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Sample records for asthma rationale study

  1. Predicting asthma in preschool children with asthma symptoms: study rationale and design

    Directory of Open Access Journals (Sweden)

    Hafkamp-de Groen Esther

    2012-10-01

    Full Text Available Abstract Background In well-child care it is difficult to determine whether preschool children with asthma symptoms actually have or will develop asthma at school age. The PIAMA (Prevention and Incidence of Asthma and Mite Allergy Risk Score has been proposed as an instrument that predicts asthma at school age, using eight easy obtainable parameters, assessed at the time of first asthma symptoms at preschool age. The aim of this study is to present the rationale and design of a study 1 to externally validate and update the PIAMA Risk Score, 2 to develop an Asthma Risk Appraisal Tool to predict asthma at school age in (specific subgroups of preschool children with asthma symptoms and 3 to test implementation of the Asthma Risk Appraisal Tool in well-child care. Methods and design The study will be performed within the framework of Generation R, a prospective multi-ethnic cohort study. In total, consent for postnatal follow-up was obtained from 7893 children, born between 2002 and 2006. At preschool age the PIAMA Risk Score will be assessed and used to predict asthma at school age. Discrimination (C-index and calibration will be assessed for the external validation. We will study whether the predictive ability of the PIAMA Risk Score can be improved by removing or adding predictors (e.g. preterm birth. The (updated PIAMA Risk Score will be converted to the Asthma Risk Appraisal Tool- to predict asthma at school age in preschool children with asthma symptoms. Additionally, we will conduct a pilot study to test implementation of the Asthma Risk Appraisal Tool in well-child care. Discussion Application of the Asthma Risk Appraisal Tool in well-child care will help to distinguish preschool children at high- and low-risk of developing asthma at school age when asthma symptoms appear. This study will increase knowledge about the validity of the PIAMA risk score and might improve risk assessment of developing asthma at school age in (specific subgroups

  2. The Prevention of Early Asthma in Kids study: design, rationale and methods for the Childhood Asthma Research and Education network.

    Science.gov (United States)

    Guilbert, Theresa W; Morgan, Wayne J; Krawiec, Marzena; Lemanske, Robert F; Sorkness, Chris; Szefler, Stanley J; Larsen, Gary; Spahn, Joseph D; Zeiger, Robert S; Heldt, Gregory; Strunk, Robert C; Bacharier, Leonard B; Bloomberg, Gordon R; Chinchilli, Vernon M; Boehmer, Susan J; Mauger, Elizabeth A; Mauger, David T; Taussig, Lynn M; Martinez, Fernando D

    2004-06-01

    Pediatric asthma remains an important public health concern as its prevalence and cost to the health care system is rising. In order to promote innovative research in asthma therapies, the National Heart, Lung and Blood Institute created the Childhood Asthma Research and Education Network in 1999. As its first study, the steering committee of the Childhood Asthma Research and Education Network designed a randomized clinical trial to determine if persistent asthma could be prevented in children at a high risk to develop the disease. This communication presents the design of its first clinical trial, the Prevention of Asthma in Kids (PEAK) trial and the organization of the Childhood Asthma Research and Education Network that developed and implemented this trial. Studies of the natural history of asthma have shown that, in persistent asthma, the initial asthma-like symptoms and loss of lung function occur predominately during the first years of life. Therefore, in the Prevention of Asthma in Kids study, children 2 and 3 years old with a positive asthma predictive index were randomized to twice daily treatment with fluticasone 88 microg or placebo via metered-dose inhaler and Aerochamber for 2 years. The double blind treatment period was followed by a 1-year observational period. Lung function was measured by spirometry and oscillometry technique at 4-month intervals throughout the study. Bronchodilator reversibility and exhaled nitric oxide (ENO) studies were performed at the end of the treatment and observation periods. The primary outcome measure was the number of asthma-free days. Other secondary outcomes included number of exacerbations, use of asthma medications and lung function. These measures were chosen to reflect the progression of the disease from intermittent wheezing to persistent asthma and measurement of the extent of airflow limitation and airway reactivity.

  3. Viral infections and atopy in asthma pathogenesis: new rationales for asthma prevention and treatment.

    Science.gov (United States)

    Holt, Patrick G; Sly, Peter D

    2012-05-04

    Prospective birth cohort studies tracking asthma initiation and consolidation in community cohorts have identified viral infections occurring against a background of allergic sensitization to aeroallergens as a uniquely potent risk factor for the expression of acute severe asthma-like symptoms and for the ensuing development of asthma that can persist through childhood and into adulthood. A combination of recent experimental and human studies have suggested that underlying this bipartite process are a series of interactions between antiviral and atopic inflammatory pathways that are mediated by local activation of myeloid cell populations in the airway mucosa and the parallel programming and recruitment of their replacements from bone marrow. Targeting key components of these pathways at the appropriate stages of asthma provides new opportunities for the treatment of established asthma but, more crucially, for primary and secondary prevention of asthma during childhood.

  4. The Jamaica asthma and allergies national prevalence survey: rationale and methods

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    Edwards Nancy C

    2010-04-01

    Full Text Available Abstract Background Asthma is a significant public health problem in the Caribbean. Prevalence surveys using standardized measures of asthma provide valid prevalence estimates to facilitate regional and international comparisons and monitoring of trends. This paper describes methods used in the Jamaica Asthma and Allergies National Prevalence Survey, challenges associated with this survey and strategies used to overcome these challenges. Methods/Design An island wide, cross-sectional, community-based survey of asthma, asthma symptoms and allergies was done among adults and children using the European Community Respiratory Health Survey Questionnaire for adults and the International Study of Asthma and Allergies in Children. Stratified multi-stage cluster sampling was used to select 2, 163 adults aged 18 years and older and 2, 017 children aged 2-17 years for the survey. The Kish selection table was used to select one adult and one child per household. Data analysis accounted for sampling design and prevalence estimates were weighted to produce national estimates. Discussion The Jamaica Asthma and Allergies National Prevalence Survey is the first population- based survey in the Caribbean to determine the prevalence of asthma and allergies both in adults and children using standardized methods. With response rates exceeding 80% in both groups, this approach facilitated cost-effective gathering of high quality asthma prevalence data that will facilitate international and regional comparison and monitoring of asthma prevalence trends. Another unique feature of this study was the partnership with the Ministry of Health in Jamaica, which ensured the collection of data relevant for decision-making to facilitate the uptake of research evidence. The findings of this study will provide important data on the burden of asthma and allergies in Jamaica and contribute to evidence-informed planning of comprehensive asthma management and education programs.

  5. Defining asthma in genetic studies

    NARCIS (Netherlands)

    Koppelman, GH; Postma, DS; Meijer, G.

    1999-01-01

    Genetic studies have been hampered by the lack of a gold standard to diagnose asthma. The complex nature of asthma makes it more difficult to identify asthma genes. Therefore, approaches to define phenotypes, which have been successful in other genetically complex diseases, may be applied to define

  6. RATIONALE FOR A SPECIFIC THERAPY OF CYTOMEGALOVIRUS INFECTION IN CHILDREN WITH BRONCHIAL ASTHMA

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    E. N. Suprun

    2013-01-01

    Full Text Available Abstract. We propose a protocol of treatment in cases of bronchial asthma with cytomegalovirus (CMV persistence. This basic therapy is administered depending on the disease severity, according to the National Programme 2009. The treatment includes administration of human immunoglobulin, with dosage according on CMV antibodies titers. The study has revealed that such regimen of antibody administration based on the content of anti-CMV antibodies in bronchial asthma treatment stops active CMV replication in bronchial mucous membrane, alleviates clinical course of the disease, diminishes changes of immune system typical to children suffering from bronchial asthma and CMV reactivation, thus allowing to reduce the volume of basic therapy, along with maintaining control of asthma control.

  7. The Global Asthma Network rationale and methods for Phase I global surveillance: prevalence, severity, management and risk factors.

    Science.gov (United States)

    Ellwood, Philippa; Asher, M Innes; Billo, Nils E; Bissell, Karen; Chiang, Chen-Yuan; Ellwood, Eamon M; El-Sony, Asma; García-Marcos, Luis; Mallol, Javier; Marks, Guy B; Pearce, Neil E; Strachan, David P

    2017-01-01

    The Global Asthma Network (GAN), established in 2012, followed the International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC Phase One involved over 700 000 adolescents and children from 156 centres in 56 countries; it found marked worldwide variation in symptom prevalence of asthma, rhinitis and eczema that was not explained by the current understanding of these diseases; ISAAC Phase Three involved over 1 187 496 adolescents and children (237 centres in 98 countries). It found that asthma symptom prevalence was increasing in many locations especially in low- and middle-income countries where severity was also high, and identified several environmental factors that required further investigation.GAN Phase I, described in this article, builds on the ISAAC findings by collecting further information on asthma, rhinitis and eczema prevalence, severity, diagnoses, asthma emergency room visits, hospital admissions, management and use of asthma essential medicines. The subjects will be the same age groups as ISAAC, and their parents. In this first global monitoring of asthma in children and adults since 2003, further evidence will be obtained to understand asthma, management practices and risk factors, leading to further recognition that asthma is an important non-communicable disease and to reduce its global burden.

  8. Validation of a web-based version of the asthma control test and childhood asthma control test

    NARCIS (Netherlands)

    Koolen, B.B.; Pijnenburg, M.W.; Brackel, H.J.; Landstra, A.M.; Berg, N.J. van den; Merkus, P.J.F.M.; Hop, W.C.J.; Vaessen-Verberne, A.A.

    2011-01-01

    RATIONALE: Recent guidelines focus on adjusting asthma treatment to the level of asthma control. The availability of a web-based asthma control questionnaire offers the possibility to assess asthma control without the need of outpatient clinic visits. The aim of this study was to evaluate the agreem

  9. Current asthma control predicts future risk of asthma exacerbation: a 12-month prospective cohort study

    Institute of Scientific and Technical Information of China (English)

    WEI Hua-hua; ZHOU Ting; WANG Lan; ZHANG Hong-ping; FU Juan-juan; WANG Lei; JI Yu-lin; WANG Gang

    2012-01-01

    Background The performance of asthma control test (ACT) at baseline for predicting future risk of asthma exacerbation has not been previously demonstrated.This study was designed to explore the ability of the baseline ACT score to predict future risk of asthma exacerbation during a 12-month follow-up.Methods This post hoc analysis included data from a 12-month prospective cohort study in patients with asthma (n=290).The time to the first asthma exacerbation was analyzed and the association between baseline ACT scores and future risk of asthma exacerbation was calculated as adjusted odds ratio (OR) using Logistic regression models.Further,sensitivity and specificity were estimated at each cut-point of ACT scores for predicting asthma exacerbations.Results The subjects were divided into three groups,which were uncontrolled (U,n=128),partly-controlled (PC,n=111),and well controlled (C,n=51) asthma.After adjustment,the decreased ACT scores at baseline in the U and PC groups were associated with an increased probability of asthma exacerbations (OR 3.65 and OR 5.75,respectively),unplanned visits (OR 8.03 and OR 8.21,respectively) and emergency visits (OR 20.00 and OR 22.60,respectively) over a 12-month follow-up period.The time to the first asthma exacerbation was shorter in the groups with U and PC asthma (all P<0.05).The baseline ACT of 20 identified as the cut-point for screening the patients at high risk of asthma exacerbations had an increased sensitivity of over 90.0% but a lower specificity of about 30.0%.Conclusion Our findings indicate that the baseline ACT score with a high sensitivity could rule out patients at low risk of asthma exacerbations and oredict future risk of asthma exacerbations in clinical practice.

  10. Red wine asthma: a controlled challenge study.

    Science.gov (United States)

    Dahl, R; Henriksen, J M; Harving, H

    1986-12-01

    Drinking red wine may provoke bronchospasm in subjects with asthma. In order to reveal some of the possible agents involved in this reaction, 18 patients with a history of red wine-induced asthma were studied. They received, in a double-blind fashion, red wine with low sulfur dioxide (SO2) and high amine, high SO2 and high amine and low SO2 and low amine content. In each challenge, the wine was administered in stepwise increasing quantities until a total of 385 ml or a fall in peak expiratory flow of greater than 15% was reached. Nine subjects demonstrated a significant fall in peak flow in one or more challenges. In all cases the most severe reaction was observed after the wine with high SO2 content. The study suggests that SO2 is the most important factor in red wine-induced asthma. It is recommended that wine labels provide information on the SO2 content.

  11. Patient And phaRmacist Telephonic Encounters (PARTE in an underserved rural population with asthma: methods and rationale

    Directory of Open Access Journals (Sweden)

    Henry N. Young, PhD

    2011-01-01

    Full Text Available Purpose: Methods used to deliver and test a pharmacy-based asthma care telephonic service for an underserved, rural patient population are described. Summary: In a randomized controlled trial (RCT, the Patient And phaRmacist Telephonic Encounters (PARTE project is assessing the feasibility, acceptability, and preliminary impact of providing pharmacy-based asthma care service telephonically. The target audience is a low income patient population across a large geographic area served by a federally qualified community health center. Ninety-eight participants have been randomized to either standard care or the intervention group who received consultation and direct feedback from pharmacists via telephone regarding their asthma self-management and medication use. Pharmacists used a counseling framework that incorporates the Indian Health Services 3 Prime Questions and the RIM Technique (Recognition, Identification, and Management for managing medication use problems. Pharmacists encouraged patients to be active partners in the decision-making process to identify and address the underlying cause of medication use problems. Uniquely, this trial collected process and summative data using qualitative and quantitative approaches. Pharmacists’ training, the fidelity and quality of pharmacists’ service delivery, and short term patient outcomes are being evaluated. This evaluation will improve our ability to address research challenges and intervention barriers, refine staff training, explore patient perspectives, and evaluate measures’ power to provide preliminary patient outcome findings. Conclusion: A mixed method evaluation of a structured pharmacist intervention has the potential to offer insights regarding staff training, service fidelity and short term outcomes using quantitative and qualitative data in an RCT. Results will provide evidence regarding the feasibility and quality of carrying out the study and service delivery from the multiple

  12. Rationale and Design of the 'MITOCARE' Study

    DEFF Research Database (Denmark)

    Clemmensen, Peter

    2012-01-01

    Treatment of acute ST-elevation myocardial infarction (STEMI) by reperfusion using percutaneous coronary intervention (PCI) or thrombolysis has provided clinical benefits; however, it also induces considerable cell death. This process is called reperfusion injury. The continuing high rates...... resonance). The study is being financed under an EU-FP7 grant and conducted under the auspices of the MITOCARE research consortium, which includes experts from clinical and basic research centers, as well as commercial enterprises, throughout Europe. Results from this study will contribute to a better...

  13. Asthma

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    Kim Harold

    2011-11-01

    Full Text Available Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA inhalers are preferred for most adults who fail to achieve control with ICS therapy. Allergen-specific immunotherapy represents a potentially disease-modifying therapy for many patients with asthma, but should only be prescribed by physicians with appropriate training in allergy. Regular monitoring of asthma control, adherence to therapy and inhaler technique are also essential components of asthma management. This article provides a review of current literature and guidelines for the appropriate diagnosis and management of asthma.

  14. Sleep in children with asthma: results of the PIAMA study.

    Science.gov (United States)

    van Maanen, Annette; Wijga, Alet H; Gehring, Ulrike; Postma, Dirkje S; Smit, Henriëtte A; Oort, Frans J; Rodenburg, Roos; Meijer, Anne Marie

    2013-04-01

    Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. Parents reported about asthma symptoms (wheezing, dyspnoea, prescription of inhaled corticosteroids and asthma diagnosis) and children reported about different aspects of sleep (bedtime, rise time, sleep quality and daytime sleepiness/tiredness). Results were analysed with (logistic) regression analysis. Children with frequent asthma symptoms significantly more often reported that they felt sleepy or tired during the day (34.4% experienced daytime sleepiness/tiredness at least once a week) than children without asthma symptoms (22.2%) and children with infrequent asthma symptoms (21.9%). This association was not confounded by sex, age of the child, parental educational level or smoking inside the house; the effect was also not modified by sex. There were no associations between asthma and bedtime, time spent in bed or sleep quality. Children with frequent asthma symptoms experienced daytime sleepiness/tiredness more often than children with infrequent or no asthma symptoms. Otherwise, children with asthma did not differ much from children without asthma with regard to sleep.

  15. Validation of an asthma symptom diary for interventional studies

    OpenAIRE

    Santanello, N.; Davies, G.(Imperial College, London, UK); Galant, S.; Pedinoff, A.; Sveum, R.; Seltzer, J.; Seidenberg, B.; Knorr, B.

    1999-01-01

    OBJECTIVE—The Pediatric Asthma Diary was developed and validated to assess efficacy of interventions in children with asthma.
DESIGN, PATIENTS, AND SETTING—Diary validation was performed in a three week, prospective study of 106 children aged 6-14 years with asthma. Children were classified at baseline as either stable (requiring no additional asthma treatment) or new onset/worse (requiring either addition of or increase in anti-inflammatory treatment).
RESULTS—A dayti...

  16. Sleep in children with asthma : results of the PIAMA study

    NARCIS (Netherlands)

    van Maanen, Annette; Wijga, Alet H.; Gehring, Ulrike; Postma, Dirkje S.; Smit, Henriette A.; Oort, Frans J.; Rodenburg, Roos; Meijer, Anne Marie

    2013-01-01

    Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (

  17. Sleep in children with asthma: results of the PIAMA study

    NARCIS (Netherlands)

    van Maanen, A.; Wijga, A.H.; Gehring, U.; Postma, D.S.; Smit, H.A.; Oort, F.J.; Rodenburg, R.; Meijer, A.M.

    2013-01-01

    Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (

  18. Asthma

    Science.gov (United States)

    ... 1.25 million of those individuals have severe asthma, a condition that can be difficult to control and treat. Learn more about his research by visiting the NHLBI Laboratory of Asthma and Lung Inflammation website: http://www.nhlbi.nih. ...

  19. Difficult Asthma

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    Ahmet Uslu

    2003-03-01

    Full Text Available Difficult asthma is a distinct entity of asthma, comprising approximately %5 of asthmatic patients. There is no agreed definition of difficult asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant and severe asthma. In this study difficult asthma; clinical features, risk factors, pathophysiology and novel therapies are summarized by literatures.

  20. Difficult asthma

    OpenAIRE

    Ahmet Uslu; Tülay Özdemir

    1989-01-01

    Difficult asthma is a distinct entity of asthma, comprising approximately %5 of asthmatic patients. There is no agreed definition of difficult asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant and severe asthma. In this study difficult asthma; clinical features, risk factors, pathophysiology and novel therapies are summarized by literatures.

  1. A STUDY OF NASAL EOSINOPHILIA IN ASTHMA PATIENTS

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    Ramachandra Prabhu

    2014-05-01

    Full Text Available INTRODUCTION: Asthma is an inflammatory, reversible and progressive disease with episodes of exacerbations. Asthma is now considered as single airway disease and hence comprehensive diagnosis, treatment and follow-up of upper and lower respiratory tract is essential. Both the Nasal and Bronchial mucosa are the elements of united airway disease and Eosinophils measured from this mucosa can be an indirect marker of Airway inflammation in asthma. Eosinophil infiltration is hallmark feature of pathogenesis of asthma which is the trigger for the chronic airway inflammation and these are raised in acute exacerbations. Hence assessing Eosinophil is evidence of serological marker for Airway inflammation (AI. Nasal Smear Eosinophils (NSE is used in asthma with Allergic Rhinitis (AR. This study Using Definition of GINA explores the utility of NSE as marker for management of Asthma. METHODS: In this study 100 patients diagnosed with bronchial asthma attending the outpatient department in KIMS were studied. The severity of asthma was assessed as per FEV1 classification- Adapted from 2007 NHLBI Guidelines for the diagnosis and treatment of Asthma Expert panel Report 3. The Statistical analysis was done with SAS 9.2, SPSS 15.0, Stata 10.1, Med Calc 9.0.1, Systat 12.0 and R environment ver.2.11.1.software. RESULTS: Asthma was more common in Females in this study with M: F ratio of 1.04 and Allergic Rhinitis was found in 55% of Asthmatics. Nasal Eosinophilia was seen in 44% in asthmatic group and 49% in Asthma with Allergic Rhinitis. Absolute Eosinophil count (AEC and Differential count (DC for Eosinophils was almost same in both groups. The Sensitivity of NSE with respect to DC is 70% and in AR group with Asthma and in Asthma group with/without AR it was 38%. Similarly the NSE with respect to AEC was 47% in AR group with Asthma whereas in Asthma group with/without AR it was 38%. CONCLUSIONS: The finding confirms that symptoms, Variable airflow Obstruction and

  2. A study of asthma severity in adult twins

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; van der Sluis, Sophie; Kyvik, Kirsten Ohm

    2012-01-01

    twins from the Danish Twin Registry, a total of 575 subjects (256 intact pairs and 63 single twins) who themselves and/or their co-twins reported a history of asthma at a questionnaire survey were clinically examined. The severity of asthma symptoms was graded according to a clinical interview...... of asthma symptoms and objectively measured asthma-related traits, respectively, seem to differ. Please cite this paper as: Thomsen SF, van der Sluis S, Kyvik KO and Backer V. A study of asthma severity in adult twins. Clin Respir J 2011; DOI:10.1111/j.1752-699X.2011.00273.x....

  3. Asthma

    OpenAIRE

    Kim, Harold; Mazza, Jorge

    2011-01-01

    Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA) inhalers are pr...

  4. Asthma

    OpenAIRE

    Kim Harold; Mazza Jorge

    2011-01-01

    Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA) inhale...

  5. Diagnosis of Asthma in Primary Health Care: A Pilot Study

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    Karin C. Ringsberg

    2014-01-01

    Full Text Available Some patients with an asthma diagnosis have a poor controlled asthma. One explanation may be an incorrect diagnosis. Aim. The aim of the study was to diagnose and classify patients with non-infectious lower respiratory tract problems in primary health care using internationally applied diagnostic criteria and diagnostic tests. Patients and Methods. New adult patients visiting a primary health care centre due to lower airway problems were included. The diagnostic tests included FEV1, FVC, PEF, two questionnaires, methacholine test, and skin prick test. Results. The patients (n=43 could be divided into four groups: asthma (28%, asthma-like disorder (44%, idiopathic cough (12%, and a nonreversible bronchial obstructive group (16%. The asthma and asthma-like groups showed similar patterns of airway symptoms and trigger factors, not significantly separated by a special questionnaire. Phlegm, heavy breathing, chest pressure/pain, cough, and wheezing were the most common symptoms. Physical exercise and scents were the dominating trigger factors. Conclusions. Nonobstructive asthma-like symptoms seem to be as common as bronchial asthma in primary health care. Due to the similarities in symptoms and trigger factors the study supports the hypothesis that asthma and nonobstructive asthma-like disorders are integrated in the same “asthma syndrome,” including different mechanisms, not only bronchial obstruction.

  6. Randomized controlled study of CBT in bronchial asthma

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    Grover Naveen

    2007-01-01

    Full Text Available The aim of the present study was to find out efficacy of cognitive behavior therapy, as an adjunct to standard pharmacotherapy, in bronchial asthma. In a random-ized two-group design with pre-and post assessments, forty asthma patients were randomly allotted to two groups: self management group and cognitive behavior therapy group. Both groups were exposed to 6-8 weeks of intervention, asthma self management program and cognitive behavior therapy. Assessment measures used were-Semi structured interview schedule, Asthma Symptom Checklist, Asthma di-ary, Asthma Bother Profile, Hospital Anxiety & Depression Scale, AQLQ and Peak Expiratory Flow Rate. Within group comparison showed significant improvement in both groups at the post assessment. Between group comparisons showed that CBT group reported significantly greater change than that of SM group. Cognitive behavior therapy helps in improving the managment of asthma.

  7. Describing and quantifying asthma comorbidity [corrected]: a population study.

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    Andrea S Gershon

    Full Text Available BACKGROUND: Asthma comorbidity has been correlated with poor asthma control, increased health services use, and decreased quality of life. Managing it improves these outcomes. Little is known about the amount of different types of comorbidity associated with asthma and how they vary by age. METHODOLOGY/PRINCIPAL FINDINGS: The authors conducted a population study using health administrative data on all individuals living in Ontario, Canada (population 12 million. Types of asthma comorbidity were quantified by comparing physician health care claims between individuals with and without asthma in each of 14 major disease categories; results were adjusted for demographic factors and other comorbidity and stratified by age. Compared to those without asthma, individuals with asthma had higher rates of comorbidity in most major disease categories. Most notably, they had about fifty percent or more physician health care claims for respiratory disease (other than asthma in all age groups; psychiatric disorders in individuals age four and under and age 18 to 44; perinatal disorders in individuals 17 years and under, and metabolic and immunity, and hematologic disorders in children four years and under. CONCLUSION/SIGNIFICANCE: Asthma appears to be associated with significant rates of various types of comorbidity that vary according to age. These results can be used to develop strategies to recognize and address asthma comorbidity to improve the overall health of individuals with asthma.

  8. NAC Manchester Asthma and Allergy Study (NACMAAS): risk factors for asthma and allergic disorders in adults.

    Science.gov (United States)

    Simpson, B M; Custovic, A; Simpson, A; Hallam, C L; Walsh, D; Marolia, H; Campbell, J; Woodcock, A

    2001-03-01

    Asthma and atopic disorders are the most common chronic diseases in the developed countries. Knowledge of the risk factors for these disorders may facilitate the development of preventive strategies aimed at reducing prevalence rates. To investigate the risk factors for asthma and allergic diseases in a large number of adults who are the parents of children in the National Asthma Campaign Manchester Asthma and Allergy Study. All pregnant women and their partners attending "Booking" antenatal clinics were invited to take part in the study. Questionnaire data were collected including the history of asthma and other atopic diseases, pet ownership and smoking habits, and skin prick tests were performed. The prevalence of atopy and the risk factors for asthma and allergic disorders were investigated in all subjects who completed the questionnaire and underwent skin testing. Statistical analysis was carried out using logistic regression. Initially, risk factors were assessed by univariate analysis to see how each potential explanatory variable affected the probability of having allergic disease. Variables were then tested in a forward stepwise multivariate analysis. In 5687 adult subjects there was a very high (48.2%) prevalence of atopy, and 9.7% of subjects had a diagnosis of asthma. In a multivariate regression analysis sensitization to dust mite, cat, dog and mixed grasses were all independently associated with asthma. The odds ratios for current asthma increased with the increasing number of positive skin tests (any two allergens - OR 4.3, 95% CI 3.3-5.5; any three allergens - OR 7.0 95% CI 5.3-9.3; all four allergens - OR 10.4, 95% CI 7.7-14; P Dog ownership (OR 1.31, 95% CI 1.10-1.57; P = 0.003) and current smoking (OR 1.36, 95% CI 1.15-1.62; P = 0.0004) were significantly and directly associated with "asthma ever". Thirteen per cent of participants reported a history of eczema. In the multivariate analysis the strongest independent associate of eczema was

  9. Lung VITAL: Rationale, design, and baseline characteristics of an ancillary study evaluating the effects of vitamin D and/or marine omega-3 fatty acid supplements on acute exacerbations of chronic respiratory disease, asthma control, pneumonia and lung function in adults.

    Science.gov (United States)

    Gold, Diane R; Litonjua, Augusto A; Carey, Vincent J; Manson, JoAnn E; Buring, Julie E; Lee, I-Min; Gordon, David; Walter, Joseph; Friedenberg, Georgina; Hankinson, John L; Copeland, Trisha; Luttmann-Gibson, Heike

    2016-03-01

    Laboratory and observational research studies suggest that vitamin D and marine omega-3 fatty acids may reduce risk for pneumonia, acute exacerbations of respiratory diseases including chronic obstructive lung disease (COPD) or asthma, and decline of lung function, but prevention trials with adequate dosing, adequate power, and adequate time to follow-up are lacking. The ongoing Lung VITAL study is taking advantage of a large clinical trial-the VITamin D and OmegA-3 TriaL (VITAL)--to conduct the first major evaluation of the influences of vitamin D and marine omega-3 fatty acid supplementation on pneumonia risk, respiratory exacerbation episodes, asthma control and lung function in adults. VITAL is a 5-year U.S.-wide randomized, double-blind, placebo-controlled, 2 × 2 factorial trial of supplementation with vitamin D3 ([cholecalciferol], 2000 IU/day) and marine omega-3 FA (Omacor® fish oil, eicosapentaenoic acid [EPA]+docosahexaenoic acid [DHA], 1g/day) for primary prevention of CVD and cancer among men and women, at baseline aged ≥50 and ≥55, respectively, with 5107 African Americans. In a subset of 1973 participants from 11 urban U.S. centers, lung function is measured before and two years after randomization. Yearly follow-up questionnaires assess incident pneumonia in the entire randomized population, and exacerbations of respiratory disease, asthma control and dyspnea in a subpopulation of 4314 randomized participants enriched, as shown in presentation of baseline characteristics, for respiratory disease, respiratory symptoms, and history of cigarette smoking. Self-reported pneumonia hospitalization will be confirmed by medical record review, and exacerbations will be confirmed by Center for Medicare and Medicaid Services data review.

  10. Childhood Asthma May Encourage Obesity, Study Suggests

    Science.gov (United States)

    ... Human Services. More Health News on: Asthma in Children Obesity in Children Recent Health News Related MedlinePlus Health Topics Asthma in Children Obesity in Children About MedlinePlus Site Map FAQs Customer ...

  11. The prevalence, management and burden of asthma - a Nigerian study.

    Science.gov (United States)

    Oni, Alexander O; Erhabor, G E; Egbagbe, E E

    2010-03-01

    Inadequate attention given to the management of asthma and ways of improving treatment could be a significant factor for the increase morbidity and mortality from asthma despite major advances in our understanding of the pathophysiology of the disease. There seems to be paucity of data concerning the management pattern and burden of asthma in Africa. This study was under taken to determine the prevalence, management pattern and the burden of asthma. This study was a cross sectional design involving clinical and lung function assessment. The diagnosis of asthma was made using the clinical features of asthma and lung function parameters (Forced expiratory volume in one second, Peak expiratory flow rate, Reversibility tests). Totally, 120 asthma patients participated in this study. All subjects completed the clinical asthma control questionnaires. All items were rated with the calculation of their mean and percentages. Student t-test was used to calculate the difference between the mean of the lung function tests for subjects and control. The prevalence of asthma among respiratory unit patients was 6.6% and higher in the first three decades of life with female preponderance (F:M=1.5-1).There is a strong family history of asthma(81.7%). Associated allergies include rhinitis (75%), pharyngitis (54%), conjunctivitis (54%) and dermatitis (30%). Percentage of asthma patients treated with bronchodilators alone (70%), combined inhaled bronchodilators and steroid (28.3%). Impaired daily activities include sports (84%), Job career (60%), Physical activity (55%), Social activity (54%), Household chores (61%), Disturbed sleep (53%), Daytime symptoms (51%), Hospitalized(50%). Subjects had significant low lung function values when compared with control (P asthma is very high despite the advanced knowledge of the pathophysiology and management of asthma.

  12. Characteristics and Prognosis of Never-Smokers and Smokers with Asthma in the Copenhagen General Population Study. A Prospective Cohort Study

    DEFF Research Database (Denmark)

    Çolak, Yunus; Afzal, Shoaib; Nordestgaard, Børge G;

    2015-01-01

    RATIONALE: Asthma is associated with complications, cardiovascular comorbidities, and higher mortality in some individuals. OBJECTIVES: To test the hypothesis that, among individuals with asthma, never-smokers have different characteristics and a better prognosis than smokers. METHODS: We recruit...... with asthma. Thus, tobacco smoking was the main explanation for poor prognosis in asthma....

  13. European birth cohort studies on asthma and atopic diseases

    DEFF Research Database (Denmark)

    Keil, T; Kulig, M; Simpson, A;

    2006-01-01

    BACKGROUND: The reasons for the rise in asthma and allergies remain unclear. To identify risk or protective factors, it is essential to carry out longitudinal epidemiological studies, preferably birth cohort studies. In Europe, several birth cohort studies on asthma and atopic diseases have been ...

  14. The Danish Alzheimer Intervention Study: Rationale, Study Design and Baseline Characteristics of the Cohort

    DEFF Research Database (Denmark)

    Waldemar, G.; Waldorff, F.B.; Buss, D.V.

    2011-01-01

    There is a lack of appropriately designed trials investigating the efficacy of psychosocial interventions for patients with mild dementia and their family caregivers. This paper reports the rationale and design of the Danish Alzheimer Disease Intervention Study and baseline characteristics...

  15. Factors influencing asthma control: results of a real-life prospective observational asthma inhaler treatment (ASIT study

    Directory of Open Access Journals (Sweden)

    Yıldız

    2013-07-01

    Full Text Available Füsun Yildiz, On behalf of the ASIT Study Group Department of Pulmonary Disease, Kocaeli University School of Medicine, Kocaeli, Turkey Background: Despite the availability of new pharmacological options and novel combinations of existing drug therapies, the rate of suboptimal asthma control is still high. Therefore, early identification of the clinical and behavioral factors responsible for poor asthma control, and interventions during routine outpatient visits to improve asthma trigger management, are strongly recommended. This study was designed to evaluate the profiles of asthmatic patients and their inhaler treatment devices in relation to asthma control in Turkey. Methods: A total of 572 patients with persistent asthma (mean [standard deviation] age: 42.7 [12.1] years; 76% female were included in this prospective observational study. A baseline visit (0 month, visit 1 and three follow-up visits (1, 3 and 6 months after enrolment were conducted to collect data on demographics, past medical and asthma history, and inhaler device use. Results: Asthma control was identified in 61.5% of patients at visit 1 and increased to 87.3% at visit 4 (P < 0.001, regardless of sociodemographics, asthma duration, body mass index or smoking status. The presence of asthma-related comorbidity had a significantly negative effect on asthma control (P = 0.004. A significant decrease was determined, in the rate of uncontrolled asthma, upon follow-up among patients who were using a variety of fixed dose combination inhalers (P < 0.001 for each. Logistic regression analysis was used to show that the presence of asthma-related comorbidity (odds ratio [OR], 0.602; 95% confidence interval [CI], 0.419; 0.863, P = 0.006 and active smoking (OR, 0.522; 95% CI, 0.330; 0.825, P = 0.005 were significant predictors of asthma control. Conclusion: Our findings indicate that, despite ongoing treatment, asthma control rate was 61.5% at visit 1 in adult outpatients with persistent

  16. Genome-wide association studies in asthma: progress and pitfalls

    Directory of Open Access Journals (Sweden)

    March ME

    2015-01-01

    Full Text Available Michael E March,1 Patrick MA Sleiman,1,2 Hakon Hakonarson1,2 1Center for Applied Genomics, Children's Hospital of Philadelphia Research Institute, 2Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA Abstract: Genetic studies of asthma have revealed that there is considerable heritability to the phenotype. An extensive history of candidate-gene studies has identified a long list of genes associated with immune function that are potentially involved in asthma pathogenesis. However, many of the results of candidate-gene studies have failed to be replicated, leaving in question the true impact of the implicated biological pathways on asthma. With the advent of genome-wide association studies, geneticists are able to examine the association of hundreds of thousands of genetic markers with a phenotype, allowing the hypothesis-free identification of variants associated with disease. Many such studies examining asthma or related phenotypes have been published, and several themes have begun to emerge regarding the biological pathways underpinning asthma. The results of many genome-wide association studies have currently not been replicated, and the large sample sizes required for this experimental strategy invoke difficulties with sample stratification and phenotypic heterogeneity. Recently, large collaborative groups of researchers have formed consortia focused on asthma, with the goals of sharing material and data and standardizing diagnosis and experimental methods. Additionally, research has begun to focus on genetic variants that affect the response to asthma medications and on the biology that generates the heterogeneity in the asthma phenotype. As this work progresses, it will move asthma patients closer to more specific, personalized medicine. Keywords: asthma, genetics, GWAS, pharmacogenetics, biomarkers

  17. Long-term prognosis of asthma, chronic obstructive pulmonary disease, and asthma-chronic obstructive pulmonary disease overlap in the Copenhagen City Heart study

    DEFF Research Database (Denmark)

    Lange, Peter; Çolak, Yunus; Ingebrigtsen, Truls Sylvan

    2016-01-01

    focus on individuals with asthma-COPD overlap. METHODS: We assigned participants from the Copenhagen City Heart Study into six subgroups: healthy never-smokers, ever-smokers without asthma and COPD, those with asthma with low cumulated smoking exposure and no airflow limitation, those with COPD, those...... mixed-effects model. FINDINGS: We included 8382 participants from the Copenhagen City Heart Study in our study: 2199 never-smokers, 5435 ever-smokers, 158 with asthma, 320 with COPD, 68 with asthma-COPD overlap with early-onset asthma, and 202 with asthma-COPD overlap with late-onset asthma...

  18. Improving Asthma during Pregnancy with Dietary Antioxidants: The Current Evidence

    Directory of Open Access Journals (Sweden)

    Vicki L. Clifton

    2013-08-01

    Full Text Available The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS. Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health.

  19. Improving asthma during pregnancy with dietary antioxidants: the current evidence.

    Science.gov (United States)

    Grieger, Jessica A; Wood, Lisa G; Clifton, Vicki L

    2013-08-14

    The complication of asthma during pregnancy is associated with a number of poor outcomes for the mother and fetus. This may be partially driven by increased oxidative stress induced by the combination of asthma and pregnancy. Asthma is a chronic inflammatory disease of the airways associated with systemic inflammation and oxidative stress, which contributes to worsening asthma symptoms. Pregnancy alone also intensifies oxidative stress through the systemic generation of excess reactive oxidative species (ROS). Antioxidants combat the damaging effects of ROS; yet antioxidant defenses are reduced in asthma. Diet and nutrition have been postulated as potential factors to combat the damaging effects of asthma. In particular, dietary antioxidants may play a role in alleviating the heightened oxidative stress in asthma. Although there are some observational and interventional studies that have shown protective effects of antioxidants in asthma, assessment of antioxidants in pregnancy are limited and there are no antioxidant intervention studies in asthmatic pregnancies on asthma outcomes. The aims of this paper are to (i) review the relationships between oxidative stress and dietary antioxidants in adults with asthma and asthma during pregnancy, and (ii) provide the rationale for which dietary management strategies, specifically increased dietary antioxidants, might positively impact maternal asthma outcomes. Improving asthma control through a holistic antioxidant dietary approach might be valuable in reducing asthma exacerbations and improving asthma management during pregnancy, subsequently impacting perinatal health.

  20. European birth cohort studies on asthma and atopic diseases

    DEFF Research Database (Denmark)

    Keil, T; Kulig, M; Simpson, A;

    2006-01-01

    BACKGROUND: The Global Allergy and Asthma European Network (GA2LEN) is a consortium of 26 leading European research centres committed to establish a European research area of excellence in the field of allergy and asthma. AIM: One of the GA2LEN work packages was designed to identify and compare...... asthma and atopic diseases. Data were collected by visiting most of the participating research teams and interviewing all relevant study personnel. For each study, the type of objective/subjective outcome parameters and potentially influential factors were recorded precisely for every time point during...... the existing European birth cohort studies on asthma and atopic diseases. The present review compares their subjective and objective outcomes as well as exposure variables. METHODS: A common database was established to assess study characteristics of observational birth cohort studies designed to examine...

