The effects of treatment in patients with childhood asthma on the elastic properties of the aorta

Introduction: The study aimed to investigate the effects of treatment in patients with childhood asthma on the elastic properties of the aorta and cardiovascular risk.Methods: The study was performed in 66 paediatric patients diagnosed with bronchial asthma (BA). All patients were administered the ß2 agonist, salbutamol, for seven days, followed by one month of montelukast and six months of inhaled steroid treatment. All patients underwent conventional transthoracic echocardiographic imaging before and after treatment. Aortic elasticity parameters were considered to be the markers of aortic function.Results: Aortic elasticity parameters, including aortic strain (15.2 ± 4.8 and 18.8 ± 9.5%, p = 0.043), aortic distensibility (7.26 ± 4.71 and 9.53±3.50 cm2/dyn, p = 0.010) and aortic stiffness index (3.2 ± 0.6 and 2.8 ± 0.5, p = 0.045 showed significant post-treatment improvement when compared to pre-treatment values. Tricuspid annular plane systolic excursion (TAPSE) was also observed to improve after treatment (1.81 ± 0.38 and 1.98 ± 0.43, p = 0.049). Conclusion: The study demonstrated that when provided at appropriate doses, medications used in BA may result in an improvement in aortic stiffness

Planned Health Care Non-Attendance and Asthma Control among Asthma Patients in Real Life Setting in an African Country: a Prospective Cohort Study

BACKGROUND: Compliance with scheduled medical visit is an indirect indicator of the adherence to treatment.The aim of this study was to determine the incidence of non-compliance with scheduled medical visits and investigate the predictors and relationship with disease control among patient with asthma in the sub-Saharan African setting. METHODS: We conducted a prospective study between January 2012 and August 2013. All patients with asthma receiving care at the Yaounde Jamot Hospital and CEDIMER medical practice were included. Planned medical visit occurred at month one; three; six and twelve following baseline evaluation. Regression models were employed to investigate the predictors of non-compliance. RESULTS: 186 patients [121 (65.1%) being female] were included. Their median age (25th-75th percentiles) was 35.5 (20.0-52.3) years. A total of 67 (36%) failed to attend at least one of the scheduled visits. The proportion of patients who failed to comply with scheduled visits was 48.4%; 68.8%; 73.5% and 79.5% at month one; three; six and twelve respectively. The accompanying rates of unacceptable asthma control were 17.2%; 24.4% and 20.8% respectively at three; six and twelve months of follow-up. Inadequate asthma control at baseline was the main predictor of non-compliance with medical visits; with adjusted odds ratio ranging from 2.00 to 4.67. Furthermore; non-sensitisation to non-pollinic aeroallergens was associated with 2.79 (95%CI 1.58-6.07) risk of non-compliance at one month of follow-up. CONCLUSION: Targeting education of patients with poorly controlled disease at baseline can potentially improve adherence to medical visit and anti-asthmatic treatments and outcomes of care

Assessing Control of Asthma in Jush; Jimma; South West Ethiopia

BACKGROUND: Despite international guidelines; asthma control is short of the goal in different parts of the world. The objective of this study was to assess control of asthma in patients older than 14 years at the Chest Clinic of Jimma University Specialized Hospital/JUSH; South West Ethiopia. METHODS: A cross sectional hospital based study was conducted on 234 physician diagnosed asthmatic patients attending the chest follow up clinic from June 01 to July 31; 2012. Asthma control was assessed using the GINA algorithm and the ACT questionnaire. Pulmonary function test was measured using a spirometer for 160 subjects. Data were cleared; entered and analyzed using SPSS version 16 and independent variables were assessed for association with the level of asthma control using bivariate and multinomial analyses. RESULTS: Using the GINA based algorithm; 42 respondents (26.2) were considered to have partly controlled asthma and the majority 117 (76.1) had uncontrolled asthma. Asthma was uncontrolled (ACT score 19) in 71.4 subjects and well controlled (ACT score

Advances in the treatment of severe asthma

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Acteurs de sante dans la prise en charge de l'asthme au Burkina Faso

