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Asthma and Treatment by Ventolin Inhalers

The present study demonstrates a normal p2-adrenoceptor sensitivity in nonmedicated patients with mild asthma and no history of exercise-induced bron-choconstriction (ie, the NEIA group). Thus, the iso-prenaline-stimulated cAMP response of lymphocytes from NEIA patients was identical to that of age and sex matched healthy control subjects. These results are in agreement with most previous reports concerning P-adrenoceptor function in white blood cells from nonmedicated allergic asthmatic patients. Although the NEIA subjects were not in a truly basal state when isoprenaline infusions were administered, due to the preceding exercise test, we found no tendency towards reduced P-adrenoceptor sensitivity in the NEIA patients under in vivo conditions either. Therefore, we chose not to study this patient group further.

In patients with EIA, on the other hand, we found reduced p2-adrenoceptor responsiveness both in vitro in lymphocytes and in vivo during isoprenaline infusions. To our knowledge, P-adrenoceptor function has not previously been examined in this subgroup of asthmatic patients.

The EIA patients had a depressed cAMP response to isoprenaline in lymphocytes, which are endowed with P-adrenoceptors of the p2-subtype. Our results, showing pAa-values for atenolol approximately four orders of magnitude higher than the p2-values for propranolol, support the concept of a pure population of P-adrenoceptors of the p2-subtype in human lymphocytes. No difference was found between healthy volunteers and asthmatic patients of either subgroup in this respect. Thus, EIA but not NEIA patients showed reduced p2-adrenoceptor sensitivity in vitro. If you want either to change your ventolin inhaler or to buy ventolin inhalers online a new one you are welcome on our web site just follow the link.

Interestingly, not all in vivo responses to isoprenaline were reduced in the EIA group. The responses which were attenuated (ie, the increase in plasma cAMP and the reduction of diastolic blood pressure) may be characterized as mainly p2-mediated. Thus, experiments comparing the influence of non-selective and prselective blockade on responses to infused catecholamines suggest that both the decrease in diastolic blood pressure and the increase in plasma cAMP are p2-mediated. Heart rate and lipolysis (ie, increases in plasma glycerol), on the other hand, are mainly pradrenoceptor mediated according to the original classification of Lands and co-workers. Therefore, our results suggest that Pradrenoceptor sensitivity is normal in EIA. The apparently increased bronchodilator response to isoprenaline in the EIA group we consider to be due to the subclinical bron-choconstriction seen in this group. The p-adrenocep-tor sensitivity in the target organ of asthmatic patients cannot be evaluated correctly using in vivo techniques, due to these differences in baseline measurements. Our findings that p2-mediated responses to isoprenaline infusions outside the target organ (ie, diastolic blood pressure and plasma cAMP) were attenuated in EIA patients are in good agreement with the above-mentioned in vitro findings and suggest that EIA is associated with reduced p2-adrenoceptor sensitivity.

The present technique of studying the plasma con-centration-effect relationship for isoprenaline improved the possibilities to reveal these signs of reduced Pradrenoceptor responsiveness in vivo in the EIA group. Even though the plasma isoprenaline concentrations rose dose-dependently in each individual, there was a fivefold to sixfold interindividual variation of the plasma concentration achieved during infusions of standardized (for body weight) doses of isoprenaline. The EIA group achieved slightly higher isoprenaline concentrations than the control group. Without determinations of these concentrations, we would have underestimated the difference in isoprenaline sensitivity between the groups.

Previous antiasthmatic treatment is not a likely explanation for our findings of reduced p2-adrenocep-tor responsiveness in the EIA group, since all medication was withdrawn at least one week before the study. Patients with severe asthma were unable to participate in the study because of this nontreatment require-

ment. One week has been shown to be sufficient to normalize white blood cell (3-adrenoceptors following withdrawal of sympathomimetic treatment. Similarly, Holgate et al noted that desensitized bronchial P-adrenoceptors were normalized within ten days after discontinuation of salbutamol treatment in healthy volunteers. Our EIA patients had a somewhat depressed specific airways conductance, which was counteracted by isoprenaline infusions, but they did not experience symptoms requiring treatment during the week preceding the study. Since the NEIA group participated in the study on the same terms without presenting signs of altered р-adrenoceptor sensitivity, it is unlikely that deterioration of the patients’ clinical condition is an explanation for the reduced p2-adre-noceptor responsiveness found in the EIA group.

