Respiratory Tract Diseases Commons^™

Patterns Of Bronchial Challenge Testing In Canada, Rémi Thériault, Amir Raz

Psychology Faculty Articles and Research

Background: Bronchial challenge testing (BCT) measures airway hyperresponsiveness; asthma guidelines recommend using BCT when symptoms manifest despite normal spirometry. Improper application of these guidelines commonly results in the misdiagnosis of asthma. Yet, statistics concerning BCT remain largely obscure. The current paper addresses this gap and explores how various health variables may elucidate adherence to asthma guidelines and patterns of BCT across Canadian provinces.

Methods: Using the Access to Information Act, medical financial claims for BCT (or equivalent procedures) were requested from each of the Canadian provinces and territories. Based on the available information (from provinces only), correlations between …

Hypersensitivity Of Vagal Pulmonary Afferents Induced By Tumor Necrosis Factor Alpha In Mice, Ruei-Lung Lin, Qihai Gu, Lu-Yuan Lee

Physiology Faculty Publications

Tumor necrosis factor alpha (TNFα), a pro-inflammatory cytokine, plays a significant role in the pathogenesis of allergic asthma. Inhalation of TNFα also induces airway hyperresponsiveness in healthy human subjects, and the underlying mechanism is not fully understood. A recent study reported that TNFα caused airway inflammation and a sustained elevation of pulmonary chemoreflex responses in mice, suggesting a possible involvement of heightened sensitivity of vagal pulmonary C-fibers. To investigate this possibility, the present study aimed to investigate the effect of a pretreatment with TNFα on the sensitivity of vagal pulmonary afferents in anesthetized mice. After TNFα (10 μg/ml, 0.03 ml) …

Indoor Tobacco Legislation Is Associated With Fewer Emergency Department Visits For Asthma Exacerbation In Children., Christina E. Ciaccio, Tami Gurley-Calvez, Theresa I. Shireman

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: During the past 3 decades, numerous cities and states have adopted laws that ban smoking in public indoor spaces. The rationale for these policies has been to protect nonsmokers from the adverse health effects of secondhand smoke.

OBJECTIVE: To determine whether the implementation of indoor smoking legislation is associated with a decrease in emergency department visits for asthma in children.

METHODS: This retrospective analysis used a natural experiment to estimate the impact of clean indoor air legislation on the rate of emergency department admissions for asthma exacerbation in children. Data were obtained from the Pediatric Health Information System. A …

Asthma Control Screening Using The Electronic Health Record, Accursia A. Baldassano, Jonathon Mack

Doctor of Nursing Practice Final Manuscripts

ABSTRACT

Experts in asthma care globally recommend screening for asthma control in all patients with asthma through the use of an evidence-based tool. This project embedded the Asthma Control Test (ACT) in the electronic health record to determine if screening for control would change compared to standard care.

Methods

An electronic template of the ACT was embedded in the electronic health record system for a community faith-based family medicine clinic. All patients 12 years and older with a previous diagnosis of asthma were included in this project. These patients were screened for asthma control using the template at every appointment. …

"Mi Niño Con Asma": Hispanic/Latina Mothers, Environmental Justice, And Photovoice At The Front Lines Of The Asthma Epidemic, Robin A. Evans-Agnew Rn, Phd, Julie Postma Rn, Phd, Lee Sledd M. Ed

Journal of Health Disparities Research and Practice

Asthma is an important environmental justice concern for first generation Mexican-Americans. Families experience disparities in housing conditions, access to care, and legal marginalization. Little is known about how Hispanic/Latina mothers of children with asthma navigate these oppressions.

Problem: The purpose of this paper is to describe the discourses of environmental justice of a group Hispanic/Latina caregivers of children with asthma.

