Associations of AMP and adenosine induced dyspnea sensation to large and small airways dysfunction in asthma.

Background: Bronchial provocation is often used to confirm asthma. Dyspnea sensation, however, associates poorly with the evoked drop in FEV. Provocation tests only use the large airways parameter FEV, although dyspnea is associated with both large- and small airways dysfunction.

Predictors of clinical response to extrafine and non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma.

We performed a post-hoc analysis of the OLiVIA-study investigating whether current and ex-smoking asthmatics with small airways dysfunction (SAD) show a better response in airway hyperresponsiveness (AHR) to small particle adenosine after treatment with extrafine compared to non-extrafine particle inhaled corticosteroids (ICS), and to investigate which clinical parameters predict a favorable response to both treatments. We show that smoking and ex-smoking asthmatics with and without SAD have a similar treatment response with either extrafine or non-extrafine particle ICS. We also found that lower blood neutrophils are associated with a smaller ICS-response in smokers and ex-smokers with asthma, independent from the level of blood eosinophils.

Extrafine compared to non-extrafine particle inhaled corticosteroids in smokers and ex-smokers with asthma.

Background: Smoking is as prevalent in asthmatics as in the general population. Asthmatic smokers benefit less from inhaled corticosteroids (ICS) than non-smoking asthmatics, possibly due to more smoking-induced small airways disease. Thus targeting small airways may be important in treating asthmatic (ex-)smokers.

Primary prevention of chronic obstructive pulmonary disease in primary care.

Chronic obstructive pulmonary disease (COPD) is a prevalent disease, with cigarette smoking being the main risk factor. Prevention is crucial in the fight against COPD. Whereas primary prevention is targeted on whole populations, patient populations are the focus of primary care; therefore, prevention in this setting is mainly aimed at preventing further deterioration of the disease in patients who present with the first signs of disease (secondary prevention).

Prescribing of asthma medication in primary care for children aged under 10.

Objective: To evaluate prescriptions of asthma medication for children in primary care.

Methods: Data on prescriptions of asthma medication for children aged 0-9 years were collected from a general practice-based network in the north eastern part of the Netherlands. Prevalence, incidence, indications, continuation beyond the age of 6 years, and predictors of continuation, were determined.

Fluticasone or montelukast for preschool children with asthma-like symptoms: Randomized controlled trial.

Rationale: Beneficial effects of anti-inflammatory therapy such as fluticasone propionate (FP) and montelukast (Mk) have been demonstrated in preschool children with asthma. However, comparative studies are lacking in this age group. Therefore, we conducted a study to evaluate and compare the effect of FP and Mk in preschool children with asthma-like symptoms.

Inhaled corticosteroids for recurrent respiratory symptoms in preschool children in general practice: randomized controlled trial.

Background: Therapy with inhaled corticosteroids (ICS) is beneficial in patients with asthma. However, in preschool children with symptoms like cough, wheeze, or shortness of breath diagnosing asthma is difficult. Therefore, the role of ICS in the management of preschool children with recurrent respiratory symptoms is unclear.

The effectiveness of inhaled corticosteroid therapy in preschool children with asthma: a systematic review of the literature.

Objective: To evaluate the effectiveness of inhaled corticosteroid therapy in asthmatic children in the age group of 0-6 years.

Study Design: Systematic review of randomised double blind placebo controlled trials of inhaled corticosteroid therapy for preschool children with asthma. 12 Trials were identified for this review.

Development, validity and responsiveness of the Clinical COPD Questionnaire.

Background: The new Global Obstructive Lung Disease (GOLD) guidelines advice to focus treatment in Chronic Obstructive Pulmonary Disease (COPD) on improvement of functional state, prevention of disease progression and minimization of symptoms. So far no validated questionnaires are available to measure symptom and functional state in daily clinical practice. The aim of this study was to develop and validate the Clinical COPD Questionnaire (CCQ).