We have previously noted a normal increase in plasma adrenaline concentrations following exercise in the EIA subjects of study 1. Interestingly, we found an inverse correlation between postexercise decreases in Sgaw and increases in plasma cAMP in the EIA patients in that study, supporting the concept of impaired p2-adrenoceptor function in EIA. P-adre-noceptor agonist treatment can prevent or reverse exercise-induced bronchoconstriction. If a lack of endogenous p2-mediated bronchodilator influences is involved in postexercise bronchoconstriction in EIA patients, the present study therefore suggests that reduced p2-adrenoceptor sensitivity may contribute to EIA.

Although pulmonary P2-adrenoceptors could not be directly studied in the present investigation for reasons discussed above, we found several indications of reduced p2-adrenoceptor responsiveness in EIA patients. The NEIA patients in our study displayed normal responsiveness, suggesting that reduced P2-adrenoceptor responsiveness is not a general finding in nonmedicated asthmatic patients. This difference between two subgroups of asthmatic patients may help to explain some of the above-mentioned controversies regarding p2-adrenoceptor function in asthma. The present findings and the previously reported inverse correlation between postexercise decreases in Sgaw and increases in plasma cAMP in EIA patients suggest that decreased p2-adrenoceptor responsiveness might be of pathophysiologic importance in this disease.

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Asthma Treated By Ventolin Inhaler

The severity of airflow obstruction in a patient with asthma varies considerably, either spontaneously or as a result of treatment. This variation occurs over hours or even minutes, and is a defining characteristic. Nocturnal asthma is well recognized clinically, and the timing of sudden deaths and of ventilatory arrests in asthmatic patients emphasize the importance of nocturnal increases in severity. Adrenal cortical function, ventilatory response to C02, catecholamine levels in the blood, and vagal tone follow circadian cycles which each tend to make asthma worse at night. Circadian rhythms, of which these are examples, should be distinguished from sleep stage related changes in breathing, which have been shown to influence breathing patterns and arterial blood gas partial pressures in patients with chronic bronchitis and emphysema.

Asthmatic patients have been studied by waking them at intervals during the night and having them make a forced expiration, measuring, for example, their peak flow rate. Among patients with chronic airflow obstruction, blue bloaters and pink puffers have been compared by measuring esophageal pressure changes, rib cage and abdominal movements, arterial oxygen saturation or partial pressure, without arousing the patient.

Airflow obstruction in patients with asthma is often associated with wheezing, and we have recently shown, for individual patients, a relationship between the degree of obstruction and the fraction of the respiratory cycle during which wheezing is present. A system has been developed which allows continuous assessment of changes in airflow obstruction by measurement of changes in sounds recorded from the chest wall and analyzed by computer. This allows monitoring for prolonged periods of time without disturbing the patient, for example by waking him; and without requiring some form of test such as a forced expiratory maneuver, which depends on effort and coordination, possibly difficult for a patient wakened during the night.

Methods

The first part of this study was designed to select the method of measuring lung sounds which would provide the best indicator of airflow obstruction. Patients seen in the Pulmonary Division of the University of Cincinnati were asked to participate if they had significant response to bronchodilator drugs documented by pulmonary function tests within the previous four weeks, and were wheezing at the time of the study. Those who agreed signed a written consent form approved by the Human Research Committee. Patients were seated in a quiet room with a contact microphone (Hewlett Packard) strapped to their chest. The microphone was attached to a portable cassette tape recorder. The patient was asked to breathe normally and was left unobserved for 30 minutes. This web site – buy-asthma-inhalers-online.com – may provide you with ventolin inhalers in case if you suffer from asthma.

At the beginning and end of each session, the patient performed forced expiratory maneuvers into a seven-liter water seal spirometer attached to a dedicated microcomputer. Two or three forced maneuvers were performed, and the best forced expiratory volume in one second (FEVi) was noted. Analysis of the recorded sounds was directed at testing several methods for estimating wheezing, and comparing the values obtained with the airflow obstruction measured by pulmonary function tests.

Some patients, chosen by availability, were asked to return to the laboratory at night, and once again, a contact microphone was attached to their chest wall. A stretch vest with impedance plethysmograph bands and an ear oximeter were used to measure ventilation and oxygen saturation. The signals from the microphone, the Respitrace sum, chest wall, and abdomen signals, and the oxygen saturation were recorded on a multichannel tape recorder.

The patient was studied through the night, from 11 pm to 6 am. Standard polysomnographic recordings were used for sleep staging. Pulmonary function tests were performed at the beginning and end of the sleep study.

