Asthma in the elderly patient

Juan Carlos Ivancevich Wednesday, 03 February 2016 13:26
Louis-Philippe Boulet
 

DOI: 10.1186/s40733-015-0015-1

Abstract

Asthma affects a significant proportion of elderly patients, but unfortunately, it is responsible for a high asthma-related morbidity and mortality in this population. This may be related not only to the development of a more severe asthma phenotype compared to younger patients, with more marked airway obstruction and a more neutrophilic type of airway inflammation, but also to the presence of many co-morbid conditions. Furthermore, in older patients, asthma is often under-diagnosed, undertreated and poorly managed. Unfortunately, elderly patients have usually been excluded of clinical trials on asthma and there is an urgent need to perform more research on the optimal management of asthma in this population.

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World Congress of Astma, Madrid March 12-15, 2016: Scientific Program Committee´s Message

Juan Carlos Ivancevich Friday, 29 January 2016 13:42

Significant achievements have been accomplished in the last few years to better understanding what is asthma, how it should be assessed in regard to control and severity and what is its optimal therapy. Unfortunately these improvements in our understanding of the disease have not always translated into better asthma management.

The 2016 World Congress on Asthma in Madrid will review the key findings from recent research on both adult and pediatric Asthma and how knowledge translation methods have evolved to better integrate research findings into care.

The origins and determinants of Asthma, triggers and inducers, the new insight gained on the role of allergy, environmental and biodiversity changes, workplace hazards, respiratory infections andvarious aspects of assessment of the disease are among the topics that will be covered by world experts. The role of phenotyping/endotyping Asthma, particularly when severe, and new therapeutic current and future advances will be covered.

A significant part of the meeting will be devoted to practical workshops on asthma testing and treatment delivery, as we'll as the integration of practice tools into day-to-day care. Sessions will discuss how to optimize the multidisciplinary approach to asthma management.

We and the members of the scientific advisory board the impressive program of WCA-2016 will be of interest to all those involved in research and care of asthma.

             
             
G. Walter Canonica   Lawrence DuBuske   Louis-Philippe Boulet   Ralph Mösges

 

on behalf of the Scientific Programme Committee –WCA 2016 Madrid INTERASMA

WCA 2016 - Scientific Program Saturday March 12, 2016

Juan Carlos Ivancevich Wednesday, 13 January 2016 03:55
  Room A
Room B
Room C

14.30

ACOS Symposium

Chairs: Stefano Centanni, Joan Soriano 

Marc Miravitlles “ACOS-The Spanish document”
Vito Brusasco “Do we need ACOS?” 

Mar Fernandez- Nieto Eosinophilic bronchitis”

SEPAR Symposium

Chairs: Inmaculada Alfageme,  Carlos Melero

Antolín Lopez-Viña“Novedades terapeuticas de la guia española para el manejo del asma GEMA 4.0”
Eva Martinez Moragon“Asma y embarazo: dos escenarios para cuidar” 
Luis Perez de Llano“Coexistencia de asma y EPOC”
"Basic Science in Asthma & Related Disorders"

Chairs: Giovanni Passalacqua, Carlos Nunes 

David Soto “The role of stem cells in asthma: pathogenic versus therapeutic”
Alberto Papi “Virus and Asthma” 
Santiago Quirce“Neutrophilic Inflammation in Asthma”

 

 

 

 

 

 

 

 

16.00 Coffee Break

16.30

Social Aspects of Respiratory Diseases (GARD Session)

Chairs: Nikolai Khaltaev, G.Walter Canonica 

Nikolai Khaltaev “Social Predictors of Health (GARD Perspective)"
Arzu Yorgancıoğlu "Social determinants of obstructive diseases other than tobacco"

Alvaro Cruz “Do socieconomic inequalities in health have an impact on Asthma and Allergic diseases?”

