scholarly journals Fração Exalada de Óxido Nítrico no Controlo e Abordagem Terapêutica da Asma

2014 ◽  
Vol 27 (1) ◽  
pp. 59 ◽  
Author(s):  
Bruno Melo ◽  
Patrício Costa ◽  
Ariana Afonso ◽  
Vânia Machado ◽  
Carla Moreira ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Asthma Control ◽  
Peak Expiratory Flow ◽  
Chronic Respiratory Disease ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Cross Sectional ◽  
Asthmatic Children ◽  
Bronchial Inflammation ◽  
Expiratory Flow

<strong>Introduction:</strong> Asthma is a chronic respiratory disease characterized by hyper-responsiveness and bronchial inflammation. The bronchial inflammation in these patients can be monitored by measuring the fractional exhaled nitric oxide. This study aims to determine fractional exhaled nitric oxide association with peak expiratory flow and with asthma control inferred by the Global Initiative for Asthma.<br /><strong>Material and Methods:</strong> Observational, analytical and cross-sectional study of children with asthma, 6-12 years-old, followed in the Outpatient Respiratory Pathology of Braga Hospital. Sociodemographic and clinical information were collected through a questionnaire. fractional exhaled nitric oxide and peak expiratory flow were determined by portable analyzer Niox Mino® and flow meter, respectively.<br /><strong>Results:</strong> The sample is constituted by 101 asthmatic children, 63 (62.4%) of males and 38 (37.6%) females. The mean age of participants in the sample is 9.18 (1.99) years. The logistic regression performed with the cutoff value obtained by ROC curve, revealed that fractional exhaled nitric oxide (bFENO classes = 0.85; χ2 Wald (1) = 8.71; OR = 2.33; p = 0.003) has a statistical significant effect on the probability of changing level of asthma control. The odds ratio of going from “controlled” to “partly controlled/uncontrolled” is 2.33 per each level of fractional exhaled nitric oxide.<br /><strong>Discussion and Conclusion: </strong>The probability of an asthmatic children change their level of asthma control, from ‘controlled’ to ‘partly controlled/uncontrolled’, taking into account a change in their fractional exhaled nitric oxide level, increases 133%.

scholarly journals Study of the role of exhaled nitric oxide (NO) in predicting controlled or uncontrolled asthma in asthmatic children

2020 ◽  
Vol 15 ◽  
Author(s):  
Xuan Ngo-Minh ◽  
Tram Tang-Thi-Thao ◽  
Nhu Doan-Thi-Quynh ◽  
Timothy J. Craig ◽  
Sy Duong-Quy
Keyword(s):  
Nitric Oxide ◽  
Asthma Control ◽  
Exhaled Nitric Oxide ◽  
Blood Eosinophil ◽  
Inhaled Corticosteroid ◽  
Uncontrolled Asthma ◽  
Cross Sectional ◽  
Total Ige ◽  
Asthmatic Children ◽  
Exhaled No

Background: Exhaled nitric oxide (NO), especially fractional concentration of exhaled NO (FENO) has been used to predict the responsiveness of inhaled corticosteroid (ICS) in children with asthma. However, the use of exhaled NO for predicting asthma control in children is still controversial.Methods: This was a randomized and cross-sectional study. Asthmatic children who were naïve to inhaled corticosteroid (ICS) were included in the present study. The measurements of FENO and CANO (concentration of NO in the gas phase of the alveolar), spirometry, blood eosinophil counts (BEC), and total IgE levels were done for each asthmatic child.Results: Ninety three asthmatic children (9±3 years) with moderate (63.4%) to severe (36.6%) asthma were included and finished the 3 month study. The levels of FENO and CANO at inclusion were 37±11 ppb and 5.8±1.4 ppb, respectively; the mean of BEC was 617±258 cells/µL; the level of total IgE was 1563±576 UI/mL; 89% of subjects were positive for at least one respiratory allergen. The percentage of severe asthma was reduced significantly after 3 months (P<0.001). Well controlled asthma subjects at 3 months had higher levels of FENO and lower levels of CANO at inclusion (P<0.05 and P<0.05). FENO <20 ppb or CANO >5 ppb had a risk of uncontrolled asthma at 3 months (OR: 1.7, CI 95% [(0.8) – (3.3)], P<0.05; OR: 1.9, CI 95% [(0.9) – (2.7)], p<0.05; respectively). FENO >35 ppb at inclusion had a positive predictive value for asthma control at 3 months (OR: 3.5, CI 95% [2.2 – 5.9], P<0.01).Conclusions: Exhaled NO is a biomarker of asthma which may have a potential role to predict the control of asthma in short-term follow-up in asthmatic children.

