D Robin Taylor

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..They also have a potential role in monitoring disease activity and predicting future clinical outcomes for asthma and chronic obstructive pulmonary disease. Current evidence in relation to these issues is explored in this review...

..It is recognised that with further data these recommendations may require revision after three years...

..These markers can also act as surrogate measures for future risk...

..ADRB2 genotyping of patients with severe or difficult-to-control asthma may shed light on a possible contributor to their clinical instability...

..However, many constitutional and environmental factors affect F(E)NO, making it difficult to devise reference values. Our aim was to evaluate the relative importance of factors affecting F(E)NO in a well characterised adult population...

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..They are also relevant in the design of clinical trials involving beta2-agonist therapy...

..However, a number of issues still need to be resolved, including the diagnostic role of F(E)NO in preschool children and the use of reference values versus individual F(E)NO profiles in managing patients with difficult or severe asthma...

..Either outcome is helpful in decision making. F(E)NO measurements complement the use of other tests in asthma, but more work is required to determine reference values and cut-points for appropriate interpretation...

..Whether these features are related to single nucleotide polymorphisms or to combinations (haplotypes) is unclear...

..To assess the possible effects of tobacco and cannabis smoking on lung function in young adults between the ages of 18 and 26...

..Future studies will be required to clarify the pharmacodynamic effects of ADRB2haplotypes both in vitro and in vivo...

..Polymorphisms of the beta(2) adrenoceptor influence receptor function in vitro and asthma phenotypes in vivo. However, their importance in determining responses to inhaled beta agonist treatment has not been clearly defined...

..Also, there are reports that reproducibility of FE(NO) may be reduced in patients with high FE(NO): our secondary aim was to address this issue...

..Thus, although tolerance is influenced in vitro by polymorphism of the beta2-adrenoceptor, the magnitude of between-genotype differences in vivo is unlikely to be significant...

..To evaluate the relationship between cannabis dependence and respiratory symptoms and lung function in young adults, while controlling for the effects of tobacco smoking...

..To determine the frequency of relapse of asthma in young adults in remission at 18 years of age, during a follow-up period of 8 years, and to identify possible prognostic markers for relapse...

..The results of prospective studies based on selection by ADRB2 haplotype will be necessary before a more general application of this knowledge can be encouraged...

..The well-tried model used in cardiovascular disease to assess absolute risk might possibly be adapted for use in COPD, and this should be actively explored...

..Clinicians need to be aware of how to identify and manage patients for whom beta-agonist treatment is a problem rather than a solution. They constitute a small but important subgroup of patients with difficult asthma...

..The role of obesity in mediating this association is also unclear. We explored the associations between respiratory symptoms, lung function, and gastro-oesophageal reflux symptoms in a birth cohort of approximately 1000 individuals...

..Exhaled nitric oxide is a noninvasive measure of asthmatic airway inflammation...

..Response is more likely to occur in association with eosinophilic airway inflammation, for which the fraction of exhaled nitric oxide (Fe(NO)) is a good surrogate marker...

..ICS use led to phenotype misclassification. Steroid responsiveness was greater in EA, but the absence of eosinophilia did not indicate the absence of a steroid response. In NEA this was best predicted by baseline exhaled nitric oxide...

..Exhaled nitric oxide is a noninvasive measure of asthmatic airway inflammation...

..This classification can help determine whether corticosteroid treatment is indicated. We assessed the stability of these phenotypes over time and with different treatment regimens...

..We assessed: the efficacy of cromoglycate, formoterol and montelukast in patients with EIW and low F(E)NO (<35 ppb) in a randomized cross-over trial, and the efficacy of inhaled corticosteroid in a high F(E)NO (>35 ppb) group...

..It remains unclear if this association is due to genuine asthma or to symptoms caused by overweight, at what age the association develops, and whether it is confined to females...

..This is often difficult to judge. Our aim was to evaluate a decision-support algorithm incorporating FENO measurements in a nurse-led asthma clinic...

..We explored the association between the forced expiratory volume in one second (FEV(1)) and the systemic inflammatory marker C-reactive protein (CRP) in young adults...

..CONCLUSIONS: With the use of FE(NO) measurements, maintenance doses of inhaled corticosteroids may be significantly reduced without compromising asthma control...

..We conclude that caffeinated foods and beverages are unlikely to acutely influence FENO in subjects with asthma, and protocols for laboratory measurement do not need to take this factor into account...

..However, clear evidence for either an additive or a synergistic pathologic interaction between obesity and asthma is lacking in humans...

..This highlights the risks of excessive SABA use in patients who neglect ICS therapy and/or who rely on 'relievers'...

..Cigarette smoke has immunosuppressant effects, but its effect on allergic sensitization is unclear...

..To examine levels of sleep-disordered breathing, daytime sleepiness, and impaired performance in 60 motor vehicle crash drivers and 60 controls matched for age, gender, and body mass index...