  1. Basal or stress-induced cortisol and asthma development: the TRAILS study.

    Science.gov (United States)

    Vink, Nienke M; Boezen, H Marike; Postma, Dirkje S; Rosmalen, Judith G M

    2013-04-01

    We examined the association between: 1) cortisol levels and asthma or asthma development; 2) cortisol levels upon stress and asthma. In addition, we performed a post hoc meta-analysis on results from the literature. Cortisol, cortisol upon stress, asthma (doctor diagnosis of asthma and/or symptoms and/or treatment in the past 12 months) and asthma development (asthma at a specific survey while not having asthma at the previous survey(s)) were assessed in the TRAILS study (n=2230, mean age at survey 1 11 years, survey 2 14 years and survey 3 16 years). Logistic regression models were used to study associations between: 1) cortisol (cortisol awakening response, area under the curve (AUC) with respect to the ground (AUCg) or with respect to the increase (AUCi), and evening cortisol) and asthma or asthma development; 2) cortisol upon stress (AUCg or AUCi) and asthma. The meta-analyses included nine case-control articles on basal cortisol in asthma. No significant association was found between: 1) cortisol and asthma (age 11 years) or asthma development (age 14 or 16 years); 2) cortisol upon stress and asthma (age 16 years). The meta-analysis found lower morning and evening cortisol levels in asthmatics compared to non-asthmatics; however, the summary estimates were not significant. We found no evidence supporting a role for cortisol in asthma and asthma development.

  2. Fixed airways obstruction among patients with severe asthma: findings from the Singapore General Hospital-Severe Asthma Phenotype Study

    OpenAIRE

    Yii, Anthony Chau Ang; Tan, Gan Liang; Tan, Keng Leong; Lapperre, Therese Sophie; Mariko Siyue KOH

    2014-01-01

    Background A subset of severe asthma patients has fixed airways obstruction, which is characterized by incomplete reversibility to bronchodilator challenge. We aimed to elucidate the factors associated with fixed airways obstruction in a cohort of patients with severe asthma in Singapore. Methods 245 patients from the Singapore General Hospital-Severe Asthma Phenotype Study (SGH-SAPS) were screened. These patients fulfilled World Health Organization criteria for "treatment-resistant severe as...

  3. Determinants and impact of suboptimal asthma control in Europe: The INTERNATIONAL CROSS-SECTIONAL AND LONGITUDINAL ASSESSMENT ON ASTHMA CONTROL (LIAISON) study

    NARCIS (Netherlands)

    F. Braido (Fulvio); G.G. Brusselle (Guy); D. Guastalla (Daniele); E. Ingrassia (Eleonora); G. Nicolini (Gabriele); D. Price (David); N. Roche (Nicolas); J.B. Soriano (Joan B.); H. Worth (Heinrich)

    2016-01-01

    textabstractBackground: According to the Global Initiative of Asthma, the aim of asthma treatment is to gain and maintain control. In the INTERNATIONAL CROSS-SECTIONAL AND LONGITUDINAL ASSESSMENT ON ASTHMA CONTROL (LIAISON) study, we evaluated the level of asthma control and quality of life (QoL), a

  4. Eastern Carolina Asthma Prevention Program (ECAPP): An Environmental Intervention Study Among Rural and Underserved Children with Asthma in Eastern North Carolina

    OpenAIRE

    2014-01-01

    OBJECTIVE Asthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing me...

  5. The Vitamin D Antenatal Asthma Reduction Trial (VDAART): rationale, design, and methods of a randomized, controlled trial of vitamin D supplementation in pregnancy for the primary prevention of asthma and allergies in children.

    Science.gov (United States)

    Litonjua, Augusto A; Lange, Nancy E; Carey, Vincent J; Brown, Stacey; Laranjo, Nancy; Harshfield, Benjamin J; O'Connor, George T; Sandel, Megan; Strunk, Robert C; Bacharier, Leonard B; Zeiger, Robert S; Schatz, Michael; Hollis, Bruce W; Weiss, Scott T

    2014-05-01

    There is intense interest in the role of vitamin D in the development of asthma and allergies. However, studies differ on whether a higher vitamin D intake or status in pregnancy or at birth is protective against asthma and allergies. To address this uncertainty, the Vitamin D Antenatal Asthma Reduction Trial (VDAART) was developed. VDAART is a randomized, double-blind, placebo-controlled trial of vitamin D supplementation in pregnant women to determine whether prenatal supplementation can prevent the development of asthma and allergies in women's offspring. A secondary aim is to determine whether vitamin D supplementation can prevent the development of pregnancy complications, such as preeclampsia, preterm birth, and gestational diabetes. Women were randomized to the treatment arm of 4000IU/day of vitamin D3 plus a daily multivitamin that contained 400IU of vitamin D3 or the placebo arm of placebo plus a multivitamin that contained 400IU daily of vitamin D3. Women who were between the gestational ages of 10 and 18 weeks were randomized from three clinical centers across the United States - Boston Medical Center, Washington University in St. Louis, and Kaiser Permanente Southern California Region (San Diego, CA). Supplementation took place throughout pregnancy. Monthly monitoring of urinary calcium to creatinine ratio was performed in addition to medical record review for adverse events. Offspring are being evaluated quarterly through questionnaires and yearly during in-person visits until the 3rd birthday of the child. Ancillary studies will investigate neonatal T-regulatory cell function, maternal vaginal flora, and maternal and child intestinal flora.

  6. Outpatient management of childhood asthma by paediatrician or asthma nurse : randomised controlled study with one year follow up

    NARCIS (Netherlands)

    Kamps, AWA; Brand, PLP; Kimpen, JLL; Maille, AR; Overgoor-van de Groes, AW; van Helsdingen-Peek, LCJAM

    2003-01-01

    Background: Until now, care provided by asthma nurses has been additional to care provided by paediatricians. A study was undertaken to compare nurse led outpatient management of childhood asthma with follow up by a paediatrician. Methods: Seventy four children referred because of insufficient contr

  7. The Acute Asthma Severity Assessment Protocol (AASAP) Study: Objectives and Methods of a Study to Develop an Acute Asthma Clinical Prediction Rule

    OpenAIRE

    2011-01-01

    Acute asthma exacerbations are one of the most common reasons for pediatric emergency department (PED) visits and hospitalizations, and relapse frequently necessitates repeat urgent care. While care plans exist, there are no acute asthma prediction rules (APR)to assess severity and predict outcome. The primary objective of the Acute Asthma Severity Assessment Protocol (AASAP) study is to develop a multivariable APR for acute asthma exacerbations in the pediatric patient.

  8. Exploring the association between severe respiratory syncytial virus infection and asthma: a registry-based twin study

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; van der Sluis, Sophie; Stensballe, Lone G;

    2009-01-01

    RATIONALE: Severe respiratory syncytial virus (RSV) infection is associated with asthma but the nature of this association is imperfectly understood. OBJECTIVES: To examine the nature of the association between severe RSV infection and asthma in a population-based sample of twins. METHODS: Data...

  9. Low-dose budesonide treatment reduces severe asthma-related events in patients with infrequent asthma symptoms at baseline

    DEFF Research Database (Denmark)

    Reddel, H. K.; Busse, W. W.; Pedersen, Søren

    2015-01-01

    RATIONALE: Inhaled corticosteroids (ICS) are highly effective in low doses for reducing asthma-related exacerbation risk and mortality. Previously, ICS treatment was recommended for patients with 'persistent' asthma, defined by symptoms >2 days/week.1 However, for patients with less frequent...... symptoms, evidence is lacking for the benefit of ICS and safety of bronchodilator-only treatment. We investigated asthma outcomes by baseline symptom frequency in a post-hoc analysis of the multinational inhaled Steroid Treatment As Regular Therapy in early asthma (START) study.2 METHODS: Patients aged 4...

  10. Persistent asthma increases the risk of chronic kidney disease: a retrospective cohort study of 2354 patients with asthma

    Institute of Scientific and Technical Information of China (English)

    LIU Dong-wei; ZHEN Xing-gang; LIANG Yan; JING Xiao-gang; ZHANG Tie-shuan; ZHANG Guo-jun; LIU Zhang-suo

    2013-01-01

    Background Chronic kidney disease (CKD) is a growing public health problem with well-established risk factors.Other contributing factors,however,remain to be identified.Systemic inflammation in asthma plays a significant role in the development of other diseases.We therefore initiated a study to assess whether the growing prevalence of asthma is associated with an increase in the risk of CKD.Methods We conducted a retrospective cohort study using data from 3015 patients with asthma aged 14 years and older who were registered and followed up in Asthma Control Study at the Department of Respiratory Medicine of three medical centers from 2005 to 2011.History,asthma control test (ACT),and asthma stage were used to assess the traits of asthma.CKD was defined as proteinuria and/or reduced estimated glomerular filtration rate (eGFR) (<60 ml·min-1·1.73 m-2) in two consecutive follow-up surveys.We used logistic regression models,adjusting for age,sex,and other confounding factor to determine associations between the traits of asthma and CKD.Kaplan-Meier curves were used to analyze patient outcomes.Results A total of 2354 subjects with complete data were recruited for this study with mean age (45.4±10.4) years.After 6 years of follow-up,9.6% (n=227) of the analytic cohort developed proteinuria and 3.1% (n=72) progressed to eGFR <60 ml·min-1·1.73 m-2.The patients with >20 years asthma history,not well-controlled or persistent asthma patients had higher incidence of proteinuria and reduced eGFR compared with patients with <20 years asthma history,at least well-controlled or remission asthma,respectively.The multivariable adjusted OR for proteinuria and reduced eGFR in participants with persistent asthma was 1.49; (95% confidence interval (CI) 1.17-1.91) and 2.07 (95% CI 1.34-4.42).Compared to patients with no asthma traits,there was a significant risk (OR,3.39; 95% CI 1.36-8.73) for those who met all three traits,including asthma history >20 years

  11. SHPPS 2006: School Health Policies and Programs Study--Asthma

    Science.gov (United States)

    Centers for Disease Control and Prevention, 2007

    2007-01-01

    The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and practices at the state, district, school, and classroom levels. This brief contains information on asthma relative to health education, physical education and activity, and health services. Included is data on the…

  12. Association between Allergic Rhinitis and Asthma Control in Peruvian School Children: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Justo Padilla

    2013-01-01

    Full Text Available Background. Asthma and allergic rhinitis are highly prevalent conditions that cause major illness worldwide. This study aimed to assess the association between allergic rhinitis and asthma control in Peruvian school children. Methods. A cross-sectional study was conducted among 256 children with asthma recruited in 5 schools from Lima and Callao cities. The outcome was asthma control assessed by the asthma control test. A score test for trend of odds was used to evaluate the association between allergic rhinitis severity and the prevalence of inadequate asthma control. A generalized linear regression model was used to estimate the adjusted prevalence ratios of inadequate asthma control. Results. Allergic rhinitis was present in 66.4% of the population with asthma. The trend analysis showed a positive association between allergic rhinitis and the probability of inadequate asthma control (. It was associated with an increased prevalence of inadequate asthma control, with adjusted prevalence ratios of 1.53 (95% confidence interval: 1.19−1.98. Conclusion. This study indicates that allergic rhinitis is associated with an inadequate level of asthma control, giving support to the recommendation of evaluating rhinitis to improve asthma control in children.

  13. The microbiome in asthma.

    Science.gov (United States)

    Huang, Yvonne J; Boushey, Homer A

    2015-01-01

    The application of recently developed sensitive, specific, culture-independent tools for identification of microbes is transforming concepts of microbial ecology, including concepts of the relationships between the vast complex populations of microbes associated with ourselves and with states of health and disease. Although most work initially focused on the community of microbes (microbiome) in the gastrointestinal tract and its relationship to gastrointestinal disease, interest has expanded to include study of the relationships of the airway microbiome to asthma and its phenotypes and to the relationships between the gastrointestinal microbiome, development of immune function, and predisposition to allergic sensitization and asthma. Here we provide our perspective on the findings of studies of differences in the airway microbiome between asthmatic patients and healthy subjects and of studies of relationships between environmental microbiota, gut microbiota, immune function, and asthma development. In addition, we provide our perspective on how these findings suggest the broad outline of a rationale for approaches involving directed manipulation of the gut and airway microbiome for the treatment and prevention of allergic asthma.

  14. Asthma in seven year old children: a report from the Dunedin Multidisciplinary Child Development Study.

    Science.gov (United States)

    Sears, M R; Jones, D T; Silva, P A; Simpson, A; Williams, S M

    1982-08-11

    The prevalence of asthma between birth and seven years was determined by questionnaire in 875 children as part of the Dunedin Multidisciplinary Child Development Study. From the combinations of asthma and/or wheezing reported in association with bronchitis, hayfever, eczema and allergies, a diagnosis of certain or probable asthma was made in 12.6 percent of these children. A further 22.6 percent admitted to wheezing, but a diagnosis of asthma could not be made with any certainty. Bronchitis was reported frequently, usually associated with wheezing. Children with more obvious asthma showed a male preponderance and significant differences in body build and school attendance compared with asymptomatic children.

  15. The Copenhagen Prospective Study on Asthma in Childhood (COPSAC)

    DEFF Research Database (Denmark)

    Bisgaard, Hans

    2004-01-01

    . Exposure assessments comprise respiratory, intestinal, and skin microbiology; the child's diet; indoor and outdoor air quality; allergens; and indicators of lifestyle. Genetic characteristics of probands and parents are evaluated. Quality assurance follows Good Clinical Practice guidelines. RESULTS: Four....... OBJECTIVE: To investigate the relationships among genetic, environmental, and lifestyle factors in the development of atopic diseases in high-risk children with the aim of developing evidence-based prevention strategies. METHODS: The Copenhagen Prospective Study on Asthma in Childhood is a single......-center, birth cohort study of children of asthmatic mothers. Objective assessments begin at birth, with scheduled visits every 6 months and when acute symptoms manifest. Clinical outcomes comprise preasthma, asthma, atopic dermatitis, allergic rhinitis, allergy, lung function, and bronchial responsiveness...

  16. Inflammation and Exercise (INFLAME): study rationale, design, and methods

    Science.gov (United States)

    Thompson, Angela; Mikus, Catherine; Rodarte, Ruben Q.; Distefano, Brandy; Priest, Elisa L.; Sinclair, Erin; Earnest, Conrad P.; Blair, Steven N.; Church, Timothy S.

    2008-01-01

    Purpose The INFLAME study is designed to determine the effect of exercise training on elevated high-sensitivity C-Reactive Protein (CRP) concentrations in initially sedentary women and men. Methods INFLAME will recruit 170 healthy, sedentary women and men with elevated CRP (≥2.0 mg/L) to be randomized to either an exercise group or non-exercise control group. Exercising individuals will participate in four months of supervised aerobic exercise with a total energy expenditure of 16 kcal • kg−1 • week−1 (KKW). Exercise intensity will be 60–80% of maximal oxygen consumption (VO2 max). Outcome The primary outcome will be change in plasma CRP concentration. Secondary outcomes include visceral adiposity, the cytokines IL-6 and TNF-α, and heart rate variability (HRV) in order to examine potential biological mechanisms whereby exercise might affect CRP concentrations. Summary INFLAME will help us understand the effects of moderate to vigorous exercise on CRP concentrations in sedentary individuals. To our knowledge this will be the largest training study specifically designed to examine the effect of exercise on CRP concentrations. This study has the potential to influence therapeutic applications since CRP measurement is becoming an important clinical measurement in Coronary Heart Disease risk assessment. This study will also contribute to the limited body of literature examining the effect of exercise on the variables of visceral adiposity, cytokines, and heart rate variability. PMID:18024231

  17. A nationwide study of asthma incidence rate and its determinants in Swedish pre-school children.

    Science.gov (United States)

    Bröms, Kristina; Norbäck, Dan; Sundelin, Claes; Eriksson, Margaretha; Svärdsudd, Kurt

    2012-09-01

    While many studies on asthma prevalence have been published, the number of studies on asthma incidence in pre-school children is limited. In this project, a nationwide sample of pre-school children was followed with the aim of estimating cumulative 5-year asthma incidence and its determinants. Parents of 5,886 children 1-6 years of age, sampled from day-care centres in 62 municipalities all over Sweden, responded in 2002 to a baseline postal questionnaire with questions regarding symptoms indicating possible asthma or atopic conditions, and a number of other variables. In 2007, parents of 4,255 children responded to an almost identical follow-up questionnaire. Of these, the 3,715 children who were free from asthma at baseline constitute the study population for this report. A large number of potential baseline determinants for cumulative 5-year asthma incidence were identified. Of these, food allergy, rhinitis, incomplete asthma diagnosis criteria (wheezing last 12 months, and ever had asthma but no current symptoms), parental rhinitis, parental asthma, age, and eczema, in ranking order of importance, remained significant in multivariate logistic regression analysis. The asthma incidence rate was highly dependent on presence or absence of these variables, the average annual rate ranging from 2/1,000/year in 6-year-olds with no determinants to 154/1,000/year in 1-year-olds with all determinants, corresponding to 11/1,000/year based on the whole study population.

  18. National asthma observational survey of severe asthmatics in Israel: the no-air study

    Directory of Open Access Journals (Sweden)

    Izbicki Gabriel

    2012-06-01

    Full Text Available Abstract Background Asthma is considered a global public health issue requiring a significant medical expenditure as a result of its high prevalence and the low rate of disease control. Objective This is the first nationwide survey of severe asthma patients carried out in Israel. In this study we aimed to assess health resources utilization, compliance with treatment and disease-control in a subgroup of patients with severe asthma in Israel. Material and method One hundred and twenty-three patients with a diagnosis of asthma for more then one year, as well as a hospitalization during the last 12 months due to asthma exacerbation or maintenance systemic steroids therapy, were included in this non-interventional observational study. Results Asthma was uncontrolled in 43.9%, partly controlled in 50.4% and well controlled in only 5.7%. The majority of the patients (83% were compliant with drug treatment. Conclusion The fact that 83% of the asthma patients included in this study were compliant with their asthma therapy was not manifested in asthma control. Therefore concrete tools are required for achieving and maintaining asthma control, especially in the treatment of the most severe asthmatic patients.

  19. Low-dose budesonide treatment improves lung function in patients with infrequent asthma symptoms at baseline

    DEFF Research Database (Denmark)

    Reddel, H. K.; Busse, W. W.; Pedersen, Søren;

    2015-01-01

    in patients with less frequent symptoms at presentation. This was investigated in a post-hoc analysis of the multinational inhaled Steroid Treatment As Regular Therapy in early asthma (START) study.2 METHODS: Patients aged 4-66 years (median 21 years) with a history of recent-onset mild asthma (11 years......RATIONALE: Inhaled corticosteroids (ICS) are highly effective in low doses for improving asthma outcomes, including lung function. In the past, ICS treatment was recommended for patients with 'persistent' asthma, defined by symptoms >2 days/week.1 However, evidence is lacking for the benefit of ICS...... symptom frequency groups (Figure). CONCLUSIONS: Long-term, once-daily, low-dose budesonide treatment plus usual asthma medication improves lung function in patients with mild, recent-onset asthma. These beneficial effects were seen even in patients with the lowest baseline asthma symptom frequency (0...

  20. The Pediatric Obsessive-Compulsive Disorder Treatment Study II: rationale, design and methods

    OpenAIRE

    March John S; Khanna Muniya S; Sapyta Jeffrey J; Moore Phoebe S; Garcia Abbe M; Choate-Summers Molly L; Freeman Jennifer B; Foa Edna B; Franklin Martin E

    2009-01-01

    Abstract This paper presents the rationale, design, and methods of the Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II), which investigates two different cognitive-behavior therapy (CBT) augmentation approaches in children and adolescents who have experienced a partial response to pharmacotherapy with a serotonin reuptake inhibitor for OCD. The two CBT approaches test a "single doctor" versus "dual doctor" model of service delivery. A specific goal was to develop and test...

  1. Risk factors for asthma in young adults: a co-twin control study

    DEFF Research Database (Denmark)

    Thomsen, S F; Ulrik, C S; Kyvik, K O;

    2006-01-01

    BACKGROUND: The liability to asthma is influenced both by genetic and environmental factors. The objective of this study was to identify risk factors for asthma in young adult twin pairs during an 8-year period. METHODS: From the birth cohorts 1953-1982 of the Danish Twin Registry, 6,090 twin pairs...... who were initially unaffected with respect to asthma at a nationwide questionnaire-based study in 1994 participated in a similar follow-up study in 2002. Subjects were regarded incident asthma cases when responding affirmatively to the question 'Do you have, or have you ever had asthma'? in 2002....... Pairs in which only one twin developed asthma -- discordant pairs -- were identified and conditional logistic regression was applied to detect effects of risk factors. RESULTS: A total of 126 monozygotic (MZ) and 273 dizygotic (DZ) discordant twin pairs were identified. In MZ twins hay fever (OR = 3...

  2. Relationship between Vitamin D and Childhood Asthma: A Case–Control Study

    OpenAIRE

    Hatami, Gissou; Ghasemi, Khadijeh; Motamed, Niloofar; Firoozbakht, Saiideh; Movahed, Ali; Farrokhi, Shokrollah

    2014-01-01

    Objective: Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma. Methods: Data were obtained from 200 asthmatic children (age 3–12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium...

  3. Asthma and Wheeze Prevalence among Nursing Professionals in Western Japan: A Cross-Sectional Study

    OpenAIRE

    Jun Kurai; Masanari Watanabe; Hiroyuki Sano; Saeko Torai; Hirokazu Yanase; Tomoaki Funakoshi; Atsuko Fukada; Sachiko Hayakawa; Eiji Shimizu; Hiroya Kitano

    2015-01-01

    Although adult asthma is attributable to occupational factors, few reports are available on asthma prevalence among health care workers in Japan. The objective of this study was to estimate the prevalence of asthma and wheeze among Japanese nursing professionals. A cross-sectional study was conducted by postal survey using a translated version of the European Community Respiratory Health Survey questionnaire from April to June 2013. The analysis included 4634 nursing professionals (257 men an...

  4. A community study of factors related to poorly controlled asthma among Brazilian urban children.

    Directory of Open Access Journals (Sweden)

    Silvia de Magalhães Simões

    Full Text Available BACKGROUND: Asthma constitutes a serious public health problem in many regions of the world, including the city of Salvador, State of Bahia-Brazil. The purpose of this study was to analyse the factors associated with poor asthma control. METHODOLOGY/PRINCIPAL FINDINGS: Two definitions were used for asthma: 1 wheezing in the last 12 months; 2 wheezing in the last 12 months plus other asthma symptoms or asthma diagnosis ever. The definition of poorly controlled asthma was: at least one reported hospitalisation due to asthma and/or high frequency of symptoms, in the last year. Children with poorly controlled asthma (N = 187/374 were compared with wheezing children with controlled asthma regarding age, gender, atopy, parental asthma, rhinitis, eczema, exposure to second hand tobacco smoke, presence of moulds, pets and pests in the house, helminth infections and body mass index. Crude and logistic regression adjusted odds ratios were used as measures of association. There was a higher proportion of poorly controlled asthma among children with eczema (OR = 1.55; 95% CI 1.02; 2.37. The strength of the association was greater among children with eczema and rhinitis (42.6%, 53.4% and 57.7%, respectively, in children who had no rhinitis nor eczema, had only one of those, and had both (p = 0.02 for trend test. The presence of mould in the houses was inversely associated with poorly controlled asthma (OR = 0.54; 95% CI 0.34; 0.87. CONCLUSIONS/SIGNIFICANCE: Our results indicate an association between eczema and poor asthma control in this environment, but emphasize the role of various other individual and environmental factors as determinants of poor control.

  5. A study of neonatal and maternal outcomes of asthma during pregnancy

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    Babu Lal Meena

    2013-02-01

    Full Text Available Background: Asthma is a common problem all around the world with variable prevalence ranging from 1%–18% in different age and geographical distribution. There are proximately 300 million affected individuals. There are growing prevalence and morbidity, due to asthma associated with pregnancy. The course of asthma in pregnancy is unpredictable. Methods: 2400 consecutive pregnant women attending the antenatal clinic of S.P. Medical College and AG of Hospitals, Bikaner, were screened using asthma questionnaire translated in Hindi based on the questionnaire developed for International Union against Tuberculosis and Lung Disease. 52 patients diagnosed as asthma were subjected for PFT and classified according to clinical severity as per GINA guidelines, 2006. All subjects were followed till delivery and postpartum charts reviewed to see neonate and maternal outcome. Results: The prevalence of asthma during pregnancy was 2.1%, among them, 25 (48.1% were categorized as having intermittent asthma, 6 (11.5% with mild persistent asthma, 10 (19.2% with moderate persistent asthma and 11 (21.2% having severe persistent asthma. During the course of pregnancy, 36% had no change in the symptomatology, while (32.5% experienced improvement and (32.5% of worsening of asthma. 22 (42.31% women were newly diagnosed during our study. There was no significant adverse maternal and fetal outcome in asthmatic group compared to control. Conclusions: Asthma is an under diagnosed and under treated disorder, especially during pregnancy and overall morbidity of asthma among women & neonates does not change during pregnancy. [Int J Res Med Sci 2013; 1(1.000: 23-27

  6. Smoking patterns among adolescents with asthma attending upper secondary schools: a community-based study

    DEFF Research Database (Denmark)

    Precht, Dorthe Hansen; Keiding, Lis; Madsen, Mette

    2003-01-01

    OBJECTIVE: Smoking among people who have asthma may be a serious health problem. We studied the prevalence of smoking and the relations between smoking and asthma, symptoms, medicine, and gender differences among adolescents with asthma. METHODS: A national cross-sectional study on health...... adjusted for age, gender, parents' job and smoking, family type, body mass index, and exercise habits. RESULTS: In total, 37.7% smoked currently and 16.5% smoked daily; more girls than boys smoked. More pupils with asthma than without smoked daily (adjusted odds ratio [OR]: 1.15; 95% confidence interval...... with and without asthma were occasional smokers and ex-smokers at a similar prevalence. CONCLUSIONS: More pupils with asthma than without smoked daily, and they also smoked more cigarettes per day. This is a major health concern, as adolescents have a high smoking prevalence in Denmark. Udgivelsesdato: 2003-May...

  7. Asthma characteristics and biomarkers from the Airways Disease Endotyping for Personalized Therapeutics (ADEPT) longitudinal profiling study

    DEFF Research Database (Denmark)

    Silkoff, P E; Strambu, I; Laviolette, M;

    2015-01-01

    BACKGROUND: Asthma is a heterogeneous disease and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. The purpose of the ADEPT study was to correlate clinical features and biomarkers with molecular characteristics, by profiling asthma (NCT01274507). This re......BACKGROUND: Asthma is a heterogeneous disease and development of novel therapeutics requires an understanding of pathophysiologic phenotypes. The purpose of the ADEPT study was to correlate clinical features and biomarkers with molecular characteristics, by profiling asthma (NCT01274507......, were stable over 12 months. Use of the ADEPT data should prove useful in defining biological phenotypes to facilitate personalized therapeutic approaches....

  8. Sudden death in young persons with uncontrolled asthma--a nationwide cohort study in Denmark

    DEFF Research Database (Denmark)

    Gullach, Anders Juul; Risgaard, Bjarke; Lynge, Thomas Hadberg;

    2015-01-01

    BACKGROUND: Asthma is a common chronic disease among young adults, and several studies have reported increased mortality rates in patients with asthma. However, no study has described sudden unexpected death in a nationwide setting in patients with uncontrolled asthma. We defined uncontrolled...... in preventing sudden unexpected deaths. We therefore aimed to describe clinical characteristics, symptoms, causes of death, and contact with the healthcare system prior to sudden unexpected death in young persons with uncontrolled asthma. METHODS: Through the review of death certificates, we found 625 sudden...

  9. A comparison of three methods to measure asthma in epidemiologic studies

    DEFF Research Database (Denmark)

    Hansen, Susanne; Strøm, Marin; Maslova, Ekaterina;

    2012-01-01

    Asthma is a heterogeneous outcome and how the condition should be measured to best capture clinically relevant disease in epidemiologic studies remains unclear. We compared three methods of measuring asthma in the Danish National Birth Cohort (n>50.000). When the children were 7 years old...... the asthma prevalence was 3.6%. In conclusion, self-reported asthma, ICD-10 diagnoses from a hospitalization registry and data on anti-asthmatic medication use from a prescription registry lead to different prevalences of asthma in the same cohort of children. The non-overlap between the methods may be due......, the prevalence of asthma was estimated from a self-administered questionnaire using parental report of doctor diagnoses, ICD-10 diagnoses from a population-based hospitalization registry, and data on anti-asthmatic medication from a population-based prescription registry. We assessed the agreement between...

  10. The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

    Directory of Open Access Journals (Sweden)

    Sandel Megan T

    2009-05-01

    Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

  11. Is Chronic Asthma Associated with Shorter Leukocyte Telomere Length at Midlife?

    Science.gov (United States)

    Shalev, Idan; Sears, Malcolm R.; Hancox, Robert J.; Lee Harrington, Hona; Houts, Renate; Moffitt, Terrie E.; Sugden, Karen; Williams, Benjamin; Poulton, Richie; Caspi, Avshalom

    2014-01-01

    Rationale: Asthma is prospectively associated with age-related chronic diseases and mortality, suggesting the hypothesis that asthma may relate to a general, multisystem phenotype of accelerated aging. Objectives: To test whether chronic asthma is associated with a proposed biomarker of accelerated aging, leukocyte telomere length. Methods: Asthma was ascertained prospectively in the Dunedin Multidisciplinary Health and Development Study cohort (n = 1,037) at nine in-person assessments spanning ages 9–38 years. Leukocyte telomere length was measured at ages 26 and 38 years. Asthma was classified as life-course-persistent, childhood-onset not meeting criteria for persistence, and adolescent/adult-onset. We tested associations between asthma and leukocyte telomere length using regression models. We tested for confounding of asthma-leukocyte telomere length associations using covariate adjustment. We tested serum C-reactive protein and white blood cell counts as potential mediators of asthma-leukocyte telomere length associations. Measurements and Main Results: Study members with life-course-persistent asthma had shorter leukocyte telomere length as compared with sex- and age-matched peers with no reported asthma. In contrast, leukocyte telomere length in study members with childhood-onset and adolescent/adult-onset asthma was not different from leukocyte telomere length in peers with no reported asthma. Adjustment for life histories of obesity and smoking did not change results. Study members with life-course-persistent asthma had elevated blood eosinophil counts. Blood eosinophil count mediated 29% of the life-course-persistent asthma-leukocyte telomere length association. Conclusions: Life-course-persistent asthma is related to a proposed biomarker of accelerated aging, possibly via systemic eosinophilic inflammation. Life histories of asthma can inform studies of aging. PMID:24956257

  12. Asthma and Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Prospective Cohort Study

    Science.gov (United States)

    Chen, Mu-Hong; Su, Tung-Ping; Chen, Ying-Sheue; Hsu, Ju-Wei; Huang, Kai-Lin; Chang, Wen-Han; Chen, Tzeng-Ji; Bai, Ya-Mei

    2013-01-01

    Background: Previous cross-sectional studies have suggested an association between asthma and attention-deficit/hyperactivity disorder (ADHD), but the temporal relationship was not determined. Using a nationwide population-based prospective case-control cohort study (1:4, age-/gender-matched), we hypothesized that asthma in infanthood or early…

  13. The primary prevention of asthma in children study: design of a multifaceted prevention program.

    NARCIS (Netherlands)

    Kuiper, S.; Maas, T.; Schayck, C.P. van; Muris, J.W.M.; Schonberger, H.J.; Dompeling, E.C.; Gijsbers, B.; Weel, C. van; Knottnerus, J.A.

    2005-01-01

    The PREVASC study addresses the primary prevention of asthma in infants and small children. The objective of this study is to investigate whether a multifaceted prenatally started intervention strategy in high-risk infants leads to a decrease in the occurrence of (severe) asthma and whether a refine

  14. The Prevalence, Management and Burden of Asthma-A Nigerian Study

    Directory of Open Access Journals (Sweden)

    Alexander O. Oni

    2010-03-01

    Full Text Available Inadequate attention given to the management of asthma and ways of improving treatment could be a significant factor for the increase morbidity and mortality from asthma despite major advances in our understanding of the pathophysiology of the disease. There seems to be paucity of data concerning the management pattern and burden of asthma in Africa. This study was undertaken to determine the prevalence, management pattern and the burden of asthma.This study was a cross sectional design involving clinical and lung function assessment. The diagnosis of asthma was made using the clinical features of asthma and lung function parameters (Forced expiratory volume in one second, Peak expiratory flow rate, Reversibility tests. Totally, 120 asthma patients participated in this study. All subjects completed the clinical asthma control questionnaires. All items were rated with the calculation of their mean and percentages. Student t-test was used to calculate the difference between the mean of the lung function tests for subjects and control. The prevalence of asthma among respiratory unit patients was 6.6% and higher in the first three decades of life with female preponderance (F:M=1.5-1.There is a strong family history of asthma(81.7%. Associated allergies include rhinitis (75%, pharyngitis (54%, conjunctivitis (54% and dermatitis (30%. Percentage of asthma patients treated with bronchodilators alone (70%, combined inhaled bronchodilators and steroid (28.3%. Impaired daily activities include sports (84%, Job career (60%, Physical activity (55%, Social activity (54%, Household chores (61%, Disturbed sleep (53%, Daytime symptoms (51%, Hospitalized(50%. Subjects had significant low lung function values when compared with control (P

  15. Evidence for an asthma risk locus on chromosome Xp: a replication linkage study

    DEFF Research Database (Denmark)

    Brasch-Andersen, C; Møller, M U; Haagerup, A;

    2008-01-01

    BACKGROUND: Asthma is a complex genetic disorder characterized by chronic inflammation in the airways. Identification of genetic risk factors for asthma has been complicated due to genetic heterogeneity and influence from environmental risk factors. Despite the fact that multiple genetic linkage...... studies have been carried out the results are still conflicting and call for replication experiments. A Danish genome-wide scan has prior reported evidence for candidate regions for asthma susceptibility genes on chromosomes 1p, 5q, 6p, 12q and Xp. Linkage to chromosome 12q was later confirmed in the same...... replication sample as used in the present study. The aim of the study was to replicate linkage to candidate regions for asthma in an independent Danish sample. METHODS: We performed a replication study investigating linkage to candidate regions for asthma on chromosomes 1p36.31-p36.21, 5q15-q23.2, 6p24.3-p22...

  16. Breastfeeding, overweight and asthma in Dutch children. The PIAMA birth cohort study

    NARCIS (Netherlands)

    Scholtens, S.

    2008-01-01

    Breastfeeding has been linked to a lower risk of overweight and asthma in children, however the results of previous studies are conflicting and controversy remains. An important gap in the current knowledge on the association between breastfeeding and overweight and asthma is whether and how the ass

  17. Effects of pets on asthma development up to 8 years of age: the PIAMA study.

    NARCIS (Netherlands)

    Kerkhof, M. van de; Wijga, A.H.; Brunekreef, B.; Smit, H.A.; Jongste, J.C. de; Aalberse, R.; Hoekstra, M.O.; Gerritsen, J.; Postma, D.S.

    2009-01-01

    BACKGROUND: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. METHODS: Event history analysis was

  18. Effects of pets on asthma development up to 8 years of age : the PIAMA study

    NARCIS (Netherlands)

    Kerkhof, M.; Wijga, A. H.; Brunekreef, B.; Smit, H. A.; de Jongste, J. C.; Aalberse, R. C.; Hoekstra, M. O.; Gerritsen, J.; Postma, D. S.

    2009-01-01

    Background: Recall bias may provide discrepant relationships of pet exposure with sensitization and asthma development. We studied prospectively effects of pets at home on development of sensitization, asthma and respiratory symptoms from birth up to age 8 years. Methods: Event history analysis was

  19. Predictors of changes in sick leave in workers with asthma: a follow-up study.

    NARCIS (Netherlands)

    Boot, C.R.L.; Vercoulen, J.H.M.M.; Gulden, J.W.J. van der; Orbon, K.H.; Rooijackers, J.; Weel, C. van; Folgering, H.T.M.

    2005-01-01

    OBJECTIVE: The aim of this prospective study was to investigate predictors of 1-year changes in sick leave in workers with asthma. METHODS: The initial cohort consisted of 111 workers with asthma. One-hundred and one participants completed the follow-up after 1 year. Self-reported sick leave over th

  20. The Inhaled Steroid Treatment As Regular Therapy in Early Asthma (START) study 5-year follow-up: effectiveness of early intervention with budesonide in mild persistent asthma

    DEFF Research Database (Denmark)

    Busse, William W; Pedersen, Søren; Pauwels, Romain A;

    2008-01-01

    BACKGROUND: The Inhaled Steroid Treatment as Regular Therapy in Early Asthma (START) study enrolled 7241 patients aged 5 to 66 years with recent-onset, mild persistent asthma to assess early intervention with the inhaled corticosteroid budesonide on long-term asthma control. OBJECTIVE: The open......-label phase of the START study was included to determine the effect on lung function and asthma control of adding budesonide to the reference group patients who had not initially received inhaled corticosteroids. METHODS: Patients were randomized to double-blind treatment with budesonide, 200 mug (those aged...... asthma therapy for 3 years, after which all patients received 2 years of open-label treatment with budesonide once daily. RESULTS: During the full 5-year study period, postbronchodilator FEV(1) percent predicted decreased, irrespective...

  1. Risk of Migraine in Patients With Asthma: A Nationwide Cohort Study.

    Science.gov (United States)

    Peng, Yi-Hao; Chen, Kuan-Fei; Kao, Chia-Hung; Chen, Hsuan-Ju; Hsia, Te-Chun; Chen, Chia-Hung; Liao, Wei-Chih

    2016-03-01

    Asthma has been described as an "acephalic migraine" and "pulmonary migraine." However, no study has investigated the temporal frequency of migraine development in patients with asthma, and the results of previous studies may be difficult to generalize.We investigated the effect of asthma on the subsequent development of migraine by using a population-based data set in Taiwan.We retrieved our study sample from the National Health Insurance Research Database. Specifically, 25,560 patients aged 12 years and older with newly diagnosed asthma were identified as the asthma group, and 102,238 sex and age-matched patients without asthma were identified as the nonasthma group. Cox proportional-hazards regression models were employed to measure the risk of migraine for the asthmatic group compared with that for the nonasthmatic group.The risk of migraine in the asthmatic group was 1.45-fold higher (95% confidence interval 1.33-1.59) than that in the nonasthmatic group after adjustment for sex, age, the Charlson comorbidity index, common medications prescribed for patients with asthma, and annual outpatient department visits. An additional stratified analysis revealed that the risk of migraine remained significantly higher in both sexes and all age groups older than 20 years.Asthma could be an independent predisposing risk factor for migraine development in adults.

  2. Asthma during pregnancy in a population-based study--pregnancy complications and adverse perinatal outcomes.

    Directory of Open Access Journals (Sweden)

    Gustaf Rejnö

    Full Text Available BACKGROUND: Asthma is one of the most common chronic diseases, and prevalence, severity and medication may have an effect on pregnancy. We examined maternal asthma, asthma severity and control in relation to pregnancy complications, labour characteristics and perinatal outcomes. METHODS: We retrieved data on all singleton births from July 1, 2006 to December 31, 2009, and prescribed drugs and physician-diagnosed asthma on the same women from multiple Swedish registers. The associations were estimated with logistic regression. RESULTS: In total, 266 045 women gave birth to 284 214 singletons during the study period. Maternal asthma was noted in 26 586 (9.4% pregnancies. There was an association between maternal asthma and increased risks of pregnancy complications including preeclampsia or eclampsia (adjusted OR 1.15; 95% CI 1.06-1.24 and premature contractions (adj OR 1.52; 95% CI 1.29-1.80. There was also a significant association between maternal asthma and emergency caesarean section (adj OR 1.29; 95% CI 1.23-1.34, low birth weight, and small for gestational age (adj OR 1.23; 95% CI 1.13-1.33. The risk of adverse outcomes such as low birth weight increased with increasing asthma severity. For women with uncontrolled compared to those with controlled asthma the results for adverse outcomes were inconsistent displaying both increased and decreased OR for some outcomes. CONCLUSION: Maternal asthma is associated with a number of serious pregnancy complications and adverse perinatal outcomes. Some complications are even more likely with increased asthma severity. With greater awareness and proper management, outcomes would most likely improve.