Method: A photovoice design was used with Hispanic/Latina mothers (n=11) in Tacoma, Washington, to take, discuss, select and display phototexts to policymakers that communicated their experiences and opinions in managing asthma for their child. Using critical narrative analysis, phototexts were …

Obesity And Asthma: Adiponectin Receptor 1 (Adipo R1) And Adiponectin Receptor 2 (Adipo R2) Are Expressed By Normal Human Bronchial Epithelial (Nhbe) Cells At Air-Liquid Interface (Ali) And Expression Changes With Il-13 Stimulation, Jennifer L. Bradley

Theses and Dissertations

Obesity is recognized as an important risk factor for the development of many chronic diseases such as hypertension, Type 2 diabetes mellitus (T2DM) cardiovascular disease, cancer, renal disease, neurologic dysfunction, metabolic syndrome and asthma (3, 4). Circulating serum adiponectin levels in obese asthmatics have been reported to be low. Therefore, we aimed to investigate the role of adiponectin in a mucus hypersecretion model and hypothesized that adiponectin would decrease IL-13 induced MUC5AC expression from differentiated NHBE cells and that increasing concentrations of IL-13 would cause a decrease in Adipo R1 and Adipo R2 expression. MUC5AC expression with exposure to adiponectin …

Genetic Variation In The Histamine Production, Response, And Degradation Pathway Is Associated With Histamine Pharmacodynamic Response In Children With Asthma., Bridgette Jones, Catherine M T Sherwin, Xiaoxi Liu, Hongying Dai, Carrie A. Vyhlidal

Manuscripts, Articles, Book Chapters and Other Papers

Introduction: There is growing knowledge of the wide ranging effects of histamine throughout the body therefore it is important to better understand the effects of this amine in patients with asthma. We aimed to explore the association between histamine pharmacodynamic (PD) response and genetic variation in the histamine pathway in children with asthma. Methods: Histamine Iontophoresis with Laser Doppler Monitoring (HILD) was performed in children with asthma and estimates for area under the effect curve (AUEC), maximal response over baseline (Emax), and time of Emax (Tmax) were calculated using non-compartmental analysis and non-linear mixed-effects model with a linked effect PK/PD …

Is The Addition Of Vitamin D In Treatment For Asthma Effective In Children Less Than 18 Years Old?, Danielle M. Read

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the addition of vitamin D in treatment for asthma is effective in children less than 18 years old.

STUDY DESIGN: Review of three English language, randomized, controlled, double blind studies after 1999.

DATA SOURCES: Randomized, controlled double blind studies comparing the addition of vitamin D with an inhaled corticosteroid in treatment of asthma with a control group of inhaled corticosteroid alone. All articles were found in PubMed.

OUTCOMES MEASURED: Each study assessed the number of asthma exacerbations or symptoms in the control group and in the …

Aligning Asthma Education Across The Continuum Of Physician Education: Impact On Clinical Metrics, Lisa Sullivan Vedder, Deborah Simpson, Jacob L. Bidwell, John R. Brill, Theresa Frederick

Journal of Patient-Centered Research and Reviews

Background: All trainees entering family medicine residency training programs after June 1, 2012, must complete the same American Board of Family Medicine (ABFM) Maintenance of Certification (MOC) requirements as practicing physicians. These shared requirements provide an opportunity to align physician education initiatives across the continuum focused around a clinical care topic to improve health care system metrics.

Purpose: To assess the initial effectiveness of an ABFM Asthma Part IV approved MOC module, aligned to meet residency and medical student program accreditation requirements, on health care system metrics.

Methods: An ABFM Asthma Part IV MOC module was implemented for family medicine …

Are Probiotics Effective At Reducing The Symptoms Of Asthma In Children From Birth To Twelve-Years Old?, Rachel Sulat

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this systematic review is to determine whether or not probiotics are effective at reducing the symptoms of asthma in children ages birth to twelve-years old.

STUDY DESIGN: Review of three English-language, double-blinded randomized controlled trials (RCTs) from 2010 and 2011.

