"Severe-controlled" asthma 4 years later: is it still controlled?

Background: Controlled severe asthma is based on needing regular medication and 4 markers of good asthma control. This study reevaluated a community sample defined 4 years earlier as "severe-controlled" based on electronic medical records of medications dispensed over 12 months.

Objectives: Determine the current extent of clinically-controlled asthma and asthma-related quality-of-life among patients previously considered "severe-controlled".

Severe and non-severe asthma in the community: A large electronic database analysis.

Background: A large electronic database analysis was conducted in a community of 351,799 people, ages 20-70 years to determine the prevalence and clinical characteristics of severe asthma, according to 2014 international guidelines and healthcare utilization.

Methods: Severe asthmatics were grouped into controlled severe-asthma and uncontrolled severe-asthma and additional subgroups of uncontrolled severe asthma on the basis of medications dispensed. Non-asthmatic population at the same ages served as controls.

[Perspectives in future asthma therapy].

Five to ten percent of all asthmatics, many dozens of millions of patients all over the world, do not respond to maximal medical therapy, including systemic steroids, and the toll of treating them constitutes about eighty percent of the total cost of managing all asthmatics. Other asthmatics who do respond to medical therapy either are not compliant with their medications or suffer from disabling adverse effects. The future therapy of asthma will concentrate on finding medical solutions to these sub-groups of patients but the entire asthmatic population will enjoy its achievements.

[Posture-dependent refractory hypoxemia].

Patent foramen ovate is a common finding in the general population. However, interatrial right to left shunt causing severe hypoxemia in the absence of pulmonary hypertension is a rare finding. The authors describe two such patients suffering from severe hypoxemia refractory to oxygen supplementation.

[Reasons for the gap between asthma in reality and GINA guidelines].

Asthma is a common chronic disease worldwide, affecting 300 million people of all ages. In spite of the existence of scientifically proven clinical guidelines for the past 15 years and efficient controller medications, the gaps between asthma management in reality and the goals of the Global Initiative for Asthma (GINA) guidelines are huge. Asthma, being a chronic disease, might be a companion from early childhood to the end of life and, as such, may impose major obstacles in disease management.

[Acute eosinophilic pneumonia: a potentially fatal disease under a mask of acute community-acquired bacterial pneumonia].

Acute eosinophilic pneumonia (AEP) is a rare and sometimes fatal disease. Diagnosis of AEP may be especially difficult in its early stages, before development of peripheral eosinophilia. This is a case study of AEP in a 27 years old female, reviewing etiologic factors, clinical presentation, diagnostic procedures and current treatment strategies.

Genetic polymorphisms of the beta-2 adrenergic receptor in Israelis with severe asthma compared to non-asthmatic Israelis.

Background: It has been argued that arginine replacement in locus 16 (Arg16) of beta 2 adrenergic receptor with glycin (Gly16) increases asthma severity, while glutamin replacement in locus 27 (Gln27) with glutamic acid (Glu27) decreases it. In addition, ethnic dependency of these polymorphisms has been described, but few studies investigated its relation to asthma severity in a non-anglosaxic population.

Objectives: To investigate non-anglosaxic ethnic influences on beta 2AR polymorphisms and its correlations to asthma severity.

[Water-pipe tobacco smoking among school children in Israel: frequencies, habits, and attitudes].

Background: Tobacco smoking via a water-pipe (Nargile) is a new phenomena among school children in Israel in recent years. Water-pipe tobacco has the potential for nicotine addiction, for other smoking-related damages and for drug abuse.

Goals: Our primary goal was to characterize the frequencies of water-pipe smoking among school children in Israel, its distribution according to age, gender, habits and attitudes.

Bilateral and unilateral spontaneous massive hemothorax as a presenting manifestation of rare tumors.

Spontaneous true hemothorax is quite a rare manifestation of a presenting disease. This is a report of two patients, one with bilateral spontaneous massive hemothorax as a presenting manifestation of angiosarcoma involving the lungs and pleura, and the other with unilateral spontaneous hemothorax and hemorrhagic shock as a presenting manifestation of 'cystic' chondroblastoma. Differential diagnosis of spontaneous true hemothorax and its evaluation and management are discussed.

Bronchial asthma in Israel.

Asthma in Israel is a growing medical problem, affecting at least 7% of children and 3.7% of the total population. Mortality rates in the age group 5-34 years were on a rise between 1976 and 1990 but show a marked decrease in recent years, perhaps due to the sharp increase in sales of inhaled corticosteroids.