Oral corticosteroid use, obesity, and ethnicity in children with asthma.

Conclusions: Children with obesity received more oral steroid prescriptions than those at a healthy weight, which may be indicative of worse asthma control. We did not observe significant ethnic disparities. PMID: 31437069 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research

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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...
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Review Source Type: research
Publication date: July–August 2019Source: The Journal of Allergy and Clinical Immunology: In Practice, Volume 7, Issue 6Author(s): Tianshi David Wu, Emily P. Brigham, Corinne A. Keet, Todd T. Brown, Nadia N. Hansel, Meredith C. McCormackBackgroundMetabolic dysfunction may contribute to worsened asthma in obesity. The relationship between prediabetes and diabetes, metabolic conditions more common in obesity, and asthma outcomes is not well characterized.ObjectiveWe sought to determine the association between prediabetes/diabetes and asthma exacerbations in an obese asthma cohort.MethodsA retrospective cohort of US obe...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
ConclusionsPoorly controlled asthma is more frequent among publicly versus privately insured pregnancies in the United States. Dispensing of long-term controller medications during pregnancy remains low, even for symptomatic patients.
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
CONCLUSIONS: Excess weight status is a possible determinant of primary nonadherence in children initiating low-dose ICS and secondary nonadherence to higher-dose ICS regimens. This hypothesis-generating study suggests that nonadherence may be a potential contributor to higher morbidity in children with obese-asthma. PMID: 30912698 [PubMed - as supplied by publisher]
Source: Journal of Asthma - Category: Respiratory Medicine Tags: J Asthma Source Type: research
Publication date: Available online 8 March 2019Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Tianshi David Wu, Emily P. Brigham, Corinne A. Keet, Todd T. Brown, Nadia N. Hansel, Meredith C. McCormackAbstractBackgroundMetabolic dysfunction may contribute to worsened asthma in obesity. The relationship between pre-diabetes and diabetes, metabolic conditions more common in obesity, and asthma outcomes is not well-characterized.ObjectiveWe sought to determine the association between pre-diabetes/diabetes and asthma exacerbations in an obese asthma cohort.MethodsA retrospective cohort of US obese...
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Gastro-oesophageal reflux disease (GORD) has long been associated with poor asthma control without an established cause-effect relationship.610 asthmatics (421 severe/88 mild-moderate) and 101 healthy controls were assessed clinically and a subset of 154 severe asthmatics underwent proteomic analysis of induced sputum using untargeted mass spectrometry, LC-IMS-MSE. Univariate and multiple logistic regression analyses (MLR) were conducted to identify proteins associated with GORD in this cohort.When compared to mild/moderate asthmatics and healthy individuals, respectively, GORD was three- and ten-fold more prevalent in sev...
Source: Respiratory Medicine - Category: Respiratory Medicine Authors: Source Type: research
The obese asthmatic is thought to disproportionally experience greater severity, morbidity, increased exacerbations, and reduced inhaled corticosteroid responsiveness. We have previously reported that care provided by a community-based healthcare delivery system, the Breathmobile, results in improved asthma control, and reduced morbidity. We hypothesized that this system of care could provide similar outcomes for the morbidly obese compared to the normal weight asthmatic child.
Source: Journal of Allergy and Clinical Immunology - Category: Allergy & Immunology Authors: Source Type: research
CONCLUSIONS: Our machine learning-based approaches provide new insights into mechanisms of CS responsiveness in asthma with the potential to improve disease treatment. PMID: 30682261 [PubMed - as supplied by publisher]
Source: American Journal of Respiratory and Critical Care Medicine - Category: Respiratory Medicine Authors: Tags: Am J Respir Crit Care Med Source Type: research
Conclusion: The main reasons for OMZ withdrawal were the lack of response and side effects. These patients were more frequently obese, former/current smokers, had lower levels of IgE, poorer functional capacity and more frequently require inhaled LAMA and oral corticosteroids. Current OMZFormer OMZSexFemale n(%)Male n(%)27(79.4)27(79.4)15(68.2)7(31.8)Age56±1454±17Obesity*Yes n(%)No n(%)4(33.3)31(68.9)8 (66.7)14(31.1)Smoking status*Former n(%)Current n(%)No n(%)0(0)10(28.6)25(71.4)4(18.2)6(27.3)12(54.5)Rhinoconjunctivitis*Yes n(%)No n(%)No info n(%)5(14.3)6(17.1)24(68.6)11(50.0)5(22.7)6(27.3)Nasal polyps n(%)1...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
Conclusion: ACT and miniPAQLQ are complemental to reveal long-standing characteristics: overweight, increased lung volumes and gas trapping, rather than current inflammation or airway obstruction in regularly treated patients.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Paediatric asthma and allergy Source Type: research
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