Related Articles

Analysis of factors associated with the frequency of exacerbations in chronic cough.

Chest. 2014 Mar 1;145(3 Suppl):569A

Authors: Gotera C, Jurkojc Mohremberger C, Pacheco A

Abstract
SESSION TITLE: Symptoms of Respiratory Disease PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: The purpose of our work is to determine the profile of patients most likely to develop these episodes taking into account obstructive airway problems such as asthma or COPD as the most common and therefore investigated the airway eosinophilic inflammation (asthma type cough and eosinophilic bronchitis) as well as active smoking or the presence of chronic airflow obstruction (CAO).
METHODS: The cough type asthma diagnosis when chronic cougher history compatible with asthma and at least one positive physiological test: bronchial hyperresponsiveness with methacholine challenge, peak flow significantly Uncertainty or salbutamol bronchodilator test positive. Eosinophilic bronchitis is diagnosed by the presence of eosinophils in the sputum than 2% or more than 4% in BAL, plus a negative methacholine challenge. CAO also analyzed variables, current smoker and former smoker. The variable exacerbation of chronic cough is considered chronic when cougher reported experiencing greater presence of cough for at least 2 weeks with or without wheezing dyspnea, considered positive if there were 2 or more episodes per year.
RESULTS: In a series of 270 cases of chronic cough prospectively analyzed the airway eosinophilic inflammation was observed in 116 cases (80 type cough asthma, eosinophilic bronchitis, 25 and 11 do not eosinophilic bronchitis asthma), and when compared to the group without airway eosinophilic inflammation coughers, 72 cases, there was no significance in association with annual exacerbations of chronic cough. Comparing the group with non-CAO vs CAO association is significant for cough have more exacerbations per year in the CAO group, however we found no association between current smoking or having smoked to more exacerbations
CONCLUSIONS: The increased frequency of exacerbations of cough episodes per year in patients with chronic cough is associated with CAO not linked to smoking. Chronic cough phenotype linked to airway eosinophilic inflammationI not significantly related to cough more exacerbations per year, so it is necessary to investigate in the future, other phenotypes of chronic cough that link these events significantly worse quality of life in patients with chronic cough
CLINICAL IMPLICATIONS: there is a higher frequency of exacerbations of cough with or without wheezing dyspnea related to eosinophilic airway inflammation, smoking or OAD, so it may be difficult to control these parameters in order to avoid relapses .
DISCLOSURE: The following authors have nothing to disclose: Carolina Gotera, Carolina Jurkojc Mohremberger, Adalberto PachecoNo Product/Research Disclosure Information.

PMID: 24638718 [PubMed - in process]

Related Articles

The relationship between sleep quality and the control and severity of bronchial asthma.

Chest. 2014 Mar 1;145(3 Suppl):608A

Authors: Becker C, Martinez Rivera C, Abad Capa J, Martinez Ortiz ML, Rivera Ortún M, Stojanovic Z, Rodriguez Pons L, Bruguera Avila N, Ruiz J

