Medical and physiotherapy management of asthma.
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https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills

BTS/SIGN (2016) British guideline on the management of asthma [153]. British Thoracic Society/ Scottish Intercollegiate Guidelines Network.
https://www.brit-thoracic.org.uk/document-library/clinical-information/asthma/btssign-asthma-guideline-2016/

RCP Report on ALLERGY SERVICES in the UK (2010)
bookshop.rcplondon.ac.uk/contents/pub317-44f79458-267d-4006-af05-3f0e468e22c5.pdf

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COCHRANE report on IMMUNOTHERAPY (2010)
www.library.nhs.uk/RESPIRATORY/ViewResource.aspx?resID=236885&tabID=289

UK DEPARTMENT OF HEALTH (2011) - An outcomes strategy for people with COPD and asthma
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ASTHMA UK Report on Unsafe Prescribing (2015)
www.asthma.org.uk/patient-safety
• over 22,000 people with asthma in the UK, including 2,000 children, have been prescribed long-acting reliever inhalers in a way that could pose a risk; almost 100,000 people have been prescribed too many short-acting reliever inhalers without national clinical guidelines being followed.


Aguilar PR (2014) Other asthma considerations. Otolaryngol Clin North Am; 47(1):147-60. doi: 10.1016/j.otc.2013.08.015

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• smoking reduces the efficacy of steroids in asthma

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• SOB perception relates to depression and advanced age.

Bๅrnes CB, Ulrik CS (2015) Asthma and adherence to inhaled corticosteroids: current status and future perspectives. Respir Care; 60(3):455-468

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• asthma can lead to obesity, and obesity is a risk factor for asthma, possibly due to inflammatory, immunologic, genetic or mechanical mechanisms

B้dard A, Varraso R, Sanchez M et al (2014) Cleaning sprays, household help and asthma among elderly women. Respir Med; 108(1):171-180

B้rub้ D, Djandji M, Sampalis JS et al (2014) Effectiveness of montelukast administered as monotherapy or in combination with inhaled corticosteroid in pediatric patients with uncontrolled asthma: a prospective cohort study. Allerg Asthma Clin Immun; 10,21. doi:10.1186/1710-1492-10-21
• Montelukast provides asthma control in the majority of children

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• high-frequency oscillation may help clear thick secretions

Burgess JA (2011) Factors influencing asthma remission: a longitudinal study from childhood to middle age. Thorax, 66, 508-513
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• effect of allergic rhinitis or eczema on asthma remission might be altered by early, aggressive treatment,
• Importance of avoiding exposure to tobacco smoke.

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• nebulised ฿2-agonists must be given with oxygen in hypoxic patients to counteract the shunt of vasodilation

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• hard fruit such as apples are better for asthma than soft or citrus fruit

Campainha S, Ribeiro C, Guimarใes M et al (2012) Vocal cord dysfunction: a frequently forgotten entity. Case Rep Pulmonol: 525493. doi:10.1155/2012/525493
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• diesel exhaust penetrates deeply into the lung and has been strongly associated with acute deterioration of asthmatic lung function.

Carson KV, Chandratilleke MG, Picot J et al (2013) Physical training for asthma. Cochrane Syst Rev. Sep 30;9:CD001116

Carson KV, Usmani ZA, Smith BJ (2014) Noninvasive ventilation in acute severe asthma: current evidence and future perspectives. Curr Opin Pulm Med; 20(1):118-23

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Cavallaria JM, Jawaroa TS, Awada NI et al (2017) Glucagon for refractory asthma exacerbation. Am J Emerg Med; 35(1):144–145

Chida Y (2008) A bidirectional relationship between psychosocial factors and atopic disorders: a systematic review and meta-analysis. Psychosom Med, 70, 102-116
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• strong relationship between psychosocial factors and atopic disorders

Choo XN, Pavord ID (2016) Morbidity associated with oral corticosteroids in patients with severe asthma. Thorax; 71(4):302-304. doi: 10.1136/thoraxjnl-2015-208242

Chowdhury BA et al (2011) Assessing the safety of adding long-acting beta-agonists to inhaled corticosteroids for treating asthma. N Engl J Med, 364, 2473-2475
• long-acting beta-agonists have been associated with serious adverse outcomes such as asthma-related hospitalization, need for intubation and death.

