Publications by authors named "K S Bennoor"

19 Publications

  • Page 1 of 1

Management of anaphylaxis due to COVID-19 vaccines in the elderly.

Authors:
Jean Bousquet Ioana Agache Hubert Blain Marek Jutel Maria Teresa Ventura Margitta Worm Stefano Del Giacco Athanasios Benetos M Beatrice Bilo Wienczyslawa Czarlewski Amir Hamzah Abdul Latiff Mona Al-Ahmad Elizabeth Angier Isabella Annesi-Maesano Marina Atanaskovic-Markovic Claus Bachert Annick Barbaud Anna Bedbrook Kazi S Bennoor Elena Camelia Berghea Carsten Bindslev-Jensen Sergio Bonini Sinthia Bosnic-Anticevich Knut Brockow Luisa Brussino Paulo Camargos G Walter Canonica Victoria Cardona Pedro Carreiro-Martins Ana Carriazo Thomas Casale Jean-Christoph Caubet Lorenzo Cecchi Antonio Cherubini George Christoff Derek K Chu Alvaro A Cruz Dejan Dokic Yehia El-Gamal Motohiro Ebisawa Bernadette Eberlein John Farrell Montserrat Fernandez-Rivas Wytske J Fokkens Joao A Fonseca Yadong Gao Gaëtan Gavazzi Radolslaw Gawlik Asli Gelincik Bilun Gemicioğlu Maia Gotua Olivier Guérin Tari Haahtela Karin Hoffmann-Sommergruber Hans Jürgen Hoffmann Maja Hofmann Martin Hrubisko Madda lenaIllario Carla Irani Zhanat Ispayeva Juan Carlos Ivancevich Kaja Julge Igor Kaidashev Musa Khaitov Edward Knol Helga Kraxner Piotr Kuna Violeta Kvedariene Antti Lauerma Lan Tt Le Vincent Le Moing Michael Levin Renaud Louis Olga Lourenco Vera Mahler Finbarr C Martin Andrea Matucci Branislava Milenkovic Stéphanie Miot Emma Montella Mario Morais-Almeida Charlotte G Mortz Joaquim Mullol Leyla Namazova-Baranova Hugo Neffen Kristof Nekam Marek Niedoszytko Mikaëla Odemyr Robyn E O'Hehir Yoshitaka Okamoto Markus Ollert Oscar Palomares Nikolaos G Papadopoulos Petr Panzner Gianni Passalacqua Vincenzo Patella Mirko Petrovic Oliver Pfaar Nhân Pham-Thi Davor Plavec Todor A Popov Marysia T Recto Frederico S Regateiro Jacques Reynes Regina E Roller-Winsberger Yves Rolland Antonino Romano Carmen Rondon Menachem Rottem Philip W Rouadi Nathalie Salles Boleslaw Samolinski Alexandra F Santos Faradiba Sarquis Serpa Joaquin Sastre Jos M G A Schols Nicola Scichilone Anna Sediva Mohamed H Shamji Aziz Sheikh Isabel Skypala Sylwia Smolinska Milena Sokolowska Bernardo Sousa-Pinto Milan Sova Rafael Stelmach Gunter Sturm Charlotte Suppli Ulrik Ana Maria Todo-Bom Sanna Toppila-Salmi Ioanna Tsiligianni Maria Torres Eva Untersmayr Marilyn Urrutia Pereira Arunas Valiulis Joana Vitte Alessandra Vultaggio Dana Wallace Jolanta Walusiak-Skorupa De-Yun Wang Susan Waserman Arzu Yorgancioglu Osman M Yusuf Mario Zernotti Mihaela Zidarn Tomas Chivato Cezmi A Akdis Torsten Zuberbier Ludger Klimek

Allergy 2021 Apr 2. Epub 2021 Apr 2.

Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, and Center for Rhinology and Allergology, Wiesbaden, Germany.

Older adults, especially men and/or those with diabetes, hypertension and/or obesity, are prone to severe COVID-19. In some countries, older adults, particularly those residing in nursing homes, have been prioritised to receive COVID-19 vaccines due to high risk of death. In very rare instances,the COVID-19 vaccines can induce anaphylaxis, and the management of anaphylaxis in older people should be considered carefully. An ARIA-EAACI-EuGMS (Allergic Rhinitis and its Impact on Asthma, European Academy of Allergy and Clinical Immunology, and European Geriatric Medicine Society)Working Group has proposed some recommendations for older adults receiving the COVID-19 vaccines. Anaphylaxis to COVID-19 vaccines is extremely rare (from 1 per 100,000 to 5 per million injections). Symptoms are similar in younger and older adults but they tend to be more severe in the older patients. Adrenaline is the mainstay treatment and should be readily available. A flowchart is proposed to manage anaphylaxis in the older patients.
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http://dx.doi.org/10.1111/all.14838DOI Listing
April 2021

Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold- An ARIA-EAACI-GA LENconsensus.

Authors:
Jan Hagemann Gabrielle L Onorato Marek Jutel Cezmi A Akdis Ioana Agache Torsten Zuberbier Wienczyslawa Czarlewski Joaquim Mullol Anna Bedbrook Claus Bachert Kazi S Bennoor Karl-Christian Bergmann Fulvio Braido Paulo Camargos Luis Caraballo Victoria Cardona Thomas Casale Lorenzo Cecchi Tomas Chivato Derek K Chu Cemal Cingi Jaime Correia-de-Sousa Stefano Del Giacco Dejan Dokic Mark Dykewicz Motohiro Ebisawa Yehia El-Gamal Regina Emuzyte Jean-Luc Fauquert Alessandro Fiocchi Wytske J Fokkens Joao A Fonseca Bilun Gemicioglu Maximiliano Gomez Gotua Maia Tari Haahtela Eckard Hamelmann Tomohisa Iinuma Juan Carlos Ivancevich Ewa Jassem Omer Kalayci Przemyslaw Kardas Musa Khaitov Piotr Kuna Violeta Kvedariene Desiree E Larenas-Linnemann Brian Lipworth Michael Makris Jorge F Maspero Neven Miculinic Florin Mihaltan Yousser Mohammad Stephen Montefort Mario Morais-Almeida Ralph Mösges Robert Naclerio Hugo Neffen Marek Niedoszytko Robyn E O'Hehir Ken Ohta Yoshitaka Okamoto Kimi Okubo Petr Panzner Nikolaos G Papadopoulos Giovanni Passalacqua Vincenzo Patella Ana Pereira Oliver Pfaar Davor Plavec Todor A Popov Emmanuel P Prokopakis Francesca Puggioni Filip Raciborski Jere Reijula Frederico S Regateiro Sietze Reitsma Antonino Romano Nelson Rosario Menachem Rottem Dermot Ryan Boleslaw Samolinski Joaquin Sastre Dirceu Solé Milan Sova Cristiana Stellato Charlotte Suppli-Ulrik Ioanna Tsiligianni Antonio Valero Arunas Valiulis Erkka Valovirta Tuula Vasankari Maria Teresa Ventura Dana Wallace De Yun Wang Iân Williams Arzu Yorgancioglu Osman M Yusuf Mario Zernotti Jean Bousquet Ludger Klimek

Allergy 2021 Mar 17. Epub 2021 Mar 17.

Department of Otolaryngology, Head and Neck Surgery, Universitätsmedizin Mainz, Mainz, Germany.

Background: Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken withthe common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms betweenthe three diseases.

Methods: A modified Delphi process was used and ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold andallergic rhinitis.

Results: Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded. 87 questionnaires were analysed. The consensus was then reported.A two-way ANOVA analysis revealed significant differences inthe symptom intensity between the three diseases (p<0.001).

Conclusions: This modified Delphi approach enabled thedifferentiationof upper respiratory symptoms betweenCOVID-19, common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.
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http://dx.doi.org/10.1111/all.14815DOI Listing
March 2021

ARIA-EAACI statement on asthma and COVID-19 (June 2, 2020).