The recorded sound signal was subsequently analyzed. Several methods for sampling and for wheeze detection were investigated. Five minutes of sound was chosen as the time period to be analyzed. Two hundred and fifty millisecond segments of the sound signal were analyzed using the Fast Fourier Transform (FFT). The sound signal was digitized at 2,048 samples per second, and a FFT was performed on 250 ms segments using a spectrum analyzer. The frequency spectrum was stored in a controlling computer for later analysis. Random segments were selected from each five-minute period.

Each spectrum was analyzed for the presence or absence of a peak at a frequency between 150 and 1,000 Hz. The number of spectrums with peaks divided by the total number of spectrums analyzed over the five-minute period was an estimate of the duration of wheezing present during the five minutes (Est Tw/Ttot).

The linear correlation coefficient between Est Tw/Ttot and FEV, was determined using the least squares technique. The F-test for simple effects was applied to determine the variation within subjects and between subjects. Comparisons between groups were tested for significance, using the Mann-Whitney U-test. A p value of less than 0.05 was considered significant.

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Asthma Management by Ventolin Inhaler

Exacerbation of asthma has various etiologies. The bronchitis associated with these exacerbations depends on the cause of the exacerbation. This can be now be accurately measured by quantitative sputum cell counts. An eosinophilic bronchitis is generally associated with hypersensitivity to environmental antigens, whereas a neutrophilic bronchitis usually suggests an infection. We present a case of recurrent asthma exacerbations in a patient whose sputum cell counts showed neutrophilic bronchitis. This led to the identification of Chlamydophila pneumoniae as the cause of bronchitis and asthma exacerbations that were prevented by prophylactic antibiotic therapy. We also discuss investigation and management of exacerbations of asthma associated with neutrophilic bronchitis. Buy Ventolin Online and you will see te result of your asthma treatment.

Case Report

A 47-year-old woman had asthma since childhood and a history of nasal polyps, aspirin sensitivity, and gastroesophageal reflux. She was a lifetime nonsmoker with no reported occupational exposures. Her asthma was well controlled with budesonide, 200 μg three for four puffs bid, and formoterol, 12 μg two puffs bid, until 2 years ago. Over the last 2 years, she had three episodes of cough and yellow sputum. A high-resolution CT scan of the thorax did not show any abnormalities. Most recently, the patient presented with a 10-day history of nocturnal wheezing and mucopurulent sputum. She had started herself on prednisone, 30 mg/d, as had been the previous practice. This did not relieve her symptoms. Sputum induction with a hypertonic saline solution aerosol as described previously revealed a total cell count of 98.4 X 106 cells/g, of which 93% were neutrophils and there were no eosinophils (healthy adults: < 9.7 X 106 cells/g, < 64.4%, and < 2% respectively). Sputum routine culture findings were negative for seven common respiratory viruses and bacteria. The CBC count showed mildly low total lymphocytes and a low CD4+ component. Microimmunofluorescence assay for Chlamydia and Mycoplasma species were negative. A quantitative polymerase chain reaction (PCR) analysis of blood and sputum was positive for C pneumoniae and negative for Chlamydophila trachomatis. The patient was prescribed azithromycin, 500 mg qd for 3 days, and 500 mg 1 day per week for the following 5 weeks. She was advised to discontinue prednisone. Over the following 4 years, monitoring of sputum cells and prophylactic macrolide therapy with increasing C pneumoniae titers prevented exacerbations without the need for systemic corticosteroids and enabled the reduction of budesonide dose to 1,200 to 1,600 μg/d. A summary of the course of the symptoms, lung function tests, and treatment is provided in Table 1.

Table 1—Serial Clinical and Sputum Characteristics

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Relation of p2-Adrenoceptor Polymorphisms at Codons 16 and 27 to Persistence of Asthma Symptoms After the Onset of Puberty: Materials and Methods

Asthma is a common disease among school-age children in developed countries, and its prevalence has been increasing over the last decades. In a large British cohort, the cumulative incidence of asthma or wheezy bronchitis was found to be 18.2% and 21.8% by the ages of 7 years and 11 years, respectively. It has long been recognized that many children with asthma may outgrow the disease during adolescence. However, little is known about the genetic factors affecting the remission or persistence of asthma symptoms at puberty.

