scholarly journals Retrospective Cohort Study of Leukotriene Receptor Antagonist Therapy for Preventing Upper Respiratory Infection-Induced Acute Asthma Exacerbations

2013 ◽  
Vol 4 (3) ◽  
pp. ar.2013.4.0062 ◽  
Author(s):  
Hiroto Matsuse ◽  
Tomoko Tsuchida ◽  
Susumu Fukahori ◽  
Tetsuya Kawano ◽  
Shinya Tomari ◽  
...  
Keyword(s):  
Asthma Exacerbation ◽  
Acute Asthma ◽  
Leukotriene Receptor Antagonist ◽  
Asthmatic Patients ◽  
Asthma Exacerbations ◽  
Adult Asthmatic ◽  
Acute Asthma Exacerbation ◽  
Leukotriene Receptor ◽  
Upper Respiratory ◽  
Acute Asthma Exacerbations

Upper respiratory tract infections (URIs) represent the most frequent cause of acute asthma exacerbations. It has yet to be determined whether leukotriene receptor antagonist (LTRA) treatment prevents URI-induced acute asthma exacerbations in adults. The objective of the present study was to evaluate the preventive effects of LTRA treatment on URI-induced acute asthma exacerbations. The incidences of URI alone, acute asthma exacerbation without URI, and URI-induced acute asthma exacerbation were determined retrospectively by analyzing diary and medical records of 321 adult asthmatic patients (mean age, 56.3 ± 17.2 years; male/female ratio, 117:204) over 1 year. Results were compared between patients who had been taking an LTRA (n = 137) and those who had never taken any LTRA (n = 184) during the study periods. Significantly fewer URIs alone and acute asthma exacerbations without URI occurred in patients with than in those without prophylactic daily use of LTRA. LTRA treatment significantly reduced the durations of URIs alone and of total acute asthma exacerbations, as well as the incidence of mild exacerbations of asthma. In contrast, in patients with URI-induced acute asthma exacerbations, LTRA treatment failed to significantly reduce the interval between URI onset and acute asthma exacerbation, as well as the duration and severity of both URIs and acute asthma exacerbations. Use of an LTRA for adult asthmatic patients appears to reduce the incidences of URIs alone and acute asthma exacerbations without URI, but it failed to prevent URI-induced acute asthma exacerbations once a URI occurred.

Intravenous versus Oral Corticosteroids for Treatment of Acute Asthma Exacerbations

2002 ◽  
Vol 36 (4) ◽  
pp. 565-570 ◽  
Author(s):  
Patricia Pecora Fulco ◽  
Amista A Lone ◽  
Carol B Pugh
Keyword(s):  
Medical History ◽  
Flow Rate ◽  
Peak Expiratory Flow Rate ◽  
Asthma Exacerbation ◽  
Acute Asthma ◽  
Past Medical History ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbation ◽  
Oral Corticosteroids ◽  
Acute Asthma Exacerbations

OBJECTIVE: To compare the duration of hospitalization of patients treated with either oral or intravenous corticosteroids for an acute asthma exacerbation. METHODS: A retrospective chart review was performed on a random sample of inpatients. Patients were included with the following: a discharge diagnosis of an acute asthma exacerbation, a past medical history significant for asthma, age between 16 and 60 years, and treatment with either oral or intravenous corticosteroids at the time of admission. Exclusion criteria included: patients receiving chronic prednisone therapy, a past medical history significant for chronic obstructive pulmonary disease, an admission to the intensive care unit, or a consistent smoking habit of at least 1 pack daily. Length of hospitalization was the primary outcome measured. Secondary outcomes included 24-hour peak expiratory flow rate, 24-hour pulse oximetry (pO2), and amount of β-agonist and ipratropium used. RESULTS: Fifty-three patients were included in the final data analysis. Patients were grouped by route of corticosteroid administration (intravenous or oral). No significant differences were noted between the 2 groups for race, gender, age, height, weight, admission peak expiratory flow rate, admission pO2, or types of asthma medications used prior to admission. No significant differences were demonstrated in any of the outcome measures. CONCLUSIONS: Both the intravenous and oral corticosteroid groups demonstrated similar clinical outcomes and lengths of hospitalization in the treatment of acute asthma exacerbations. These results support the initial use of oral corticosteroids for the treatment of acute asthma exacerbations in adult patients admitted to a general medical service.

