Inhaled corticosteroid use and outcomes in pregnancy.

Background: Current asthma management guidelines recommend aggressive asthma treatment for women who are pregnant.

Objective: To examine asthma medication use and asthma-related health care use before and during pregnancy.

Methods: Women aged 15 to 45 years with a pregnancy claim (index event) and an asthma claim (diagnosis or asthma medication prescription) were identified from a database of US managed care organizations (PharMetrics Patient-Centric Database).

Asthma medication use in pregnancy and fetal growth.

Background: Given the high prevalence of asthma in pregnancy, it is important to understand the relationship between asthma medications and fetal growth in the context of appropriate treatment.

Objective: This study examines the effect of inhaled corticosteroids, systemic corticosteroids, and beta(2)-agonists on fetal growth in 654 infants born to women with asthma compared with 303 infants born to controls without asthma.

Methods: Subjects for this prospective study were enrolled throughout North America between 1998 and 2003 and followed up by the Organization of Teratology Information Services.

Soluble transferrin receptor and zinc protoporphyrin--competitors or efficient partners?

Objectives: Soluble transferrin receptor (sTfR) and zinc protoporphyrin (ZPP) are both parameters of iron deficient erythropoiesis (IDE), the sTfR measurement is commonly regarded to be the more sensitive test. sTfR also reflects erythropoietic activity, it is increased in enhanced erythropoiesis.

Methods: We investigated the diagnostic accuracy of sTfR in assessment of iron deficiency (ID) and compared it with ZPP.

Fourier shell correlation threshold criteria.

The resolution value claimed for an electron microscopical three-dimensional reconstruction indicates the overall quality of the experiment. The Fourier shell correlation (FSC) criterion has now become the standard quality measure. However, what has continued to be controversial is the issue of the FSC threshold level at which one defines the reproducible resolution.

Complex-ordered patterns in shaken convection.

We report and analyze complex patterns observed in a combination of two standard pattern forming experiments. These exotic states are composed of two distinct spatial scales, each displaying a different temporal dependence. The system is a fluid layer experiencing forcing from both a vertical temperature difference and vertical time-periodic oscillations.

The prevalence of reversible airflow obstruction and/or methacholine hyperreactivity in random adult asthma patients identified by administrative data.

Background: Asthma is a chronic inflammatory lung disease. It is commonly diagnosed and treated on the basis of clinical impression, although national guidelines recommend documenting reversible airflow obstruction.

Objectives: Determine the frequency of reversible airflow obstruction, and/or methacholine hyperreactivity during 2003 in a well-characterized population with a low-risk asthma diagnosis during 2001.

Short-term and long-term asthma control in patients with mild persistent asthma receiving montelukast or fluticasone: a randomized controlled trial.

Purpose: To determine whether montelukast is as effective as fluticasone in controlling mild persistent asthma as determined by rescue-free days.

Subjects And Methods: Participants aged 15 to 85 years with mild persistent asthma (n = 400) were randomized to oral montelukast (10 mg once nightly) or inhaled fluticasone (88 mug twice daily) in a year-long, parallel-group, multicenter study with a 12-week, double-blind period, followed by a 36-week, open-label period.

Results: The mean percentage of rescue-free days was similar between treatments after 12 weeks (fluticasone: 74.

Modeling the MHC class I pathway by combining predictions of proteasomal cleavage, TAP transport and MHC class I binding.

Epitopes presented by major histocompatibility complex (MHC) class I molecules are selected by a multi-step process. Here we present the first computational prediction of this process based on in vitro experiments characterizing proteasomal cleavage, transport by the transporter associated with antigen processing (TAP) and MHC class I binding. Our novel prediction method for proteasomal cleavages outperforms existing methods when tested on in vitro cleavage data.

Relationships among quality of life, severity, and control measures in asthma: an evaluation using factor analysis.

Background: Validated psychometric tools measuring quality of life, asthma control, and asthma severity have been developed, but their relationships with each other and with other important patient-centered outcomes have not been rigorously assessed.

Objective: To use factor analysis to evaluate the relationships of these validated tools with each other and with other patient-centered outcomes.

Methods: Surveys were completed by a random sample of 2854 Health Maintenance Organization members age 18 to 56 years with persistent asthma.

Treatment of asthma during pregnancy and perinatal outcomes.

Purpose Of Review: Asthma is the most common, potentially serious medical problem to complicate pregnancy. Women with asthma have been shown to be at increased risk of complications during pregnancy. Managing asthma during pregnancy is unique because the effect of both the illness and the treatment on the developing fetus as well as the patient must be considered.

Relationship of validated psychometric tools to subsequent medical utilization for asthma.

Background: Risk stratification is used to identify patients with asthma at increased risk of experiencing morbidity and resource utilization. Validated psychometric tools are infrequently studied sources of data for this purpose.

Purpose: To evaluate 4 types of validated psychometric tools as predictors for subsequent asthma utilization and determine their clinical usefulness.