Objectif : Identifier les entraves a la meilleure prise en charge du patient asthmatique par les acteurs de la sante a Ouagadougou. Methode: Etude transversale a visee descriptive de Janvier a decembre 2012; associee a une revue de la litterature portant sur le role des acteurs de sante dans la prise en charge de l'asthme. Resultat: La technique de demonstration de la prise de l'aerosol doseur etait maitrisee chez 46 des medecins. Une ordonnance medicale etait exigee par 9 des pharmaciens avant la delivrance des medicaments asthmatiques. La verification de la conformite de la prescription medicale etait faite par 30 des pharmaciens; la demonstration de la prise de l'aerosol doseur a l'officine etait assuree par 73;6 des pharmaciens et bien maitrisee par 34;5. Dans le cadre du traitement de l'asthme; 43;2 des infirmiers savaient que les bronchodilatateurs et les corticoides etaient les medicaments les plus utilises. Les bronchodilatateurs inhales d'action rapide etaient recommandes par 40;6 des infirmiers dans l'asthme intermittent; cette prescription n'est pas conforme aux recommandations de la GINA. Conclusion : Un besoin de formation/recyclage est exprime par la quasi totalite des acteurs de sante intervenant dans la prise en charge de l'asthme au Burkina Faso

A Synopsis of Asthma Research in Nigeria between 1970 and 2010

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Physiological Mechanisms Underlying the Use of Garcinia Kola Heckel in the Treatment of Asthma

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Connaissances; attitudes et pratiques des medecins generalistes sur l'asthme a Ouagadougou

Contexte : Malgre une meilleure comprehension de la physiopathologie de l'asthme et de l'existence de molecules efficaces; la morbidite et la mortalite de l'asthme a travers le monde sont en constante augmentation. Le constat est que les directives internationales ne semblent pas etre appliquees. Cette etude se propose d'evaluer les connaissances; les attitudes et les pratiques des medecins generalistes sur l'asthme a Ouagadougou. Methode : Il s'agit d'une etude transversale descriptive et analytique par questionnaire anonyme auto administre qui a concerne 93 medecins generalistes exercant a Ouagadougou. Resultats : Le taux de participation etait de 63;4soit 59 repondants. La majorite des medecins (88) connaissait le caractere chronique de l'asthme et 61des medecins avaient une bonne connaissance des signes de l'asthme aigue grave. L'asthme post-exercice et l'asthme medicamenteux etaient respectivement connus de 22et de 15des medecins. La connaissance de la technique d'utilisation des aerosols doseurs pressurises etait mauvaise chez 54des medecins. Dans l'asthme intermittent; 52;5des medecins prescrivaient des corticoides dont 27sous forme orale. Dans l'asthme persistant; les corticoides inhales etaient associes au mimetiques par 34des medecins. Apres la prise en charge initiale; 44des medecins de l'etude referaient systematiquement leurs malades aux pneumologues. Le cout des medicaments; le manque de formation continue et le manque de directives nationales etaient percus comme des obstacles par respectivement 56; 66et 44des medecins generalistes. Conclusion : La prise en charge de l'asthme n'est pas optimale. La formation des medecins generalistes sur la prise en charge de cette maladie s'avere indispensable

Asthme : traitement au long cours

Il faut garder a l'esprit que la crise d'astheme peuvent survenir pendant un traitement au long court.Ce qui necessite une prise en charge a part .Nous resumons ici les traitements continus visant a minimiser la frequence des troubles respiratoires

Milestones in Asthma Management

Background: Asthma is an old and common disorder of respiratory function whose prevalence is increasing everywhere particularly in urban centres. This situation; coupled with the problem of suboptimal management has led to an increase in the morbidity of the disease and enormous economic losses through lost productivity and absenteeism from work and schools. There is therefore a need to review the evolution of the management of this disease with a view to drawing attention to currently recommended management guidelines. This should help to improve the outlook for the asthma patient and hopefully reduce the morbidity and mortality of this rampant disease.Methods: A review of the literature regarding the history of asthma and the evolution of its management was undertaken with the aid of textbooks; journal publications and the Internet via Google Pubmed. The history of asthma and the evolution of the management of asthma was surveyed with emphasis on major and spectacular developments particularly in respect of chronic asthma.Results: Asthma management started from the naming of the disorder; a description of its pathogenesis; pathology and attempts at the therapy of the disease with a variety of agents notably adrenaline; noradrenaline and cortisone. This was followed by the invention of various drug delivery systems and the discovery of salbutamol and cromoglycate. The invention of the bronchoscope led to the development of anti- inflammatory drugs like inhaled corticosteroids and leucotriene antagonists while the discovery of the synergy between salmeterol and fluticasone (an inhaled corticosteroid); made possible the development of combination therapy. Guidelines were devised to ensure the optimal management of the disease through the proper classification of the disease according to severity as well as the efficient utilization of available effective therapies.Conclusion: Although asthma management began in the pre-christian era; the most spectacular and revolutionary developments occurred during the last 55 years and include the discovery of various drug delivery systems; salbutamol; combination therapy and the development of asthma management guidelines