You may have heard recent reports that the U.S. has suffered a bad flu season this year; so much so, it has been classed officially as an epidemic, killing hundreds more people than last year. Fortunately, it appears their flu season is winding down, but for us that means trouble could be on the way.
Some research studies conducted to find possible causes or treatments for asthma, or to investigate social or psychological aspects of the condition, require human involvement. These are known as clinical trials.
Clinical trials are research studies that are carefully designed to answer specific questions concerning the safety and effectiveness of a drug, treatment, or diagnostic method, or to find ways to improve patients' quality of life.
Among adults with mild to moderate persistent asthma controlled with low-dose inhaled corticosteroid therapy, the use of either biomarker-based or symptom-based adjustment of inhaled corticosteroids was not superior to physician assessment–based adjustment of inhaled corticosteroids in time to treatment failure.
The present systematic review is the most comprehensive summary of the evidence assessing the benefits and harms of intermittent iron supplementation regimens in pregnant women on haematological and pregnancy outcomes. The findings suggest that intermittent iron+folic acid regimens produce similar maternal and infant outcomes at birth as daily supplementation but are associated with fewer side effects. Women receiving daily supplements had increased risk of developing high levels of Hb in mid and late pregnancy but were less likely to present mild anaemia near term. Although the evidence is limited and the quality of the trials was low or very low, intermittent may be a feasible alternative to daily iron supplementation among those pregnant women who are not anaemic and have adequate antenatal care.
We included four completed studies conducted amongst adults (n = 197). Two were published as abstracts, and two as full articles. Interventions included supervised physical activity, low calorie diet and anti-obesity drugs (singly or in combination), and were compared to usual care (two studies), low calorie diet (one study), while one study had three intervention arms (physical activity versus low calorie diet versus a combination of the two). Two studies were conducted in high-income countries, while two were conducted in upper, middle-income countries.
All studies had an unclear risk of selection and a high risk of detection bias. One of the studies found a statistically significant reduction in symptoms scores in treatment compared to control groups: the difference between groups in total St. George's Respiratory Questionnaire (SGRQ) score was −10 units (95% CI -18 to−1; P = 0.02). One study showed reduction in doses of rescue medication in treatment compared with control groups in the short term. Weight loss was associated with some improvement in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) in one study, which was statistically significant, but clinically unimportant; there was no improvement in peak expiratory flow rate (PEFR). No data were reported on health care utilization and adverse effects. One study reported statistically significant weight loss in the treatment group compared to controls with no intervention, which was still significant at one year follow-up.
The authors concluded that overweight and obese adults with asthma experience a high symptomatic remission rate and significant improvements in asthma control, including objective measures of disease activity, after weight loss. Although these positive effects of weight loss on asthma-related health outcomes seem not to be accompanied by remission or improvements in markers of eosinophilic airway inflammation, it has potentially important implications for the future burden of asthma.
The best evidence available points towards a putative protective role of ACE inhibitors but not ARBs in risk of pneumonia. Patient populations that may benefit most are those with previous stroke and Asian patients. ACE inhibitors were also associated with a decrease in pneumonia related mortality, but the data lacked strength.
Welcome to Facts about Flu – Our week-long series of articles about influenza.Ever wonder why the flu, coughs and colds that you suffered from in your youth have become a monster killer that rolls out…...
Christmas is just around the corner and it is that time of the year when people are busy with celebrations, holidays and preparation for the perfect Christmas. Unfortunately, along with the festive season come some particular asthma triggers.
During this season if you forget about your daily routine, your preventer medication and don’t follow your asthma action plan, those Christmas triggers could really spoil your celebrations, so here’s a few tips to help you enjoy every moment.
Since 2002, Botox, the trade name for botulinum toxin, has been most commonly associated with cosmetic procedures used to reduce facial wrinkles by blocking messages from nerves to muscles, stopping the muscles from contracting. We do know that Botox has other medical applications too. It’s current and potential uses include the treatment of chronic migraines, eye conditions, movement disorders, excessive sweating as well as many others. It is an area in which there is a lot of research being conducted.
This review shows that tiotropium treatment was associated with a significant improvement in patients' quality of life and it reduced the risk of exacerbations, with a number needed to treat to benefit (NNTB) of 16 to prevent one exacerbation. Tiotropium also reduced exacerbations leading to hospitalisation but no significant difference was found for hospitalisation of any cause or mortality. Thus, tiotropium appears to be a reasonable choice for the management of patients with stable COPD, as proposed in guidelines. The review however, shows that tiotropium delivered via the Respimat soft mist inhaler was associated with a significantly increased risk of mortality compared with placebo, which calls for caution with this device whilst awaiting the results of an ongoing head-to-head trial comparing tiotropium delivery devices and doses.
Patients and clinicians should balance the potential benefits of inhaled steroids in COPD (reduced rate of exacerbations, reduced rate of decline in quality of life and possibly reduced rate of decline in FEV1) against the potential side effects (oropharyngeal candidiasis and hoarseness, and risk of pneumonia).
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