Clark NA, Demers PA, Karr CJ et al (2010) Effect of early life exposure to air pollution on development of childhood asthma. Environ Health Perspect, 118, 2, 284–290
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Compalati E, Fulvio B, Canonica GW (2014) An update on allergen immunotherapy and asthma. Curr Opin Pulm Med; 20(1):109-117. doi: 10.1097/MCP.0000000000000016

Confino-Cohen R, Brufman I, Goldberg A et al (2014) Vitamin D, asthma prevalence and asthma exacerbations: a large adult population-based study. Allergy; 69(12):1673–1680. doi: 10.1111/all.12508
• adequate vitamin D may help prevent exacerbations

Cowie RL, Conley DP, Underwood MF et al (2008) A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Respir Med, 102, 5, 726-732

D'Amato M, Stanziola AA, de Laurentiis G et al (2014) Nocturnal continuous positive airway pressure in severe non-apneic asthma. A pilot study. Clin Respir J; 8(4):417-24. doi: 10.1111/crj.12088

Da Silva PL (2012) Interdisciplinary therapy improves biomarkers profile and lung function in asthmatic obese adolescents. Pediatr Pulmonol, 47, 1, 8–17

D'Amato G, Vitale C, Lanza M et al (2016) Near fatal asthma: treatment and prevention. Eur Ann Allergy Clin Immunol; 48(4):116-22
• ‘near fatal asthma’, occurs when status asthmaticus progresses to respiratory failure and PaCO2 > 6.66 kPa (50 mmHg), with or without altered consciousness, requiring mechanical ventilation

Dave ND, Xiang L, Rehm KE et al (2012) Stress and allergic diseases. Immunol Allergy Clin North Am, 31, 1, 55–68
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Davidson R, Roberts SE, Wotton CJ (2010) Influence of maternal and perinatal factors on subsequent hospitalisation for asthma in children. BMC Pulm Med, 10, 14, doi:10.1186/1471-2466-10-14
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• perinatal risk factors include maternal asthma, maternal smoking, low birth weight, short gestational age, lack of breast-feeding, older siblings and possibly caesarean delivery

Daviskas E, Anderson SD, Eberl S et al (2010). Beneficial effect of inhaled mannitol and cough in asthmatics with mucociliary dysfunction. Respir Med; 104(11):1645-53. doi: 10.1016/j.rmed.2010.05.019
• mannitol improved both mucociliary and cough clearance in asthmatics with mucociliary dysfunction and ineffective cough clearance

Deakins KM (2015) Year in review 2014: asthma. Respir Care; 60(5):744-748

De Benedictis F, Bush A (2012) Corticosteroids in respiratory diseases in children. Am J Respir Crit Care Med, 185, 1, 12-23
• in children, adverse effects, especially growth and adrenal suppression, are induced by systemic steroids, and to a lesser extent by inhaled steroids

Desai M, Oppenheimer JJ (2011) Medication adherence in the asthmatic child and adolescent. Curr Allergy Asthma Rep; 11, 6: 454-64.

Deshpande DA (2010) Bitter taste receptors on airway smooth muscle bronchodilate by localized calcium signaling and reverse obstruction. Nature Med, 16, 1299–1304
• inhalation of bitter substances dilates airways x3 more than beta-agonists

Devillier P, Fadel R, de Beaumont O (2016) House dust mite sublingual immunotherapy is safe in patients with mild-to-moderate, persistent asthma: a clinical trial. Allergy; 71(2):249-57. doi: 10.1111/all.12791

Ding G, Ji R, Bao Y (2015) Risk and protective factors for the development of childhood asthma. Paed Respir Rev; 16(2):133–139. doi:10.1016/j.prrv.2014.07.004

Divekar R (2014) Heterogeneity of asthma in society. Adv Exp Med Biol; 795:31-41. doi: 10.1007/978-1-4614-8603-9_3

Donno MD, Bittersnich D, Chetta A (2000) The effect of inflammation on mucociliary clearance in asthma. Chest, 118, 1142-9
• secretions are thicker and more difficult to clear than with other obstructive diseases
• sodium cromoglycate helps mucociliary transport in asthma