DATA SOURCES: Three peer-reviewed RCTs were found using PubMed database. These studies compared probiotics to placebos in patients with episodes of wheezing.

OUTCOMES MEASURED: Reduction in symptoms of asthma (particularly wheezing) measured with the use of diary cards and symptom scores.

RESULTS: Chen et al. demonstrated statistically significant improvement in daytime asthma symptoms in probiotic treated …

Survey Of Certified Asthma Educator (Ae-C) Pharmacists – Who Are They And How Is This Credential Being Used?, Timothy R. Hudd, Susan G. Bollmeier, Enrique Seoane-Vazquez

Pharmacy Faculty Articles and Research

Objective: A survey was developed and distributed to pharmacists who have earned the certified asthma educator credential (AE-C) to assess asthma education services provided and their perceived value of the AE-C.

Design: A 28 item survey was developed, pretested and distributed electronically.

Participants: 224 AE-C certified pharmacists practicing within the United States were invited to participate.

Main Outcome Measures: Information pertaining to the level of education, professional affiliations, and practice setting was collected along with other demographic attributes.We also inquired about the types of asthma education services provided, related clinical activities, and whether AE-C pharmacists or …

Pediatric Asthma Telemonitoring: Literature, Theory, And Application To Practice, Erin Christine Shankel

DNP Projects

Asthma is one of the most prevalent and costly chronic diseases faced by Americans today. It is marked by inflammation and hyperresponsiveness of the airways which fluctuates, often unpredictably, in response to triggers. As such, it causes particular challenges symptom management, especially on the part of the patient who is tasked with dealing with these frequent fluctuations for months at a time between regularly scheduled health care appointments. This is further complicated when the patient is a child, and symptoms must be interpreted and managed second-hand by a caregiver. Uncertainty about how to manage symptoms, as well as minimization of …

Is Oral Dexamethasone Safe And Effective For Treating Asthma Exacerbations In Pediatric Patients?, Benhamin J. Kunze

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective evidence based medicine review is to determine whether or not a one or two dose regimen of dexamethasone (DEX) is a safe and effective treatment for asthma exacerbations in the pediatric population.

STUDY DESIGN: Review of three English language, primary randomized controlled trials (RCT) published from 2001-2008.

DATA SOURCES: Three RCTs examining the efficacy of DEX either in a single dose or one dose for two days, compared to a traditional five day regimen of prednisone (PRED).

OUTCOMES MEASURED: The studies examined the number of relapses within 10 days of …

Does The Use Of Fascial Manipulative Therapy Help To Improve Overall Asthma Quality Of Life By Descreasing Asthma Symptoms?, Christie Mecouch

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not the use of fascial manipulative therapy helps to improve overall asthma quality of life by decreasing asthma symptoms.

STUDY DESIGN: Review of two randomized controlled trials (RCTs) and one case study, published between 2005-current, all in the English language.

DATA SOURCES: Two randomized controlled trials (RCTs) and one case study, all of which evaluate the effectiveness of fascial manipulative therapy as it pertains to asthma quality of life. All studies were found using PubMed.

OUTCOMES MEASURED: The outcomes measured were an improvement …

The Common Allergic Mechanism Of Rhinitis And Asthma, Esther Feinstein

The Science Journal of the Lander College of Arts and Sciences

Allergic rhinitis and asthma are closely linked diseases which are very prevalent within the population, affecting millions. They are both characterized by chronic airway inflammation. They are often present in the same patients and rhinitis is even considered an independent risk factor for asthma. Treating allergic rhinitis can reduce the severity of asthma. Mechanisms connecting the two have been researched for many years. Studies show that they have a similar allergic mechanism that is mediated by the same cells. The allergic inflammation is characterized by the presence of eosinophils and is mediated by T-helper type 2 lymphocytes. The circulation of …

Assessing Two Spirometric Criteria Of Pre-Bronchodilator And Post-Bronchodilator Fev1/Fvc Ratio In Detecting Air Flow Obstruction, Zeeshan Waheed, Muhammad Irfan, Ahmed Suleman Haque, Najmul Hasan Siddiqui, Safia Awan, Beenish Syed, Javaid Khan

Section of Pulmonary & Critical Care

OBJECTIVES: To assess the Pre-bronchodilator criteria and the Post-bronchodilator criteria of FEV1/FVC ratio in diagnosing Airflow obstruction.

