Professor Maureen said that their goal is to develop a vaccine that can completely bring in two or three doses. That means that those who suffer from a house dust mite allergy will have an easy breath of air from their final dose.

The cost of allergy from the Australians reach approximately seven billion dollar each year. Professor O’Hehir also made an important gain in developing a vaccine for those who have allergy in peanut. There is no specific treatment for the allergy in peanut; hence the only option for that are avoidance and the emergency treatment of anaphylaxis with adrenaline.

Laboratory testing has shown that genetic predisposition exists to be allergic to more than one allergen. Dr. Meeusen said that they have found out the being allergic to peanut also has likelihood in developing allergy to house dust mites. It is difficult to human to know how early the stage of allergy occurs. The scientists will see which models are going to build up allergy and which are not, that is to resolve the difference between the two.

Using the knowledge of normal vaccines for infectious diseases will help researchers to have a good understanding on how the allergy vaccines work in order to develop a more safe and effective product.

Effects of short-term treatment with atorvastatin in smokers with asthma – a randomized controlled trial

The immune modulating properties of statins may benefit smokers with asthma. We tested the hypothesis that short-term treatment with atorvastatin improves lung function or indices of asthma control in smokers with asthma.

Methods: Seventy one smokers with mild to moderate asthma were recruited to a randomized double-blind parallel group trial comparing treatment with atorvastatin (40 mg per day) versus placebo for 4 weeks.

After 4 weeks treatment inhaled beclometasone (400 ug per day) was added to both treatment arms for a further 4 weeks. The primary outcome was morning peak expiratory flow after 4 weeks treatment.

Secondary outcome measures included indices of asthma control and airway inflammation.

Results: At 4 weeks, there was no improvement in the atorvastatin group compared to the placebo group in morning peak expiratory flow [-10.67 L/min, 95% CI -38.70 to 17.37, p=0.449], but there was an improvement with atorvastatin in asthma quality of life score [0.52, 95% CI 0.17 to 0.87 p=0.005]. There was no significant improvement with atorvastatin and inhaled beclometasone compared to inhaled beclometasone alone in outcome measures at 8 weeks.

Conclusions: Short-term treatment with atorvastatin does not alter lung function but may improve asthma quality of life in smokers with mild to moderate asthma.

Reminder: MediciNova to Host Business Update Conference Call by Management on April 7, 2011

SAN DIEGO, April 7, 2011 (GLOBE NEWSWIRE) — MediciNova, Inc., a biopharmaceutical company that is publicly traded on the Nasdaq Global Market (Nasdaq:MNOV) and the Jasdaq Market of the Osaka Securities Exchange (Code Number: 4875), today announced details on its planned business update conference call conducted by management today, Thursday, April 7, 2011 at 4:30pm(Eastern).

Conference Call/Webcast Information

MediciNova will host a conference call and audio webcast to make a business update presentation followed by a question and answer session with members of management. Management on the call will include Dr. Yuichi Iwaki the President and Chief Executive Officer, Michael Coffee the Chief Business Officer and Interim-Chief Financial Officer, and Dr. Kirk Johnson the Chief Scientific Officer. The call is scheduled for today, April 7th, at 4:30 P.M. Eastern time.

To participate in this call, dial 866-203-2528 (domestic), 617-213-8847 (international), passcode: 61797215, shortly before 4:30 P.M., Eastern time. For a limited period following the call, a replay of the call will be available, beginning at 7:30 P.M. Eastern time; the replay can be accessed by calling 888-286-8010 (domestic), 617-801-6888 (international), passcode: 52603635. The audio webcast will be available on MediciNova’s investor relations website ( for approximately 60 days following the call.