Increased expression of serum periostin and YKL40 in children with severe asthma and asthma exacerbation

2018 ◽  
Vol 66 (8) ◽  
pp. 1102-1108 ◽  
Author(s):  
Noussa Ragab El Basha ◽  
Hanan Mohsen Osman ◽  
Amaal Abdo Abdelaal ◽  
Salma Mohamed Saed ◽  
Hala Hamdy Shaaban
Keyword(s):  
Asthma Exacerbation ◽  
Acute Asthma ◽  
Serum Levels ◽  
Asthma Severity ◽  
P Value ◽  
Children With Asthma ◽  
Acute Asthma Exacerbation ◽  
Healthy Control ◽  
Acute Asthma Exacerbations ◽  
Serum Periostin

Children with severe asthma or acute asthma exacerbation may encounter difficulties in performing pulmonary function tests. In this situation, serum biomarkers can play a great role in evaluation of such patients. The aim of this study was to estimate the serum levels of human chitinase-3-like protein 1 (YKL40) and periostin in a group of Egyptian children with asthma during acute asthma exacerbation and in stable asthmatics compared with healthy control, and to correlate these findings with the severity of asthma. This cross-sectional study enrolled 120 childrenwith asthma with different degrees of asthma severity, according to the Global Initiative for Asthma guidelines, along with 60 age-matched and sex-matched healthy control. A complete blood count and an estimation of serum periostin and YKL40 levels were performed for all cases and control. Individual and mean values of periostin and YKL40 were significantly higher during acute asthma exacerbations, p<0.001. A highly significant relation between serum levels of periostin and YKL40 and asthma severity, p value for each was <0.001. Absolute eosinophil count was significantly correlated with the serum periostin levels in stable asthmatic group (p=0.01) only. There was significantly positive correlation (P<0.001) between both markers in stable asthmatic group. Spearman’s correlation coefficient shows a statistically significant positive correlation between both markers and patient’s age and duration of asthma, p value for each was 0.001. These findings highlight the importance of periostin and YKL40 as serum biomarkers for assessment of asthma severity and acute asthma exacerbations in children with asthma.

Survey of physicians’ attitudes toward the use of magnesium sulfate for acute asthma exacerbations in Turkey

2016 ◽  
Vol 53 (5) ◽  
pp. 525-531 ◽  
Author(s):  
Ayşe Baççıoğlu ◽  
Arzu Bakırtaş ◽  
Ferda Öner Erkekol ◽  
Ömer Kalaycı ◽  
Sevim Bavbek
Keyword(s):  
Magnesium Sulfate ◽  
Acute Asthma ◽  
Asthma Exacerbations ◽  
Acute Asthma Exacerbations

Oral Dexamethasone to Control Wheezing in Children at an Outpatient Clinic

2018 ◽  
Vol 58 (2) ◽  
pp. 151-158 ◽  
Author(s):  
Angela S. Volk ◽  
Stephanie A. Marton ◽  
Brittany S. Richardson ◽  
Luis Rauda ◽  
Heidi L. Schwarzwald ◽  
...  
Keyword(s):  
Hospital Admissions ◽  
Acute Asthma ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
Office Visit ◽  
Asthma Exacerbations ◽  
Oral Dexamethasone ◽  
Cost Effective Treatment ◽  
Ed Visits ◽  
Acute Asthma Exacerbations

Asthma, a chronic childhood disease, has resulted in increased emergency department (ED) visits with high costs. Many asthma ED visits are nonemergent and could be treated in outpatient clinics. Literature has concluded that a 2-day course of oral dexamethasone has comparable outcomes to a 5-day course of prednisone in the ED and hospital setting. A retrospective chart review was performed on children requiring in-house treatment with a corticosteroid (dexamethasone n = 23, prednisone n = 40) for acute asthma exacerbations at an ambulatory medical home. The rates of hospital admissions, ED visits, and symptom follow-up were similar between the 2 groups ( P > .05). The cost for a course of dexamethasone was US$1.28 versus US$16.20 for prednisolone. The average cost for an asthma exacerbation office visit was US$79.89 compared with US$3113.28 for an ED visit. A 2-day course of oral dexamethasone appears to be a promising clinical and cost-effective treatment for acute asthma exacerbations at the primary care level.

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