Rationale: Asthma is heterogeneous and knowledge on exacerbation patterns is lacking. Previous studies have had a relatively short follow-up or focused on severe disease.
Objectives: To describe exacerbation patterns over a prolonged follow-up in a population that includes patients of all disease severity.
Methods: We used electronic health care records to identify patients with asthma aged 18-55 years and their exacerbations from 2007 to 2015. A cohort with greater than or equal to 7 years of data was used to describe exacerbation patterns by asthma severity defined by medication use. Effect estimates for risk factors were calculated for sporadic (single year of exacerbations) and recurrent (>1 yr) exacerbation patterns, using logistic regression. In a nested case-control design, the association between a history of exacerbations, spanning 5 years, and a future exacerbation was examined.
Measurements And Main Results: A total of 51,462 patients were eligible for the 7-year cohort; 64% had no exacerbations. Of those who exacerbated, 51% did so only once; exacerbation frequency increased with disease severity. Only 370 patients (0.7%) were characterized by a frequent-exacerbator phenotype (yearly exacerbations), of whom 58% had mild/moderate asthma. Exacerbation risk factors were not uniquely associated with a particular exacerbation pattern. A past exacerbation increased the risk of a future exacerbation more than all other factors, although this effect dissipated over 5 years.
Conclusions: During 7 years of follow-up, exacerbations occur in around one-third of patients. Of those who exacerbate, half do not do so again; the timing of future exacerbations is largely unpredictable. Just 2% exhibit a frequent-exacerbator phenotype. Past exacerbation patterns are the most informative risk factor for predicting future exacerbations.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1164/rccm.201808-1516OC | DOI Listing |
Gynecol Obstet Invest
December 2024
Objective: Abnormal expression of circular RNA (circRNA) leads to the occurrence and development of endometriosis (EM), but its underlying mechanisms are largely unknown.
Methods: Abnormally expressed circRNAs were screened in EM and normal tissues. A series of gain-of-function or loss-of-function experiments were conducted to evaluate the biological behavior of circ_0008927 in EM cells.
Diabetes
December 2024
Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Advances in fundus imaging are revealing disruptions in the neurovascular unit in diabetic retinopathy (DR). In the era of anti-VEGF treatment, a thorough characterization of neurodegeneration is imperative until DR patients are sufficiently cured. Here we demonstrate that extracellular mitochondria exacerbate retinal pigment epithelium (RPE) degeneration and inflammation in DR.
View Article and Find Full Text PDFAm J Respir Crit Care Med
December 2024
University of Michigan, Pulmonary & Critical Care, Ann Arbor, Michigan, United States.
The impact of COPD screening on US primary care clinician behavior and patient outcomes is unclear. Assess the impact of receiving CAPTURE (COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk) screening scores on clinical and patient outcomes. Cluster randomized trial included 49 usual care (COPD education only) and 51 intervention (COPD and CAPTURE education plus screening scores) primary care practices.
View Article and Find Full Text PDFJ Autism Dev Disord
December 2024
Social Work Department, Faculty of Social Sciences & Humanities, Tel-Hai College, Qiryat Shemona, Israel.
During emergencies like wartime, parents of children with Autism Spectrum Disorder (ASD) face heightened challenges, potentially leading to Parental Burnout (PB). Wartime conditions can exacerbate children's behavioral difficulties, contributing to PB. Protective factors such as successful Emotional Regulation (ER) and perceived social support may mitigate PB.
View Article and Find Full Text PDFMol Neurobiol
December 2024
NHC Key Laboratory of Drug Addiction Medicine, School of Forensic Medicine, Kunming Medical University, 1168 West Chunrong Road, Yuhua Avenue Chenggong District, Kunming, 650500, China.
Co-exposure to methamphetamine (METH) abuse and HIV infection exacerbates central nervous system damage. However, the underlying mechanisms of this process remain poorly understood. This study aims to explore the roles of neuronal autophagy in the synergistic damage to the central nervous system caused by METH and HIV proteins.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!