Frequency and clinical characteristics of rapid-onset fatal and near-fatal asthma

Plaza, Vicente; Serrano, J.; Picado, César; Sanchís, J.

doi:10.1183/09031936.02.00241502

Cited by 96 publications

(59 citation statements)

References 31 publications

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“…Studies of rapid-onset and slow-onset attacks of near-fatal asthma have suggested that rapid-onset attacks may have different trigger factors and lower rates of infection than slow-onset attacks cases [30,31].…”

Section: Time To Death In Asthmamentioning

confidence: 99%

Time to death, airway wall inflammation and remodelling in fatal asthma

James¹,

Elliot²,

Abramson³

et al. 2005

Eur Respir J

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Fatal asthma is characterised pathologically by airway wall remodelling, eosinophil and neutrophil infiltration, accumulation of mucus in the airway lumen and smooth muscle shortening. The durations of fatal attacks of asthma show a clear bimodal distribution. Airway smooth muscle contraction and the accumulation of luminal mucus may contribute to death from asthma and relate to time to death.The current authors have examined these two components in uninflated lung tissue in cases of fatal asthma from the second Victorian asthma mortality study. Based on time from onset of symptoms to death, cases fell into two distinct groups: short course ,3 (1.5¡0.6 mean¡SD) h; and long course .8 (12.3¡5.9) h. Short course cases had more muscle shortening, higher levels of salbutamol and higher ratios of neutrophils to eosinophils than long course cases, who tended to have more mucus in the lumen.In conclusion, this study confirms the dichotomy of both time to death and the eosinophil/ neutrophil ratio in cases of fatal asthma. It suggests that in short course cases acute airway narrowing is due, predominantly, to bronchoconstriction despite higher blood levels of salbutamol. Mucus accumulation may be more important in long course cases.

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Section: Time To Death In Asthmamentioning

confidence: 99%

Time to death, airway wall inflammation and remodelling in fatal asthma

James¹,

Elliot²,

Abramson³

et al. 2005

Eur Respir J

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“…A detailed description of the method used has been published previously [14]. Briefly, a descriptive prospective multicentric study was carried out in 33 hospitals in Spain.…”

Section: Methodsmentioning

confidence: 99%

Alexithymia: a relevant psychological variable in near-fatal asthma

Serrano

Plaza²,

Sureda³

et al. 2006

Eur Respir J

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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.

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“…Hızlı gelişen ataklar birkaç saatte en üst seviyeye varır. Bunlarda CD8 lenfosit ve nötrofil hakimiyeti söz konusudur (23). Esas sorun inflamasyon kadar düz kas kasılma-sının varlığıdır.…”

Section: Astımunclassified

“…Yavaş gelişenler birkaç gün içinde, ortalama 3-7 günde en üst seviyeye gelip, yine bu sürelerde düzelir. Bunlarda CD4 lenfosit ve eozinofil hakimiyeti vardır (23).…”

Section: Astımunclassified