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Copyright of Romanian Journal of Family Medicine / Revista Română de Medicina Familiei is the property of Media DOM Express and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Asthma is a chronic inflammatory airway disease, with an increasing prevalence in children, up to 10-15%. This is a presentation of a clinical case of a 7-year-old boy which helps us understand more easily the clinical manifestations, particularly in young children, how to diagnose asthma at this age, and the case management difficulties. The presentation of hereditary factors and of the asthma trigers, the clinical manifestations and the investigations we can use and recommend to support our diagnosis help us to understand the patient with bronchial asthma and to establish the monitoring plan. The correct treatment of asthma in children leads to the disappearance of symptoms in adulthood and to the avoidance of future complications. [ABSTRACT FROM AUTHOR]

Asthma is the most common chronic noncommunicable disease, having a complex determinism. Early exposure to various environmental factors such as caesarean delivery, use of antibiotics during the neonatal period and formula fed in the first months of life are all associated with an increase in the prevalence of asthma. Also, the intestinal and lung microbiota can have an impact on the association with asthma through changes in the immunomodulatory cells, in the composition of microbiota, but also through changes in the metabolites of the intestinal microflora. The gut microbiome also impacts systemic immunity. There is also evidence which suggests that changes in gut microbiota may play a role in obesityrelated asthma. [ABSTRACT FROM AUTHOR]

Asthma is the most common chronic lung disorder and affects approximately 15-20% of the population in developed countries, whereas the rate is around 2-4% in less developed countries. The incidence rates are much higher in children, with roughly 40% of children reporting having a wheezing episode which can turn at some point into asthma. Understanding pathogenesis can help to better treat those patients. The release of these inflammatory mediators is the primary cause of the key feature of asthma – chronic airway inflammation. This in turn leads to the airway remodeling phenomenon, which is seen by the thickened airway walls and hence the narrowing of the air passages, ultimately having a profound impact on the course and chronicity of the condition. [ABSTRACT FROM AUTHOR]

Anxiety is a comorbidity among patients with chronic respiratory diseases such as asthma, COPD and COPD-asthma. Anxiety disorders in this population have a considerable influence on asthma management, because they influence the perception of symptoms, and anxiety related to treatment can influence compliance. Patient noncompliance with treatment for chronic respiratory diseases compromises the success of treatment and the patient's quality of life, while increasing medical costs. Therefore, the aim of our study was to provide patientcentered care and determine which dimension of anxiety is associated with asthma, COPD and COPD-asthma in the general population after controlling age, background and sex. In order to obtain information on the response to treatment, questionnaires on symptom control (Asthma Control Test (ACT), COPD Assessment Test (CAT)) and asses anxiety using the ASQ questionnaire. The result obtained indicates that no compliant person presented a high score of the dimensions of anxiety (somatic, behavioral and cognitive dimension.) and predominates a low overall score. The symptoms associated with anxiety have a low, medium overall score but also a high score on the first visit. The first and second age categories have a low score in both the behavioral and somatic dimensions. In the age category 3 and 4 are people with low score and medium score behavioral dimension and cognitive dimension. In conclusion we can say that through repetitive control we obtained increased treatment compliance was achieved, leading to improved lung function, symptoms control and therefore reduced anxiety in the case of patients with asthma, COPD and COPD-asthma. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic that we are still going through continues to bring challenges in the management of many chronic diseases that change their evolutionary course or is the source of pathologies for which not enough information has yet been accumulated for a common diagnostic and therapeutic denominator, in adults and especially in children. Although most children who had SARS-CoV-2 infection had mild to moderate manifestations, there were also cases with severe forms that frequently associated a chronic pathology with little or no therapeutic control. The authors present the case of a patient diagnosed with noncompliant therapeutic asthma, who after a SARS-CoV-2 infection presented spontaneous pneumothorax, a life threatening complication that required emergency surgery. [ABSTRACT FROM AUTHOR]

