The latest edition of the BTS/SIGN guideline on the management of asthma (2014) is available now

Juan Carlos Ivancevich Monday, 03 November 2014 03:00

The 2014 update includes a new section highlighting key recommendations for implementation (section 2), completely re-written sections on supported self management (section 4) and organisation and delivery of care (section 13), and an extensively revised section on non-pharmacological management. All other sections, with the exception of diagnosis and monitoring (section 3) and asthma in adolescents (section 10) have also been revised and updated to reflect new evidence that has become available.

Current Guidelines 


Publication Date



BTS/SIGN Asthma Guideline 2014 October 2014

BTS/SIGN British Guideline on the Management of Asthma, October 2014

BTS/SIGN Asthma Guideline Quick Reference Guide 2014 October 2014   Valid





Effect of low birth weight on childhood asthma: a meta-analysis

Juan Carlos Ivancevich Friday, 31 October 2014 04:18
Open Access
Xue-Feng Xu1Ying-Jun Li2Yuan-Jian Sheng1Jin-Ling Liu1Lan-Fang Tang1 and Zhi-Min Chen1*
  • *Corresponding author: Zhi-Min Chen This email address is being protected from spambots. You need JavaScript enabled to view it.

Author Affiliations

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BMC Pediatrics 2014, 14:275  doi:10.1186/1471-2431-14-275



Low birth weight is strongly correlated with an increased risk of adult diseases. Additionally, low birth weight might be a risk factor for asthma later in life.


A systematic literature search of the PubMed database from 1966 to November 2013 was conducted. The criteria for inclusion of papers were as follows: case–control or cohort studies; the odds ratio (OR) or risk ratio (RR) estimates with the corresponding 95% confidence intervals (CIs) were presented, or there were sufficient data for calculation; and studies were published in English up to October 2013. Random-effect and fixed-effect meta-analyses, meta-regression, and cumulative meta-analysis were conducted.


Thirteen cohort studies and 1,105,703 subjects were included. The overall pooled RRs (95% CIs) of asthma risk for low birth weight were 1.162 (fixed-effects model, 95% CI, 1.128–1.197) and 1.152 (random-effects model, 95% CI, 1.082–1.222). In stratified analyses, the effect of low birth weight on childhood asthma was strong, particularly in studies conducted in Europe, those with a small sample size, and those published recently. A meta-regression analysis did not find significant determinants.


This meta-analysis shows that low birth weight significantly increases the risk of childhood asthma.

Keywords:  Birth weight; Childhood asthma; Meta-analysis; Systematic review 

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Possible molecular mechanisms linking air pollution and asthma in children

Juan Carlos Ivancevich Friday, 10 October 2014 23:40
Open AccessHighly Accessed

Susanna Esposito*Rossana TenconiMara LeliiValentina PretiErica NazzariSilvia Consolo and Maria Francesca Patria

  • *Corresponding author: Susanna Esposito This email address is being protected from spambots. You need JavaScript enabled to view it.

Exacerbation of asthma and airway infection: is the virus the villain?

Juan Carlos Ivancevich Thursday, 23 October 2014 13:53

Lusmaia D.C. Costa, Paulo Sucasas Costa, Paulo A.M. Camargos


to review the available literature on the association between acute viral respiratory tract infection and the onset of asthma exacerbations, identifying the most prevalent viruses, detection methods, as well as preventive and therapeutic aspects.

a search was conducted in PubMed, Lilacs, and SciELO databases, between the years 2002 and 2013, using the following descriptors: asthma exacerbation, virus, child, and acute respiratory infection.

Summary of the findings
A total of 42 original articles addressing the identification of respiratory viruses during episodes of asthma exacerbation were selected, mostly cross-sectional studies. There was a wide variation in the methodology of the assessed studies, particularly in relation to the children's age and methods of collection and viral detection. The results indicate that, in up to 92.2% of exacerbations, a viral agent was potentially the main triggering factor, and human rhinovirus was the most frequently identified factor. The pattern of viral circulation may have been responsible for the seasonality of exacerbations. The association between viral infections and allergic inflammation appears to be crucial for the clinical and functional uncontrolled asthma, but few studies have evaluated other triggering factors in association with viral infection.

Respiratory viruses are present in the majority of asthmatic children during episodes of exacerbation. The involved physiopathological mechanisms are yet to be fully established, and the synergism between allergic inflammation and viral infection appears to determine uncontrolled disease. The role of other triggering and protective agents is yet to be clearly determined.

Rhinovirus infection in children hospitalized with acute bronchiolitis and its impact on subsequent wheezing or asthma: a comparison of etiologies

Juan Carlos Ivancevich Sunday, 05 October 2014 04:37
Jamaree Teeratakulpisarn, Chamsai Pientong, Tipaya Ekalaksananan, Hunsa Ruangsiripiyakul, Rattapon Uppala

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Editor: Juan C. Ivancevich, MD

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