title: Influence of upper airway abnormalities on the control of severe asthma: a cross-sectional study.
abstract: BACKGROUND
  A better understanding of severe uncontrolled asthma (UA) in the upper airways is needed. The aims of this study were to assess the prevalence of upper airway abnormalities and their associations with UA.
  
  
  METHODS
  An observational study enrolled individuals with severe asthma. Sociodemographic and clinical questionnaires regarding asthma, rhinosinusitis, and laryngopharyngeal reflux (LPR) were administered. Skin-prick tests and fiber optic nasolaryngoscopies were also performed. Descriptive statistical analysis was performed, using a multiple Poisson regression model to obtain adjusted prevalence ratios (PRs) and to identify the clinical profiles associated with the highest and lowest percentages of the dependent variable, lack of asthma control.
  
  
  RESULTS
  The sample consisted of 64 participants who were divided into 2 groups according to asthma control. Thus, group I comprised 27 individuals with severe controlled asthma (CA), and group II consisted of 37 individuals with UA. Women represented 87.5% of the study population. The median age was 54 years, and 86% of the sample had rhinosinusitis. Relevant associations were detected between UA and hyposmia (PR = 2.04), hypersensitivity to nonsteroidal anti-inflammatory drugs (NSAIDs) (PR = 1.45), arytenoids hyperemia (PR = 1.45), LPR (PR = 1.37), a positive family history of asthma (PR = 1.35), onset of asthma at age 10 years or older (PR = 0.59), and swelling of the vocal cords (PR = 0.54).
  
  
  CONCLUSIONS
  This study found a very high prevalence of rhinosinusitis in patients with severe asthma as well as associations between UA and hyposmia, hypersensitivity to NSAIDs, arytenoids hyperemia, and LPR. Clinical profiles prone to UA were identified.
authors.affiliation: Program for Asthma Control in Bahia (PROAR), Bahia School of Medicine (FMB), Federal University of Bahia (UFBA), Salvador, BA, Brazil.|Post-Graduate Program in Health Sciences (PPgCS), FMB, UFBA, Salvador, BA, Brazil.
authors.forename: Francisco Soares
authors.initials: FS
authors.lastname: Nascimento-Sampaio
authors.affiliation: Program for Asthma Control in Bahia (PROAR), Bahia School of Medicine (FMB), Federal University of Bahia (UFBA), Salvador, BA, Brazil.
authors.forename: Mylene dos Santos
authors.initials: Mdos S
authors.lastname: Leite
authors.affiliation: Department of Surgery, College of Medicine, University of Vermont, Burlington, VT.
authors.forename: Donald Arthur
authors.initials: DA
authors.lastname: Leopold
authors.affiliation: Program for Asthma Control in Bahia (PROAR), Bahia School of Medicine (FMB), Federal University of Bahia (UFBA), Salvador, BA, Brazil.
authors.forename: Suzam Guedes Oliva da
authors.initials: SG
authors.lastname: Silva
authors.affiliation: Department of Nutrition, University of Pernambuco (UPE), Petrolina, PE, Brazil.
authors.forename: Paulo Adriano
authors.initials: PA
authors.lastname: Schwingel
authors.affiliation: Post-Graduate Program in Interactive Processes of Organs and Systems, Institute of Health Sciences (ICS), UFBA, Salvador, BA, Brazil.
authors.forename: Carlos Maurício Cardeal
authors.initials: CM
authors.lastname: Mendes
authors.affiliation: Program for Asthma Control in Bahia (PROAR), Bahia School of Medicine (FMB), Federal University of Bahia (UFBA), Salvador, BA, Brazil.|Department of Biomorphology, ICS, UFBA, Salvador, BA, Brazil.
authors.forename: Adelmir
authors.initials: A
authors.lastname: Souza-Machado
authors.affiliation: Post-Graduate Program in Health Sciences (PPgCS), FMB, UFBA, Salvador, BA, Brazil.
authors.forename: Régis de Albuquerque
authors.initials: Rde A
authors.lastname: Campos
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D001249:Asthma / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006967:Hypersensitivity; D057045:Laryngopharyngeal Reflux / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012220:Rhinitis / Q000150:complications*; D012852:Sinusitis / Q000150:complications*; D011795:Surveys and Questionnaires
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: aspirin; dyspnea; laryngopharyngeal reflux; olfaction disorders; sinusitis