Current situation: Bronchial asthma is currently a civilization disease with a rapid increase in incidence and prevalence. The knowledge of its health, socioeconomic aspects can help us to predict, eliminate or support factors that will stabilize bronchial asthma. Subject: We have focused on the social situation of adult respondents with bronchial asthma associated with anti-asthmatic treatment. Objectives: According to the subject of research we have set partial objectives (to map out the current treatment of adult respondents with bronchial asthma, to map out the factors that cause the change of asthmatic problems from a health point of view, to map out the factors determining the change of asthmatic problems from a socio-economic point of view, to compare the importance of health and social factors within socially diverse groups of adult asthmatic patients, to identify, diagnose and monitor the use of social security for adult asthmatic patients in the Slovak Republic). Methodology: The following research methods were used - questionnaire, content analysis of documents, standardized asthma control test ACTTM. The obtained data were processed by qualitative and quantitative methods, fuzzy c-cluster analysis too. Research set: The set consisted of specifically selected 506 respondents aged 19 and over with a diagnosis of bronchial asthma in the pneumophysiologic ambulance of the Internal Clinic of the Faculty Hospital in Nitra from 1.5.2014 to 1.5.2015. Results: We have found that better socioeconomic conditions of respondent have positive impact on continuing with the treatment of bronchial asthma, with higher score in ACTTM. The stabilization of asthma getting worse by increased BMI. The cost of anti-asthmatic treatment was higher for obese respondents as well as any additional costs. We have confirmed that the socioeconomic situation of the respondent affects the healing costs of bronchial asthma. Treatment costs are positively reduced by lower age, higher education, higher income, psychical type of work. This shows in lower usage of hospitalization, sick leaves based on bronchial-asthma diagnoses. The stability of asthma is kept by older respondents by using spa treatments. It has been proven that the cost of treating bronchial asthma has increased due to several known allergens and risk factors. Because of impurities (dust, mites, moulds and feathers) there has been an increase in asthmatic complications. In addition, we experienced dyspnoea due to cold, humidity and seasonal changes in younger asthmatics who also were affected by air conditioning used mainly at work. With their knowledge and aimed elimination, asthmatic patients can achieve bronchial asthma stabilization as well as reduced treatment costs. Conclusion: Positive socioeconomic characteristics of asthma patients have a positive effect on their health status - control and stabilization of asthma.