  3. Acceptance of Asthma Pharmacogenetic Study by Children and Adults

    Science.gov (United States)

    Wu, Ann Chen; Davis, Robert; Tantisira, Kelan; Dutta-Linn, M. Maya; Hemmes, Mia; Weiss, Scott T.

    2012-01-01

    Background Pharmacogenetic testing may change clinical medicine by allowing clinicians to tailor medications based on a patient’s genetic makeup, however, these tests must first be validated in large, real-life populations of subjects that include children. A dearth of knowledge exists for whether pediatric populations are as willing as adult populations to provide samples for such studies. Objective (1) To assess whether pediatric and adult patients with persistent asthma are willing to provide specimens for DNA extraction and genetic studies. (2) To assess whether patients’ willingness to provide blood as compared to buccal smear specimens differ. Methods Of 644 patients ages 4–38 years who had three or more prescription fills for inhaled corticosteroids in one year, 60% (385) were randomized to the blood specimen group and 40% (259) were randomized to the buccal smear group in order to study acceptance of different biospecimen collection methods. Research assistants contacted subjects to obtain consent, perform a phone survey, and request a specimen. Results There were no baseline differences between subjects randomized to the blood specimen group versus buccal smear group with respect to age, gender, or number of dispensings of inhaled corticosteroids. Of 259 subjects in the buccal smear group, 30% (78) provided samples, and of 385 subjects in the blood specimen group, 16% (60) provided samples. Subjects randomized to the buccal smear group were more likely to provide specimens for genetic study compared to subjects randomized to the blood specimen group (RR 1.21; 95% CI 1.10 – 1.32), even after adjusting for age. Pediatric subjects were more likely to provide specimens for genetic study than adult subjects with 23% (113) of pediatric subjects providing samples and 15% (25) of adult subjects providing samples (p=0.03). Conclusion Children with asthma are as likely to participate in genetic studies as adults. Both children and adult subjects are more

  4. Indicators of violence and asthma: An ecological study

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    Fábio de Oliveira Tabalipa

    2015-10-01

    Conclusions: There was a direct correlation between indicators of violence and rates of admission due asthma, and an inverse correlation with indicators of development. These results suggest that social detriment can act as a risk factor for hospital admissions due to asthma.

  5. Comorbidities of asthma during childhood : possibly important, yet poorly studied

    NARCIS (Netherlands)

    de Groot, E. P.; Duiverman, E. J.; Brand, P. L. P.

    2010-01-01

    Asthma in adults is associated with comorbidities such as obesity, gastro-oesophageal reflux, dysfunctional breathing and mental disorders. Herein, we provide an overview of the current state of evidence on these comorbidities in childhood asthma. The prevalence, known mechanisms and possible treatm

  6. General and abdominal obesity and incident asthma in adults: the HUNT study.

    Science.gov (United States)

    Brumpton, Ben; Langhammer, Arnulf; Romundstad, Pål; Chen, Yue; Mai, Xiao-Mei

    2013-02-01

    Measures of body mass index (BMI) and waist circumference define general obesity and abdominal obesity respectively. While high BMI has been established as a risk factor for asthma in adults, waist circumference has seldom been investigated. To determine the association between BMI, waist circumference and incident asthma in adults, we conducted a prospective study (n=23,245) in a population living in Nord-Trøndelag, Norway in 1995-2008. Baseline BMI and waist circumference were measured and categorised as general obesity (BMI ≥30.0 kg·m(2)) and abdominal obesity (waist circumference ≥88 cm in females and ≥102 cm in males). Incident asthma was self-reported new-onset cases during an 11-yr follow-up period. Odds ratios for asthma associated with obesity were calculated using multivariable logistic regression. General obesity was a risk factor for asthma in females (OR 1.96, 95% CI 1.52-2.52) and males (OR 1.84, 95% CI 1.30-2.59). In females, after additional adjustment for BMI, abdominal obesity remained a risk factor for asthma development (OR 1.46, 95% CI 1.04-2.05). Abdominal obesity seems to increase the risk of incident asthma in females in addition to BMI, indicating that using both measures of BMI and waist circumference in females may be a superior clinical assessment for asthma risk than any measure alone.

  7. A telehealth integrated asthma-COPD service for primary care: a proposal for a pilot feasibility study in Crete, Greece

    OpenAIRE

    Tzanakis Nikolaos E; van der Molen Thys; Tsiligianni Ioanna G; Siafakas Nikolaos M; van Heijst Ellen; Lionis Christos

    2010-01-01

    Abstract Background Chronic obstructive pulmonary disease (COPD) and asthma are considered underdiagnosed and misdiagnosed chronic diseases. In The Netherlands, a COPD-asthma telemedicine service has been developed to increase GPs' ability to diagnose and manage COPD and asthma. A telemedicine COPD-asthma service may benefit Greece as it is a country, partly due to its geography, that does not have easy access to pulmonologists. Findings Therefore, a pilot feasibility study has been designed ...

  8. The Asthma Mobile Health Study, a large-scale clinical observational study using ResearchKit.

    Science.gov (United States)

    Chan, Yu-Feng Yvonne; Wang, Pei; Rogers, Linda; Tignor, Nicole; Zweig, Micol; Hershman, Steven G; Genes, Nicholas; Scott, Erick R; Krock, Eric; Badgeley, Marcus; Edgar, Ron; Violante, Samantha; Wright, Rosalind; Powell, Charles A; Dudley, Joel T; Schadt, Eric E

    2017-04-01

    The feasibility of using mobile health applications to conduct observational clinical studies requires rigorous validation. Here, we report initial findings from the Asthma Mobile Health Study, a research study, including recruitment, consent, and enrollment, conducted entirely remotely by smartphone. We achieved secure bidirectional data flow between investigators and 7,593 participants from across the United States, including many with severe asthma. Our platform enabled prospective collection of longitudinal, multidimensional data (e.g., surveys, devices, geolocation, and air quality) in a subset of users over the 6-month study period. Consistent trending and correlation of interrelated variables support the quality of data obtained via this method. We detected increased reporting of asthma symptoms in regions affected by heat, pollen, and wildfires. Potential challenges with this technology include selection bias, low retention rates, reporting bias, and data security. These issues require attention to realize the full potential of mobile platforms in research and patient care.

  9. Serum Based Diagnosis of Asthma Using Raman Spectroscopy: An Early Phase Pilot Study

    Science.gov (United States)

    Sahu, Aditi; Dalal, Krishna; Naglot, Sarla; Aggarwal, Parveen; Murali Krishna, C.

    2013-01-01

    The currently prescribed tests for asthma diagnosis require compulsory patient compliance, and are usually not sensitive to mild asthma. Development of an objective test using minimally invasive samples for diagnosing and monitoring of the response of asthma may help better management of the disease. Raman spectroscopy (RS) has previously shown potential in several biomedical applications, including pharmacology and forensics. In this study, we have explored the feasibility of detecting asthma and determining treatment response in asthma patients, through RS of serum. Serum samples from 44 asthma subjects of different grades (mild, moderate, treated severe and untreated severe) and from 15 reference subjects were subjected to Raman spectroscopic analysis and YKL-40 measurements. The force expiratory volume in 1 second (FEV1) values were used as gold standard and the serum YKL-40 levels were used as an additional parameter for diagnosing the different grades of asthma. For spectral acquisition, serum was placed on a calcium fluoride (CaF2) window and spectra were recorded using Raman microprobe. Mean and difference spectra comparisons indicated significant differences between asthma and reference spectra. Differences like changes in protein structure, increase in DNA specific bands and increased glycosaminoglycans-like features were more prominent with increase in asthma severity. Multivariate tools using Principal-component-analysis (PCA) and Principal-component based-linear-discriminant analysis (PC-LDA) followed by Leave-one-out-cross-validation (LOOCV), were employed for data analyses. PCA and PC-LDA results indicate separation of all asthma groups from the reference group, with minor overlap (19.4%) between reference and mild groups. No overlap was observed between the treated severe and untreated severe groups, indicating that patient response to treatment could be determined. Overall promising results were obtained, and a large scale validation study on

  10. Heritability of self-reported asthma and allergy : A study in adult Dutch twins, siblings and parents

    NARCIS (Netherlands)

    Willemsen, Gonneke; van Beijsterveldt, Toos C. E. M.; van Baal, Caroline G. C. M.; Postma, Dirkje; Boomsma, Dorret I.

    2008-01-01

    The present study assessed the prevalence of asthma and allergy, and estimated the importance of genetic and environmental influences on asthma and allergy liability and their association. Longitudinal data on self-reported, doctor-diagnosed asthma and allergy were collected in over 14,000 individua

  11. Does Design Rationale Enhance Creativity?

    Directory of Open Access Journals (Sweden)

    Jing Wang

    2010-01-01

    Full Text Available Creativity and rationale are often viewed as two contrasting facets in software design. A lack in recognizing the facilitative relationship between creativity and rationale not only underestimates the benefits designers can obtain from rationale practices, but also confines the approaches that support creativity in software design. Our exploratory study provides empirical evidence of the positive correlation between rationale and creativity. Furthermore, we found that the feasibility of design alternatives and the comprehensiveness of tradeoff evaluation are critical to enhancing novelty, persuasiveness, and insightfulness. We also discuss future directions to further understand how these properties, or rationale quality in general, affects design creativity.

  12. Asthma Basics

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Asthma Basics KidsHealth > For Parents > Asthma Basics A A ... Asthma Categories en español Asma: aspectos fundamentales About Asthma Asthma is a common lung condition in kids ...

  13. The use of remotely sensed environmental data in the study of asthma disease

    Science.gov (United States)

    Ayres-Sampaio, D.; Teodoro, A. C.; Freitas, A.; Sillero, N.

    2012-09-01

    Despite the growing use of Remote Sensing (RS) data in epidemiological studies, several diseases, including asthma, have not been studied yet using RS potentialities. Asthma is a chronic inflammatory disorder of the airway that affects people of all ages throughout the world. The expression of this disease can be influenced by some environmental factors such as allergens, air pollution or climate conditions. In this study, we modeled the distribution of asthma in each season, using Maximum entropy (Maxent) model and presence data obtained from a national database with asthma public hospitals admissions in Mainland Portugal, with discharges between years 2003 and 2008. We considered data from the Moderate Resolution Imaging Spectroradiometer (MODIS) to retrieve estimates of near-surface air temperature and relative humidity. Land-use regression (LUR) models were developed to produce estimates of three pollutants: PM10, NO2, and CO. Moreover, MODIS Normalized Difference Vegetation Index (NDVI) was also used in the construction of Maxent models. All Maxent models predicted similar suitable areas and obtained acceptable area under the curve (AUC) values (~0.75) of the ROC plot. Our results show a strong relationship between asthma presence and NO2, suggesting that asthmatic people living in urban areas with high traffic volume have an increased risk of suffering asthma attacks. Furthermore, there is evidence of the effect of PM10, CO, and RH (during the Summer) in asthma expression. RS data have a great potential but also presents limitations that should be addressed to allow studying more complex diseases.

  14. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study.

    Science.gov (United States)

    Whitrow, Melissa J; Moore, Vivienne M; Rumbold, Alice R; Davies, Michael J

    2009-12-15

    This study aimed to investigate the effect of the timing, dose, and source of folate during pregnancy on childhood asthma by using data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participated in the study, respectively. Maternal folate intake from diet and supplements was assessed by food frequency questionnaire in early (late (30-34 weeks) pregnancy. The primary outcome was physician-diagnosed asthma, obtained by maternal-completed questionnaire. Asthma was reported in 11.6% of children at 3.5 years (n = 57) and in 11.8% of children at 5.5 years (n = 50). Folic acid taken in supplement form in late pregnancy was associated with an increased risk of childhood asthma at 3.5 years (relative risk (RR) = 1.26, 95% confidence interval (CI): 1.08, 1.43) and with persistent asthma (RR = 1.32, 95% CI: 1.03, 1.69). The effect sizes did not change with adjustment for potential confounders. The association was similar at 5.5 years but did not reach statistical significance (RR = 1.17, 95% CI: 0.96, 1.42) in univariable models. These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.

  15. Relationship between obesity and asthma symptoms among children in Ahvaz, Iran: a cross sectional study

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    Alipoor Mohammad

    2011-01-01

    Full Text Available Abstract Background Obesity has been identified as a risk factor for higher prevalence of asthma and asthma-related symptoms in children. The objective of this study was to evaluate the relationship between the prevalence of asthma symptoms and obesity among school-age children in the city of Ahvaz, Iran. Methods A total of 903 children, 7 to 11 years of age, were enrolled in this study through cluster sampling. The International Study of Asthma and Allergies in Childhood (ISAAC questionnaire was used to identify the children who were currently suffering from asthma. Height and weight were measured and body mass index (BMI was calculated in kg/m2. Overweight was defined as BMI greater than the age- and sex-specific 85th percentile, and obesity as BMI greater than the 95th percentile. We determined the relationship between obesity and asthma symptoms by chi-square tests. Results The prevalence of wheeze ever, current wheezing, obesity, and overweight was 21.56%, 8.7%, 6.87%, and 9.5%, respectively. The current prevalence of wheezing among obese and overweight children was 68.75% and 37%, respectively, and there was a statistical association between obesity and the prevalence of current wheezing (p Conclusion There is a strong association between asthma symptoms and both overweight and obesity in both sexes among school-age children.

  16. The Urban-Rural Gradient In Asthma: A Population-Based Study in Northern Europe

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    Signe Timm

    2015-12-01

    Full Text Available The early life environment appears to have a persistent impact on asthma risk. We hypothesize that environmental factors related to rural life mediate lower asthma prevalence in rural populations, and aimed to investigate an urban-rural gradient, assessed by place of upbringing, for asthma. The population-based Respiratory Health In Northern Europe (RHINE study includes subjects from Denmark, Norway, Sweden, Iceland and Estonia born 1945–1973. The present analysis encompasses questionnaire data on 11,123 RHINE subjects. Six categories of place of upbringing were defined: farm with livestock, farm without livestock, village in rural area, small town, city suburb and inner city. The association of place of upbringing with asthma onset was analysed with Cox regression adjusted for relevant confounders. Subjects growing up on livestock farms had less asthma (8% than subjects growing up in inner cities (11% (hazard ratio 0.72 95% CI 0.57–0.91, and a significant urban-rural gradient was observed across six urbanisation levels (p = 0.02. An urban-rural gradient was only evident among women, smokers and for late-onset asthma. Analyses on wheeze and place of upbringing revealed similar results. In conclusion, this study suggests a protective effect of livestock farm upbringing on asthma development and an urban-rural gradient in a Northern European population.

  17. Risks of pneumonia in patients with asthma taking inhaled corticosteroids

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Soren; Carlsson, Lars-Göran

    2011-01-01

    Rationale: Inhaled corticosteroids (ICS) are the mainstay of asthma treatment. Studies in chronic obstructive pulmonary disease reported increased rates of pneumonia with ICS. Concerns exist about an increased pneumonia risk in patients with asthma taking ICS. Objectives: To evaluate the risks...... of pneumonia in patients with asthma taking ICS. Methods: A retrospective analysis evaluated studies of the ICS budesonide in asthma. The primary data set were all double-blind, placebo-controlled trials lasting at least 3 months, involving budesonide (26 trials, n = 9,067 for budesonide; n = 5...... effect of ICS on pneumonia adverse events (AEs) or serious adverse events (SAEs). Measurements and Main Results: In the primary data set, the occurrence of pneumonia AEs was 0.5% (rate 10.0 events/1,000 patient-years [TPY]) for budesonide and 1.2% (19.3 per TPY) for placebo (hazard ratio, 0.52; 95...

  18. Preeclampsia Associates with Asthma, Allergy, and Eczema in Childhood

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Sevelsted, Astrid; Anderson, Ulrik D

    2017-01-01

    .55 to -0.06]; P = 0.0348), and allergic rhinitis (adjusted odds ratio, 4.83 [95% CI, 1.58-14.78]; P = 0.0057) in the 7-year-old children. Furthermore, the children had an increased risk of sensitization to both aeroallergens and food allergens, and increased amount of total IgE during childhood......RATIONALE: Preeclampsia reflects an unusual increase in systemic inflammation during pregnancy. OBJECTIVES: We studied associations between preeclampsia and asthma, allergy, and eczema in Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) and in national registries. METHODS....... In the registry-based cohort, 3.7% (n = 62,728) were born to mothers with preeclampsia. Preeclampsia was associated with increased risk of asthma, eczema, and aeroallergen and food allergy, especially pronounced after a duration of preeclampsia of 14 days or more. Maternal asthma increased the risk...

  19. Study of Therapeutic Mechanism of Acupuncture in Treating Bronchial Asthma

    Institute of Scientific and Technical Information of China (English)

    LI; Ji

    2001-01-01

    It has been considered by modern medicine that bronchial asthma is a chronic airway allergic inflammation (AAI) which is the major factor that induces reversible airway ventilating disturbance and bronchial hyper-responsiveness (BHR) in asthmatic patients, as well as a correlation between the delayed-phase onset of asthma and AAI is more significant than immediate-phase onset of asthma in its pathogenesis. Anti-inflammatory therapy as a fundamental principle of treatment for bronchial asthma has been brought forward during the interval phase so that a large number of anti-AAI drugs to significantly enhance the curative effect such as inhalant corticoid, disodium cromoglycate, and leukotriene receptors antagonist, etc., has been rapidly developed. Additionally, traditional Chinese medicine (TCM) and integration of TCM and western medicine (WM) therapies, including acupuncture, are gradually taken into account by the medical circle as a characteristic in our country for treatment of bronchial asthma. It is worthy of being pointed out that the curative effect of acupuncture and moxibustion in treating asthma is evident, and that its therapeutic mechanism has to a certain extent, been found along with the recent deep-going acupunctural research.……

  20. Study of Therapeutic Mechanism of Acupuncture in Treating Bronchial Asthma

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@  It has been considered by modern medicine that bronchial asthma is a chronic airway allergic inflammation (AAI) which is the major factor that induces reversible airway ventilating disturbance and bronchial hyper-responsiveness (BHR) in asthmatic patients, as well as a correlation between the delayed-phase onset of asthma and AAI is more significant than immediate-phase onset of asthma in its pathogenesis. Anti-inflammatory therapy as a fundamental principle of treatment for bronchial asthma has been brought forward during the interval phase so that a large number of anti-AAI drugs to significantly enhance the curative effect such as inhalant corticoid, disodium cromoglycate, and leukotriene receptors antagonist, etc., has been rapidly developed. Additionally, traditional Chinese medicine (TCM) and integration of TCM and western medicine (WM) therapies, including acupuncture, are gradually taken into account by the medical circle as a characteristic in our country for treatment of bronchial asthma. It is worthy of being pointed out that the curative effect of acupuncture and moxibustion in treating asthma is evident, and that its therapeutic mechanism has to a certain extent, been found along with the recent deep-going acupunctural research.

  1. Sex differences in the relationship between asthma and overweight in Dutch children: a survey study.

    Directory of Open Access Journals (Sweden)

    Maartje Willeboordse

    Full Text Available OBJECTIVE: Obesity has been identified as a risk factor for asthma in children. However, in the Netherlands, the obesity prevalence is rising while the asthma prevalence in children is stabilising. The aim of this study is to clarify the association between asthma and Body Mass Index (BMI in children and whether this association is influenced by sex. STUDY DESIGN: Parents of 39,316 children (6-16 years in the south of the Netherlands were invited to complete an online questionnaire on respiratory symptoms, anthropometric variables and several potential confounding factors for asthma and obesity (including sex, birth weight and breastfeeding. Data was analysed by multivariable logistic regression models and an ordinal regression model. RESULTS: The response rate was 24% (n boys= 4,743, n girls= 4,529. The prevalence of asthma, overweight and obesity was 8%, 15% and 2% respectively. Body mass index--standard deviation Score (BMI-SDS was related to current asthma (adjusted OR: 1.29; 95%CI: 1.14-1.45, p ≤ 0.001. When stratified for sex, asthma and BMI-SDS were only related in girls (Girls: adjusted OR: 1.31; 95%CI: 1.13-1.51, p ≤ 0.001. Boys: adjusted OR: 1.01; 95%CI: 0.91-1.14, p=0.72. CONCLUSIONS: The positive association between BMI-SDS and asthma is only present in girls, not boys. Future studies into obesity and asthma should correct for sex in their analyses.

  2. Obesity and Asthma

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is more prevalent in obese compared with normal weight subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy.Several studies have shown that overweight and obesity is associated with more severe asthma...... and impaired quality of life compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency...... department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index (BMI) on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy with regard...

  3. Role of sulfite additives in wine induced asthma: single dose and cumulative dose studies

    OpenAIRE

    Vally, H; Thompson, P.

    2001-01-01

    BACKGROUND—Wine appears to be a significant trigger for asthma. Although sulfite additives have been implicated as a major cause of wine induced asthma, direct evidence is limited. Two studies were undertaken to assess sulfite reactivity in wine sensitive asthmatics. The first study assessed sensitivity to sulfites in wine using a single dose sulfited wine challenge protocol followed by a double blind, placebo controlled challenge. In the second study a cumulative dose su...

  4. Association of Different Human Rhinovirus Species with Asthma in Children: A Preliminary Study

    Institute of Scientific and Technical Information of China (English)

    Min Zhao; Wen-Jing Zhu; Yuan Qian; Yu Sun; Ru-Nan Zhu; Jie Deng; Fang Wang

    2016-01-01

    Background:Human rhinoviruses (HRVs) are divided into three genetic species:HRV-A,HRV-B,and HRV-C.The association of different HRV species with asthma in children in China has not yet been evaluated.This preliminary study aimed to assess the associations between different HRV species,particularly HRV-C,and asthma in young children in China.Methods:A total of 702 nasopharyngeal aspirates were obtained from 155 children with asthma (asthma group),461 children with acute respiratory infection (ARI) without asthma (nonasthma ARI group),and 86 children from the control group.Semi-nested polymerase chain reaction (PCR) was used to detect HRVs,and PCR products were sequenced for species identification.Epidemiological characteristics of HRV-positive cases were analyzed.Results:HRVs were the most common pathogen (15.4%;108/702) in the patients in this study.The prevalence of HRV was significantly different (F =20.633,P =0.000) between the asthma (25.8%) and nonasthma ARI groups (11.1%).Phylogenetic analysis indicated that in the 108 cases positive for HRVs,41 were identified as HRV-A,8 as HRV-B,and 56 as HRV-C.Comparing the asthma with the nonasthma ARI group,Spearman's rank correlation analysis revealed an association between HRV-A (P < 0.05) and C (P < 0.01) and asthma,confirmed by regression analysis,with odds ratios of 2.2 (HRV-A) and 4.2 (HRV-C).Conclusions:Our data revealed a high prevalence of HRVs in children in China,regardless of clinical status.HRV-C was the dominant species and may be one of the key factors in the association of HRVs with asthma.

  5. An international observational prospective study to determine the cost of asthma exacerbations (COAX).

    Science.gov (United States)

    Lane, Stephen; Molina, Jesus; Plusa, Tadeusz

    2006-03-01

    Asthma is a common chronic condition that places substantial burden on patients and healthcare services. Despite the standards of asthma control that international guidelines recommend should be achieved, many patients continue to suffer sub-optimal control of symptoms and experience exacerbations (acute asthma attacks). In addition to being associated with reduced quality of life, asthma exacerbations are a key cost driver in asthma management. Routine clinical practice for the management of asthma exacerbations varies in different healthcare systems, so healthcare providers require local costs to be able to assess the value of therapies that reduce the frequency and severity of exacerbations. This prospective study, conducted in a total of 15 countries, assessed the local cost of asthma exacerbations managed in either primary or secondary care. Healthcare resources used were costed using actual values appropriate to each country in local currency and in Euros. Results are presented for exacerbations managed in primary care in Brazil, Bulgaria, Croatia, Czech Republic, Hungary, Poland, Russia, Slovakia, Slovenia, Spain and Ukraine, and in secondary care in Croatia, Denmark, Ireland, Latvia, Norway, Poland, Russia, Slovakia, Slovenia and Spain. Multiple regression analysis of the 2052 exacerbations included in the economic analysis showed that the cost of exacerbations was significantly affected by country (P<0.0001). Mean costs were significantly higher in secondary care (euro 1349) than primary care (euro 445, P=0.0003). Age was a significant variable (P=0.0002), though the effect showed an interaction with care type (P<0.0001). As severity of exacerbation increased, so did secondary care costs, though primary care costs remained essentially constant. In conclusion, the study showed that asthma exacerbations are costly to manage, suggesting that therapies able to increase asthma control and reduce the frequency or severity of exacerbations may bring economic

  6. Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study.

    Science.gov (United States)

    Willers, S M; Wijga, A H; Brunekreef, B; Scholtens, S; Postma, D S; Kerkhof, M; de Jongste, J C; Smit, H A

    2011-05-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort enrolled 4,146 participants at baseline, who were followed up to 8 yrs of age. Dietary intakes of interest were fruit, vegetables, brown/wholemeal bread, fish, milk, butter and margarine. Associations between food intake at early (2-3 yrs) and later (7-8 yrs) age, and long-term intake, asthma and atopy at 8 yrs of age were calculated by logistic regression. Complete longitudinal dietary data for at least one of the food groups were available for 2,870 children. Fruit consumption at early age was associated with reduced asthma symptoms (OR per 1 consumption day per week increase 0.93, 95% CI 0.85-1.00). Long-term fruit intake was inversely associated with asthma symptoms (OR 0.90, 95% CI 0.82-0.99) and sensitisation to inhaled allergens (OR 0.90, 95% CI 0.82-0.99). We found no consistent associations between diet and outcomes for other foods. This study indicates no consistent effects of increased early or late consumption, or long-term intake of certain foods on asthma and atopy in 8-yr-olds, with a possible exception for fruit.

  7. [Descriptive study of morbidity and mortality due to asthma at a Health Sector institution].

    Science.gov (United States)

    Segura Méndez, N H; Salas Ramírez, M; Martínez-Cairo Cueto, S

    1994-01-01

    The objective of this study was to determine the morbidity and mortality rate due to asthma from a Health Institution, which represents the majority of working population. Asthma data were obtained from the National Institute of Informatical, Geography and Statistics (INEGI), Mexican Health Secretary (SS) and Mexican Social Security Institute (IMSS). The underlying cause of death hospitalization or visit were obtained. Asthma was coded according to the International Classification of Disease (ninth revision). Asthma death rate was adjusted by age using direct method. In the IMSS, asthma death rate increased from 3.24/200,000 in 1980 to 12.76/100,000 in 1990. The asthma letality increased from 0.34 in 1980 to 1.23 in 1990. The average length of hospital stay was 3.96 days in 1990; there was noy significant differences by sex the most affected groups were children under 4 years of age and persons older than 65 years of age. In conclusion, from 1980 to 1990, the morbidity and mortality rate due to asthma in IMSS increased. It suggests that future health policy efforts should be focused to reduce the morbidity, mainly in high risk groups.

  8. Anthroposophic therapy for asthma: A two-year prospective cohort study in routine outpatient settings

    Directory of Open Access Journals (Sweden)

    Harald J Hamre

    2009-11-01

    Full Text Available Harald J Hamre1, Claudia M Witt2, Gunver S Kienle1, Christof Schnürer3, Anja Glockmann1, Renatus Ziegler4, Stefan N Willich2, Helmut Kiene11Institute for Applied Epistemology and Medical Methodology, Freiburg, Germany; 2Institute of Social Medicine, Epidemiology, and Health Economics, Charité University Medical Center, Berlin, Germany; 3Internal Medicine Practice, A Fraenkel Centrum, Badenweiler, Germany; 4Society for Cancer Research, Arlesheim, SwitzerlandBackground: Anthroposophic treatment for asthma includes special artistic and physical therapies and special medications.Methods: We studied consecutive outpatients starting anthroposophic treatment for asthma under routine conditions in Germany. Main outcomes were average asthma severity (0–10, primary outcome; symptoms (1–4; and asthma-related quality of life at 12-month follow-up (Asthma Quality of Life Questionnaire [AQLQ] overall score, 1–7, for adults; KINDL Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents, asthma module, 0–100, for children at 12-month follow-up.Results: Ninety patients (54 adults, 36 children were included. Anthroposophic treatment modalities used were medications (88% of patients, n = 79/90; eurythmy therapy (22%; art therapy (10%; and rhythmical massage therapy (1%. Median number of eurythmy/art/massage sessions was 12 (interquartile range 10–20, median therapy duration was 120 days (84–184. From baseline to 12-month follow-up, all outcomes improved significantly (P < 0.001 for all comparisons. Average improvements were: average asthma severity 2.61 points (95% confidence interval CI: 1.90–3.32; cough 0.93 (95% CI: 0.60–1.25; dyspnea 0.92 (95% CI: 0.56–1.28; exertion-induced symptoms 0.95 (95% CI: 0.64–1.25; frequency of asthma attacks 0.78 (95% CI:0.41–1.14; awakening from asthma 0.90 (95% CI: 0.58–1.21; AQLQ overall score 1.44 (95% CI:0.97–1.92; and KINDL asthma module 14.74 (95% CI: 9.70–19

  9. A longitudinal study of adult-onset asthma incidence among HMO members

    Directory of Open Access Journals (Sweden)

    Rosiello Richard A

    2003-08-01

    Full Text Available Abstract Background HMO databases offer an opportunity for community based epidemiologic studies of asthma incidence, etiology and treatment. The incidence of asthma in HMO populations and the utility of HMO data, including use of computerized algorithms and manual review of medical charts for determining etiologic factors has not been fully explored. Methods We identified adult-onset asthma, using computerized record searches in a New England HMO. Monthly, our software applied exclusion and inclusion criteria to identify an "at-risk" population and "potential cases". Electronic and paper medical records from the past year were then reviewed for each potential case. Persons with other respiratory diseases or insignificant treatment for asthma were excluded. Confirmed adult-onset asthma (AOA cases were defined as those potential cases with either new-onset asthma or reactivated mild intermittent asthma that had been quiescent for at least one year. We validated the methods by reviewing charts of selected subjects rejected by the algorithm. Results The algorithm was 93 to 99.3% sensitive and 99.6% specific. Sixty-three percent (n = 469 of potential cases were confirmed as AOA. Two thirds of confirmed cases were women with an average age of 34.8 (SD 11.8, and 45% had no evidence of previous asthma diagnosis. The annualized monthly rate of AOA ranged from 4.1 to 11.4 per 1000 at-risk members. Physicians most commonly attribute asthma to infection (59% and allergy (14%. New-onset cases were more likely attributed to infection, while reactivated cases were more associated with allergies. Medical charts included a discussion of work exposures in relation to asthma in only 32 (7% cases. Twenty-three of these (72% indicated there was an association between asthma and workplace exposures for an overall rate of work-related asthma of 4.9%. Conclusion Computerized HMO records can be successfully used to identify AOA. Manual review of these records is

  10. Intravenous magnesium for acute asthma?

    Science.gov (United States)

    2003-10-01

    Each year in the UK, around 1,500 people die from asthma. Standard treatment has been based on bronchodilators (e.g. beta 2-stimulants) and anti-inflammatory drugs (corticosteroids). The recently revised British Guideline on the Management of Asthma suggests also using a single dose of i.v. magnesium sulphate in patients with acute severe asthma, an unlicensed indication. Here we discuss the rationale for giving i.v. magnesium and whether it offers any advantage for patients with acute severe asthma.

  11. Maternal and paternal beliefs, support and parenting as determinants of sport participation of adolescents with asthma

    NARCIS (Netherlands)

    Tiggelman, D.; Ven, M.O.M. van de; Schayck, C.P. van; Engels, R.C.M.E.; Sluijs, E.M.F. van

    2015-01-01

    RATIONALE: Few studies have examined determinants of physical activity in patients with chronic illnesses, like asthma. The aim of this study was to examine whether baseline maternal and paternal beliefs, support and parenting were associated with changes in sport participation of adolescents with a

  12. Maternal smoking in pregnancy and asthma in preschool children: a pooled analysis of eight birth cohorts

    NARCIS (Netherlands)

    Neuman, A.; Hohmann, C.; Pershagen, G.; Eller, E.; Kjaer, H.F.; Gehring, U.; Granell, R.; Henderson, J.; Lau, S.; Nieuwenhuijsen, M.; Sunyer, J.; Tischer, C.; Torrent, M.; Wahn, U.; Wijga, A.H.; Wickman, M.; Keil, T.; Bergström, A.

    2012-01-01

    Rationale: Although epidemiological studies suggest that exposure to maternal smoking during fetal and early life increases the risk of childhood wheezing and asthma, previous studies were not able to differentiate the effects of prenatal from postnatal exposure. Objectives: To assess the effect of

  13. The state of pediatric asthma in Chicago's Humboldt Park: a community-based study in two local elementary schools

    Directory of Open Access Journals (Sweden)

    Smith Bridget

    2010-06-01

    Full Text Available Abstract Background Pediatric asthma is a serious public health problem in Chicago and has been designated a high priority concern by residents of Chicago's Humboldt Park, a diverse community area with a large number of Puerto Rican, African American, and Mexican American families. Methods In May 2009, following the principles of community-based participatory research, a cross-sectional asthma screening survey was administered to adult caregivers of children attending two Humboldt Park elementary schools. Data were analyzed to determine the prevalence of diagnosed and probable asthma as well as the degree of asthma control among affected children; associations between asthma outcomes and mutable triggers were evaluated. Results Surveys from 494 children were evaluated. Physician-diagnosed asthma was reported for 24.9% of children and probable asthma identified in an additional 16.2% of children. Asthma was poorly or moderately controlled in 60.0% of diagnosed children. Smoking occurred inside 25.0% of households and 75.0% of caregivers reported idling of vehicles in their community. Report of general stress among caregivers, stress due to community crime, and/or an inability to cope with everyday life were significantly and positively associated with poor asthma morbidity and control among affected children. Conclusions Despite high prevalence rates and poor asthma morbidity and control in Humboldt Park, the association of these measures with mutable variables is promising. A community-based asthma intervention to address the issues identified in this study is needed to affect positive change.

  14. Evaluation of CHESS: Utah asthma study, 1971-1972. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Olsen, A.R.; Tolley, H.D.; Simpson, J.C.; Namekata, T.; Woods, J.S.

    1983-02-01

    This report is divided into five main sections. The first reviews the use of asthma as a health indicator in environmental epidemiology, including a review of selected asthma panel studies. The next two sections consider the impact of the data quality: the limitations and characteristics of the aerometric data and of the panelists' data, respectively. The last two sections contain statistical analyses: analyses correcting for variation among panelists and analyses based on person-days.

  15. Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children: Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC).

    NARCIS (Netherlands)

    Anderson, H.R.; Ruggles, R.; Pandey, K.D.; Kapetanakis, V.; Brunekreef, B.; Lai, C.K.; Strachan, D.P.; Weiland, S.K.

    2010-01-01

    OBJECTIVES: To investigate the effect of ambient particulate matter on variation in childhood prevalence of asthma, rhinoconjunctivitis and eczema. METHODS: Prevalences of asthma, rhinoconjunctivitis and eczema obtained in Phase One of the International Study of Asthma and Allergies in Childhood (IS

  16. Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children : Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC)

    NARCIS (Netherlands)

    Anderson, H. Ross; Ruggles, Ruth; Pandey, Kiran D.; Kapetanakis, Venediktos; Brunekreef, Bert; Lai, Christopher K. W.; Strachan, David P.; Weiland, Stephan K.

    2010-01-01

    Objectives To investigate the effect of ambient particulate matter on variation in childhood prevalence of asthma, rhinoconjunctivitis and eczema. Methods Prevalences of asthma, rhinoconjunctivitis and eczema obtained in Phase One of the International Study of Asthma and Allergies in Childhood (ISAA

  17. Rationale and Design of the Echocardiographic Study of Hispanics / Latinos (ECHO-SOL)

    Science.gov (United States)

    Rodriguez, Carlos J.; Dharod, Ajay; Allison, Matthew A.; Shah, Sanjiv J.; Hurwitz, Barry; Bangdiwala, Shrikant I.; Gonzalez, Franklyn; Kitzman, Dalane; Gillam, Linda; Spevack, Daniel; Dadhania, Rupal; Langdon, Sarah; Kaplan, Robert

    2015-01-01

    Background Information regarding the prevalence and determinants of cardiac structure and function (systolic and diastolic) among the various Hispanic background groups in the United States is limited. Methods and Results The Echocardiographic Study of Latinos (ECHO-SOL) ancillary study recruited 1,824 participants through a stratified-sampling process representative of the population-based Hispanic Communities Health StudyStudy of Latinos (HCHS-SOL) across four sites (Bronx, NY; Chicago, Ill; San Diego, Calif; Miami, Fla). The HCHS-SOL baseline cohort did not include an echo exam. ECHO-SOL added the echocardiographic assessment of cardiac structure and function to an array of existing HCHS-SOL baseline clinical, psychosocial, and socioeconomic data and provides sufficient statistical power for comparisons among the Hispanic subgroups. Standard two-dimensional (2D) echocardiography protocol, including M-mode, spectral, color and tissue Doppler study was performed. The main objectives were to: 1) characterize cardiac structure and function and its determinants among Hispanics and Hispanic subgroups; and 2) determine the contributions of specific psychosocial factors (acculturation and familismo) to cardiac structure and function among Hispanics. Conclusion We describe the design, methods and rationale of currently the largest and most comprehensive study of cardiac structure and function exclusively among US Hispanics. ECHO-SOL aims to enhance our understanding of Hispanic cardiovascular health as well as help untangle the relative importance of Hispanic subgroup heterogeneity and sociocultural factors on cardiac structure and function. (Ethn Dis. 2015;25[2]:180–186) PMID:26118146

  18. Rationale and design of the Japan molecular epidemiology for lung cancer study.

    Science.gov (United States)

    Kawaguchi, Tomoya; Ando, Masahiko; Ito, Norimasa; Isa, Shun-Ichi; Tamiya, Akihiro; Shimizu, Shigeki; Saka, Hideo; Kubo, Akihito; Koh, Yasuhiro; Matsumura, Akihide

    2013-09-01

    We present the rationale for the Japan Molecular Epidemiology for Lung Cancer study designed to elucidate molecular mechanisms of carcinogenesis in smokers and never-smokers with non-small-cell lung cancer. This prospective, ongoing, multicenter study is being conducted nationwide in Japan. Although there is no doubt that active smoking is the major cause of lung cancer, the contribution of other possible factors, including environmental tobacco or wood smoke, human papilloma virus, radon, occupational exposures, and genetic susceptibility, is highly likely, based on studies of never-smokers with non-small-cell lung cancer. Because of the predominance of women in the never-smoker subgroup, the role of female hormones in lung cancer development has also been considered. We hypothesize that driver mutations, which are critical for the development of lung cancer, are triggered by the environmental factors with or without the influence of the hormone. The SWOG-led intergroup molecular epidemiology study S0424 was conducted to focus on these issues by using a detailed questionnaire and specimen collection in statistically significant cohorts of smokers and never-smokers from both sexes. The Japan Molecular Epidemiology for Lung Cancer study follows and extends the S0424 molecular epidemiology concept in principle by using a similar approach that will facilitate future comparisons between the studies but with a greater focus on more recently defined driver mutations and broad genomic sequencing.

  19. Prediction of asthma exacerbations in children by innovative exhaled inflammatory markers: results of a longitudinal study.