Asthma is an important disease both in adults and children, which frequently results in severe financial and health implications globally, afflicting in excess of 300 million people worldwide. Asthma is initially seen in childhood and manifests in conjunction with conditions such as hay fever and atopic dermatitis. Assessing functional respiratory parameters is often challenging, especially in children, where spirometry requires the full collaboration in order to correctly aquire and interpret flows and volumes. Guidelines, techniques and the interpretation of results are discussed regarding the use of spirometry in children. [ABSTRACT FROM AUTHOR]

Medications prescribed for chronic diseases such as asthma, chronic obstructive pulmonary disease (COPD) or asthma-COPD overlap (ACO) syndrome should be administered in the long term and compliance becomes a health care concern. Noncompliance adversely affects the outcome of treatment and results in the consumption of human and material resources. The aim of our study was to identify the factors that cause non-compliance with treatment in children, adolescents, and adults with asthma/COPD/ACO in Romania, the methods by which these factors can be understood and corrected, and the evaluation of symptoms. To achieve the goal, regular visits were carried out with symptom control questionnaires (Asthma Control Test (ACT), COPD Assessment Test (CAT)) and FEV1 evaluation using spirometry. The results obtained indicate low long-term compliance (12.35%) due to patients' abstinence from regular check-ups. In conclusion, we can say that the factors related to doctors have been successfully corrected, but it remains a challenge in correcting the factors related to patients and the health regime. [ABSTRACT FROM AUTHOR]

In December 2019, the WHO identified a novel coronavirus that leads to severe acute respiratory syndrome (SARSCoV- 2). COVID-19, the disease produced by the novel coronavirus, seem to less affect children and cause severe disease compared to adults, being associated with lower case-fatality rates. Asthma and cystic fibrosis (CF) are the most common chronic lung diseases that affect children and adolescents. It is not well established if there is a higher risk of poor outcomes due to infection with SARS-CoV-2. Research that demonstrated that the angiotensin-converting enzyme 2 (ACE2) receptor required for coronavirus recognition and infection may be under-expressed in airways of atopic children, led to a paradox that sets asthma as being a protective condition for COVID-19. Patients with CF manifest cytokine dysfunction and chronic inflammation enhanced by the diversity of pathogens in the airways, mechanisms that overlap with the pathophysiology of COVID-19. International data suggest that very few CF patients experienced symptoms and complications due to COVID-19 and, if the disease is milder than anticipated in CF, this could be related to some protection due to the cellular effect of CFTR mutations associated with viral processing. Taken together, asthma and cystic fibrosis, chronic diseases with significant impact on morbidity and mortality in both children and adults, may serve as a model of factors that may mitigate the impact of SARS-CoV-2 and creates opportunities for developing research. [ABSTRACT FROM AUTHOR]

Obesity represents a risk factor concerning the severity and frequency of asthma attacks. A number of obesity-related factors contribute to the increased risk and severity of asthma. The relationship between obesity and asthma derives from a complex interaction of biological, physiological and environmental factors. Some of these factors are causes for increased the severity of SARS-CoV-2 infection forms. Encouraging weight loss strategies, through a change in lifestyle, a balanced diet, as well as combating a sedentary lifestyle, is an essential stage of asthma management within the family doctor's field. Further studies are needed to further develop the strategy regarding the comorbidity of obesity – asthm – -SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Asthma is a chronic inflammatory disease of the airways, classically characterized by two pathogenic mechanisms: allergic and non-allergic. The clinical manifestations include dyspnoea, wheezing and cough, reversible upon removal of the trigger. Triggering factors, natural history and molecular biology are currently explained by mechanisms underlying the clinical management of asthma. [ABSTRACT FROM AUTHOR]

The manifestations of allergy at pediatric age are diverse, being the clinical mirror of an extended spectrum of pathologies. The incidence of childhood allergy is increasing both worldwide and in Romania. This study attempts to achieve an epidemiological profile for the child with allergy by identifying common elements in a group of 1,567 children. [ABSTRACT FROM AUTHOR]

