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Titolo:
Differences between asthma exacerbations and poor asthma control
Autore:
Reddel, H; Ware, S; Marks, G; Salome, C; Jenkins, C; Woolcock, A;
Indirizzi:
Royal Prince Alfred Hosp, Inst Resp Med, Camperdown, NSW 2050, Australia Royal Prince Alfred Hosp Camperdown NSW Australia 2050 SW 2050, Australia Univ Sydney, Camperdown, NSW 2050, Australia Univ Sydney Camperdown NSW Australia 2050 Camperdown, NSW 2050, Australia
Titolo Testata:
LANCET
fascicolo: 9150, volume: 353, anno: 1999,
pagine: 364 - 369
SICI:
0140-6736(19990130)353:9150<364:DBAEAP>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
ADRENERGIC-RECEPTORS; FLOW; INFECTIONS; SYMPTOMS; CHILDREN; VIRUSES; PRECIPITANTS; MECHANISMS; RESPONSES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Reddel, H Royaltraliae Alfred Hosp, Inst Resp Med, POB M77, Camperdown, NSW 2050, Aus Royal Prince Alfred Hosp POB M77 Camperdown NSW Australia 2050 s
Citazione:
H. Reddel et al., "Differences between asthma exacerbations and poor asthma control", LANCET, 353(9150), 1999, pp. 364-369

Abstract

Background Increased variation in peak expiratory flow (PEF) is characteristic of poorly controlled asthma, and measurement of diurnal variability ofPEF has been recommended for assessment of asthma severity, including during exacerbations. We aimed to test whether asthma exacerbations had the same PEF characteristics as poor asthma control. Methods Electronic PEF records from 43 patients with initially poorly controlled asthma were examined for all exacerbations that occurred after PEF reached a plateau with inhaled corticosteroid treatment. Diurnal variabilityof PEF was compared during exacerbations, run-in (poor asthma control), and the period of stable asthma before each exacerbation. Findings Diurnal variability was 21.3% during poor asthma control and improved to 53% (stable asthma) with inhaled corticosteroid treatment. 40 exacerbations occurred in 26 patients over 2-16 months; 38 (95%) of exacerbations were associated with symptoms of clinical respiratory infection. During exacerbations, consecutive PEF values fell linearly over several days then improved linearly. However, diurnal variability during exacerbations (7.7%) was not significantly higher than during stable asthma (5.4%, p = 0.1). PEFdata were consistent with impaired response to inhaled beta(2)-agonist during exacerbations but not during poorly controlled asthma. Interpretation Asthmatics remain vulnerable to exacerbations during clinical respiratory infections, even after asthma is brought under control. Calculation of diurnal variability may fail to detect important changes in lungfunction. PEF variation is strikingly different during exacerbations compared with poor asthma control, suggesting differences in beta(2)-adrenoceptor function between these conditions.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/10/20 alle ore 12:33:34