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Targeting Improvements in Asthma Morbidity in Chicago: Legislative Activities

Chicago continues to be “asthma ground zero” due to its disproportionately high rates of asthma-related hospitalization and mortality. Prevalence rates for asthma for persons in Chicago are higher for whites and African Americans than the national average. However, this increased prevalence does not explain that the Chicago asthma hospitalization rate for African Americans is nearly double that of the nation as a whole. In the mid 1990s, with the help of The Otho S.A. Sprague

Considerations in Case of Airway Remodeling in Severe Asthma

Airway remodeling describes structural changes that in the asthmatic airway collectively result in thickening of the airway wall. CT imaging of the airways is being developed as a technique to study airway remodeling in vivo. Multiple studies, have documented increased airway WT in asthma using CT. Most of these studies employed manual tracing methods, using either manual or digital measurement of airway dimensions. These previous studies using manual tracing methods have demonstrated significant differences in

Outcomes of Airway Remodeling in Severe Asthma

Demographics The characteristics of the subjects in our study (Table 1) demonstrated that those with severe persistent asthma, on average, were older, reported more frequent symptoms of allergies, and had elevated levels of IgE, increased airway hyperresponsiveness, and decreased baseline FEV1 percent predicted compared to patients with mild-to-moderate asthma and healthy subjects. Subjects in the biopsy subset were representative of the overall cohort (Table 1) with the exception that patients with mild-to-moderate asthma had an

Resources of Airway Remodeling in Severe Asthma

Study Design As part of the Severe Asthma Research Program (SARP) at the National Institutes of Health, a prospective cohort of subjects, following informed consent, underwent detailed testing and MDCT scanning using a standardized protocol that was developed by the SARP. MDCT scan data were analyzed and compared in a total of 123 subjects, as follows: patients with severe asthma, n = 63; patients with mild-to-moderate asthma, n = 35; healthy subjects, n = 25.

Diagnosis of Bronchial Asthma by Clinical Evaluation: Disscusion

In order to interpret our results, we used a positive methacholine inhalational challenge as the standard indicator of the underlying asthmatic condition. It was considered a standard for the following reasons: (1) all agree that the asthmatic state is characterized by increased bronchial reactivity to multiple physical, chemical, and pharmacologic stimuli, such as histamine, carbachol, methacholine, exercise, and cold, dry air; (2) it is widely accepted that bronchial hyperreactivity is present and potentially demonstrable in virtually all

Diagnosis of Bronchial Asthma by Clinical Evaluation: Results

Assessment for Bronchial Hyperreactivity On the basis of the degree of bronchial hyperreactivity measured by MIC, our patients fell into two significantly different and distinct groups (Fig 1). Twenty-two patients had normal MICs with a mean decrease in FEV! from baseline of 4 percent; this response was almost identical with that of our control group, who had a mean decrease in FEV! from baseline of 5 percent. On the other hand, 12 patients had abnormal

Diagnosis of Bronchial Asthma by Clinical Evaluation: Methods and Materials

A universally accepted definition for bronchial asthma remains an elusive goal. This difficulty has led to controversy regarding diagnostic criteria for asthma. However, one area of agreement is that the asthmatic state is characterized by increased bronchial reactivity to multiple physical, chemical, and pharmacologic stimuli. Although it is widely accepted that this bronchial hyperreactivity is present and demonstrable in virtually all asthmatic patients, the diagnosis is usually made on the basis of a history and

Genetics of Asthma: Genetics of Asthma in Hispanics

Genome-Wide Linkage Analyses The CSGA included Hispanic families, most of whom came from an area of Albuquerque (New Mexico) where 38% of Hispanics are of Mexican descent and 60% of Hispanics identify themselves as other Hispanic or Latino. The initial genome-wide linkage analysis of asthma in the CSGA included 48 Hispanics with asthma in 18 families. This analysis identified a modest evidence of linkage (p < 0.01) between two genomic regions (chromosomes 2q and 21q)

Pathogenesis of Asthma: Neurohumoral and Pharmacologic Interactions

Some recent investigations have focused on the interactions between various neurohumoral and pharmacologic mechanisms. Combined neurohumoral influences may serve to augment or inhibit smooth muscle contraction. There are several interactions between the histamine (Hi)-receptor and the autonomic nervous system. In addition to being one potential stimulant of the afferent vagal irritant receptor, a nonreflex synergism between electrical stimulation of the vagus nerve and exogenously administered histamine has been reported in dogs. Histamine may also serve