Search

Efficacious, effective and efficient communication between healthcare professionals (HCP) and patients is essential to achieve a successful therapeutic alliance. Telemedicine (TM) has been used for decades but during the COVID‐19 pandemic its use has become widespread. This position paper aims to describe the terminology and most important forms of TM among HCP and patients and review the existing studies on the uses of TM for asthma and allergy. Besides, the advantages and risks of TM are discussed, concluding that TM application reduces costs and time for both, HCP and patients, but cannot completely replace face‐to‐face visits for physical examinations and certain tests that are critical in asthma and allergy. From an ethical point of view, it is important to identify those involved in the TM process, ensure confidentiality and use communication channels that fully guarantee the security of the information. Unmet needs and directions for the future regarding implementation, data protection, privacy regulations, methodology and efficacy are described. [ABSTRACT FROM AUTHOR]

Given the ongoing rise in the occurrence of allergic disorders, alterations in dietary patterns have been proposed as a possible factor contributing to the emergence and progression of these conditions. Currently, there is a significant focus on the development of dietary therapies that utilize natural compounds possessing anti-allergy properties. Dietary polyphenols and plant metabolites have been intensively researched due to their well-documented anti-inflammatory, antioxidant, and immunomodulatory characteristics, making them one of the most prominent natural bioactive chemicals. This study seeks to discuss the in-depth mechanisms by which these molecules may exert anti-allergic effects, namely through their capacity to diminish the allergenicity of proteins, modulate immune responses, and modify the composition of the gut microbiota. However, further investigation is required to fully understand these effects. This paper examines the existing evidence from experimental and clinical studies that supports the idea that different polyphenols, such as catechins, resveratrol, curcumin, quercetin, and others, can reduce allergic inflammation, relieve symptoms of food allergy, asthma, atopic dermatitis, and allergic rhinitis, and prevent the progression of the allergic immune response. In summary, dietary polyphenols and plant metabolites possess significant anti-allergic properties and can be utilized for developing both preventative and therapeutic strategies for targeting allergic conditions. The paper also discusses the constraints in investigating and broad usage of polyphenols, as well as potential avenues for future research. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to investigate the impact of bronchial asthma‐related factors on the emotional well‐being of adolescents with bronchial asthma and their primary caregivers. Background: Bronchial asthma is a common chronic disease in childhood and adolescence that can have a psychological impact on both patients and their primary caregivers. Methods: The study used a cross‐sectional design and included 150 patient–caregiver dyads diagnosed with bronchial asthma, aged between 12 and 16 years and collected between 2018 and 2020. It assessed the emotional adjustment of both patients and caregivers and recorded variables related to the disease. Qualitative and quantitative analyses were conducted to perform statistical analyses. Results: Caregivers had higher anxiety and depression scores than patients. Good adherence to treatment was necessary for the emotional adjustment of the dyad. Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. Conclusions: The study highlights the importance of assessing anxiety and depression levels in both patients and caregivers because the presence of these symptoms can lead to the misuse of medication, inadequate inhalation techniques, the omission of medication and reduced confidence in controlling asthma symptoms. Summary statement: What is already known about this topic? Certain variables related to asthma, such as its degree of control, severity, duration of diagnosis and adherence, have been linked to adjustment to the disease by the adolescent–caregiver dyad. What this paper adds? Caregivers had higher anxiety and depression scores than patients.Good adherence to treatment was necessary for the emotional adjustment of the dyad.Controlled asthma, good adherence to treatment and a reduction in medical treatment were the primary predictors of emotional adjustment. The implications of this paper: The study evaluated the variables in combination to identify risk and healthier profiles in the dyad's emotional adjustment and identified variables related to the disease most associated with emotional adjustment to the disease in the dyad.Identifying the risk and health profiles in emotional adjustment in both the adolescent and his or her caregiver may be used to mitigate future consequences related to poor adjustment to asthma.Knowledge of these variables allows health professionals to design psychoeducational programmes to ensure better adaptation to the disease. [ABSTRACT FROM AUTHOR]

