The Journal of asthma : official journal of the Association for the Care of Asthma
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National and International Guidelines concur that inhaled corticosteroids (ICS) are the preferred long-term maintenance drug therapy for mild persistent asthma for all ages. For moderate and severe persistent asthma, ICS are essential to optimal management, often concurrent with other key therapies. Despite strong evidence and consensus guidelines, ICS are still underused. ⋯ To help ensure adherence to ICS therapy, patient education regarding both airway inflammation (show airway models/colored pictures) and the strong evidence of efficacy is vital. Teaching ICS inhaler technique, environmental control, and giving a written action plan are essential. Lack of initiation of ICS with appropriate patient education before discharge from the ED in patients with persistent asthma is common but unfortunately associated with continued poor patient outcomes.
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The current asthma guidelines encourage use of a diary for assessing and monitoring symptoms and airway function. However, patient compliance and acceptability are usually poor owing to the burden of frequent and prolonged assessment. ⋯ Good patient compliance and acceptability can be achieved when a study takes into account patient convenience, uses user friendly electronic devices, and is less disruptive to patients' daily life.
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Airway narrowing after hypertonic saline challenge (HSC) is postulated to be mediated by bronchoconstrictors and inflammatory mediators. ⋯ EBC analysis suggests that HSC causes an increase in pH and mucin in both groups, but EBC volume and histamine only increased in the BHR(+) group. This suggests that mast cells are activated and fluid flux is associated with the positive response, while mucin release is independent of BHR in HSC.
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Countries in the Asia-Pacific region have experienced an increase in the prevalence of asthma, and they have been actively involved in asthma research recently. This study aimed to analyze asthma research from Asia-Pacific in the last decade by bibliometric method. ⋯ Asthma research in Asia-Pacific were mainly conducted in countries in Oceania and Northeast Asia and research performance strongly correlated with the nation's wealth. Interesting asthma research projects in the region were recommended.