Authors:
Jean Bousquet Marek Jutel Cezmi A Akdis Ludger Klimek Oliver Pfaar Kari C Nadeau Thomas Eiwegger Anna Bedbrook Ignacio J Ansotegui Josep M Anto Claus Bachert Eric D Bateman Kazi S Bennoor Elena Camelia Berghea Karl-Christian Bergmann Hubert Blain Mateo Bonini Sinthia Bosnic-Anticevich Louis-Philippe Boulet Luisa Brussino Roland Buhl Paulo Camargos Giorgio Walter Canonica Victoria Cardona Thomas Casale Sharon Chinthrajah Mübeccel Akdis Tomas Chivato George Christoff Alvaro A Cruz Wienczyslawa Czarlewski Stefano Del Giacco Hui Du Yehia El-Gamal Wytske J Fokkens Joao A Fonseca Yadong Gao Mina Gaga Bilun Gemicioglu Maia Gotua Tari Haahtela David Halpin Eckard Hamelmann Karin Hoffmann-Sommergruber Marc Humbert Nataliya Ilina Juan-Carlos Ivancevich Guy Joos Musa Khaitov Bruce Kirenga Edward F Knol Fanny W Ko Seppo Koskinen Marek L Kowalski Helga Kraxner Dmitry Kudlay Piotr Kuna Maciej Kupczyk Violeta Kvedariene Amir H Abdul Latiff Lan T Le Michael Levin Desiree Larenas-Linnemann Renaud Louis Mohammad R Masjedi Erik Melén Florin Mihaltan Branislava Milenkovic Yousser Mohammad Mario Morais-Almeida Joaquim Mullol Leyla Namazova Hugo Neffen Elisabete Nunes Paul O'Byrne Robyn O'Hehir Liam O'Mahony Ken Ohta Yoshitaka Okamoto Gabrielle L Onorato Petr Panzner Nikos G Papadopoulos Gianni Passalacqua Vincenzo Patella Ruby Pawankar Nhân Pham-Thi Bernard Pigearias Todor A Popov Francesca Puggioni Frederico S Regateiro Giovanni Rolla Menachem Rottem Boleslaw Samolinski Joaquin Sastre Jurgen Schwarze Aziz Sheikh Nicola Scichilone Manuel Soto-Quiros Manuel Soto-Martinez Milan Sova Stefania Nicola Rafael Stelmach Charlotte Suppli-Ulrik Luis Taborda-Barata Teresa To Peter-Valentin Tomazic Sanna Toppila-Salmi Ioanna Tsiligianni Omar Usmani Arunas Valiulis Maria Teresa Ventura Giovanni Viegi Theodor Vontetsianos De Yun Wang Sian Williams Gary W K Wong Arzu Yorgancioglu Mario Zernotti Mihaela Zidarn Torsten Zuberbier Ioana Agache

Allergy 2021 03 21;76(3):689-697. Epub 2020 Sep 21.

Transylvania University Brasov, Brasov, Romania.

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http://dx.doi.org/10.1111/all.14471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361514PMC
March 2021

ARIA digital anamorphosis: Digital transformation of health and care in airway diseases from research to practice.

Authors:
Jean Bousquet Josep M Anto Claus Bachert Tari Haahtela Torsten Zuberbier Wienczyslawa Czarlewski Anna Bedbrook Sinthia Bosnic-Anticevich G Walter Canonica Victoria Cardona Elisio Costa Alvaro A Cruz Marina Erhola Wytske J Fokkens Joao A Fonseca Maddalena Illario Juan-Carlos Ivancevich Marek Jutel Ludger Klimek Piotr Kuna Violeta Kvedariene Ltt Le Désirée E Larenas-Linnemann Daniel Laune Olga M Lourenço Erik Melén Joaquim Mullol Marek Niedoszytko Mikaëla Odemyr Yoshitaka Okamoto Nikos G Papadopoulos Vincenzo Patella Oliver Pfaar Nhân Pham-Thi Christine Rolland Boleslaw Samolinski Aziz Sheikh Mikhail Sofiev Charlotte Suppli Ulrik Ana Todo-Bom Peter-Valentin Tomazic Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Maria-Teresa Ventura Samantha Walker Sian Williams Arzu Yorgancioglu Ioana Agache Cezmi A Akdis Rute Almeida Ignacio J Ansotegui Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagaña Eric D Bateman Annabelle Bédard Martin Bedolla-Barajas Sven Becker Kazi S Bennoor Samuel Benveniste Karl C Bergmann Michael Bewick Slawomir Bialek Nils E Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Matteo Bonini Philippe Bonniaud Isabelle Bosse Jacques Bouchard Louis-Philippe Boulet Rodolphe Bourret Koen Boussery Fluvio Braido Vitalis Briedis Andrew Briggs Christopher E Brightling Jan Brozek Guy Brusselle Luisa Brussino Roland Buhl Roland Buonaiuto Moises A Calderon Paulo Camargos Thierry Camuzat Luis Caraballo Ana-Maria Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Niels H Chavannes Ekaterine Chkhartishvili Derek K Chu Cemal Cingi Jaime Correia de Sousa David J Costa Anne-Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejan Dokic Yves Dauvilliers Giulia De Feo Govert De Vries Philippe Devillier Stefania Di Capua Gerard Dray Ruta Dubakiene Stephen R Durham Mark Dykewicz Motohiro Ebisawa Mina Gaga Yehia El-Gamal Enrico Heffler Regina Emuzyte John Farrell Jean-Luc Fauquert Alessandro Fiocchi Antje Fink-Wagner Jean-François Fontaine José M Fuentes Perez Bilun Gemicioğlu Amiran Gamkrelidze Judith Garcia-Aymerich Philippe Gevaert René Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam Yunuen R Huerta Villalobos Marc Humbert Guido Iaccarino Despo Ierodiakonou Tomohisa Iinuma Ewa Jassem Guy Joos Ki-Suck Jung Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Musa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Rostislav Kouznetsov Marek L Kowalski Vicky Kritikos Inger Kull Stefania La Grutta Lisa Leonardini Henrik Ljungberg Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Catarina Lopes-Pereira Claudia C Loureiro Renaud Louis Alpana Mair Bassam Mahboub Michaël Makris Joao Malva Patrick Manning Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Pedro Carreiro-Martins Mika Makela Eve Mathieu-Dupas Marcus Maurer Esteban De Manuel Keenoy Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Yann Micheli Neven Miculinic Florin Mihaltan Branislava Milenkovic Dimitirios I Mitsias Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralph Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leyla Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Björn Nordlund Ettore Novellino Dieudonné Nyembue Robyn O'Hehir Ken Ohta Kimi Okubo Gabrielle L Onorato Valentina Orlando Solange Ouedraogo Julia Palamarchuk Isabella Pali-Schöll Peter Panzner Hae-Sim Park Gianni Passalacqua Jean-Louis Pépin Ema Paulino Ruby Pawankar Jim Phillips Robert Picard Hilary Pinnock Davor Plavec Todor A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Fotis Psarros Benoit Pugin Francesca Puggioni Pablo Quinones-Delgado Filip Raciborski Rojin Rajabian-Söderlund Frederico S Regateiro Sietze Reitsma Daniela Rivero-Yeverino Graham Roberts Nicolas Roche Erendira Rodriguez-Zagal Christine Rolland Regina E Roller-Wirnsberger Nelson Rosario Antonino Romano Menachem Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Joaquin Sastre Glenis K Scadding Sophie Scheire Peter Schmid-Grendelmeier Holger J Schünemann Faradiba Sarquis Serpa Mohamed Shamji Juan-Carlos Sisul Mikhail Sofiev Dirceu Solé David Somekh Talant Sooronbaev Milan Sova François Spertini Otto Spranger Cristiana Stellato Rafael Stelmach Michel Thibaudon Teresa To Mondher Toumi Omar Usmani Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Marilyn Urrutia Pereira Rianne van der Kleij Michiel Van Eerd Olivier Vandenplas Tuula Vasankari Antonio Vaz Carneiro Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Yun Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Osman M Yusuf Heather J Zar Stéphane Zeng Mario E Zernotti Luo Zhang Nan Shan Zhong Mihaela Zidarn

Allergy 2021 01 23;76(1):168-190. Epub 2020 Oct 23.

