Tag: Severe

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[Severe asthma – where are we today?]

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[Severe asthma – where are we today?]

Ugeskr Laeger. 2014 Jan 13;176(3A)

Authors: von Bülow A, Backer V, Porsbjerg C

Abstract
Severe asthma is defined by persistent symptoms and frequent exacerbations despite intensive asthma therapy. The prevalence is estimated to be 5-10% of all asthmatics. Severe asthma is responsible for a major burden of illness including low quality of life and a disproportionate use of health-care resources. The clinical assessment of severe asthma must include verification of the correct diagnosis, adherence to medication, excluding differential diagnosis and identification and treatment of aggravating co-morbidities and trigger factors.

PMID: 25347175 [PubMed – as supplied by publisher]

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Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco.

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Risk factors for a poor outcome among children admitted with clinically severe pneumonia to a university hospital in Rabat, Morocco.

Int J Infect Dis. 2014 Oct 8;

Authors: Jroundi I, Mahraoui C, Benmessaoud R, Moraleda C, Tligui H, Seffar M, Kettani SE, Benjelloun BS, Chaacho S, Muñoz-Almagro C, Ruiz J, Alonso PL, Bassat Q

Abstract
OBJECTIVES: Data on prognostic factors among children with severe pneumonia are scarce in middle-income countries. We investigated prognostic factors for an adverse outcome among children admitted to the Hôpital d’Enfants de Rabat, Morocco with World Health Organization-defined clinically severe pneumonia (CSP).
METHODS: Children aged 2-59 months admitted to the hospital and fulfilling the CSP definition were recruited into this 13-month prospective study. A poor prognosis was defined as death, a need for intensive care, or a Respiratory Index of Severity in Children (RISC) score ?3. Multivariate logistic regression was performed to ascertain independent predictive factors for a poor prognosis.
RESULTS: Of the 689 children included in this analysis, 55 (8.0%) required intensive care and 28 died (4.0%). Five hundred and two (72.8%) children were classified as having a good prognosis and 187 (27.2%) as having a poor prognosis. A history of prematurity (odds ratio (OR) 2.50, 95% confidence interval (CI) 1.24-5.04), of fever (OR 2.25, 95% CI 1.32-3.83), living in a house with smokers (OR 1.79, 95% CI 1.18-2.72), impaired consciousness (OR 10.96, 95% CI 2.88-41.73), cyanosis (OR 2.09, 95% CI 1.05-4.15), pallor (OR 2.27, 95% CI 1.34-3.84), having rhonchi on auscultation (OR 2.45, 95% CI 1.58-3.79), and human metapneumovirus infection (OR 2.13, 95% CI 1.13-4.02) were all independent risk factors for an adverse outcome, whereas a history of asthma (OR 0.46, 95% CI 0.25-0.84) was the only independent risk factor for a positive outcome.
CONCLUSIONS: The early identification of factors associated with a poor prognosis could improve management strategies and the likelihood of survival of Moroccan children with severe pneumonia.

PMID: 25305555 [PubMed – as supplied by publisher]

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Mepolizumab reduces exacerbations in severe eosinophilic asthma [MENSA trial] – 2 Minute Medicine


2 Minute Medicine

Mepolizumab reduces exacerbations in severe eosinophilic asthma [MENSA trial]
2 Minute Medicine
1. The rate of asthma exacerbations was significantly reduced in patients with severe eosphinophilic asthma receiving either intravenous or subcutaneous mepolizumab, compared to patients receiving placebo. 2. The safety profile of mepolizumab was …
Seven developments in asthma researchHealio

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Th1/Th2 cytokine pattern in Arab children with severe asthma.

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Th1/Th2 cytokine pattern in Arab children with severe asthma.

Int J Clin Exp Med. 2014;7(8):2286-91

Authors: Al-Daghri NM, Alokail MS, Draz HM, Abd-Alrahman SH, Yakout SM, Clerici M

Abstract
BACKGROUND: Bronchial Asthma has recently emerged as one of the most prevalent diseases in Arab countries. Environmental and geographical influences were shown to be the reasons of the variations in the rates of prevalence; no analyses have nevertheless yet been performed on the immunologic background associated with this condition in Arabic children.
OBJECTIVES: To examine the cytokine production from T cells in children with and without asthma, and to determine the role of the most related cytokine patterns in childhood asthma.
METHODS: A total of 195 Saudis children (98 asthma pediatric patients and 97 healthy controls) were randomly selected from the Riyadh Cohort Study for inclusion. Asthma was based on established pediatric diagnosis and medications taken.
RESULTS: Significant differences were observed between the two groups, thus, GMCSF, INF-?, IL-5, IL-6, IL-8 and IgG-3 were reduced in patients compared to controls; in these same patients IgE, resistin, IL-4 and IgG-4 were significantly increased. In contrast with these results no differences between patients and controls were seen in CRP, TNF-?, IL-1, IL-2, IL-7, IL-10, IL-13, IgG-1, IgG-2, IgG-A and IgG-M. Result of a principal component analysis suggested that IL4. INF-? and IgE are major players in the pathogenesis of asthma in Arabic children.
CONCLUSION: These are the first data obtained in asthmatic children in Saudi; data herein confirm that this disease is associated with a profound degree of immune impairment independently of the peculiar genetic of the analyzed individuals, and of the environmental conditions that are present in this part of the world.

PMID: 25232422 [PubMed]

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