Browsing by Subject "pulmonologist"

Now showing 1 - 3 of 3
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    Climate change and respiratory health: a European Respiratory Society position statement
    (European Respiratory Society, 2023) Vicedo-Cabrera A.M.; Melén E.; Forastiere F.; Gehring U.; Katsouyanni K.; Yorgancioglu A.; Ulrik C.S.; Hansen K.; Powell P.; Ward B.; Hoffmann B.; Andersen Z.J.
    [No abstract available]
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    Key recommendations for primary care from the 2022 Global Initiative for Asthma (GINA) update
    (Nature Research, 2023) Levy M.L.; Bacharier L.B.; Bateman E.; Boulet L.-P.; Brightling C.; Buhl R.; Brusselle G.; Cruz A.A.; Drazen J.M.; Duijts L.; Fleming L.; Inoue H.; Ko F.W.S.; Krishnan J.A.; Mortimer K.; Pitrez P.M.; Sheikh A.; Yorgancıoğlu A.; Reddel H.K.
    The Global Initiative for Asthma (GINA) was established in 1993 by the World Health Organization and the US National Heart Lung and Blood Institute to improve asthma awareness, prevention and management worldwide. GINA develops and publishes evidence-based, annually updated resources for clinicians. GINA guidance is adopted by national asthma guidelines in many countries, adapted to fit local healthcare systems, practices, and resource availability. GINA is independent of industry, funded by the sale and licensing of its materials. This review summarizes key practical guidance for primary care from the 2022 GINA strategy report. It provides guidance on confirming the diagnosis of asthma using spirometry or peak expiratory flow. GINA recommends that all adults, adolescents and most children with asthma should receive inhaled corticosteroid (ICS)-containing therapy to reduce the risk of severe exacerbations, either taken regularly, or (for adults and adolescents with “mild” asthma) as combination ICS–formoterol taken as needed for symptom relief. For patients with moderate–severe asthma, the preferred regimen is maintenance-and-reliever therapy (MART) with ICS–formoterol. Asthma treatment is not “one size fits all”; GINA recommends individualized assessment, adjustment, and review of treatment. As many patients with difficult-to-treat or severe asthma are not referred early for specialist review, we provide updated guidance for primary care on diagnosis, further investigation, optimization and treatment of severe asthma across secondary and tertiary care. While the GINA strategy has global relevance, we recognize that there are special considerations for its adoption in low- and middle-income countries, particularly the current poor access to inhaled medications. © 2023, The Author(s).
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    Stepwise Approach in Asthma Revisited 2023: Expert Panel Opinion of Turkish Guideline of Asthma Diagnosis and Management Group
    (AVES, 2023) Çelik G.E.; Aydın Ö.; Damadoğlu E.; Baççıoğlu A.; Özdemir S.K.; Bavbek S.; Ediger D.; Erkekol F.Ö.; Gemicioğlu B.; Işık S.R.; Kalpaklıoğlu A.F.; Kalyoncu A.F.; Karakaya G.; Keren M.; Mungan D.; Oğuzülgen İ.K.; Yıldız F.; Yılmaz İ.; Yorgancıoğlu A.
    Introduction of inhaled corticosteroids (ICS) has been the cornerstone of the long-term management of asthma. ICSs either alone or in combination with long-acting beta-2 agonists have been shown to be associated with favorable asthma outcomes. However, asthma con-trol is still reported to be below expectations all around the world. Research in the last decades focusing on the use of ICS/formoterol both as maintenance and as needed (maintenance and reliever therapy approach) showed improved asthma outcomes. As a result of recent developments, Turkish Asthma Guidelines group aimed to revise asthma treatment recommendations. In general, we recommend physicians to consider the risk factors for poor asthma outcomes, patients’ compliance and expectations and then to determine “a personalized treatment plan.” Importantly, the use of short-acting beta-2 agonists alone as a symptom reliever in asthma patients not using regular ICS is no longer recommended. In stepwise treatment approach, we primarily recommend to use ICS-based controllers and initiate ICS as soon as possible. We define 2 different treatment tracks in stepwise approaches as maintenance and reliever therapy or fixed-dose therapy and equally recommend each track depending on the patient’s risks as well as decision of physicians in a personalized manner. For both tracks, a strong recommendation was made in favor of using add-on treatments before initiating phenotype-specific treatment in step 5. A strong recommendation was also made in favor of using biologic agents and/or aspirin treatment after desensitization in severe asthma when indicated. © Author(s).