Asthma is one of the most common chronic diseases in childhood, and its pathogenesis is not yet clear. In recent years, the imbalance of intestinal flora has attracted more and more attention to the occurrence and development of childhood asthma. Traditional Chinese medicine believes that the lung and the large intestine are interrelated, and the occurrence of childhood asthma is closely related to the dysfunction of the lung and the large intestine, while Western medicine believes that the occurrence of childhood asthma is related to various factors. Among them, pulmonary immune imbalance caused by intestinal flora disorder is one of the important causes of its occurrence. This paper discussed the occurrence of childhood asthma by focusing on pulmonary and intestinal pathophysiology, so as to provide new targets or therapeutic ideas for the prevention and treatment of childhood asthma. [ABSTRACT FROM AUTHOR]

Asthma, a common chronic respiratory disease among children and adults, affects more than 200 million people worldwide and causes about 450,000 deaths each year. Machine learning is increasingly applied in healthcare to assist health practitioners in decision-making. In asthma management, machine learning excels in performing well-defined tasks, such as diagnosis, prediction, medication, and management. However, there remain uncertainties about how machine learning can be applied to predict asthma exacerbation. This study aimed to systematically review recent applications of machine learning techniques in predicting the risk of asthma attacks to assist asthma control and management. A total of 860 studies were initially identified from five databases. After the screening and full-text review, 20 studies were selected for inclusion in this review. The review considered recent studies published from January 2010 to February 2023. The 20 studies used machine learning techniques to support future asthma risk prediction by using various data sources such as clinical, medical, biological, and socio-demographic data sources, as well as environmental and meteorological data. While some studies considered prediction as a category, other studies predicted the probability of exacerbation. Only a group of studies applied prediction windows. The paper proposes a conceptual model to summarise how machine learning and available data sources can be leveraged to produce effective models for the early detection of asthma attacks. The review also generated a list of data sources that other researchers may use in similar work. Furthermore, we present opportunities for further research and the limitations of the preceding studies. [ABSTRACT FROM AUTHOR]

Background: The healthcare sector is responsible for 5.2% of CO2 emissions in Germany. The prescribing of medicines is a significant contributor. Among the prescribed medicines, metered dose inhalers (MDIs) play a decisive role due to the propellant gases they contain. A relevant reduction in emissions is possible by switching to dry powder inhalation systems (DPI). Aim: The guideline "Climate-conscious prescribing of inhalants" is intended to provide assistance in the prescribing of inhaled medicines by summarising the available evidence on the decision between DPI and MDI and explicitly addressing the aspect of climate damage caused by propellants. It addresses everyone involved in prescribing and counselling those affected. Materials and methods: The S2k guideline was drawn up under the joint leadership of DEGAM (German College of General Practitioners and Family Physicians) and the German Society for Pneumology and Respiratory Medicine (DGP) under moderation of the AWMF (Association of the Scientific Medical Societies in Germany). The main contents from a practical perspective are presented in this paper. Results: Overall, MDIs account for a high proportion of inhaler prescriptions in Germany. The aspects of climate damage should be considered when prescribing MDIs. In order to facilitate implementation in practice, several decision aids were developed. Conclusion: The guideline is the first to address the importance of prescribing a group of medicines in relation to climate change. The degree of implementation of the guideline recommendations can be determined by future analyses of prescription data. A planned practical test is required to check the acceptance of the decision aids. [ABSTRACT FROM AUTHOR]

Asthma is a chronic inflammatory airway disease, and airway inflammation, airway hyper-responsiveness and airway remodeling are the major pathological alterations in asthma. Numerous studies have demonstrated sphingosine metabolism disorders exist in asthma patients, and sphingosine-1-phosphate （S1P） is the end product of sphingolipid metabolism, which has become the focus of research as an important mediator of immune and inflammatory diseases, and is closely related to the development of asthma. In this paper, we summarize the role of S1P in the pathological changes of asthma from the relationship between S1P and asthma as well as its application in the clinical diagnosis, treatment and efficacy assessment of asthma, with a view to exploring more directions in the diagnosis and treatment of asthma. [ABSTRACT FROM AUTHOR]