Population-based longitudinal cohort studies- have consistently shown that severity and frequency of asthma symptoms are among the strongest predictors for the persistence of asthma from childhood to adulthood. Severity of asthma, in turn, has been shown to be affected by the genetic variation of the (32-adrenoceptor (p2AR). Although the polymorphisms at codons 16 (Arg163 Gly16) and 27 (Gln273Glu27) of the (32AR have not been associated with the development of the disease per se, several studies have reported an association between the Gly16 polymorphism and severe asthma. In the original report describing these polymorphisms, Reihsaus et al found that patients with asthma who required oral steroids were significantly more likely to be homozygous for Gly16 than those with a milder form of the disease. Similarly, Holloway et al found that patients with at least one admission to hospital with asthma were almost twice as likely to be homozygous for Gly16 than control subjects. No such association was present among patients with mild asthma. In another study, Weir et al reported the Gly16-Gln27 haplotype to be more prevalent in patients with moderate asthma (defined as receiving > 400 ^g/d of inhaled beclomethasone or equivalent and/or having an FEV1 < 75% of predicted) than in those with mild asthma. Based on the link between P2AR polymorphisms at codons 16 and 27 and severity of asthma, we hypothesized that these polymorphisms may be associated with the persistence of the disease after the onset of puberty.

Study Population

The children included in this study are a subset from the large birth cohort of the Tucson Children’s Respiratory Study. Detailed information on the design and the enrollment process of this study has been provided elsewhere. Briefly, between May 1980 and October 1984, parents planning to use the pediatricians of a health maintenance organization in Tucson, AZ, were contacted shortly after their child was born, and a total of 1,246 healthy infants were enrolled in the study. Information on the ethnic backgrounds of both parents was available for 1,101 children. Among them, 997 children (91%) had both parents of either white or Hispanic ethnicity (the two major ethnic groups in the Tucson area) and were selected for this analysis. Parents completed questionnaires on their child’s health status at enrollment and at the year 2 survey (mean age ± SD, 1.62 ± 0.3 years), year 3 survey (mean age, 2.92 ± 0.5 years), year 6 survey (mean age, 6.27 ± 0.9 years), year 8 survey (mean age, 8.62 ± 0.7 years), year 11 survey (mean age, 10.90 ± 0.7 years), year 13 survey (mean age, 13.47 ± 0.6 years), and year 16 survey (mean age, 16.61 ± 0.6).

Puberty Onset

The questionnaires at year 13 and year 16 included questions on whether and when puberty started. Specific examples of signs indicating the onset of puberty (pubic and/or underarm hair, breast development or menstruation in girls, voice changes in boys) were provided. We defined the prepubertal period as that between the year 6 survey and the reported onset of puberty. Remission and persistence of wheezing and asthma were studied between the onset of puberty and up to the year 16 survey (mean follow-up, 4.3 ± 1.6 years).

Wheezing and Asthma

Questions on the presence and frequency of wheezing episodes during the previous year were asked in each of the surveys.

Wheezing in the prepubertal period was defined as the report of any wheezing episodes in any of the surveys completed between year 6 and the onset of puberty. Children who reported active wheezing in all the surveys completed during the prepubertal period were defined as having continuous wheezing in prepubertal period. Asthma in the prepubertal period was defined as either the report of more than three wheezing episodes during the previous year in at least one survey, or a physician-confirmed diagnosis of asthma during that period.

Outcomes in adolescence were then assessed among children who had wheezing and/or asthma in the prepubertal period. Wheezing and asthma groups were classified as persistent if any wheezing episodes were reported in at least one survey after the onset of puberty and remitting if they were not. The frequency of persistent wheezing after the onset of puberty was also assessed. Those who reported more than three wheezing episodes during the previous year in at least one survey after the onset of puberty were defined as having frequent persistent wheezing. Otherwise, persistent wheezing was coded as infrequent.

Risk Factors and Potential Confounders

Weight and height were measured by the study nurses at years 6, 11, and 16. Body mass index percentile was calculated for each child using current US sex- and age-standardized values for children. Children > 85th percentile were defined as overweight.

At years 6, 11, and 16, skin-prick tests were performed for common allergens in the Tucson area. For reasons of consistency, only responses to the six allergens (ie, Alternaria alternata, Bermuda grass, olive, careless weed, mesquite, and mulberry) tested in each of the three surveys were considered. Positive skin-prick test results were defined as a wheal at least 3 mm larger than the control wheal for at least one tested allergen in at least one of the surveys. At the time of the year 11 survey, parents were surveyed by phone about specific medications (including P-agonists and corticosteroids) received by their child for asthma or wheezing problems in the last 12 months.