Despite the progress made regarding the understanding of the pathophysiological mechanism of the disease and the existing therapeutic arsenal, the morbidity and mortality rates of asthma are still high. Starting from recent recommendations regarding the asthma treatment, the RespiRo Group, which brings together family physicians with a special interest in respiratory health, proposes to professional societies, patients’ associations, mass media representatives and political decision-makers to join the Asthma Right Care campaign, initiated under the auspices of the International Primary Care Respiratory Group. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Physical Therapy / Revista Romana de Kinetoterapie is the property of University of Oradea Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Asthma is a chronic inflammatory disease of the airways of the lung, whose symptoms are recurrent episodes of wheezing, breathlessness, chest tightness and coughing. Daily medication is used in persistent asthma in order to achieve control. Inhaled corticosteroids have great efficacy, because they treat the inflammatory cause of asthma; they also have a good safety profile. In a stepwise approach, long-acting beta agonist and other drugs are used along inhaled corticosteroid as controller therapy. During asthma exacerbations, short-acting beta2 agonists are the preferred therapy. The patient should know how important is to adhere to chronic use of inhaled drugs. They also should know how and when to use the controller medication and quick-relief drugs. The pharmacists should be able to provide education to the patient and to counsel the patient on proper use of inhalers. The present paper reviews actual guideline for asthma management and drugs for asthma available in Romania. [ABSTRACT FROM AUTHOR]

Allergic diseases, including allergic rhinitis/ rhinoconjuctivitis, asthma, and urticaria, are common conditions in the adult population, affecting women at the fertile age. Although, ideally, pregnant women should not receive pharmacologic treatment because of associated risks for the unborn child, sometimes quality of life impairment or risks of associated complications make medication necessary. The benefit/risk ratios associated with treatment in allergic diseases are favourable and allow the safe administration of several pharmacological classes. Oral antihistamines, predominantly loratadine and cetirizine, have a good safety profile in pregnant women. Treating asthma is extremely important because of the risks associated with the disease, and the preferred treatment is inhaled corticosteroids, and other classes of antiasthmatic drugs can also be administered. Allergen-specific immunotherapy can be continued during pregnancy safely, and some studies suggest a possible protective effect on the subsequent development of allergic diseases in the child. [ABSTRACT FROM AUTHOR]

Asthma is a chronic inflammatory airway disease, which can be triggered by a variety of environmental factors. Although profound insights have been made into the pathophysiology of bronchial asthma and it is known that the typical symptoms of asthma are caused by chronic inflammation and remodeling of the conducting airways, the exact mechanisms inducing and regulating the disease are still not fully understood. The immunoglobulin E, produced by circulating plamocytes, in germinal centers or at the level of bronchial mucosa, plays a central role in triggering the immediate and late phase allergic response. There are many evidences supporting the role of IgE in atopic and non-atopic asthma, making this immunoglobulin an important tool for diagnosis and also a target for therapeutical modulation of long-term asthma evolution. [ABSTRACT FROM AUTHOR]

Copyright of Romanian Journal of Physical Therapy / Revista Romana de Kinetoterapie is the property of University of Oradea Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Asthma is among the most important problems of medicine and is one of the most frequent chronic respiratory diseases. It is characterized by recurrent attacks of shortness of breath and wheezing, which vary from person to person. After a few years of treatment with medication, the patients with asthma have dysfunctions and disabilities. There is a real need of additional, non-drug remedies that can affect the basic clinical manifestations of the disease to improve the efficiency of treatment of such patients and reduce the drug load. The main goal of the rehabilitation treatment of asthma (allergic and non-allergic asthma, but also late onset asthma and asthma with fixed airflow limitation) is to restore the homeostatic self-regulation of the body and consists of many methods such as education, postural drainage, respiratory gymnastics, physical training, climatotherapy, speleotherapy, halotherapy, balneotherapy, and even spa treatment. [ABSTRACT FROM AUTHOR]