About MediciNova

MediciNova, Inc. is a publicly traded biopharmaceutical company founded upon acquiring and developing novel, small-molecule therapeutics for the treatment of serious diseases with a commercial focus on the U.S. market. Through strategic alliances primarily with Japanese pharmaceutical companies, MediciNova holds rights to a diversified portfolio of clinical and preclinical product candidates, each of which MediciNova believes has a well-characterized and differentiated therapeutic profile, attractive commercial potential, and patent coverage of commercially adequate scope. MediciNova’s pipeline includes six clinical-stage compounds for the treatment of acute exacerbations of asthma, chronic obstructive pulmonary disease exacerbations, multiple sclerosis and other neurologic conditions, asthma, interstitial cystitis, solid tumor cancers, Generalized Anxiety Disorder, preterm labor and urinary incontinence and two preclinical-stage compounds for the treatment of thrombotic disorders. MediciNova’s current strategy is to focus on its two prioritized product candidates, MN-221, for the treatment of acute exacerbations of asthma and chronic obstructive pulmonary disease exacerbations, and Ibudilast (MN-166/AV411), for the treatment of multiple sclerosis, chronic pain, spinal cord injury, or drug addiction. Each drug candidate is involved in clinical trials under U.S. and Investigator INDs. MediciNova is engaged in strategic partnering discussions to support further development of the MN-221 and Ibudilast programs. Additionally, MediciNova will seek to monetize opportunistically its other pipeline candidates.

Don’t Let Seasonal Allergies Spoil Your Spring

The arrival of spring means warmer temperatures, open doors and windows, and the start of allergy season are all on the way. Instead of putting up with weeks of sniffling, sneezing, and itching eyes, try these tips from the American College of Allergy, Asthma and Immunology to keep your allergy symptoms under control.
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• Know your allergens – Your allergen is the thing you are allergic to. It could be pollen from certain plants that bloom in the spring, or it could be something that is around year ’round. More than two-thirds of all people who think they have spring allergies actually have allergies all year. Knowing what you are allergic to can help you decide when it’s time to start treatment. An allergist can determine what your allergens are and set up a plan to help you deal with them.

• Get the best meds – There are many over-the-counter (OTC) medications available that claim to be the best thing to treat allergies. If one treatment doesn’t work, you may be tempted to just keep buying and trying new things in the hope that something will do the job. Rather than spending money randomly, consider meeting with an allergy specialist who can isolate your allergen and prescribe the best medication to treat your symptoms. In general, prescription medications are better at treating a stuffy nose and inflammation in the sinuses. Another option that can provide long-term relief is immunotherapy. This treatment involves weekly allergy shots to help your body learn not to react to your allergen.

• Take meds on time – If you wait until your nose is stuffy and you are miserable to take allergy medications, you will have an uphill battle to feel better. If you know that your allergies kick in during the spring, start taking your medication before your symptoms can get a head start. Warm weather generally means the start of allergy season when plants release pollen and molds resume growing.

• Avoid your allergens – The less you are around your allergens, the less you will have symptoms. So stay indoors during the middle of the day when pollen counts are highest.

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Asthma Treatment Today

2011-03-16 / Asthma / 1 Comments

Asthma sufferers in the bush worse off

An Australian Institute of Health and Welfare report has found a stark contrast between the quality of care provided to asthma sufferers in poor and remote areas compared with patients in the city.

The report found asthma sufferers in low socio-economic and remote areas are more likely to end up in hospital within 28 days of an attack.

Overall the number of people who end up in hospital for asthma has dropped over the past decade, but the study shows the number of people who are readmitted within a month of treatment remains stable.

Professor Guy Marks from the Australian Centre for Asthma Monitoring led the study and says children under the age of five or adults over 35 are more likely to be admitted to hospital for treatment than older children and young adults.

“About 4.5 per cent of people who are admitted to hospital are re-admitted within 28 days,” he said.

“Between 1996-97 and 2004-05 there were 335,461 admissions to hospital for asthma among 287,924 individuals. Among these individuals around 13,551, that is 4.71 per cent, were readmitted to hospital for asthma within 28 days.”

The study has also found the risk of readmission to hospital was higher in some areas compared with others.

Professor Marks says people in disadvantaged areas and those that live in remote parts of the country are more likely to be readmitted within 28 days compared to those living in major cities.