University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Digital anamorphosis is used to define a distorted image of health and care that may be viewed correctly using digital tools and strategies. MASK digital anamorphosis represents the process used by MASK to develop the digital transformation of health and care in rhinitis. It strengthens the ARIA change management strategy in the prevention and management of airway disease. The MASK strategy is based on validated digital tools. Using the MASK digital tool and the CARAT online enhanced clinical framework, solutions for practical steps of digital enhancement of care are proposed.
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http://dx.doi.org/10.1111/all.14422DOI Listing
January 2021

Helsinki by nature: The Nature Step to Respiratory Health.

Clin Transl Allergy 2019 30;9:57. Epub 2019 Oct 30.

29FILHA, Finnish Lung Health Association, Helsinki, Finland.

Background: was the overarching theme of the 12th General Meeting of the Global Alliance against Chronic Respiratory Diseases (GARD) in Helsinki, August 2018. New approaches are needed to improve respiratory health and reduce premature mortality of chronic diseases by 30% till 2030 (UN Sustainable Development Goals, SDGs). Planetary health is defined as the health of human civilization and the state of the natural systems on which it depends. Planetary health and human health are interconnected, and both need to be considered by individuals and governments while addressing several SDGs.

Results: The concept of the Nature Step has evolved from innovative research indicating, how changed lifestyle in urban surroundings reduces contact with biodiverse environments, impoverishes microbiota, affects immune regulation and increases risk of NCDs. The Nature Step calls for strengthening connections to nature. Physical activity in natural environments should be promoted, use of fresh vegetables, fruits and water increased, and consumption of sugary drinks, tobacco and alcohol restricted. Nature relatedness should be part of everyday life and especially emphasized in the care of children and the elderly. Taking "nature" to modern cities in a controlled way is possible but a challenge for urban planning, nature conservation, housing, traffic arrangements, energy production, and importantly for supplying and distributing food. Actions against the well-known respiratory risk factors, air pollution and smoking, should be taken simultaneously.

Conclusions: In Finland and elsewhere in Europe, successful programmes have been implemented to reduce the burden of respiratory disorders and other NCDs. Unhealthy behaviour can be changed by well-coordinated actions involving all stakeholders. The growing public health concern caused by NCDs in urban surroundings cannot be solved by health care alone; a multidisciplinary approach is mandatory.
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http://dx.doi.org/10.1186/s13601-019-0295-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6822361PMC
October 2019

Next-generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases.

Authors:
J Jean Bousquet Holger J Schünemann Alkis Togias Marina Erhola Peter W Hellings Torsten Zuberbier Ioana Agache Ignacio J Ansotegui Josep M Anto Claus Bachert Sven Becker Martin Bedolla-Barajas Michael Bewick Sinthia Bosnic-Anticevich Isabelle Bosse Louis P Boulet Jean Marc Bourrez Guy Brusselle Niels Chavannes Elisio Costa Alvaro A Cruz Wienczyslawa Czarlewski Wytske J Fokkens Joao A Fonseca Mina Gaga Tari Haahtela Maddalena Illario Ludger Klimek Piotr Kuna Violeta Kvedariene L T T Le Desiree Larenas-Linnemann Daniel Laune Olga M Lourenço Enrica Menditto Joaquin Mullol Yashitaka Okamoto Nikos Papadopoulos Nhân Pham-Thi Robert Picard Hilary Pinnock Nicolas Roche Regina E Roller-Wirnsberger Christine Rolland Boleslaw Samolinski Aziz Sheikh Sanna Toppila-Salmi Ioanna Tsiligianni Arunas Valiulis Erkka Valovirta Tuula Vasankari Maria-Teresa Ventura Samantha Walker Sian Williams Cezmi A Akdis Isabella Annesi-Maesano Sylvie Arnavielhe Xavier Basagana Eric Bateman Anna Bedbrook K S Bennoor Samuel Benveniste Karl C Bergmann Slawomir Bialek Nils Billo Carsten Bindslev-Jensen Leif Bjermer Hubert Blain Mateo Bonini Philippe Bonniaud Jacques Bouchard Vitalis Briedis Christofer E Brightling Jan Brozek Roland Buhl Roland Buonaiuto Giorgo W Canonica Victoria Cardona Ana M Carriazo Warner Carr Christine Cartier Thomas Casale Lorenzo Cecchi Alfonso M Cepeda Sarabia Eka Chkhartishvili Derek K Chu Cemal Cingi Elaine Colgan Jaime Correia de Sousa Anne Lise Courbis Adnan Custovic Biljana Cvetkosvki Gennaro D'Amato Jane da Silva Carina Dantas Dejand Dokic Yves Dauvilliers Antoni Dedeu Giulia De Feo Philippe Devillier Stefania Di Capua Marc Dykewickz Ruta Dubakiene Motohiro Ebisawa Yaya El-Gamal Esben Eller Regina Emuzyte John Farrell Antjie Fink-Wagner Alessandro Fiocchi Jean F Fontaine Bilun Gemicioğlu Peter Schmid-Grendelmeir Amiran Gamkrelidze Judith Garcia-Aymerich Maximiliano Gomez Sandra González Diaz Maia Gotua Nick A Guldemond Maria-Antonieta Guzmán Jawad Hajjam John O'B Hourihane Marc Humbert Guido Iaccarino Despo Ierodiakonou Maddalena Illario Juan C Ivancevich Guy Joos Ki-Suck Jung Marek Jutel Igor Kaidashev Omer Kalayci Przemyslaw Kardas Thomas Keil Mussa Khaitov Nikolai Khaltaev Jorg Kleine-Tebbe Marek L Kowalski Vicky Kritikos Inger Kull Lisa Leonardini Philip Lieberman Brian Lipworth Karin C Lodrup Carlsen Claudia C Loureiro Renaud Louis Alpana Mair Gert Marien Bassam Mahboub Joao Malva Patrick Manning Esteban De Manuel Keenoy Gailen D Marshall Mohamed R Masjedi Jorge F Maspero Eve Mathieu-Dupas Poalo M Matricardi Eric Melén Elisabete Melo-Gomes Eli O Meltzer Enrica Menditto Jacques Mercier Neven Miculinic Florin Mihaltan Branislava Milenkovic Giuliana Moda Maria-Dolores Mogica-Martinez Yousser Mohammad Steve Montefort Ricardo Monti Mario Morais-Almeida Ralf Mösges Lars Münter Antonella Muraro Ruth Murray Robert Naclerio Luigi Napoli Leila Namazova-Baranova Hugo Neffen Kristoff Nekam Angelo Neou Enrico Novellino Dieudonné Nyembue Robin O'Hehir Ken Ohta Kimi Okubo Gabrielle Onorato Solange Ouedraogo Isabella Pali-Schöll Susanna Palkonen Peter Panzner Hae-Sim Park Jean-Louis Pépin Ana-Maria Pereira Oliver Pfaar Ema Paulino Jim Phillips Robert Picard Davor Plavec Ted A Popov Fabienne Portejoie David Price Emmanuel P Prokopakis Benoit Pugin Filip Raciborski Rojin Rajabian-Söderlund Sietze Reitsma Xavier Rodo Antonino Romano Nelson Rosario Menahenm Rottem Dermot Ryan Johanna Salimäki Mario M Sanchez-Borges Juan-Carlos Sisul Dirceu Solé David Somekh Talant Sooronbaev Milan Sova Otto Spranger Cristina Stellato Rafael Stelmach Charlotte Suppli Ulrik Michel Thibaudon Teresa To Ana Todo-Bom Peter V Tomazic Antonio A Valero Rudolph Valenta Marylin Valentin-Rostan Rianne van der Kleij Olivier Vandenplas Giorgio Vezzani Frédéric Viart Giovanni Viegi Dana Wallace Martin Wagenmann De Y Wang Susan Waserman Magnus Wickman Dennis M Williams Gary Wong Piotr Wroczynski Panayiotis K Yiallouros Arzu Yorgancioglu Osman M Yusuf Heahter J Zar Stéphane Zeng Mario Zernotti Luo Zhang Nan S Zhong Mihaela Zidarn

Clin Transl Allergy 2019 9;9:44. Epub 2019 Sep 9.

