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Fulltext What are the clinical factors that affect quality of life in adult asthmatics?

Hooi LN

Med J Malaysia, 2003 Oct;58(4):506-15.
PMID: 15190625

A study was conducted to determine the clinical factors that affect the quality of life in adult asthmatics. As part of their routine follow-up visit, 399 patients completed the SF-36 quality of life questionnaire, had peak expiratory flow rate readings (PEFR) taken and were interviewed to determine current symptom severity. The grade of severity of asthma was verified by the consultant physician in-charge. The mean age of the patients was 41.8 years and 31.8% of the patients were men. Most of the patients were Malay (64.7%), 89% had at least secondary level education and the mean duration of asthma was 17.6 years. The majority of patients had moderate or severe disease (43.6% and 55.9% respectively). For asthmatics with moderate or severe symptoms of chest tightness and/or shortness of breath, all domains of SF-36 scored significantly lower than those with mild symptoms, with the exception of the domain bodily pain. Patients with moderate/severe cough recorded significantly lower scores than those with mild cough for all domains except for bodily pain and social functioning. Only the physical functioning, role physical, general health and role emotional scores were significantly worse in those with a consultant grade of severe asthma compared to those with mild/moderate asthma. Patients with PEFR < 80% predicted had lower scores for the domains physical functioning, role physical and general health than those with PEFR > or = 80% predicted, but the scores for the other domains were similar in both groups. Quality of life is significantly impaired in adult asthmatics with current respiratory symptoms. However, consultant grade of severity of asthma and PEFR readings do not affect quality of life scores as much.
Study site: Asthma clinics, hospitals, Malaysia

Matched MeSH terms: Asthma/physiopathology*
Fulltext Nasal epithelial cells can act as a physiological surrogate for paediatric asthma studies

Thavagnanam S, Parker JC, McBrien ME, Skibinski G, Shields MD, Heaney LG

PLoS One, 2014;9(1):e85802.
PMID: 24475053 DOI: 10.1371/journal.pone.0085802

Differentiated paediatric epithelial cells can be used to study the role of epithelial cells in asthma. Nasal epithelial cells are easier to obtain and may act as a surrogate for bronchial epithelium in asthma studies. We assessed the suitability of nasal epithelium from asthmatic children to be a surrogate for bronchial epithelium using air-liquid interface cultures.

Matched MeSH terms: Asthma/physiopathology*
The Effect of 20-Minute Mindful Breathing on the Rapid Reduction of Dyspnea at Rest in Patients With Lung Diseases: A Randomized Controlled Trial

Tan SB, Liam CK, Pang YK, Leh-Ching Ng D, Wong TS, Wei-Shen Khoo K, et al.

J Pain Symptom Manage, 2019 04;57(4):802-808.
PMID: 30684635 DOI: 10.1016/j.jpainsymman.2019.01.009

CONTEXT: Dyspnea is a common and distressing symptom in respiratory diseases. Despite advances in the treatment of various lung diseases, the treatment modalities for dyspnea remain limited.
OBJECTIVES: This study aims to examine the effect of 20-minute mindful breathing on the rapid reduction of dyspnea at rest in patients with lung cancer, chronic obstructive pulmonary disease, and asthma.
METHODS: We conducted a parallel-group, nonblinded, randomized controlled trial of standard care plus 20-minute mindful breathing vs. standard care alone for patients with moderate to severe dyspnea due to lung disease, named previously, at the respiratory unit of University Malaya Medical Centre in Malaysia, from August 1, 2017, to March 31, 2018.
RESULTS: Sixty-three participants were randomly assigned to standard care plus a 20-minute mindful breathing session (n = 32) or standard care alone (n = 31), with no difference in their demographic and clinical characteristics. There was statistically significant reduction in dyspnea in the mindful breathing group compared with the control group at minute 5 (U = 233.5, n1 = 32, n2 = 31, mean rank1 = 23.28, mean rank2 = 37.72, z = -3.574, P asthma.

Matched MeSH terms: Asthma/physiopathology*
Asthma control in the Asia-Pacific region: the Asthma Insights and Reality in Asia-Pacific Study

Lai CK, De Guia TS, Kim YY, Kuo SH, Mukhopadhyay A, Soriano JB, et al.

J Allergy Clin Immunol, 2003 Feb;111(2):263-8.
PMID: 12589343

Few data on asthma management are available for the Asia-Pacific region.