He says the study suggests there is a gap in the quality of care between remote and urban areas.

But he says the study does not indicate where the problem with the quality of care arises.

“It is important to recognise that although this is about admissions, it is not necessarily saying it is the quality of care in hospital that is the problem,” he said.

“It is really across the continuum of care from being in hospital to primary care to specialist care in the community and also to communication among those very sectors of care because management of asthma really involves a continuum of care that involves GPs, specialists and hospital care and communication amongst those people.”

Michelle Goldman from the Asthma Foundation of New South Wales says GPs, pharmacists, the Asthma Foundation and hospitals need to work together to make sure people who are leaving the emergency department are put in touch with the right services.

Ms Goldman says the Asthma Foundation provides access to a wide variety of information and support services for asthma sufferers. She says she is not surprised by the study.

“It makes sense that admissions are higher in lower socio-economic areas,” she said.

“Basically people in those areas don’t have access to the services to help them manage their asthma or they simply can’t afford them, so it is how can we provide services that are free and that will help people to better understand and manage their asthma in the vacuum of physical services.”

Mercy specialist offers allergy-coping advice

Despite some chilly days in March, spring is already in air, and allergy season is now – and progressing.

“Even though it looks dreary outside, tree pollen typically begins to emerge in February, that’s why we tell our patients to start their allergy medications early,” said Sarah Samimi Field, MD, a specialist in allergy and immunology. “If you’re allergic to pollens from grasses, trees and weeds, your symptoms could worsen as the season progresses, and pollen is stubborn. Just as you see it on your car, windows and patio furniture, it is likely on you as well, and it gets tracked into your home.”

Typical seasonal allergy symptoms include itchy nose and eyes, sneezing, stuffy nose and runny nose. People with asthma may experience increased coughing or wheezing. How people react depends on how severe their allergies are.

Dr. Field recommends that people with seasonal allergies run the air conditioning, keep their windows closed at home, work and in the car, change their home air filter frequently and shower before bed to wash pollens away. She also recommends using over-the-counter medications to ease symptoms rather than avoid outdoor activities.

“The ultimate goal is for people with seasonal allergies to go outside and enjoy the weather and everything the outdoors has to offer,” Dr. Field said. “There is no cure for allergies, but with the right treatment, you can go outside and have fun.”

She added, “There are a lot of great over-the-counter medications available, but they don’t work for everyone. If they don’t work for you, or you’re having increased sinus infections, or your asthma symptoms seem to be out of control, then it’s time to talk to your doctor or see a specialist who can offer treatments with the most benefits and the least side effects.”

Dr. Field is board certified in Allergy and Clinical Immunology, she sees both children and adults. Her office is located in Suite 208 in the St. John’s Mercy Medical Building, 851 E. Fifth Street in Washington. For more information or to schedule an appointment, call 636-432-0111.

New Asthma Treatment Offers Relief

A new treatment could bring relief for those with severe asthma symptoms. It is called bronchial thermoplasty, and it is being performed by doctors at Mount Carmel Hospital in Columbus.

“This is the first novel treatment for asthma that has come on board in years,” said Dr. Roy St. John, of Pulmonary and Critical Care at Mount Carmel West Hospital. Dr. St. John is the first doctor in Columbus performing this new procedure, which was recently approved by the Food and Drug Administration.

Asthma affects 23 million people including nearly 7 million children in the United States, according to the Centers for Disease Control and Prevention. Symptoms of asthma include coughing, wheezing, shortness of breath, and pressure or tightness in the chest. It can be both painful and frightening, and often leads to a series of medications.

4 Your Health got an inside look at bronchial thermoplasty, as it was performed on Sami Snokes, a Columbus mother of four who has suffered from asthma for more than ten years.

“It gets scary sometimes. Your chest tightens up. You feel like you can’t breathe and you panic,” said Snokes who is on numerous medications to treat her asthma symptoms. Snokes is trying bronchial thermoplasty with hopes that she can reduce her medication and emergency room visits.