Objectives. The aim of this study was to determine the manner in which the level of exhaled nitric oxide (FENO) infl uences the atopic status in children with asthma. Methods. The study included 92 asthmatic children (aged 5-18 years) admitted on the Pediatric Clinic of “Grigore Alexandrescu” Emergency Clinical Hospital for Children. The atopic status was evaluated through anamnesis, clinical examination and laboratory determination of serum eosinophils and total Ig E. All children underwent measurement of FENO. Results. Children with atopic asthma had higher levels of FENO than children with nonatopic asthma. The FENO values correlate with eosinophilia and high values of immunoglobulin E. Conclusion. FENO is a useful marker for the evaluation of airway inflammation in children with atopic asthma. [ABSTRACT FROM AUTHOR]

Cystic fi brosis (CF) is the most common autosomal recessive disease in Caucasians. Lung disease is characterized by impaired mucocilliary clearance with airway obstruction and chronic pulmonary infection and infl ammation. Wheeze is a common symptom in CF, but in some cases the wheeze is due to the presence of concomitant asthma. There is no consensus on how to defi ne CF asthma, but the diagnosis is predominantly based on the patient's strong family and personal history of atopy. [ABSTRACT FROM AUTHOR]

Asthma is a primary cause of death in 0.4% of total deaths; this could be avoided with correct treatment, according to the standards. In the clinical manifestation of asthma, the respiratory infections play an important role, as a possible trigger for the development of the disease or its exacerbation. The type and number of infections occurring in the childhood could direct the immune system towards an atopic or non-atopic pattern (while the sincitial respiratory virus is a risk factor for the development of recurrent wheezing in childhood and later development of asthma, exposure to other viral infections may protect against asthma - hygiene hypothesis of asthma). Most of the exacerbations in children and adults are associated with viral infections; also, due to asthma, these patients have lower resistance to infections. Among bacterial infections, the infections with Mycoplasma or Chlamydia at early age may predict atopy and asthma. At the asthmatic patient, these infections are predictive for severe exacerbations and the persistence of these bacteria is a predictor for uncontrolled, difficult to treat asthma. On the other hand, Mycoplasma infections at non-atopic patients have a protective role against later development of atopy. Many times in the asthma history, the patient receives antibiotic treatment during exacerbations, against the lack of guideline recommendation. One new indication of antibiotic use in asthma could be for macrolides as antiinflammatory in patients with severe exacerbations or uncontrolled asthma, but further studies are required. [ABSTRACT FROM AUTHOR]

Asthma is a primary cause of death in 0.4% of total deaths; this could be avoided with correct treatment, according to the standards. In the clinical manifestation of asthma, the respiratory infections play an important role, as a possible trigger for the developpment of the disease or its exacerbation. Occuring in the childhood, the type and number of infections could direct the immune system towards an atopic or non-atopic pattern (while the sincitial respiratory virus is a risk factor for development of recurent wheezing in childhood and later development of asthma, exposure to other viral infections may protect against asthma - hygiene hypothesis of asthma). Most of the exacerbations in children and adults are associated with viral infections; also, due to asthma, these patients have lower resistance to these infections. Among bacterial infections, the infections with Mycoplasma or Chlamydia at early age may predict atopy and asthma. At the asthmatic patient, these infections are predictive for severe exacerbations and the persistence of these bacteria is a predictor for uncontrolled, difficult to treat asthma. On the other hand, Mycoplasma infections at non-atopic patients have a protective role against later development of atopy. Many times in the asthma history, the patient receives antibiotic treatment during exacerbations, against the lack of guideline recommendation. One new indication of antibiotic use in asthma could be for macrolides, as anti-inflammatory use in patients with severe exacerbations or uncontrolled asthma, but further studies are required. [ABSTRACT FROM AUTHOR]