METHODS: An observational study was conducted from 1988 to 2006 at the Aga Khan University Hospital Patients referred to the pulmonary function test laboratory for spirometry with bronchodilator reversibility at the hospital during the above said period were enrolled. Forced spirometry was performed according to ATS guidelines. All patients who had pre-bronchodilator criteria of airflow obstruction were analyzed and compared with the post bronchodilator criteria.

RESULTS: A total of 4222 individuals underwent spirometry out of which 4072 individuals were studied. Using the pre …

The Effects Of Computer-Based Education On Children's Knowledge About Asthma, Matyt L. Adler

Evidence-Based Practice Project Reports

Asthma is a global health problem affecting people of all ages that can cause severe limitations when uncontrolled. In the United States, asthma was the most prevalent chronic disease among children and youth in 2008 (U.S. Department of Health and Human Services, 2009). Because day-to-day management of asthma is the responsibility of the child or the parent, education of patients is one of four crucial components to effectively provide quality asthma care. Changes in workload complexities with primary care visits has increased and visit duration decreased, resulting in less available time to address individual patient needs including the education aspect …

The Role Of The Ras Superfamily Small G-Proteins In The Proinflammatory Environment Of Rhinovirus-Exposed Monocytic-Lineage Cells, Michael Schreiber

Lawrence University Honors Projects

Rhinoviral infections are a major cause of asthma exacerbations, and though productive rhinovirus infection occurs predominantly in the bronchial epithelial cells of the upper airway, monocytic-lineage cells are implicated in establishing the inflammatory microenvironment observed during rhinoviral asthma exacerbation. It has remained unclear whether small G-protein activation plays a role in establishing this inflammatory microenvironment. The small molecular- weight G-proteins are known to be activated in a variety of cell types upon exposure to a range of viruses. However, it is unclear if small G-protein activation during viral exposure is a byproduct of receptor attachment, is important for viral replication, …

Assessment Of Asthma Control Using The Asthma Control Test At A Tertiary Care Centre In Karachi, Pakistan, Sana Shoukat, Saqib Ali Gowani, Ameer Ali Khowaja, Javaid Khan

Section of Pulmonary & Critical Care

The aim of our study was to assess asthma control among asthmatics at a tertiary care setting in Karachi using ACT questionnaire. The ACT questionnaire was filled by known asthmatics in January 2007. A total of 150 questionnaires were filled of which, 61 (40%) were males and 89 (60%) females. Mean ACT score was 17.71 +/- 4.41. Association between sex and asthma control was not statistically significant. Significant association was seen with asthma control and Ipratropium bromide inhaler. Asthma control among patients at a tertiary care centre is moderate. ACT can be used to follow patients in the hospital.

An Assessment Of High School Coaches Knowledge Of Exercise-Induced Asthma, Shannon L. Wilson

Human Movement Studies & Special Education Theses & Dissertations

Exercise-induced asthma (EIA) is a common disorder that occurs in individuals who compete in recreational activities. The purpose of this study was to determine the knowledge of EIA for high school athletic coaches. A 22 question demographic instrument was used for background information, and an 18 question multiple-choice assessment was used to assess knowledge of prevention, recognition and management of EIA. A panel of experts reviewed and modified the survey instruments, which were piloted at a local private high school prior to distribution. The survey was distributed to 250 high school coaches in the Hampton Roads area during a fall …