Η ενδοθηλίνη-1 (ΕΤ-1) εμπλέκεται στην παθογένεση του βρογχικού άσθματος και της χρόνιας αποφρακτικής πνευμονοπάθειας (ΧΑΠ). Η ΕΤ-1 είναι μέλος μίας οικογενείας πεπτιδίων 21 αμινοξέων. Αρχικά σχηματίζεται ένα πεπτίδιο 208 αμινοξέων, η προ-προενδοθηλίνη. Στη συνέχεια, με τη δράση της μετατρεπτάσης της φουρίνης, σχηματίζεται ένα πεπτίδιο 38 αμινοξέων η big-ενδοθηλίνη και στη συνέχεια με τη δράση του μετατρεπτικού ενζύμου ενδοθηλίνης μετατρέπεται σε πεπτίδιο 21 αμινοξέων την ενδοθηλίνη η οποία κυκλοφορεί στο πλάσμα. Η ΕΤ-1 συνδέεται σε δύο τύπους υποδοχέων Α και Β. Οι υποδοχείς τύπου Α επικρατούν στα λεία μυϊκά κύτταρα των αγγείων και των βρόγχων. Οι υποδοχείς τύπου Β επικρατούν κυρίως στα ενδοθηλιακά κύτταρα και στα λεία μυϊκά κύτταρα των αεραγωγών. Κύριες θέσεις παραγωγής της ΕΤ-1 είναι το βρογχικό επιθήλιο, το ενδοθήλιο των πνευμονικών αρτηριών, τα ενδοθηλιακά και τα λεία μυϊκά κύτταρα των αγγείων. Οι δράσεις της ΕΤ-1 στους βρόγχους αφορούν στη συστολή των λείων μυϊκών ινών των αεραγωγών, στην αναδιαμόρφωση του τοιχώματος των βρόγχων, στην έκκριση βλέννης, στη διέγερση-απελευθέρωση άλλων μεσολαβητών φλεγμονής, σε μεταβολές στην διαπερατότητα των μικροαγγείων των αεραγωγών, στην νευρορρύθμιση και τέλος στην υπεραντιδραστικότητα των αεραγωγών. Στην παρούσα μελέτη εξετάστηκαν τα επίπεδα ΕΤ-1 ορού αρτηριακού αίματος 40 ασθματικών ασθενών στην έξαρση και στην ύφεση της νόσου. Σύμφωνα με τα αποτελέσματα της μελέτης μας, τα επίπεδα της ΕΤ-1 στην έξαρση της νόσου ήταν αυξημένα σε σχέση με αυτά στην ύφεση. Υπάρχει θετική συσχέτιση ανάμεσα στην ΕΤ-1 έξαρσης και ύφεσης ανά ασθενή. Αποδείχθηκε αρνητική συσχέτιση ανάμεσα στην ΕΤ-1 έξαρσης και SatO2 έξαρσης καθώς και στην ΕΤ-1 ύφεσης και SatO2 ύφεσης, καθώς και μεταξύ ΕΤ-1 έξαρσης, FEV1 και FVC. Δεν βρέθηκε στατιστικά σημαντική συσχέτιση μεταξύ ΕΤ-1 και καπνίσματος. Οι άντρες είχαν υψηλότερα επίπεδα ΕΤ-1 κατά την έξαρση της νόσου και κατά την ύφεση από ό,τι οι γυναίκες. Δεν υπάρχει στατιστικά σημαντική συσχέτιση ανάμεσα στην χρόνια θεραπεία με κορτικοστεροειδή και στα επίπεδα ΕΤ-1 έξαρσης. Τέλος τα επίπεδα της ΕΤ-1 ύφεσης δεν συσχετίστηκαν με την διάρκεια ούτε τη δοσολογία της θεραπείας έξαρσης με κορτικοστεροειδή. Πιθανώς, η επινόηση ανταγωνιστών υποδοχέων ΕΤ-1, εκλεκτικών ή μη, να έχει ιδιαίτερη σημασία στην θεραπεία του βρογχικού άσθματος υπό την έννοια της πρόληψης πνευμονικής υπερτάσεως σε ασθενείς με βαρύ άσθμα. / Endothelin-1 (ET-1) has been implicated in the pathogenesis of asthma and chronic obstructive pulmonary disease (COPD). ET-1 is a member of a family of peptides of 21 amino-acids. The initial stage in the synthesis of ET-1 involves the formation of a 208-amino acid peptide, named pre-proendothelin, which is processed, via the activity of furin, to the 38-amino acid prohornon, big-endothelin-1, which is secreted and circulates in plasma. Big-ET-1 is then cleaved between Trp and Val to form ET-1 via an endopeptidase called “ET converting enzyme”. ET-1 binds to two types of receptors A and B. Receptors type A are expressed on vascular smooth muscle cells of vessels and bronchuses. Receptors type B are expressed predominantly on endothelial cells and to a much lesser extend on vascular smooth muscle cells. Main places of ET- 1 production are the bronchial epithelium, the epithelium of pulmonary arteries, the vascular endothelial and smooth muscle cells. ET-1 induces airway smooth muscle cell contraction, airway wall remodeling, mucus secretion, stimulation of the release of other mediators, changes in airway microvascular permeability neuromodulation and finally airway hyperresponsiveness. In the present study, we examined ET-1 arterial blood levels of 40 asthmatic patients during the exacerbation and the remission of the disease. According to the results of our study, the ET-1 levels during the exacerbation of the disease were increased concerning them, during the remission. ET-1 levels were negatively statistically significantly correlated with SatO2 during the exacerbation and the remission of the disease as well as between ET-1 levels, FEV1 and FVC during the exacerbation of the disease. There were not found statistically significant correlation between ET-1 and smoking. Men had higher ET-1 levels during the exacerbation and the remission of the disease, than women. There were not statistically significant correlation between chronic treatment with corticosteroides and the ET-1 exacerbation levels, as well as between treatment with corticosteroides during the exacerbation and the ET-1 remission levels. Probably, the invention of ET-1 receptor inhibitors (selected or not) has a particularly important meaning concerning treatment of bronchial asthma under the meaning of prevention of pulmonary hypertension in patients with heavy asthma.

