ABSTRACT
Due to current controversies regarding the effect of age on response to treatment in asthmatic patient, the present study was performed on patients referred with acute asthma attack for further evaluation of this matter. In this study 138 patients with severe persistent asthma were enrolled and divided into two categories of young [age /= 50 yrs; 56 cases, mean age 57.4 +/- 6.4 years]. Response to treatment was determined by pulmonary function tests. The mean percentage change of FEV1 from baseline in male and female patients of young and old age was 75.05 +/- 46.61 and 71.39 +/- 41.30%, [P=0.721] and 100.79 +/- 51.34% and 69 +/- 37.39% [P=0.015], respectively. The mean percentage of possible improvement of FEV1 among male and female patients of young and old age was 62.81 +/- 25.67% and 54.46 +/- 23.82% [P=0.148], and 78 +/- 24.04% and 63.58 +/- 41.24% [P=0.087]; respectively. Response to treatment was significant in both young and old age groups suffering from acute asthmatic attack except for young female patients in which, percentage change of FEV1 increased compared to older patients. Among other patients this value and percentage of possible improvement of FEV1 between the 2 groups did not change significantly and age did not play a significant role in assessing the response to treatment in acute asthmatic attack
ABSTRACT
Obesity as a common health risk is increasing all over the world. The aim of this study was evaluation of standing and sitting positions on spirometric values in obese asthmatic patients, in comparison with normal obese subjects. The study included 49 obese asthmatic patients with mean age of 42.63 years and body mass index of 36.06 kg/m2, and 51 control obese normal subjects with mean age of 39.86 years and body mass index of 36.69 kg/m2. Subjects with body mass index of [BMI]>/=30 kg/m2 were enrolled in the study. Spirometric values were measured according to American Thoracic Society [ATS] recommendation. In both groups forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1] were measured in sitting and standing positions, and the results were compared. The mean +/- SD of FVC in sitting and standing positions in obese asthmatic patients were: 3.04 +/- 0.93 lit and 3.03 +/- 0.96lit, p=0.37; and in control group: 3.68 +/- 1.12 lit and 3.72 +/- 1.11 lit, p=0.39, respectively. The mean +/- SD of FEV1 in the sitting position and standing positions in obese asthmatic patients were: 2.38 +/- 0.75 lit and 2.40 +/- 0.81 lit, p=0.20; and in control subjects: 3.17 +/- 0.92 lit and 3.21 +/- 0.93 lit, p=0.07. This study showed that spirometric values in obese asthmatic patients with BMI>/=30 are not affected by the standing and sitting positions
ABSTRACT
Corticosteroids are recommended for emergency management of an asthmatic attack. This study was designed to compare the effectiveness of oral and intramuscular steroid on spirometric results in acute asthma. We performed a randomized trial involving 88 adults, aged 15-70 years, with acute exacerbation of asthma requiring treatment with steroids. All had been treated with standard bronchodilator regimens and then received oral prednisone, 40 mg/day for 7 days, or 40 mg/day intramuscular triamcinolone long acting [LA] for 3 days. Spirometric variable and percentage of change to baseline forced vital capacity [FVC] and forced expiratory volume in 1 second [FEV1] after treatment were calculated. Baseline characteristic were comparable in the oral prednisone group [n=44] and in the intramuscular triamcinolone LA groups [n=44]. After 7 days of treatment, the mean [SD] FEV1 and FVC in both groups improved statistically over baseline values [P<0.001]. The median percentage change improvement of FEV1 between two treatment groups was statistically significant: 68 +/- 45.3% vs. 53.4 +/- 46.5%, P=0.04] respectively, but for FVC although improvement with prednisone was better than intramuscular triamcinolone LA groups, it was not statistically significant [52.6 +/- 40.1% vs. 45.8 +/- 39.9%, P=0.43] respectively. We conclude that in adults with acute asthma, oral prednisone is more effective than intramuscular triamcinolone LA in improvement of FEV1, but although efficacy of oral prednisone in improvement of FVC is more than intramuscular triamcinolone LA group, this effect is not significant