Park, Kyung-Soon;Park, Min-Ho;Kim, Kyoung-Oak;Park, Se-Jin;Kim, Seong-Sik;Lee, In-Kwang;Lee, Hye-Ran;Kim, Kyung-Ah;Cha, Eun-Jong
The Journal of the Korea Contents Association
/
v.12
no.1
/
pp.369-378
/
2012
Asthma requires continuous long-term management with at least 5% outcome of general population as well as being the second cause of death and disability after cancer. The present study developed an efficient self management system based on the commercial mobile phone network. The spirometric test results are input to the mobile phone through the communication line connected to the portable spirometer. The doctor or the care-giver can search, identify, and review the data accumulated daily by the patient, and feedback to the patient necessary recommendations by short message and color mail services. Patient can also send an emergency call to the doctor and/or the care-giver. User interface was designed as convenient as possible for maximum efficiency of these operations. The present system provides a desired remote medical services, thus would enhance health management of chronic diseased patients.
Purposes: The objective of this study was to develop a management program for Korean elementary school students suffering from asthma, which would be based on the Australian Asthma-Friendly Schools (AFS) program. Methods: On the basis of the AFS program, we designed a 6-month pilot project for asthmatic students in two elementary schools in a rural area and one elementary school in an urban area of Korea. The pilot project consisted of the following processes: identifying students with asthma in a school, educating school staffs and the parents of an asthmatic child, registering those with asthma, and installing emergency kits for asthma attacks in school health rooms. In order to evaluate these processes, group discussions were held between project team members and school staffs in each area. In addition, we conducted a postal survey of 144 households having an asthmatic child. Results: The screening process adopted in this program resulted in the early diagnosis in asthma; however, it needs to be evaluated economically due to expensive diagnostic test for asthma. For the school nurses, asthma lessons were evaluated as being very helpful for their tasks, while teachers tended to take less interest in the program with only 45% of all teachers attending these lessons. Almost all participating parents reported that such lessons would be beneficial for the care of their child, even though only 24.2% of the survey respondents (122 households) attended the lessons. Installing emergency kits in school health rooms was regarded as a key feature of this project. The introduction of a register card containing more specific health records of asthmatic students was considered necessary to replace the existing list of students with asthma. Conclusion: This study has merit in that a Korean asthma-friendly schools program was developed for the first time, despite the many obstacles to such programs becoming more common.
In addition to classic cholinergic and adrenergic pathways, the existence of a third division of autonomic control in the human airways has been proved. It is called a nonadrenergic noncholinergic(NANC) nervous system, and difficult to study in the absence of specific blockers. Neuropeptides are certainly suggested to be transmitters of this NANC nervous system. It is very frustrating to understand the pathophysiologic role of these peptides in the absence of any specific antagonists. However, further studies of neuropeptides might eventually lead to novel forms of treatment for bronchial asthma. Another study of the interaction between different components of the autonomic nervous system, either in ganglionic neurotransmission or by presynaptic modulation of neurotransmitters at the end-organ will elute neural control in airway disease, particularly in asthma. Studies of how autonomic control may be disordered in airway disease should lead to improvements in clinical management. Epithelial damage due to airway inflammation in asthma may induce bronchial hyperresponsiveness. Axon reflex mechanism is one of possible mechanisms in bronchial hyperresponsiveness. Epithelial damage may expose sensory nerve terminals and C-fiber nrve endings are stimulated by inflammatory mediators. Bi-directional communication between the nerves and mast cells may have important roles in allergic process. The psychological factors and conditioning of allergic reactions is suggested that mast cell activation might be partly regulated by the central nervous system via the peripheral nerves. Studies in animal models, in huamn airways in vitro and in patients with airway disease will uncover the interaction between allergic disease processes and psychologic factors or neural mechainsms.