    Directory of Open Access Journals (Sweden)

    Dillys van Vliet

    Full Text Available In asthma management guidelines the primary goal of treatment is asthma control. To date, asthma control, guided by symptoms and lung function, is not optimal in many children and adults. Direct monitoring of airway inflammation in exhaled breath may improve asthma control and reduce the number of exacerbations.1 To study the use of fractional exhaled nitric oxide (FeNO and inflammatory markers in exhaled breath condensate (EBC, in the prediction of asthma exacerbations in a pediatric population. 2 To study the predictive power of these exhaled inflammatory markers combined with clinical parameters.96 asthmatic children were included in this one-year prospective observational study, with clinical visits every 2 months. Between visits, daily symptom scores and lung function were recorded using a home monitor. During clinical visits, asthma control and FeNO were assessed. Furthermore, lung function measurements were performed and EBC was collected. Statistical analysis was performed using a test dataset and validation dataset for 1 conditionally specified models, receiver operating characteristic-curves (ROC-curves; 2 k-nearest neighbors algorithm.Three conditionally specified predictive models were constructed. Model 1 included inflammatory markers in EBC alone, model 2 included FeNO plus clinical characteristics and the ACQ score, and model 3 included all the predictors used in model 1 and 2. The area under the ROC-curves was estimated as 47%, 54% and 59% for models 1, 2 and 3 respectively. The k-nearest neighbors predictive algorithm, using the information of all the variables in model 3, produced correct predictions for 52% of the exacerbations in the validation dataset.The predictive power of FeNO and inflammatory markers in EBC for prediction of an asthma exacerbation was low, even when combined with clinical characteristics and symptoms. Qualitative improvement of the chemical analysis of EBC may lead to a better non-invasive prediction of

  20. Type 1 Diabetes and Increased Risk of Subsequent Asthma: A Nationwide Population-Based Cohort Study.

    Science.gov (United States)

    Hsiao, Yung-Tsung; Cheng, Wen-Chien; Liao, Wei-Chih; Lin, Cheng-Li; Shen, Te-Chun; Chen, Wei-Chun; Chen, Chia-Hung; Kao, Chia-Hung

    2015-09-01

    The association between type 1 diabetes mellitus (T1DM) and asthma remains controversial and has led to new interest in these 2 disorders. The purpose of this study was to examine the associations among young people with T1DM and asthma and offer a clinical demonstration of the balance between Th1 and Th2 responses.We conducted a retrospective cohort study by using data from the National Health Insurance (NHI) system of Taiwan. The cohort consisted of 3545 T1DM cases and 14,180 controls established during the 1998 to 2011 period. Of the 3545 T1DM patients, 55.1% were girls and 26.5% were in the age group asthma was 47% higher in the T1DM cohort than in the control cohort (6.49 vs 4.42 per 1000 person-y), with an adjusted hazard ratio (HR) of 1.34 (95% confidence interval [CI] = 1.11-1.62). Moreover, T1DM patients who visited the emergency room (ER) more than twice for diabetes had a higher adjusted HR of 17.4 (95% CI = 12.9-23.6) of developing asthma. The adjusted HR of asthma was 38.6 (95% CI = 28.5-52.2) in T1DM patients who had been hospitalized more than twice for diabetes.We observed a significantly higher incidence of asthma in young patients with T1DM than in the general population. Among young people of T1DM with more ER visits or frequent hospitalization because of diabetes mellitus were associated with risk of asthma, may indicate that poor glycemic control significantly contributes to asthma risk.

  1. Effects of BMI, fat mass, and lean mass on asthma in childhood: a Mendelian randomization study.

    Directory of Open Access Journals (Sweden)

    Raquel Granell

    2014-07-01

    Full Text Available Observational studies have reported associations between body mass index (BMI and asthma, but confounding and reverse causality remain plausible explanations. We aim to investigate evidence for a causal effect of BMI on asthma using a Mendelian randomization approach.We used Mendelian randomization to investigate causal effects of BMI, fat mass, and lean mass on current asthma at age 7½ y in the Avon Longitudinal Study of Parents and Children (ALSPAC. A weighted allele score based on 32 independent BMI-related single nucleotide polymorphisms (SNPs was derived from external data, and associations with BMI, fat mass, lean mass, and asthma were estimated. We derived instrumental variable (IV estimates of causal risk ratios (RRs. 4,835 children had available data on BMI-associated SNPs, asthma, and BMI. The weighted allele score was strongly associated with BMI, fat mass, and lean mass (all p-values<0.001 and with childhood asthma (RR 2.56, 95% CI 1.38-4.76 per unit score, p = 0.003. The estimated causal RR for the effect of BMI on asthma was 1.55 (95% CI 1.16-2.07 per kg/m2, p = 0.003. This effect appeared stronger for non-atopic (1.90, 95% CI 1.19-3.03 than for atopic asthma (1.37, 95% CI 0.89-2.11 though there was little evidence of heterogeneity (p = 0.31. The estimated causal RRs for the effects of fat mass and lean mass on asthma were 1.41 (95% CI 1.11-1.79 per 0.5 kg and 2.25 (95% CI 1.23-4.11 per kg, respectively. The possibility of genetic pleiotropy could not be discounted completely; however, additional IV analyses using FTO variant rs1558902 and the other BMI-related SNPs separately provided similar causal effects with wider confidence intervals. Loss of follow-up was unlikely to bias the estimated effects.Higher BMI increases the risk of asthma in mid-childhood. Higher BMI may have contributed to the increase in asthma risk toward the end of the 20th century. Please see later in the article for the Editors' Summary.

  2. High risk cohort study for psychiatric disorders in childhood: rationale, design, methods and preliminary results.

    Science.gov (United States)

    Salum, Giovanni Abrahão; Gadelha, Ary; Pan, Pedro Mario; Moriyama, Tais Silveira; Graeff-Martins, Ana Soledade; Tamanaha, Ana Carina; Alvarenga, Pedro; Valle Krieger, Fernanda; Fleitlich-Bilyk, Bacy; Jackowski, Andrea; Sato, João Ricardo; Brietzke, Elisa; Polanczyk, Guilherme Vanoni; Brentani, Helena; de Jesus Mari, Jair; Do Rosário, Maria Conceição; Manfro, Gisele Gus; Bressan, Rodrigo Affonseca; Mercadante, Marcos Tomanik; Miguel, Eurípedes Constantino; Rohde, Luis Augusto

    2015-03-01

    The objective of this study is to present the rationale, methods, design and preliminary results from the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders. We describe the sample selection and the components of each phases of the study, its instruments, tasks and procedures. Preliminary results are limited to the baseline phase and encompass: (i) the efficacy of the oversampling procedure used to increase the frequency of both child and family psychopathology; (ii) interrater reliability and (iii) the role of differential participation rate. A total of 9937 children from 57 schools participated in the screening procedures. From those 2512 (random = 958; high risk = 1554) were further evaluated with diagnostic instruments. The prevalence of any child mental disorder in the random strata and high-risk strata was 19.9% and 29.7%. The oversampling procedure was successful in selecting a sample with higher family rates of any mental disorders according to diagnostic instruments. Interrater reliability (kappa) for the main diagnostic instrument range from 0.72 (hyperkinetic disorders) to 0.84 (emotional disorders). The screening instrument was successful in selecting a sub-sample with "high risk" for developing mental disorders. This study may help advance the field of child psychiatry and ultimately provide useful clinical information.

  3. Asthma affects time to pregnancy and fertility: a register-based twin study.

    Science.gov (United States)

    Gade, Elisabeth J; Thomsen, Simon F; Lindenberg, Svend; Kyvik, Kirsten O; Lieberoth, Sofie; Backer, Vibeke

    2014-04-01

    Coexistence of infertility and asthma has been observed clinically. Therefore, we investigated the association between asthma and delayed pregnancy in a nationwide population-based cohort of twins. A cohort of 15 250 twins living in Denmark (aged 12-41 years) participated in a questionnaire study including questions about the presence of asthma and fertility. Differences in time to pregnancy and pregnancy outcome were analysed in subjects with asthma, allergy and in healthy individuals using multiple regression analysis. Asthma was associated with an increased time to pregnancy, the percentage of asthmatics with a time to pregnancy >1 year was 27% versus 21.6% for non-asthmatics (OR (95% CI) 1.31 (1.1-1.6); p=0.009). The association remained significant after adjustment for age, age at menarche, body mass index and socioeconomic status (OR (95% CI) 1.25 (1.0-1.6); p=0.05), and was more pronounced in those >30 years of age (32.2% versus 24.9%, OR (95% CI) 1.44 (1.1-1.9); p=0.04). Untreated asthmatics had a significant increased risk of prolonged time to pregnancy compared to healthy individuals (OR (95% CI) 1.79 (1.20-2.66); p=0.004), while asthmatics receiving any kind of treatment for asthma tended to have a shorter time to pregnancy than untreated asthmatics (OR 1.40; p=0.134). Asthma prolongs time to pregnancy. The negative effect of asthma on fertility increases with age and with disease intensity, indicating that a systemic disease characterised by systemic inflammation also can involve reproductive processes.

  4. Pediatric Asthma

    Science.gov (United States)

    ... Plan Asthma Epidemic Eating with Asthma Helping Your Child Cope With a Medical Condition Nasal Wash Guide Cleaning Dirty Items Impact on Families Asthma & Pets Peak Flow Meter Athletes & Asthma Helpful Tools for ...

  5. A Population-based Clinical Study of Allergic and Non-allergic Asthma

    DEFF Research Database (Denmark)

    Knudsen, T.B.; Thomsen, S.F.; Nolte, H.;

    2009-01-01

    Background. The aim of this study was to describe differences between allergic and non-allergic asthma in a large community-based sample of Danish adolescents and adults. Methods. A total of 1,186 subjects, 14 to 44 years of age, who in a screening questionnaire had reported a history of airway...... symptoms suggestive of asthma and/or allergy, or who were taking any medication for these conditions were clinically examined. All participants were interviewed about respiratory symptoms, and furthermore skin test reactivity, lung function, and airway responsiveness were measured. Results. A total of 489...... individuals had clinical asthma of whom 61% had allergic asthma, whereas 39% had non-allergic asthma. Subjects with non-allergic asthma were more likely to be females, OR = 2.24 (1.32-3.72), p = 0.003, and to have cough as the predominant symptom, OR = 1.96, (1.19-3.23), p = 0.008, but were less likely...

  6. Racemic salbutamol and levosalbutamol in mild persistent asthma: A comparative study of efficacy and safety

    Directory of Open Access Journals (Sweden)

    Rituparna Maiti

    2011-01-01

    Full Text Available Aim : The effect of monotherapy with racemic salbutamol and levosalbutamol on symptoms, quality of life, and pulmonary function has been assessed and compared in mild persistent asthma. Materials and Methods : A randomized, open, parallel clinical study was conducted on 60 patients of mild persistent asthma. After baseline assessments, salbutamol was prescribed to 30 patients and levosalbutamol to another 30 for 4 weeks. The efficacy variables were change in asthma symptom scoring, pulmonary function test, and Mini Asthma Quality of Life Questionnaire (MiniAQLQ scoring. At follow-up, the patients were re-evaluated and analyzed by statistical tools. Results : Shortness of breath (P<0.001, chest tightness (P=0.033, wheeze (P=0.01, cough (P=0.024, and overall asthma symptom score (P<0.001 were significantly decreased in the levosalbutamol group in comparison to the salbutamol group. Results of MiniAQLQ revealed that improvement in symptoms (P=0.018, activity limitations (P=0.03, environmental stimuli (P=0.013-related scoring and overall MiniAQLQ scoring (P<0.001 was statistically significant in the levosalbutamol group. Percentage reversibility of forced expiratory volume at one second (P=0.034, forced vital capacity (P=0.029, peak expiratory flow rate (P=0.0003 was found to be superior in the levosalbutamol group. Conclusion : Levosalbutamol was found to be superior compared to recemic salbutamol in mild persistent asthma.

  7. The risk of asthma in patients with ankylosing spondylitis: a population-based cohort study.

    Directory of Open Access Journals (Sweden)

    Te-Chun Shen

    Full Text Available The relationship between asthma and ankylosing spondylitis (AS is controversial. We examined the risk of asthma among AS patients in a nationwide population.We conducted a retrospective cohort study using data from the National Health Insurance (NHI system of Taiwan. The cohort included 5,974 patients newly diagnosed with AS from 2000 to 2010. The date of diagnosis was defined as the index date. A 4-fold of general population without AS was randomly selected frequency matched by age, gender and the index year. The occurrence and hazard ratio (HR of asthma were estimated by the end of 2011.The overall incidence of asthma was 1.74 folds greater in the AS cohort than in the non-AS cohort (8.26 versus 4.74 per 1000 person-years with a multivariable Cox method measured adjusted HR of 1.54 (95% confidence interval (CI, 1.34-1.76. The adjusted HR of asthma associated with AS was higher in women (1.59; 95% CI, 1.33-1.90, those aged 50-64 years (1.66; 95% CI, 1.31-2.09, or those without comorbidities (1.82; 95% CI, 1.54-2.13.Patients with AS are at a higher risk of developing asthma than the general population, regardless of gender and age. The pathophysiology needs further investigation.

  8. Social class in asthma and allergic rhinitis: a national cohort study over three decades.

    Science.gov (United States)

    Bråbäck, L; Hjern, A; Rasmussen, F

    2005-12-01

    The aim of this study was to assess whether the association with social class differed between allergic rhinitis and asthma and whether these associations have changed over time. The Swedish Military Service Conscription Register was linked to two other national registers for 1,247,038 male conscripts in successive cohorts born between 1952 and 1977. The percentage of asthma cases associated with allergic rhinitis was 15% in the oldest cohort and 44% in the youngest cohort. Low socio-economic status (SES) was associated with an increased risk (assessed as odds ratio) of asthma without allergic rhinitis (1.14, 95% confidence interval (CI) 1.11-1.17) but a slightly reduced risk of asthma with allergic rhinitis (0.96, 95% CI 0.93-1.00). The risk of allergic rhinitis was 0.84, 95% CI 0.82-0.85. A positive interaction between SES and year of birth occurred in all three conditions. Low SES was related to a reduced risk of asthma with allergic rhinitis in the earliest cohort (0.72, 95% CI 0.53-0.82) but a slightly increased risk in the most recent cohort (1.07, 95% CI 1.01-1.14). In conclusion, the role of social class has changed over time. The steepest increase in asthma and allergic rhinitis occurred in conscripts with a low socio-economic status.

  9. Exercise-induced bronchoconstriction : clinical studies in childhood asthma

    NARCIS (Netherlands)

    W.B. Hofstra (Winfried)

    1997-01-01

    textabstractAt present, astluna is regarded as a chronic inflammatory disorder of the airways, In susceptible individuals, asthma causes symptoms, that are usually associated with variable, but often reversible airflow obstmction. Astlulla is the most conunon lung disease in childhood, with a sympto

  10. A novel study design to investigate the early-life origins of asthma in children (SAGE study).

    Science.gov (United States)

    Kozyrskyj, A L; HayGlass, K T; Sandford, A J; Paré, P D; Chan-Yeung, M; Becker, A B

    2009-08-01

    This is a description of the Study of Asthma, Genes and the Environment (SAGE), a novel birth cohort created from provincial healthcare administrative records. It is a general population-based cohort, composed of children at high and low risk for asthma, living in urban and rural environments in Manitoba, Canada. The SAGE study captures the complete longitudinal healthcare records of children born in 1995 and contains detailed information on early-life exposures, such as antibiotic utilization and immunization, in relationship to the development of asthma. Nested within the birth cohort is a case-control study, which was created to collect information on home environmental exposures from detailed surveys and home dust sampling, to confirm asthma status in children and use this data to validate healthcare database measures of asthma, to determine differences in immune system responsiveness to innate and adaptive immune stimuli in asthma, to genotype children for genes likely associated with the development of asthma and to study the epigenetic regulation of pre-established protective vs allergic immune responses. The SAGE study is a multidisciplinary collaboration of researchers from pediatric allergy, population health, immunology, and genetic and environmental epidemiology. As such, it serves as a fertile, interdisciplinary training ground for graduate students, and postdoctoral and clinician fellows.

  11. Factors associated with asthma control.

    NARCIS (Netherlands)

    Vries, M.P. de; Bemt, E.A.J.M. van den; Lince, S.; Muris, J.W.M.; Thoonen, B.P.A.; Schayck, C.P. van

    2005-01-01

    The aim of this study was to evaluate which factors are associated with asthma control experienced by asthma patients. In a cross-sectional study patients aged 16-60 years with mild to moderate asthma were selected. The influence of the following factors on asthma control was studied in a multivaria

  12. Pet ownership and risk of asthma: a case-controlled study

    Directory of Open Access Journals (Sweden)

    Sharifi

    2008-08-01

    Full Text Available Background: In the treatment of bronchial asthma, the identification, isolation, and elimination of causative allergens is the most effective part of treatment. With the recent diversification within the pet industry, pet owner exposure to many unknown antigens is on the rise. The results of population studies have been contradictory and some epidemiological studies have failed to confirm this, some indicating that keeping pets might actually reduce the risk of sensitization and asthma. The purpose of this study was to determine the association between pet ownership and asthma. Methods: This case-control study included 300 asthmatic participants referred to the Children's Medical Center over a two-year period. Participants were asked to fill out a questionnaire regarding pet ownership, pet gender and puberty, the place it was kept, how long the pet was kept and the reason for keeping the pet. The same questions were asked from 300 age- and gender-matched nonasthmatic individuals as the control group. Statistical analysis was performed to calculate odds ratios (OR of asthma morbidity in individuals who kept pets. Results: The OR for asthma morbidity in patients who kept pets was 2.59 (CI=1.60-4.21 and p>0.001. Financial aim was the most common reason for keeping a pet and most pets were mature and kept outdoors. No significant correlations for pet genders were observed. Conclusion: This survey provides evidence that pet ownership is an important risk factor for asthma, therefore we suggest that individuals at risk for asthma (atopic individuals must avoid contact with pets. However, more research in this field in Iran is necessary.

  13. Remote monitoring of inhaled bronchodilator use and weekly feedback about asthma management: an open-group, short-term pilot study of the impact on asthma control.

    Directory of Open Access Journals (Sweden)

    David Van Sickle

    Full Text Available OBJECTIVE: Adequate symptom control is a problem for many people with asthma. We asked whether weekly email reports on monitored use of inhaled, short-acting bronchodilators might improve scores on composite asthma-control measures. METHODS: Through an investigational electronic medication sensor attached to each participant's inhaler, we monitored 4 months' use of inhaled, short-acting bronchodilators. Participants completed surveys, including the Asthma Control Test(TM (ACT, to assess asthma control at entry and monthly thereafter. After the first month, participants received weekly email reports for 3 months. The reports summarized inhaled bronchodilator use during the preceding week and provided suggestions derived from National Asthma Education and Prevention Program (NAEPP guidelines. Paired t-tests and random-effects mixed models were implemented to assess changes in primary asthma endpoints. RESULTS: Thirty individuals participated in the 4-month study; 29 provided complete asthma control information. Mean age was 36.8 years (range: 19-74 years; 52% of respondents were female. Mean ACT scores were 17.6 (Standard Deviation [SD]  = 3.35 at entry and 18.4 (SD = 3.60 at completion of the first month. No significant difference appeared between ACT values at entry and completion of the first month (p = 0.66; however, after participants began receiving email reports and online information about their inhaler use, mean ACT scores increased 1.40 points (95% CI: 0.61, 2.18 for each subsequent study month. Significant decreases occurred in 2-week histories of daytime symptoms (β = -1.35, 95% CI: -2.65, -0.04 and nighttime symptoms (β = -0.84, 95% CI: -1.25, -0.44; no significant change in activity limitation (β = -0.21, 95% CI: -0.69, 0.26 was observed. Participants reported increased awareness and understanding of asthma patterns, level of control, bronchodilator use (timing, location and triggers, and improved

  14. The Pediatric Obsessive-Compulsive Disorder Treatment Study II: rationale, design and methods

    Directory of Open Access Journals (Sweden)

    March John S

    2009-01-01

    Full Text Available Abstract This paper presents the rationale, design, and methods of the Pediatric Obsessive-Compulsive Disorder Treatment Study II (POTS II, which investigates two different cognitive-behavior therapy (CBT augmentation approaches in children and adolescents who have experienced a partial response to pharmacotherapy with a serotonin reuptake inhibitor for OCD. The two CBT approaches test a "single doctor" versus "dual doctor" model of service delivery. A specific goal was to develop and test an easily disseminated protocol whereby child psychiatrists would provide instructions in core CBT procedures recommended for pediatric OCD (e.g., hierarchy development, in vivo exposure homework during routine medical management of OCD (I-CBT. The conventional "dual doctor" CBT protocol consists of 14 visits over 12 weeks involving: (1 psychoeducation, (2, cognitive training, (3 mapping OCD, and (4 exposure with response prevention (EX/RP. I-CBT is a 7-session version of CBT that does not include imaginal exposure or therapist-assisted EX/RP. In this study, we compared 12 weeks of medication management (MM provided by a study psychiatrist (MM only with two types of CBT augmentation: (1 the dual doctor model (MM+CBT; and (2 the single doctor model (MM+I-CBT. The design balanced elements of an efficacy study (e.g., random assignment, independent ratings with effectiveness research aims (e.g., differences in specific SRI medications, dosages, treatment providers. The study is wrapping up recruitment of 140 youth ages 7–17 with a primary diagnosis of OCD. Independent evaluators (IEs rated participants at weeks 0,4,8, and 12 during acute treatment and at 3,6, and 12 month follow-up visits. Trial registration NCT00074815

  15. Asthma and Pregnancy

    Science.gov (United States)

    ... in the airways of the lungs. When an asthma attack occurs, it is difficult for air to pass through the lungs which ... others have not. In these studies, it is difficult to determine whether the problems noted were due to the mother’s asthma, the medicines needed to control the asthma, or ...

  16. The Reversal Intervention for Metabolic Syndrome (TRIMS study: rationale, design, and baseline data

    Directory of Open Access Journals (Sweden)

    Troughton Jacqui

    2011-05-01

    Full Text Available Abstract Background Recent attention has focused on strategies to combat the forecast epidemic of type-2 diabetes (T2DM and its major vascular sequelae. Metabolic syndrome (MetS comprises a constellation of factors that increase the risk of cardiovascular disease (CVD and T2DM. Our study aims to develop a structured self-management education programme for people with MetS, which includes management of cardiovascular and diabetes risk factors, and to determine its impact. This paper describes the rationale and design of the TRIMS study, including intervention development, and presents baseline data. Methods Subjects recruited from a mixed-ethnic population with MetS were randomised to intervention or control arms. The intervention arm received structured group education based on robust psychological theories and current evidence. The control group received routine care. Follow-up data will be collected at 6 and 12 months. The primary outcome measure will be reversal of metabolic syndrome in the intervention group subjects compared to controls at 12 months follow-up. Results 82 participants (44% male, 22% South Asian were recruited between November 2009 and July 2010. Baseline characteristics were similar for both the intervention (n = 42 and control groups (n = 40. Median age was 63 years (IQR 57 - 67, mean waist size 106 cm (SD ± 11, and prescribing of statins and anti-hypertensives was 51% in each case. Conclusion Results will provide information on changes in diabetes and CVD risk factors and help to inform primary prevention strategies in people with MetS from varied ethnic backgrounds who are at high risk of developing T2DM and CVD. Information gathered in relation to the programme's acceptability and effectiveness in a multi-ethnic population would ensure that our results are widely applicable. Trial registration The study is registered at ClinicalTrials.gov, study identifier: NCT01043770.

  17. Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: The Ahsmog study

    Energy Technology Data Exchange (ETDEWEB)

    McDonnell, W.F. [Environmental Protection Agency, Research Triangle Park, NC (United States). National Health and Environmental Effects Research Lab.; Abbey, D.E.; Nishino, N. [Loma Linda Univ., CA (United States). School of Public Health; Lebowitz, M.D. [Univ. of Arizona Coll. of Medicine, Tucson, AZ (United States).

    1999-02-01

    The authors conducted a prospective study of a cohort of 3091 nonsmokers, ages 27 to 87 years, to evaluate the association between long-term ambient ozone exposure and development of adult-onset asthma. Over a 15-year period, 3.2% of males and 4.3% of females reported new doctor diagnoses of asthma. For males, they observed a significant relationship between report of doctor diagnosis of asthma and 20-year mean 8-h average ambient ozone concentration. The authors observed no such relationship for females. Other variables significantly related to development of asthma were a history of ever-smoking for males, and for females, number of years worked with a smoker, age, and a history of childhood pneumonia or bronchitis. Addition of other pollutants to the models did not diminish the relationship between ozone and asthma for males. These data suggest that long-term exposure to ambient ozone is associated with development of asthma in adult males.

  18. A community-based case-control study of asthma and chronic bronchitis in relation to occupation

    Energy Technology Data Exchange (ETDEWEB)

    Buchanan, D.; Donan, P.T.; Cowie, H.A.; Miller, B.G.; Soutar, C.A.

    1997-07-01

    A community-based epidemiological study was conducted in the West Lothian and Central Regions of Scotland in 1994 by postal questionnaire to investigate the associations between occupations previously held and prevalent symptoms of asthma and chronic bronchitis. 50% of the 34,000 questionnaires were returned. The prevalence of asthma was estimated to be 8% and that of chronic bronchitis was 15%. The prevalence of asthma and of chronic bronchitis related to work was estimated to be 0.5% and 2.2% respectively. Clinical assessments of a sample of respondents confirmed the reliability of diagnoses of asthma using a self-administered questionnaire, but suggested that the work-relatedness of asthma was less reliably diagnosed. Asthma symptoms were particularly implicated with employment in the food processing, catering and textiles industries. Chronic bronchitis symptoms were associated with dusty jobs such as coal mining metal processing and manufacturing of electrical products.

  19. A quality improvement study using fishbone analysis and an electronic medical records intervention to improve care for children with asthma.

    Science.gov (United States)

    Gold, Jonathan; Reyes-Gastelum, David; Turner, Jane; Davies, H Dele

    2014-01-01

    Despite expert guidelines, gaps persist in quality of care for children with asthma. This study sought to identify barriers and potential interventions to improve compliance to national asthma prevention guidelines at a single academic pediatric primary care clinic. Using the plan-do-check-act (PDCA) quality improvement framework and fishbone analysis, several barriers to consistent asthma processes and possible interventions were identified by a group of key stakeholders. Two interventions were implemented using the electronic medical record (EMR). Physician documentation of asthma quality measures were analyzed before intervention and during 2 subsequent time points over 16 months. Documentation of asthma action plans (core group P asthma care in a pediatric primary care setting.

  20. Higher body mass index may induce asthma among adolescents with pre-asthmatic symptoms: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Myers Leann

    2011-07-01

    Full Text Available Abstract Background Limited studies have prospectively examined the role of body mass index (BMI as a major risk factor for asthma during adolescence. This study investigates whether BMI is associated with increased risk of developing physician-diagnosed asthma during 12-month follow-up among adolescents with undiagnosed asthma-like symptoms at baseline. Methods A total of 4,052 adolescents with undiagnosed asthma-like symptoms at baseline were re-examined after a 12-month follow-up. Asthma cases were considered confirmed only after diagnosis by a physician based on the New England core and International Study of Asthma and Allergies in Childhood (ISAAC criteria video questionnaires, and accompanying pulmonary function tests. Logistic regression analyses were used to evaluate the relationship of BMI and the risk of acquiring asthma. Results The results indicated that girls with higher BMI were at an increased risk of developing asthma during the 12-month follow-up. The odds ratios for girls developing physician-diagnosed asthma were 1.75 (95% CI = 1.18-2.61 and 1.12 (95% CI = 0.76-1.67, respectively, for overweight and obesity as compared to the normal weight reference group after adjustment for other covariates. A similar relationship was not observed for overweight and obese boys who were also significantly more active than their female counterparts. Conclusions Increased BMI exaggerates the risk of acquiring asthma in symptomatic adolescent females but not in adolescent males. Thus, gender is an important modifier of BMI-related asthma risk. Additional research will be required to determine whether the increased asthma risk results from genetic, physiological or behavioural differences.

  1. Bisphenol A exposure and asthma development in school-age children: a longitudinal study.

    Directory of Open Access Journals (Sweden)

    Kyoung-Nam Kim

    Full Text Available Although the effect of bisphenol A on various health outcomes has been extensively examined, few studies have investigated its effect on asthma.We hypothesized that exposure to bisphenol A in school-age children was associated with wheezing and asthma.Participants included 127 children aged 7-8 years without a previous asthma diagnosis in an elementary school in Seoul, Korea. Three surveys were conducted, each 2 years apart. Bisphenol A concentration was measured at the baseline survey, and PC20, which is defined as the methacholine concentration that induces a decrease in FEV1 of 20% from baseline, was measured at every survey. Associations between bisphenol A concentration at 7-8 years of age and wheezing, asthma, and PC20 at ages up to 11-12 years were examined using generalized estimating equations, a marginal Cox regression model, and a linear mixed model.The log-transformed creatinine-adjusted urinary bisphenol A concentration at 7-8 years was positively associated with wheezing (odds ratio, 2.48; 95% confidence interval, 1.15-5.31; P = .02 and asthma (hazard ratio, 2.13; 95% confidence interval, 1.51-3.00; P<.001 at ages up to 11-12 years. Bisphenol A was also negatively associated with PC20 (ß = -2.33; P = .02. When stratified by sex, the association between bisphenol A and asthma remained significant only in girls (hazard ratio, 2.45; 95% confidence interval, 2.18-2.76; P<.001.Increased urinary bisphenol A concentrations at 7-8 years old were positively associated with wheezing and asthma and negatively associated with PC20 at ages up to 11-12 years.

  2. Indoor air pollution on nurseries and primary schools: impact on childhood asthmastudy protocol

    Directory of Open Access Journals (Sweden)

    Sousa Sofia I V

    2012-06-01

    Full Text Available Abstract Background Several studies have demonstrated an association between the exposure to indoor air pollution (IAP and childhood asthma. Evidence is suggesting that several air pollutants may contribute to both exacerbation and development of asthma, but some uncertainty remains concerning the specific causative role of IAP. This paper reports an epidemiologic study aiming to reduce the existing lacks on the association between long-term exposure to pollution mixtures and the development and exacerbation of childhood asthma. Methods/design Based on the implementation of the study in 8 nurseries and 8 primary schools, from which, 2 nurseries and 2 primary schools in sites influenced by traffic and other 2 nurseries and 2 primary schools in background sites at urban and rural areas, the study will analyse the exposure to both urban and rural pollution as well as to traffic emissions (some homes of the children will be included in the study. Furthermore, based on the answers to validated questionnaires (as those used in the International Study of Asthma and Allergies in Childhood - ISAAC filled in by the parents and on medical exams, the study will assess the prevalence, incidence and exacerbation of asthma, thus considering both short and long-term effects. The approximate number of children in the study will never be less than 600, guaranteeing 80% of study power (significant at a 5% level. Discussion This study intends to contribute for the understanding of the role of environmental factors, namely indoor air pollution, on asthma considering a risk group of different ages, and for the development of preventive measures, which are considered priority issues by the European Commission, according to the European Environmental Agency and the World Health Organization.

  3. Rationale, design and methods of the HEALTHY study behavior intervention component.

    Science.gov (United States)

    Venditti, E M; Elliot, D L; Faith, M S; Firrell, L S; Giles, C M; Goldberg, L; Marcus, M D; Schneider, M; Solomon, S; Thompson, D; Yin, Z

    2009-08-01

    HEALTHY was a multi-center primary prevention trial designed to reduce risk factors for type 2 diabetes in adolescents. Seven centers each recruited six middle schools that were randomized to either intervention or control. The HEALTHY intervention integrated multiple components in nutrition, physical education, behavior change and communications and promotion. The conceptual rationale as well as the design and development of the behavior intervention component are described. Pilot study data informed the development of the behavior intervention component. Principles of social learning and health-related behavior change were incorporated. One element of the behavior intervention component was a sequence of peer-led, teacher-facilitated learning activities known as FLASH (Fun Learning Activities for Student Health). Five FLASH modules were implemented over five semesters of the HEALTHY study, with the first module delivered in the second semester of the sixth grade and the last module in the second semester of the eighth grade. Each module contained sessions that were designed to be delivered on a weekly basis to foster self-awareness, knowledge, decision-making skills and peer involvement for health behavior change. FLASH behavioral practice incorporated individual and group self-monitoring challenges for eating and activity. Another element of the behavior intervention component was the family outreach strategy for extending changes in physical activity and healthy eating beyond the school day and for supporting the student's lifestyle change choices. Family outreach strategies included the delivery of newsletters and supplemental packages with materials to promote healthy behavior in the home environment during school summer and winter holiday breaks. In conclusion, the HEALTHY behavior intervention component, when integrated with total school food and physical education environmental changes enhanced by communications and promotional campaigns, is a feasible and

  4. Narrative reconstruction therapy for prolonged grief disorder—rationale and case study

    Directory of Open Access Journals (Sweden)

    Tuvia Peri

    2016-05-01

    Full Text Available Background: Prolonged grief disorder (PGD is a potentially disabling condition affecting approximately 10% of bereaved people. It has been suggested that the impaired integration of the loss memory, as expressed in recurrent memories of the loss and disorganization of memory, is involved in the development of PGD. Narrative reconstruction (NR, originally designed for the treatment of posttraumatic stress disorder (PTSD in an integrative therapy module, and consisting of exposure to the loss memory, detailed written reconstruction of the loss memory narrative and an elaboration of the personal significance of that memory for the bereaved, has been shown to be effective in the treatment of intrusion symptoms. Objective: In light of findings that cognitive behavior therapy (CBT, including cognitive restructuring and exposure, is effective in the treatment of PGD, we suggest the implementation of a somewhat novel therapy module, NR, for the treatment of intrusive phenomena in bereaved patients. Method: The rationale for the implementation of NR for PGD and a case study of the treatment of a woman suffering from PGD after the death of her father are presented. Therapy took place in a university outpatient training clinic. Results: Evaluations conducted before and after treatment and at a 3-month follow-up demonstrated the effectiveness of NR in reducing symptoms of PGD and depression. The analysis of spontaneous narratives recorded before and after treatment showed an increased organization of the narratives. Conclusions: This case report demonstrates an adaptation of NR for the treatment of PGD. The results provide preliminary support for the effectiveness of NR for PGD. The significance of the study and its limitations are discussed.

  5. Asthma control: Patient and environment

    NARCIS (Netherlands)

    Rijssenbeek-Nouwens, L.H.M.

    2015-01-01

    Control of asthma, the goal of asthma treatment, seems hard to obtain. However, it is largely unknown why control of asthma remains difficult in many patients in spite of available powerful medication. In this thesis we studied non-pharmacological factors influencing asthma control: patient related

  6. Vitamin D as an adjunctive therapy in asthma. Part 2: A review of human studies.

    LENUS (Irish Health Repository)

    Kerley, Conor P

    2015-03-05

    Vitamin D deficiency (VDD) is highly prevalent worldwide, with adverse effects on bone health but also potentially other unfavorable consequences. VDD and asthma-incidence\\/severity share many common risk factors, including winter season, industrialization, poor diet, obesity, dark skin pigmentation, and high latitude. Multiple anatomical areas relevant to asthma contain both the enzyme responsible for producing activated vitamin D and the vitamin D receptor suggesting that activated vitamin D (1,25-dihydroxyvitamin D) may have important local effects at these sites. Emerging evidence suggests that VDD is associated with increased airway hyperresponsiveness, decreased pulmonary function, worse asthma control, and possibly decreased response to standard anti-asthma therapy. However the effect is inconsistent with preliminary evidence from different studies suggesting vitamin D is both beneficial and detrimental to asthma genesis and severity. Current evidence suggests that supplementation with moderate doses of vitamin D may be appropriate for maintenance of bone health in asthmatics, particularly steroid users. However emerging data from an increasing number of randomized, controlled, intervention studies of vitamin D supplementation in pediatric and adult asthma are becoming available and should help determine the importance, if any of vitamin D for asthma pathogenesis. The purpose of this second of a two-part review is to review the current human literature on vitamin D and asthma, discussing the possible consequences of VDD for asthma and the potential for vitamin D repletion as adjunct therapy.

  7. A study of air pollutants and acute asthma exacerbations in urban areas: status report

    Energy Technology Data Exchange (ETDEWEB)

    Luttinger, Daniel; Wilson, Lloyd

    2003-06-01

    Details of a study to investigate the possible roles of a variety of hazardous air pollutants on asthma exacerbations at ambient air concentrations. - A study to try to better understand the interactions between various air contaminants and acute asthma exacerbations is described. The study evaluates temporal associations between a panel of air contaminants and acute asthmatic exacerbations as measured by emergency room visits for asthma in communities in the Bronx and Manhattan in New York City (NYC). In addition, ambient levels of various air pollutants in two NYC communities are being compared. Almost 2 years of daily data have been collected for most of the air contaminants to be investigated. The air contaminants measured include gaseous compounds (ozone, sulfur dioxide, nitrogen oxides, aldehydes, nitrous acid, nitric acid, hydrochloric acid and ammonia), particulate matter components (metals, elemental and organic carbon, sulfate, hydrogen ion, pollen, mold spores and particle mass and number)

  8. Severe asthma in children.

    Science.gov (United States)

    Guilbert, Theresa W; Bacharier, Leonard B; Fitzpatrick, Anne M

    2014-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of inhaled corticosteroids or oral corticosteroids. Children with severe asthma may fall into 2 categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, or poor adherence due to adverse psychological or environmental factors. In contrast, treatment resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline-based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting β-agonists and other add-on therapies, such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control, including reviewing the diagnosis and removing causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future.

  9. Metabolic Abnormalities in Children with Asthma

    OpenAIRE

    2010-01-01

    Rationale: Childhood asthma and obesity have reached epidemic proportions worldwide, and the latter is also contributing to increasing rates of related metabolic disorders, such as diabetes. Yet, the relationship between asthma, obesity, and abnormal lipid and glucose metabolism is not well understood, nor has it been adequately explored in children.

  10. Fluticasone propionate-salmeterol versus inhaled corticosteroids plus montelukast: outcomes study in pediatric patients with asthma

    Directory of Open Access Journals (Sweden)

    Stanford RH

    2012-12-01

    Full Text Available Richard H Stanford,1 Manan Shah,2 Anna O D'Souza21GlaxoSmithKline, Research Triangle Park, Durham, NC, 2Xcenda, Palm Harbor, FL, USABackground: The purpose of this study (GSK ADA111194 was to compare asthma-related health care utilization and costs associated with fluticasone propionate (an inhaled corticosteroid [ICS] and salmeterol (a long-acting beta-agonist in a single inhalation device (fluticasone propionate-salmeterol versus the combination of ICS + montelukast in the treatment of pediatric patients with asthma.Methods: This was a retrospective, observational cohort study using a large health insurance claims database spanning January 1, 2000 to January 31, 2008. The target population was patients aged 4–11 years with at least one pharmacy claim for fluticasone propionate-salmeterol, any ICS, or montelukast during the study period. The date of first claim for the medication of interest was deemed the index date. Patients were required to be continuously eligible to receive health care services one year prior to and 30 days after the index date, and have at least one claim with an ICD-9-CM code for asthma (493.xx in the one-year pre-index period. Patients with prescriptions for fluticasone propionate-salmeterol, ICS + montelukast, or long-acting beta-agonists during the pre-index period were excluded. Patients were matched on a 1:1 basis according to three variables, ie, pre-index use of oral corticosteroids, ICS, and presence of pre-index respiratory-related hospitalizations/emergency department visits. The risk of asthma-related hospitalization, combined hospitalization/emergency department visit, and monthly asthma-related costs were assessed using multivariate methods.Results: Of the 3001 patients identified, 2231 patients were on fluticasone propionate-salmeterol and 770 were on ICS + montelukast. After matching, there were 747 pairs of fluticasone propionate-salmeterol and ICS + montelukast patients, which were well matched for

  11. Rationale, design, and methodology for the optimizing outcomes in women with gestational diabetes mellitus and their infants study

    OpenAIRE

    Berry, Diane C.; Neal, Madeline; Hall, Emily G.; Schwartz, Todd A.; Verbiest, Sarah; Bonuck, Karen; Goodnight, William; Brody, Seth; Dorman, Karen F; Menard, Mary K; Stuebe, Alison M.