Exposure to environmental tobacco smoke was defined as a positive report of current smoking by either the mother or the father at the year 6, year 8, and/or year 11 surveys. Information on years of formal education for both mother and father was collected at the time of enrollment of the child in the study.

Genotyping

Genomic DNA was prepared from peripheral blood obtained at year 11 using standard techniques. P2AR genotypes were determined by a combination of primer-induced restriction site assay and restriction fragment assay as described previously. Informed consent was obtained from the parents of participating children, and the study was approved by the Human Subjects Committee of the University of Arizona.

Statistical Analysis

Because of the nature of our data (genotypic data with unknown gametic phase), maximum-likelihood haplotype frequencies were imputed using an expectation-maximization algo-rithm. Through this method, it is possible to estimate the most likely distribution by haplotype in the total study population as well as in each ethnic group. Differences in the haplotype distributions among the ethnic groups were tested using the exact test of population differentiation. For subjects heterozygous for both p2AR-16 and p2AR-27, haplotypes were inferred using the PHASE package with the threshold probability set at 95%.

Proportions of subjects with persistent wheezing/asthma were compared using x2 tests across the p2AR-16 and paAR-27 genotypes (analysis by subjects) and the corresponding haplo-types (analysis by chromosomes). The 95% confidence intervals (CIs) of proportions were computed using the binomial distribution. Relative risks (RRs) for persistence of wheezing/asthma associated with the homozygous status for Gly16 were computed and adjusted for ethnic background using stratification according to the Mantel-Haenszel method. Interaction by gender was tested through the homogeneity test, testing the null hypothesis that the RRs for the association between the genotype Gly16/ Gly16 and persistent wheezing/asthma were equal between male and female patients. Logistic regression models were used to adjust for potential confounding and adjusted odds ratios were converted to corrected RRs, as described by Zhang and Yu, in order to provide a better estimate of the risk for persistence of wheezing after puberty associated with prepubertal risk factors. An a = 0.05 level of significance was chosen for all the performed statistical tests.

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Relation of p2-Adrenoceptor Polymorphisms at Codons 16 and 27 to Persistence of Asthma Symptoms After the Onset of Puberty: Materials and Methods

Asthma is a common disease among school-age children in developed countries, and its prevalence has been increasing over the last decades. In a large British cohort, the cumulative incidence of asthma or wheezy bronchitis was found to be 18.2% and 21.8% by the ages of 7 years and 11 years, respectively. It has long been recognized that many children with asthma may outgrow the disease during adolescence. However, little is known about the genetic factors affecting the remission or persistence of asthma symptoms at puberty.

Population-based longitudinal cohort studies- have consistently shown that severity and frequency of asthma symptoms are among the strongest predictors for the persistence of asthma from childhood to adulthood. Severity of asthma, in turn, has been shown to be affected by the genetic variation of the (32-adrenoceptor (p2AR). Although the polymorphisms at codons 16 (Arg163 Gly16) and 27 (Gln273Glu27) of the (32AR have not been associated with the development of the disease per se, several studies have reported an association between the Gly16 polymorphism and severe asthma. In the original report describing these polymorphisms, Reihsaus et al found that patients with asthma who required oral steroids were significantly more likely to be homozygous for Gly16 than those with a milder form of the disease. Similarly, Holloway et al found that patients with at least one admission to hospital with asthma were almost twice as likely to be homozygous for Gly16 than control subjects. No such association was present among patients with mild asthma. In another study, Weir et al reported the Gly16-Gln27 haplotype to be more prevalent in patients with moderate asthma (defined as receiving > 400 ^g/d of inhaled beclomethasone or equivalent and/or having an FEV1 < 75% of predicted) than in those with mild asthma. Based on the link between P2AR polymorphisms at codons 16 and 27 and severity of asthma, we hypothesized that these polymorphisms may be associated with the persistence of the disease after the onset of puberty.

Study Population

The children included in this study are a subset from the large birth cohort of the Tucson Children’s Respiratory Study. Detailed information on the design and the enrollment process of this study has been provided elsewhere. Briefly, between May 1980 and October 1984, parents planning to use the pediatricians of a health maintenance organization in Tucson, AZ, were contacted shortly after their child was born, and a total of 1,246 healthy infants were enrolled in the study. Information on the ethnic backgrounds of both parents was available for 1,101 children. Among them, 997 children (91%) had both parents of either white or Hispanic ethnicity (the two major ethnic groups in the Tucson area) and were selected for this analysis. Parents completed questionnaires on their child’s health status at enrollment and at the year 2 survey (mean age ± SD, 1.62 ± 0.3 years), year 3 survey (mean age, 2.92 ± 0.5 years), year 6 survey (mean age, 6.27 ± 0.9 years), year 8 survey (mean age, 8.62 ± 0.7 years), year 11 survey (mean age, 10.90 ± 0.7 years), year 13 survey (mean age, 13.47 ± 0.6 years), and year 16 survey (mean age, 16.61 ± 0.6).