Introduction. The effort during the training session - competitions, during the athletes daily life or nonathletic persons life, the effort of the persons with pathological bronhomotricity (asthma, BPOC) lead to significant respiratory constancy modifications. That is how a new clinical -- entity -- forms which is called bronhoconstriction induced by effort. The purpose of the assessment. Determining the tolerance, the adaptation at effort and kinetotherapeutical recovery in cases of respiratory disfunctions or bronhoconstructive conditions. Material and method. Material: a number of people divided in three groups: 1. athletes; 2. nonatheltic persons; 3. persons with pathological bronhomotricity (asthma, BPOC). Method. Prospective study on the three groups, each group is monitorised in standardized conditions and the measurements are made in three stages: before the effort, at 10 minutes after sustaining effort, and at 20 minutes after stopping. Conclusion. Effort can trigger reflex or predisposing factors, the bronhospasm. Standardized measurements of respiratory volumes and flows in children and teenagers, especially in those who practice endurance sports in special conditions, discover at an early stage emphasized bronhomotricity. The respiratory measurements, both at athletes and persons with bronhospastic conditions (asthma and BPOC) show tolerance at effort. Respiratory kinetotherapy has a tremendous recovery potential. Combined with specific drugs, respiratory kinetotherapy, leads to remarkable results regarding the tolerance at effort. [ABSTRACT FROM AUTHOR]

Background: The relationship between the upper and lower airways is well known. Allergic rhinitis is considered a risk factor in asthma development, and is also co-morbidity in asthma. Family history of asthma is known as a risk factor in asthma developing. The aim of the study was aimed to evaluate the risk of asthma in patients with allergic rhinitis using exhaled nitric oxide (FENO). Methods: 34 pts with allergic rhinitis were evaluated with Nioxmino for measuring FENO. The medical history of each patient and also the five nasal symptoms score were evaluated. Skin pick test were performed for inhaled allergens (house dust mites, pollens, cat dander, dog dander, moulds). Results: 15 pts (44.11%) were women (sex ratio f:m = 1:1.26). Mean age of the pts is 28.77 ± 10.38 years. All patients were allergic, 52.9% polysensitized more than one allergen. It was found a significant statistical correlation between family history of asthma an increased values of FENO (p = 0.001). But between polysensitized patients and monosensitized patient there was no correlation with FENO (p = 0.19), and also no correlation of FENO and rhinitis symptoms score (p = 0.08). Conclusion: Increased values of FENO could be evaluated as a risk factor for developing asthma in patients with allergic rhinitis. In allergic rhinitis severities of symptoms score was not a predictive factor in developing asthma. There was no correlation between FENO and polysensitization. [ABSTRACT FROM AUTHOR]

Background: Respiratory function exploration is difficult in children, especially in younger ages, because of the lack of cooperation for forced expiratory manoeuvres. The interrupter technique is particularly attractive in a pediatric setting as it requires only passive cooperation from the child. Objectives: Assessing the sensitivity and specificity of this method for detecting bronchodilator responsiveness in asthmatic children. Methods: The study was conducted in children with asthma, able to perform forced expiratory maneuvers. Baseline and postbronchodilator volumes and flows by spirometry and airway resistance by the interrupter technique were measured. The measurements were made at baseline and after inhaled salbutamol 400 μg . Children were divided in 2 groups according to the presence (group 1) or absence (group 2) of significant bronchodilator reversibility based on the spirometry. The correlation between Rocc and volumes and flows was then calculated in the two groups. Results: Of the 54 children 10 cases showed significant bronchial reversibility in spirometry. Baseline Rocc, but not postbronchodilator Rocc, was significantly higher in group 1 vs. group 2 (0.89 ± 0.20 kPa/L/s vs. 0.63 ± 0.18 kPa/L/s, p < 0,0001; 0.66 ± 0.21 kPa/L/s vs. 0.55 ± 0.16 kPa/L/s, p = 0,067, respectively). Rocc's changes after bronchodilator (?Rocc, expressed as percentage of change from baseline value) in the 2 groups were -19.22 ± 23.53% in group 1, and -10.31 ± 18.87% in group 2 (p = 0.06). The optimal ?Rocc cutoff value given by receiver operating characteristic curves to discriminate between children with the presence or absence of significant reversibility in FEV1 yielded 50.0% sensitivity and 86.4% specificity (cutoff value -25%, area under the curve 0.692). Conclusion: Rocc measurements allow reliable evaluation of bronchodilator responsiveness in asthmatic children and could be used as an alternative method to the spirometry when it is not feasible. [ABSTRACT FROM AUTHOR]