The coronavirus pandemic, known as coronavirus disease 2019 (COVID-19), is an infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus first identified in patients from Wuhan, China. Since December 2019, SARS-CoV-2 has spread swiftly around the world, infected more than 25 million people, and caused more than 800,000 deaths in 188 countries. Chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD) appear to be risk factors for COVID-19, however, their prevalence remains controversial. In fact, studies in China reported lower rates of chronic respiratory conditions in patients with COVID-19 than in the general population, while the trend is reversed in the United States and Europe. Although the underlying molecular mechanisms of a possible interaction between COVID-19 and chronic respiratory diseases remain unknown, some observations can help to elucidate them. Indeed, physiological changes, immune response, or medications used against SARS-CoV-2 may have a greater impact on patients with chronic respiratory conditions already debilitated by chronic inflammation, dyspnea, and the use of immunosuppressant drugs like corticosteroids. In this review, we discuss importance and the impact of COVID-19 on asthma and COPD patients, the possible available treatments, and patient management during the pandemic.
Purpose: The purpose of this study was to investigate factors affecting childhood asthma and atopic dermatitis. Methods: For this study, data for 1,170 children (1-11 years) from the Fifth Korean National Health and Nutrition Examination Survey (KNHANES V-2, 2011) were analyzed. First correlation matrices were computed to test the normality of every data set and then to be in accordance with the real demographic composition, data were added weight before being analyzed. Results: The child with asthma of a three generation family (OR=3.91, 95% CI [1.33, 11.45], p=.013) compared with a two generation family showed higher asthma development, and maternal asthma (OR=9.71, 95% CI [2.66, 35.40], p=.001) showed higher asthma development in child. The only factor affecting atopic dermatitis was parental perceptions of child health: poor (OR=3.40, 95% CI [1.29, 8.98], p=.014). Conclusion: These results suggest that childhood asthma and atopic dermatitis are both affected by parental perceptions of child health. Accordingly, management and support programs for children who have asthma and/or atopic dermatitis and their families should be comprehensive and also give attention to any other health problems because health perception represents quality of life.
Background : Asthma is the most common respiratory crisis encountered in clinical practice, occurring in up to 4% of all pregnancies. Pregnancy often appears to alter the course of asthma. But the mechanisms responsible for variable changes in the asthma course during pregnancy remain unknown. Poor control and exacerbations of asthma during pregnancy may result in serious maternal and fetal complications. To investigate the course of asthma during pregnancy in korean women, we did a retrograde study of 27 pregnant women who had been admitted to Korea University Hospital for asthma worsened. Method: Twenty seven pregnant women who had been visited to Korea University Hospital for asthma worsened were enrolled in our retrospective study. We reviewed medical recordings and interviewed patients with asthma. Results: Twenty seven pregnant women with asthma were evaluated, and 25 patients were enrolled to our study. Two patients experienced abortions at 6 weeks and 25 weeks gestation, respectively. The period of asthma worsened was commonly during weeks 20 to 28 of gestation. And all patients wosened were improved during the last 4 weeks of pregnancy. Twenty(80%) of 25 women whose asthma worsened during pregnancy reverted toward their prepregnancy status after delivery(p<0.002). The causes of asthma worsened during pregnancy are reduction or even complete cessaton of medication due to fears about its safety(40%), worsening after upper respiratory infection (28%), and unknown(32%). There were no adverse perinatal outcomes in 25 pregnant asthma subjects. Conclusions: A major problem of therapy for asthma during pregnancy is reduction or even complete cessation of medication due to fears of fetal effects. Therefore, maternal education and optimal clinical and pharmacologic management is necessary to mitigate maternal and fetal complications.