Summary Bronchial asthma (BA) is considered to be the disease of civilization. Life conditions of the people improve and liability to alergies becomes more intensive. Air polution determines, that asthma spreads fastly in all the world and has become a world problem of health. Asthma has exacerbated quality of life of many asthmatic people: it causes discomfort, psychological tension. Financial losses are much easier beared by a patient than social barrier, however, poor financial situation influences deeply the quality life of the asthmatic people. The goal of this work: to estimate the quality of life of asthmatic people. The following tasks have been set up in achieving this goal: 1. To evaluate the quality of life of astmatic people using SGPQ. 2. To evaluate the influence of BA to patient’s quality of life; 3. To define training impact of BA to quality of life. Investigations have been carried out using SGPQ. 100 patients - asthmatic people have been interviewed according to unanimous questionnarie for no less than one year. Totally the interview have passed 53 men and 47 women, i.e. 53 percentage of men and 47 percentage of women of totally interviewed. Age census of both gender groups was from 18 till 75 years old. Accordingly, the average age of the investigated group was 49,8. Hence, while evaluating harm character of QL, the patients pointed, that the following symptoms mostly disorganize their quality of life (defined calculated interval –... [to full text]

Tyrimo problema. Bronchų astma tampa globaline sveikatos problema: ji dažnėja, jaunėja. Manoma, kad šia liga daugelis žmonių suserga ankstyvoje vaikystėje (Anandan et al., 2010). Tai Chi – kinų kovos menas apimantis suderintą kvėpavimą su kūno judesiais, tai padeda mažinti stresą, atsipalaiduoti, išlaikyti kūno pusiausvyrą. Taip pat gali padėti sergantiems astma geriau kontroliuoti astmos priepuolius ir pagerinti fizinį pajėgumą (Kiatboonsri et al., 2008). Moksliniuose straipsniuose (Fanelli et al., 2007; Chang et al., 2008) teigiama, jog Tai Chi pratimai žymiai pagerina vaikų, sergančių bronchų astma, kvėpavimo funkciją. Tyrimo objektas: 8–11 metų vaikų, sergančių bronchų astma kvėpavimo funkcijos kitimas taikant Tai Chi pratimus ir įprastinę kineziterapiją. Tyrimo hipotezė: manome, kad Tai Chi pratimų taikymas vaikų, sergančių bronchų astma, kvėpavimo funkcijai turėtų būti veiksmingesnis nei įprastinė kineziterapija Tyrimo tikslas: įvertinti Tai Chi pratimų poveikį kvėpavimo funkcijai, gydant 8–11 metų vaikus, sergančius bronchų astma. Tyrimo uždaviniai: 1. Nustatyti kvėpavimo funkcijos rodiklių kitimą taikant įprastinę kineziterapiją. 2. Nustatyti kvėpavimo funkcijos rodiklių kitimą taikant Tai Chi pratimus. 3. Nustatyti, kuri pratimų programa buvo veiksmingesnė gerinant kvėpavimo funkciją. Tyrimas buvo atliktas VŠĮ Kačerginės vaikų sanatorijoje „Žibutė“. Buvo ištirtos dvi grupės po 25 vaikus, sergančius bronchų astma, kurių amžius nuo 8 iki 11 metų. Tiriamajai grupei... [toliau žr. visą tekstą] / Research Problem: Bronchial asthma is becoming a global health issue: it is an increasingly common illness diagnosed in very young children. It is believed that the majority of people develop this disease in the early childhood (Anandan et al., 2010). Tai Chi, which is a Chinese martial art combining harmonious breathing and body movements, can help to reduce stress, relax and maintain body balance. In addition, it allows those with asthma to better control their asthmatic fits and to improve physical potential (Kiatboonsri et al., 2008). According to scientific articles (Fanelli et al., 2007; Chang et al., 2008), Tai Chi exercises improve the respiratory function of children who suffer from bronchial asthma. Research Object: How Tai Chi exercises and regular physiotherapy cause changes in the respiratory function of 8–11 years-old children who have bronchial asthma. Research Hypothesis: In terms of the respiratory function Tai Chi exercises seem to be more effective in children with bronchial asthma than regular physiotherapy. Research Objectives: To assess how Tai Chi exercises affect the respiratory function of 8–11 years – old children who undergo treatment for bronchial asthma. Research Tasks: 1. To establish how respiratory function indicators begin to change when applying regular physiotherapy. 2. To determine how respiratory function indicators begin to change when applying Tai Chi exercises. 3. To find out which exercise programme proved to be the most effective... [to full text]