Bronchial thermoplasty works by applying low level, radiofrequency heat to the smooth muscle in the lungs that thickens in asthma patients and contracts causing their symptoms. Dr. St. John uses a specially designed catheter to go deep into Snoke’s airway. On the end of the catheter, is a small tool that does all the work.

“You can see on the end of the catheter it looks like a little whisk or basket and then on the tips of those are where the heat gets delivered,” said Dr. St. John as he showed NBC4 medical reporter Ellie Merritt how the device works.

The heat that is applied to the muscle helps to clear the airway, making it easier to breathe. The procedure takes about an hour, as Dr. St. John works his way through the airway with the catheter. It takes three separate treatments to complete.

Dr. St. John said bronchial thermoplasty is only for patients with severe asthma symptoms. He said the results are dramatic, with studies showing an 84 percent reduction in emergency room visits and some patients can reduce or even eliminate their medications. However, since this treatment is so new, Dr. St. John said insurance does not cover the procedure, which costs approximately $20,000.

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Asthma News and Treatment

2011-02-26 / Asthma / 0 Comments

The Wheezing Game: What Really Triggers Asthma?

According to the Mayo Clinic, asthma is a condition where the airways (the tubes that bring air into-and-out of) the lungs are obstructed. During an attack, the airways narrow and swell, producing extra mucus, and exhaling becomes difficult. The most common signs of asthma include coughing, wheezing, chest tightness and shortness of breath. Asthma attacks vary. For some, they may be constant while others may have an attack only once a year. Asthma symptoms can be triggered by different variables including stress, dust, pet hair, dander, changes in weather, mold, pollen, exercise and even aspirin.

TREATMENT: Asthma can’t be cured but symptoms can be controlled and improve overtime. The ultimate goal of treatment is avoiding asthma triggers and monitoring symptoms. Doctors may take a series of blood tests, chest x-rays and lung function tests to first diagnose asthma and then determine the most appropriate treatment. Two medicines are prescribed for the treatment of asthma – medicine to prevent attacks and medicine to provide quick relief during an attack. (SOURCE: National Asthma Education and Prevention Program)

MANAGEMENT: With proper self-management and medical treatment, most people diagnosed with asthma can live normal lives. Those who have infrequent attacks may use quick relief medication as needed. Those with frequent episodes need to take medications on a regular basis to prevent symptoms. Complications from asthma can be severe: at the extreme level it can lead to death, severe chest pain, and changes in lung functionality. Persistent cough and drowsiness is also possible. (SOURCE: National Heart, Lung, and Blood Institute)

PREVENTATIVE TIPS: Keeping yourself far, far away from a flare-up is a key tenet of living with asthma. Just how to go about doing that isn’t always easy. The tips below should help.

– Avoiding triggers and substances that irritate the airways are possible.

– Cover bedding with “allergy proof” casings to reduce exposure to dust mites.

– Remove carpets from bedrooms and vacuum regularly around the house.

– Use unscented detergents and cleaning materials.

– Avoid smoking and/or homes/areas where tobacco use is common

Steroids to treat asthmatic children

A new University of Montreal study is evaluating the impact of steroid use on the immune system of kids.

The study has suggested that kids experiencing an asthma attack who are treated with a short burst of oral steroids may have a transient depression of immune response.

These findings have implications for asthmatic children who have flare-ups and who may be exposed to new contagious diseases.

“There is no question that the administration of corticosteroids reduces the risk and duration of hospital admission in children with acute asthma remain the most effective treatment for moderate and severe asthma exacerbations,” said first author Francine M. Ducharme of the University of Montreal.

“However, the safety profile of these medications continues to raise concerns among parents and physicians. New concerns over their possible impact on the immune system stem from rare reports linking or severe chickenpox infections linked with corticosteroid administration,” said Ducharme.

Ducharme and colleagues evaluated the immune response of children aged 3 to 17 years, who had arrived at the emergency department (ED) with an asthma attack.

