No abstract available.
Asthma, Exercise-Induced*

No abstract available.
Asthma* ; Asthma, Exercise-Induced ; Bronchoconstriction* ; Child* ; Humans

No abstract available.
Asthma, Exercise-Induced* ; Child* ; Humans ; Incidence*

BACKGROUND: Exercise is a very common precipitant of asthma. Broncho-constriction associated with exercise can occur in 75~90% of individuals with asthma. The estimated prevalence ( 30~85% ) of gastroesophageal reflux ( GER ) in patients with asthma is significantly higher than in general population. We performed pH monitoring during the exercise in order to evalute whetherexercise induced asthma EIA ( 6 men, 12 women ) were studied. Monitoring of intraesophageal pH, ECG and spirometry was done for 1 hour before treadmill exercise. After baseline monitoring, subjects underwent symptom-limited treadmill exercise with Bruce protocol and continuous monitoring for 60 min after exercise. Spirometry was done at baseline prior to exercise, and repeated every 10 min after full exercise for 60 min. RESULTS: Exercise-induced bronchoconstriction was noted in 15 patients, who performed MBPT and 12 patients confirmed for bronchial asthma and 3 patients were diagnosed exercise-induced astham. Five 15 EIA patients demonstrated a pathologic degree of GER. CONCLUSION: We suggest that GER may be one of pathophysiologic factors of ELA and evoke further concentration on the GER in the EIA patients.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Electrocardiography ; Female ; Gastroesophageal Reflux* ; Humans ; Hydrogen-Ion Concentration ; Male ; Prevalence ; Spirometry

BACKGROUND: Patients with bronchial asthma frequently have exercise-induced bronchocon striction. Exercise-induced bronchoconstriction limits the activities important for physical and social development in children. Leukotriene receptor antagonist has been shown to protect against exercise-induced bronchoconstriction. The purpose of this study is to determine the effect of montelukast in protecting or controlling exercise-induced asthma. METHOD: 22 patients were enrolled and received montelukast(5 mg/day) for 2 months. Exercise challenges were performed before and after treatment and medication was not given for at least 48 hours before follow-up test. The form of exercise was free running for 8 minutes. The respiratory symptom scores, maximum percent fall in FEV1 from pre-exercise baseline and time to recovery of FEV1 to within 10% of pre-exercise baseline were evaluated. RESULTS: The respiratory symptoms score was siginificantly improved after 2 months of therapy(p<0.05). The maximum percent fall in FEV1 after exercise and the time from maximum percent fall in FEV1 to return to within 10 precent of pre-exercise FEV1 were also siginificantly improved after 2 months of therapy(p<0.05). In 3 patients with exercise-induced asthma, the maximum percent fall in FEV1 was decreased after 2 months of therapy, but was increased after follow-up 2 months without therapy. CONCLUSION: Montelukast, a leukotriene-receptor antagonist, is effective for protection and control of exercise-induced asthma in children.
Asthma ; Asthma, Exercise-Induced* ; Bronchoconstriction ; Child ; Follow-Up Studies ; Humans ; Receptors, Leukotriene ; Running ; Social Change

PURPOSE: Airway dehydration and subsequent hyperosmolarity of periciliary fluid are considered critical events in exercise-induced bronchoconstriction. The aim of this study was to establish if a hyperosmolar challenge could induce activation of eosinophils. METHODS: Human eosinophilic leukaemic cell lines, EoL-1 cells were incubated with hyperosmolar solutions for 15 minutes. Activation of EoL-1 cells was monitored by degranulation and superoxide anion production. In addition, we examined surface expression of CD69 and ICAM-1. RESULTS: Hyperosmolar stimuli didn't induce superoxide anion production and degranulation. In addition, EoL-1 cells cultured with hyperosmolar medium at 930 mOsm/kg H2O resulted in no significant increment in fluorescent intensity of CD69 and ICAM-1 expression compared with results for cells incubated with isomolar medium. CONCLUSION: We found that hyperosmolar stimuli don't cause activation of EoL-1 cells, but further studies are required to determine the role of eosinophil in the mechanism of exercise-induced asthma.
Asthma, Exercise-Induced ; Bronchoconstriction ; Cell Line ; Dehydration ; Eosinophils* ; Humans* ; Intercellular Adhesion Molecule-1 ; Superoxides

