The journal of allergy and clinical immunology. In practice
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J Allergy Clin Immunol Pract · Nov 2014
Optimum predictors of childhood asthma: persistent wheeze or the Asthma Predictive Index?
The Asthma Predictive Index (API) and persistent wheezing phenotypes are associated with childhood asthma, but previous studies have not assessed their ability to predict objectively confirmed asthma. ⋯ Both a positive ucAPI and persistent wheeze at age 3 were associated with objectively confirmed asthma at age 7; however, the highest risk was associated with ucAPI. These results demonstrate the ucAPI as a clinically useful tool for predicting future asthma in school-age children.
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J Allergy Clin Immunol Pract · Nov 2014
High blood eosinophil count is a risk factor for future asthma exacerbations in adult persistent asthma.
Exacerbation-associated uncontrolled asthma represents a major public health problem. The relationship of elevated blood eosinophils to this process needs study. ⋯ A high blood eosinophil count is a risk factor for increased future asthma exacerbations and excessive short-acting β2-agonist use after adjustment of potential confounders in adults with persistent asthma, which suggests a higher disease burden in patients with asthma and with high blood eosinophil counts.
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J Allergy Clin Immunol Pract · Nov 2014
Multicenter Study Observational StudyA multicenter observational study of US adults with acute asthma: who are the frequent users of the emergency department?
Despite the substantial burden of asthma-related emergency department (ED) visits, there have been no recent multicenter efforts to characterize this high-risk population. ⋯ This multicenter study of US adults with acute asthma demonstrated many frequent ED users and suboptimal preventive management in this high-risk population. Future reductions in asthma morbidity and associated health care utilization will require continued efforts to bridge these major gaps in asthma care.
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J Allergy Clin Immunol Pract · Nov 2014
ReviewAspirin or other nonsteroidal inflammatory agent exacerbated asthma.
Aspirin-exacerbated respiratory disease (AERD) is an asthma phenotype with a prevalence that ranges from 2% to 25% of the asthma population. The 2% prevalence applies to patients with mild and 25% to severe, persistent asthma. COX-1-inhibiting nonsteroidal anti-inflammatory drugs, including aspirin, aggravate the preexisting upper and lower respiratory disease, sometimes in a life-threatening manner. ⋯ A variety of single nucleotide polymorphisms and genes are associated with AERD, but the studies to date are limited to select populations and have not conclusively demonstrated a uniform genetic pattern in subjects with this disease. Treatment of AERD can be challenging because the nasal symptoms, including polyposis, are often refractory to both surgery and medical treatment, and the asthma can be difficult to control. Aspirin desensitization, followed by daily aspirin administration, can improve both upper and lower respiratory tract symptoms in up to 60% of individuals.
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J Allergy Clin Immunol Pract · Nov 2014
The prevalence of severe asthma and low asthma control among Danish adults.
The prevalence of severe asthma is unknown. However, international expert statements estimate that severe asthma represents 5% to 10 % of the entire asthma population. ⋯ Based on the level of treatment, 8.1% of a nationwide population of current patients with asthma was classified as having severe asthma. Low asthma control was more frequent among subjects with severe asthma, and only a minority had access to specialist care. There is room for optimizing asthma management, particularly among patients with severe disease.