260University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

Background: In all societies, the burden and cost of allergic and chronic respiratory diseases are increasing rapidly. Most economies are struggling to deliver modern health care effectively. There is a need to support the transformation of the health care system into integrated care with organizational health literacy.

Main Body: As an example for chronic disease care, MASK (Mobile Airways Sentinel NetworK), a new project of the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, and POLLAR (Impact of Air POLLution on Asthma and Rhinitis, EIT Health), in collaboration with professional and patient organizations in the field of allergy and airway diseases, are proposing real-life ICPs centred around the patient with rhinitis, and using mHealth to monitor environmental exposure. Three aspects of care pathways are being developed: (i) Patient participation, health literacy and self-care through technology-assisted "patient activation", (ii) Implementation of care pathways by pharmacists and (iii) Next-generation guidelines assessing the recommendations of GRADE guidelines in rhinitis and asthma using real-world evidence (RWE) obtained through mobile technology. The EU and global political agendas are of great importance in supporting the digital transformation of health and care, and MASK has been recognized by DG Santé as a Good Practice in the field of digitally-enabled, integrated, person-centred care.

Conclusion: In 20 years, ARIA has considerably evolved from the first multimorbidity guideline in respiratory diseases to the digital transformation of health and care with a strong political involvement.
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http://dx.doi.org/10.1186/s13601-019-0279-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734297PMC
September 2019

Association of Serum Vitamin D (25OHD) Level with Acute Exacerbation of Chronic Obstructive Pulmonary Disease.

Mymensingh Med J 2019 Apr;28(2):441-448

Dr Samprity Islam, Medical Officer, Department of Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.

Acute exacerbations of COPD is characterized by a change in the patients baseline dyspnoea, cough and/or sputum that is beyond normal day to day differences and guides to a change in standard medications in a patient with COPD. Vitamin D influences the innate & adaptive immune system, and exerts pleiotropic antimicrobial and anti-inflammatory responses. Vitamin D deficiency is frequent among COPD patients but its contributory role in disease exacerbations is widely debated. This study was aimed to assess relationship between reduced serum vitamin D (25-OHD) level with COPD severity and acute exacerbation. This observational cross-sectional study was carried out in the department of Respiratory Medicine, NIDCH, Mohakhali, Dhaka, Bangladesh from October 2016 to September 2017. Consecutive 80 hospital admitted patients with acute exacerbation of chronic obstructive pulmonary disease diagnosed on the basis of clinical history & pulmonary function tests and 78 age & sex matched controls were investigated for serum vitamin D (25-OHD) level. Among the COPD patients, 37% had Vitamin D deficiency (<20ng/ml) and 28.75% had Vitamin D insufficiency (20-29ng/ml). Mean vitamin D (25-OHD) level of COPD patients (25.82±10.62ngm/ml) was found to be significantly lower than healthy controls (32.57±11.32ngm/ml). Vitamin D deficiency was found, by Pearson correlation test, to be significantly associated with severity of COPD. Multivariate analysis showed that age (in years), FEV1 (percent predicted), frequent exacerbators (≥2 in the last year), and smoking (>40 pack year) were significantly associated with Vitamin D deficiency. Acute exacerbation of chronic obstructive pulmonary disease patients was found to have vitamin D deficiency and vitamin D deficiency was significantly associated with severity of COPD. Vitamin D deficiency was also associated with frequent disease exacerbation.
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April 2019

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology.

Authors:
Jean Bousquet Peter W Hellings Ioana Agache Flore Amat Isabella Annesi-Maesano Ignacio J Ansotegui Josep M Anto Claus Bachert Eric D Bateman Anna Bedbrook Kazi Bennoor Mickael Bewick Carsten Bindslev-Jensen Sinthia Bosnic-Anticevich Isabelle Bosse Jan Brozek Luisa Brussino Giorgio W Canonica Victoria Cardona Thomas Casale Alfonso M Cepeda Sarabia Niels H Chavannes Lorenzo Cecchi Jaime Correia de Sousa Elisio Costa Alvaro A Cruz Wienczyslawa Czarlewski Giuseppe De Carlo Giulia De Feo Pascal Demoly Philippe Devillier Mark S Dykewicz Yehia El-Gamal Esben E Eller Joao A Fonseca Jean-François Fontaine Wytske J Fokkens Maria-Antonieta Guzmán Tari Haahtela Maddalena Illario Juan-Carlos Ivancevich Jocelyne Just Igor Kaidashev Musa Khaitov Omer Kalayci Thomas Keil Ludger Klimek Marek L Kowalski Piotr Kuna Violeta Kvedariene Desiree Larenas-Linnemann Daniel Laune Lan T T Le Karin Lodrup Carlsen Olga Lourenço Bassam Mahboub Alpana Mair Enrica Menditto Branislava Milenkovic Mario Morais-Almeida Ralph Mösges Joaquim Mullol Ruth Murray Robert Naclerio Leyla Namazova-Baranova Ettore Novellino Robyn E O'Hehir Ken Ohta Yoshitaka Okamoto Kimi Okubo Gabrielle L Onorato Susanna Palkonen Petr Panzner Nikos G Papadopoulos Hae-Sim Park Ema Paulino Ruby Pawankar Oliver Pfaar Davor Plavec Ted A Popov Paul Potter Emmanuel P Prokopakis Menachem Rottem Dermot Ryan Johanna Salimäki Boleslaw Samolinski Mario Sanchez-Borges Holger J Schunemann Aziz Sheikh Juan-Carlos Sisul Rojin Rajabian-Söderlund Talant Sooronbaev Cristiana Stellato Teresa To Ana-Maria Todo-Bom Peter-Valentin Tomazic Sanna Toppila-Salmi Antonio Valero Arunas Valiulis Erkka Valovirta Maria-Teresa Ventura Martin Wagenmann De Yun Wang Dana Wallace Susan Waserman Magnus Wickman Arzu Yorgancioglu Luo Zhang Nanshan Zhong Mihaela Zidarn Torsten Zuberbier

J Allergy Clin Immunol 2019 03 29;143(3):864-879. Epub 2018 Sep 29.

Comprehensive Allergy Center Charité, Department of Dermatology and Allergy, Charité-Universitätsmedizin Berlin, and Global Allergy and Asthma European Network (GA2LEN), Berlin, Germany.

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional.
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http://dx.doi.org/10.1016/j.jaci.2018.08.049DOI Listing
March 2019

