The Journal of asthma : official journal of the Association for the Care of Asthma
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Macrophages are heterogeneous cells, which possess pleotropic effector and immunoregulatory functions. The phenotypic diversity of macrophages is best exemplified by the ability of IL-4 or IL-13, two key cytokines in asthma to promote macrophages into a suppressive/anti-inflammatory phenotype (e.g. alternatively activated or M2) whereas exposure to IFN-γ followed by microbial trigger renders macrophages pro-inflammatory (e.g. classically activated or M1). Intriguingly, only limited data exists regarding the expression of miRNA in M2 macrophages. ⋯ Our data establish miR-511 as a bona fide M2-associated miRNA. These data may have significant implications in asthma where the expression of IL-4 and IL-13 are highly increased.
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Long-term subcutaneous or intravenous infusion of terbutaline has been used to stabilize asthma in patients enduring frequent hospital admissions due to severe asthma despite maximum therapy. However, this treatment is not supported by significant body of evidence. ⋯ Continuous terbutaline infusion could be a treatment option for severe unstable asthma and may reduce hospital admissions. However, the treatment was associated with significant side effects and its use should be limited to centers possessing necessary expertise.
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The last half-century has seen substantial changes in asthma treatment and care. We investigated whether arterial blood gas parameters in acute and non-acute asthma have changed historically. ⋯ In studies of habitual-state asthma, mean reported P(aO2) and P(aCO2) levels were found to have increased since 1967. In acute asthma studies, mean P(aO2) and P(aCO2) were associated with mean FEV1% but not with either publication year or patient age.
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Comparative Study
Asthma management and inhalation techniques among community pharmacists in 2009: a comparison with the 1999 survey.
In a 1999 survey, community pharmacists from the Alsace region of France had a reasonably good knowledge of asthma treatment and prevention, but their skill in the use of asthma inhalation devices left room for improvement. Since then, health authorities have encouraged the involvement of community pharmacists in patient care and education in order to improve asthma control. The aim of this study was to assess the change in the knowledge of asthma management and inhaler technique skills of community pharmacists in the same geographic area after a 10-year interval. ⋯ Since 1999, pharmacists' skill in the use of inhalers has improved, but theoretical knowledge of asthma management is still average, pointing to the importance of continuing pharmaceutical education.
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Effective management of asthma requires the development of a partnership between the patient and his or her health care professionals. In a number of countries, including Turkey, pharmacy workers are the last link in the asthma therapy chain and usually give information to their patients about the use of these drugs and asthma. As a result, we investigated knowledge of asthma and the use of inhaler devices in pharmacy workers in Istanbul pharmacies. ⋯ Istanbul pharmacy workers have limited knowledge about asthma and inhaler devices and need further education, which may contribute to improved asthma control in Turkey.