Purpose : Cysteinyl leukotrienes are important inflammatory mediators in the pathogenesis of asthma; therefore interruption of cysteinyl leukotrienes by leukotriene receptor antagonists improves clinical symptoms in the management of patients with mild to moderate asthma. We evaluated whether clinical response to montelukast, a leukotriene receptor antagonist, in childhood asthma was predicted by genotypes of leukotriene $C_4$ synthase($LTC_4S$) promoter gene polymorphism. Methods : An 8-week prospective, open trial of montelukast was carried out in 161 children with mild to moderate asthma. Genotyping of $LTC_4S$ gene polymorphism was determined by restriction fragment length polymorphism. Results : The distribution of the $LTC_4S$ genotypes AA, AC, and CC was 70.8 percent, 23.6 percent, and 5.6 percent, respectively in asthma group and 74.0 percent, 22.6 percent, and 3.4 percent, respectively in control group. A statistically significant difference in the distribution of $LTC_4S$ genotype was not observed between the asthma and the control groups, and there was no significant difference between the $LTC_4S$ genotype and asthma severity. The responders to montelukast were significantly prevalent in the mild asthma group(P<0.05). There was no significant difference in the distribution of the responders compared to non-responders within genotype in the total asthma group or the moderate asthma group. However, the responsiveness for montelukast was significant difference within genotype for both AA and AC/CC in the mild asthma group : The AA genotype was more included in the responder group(P<0.05). Conclusion : In the mild persistent asthma group, the A allele of $LTC_4S$ polymorphism may be regarded as a predictable factor for clinical response to montelukast. However, LTC4S polymorphism was not significantly associated with the clinical response to montelukast in asthmatic children.
Kim, Su-Jin;Kim, Sung-Mok;Choi, Byung-Chul;Sohn, Uy-Dong
YAKHAK HOEJI
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v.54
no.6
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pp.507-521
/
2010
Training for asthma patients by professionals has been highly emphasized for patients' self-management. In the present study, three standardized training sessions targeting hospital pharmacists were performed. On the basis of the number of training sessions taken, a non-educated group (CG), an once-educated group (NG), and a twice more-educated group (IG) were allocated. The most frequent errors of using an inhalant were shaking before the use in MDI while taking breathe out before inhaling in the case of DPI, and the total average number of errors were the biggest for CG and the smallest in IG. On comparison in the number of the four symptoms of asthma according to the level of seriousness, it was revealed that the total average number was the biggest in CG and the smallest in IG. In the level of awareness regarding the contents of training for patients, patients over 50 tended to answer that they were aware of education contents, and particularly in mouth rinsing and the use before/after a meal, significant similarity was examined. Regular asthma patient training performed by hospital pharmacists appeared to reduce errors in the inhaler usage, increase the quality of life of an patient, and help a patient remember the contents of the training. Especially among patients over 50, it was found to be more effective and retraining of more than two sessions was requisite.
Purpose of this study was to develop a self-care program for patients with asthma and test its effects on self-efficacy, compliance, Quality of Life. One group pretest and posttest design was used to test the effects of the intervention. Sixteen asthma patients were recruited conveniently from C university hospital. Date were collected from February 1st to Spring 30th, 2011. Self-care program was composed asthma related education and demonstration of usage of MID & PEFR. The data were analyzed using Wilcoxon signed Rank test by SPSS 18.0. There was a significant increased in self-efficacy(Z=-3.26, p=.001), compliance(Z=-3.52, p<.001), QOL(Z=-3.41, p=.001). Based on data, we recommened the refinement of the intervention in the following areas for future studies: duration, research design, sample size.
Bronchial asthma is one of the most common chronic diseases globally and currently affects approximately 300 million people worldwide. As per scientific data, approximately 10-12% of adults; and 15% of children are affected by the disease. The increasing global prevalence of the disease imposes a high health care costs into its mechanisms and treatment. Unani system of medicine (USM) is a well known traditional therapy for number of diseases since ancient times. Time has proved that USM has a special role in treatment of chronic diseases, due its special Usooleillaj (Line of treatment). Dhiq al-Nafas (bronchial asthma) is also considered as a chronic disease. Since ancient times, the disease was cured by number of single as well as compound formulations by renowned Unani scholars. This review provides a comprehensive summary of medicinal plant throughout the world, with reference to renowned Unani scholars and physicians for treatment of Dhiq al-Nafas. A number of Unani single and compound drugs, highly efficacious and safe drugs are available for the asthma. The data were taken from classical literature of USM, Modern reference books & electronic journals. The recent information was collected from different authentic search engines. This review will provide the centuries therapeutic information's of classical literature and recent scientific studies of 12 herbal drugs mentioned in USM, which will help the academia, clinicians, research scholars and post graduate students from Unani Medicine, Traditional & Complementary Medicine and other related disciplines, having research interest or work in the Unani medicine.
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