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

Authors:
J Bousquet J Farrell G Crooks P Hellings E H Bel M Bewick N H Chavannes J Correia de Sousa A A Cruz T Haahtela G Joos N Khaltaev J Malva A Muraro M Nogues S Palkonen S Pedersen C Robalo-Cordeiro B Samolinski T Strandberg A Valiulis A Yorgancioglu T Zuberbier A Bedbrook W Aberer M Adachi A Agusti C A Akdis M Akdis J Ankri A Alonso I Annesi-Maesano I J Ansotegui J M Anto S Arnavielhe H Arshad C Bai I Baiardini C Bachert A K Baigenzhin C Barbara E D Bateman B Beghé A Ben Kheder K S Bennoor M Benson K C Bergmann T Bieber C Bindslev-Jensen L Bjermer H Blain F Blasi A L Boner M Bonini S Bonini S Bosnic-Anticevitch L P Boulet R Bourret P J Bousquet F Braido A H Briggs C E Brightling J Brozek R Buhl P G Burney A Bush F Caballero-Fonseca D Caimmi M A Calderon P M Calverley P A M Camargos G W Canonica T Camuzat K H Carlsen W Carr A Carriazo T Casale A M Cepeda Sarabia L Chatzi Y Z Chen R Chiron E Chkhartishvili A G Chuchalin K F Chung G Ciprandi I Cirule L Cox D J Costa A Custovic R Dahl S E Dahlen U Darsow G De Carlo F De Blay T Dedeu D Deleanu E De Manuel Keenoy P Demoly J A Denburg P Devillier A Didier A T Dinh-Xuan R Djukanovic D Dokic H Douagui G Dray R Dubakiene S R Durham M S Dykewicz Y El-Gamal R Emuzyte L M Fabbri M Fletcher A Fiocchi A Fink Wagner J Fonseca W J Fokkens F Forastiere P Frith M Gaga A Gamkrelidze J Garces J Garcia-Aymerich B Gemicioğlu J E Gereda S González Diaz M Gotua I Grisle L Grouse Z Gutter M A Guzmán L G Heaney B Hellquist-Dahl D Henderson A Hendry J Heinrich D Heve F Horak J O' B Hourihane P Howarth M Humbert M E Hyland M Illario J C Ivancevich J R Jardim E J Jares C Jeandel C Jenkins S L Johnston O Jonquet K Julge K S Jung J Just I Kaidashev M R Khaitov O Kalayci A F Kalyoncu T Keil P K Keith L Klimek B Koffi N'Goran V Kolek G H Koppelman M L Kowalski I Kull P Kuna V Kvedariene B Lambrecht S Lau D Larenas-Linnemann D Laune L T T Le P Lieberman B Lipworth J Li K Lodrup Carlsen R Louis W MacNee Y Magard A Magnan B Mahboub A Mair I Majer M J Makela P Manning S Mara G D Marshall M R Masjedi P Matignon M Maurer S Mavale-Manuel E Melén E Melo-Gomes E O Meltzer A Menzies-Gow H Merk J P Michel N Miculinic F Mihaltan B Milenkovic G M Y Mohammad M Molimard I Momas A Montilla-Santana M Morais-Almeida M Morgan R Mösges J Mullol S Nafti L Namazova-Baranova R Naclerio A Neou H Neffen K Nekam B Niggemann G Ninot T D Nyembue R E O'Hehir K Ohta Y Okamoto K Okubo S Ouedraogo P Paggiaro I Pali-Schöll P Panzner N Papadopoulos A Papi H S Park G Passalacqua I Pavord R Pawankar R Pengelly O Pfaar R Picard B Pigearias I Pin D Plavec D Poethig W Pohl T A Popov F Portejoie P Potter D Postma D Price K F Rabe F Raciborski F Radier Pontal S Repka-Ramirez S Reitamo S Rennard F Rodenas J Roberts J Roca L Rodriguez Mañas C Rolland M Roman Rodriguez A Romano J Rosado-Pinto N Rosario L Rosenwasser M Rottem D Ryan M Sanchez-Borges G K Scadding H J Schunemann E Serrano P Schmid-Grendelmeier H Schulz A Sheikh M Shields N Siafakas Y Sibille T Similowski F E R Simons J C Sisul I Skrindo H A Smit D Solé T Sooronbaev O Spranger R Stelmach P J Sterk J Sunyer C Thijs T To A Todo-Bom M Triggiani R Valenta A L Valero E Valia E Valovirta E Van Ganse M van Hage O Vandenplas T Vasankari B Vellas J Vestbo G Vezzani P Vichyanond G Viegi C Vogelmeier T Vontetsianos M Wagenmann B Wallaert S Walker D Y Wang U Wahn M Wickman D M Williams S Williams J Wright B P Yawn P K Yiallouros O M Yusuf A Zaidi H J Zar M E Zernotti L Zhang N Zhong M Zidarn J Mercier

Clin Transl Allergy 2017 20;7. Epub 2017 Feb 20.

Department of Physiology, CHRU and Vice President for Research, University Montpellier, Montpellier, France.

[This corrects the article DOI: 10.1186/s13601-016-0116-9.].
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http://dx.doi.org/10.1186/s13601-016-0135-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5319069PMC
February 2017

ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle.

Authors:
J Bousquet P W Hellings I Agache A Bedbrook C Bachert K C Bergmann M Bewick C Bindslev-Jensen S Bosnic-Anticevitch C Bucca D P Caimmi P A M Camargos G W Canonica T Casale N H Chavannes A A Cruz G De Carlo R Dahl P Demoly P Devillier J Fonseca W J Fokkens N A Guldemond T Haahtela M Illario J Just T Keil L Klimek P Kuna D Larenas-Linnemann M Morais-Almeida J Mullol R Murray R Naclerio R E O'Hehir N G Papadopoulos R Pawankar P Potter D Ryan B Samolinski H J Schunemann A Sheikh F E R Simons C Stellato A Todo-Bom P V Tomazic A Valiulis E Valovirta M T Ventura M Wickman I Young A Yorgancioglu T Zuberbier W Aberer C A Akdis M Akdis I Annesi-Maesano J Ankri I J Ansotegui J M Anto S Arnavielhe A Asarnoj H Arshad F Avolio I Baiardini C Barbara M Barbagallo E D Bateman B Beghé E H Bel K S Bennoor M Benson A Z Białoszewski T Bieber L Bjermer H Blain F Blasi A L Boner M Bonini S Bonini I Bosse J Bouchard L P Boulet R Bourret P J Bousquet F Braido A H Briggs C E Brightling J Brozek R Buhl C Bunu E Burte A Bush F Caballero-Fonseca M A Calderon T Camuzat V Cardona P Carreiro-Martins A M Carriazo K H Carlsen W Carr A M Cepeda Sarabia M Cesari L Chatzi R Chiron T Chivato E Chkhartishvili A G Chuchalin K F Chung G Ciprandi J Correia de Sousa L Cox G Crooks A Custovic S E Dahlen U Darsow T Dedeu D Deleanu J A Denburg G De Vries A Didier A T Dinh-Xuan D Dokic H Douagui G Dray R Dubakiene S R Durham G Du Toit M S Dykewicz P Eklund Y El-Gamal E Ellers R Emuzyte J Farrell A Fink Wagner A Fiocchi M Fletcher F Forastiere M Gaga A Gamkrelidze B Gemicioğlu J E Gereda R Gerth van Wick S González Diaz I Grisle L Grouse Z Gutter M A Guzmán B Hellquist-Dahl J Heinrich F Horak J O' B Hourihane M Humbert M Hyland G Iaccarino E J Jares C Jeandel S L Johnston G Joos O Jonquet K S Jung M Jutel I Kaidashev M Khaitov O Kalayci A F Kalyoncu P Kardas P K Keith M Kerkhof H A M Kerstjens N Khaltaev M Kogevinas V Kolek G H Koppelman M L Kowalski M Kuitunen I Kull V Kvedariene B Lambrecht S Lau D Laune L T T Le P Lieberman B Lipworth J Li K C Lodrup Carlsen R Louis C Lupinek W MacNee Y Magar A Magnan B Mahboub D Maier I Majer J Malva P Manning E De Manuel Keenoy G D Marshall M R Masjedi E Mathieu-Dupas M Maurer S Mavale-Manuel E Melén E Melo-Gomes E O Meltzer J Mercier H Merk N Miculinic F Mihaltan B Milenkovic J Millot-Keurinck Y Mohammad I Momas R Mösges A Muraro L Namazova-Baranova R Nadif H Neffen K Nekam A Nieto B Niggemann L Nogueira-Silva M Nogues T D Nyembue K Ohta Y Okamoto K Okubo M Olive-Elias S Ouedraogo P Paggiaro I Pali-Schöll S Palkonen P Panzner A Papi H S Park G Passalacqua S Pedersen A M Pereira O Pfaar R Picard B Pigearias I Pin D Plavec W Pohl T A Popov F Portejoie D Postma L K Poulsen D Price K F Rabe F Raciborski G Roberts C Robalo-Cordeiro F Rodenas L Rodriguez-Mañas C Rolland M Roman Rodriguez A Romano J Rosado-Pinto N Rosario M Rottem M Sanchez-Borges J Sastre-Dominguez G K Scadding N Scichilone P Schmid-Grendelmeier E Serrano M Shields V Siroux J C Sisul I Skrindo H A Smit D Solé T Sooronbaev O Spranger R Stelmach P J Sterk T Strandberg J Sunyer C Thijs M Triggiani R Valenta A Valero M van Eerd E van Ganse M van Hague O Vandenplas L L Varona B Vellas G Vezzani T Vazankari G Viegi T Vontetsianos M Wagenmann S Walker D Y Wang U Wahn T Werfel B Whalley D M Williams S Williams N Wilson J Wright B P Yawn P K Yiallouros O M Yusuf A Zaidi H J Zar M E Zernotti L Zhang N Zhong M Zidarn

Clin Transl Allergy 2016 30;6:47. Epub 2016 Dec 30.