Puberty Onset

The questionnaires at year 13 and year 16 included questions on whether and when puberty started. Specific examples of signs indicating the onset of puberty (pubic and/or underarm hair, breast development or menstruation in girls, voice changes in boys) were provided. We defined the prepubertal period as that between the year 6 survey and the reported onset of puberty. Remission and persistence of wheezing and asthma were studied between the onset of puberty and up to the year 16 survey (mean follow-up, 4.3 ± 1.6 years).

Wheezing and Asthma

Questions on the presence and frequency of wheezing episodes during the previous year were asked in each of the surveys.

Wheezing in the prepubertal period was defined as the report of any wheezing episodes in any of the surveys completed between year 6 and the onset of puberty. Children who reported active wheezing in all the surveys completed during the prepubertal period were defined as having continuous wheezing in prepubertal period. Asthma in the prepubertal period was defined as either the report of more than three wheezing episodes during the previous year in at least one survey, or a physician-confirmed diagnosis of asthma during that period.

Outcomes in adolescence were then assessed among children who had wheezing and/or asthma in the prepubertal period. Wheezing and asthma groups were classified as persistent if any wheezing episodes were reported in at least one survey after the onset of puberty and remitting if they were not. The frequency of persistent wheezing after the onset of puberty was also assessed. Those who reported more than three wheezing episodes during the previous year in at least one survey after the onset of puberty were defined as having frequent persistent wheezing. Otherwise, persistent wheezing was coded as infrequent.

Risk Factors and Potential Confounders

Weight and height were measured by the study nurses at years 6, 11, and 16. Body mass index percentile was calculated for each child using current US sex- and age-standardized values for children. Children > 85th percentile were defined as overweight.

At years 6, 11, and 16, skin-prick tests were performed for common allergens in the Tucson area. For reasons of consistency, only responses to the six allergens (ie, Alternaria alternata, Bermuda grass, olive, careless weed, mesquite, and mulberry) tested in each of the three surveys were considered. Positive skin-prick test results were defined as a wheal at least 3 mm larger than the control wheal for at least one tested allergen in at least one of the surveys. At the time of the year 11 survey, parents were surveyed by phone about specific medications (including P-agonists and corticosteroids) received by their child for asthma or wheezing problems in the last 12 months.

Exposure to environmental tobacco smoke was defined as a positive report of current smoking by either the mother or the father at the year 6, year 8, and/or year 11 surveys. Information on years of formal education for both mother and father was collected at the time of enrollment of the child in the study.

Genotyping

Genomic DNA was prepared from peripheral blood obtained at year 11 using standard techniques. P2AR genotypes were determined by a combination of primer-induced restriction site assay and restriction fragment assay as described previously. Informed consent was obtained from the parents of participating children, and the study was approved by the Human Subjects Committee of the University of Arizona.

Statistical Analysis

Because of the nature of our data (genotypic data with unknown gametic phase), maximum-likelihood haplotype frequencies were imputed using an expectation-maximization algo-rithm. Through this method, it is possible to estimate the most likely distribution by haplotype in the total study population as well as in each ethnic group. Differences in the haplotype distributions among the ethnic groups were tested using the exact test of population differentiation. For subjects heterozygous for both p2AR-16 and p2AR-27, haplotypes were inferred using the PHASE package with the threshold probability set at 95%.

Proportions of subjects with persistent wheezing/asthma were compared using x2 tests across the p2AR-16 and paAR-27 genotypes (analysis by subjects) and the corresponding haplo-types (analysis by chromosomes). The 95% confidence intervals (CIs) of proportions were computed using the binomial distribution. Relative risks (RRs) for persistence of wheezing/asthma associated with the homozygous status for Gly16 were computed and adjusted for ethnic background using stratification according to the Mantel-Haenszel method. Interaction by gender was tested through the homogeneity test, testing the null hypothesis that the RRs for the association between the genotype Gly16/ Gly16 and persistent wheezing/asthma were equal between male and female patients. Logistic regression models were used to adjust for potential confounding and adjusted odds ratios were converted to corrected RRs, as described by Zhang and Yu, in order to provide a better estimate of the risk for persistence of wheezing after puberty associated with prepubertal risk factors. An a = 0.05 level of significance was chosen for all the performed statistical tests.