Explanatory Power Of The Behavior Model Of Utilization For Pediatric Asthma Health Care In An Urban Managed Care Setting, Kathie Marie Sawyer Zimbro

Health Services Research Dissertations

The Behavior Model of Utilization played a key role in explaining health services use for pediatric members with asthma in one urban, regional managed care company. The critical role the asthma management program played in promoting the health and well-being of enrolled members was elucidated. Information gleaned from this empirical study can be used to encourage appropriate resource utilization, formulate pediatric asthma health policy, and deliver cost-effective, quality health care. More importantly, managed care company administrators and clinicians can demonstrate the value of their efforts by achieving measurable improvements in the health and well-being of children in the communities they …

The Pediatric Breathing Survey, Linda J. Galloway

Health Services Research Dissertations

To ensure culturally-sensitive assessments, the researcher designed a Pediatric Breathing Survey (PBS) to measure quality of life for African-American children. The purpose of this study was to test whether the PBS is a reliable and valid instrument. Comparisons of group differences on race, income and parent's level of education based on parent responses to the questionnaires were conducted. More specifically, differences in Health Related Quality of Life (HRQOL) between Caucasian and African-American children were examined. The researcher-designed instrument was compared to Juniper's Pediatric Asthma Quality of Life Questionnaire. The sample consisted of parents of 84 school-aged children diagnosed with asthma. …

Factors Associated With Asthma Readmissions In Children's Hospitals, Maria Acedo Kronenburg

Health Services Research Dissertations

Asthma is the most common chronic illness of childhood. Pediatric asthma hospitalization rates and costs of care have risen in recent years. Readmissions, an adverse outcome often used to monitor quality of care, may account for the increase in asthma hospitalization rates. This research examined selected hospital and patient risk factors related to asthma readmissions, using Donabedian's framework for structure, process, and outcomes to assess the quality of care for children with asthma. Outcome measures included readmission for asthma within one year of initial hospitalization, readmission within 30 days, and multiple readmissions within one year. Structure factors measured were insurance …

Efficient Vasoactive Intestinal Polypeptide Hydrolyzing Autoantibody Light Chains Selected By Phage Display, Sonia Tyutyulkova, Qing-Sheng Gao, Austin Thompson, Stephen I. Rennard, Sudhir Paul

Journal Articles: Pulmonary & Critical Care Med

An immunoglobulin light chain (L chain) library derived from the peripheral blood lymphocytes of a patient with asthma was cloned into a phagemid vector. Phage particles displaying L chains capable of binding vasoactive intestinal polypeptide (VIP) were isolated by affinity chromatography. Two VIP binding L chains were expressed in Escherichia coli in soluble form and purified to electrophoretic homogeneity by metal chelating and protein L affinity chromatography. Both L chains catalyzed the hydrolysis of [tyr10-125I]VIP substrate. The catalytic activity eluted at the molecular mass of the monomer form of the L chain (28 kDa) from a gel filtration column. The …

Churg-Strauss Syndrome With Intestinal Perforation, Javaid A. Khan, Imran Hassan, Shahid Pervez, Wasim Jafri, Shaista Khan

Department of Pathology and Laboratory Medicine

No abstract provided.

Question: What Is The Difference Between Volmax® And Proventil Repetabs®?, Jeffery A. Goad, Robert Andonian, Chris Chang, Greg Thompson

Pharmacy Faculty Articles and Research

Answer: There are noticeable differences between Volmax and Proventil Repetabs, two of the available oral forms of administering albuterol to patients suffering from asthma. These differences are discussed below.

Plants And Asthma, Robert Dunlop Royce

Journal of the Department of Agriculture, Western Australia, Series 4

ASTHMA is defined in the dictionary as being a disease characterised by recurring attacks of difficulty in breathing, and the causes are stated to include the inhalation of dust, or the odour of plants, flowers or animals.

Hay fever is a similar condition and this too, is caused by plants, usually at the time of flowering, when large quantities of pollen are produced.