University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia.

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA-disseminated and implemented in over 70 countries globally-is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA ()-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
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http://dx.doi.org/10.1186/s13601-016-0137-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203711PMC
December 2016

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

Authors:
J Bousquet J Farrell G Crooks P Hellings E H Bel M Bewick N H Chavannes J Correia de Sousa A A Cruz T Haahtela G Joos N Khaltaev J Malva A Muraro M Nogues S Palkonen S Pedersen C Robalo-Cordeiro B Samolinski T Strandberg A Valiulis A Yorgancioglu T Zuberbier A Bedbrook W Aberer M Adachi A Agusti C A Akdis M Akdis J Ankri A Alonso I Annesi-Maesano I J Ansotegui J M Anto S Arnavielhe H Arshad C Bai I Baiardini C Bachert A K Baigenzhin C Barbara E D Bateman B Beghé A Ben Kheder K S Bennoor M Benson K C Bergmann T Bieber C Bindslev-Jensen L Bjermer H Blain F Blasi A L Boner M Bonini S Bonini S Bosnic-Anticevitch L P Boulet R Bourret P J Bousquet F Braido A H Briggs C E Brightling J Brozek R Buhl P G Burney A Bush F Caballero-Fonseca D Caimmi M A Calderon P M Calverley P A M Camargos G W Canonica T Camuzat K H Carlsen W Carr A Carriazo T Casale A M Cepeda Sarabia L Chatzi Y Z Chen R Chiron E Chkhartishvili A G Chuchalin K F Chung G Ciprandi I Cirule L Cox D J Costa A Custovic R Dahl S E Dahlen U Darsow G De Carlo F De Blay T Dedeu D Deleanu E De Manuel Keenoy P Demoly J A Denburg P Devillier A Didier A T Dinh-Xuan R Djukanovic D Dokic H Douagui G Dray R Dubakiene S R Durham M S Dykewicz Y El-Gamal R Emuzyte L M Fabbri M Fletcher A Fiocchi A Fink Wagner J Fonseca W J Fokkens F Forastiere P Frith M Gaga A Gamkrelidze J Garces J Garcia-Aymerich B Gemicioğlu J E Gereda S González Diaz M Gotua I Grisle L Grouse Z Gutter M A Guzmán L G Heaney B Hellquist-Dahl D Henderson A Hendry J Heinrich D Heve F Horak J O' B Hourihane P Howarth M Humbert M E Hyland M Illario J C Ivancevich J R Jardim E J Jares C Jeandel C Jenkins S L Johnston O Jonquet K Julge K S Jung J Just I Kaidashev M R Kaitov O Kalayci A F Kalyoncu T Keil P K Keith L Klimek B Koffi N'Goran V Kolek G H Koppelman M L Kowalski I Kull P Kuna V Kvedariene B Lambrecht S Lau D Larenas-Linnemann D Laune L T T Le P Lieberman B Lipworth J Li K Lodrup Carlsen R Louis W MacNee Y Magard A Magnan B Mahboub A Mair I Majer M J Makela P Manning S Mara G D Marshall M R Masjedi P Matignon M Maurer S Mavale-Manuel E Melén E Melo-Gomes E O Meltzer A Menzies-Gow H Merk J P Michel N Miculinic F Mihaltan B Milenkovic G M Y Mohammad M Molimard I Momas A Montilla-Santana M Morais-Almeida M Morgan R Mösges J Mullol S Nafti L Namazova-Baranova R Naclerio A Neou H Neffen K Nekam B Niggemann G Ninot T D Nyembue R E O'Hehir K Ohta Y Okamoto K Okubo S Ouedraogo P Paggiaro I Pali-Schöll P Panzner N Papadopoulos A Papi H S Park G Passalacqua I Pavord R Pawankar R Pengelly O Pfaar R Picard B Pigearias I Pin D Plavec D Poethig W Pohl T A Popov F Portejoie P Potter D Postma D Price K F Rabe F Raciborski F Radier Pontal S Repka-Ramirez S Reitamo S Rennard F Rodenas J Roberts J Roca L Rodriguez Mañas C Rolland M Roman Rodriguez A Romano J Rosado-Pinto N Rosario L Rosenwasser M Rottem D Ryan M Sanchez-Borges G K Scadding H J Schunemann E Serrano P Schmid-Grendelmeier H Schulz A Sheikh M Shields N Siafakas Y Sibille T Similowski F E R Simons J C Sisul I Skrindo H A Smit D Solé T Sooronbaev O Spranger R Stelmach P J Sterk J Sunyer C Thijs T To A Todo-Bom M Triggiani R Valenta A L Valero E Valia E Valovirta E Van Ganse M van Hage O Vandenplas T Vasankari B Vellas J Vestbo G Vezzani P Vichyanond G Viegi C Vogelmeier T Vontetsianos M Wagenmann B Wallaert S Walker D Y Wang U Wahn M Wickman D M Williams S Williams J Wright B P Yawn P K Yiallouros O M Yusuf A Zaidi H J Zar M E Zernotti L Zhang N Zhong M Zidarn J Mercier

Clin Transl Allergy 2016 29;6:29. Epub 2016 Jul 29.

Department of Physiology, CHRU and Vice President for Research, University Montpellier, Montpellier, France.

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.
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http://dx.doi.org/10.1186/s13601-016-0116-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4966705PMC
August 2016

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation.

Authors:
J Bousquet H J Schunemann J Fonseca B Samolinski C Bachert G W Canonica T Casale A A Cruz P Demoly P Hellings A Valiulis M Wickman T Zuberbier S Bosnic-Anticevitch A Bedbrook K C Bergmann D Caimmi R Dahl W J Fokkens I Grisle K Lodrup Carlsen J Mullol A Muraro S Palkonen N Papadopoulos G Passalacqua D Ryan E Valovirta A Yorgancioglu W Aberer I Agache M Adachi C A Akdis M Akdis I Annesi-Maesano I J Ansotegui J M Anto S Arnavielhe H Arshad I Baiardini A K Baigenzhin C Barbara E D Bateman B Beghé E H Bel A Ben Kheder K S Bennoor M Benson M Bewick T Bieber C Bindslev-Jensen L Bjermer H Blain A L Boner L P Boulet M Bonini S Bonini I Bosse R Bourret P J Bousquet F Braido A H Briggs C E Brightling J Brozek R Buhl P G Burney A Bush F Caballero-Fonseca M A Calderon P A M Camargos T Camuzat K H Carlsen W Carr A M Cepeda Sarabia N H Chavannes L Chatzi Y Z Chen R Chiron E Chkhartishvili A G Chuchalin G Ciprandi I Cirule J Correia de Sousa L Cox G Crooks D J Costa A Custovic S E Dahlen U Darsow G De Carlo F De Blay T Dedeu D Deleanu J A Denburg P Devillier A Didier A T Dinh-Xuan D Dokic H Douagui G Dray R Dubakiene S R Durham M S Dykewicz Y El-Gamal R Emuzyte A Fink Wagner M Fletcher A Fiocchi F Forastiere A Gamkrelidze B Gemicioğlu J E Gereda S González Diaz M Gotua L Grouse M A Guzmán T Haahtela B Hellquist-Dahl J Heinrich F Horak J O 'b Hourihane P Howarth M Humbert M E Hyland J C Ivancevich E J Jares S L Johnston G Joos O Jonquet K S Jung J Just I Kaidashev O Kalayci A F Kalyoncu T Keil P K Keith N Khaltaev L Klimek B Koffi N'Goran V Kolek G H Koppelman M L Kowalski I Kull P Kuna V Kvedariene B Lambrecht S Lau D Larenas-Linnemann D Laune L T T Le P Lieberman B Lipworth J Li R Louis Y Magard A Magnan B Mahboub I Majer M J Makela P Manning E De Manuel Keenoy G D Marshall M R Masjedi M Maurer S Mavale-Manuel E Melén E Melo-Gomes E O Meltzer H Merk N Miculinic F Mihaltan B Milenkovic Y Mohammad M Molimard I Momas A Montilla-Santana M Morais-Almeida R Mösges L Namazova-Baranova R Naclerio A Neou H Neffen K Nekam B Niggemann T D Nyembue R E O'Hehir K Ohta Y Okamoto K Okubo S Ouedraogo P Paggiaro I Pali-Schöll S Palmer P Panzner A Papi H S Park I Pavord R Pawankar O Pfaar R Picard B Pigearias I Pin D Plavec W Pohl T A Popov F Portejoie D Postma P Potter D Price K F Rabe F Raciborski F Radier Pontal S Repka-Ramirez C Robalo-Cordeiro C Rolland J Rosado-Pinto S Reitamo F Rodenas M Roman Rodriguez A Romano N Rosario L Rosenwasser M Rottem M Sanchez-Borges G K Scadding E Serrano P Schmid-Grendelmeier A Sheikh F E R Simons J C Sisul I Skrindo H A Smit D Solé T Sooronbaev O Spranger R Stelmach T Strandberg J Sunyer C Thijs A Todo-Bom M Triggiani R Valenta A L Valero M van Hage O Vandenplas G Vezzani P Vichyanond G Viegi M Wagenmann S Walker D Y Wang U Wahn D M Williams J Wright B P Yawn P K Yiallouros O M Yusuf H J Zar M E Zernotti L Zhang N Zhong M Zidarn J Mercier

