Is asthma in the elderly different? Functional and clinical characteristics of asthma in individuals aged 65 years and older

Juan Carlos Ivancevich Wednesday, 20 March 2019 12:25
The following new articles have just been published in Asthma Research and Practice

RESEARCH

Is asthma in the elderly different? Functional and clinical characteristics of asthma in individuals aged 65 years and older

Asthma Research and Practice 2019, 5:2 | Published on: 19 March 2019
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What is safe enough - asthma in pregnancy - a review of current literature and recommendations

Juan Carlos Ivancevich Sunday, 03 March 2019 14:08

Asthma Research and Practice

Review

What is safe enough - asthma in pregnancy - a review of current literature and recommendations

Although asthma is one of the most serious diseases causing complications during pregnancy, half of the women discontinue therapy thus diminishing the control of the disease, mostly due to the inadequate educa...

Authors: Slavica Labor, Alba Maria Dalbello Tir, Davor Plavec, Iva Juric, Mihovil Roglic, Justinija Pavkov Vukelic and Marina Labor

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Do not respond to messages requesting money on behalf of the President or members of the Interasma Board

Juan Carlos Ivancevich Tuesday, 29 January 2019 00:11

Dear Interasma members and specially members of the Executive Committee and Board of Directors:

Do not respond to messages requesting money on behalf of the President or members of the Interasma Board, since it is a hoax.

Thank you.

Juan Carlos Ivancevich on behalf of our President Louis-Philippe Boulet.

Factors associated with exacerbations among adults with asthma according to electronic health record data

Juan Carlos Ivancevich Sunday, 20 January 2019 14:13

Asthma Research and Practice

Research Open Access
Rebecca E. GreenblattEdward J. ZhaoSarah E. HenricksonAndrea J. ApterRebecca A. Hubbard and Blanca E. HimesEmail authorView ORCID ID profile

Abstract

Background

Asthma is a chronic inflammatory lung disease that affects 18.7 million U.S. adults. Electronic health records (EHRs) are a unique source of information that can be leveraged to understand factors associated with asthma in real-life populations. In this study, we identify demographic factors and comorbidities associated with asthma exacerbations among adults according to EHR-derived data and compare these findings to those of epidemiological studies.

Methods

We obtained University of Pennsylvania Hospital System EHR-derived data for asthma encounters occurring between 2011 and 2014. Regression analyses were performed to model asthma exacerbation frequency as explained by age, sex, race/ethnicity, health insurance type, smoking status, body mass index (BMI) and various comorbidities. We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2001 to 2012 to compare findings with those from the EHR-derived data.

Results

Based on data from 9068 adult patients with asthma, 33.37% had at least one exacerbation over the four-year study period. In a proportional odds logistic regression predicting number of exacerbations during the study period (levels: 0, 1–2, 3–4, 5+ exacerbations), after controlling for age, race/ethnicity, sex, health insurance type, and smoking status, the highest odds ratios (ORs) of significantly associated factors were: chronic bronchitis (2.70), sinusitis (1.50), emphysema(1.39), fluid and electrolyte disorders (1.35), class 3 obesity (1.32), and diabetes(1.28). An analysis of NHANES data showed associations for class 3 obesityanemiaand chronic bronchitis with exacerbation frequency in an adjusted model controlling for age, race/ethnicity, sex, financial class and smoking status.

Conclusions

EHR-derived data is helpful to understand exacerbations in real-life asthma patients, facilitating design of detailed studies and interventions tailored for specific populations.

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What is safe enough - asthma in pregnancy - a review of current literature and recommendations

Juan Carlos Ivancevich Thursday, 27 December 2018 16:22
Review - Open Access
 
Slavica LaborAlba Maria Dalbello TirDavor PlavecIva JuricMihovil RoglicJustinija Pavkov Vukelic and Marina Labor Email authorView ORCID ID profile
 

Abstract

Background

Although asthma is one of the most serious diseases causing complications during pregnancy, half of the women discontinue therapy thus diminishing the control of the disease, mostly due to the inadequate education and fear of adverse events. Sadly, this is sometimes encouraged by insufficiently educated physicians. Since the incidence and the prevalence of asthma is increasing, it is important to arouse the importance of proper asthma therapy during pregnancy. Inadequate therapy, as well as interrupting or discontinuing therapy, may result in adverse perinatal outcomes for both mother and child.