    2013-01-01

    Background Women who are diagnosed with gestational diabetes mellitus (GDM) are at increased risk for developing prediabetes and type 2 diabetes mellitus (T2DM). To date, there have been few interdisciplinary interventions that target predominantly ethnic minority low-income women diagnosed with GDM. This paper describes the rationale, design and methodology of a 2-year, randomized, controlled study being conducted in North Carolina. Methods/Design Using a two-group, repeated measures, experi...

  12. Pediatric asthma case management: a review of evidence and an experimental study design.

    Science.gov (United States)

    Schulte, Amanda; Musolf, Jeanne; Meurer, John R; Cohn, Jennifer H; Kelly, Kevin J

    2004-08-01

    Asthma is a complex disease that involves physiological, environmental, and psychosocial factors. This paper reviews childhood asthma case management by social service professionals, lay health workers, and nurses, and it presents a new randomized controlled study using nurse case management in a local community coalition. Evidence suggests the common factor for success involves case managers spending time contacting and patiently and persistently working with the family, thus building a trusting relationship. Although case management time is an expense for a health care payer, provider, and the child and family, the positive outcomes achieved can demonstrate the benefit of these interventions to all parties involved. The described experimental study assesses the cost and effectiveness of home-based nurse case management by a community coalition for children visiting an emergency department for asthma care.

  13. Review on Pharmacogenetics and Pharmacogenomics Applied to the Study of Asthma.

    Science.gov (United States)

    Sánchez-Martín, Almudena; García-Sánchez, Asunción; Isidoro-García, María

    2016-01-01

    Nearly one-half of asthmatic patients do not respond to the most common therapies. Evidence suggests that genetic factors may be involved in the heterogeneity in therapeutic response and adverse events to asthma therapies. We focus on the three major classes of asthma medication: β-adrenergic receptor agonist, inhaled corticosteroids, and leukotriene modifiers. Pharmacogenetics and pharmacogenomics studies have identified several candidate genes associated with drug response.In this chapter, the main pharmacogenetic and pharmacogenomic studies in addition to the future perspectives in personalized medicine will be reviewed. The ideal treatment of asthma would be a tailored approach to health care in which adverse effects are minimized and the therapeutic benefit for an individual asthmatic is maximized leading to a more cost-effective care.

  14. [Venous thromboembolism's risk assessment: rationale, objectives, and methodology--the ARTE study].

    Science.gov (United States)

    França, Ana; De Sousa, Joaquim Abreu; Felicíssimo, Paulo; Ferreira, Daniel

    2011-12-01

    ), haemorrhagic events (major and minor haemorrhages) and death at 6 months after discharge. Each patient will be contacted by telephone at 3 and 6 months after discharge, in order to assess the occurrence of thromboembolic and haemorrhagic events, as well as any readmission. This article describes the ARTE study's rationale, objectives, and methodology.

  15. The Canadian Healthy Infant Longitudinal Development (CHILD) Study: examining developmental origins of allergy and asthma.

    Science.gov (United States)

    Subbarao, Padmaja; Anand, Sonia S; Becker, Allan B; Befus, A Dean; Brauer, Michael; Brook, Jeffrey R; Denburg, Judah A; HayGlass, Kent T; Kobor, Michael S; Kollmann, Tobias R; Kozyrskyj, Anita L; Lou, W Y Wendy; Mandhane, Piushkumar J; Miller, Gregory E; Moraes, Theo J; Pare, Peter D; Scott, James A; Takaro, Tim K; Turvey, Stuart E; Duncan, Joanne M; Lefebvre, Diana L; Sears, Malcolm R

    2015-10-01

    The Canadian Healthy Infant Longitudinal Development (CHILD) birth cohort study recruited 3624 pregnant women, most partners and 3542 eligible offspring. We hypothesise that early life physical and psychosocial environments, immunological, physiological, nutritional, hormonal and metabolic influences interact with genetics influencing allergic diseases, including asthma. Environmental and biological sampling, innate and adaptive immune responses, gene expression, DNA methylation, gut microbiome and nutrition studies complement repeated environmental and clinical assessments to age 5. This rich data set, linking prenatal and postnatal environments, diverse biological samples and rigorous phenotyping, will inform early developmental pathways to allergy, asthma and other chronic inflammatory diseases.

  16. Epigenetics of asthma.

    Science.gov (United States)

    Durham, Andrew L; Wiegman, Coen; Adcock, Ian M

    2011-11-01

    Asthma is caused by both heritable and environmental factors. It has become clear that genetic studies do not adequately explain the heritability and susceptibility to asthma. The study of epigenetics, heritable non-coding changes to DNA may help to explain the heritable component of asthma. Additionally, epigenetic modifications can be influenced by the environment, including pollution and cigarette smoking, which are known asthma risk factors. These environmental trigger-induced epigenetic changes may be involved in skewing the immune system towards a Th2 phenotype following in utero exposure and thereby enhancing the risk of asthma. Alternatively, they may directly or indirectly modulate the immune and inflammatory processes in asthmatics via effects on treatment responsiveness. The study of epigenetics may therefore play an important role in our understanding and possible treatment of asthma and other allergic diseases. This article is part of a Special Issue entitled: Biochemistry of Asthma.

  17. A methodology to establish a database to study gene environment interactions for childhood asthma

    Directory of Open Access Journals (Sweden)

    McCormick Jonathan

    2010-12-01

    Full Text Available Abstract Background Gene-environment interactions are likely to explain some of the heterogeneity in childhood asthma. Here, we describe the methodology and experiences in establishing a database for childhood asthma designed to study gene-environment interactions (PAGES - Paediatric Asthma Gene Environment Study. Methods Children with asthma and under the care of a respiratory paediatrician are being recruited from 15 hospitals between 2008 and 2011. An asthma questionnaire is completed and returned by post. At a routine clinic visit saliva is collected for DNA extraction. Detailed phenotyping in a proportion of children includes spirometry, bronchodilator response (BDR, skin prick reactivity, exhaled nitric oxide and salivary cotinine. Dietary and quality of life questionnaires are completed. Data are entered onto a purpose-built database. Results To date 1045 children have been invited to participate and data collected in 501 (48%. The mean age (SD of participants is 8.6 (3.9 years, 57% male. DNA has been collected in 436 children. Spirometry has been obtained in 172 children, mean % predicted (SD FEV1 97% (15 and median (IQR BDR is 5% (2, 9. There were differences in age, socioeconomic status, severity and %FEV1 between the different centres (p≤0.024. Reasons for non-participation included parents not having time to take part, children not attending clinics and, in a small proportion, refusal to take part. Conclusions It is feasible to establish a national database to study gene-environment interactions within an asthmatic paediatric population; there are barriers to participation and some different characteristics in individuals recruited from different centres. Recruitment to our study continues and is anticipated to extend current understanding of asthma heterogeneity.

  18. Prospective Study of One Million Deaths in India: Rationale, Design, and Validation Results.

    Directory of Open Access Journals (Sweden)

    2005-12-01

    Full Text Available BACKGROUND: Over 75% of the annual estimated 9.5 million deaths in India occur in the home, and the large majority of these do not have a certified cause. India and other developing countries urgently need reliable quantification of the causes of death. They also need better epidemiological evidence about the relevance of physical (such as blood pressure and obesity, behavioral (such as smoking, alcohol, HIV-1 risk taking, and immunization history, and biological (such as blood lipids and gene polymorphisms measurements to the development of disease in individuals or disease rates in populations. We report here on the rationale, design, and implementation of the world's largest prospective study of the causes and correlates of mortality. METHODS AND FINDINGS: We will monitor nearly 14 million people in 2.4 million nationally representative Indian households (6.3 million people in 1.1 million households in the 1998-2003 sample frame and 7.6 million people in 1.3 million households in the 2004-2014 sample frame for vital status and, if dead, the causes of death through a well-validated verbal autopsy (VA instrument. About 300,000 deaths from 1998-2003 and some 700,000 deaths from 2004-2014 are expected; of these about 850,000 will be coded by two physicians to provide causes of death by gender, age, socioeconomic status, and geographical region. Pilot studies will evaluate the addition of physical and biological measurements, specifically dried blood spots. Preliminary results from over 35,000 deaths suggest that VA can ascertain the leading causes of death, reduce the misclassification of causes, and derive the probable underlying cause of death when it has not been reported. VA yields broad classification of the underlying causes in about 90% of deaths before age 70. In old age, however, the proportion of classifiable deaths is lower. By tracking underlying demographic denominators, the study permits quantification of absolute mortality rates

  19. Prospective study of one million deaths in India: rationale, design, and validation results.

    Directory of Open Access Journals (Sweden)

    Prabhat Jha

    2006-02-01

    Full Text Available BACKGROUND: Over 75% of the annual estimated 9.5 million deaths in India occur in the home, and the large majority of these do not have a certified cause. India and other developing countries urgently need reliable quantification of the causes of death. They also need better epidemiological evidence about the relevance of physical (such as blood pressure and obesity, behavioral (such as smoking, alcohol, HIV-1 risk taking, and immunization history, and biological (such as blood lipids and gene polymorphisms measurements to the development of disease in individuals or disease rates in populations. We report here on the rationale, design, and implementation of the world's largest prospective study of the causes and correlates of mortality. METHODS AND FINDINGS: We will monitor nearly 14 million people in 2.4 million nationally representative Indian households (6.3 million people in 1.1 million households in the 1998-2003 sample frame and 7.6 million people in 1.3 million households in the 2004-2014 sample frame for vital status and, if dead, the causes of death through a well-validated verbal autopsy (VA instrument. About 300,000 deaths from 1998-2003 and some 700,000 deaths from 2004-2014 are expected; of these about 850,000 will be coded by two physicians to provide causes of death by gender, age, socioeconomic status, and geographical region. Pilot studies will evaluate the addition of physical and biological measurements, specifically dried blood spots. Preliminary results from over 35,000 deaths suggest that VA can ascertain the leading causes of death, reduce the misclassification of causes, and derive the probable underlying cause of death when it has not been reported. VA yields broad classification of the underlying causes in about 90% of deaths before age 70. In old age, however, the proportion of classifiable deaths is lower. By tracking underlying demographic denominators, the study permits quantification of absolute mortality rates

  20. Effects of asthma on stability of Wisconsin card sorting test measures A twin study

    Institute of Scientific and Technical Information of China (English)

    Yixiao Fu; Huaqing Meng; Hengshu Zhang; Lu Jia; Qinghua Luo

    2008-01-01

    BACKGROUND:The four measures used to assess the stability of the Wisconsin card sorting test (WEST),that is,the number of preservative errors,percentage of preservative errors,number of categories completed,and the number of trials to complete the first category,reflect the function of the frontal lobe.OBJECTIVE:This study was designed to investigate the effects of asthma on the stability of WCST measurements through the use of a twin study,and to analyze whether egg-type difference exists.DESIGN:A cohort study.SETTING:Mental Health Center,the First Affiliated Hospital of Chongqing Medical University.PARTICIPANTS:Fifty-nine pairs of twins,aged 6-16 years,were primarily selected from schools between August 2005 and February 2007 and the WeST and Zygosity identification test was applied.Twins with achromatopsia,severe upper limb diseases,somatic diseases,or mental disorders were excluded.According to disease history of asthmatic attack,children were assigned into asthma(n=16)and non-asthma(n=43)groups.METHODS:Four WCST measurements were determined in the 59 pairs of twins,and egg-type differences were identified in conjunction.RESULTS:All 59 pairs of twins were included in the final analysis.Among the pairs of twins,28 (48.5%)were monozygotic twins,and 31(52%)were dizygotic twins.Among the monozygotic and dizygotic twins,the number of preservative errors and percentage of preservative errors were significantly higher in the asthma group than in the non-asthma group(P0.05).CONCLUSION:Asthma may affect the stability of WCST measures,but egg-type differences do not exist.

  1. The Strathclyde Evaluation of Children's Active Travel (SE-CAT: study rationale and methods

    Directory of Open Access Journals (Sweden)

    McMinn David

    2011-12-01

    Full Text Available Abstract Background The school commute is a prime opportunity to increase children's physical activity levels. However, active commuting has decreased over the past 40 years. Strategies that increase walking to school are therefore needed. Travelling Green (TG is a school-based active travel resource aimed at increasing children's walking to school. The resource consists of a curriculum-based program of lessons and goal setting activities. A previous study found that children who received the TG intervention increased self-reported distance travelled to school by active modes and reduced the distance travelled by inactive modes. This study was limited by self-reported outcome measures, a small sample, and no follow-up measures. A more robust evaluation of TG is required to address these limitations. This paper describes the rationale and methods for such an evaluation of Travelling Green, and describes the piloting of various active commuting measures in primary school children. Methods/Design Measures of active commuting were piloted in a sample of 26 children (aged 8-9 years over one school week. These measures were subsequently used in an 18-month quasi-experimental design to evaluate the effect of TG on commuting behaviour. Participants were 166 children (60% male aged 8-9 years from 5 primary schools. Two schools (n = 79 children received TG in September/October 2009. Three schools (n = 87 children acted as a comparison group, and subsequently received TG at a later date. Physical activity was measured using Actigraph GT1M accelerometers. Personal and environmental determinants of active commuting were measured via parent and child questionnaires, as were factors related to the Theory of Planned Behaviour and the construct of habit. Measures were taken pre- and post-intervention and at 5 and 12 months follow-up. Discussion The piloted protocol was practical and feasible and piloted measures were reliable and valid. All study data, including

  2. Obesity and asthma

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Diamant, Zuzana; Ulrik, Charlotte Suppli

    2015-01-01

    PURPOSE OF REVIEW: Obesity has significant impact on asthma incidence and manifestations. The purpose of the review is to discuss recent observations regarding the association between obesity and asthma focusing on underlying mechanisms, clinical presentation, response to therapy and effect...... of weight reduction. RECENT FINDINGS: Clinical and epidemiological studies indicate that obese patients with asthma may represent a unique phenotype, which is more difficult to control, less responsive to asthma medications and by that may have higher healthcare utilization. A number of common comorbidities...... have been linked to both obesity and asthma, and may, therefore, contribute to the obese-asthma phenotype. Furthermore, recently published studies indicate that even a modest weight reduction can improve clinical manifestations and outcome of asthma. SUMMARY: Compared with normal-weight patients, obese...

  3. Asthma and suicide-related adverse events: a review of observational studies

    Directory of Open Access Journals (Sweden)

    N. Iessa

    2011-12-01

    Full Text Available Suicide is a major public health concern. There are several risk factors associated with suicide. Chronic illnesses, such as asthma, have been linked to an increased risk of suicide-related events. This study reviews the evidence of an association between asthma and suicide using published epidemiological observational studies. An electronic search using PubMed and EMBASE was performed. Studies that investigated the association of asthma with suicide-related behaviour were selected. Studies were examined to form a descriptive analysis. Six observational studies met the selection criteria, of which at least one suicide-related adverse event was studied. Three studies investigated completed suicide, two suicide attempts and four suicide ideation. Two of the studies focused on individuals aged <18 yrs. Evidence from observational data support the hypothesis of an association between asthma and suicide-related behaviour (ideation, attempts and completion; however, epidemiological studies, with more objective measures and larger sample sizes, adjusting for a wider scope of suicide-related confounding factors (e.g. comorbidities, and with a longitudinal design, are needed for a more conclusive answer.

  4. Long-term studies of the natural history of asthma in childhood

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Bønnelykke, Klaus

    2010-01-01

    ). Prospective identification of endophenotypes allowing accurate prediction of the clinical course is currently not possible. The variability of the clinical course remains an enigma and difficult to predict. Three of 4 school-aged children with asthma have outgrown disease by midadulthood. The risk...... secondary prevention through the use of inhaled corticosteroids can effectively halt the long-term disease progression in childhood. In conclusion, the natural history of asthma and the associated airway changes is still poorly understood, and we have not managed to translate findings from long-term studies...

  5. A longitudinal study on early hospitalized airway infections and subsequent childhood asthma.

    Directory of Open Access Journals (Sweden)

    Mei-Jy Jeng

    Full Text Available Acute airway infections, including bronchiolitis, are common causes of early childhood hospitalization. The development of later asthma may be related to early airway infections in young children. This study is to investigate the relationship between hospitalized airway infections (HAI in young children (< 3 years old and later childhood asthma.Hospitalized children (< 3 years old with bronchiolitis or other acute airway infections (other HAI group from 1997-2000 were retrieved from the National Health Insurance Research Database of Taiwan, and compared to age- and gender-matched subjects with regards to asthma until 10 years of age; and potential comorbidities and medical care conditions.In total, 3,264 children (1,981 with bronchiolitis; 1,283 with other HAIs were compared to 18,527 controls. The incidence of childhood asthma was higher in the study (16.2% than the control (11.7% group, and most cases were diagnosed between 3-5 years old. The hazard ratios were 1.583 (95% CI: 1.414-1.772 and 1.226 (95% CI: 1.053-1.428 for the bronchiolitis and other HAI subgroups, respectively, compared to the control group, and 1.228 (95% CI: 1.075-1.542 in the bronchiolitis subgroup compared to the other HAIs subgroup. A significantly higher odds ratio (1.973, 95% CI: 1.193-3.263 for the children with congenital heart disease (CHD in the bronchiolitis subgroup was found at an age of 3-5 years compared to the control group.Young children (< 3 years old hospitalized due to acute HAIs are at a higher risk of developing childhood asthma at age 3 to 10 years. The parents of children with HAIs at age 0 to 2 years should be informed for the higher risk of developing childhood asthma, especially in children with CHD and bronchiolitis.

  6. Physical activity and incident asthma in adults: the HUNT Study, Norway

    Science.gov (United States)

    Brumpton, Ben M; Langhammer, Arnulf; Ferreira, Manuel A R; Chen, Yue; Mai, Xiao-Mei

    2016-01-01

    Objective We aimed to investigate the associations of physical activity and change in physical activity with incident asthma in a cohort of Norwegian adults. Design We conducted a prospective cohort study using data on self-reported physical activity from 3 waves of the Nord-Trøndelag Health Study. Physical activity was reported at the first and second surveys (1985–1986 and 1995–1997). Physical activity was defined from the second survey as inactive or active and the active group was further defined as very low, low, moderate and high. Change in physical activity was defined from the first and second surveys. Setting A large population-based health survey in Norway. Participants We followed 18 894 adults over 11 years who were free from asthma at baseline in 1995–1997. Outcome Incident asthma was reported in the third survey (2006–2008). Results The cumulative incidence of asthma was 3.6% over the 11 years. The adjusted OR for incident asthma among active participants compared with inactive participants was 0.95 (95% CI 0.69 to 1.34). The adjusted OR for those who were active in the first or second survey versus those who were inactive in both surveys was 0.64 (95% CI 0.34 to 1.38); however, this association was strongly attenuated in sensitivity analysis (OR 0.93, 95% CI 0.38 to 3.09). Conclusions We did not observe statistically significant associations of physical activity or change in physical activity with incident asthma in adults over the 11-year follow-up. PMID:27864254

  7. Validating childhood asthma in an epidemiological study using linked electronic patient records

    NARCIS (Netherlands)

    Cornish, Rosaleen P; Henderson, John; Boyd, Andrew W; Granell, Raquel; Van Staa, Tjeerd; Macleod, John

    2014-01-01

    OBJECTIVE: To investigate the performance of parent-reported data in identifying physician-confirmed asthma. DESIGN AND SETTING: Validation study using linkage between the Avon Longitudinal Study of Parents and Children (ALSPAC) and electronic patient records held within the General Practice Researc

  8. The association of effort-reward imbalance and asthma: findings from two cross-sectional studies

    NARCIS (Netherlands)

    A. Loerbroks; R.M. Herr; J. Li; J.A. Bosch; M. Seegel; M. Schneider; P. Angerer; B. Schmidt

    2014-01-01

    Purpose: There is evidence to suggest that work stress is positively associated with the occurrence of asthma. A limitation is that the small number of prior studies utilized unestablished work stress measures, thus constraining interpretation and generalizability. The present study re-examined this

  9. Child/Adolescent Anxiety Multimodal Study (CAMS: rationale, design, and methods

    Directory of Open Access Journals (Sweden)

    Waslick Bruce D

    2010-01-01

    Full Text Available Abstract Objective To present the design, methods, and rationale of the Child/Adolescent Anxiety Multimodal Study (CAMS, a recently completed federally-funded, multi-site, randomized placebo-controlled trial that examined the relative efficacy of cognitive-behavior therapy (CBT, sertraline (SRT, and their combination (COMB against pill placebo (PBO for the treatment of separation anxiety disorder (SAD, generalized anxiety disorder (GAD and social phobia (SoP in children and adolescents. Methods Following a brief review of the acute outcomes of the CAMS trial, as well as the psychosocial and pharmacologic treatment literature for pediatric anxiety disorders, the design and methods of the CAMS trial are described. Results CAMS was a six-year, six-site, randomized controlled trial. Four hundred eighty-eight (N = 488 children and adolescents (ages 7-17 years with DSM-IV-TR diagnoses of SAD, GAD, or SoP were randomly assigned to one of four treatment conditions: CBT, SRT, COMB, or PBO. Assessments of anxiety symptoms, safety, and functional outcomes, as well as putative mediators and moderators of treatment response were completed in a multi-measure, multi-informant fashion. Manual-based therapies, trained clinicians and independent evaluators were used to ensure treatment and assessment fidelity. A multi-layered administrative structure with representation from all sites facilitated cross-site coordination of the entire trial, study protocols and quality assurance. Conclusions CAMS offers a model for clinical trials methods applicable to psychosocial and psychopharmacological comparative treatment trials by using state-of-the-art methods and rigorous cross-site quality controls. CAMS also provided a large-scale examination of the relative and combined efficacy and safety of the best evidenced-based psychosocial (CBT and pharmacologic (SSRI treatments to date for the most commonly occurring pediatric anxiety disorders. Primary and secondary results

  10. Population-based cohort study of outpatients with pneumonia: rationale, design and baseline characteristics

    Directory of Open Access Journals (Sweden)

    Eurich Dean T

    2012-06-01

    Full Text Available Abstract Background The vast majority of research in the area of community-acquired pneumonia (CAP has been based on patients admitted to hospital. And yet, the majority of patients with CAP are treated on an ambulatory basis as outpatients, either by primary care physicians or in Emergency Departments. Few studies have been conducted in outpatients with pneumonia, and there is a paucity of data on short and long term morbidity or mortality and associated clinical correlates in this group of patients. Methods From 2000–2002, all CAP patients presenting to 7 Emergency Departments in Edmonton, Alberta, Canada were prospectively enrolled in a population-based registry. Clinical data, including pneumonia severity index (PSI were collected at time of presentation. Patients discharged to the community were then followed for up to 5 years through linkage to the provincial administrative databases. The current report provides the rationale and design for the cohort, as well as describes baseline characteristics and 30-day morbidity and mortality. Results The total sample included 3874 patients. After excluding patients who were hospitalized, died or returned to the Emergency Department the same day they were initially discharged (n = 451; 12 %, and patients who could not be linked to provincial administrative databases (n = 237; 6 %, the final cohort included 3186 patients treated according to a validated clinical management pathway and discharged back to the community. Mean age was 51 (SD = 20 years, 53 % male; 4 % resided in a nursing home, 95 % were independently mobile, and 88 % had mild (PSI class I-III pneumonia. Within 30-days, return to Emergency Department was common (25 % as was hospitalization (8 % and 1 % of patients had died. Conclusions To our knowledge, this represents the largest clinically-detailed outpatient CAP cohort assembled to date and will add to our understanding of the determinants and outcomes

  11. Individual traffic-related air pollution and new onset adult asthma:A GIS-based pilot study

    DEFF Research Database (Denmark)

    Lysbeck Hansen, Carl; Jensen, Steen Solvang; Baelum, Jesper

    individual traffic-related air pollution exposure and new onset asthma and wheeze. It is recommended that the analytic methods developed in this pilot study are used in a larger prospective cohort to investigate individual traffic-related air pollutants as a risk factor for the development of new asthma......The background for the project is that traffic-related air pollution may provoke the onset of asthma. The objective of this pilot study is to investigate the relation between asthma and wheeze debut and individually estimated exposure to traffic-related air pollutants with a validated exposure...... successfully identified for all study participants (N=33). Using AirGIS traffic-related air pollutant levels from both urban background and street level were estimated for the 10 year study period on an hourly basis. Individual levels of air pollutants in the years preceding debut of asthma or wheeze were...

  12. Greater risk of incident asthma cases in adults with Allergic Rhinitis and Effect of Allergen Immunotherapy: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Piccillo Giovita

    2005-12-01

    Full Text Available Abstract Asthma and rhinitis are often co-morbid conditions. As rhinitis often precedes asthma it is possible that effective treatment of allergic rhinitis may reduce asthma progression. The aim of our study is to investigate history of allergic rhinitis as a risk factor for asthma and the potential effect of allergen immunotherapy in attenuating the incidence of asthma. Hospital-referred non-asthmatic adults, aged 18–40 years between 1990 and 1991, were retrospectively followed up until January and April 2000. At the end of follow up, available subjects were clinically examined for asthma diagnosis and history of allergen specific immunotherapy, second-hand smoking and the presence of pets in the household. A total of 436 non-asthmatic adults (332 subjects with allergic rhinitis and 104 with no allergic rhinitis nor history of atopy were available for final analyses. The highest OR (odds ratio associated with a diagnosis of asthma at the end of follow-up was for the diagnosis of allergic rhinitis at baseline (OR, 7.8; 95%CI, 3.1–20.0 in the model containing the covariates of rhinitis diagnosis, sex, second-hand smoke exposure, presence of pets at home, family history of allergic disorders, sensitization to Parietaria judaica; grass pollen; house dust mites; Olea europea: orchard; perennial rye; and cat allergens. Female sex, sensitization to Parietaria judaica and the presence of pets in the home were also significantly predictive of new onset asthma in the same model. Treatment with allergen immunotherapy was significantly and inversely related to the development of new onset asthma (OR, 0.53; 95%CI, 0.32–0.86. In the present study we found that allergic rhinitis is an important independent risk factor for asthma. Moreover, treatment with allergen immunotherapy lowers the risk of the development of new asthma cases in adults with allergic rhinitis.

  13. Characteristics and severity of asthma in children with and without atopic conditions : a cross-sectional study

    NARCIS (Netherlands)

    Arabkhazaeli, Ali; Vijverberg, Susanne J H; van Erp, Francine C; Raaijmakers, Jan A M; van der Ent, Cornelis K.; Maitland van der Zee, Anke H

    2015-01-01

    BACKGROUND: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children wi

  14. A daily SMS reminder increases adherence to asthma treatment: a three-month follow-up study

    DEFF Research Database (Denmark)

    Strandbygaard, Ulla; Thomsen, Simon Francis; Backer, Vibeke

    2010-01-01

    Poor adherence to asthma treatment is a well-recognised challenge and is associated with increased morbidity, mortality and consumption of health care resources. This study examined the impact of receiving a daily text message reminder on one's cell phone on adherence to asthma treatment....

  15. Characteristics and severity of asthma in children with and without atopic conditions: A cross-sectional study

    NARCIS (Netherlands)

    Arabkhazaeli, Ali; Vijverberg, Susanne J. H.; van Erp, Francine C.; Raaijmakers, Jan A. M.; van der Ent, Cornelis K.; Maitland van der Zee, Anke H.

    2015-01-01

    Background: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children wi

  16. Basal or stress-induced cortisol and asthma development : the TRAILS study

    NARCIS (Netherlands)

    Vink, Nienke M; Boezen, Hendrika; Postma, Dirkje S; Rosmalen, Judith G M

    2013-01-01

    We examined the association between: 1) cortisol levels and asthma or asthma development; 2) cortisol levels upon stress and asthma. In addition, we performed a post hoc meta-analysis on results from the literature. Cortisol, cortisol upon stress, asthma (doctor diagnosis of asthma and/or symptoms a

  17. Biological studies on the effect of estrogen on experimentally induced asthma in mice.

    Science.gov (United States)

    El-Desouki, Nabila I; Tabl, Ghada A; Elkhodary, Yasmin A A

    2016-01-01

    This study evaluates the influence of estrogen hormone on the experimentally induced asthma in male mice. The animals were divided into four groups, with 20 mice in each group; group I (control mice) included mice that received no treatment, group II included mice that received intraperitoneal estrogen injection (0.25 mg/kg body weight (bw), twice on day 28 of the experiment), group III (asthmatic mice) included asthmatic mice that received intraperitoneal injection of two doses of ovalbumin (OVA; 2 µg of OVA mixed with 100 µg of aluminum potassium sulfate) on days 1 and 14 of the experiment and then challenged intranasally with a single dose of OVA (50 µg dissolved in 0.05 ml phosphate-buffered saline; PBS) on day 28 of the experiment, and group IV (asthmatic mice treated with estrogen) included asthma model male mice that received the estrogen (0.5 mg/kg bw in 40 ml PBS, twice on the day 28 of the experiment). The immunohistochemical studies observed a marked intensity of CD15 immunoreactivity in the lung tissues of asthma model mice. Physiological results recorded that the total and differential count of leukocytes in bronchoalveolar lavage fluid (BALF) of asthma model mice recorded a significant increase in the number of leukocytes especially in the number of eosinophil cells. The BALF of asthma model mice showed high levels of interleukins 4 and 5 (IL-4 and IL-5), and there was a significant decrease in both the levels of IL-4 and IL-5 in BALF of asthma model mice treated with estrogen. In conclusion, the obtained results indicated that the asthma is responsible for certain immunohistochemical and physiological alterations induced in lung tissues of mice. The administration of estrogen to asthmatic male mice could improve these changes. For this reason, the present findings support the possible role of estrogen in modulating the inflammatory effects caused by asthma in male mice and may be helpful to cure many asthmatic progressions.

  18. Inverse Relationship Between Helicobacter Pylori Infection and Asthma Among Adults Younger than 40 Years: A Cross-Sectional Study.

    Science.gov (United States)

    Lim, Joo Hyun; Kim, Nayoung; Lim, Seon Hee; Kwon, Jin-Won; Shin, Cheol Min; Chang, Yoon-Seok; Kim, Joo Sung; Jung, Hyun Chae; Cho, Sang-Heon

    2016-02-01

    Recent studies have suggested that Helicobacter pylori could prevent allergic disease, particularly in children. However, whether this is true in adults is controversial. The aim of this study was to investigate whether there is negative association between H. pylori infection and asthma among adults in an area with a high prevalence of H. pylori.This was a cross-sectional study using 2011 health surveillance data. Blood samples were taken from all participants to measure serum H. pylori IgG status. Information on demographics, socioeconomic status, and medical history, including asthma and other allergic conditions were collected by a questionnaire.Of the 15,032 patients, 9492 (63.1%) had a history of H. pylori infection, 359 (2.4%) had asthma, and 3277 (21.8%) had other allergic conditions. H. pylori infection was positively correlated with age (OR, 1.050; 95% CI, 1.047-1.053, P Asthma history was positively correlated with age (OR, 1.022; 95% CI, 1.013-1.032, P asthma in the total participants (OR, 1.041; 95% CI, 1.021-1.062, P asthma (OR, 0.503; 95% CI, 0.280-0.904, P = 0.021). Other allergic conditions were not related with H. pylori infection among the total and those asthma among young adults suggests that the underlying immune mechanism induced by H. pylori infection may affect allergic reactions associated with asthma in young adults.

  19. Asthma medication prescribing before, during and after pregnancy : A study in seven European regions

    NARCIS (Netherlands)

    Charlton, Rachel A; Pierini, Anna; Klungsøyr, Kari; Neville, Amanda J; Jordan, Susan; Jong-van den Berg, de Lolkje; Thayer, Daniel; Bos, H Jens; Puccini, Aurora; Hansen, Anne V; Gini, Rosa; Engeland, Anders; Nybo Andersen, Anne-Marie; Dolk, Helen; Garne, Ester

    2016-01-01

    OBJECTIVES: To explore utilisation patterns of asthma medication before, during and after pregnancy as recorded in seven European population-based databases. DESIGN: A descriptive drug utilisation study. SETTING: 7 electronic healthcare databases in Denmark, Norway, the Netherlands, Italy (Emilia Ro

  20. A multicentre study of air pollution exposure and childhood asthma prevalence: the ESCAPE project

    NARCIS (Netherlands)

    Mölter, Anna; Simpson, Angela; Berdel, Dietrich; Brunekreef, Bert; Custovic, Adnan; Cyrys, Josef; de Jongste, Johan; de Vocht, Frank; Fuertes, Elaine; Gehring, Ulrike; Gruzieva, Olena; Heinrich, Joachim; Hoek, Gerard; Hoffmann, Barbara; Klümper, Claudia; Korek, Michal; Kuhlbusch, Thomas A J; Lindley, Sarah; Postma, Dirkje; Tischer, Christina; Wijga, Alet; Pershagen, Göran; Agius, Raymond

    2015-01-01

    The aim of this study was to determine the effect of six traffic-related air pollution metrics (nitrogen dioxide, nitrogen oxides, particulate matter with an aerodynamic diameter <10 μm (PM10), PM2.5, coarse particulate matter and PM2.5 absorbance) on childhood asthma and wheeze prevalence in five E

  1. Occupational asthma

    Science.gov (United States)

    ... Names Asthma - occupational exposure; Irritant-induced reactive airways disease Images Spirometry Respiratory system References Lemiere C, Vandenplas O. Occupational allergy and asthma. In: Adkinson NF Jr., Bochner ...

  2. Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: A birth cohort study

    DEFF Research Database (Denmark)

    Rebordosa, Cristina; Kogevinas, Manolis; Sørensen, Henrik T

    2008-01-01

    BACKGROUND: Paracetamol use has been associated with increased prevalence of asthma in children and adults, and one study reported an association between pre-natal exposure to paracetamol and asthma in early childhood. METHODS: To examine if pre-natal exposure to paracetamol is associated...... with the risk of asthma or wheezing in early childhood, we selected 66 445 women from the Danish National Birth Cohort for whom we had information on paracetamol use during pregnancy and who participated in an interview when their children were 18-months-old and 12 733 women whose children had reached the age...... of 7 and estimated the prevalence of physician-diagnosed asthma and wheezing at the ages of 18 months and 7 years. We also linked our population to the Danish National Hospital Registry to record all hospitalizations due to asthma up to age of 18 months. RESULTS: Paracetamol use during any time...

  3. Diagnostic properties of inhaled mannitol in the diagnosis of asthma: a population study

    DEFF Research Database (Denmark)

    Sverrild, Asger; Porsbjerg, Celeste; Thomsen, Simon Francis;

    2009-01-01

    BACKGROUND: A new indirect bronchial provocation test measuring airway responsiveness by using inhaled mannitol was recently introduced. OBJECTIVE: The aim of this study was to examine the diagnostic properties of airway responsiveness to inhaled mannitol in the assessment of asthma in an unselec......BACKGROUND: A new indirect bronchial provocation test measuring airway responsiveness by using inhaled mannitol was recently introduced. OBJECTIVE: The aim of this study was to examine the diagnostic properties of airway responsiveness to inhaled mannitol in the assessment of asthma...... operating characteristic curve was constructed, and the accuracy of the test, defined as the area under the curve, was computed. RESULTS: Fifty-one (21.4%) subjects had current asthma. Of 33 subjects with airway hyperresponsiveness to mannitol, 30 had current asthma. The specificity and sensitivity were 98.......4% (95% CI, 96.2% to 99.4%) and 58.8% (95% CI, 50.7% to 62.6%), respectively. The positive predictive value (PPV) and negative predictive value (NPV) were 90.9% (95% CI, 78.4% to 96.8%) and 89.8 (95% CI, 87.7% to 90.7%), respectively. The area under the receiver operating characteristic curve was 0...

  4. A Citizen-Science Study Documents Environmental Exposures and Asthma Prevalence in Two Communities

    Directory of Open Access Journals (Sweden)

    Samantha Eiffert

    2016-01-01

    Full Text Available A citizen-science study was conducted in two low-income, flood-prone communities in Atlanta, Georgia, in order to document environmental exposures and the prevalence of occupant asthma. Teams consisting of a public-health graduate student and a resident from one of the two communities administered a questionnaire, inspected residences for mold growth, and collected a dust sample for quantifying mold contamination. The dust samples were analyzed for the 36 molds that make up the Environmental Relative Moldiness Index (ERMI. Most residents (76% were renters. The median duration of residence was 2.5 years. Although only 12% of occupants reported a history of flooding, 46% reported at least one water leak. Homes with visible mold (35% had significantly (P<0.05 higher mean ERMI values compared to homes without (14.0 versus 9.6. The prevalence of self-reported, current asthma among participants was 14%. In logistic regression models controlling for indoor smoking, among participants residing at their current residence for two years or less, a positive association was observed between asthma and the homes’ ERMI values (adjusted odds ratio per unit increase in ERMI = 1.12, 95% confidence intervals (CI: 1.01–1.25; two-tailed P=0.04. Documentation of the exposures and asthma prevalence has been presented to the communities and public officials. Community-based organizations have taken responsibility for planning and implementing activities in response to the study findings.

  5. The association between asthma and invasive pneumococcal disease: a nationwide study in Korea.

    Science.gov (United States)

    Kwak, Byung Ok; Choung, Ji Tae; Park, Yong Mean

    2015-01-01

    The purpose of this study was to investigate the association between asthma and invasive pneumococcal disease (IPD) in Korea. A retrospective population-based cohort study was conducted using the Korean Health Insurance Review and Assessment database 2010-2011. The subjects included 935,106 (2010) and 952,295 (2011), of whom 398 (2010) and 428 (2011) patients with IPD were identified. There was significant difference in the prevalence of IPD in patients with and without asthma (0.07% vs. 0.02% in 2010 and 0.08% vs. 0.01% in 2011; Pasthma showed over a three-fold increased risk of IPD compared with patients without asthma (adjusted odds ratio [aOR] 3.90, 95% confidence interval [CI] 3.02-5.03 in 2010 / aOR, 5.44; 95% CI, 4.10-7.22 in 2011; Pdiabetes mellitus was also significantly associated with IPD, relatively low ORs compared with those of asthma were noted (aOR, 1.85; 95% CI, 1.35-2.54 in 2010 / aOR, 2.40; 95% CI, 1.78-3.24 in 2011; Pasthma are at increased risk of developing IPD.

  6. Asthma and Allergies in Children With Autism Spectrum Disorders: Results From the CHARGE Study.

    Science.gov (United States)

    Lyall, Kristen; Van de Water, Judy; Ashwood, Paul; Hertz-Picciotto, Irva

    2015-10-01

    Immune aberrations are often noted in children with autism spectrum disorder (ASD), but whether asthma and allergy are related to ASD is not well defined. This study examined asthma and allergies in association with ASD and phenotypic subsets. Participants were 560 children with confirmed ASD and 391 typically developing children from the CHildhood Autism Risks from Genetics and the Environment study. Maternally reported child asthma and allergy was compared between cases and controls, and in association with cognitive and behavioral test scores. Prevalence of asthma and overall allergies did not differ between cases and controls, but overall allergy in children with ASD was associated with higher stereotypy scores as measured by the Aberrant Behavior Checklist. In addition, reported food allergies were significantly associated with ASD (adjusted odds ratio = 2.23, 95% confidence interval 1.28, 3.89). Our results suggest food allergies and sensitivities may be more common in children with ASD, and that these issues may correlate with other behaviors.