Dhooria S, Agarwal R (2015) Controlling asthma by breathing techniques: role of anxiety. Chest; 147(3):e130. doi: 10.1378/chest.14-2755

Dowell ML (2014) Airway smooth muscle: a potential target for asthma therapy. Curr Opin Pulm Med; 20(1):66-72

Durrington HJ, Farrow SN, Loudon AS et al (2014) Basic science for the chest physician: the circadian clock and asthma. Thorax; 69(1):90-92. doi:10.1136/thoraxjnl-2013-203482

Ellwood P (2013) Do fast foods cause asthma, rhinoconjunctivitis and eczema? Global findings from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase Three. Thorax; 68(4):351-60

Emtner M, Hedin A (2005) Adherence to and effects of physical activity on health in adults with asthma. Advances Physiother, 7, 3, 123-34
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• exercise programmes increase patients’ ability to control their asthma

Farha S, Asosingh K, Laskowski D et al (2012) Effects of the menstrual cycle on lung function variables in women with asthma. Am J Respir Crit Care Med, 180(4): 304–310
www.ncbi.nlm.nih.gov/pmc/articles/PMC2731807/?tool=pmcentrez

Federico MJ, Hoch HE, Anderson WC et al (2016) Asthma management for children: risk identification and prevention. Adv Pediatrics; 63(1):103–126

Fens N, Zwinderman AH, van der Schee MP et al (2009) Exhaled breath profiling enables discrimination of chronic obstructive pulmonary disease and asthma. Am J Respir Crit Care Med, 180, 1076-82
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Findley SE, Thomas SG, Madera-Reese R et al (2011) A community-based strategy for improving asthma management and outcomes for preschoolers. J Urban Health, 88(Suppl 1), 85–99
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Fitzgerald DA (2015) Childhood asthma in 2015: the fuss and the future. Paed Respir Rev; 16(2):81–82. doi:10.1016/j.prrv.2015.01.001

Fortun M (2014) Asthma, culture, and cultural analysis: continuing challenges. Adv Exp Med Biol; 795:321-32

Garcia-Aymerich J, Varraso J, Ant๓ JM et al (2009) Prospective study of physical activity and risk of asthma exacerbations in older women. Am J Respir Crit Care Med, 179, 11, 999–1003
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• exercise reduces the risk of exacerbations in women

Garcia-Larsen V, Newson RB, Potts JF et al (2007) Dietary intake of fruit and childhood asthma. Thorax, 62 (Suppl.III), A21

Georas SN, van Wijngaarden E, Rich DQ et al (2015) Air pollution and asthma incidence: doubt no more? Lancet Respir Med; 3(12):902–903. doi: dx.doi.org/10.1016/S2213-2600(15)00473-7
• early life or in-utero exposure to air pollution predispose to asthma

Ghaffari J, Hossiani RF, Khalilian A et al (2014) Vitamin E supplementation, lung functions and clinical manifestations in children with moderate asthma: a randomized double blind placebo- controlled trial. Iranian Allergy, Asthma Immunol; 13(2):98-103.

Gonzแlez Garcํa L, Rey C, Medina A et al (2016) Severe subcutaneous emphysema and pneumomediastinum secondary to noninvasive ventilation support in status asthmaticus. Indian J Crit Care Med; 20(4):242-244. doi: 10.4103/0972-5229.180047.

Gore RB (2010) The utility of antifungal agents for asthma. Curr Opin Pulm Med, 16, 1, 36-41
• refractory asthma may indicate sensitivity to environmental fungi

Groth SW, Rhee H, Kitzman H (2016) Relationships among obesity, physical activity and sedentary behavior in young adolescents with and without lifetime asthma. J Asthma; 53(1):19-24. doi:10.3109/02770903.2015.1063646

Gruenberg D, Busse W (2010) Biologic therapies for asthma. Curr Opin Pulm Med, 16, 1, 19-24
• people with difficult asthma may benefit from adjunctive treatments such as anti-immunoglobulin E and anti-interleukin-5.