“Several corticosteroid-treated children had a significantly lower immune response, as measured by the amount of antibody produced, than non-treated kids,” said Ducharme.

Children enrolled in the study were revaccinated with the antigen five weeks following their initial ED visit. Comparable immune responses were measured in children exposed to oral corticosteroids and not exposed to corticosteroids.

“These findings indicate there is a transient, not sustained, immune suppression in some children exposed to a new antigen at the same time as a corticosteroid administration.

In summary, our finding suggest a transient immune suppression occurs in some children who are concomitantly exposed to a new antigen and corticosteroids during an asthma attack, with a recovery within six weeks,” said Ducharme.

“Given the high frequency of use of these drugs over the past 20 years, the very rare occurrence of severe infectious disease is reassuring and would suggest that the window of risk is very small and only applies to exposure to a new antigen. However, before prescribing oral corticosteroids, it would appear prudent to systematically enquire about recent exposure to chickenpox in children who did not have chickenpox or the vaccine,” added Ducharme.

Mild asthma might not need to be treated daily

Mild asthma might not need to be treated every day, say US researchers.

A “preventer” inhaler containing corticosteroid is part of many asthma sufferers’ daily routine, but it can result in reduced growth and children often forget to take it.

This study, published in The Lancet, shows that it is possible to manage the symptoms without a daily dose.

Asthma UK said daily treatment was still the most effective, and concerned patients should speak to their doctor.

The disease causes inflammation of the tubes which carry air to and from the lungs. If they become irritated, then the airways narrow, sticky mucus is produced and breathing becomes difficult.

More than 5 million people in the UK are being treated for the illness and Asthma UK estimates 1.1 million have asthma which is mild and under control.
Missing doses

Researchers at the University of Arizona believe there is a problem with the way the disease is managed.

Two types of inhalers are used: “relievers” which are used when breathing is difficult and “preventers” which are taken every morning and evening.

However, the researchers said that many children stop taking the daily medication if their symptoms disappear.
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Professor Fernando Martinez, from the University of Arizona, told the BBC: “If you have a daily drug and a very significant number are not taking it, then that tells you it’s a losing strategy.”

“We want to find something which is more child- and parent-friendly as well as avoid the growth effect.”

In all, 288 children and teenagers with mild and persistent asthma took part in the 44-week trial.

The study showed that taking corticosteroids twice a day was still the most effective treatment, However, those taking the medication grew by 1.1cm (0.5in) less than children not taking the drug during the trial.
Potent combination

Importantly, asthma was also managed without daily treatment if the corticosteroids were combined with the “reliever” inhaler.

This eliminated the effect on growth and the researchers say it would be an easier form of treatment for children.

Further clinical trials will be needed to verify the results.

Professor Martinez said: “I’m continuing to recommend daily corticosteroid to my patients, but I know some of them will not take it.”

Asthma UK said the study confirmed that daily inhaled corticosteroids were the most effective treatment.

Dr Samantha Walker, executive director of research and policy at Asthma UK, said: “We know that long-term adherence to medicine treatment plans can be difficult, particularly when a child’s asthma seems to be under control.

“The use of combined ‘preventer’ and ‘reliever’ medicines as rescue therapy appears to be superior to ‘reliever’ inhalers alone and offers a new ‘step-down’ approach to the management of mild, well-controlled asthma in children and young people who find it difficult to adhere to long-term daily treatment with inhaled steroids.

“Many parents have concerns about their child’s steroid intake. However, research shows that children on low daily doses of ‘preventer’ medicines show no difference in growth. At higher doses, the picture is less clear. For all children, treatment plans should be reviewed at least every six months.

“If you have any concerns about your asthma treatment, Asthma UK recommends you speak to your doctor or asthma nurse.”

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Astma Today

2010-10-19 / Asthma / 0 Comments

Acetaminophen no asthma trigger after all?

