As many as 15% to 20% of patients with asthma have incompletely or poorly controlled asthma despite treatment with inhaled corticosteroids and long-acting beta-agonist bronchodilators. They are vulnerable to burdensome symptoms, limitations to their exercise capacity, and asthma attacks that can be frightening and potentially life-threatening. This article outlines a systematic approach to their evaluation, attempting to identify remediable factors that are making their asthma more severe than most other persons with asthma. This approach includes an emphasis on ensuring the correct diagnosis, minimizing exposures to stimuli that worsen airway inflammation, alleviating modifiable comorbidities such as chronic rhinosinusitis and gastroesophageal reflux, and supporting regular medication adherence and effective technique for administering inhaled medications. A basic diagnostic laboratory work-up is recommended, to be modified and amplified according to individual patient needs.
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http://dx.doi.org/10.1016/j.mcna.2022.08.003 | DOI Listing |
Ann Intern Med
January 2025
Austin Hospital and University of Melbourne, Melbourne, Victoria, Australia (C.F.M.).
GIM/FP/GP: [Formula: see text] Allerg & Immunol: [Formula: see text] Pulmonology: [Formula: see text].
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Copenhagen Prospective Studies on Asthma in Childhood, Herlev and Gentofte Hospital, University of Copenhagen, Copenhagen, Denmark.
Importance: A high infection burden in early childhood is common and a risk factor for later disease development. However, longitudinal birth cohort studies investigating early-life infection burden and later risk of infection and antibiotic episodes are lacking.
Objective: To investigate whether early-life infection burden is associated with a later risk of infection and systemic antibiotic treatment episodes in childhood.
J Asthma
January 2025
Department of Respiratory and Critical Care Medicine, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, Zhejiang, China.
Background: Serum albumin (Alb) is an essential indicator of human physiological function, which can reflect the functionality of multiple organs, including the liver and kidneys. Presently, numerous studies have indicated that levels of blood albumin serve as important biomarkers for a range of respiratory illnesses. These findings can better guide clinical practice and disease prevention.
View Article and Find Full Text PDFJ Asthma
January 2025
Pediatric Department, The Affiliated LiHuiLi Hospital of Ningbo University, Ningbo, Zhejiang, China.
ObjectiveDietary flavonoids in various green plants have anti-inflammatory, antioxidant, and immune-modulating properties. While numerous studies have confirmed that flavonoid substances benefit asthma, evidence remains limited in epidemiological research and human experiments. This study aimed to explore the relationship between childhood asthma and dietary flavonoids.
View Article and Find Full Text PDFRev Med Chil
July 2024
Institute for Healthcare Improvement, Boston, MA, Estados Unidos.
Unlabelled: Asthma is a chronic non-communicable disease considered a serious health problem worldwide. The Chronic Care Model promotes the self-management of patients' chronic conditions. This process requires an active engagement of health professionals to provide education for patients to manage their disease better.
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