Grzelewski T, Stelmach W,Stelmach RAJA et al (2016) Spirometry-adjusted fraction of exhaled nitric oxide allows asthma diagnosis in children, adolescents, and young adults. Respir Care; 61(2):162-172

Guilleminault L, Ouksel H, Belleguic C et al (2017) Personalised medicine in asthma: from curative to preventive medicine. Eur Respir Rev; 26(143). pii: 160010. doi: 10.1183/16000617.0010-2016
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Hamdan AL, Jaffal H, Btaiche R et al (2016) Laryngopharyngeal symptoms in patients with asthma: a cross-sectional controlled study. Clin Respir J; 10(1):40-47. doi: 10.1111/crj.12179
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Hisamuddin NARN (2009) Correlations between capnographic waveforms and peak flow meter measurement in emergency department management of asthma. Int J Emerg Med, 2, 2, 83-9

Holloway E, Ram FSF (2001) Breathing exercises for asthma. Cochrane Library, 1, Oxford: update software.

Hulme KM, Salome CM, Brown NJ et al (2013) Deep inspiration volume and the impaired reversal of bronchoconstriction in asthma. Resp Physiol Neurobiol; 189(3):506-512

Inwald D, Roland M (2001) Oxygen treatment for acute severe asthma. Br Med J, 323, 98-100
• important info on the need for oxygen as the first treatment for acute severe asthma

Jones MG, Rae W, Lwin AA (2013) Pneumomediastinum leading to respiratory compromise as a complication of acute severe asthma. Am J Respir Crit Care Med; 187(3):e5-6

Julian V, Amat F, Petit I et al (2015), Impact of a short early therapeutic education program on the quality of life of asthmatic children and their families. Ped Pulmonol; 50(3):50: 213–221. doi: 10.1002/ppul.23013
• short education programme for families has shown rapid and beneficial effects for children

Karam M, Kaur BP, Baptist AP (2017) A modified breathing exercise program for asthma is easy to perform and effective. J Asthma; 54(2):217-22

Karvonen AM, Hyvไrinen A, Korppi M et al (2015) Moisture damage and asthma: a birth cohort study. Pediatrics; 135(3): e598-e606. doi: 10.1542/peds.2014-1239
• mould and damp homes increases asthma risk

Kaur BP, Lahewala S, Arora S et al (2015) Asthma: hospitalization trends and predictors of in-hospital mortality and hospitalization costs in the USA (2001-2010). Int Arch Allergy Immunol; 168(2):71-78
• mechanical ventilation for people with acute severe asthma brings mortality as high as 9.8%

Kellet C, Mullan J (2002) Breathing control techniques in the management of asthma. Physiotherapy, 88, 751-8
• Bukeyko and other breathing techniques

King MJ, Hanania NA (2010) Asthma in the elderly: current knowledge and future directions. Curr Opin Pulm Med, 16, 1, 55-59,
• asthma is common in elderly people but is frequently undiagnosed and undertreated

Kline JN, Rose RM (2014) Central nervous system influences in asthma. Adv Exp Med Biol; 795:309-19

Kuniyoshi K, Kumiya S, Toda M et al (2012) Relationship between sensitivity to dyspnea and fluctuating peak expiratory flow rate in the absence of asthma symptoms. Asia Pac Allergy; 2(1):49–58.
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• patients with severe acute asthma tend to have a reduced sensitivity to dyspnoea

Kuyper LM (2003) Characterization of airway plugging in fatal asthma. Am J Med, 115, 6–11
• mucus plugging is usually found in fatal asthma

Leatherman J (2015) Mechanical ventilation for severe asthma. Chest; 147(6):1671-80. doi: 10.1378/chest.14-1733

Lee YC, Lee CT, Lai YR et al (2016) Association of asthma and anxiety: a nationwide population-based study in Taiwan. J Affect Disord; 189:98-105. doi: 10.1016/j.jad.2015.09.040

Levy ML, Winter R (2015) Asthma deaths: what now? Thorax;70:209-210. doi:10.1136/thoraxjnl-2015-206800
• the vast majority of asthma deaths in the UK are preventable
• the over-prescription of reliever inhalers is 'scarcely believable'
• use of more than one bronchodilator inhaler per month suggests poor asthma control and a need for urgent review
• less than a quarter of people who die have a personal asthma action plan