Disruption of the airway epithelium triggers a defensive immune response that begins with the production and release of alarmin cytokines. These epithelial-derived alarmin cytokines, including thymic stromal lymphopoietin (TSLP), are produced in response to aeroallergens, viruses, and toxic inhalants. An alarmin response disproportionate to the inhaled trigger can exacerbate airway diseases such as asthma. Allergens inhaled into previously sensitized airways are known to drive a T2 inflammatory response through the polarization of T cells by dendritic cells mediated by TSLP. Harmful compounds found within air pollution, microbes, and viruses are also triggers causing airway epithelial cell release of TSLP in asthmatic airways. The release of TSLP leads to the development of inflammation which, when unchecked, can result in asthma exacerbations. Genetic and inheritable factors can contribute to the variable expression of TSLP and the risk and severity of asthma. This paper will review the various triggers and consequences of TSLP release in asthmatic airways. [ABSTRACT FROM AUTHOR]

Multiple prolonged symptoms are observed in patients who recover from an acute COVID-19 infection, which is defined as long COVID. General fatigue is frequently observed in patients with long COVID during acute and post-acute phases. This study aimed to identify the specific risk factors for general fatigue in long COVID. Hospitalized patients with COVID-19 aged over 18 years were enrolled in a multicenter cohort study at 26 medical institutions. Clinical data during hospitalization and patient-reported outcomes after discharge were collected from medical records, paper-based questionnaires, and smartphone apps. Among prolonged symptoms through 1-year follow-ups, general fatigue was the most interfering symptom in daily life. Patients with protracted fatigue at all follow-up periods had lower quality of life scores at the 12-month follow-up. Univariate logistic regression analysis of the presence or absence of general fatigue at the 3-month, 6-month, and 12-month follow-ups identified asthma, younger age, and female sex as risk factors for prolonged fatigue. Multivariable logistic regression analysis revealed that asthma was an independent risk factor for persistent fatigue during the 12-month follow-up period. Longitudinal changes in the symptoms of patients with or without asthma demonstrated that general fatigue, not cough and dyspnea, was significantly prolonged in patients with asthma. In a Japanese population with long COVID, prolonged general fatigue was closely linked to asthma. A preventive approach against COVID-19 is necessary to avoid sustained fatigue and minimize social and economic losses in patients with asthma. [Display omitted] [ABSTRACT FROM AUTHOR]

Australia has a high prevalence of asthma amongst its population. Literature shows rural asthma patients have a higher need to access emergency healthcare due to asthma-related emergencies than those living in metropolitan areas, and that underutilisation of ambulance resources is evident in rural areas. This study aims to explore the barriers preventing patients from accessing emergency healthcare resources during an asthma-related emergency in rural New South Wales (NSW). A qualitative interpretative design comprising 12 semi-structured interviews was conducted between May and July 2021. Participants had accessed emergency healthcare in rural NSW during a moderate to severe asthma exacerbation in NSW within the last five years. Interviews were recorded and transcribed verbatim to allow thematic analysis, which produced four overarching themes. This paper explores two of those themes due to the depth and range of the data. The impact of healthcare logistics, including access and availability of emergency healthcare resources, response times, environmental concerns, and issues with transport home from the hospital, were identified as barriers. Additionally, financial cost, the presumed cost to healthcare workers and societal cost were also found to influence participants’ decisions to access emergency healthcare. Overall, multiple factors were identified as potential barriers to asthma patients in rural NSW accessing emergency healthcare. Introducing improved mapping systems and mobile/radio reception, in addition to better staff resourcing in rural locations may help reduce the reluctance of asthma patients to access healthcare due to logistical concerns and fear of being a burden on the emergency healthcare system. [ABSTRACT FROM AUTHOR]