Major structural differences and novel potential virulence mechanisms from the genomes of multiple campylobacter species.

Sequencing and comparative genome analysis of four strains of Campylobacter including C. lari RM2100, C. upsaliensis RM3195, and C.

Pregnancy and asthma: recent developments.

Purpose Of Review: Asthma is the most common potentially serious medical problem to complicate pregnancy. Asthmatic women have been shown to be at an increased risk of complications during pregnancy. Managing asthma during pregnancy is unique because the effects of both the illness and the treatment on the developing fetus and the patient must be considered.

Secondary instabilities of hexagonal patterns in a Bénard-Marangoni convection experiment.

We have identified experimentally secondary instability mechanisms that restrict the stable band of wave numbers for ideal hexagons in Bénard-Marangoni convection. We use "thermal laser writing" to impose long wave perturbations of ideal hexagonal patterns as initial conditions and measure the growth rates of the perturbations. For epsilon=0.

Variability of symptoms in mild persistent asthma: baseline data from the MIAMI study.

Objective: To describe the variability of the asthma phenotype in patients with mild persistent asthma enrolled in the Mild Asthma Montelukast versus Inhaled Corticosteroid (MIAMI) study.

Methods: The variability of asthma rescue-free days, asthma symptoms, albuterol use, medical resource use, and exercise Limitations among patients with documented mild persistent asthma was compared between the month before study enrollment and the last 2 weeks of the run-in period.

Results: Patients eligible for randomization (n = 400), aged 15-85 years, exhibited symptoms (mean +/- SD) 3.

Routine Penicillin Skin Testing in Hospitalized Patients with a History of Penicillin Allergy.

Background: In selected inpatient settings, penicillin skin testing has been shown to affect antibiotic use. Routine penicillin skin testing has not been studied in hospitalized patients with a history of penicillin allergy.

Objectives: To determine whether routine penicillin skin testing at a large regional hospital affected antibiotic use and/or antibiotic side effects in hospitalized persons with a history of penicillin allergy.

The relationship of asthma medication use to perinatal outcomes.

Background: Maternal asthma has been reported to increase the risk of preeclampsia, preterm deliveries, and lower-birth-weight infants, but the mechanisms of this effect are not defined.

Objective: We sought to evaluate the relationship between the use of contemporary asthma medications and adverse perinatal outcomes.

Methods: Asthmatic patients were recruited from the 16 centers of the National Institute of Child Health and Human Development Maternal Fetal Medicine Units Network from December 1994 through February 2000.

Update in the treatment of asthma during pregnancy.

Asthma is the most common potentially serious medical problem to complicate pregnancy. Recent reports suggest that 7 of every 100 pregnant women suffer from asthma during pregnancy. Asthmatic women have been shown to be at an increased risk of complications during pregnancy.

Sex differences among children 2-13 years of age presenting at the emergency department with acute asthma.

Hospitalization rates for asthma have been reported to be higher in males than females in children under age 15, but it is not clear whether this disparity reflects gender differences in prevalence, severity, or treatment. We performed a prospective cohort study as part of the Emergency Medicine Network. Patients aged 2-13 years who presented to the emergency department (ED) with acute asthma underwent a structured interview in the ED and another by telephone 2 weeks later.

Randomized trial of inhaled beclomethasone dipropionate versus theophylline for moderate asthma during pregnancy.

Objective: This study was undertaken to compare the efficacy of inhaled beclomethasone dipropionate to oral theophylline for the prevention of asthma exacerbation(s) requiring medical intervention.

Study Design: A prospective, double-blind, double placebo-controlled randomized clinical trial of pregnant women with moderate asthma was performed.

Results: There was no significant difference (P=.

Use of inhaled steroids by pregnant asthmatic women does not reduce intrauterine growth.

Background: Inhaled steroids are recommended for the treatment of persistent asthma during pregnancy, but their potential effects on intrauterine growth have been inadequately evaluated.

Objective: The purpose of this study was to evaluate the association between maternal use of specific inhaled steroids and inhaled steroid dose during pregnancy and the incidence of infants who are small for gestational age (SGA) and mean birth weight.

Methods: Pregnant asthmatic women being treated with inhaled steroids were enrolled in the study before delivery by their managing allergists.

Effectiveness of budesonide administered via dry-powder inhaler versus triamcinolone acetonide administered via pressurized metered-dose inhaler for adults with persistent asthma in managed care settings.

Background: Clinical studies have demonstrated the efficacy and relative safety of inhaled corticosteroids in the treatment of asthma. However, effectiveness and cost-effectiveness comparisons of available inhaled corticosteroids in real-life clinical settings are lacking.

Objective: This study compared the effectiveness and safety of budesonide administered via dry-powder inhaler versus that of triamcinolone acetonide administered via pressurized metered-dose inhaler in the treatment of adult patients with persistent asthma treated in a managed care setting.