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Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

[georgeeflynnn-blog]

New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

[georgeeflynnn-blog]

New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

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Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

<p><img class="alignleft wp-image-3987 size-full" title="Asthma" src="http://asthma-inhalers-treatment.com/wp-content/uploads/2015/07/1853.jpg" alt="Asthma" height="221" width="228">Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.</p><!–more–><p>Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.</p><p><img class=" wp-image-3988 size-full alignright" title="Respiratory" src="http://asthma-inhalers-treatment.com/wp-content/uploads/2015/07/2723.jpg" alt="respiratory" height="222" width="227">The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.</p><p><strong>Subjects</strong></p><p>Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.</p><p><strong>Questionnaire</strong></p><p><img class="alignleft wp-image-3989 size-medium" title="Asthma control" src="http://asthma-inhalers-treatment.com/wp-content/uploads/2015/07/373-300×1073.jpg" alt="Asthma control" height="107" width="300">The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.</p><p><strong>Interview</strong></p><p>The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.</p><p><strong>Statistical Analysis</strong></p><p>Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).</p><p><strong>Table 1—Clinical Characteristics</strong></p><table border="1"> <tbody> <tr> <td><span class="font1">Characteristics</span></td> <td><span class="font1">No.</span></td> <td><span class="font1">^Ag^</span>

<span class="font1">yr</span></td> <td><span class="font1">Male/Female Gender, No.</span></td> <td><span class="font1">FEVj, % Predicted (Range)</span></td> <td><span class="font1">Mean ICS</span>

<span class="font1">Dose, mg</span></td> </tr> <tr> <td><span class="font1">All patients</span></td> <td><span class="font1">378</span></td> <td><span class="font1">42.3</span></td> <td><span class="font1">113/265</span></td> <td><span class="font1">89.7</span><span class="font4"> (</span><span class="font1">44</span><span class="font4">-</span><span class="font1">132</span><span class="font4">)</span></td> <td><span class="font1">663</span></td> </tr> <tr> <td><span class="font1">Mild intermittent</span></td> <td><span class="font1">28</span></td> <td><span class="font1">39.5</span></td> <td><span class="font1">10/18</span></td> <td><span class="font1">103.4</span><span class="font4"> (</span><span class="font1">88</span><span class="font4">-</span><span class="font1">122</span><span class="font4">)</span></td> <td></td> </tr> <tr> <td><span class="font1">Mild persistent</span></td> <td><span class="font1">131</span></td> <td><span class="font1">42.4</span></td> <td><span class="font1">38/93</span></td> <td><span class="font1">96.1</span><span class="font4"> (</span><span class="font1">81</span><span class="font4">-</span><span class="font1">132</span><span class="font4">)</span></td> <td><span class="font1">350</span></td> </tr> <tr> <td><span class="font1">Moderate</span></td> <td><span class="font1">178</span></td> <td><span class="font1">44.7</span></td> <td><span class="font1">58/120</span></td> <td><span class="font1">87.6</span><span class="font4"> (</span><span class="font1">68</span><span class="font4">-</span><span class="font1">108</span><span class="font4">)</span></td> <td><span class="font1">770</span></td> </tr> <tr> <td><span class="font1">Severe</span></td> <td><span class="font1">41</span></td> <td><span class="font1">46.8</span></td> <td><span class="font1">7/34</span></td> <td><span class="font1">77.7</span><span class="font4"> (</span><span class="font1">44</span><span class="font4">-</span><span class="font1">84</span><span class="font4">)</span></td> <td><span class="font1">1655</span></td> </tr> </tbody> </table>

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New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655

[georgeeflynnn-blog]

New Post has been published on Asthma Inhalers Treatment

New Post has been published on http://asthma-inhalers-treatment.com/control-of-asthma-under-specialist-care-materials-and-methods.html

Control of Asthma Under Specialist Care: Materials and Methods

Asthma is a chronic and common disease that affects not only health but also the quality of life of asthmatic patients. In order to combat the problem of asthma, global guidelines have been published to promote standardized methods for the diagnosis and treatment of the disease. These guidelines have been disseminated widely, and there are reports showing that doctors are aware of the recommendations2 and that the quality of life of mild asthmatics is similar to that of the general population. However, studies2- also show that although doctors accept the guidelines, their patients are not always treated accordingly, and a multinational survey shows that the life of asthma patient is affected by the disease to a great extent. This is supported by a number of studies of patients’ perception of the disease and the handicaps that asthma and asthma medications impose on the lifestyle of these patients. These studies are important because they help define the problem of asthma from the patients’ point of view, allow better understanding, and lead to better treatment of the disease.