PURPOSE: Exercise-induced bronchoconstriction (EIB) is common in “high ventilation” athletes, and the Eucapnic Voluntary Hyperpnea (EVH) airway provocation test is the standard EIB screen. Although the EVH test is widely used, the in-test performance in high ventilation athletes as well as the reproducibility of that performance has not been determined. Reproducibility of pre- and post-test spirometry and self-reported atopy/cough was also examined. METHODS: High ventilation athletes (competitive swimmers; n=11, 5 males) completed an atopy/cough questionnaire and EVH testing (operator controlled FiCO₂) on 2 consecutive days. RESULTS: Swimmers achieved 85%±9% and 87%±9% of target FEV1 volume on days 1 and 2, respectively, (P=0.45; ICC 0.57 [0.00-0.86]) resulting in a total ventilation of 687 vs 684 L [P=0.89, ICC 0.89 (0.65-0.97]) equating to 83%±8% and 84%±9% of predicted total volume (ICC 0.54 [0.00-0.85]) between days 1 and 2. FiCO₂ required to maintain eucapnic conditions was 2.5%. Pre-test FEV1 was less on day 2 (P=0.04; ICC >0.90). Day 1 to 2 post-test FEV1 was not different, and 4 swimmers were EIB positive (>10% fall in pre-post FEV1) on day 1 (3 on day 2). CONCLUSIONS: EVH in-test performance is reproducible however required less FiCO₂ than standard protocol and the swimmers under-ventilated by 125 and 139 L/min for days 1 and 2, respectively. How this affects EIB diagnosis remains to be determined; however, our results indicate a post-test FEV1 fall of ≥20% may be recommended as the most consistent diagnostic criterion.
Asthma, Exercise-Induced ; Athletes* ; Bronchoconstriction ; Cough ; Diagnosis ; Humans ; Respiratory Hypersensitivity ; Spirometry ; Swimming ; Ventilation*

BACKGROUND: The purpose of the present study was to determine the protective effect of antiasthmatic activity of inhaled heparin, cromolyn sodium, budesonide, furosemide in exercise-induced asthma(EIA). The other important considerable point of this study was the mechanism of bronchoconstriction on EIA. METHOD: Eight subjects with a history of EIA were studied on 5 different experiment days. After obtaining baseline FEV(1) and FVC, subjects performed a standardized exercise challenge. EIA was assessed by measurement of FEV(1) before and after exercise. On experiment day 4, the exercise challengs was performed after the subjects inhaled either heparin (1,000 units/kg/day for 5 days), furosemide (1 mg/kg for 5 days), cromolyn(4 mg/kg for 5 days), or budesonide (400 micrograms/day for 5 days). On experiment day 5, the methacholine brochial provocation test was performed. On experiment day 3, activated partial thromboplastine time(aPTT) was checked. RESULTS: Maximum decrements of FEV(1)(mean+/-SE) among o to 120 minutes after exerise were as follows : heparin was 83.1+/-4.81% (p=0.010), furosemide was 80.5+/-6.87% (p=0.071), cromolyn was 86.8+/-6.53% (p=0.340), and budesonide was 79.4+/-7.31% (p=0.095). Above medications were copmpared to the control value (72.5+/-18.2%) by paired t-test. No medications had effect on PD of methacholine bronchial provocation test. The results were control (1.58+/-0.49 mumol), heparin(4.17+/-1.96 mumol), forosemide (1.85+/-0.86 mumol), cromolyn (2.19+/-0.89 mumol) and budesonide (3.38+/-1.77 mumol), respectively(p>0.05). The inhaled heparin had no effect of anticoagulation. CONCLUSION: These data demonstrate that inhaled heparin has a protective effect on EIA. The effect of inhaled cromolyn was statisitically absent with manufacture's recommended dosage on EIA. So, the dosage of cromolyn should be carefully evaluated in future. Although inhalation of budesonide and furosemide have no statistical significance compared to control, these drugs also have some protective effects on EIA.
Asthma, Exercise-Induced* ; Bronchial Provocation Tests ; Bronchoconstriction ; Budesonide* ; Cromolyn Sodium* ; Furosemide* ; Heparin* ; Inhalation ; Methacholine Chloride ; Thromboplastin