Li L, Xu Z, Jin X et al (2015) Sleep-disordered breathing and asthma: evidence from a large multicentric epidemiological study in China. Respir Res; 16:56. doi: 10.1186/s12931-015-0215-5.
• higher-than-normal incidence of sleep-disordered breathing in children with asthma

Lilley A, Turner L (2016) Assessing the benefits of having a specialist paediatric pharmacist and physiotherapist in the community to improve childhood asthma outcomes. Arch Dis Child; 101(9):e2. doi: 10.1136/archdischild-2016-311535.6

Looijmans-van den Akker I, van Luijn K, Verheij T (2016) Overdiagnosis of asthma in children in primary care: a retrospective analysis. Br J Gen Pract; 66(644):e152-7. doi: 10.3399/bjgp16X683965
• only 16.1% of children identified as having asthma received the recommended lung function test as confirmation

Ma J, Strub P, Camargo CA (2010) The breathe easier through weight loss lifestyle intervention. BMC Pulm Med, 10, 16. doi:10.1186/1471-2466-10-16
www.biomedcentral.com/1471-2466/10/16
• link between obesity and asthma
• obesity tips asthma into being more difficult to manage

Mac๊do TM, Freitas DA, Chaves GS et al (2016) Breathing exercises for children with asthma. Cochrane Database Syst Rev. Apr 12;4:CD011017. doi: 10.1002/14651858.CD011017.pub2

Malka J, Spahn JD (2016) When cough wheeze and shortness of breath don't equal asthma. J Allergy Clin Immunol Pract; 4(1):179-81. doi: 10.1016/j.jaip.2015.08.008
• only one-third of preschool-aged children with recurrent wheeze will go on to have asthma.
• cough and wheezing are two of the most common features of asthma, yet not all who cough or wheeze will have asthma.

Masuda Y, Tatsumi H, Goto K et al (2014) Treatment of life-threatening hypercapnia with isoflurane in an infant with status asthmaticus. J Anesth; 28(4):610-612
• manual deflation of a hyperinflated chest in a 2 y.o. with severe acute asthma

Mekonnen D (2012) Clinical effects of yoga on asthmatic patients. Ethiop J Health Sci, 20, 2, 107–112
www.ncbi.nlm.nih.gov/pmc/articles/PMC3275836/?tool=pmcentrez

Melnik BC (2014) The potential mechanistic link between allergy and obesity development and infant formula feeding. Allerg Asthma Clin Immun; 10,37. doi:10.1186/1710-1492-10-37.
• breastfeeding helps protect against asthma

Michils A, Malinovschi A, Haccuria A et al (2016) Different patterns of exhaled nitric oxide response to β2-agonists in asthmatic patients according to the site of bronchodilation. J Allergy Clin Immunol; 137(3):806-12. doi: 10.1016/j.jaci.2015.09.054

O'Keefe JH, Bhatti SK, Patil HR et al (2013) Effects of habitual coffee consumption on cardiometabolic disease, cardiovascular health, and all-cause mortality. J Am Coll Cardiol; 62(12):1043-51. doi: 10.1016/j.jacc.2013.06.035
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• habitual coffee drinking potentially improves asthma control

Op't Holt TB (2015) Intratracheal albuterol: a potential intervention for the asthma toolbox. Respir Care; 60(5):756-756

Osborne CA, O’Connor BJ, Lewis A (2000) Hyperventilation and asymptomatic chronic asthma. Thorax, 55:1016–22
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• mild asthma is associated with reduced arterial and ETCO2 which relates to airway hyperresponsiveness rather than to airway obstruction or mucosal inflammation

Parsons JP (2014) Exercise-induced bronchoconstriction. Otolaryngol Clin North Am; 47(1):119-26. doi: 10.1016/j.otc.2013.09.003

Pearson MG (2007) Breathing exercises for asthma: panacea or placebo? Thorax, 62, 1033-4.
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Pereira MC (2014) Physical training for asthma. Sao Paulo Med J; 132(3):193-4

