An observational study of the impact of an antenatal asthma management service on asthma control during pregnancy.

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An observational study of the impact of an antenatal asthma management service on asthma control during pregnancy.

Eur J Obstet Gynecol Reprod Biol. 2015 Dec 2;197:48-53

Authors: Grzeskowiak LE, Smith B, Roy A, Dekker GA, Clifton VL

Abstract
OBJECTIVE: We sought to investigate the impact of introducing an antenatal asthma management service (AMS) on asthma control during pregnancy and subsequent perinatal outcomes.
STUDY DESIGN: Prospective, observational cohort study of pregnant asthmatic women attending a tertiary hospital antenatal clinic. Asthmatic women were recruited from the antenatal clinic and were followed prospectively with visits at 12, 20, 28 and 36 weeks gestation. A new nurse-led AMS was introduced offering asthma self-management education and support. Outcomes were compared between women recruited before and after the AMS was introduced (n=89 and 80, respectively) and included; prevalence of exacerbations during pregnancy, asthma control throughout pregnancy and perinatal outcomes, including preterm birth and small-for-gestational-age (SGA).
RESULTS: The relative risk for exacerbations (0.69; CI: 0.33-1.42), loss of control (0.67; CI 0.46-0.99) and persistent uncontrolled asthma (0.48; CI 0.26-0.9) were all reduced with attendance to AMS during pregnancy. AMS was associated with non-statistically significant reductions in asthma exacerbations (19.1-15.0%; p=0.480) and uncontrolled asthma at ?2 study visits (21.3-11.3%; p=0.078).
CONCLUSIONS: These findings demonstrate the potential impact of an AMS in improving asthma control during pregnancy, supporting the need for an adequately powered RCT to determine its clinical- and cost-effectiveness.

PMID: 26706835 [PubMed – as supplied by publisher]

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Cyclooxygenase 2: its regulation, role and impact in airway inflammation.

Cyclooxygenase 2: its regulation, role and impact in airway inflammation.

Clin Exp Allergy. 2015 Dec 18;

Authors: Rumzhum NN, Ammit AJ

Abstract
Cyclooxygenase 2 (COX-2: official gene symbol – PTGS2) has long been regarded as playing a pivotal role in the pathogenesis of airway inflammation in respiratory diseases including asthma. COX-2 can be rapidly and robustly expressed in response to a diverse range of pro-inflammatory cytokines and mediators. Thus, increased levels of COX-2 protein and prostanoid metabolites serve as key contributors to pathobiology in respiratory diseases typified by dysregulated inflammation. But COX-2 products may not be all bad: prostanoids can exert anti-inflammatory/bronchoprotective functions in airways in addition to their pro-inflammatory actions. Herein we outline COX-2 regulation and review the diverse stimuli known to induce COX-2 in the context of airway inflammation. We discuss some of the positive and negative effects that COX-2/prostanoids can exert in in vitro and in vivo models of airway inflammation, and suggest that inhibiting COX-2 expression to repress airway inflammation may be too blunt an approach; because although it might reduce the unwanted effects of COX-2 activation, it may also negate the positive effects. Evidence suggests that prostanoids produced via COX-2 upregulation show diverse actions (and herein we focus on prostaglandin E2 as a key example); these can be either beneficial or deleterious and their impact on respiratory disease can be dictated by local concentration and specific interaction with individual receptors. We propose that understanding the regulation of COX-2 expression and associated receptor-mediated functional outcomes may reveal number of critical steps amenable to pharmacological intervention. These may prove invaluable in our quest towards future development of novel anti-inflammatory pharmacotherapeutic strategies for the treatment of airway diseases. This article is protected by copyright. All rights reserved.

PMID: 26685098 [PubMed – as supplied by publisher]

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Clinical Effectiveness and Economical Impact of Medical Indoor Environment Counselors Visiting Homes of Asthma Patients

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Interventions:   Other: First home intervention with advice;   Other: First home intervention without any advice;   Other: Final home visit
Sponsors:   Rennes University Hospital;   EHESP – Ecole des Hautes Etudes en Santé Publique;   IRDES – Institut de Recherche et Documentation en Economie de la Santé;   INSERM 0203 – Institut National de la Santé et de la Recherche Médicale
Not yet recruiting – verified August 2014

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New study investigating impact of asthma on school children launches today – HealthCanal.com

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