Allergy 2015 Nov 13;70(11):1372-92. Epub 2015 Sep 13.

Vice President for Research, University Montpellier, Montpellier, France.

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.
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http://dx.doi.org/10.1111/all.12686DOI Listing
November 2015

Integrated care pathways for airway diseases (AIRWAYS-ICPs).

Authors:
J Bousquet A Addis I Adcock I Agache A Agusti A Alonso I Annesi-Maesano J M Anto C Bachert C E Baena-Cagnani C Bai A Baigenzhin C Barbara P J Barnes E D Bateman L Beck A Bedbrook E H Bel O Benezet K S Bennoor M Benson M Bernabeu-Wittel M Bewick C Bindslev-Jensen H Blain F Blasi M Bonini S Bonini L P Boulet A Bourdin R Bourret P J Bousquet C E Brightling A Briggs J Brozek R Buhl A Bush D Caimmi M Calderon P Calverley P A Camargos T Camuzat G W Canonica K H Carlsen T B Casale M Cazzola A M Cepeda Sarabia A Cesario Y Z Chen E Chkhartishvili N H Chavannes R Chiron A Chuchalin K F Chung L Cox G Crooks M G Crooks A A Cruz A Custovic R Dahl S E Dahlen F De Blay T Dedeu D Deleanu P Demoly P Devillier A Didier A T Dinh-Xuan R Djukanovic D Dokic H Douagui R Dubakiene S Eglin F Elliot R Emuzyte L Fabbri A Fink Wagner M Fletcher W J Fokkens J Fonseca A Franco P Frith A Furber M Gaga J Garcés J Garcia-Aymerich A Gamkrelidze S Gonzales-Diaz F Gouzi M A Guzmán T Haahtela D Harrison M Hayot L G Heaney J Heinrich P W Hellings J Hooper M Humbert M Hyland G Iaccarino D Jakovenko J R Jardim C Jeandel C Jenkins S L Johnston O Jonquet G Joos K S Jung O Kalayci S Karunanithi T Keil N Khaltaev V Kolek M L Kowalski I Kull P Kuna V Kvedariene L T Le K C Lodrup Carlsen R Louis W MacNee A Mair I Majer P Manning E de Manuel Keenoy M R Masjedi E Melen E Melo-Gomes A Menzies-Gow G Mercier J Mercier J P Michel N Miculinic F Mihaltan B Milenkovic M Molimard I Momas A Montilla-Santana M Morais-Almeida M Morgan M N'Diaye S Nafti K Nekam A Neou L Nicod R O'Hehir K Ohta P Paggiaro S Palkonen S Palmer N G Papadopoulos A Papi G Passalacqua I Pavord B Pigearias D Plavec D S Postma D Price K F Rabe F Radier Pontal J Redon S Rennard J Roberts J M Robine J Roca N Roche F Rodenas A Roggeri C Rolland J Rosado-Pinto D Ryan B Samolinski M Sanchez-Borges H J Schünemann A Sheikh M Shields N Siafakas Y Sibille T Similowski I Small O Sola-Morales T Sooronbaev R Stelmach P J Sterk T Stiris P Sud V Tellier T To A Todo-Bom M Triggiani R Valenta A L Valero A Valiulis E Valovirta E Van Ganse O Vandenplas T Vasankari J Vestbo G Vezzani G Viegi L Visier C Vogelmeier T Vontetsianos R Wagstaff U Wahn B Wallaert B Whalley M Wickman D M Williams N Wilson B P Yawn P K Yiallouros A Yorgancioglu O M Yusuf H J Zar N Zhong M Zidarn T Zuberbier

Eur Respir J 2014 Aug 12;44(2):304-23. Epub 2014 Jun 12.

GALEN, Global Allergy and Asthma European Network Charité University Hospital, Allergy Centre Charité, Berlin, Germany.

The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).
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http://dx.doi.org/10.1183/09031936.00014614DOI Listing
August 2014

Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs.

Authors:
J Bousquet H J Schünemann B Samolinski P Demoly C E Baena-Cagnani C Bachert S Bonini L P Boulet P J Bousquet J L Brozek G W Canonica T B Casale A A Cruz W J Fokkens J A Fonseca R Gerth van Wijk L Grouse T Haahtela N Khaltaev P Kuna R F Lockey K C Lodrup Carlsen J Mullol R Naclerio R E O'Hehir K Ohta S Palkonen N G Papadopoulos G Passalacqua R Pawankar D Price D Ryan F E R Simons A Togias D Williams A Yorgancioglu O M Yusuf W Aberer M Adachi I Agache N Aït-Khaled C A Akdis A Andrianarisoa I Annesi-Maesano I J Ansotegui I Baiardini E D Bateman A Bedbrook B Beghé M Beji E H Bel A Ben Kheder K S Bennoor K C Bergmann F Berrissoul T Bieber C Bindslev Jensen M S Blaiss A L Boner J Bouchard F Braido C E Brightling A Bush F Caballero M A Calderon M A Calvo P A M Camargos L R Caraballo K H Carlsen W Carr A M Cepeda A Cesario N H Chavannes Y Z Chen A M Chiriac T Chivato Pérez E Chkhartishvili G Ciprandi D J Costa L Cox A Custovic R Dahl U Darsow F De Blay D Deleanu J A Denburg P Devillier T Didi D Dokic W K Dolen H Douagui R Dubakiene S R Durham M S Dykewicz Y El-Gamal A El-Meziane R Emuzyte A Fiocchi M Fletcher T Fukuda A Gamkrelidze J E Gereda S González Diaz M Gotua M A Guzmán P W Hellings B Hellquist-Dahl F Horak J O'B Hourihane P Howarth M Humbert J C Ivancevich C Jackson J Just O Kalayci M A Kaliner A F Kalyoncu T Keil P K Keith G Khayat Y Y Kim B Koffi N'goran G H Koppelman M L Kowalski I Kull V Kvedariene D Larenas-Linnemann L T Le C Lemière J Li P Lieberman B Lipworth B Mahboub M J Makela F Martin G D Marshall F D Martinez M R Masjedi M Maurer S Mavale-Manuel A Mazon E Melen E O Meltzer N H Mendez H Merk F Mihaltan Y Mohammad M Morais-Almeida A Muraro S Nafti L Namazova-Baranova K Nekam A Neou B Niggemann E Nizankowska-Mogilnicka T D Nyembue Y Okamoto K Okubo M P Orru S Ouedraogo C Ozdemir P Panzner I Pali-Schöll H S Park B Pigearias W Pohl T A Popov D S Postma P Potter K F Rabe J Ratomaharo S Reitamo J Ring R Roberts B Rogala A Romano M Roman Rodriguez J Rosado-Pinto L Rosenwasser M Rottem M Sanchez-Borges G K Scadding P Schmid-Grendelmeier A Sheikh J C Sisul D Solé T Sooronbaev V Spicak O Spranger R T Stein S W Stoloff J Sunyer A Szczeklik A Todo-Bom E Toskala Y Tremblay R Valenta A L Valero D Valeyre A Valiulis E Valovirta P Van Cauwenberge O Vandenplas C van Weel P Vichyanond G Viegi D Y Wang M Wickman S Wöhrl J Wright B P Yawn P K Yiallouros H J Zar M E Zernotti N Zhong M Zidarn T Zuberbier P G Burney S L Johnston J O Warner

