Pulmonology

Putting the Brakes on Asthma Airway Inflammation in Children

Asthma is the most common chronic disease of childhood and its prevalence has substantially increased worldwide, particularly in pre-school children. Chronic inflammation and smooth muscle dysfunction are consistent features of asthma pathophysiology, responsible for disease progression and airway remodelling. Montelukast, a cysteinyl leukotriene 1 receptor antagonist, is indicated as an alternative treatment in paediatric asthma management and to relieve symptoms of seasonal allergies.

Modern Medicine – Issue 1 2022

As-needed Combined Asthma Treatment Yields Better Symptom Control

The Global Initiative for Asthma (GINA) recommends as-needed inhaled corticosteroid (ICS)-formoterol as an alternative to maintenance ICS plus short-acting β2-agonist (SABA) reliever at step 2 of its stepwise treatment algorithm. As-needed ICS-formoterol may be the preferred option when prevention of severe exacerbation is the primary aim of treatment.

Modern Medicine – Issue 6 2021

SABA Alone no Longer Recommended for Asthma Management

The Global Initiative for Asthma (GINA) critically revises evidence on asthma management yearly and provides a structured set of recommendations. The 2020 GINA Report maintains a major change in the management recommendations, which were introduced in 2019, in relation to pharmacological treatment. GINA no longer recommends treatment of asthma in adults and adolescents with short-acting beta-2 agonists alone.

Modern Medicine – Issue 5 2021

Manifesto on United Airways Diseases (UAD) An Interasma (Global Asthma Association) Document

The large amount of evidence and the renewed interest in upper and lower airways involvement in infectious and inflammatory diseases has led Interasma (Global Asthma Association) to take a position on United Airways Diseases (UAD). Patients with UAD need to have a timely and adequate diagnosis, treatment, and, when recommended, referral for management in a specialised centre. Diagnostic testing including skin prick or serum specific IgE, lung function, fractional exhaled nitric oxide (FeNO), polysomnography, allergen-specific immunotherapies, biological therapies and home based continuous positive airway pressure whenever these are recommended, should be part of the management plan for UAD. This is a shortened version of the original article.

Modern Medicine – Issue 5 2021

Nebulised ICS Targets Respiratory Disease in Kids

Acute asthma attack is a frequent condition in children. It is one of the most common reasons for emergency department visits and hospitalisation. It can be triggered by viral infections, atypical bacteria (ie, Mycoplasma pneumoniae) infections, allergens and/or air pollutants, including tobacco smoke, medications, physical exercise, and stress and emotions. Despite advances in therapy, asthma remains a disease that is not optimally controlled in many children.

Modern Medicine – Issue 2 2021

Pulmonary Hypertension A rare but important cause of dyspnoea

Pulmonary hypertension can be a devastating disease that is easily missed in the early stages because of its typically nonspecific presentation with gradually increasing dyspnoea, and may coexist with other sources of dyspnoea. With advances in management, most forms of pulmonary hypertension are treatable with medication. Early diagnosis and treatment are key to improving functional and haemodynamic outcomes and survival.

Modern Medicine – Issue 5 2020

Continuous Airways: Allergic and Nonallergic Associations Between the Nose and Lungs

Rhinitis is a common chronic illness with a lifetime annual incidence of
at least seven per 1000 people. Over 80% of patients with asthma
have rhinitis and 10 to 40% of patients with rhinitis have asthma.
Both allergic and nonallergic rhinitis are independent risk factors for the
development of asthma. Treatment of rhinitis can influence asthma
outcomes. Aspirin-exacerbated respiratory disease occurs in more
than 14% of patients with severe asthma.

Modern Medicine – July 2017