Adrenergic receptors have a wide distribution in the human body. There has been a progression in the discovery of their various subtypes, at least nine such receptors having been described so far. The message stimulation and translation of these receptors is extremely complex, going beyond the classical description of the second-messenger activation (cyclic adenylmonophosphate - cAMP); there is a complex chain of events which involves the participation of multiple protein isoforms/subunits (G protein, adenyl cyclase, phosphokinase, etc.) as well as their blockers. If the possible genotypic differences of β2 receptors are also taken into consideration, then it would be possible to predict the different clinical responses to therapy1. On the other hand, the condition of the patient, whether aggravated or stable, may also influence the response to treatment. Bronchial asthma and chronic obstructive pulmonary disease (COPD) offer a wide possibility of using short- or long-term-acting β-antagonists. Their administration in association with inhaled corticosteroids (ICS) enhances both their effectiveness and their safety. [ABSTRACT FROM AUTHOR]

We present the case of a male patient, 37 years old, who for two weeks had complained of right stabbing thoracic pain, cough with sero-muccous expectoration, 38°C body temperature and dyspnea at exercise. He had taken temperature-lowering drugs, but without effect. Seven years before, he had been diagnosed with bronchial asthma, for which he was treated with a combination of inhalation corticosteroids and long-term action bronchodilators for about 3 years, with good evolution. He discontinued chronic asthma therapy for 2 years, but he was recommended to take Ventolin whenever necessary; he was free of bronchial obstructive bouts for about 2 years. Chest auscultation evidenced basal crackles (rales), while chest X-ray revealed a tendency of right basal condensation at the level of the posterior segment. The diagnosis was right basal pneumonia and therapy included antibiotics, muccolithic agents, and antipyretics. Evolution was good during the treatment and for another 2 weeks, when suddenly his condition worsened and was readmitted to the hospital in a more severe state than the first time. Differential diagnosis included: pulmonary neoplasm, pulmonary tuberculosis, pulmonary abscess. Complex investigations eventually elucidated the diagnosis. [ABSTRACT FROM AUTHOR]

We present the case of a male patient, 37 years old, who for two weeks had complained of right stabbing thoracic pain, cough with sero-muccous expectoration, 38°C body temperature and dyspnea at exercise. He had taken temperature-lowering drugs, but without effect. Seven years before, he had been diagnosed with bronchial asthma, for which he was treated with a combination of inhalation corticosteroids and long-term action bronchodilators for about 3 years, with good evolution. He discontinued chronic asthma therapy for 2 years, but he was recommended to take Ventolin whenever necessary; he was free of bronchial obstructive bouts for about 2 years. Chest auscultation evidenced basal crackles (rales), while chest X-ray revealed a tendency of right basal condensation at the level of the posterior segment. The diagnosis was right basal pneumonia and therapy included antibiotics, muccolithic agents, and antipyretics. Evolution was good during the treatment and for another 2 weeks, when suddenly his condition worsened and was readmitted to the hospital in a more severe state than the first time. Differential diagnosis included: pulmonary neoplasm, pulmonary tuberculosis, pulmonary abscess. Complex investigations eventually elucidated the diagnosis. [ABSTRACT FROM AUTHOR]