J Allergy Clin Immunol 2012 Nov 4;130(5):1049-62. Epub 2012 Oct 4.

Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children.
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http://dx.doi.org/10.1016/j.jaci.2012.07.053DOI Listing
November 2012

Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper.

Authors:
J Bousquet J M Anto P Demoly H J Schünemann A Togias M Akdis C Auffray C Bachert T Bieber P J Bousquet K H Carlsen T B Casale A A Cruz T Keil K C Lodrup Carlsen M Maurer K Ohta N G Papadopoulos M Roman Rodriguez B Samolinski I Agache A Andrianarisoa C S Ang I Annesi-Maesano F Ballester C E Baena-Cagnani X Basagaña E D Bateman E H Bel A Bedbrook B Beghé M Beji A Ben Kheder M Benet K S Bennoor K C Bergmann F Berrissoul C Bindslev Jensen E R Bleecker S Bonini A L Boner L P Boulet C E Brightling J L Brozek A Bush W W Busse P A M Camargos G W Canonica W Carr A Cesario Y Z Chen A M Chiriac D J Costa L Cox A Custovic R Dahl U Darsow T Didi W K Dolen H Douagui R Dubakiene A El-Meziane J A Fonseca W J Fokkens E Fthenou A Gamkrelidze J Garcia-Aymerich R Gerth van Wijk E Gimeno-Santos S Guerra T Haahtela H Haddad P W Hellings B Hellquist-Dahl C Hohmann P Howarth J O Hourihane M Humbert B Jacquemin J Just O Kalayci M A Kaliner F Kauffmann M Kerkhof G Khayat B Koffi N'Goran M Kogevinas G H Koppelman M L Kowalski I Kull P Kuna D Larenas I Lavi L T Le P Lieberman B Lipworth B Mahboub M J Makela F Martin F D Martinez G D Marshall A Mazon E Melen E O Meltzer F Mihaltan Y Mohammad A Mohammadi I Momas M Morais-Almeida J Mullol A Muraro R Naclerio S Nafti L Namazova-Baranova M C Nawijn T D Nyembue S Oddie R E O'Hehir Y Okamoto M P Orru C Ozdemir G S Ouedraogo S Palkonen P Panzner G Passalacqua R Pawankar B Pigearias I Pin M Pinart C Pison T A Popov D Porta D S Postma D Price K F Rabe J Ratomaharo S Reitamo D Rezagui J Ring R Roberts J Roca B Rogala A Romano J Rosado-Pinto D Ryan M Sanchez-Borges G K Scadding A Sheikh F E R Simons V Siroux P D Schmid-Grendelmeier H A Smit T Sooronbaev R T Stein P J Sterk J Sunyer I Terreehorst E Toskala Y Tremblay R Valenta D Valeyre O Vandenplas C van Weel M Vassilaki R Varraso G Viegi D Y Wang M Wickman D Williams S Wöhrl J Wright A Yorgancioglu O M Yusuf H J Zar M E Zernotti M Zidarn N Zhong T Zuberbier

Int Arch Allergy Immunol 2012 ;158(3):216-31

Centre Hospitalier Universitaire Montpellier, Montpellier Cedex 05, France.

Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.
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http://dx.doi.org/10.1159/000332924DOI Listing
August 2012

Incidence of pulmonary tuberculosis in garments workers of Dhaka City, Bangladesh.

Bangladesh Med Res Counc Bull 2005 Apr;31(1):7-14

Deptt. of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka.

This study was conducted to find out the incidence of Pulmonary Tuberculosis (PT) in garments workers of Dhaka city and to find-out the relationship between the incidence of PT and socio-demographic factors of the respondents. From all garments factories of Dhaka city, 30 factories were included by stratified random sampling method. Then workers were selected by simple random sampling technique. Following selection, detailed history was taken and recorded in a pre-tested questionnaire. Chest X-ray, Sputum for AFB, M.T and ESR were done in the suspected cases. PT was diagnosed when any patient fulfilled predefined inclusion criteria. Out of 2400 selected workers, 2281 workers were studied finally. A total of 22 (9.6 per 1000) definite PT cases were identified. Sputum positive were 4/2281 (1.75 per 1000) cases. All were diagnosed as new cases; none had received any treatment of tuberculosis in the past. The study concludes that PT among the garments workers is a more alarming health issue than among the general population of Bangladesh. Improved and regular health check-up system and 'directly observed treatment shortcourse' (DOTS) should be implemented in the working places particularly where clusters of workers are working together.
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April 2005

Self-reported asthma symptoms in children and adults of Bangladesh: findings of the National Asthma Prevalence Study.

Int J Epidemiol 2002 Apr;31(2):483-8

Institute of Diseases of the Chest and Hospital, Mohakhali, Dhaka-1212, Bangladesh.

Background: No population-based studies to determine the magnitude of the asthma problem have been carried out in Bangladesh. This study aimed to define the prevalence of asthma as well as to identify the risk factors of asthma in the general population of Bangladesh.

Methods: A cross-sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people. Data were collected from randomly selected primary sampling units of 8 municipality blocks of 4 large metropolitan cities, 12 municipality blocks of 6 district towns and 12 villages of 6 districts chosen randomly from all 64 districts of the country. Face-to-face interviews were performed with the housewives or other guardians at the household level using a structured questionnaire.

Results: The prevalence of asthma (wheeze in the last 12 months) was 6.9% (95% CI : 6.2-7.6). The prevalence of other asthma definitions were: ever wheeze (lifetime wheeze) 8.0% (95% CI : 7.3-8.7); perceived asthma (perception of having asthma) 7.6% (95% CI : 6.9-8.3); doctor diagnosed asthma (diagnosis of asthma by any category of doctor either qualified or unqualified) 4.4% (95% CI : 3.9-4.9). The prevalence of asthma in children (5-14 years) was higher than in adults (15-44 years) (7.3% versus 5.3%; odds ratio [OR] = 1.41, 95% CI : 1.09-1.82). Asthma in children was found to be significantly higher in households with
Conclusions: Asthma in Bangladesh appears to be a substantial public health problem: an estimated 7 million people including 4 million children suffer from asthma-related symptoms.
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April 2002

Effect of Momordica charantia (Karolla) extracts on fasting and postprandial serum glucose levels in NIDDM patients.

Bangladesh Med Res Counc Bull 1999 Apr;25(1):11-3

Department of Pathology, Sher-e-Bangla Medical College, Barisal.

Effect of Momordica charantia, a bitter vegetable popularly known as Karolla, on fasting and post prandial (2 hours after 75 gm oral glucose intake) serum glucose levels were studied in 100 cases of moderate non-insulin dependent diabetic subjects. Drinking of the aqueous homogenized suspension of the vegetable pulp led to significant reduction (p < 0.001) of both fasting and post-prandial serum glucose levels. This hypoglycaemic action was observed in 86 (86%) cases. Five cases (5%) showed lowering of fasting serum glucose only.
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April 1999