AbstractObjectiveData SourcesSelected StudiesResultsConclusionThis study investigated the utilization of nebulized budesonide for acute asthma and COPD exacerbations as well as for maintenance therapy in adults.We conducted a search on PubMed for nebulized budesonide treatment.Selecting all English-language papers that utilize Mesh phrases "asthma," "COPD," "budesonide," "nebulized," "adult," "exacerbation," and "maintenance" without temporal restrictions, and narrowing down to clinical research such as RCTs, observational studies, and real-world studies.Analysis of 25 studies was conducted to assess the effectiveness of nebulized budesonide in asthma (n = 10) and COPD (n = 15). The panel in Thailand recommended incorporating nebulized budesonide as an additional or alternative treatment option to the standard of care and systemic corticosteroids (SCS) based on the findings.Nebulized budesonide is effective and well-tolerated in treating asthma and COPD, with less systemic adverse effects compared to systemic corticosteroids. High-dose nebulized budesonide can enhance clinical outcomes for severe and mild exacerbations with slow systemic corticosteroid response. Nebulized budesonide can substitute systemic corticosteroids in some situations. [ABSTRACT FROM AUTHOR]

AbstractObjectiveData sourcesStudy selectionsResultsConclusionsIt is believed that gut microbiota alteration leads to both intestinal and non-intestinal diseases in children. Since infants inherit maternal microbiota during pregnancy and lactation, recent studies suggest that changes in maternal microbiota can cause immune disorders as well. This systematic review was designed to assess the association between the child and mother’s gut microbiome and allergy development in childhood.In this systematic review, international databases including PubMed, Scopus, and ISI/WOS were searched until January 2023 to identify relevant studies.Observational studies that analyzed infant or maternal stool microbiome and their association with allergy development in children were included in this study. Data extraction and quality assessment of the included studies were independently conducted by two researchers.Of the 1694 papers evaluated, 21 studies examined neonate gut microbiome by analyzing stool samples and six studies examined maternal gut microbiota. A total of 5319 participants were included in this study. Asthma followed by eczema and dermatitis were the most common allergy disorders among children. Urbanization caused a lack of diversity in the bacterial microbiota as well as lower levels of Bifidobacterium and Lachnospira associated with a higher risk of allergy. In contrast, higher levels of Roseburia and Flavonifractor were associated with lower allergy risk.This systematic review shows that gut microbiota may be associated with allergy development. Further studies are required to provide a definitive answer. [ABSTRACT FROM AUTHOR]

Asthma, a prevalent respiratory disease, remains incompletely understood in terms of its pathogenesis. Airway remodeling, a prominent feature of asthma, occurs early in the disease process. Airway smooth muscle cells (ASMC) are recognized as a critical target in asthmatic airway remodeling, and the phenotypic transformation from normal contraction to proliferation/synthesis is one of the important characteristics of airway remodeling. Autophagy, a cellular process that serves as a defense mechanism, plays a significant regulatory role in the pathogenesis of asthma, particularly in the phenotype transformation of ASMC to promote airway remodeling. In this paper, we review the relationship between autophagy and phenotype transformation of ASMC, as well as relevant findings in the context of asthma pathogenesis, with the aim of inspiring future research endeavors in this field. [ABSTRACT FROM AUTHOR]

Globally, obesity and asthma pose significant health challenges, with obesity being a key factor influencing asthma. Despite this, effective treatments for obese asthma, a distinct phenotype, remain elusive. Since the discovery of transient receptor potential (TRP) channels in 1969, their value as therapeutic targets for various diseases has been acknowledged. TRP channels, present in adipose tissue cells, influence fat cell heat production and the secretion of adipokines and cytokines, which are closely associated with asthma and obesity. This paper aims to investigate the mechanisms by which obesity exacerbates asthma-related inflammation and suggests that targeting TRP channels in adipose tissue could potentially suppress obese asthma and offer novel insights into its treatment. [ABSTRACT FROM AUTHOR]

