Treatment Strategies for the Yellow Zone
Asthma control changes over time and many factors contribute to this variability. Environmental exposures such as seasonal allergen fluctuations, second-hand tobacco exposure, and viral upper respiratory tract infections (RTI) are just a few of the known triggers of lability 1. In addition, host factors such as inhaler technique and co-morbid conditions including atopic diseases, obesity, and acid reflux can also contribute to this changeability. During times of lability, overzealous intervention can lead to overuse of oral corticosteroids (OCS) and healthcare visits, while delayed treatment can lead to severe exacerbation, with potential hospitalization, or even death.
It’s hardly news that the gastrointestinal tract is important to human health: It transports food from the mouth to the stomach, converts it into absorbable nutrients and stored energy, and shuttles waste back out of the body. If you don’t properly nourish yourself, you don’t live. It’s that simple. But in recent years, scientists have discovered that the GI system has an even bigger, more complex job than previously appreciated. It’s been linked to numerous aspects of health that have seemingly nothing to do with digestion, from immunity to emotional stress to chronic illnesses, including can...
Antibiotics can be lifesaving, but they can have serious downsides — including increasing the risk of obesity when they are given early in life, according to a recent study. Antibiotics kill bacteria. That can be a very good thing when the bacteria are causing a serious infection. But antibiotics don’t limit themselves to killing infection-causing bacteria; they kill other bacteria in the body, too. And that can be a very bad thing. Our bodies are full of bacteria. These bacteria, part of our microbiome, are important. Along with other micro-organisms in our body, they play a role in how we digest foods, in nor...
ConclusionRegardless of sex, abdominal visceral fat was associated with reduced asthma quality of life independent of other obesity indices, and this may be explained by the impact of abdominal visceral fat on reduced FEV1 % predicted and higher risk for GERD and depression. Therefore, visceral adiposity may have more clinical influence on asthma symptoms than any other obesity indices.
Conclusions: Asthma was associated to bronchiectasis in 76% of the patients but it was estimated as etiology in only every fifth patient. However, retrospectively it is difficult to exclude asthma as a background cause in many cases with recurrent asthma like symptoms and respiratory infections. Nevertheless, in one fifth of the patients no identifiable cause was found. None of the patients had had tuberculosis. Lung function test results were well preserved and in 66% bronchiectasis was restricted to one-three lobes.
Background: Multiple co-morbidities are associated with disease control, healthcare utilization and quality of life in difficult asthma.Aim: To evaluate the prevalence of comorbidities in patients with difficult asthma in the Wessex AsThma CoHort of difficult asthma (WATCH).Methods: Our prospective observation cohort study has enrolled 380 patients with severe asthma. History of co-morbidities is collected at enrolment. Data is presented as percentages and chi squared tests were used to calculate differences between groups.Results: Comorbidity(n)Prevalence (%)Gender Difference(male % vs female %)Age of Onset Difference (ea...
Conclusions Most elderly asthmatic patients followed up in our tertiary center were atopic and higher values of total serum IgE suggest atopy. Atopy was inversely correlated with age of asthma onset. The diagnosis of allergic asthma in the elderly population is essential to treat patients more properly, improving their quality of life and decreasing asthma morbidity and mortality.
We describe the prevalence, impact and treatment effects of these comorbidities in the difficult asthma population, emphasizing gaps in the current literature. We examine the associations between individual comorbidities and highlight the potential for comorbidity clusters to exert combined effects on asthma outcomes. We conclude by outlining a pragmatic clinical approach to assess comorbidities in difficult asthma.
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ConclusionsAn international effort in the implementation of SUA patients registries could help to better understand the clinical features and to manage severe asthma, representing a non negligible socio‐economic burden for health services.This article is protected by copyright. All rights reserved.
Conclusions Almost all patients with difficult-to-control asthma have comorbidities, in particular asthmatic women of older age, former smokers, and asthmatics who are prednisone dependent. Recognition of these typical characteristics can help physicians in the diagnostic workup, so that adequate preventive measures can be taken.