A proposed scheme to cope with comorbidities in asthma
Publication date: Available online 25 August 2018Source: Pulmonary Pharmacology &TherapeuticsAuthor(s): Luane Marques de Mello, Álvaro A. CruzAbstractThe prevalence of non-communicable chronic diseases has been on the rise and the co-occurrence of morbidities is becoming more common. Multimorbidities are found more frequently among women, those with a history of mental disorders, lower level of schooling, and unfavorable socioeconomic condition. Physical inactivity, smoking and obesity are also associated with multimorbidities. Its occurrence is directly related to the age, affecting the majority of the individuals with more than 50 years. It is important to consider the possibility of comorbid conditions that aggravate, complicate or simulate the symptoms of the disease in the face of a patient with asthma and poor response to treatment. Among subjects with asthma, some conditions stand out as the most frequent: chronic rhinitis or rhinosinusitis, gastroesophageal reflux disease, obstructive sleep apnea syndrome, obesity, and cardiovascular disorders. Comorbidities reduce the chances of optimal asthma control. It is essential to assess and manage properly these complex situations, choosing wisely preventive strategies and treatment options to avoid adverse events and optimize outcomes. Medications for asthma have the potential to worsen cardiovascular conditions, while beta-adrenergic receptor blockers and angiotensin conversion enzyme inhibitors used for cardiova...
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Purpose of review Severe asthma is often associated with numerous comorbidities that complicate disease management and affect patient's outcomes. They contribute to poor disease control and mimic asthma symptoms. Although some comorbidities such as obstructive sleep apnea, bronchiectasis, and chronic obstructive pulmonary disease are generally well recognized, many other may remain undiagnosed but may be detected in an expert specialist setting. The management of comorbidities seems to improve asthma outcomes, and optimizes therapy by avoiding overtreatment. The present review provides recent knowledge regarding the most...
Poor control in patients with difficult-to-treat asthma might be due to several factors, including poor adherence and undertreated asthma co-morbidities. After an assessment addressing these issues, only few patients still need targeted therapy.We aimed to evaluate the effect of a multidimensional intervention in improvement asthma control in patients with difficult asthma.Fifty patients with difficult asthma were prospectively included in this study conducted in AbderrahmenMami hospital between March 2018 and September 2018. Clinical, biological and functional characteristics were collected. Then, coexisting conditions (p...
Conclusions:The absence of demographic or clinical predictors of OSA supports using general indications for PSG in children with ASD.Citation:Tomkies A, Johnson RF, Shah G, Caraballo M, Evans P, Mitchell RB. Obstructive sleep apnea in children with autism.J Clin Sleep Med. 2019;15(10):1469–1476.
This study analyzed the characteristics of patients with suspected OSA from the European Sleep Apnea Database according to presence/absence of physician-diagnosed asthma. Cross-sectional data in 16,236 patients (29.1% female) referred for suspected OSA were analyzed according to occurrence of physician-diagnosed asthma for anthropometrics, OSA severity and sleepiness. Sleep structure was assessed in patients studied by polysomnography (i.e. 48% of the sample). The prevalence of physician-diagnosed asthma in the entire cohort was 4.8% (7.9% in women, 3.7% in men, p
Conclusions: As compatible with previous research, we recognized asthma and PBB as the most frequent causes of chronic cough. We believe that implementation of a standardized algorithm including investigation of OSA as an etiological factor of chronic cough in children may improve clinical outcomes.Figure-1: Etiologies of patients (n=251)*: Three patients were diagnosed as astma and gastroesophageal reflux
Conclusion According to the current literature data and the values obtained in our paper, we can correlate through expressive values obesity with OSA and their apnea hypopnea index (AHI) values. However, despite significant prevalence of OSA with other comorbidities, our study could not render expressive significance values able to justify their correlations.[...]Thieme Publicações Ltda Rio de Janeiro, BrazilArticle in Thieme eJournals:Table of contents | Abstract | open access Full text
Conclusions Outcomes after DS vary by health insurance. These findings may facilitate management of DS patients.
Conclusion In this analysis of a national database defining the 3 most prioritized diagnoses, GER is independently associated with OSA, with double the odds of concurrent occurrence, even while controlling for potentially related conditions.
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