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For people with uncontrolled asthma on inhaled steroids, is it better to increase the dose or add a long-acting muscarinic antagonist? | Cochrane

We don't yet know whether adding LAMA to ICS is better or worse than increasing the dose of ICS. It is important that future studies include a treatment group for people given a double dose of ICS, because this is an option for doctors treating people with asthma.  
cochrane.org
about 5 years ago
Www.bmj
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Self management for a man with asthma

A 35 year old man with a history of asthma attended the practice asthma clinic a few weeks after an acute exacerbation. He was a non-smoker who had asthma as a child but “grew out of” the more troublesome symptoms in his teens. He regards his asthma as well controlled, although his computer record suggested that he has had six short acting bronchodilator inhalers in the past year. He is more troubled by hay fever, which he manages with antihistamines that he buys from the pharmacy. He has a sedentary lifestyle so avoids exercise induced symptoms. He has a repeat prescription for an inhaled steroid (which he takes “when he needs it”) and carries a salbutamol inhaler with him in case he experiences any chest tightness. Despite annual invitations to the asthma clinic he last attended six years ago.  
feeds.bmj.com
about 5 years ago
Www.bmj
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Antibiotics in fetal and early life and subsequent childhood asthma: nationwide population based study with sibling analysis

Objective To investigate the association between exposure to antibiotics in fetal and early life and asthma in childhood, with adjustment for confounding factors.  
feeds.bmj.com
about 5 years ago
Static.www.bmj
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Adenotonsillectomy reduces acute asthma exacerbations in children, study shows

Children who undergo adenotonsillectomy have a 30% reduction in acute exacerbations of asthma in the year after their surgery compared with the year before, a large US study has shown.1  
feeds.bmj.com
about 5 years ago
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Mepolizumab as opposed to placebo for asthma | Cochrane

Asthma is an inflammatory lung condition characterised by the narrowing of the airways, breathlessness, a tight chest and reduced quality of life. By the year 2025, there may be up to 400 million people with asthma worldwide. Mepolizumab is one treatment that may help to reduce the symptoms.  
cochrane.org
about 5 years ago
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Severe Asthma Exacerbation

This week's case is written by Dr. Andrew Hall. He is an Assistant Professor in the Department of Emergency Medicine at Queen’s University where he is a Simulation-based Resuscitation Rounds Instructor and runs the Simulation-based OSCE Assessment Program for EM residents. He's also one of the advisory board members here at EMSimCases. Why it Matters…  
emsimcases.com
about 5 years ago
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Management of Mild to Moderate Asthma Exacerbations - R.E.B.E.L. EM - Emergency Medicine Blog

This post accompanies the REBEL Cast episode on The Crashing Asthmatic from June 2015 and about management of the mild to moderate asthma exacerbation  
rebelem.com
about 5 years ago
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Does adding a long-acting muscarinic antagonist (LAMA) to an inhaled steroid help people with uncontrolled asthma more than an inhaled steroid alone? | Cochrane

Main point: People with poorly controlled asthma are less likely to have an asthma attack needing treatment with oral steroids if they take a LAMA on top of their inhaled steroid. LAMA also improve lung function compared with inhaled steroids alone, but their benefit is uncertain for hospital admissions, serious adverse events, quality of life and asthma control.  
cochrane.org
almost 5 years ago
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Sublingual immunotherapy for asthma | Cochrane

We assessed the evidence on the use of sublingual immunotherapy (SLIT) for people with asthma compared with placebo or with normal treatment for asthma. We focused on whether SLIT is a good treatment for asthma and whether it is safe.  
cochrane.org
almost 5 years ago
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Beta2-agonist drugs for treating cough or a clinical diagnosis of acute bronchitis | Cochrane

Acute bronchitis is a chest infection, with cough and sometimes sputum production, chest pain and fever. People affected feel unwell and for those who do not have asthma or chronic lung disease there is no clear treatment. Viruses cause most cases of bronchitis, so antibiotics usually do not help. Beta2-agonists (such as albuterol or salbutamol) are drugs that relieve asthma by relaxing muscles that cause narrowing in the passages to the lungs. They are sometimes used to relieve the cough in acute bronchitis, even in people who do not have asthma.  
cochrane.org
almost 5 years ago
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The Wide-Ranging Role of the Microbiome

What goes in your stomach can influence countless disorders, from cancer to asthma. Dr David Johnson surveys the latest data underlining the ever-increasing importance of a low-fat, high-fiber diet.  
medscape.com
almost 5 years ago
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Should macrolides be used for chronic asthma? | Cochrane

Main point: Studies do not show that macrolides are better than placebo for most outcomes. There may be a benefit on lung function but it depends on how this is measured. The evidence was very low quality so we can't rule out the possibility of other benefits or harms.  
cochrane.org
almost 5 years ago
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Asthma Diary Helpful for Monitoring Exacerbations in Preschoolers

An asthma flare-up diary may help assess the severity of asthma exacerbation in young children, according to a Canadian study.  
medscape.com
almost 5 years ago
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Leukotriene-Receptor Antagonists Improve Asthma Control

Leukotriene-receptor antagonists, alone or with inhaled corticosteroids, significantly improved asthma control and reduced exacerbations, according to a systematic review.  
medscape.com
almost 5 years ago
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magnesium-for-asthma

Thanks to Dr. Kim for the writeup of this post Case A 36-year-old female with a history of asthma presents with wheezing, tachypnea, and a room air O2 Saturation of 90%. Her albuterol and flovent inhalers failed to control her symptoms at home. Her auscultatory exam reveals bilateral diffuse wheezing. She is afebrile, normotensive, and…  
tjuhem.wordpress.com
almost 5 years ago
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Reslizumab Works Best in Late-Onset Eosinophilic Asthma

A new analysis of phase 3 data shows that the anti-interleukin-5 antibody is more effective in patients older than 40 years.  
medscape.com
almost 5 years ago
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Pulse oximeters used to self monitor oxygen saturation levels as part of a personalised asthma action plan for people with asthma | Cochrane

We became aware through talking with people with asthma that some are using pulse oximeters to monitor their own blood oxygen levels during an asthma attack. Pulse oximeters are marketed by some suppliers as essential equipment for the home medicine cabinet. We wanted to find out if reliable evidence is available on use of pulse oximeters to self monitor asthma exacerbations at home. We decided to include only trials that used pulse oximeters as part of a personalised asthma action plan because it is important that decisions are made on the basis of symptoms as well as oxygen saturation, and that patients have a clear protocol to follow when their asthma worsens.  
cochrane.org
almost 5 years ago
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Gut Bacteria Disparities Offer Clues to Asthma Etiology

Children at the highest risk for asthma had a lower abundance of four bacteria in their gut in their first 3 months of life, a critical period that may offer future opportunities for prevention.  
medscape.com
almost 5 years ago
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Critical Asthma Patient: Pearls/Pitfalls of Management - emdocs

You've tried your normal asthma treatment pathway, and it's not working... What's next?  
emdocs.net
almost 5 years ago
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H3K18 Acetylation in Epithelial Cells of Asthmatic Subjects

What's the interaction between histone modifications and gene regulation in asthma?  
medscape.com
almost 5 years ago