Pommer AM, Pouwer F, Denollet J et al (2012) Managing co-morbid depression and anxiety in primary care patients with asthma and/or chronic obstructive pulmonary disease: study protocol for a randomized controlled trial. Pop Trials, 13, 6

Reddy AP, Gupta MR (2014) Management of asthma: the current US and European guidelines. Adv Exp Med Biol; 795:81-103

Rhee H, Belyea MJ, Hunt JF et al (2012) Effects of a peer-led asthma self-management program for adolescents. Arch Pediatr Adolesc Med, 165, 6, 513–519
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Ricciardolo FL (2014) Revisiting the role of exhaled nitric oxide in asthma. Curr Opin Pulm Med; 20(1):53-9. doi: 10.1097/MCP.0000000000000006

Risnes KR, Belanger D, Murk W et al (2011) Antibiotic exposure by 6 months and asthma and allergy at 6 years: findings in a cohort of 1,401 us children. Am J Epidemiol, 173, 3, 310–318
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Ritz T, Rosenfield D, Steele AM et al (2014) Controlling asthma by training of capnometry-assisted hypoventilation (CATCH) vs slow breathing: a randomized controlled trial. Chest; 146(5): 1237–1247
• reducing minute volume with capnography leads to improved QoL, and reduced symptoms, PF variability, bronchodilator use and airway hyperreactivity

Roche N, Pribil C, Devillier P et al (2016) Limited treatment adaptation despite poor asthma control in asthma patients treated with inhaled corticosteroids. J Asthma; 53(1):76-85. doi:10.3109/02770903.2015.1065421
• most patients on steroids are not well controlled on these drugs because of lack of medication reviews

Rom RN, Reibman J, Rogers L (2010) Emerging exposures and respiratory health: world trade center dust. Proc Am Thorac Soc, 7, 2, 142–5
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Rosenkranz MA, Esnault S, Christian BT et al (2016) Mind-body interactions in the regulation of airway inflammation in asthma: a PET study of acute and chronic stress. Brain Behav Immun; pii: S0889-1591(16)30068-X. doi: 10.1016/j.bbi.2016.03.024

Rubin BK, Pohanka V (2012) Beyond the guidelines: Fatal and near-fatal asthma. Paed Respir Rev, 13, 2, 106-111

Rubin BK (2015) Asthma myths, controversies, and dogma. Paed Respir Rev; 16(2):83–87. doi:10.1016/j.prrv.2014.09.001

Sahadevan A (2016) Palliative subcutaneous terbutaline infusion in severe asthma. Ir Med J; 109(5):410

Suau SJ, DeBlieux MC (2016) Management of acute exacerbation of asthma and chronic obstructive pulmonary disease in the emergency department. Emerg Med Clinics; 34(1):15–37

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Slats AM et al (2008) Enhanced airway dilation by positive-pressure inflation of the lungs compared with active deep inspiration in patients with asthma. J Appl Physiol, 105, 1725-32
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• positive-pressure inflation can enhance bronchodilation in patients with asthma.

Sodhi C, Singh S, Bery A (2014) Assessment of the quality of life in patients with bronchial asthma, before and after yoga: a randomised trial. Iranian Allergy, Asthma Immunol; 13(1):55-60

Soyer O, Ozen C, Cavkaytar O et al (2016) Right middle lobe atelectasis in children with asthma and prognostic factors. Allergol Int; 65(3):253-8. doi: 10.1016/j.alit.2015.12.002
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Steinmann M, Abbas C, Singer F et al (2015) Arterial stiffness is increased in asthmatic children. Europ J Pediatrics; 174(4):519-523
• severe disease has detrimental effects on the cardiovascular system through arterial stiffness

Sutter SA, Stein EM (2016) The skeletal effects of inhaled glucocorticoids. Curr Osteoporos Rep; 14(3):106-13. doi: 10.1007/s11914-016-0308-1
• children with asthma treated with inhaled glucocorticoids have lower growth velocity, bone density, and adult height.

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ABGs = arterial blood gases
BTS = British Thoracic Society
ETCO2 = end-tidal CO2 monitor
PEP = positive expiratory pressure
QoL = quality of life
RR = respiratory rate
RCP = Royal College of Physicians (UK)