Montelukast (ML) is primarily an antagonist of type 1 cysteinyl leukotriene receptors (CysLT1R), an activity which underpins its therapeutic efficacy in bronchial asthma. However, ML has also been reported to be useful in the treatment of acute and chronic inflammatory disorders of both infective and non-infective origin in which CysLTs are unlikely to be the predominant mediators of harmful inflammatory responses. These include conditions such as chronic obstructive pulmonary disease and cystic fibrosis in which the neutrophil is believed to be the primary offender, suggesting that ML may possess neutrophil-targeted, CysLT1R-independent mechanisms of anti-inflammatory activity. Accordingly, the laboratory research presented in this thesis was designed with the primary objectives of characterizing possible CysLT1R-dependent and – independent neutrophil-targeted anti-inflammatory activities of ML in vitro, and consisted of 3 phases. These were investigation of: i) the effects of the CysLTs, LTC4 and LTD4 (in the absence and presence of ML) on mobilization of intracellular Ca2+ stores, generation of reactive oxygen species (ROS) and release of primary and secondary granule proteinases; ii) the effects of ML on a series of pro-inflammatory activities of neutrophils following activation of the cells with the chemoattractants FMLP and platelet-activating factor (PAF); and iii) the interactive, anti-inflammatory effects on neutrophils of ML in combination with the long-acting beta-2 agonist, formoterol. In addition to the aforementioned activities, measurement of the production and expression of CR3, as well as generation of inositol triphosphate (IP3), cyclic AMP, and activities of the enzymes cAMP- and cGMP-phosphodiesterases (PDEs) in isolated neutrophil cytosol and membrane fractions, were also included. The following assays were used: i) chemiluminescence procedures for the detection of ROS; ii) a colourimetric procedure for the detection of elastase; iii) ELISA procedures for the detection of the matrix metalloproteinases (MMPs) 8- and -9, LTB4, and cyclic AMP; iv) fura-2-based spectrofluorimetry and a radiometric procedure for monitoring cytosolic Ca2+ fluxes; v) flow cytometry for CR3; and vi) radioassays for IP3 and activity of cAMP- and cGMP-PDEs. Exposure of neutrophils to LTD4, but not LTC4, activated a very modest and transient increase in cytosolic Ca2+, but failed to initiate the generation of ROS or release of elastase or MMP-8. However, brief pre-treatment with either LTC4 or LTD4 sensitized the cells for increased production of ROS and release of granule proteinases following activation with FMLP, which was partially attenuated by inclusion of ML. In the second part of the study, pre-treatment of neutrophils with ML, at therapeutically relevant concentrations, resulted in dose-related inhibition of the FMLP- or PAF-activated generation of ROS and LTB4, as well as the release of elastase, with the former being unaffected by an inhibitor of 5-lipoxygenase (MK886), compatible with a CysLT1R-independent mechanism of anti-inflammatory activity. From a mechanistic perspective, these interactions of ML with neutrophils were associated with accelerated clearance of Ca2+ from the cytosol of the cells which could not be attributed to inhibition of production of IP3, but was, however, associated with increased levels of cAMP, apparently as a consequence of non- specific inhibition of cyclic nucleotide phosphodiesterases. In the third part of the study, combining ML with formoterol caused (in most cases) additive inhibitory effects on the generation of ROS and LTB4, release of granule proteinases, as well as expression of CR3, which again were associated with elevations in cAMP and interference with Ca2+ mobilization. In conclusion, ML appears to attenuate neutrophil activation by CysLT1R-dependent and –independent mechanisms. In the case of the former by interfering with the modest sensitizing (priming) interactions of LTC4 and LTD4 with neutrophils, and in the latter by inhibition of PDEs, leading a to sustained elevation in cAMP, resulting in rapid clearance of Ca2+ from the cytosol and decreased uptake of the cation from the extracellular milieu. / Thesis (PhD)--University of Pretoria, 2011. / Immunology / Unrestricted