  7. Asthma and Wheeze Prevalence among Nursing Professionals in Western Japan: A Cross-Sectional Study.

    Science.gov (United States)

    Kurai, Jun; Watanabe, Masanari; Sano, Hiroyuki; Torai, Saeko; Yanase, Hirokazu; Funakoshi, Tomoaki; Fukada, Atsuko; Hayakawa, Sachiko; Shimizu, Eiji; Kitano, Hiroya

    2015-12-04

    Although adult asthma is attributable to occupational factors, few reports are available on asthma prevalence among health care workers in Japan. The objective of this study was to estimate the prevalence of asthma and wheeze among Japanese nursing professionals. A cross-sectional study was conducted by postal survey using a translated version of the European Community Respiratory Health Survey questionnaire from April to June 2013. The analysis included 4634 nursing professionals (257 men and 4377 women) and the overall response rate was 84.8%. The prevalence of current asthma and wheeze were 10.7% (95% confidence interval (CI), 9.9%-11.7%) and 15.6% (95% CI, 14.5%-16.6%), respectively. More than one year of work experience as a nursing professional and more than one year of experience with bed-making tasks were associated with odds ratios (ORs) of 1.95 (95% CI, 1.12-3.39) and 1.64 (95% CI, 1.15-2.23) for wheeze, respectively. Current smoking was significantly associated with the presence of wheeze, with ORs of 2.27 for men (95% CI, 1.11-4.64) and 2.01 for women (95% CI, 1.54-2.64). Among female nurses, latex allergy was associated with wheeze (OR, 1.87; 95% CI, 1.56-2.23), as was body mass index ≥30 (OR, 2.76; 95% CI, 1.65-4.62). This study has provided the prevalence of asthma and wheeze among Japanese nursing professionals. Employment period, bed-making tasks, latex allergy, obesity, and smoking may be risk factors for prevalent wheeze among nursing professionals.

  8. Asthma and Wheeze Prevalence among Nursing Professionals in Western Japan: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Jun Kurai

    2015-12-01

    Full Text Available Although adult asthma is attributable to occupational factors, few reports are available on asthma prevalence among health care workers in Japan. The objective of this study was to estimate the prevalence of asthma and wheeze among Japanese nursing professionals. A cross-sectional study was conducted by postal survey using a translated version of the European Community Respiratory Health Survey questionnaire from April to June 2013. The analysis included 4634 nursing professionals (257 men and 4377 women and the overall response rate was 84.8%. The prevalence of current asthma and wheeze were 10.7% (95% confidence interval (CI, 9.9%–11.7% and 15.6% (95% CI, 14.5%–16.6%, respectively. More than one year of work experience as a nursing professional and more than one year of experience with bed-making tasks were associated with odds ratios (ORs of 1.95 (95% CI, 1.12–3.39 and 1.64 (95% CI, 1.15–2.23 for wheeze, respectively. Current smoking was significantly associated with the presence of wheeze, with ORs of 2.27 for men (95% CI, 1.11–4.64 and 2.01 for women (95% CI, 1.54–2.64. Among female nurses, latex allergy was associated with wheeze (OR, 1.87; 95% CI, 1.56–2.23, as was body mass index ≥30 (OR, 2.76; 95% CI, 1.65–4.62. This study has provided the prevalence of asthma and wheeze among Japanese nursing professionals. Employment period, bed-making tasks, latex allergy, obesity, and smoking may be risk factors for prevalent wheeze among nursing professionals.

  9. Genetic Ancestry and Asthma and Rhinitis Occurrence in Hispanic Children: Findings from the Southern California Children's Health Study.

    Directory of Open Access Journals (Sweden)

    Muhammad T Salam

    Full Text Available Asthma and rhinitis are common childhood health conditions. Being an understudied and rapidly growing population in the US, Hispanic children have a varying risk for these conditions that may result from sociocultural (including acculturative factors, exposure and genetic diversities. Hispanic populations have varying contributions from European, Amerindian and African ancestries. While previous literature separately reported associations between genetic ancestry and acculturation factors with asthma, whether Amerindian ancestry and acculturative factors have independent associations with development of early-life asthma and rhinitis in Hispanic children remains unknown. We hypothesized that genetic ancestry is an important determinant of early-life asthma and rhinitis occurrence in Hispanic children independent of sociodemographic, acculturation and environmental factors.Subjects were Hispanic children (5-7 years who participated in the southern California Children's Health Study. Data from birth certificates and questionnaire provided information on acculturation, sociodemographic and environmental factors. Genetic ancestries (Amerindian, European, African and Asian were estimated based on 233 ancestry informative markers. Asthma was defined by parental report of doctor-diagnosed asthma. Rhinitis was defined by parental report of a history of chronic sneezing or runny or blocked nose without a cold or flu. Sample sizes were 1,719 and 1,788 for investigating the role of genetic ancestry on asthma and rhinitis, respectively.Children had major contributions from Amerindian and European ancestries. After accounting for potential confounders, per 25% increase in Amerindian ancestry was associated with 17.6% (95% confidence interval [CI]: 0.74-0.99 and 13.6% (95% CI: 0.79-0.98 lower odds of asthma and rhinitis, respectively. Acculturation was not associated with either outcome.Earlier work documented that Hispanic children with significant

  10. [Severe asthma].

    Science.gov (United States)

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended.

  11. An ADAM33 polymorphism associates with progression of preschool wheeze into childhood asthma: a prospective case-control study with replication in a birth cohort study.

    Directory of Open Access Journals (Sweden)

    Ester M M Klaassen

    Full Text Available The influence of asthma candidate genes on the development from wheeze to asthma in young children still needs to be defined.To link genetic variants in asthma candidate genes to progression of wheeze to persistent wheeze into childhood asthma.In a prospective study, children with recurrent wheeze from the ADEM (Asthma DEtection and Monitoring study were followed until the age of six. At that age a classification (transient wheeze or asthma was based on symptoms, lung function and medication use. In 198 children the relationship between this classification and 30 polymorphisms in 16 asthma candidate genes was assessed by logistic regression. In case of an association based on a p<0.10, replication analysis was performed in an independent birth cohort study (KOALA study, n = 248 included for the present analysis.In the ADEM study, the minor alleles of ADAM33 rs511898 and rs528557 and the ORMDL3/GSDMB rs7216389 polymorphisms were negatively associated, whereas the minor alleles of IL4 rs2243250 and rs2070874 polymorphisms were positively associated with childhood asthma. When replicated in the KOALA study, ADAM33 rs528557 showed a negative association of the CG/GG-genotype with progression of recurrent wheeze into childhood asthma (0.50 (0.26-0.97 p = 0.04 and no association with preschool wheeze.Polymorphisms in ADAM33, ORMDL3/GSDMB and IL4 were associated with childhood asthma in a group of children with recurrent wheeze. The replication of the negative association of the CG/GG-genotype of rs528557 ADAM33 with childhood asthma in an independent birth cohort study confirms that a compromised ADAM33 gene may be implicated in the progression of wheeze into childhood asthma.

  12. Relationship between Vitamin D and Childhood Asthma: A Case–Control Study

    Science.gov (United States)

    Hatami, Gissou; Ghasemi, Khadijeh; Motamed, Niloofar; Firoozbakht, Saiideh; Movahed, Ali; Farrokhi, Shokrollah

    2014-01-01

    Objective: Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma. Methods: Data were obtained from 200 asthmatic children (age 3–12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium, phosphorus, parathormone (PTH) and eosinophil count were measured in both asthmatic children and healthy controls. Also, the mean values of 25(OH) vitamin D were compared with asthma symptom severities. Findings: There was a significant decrease in the concentration of serum 25(OH) vitamin D in the asthmatic patients as compared with the controls (20.34±2.8 vs 25.39±4.1 ng/mL, 95%CI: 1.46–3.86, P=0.01). Out of total asthmatic subjects, 40 (20%) were vitamin D sufficient, 48 (24%) were insufficient, and 112 (56%) were deficient. Total IgE concentration was also significantly higher in asthmatic patients having vitamin D deficiency (132.4±20.1 IU/ml, 95%CI: 1.38–3.75, P=0.03). Comparing asthmatic patients with healthy controls, odds of having vitamin D level less than 20ng/mL was 2.47. Conclusion: Our findings suggest that vitamin D deficiency or insufficiency may be positively related to the prevalence of asthma in children. PMID:26019776

  13. Asthma and obesity

    DEFF Research Database (Denmark)

    Ulrik, Charlotte S

    2016-01-01

    PURPOSE OF REVIEW: Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. RECENT FINDINGS: Clinical studies have shown that weight...... reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness...... reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma....

  14. Precision cut lung slices : An in vitro model to study the role of Tgfβ1 and muscarinic receptors in airway remodeling

    NARCIS (Netherlands)

    Oenema, Tjitske; Maarsingh, Harm; Smit, Marieke; Groothuis, Genoveva; Meurs, Hermanus; Gosens, Reinoud

    2012-01-01

    RATIONALE: Airway remodelling in chronic asthma is characterized by thickening of the airway wall, including thickening of the smooth muscle layer. Although studies using cellular and molecular models have provided important insights into the mechanisms that underpin airway remodelling, limitations

  15. Africa South of the Sahara, Rationale and Introduction: An Experimental Program of Study for Secondary School Social Studies Students. Teaching Guide.

    Science.gov (United States)

    Carnegie-Mellon Univ., Pittsburgh, PA. Project Africa.

    The articulation of a rationale for Project Africa's instructional program, the collection of materials for improving inquiry-oriented instruction at the secondary level about Africa south of the Sahara, and the preparation of teaching and study guides have been completed. This geographic region, rather than the whole continent, was chosen to…

  16. Factor analysis in the Genetics of Asthma International Network family study identifies five major quantitative asthma phenotypes

    NARCIS (Netherlands)

    Pillai, S. G.; Tang, Y.; van den Oord, E.; Klotsman, M.; Barnes, K.; Carlsen, K.; Gerritsen, J.; Lenney, W.; Silverman, M.; Sly, P.; Sundy, J.; Tsanakas, J.; von Berg, A.; Whyte, M.; Ortega, H. G.; Anderson, W. H.; Helms, P. J.

    2008-01-01

    Background Asthma is a clinically heterogeneous disease caused by a complex interaction between genetic susceptibility and diverse environmental factors. In common with other complex diseases the lack of a standardized scheme to evaluate the phenotypic variability poses challenges in identifying the

  17. Rationale for delayed-start study of pramipexole in Parkinson's disease: the PROUD study.

    Science.gov (United States)

    Schapira, Anthony H V; Albrecht, Stefan; Barone, Paolo; Comella, Cynthia L; McDermott, Michael P; Mizuno, Yoshikuni; Poewe, Werner; Rascol, Olivier; Marek, Kenneth

    2010-08-15

    Perhaps the most important unmet need in Parkinson's disease (PD) is the ability to slow or prevent progression of the neurodegeneration that underlies the motor and nonmotor features of this disorder. Pramipexole, a dopamine agonist used for the symptomatic treatment of PD, has demonstrated neuroprotective properties in laboratory studies. The PRamipexole On Underlying Disease (PROUD) study is a randomized, double-blind clinical trial evaluating the ability of pramipexole to modify disease progression using a delayed-start design. PD patients (n = 535) with mean age 62.5 years, mean duration since diagnosis of 4.4 months, and mean total Unified Parkinson's disease Rating Scale (UPDRS) score of 24.5 were recruited. In Phase I, patients were randomly assigned to be titrated to 1.5 mg pramipexole or placebo and maintained on study drug for 6-9 months. In Phase II, all patients were titrated to 1.5 mg pramipexole and maintained on study drug until the end of the study at 15 months. No rescue medication was allowed in the protocol. The primary endpoint is the change in total UPDRS score (parts I-III) from baseline to 15 months. A range of secondary endpoints separately assess UPDRS subscales, quality of life, depression, and impulse control disorders. A sub-study examined dopamine transporter uptake scans at baseline and 15 months. The results of PROUD will provide insight into the potential for early versus delayed treatment with pramipexole to modify motor outcome at 15 months in recently diagnosed PD patients.

  18. Living with diabetes: rationale, study design and baseline characteristics for an Australian prospective cohort study

    Directory of Open Access Journals (Sweden)

    Donald Maria

    2012-01-01

    Full Text Available Abstract Background Diabetes mellitus is a major global public health threat. In Australia, as elsewhere, it is responsible for a sizeable portion of the overall burden of disease, and significant costs. The psychological and social impact of diabetes on individuals with the disease can be severe, and if not adequately addressed, can lead to the worsening of the overall disease picture. The Living With Diabetes Study aims to contribute to a holistic understanding of the psychological and social aspects of diabetes mellitus. Methods/Design The Living With Diabetes Study is a 5-year prospective cohort study, based in Queensland, Australia. The first wave of data, which was collected via a mailed self-report survey, was gathered in 2008, with annual collections thereafter. Measurements include: demographic, lifestyle, health and disease characteristics; quality of life (EQ-5D, ADDQoL; emotional well-being (CES-D, LOT-R, ESSI; disease self-management (PAM; and health-care utilisation and patient-assessed quality of care (PACIC. 29% of the 14,439 adults who were invited to participate in the study agreed to do so, yielding a sample size of 3,951 people. Discussion The data collected by the Living With Diabetes Study provides a good representation of Australians with diabetes to follow over time in order to better understand the natural course of the illness. The study has potential to further illuminate, and give a comprehensive picture of the psychosocial implications of living with diabetes. Data collection is ongoing.

  19. [Study of cellular inflammatory response with bronchoalveolar lavage in allergic asthma, aspirin asthma and in extrinsic infiltrating alveolitis].

    Science.gov (United States)

    Muiño, Juan C; Garnero, Roberto; Caillet Bois, Ricardo; Gregorio, María J; Ferrero, Mercedes; Romero-Piffiguer, Marta

    2002-01-01

    The asthmatic inflammatory responses present different type of cells involved in this process, such as: Lymphocytes and Eosinophils. In experienced hands the bronchoalveolar lavage (BAL) is a well-tolerated and valuable tool for investigation of basic mechanisms in asthma and other immunological respiratory diseases. The purpose of this work was to study the different cells involved in asthmatic inflammatory responses in allergic and aspirin sensitivity patients and compared with Extrinsic Allergic Alveolitis patients (EAA) by BAL procedure. We studied 27 asthmatic patients. This group was divided by etiological conditions in: allergic asthmatic patients (a) (n: 19), (9 male and 10 female) demonstrated by reversible fall of FEV 1 (3) 20% and 2 or more positive skin test for common aeroallergens. The aspirin asthmatic patients (b) (n: 8) (5 male and 3 female) demonstrated by progressive challenge with aspirin and fall of FEV 1 (3) 20%. The third group with compatible symptoms and signs of EAA, demonstrated by lung biopsy, (n: 9) (8 male and 1 female) (c). We determined in all patients: Total IgE serum level by ELISA test. BAL was performed by standard procedure in all patients. The cells count were performed in BAL and were separated in Eosinophils, T lymphocytes defined by monoclonal anti CD 3 antibody, Lymphocytes CD 4 and CD 8 by monoclonal anti CD 4 and CD 8 antibodies respectively. The B lymphocytes defined by surface immunoglobulin isotypes IgG, IgM, IgA and IgE. The IgE level was in (a) 630 +/- 350 kU/L, in (b) it was 85 +/- 62 kU/L and in EAA (c) 55 +/- 23 kU/L, p allergic asthmatic patients as well as in aspirin sensitivity asthmatic patients. The LBA cellular profile of E.AA patients presented eosinophilia and CE8+ Lymphocite predominance when compared with both asthmatic cellular profile.

  20. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma curriculum…

  1. Prescription of respiratory medication without an asthma diagnosis in children : a population based study

    NARCIS (Netherlands)

    Zuidgeest, Mira Gp; van Dijk, Liset; Smit, Henriette A.; van der Wouden, Johannes C.; Brunekreef, Bert; Leufkens, Hubert G. M.; Bracke, Madelon

    2008-01-01

    Background: In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma medic

  2. Prescription of respiratory medication without an asthma diagnosis in children: a population based study.

    NARCIS (Netherlands)

    Zuidgeest, M.G.P.; Dijk, L. van; Smit, H.A.; Wouden, J.C. van der; Brunekreef, B.; Leufkens, H.G.M.; Bracke, M.

    2008-01-01

    BACKGROUND: In pre-school children a diagnosis of asthma is not easily made and only a minority of wheezing children will develop persistent atopic asthma. According to the general consensus a diagnosis of asthma becomes more certain with increasing age. Therefore the congruence between asthma medic

  3. Learning from failure - rationale and design for a study about discontinuation of randomized trials (DISCO study

    Directory of Open Access Journals (Sweden)

    Kasenda Benjamin

    2012-08-01

    Full Text Available Abstract Background Randomized controlled trials (RCTs may be discontinued because of apparent harm, benefit, or futility. Other RCTs are discontinued early because of insufficient recruitment. Trial discontinuation has ethical implications, because participants consent on the premise of contributing to new medical knowledge, Research Ethics Committees (RECs spend considerable effort reviewing study protocols, and limited resources for conducting research are wasted. Currently, little is known regarding the frequency and characteristics of discontinued RCTs. Methods/Design Our aims are, first, to determine the prevalence of RCT discontinuation for specific reasons; second, to determine whether the risk of RCT discontinuation for specific reasons differs between investigator- and industry-initiated RCTs; third, to identify risk factors for RCT discontinuation due to insufficient recruitment; fourth, to determine at what stage RCTs are discontinued; and fifth, to examine the publication history of discontinued RCTs. We are currently assembling a multicenter cohort of RCTs based on protocols approved between 2000 and 2002/3 by 6 RECs in Switzerland, Germany, and Canada. We are extracting data on RCT characteristics and planned recruitment for all included protocols. Completion and publication status is determined using information from correspondence between investigators and RECs, publications identified through literature searches, or by contacting the investigators. We will use multivariable regression models to identify risk factors for trial discontinuation due to insufficient recruitment. We aim to include over 1000 RCTs of which an anticipated 150 will have been discontinued due to insufficient recruitment. Discussion Our study will provide insights into the prevalence and characteristics of RCTs that were discontinued. Effective recruitment strategies and the anticipation of problems are key issues in the planning and evaluation of trials

  4. Prevalence and association of asthma and allergic sensitization with dietary factors in schoolchildren: data from the french six cities study

    OpenAIRE

    Saadeh, Danielle; Salameh, Pascale; Caillaud, Denis; Charpin, Denis; De Blay, Frédéric; Kopferschmitt, Christine; Lavaud, François; Annesi-Maesano, Isabella; Baldi,Isabelle; Raherison, Chantal

    2015-01-01

    International audience; Background: The prevalence of asthma and allergy has recently risen among children. This increase in prevalence might be related to various factors, particularly diet. The aim of this study is to assess the prevalence and association of asthma and allergic sensitization with dietary factors in the French Six Cities Study. Methods: Cross-sectional studies were performed among 7432 schoolchildren aged 9-11 years in Bordeaux, Clermont-Ferrand, Creteil, Marseille, Reims, a...

  5. Asthma and asthma related symptoms in 23,326 Chinese children in relation to indoor and outdoor environmental factors: The Seven Northeastern Cities (SNEC) Study

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Fan, E-mail: liufan-sky@163.com [Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning Province 110001 (China); Zhao, Yang, E-mail: zhaoyang_cmu@126.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Liu, Yu-Qin, E-mail: xinxin_lyq@163.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Liu, Yang, E-mail: liuyang071506@126.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Sun, Jing, E-mail: sunjingjl_2007@126.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Huang, Mei-Meng, E-mail: gghuangmeimeng@163.com [Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning Province 110001 (China); Liu, Yi, E-mail: liuyi256@126.com [Department of Orthodontics, School of Stomatology, China Medical University, Shenyang, Liaoning Province 110001 (China); Dong, Guang-Hui, E-mail: donggh5@mail.sysu.edu.cn [Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province 510080 (China)

    2014-11-01

    Background: Both the levels and patterns of outdoor and indoor air pollutants have changed dramatically during the last decade in China. However, few studies have evaluated the effects of the present air pollution on the health of Chinese children. This study examines the association between outdoor and indoor air pollution and respiratory diseases among children living in Liaoning, a heavy industrial province of China. Methods: A cross-sectional study of 23,326 Chinese children aged 6 to 13 years was conducted in 25 districts of 7 cities in Northeast China during 2009. Three-year (2006–2008) average concentrations of particles with an aerodynamic diameter of ≤ 10 μm (PM{sub 10}), sulfur dioxide (SO{sub 2}), nitrogen dioxides (NO{sub 2}), and ozone (O{sub 3}) were calculated from monitoring stations in each of the 25 districts. We used two-level logistic regression models to examine the effects of yearly variations in exposure to each pollutant, controlling for important covariates. Results: The prevalence of respiratory symptoms was higher for those dwelling close to a busy road, those living near smokestacks or factories, those living with smokers, those living in one-story houses typically with small yards, and those with home renovation, bedroom carpet or pets. Ventilation device use was associated with decreased odds of asthma in children. The adjusted odds ratio for diagnosed-asthma was 1.34 (95% confidence interval [CI], 1.24–1.45) per 31 μg/m{sup 3} increase in PM{sub 10}, 1.23 (95%CI, 1.14–1.32) per 21 μg/m{sup 3} increase in SO{sub 2}, 1.25 (95%CI, 1.16–1.36) per 10 μg/m{sup 3} increase in NO{sub 2}, and 1.31 (95%CI, 1.21–1.41) per 23 μg/m{sup 3} increase in O{sub 3}, respectively. Conclusion: Outdoor and indoor air pollution was associated with an increased likelihood of respiratory morbidity among Chinese children. - Highlights: • We studied air pollution and respiratory health in 23,326 Chinese children. • Home renovation, carpet

  6. The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control

    Directory of Open Access Journals (Sweden)

    Malin Axelsson

    2015-01-01

    Full Text Available Objective. The aim was to investigate adherence to asthma medication treatment, medication beliefs, and asthma control in relation to asthma follow-up consultations in asthmatics in the general population. A further aim was to describe associations between adherence, medication beliefs, and asthma control. Method. In the population-based West Sweden Asthma Study, data allowing calculation of adherence for 4.5 years based on pharmacy records were obtained from 165 adult asthmatics. Additional data were collected through questionnaires and structured interviews. Results. The mean adherence value for filled prescriptions for regular asthma medication was 68% (median 55.3% but varied over the year under study. Adherence to combination inhalers with corticosteroids and long-acting beta2 agonists was higher than adherence to single inhalers with corticosteroids only. More than one-third of participants reported not having seen an asthma nurse or physician for several years. Regular asthma follow-up consultations were associated with both higher adherence and the belief that asthma medication was necessary but were not associated with asthma control. Conclusions. Adherence to asthma medication treatment was low and varied over the year under study. The current study suggests that quality improvements in asthma care are needed if adherence to asthma medication is to be improved.

  7. Concurrent physician-diagnosed asthma and chronic obstructive pulmonary disease: A population study of prevalence, incidence and mortality

    Science.gov (United States)

    Sadatsafavi, Mohsen; Aaron, Shawn D.; To, Teresa M.; Lougheed, M. Diane; FitzGerald, J. Mark; Gershon, Andrea S.

    2017-01-01

    Objective We conducted a population-based cohort study to estimate trends in prevalence, incidence, and mortality of concurrent physician-diagnosed asthma and chronic obstructive pulmonary disease (COPD). Study design and setting Two validated health administrative case definitions were used to identify asthma and COPD among all individuals aged 35 years and older living in Ontario, Canada. Annual asthma, COPD, and concurrent asthma and COPD prevalence, incidence, and mortality, standardized for age and sex, were estimated, and compared from 2002 to 2012, using generalized linear models. Results Standardized prevalence of concurrent asthma and COPD increased by 10.5%, from 2.9% in 2002 to 3.2% in 2012 overall, but more prominently in women compared to men. Overall, standardized incidence decreased by16%, from 2.5 to 2.1 per 1000 individuals, but increased significantly in young adults. All-cause mortality among patients with concurrent asthma and COPD decreased by 11.2%, from 2.6% to 2.2%. Being diagnosed with both diseases was significantly associated with higher all-cause mortality compared to asthma (OR = 1.56, 95% CI: 1.50–1.58), but not compared to COPD (OR = 0.97, 0.96–0.98), except in young adults aged 35 to 49 years where people with asthma and COPD had higher mortality (OR = 1.21, 1.15–1.27). Conclusions In a large North American population, the burden of concurrent physician-diagnosed asthma and COPD is increasing, particularly in women and young adults. PMID:28301574

  8. Body mass index, asthma and allergic rhinoconjunctivitis in Swedish conscripts-a national cohort study over three decades.

    Science.gov (United States)

    Bråbäck, Lennart; Hjern, Anders; Rasmussen, Finn

    2005-08-01

    Obesity and overweight have been associated with an increased risk of asthma in children as well as adults. The association between atopy and body mass index (BMI) is less clear. It has also been suggested that the link between a high BMI and asthma could be a recent phenomenon. The objective of this study was to assess whether the association with BMI differed between allergic rhinoconjunctivitis and asthma and if these associations have changed over time. The Swedish Military Service Conscription Register was linked to the Register of the Total Population and the Population and Housing Censuses. Asthma (with and without allergic rhinoconjunctivitis) and allergic rhinoconjunctivitis at conscription were analysed in relation to BMI for 1,247,038 male conscripts in successive cohorts born between 1952 and 1977. Obesity was associated with asthma without allergic rhinoconjunctivitis, adjusted OR 1.53 (95% CI 1.43-1.63), and with asthma with allergic rhinoconjunctivitis, adjusted OR 1.34 (95% CI 1.20-1.50), but not with allergic rhinoconjunctivitis, OR 1.00 (95% CI 0.97-1.03) after multivariate analyses with adjustments for confounders. The odds ratios were similar in three successive cohorts (conscripts born in 1952-1961, 1962-1971 and 1972-1977). Underweight was associated with a slightly increased risk for all three conditions. The increased risk of asthma in young Swedish men with obesity has remained unchanged over a period of three decades.

  9. Prevalence of asthma and allergic diseases in adolescents: nine-year follow-up study (2003-2012

    Directory of Open Access Journals (Sweden)

    Dirceu Solé

    2015-02-01

    Full Text Available OBJECTIVE: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema in adolescents (AD; 13-14 years living in seven Brazilian cities, by applying the standardized written questionnaire (WQ of the International Study of Asthma and Allergies in Childhood (ISAAC, and to evaluate the time trend nine years after the last assessment of ISAAC phase 3 (ISP3. METHODS: The ISAAC-WQ was answered by 20,099 AD from the Northern, Northeastern, Southeastern, and Southern Brazilian regions. Values obtained were compared to those observed in ISP3 using nonparametric (chi-squared or Fisher tests, and the ratio of annual increment/decrement was established for each of the centers, according to the symptom assessed. RESULTS: Considering the national data and comparing to values of ISP3, there was a decrease in the mean prevalence of active asthma (18.5% vs. 17.5% and an increase in the frequency of severe asthma (4.5% vs. 4.7% and physician-diagnosed asthma (14.3% vs. 17.6%. An increase in prevalence of rhinitis, rhinoconjunctivitis, and atopic eczema was also observed. CONCLUSIONS: The prevalence of asthma, rhinitis, and atopic eczema in Brazil was variable; higher prevalence values, especially of asthma and eczema, were observed in regions located closer to the Equator.

  10. Decision-making program for rural adolescents with asthma: a pilot study.

    Science.gov (United States)

    Rhee, Hyekyun; Hollen, Patricia J; Belyea, Michael J; Sutherland, Melissa A

    2008-12-01

    Although a high prevalence of substance use and its adverse effects on the course of the disease have been reported in adolescents with asthma, no studies have attempted to ameliorate the risk through adequate interventions. This pilot study evaluates and supports the feasibility and the effectiveness of a decision-making program in improving decision-making quality and reducing risk motivation over a 6-month study period. Differential effectiveness of the intervention was observed by race and gender. Although the improvement of decision-making quality was observed only in Whites, changes in risk motivation were detected only in non-Whites and girls. No significant reduction in actual substance use behavior was found. The intervention was favorably received by participants. An approach enhancing decision-making quality can be effective in addressing the risk of substance use in adolescent with asthma by altering motivations.

  11. Correlation study on the daily exercise and asthma control in adult patients with asthma%成年哮喘患者日常运动和哮喘控制的相关性研究

    Institute of Scientific and Technical Information of China (English)

    朱巧巧

    2016-01-01

    目的:研究成年哮喘患者日常活动和哮喘控制的关联。方法:收治哮喘患者214例,患者完成哮喘控制问卷(ACG)、哮喘生活质量问卷(AQLQ)和空闲时间体力活动(LTPA)。结果:LTPA与哮喘控制存在关联(β=0.013),适度LTPA的哮喘患者哮喘控制明显优于非活动患者。与夏季LTPA(β=0.019)相比,冬季LTPA(β=0.027)与ACQ评分联系更密切。LTPA和哮喘控制无相关性。结论:较高强度LTPA与成年哮喘患者更好的哮喘控制相关。%Objective:To study the correlation of daily exercise and asthma control in adult patients with asthma.Methods:214 patients with asthma were selected.The patients completed the asthma control questionnaire(ACG) and the asthma quality of life questionnaire(AQLQ) and leisure time physical activity(LTPA).Results:LTPA and asthma control had correlation(β=0.013).The asthma control of asthma patients with moderate LTPA was significantly better than that of non active patients.Compared with the summer LTPA( β =0.019),the relation between winter LTPA( β =0.027) and the ACQ score was more close.There was no correlation between LTPA and asthma control.Conclusion:Higher intensity of LTPA is associated with better asthma control in adult patients with asthma.

  12. A Case-Control Study of the Role of Cold Symptoms and other Historical Triggering Factors in Asthma Exacerbations

    Directory of Open Access Journals (Sweden)

    Susan M Tarlo

    2000-01-01

    Full Text Available BACKGROUND: Asthma exacerbations can be provoked by many triggers such as allergens, respiratory irritants and viral infections. The relative importance of these has not been prospectively documented in a case-control study.

  13. AB012. Current burden of uncontrolled asthma in the general population: the OPCRD asthma state of the Union study

    Science.gov (United States)

    Nibber, Anjan; Thomas, Mike; Thomas, Vicky; van Aalderen, Wim; Bleecker, Eugene; Campbell, Jonathan; Roche, Nicolas; Haughney, John; Van Ganse, Eric; Park, Hye-Yun; Rhee, Chin Kook; Skinner, Derek; Chisholm, Alison; van Boven, Job FM; Soriano, Joan B.; Price, David

    2016-01-01

    Background Questionnaire-based surveys report that uncontrolled asthma is common in Europe, and associated with high healthcare costs. The relationship between treatment step control are less well described. To quantify the asthma burden within routine primary care in the UK, specifically the distribution of asthma control across guideline-recommended management steps and the association between patients’ control and smoking status. Methods Patients were retrospectively identified using the Optimum Patient Care Research Database and prospectively followed-up for at least 1-year. Patients’ routine clinical data and self reports were used to assess GINA control status; clinical records were used to categorise current treatment by GINA management steps and patients’ smoking status. Results A total of 105,018 eligible asthma patients were identified, mean (SD) age 45 (23) years; 55% female; 15% current and 24% ex-smokers. Only 20% of patients were controlled, 59% were partially controlled and 21% were uncontrolled. Control was only weakly correlated to GINA management steps (Spearman’s rho=0.15, P<0.001), 27.5%, 21.5%, 20.3%, 15.1% and 12.1% achieving control across Step 1 to 5, respectively. Similarly, the proportion with uncontrolled asthma rose across higher GINA steps (12.6%, 18.2%, 19.6%, 29.2% and 36.6%). About 13% of patients experienced at least one exacerbation in the 1-year follow-up period. Frequent exacerbations (2 or more per year) were very uncommon at lower treatment steps (step 1 11.6%, step 2 12.8%) but were significantly more common at steps 3 and 4 at 18.8% and 28.2% respectively (P<0.001 for trend with ascending treatment step). Conclusions In this cohort of UK primary care asthma patients, the majority failed to achieve GINA defined control. GINA management step was only weakly correlated with control status, but higher step management was associated with a greater risk of exacerbation.

  14. Linking obesity and asthma.

    Science.gov (United States)

    Sutherland, E Rand

    2014-04-01

    A growing body of literature suggests that obesity has a significant impact on asthma risk, phenotype, and prognosis. Epidemiological studies have clearly demonstrated that asthma is more likely to occur in obese patients, and health status is impaired in obese individuals with asthma, with obese asthmatics experiencing more symptoms, worse quality of life, increased healthcare use, and increased asthma severity. However, obesity has well-described effects on lung function and mechanics that can lead to symptoms of dyspnea without causing the pathophysiologic changes of asthma. Adding to the challenges of evaluating this association, some studies have failed to demonstrate a robust relationship between obesity and traditional biomarkers of airway inflammation in adult asthmatics, leading to the conclusion that obesity does not necessarily worsen airway inflammation in asthma. In this regard, emerging data suggest that nonatopic mechanisms may be relevant in obese asthmatics, and that these mechanisms may have a direct impact on the response of obese asthmatics to asthma therapies, most notably inhaled glucocorticoids. This article will review selected aspects of the contributions of obesity-related airway and systemic inflammation to asthma, with a focus on the impact of obesity as a modifier of risk, prognosis, and therapeutic response in asthma.

  15. Pharmacogenomics of pediatric asthma

    Directory of Open Access Journals (Sweden)

    Gupta Sarika

    2010-01-01

    Full Text Available Context: Asthma is a complex disease with multiple genetic and environmental factors contributing to it. A component of this complexity is a highly variable response to pharmacological therapy. Pharmacogenomics is the study of the role of genetic determinants in the variable response to therapy. A number of examples of possible pharmacogenomic approaches that may prove of value in the management of asthma are discussed below. Evidence Acquisition: A search of PubMed, Google scholar, E-Medicine, BMJ and Mbase was done using the key words "pharmacogenomics of asthma", "pharmacogenomics of β-agonist, glucocorticoids, leukotriene modifiers, theophylline, muscarinic antagonists in asthma". Results: Presently, there are limited examples of gene polymorphism that can influence response to asthma therapy. Polymorphisms that alter response to asthma therapy include Arg16Gly, Gln27Glu, Thr164Ile for β-agonist receptor, polymorphism of glucocorticoid receptor gene, CRHR1 variants and polymorphism of LTC4S, ALOX5. Polymorphic variants of muscarinic receptors, PDE4 and CYP450 gene variants. Conclusion: It was concluded that genetic variation can improve the response to asthma therapy. However, no gene polymorphism has been associated with consistent results in different populations. Therefore, asthma pharmacogenomic studies in different populations with a large number of subjects are required to make possible tailoring the asthma therapy according to the genetic characteristic of individual patient.

  16. Genetic, familial and environmental correlates of asthma among early adolescents in Sri Lanka: a case control study

    OpenAIRE

    2015-01-01

    Background Despite advances in management, the mortality and morbidity due to asthma are increasing globally. Identification of specific correlates in the local context is useful in disease management. The objective of this study was to estimate the prevalence and to describe selected correlates of asthma among12-14 year old school children in a district in Sri Lanka. Method A school based cross-sectional study was conducted using a self administered questionnaire. Multi-staged stratified clu...

  17. Study of nasal exhaled nitric oxide levels in diagnosis of allergic rhinitis in subjects with and without asthma

    Science.gov (United States)

    Duong-Quy, Sy; Vu-Minh, Thuc; Hua-Huy, Thong; Tang-Thi-Thao, Tram; Le-Quang, Khiet; Tran-Thanh, Dinh; Doan-Thi-Quynh, Nhu; Le-Dong, Nhat-Nam; Craig, Timothy J; Dinh-Xuan, Anh-Tuan

    2017-01-01

    Background The measure of fractional exhaled nitric oxide (FENO) in the airways is a useful tool to guide the diagnosis and titration of inhaled corticosteroids in patients with asthma. However, its role in diagnosis of allergic rhinitis (AR), especially in subjects with asthma, is not well established. Objective To study the cutoff of nasal FENO in the diagnosis of subjects with AR and AR-asthma compared to age-matched subjects without AR or asthma and its correlations with the clinical and functional characteristics. Methods The study was cross sectional and descriptive. Subjects were grouped into control subjects, AR, and AR-asthma, based on the inclusion criteria. Exhaled NO (nasal FENO, bronchial FENO, and alveolar concentration of NO) was measured by multiple flow electro-luminescence device. Results Six hundred twenty-eight subjects were included: 217 control subjects (children: n=98, 10±4 years; adults: n=119, 50±16 years), 168 subjects with AR (children: n=54, 10±3 years; adults: n=114, 49±15 years), and 243 subjects with AR-asthma (children: n=115, 10±3 years; adults: n=128, 51±14 years). Nasal peak inspiratory flow and peak expiratory flow were lower in subjects with AR and AR-asthma than in control subjects (P<0.01 and P<0.01; and P<0.05 and P<0.01, respectively). Nasal FENO levels were significantly higher in subjects with AR and AR-asthma than in control subjects (1614±629 and 1686±614 ppb vs 582±161 ppb; P<0.001 and P<0.001, respectively). In subjects with AR non-asthma, the cutoffs of nasal FENO for those diagnosed with AR were 775 ppb in children, 799 ppb in adults, and 799 in the general population (sensitivity: 92.68%, 92.63%, and 92.65%, respectively; specificity: 91.67%, 95.00%, and 96.87%, respectively). In subjects with AR-asthma, the cutoffs of nasal FENO were higher, especially in asthma children (1458 ppb; sensitivity: 72.97% and specificity: 95.83%). Conclusion Nasal FENO measurement is a useful technique for the diagnosis of AR

  18. Mining and Visualizing Family History Associations in the Electronic Health Record: A Case Study for Pediatric Asthma.

    Science.gov (United States)

    Chen, Elizabeth S; Melton, Genevieve B; Wasserman, Richard C; Rosenau, Paul T; Howard, Diantha B; Sarkar, Indra Neil

    2015-01-01

    Asthma is the most common chronic childhood disease and has seen increasing prevalence worldwide. While there is existing evidence of familial and other risk factors for pediatric asthma, there is a need for further studies to explore and understand interactions among these risk factors. The goal of this study was to develop an approach for mining, visualizing, and evaluating association rules representing pairwise interactions among potential familial risk factors based on information documented as part of a patient's family history in the electronic health record. As a case study, 10,260 structured family history entries for a cohort of 1,531 pediatric asthma patients were extracted and analyzed to generate family history associations at different levels of granularity. The preliminary results highlight the potential of this approach for validating known knowledge and suggesting opportunities for further investigation that may contribute to improving prediction of asthma risk in children.

  19. Conventional epidemiology underestimates the incidence of asthma and wheeze-a longitudinal population-based study among teenagers

    Directory of Open Access Journals (Sweden)

    Hedman Linnéa

    2012-01-01

    Full Text Available Abstract Background Because of shifts in the gender ratio and incidence and remission rates of asthma during the teen ages, the methodology of incidence studies among teenagers is important, i.e. if the time intervals between surveys are too long, the incident cases might not be properly identified. The aim was to study the impact of study design on the incidence rates of asthma and wheeze during the teen ages. Methods In a study about asthma and allergic diseases within the OLIN studies (Obstructive Lung Disease in northern Sweden, a cohort of school children (n = 3,430 was followed annually by questionnaire from age 8 yrs. In the endpoint survey (age 18 yrs 2,582 (75% of original responders participated. Incident cases from age 12-18 yrs were identified by two methods: annual questionnaire reports (AR and baseline-endpoint surveys only (BE. Results The cumulative incidence of asthma and wheeze was significantly higher based on AR compared to BE. Compared to the incidence rates based on all the annual surveys, the calculated average annual rates based on BE were in general lower both among the boys and among the girls. There were no differences between boys and girls in incidence rates of asthma or wheeze during the early teen years. However, from the age of 15 years, the annual incidence rates were significantly or borderline significantly higher among girls than boys. At onset, the additional cases of current asthma identified by AR had significantly less severe asthma than those identified in BE (p Conclusion the size of the incidence of asthma and wheeze during the teen ages was influenced by study design. By using the conventional prospective study design with longer follow-up time, the incidence was underestimated.

