Adolescents with asthma: Consequences of transition from paediatric to adult healthcare

Bergström, Sten-Erik; Sundell, Kerstin; Hedlin, Gunilla

doi:10.1016/j.rmed.2009.09.021

Cited by 29 publications

(50 citation statements)

References 73 publications

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“…In the test for bronchial hyperresponsiveness, the medianPD 20 value for histamine chloride was 440 µg. Fifty‐eight per cent of the subjects demonstrated a high working capacity compared with 20% at the time of the 5‐year follow‐up (8). Participating in regular physical activity decreased from 57% at the time of entry into the study (Table 1) to 28% at follow‐up.…”

Section: Resultsmentioning

confidence: 97%

Quality of life in adolescents with asthma, during the transition period from child to adult

Sundell¹,

Bergström²,

Hedlin³

et al. 2010

The Clinical Respiratory Journal

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Aim: The present investigation was designed to evaluate the health-related quality of life (HRQOL) of adolescents with asthma between the age of 16 and 21, when they are transferred from paediatric to adult care. Methods: In this prospective study, 156 teenagers (69 females) with asthma were screened employing spirometry, a histamine challenge, skin prick test for allergy and filled out the 'Living with Asthma Questionnaire' both at the time of entry into the study and after 2 and 5 years of follow-up. An exercise test and questions concerning regular performed exercise were carried out at baseline and 5 years later. Results: At all three time-points, the HRQOL of the men was generally better than that of the women. At the same time, the HRQOL of both genders was significantly better, both in terms of the overall scores (P < 0.001) as well as the scores for most of the individual domains, in connection with the 5-year follow-up. The young women who exercised regularly at the time of their entry exhibited better HRQOL at this time than those who did not (P < 0.001), whereas regular exercise had no impact on the HRQOL of the young men. The women with severe asthma demonstrated a poorer HRQOL than those suffering from mild-to-moderate asthma. Conclusion:The HRQOL of adolescents with asthma improves with age. The pronounced positive correlation between regular exercise and HRQOL in female adolescents with asthma revealed here deserves special attention in the care of young women and deserves further exploration.Please cite this paper as: Sundell K, Bergström S-E, Hedlin G, Ygge B-M and Tunsäter A. Quality of life in adolescents with asthma, during the transition period from child to adult. Clin Respir J 2011; 5: 195-202.

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Section: Resultsmentioning

confidence: 97%

Quality of life in adolescents with asthma, during the transition period from child to adult

Sundell¹,

Bergström²,

Hedlin³

et al. 2010

The Clinical Respiratory Journal

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“…Adolescence is associated with increased asthma and asthma severity among females [43]. Furthermore, psychosocial factors become increasingly important associations of severe disease [44][45][46].…”

Section: Problematic Severe Asthma: Phenotypes and Agementioning

confidence: 99%

Problematic severe asthma in children, not one problem but many: a GA2LEN initiative

Hedlin

Bush²,

Carlsen³

et al. 2010

European Respiratory Journal

146

130

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Although most children with asthma are easy to treat with low doses of safe medications, many remain symptomatic despite every therapeutic effort. The nomenclature regarding this group is confusing, and studies are difficult to compare due to the proliferation of terms describing poorly defined clinical entities.In this review of severe asthma in children, the term problematic severe asthma is used to describe children with any combination of chronic symptoms, acute severe exacerbations and persistent airflow limitation despite the prescription of multiple therapies.The approach to problematic severe asthma may vary with the age of the child, but, in general, three steps need to be taken in order to separate difficult-to-treat from severe therapy-resistant asthma. First, confirmation that the problem is really due to asthma requires a complete diagnostic re-evaluation. Secondly, the paediatrician needs to systematically exclude comorbidity, as well as personal or family psychosocial disorders. The third step is to re-evaluate medication adherence, inhaler technique and the child's environment.There is a clear need for a common international approach, since there is currently no uniform agreement regarding how best to approach children with problematic severe asthma. An essential first step is proper attention to basic care.

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“…It occurs in people of all ages, but is particularly prevalent in children and young adults (Barnes 2001;Bergstrom et al 2010;Sundell et al 2011). The primary clinical features of asthma include airway inflammation, AHR, and airway remodeling.…”

Section: Pathogenesis and Pathophysiology Of Asthmamentioning

confidence: 99%

Revisiting the usefulness of thromboxane-A₂modulation in the treatment of bronchoconstriction in asthma

Hernandez

Janssen

2015

Can. J. Physiol. Pharmacol.

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Airway smooth muscle (ASM) is the effector cell in the bronchoconstrictory pathway. It is believed that the bronchoconstriction present in asthma is associated with changes in the airway milieu that affect ASM excitation-contraction coupling and Ca(2+)-handling. Asthmatics also react differently to ventilatory mechanical strain. Deep inspiration (DI), which produces bronchodilation in healthy individuals, is less effective in asthmatics, and even enhances bronchoconstriction in moderate to severely affected patients. Our laboratory has previously studied the mechanotransductory pathway of airway stretch-activated contractions (Rstretch) leading to DI-induced bronchoconstriction. We demonstrated the ability of agonists acting through thromboxane A2 (TxA2) receptors to amplify airway Rstretch responses. Despite the involvement of excitatory prostanoids in bronchoconstriction, clinical trials on treatments targeting TxA2-synthase inhibition and TP-receptor antagonism have produced mixed results. Studies in Western populations produced mostly negative results, whereas studies performed in Asian populations showed mostly positive outcomes. In this review, we discuss the role of TxA2-synthase inhibition and TP-receptor antagonism in the treatment of asthmatics. We present information regarding variations in study designs and the possible role of TP-receptor gene polymorphisms in previous study outcome discrepancies. Perhaps future studies should focus on asthmatic patients with DI-induced bronchoconstriction in particular, planting the seed for the individualized treatments for asthmatics.

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Adolescents with asthma: Consequences of transition from paediatric to adult healthcare

Cited by 29 publications

References 73 publications

Quality of life in adolescents with asthma, during the transition period from child to adult

Quality of life in adolescents with asthma, during the transition period from child to adult

Problematic severe asthma in children, not one problem but many: a GA2LEN initiative

Revisiting the usefulness of thromboxane-A₂modulation in the treatment of bronchoconstriction in asthma

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Adolescents with asthma: Consequences of transition from paediatric to adult healthcare

Cited by 29 publications

References 73 publications

Quality of life in adolescents with asthma, during the transition period from child to adult

Quality of life in adolescents with asthma, during the transition period from child to adult

Problematic severe asthma in children, not one problem but many: a GA2LEN initiative

Revisiting the usefulness of thromboxane-A2modulation in the treatment of bronchoconstriction in asthma

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Product

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Revisiting the usefulness of thromboxane-A₂modulation in the treatment of bronchoconstriction in asthma