Associations between air pollutants and peak expiratory flow and fractional exhaled nitric oxide in students

2020 ◽  
Vol 24 (2) ◽  
pp. 189-195
Author(s):  
M. A. Adman ◽  
J. H. Hashim ◽  
M. R. A. Manaf ◽  
D. Norback
Keyword(s):  
Nitric Oxide ◽  
Air Pollution ◽  
Peak Expiratory Flow ◽  
Air Pollutants ◽  
Exhaled Nitric Oxide ◽  
Air Pollutant ◽  
Outdoor Air ◽  
Fractional Exhaled Nitric Oxide ◽  
Outdoor Air Pollution ◽  
Expiratory Flow

BACKGROUND: Studies on the effects of outdoor air pollution on the respiratory health of students in tropical countries such as Malaysia are limited.OBJECTIVE: To assess associations between outdoor air pollutants and peak expiratory flow (PEF) and fractional exhaled nitric oxide (FeNO).METHOD: PEF and FeNO levels of 487 students recruited in Melaka and Putrajaya, Malaysia, were measured in April and June 2014. Multiple linear regression with mutual adjustment was used to analyse the associations between exposure to air pollution and health.RESULTS: PEF was significantly associated with ozone for 1-day exposure (β = −13.3 l/min, 95% CI −22.7 to −3.8), carbon monoxide for 2-day exposure (β = −57.2 l/min, 95% CI −90.7 to −23.7) and particulate matter ≦10 μm in diameter for 3-day exposure (β = −6.0 l/min, 95% CI −9.2 to −2.8) and 7-day exposure (β = −8.6 l/min, 95% CI −13.0 to −4.1). Stratified analysis showed that associations between PEF and outdoor air pollutant exposures were similar in students with and without elevated FeNO levels.CONCLUSION: Outdoor air pollution in Malaysia may cause airway obstruction unrelated to eosinophilic airway inflammation among students as measured using FeNO.

scholarly journals Association of longitudinal fractional exhaled nitric oxide measurements with asthma control in atopic children

2015 ◽  
Vol 109 (5) ◽  
pp. 572-579 ◽  
Author(s):  
Sohyoung Yang ◽  
Joohyun Park ◽  
Youn Kyung Lee ◽  
Heon Kim ◽  
Youn-Soo Hahn
Keyword(s):  
Nitric Oxide ◽  
Asthma Control ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide

scholarly journals Clinical and Economic Consequences of Switching From Omalizumab to Mepolizumab in Uncontrolled Severe Eosinophilic Asthma: an Observational Retrospective Study

2020 ◽  
Author(s):  
Giovanna Elisiana Carpagnano ◽  
Emanuela Resta ◽  
Massimiliano Povero ◽  
Corrado Pelaia ◽  
Mariella D'Amato ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Asthma Control ◽  
Exhaled Nitric Oxide ◽  
Blood Eosinophil ◽  
Fractional Exhaled Nitric Oxide ◽  
Eosinophilic Asthma ◽  
Exacerbation Rate ◽  
Serum Ige ◽  
Severe Eosinophilic Asthma ◽  
Oral Corticosteroids

Abstract Background: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids, which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab to mepolizumab in patients eligible for both biologics, but not optimally controlled by omalizumab.Methods: We retrospectively enrolled uncontrolled severe asthmatic patients, referred to seven asthma clinics in Italy, who switched from omalizumab to mepolizumab during the last two years. Clinical, functional, and laboratory information included blood eosinophil count, asthma control test, spirometry, serum IgE, fractional exhaled nitric oxide, oral corticosteroids intake, use of controller and rescue drugs, exacerbations/hospitalizations, visits and diagnostic exams. Within the perspective of Italian National Health System, a pre- and post-mepolizumab 12-month standardized total cost per patient was calculated.Results: 33 patients were enrolled: 5 males and 28 females, mean age 57 years, mean disease onset 24 years. At omalizumab discontinuation, 88% were oral corticosteroids-dependent with annual mean rate of 4.0 clinically significant exacerbations, 0.30 exacerbations needing emergency room visits or hospitalization; absenteeism due to disease was 10.4 days per patient. Switch to mepolizumab improved all clinical outcomes, reducing total exacerbation rate (RR = 0.06, 95% CI 0.03 to 0.14), oral corticosteroids -dependent patients (OR = 0.02, 95% CI 0.005 to 0.08), and the number of lost working days because of uncontrolled disease (Δ = -7.9, 95% CI -11.2 to -4.6). Pulmonary function improved, as well as serum IgE, fractional exhaled nitric oxide and eosinophils decreased. Mean annual costs were € 12,239 for omalizumab and € 12,639 for mepolizumab (Δ = € 400, 95% CI -1,588 to 2,389); the increment due to drug therapy (+ € 1,581) was almost offset by savings regarding all other cost items (- € 1,181). Conclusions: Patients with severe eosinophilic asthma, not controlled by omalizumab, experienced comprehensive benefits in asthma control by switching to mepolizumab. These relevant improvements were burdened by only very slight increases in economic costs.

Fractional Exhaled Nitric Oxide (FENO), Lung Function and Airway Hyperresponsiveness in Naïve Atopic Asthmatic Children

2004 ◽  
Vol 41 (7) ◽  
pp. 759-765 ◽  
Author(s):  
Michele Miraglia del Giudice ◽  
F. P. Brunese ◽  
G. L. Piacentini ◽  
M. Pedullà ◽  
C. Capristo ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Lung Function ◽  
Airway Hyperresponsiveness ◽  
Exhaled Nitric Oxide ◽  
Fractional Exhaled Nitric Oxide ◽  
Asthmatic Children
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