  20. Asthma, sports, and death.

    Science.gov (United States)

    DiDario, A Geoffrey; Becker, Jack M

    2005-01-01

    The impact of asthma on the general population has been described in detail in medical literature. However, asthma also has a significant impact on the pediatric and adult athlete. This is rarely reported in either the lay press or the medical literature. In 2003, Becker and coworkers conducted a retrospective analysis of the incidence of asthma as a direct cause of death in competitive athletes across the United States between 1993 and 2000. They sought to raise awareness that severe asthma exacerbations and even death can occur during sports from asthma in athletes, while still supporting the concept of maximal participation in sporting activities. To their knowledge, this remains the only published study looking specifically at this issue. Fortunately, fatal asthma events are infrequent in either the adult or the pediatric populations. Those rare cases involving athletes are commonly highlighted in the lay press when they do occur, e.g., when the victim is a college football player such as Rashidi Wheeler. Wheeler died of a fatal asthma exacerbation on August 3, 2002, during a conditioning drill as a member of the Northwestern University football team. Although he was known to have chronic asthma with no obvious barriers to health care, he nevertheless succumbed to his condition. Here, we report a similar, although less well-known, case of an adolescent who died as a direct result of an asthma exacerbation during a high school physical education class. We also offer a brief review of the literature regarding morbidity and mortality in athletes.

  1. A telehealth integrated asthma-COPD service for primary care: a proposal for a pilot feasibility study in Crete, Greece

    Directory of Open Access Journals (Sweden)

    Tzanakis Nikolaos E

    2010-07-01

    Full Text Available Abstract Background Chronic obstructive pulmonary disease (COPD and asthma are considered underdiagnosed and misdiagnosed chronic diseases. In The Netherlands, a COPD-asthma telemedicine service has been developed to increase GPs' ability to diagnose and manage COPD and asthma. A telemedicine COPD-asthma service may benefit Greece as it is a country, partly due to its geography, that does not have easy access to pulmonologists. Findings Therefore, a pilot feasibility study has been designed in Greece in order to establish this telemedicine service. Ten rural practices, in the island of Crete, with an average population of 2000 patients per practice will pilot the project supported by three pulmonologists. This paper presents the translated interfaces, the flowcharts and the steps that are considered as necessary for this feasibility study in Crete, Greece.

  2. Residential traffic exposure and children's emergency department presentation for asthma: a spatial study

    Directory of Open Access Journals (Sweden)

    Pereira Gavin

    2009-11-01

    Full Text Available Abstract Background There is increasing evidence that residential proximity to roadways is associated with an elevated risk of asthma exacerbation. However, there is no consensus on the distance at which these health effects diminishes to background levels. Therefore the optimal, clinically relevant measure of exposure remains uncertain. Using four spatially defined exposure metrics, we evaluated the association between residential proximity to roadways and emergency department (ED presentation for asthma in Perth, Western Australia. Method The study population consisted of 1809 children aged between 0 and 19 years who had presented at an ED between 2002 and 2006 and were resident in a south-west metropolitan area of Perth traversed by major motorways. We used a 1:2 matched case-control study with gastroenteritis and upper limb injury as the control conditions. To estimate exposure to traffic emissions, we used 4 contrasting methods and 2 independently derived sources of traffic data (video-monitored traffic counts and those obtained from the state government road authority. The following estimates of traffic exposure were compared: (1 a point pattern method, (2 a distance-weighted traffic exposure method, (3 a simple distance method and (4 a road length method. Results Risk estimates were sensitive to socio-economic gradients and the type of exposure method that was applied. Unexpectedly, a range of apparent protective effects were observed for some exposure metrics. The kernel density measure demonstrated more than a 2-fold (OR 2.51, 95% CI 2.00 - 3.15 increased risk of asthma ED presentation for the high exposure group compared to the low exposure group. Conclusion We assessed exposure using traffic data from 2 independent sources and compared the results of 4 different exposure metric types. The results indicate that traffic congestion may be one of the most important aspects of traffic-related exposures, despite being overlooked in many

  3. The New Zealand Asthma and Allergy Cohort Study (NZA2CS: Assembly, Demographics and Investigations

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    Epton Michael J

    2007-02-01

    Full Text Available Abstract Background Asthma and allergy are highly prevalent in industrialised countries. Longitudinal and cross-sectional studies have identified a number of potential risk factors for these conditions, including genetic and environmental factors, with significant gene-environment relationships. Birth cohort studies have been proposed as an important tool to explore these risk factors, particularly exposures in early life that are associated with later disease or protection from disease. This paper describes the establishment of a birth cohort in New Zealand. Methods A birth cohort was established in 1996 in Christchurch and Wellington and infants recruited between 1997–2001. Expectant mothers were recruited by midwives. Children and mothers have undergone assessment by serial questionnaires, environmental assessment including mould and allergen exposure, skin-prick testing, and at age six years are undergoing full assessment for the presence of asthma, atopy and allergic disease, including genetic assessment. Results A total of 1105 children have been recruited, and the retention rate at fifteen months was 91.4%. 15.2% of the children at recruitment have been identified as Maori. A positive family history of asthma, eczema or hay fever has been reported in 84% of children. All children have now been assessed at fifteen months and 685 children from the cohort have reached age six years and have completed the six year assessment. Conclusion The cohort is fully assembled, and assessment of children is well advanced, with good retention rates. The study is well placed to address many current hypotheses about the risk factors for allergic disease and asthma.

  4. Snow crab allergy and asthma among Greenlandic workers – a pilot study

    Directory of Open Access Journals (Sweden)

    Jakob Hjort Bønløkke

    2012-08-01

    Full Text Available Objectives. To study snow crab sensitization, occupational allergy and asthma in the snow crab industry in Greenland, as high rates have been found in Canada, but no reports have emerged from the same industry in Greenland. Study design. Pilot survey. Methods. Twenty workers (19 of Inuit and 1 of other origin in a snow crab (Chionoecetes opilio and Atlantic shrimp (Pandalus borealis processing plant in Greenland were assessed with skin prick tests (SPTs with common aeroallergens and specific allergens from snow crab and shrimp extracts, spirometry, blood sampling for total IgE and specific IgE determination. Eighteen workers contributed a questionnaire-based medical interview. Results. Positive skin prick test reactions were common to snow crab (40% and shrimp (20%. Specific IgE to snow crab were positive in 4 workers (21%. Two workers had elevated total IgE levels. Symptoms suggestive of asthma were common (45%. Work-related symptoms of skin rash, rhinitis, and/or conjunctivitis were reported by 50%, and symptoms from the lower airways by 39%. Combining history of work-related symptoms with results from specific SPTs and/or specific IgE determination suggested that 11 and 22% of workers suffered from probable and possible occupational asthma, respectively, whereas 22% had possible occupational dermatitis or rhinitis. Conclusions. Greenlander Inuit do not appear to be protected against sensitization to snow crab or shrimp when occupationally exposed to these. This pilot study suggests that occupational allergy and asthma may be as common a problem in Greenlandic workers as in Canadian.

  5. ACADEMIC PERFORMANCE IN CHILDREN WITH NEW-ONSET SEIZURES AND ASTHMA: A PROSPECTIVE STUDY

    Science.gov (United States)

    Dunn, David W.; Johnson, Cynthia S.; Austin, Joan K.; Perkins, Susan M.

    2007-01-01

    The study purpose was to compare teacher ratings of academic performance (TRP) over 24 months between children with new-onset seizures (N = 121) and new-onset asthma (N = 54) ages 4 to 14 years. At each data collection point (baseline, 12 months, 24 months), children with seizures were placed into two groups according to their recurrent seizure status (yes/no) during that period. Longitudinal linear mixed models were used to explore differences between the asthma group and the two seizure groups and to identify if differences in TRP in children with seizures were associated with age, gender, or use of medication. In the seizure sample, scores for children in both groups (with and without recurrent seizures) initially declined at 12 months; however, at 24 months, children who did not have recurrent seizures improved while children who continued to have recurrent seizures declined. There was a trend for younger children to decline more than older children. PMID:17293164

  6. The effects on depression of Internet-administered behavioural activation and physical exercise with treatment rationale and relapse prevention: study protocol for a randomised controlled trial

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    Carlbring Per

    2013-02-01

    Full Text Available Abstract Background Despite their potential as low-threshold, low-cost and high-flexibility treatments of depression, behavioural activation and physical exercise have not yet been directly compared. This study will examine the effects of these interventions, administered via the Internet. The added effect of providing a treatment rationale will also be studied, as well as a relapse prevention program featuring cognitive behavioural therapy components. Methods/Design This randomised controlled trial will include 500 participants meeting the diagnostic criteria for major depression, recruited in multiple cycles and randomised to either a waiting list control group with delayed treatment, or one of the four treatment groups: (1 physical exercise without a clear treatment rationale; (2 physical exercise with treatment rationale; (3 behavioural activation with treatment rationale; or (4 behavioural activation without a clear treatment rationale. Post treatment, half of the participants will be offered a relapse prevention program. Primary outcome measure will be the Patient Health Questionnaire 9-item. Secondary measures include diagnostic criteria for depression, as well as self-reported anxiety, physical activity and quality of life. Measurements - done via telephone and the Internet - will be collected pre-treatment, weekly during treatment period, immediately post treatment and then monthly during a 24-month follow-up period. Discussion The results of this study will constitute an important contribution to the body of knowledge of the respective interventions. Limitations are discussed. Trial registration ClinicalTrials.gov: NCT01619930

  7. Diseases Concomitant With Asthma in Middle-Aged and Elderly Subjects in Korea: A Population-Based Study

    OpenAIRE

    2012-01-01

    Purpose Asthma is prevalent in many countries. Few studies have investigated the association between asthma and concomitant diseases. We retrospectively analyzed the fourth Korean National Health and Nutrition Survey database, performed in 2008 using nationwide stratified random sampling to obtain a representative cohort of the Korean population. Methods We evaluated the association between both self-reported ever-asthmatics and wheezers and concomitant diseases such as arthritis, hypertensio...

  8. Early eczema and the risk of childhood asthma: a prospective, population-based study

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    Saunes Marit

    2012-10-01

    Full Text Available Abstract Background Severe eczema in young children is associated with an increased risk of developing asthma and rhino-conjunctivitis. In the general population, however, most cases of eczema are mild to moderate. In an unselected cohort, we studied the risk of current asthma and the co-existence of allergy-related diseases at 6 years of age among children with and without eczema at 2 years of age. Methods Questionnaires assessing various environmental exposures and health variables were administered at 2 years of age. An identical health questionnaire was completed at 6 years of age. The clinical investigation of a random subsample ascertained eczema diagnoses, and missing data were handled by multiple imputation analyses. Results The estimate for the association between eczema at 2 years and current asthma at 6 years was OR=1.80 (95% CI 1.10-2.96. Four of ten children with eczema at 6 years had the onset of eczema after the age of 2 years, but the co-existence of different allergy-related diseases at 6 years was higher among those with the onset of eczema before 2 years of age. Conclusions Although most cases of eczema in the general population were mild to moderate, early eczema was associated with an increased risk of developing childhood asthma. These findings support the hypothesis of an atopic march in the general population. Trial registration The Prevention of Allergy among Children in Trondheim study has been identified as ISRCTN28090297 in the international Current Controlled Trials database

  9. Role of Obesity in Asthma Control, the Obesity-Asthma Phenotype

    OpenAIRE

    2013-01-01

    Asthma is a disease with distinct phenotypes that have implications for both prognosis and therapy. Epidemiologic studies have demonstrated an association between asthma and obesity. Further studies have shown that obese asthmatics have poor asthma control and more severe asthma. This obese-asthma group may represent a unique phenotype. The mechanisms behind poor asthma control in obese subjects remain unclear, but recent research has focused on adipokines and their effects on the airways as ...

  10. Maternal depressive symptoms across early childhood and asthma in school children: findings from a Longitudinal Australian Population Based Study.

    Directory of Open Access Journals (Sweden)

    Rebecca Giallo

    Full Text Available There is a growing body of evidence attesting to links between early life exposure to stress and childhood asthma. However, available evidence is largely based on small, genetically high risk samples. The aim of this study was to explore the associations between the course of maternal depressive symptoms across early childhood and childhood asthma in a nationally representative longitudinal cohort study of Australian children. Participants were 4164 children and their biological mothers from the Longitudinal Study of Australian Children. Latent class analysis identified three trajectories of maternal depressive symptoms across four biennial waves from the first postnatal year to when children were 6-7 years: minimal symptoms (74.6%, sub-clinical symptoms (20.8%, and persistent and increasing high symptoms (4.6%. Logistic regression analyses revealed that childhood asthma at age 6-7 years was associated with persistent and increasing high depressive symptoms after accounting for known risk factors including smoking during pregnancy and maternal history of asthma (adjusted OR 2.36, 95% CI 1.61-3.45, p.001. Our findings from a nationally representative sample of Australian children provide empirical support for a relationship between maternal depressive symptoms across the early childhood period and childhood asthma. The burden of disease from childhood asthma may be reduced by strengthening efforts to promote maternal mental health in the early years of parenting.

  11. Maternal depressive symptoms across early childhood and asthma in school children: findings from a Longitudinal Australian Population Based Study.

    Science.gov (United States)

    Giallo, Rebecca; Bahreinian, Salma; Brown, Stephanie; Cooklin, Amanda; Kingston, Dawn; Kozyrskyj, Anita

    2015-01-01

    There is a growing body of evidence attesting to links between early life exposure to stress and childhood asthma. However, available evidence is largely based on small, genetically high risk samples. The aim of this study was to explore the associations between the course of maternal depressive symptoms across early childhood and childhood asthma in a nationally representative longitudinal cohort study of Australian children. Participants were 4164 children and their biological mothers from the Longitudinal Study of Australian Children. Latent class analysis identified three trajectories of maternal depressive symptoms across four biennial waves from the first postnatal year to when children were 6-7 years: minimal symptoms (74.6%), sub-clinical symptoms (20.8%), and persistent and increasing high symptoms (4.6%). Logistic regression analyses revealed that childhood asthma at age 6-7 years was associated with persistent and increasing high depressive symptoms after accounting for known risk factors including smoking during pregnancy and maternal history of asthma (adjusted OR 2.36, 95% CI 1.61-3.45), p.001). Our findings from a nationally representative sample of Australian children provide empirical support for a relationship between maternal depressive symptoms across the early childhood period and childhood asthma. The burden of disease from childhood asthma may be reduced by strengthening efforts to promote maternal mental health in the early years of parenting.

  12. Outdoor particulate matter and childhood asthma admissions in Athens, Greece: a time-series study

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    Roma Eleftheria S

    2010-07-01

    Full Text Available Abstract Background Particulate matter with diameter less than 10 micrometers (PM10 that originates from anthropogenic activities and natural sources may settle in the bronchi and cause adverse effects possibly via oxidative stress in susceptible individuals, such as asthmatic children. This study aimed to investigate the effect of outdoor PM10 concentrations on childhood asthma admissions (CAA in Athens, Greece. Methods Daily counts of CAA from the three Children's Hospitals within the greater Athens' area were obtained from the hospital records during a four-year period (2001-2004, n = 3602 children. Mean daily PM10 concentrations recorded by the air pollution-monitoring network of the greater Athens area were also collected. The relationship between CAA and PM10 concentrations was investigated using the Generalized Linear Models with Poisson distribution and logistic analysis. Results There was a statistically significant (95% CL relationship between CAA and mean daily PM10 concentrations on the day of exposure (+3.8% for 10 μg/m3 increase in PM10 concentrations, while a 1-day lag (+3.4% for 10 μg/m3 increase in PM10 concentrations and a 4-day lag (+4.3% for 10 μg/m3 increase in PM10 concentrations were observed for older asthmatic children (5-14 year-old. High mean daily PM10 concentration (the highest 10%; >65.69 μg/m3 doubled the risk of asthma exacerbations even in younger asthmatic children (0-4 year-old. Conclusions Our results provide evidence of the adverse effect of PM10 on the rates of paediatric asthma exacerbations and hospital admissions. A four-day lag effect between PM10 peak exposure and asthma admissions was also observed in the older age group.

  13. Rhinitis: a complication to asthma

    DEFF Research Database (Denmark)

    Hansen, J W; Thomsen, S F; Nolte, H;

    2010-01-01

    Asthma and rhinitis often co-occur, and this potentially increases the disease severity and impacts negatively on the quality of life. We studied disease severity, airway responsiveness, atopy, quality of life and treatment in subjects with both asthma and rhinitis compared to patients with asthma...

  14. Factors associated with health-related quality of life in adults with asthma. A cross-sectional study

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    Gonzalez-Barcala Francisco-Javier

    2012-10-01

    Full Text Available Abstract Background The measurement of health-related quality of life (HRQoL is increasingly recognized as an important endpoint, as a reflection of the effects of the disease from a patient perspective. Our aim was to evaluate the factors determining the HRQoL in patients with asthma, according to the EQ-5D questionnaire. Methods Patients were included using multi-stage sampling, from Primary Care clinics from all the Autonomous Communities in Spain. The patients included were: over 18 years-old, with a confirmed diagnosis of asthma for at least one year, and had visited a Health Centre in the previous 2 years. The characteristics of the asthma disease, the adherence to treatment, the socio-demographic variables, the smoking habits, and the asthma control were collected using a questionnaire. The influence of the different variables included in the study on the EQ-5D was evaluated using multivariate logistic regression analysis. Results A total of 2,125 patients were finally included (57.7% females, mean age 48 years. The response rate was 95.4%. Some factors showed a considerable detrimental effect on the HRQoL of asthmatics. Advanced age, lower educational level and poor control of asthma are significantly associated with a worse quality of life in all the dimensions assessed by the EQ-5D scale. The baseline severity of the asthma, and having been admitted to hospital are related to a worse quality of life in 5 of the 6 dimensions analyzed. Conclusion In our study, we could identify some factors related to quality of life in asthma patients. The most important were advanced age, lower education level, and poor control of the asthma.

  15. Trends in asthma-related direct medical costs from 2002 to 2007 in British Columbia, Canada: a population based-cohort study.

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    Pierrick Bedouch

    Full Text Available BACKGROUND: Asthma-related health resource use and costs may be influenced by increasing asthma prevalence, changes to asthma management guidelines, and new medications over the last decade. The objective of this work was to analyze direct asthma-related medical costs, and trends in total and per-patient costs of hospitalizations, physician visits, and medications. METHODS: A cohort of asthma patients from British Columbia (BC, Canada, was created. Asthma patients were identified using a validated case definition. Costs for hospitalizations, physician visits, and medications were calculated from billing records (in 2008 Canadian dollars. Trends in total and per-patient costs over the study period were analyzed using Generalized Linear Models. RESULTS: 398,235 patients satisfied the asthma case definition (mid-point prevalence 8.0%. Patients consumed $315.9 million (M in direct asthma-related health resources between 2002 and 2007. Hospitalizations, physician visits, and medication costs accounted for 16.0%, 15.7% and 68.2% of total costs, respectively. Cost of asthma increased from $49.4 M in 2002 to $54.7 M in 2007. Total annual costs attributable to hospitalizations and physician visits decreased (-39.8% and -25.5%, respectively; p<0.001, while medication costs increased (+38.7%; p<0.001. INTERPRETATION: This population-based analysis shows that the total direct cost of asthma in BC has increased since 2002, mainly due to a rise in asthma prevalence and cost of medication. Combination therapy with inhaled corticosteroids/long-acting beta-agonists has become a significant component of the cost of asthma. Although billing records capture only a fraction of the true burden of asthma, the simultaneous increase in medication costs and reductions in hospitalization and physician visit costs provides valuable insight for policy makers into the shifts in asthma-related resource use.

  16. Studying the effects of classic hallucinogens in the treatment of alcoholism: rationale, methodology, and current research with psilocybin.

    Science.gov (United States)

    Bogenschutz, Michael P

    2013-03-01

    Recent developments in the study of classic hallucinogens, combined with a re-appraisal of the older literature, have led to a renewal of interest in possible therapeutic applications for these drugs, notably their application in the treatment of addictions. This article will first provide a brief review of the research literature providing direct and indirect support for the possible therapeutic effects of classic hallucinogens such as psilocybin and lysergic acid diethylamide (LSD) in the treatment of addictions. Having provided a rationale for clinical investigation in this area, we discuss design issues in clinical trials using classic hallucinogens, some of which are unique to this class of drug. We then discuss the current status of this field of research and design considerations in future randomized trials.

  17. Undiagnosed asthma in childhood

    NARCIS (Netherlands)

    van Gent, R.

    2008-01-01

    Asthma is the most prevalent chronic disease in childhood. To study the actual prevalence and impact of undiagnosed childhood asthma in daily life (i.e. quality of life, participation in physical and school activities) we performed a survey in schoolchildren (aged 7-10 years) in the southern part of

  18. Reflexology and bronchial asthma

    DEFF Research Database (Denmark)

    Brygge, T; Heinig, J H; Collins, P

    2001-01-01

    Many asthma patients seek alternative or adjunctive therapies. One such modality is reflexology, whereby finger pressure is applied to certain parts of the body. The aim of the study was to examine the popular claim that reflexology treatment benefits bronchial asthma. Ten weeks of active...

  19. Asthma control in children

    DEFF Research Database (Denmark)

    Pedersen, Søren

    2016-01-01

    The goal of asthma management is to achieve disease control. Poorly controlled asthma is associated with an increased number of days lost from school, exacerbations and days in hospital. Furthermore, children with uncontrolled asthma have more frequent contacts with the health-care system. Recent...... studies have added new information about the effects of poorly controlled asthma on a range of important, but less studied outcomes, including risk of obesity, daily physical activity, cardiovascular fitness, stress, concentration and focused attention, learning disabilities and risk of depression. From...... these studies it seems that poor asthma control may have a greater impact on the child than previously thought. This may have important long-term consequences for the child such as an increased risk of life-style associated diseases and poorer school performance. The level of control seems to be the most...

  20. Fertility outcomes in asthma

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis; Lindenberg, Svend;

    2016-01-01

    Evidence is increasing of an association between asthma and aspects of female reproduction. However, current knowledge is limited and furthermore relies on questionnaire studies or small populations. In a prospective observational cohort study to investigate whether time to pregnancy, the number...... of fertility treatments, and the number of successful pregnancies differ significantly between women with unexplained infertility with and without asthma.245 women with unexplained infertility (aged 23-45 years) underwent questionnaires and asthma and allergy testing while undergoing fertility treatment. 96...... women entering the study had either a former doctor's diagnosis of asthma or were diagnosed with asthma when included. After inclusion they were followed for a minimum of 12 months in fertility treatment, until they had a successful pregnancy, stopped treatment, or the observation ended.The likelihood...

  1. Influence of maternal and perinatal factors on subsequent hospitalisation for asthma in children: evidence from the Oxford record linkage study

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    Wotton Clare J

    2010-03-01

    Full Text Available Abstract Background There is much interest in the possibility that perinatal factors may influence the risk of disease in later life. We investigated the influence of maternal and perinatal factors on subsequent hospital admission for asthma in children. Methods Analysis of data from the Oxford record linkage study (ORLS to generate a retrospective cohort of 248 612 records of births between 1970 and 1989, with follow-up to records of subsequent hospital admission for 4 017 children with asthma up to 1999. Results Univariate analysis showed significant associations between an increased risk of admission for asthma and later years of birth (reflecting the increase in asthma in the 1970s and 1980s, low social class, asthma in the mother, unmarried mothers, maternal smoking in pregnancy, subsequent births compared with first-born, male sex, low birth weight, short gestational age, caesarean delivery, forceps delivery and not being breastfed. Multivariate analysis, identifying each risk factor that had a significant effect independently of other risk factors, confirmed associations with maternal asthma (odds ratio (OR 3.1, 95% confidence interval 2.7-3.6, male sex (versus female, 1.8, 1.7-2.0, low birth weight (1000-2999 g versus 3000-3999 g, 1.2, 1.1-1.3, maternal smoking (1.1, 1.0-1.3 and delivery by caesarean section (1.2; 1.0-1.3. In those first admitted with asthma under two years old, there were associations with having siblings (e.g. second child compared with first-born, OR 1.3, 1.0-1.7 and short gestational age (24-37 weeks versus 38-41 weeks, 1.6, 1.2-2.2. Multivariate analysis confined to those admitted with asthma aged six years or more, showed associations with maternal asthma (OR 3.8, 3.1-4.7, age of mother (under 25 versus 25-34 at birth, OR 1.16, 1.03-1.31; over 35 versus 25-34, OR 1.4, 1.1-1.7; high social class was protective (1 and 2, compared with 3, 0.72; 0.63-0.82. Hospital admission for asthma in people aged over six was more

  2. An integrated model of environmental factors in adult asthma lung function and disease severity: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Katz Patricia P

    2010-05-01

    Full Text Available Abstract Background Diverse environmental exposures, studied separately, have been linked to health outcomes in adult asthma, but integrated multi-factorial effects have not been modeled. We sought to evaluate the contribution of combined social and physical environmental exposures to adult asthma lung function and disease severity. Methods Data on 176 subjects with asthma and/or rhinitis were collected via telephone interviews for sociodemographic factors and asthma severity (scored on a 0-28 point range. Dust, indoor air quality, antigen-specific IgE antibodies, and lung function (percent predicted FEV1 were assessed through home visits. Neighborhood socioeconomic status, proximity to traffic, land use, and ambient air quality data were linked to the individual-level data via residential geocoding. Multiple linear regression separately tested the explanatory power of five groups of environmental factors for the outcomes, percent predicted FEV1 and asthma severity. Final models retained all variables statistically associated (p Results Mean FEV1 was 85.0 ± 18.6%; mean asthma severity score was 6.9 ± 5.6. Of 29 variables screened, 13 were retained in the final model of FEV1 (R2 = 0.30; p 2 = 0.16; p 1 as an independent variable to the severity model further increased its explanatory power (R2 = 0.25. Conclusions Multivariate models covering a range of individual and environmental factors explained nearly a third of FEV1 variability and, taking into account lung function, one quarter of variability in asthma severity. These data support an integrated approach to modeling adult asthma outcomes, including both the physical and the social environment.

  3. Phenotypes and endotypes of severe asthma in children

    Directory of Open Access Journals (Sweden)

    Young Yoo

    2013-05-01

    Full Text Available Severe childhood asthma is a complicated and heterogeneous disorder with distinct phenotypes. Children with severe asthma have more persistent symptoms despite receiving treatment, more atopy, greater airway obstruction, and more air trapping than those with mild-to-moderate asthma. They also have higher morbidity and substantial airflow limitations that persist throughout adulthood. Identification of the phenotype clusters and endotypes of severe asthma can allow further modulation of the natural history of severe asthma and may provide the pathophysiologic rationale for appropriate management strategies.

  4. Declines with Age in Childhood Asthma Symptoms and Health Care Use: An Adjustment for Evaluations

    Science.gov (United States)

    Ko, Yi-An; Song, Peter X. K.; Clark, Noreen M.

    2014-01-01

    Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline…

  5. Sources of Stress in Children with Asthma.

    Science.gov (United States)

    Walsh, Michelle; Ryan-Wenger, Nancy M.

    1992-01-01

    Children with asthma were studied to determine their perceptions of the frequency and severity of stressors they experienced other than asthma. Results indicated children with asthma were similar to peers regarding perceptions of stressors. Perceptions of most stressors related more strongly to gender role development than to asthma. (SM)

  6. Leveraging Mobile Technology in a School-Based Participatory Asthma Intervention: Findings from the Student Media-Based Asthma Research Team (SMART) Study

    Science.gov (United States)

    Warren, Christopher M.; Dyer, Ashley; Blumenstock, Jesse; Gupta, Ruchi S.

    2016-01-01

    Background: Asthma places a heavy burden on Chicago's schoolchildren, particularly in low-income, minority communities. Recently, our group developed a 10-week afterschool program, the Student Asthma Research Team (START), which successfully engaged high school youth in a Photovoice investigation of factors impacting their asthma at school and in…

  7. Childhood diet and asthma and atopy at 8 years of age : the PIAMA birth cohort study

    NARCIS (Netherlands)

    Willers, S. M.; Wijga, A. H.; Brunekreef, B.; Scholtens, S.; Postma, D. S.; Kerkhof, M.; de Jongste, J. C.; Smit, H. A.

    2011-01-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA)

  8. Prevalence of asthma-like symptoms, asthma and its treatment in elite athletes

    DEFF Research Database (Denmark)

    Lund, T; Pedersen, L; Larsson, B;

    2008-01-01

    The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006. All elite athletes (N=418) financially supported by the national...... organization of elite athletes comprised the study group; 329 (79%) completed the questionnaire concerning their sport, asthma-like symptoms, asthma and use of asthma medication. Asthma-like symptoms at rest were reported by 41% of respondents; 55% reported asthma-like symptoms at rest or at exercise...... among Danish elite athletes....

  9. Arginase 1 and arginase 2 variations associate with asthma, asthma severity and beta(2) agonist and steroid response

    NARCIS (Netherlands)

    Vonk, Judith M.; Postma, Dirkje S.; Maarsingh, Harm; Bruinenberg, Marcel; Koppelman, Gerard H.; Meurs, Herman

    2010-01-01

    Rationale Arginase probably plays an important role in asthma development, severity and progression. Polymorphisms in arginase 1 and arginase 2 genes have been associated with childhood asthma and FEV1 reversibility to beta(2) agonists. Objectives We investigated the association between arginase 1 a

  10. [Occupational asthma in Hungary].

    Science.gov (United States)

    Endre, László

    2015-05-10

    Occupational asthma belongs to communicable diseases, which should be reported in Hungary. During a 24-year period between January 1990 and December 2013, 180 occupational asthma cases were reported in Hungary (52 cases between 1990 and 1995, 83 cases between 1996 and 2000, 40 cases between 2001 and 2006, and 5 cases between 2007 and 2013). These data are unusual, because according to the official report of the National Korányi Pulmonology Institute in Budapest, at least 14,000 new adult asthma cases were reported in every year between 2000 and 2012 in Hungary. Also, international data indicate that at least 2% of adult patients with asthma have occupational asthma and at least 50 out of 1 million employees develop occupational asthma in each year. In 2003, 631 new occupational asthma patients were reported in the United Kingdom, but only 7 cases in Hungary. Because it is unlikely that the occupational environment in Hungary is much better than anywhere else in the world, it seems that not all new occupational asthma cases are reported in Hungary. Of the 180 reported cases in Hungary, 55 were bakers or other workers in flour mills. There were 11 metal-workers, 10 health care assistants, 9 workers dealing with textiles (tailors, dressmakers, workers in textile industry) and 9 employees worked upon leather and animal fur. According to international data, the most unsafe profession is the animal keeper in scientific laboratories, but only 4 of them were reported as having occupational asthma during the studied 24 years in Hungary. Interestingly, 3 museologists with newly-diagnosed occupational asthma were reported in 2003, but not such cases occurred before or after that year. In this paper the Hungarian literature of occupational asthma is summarized, followed by a review on the classification, pathomechanism, clinical presentation, predisposing factors, diagnostics and therapeutic aspects of the disease. Epidemiological data of adult asthma in Hungary and data from

  11. Prevalence of asthma-like symptoms, asthma and its treatment in elite athletes.

    Science.gov (United States)

    Lund, T; Pedersen, L; Larsson, B; Backer, V

    2009-04-01

    The objective was to determine the prevalence of asthma-like symptoms and asthma and the use of asthma medication in Danish elite athletes. A cross-sectional questionnaire survey of Danish elite athletes was conducted in 2006. All elite athletes (N=418) financially supported by the national organization of elite athletes comprised the study group; 329 (79%) completed the questionnaire concerning their sport, asthma-like symptoms, asthma and use of asthma medication. Asthma-like symptoms at rest were reported by 41% of respondents; 55% reported asthma-like symptoms at rest or at exercise. Physician-diagnosed asthma was present in 16% and 14% had current asthma. Asthma medication was taken by 7% of the athletes, of whom 79% used inhaled corticosteroids and 21% used inhaled beta(2)-agonists only. Athletes participating in endurance sports had higher prevalences of current asthma (24%) and use of asthma medication (15%) than all other athletes (Pendurance sports have a higher prevalence of asthma and use of asthma medication. The frequency of asthma medication is lower than the prevalence of current asthma indicating that there is no overuse of asthma medication among Danish elite athletes.

  12. Anxiety mediates the effect of smoking on insomnia in people with asthma: evidence from the HUNT3 study

    Directory of Open Access Journals (Sweden)

    Andenæs R

    2016-01-01

    Full Text Available Randi Andenæs,1 Carolyn E Schwartz1–31Department of Nursing and Health Promotion, Faculty of Health Science, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; 2DeltaQuest Foundation, Inc., Concord, 3Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USAObjective: The aim of this study was to investigate factors related to insomnia in a cohort of people with asthma.Design: This secondary analysis utilized cross-sectional data from the Norwegian Nord-Trøndelag Health Study, a population-based health survey (n=50,807.Participants: We used self-reported data from 1,342 men and women with a physician-confirmed asthma diagnosis ranging in age from 19.5 to 91 years.Measurements: Data on sleep, lifestyle variables (smoking and exercise, anxiety, and depression were included. An insomnia scale and asthma impact scale were constructed using factor analysis. Hierarchical series of multiple regression models were used to investigate direct and mediational relationships between the study variables and insomnia.Results: The hierarchical models revealed significant independent contributions of female sex, higher age, not exercising, asthma impact, anxiety, and depression on insomnia (R2=25.2%. Further, these models suggested that the impact of smoking on insomnia was mediated by anxiety, and that the beneficial impact of exercise was mitigated by depression symptoms.Conclusion: Smokers with asthma have more insomnia, and this relationship may be mediated by anxiety. Further, people with asthma who experience depression symptoms are less likely to benefit from physical exercise as a method to enhance sleep quality. Our findings would suggest that helping smokers to manage their anxiety and depression through behavioral methods may reduce their insomnia symptoms, and enable them to engage in other health-enhancing pursuits, such as physical exercise.Keywords: insomnia, asthma, anxiety

  13. Understanding mild persistent asthma in children

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Szefler, Stanley J

    2005-01-01

    Limitations in asthma prevalence studies and difficulties in diagnosing pediatric asthma lead to uncertainty over the full extent of mild persistent asthma in children and adolescents. Although recent surveys have reported that the majority of pediatric patients with asthma in the United States...... and Europe have symptoms consistent with mild disease, these surveys have limitations in design. Thus, the true prevalence of mild asthma remains unknown. It is unclear whether children with mild persistent asthma progress to more severe asthma, but the risk of severe asthma exacerbations seems...... to be unrelated to the symptom severity. Clinical studies restricted to pediatric patients with mild asthma are limited, but available data do suggest substantial morbidity of mild persistent asthma in this population and support inhaled corticosteroid intervention. There is a need for further investigation...

  14. Are Sudanese community pharmacists capable to prescribe and demonstrate asthma inhaler devices to patrons? A mystery patient study

    Directory of Open Access Journals (Sweden)

    Osman A

    2012-06-01

    Full Text Available Although community pharmacists have become more involved in the care of asthma patients, several studies have assessed pharmacists’ ability to illustrate appropriately inhalation technique of different asthma devices. Many studies addressed inappropriate use of asthma devices by patients and pharmacists, in addition to its clinical, humanistic and economic burden.Objective: To evaluate community pharmacists’ practical knowledge and skills of demonstrating proper inhalation technique of asthma inhaler devices available in Sudan.Method: Three hundred community pharmacies located around the three major hospitals in the capital city (Khartoum and four other provinces were approached, and four asthma devices were assessed: Metered-dose inhaler (MDI (n=105, MDI with Spacer (n=83, Turbuhaler (n=61, and Diskus (n=51. Investigator (a pharmacist acted as a mystery patient. He selected one device and asked the serving pharmacist to demonstrate how to use the device. Investigator completed a checklist of 9 steps of inhaler device use immediately after leaving the pharmacy. Essential steps derived from published literature were pre-specified for each device. Five evaluation categories were accordingly formulated as follows: optimal technique, adequate technique, poor technique, totally unfamiliar with the device, and does not know.Results: More than half of the pharmacists approached with metered dose inhaler did not know how to use optimal technique (ie all steps correct all through. A third poorly demonstrated the technique, and only one pharmacist was categorized as being able to demonstrate an “optimal technique”. The majority of pharmacists approached with spacing chamber and dry powder inhalers (Turbuhaler and Diskus either did not know proper technique or were totally unfamiliar with the devices.Conclusion: The majority of community pharmacists, who were expected to educate asthma patients on their dispensed inhalers, lack the basic knowledge

  15. Endotoxin as a determinant of asthma and wheeze among rural dwelling children and adolescents: A case–control study

    Directory of Open Access Journals (Sweden)

    Lawson Joshua A

    2012-09-01

    Full Text Available Abstract Background The association between endotoxin exposure and asthma is complex and has been associated with rural living. We examined the relationship between domestic endotoxin and asthma or wheeze among rural school-aged children (6–18 years and assessed the interaction between endotoxin and other characteristics with these outcomes. Methods Between 2005 and 2007 we conducted a case–control study of children 6–18 years in the rural region of Humboldt, Canada. Cases (n = 102 reported doctor-diagnosed asthma or wheeze in the past year. Controls (n = 208 were randomly selected from children without asthma or wheeze. Data were collected to ascertain symptoms, asthma history and indoor environmental exposures (questionnaire, endotoxin (dust collection from the play area floor and child’s mattress, and tobacco smoke exposure (saliva collection. Statistical testing was completed using multiple logistic regression to account for potential confounders and to assess interaction between risk factors. A stratified analysis was also completed to examine the effect of personal history of allergy. Results Among children aged 6–12 years, mattress endotoxin concentration (EU/mg and load (EU/m2 were inversely associated with being a case [odds ratio (OR = 0.44, 95% confidence interval (CI = 0.20-0.98; and OR = 0.38, 95% CI = 0.20-0.75, respectively]. These associations were not observed in older children or with play area endotoxin. Conclusions Our results suggest that endotoxin exposure might be protective for asthma or wheeze. The protective effect is found in younger school-aged, non-allergic children. These results may help explain the inconsistencies in previous studies and suggest that the protective effects of endotoxin in the prevention of atopy and asthma or wheeze are most effective earlier in life.

  16. Air pollution and asthma: clinical studies with sulfuric acid aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Utell, M.J.; Frampton, M.W.; Morrow, P.E. (University of Rochester School of Medicine and Dentistry, NY (United States))

    1991-11-01

    Until recently, acid deposition has been widely considered a serious ecological problem but not a threat to human health. The controlled clinical study is an important approach in linking acidic aerosol inhalation with respiratory effects. Asthmatic patients represent a subpopulation most responsive to sulfuric acid aerosols. In a series of studies with asthmatic volunteers, several factors have been identified that may modulate the intensity of the bronchoconstrictor response to inhaled acidic aerosols. We found (1) enhancement of the bronchoconstrictor response during exercise, (2) the more acidic aerosols provoke the greatest changes in lung function, and (3) mitigation of airway responses during sulfuric acid aerosol inhalation caused by high respiratory ammonia concentrations. Additional factors influencing responsiveness await identification.

  17. The intervention composed of aerobic training and non-exercise physical activity (I-CAN) study: Rationale, design and methods.

