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A systematic review of predictive models for asthma development in children.

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A systematic review of predictive models for asthma development in children.

BMC Med Inform Decis Mak. 2015;15(1):99

Authors: Luo G, Nkoy FL, Stone BL, Schmick D, Johnson MD

Abstract
BACKGROUND: Asthma is the most common pediatric chronic disease affecting 9.6 % of American children. Delay in asthma diagnosis is prevalent, resulting in suboptimal asthma management. To help avoid delay in asthma diagnosis and advance asthma prevention research, researchers have proposed various models to predict asthma development in children. This paper reviews these models.
METHODS: A systematic review was conducted through searching in PubMed, EMBASE, CINAHL, Scopus, the Cochrane Library, the ACM Digital Library, IEEE Xplore, and OpenGrey up to June 3, 2015. The literature on predictive models for asthma development in children was retrieved, with search results limited to human subjects and children (birth to 18 years). Two independent reviewers screened the literature, performed data extraction, and assessed article quality.
RESULTS: The literature search returned 13,101 references in total. After manual review, 32 of these references were determined to be relevant and are discussed in the paper. We identify several limitations of existing predictive models for asthma development in children, and provide preliminary thoughts on how to address these limitations.
CONCLUSIONS: Existing predictive models for asthma development in children have inadequate accuracy. Efforts to improve these models’ performance are needed, but are limited by a lack of a gold standard for asthma development in children.

PMID: 26615519 [PubMed – in process]

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A Computational Physiology Approach to Personalized Treatment Models: The Beneficial Effects of Slow Breathing on the Human Cardiovascular System.

A Computational Physiology Approach to Personalized Treatment Models: The Beneficial Effects of Slow Breathing on the Human Cardiovascular System.

Am J Physiol Heart Circ Physiol. 2014 Jul 25;

Authors: Fonoberova M, Mezic I, Buckman JF, Fonoberov VA, Mezic A, Vaschillo E, Mun EY, Vaschillo B, Bates ME

Abstract
Heart rate variability biofeedback intervention involves slow breathing at a rate of ~6 breaths per min (resonance breathing) to maximize respiratory and baroreflex effects on heart period oscillations. This intervention has wide-ranging clinical benefits and is gaining empirical support as an adjunct therapy for biobehavioral disorders, including asthma and depression. Yet, little is known about the system-level cardiovascular changes that occur during resonance breathing or the extent to which individuals differ in cardiovascular benefit. This study used a computational physiology approach to dynamically model the human cardiovascular system at rest and during resonance breathing. Noninvasive measurements of heart period, beat-to-beat systolic and diastolic blood pressure, and respiration period were obtained from 24 healthy young men and women. A model with respiration as input was parameterized to better understand how the cardiovascular processes that control variability in heart period and blood pressure change from rest to resonance breathing. The cost function used in model calibration corresponded to the difference between the experimental data and model outputs. A good match was observed between the data and model outputs (heart period, blood pressure, and corresponding power spectral densities). Significant improvements in several modeled cardiovascular functions (e.g., blood flow to internal organs, sensitivity of the sympathetic component of the baroreflex, ventricular elastance) were observed during resonance breathing. Individual differences in the magnitude and nature of these dynamic responses suggest that computational physiology may be clinically useful for tailoring heart rate variability biofeedback interventions for the needs of individual patients.

PMID: 25063789 [PubMed – as supplied by publisher]

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Are mouse models of asthma appropriate for investigating the pathogenesis of airway hyper-responsiveness?

Are mouse models of asthma appropriate for investigating the pathogenesis of airway hyper-responsiveness?

Front Physiol. 2012;3:312

Authors: Kumar RK, Foster PS

Abstract
Whether mouse models of chronic asthma can be used to investigate the relationship between airway inflammation/remodeling and airway hyper-responsiveness (AHR) is a vexed question. It raises issues about the extent to which such models replicate key features of the human disease. Here, we review some of the characteristic pathological features of human asthma and their relationship to AHR and examine some limitations of mouse models that are commonly used to investigate these relationships. We compare these conventional models with our mouse model of chronic asthma involving long-term low-level inhalational challenge and review studies of the relationship between inflammation/remodeling and AHR in this model and its derivatives, including models of an acute exacerbation of chronic asthma and of the induction phase of childhood asthma. We conclude that while extrapolating from studies in mouse models to AHR in humans requires cautious interpretation, such experimental work can provide significant insights into the pathogenesis of airway responsiveness and its molecular and cellular regulation.

PMID: 23060800 [PubMed – in process]

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Anti-inflammatory and antinociceptive effects of salbutamol on acute and chronic models of inflammation in rats: involvement of an antioxidant mechanism.

Anti-inflammatory and antinociceptive effects of salbutamol on acute and chronic models of inflammation in rats: involvement of an antioxidant mechanism.