..Factors affecting the fraction of nitric oxide in exhaled air (FE(NO)) are multiple. Interpreting values when assessing airways disease may be problematic. Clinically optimum levels have not been defined...

..However, no relationships could be identified between baseline data, including the identification of positional OSA, and objective outcomes that might predict patients who are likely to benefit from treatment in an elevated position...

..Small trials have failed to show a significant benefit, but a systematic study to evaluate the steroid-sparing effect of statin treatment has not been carried out...

..We conclude that FE(NO) measurements and induced sputum analysis are superior to conventional approaches, with exhaled nitric oxide being most advantageous because the test is quick and easy to perform...

..METHODS. Fifty laboratory animal workers participated. Measurements of FE(NO) and spirometry were obtained at baseline (Friday) and twice-daily following a weekend with no animal contact...

..We conclude that ECP is not a sensitive or reliable means of evaluating airway inflammation, and can not be recommended for assessing responses to anti-inflammatory therapy...

..To assess whether exhaled nitric oxide (FENO) measurements improve management and clinician confidence in patients presenting with non-specific respiratory symptoms...

..Increasing bronchoconstriction conferred greater susceptibility to the effects of bronchodilator tolerance...

..One possible explanation might be that these studies have used body mass index to identify adiposity, which might be a less reliable measure of body fat in men than in women...

..Our aim was to evaluate the efficacy of a thoracic anti-supine band (TASB), designed to mimic the so-called 'tennis ball technique', compared with nasal CPAP (nCPAP)...

..It is unclear whether the dynamic changes that occur during bronchoconstriction differ between obese versus nonobese patients with asthma...

..The effect of therapy using a cervicomandibular support collar (CMSC) to manage obstructive sleep apnea (OSA) was compared with standard therapy, nasal continuous positive airway pressure (nCPAP)...

..This review highlights recent advances in applying this technology to the diagnosis and ongoing assessment of asthma in the clinical and epidemiological settings...

..This assay will facilitate studies of ADRB2haplotypes in phenotypes such as patient responses to beta2-agonists, bronchial hyper-responsiveness, and cardiovascular conditions...

..However, our findings indicate that SDB abnormalities may be transient. Sleep studies to investigate SDB as a potential risk factor for cardiovascular morbidity should be carried out when the patient is clinically stable...

..This bronchodilator tolerance is evident in circumstances of acute bronchconstriction...

..Improvements in AHI may be explained by the MAS maintaining the new or existing relationship of the hyoid and its surrounding structures, thus preventing obstruction in the upper airway during sleep...

..The relationship found in this study was linear over the dose range 0-500 microg x day(-1) soon after commencing therapy and continued over time...

..Cannabis use was associated with higher lung volumes, suggesting hyperinflation and increased large-airways resistance, but there was little evidence for airflow obstruction or impairment of gas transfer...

..Most of these studies have been cross sectional in design and have relied on subjective markers of asthma such as symptoms of wheeze. Many have been unable to control adequately for potential confounding factors...

..However, the degree of hypokalemia noted as a result of this drug interaction may be of clinical significance in the hypoxic conditions of acute airways obstruction...

..Guidelines for the management of patients with chronic persistent asthma are likely to require modification to reflect these developments...

..This underscores the importance of SMP in more severe asthma. Symptoms are more important then PEF in prompting patients to alter treatment. This ought to modify our approach in constructing individual asthma SMP...

..Additional larger prospective studies are required to identify suitable candidates for TSD use in the treatment of snoring and SDB...

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..We conclude that eNO measurements are as useful as induced sputum analysis and AHR in assessing airway inflammation, with the advantage that they are easy to perform...

..This disappeared after adjustment in females but remained in males. The effects of thoracic and abdominal body fat on respiratory function are comparable but cannot be separated from one another...

..Other strategies are required...

..62; p = 0.02) than in males (HR, 1.35; p = 0.12). CONCLUSION: The influence of parental atopy on the development for wheeze differs between males and females and between childhood- and adolescent-onset wheeze...

..The outcome of childhood asthma in adults has been described in high-risk cohorts, but few population-based studies have reported the risk factors for persistence and relapse...

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..We suggest that rather than considering AHR as a marker of asthma, it should be regarded as a parallel pathological process that may lead to subsequent symptoms and clinical evidence of asthma...

..The characterization of fluctuations in airway function provides a quantitative basis for objective risk prediction of asthma episodes and for evaluating the effectiveness of therapy...

..Breastfeeding is widely advocated to reduce risk of atopy and asthma, but the evidence for such an effect is conflicting. We aimed to assess long-term outcomes of asthma and atopy related to breastfeeding in a New Zealand birth cohort...

..To determine the therapeutic efficacy and viability of a novel oral interface for continuous positive airway pressure (CPAP) compared with conventional nasal interfaces...

..These data suggest that airway remodeling in asthma, as manifested by impaired lung function, begins in childhood and continues into adult life...