It is observed that the exposure to environmental factors such as indoors and outdoors air pollution, cigarette smoke, and allergens are highly related to asthma attacks. It is also reported that limited exposure to asthma riggers, cure due to medicine, the attacks of asthma can be minimized. In this paper, we formulate the dynamics of asthma with smoking and environmental factors classes in the fractional Caputo-Fabrizio (CF) framework to visualize its dynamical behaviour. We delineate the important properties of the CF derivative for the analysis of our model. The model is then analyzed for the basic properties and the uniqueness and existence of the hypothesized asthma system are investigated via the theory of fixed point. Furthermore, a novel numerical scheme is presented for the solution of our fractional system to illustrate the time series of asthma model. The dynamical behaviour of our asthma model is then highlighted numerically to show the impact of fractional-order ϧ on the system and to visualize the role of input factors on the dynamics of asthma disease. [ABSTRACT FROM AUTHOR]

Individuals with severe asthma often report poor Health-related quality of life (HRQoL) and more research is essential to increase understanding of how they may be helped to improve HRQoL. The main aim of the current paper is to evaluate HRQoL, and possible factors influencing HRQoL, in individuals with severe asthma. The aim is also to explore associations among anxiety, depression, beliefs of medication, self-efficacy, and HRQoL among individuals with severe and other asthma as well as those with no asthma. Participants with severe asthma (n = 59), other asthma (n = 526), and no asthma (n = 902) were recruited from West Sweden Asthma Study, a population-based study, which includes both questionnaire surveys and clinical examinations. Individuals with severe asthma had worse physical HRQoL (measured with SF-8) than those with other and no asthma (median 48.4, 51.9, and 54.3, respectively). They also had worse mental HRQoL (median 46.7) and reported higher anxiety and depression scores (measured using HADS, median 5.0 and 3.5, respectively) compared to no asthma (median 4.0 and 2.0, respectively). HRQoL was particularly affected among women with severe asthma. Individuals with severe asthma believed that their asthma medication was more necessary than those with other asthma, but they reported more concern for the medication. Asthma control and packyears predicted physical HRQoL and anxiety predicted mental HRQoL among individuals with severe asthma. Efforts to improve asthma control and to reduce anxiety may improve HRQoL in individuals with severe asthma. Especially, women with severe asthma seem to need support to improve their HRQoL. Reducing concerns with asthma medication is most likely essential as high concerns may lead to poor adherence, which in turn may negatively affect asthma control and HRQoL. [ABSTRACT FROM AUTHOR]

Background Despite the growing utilization of data-driven methods to investigate multimorbidity patterns, there is currently no consensus or guidance on the conditions to include when identifying patterns. This scoping review aims to systematically examine the nature of conditions included in existing studies using data-driven techniques. Methods A comprehensive search of three electronic databases (MEDLINE, Web of Science and Scopus) was conducted to identify relevant publications from inception to 28 February 2022 using predefined search terms and inclusion/exclusion criteria. The reference lists and citations of relevant papers were also searched. Results Among 7326 search results, 5444 relevant articles were identified. After screening against the eligibility criteria, 60 articles were included in the review. Half of the reviewed studies reported selection criteria for conditions, with prevalence in the population of interest being the most common criterion (40%). Most studies included at least one neurological [59 (98.3%)], musculoskeletal [58 (96.7%)], respiratory [57 (95.0%)] or mental health [56 (93.3%)] condition. In contrast, only a small proportion of studies included skin [17 (28.3%)], infections [14 (23.3%)] or autoimmune conditions [10 (16.7%)]. Nine conditions (hypertension, diabetes, cancer, arthritis, COPD, asthma, depression, stroke and osteoporosis) were included by more than half of the studies. Conclusions This review highlights the considerable heterogeneity among the conditions included in analyses of multimorbidity patterns. Researchers should provide a clear rationale for the selection of conditions to facilitate comparisons across studies and ensure reproducibility, as well as consider selecting a diverse range of conditions to capture the complexity of multimorbidity. [ABSTRACT FROM AUTHOR]