Greece is a country with a rather low prevalence of asthma, but nevertheless it is estimated that > 500,000 people have the disease. Greek guidelines for asthma treatment were published in Greece in 199411 and were distributed to respiratory physicians by the Hellenic Thoracic Society. The first Global Initiative for Asthma (GINA) guidelines were translated into Greek in 199712 and have been widely disseminated, while the most recent update before the study was translated, published, and disseminated in 2003. Furthermore, the Greek National Health System (NHS) is structured in such a way that all patients have easy access to specialist care and all medication classes are available through the NHS and are 90 to 100% refunded. Most of the patients living in urban areas are attended by respiratory physicians either in the outpatient clinics of NHS hospitals or of I.K.A., the national insurance organization.

The aim of our study was to examine the treatment outcome, ie, whether control of asthma is achieved in asthmatic patients in urban areas in Greece, where most patients are treated by respiratory specialists, This report presents data on symptoms, limitations, medication, and overall control of asthma in patients receiving specialist care.

Subjects

Asthmatic patients who participated in the study were a random sample of patients who presented to asthma clinics of four Respiratory Medicine Departments in three large cities in Greece: Athens, Thessaloniki, and Ioannina. The majority of patients reviewed in these clinics come from within and around the above cities where 70% of the Greek population lives, while approximately 10% of the outpatients come from other areas in Greece. All patients (n = 437) who presented to these clinics on randomly selected days for a period of 3 months were asked to complete the questionnaire described below. Inclusion criteria were a diagnosis of asthma by a physician based on history and lung function testing, and a history of asthma prescriptions. All patients had an increase in FEV1 of > 12% (and > 200 mL) after bronchodilation and/or a positive methacholine challenge result, either on the study day or recorded in their medical files. Furthermore, data on prescribed medication and dosing as well as asthma severity classification according to the GINA guidelines were noted from the files and are presented in Table 1. Spirometry was performed using appropriate equipment (Benchmark Pulmonary Function Testing; P.K. Morgan Ltd; Chatham, UK; Fukuda ST300; Fukuda Sangyo; Chiba, Japan; Spirotrac IV; Vitalograph; Buckingham, UK; or Jaeger Masterscreen; Jaeger, Wurzburg, Germany). The spirometers and the procedure for spirometry testing fulfilled American Thoracic Society criteria. The study was approved by the ethics committees of all hospitals involved, and patients gave informed consent.

Questionnaire

The questionnaire used was developed from previously existing, validated, and extensively used questionnaires (American Thoracic Society, European Community Respiratory Health Survey), which have been shown to be valid for the measurement of asthma symptoms and were translated and validated in Greek. The questionnaire was structured with eight domains of patient characteristics, drug use at baseline and during exacerbations, regular follow-up, type and frequency of symptoms, emergency visits, patient perception of asthma control, and activity limitations.

Interview

The patients were asked to participate in the study and on consent were administered the questionnaire. The questionnaires were completed anonymously. If there were doubts about the questions, there was minimal help with understanding but no interference from the physicians.

Statistical Analysis

Simple descriptive statistics were used to describe the study population. Statistical comparison was done using x2 analysis (with Fisher exact test where indicated by low expected cell count), and correlations were tested using univariate logistic regression, followed by multivariate logistic regression analysis for variables showing significance. Results were given as odds ratios (ORs) with 95% confidence intervals (CIs); p < 0.05 was considered significant. All analyses were performed using software (Sigma-Stat version 3.0; Systat Software GmbH; Erkrath, Germany).

Table 1—Clinical Characteristics

Characteristics No. Ag^

yr

Male/Female Gender, No. FEVj, % Predicted (Range) Mean ICS

Dose, mg

All patients 378 42.3 113/265 89.7 (44–132) 663 Mild intermittent 28 39.5 10/18 103.4 (88–122) Mild persistent 131 42.4 38/93 96.1 (81–132) 350 Moderate 178 44.7 58/120 87.6 (68–108) 770 Severe 41 46.8 7/34 77.7 (44–84) 1655