In response to the increasing amount of drug information, the teaching strategy of Pharmacotherapeutics was changed from Teacher-based Classroom Lecture to Small Group Discussion ( SGD ) revolving around ten to twelve of the most prevalent diseases in the country.

OBJECTIVES: To investigate the effect of small group discussion on the performance of Pharmacology students by 1) Comparing the drug choices of students during Medical Internship with those of Pharmacology teachers for five selected clinical conditions 2) Describing the attitudes of Medical Students while in Medical Clerkship towards SGD 3) Determining areas of disagreements in prescribing choices between Clinical Consultants and Pharmacologists.

METHODS: Medical Interns and their pharmacology teachers were concurrently administered the same questionnaire testing their drug choices for five clinical conditions. Attitudes of Medical Interns during their Clinical clerkship towards SGD was determined using their reflection papers. A survey was also conducted among interns to determine which diseases showed more frequent disagreements in prescribing between clinical consultants and pharmacologists.

RESULTS: Ninety one medical interns participated in the study. Agreement on the choice of drugs was generally low ( 23%-44% ) except for Exercise-induced Asthma (89%). Majority of 147 reflection papers by clinical clerks expressed positive attitude towards SGD as a learning tool for Pharmacotherapeutics. Medical interns also perceived that drug choices of their clinical consultants/residents agree with what they were taught in Pharmacology 70% of the time. But it was actually 43% low when they were given five clinical cases to virtually treat. It is presumed that their drug choices only reflected their actual prescribing practice while under the supervision of their Residents/ Consultants. Most disagreements were observed in the treatment of Hypertension and UTI.

CONCLUSIONS: There was poor retention of knowledge about drug choices from undergraduate Pharmacology especially for eradication of H. pylori and recurrent UTI at 23% and 28%, respectively. Forty six percent of medical interns concur that Small Group Discussion is an acceptable strategy for case -based learning. It likewise positively influenced their prescribing decisions as Medical Interns. 

Human ; Male ; Female ; Students, Medical ; Internship And Residency ; Asthma, Exercise-induced ; Perception ; Choice Behavior ; Attitude ; Hypertension

Asthma is one of the most common allergic diseases in children. As a result of the advances in immunology and the studies of BAL and lung biopsy, the definition of asthma has been changed as a 'chronic inflammatory disorder of the airways'. Therefore pharmacologic therapy of asthma is focused on the control of allergic inflammation. According to its purpose, the asthma medication could be classified into two groups, that is, quick-relief agents and long-term control agents. Quick-relief agents give a prompt relief of acute symptoms (coughing, wheezing, difficulty of breathing, and chest tightness) and prevent exercise-induced bronchospasm. Short-acting inhaled β2-agonist is at present the most effective quick-relief agent. Long-term control agents are taken daily and chronically (for a long period of time) to maintain the control of persistent asthma and to prevent exacerbations, and include inhaled corticosteroid, cromolyn sodium, and others. A stepwise approach is recommended for treating a child with asthma to attain and maintain asthma control. Medications should be carefully chosen according to the severity of asthma and age of children.
Allergy and Immunology ; Asthma* ; Asthma, Exercise-Induced ; Biopsy ; Child ; Cromolyn Sodium ; Humans ; Inflammation ; Lung ; Respiration ; Respiratory Sounds ; Respiratory Therapy ; Thorax