Matched MeSH terms: Asthma/physiopathology
Frequency analysis of capnogram signals to differentiate asthmatic and non-asthmatic conditions using radial basis function neural networks

Kazemi M, Bala Krishnan M, Aik Howe T

Iran J Allergy Asthma Immunol, 2013 Sep;12(3):236-46.
PMID: 23893807

In this paper, the method of differentiating asthmatic and non-asthmatic patients using the frequency analysis of capnogram signals is presented. Previously, manual study on capnogram signal has been conducted by several researchers. All past researches showed significant correlation between capnogram signals and asthmatic patients. However all of them are just manual study conducted through the conventional time domain method. In this study, the power spectral density (PSD) of capnogram signals is estimated by using Fast Fourier Transform (FFT) and Autoregressive (AR) modelling. The results show the non-asthmatic capnograms have one component in their PSD estimation, in contrast to asthmatic capnograms that have two components. Furthermore, there is a significant difference between the magnitude of the first component for both asthmatic and non-asthmatic capnograms. The effectiveness and performance of manipulating the characteristics of the first frequency component, mainly its magnitude and bandwidth, to differentiate between asthmatic and non-asthmatic conditions by means of receiver operating characteristic (ROC) curve analysis and radial basis function (RBF) neural network were shown. The output of this network is an integer prognostic index from 1 to 10 (depends on the severity of asthma) with an average good detection rate of 95.65% and an error rate of 4.34%. This developed algorithm is aspired to provide a fast and low-cost diagnostic system to help healthcare professional involved in respiratory care as it would be possible to monitor severity of asthma automatically and instantaneously.

Matched MeSH terms: Asthma/physiopathology*
Different inflammatory mechanisms in lungs of severe and mild asthma: crosstalk of NF-kappa-B, TGFbeta1, Bax, Bcl-2, IL-4 and IgE

Abdulamir AS, Hafidh RR, Abubakar F

Scand J Clin Lab Invest, 2009;69(4):487-95.
PMID: 19347746 DOI: 10.1080/00365510902749131

To examine differences in the apoptotic, inflammatory, allergic and immunological features in the lungs of adults with asthma.

Matched MeSH terms: Asthma/physiopathology*
Fulltext Changing survival, memory cell compartment, and T-helper balance of lymphocytes between severe and mild asthma

Abdulamir AS, Hafidh RR, Abubakar F, Abbas KA

BMC Immunol, 2008;9:73.
PMID: 19087256 DOI: 10.1186/1471-2172-9-73

BACKGROUND: Asthma is a complicated network of inflammatory reactions. It is classified into mild, moderate, and severe persistent asthma. The success of asthma therapy relies much on understanding the underlying mechanisms of inflammation at each stage of asthma severity. The aim of this study was to explore the differences in apoptotic potential, CD4/CD8 ratio, memory compartment, and T- helper (Th) 1 and 2 profile of peripheral blood lymphocytes (PBL) in patients with mild intermittent asthma and severe persistent asthma during exacerbation periods.
RESULTS: Four research lines were investigated and compared among mild asthmatics, severe asthmatics, and healthy groups by applying immunocytochemical staining of PBL. Antiapoptotic and proapoptotic proteins with Bcl-2/Bax ratio, CD4, CD8 markers with CD4+/CD8+ ratio, CD45RO+, CD45RA+ markers with memory/naive ratio (CD45RO+/CD45RA+). Th2/Th1 cytokines balance represented by IL-4/IFN-gamma ratio was measured by enzyme-linked immunosorbent assay (ELISA) for in vitro PBL cytokine synthesis. It was found that Bcl-2/Bax ratio was higher in severe than in mild asthmatics which in turn was higher than in healthy group. And memory/naive ratio of PBL was higher in severe than in mild asthmatics. Moreover, memory cells, CD45RO+ and CD45RO+/CD45RA+ ratio were correlated directly with Bcl-2/Bax, in severe and mild asthma patients. In contrast, CD4+/CD8+ ratio was not changed significantly among healthy group, mild and severe asthmatics. However, CD8+ cells were correlated directly with memory cells, CD45RO+, in severe asthmatics only. Interestingly, the dominant profile of cytokines appeared to change from T helper 2 (Th2) in mild asthmatics to T helper 1 (Th1) in severe asthmatics where the lowest in vitro IL-4/IFN-gamma ratio and highest IFN-gamma were found.
CONCLUSION: It was concluded that the underlying mechanisms of inflammation might vary greatly with asthma stage of severity. Mild intermittent asthma is mainly Th2 allergen-oriented reaction during exacerbations with good level of apoptosis making the inflammation as self-limiting, while in severe persistent asthma, the inflammatory reaction mediated mainly by Th1 cytokines with progressive loss of apoptosis leading to longer exacerbations, largely expanded memory cells, CD45RO+, leading to persistent baseline inflammation.

Matched MeSH terms: Asthma/physiopathology