By Frederik Joelving

NEW YORK | Tue Oct 19, 2010 12:28am IST

(Reuters Health) – Doctors have been scratching their heads for years over the higher asthma risk in kids who use acetaminophen, a common painkiller known as Tylenol in the US.

Just last August, researchers studying toddlers in Ethiopia said it was “increasingly likely” that the drug had triggered much of the wheezing that troubled eight percent of those children. And another study hinted it might be fueling a large part of the worldwide increase in asthma (see Reuters Health story of Aug 13).

In a letter to the editor of the Journal of Allergy and Clinical Immunology, however, researchers from Germany say there is no cause for alarm.

Using long-term data for more than 3,000 children, they report that the link between asthma and acetaminophen only held when the medication was used to treat airway infections — not stomach flu or urinary tract infections.

“A lot of people associate (acetaminophen) with asthma,” said Dr. Eva Schnabel, of the German Research Center for Environmental Health in Neuherberg, who worked on the new analysis.

“Perhaps they should think it over and read the studies again,” she suggested.

Schnabel, who has no ties to drugmakers, said most earlier studies hadn’t followed children from the get-go and often relied on parents’ recall.

But parents whose kids have frequent airway infections might be more likely to remember using a painkiller to lower the fever. And it’s possible that the infections that led to acetaminophen use, and not the drug per se, could have caused asthma later on or revealed an underlying vulnerability to the disease.

“There have been several studies showing that viral infections are a risk factor for asthma,” Schnabel told Reuters Health.

The letter by Schnabel and her colleagues, which was reviewed by independent experts, is based on published data from kids followed closely up to age six.

Parents were asked to record all cases of fever in their child’s first year of life as well as airway, stomach and urinary tract infections. They also jotted down the medications they used in these cases.

Thirteen percent of the children developed asthma. Although use of acetaminophen — the most common painkiller by far — was more common in those who went on to have asthma, that difference was only found for airway infections.

“This analysis indicates that increased respiratory tract infection morbidity and not (acetaminophen) use during infancy is associated with the later development of asthma,” the researchers write.

“There is no argument anymore that (acetaminophen) shouldn’t be prescribed during infancy,” concludes Schnabel.

The researchers who suggested acetaminophen might trigger asthma could not be reached for comments.

SOURCE: Journal of Allergy and Clinical Immunology, online October 4, 2010.

Giving infants antibiotics triggers asthma?

Canadian medical researchers are conducting a 2.5-million-dollar study to answer whether giving antibiotics to infants in their first year of life triggers asthma and allergies that develop later on in childhood.

More than 50 percent of Canadian infants receive a prescription for antibiotics before they turn one year old, reports Discovery News .

The study aim is two-fold: first, to discern how intestinal bacteria inside newborns changes after taking antibiotics, and second, to study if those changes trigger medical conditions later.

The researchers are intrigued by microbiota. Considered to be ‘good’ intestinal bacteria, microbiota protect against harmful bacteria and help the body absorb nutrients.

Except no one is born with microbiota. It develops during the first year of life. Hence the age of the research subjects.

The study’s proof will be in the dirty diapers. Researchers will analyze the composition of microbiota from fecal samples at three months and again, at one year of age. DNA culled from the baby poop will identify bacteria in the microbiota.

School Bus Contractor Awarded by Asthma Group

Riteway Bus Service of Milwaukee, Wisc., was awarded the Wisconsin Asthma Coalition (WAC) 2010 WAC Taking Action for Asthma Award at a recent meeting.

The award was presented at the WAC meeting on Oct. 15 and highlighted the green efforts made by the school bus contractor. These environmentally friendly practices include idle reduction, fuel conservation programs, emission control technologies, newer, lower emission emitting buses and a plan to introduce hybrid school buses into the fleet sometime next year.

Riteway President Ronald Bast was on hand to accept the award, which was presented by WAC Chair Rhonda Yngsdal-Krenz. This is not a first for Riteway, as the company has received other accolades for its green efforts, including the 2010 Wisconsin Partners for Clean Air Award and the 2010 United Motorcoach Association Green Highway Award.

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