Objective: To determine age-related risk factors for chronic rhinosinusitis (CRS) with asthma. Methods: Data were obtained from a national survey of non-hospitalized civilians conducted by the Korean Center for Disease Control and Prevention. CRS diagnosis was based on the guidelines of the European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Asthma was judged based on whether the patient had been diagnosed with asthma in the past. Of the 45,811 survey participants, 26,335 were included in the cross-sectional study. Participants included in the study were divided into the control, CRS, and CRS with asthma groups. Age-related risk factors were analyzed in patients aged < 60 or > 60 years. Univariate logistic analyses were performed to evaluate the relationship between groups. Risk factors included age, sex, household income, residence, education level, occupation, and body mass index (BMI). Results: Education level (Odds Ratio [OR]: 0.342, P =.0003), BMI (OR: 1.09, P =.0082), and total IgE (TIgE) levels (OR: 5.582, P =.003) were significantly different between the control and the CRS with asthma group. Education level (OR: 0.478, P =.0016) and TIgE levels (OR: 4, P =.0218) were significantly different between the CRS and CRS with asthma groups under 60 years of age. BMI (OR: 1.087, P =.0443; OR: 1.104, P =.0224) showed a significant difference between all three groups with age > 60 years. Conclusion: Progression to CRS with asthma is influenced by education level, occupation, and TIgE levels in patients under 60 years of age. BMI was the only influencing factor associated with the progression to CRS with asthma in those aged > 60 years. [ABSTRACT FROM AUTHOR]

Given the prevalent use of inhaled beta2‐agonists in sports, there is an ongoing debate as to whether they enhance athletic performance. Over the last decades, inhaled beta2‐agonists have been claimed not to enhance performance with little consideration of dose or exercise modality. In contrast, orally administered beta2‐agonists are perceived as being performance enhancing, predominantly on muscle strength and sprint ability, but can also induce muscle hypertrophy and slow‐to‐fast fiber phenotypic switching. But because inhaled beta2‐agonists are more efficient to achieve high systemic concentrations than oral delivery relative to dose, it follows that the inhaled route has the potential to enhance performance too. The question is at which inhaled doses such effects occur. While supratherapeutic doses of inhaled beta2‐agonists enhance muscle strength and short intense exercise performance, effects at low therapeutic doses are less apparent. However, even high therapeutic inhaled doses of commonly used beta2‐agonists have been shown to induce muscle hypertrophy and to enhance sprint performance. This is concerning from an anti‐doping perspective. In this paper, we raise awareness of the circumstances under which inhaled beta2‐agonists can constitute a performance‐enhancing benefit. [ABSTRACT FROM AUTHOR]

Ambient air pollution has been associated with asthma onset and exacerbation in children. Whether improvement in air quality due to reduced industrial emissions has resulted in improved health outcomes such as asthma in some localities has usually been assessed indirectly with studies on between-subject comparisons of air pollution from all sources and health outcomes. In this study we directly assessed, within small areas in the province of Quebec (Canada), the influence of changes in local industrial fine particulate matter (PM 2.5), nitrogen dioxide (NO 2), and sulfur dioxide (SO 2) concentrations, on changes in annual asthma onset rates in children (≤12 years old) with a longitudinal ecological design. We identified the yearly number of new cases of childhood asthma in 1282 small areas (census tracts or local community service centers) for the years 2002, 2004, 2005, 2006, and 2015. Annual average concentrations of industrial air pollutants for each of the geographic areas, and three sectors (i.e. , pulp and paper mills, petroleum refineries, and metal smelters) were estimated by the Polair3D chemical transport model. Fixed-effects negative binomial models adjusted for household income were used to assess associations; additional adjustments for environmental tobacco smoke, background pollutant concentrations, vegetation coverage, and sociodemographic characteristics were conducted in sensitivity analyses. The incidence rate ratios (IRR) for childhood asthma onset for the interquartile increase in total industrial PM 2.5 , NO 2 , and SO 2 were 1.016 (95% confidence interval, CI: 1.006–1.026), 1.063 (1.045–1.090), and 1.048 (1.031–1.080), respectively. Positive associations were also found with pollutant concentrations from most individual sectors. Results suggest that changes in industrial pollutant concentrations influence childhood asthma onset rates in small localities. • Industrial PM 2.5 , NO 2 , and SO 2 levels were estimated by a chemical transport model. • Childhood asthma onset rates decreased with decreased industrial pollutants levels. • The strongest association by industrial sector was with PM 2.5 from metal smelters. [ABSTRACT FROM AUTHOR]