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第17779号 / 医博第3805号 / 新制||医||999(附属図書館) / 30586 / 京都大学大学院医学研究科医学専攻 / (主査)教授 川上 浩司, 教授 伊達 洋至, 教授 三森 経世 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

The thesis examines the nursing care of children diagnosed with bronchial asthma. The thesis has three objectives. Firstly, it aims to identify differences in the care of asthmatic children in hospitals and outside hospital-type medical facilities; it also seeks to point out the most common problems of asthmatic children in each age category. Lastly, it examines the awareness of asthma amongst children and parents. Both quantitative and qualitative research was carried out to achieve the above objectives, using questionnaire and semi-structured interview techniques, respectively. The research part of the thesis was divided into two parts (two research samples). The first research sample consisted of children diagnosed with asthma and their parents, the other experimental group included nurses from selected hospitals and children's sanatoria/spas.

The thesis deals with a swimming training of asthmatic children and its impact on this disease. The work is divided into two parts. In the theoretical part the focus is on the description of the bronchial asthma, causes o fit as well as on the symptoms, diagnosis and treatment. Furthermore, the importance of swimming for asthmatic children and how the water environment affects their health impairments are measured. The practical part is focused on swimming training of children who have been diagnosed with asthma. Various physiological parameters of children are being monitored during the training. These parameters include the frequency of breathing, heart rate, frequency of asthma attacks during swimming lessons from the first one to the last one. The last measured parameter is the of improvement or worsening of the conditions of swimmers (number of meters swimmed depending on time) - asthmatics, dependent on the swimming training. Keywords bronchial asthma, children diagnosed with asthma, spirometry, swimming, swimming training

Title: Possibilities of physical and sports activities for patients with asthma and their influence on the medical condition Objectives: The aim of the thesis is to discover the level of active lifestyle of asthmatic patients and their participation on physical activity and sport. Another aim is to find out whether asthmatic patients are limited in physical activity or sport because of the medical condition and how the physically active lifestyle influences the medical condition and whether it takes part on improving quality of life. Methods: A survey was used for data collection. A questionnaire was distributed to people working with asthmatic patients, to sports club and university students. The research group consists of 125 respondents. The obtained data was processed into tables and charts via Microsoft Office Word 2016, Microsoft Office Excel 2016 and SPSS program. A verification of hypotheses was carried out according to the results of the survey and the independence test - chi-squared test. Research results are in the form of tables and graphs summarized at the end of the thesis. The results were compared to the resources dealing with the topic to verify if the hypothesis was true or not. Results: According to the chosen data processing methods, the limitation of asthmatic patients in...

Introduction: Bronchial thermoplasty (B.T.) is a therapeutic bronchoscopic procedure in which controlled thermal energy is applied to the airway wall to decrease smooth muscle mass. Immediate complications of B.T. include acute exacerbation of bronchial asthma, upper and lower respiratory tract infection, hemoptysis, among others. Our study assessed these immediate adverse events and the changes in forced expiratory volume in one second (FEV1%) measured four hours after each procedure from baseline. The study also aimed to examine the number of activations during each cycle of treatment and its correlation to the corresponding change in FEV1% from baseline. Methods: A case-series analysis of 17 patients who underwent B.T. between 2014 and 2019 was done. Demographic, clinical characteristics, including pre and post-BT FEV1% measures, and the number of activations were obtained. Results: Acute exacerbation of asthma was the commonest complication accounting for 33%, 57%, and 75% after BT1, BT2, and BT3, respectively. There was deterioration in FEV1% after each treatment phase, the most significant being in BT3. There was no correlation between the number of heat activations with the change in FEV1% from baseline. Conclusion: The number of activations in B.T. does not correlate with the immediate deterioration in FEV1%, although exacerbation of asthma is the commonest complication post-B.T.