This real-life study confirms that omalizumab is very efficacious and very well tolerated in patients with uncontrolled severe asthma. Results did not vary in the subgroup of patients with IgE levels >700 IU/ml.

Alexithymia is a psychological trait characterised by difficulty in perceiving and expressing emotions and body sensations. Failure to perceive dyspnoea could lead alexithymic asthmatics to underestimate the severity of an asthma exacerbation, and thereby increase the risk of developing a fatal or near-fatal asthma (NFA) attack. The objective of the present study was to determine the prevalence of alexithymia in NFA patients and to analyse their clinical characteristics.Alexithymia was assessed using the Toronto Alexithymia Scale in this multicentric prospective observational study. From 33 Spanish hospitals, 179 NFA patients and 40 non-NFA patients, as a control group, were enrolled.There was a higher proportion of alexithymia in the NFA group than in the non-NFA group (36 versus 13%). Patients with NFA and alexithymia were older than the rest of the NFA group, and had a lower level of education, a higher level of psychiatric morbidity, a higher proportion of severe persistent asthma and a greater number of prior very severe asthma exacerbations (49 versus 27%). Alexithymia, severe persistent asthma and a low level of education were identified as independent variables related to repeated very severe asthma exacerbations.The results show that alexithymia is more frequent in near-fatal asthma patients compared to the rest of asthmatics and is associated with recurrent very severe asthma exacerbations.

This study was designed to validate a new home portable respiratory recording device (PRRD) to identify sleep apnoea and hypopnoea in a group of subjects (n=116), from a sample of the general population. Full night polysomnography (PSG) was used as the gold standard and simultaneously performed with PRRD. PRRD measurements included oronasal airflow (thermistry), chest wall impedance, oxygen saturation, snoring and body position. The sensors were unique for each recording system. Data obtained was blindly reviewed and analysed. A high level of agreement between both methods apnoea/hypopnoea index by PSG and the respiratory disturbance index (RDI) by PRRD was observed. Accuracy of the PRRD was evaluated in terms of sensitivity and specificity for different RDI-PRRD cut-off points with respect to AHI-PSG >10 and AHI-PSG >30. A logistic regression model was performed to estimate the chance per unit of RDI of apnoeas. A received operating characteristic (ROC) curve was drawn to obtain the sensitivity/specificity profile for each observed RDI value obtained. From the ROC curve the authors identified the better cut-off points, which represent a balanced sensitivity/specificity. Through a classification table defined by the cut-off point, the post-odds to exhibit the disease was calculated. For a full PSG cut-off point of 10 a PRRD of six showed a balanced sensitivity of 95% and a specificity of 92%. For a full PSG cut-off point of 30 a PRRD of 16 shows a balanced sensitivity/specificity (100% and 97%, respectively). Post odds of apnoea were calculated for each cut-off point. In conclusion, these data suggest that the portable respiratory recording device is an effective device to identify apnoeas and hypopnoeas in a general population and is therefore a suitable device to be used in epidemiological studies.

We assessed the effectiveness of an asthma educational programme based on a repeated short intervention (AEP-RSI) to improve asthma control (symptom control and future risk) and quality of life.A total of 230 adults with mild-to-moderate persistent uncontrolled asthma participated in a 1-year cluster randomised controlled multicentre study. The AEP-RSI was given in four face-to-face sessions at 3-month intervals, and included administration of a written personalised action plan and training on inhaler technique. Centres were randomised to the AEP-RSI (intervention) group or usual clinical practice group. Specialised centres using a standard educational programme were the gold standard group. A significant improvement in the Asthma Control Test score was observed in all three groups ( p<0.001), but improvements were higher in the intervention and gold standard groups than in the usual clinical practice group (p=0.042), which also showed fewer exacerbations (mean±SD; 1.20±2.02 and 0.56±1.5 versus 2.04±2.72, respectively) and greater increases in the Mini Asthma Quality of Life Questionnaire scores (0.95±1.04 and 0.89±0.84 versus 0.52±0.97, respectively).The AEP-RSI was effective in improving asthma symptom control, future risk and quality of life. @ERSpublications An educational programme based on a repeated short intervention for asthma is effective and easily to use in practice

A cross-sectional study was carried out on a random sample of 2,216 schoolchildren 9 to 14 yr of age to determine the prevalence of exercise-induced airway narrowing (EIAN) in a Mediterranean town (Mataró). A complementary case-control study measured the association between EIAN and respiratory symptoms. A free-running test was performed during school time. Peak expiratory flow rate (PEFR) was measured at rest and at 2, 5, 10, and 15 min after exercise. A total of 136 of 2,056 satisfactory runs showed a decrease of PEFR equal to or higher than 15% at each of these times after exercise. Five more children developed wheezing during running and were considered to have EIAN. Prevalence of EIAN was 6.9% (95% CI = 5.9 to 7.9). Prevalence decreased progressively with age. No sex difference was found. In the case-control study a questionnaire of respiratory symptoms was applied to the mothers of hyperresponsive children, as well as to two matched control subjects for each case. Questionnaire analysis showed a strong association between EIAN and respiratory symptoms or rhinitis. Association with bronchitis before 2 yr of age and parental asthma was less but significant.