Jaime Correia de Sousa “The role of primary care in dealing with social determinants”

SEAIC Symposium

Chairs: TBA

Mar Fernandez-Nieto “New developments in occupational asthma”
Irina Bobolea “Clinical Management of aspirin-exacerbated respiratory disease” 
Silvia Sanchez-Garcia“Childhood Asthma: Role of alergens”
Workshop:"Diet and Lifestyle"

Chairs: Carlo Lombardi, Ruby Pawankar 

Catherine Hawrylowicz“Vitamin D and Corticosteroid Response”
Sergio Bonini “Regulatory aspects of anti-asthmatic drugs” 
Jonathan Bernstein“Occupational Asthma”

 

 

 

18.00

Keynote Lecture


Chairs
  Joaquin Sastre, Inmaculada Alfageme, G.Walter Canonica

Kian Fan Chung
"Systems Medicine as Pathway to Precision Medicine"

 

18.30
Opening Ceremony

20.00

Poster Discussion

The geriatric asthma: pitfalls and challenges

Juan Carlos Ivancevich Thursday, 07 January 2016 05:09

Alida Benfante and Nicola Scichilone

Abstract

Historically, asthma has been envisioned as a disease of younger ages. This has led to the assumption that respiratory symptoms suggestive of asthma occurring in older ages are to be attributed to conditions other than asthma, mainly COPD. Old observational reports and new epidemiological studies confirm that asthma is as frequent in older as it is in younger populations. Nevertheless, under-recognition, misdiagnosis and under-treatment are still relevant issues. The characterization of asthma in the aged suffers from the fact that there has been very little original research in this field. Indeed, geriatric asthma is often excluded from clinical trials because of age and comorbidities. The current review paper revises the areas that need to be elucidated, and highlights the gaps in the management of this condition. It follows that a multidimensional management is advocated for elderly asthmatics to evaluate the severity and establish the complexity of the disease. We suggest that the term “geriatric” asthma should be preferred to “senile” asthma, which is confined to the age-related changes in the lung, or the more generic “asthma in the elderly”, which is only descriptive of the prevalence in specific age groups.

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Higher serum levels of periostin and the risk of exacerbations in moderate asthmatics

Juan Carlos Ivancevich Wednesday, 06 January 2016 13:12

DOI: 10.1186/s40733-015-0019-x

Abstract

Background

In asthma, exacerbations and poor disease control are linked to airway allergic inflammation. Serum periostin has been proposed as a systemic biomarker of eosinophilic inflammation. This pilot study aims at evaluating whether in patients with moderate asthma, higher baseline levels of serum periostin are associated with a greater risk of exacerbation.

Methods

Fifteen outpatients with moderate allergic asthma were recruited. Serum concentrations of periostin were assessed (ELISA) at baseline, and the frequency of asthma exacerbations was recorded during a one-year follow-up.

Results

Patients (M/F: 10/5, mean age of 47.6 ± 11.0 years) had mean ACQ score of 5.5 ± 4.2 and FEV1%pred of 81.9 ± 21.7 %. Baseline serum levels of periostin did not correlate with lung function parameters, nor with the ACQ score (p ≥0.05 for all analyses). Five subjects (33 % of the study group) reported one or more exacerbations during the following year. Baseline serum levels of periostin were significantly higher in subjects who experienced one or more exacerbations during the one year period of follow-up, compared with subjects with no exacerbations: median serum periostin level was 4047 ng/ml (range: 2231 to 4889 ng/ml) and 222 ng/ml (range 28.2 to 1631 ng/ml) respectively; p = 0.001.

Conclusion

The findings of the present pilot study could form the basis for the design of larger studies aiming at developing strategies to identify asthmatic patients at risk for exacerbations.

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The WEB-based Asthma Control: an intriguing connection or a dangerous hazard?