Mediators Inflamm. 2012;2012:438912

Authors: Uzkeser H, Cadirci E, Halici Z, Odabasoglu F, Polat B, Yuksel TN, Ozaltin S, Atalay F

Abstract
The possible role of ?-2 adrenergic receptors in modulation of inflammatory and nociceptive conditions suggests that the ?-2 adrenergic receptor agonist, salbutamol, may have beneficial anti-inflammatory and analgesic effects. Therefore, in this study, we induced inflammatory and nociceptive responses with carrageenan-induced paw edema or cotton-pellet-induced granuloma models, both of which result in oxidative stress. We hypothesized that salbutamol would prevent inflammatory and nociceptive responses by stimulating ?-2 adrenergic receptors and the prevention of generation of ROS during the acute inflammation process in rats. Both doses of salbutamol used in the study (1 and 2?mg/kg) effectively blocked the acute inflammation and inflammatory nociception induced by carrageenan. In the cotton-pellet-induced granuloma test, both doses of salbutamol also significantly decreased the weight of granuloma tissue on the cotton pellets when compared to the control. Anti-inflammatory and analgesic effects of salbutamol were found to be comparable with those of indomethacin. Salbutamol decreased myeloperoxidase (MPO) activity and lipid peroxidation (LPO) level and increased the activity of superoxide dismutase (SOD) and level of glutathione (GSH) during the acute phase of inflammation. In conclusion, salbutamol can decrease acute and chronic inflammation, possibly through the stimulation of ?-2 adrenergic receptors. This anti-inflammatory effect may be of significance in asthma treatment, where inflammation also takes part in the etiopathology. This study reveals that salbutamol has significant antioxidative effects, which at least partially explain its anti-inflammatory capabilities. These findings presented here may also shed light on the roles of ?-2 adrenergic receptors in inflammatory and hyperalgesic conditions.

PMID: 22665951 [PubMed – in process]

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Outpatient pulmonary rehabilitation – rehabilitation models and shortcomings in outpatient aftercare.

Outpatient pulmonary rehabilitation – rehabilitation models and shortcomings in outpatient aftercare.

GMS Health Technol Assess. 2010;6:Doc11

Authors: Korczak D, Huber B, Steinhauser G, Dietl M

BACKGROUND : The chronic obstructive pulmonary disease (COPD) and the bronchial asthma are widespread diseases. They need long-lasting and sustainable rehabilitation. OBJECTIVES : The goal of this HTA is to describe the present supply and the economic relevance of out-patient pulmonary rehabilitation in conjunction with its social aspects. A further target is to derivate options for actions in the health-care system and possible research necessities. METHODS : Relevant publications are identified by means of a structured search in 37 database accessed through the German Institute of Medical Documentation and Information (DIMDI). In addition a manual search of identified reference lists has been done. The present report includes German and English literature published from 2004 to 2009. The methodological quality was assessed by two independent researchers according to pre-defined quality criteria of evidence based medicine. RESULTS : Among 860 publications 31 medical studies, four economic studies and 13 ethical studies meet the inclusion criteria. The studies cover rehabilitation programmes in 19 countries. The majority of them has a high level of evidence (1A to 2C). The pulmonary rehabilitation programmes differ by the setting (in-patient, out-patient, in-home, community-based), by the length of intervention (from two weeks to 36 months), by the way and the frequency of intervention and by the duration of the follow-up treatment. Overall out-patient rehabilitation programmes achieve the same positive effects for COPD patients as in-patient programmes do. This is especially true for physical performance and health related quality of life. There are only a few studies dealing with asthma. Therefore, valid statements cannot be given. The results for cost-effectiveness are not distinct enough. DISCUSSION : Goals of pulmonary rehabilitation like prevention and adequate treatment of acute exacerbations, the minimisation of hospitalisation and the reduction of mortality are attained in out-patient as well as in in-patient pulmonary rehabilitation. Regarding the best frequency of training units per week or the duration and the content of a unit further research is needed. Final results for the ideal length of an in-patient rehabilitation are still missing. None of the studies deals with the analysis of the different treatment forms of a COPD which are frequently defined by an alteration of in-patient and out-patient treatments and participation in sports clubs or self-help groups. There are some other limitations of the studies. The results concerning self-management programmes are not distinct. (Self-) Selection leads to high drop-out rates. Many studies have only small sample sizes. Confounder and long-time effects are seldom researched, relevant economic evaluations do not exist The improvement of health related quality of life is primarily obtained by an improved disease management than by an improvement of a medical parameter. CONCLUSION : Out-patient pulmonary rehabilitation is as effective as in-patient pulmonary rehabilitation. But there is a critical shortage of out-patient pulmonary rehabilitation supply in Germany. Domains for further research are the evaluation of models for integrated care, the length, frequency and content of training programmes, psychiatric assessments and the cost-effectiveness of out-patient pulmonary rehabilitation.

PMID: 21289884 [PubMed – in process]

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Systemic lupus erythematosus: From mouse models to human disease and treatment

On Sept. 2-3, 2010, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Cancer Institute (NCI), the National Institute of Allergy and Infectious Diseases (NIAID), and the NIH Office of Research on Women’s Health (ORWH) will convene a two-day conference on Systemic Lupus Erythematosus: From Mouse Models to Human Disease and Treatment. This meeting will bring together basic research scientists working on models of autoimmune disease relevant to systemic lupus erythematosus (SLE), with clinicians treating lupus patients. There are numerous mouse models of lupus, but their relevance to the actual disorder is still a subject for debate. Moreover, since SLE is a heterogeneous disease, some features of the disorder may be better reflected in one or another mouse model.

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