Main body

The main goal of asthma control during pregnancy is control of symptoms and prevention of exacerbations, same as in every asthmatic, but even more important. Maintaining optimal lung function, as well as regular daily activities, ensures maintenance of optimal fetal oxygenation. The therapy should be adapted depending on the frequency and severity of daily and nocturnal symptoms, demand for reliever therapy, by the limitations in everyday activities and the frequency of emergency asthma-related hospitalizations. Pre-conceptual education and therapy are very important and should be supported by an asthma action plan adjusted for the period of pregnancy. It is very important to note that most of the drugs used before pregnancy can be safely continued during pregnancy. Pharmacological and non-pharmacological therapy should be used in parallel. Pregnant women should be informed about the nature of the disease, therapy used during pregnancy, possible complications, avoidance of triggers, proper administration of therapy and, most important, why should the therapy be continued throughout the pregnancy on individual basis. Although drug treatment should be based on using drugs with less harm risk, if control of severe symptoms is needed to be achieved in order to protect both mother and child, any anti-asthmatic drug would have the beneficial benefit/harm ratio.

Conclusion

There is no solid evidence that asthma treatment during pregnancy causes adverse outcomes for the mother and child but for many, especially new drugs, there is not enough data gathered. On the other hand, harmfulness of uncontrolled asthma during pregnancy is well documented so every effort should be put on preserving good control of asthma during pregnancy.

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Juan Carlos Ivancevich Thursday, 27 December 2018 13:13
 
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Biomarkers in asthma: state of the art

Juan Carlos Ivancevich Saturday, 22 December 2018 18:23
 
Review - Open Access

Abstract

Asthma is a heterogenous disease characterized by multiple phenotypes driven by different mechanisms. The implementation of precision medicine in the management of asthma requires the identification of phenotype-specific markers measurable in biological fluids. To become useful, these biomarkers need to be quantifiable by reliable systems, reproducible in the clinical setting, easy to obtain and cost-effective.

Using biomarkers to predict asthma outcomes and therapeutic response to targeted therapies has a great clinical significance, particularly in severe asthma. In the last years, significant research has been realized in the identification of valid biomarkers for asthma. This review focuses on the existent and emerging biomarkers with clinical higher applicability in the management of asthma.

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Meet the new Interasma's Executive Board

Juan Carlos Ivancevich Thursday, 29 November 2018 13:07
EXECUTIVE BOARD
     

PRESIDENT:

LOUIS PHILIPPE BOULET

Canada

PRESIDENT ELECT:

JONATHAN BERNSTEIN

USA

FIRST VICE PRESIDENT:

FULVIO BRAIDO

Italy

     

SECOND VICE PRESIDENT:

NELSON ROSARIO

Brasil

    PAST PRESIDENT:

LAWRENCE DUBUSKE

               USA

CHIEF EXECUTIVE DIRECTOR: 

GIORGIO WALTER CANONICA

                  Italy

     

SECRETARY GENERAL:

PIERACHILLE SANTUS

Italy

TREASURER:

IGNACIO J. ANSOTEGUI

Spain

HISTORIAN:

CARLOS NUNES

Portugal

 

AMC:

NIKI GARGASSOULA

Greece

 
MEMBERS AT LARGE
       

ALVARO CRUZ 

Brazil

SANDRA GONZALEZ-DIAZ

Mexico

FRANSESCA PUGGIONI

Italy

JUAN CARLOS IVANCEVICH 

Argentina

       

PIOTR KUNA 

Poland

CATHERINE LEMIERE

Canada

 SHIGENORI NAKAJIMA 

Japan

KEN OHTA 

Japan

       

HELEN REDDEL 

Australia

SAN HEON CHO 

Korea

MICHAEL WECHSLER 

USA

ARZU YORGANCIOGLU

Turkey

       
 

KRZYSZTOF KOWAL 

Poland

YURIY BISYUK 

Ukraine

 

KAYDASHEV IGOR 

Ukraine

ADJUNCT MEMBERS
       

JUAN CELEDON 

USA

KUNIO DOBASHI 

Japan

FERNANDO HOLGUIN 

USA

GIOVANNI PASSALACQUA

Italy

       

RUBY PAWANKAR 

Japan

ANDRAS BIKOV 

UK

OSMAN YUSUF 

UK

MARIO SANCHEZ BORGES

Venezuela

       

MARINA LABOR 

Croatia

LIER LAHOUSSE 

Belgium

DERMOT RYAN 

UK

ANAHI YANEZ 

Argentina

       

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Editor: Juan C. Ivancevich, MD

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