Juan Carlos Ivancevich Tuesday, 29 December 2015 03:09

Carlo Lombardi, Giovanni Passalacqua and Giorgio Walter Canonica

Abstract

Globally, an estimated 300 million people have asthma, presenting a considerable and increasing burden of disease for healthcare systems, families, and patients themselves. Despite two decades of guidelines, asthma seems to remain not optimally controlled in a substantial proportion of people. The achievement of asthma control is the result of the interaction among different variables concerning the disease pattern and patients’ and physicians’ knowledge and behavior. It is well known that adherence to treatment increases in parallel to patient education. There is now a growing interest in the use of digital information technologies to promote asthma control and improve outcomes. Mobile health, or mHealth, refers to mobile devices, medical sensors, and communication technologies that can enhance chronic disease care and monitoring. Aim of this review was to evaluate the web resources nowadays available and to analyze the published studies about the web-based instruments used to improve asthma knowledge, control asthma outcomes. In general, studies revealed that the technology is well accepted. Interactive asthma technology may be, in addition, of help in reaching populations difficult to reach, such as inner city populations. The number of tools and apps available continues to increase, and agencies such as the FDA, become involved in their regulation, thus the mHealth landscape will continue to evolve. Although asthma tools and apps have great potential to improve care for asthma, the proof of data reproducibility, the demonstration of effectiveness, and the privacy issues still represent the major technical problems.

Keywords

Asthma control Asthma knowledge Patient behavior Internet engines Social network Apps
 

The WCA-2016 Board wishes you Happy Holidays and a productive & prosperous New Year!

Juan Carlos Ivancevich Monday, 21 December 2015 23:26

Sickle cell disease: wheeze or asthma?

Juan Carlos Ivancevich Wednesday, 09 December 2015 12:17
  • Robyn T. Cohen, Elizabeth S. Klings and Robert C. Strunk

Abstract

Sickle cell disease (SCD) is the most common life-limiting genetic disease among African Americans, affecting more than 100,000 people in the United States. Respiratory disorders in patients with sickle cell disease have been associated with increased morbidity and mortality. Associations between asthma and pain, acute chest syndrome (ACS), and even death have long been reported. More recently wheezing, even in the absence of an asthma diagnosis, has gained attention as a possible marker of SCD severity. Several challenges exist with regards to making the diagnosis of asthma in patients with SCD, including the high prevalence of wheezing, evidence of airway obstruction on pulmonary function testing, and/or airway hyperresponsiveness among patients with SCD. These features often occur in isolation, in the absence of other clinical criteria necessary for an asthma diagnosis. In this review we will summarize: 1) Our current understanding of the epidemiology of asthma, wheezing, airway obstruction, and airway responsiveness among patients with SCD; 2) The evidence supporting associations with SCD morbidity; 3) Our understanding of the pathophysiology of airway inflammation in SCD; 4) Current approaches to diagnosis and management of asthma in SCD; and 5) Future directions.

 

Table of Contents

 

Small airway dysfunction and bronchial asthma control : the state of the art

Juan Carlos Ivancevich Tuesday, 01 December 2015 13:19
Marcello Cottini, Carlo Lombardi,Claudio Micheletto

DOI: 10.1186/s40733-015-0013-3

Abstract

According to national and international guidelines, achieving and maintaining asthma control is a major goal of disease management. In closely controlled clinical trials, good asthma control can be achieved , with the medical treatments currently available, in the majority of patients , but large population-based studies suggest that a significant proportion of patients in real-life setting experience suboptimal levels of asthma control and report lifestyle limitations with a considerable burden on quality of life. Poor treatment adherence and persistence, failure to use inhalers correctly, heterogeneity of asthma phenotypes and associated co-morbidities are the main contributing factors to poor disease control. Now, it is widely accepted that peripheral airway dysfunction , already present in patients with mild asthma, is a key contributor of worse control. The aim of this paper is to investigate the association between small-airways dysfunction and asthma symptoms/control. We therefore performed a PubMed search using keywords : small airways; asthma (limits applied: Humans, English language) and selected papers with a study population of asthmatic patients, reporting measurement of small-airways parameters and clinical symptoms/control.

Keywords Small-airways disease Bronchial asthma Phenotypes Asthma control

XXIII WCA 2016 - Call for abstracts deadline

Juan Carlos Ivancevich Thursday, 12 November 2015 14:56

Call for Abstracts

Deadline November 30, 2015

Dear Participant,

As the deadline is fast approaching, we kindly invite you to submit an abstract, for the XXIII World Congress of Asthma  / WCA-2016 in Madrid, by Monday November 30, 2015 at 23.59h (GMT).

To submit an abstract electronically please click here: www.wca-2016.com/submission.

For further details on abstracts & the online submission please click here: www.wca-2016.com/abstracts.

www.wca-2106.com

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Editor: Juan C. Ivancevich, MD

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