Cysteinyl leukotrienes, synthesized de novo from cell membrane phospholipids, are proinflammatory mediators that play an important role in the pathophysiology of asthma. These mediators are among the most potent of bronchoconstrictors and cause vasodilation, increased microvascular permeability, exudation of macromolecules and edema. The cysteinyl leukotrienes also have potent chemoattractant p...

BACKGROUND Recent surveys in emergency medicine departments show inadequacies in many aspects of acute asthma management. OBJECTIVE The objective of this study was to evaluate the adherence to management algorithm for acute asthma in the emergency department which focused on evidence-based treatment steps rather than documentation and patient classification. METHODS A retrospective audit of...

Beclomethasone dipropionate was used in pressurized aerosols for the treatment of 60 cases of chronic allergic asthma for up to 15 months. Twenty-eight out of 37 cases were transferred to this treatment after being dependent on oral steroids for up to 16 years. Nineteen out of 23 other asthmatics not dependent on steroids were also completely controlled. No biochemical evidence of adrenal suppr...

BACKGROUND The efficacy of a new pharmacologic agent for asthma, in this instance the leukotriene receptor antagonist montelukast, is determined in controlled trials in research subjects. The utility of a new drug is determined by multiple uncontrollable factors in individual patients. OBJECTIVE To assess the utility of montelukast in the management of persistent asthma. DESIGN Observationa...

OBJECTIVES To observe whether American Indian and Alaskan Native (AI/AN) patients at the Yakama Indian Health Service seen at the pharmacist-managed asthma clinic improved asthma outcomes. DESIGN Retrospective chart review, single group, preintervention and postintervention. SETTING Pharmacist-managed asthma clinic at an Indian Health Service ambulatory care clinic. PATIENTS Sixty-one AI/...

OBJECTIVE To examine whether in utero exposure to local and systemic corticosteroids is associated with asthma development in offspring. DESIGN Cohort study. SETTING Denmark. PARTICIPANTS We included all singletons born alive in Denmark between 1996 and 2009. Data on maternal corticosteroid use, asthma in offspring and covariates were obtained from medical registries. MAIN OUTCOME MEASU...

The tetrad of bronchial asthma, severe sinusitis, nasal polyp, eosinophilia, and systemic vasculitis is the main feature of allergic granulomatosis and angitis (Churg- Strauss Syndrome). This vasculitis is usually seen idiopathic in patients with a long history of asthma; oral steroids using steroid inhalers, vaccination and desensitization might be triggering factors. Drugs such as leukotriene...

Corticosteroid insensitivity represents a major barrier to the treatment of chronic obstructive pulmonary disease (COPD) and severe asthma. It is caused by oxidative stress, leading to reduced histone deacetylase-2 (HDAC2) function through activation of phosphoinositide-3-kinase-δ (PI3Kδ). The tricyclic antidepressant nortriptyline has been identified in high-throughput screens as an agent that...

Omalizumab has been shown to reduce exacerbation rates in moderate to severe allergic asthma. Our aim was to evaluate omalizumab efficacy and safety in a real-life setting in severe asthmatic children. 104 children (aged 6-18 years), followed up in paediatric pulmonary tertiary care centres, were included at the beginning of omalizumab treatment. Asthma control levels, exacerbations, inhaled co...

Asthma is the most common chronic paediatric disease treated in the emergency department (ED). Rapid corticosteroid administration is associated with improved outcomes, but our busy ED setting has made it challenging to achieve this goal. Our primary aim was to decrease the time to corticosteroid administration in a large, academic paediatric ED. We conducted an interrupted time series analysis...