Abstract
SESSION TITLE: SleepSESSION TYPE: Slide PresentationsPRESENTED ON: Monday, March 24, 2014 at 10:45 AM - 11:45 AMPURPOSE: To evaluate sleep quality using polysomnographic parameters and validated questionnaires and to analize its relationship with asthma control.
METHODS: We performed full polysomnography in 30 selected patients with asthma. We gathered data on their sleep quality through the Pittsburgh sleep quality index (PSQI), the Epworth test and the Insomnia Severity Index (ISI), and we collected data on asthma control (ACT), health resource utilization in the previous year, pulmonary function, and treatment. The Hospital Anxiety and Depression (HAD) test, the Nijmegen questionnaire to detect hyperventilation, and the Sidney Asthma Quality of Life Questionnaire (AQLQ Sidney) were also handed out. We divided patients into partially and uncontrolled if the ACT score was < 20, and into well controlled if the ACT≥ 20. Patients with ISI ≥15 were classified as clinical insomnia, and if they had a PSQI score ≥ 5, as poor sleep quality.
RESULTS: The mean ACT was 19,1 and the mean FEV1 75, 8%. In patients with ACT< 20 the sleep latency was higher with no significant difference (34 vs.22, p = 0.32), they had the worse sleep quality according to the PSQI (9,92 vs.4,75, p = 0.014) and the worse ISI score (11,69 vs. 4,55, p = 0.011). Patients with clinical insomnia had worse ACT score (19,7 vs. 13,8, p=0.03), worse overall AQLQ (1,9 vs. 5,9, p = 0.001), more hyperventilation (Nijmegen 12,7 vs. 29,5, p = 0.012), more anxiety (HDA 6 vs. 16, p = 0.001), more depression (HDA 3,26 vs. 11,25, p = 0.001), and more exacerbations (0,84 vs. 2,2, p=0.088).
CONCLUSIONS: There is probably a bidirectional relation between asthma control and poor quality of sleep. We found poor correlation between polysomnographic parameters, sleep quality questionnaires and characteristics of asthma.
CLINICAL IMPLICATIONS: Assessing sleep disturbance in patients with asthma and its effect on health-related quality of life will help us optimize its treatment and to achieve a better control.
DISCLOSURE: The following authors have nothing to disclose: Caroline Becker, Carlos martinez Rivera, Jorge Abad Capa, Maria Luisa Martinez Ortiz, Marisa Rivera Ortún, Zoran Stojanovic, Laura Rodriguez Pons, Nuria Bruguera Avila, Joan RuizNo Product/Research Disclosure Information.

PMID: 24638754 [PubMed - in process]

Related Articles

Safety and efficacy of oral versus inhaled corticosteroids in moderate persistent asthma in children 6 to 15 years old: a randomized controlled trial.

Chest. 2014 Mar 1;145(3 Suppl):8A

Authors: Estrera Y, Jiao AG, Valles J, Venturina JN

Abstract
SESSION TITLE: Asthma PostersSESSION TYPE: Poster PresentationsPRESENTED ON: Saturday, March 22, 2014 at 01:15 PM - 02:15 PMPURPOSE: This study aimed to determine if the use of low dose oral corticosteroid is a safe and effective alternative treatment for children with moderate persistent asthma.
METHODS: Forty patients, 6 to 15 years old, with newly diagnosed moderate persistent asthma were randomized into two groups. For 3 months, the control group received inhaled corticosteroid (budesonide) at 200mcg twice daily while treatment group received a single morning dose of oral corticosteroid (prednisone) at 0.5mg/kg (maximum dose:10mg/day). Efficacy was assessed based on daytime and nighttime coughing, limitation of activity, use of bronchodilators, FEV1, PEFR and level of asthma control. Safety parameters evaluated were blood pressure, pre and posttreatment determination of serum cortisol and fasting blood sugar levels.
RESULTS: Study participants from both groups showed comparable improvement in daytime and nighttime cough, need for bronchodilators and limitation of activity. PEFR is the only parameter that showed a significant difference, participants under the inhaled corticosteroid group showed lower PEFR values than the oral corticosteroid group throughout the entire study period. There was no significant difference in their FEV1 but basically had the same trend as that of the PEFR. There was no significant difference in the safety parameters evaluated. Study participants from both groups showed a decrease in cortisol levels after 3 months of treatment but none had signs and symptoms of adrenal insufficiency.
CONCLUSIONS: There was no significant difference in the safety and efficacy of oral versus inhaled corticosteroid in the treatment of children with moderate persistent asthma after 3 months of treatment.
CLINICAL IMPLICATIONS: These findings do not aim to replace inhaled corticosteroid as the mainstay of treatment for persistent asthma but to find a suitable, effective and more importantly, a safe alternative treatment for patients with uncontrolled asthma in third world countries.
DISCLOSURE: The following authors have nothing to disclose: Yadnee Estrera, Arnel Gerald Jiao, Jemaila Valles, Josy Naty VenturinaNo Product/Research Disclosure Information.

PMID: 24638808 [PubMed - in process]