    Science.gov (United States)

    Swift, Damon L; Dover, Sara E; Nevels, Tyara R; Solar, Chelsey A; Brophy, Patricia M; Hall, Tyler R; Houmard, Joseph A; Lutes, Lesley D

    2015-11-01

    Recent data has suggested that prolonged sedentary behavior is independent risk factor for cardiovascular and all-cause mortality independent of adequate amounts of moderate to vigorous physical activity. However, few studies have prospectively evaluated if exercise training and increasing non-exercise physical activity leads to greater reduction in cardiometabolic risk compared to aerobic training alone. The purpose of the Intervention Composed of Aerobic Training and Non-Exercise Physical Activity (I-CAN) study is to determine whether a physical activity program composed of both aerobic training (consistent with public health recommendations) and increasing non-exercise physical activity (3000 steps above baseline levels) leads to enhanced improvements in waist circumference, oral glucose tolerance, systemic inflammation, body composition, and fitness compared to aerobic training alone in obese adults (N=45). Commercially available accelerometers (Fitbits) will be used to monitor physical activity levels and behavioral coaching will be used to develop strategies of how to increase non-exercise physical activity levels. In this manuscript, we describe the design, rationale, and methodology associated with the I-CAN study.

  18. Combined targeting of EGFR-dependent and VEGF-dependent pathways: rationale, preclinical studies and clinical applications.

    Science.gov (United States)

    Tortora, Giampaolo; Ciardiello, Fortunato; Gasparini, Giampietro

    2008-09-01

    Cellular heterogeneity, redundancy of molecular pathways and effects of the microenvironment contribute to the survival, motility and metastasis of cells in solid tumors. It is unlikely that tumors are entirely dependent on only one abnormally activated signaling pathway; consequently, treatment with an agent that interferes with a single target may be insufficient. Combined blockade of functionally linked and relevant multiple targets has become an attractive therapeutic strategy. The EGFR and ERBB2 (HER2) pathways and VEGF-dependent angiogenesis have a pivotal role in cancer pathogenesis and progression. Robust experimental evidence has shown that these pathways are functionally linked and has demonstrated a suggested role for VEGF in the acquired resistance to anti-ERBB drugs when these receptors are pharmacologically blocked. Combined inhibition of ERBB and VEGF signaling interferes with a molecular feedback loop responsible for acquired resistance to anti-ERBB agents and promotes apoptosis while ablating tumor-induced angiogenesis. To this aim, either two agents highly selective against VEGF and ERBB respectively, or, alternatively, a single multitargeted agent, can be used. Preclinical studies have proven the efficacy of both these approaches and early clinical studies have provided encouraging results. This Review discusses the experimental rationale for, preclinical studies of and clinical trials on combined blockade of ERBB and VEGF signaling.

  19. Hormonal contraception increases risk of asthma among obese but decreases it among nonobese subjects: a prospective, population-based cohort study

    Directory of Open Access Journals (Sweden)

    Melanie C. Matheson

    2015-11-01

    Full Text Available Epidemiological data on asthma suggest a sex difference that varies with age. Hormonal effects have been suggested as a possible explanation for these differences but there is a scarcity of evidence on these relationships. Our objective was to examine the relationship between reproductive factors and asthma risk among females and to examine whether body mass index (BMI modifies this relationship. Female participants in the 2004 fifth decade follow-up postal survey of the Tasmanian Longitudinal Health Study formed the study population. Reproductive history and data on hormonal contraceptive (HC use were collected on 2764 females. Multiple logistic regression was used to assess the association between the reproductive factors and current asthma. The mean age of participants was 43 years and the prevalence of middle-aged current asthma was 12.8%. Females with very early menarche (≤10 years had higher odds of middle-aged current asthma (OR 1.91, 95% CI 1.14–3.2. Pregnancy history (number of births and age at first pregnancy were not associated with current asthma risk at 44 years. Ever having used HCs, years of use and age started using HCs were not individually associated with current asthma risk. However, body mass index significantly modified the relationship between HC use and asthma. We found increasing years of pill use was associated with a significantly increased risk of current asthma in overweight/obese women but a reduced risk in normal weight women (interaction p=0.015. Hormonal effects from use of HCs and early menarche may contribute to the sex differential in asthma risk. Our findings suggest that in obese women with a history of long-term HC use may be at an increased risk of chronic respiratory disease, and regular monitoring for asthma and asthma symptoms may be recommended.

  20. Parent and Clinician Preferences for an Asthma App to Promote Adolescent Self-Management: A Formative Study

    Science.gov (United States)

    Roberts, Courtney A; Sage, Adam J; Coyne-Beasley, Tamera; Sleath, Betsy L; Carpenter, Delesha M

    2016-01-01

    Background Most youth asthma apps are not designed with parent and clinician use in mind, and rarely is the app development process informed by parent or clinician input. Objective This study was conducted to generate formative data on the use, attitudes, and preferences for asthma mHealth app features among parents and clinicians, the important stakeholders who support adolescents with asthma and promote adolescent self-management skills. Methods We conducted a mixed-methods study from 2013 to 2014 employing a user-centered design philosophy to acquire feedback from a convenience sample of 20 parents and 6 clinicians. Participants were given an iPod Touch and asked to evaluate 10 features on 2 existing asthma apps. Participant experiences using the apps were collected from questionnaires and a thematic analysis of audio-recorded and transcribed (verbatim) interviews using MAXQDA. Descriptive statistics were calculated to characterize the study sample and app feature feedback. Independent samples t tests were performed to compare parent and clinician ratings of app feature usefulness (ratings: 1=not at all useful to 5=very useful). Results All parents were female (n=20), 45% were black, 20% had an income ≥US $50,000, and 45% had a bachelor’s degree or higher education. The clinician sample included 2 nurses and 4 physicians with a mean practice time of 13 years. Three main themes provided an understanding of how participants perceived their roles and use of asthma app features to support adolescent asthma self-management: monitoring and supervision, education, and communication/information sharing. Parents rated the doctor report feature highest, and clinicians rated the doctor appointment reminder highest of all evaluated app features on usefulness. The peak flow monitoring feature was the lowest ranked feature by both parents and clinicians. Parents reported higher usefulness for the doctor report (t(10)=2.7, Pdesigned to help support youth asthma management

  1. Asthma and Adolescents: Review of Strategies to Improve Control

    Science.gov (United States)

    Hennessy-Harstad, Ellen

    2013-01-01

    One of every 10 adolescents in the United States has asthma. Adolescents who lack asthma control are at increased risk for severe asthma episodes and death. The National Heart, Lung, and Blood Institute 2007 asthma guidelines and research studies indicated that school nurses are instrumental in assisting adolescents to monitor their asthma, learn…

  2. Path analytic, sib-pair linkage and co-twin control studies of asthma and atopy

    Energy Technology Data Exchange (ETDEWEB)

    Duffy, D.L.; Healey, S.C.; Martin, N.G. [Queensland Institute of Medical Research, Brisband (Austria)

    1994-09-01

    Asthma and atopy are complex traits with multifactorial determinants, and require appropriate choice of phenotypes and analyses, including a linkage analysis of the putative 11q atopy locus. Participants in a large registry-based twin study of asthma were invited to take part in clinical testing. A total of 863 individuals including 419 complete twin pairs (where one or both members reported a history of wheeze) underwent histamine inhalation challenge, allergen skin prick testing, and venesection. Total serum immunoglobulin E (IgE) and bronchial responsiveness (BR) to histamine were highest in those who had wheezed most recently, and whose skin tests demonstrated allergy to house dust mite, cockroach, and rye grass. In ascertainment-corrected path analyses (FISHER), the heritability of IgE and BR were both 60%. Monozygotic (MZ) co-twin control analyses suggested house dust mite sensitization was the single strongest environmentally controlled risk factor for wheeze, while path analyses suggested genetic determination. In dizygotic (DZ) co-twin control analyses, sensitization to grasses was also an important predictor, suggesting pollinosis to be genetically correlated with wheezing, rather than causative. Multivariate path analyses suggested separate (correlated) genetic factors for BR, IgE, and allergy to house dust mite. A sib-pair (Haseman-Elston) linkage analysis of 220 DZ twin pairs did not support linkage to the high-affinity IgE receptor beta-subunit gene on 11q13 of atopy or BR. More recent linkage analyses that include parental genotyping will also be discussed. We conclude that the atopic phenotype consists of a number of traits with specific genetic allergens. Exposure to particular allergens can then cause specific outcomes, such as asthma.

  3. The Study of the Effects of Diet on Metabolism and Nutrition (STEDMAN) weight loss project: Rationale and design.

    Science.gov (United States)

    Haqq, Andrea M; Lien, Lillian F; Boan, Jarol; Arlotto, Michelle; Slentz, Cris A; Muehlbauer, Michael J; Rochon, James; Gallup, Dianne; McMahon, Ross L; Bain, James R; Stevens, Robert; Millington, David; Butler, Mark D; Newgard, Christopher B; Svetkey, Laura P

    2005-12-01

    This paper outlines the rationale and design of the Study of the Effects of Diet on Metabolism and Nutrition (STEDMAN) weight loss project, in which detailed biologic profiling of three hundred and fifty obese individuals (body mass index (BMI): 30-50 kg/m(2)) will be conducted as they lose weight via seven distinct interventions. These profiles will be compared to those of fifty normal, healthy, control participants (BMI: 18.5-24.9 kg/m(2)). The interventions include the following: Roux-en-Y gastric bypass surgery, dietary interventions of differing macronutrient composition and diverse pharmacologic interventions. Outcome variables include eight conventional metabolites and CRP measured by standard clinical chemistry techniques, twenty hormones of energy balance and fuel homeostasis measured by radioimmunoassay (RIA) or by enzyme-linked Immunosorbent assay (ELISA), ten pro- and anti-inflammatory cytokines measured using Luminex xMAP technology, one hundred and one intermediary metabolites measured by targeted mass-spectrometry-based methods, and physiologic variables such as body composition measured by dual energy X-ray absorptiometry (DEXA), air displacement plethysmography, and abdominal computerized tomography (CT), insulin sensitivity measured by intravenous glucose tolerance test (IV-GTT) and metabolic rate measured by indirect calorimetry. Results from this study will expand our knowledge of the biology of obesity and weight regulation and may lead to targeted strategies for its treatment and control.

  4. Skirting around Critical Feminist Rationales for Teaching Women in Social Studies

    Science.gov (United States)

    Schmeichel, Mardi

    2015-01-01

    Feminist practices can provide firm theoretical grounding for the kind of social studies that scholars promote, especially in relation to efforts to include women in the curriculum. However, in P-12 social studies education, neither women nor feminism receive much attention. The study described in this article was a discourse analysis of 16…

  5. The impact of parental history on children's risk of asthma: a study based on the National Health and Nutrition Examination Survey-III

    Directory of Open Access Journals (Sweden)

    Xu R

    2015-05-01

    Full Text Available Rengyi Xu,1 Sara B DeMauro,2 Rui Feng1 1Department of Biostatistics and Epidemiology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA; 2Division of Neonatology, Perelman School of Medicine at the University of Pennsylvania and The Children's Hospital of Philadelphia, Philadelphia, PA, USA Purpose: This study aimed to examine the separate effects of maternal and paternal history on the onset of asthma in children and evaluate the relationship between age of asthma onset in parents and risk of asthma in their children. Methods: We used data from the third National Health and Nutrition Examination Survey. We developed new continuous standardized scores for survey data to quantify parental history that incorporated both the occurrence of asthma and the age at onset, and associated these scores with asthma risk in the children. The association analysis was adjusted for sex and obesity status. Results: Children with maternal history have elevated asthma risk (hazard ratio of 3.71, 95% CI: 1.19–11.60 than those without, and those whose mothers had earlier age of onset have increased risk of asthma compared to those whose mothers had later age of onset. On the contrary, paternal history had a relatively smaller effect that may be only detectable in larger samples (hazard ratio of 2.17, 95% CI: 0.69–6.79. Conclusion: Maternal asthma history was strongly associated with the onset of asthma in the second generation, and children whose mother had an earlier age of onset had an increased risk of 3.71. For an approximately 10-year decrease in mother’s age at onset of asthma, the risk of asthma for the offspring increased by 1.37-fold. Using our new risk scores led to smaller standard errors and thus more precise estimates than using a binary indicator. Keywords: parental history, asthma risk, maternal history, survey, family data

  6. Twins eye study in Tasmania (TEST): rationale and methodology to recruit and examine twins.

    Science.gov (United States)

    Mackey, David A; Mackinnon, Jane R; Brown, Shayne A; Kearns, Lisa S; Ruddle, Jonathan B; Sanfilippo, Paul G; Sun, Cong; Hammond, Christopher J; Young, Terri L; Martin, Nicholas G; Hewitt, Alex W

    2009-10-01

    Visual impairment is a leading cause of morbidity and poor quality of life in our community. Unravelling the mechanisms underpinning important blinding diseases could allow preventative or curative steps to be implemented. Twin siblings provide a unique opportunity in biology to discover genes associated with numerous eye diseases and ocular biometry. Twins are particularly useful for quantitative trait analysis through genome-wide association and linkage studies. Although many studies involving twins rely on twin registries, we present our approach to the Twins Eye Study in Tasmania to provide insight into possible recruitment strategies, expected participation rates and potential examination strategies that can be considered by other researchers for similar studies. Five separate avenues for cohort recruitment were adopted: (1) piggy-backing existing studies where twins had been recruited, (2) utilizing the national twin registry, (3) word-of-mouth and local media publicity, (4) directly approaching schools, and finally (5) collaborating with other research groups studying twins.

  7. A study on indoor environment contaminants related to dust mite in dwellings of allergic asthma patients and of healthy subjects.

    Science.gov (United States)

    Feng, M; Yang, B; Zhuang, Y J; Yanagi, U; Cheng, X J

    2012-02-01

    This study investigated the pollution of dust mite allergens in the houses of 30 families and their infection to young allergic asthma patients in Shanghai. Medical records, family information, and dust samples were collected from the dwellings of 15 young allergic asthma patients and 15 healthy subjects. Der 1 allergen, which is a common allergen causing allergic asthma, was measured in collected dust samples using the Pharmacia Uni-CAP System. A significant correlation was found between the number of Der 1 allergens collected from floor surfaces and the number of Der 1 allergens collected from bed surfaces. Some factors influencing Der 1 allergen levels were found in this study. Relative humidity in dwellings was found to be most influential to the allergen levels. The findings suggested that traditional reduction methods for coarse particles, such as opening windows and periodic cleaning of beddings, may be effective in removing dust mite allergens.

  8. A study of New Zealand wood workers: exposure to wood dust, respiratory symptoms, and suspected cases of occupational asthma.

    Science.gov (United States)

    Norrish, A E; Beasley, R; Hodgkinson, E J; Pearce, N

    1992-05-27

    A randomly selected group of 50 New Zealand wood workers was studied. The level of airborne wood dust to which they were exposed ranged from 1.0-24.5 mg/m3. The wood workers reported experiencing higher rates of both lower and upper respiratory tract symptoms than a control group of office workers. Inhaled wood dust, in particular from rimu (Dacrydium cupressinum), was frequently cited by workers as being associated with respiratory tract symptoms. The wood workers' responses to the respiratory symptom questionnaire, and serial recordings of peak expiratory flow rate were used to screen the group for suspected cases of occupational asthma. Five cases fulfilled the study's criteria for suspected occupational asthma. In four of these, further evidence was found to support this diagnosis. We conclude that exposure to wood dust may cause occupational asthma in the woodworking industry in New Zealand.

  9. Complementary therapy use by patients and parents of children with asthma and the implications for NHS care: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharp Debbie

    2006-06-01

    Full Text Available Abstract Background Patients are increasingly using complementary therapies, often for chronic conditions. Asthma is the most common chronic condition in the UK. Previous research indicates that some asthma patients experience gaps in their NHS care. However, little attention has been given to how and why patients and parents of children with asthma use complementary therapies and the implications for NHS care. Methods Qualitative study, comprising 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma (plus a parent, recruited from a range of NHS and non-NHS settings in Bristol, England. Data analysis was thematic, drawing on the principles of constant comparison. Results A range of complementary therapies were being used for asthma, most commonly Buteyko breathing and homeopathy. Most use took place outside of the NHS, comprising either self-treatment or consultation with private complementary therapists. Complementary therapies were usually used alongside not instead of conventional asthma treatment. A spectrum of complementary therapy users emerged, including "committed", "pragmatic" and "last resort" users. Motivating factors for complementary therapy use included concerns about conventional NHS care ("push factors" and attractive aspects of complementary therapies ("pull factors". While participants were often uncertain whether therapies had directly helped their asthma, breathing techniques such as the Buteyko Method were most notably reported to enhance symptom control and enable reduction in medication. Across the range of therapies, the process of seeking and using complementary therapies seemed to help patients in two broad ways: it empowered them to take greater personal control over their condition rather than feel dependant on medication, and enabled exploration of a broader range of possible causes of their asthma than commonly discussed within NHS settings. Conclusion Complementary therapy

  10. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study : rationale and methods

    NARCIS (Netherlands)

    Kaplan, Bonnie J.; Giesbrecht, Gerald F.; Leung, Brenda M. Y.; Field, Catherine J.; Dewey, Deborah; Bell, Rhonda C.; Manca, Donna P.; O'Beirne, Maeve; Johnston, David W.; Pop, Victor J.; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P.; Eliasziw, Misha; McCargar, Linda J.; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M.; Letourneau, Nicole; Martin, Jonathan W.

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offsp

  11. The Netherlands Study of Depression and Anxiety (NESDA): rationale, objectives and methods.

    NARCIS (Netherlands)

    Penninx, B.W.J.H.; Beekman, A.T.F.; Smit, J.H.; Zitman, F.G.; Nolen, W.A.; Spinhoven, P.; Cuijpers, P.; Jong, P.J. de; Marwijk, H.W.J. van; Assendelft, W.J.J.; Meer, K. van der; Verhaak, P.; Wensing, M.; Graaf, R. de; Hoogendijk, W.J.; Ormel, J.; Dyck, R. van

    2008-01-01

    The Netherlands Study of Depression and Anxiety (NESDA) is a multi-site naturalistic cohort study to: (1) describe the long-term course and consequences of depressive and anxiety disorders, and (2) to integrate biological and psychosocial research paradigms within an epidemiological approach in orde

  12. The Netherlands Study of Depression and Anxiety (NESDA) : rationale, objectives and methods

    NARCIS (Netherlands)

    Penninx, B.W.J.H.; Beekman, A.T.F.; Smit, J.H.; Zitman, F.G.; Nolen, W.A.; Spinhoven, P.; Cuijpers, P.; de Jong, P.J.; Van Marwijk, H.W.J.; Assendelft, W.J.J.; van der Meer, K.; Verhaak, P.; Wensing, M.; de Graaf, R.; Hoogendijk, W.J.; Ormel, J.; Van Dyck, R.

    2008-01-01

    The Netherlands Study of Depression and Anxiety (NESDA) is a multi-site naturalistic cohort study to: (1) describe the long-term course and consequences of depressive and anxiety disorders, and (2) to integrate biological and psychosocial research paradigms within an epidemiological approach in orde

  13. Asthma medication use before and after the onset of type 1 diabetes in children and adolescents: A population-based cohort study

    NARCIS (Netherlands)

    Ahmadizar, Fariba; Maitland-Van Der Zee, Anke-Hilse; De Boer, Anthonius; Souverein, Patrick; Arets, Hubertus

    2015-01-01

    Background: It has been reported that patients with type 1 diabetes (T1DM) have a decreased lung function. Studies on the association of T1DM and asthma in children show controversial results. Objectives: The aim of this study was to quantify asthma medication use in children and adolescents with an

  14. Asthma-like symptoms in the first year of life and health-related quality of life at age 12 months: The Generation R study

    NARCIS (Netherlands)

    Mohangoo, A.D.; Koning, H.J. de; Jongste, J.C. de; Landgraf, J.M.; Wouden, J.C. van der; Jaddoe, V.W.V.; Hofman, A.; Moll, H.A.; Mackenbach, J.P.; Raat, H.

    2012-01-01

    Purpose: This study compares HRQOL among subgroups of infants with asthma-like symptoms to a subgroup without such symptoms and examines independent associations between asthma-like symptoms during the first year of life and HRQOL at age 12 months. Methods: Our study sample included 5,000 infants pa

  15. Rationale and design of the Feeding Dynamic Intervention (FDI) study for self-regulation of energy intake in preschoolers.

    Science.gov (United States)

    Eneli, Ihuoma U; Tylka, Tracy L; Hummel, Jessica; Watowicz, Rosanna P; Perez, Susana A; Kaciroti, Niko; Lumeng, Julie C

    2015-03-01

    In 2011, the Institute of Medicine Early Childhood Prevention Policies Report identified feeding dynamics as an important focus area for childhood obesity prevention and treatment. Feeding dynamics includes two central components: (1) caregiver feeding practices (i.e., determining how, when, where, and what they feed their children) and (2) child eating behaviors (i.e., determining how much and what to eat from what food caregivers have provided). Although there has been great interest in overweight and obesity prevention and treatment in young children, they have not focused comprehensively on feeding dynamics. Interventions on feeding dynamics that reduce caregivers' excessive controlling and restrictive feeding practices and encourage the development of children's self-regulation of energy intake may hold promise for tackling childhood obesity especially in the young child but currently lack an evidence base. This manuscript describes the rationale and design for a randomized controlled trial designed to compare a group of mothers and their 3-to 5-year old children who received an intervention focused primarily on feeding dynamics called the Feeding Dynamic Intervention (FDI) with a Wait-list Control Group (WLC). The primary aim of the study will be to investigate the efficacy of the FDI for decreasing Eating in the Absence of Hunger (EAH) and improving energy compensation (COMPX). The secondary aim will be to examine the effect of the FDI in comparison to the WLC on maternal self-reported feeding practices and child satiety responsiveness.

  16. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma…

  17. Children, parents, and pets exercising together (CPET) randomised controlled trial: study rationale, design, and methods

    OpenAIRE

    Yam, P.S.; Morrison, R; Penpraze, V.; Westgarth, C.; D. S. Ward; Mutrie, N; Hutchison, P.; Young, D.; Reilly, J. J.

    2012-01-01

    Abstract Background Objectively measured physical activity is low in British children, and declines as childhood progresses. Observational studies suggest that dog-walking might be a useful approach to physical activity promotion in children and adults, but there are no published public health interventions based on dog-walking with children. The Children, Parents, and Pets Exercising Together Study aims to develop and evaluate a theory driven, generalisable, family-based, dog walking interve...

  18. The Alberta Pregnancy Outcomes and Nutrition (APrON) cohort study: rationale and methods.

    Science.gov (United States)

    Kaplan, Bonnie J; Giesbrecht, Gerald F; Leung, Brenda M Y; Field, Catherine J; Dewey, Deborah; Bell, Rhonda C; Manca, Donna P; O'Beirne, Maeve; Johnston, David W; Pop, Victor J; Singhal, Nalini; Gagnon, Lisa; Bernier, Francois P; Eliasziw, Misha; McCargar, Linda J; Kooistra, Libbe; Farmer, Anna; Cantell, Marja; Goonewardene, Laki; Casey, Linda M; Letourneau, Nicole; Martin, Jonathan W

    2014-01-01

    The Alberta Pregnancy Outcomes and Nutrition (APrON) study is an ongoing prospective cohort study that recruits pregnant women early in pregnancy and, as of 2012, is following up their infants to 3 years of age. It has currently enrolled approximately 5000 Canadians (2000 pregnant women, their offspring and many of their partners). The primary aims of the APrON study were to determine the relationships between maternal nutrient intake and status, before, during and after gestation, and (1) maternal mood; (2) birth and obstetric outcomes; and (3) infant neurodevelopment. We have collected comprehensive maternal nutrition, anthropometric, biological and mental health data at multiple points in the pregnancy and the post-partum period, as well as obstetrical, birth, health and neurodevelopmental outcomes of these pregnancies. The study continues to follow the infants through to 36 months of age. The current report describes the study design and methods, and findings of some pilot work. The APrON study is a significant resource with opportunities for collaboration.

  19. Rationale and Design of the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) Study. Sarcoidosis Protocol.

    Science.gov (United States)

    Moller, David R; Koth, Laura L; Maier, Lisa A; Morris, Alison; Drake, Wonder; Rossman, Milton; Leader, Joseph K; Collman, Ronald G; Hamzeh, Nabeel; Sweiss, Nadera J; Zhang, Yingze; O'Neal, Scott; Senior, Robert M; Becich, Michael; Hochheiser, Harry S; Kaminski, Naftali; Wisniewski, Stephen R; Gibson, Kevin F

    2015-10-01

    Sarcoidosis is a systemic disease characterized by noncaseating granulomatous inflammation with tremendous clinical heterogeneity and uncertain pathobiology and lacking in clinically useful biomarkers. The Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis (GRADS) study is an observational cohort study designed to explore the role of the lung microbiome and genome in these two diseases. This article describes the design and rationale for the GRADS study sarcoidosis protocol. The study addresses the hypothesis that distinct patterns in the lung microbiome are characteristic of sarcoidosis phenotypes and are reflected in changes in systemic inflammatory responses as measured by peripheral blood changes in gene transcription. The goal is to enroll 400 participants, with a minimum of 35 in each of 9 clinical phenotype subgroups prioritized by their clinical relevance to understanding of the pathobiology and clinical heterogeneity of sarcoidosis. Participants with a confirmed diagnosis of sarcoidosis undergo a baseline visit with self-administered questionnaires, chest computed tomography, pulmonary function tests, and blood and urine testing. A research or clinical bronchoscopy with a research bronchoalveolar lavage will be performed to obtain samples for genomic and microbiome analyses. Comparisons will be made by blood genomic analysis and with clinical phenotypic variables. A 6-month follow-up visit is planned to assess each participant's clinical course. By the use of an integrative approach to the analysis of the microbiome and genome in selected clinical phenotypes, the GRADS study is powerfully positioned to inform and direct studies on the pathobiology of sarcoidosis, identify diagnostic or prognostic biomarkers, and provide novel molecular phenotypes that could lead to improved personalized approaches to therapy for sarcoidosis.

  20. Few Associations Found between Mold and Other Allergen Concentrations in the Home versus Skin Sensitivity from Children with Asthma after Hurricane Katrina in the Head-Off Environmental Asthma in Louisiana Study

    Directory of Open Access Journals (Sweden)

    L. F. Grimsley

    2012-01-01

    Full Text Available Mold and other allergen exposures exacerbate asthma symptoms in sensitized individuals. We evaluated allergen concentrations, skin test sensitivities, and asthma morbidity for 182 children, aged 4–12 years, with moderate to severe asthma, enrolled 18 months after Katrina, from the city of New Orleans and the surrounding parishes that were impacted by the storm, into the Head-off Environmental Asthma in Louisiana (HEAL observational study. Dust (indoor and air (indoor and outdoor samples were collected at baseline of 6 and 12 months. Dust samples were evaluated for dust mite, cockroach, mouse, and Alternaria by immunoassay. Air samples were evaluated for airborne mold spore concentrations. Overall, 89% of the children tested positive to ≥1 indoor allergen, with allergen-specific sensitivities ranging from 18% to 67%. Allergen concentration was associated with skin sensitivity for 1 of 10 environmental triggers analyzed (cat. Asthma symptom days did not differ with skin test sensitivity, and surprisingly, increased symptoms were observed in children whose baseline indoor airborne mold concentrations were below median levels. This association was not observed in follow-up assessments. The lack of relationship among allergen levels (including mold, sensitivities, and asthma symptoms points to the complexity of attempting to assess these associations during rapidly changing social and environmental conditions.

  1. Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke

    DEFF Research Database (Denmark)

    O'Donnell, M; Serpault, Damien Xavier; Diener, C;

    2010-01-01

    Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90% ...

  2. European Prospective Investigation into Cancer and Nutrition (EPIC) calibration study: rationale, design and population characteristics

    DEFF Research Database (Denmark)

    Slimani, N.; Kaaks, R.; Ferrari, P.;

    2002-01-01

    The European Prospective Investigation into Cancer and Nutrition (EPIC), which covers a large cohort of half a million men and women from 23 European centres in 10 Western European countries, was designed to study the relationship between diet and the risk of chronic diseases, particularly cancer...

  3. Why Communication Is Important: A Rationale for the Centrality of the Study of Communication.

    Science.gov (United States)

    Morreale, Sherwyn P.; Osborn, Michael M.; Pearson, Judy C.

    2000-01-01

    Presents annotations of articles, commentaries, and publications that emphasize the importance of communication and the role of the study of communication in contemporary life. Discusses six emergent themes. Concludes that communication education develops the whole person, improves the work of education, advances the interests of society, bridges…

  4. Rationale, design and methods of the HEALTHY study physical education intervention component

    Science.gov (United States)

    The HEALTHY primary prevention trial was designed to reduce risk factors for type 2 diabetes in middle school students. Middle schools at seven centers across the United States participated in the 3-year study. Half of them were randomized to receive a multi-component intervention. The intervention ...

  5. The Logic of School Gardens: A Phenomenological Study of Teacher Rationales

    Science.gov (United States)

    Jorgenson, Simon

    2013-01-01

    Despite the importance of teachers to the school garden movement, we still know very little about what drives particular teachers to incorporate a school garden into their pedagogy. In response, this article reports the findings of a study designed to investigate the internal processes and products involved in rationalising and sustaining…

  6. Rationale and protocol for using a smartphone application to study autism spectrum disorders: SMARTAUTISM

    Science.gov (United States)

    Bonnot, Olivier; Bonneau, Dominique; Doudard, Aude; Duverger, Philippe

    2016-01-01

    Introduction Longitudinal studies on the evolution of autism spectrum disorder (ASD) symptoms are limited and have primarily used repeated measurements performed several months apart. However, measurements of changes in everyday life should more closely reflect the ‘real life’ of the patient and his or her family. We propose to study the child's ASD symptoms and their effect on the quality of life, psychological status and anxiety of the child's parents over a 6-month period using SMARTAUTISM, a smartphone application. Method and analysis This is a prospective, longitudinal, exploratory, open study with a 6-month follow-up period. Data will be recorded longitudinally over multiple weeks under natural conditions. The factors affecting the quality of life and anxiety of parents of children with ASD and the children's functional symptoms will be examined, and the feasibility of using a smartphone application designed for parents of ASD patients will be assessed. Primary objective: Explore the evolution of a child's behaviour over 6 months and the (psychological and social) effects of these changes on the family. Secondary objective: Assess the feasibility of our application by examining the filling rate and application usage by parents for 6 months. 100 families containing 1 child diagnosed with ASD will be included. At baseline, sociodemographic, psychiatric and medical data will be recorded. The correlations of the general epidemiological variables (primary outcome measure) will be evaluated via multivariate analysis. The application filling rate (relative to the ideal filling rate) will be used to assess the feasibility of the application (secondary outcome measure). Ethics and dissemination The SMARTAUTISM study has the approval of the local ethics committee, and data security will be ensured via the use of encryption and a secure medical server. The use of this application will be proposed at autism resource centres across France. PMID:27881525

  7. Rationale, design and methods of the HEALTHY study nutrition intervention component.

    Science.gov (United States)

    Gillis, B; Mobley, C; Stadler, D D; Hartstein, J; Virus, A; Volpe, S L; El ghormli, L; Staten, M A; Bridgman, J; McCormick, S

    2009-08-01

    The HEALTHY study was a randomized, controlled, multicenter and middle school-based, multifaceted intervention designed to reduce risk factors for the development of type 2 diabetes. The study randomized 42 middle schools to intervention or control, and followed students from the sixth to the eighth grades. Here we describe the design of the HEALTHY nutrition intervention component that was developed to modify the total school food environment, defined to include the following: federal breakfast, lunch, after school snack and supper programs; a la carte venues, including snack bars and school stores; vending machines; fundraisers; and classroom parties and celebrations. Study staff implemented the intervention using core and toolbox strategies to achieve and maintain the following five intervention goals: (1) lower the average fat content of foods, (2) increase the availability and variety of fruits and vegetables, (3) limit the portion sizes and energy content of dessert and snack foods, (4) eliminate whole and 2% milk and all added sugar beverages, with the exception of low fat or nonfat flavored milk, and limit 100% fruit juice to breakfast in small portions and (5) increase the availability of higher fiber grain-based foods and legumes. Other nutrition intervention component elements were taste tests, cafeteria enhancements, cafeteria line messages and other messages about healthy eating, cafeteria learning laboratory (CLL) activities, twice-yearly training of food service staff, weekly meetings with food service managers, incentives for food service departments, and twice yearly local meetings and three national summits with district food service directors. Strengths of the intervention design were the integration of nutrition with the other HEALTHY intervention components (physical education, behavior change and communications), and the collaboration and rapport between the nutrition intervention study staff members and food service personnel at both school

  8. Better exercise adherence after treatment for cancer (BEAT Cancer) study: Rationale, design, and methods

    OpenAIRE

    Rogers, Laura Q; McAuley, Edward; Anton, Philip M.; Courneya, Kerry S.; Vicari, Sandra; Hopkins-Price, Patricia; Verhulst, Steven; Mocharnuk, Robert; Hoelzer, Karen

    2011-01-01

    Most breast cancer survivors do not engage in regular physical activity. Our physical activity behavior change intervention for breast cancer survivors significantly improved physical activity and health outcomes post-intervention during a pilot, feasibility study. Testing in additional sites with a larger sample and longer follow-up is warranted to confirm program effectiveness short and longer term. Importantly, the pilot intervention resulted in changes in physical activity and social cogn...

  9. Impact of Emerging Health Insurance Arrangements on Diabetes Outcomes and Disparities: Rationale and Study Design

    OpenAIRE

    Wharam, James Franklin; Soumerai, Steve; Trinacty, Connie; Eggleston, Emma; Zhang, Fang; LeCates, Robert F; Canning, Claire; Ross-Degnan, Dennis

    2013-01-01

    Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decrease essential care. The expansion of high-deductible health plans (HDHPs) represents a natural experiment of tremendous proportion. We designed a pre–post, longitudinal, quasi-experimental study to determine the effect of HDHPs on diabetes q...

  10. Learning environments’ activity potential for preschoolers (LEAPP: study rationale and design

    Directory of Open Access Journals (Sweden)

    Patricia Tucker

    2013-09-01

    Full Text Available Background. The purpose of this paper is to provide an overview of the study protocol for the Learning Environments’ Activity Potential for Preschoolers (LEAPP study, the goal of which is to describe the activity levels of preschoolers attending various early learning venues and explore which attributes of these facilities (e.g. curriculum, policies, equipment, etc. support activity participation.Design and Methods. This cross-sectional study aimed to recruit approximately 30 early learning environments requesting participation from preschoolers aged 2.5-5 years. Data collection included: Actical accelerometers (MiniMitter, Oregon, USA to measure the activity levels of children for five consecutive days (15-second epoch length while in care; the Environment and Policy Assessment and Observation tool to explore the early learning environment’s impact on activity; anthropometric data; the Child Temperament Questionnaire to assess the influence of preschoolers’ temperament on physical activity; and demographic information from parents/guardians and early learning staff. ANOVA and linear regression analyses will be conducted to assess variances in activity levels among preschoolers attending different early learning types and to explore the impact of early learning environments on their activity levels. Independent sample t-tests will be used to examine differences in activity levels based on sex and weight status.Expected impact of the study for public health. This research will provide the first Canadian data to address environmental influences on preschoolers’ activity levels in differing early learning environments. Additionally, this work will highlight the extent to which activity levels vary among preschoolers enrolled in full-day kindergarten, centre-, and home-based childcare.

  11. ACCISS study rationale and design: activating collaborative cancer information service support for cervical cancer screening

    Directory of Open Access Journals (Sweden)

    Bullard Emily

    2009-12-01

    Full Text Available Abstract Background High-quality cancer information resources are available but underutilized by the public. Despite greater awareness of the National Cancer Institute's Cancer Information Service among low-income African Americans and Hispanics compared with Caucasians, actual Cancer Information Service usage is lower than expected, paralleling excess cancer-related morbidity and mortality for these subgroups. The proposed research examines how to connect the Cancer Information Service to low-income African-American and Hispanic women and their health care providers. The study will examine whether targeted physician mailing to women scheduled for colposcopy to follow up an abnormal Pap test can increase calls to the Cancer Information Service, enhance appropriate medical follow-up, and improve satisfaction with provider-patient communication. Methods/Design The study will be conducted in two clinics in ethnically diverse low-income communities in Chicago. During the formative phase, patients and providers will provide input regarding materials planned for use in the experimental phase of the study. The experimental phase will use a two-group prospective randomized controlled trial design. African American and Hispanic women with an abnormal Pap test will be randomized to Usual Care (routine colposcopy reminder letter or Intervention (reminder plus provider recommendation to call the Cancer Information Service and sample questions to ask. Primary outcomes will be: 1 calls to the Cancer Information Service; 2 timely medical follow-up, operationalized by whether the patient keeps her colposcopy appointment within six months of the abnormal Pap; and 3 patient satisfaction with provider-patient communication at follow-up. Discussion The study examines the effectiveness of a feasible, sustainable, and culturally sensitive strategy to increase awareness and use of the Cancer Information Service among an underserved population. The goal of linking a

  12. The Cooperative Health Research in South Tyrol (CHRIS) study: rationale, objectives, and preliminary results.

    Science.gov (United States)

    Pattaro, Cristian; Gögele, Martin; Mascalzoni, Deborah; Melotti, Roberto; Schwienbacher, Christine; De Grandi, Alessandro; Foco, Luisa; D'Elia, Yuri; Linder, Barbara; Fuchsberger, Christian; Minelli, Cosetta; Egger, Clemens; Kofink, Lisa S; Zanigni, Stefano; Schäfer, Torsten; Facheris, Maurizio F; Smárason, Sigurður V; Rossini, Alessandra; Hicks, Andrew A; Weiss, Helmuth; Pramstaller, Peter P

    2015-11-05

    The Cooperative Health Research In South Tyrol (CHRIS) study is a population-based study with a longitudinal lookout to investigate the genetic and molecular basis of age-related common chronic conditions and their interaction with life style and environment in the general population. All adults of the middle and upper Vinschgau/Val Venosta are invited, while 10,000 participants are anticipated by mid-2017. Family participation is encouraged for complete pedigree reconstruction and disease inheritance mapping. After a pilot study on the compliance with a paperless assessment mode, computer-assisted interviews have been implemented to screen for conditions of the cardiovascular, endocrine, metabolic, genitourinary, nervous, behavioral, and cognitive system. Fat intake, cardiac health, and tremor are assessed instrumentally. Nutrient intake, physical activity, and life-course smoking are measured semi-quantitatively. Participants are phenotyped for 73 blood and urine parameters and 60 aliquots per participant are biobanked (cryo-preserved urine, DNA, and whole and fractionated blood). Through liquid-chromatography mass-spectrometry analysis, metabolite profiling of the mitochondrial function is assessed. Samples are genotyped on 1 million variants with the Illumina HumanOmniExpressExome array and the first data release including 4570 fully phenotyped and genotyped samples is now available for analysis. Participants' follow-up is foreseen 6 years after the first visit. The target population is characterized by long-term social stability and homogeneous environment which should both favor the identification of enriched genetic variants. The CHRIS cohort is a valuable resource to assess the contribution of genomics, metabolomics, and environmental factors to human health and disease. It is awaited that this will result in the identification of novel molecular targets for disease prevention and treatment.

  13. Children, parents, and pets exercising together (CPET randomised controlled trial: study rationale, design, and methods

    Directory of Open Access Journals (Sweden)

    Yam Philippa S

    2012-03-01

    Full Text Available Abstract Background Objectively measured physical activity is low in British children, and declines as childhood progresses. Observational studies suggest that dog-walking might be a useful approach to physical activity promotion in children and adults, but there are no published public health interventions based on dog-walking with children. The Children, Parents, and Pets Exercising Together Study aims to develop and evaluate a theory driven, generalisable, family-based, dog walking intervention for 9-11 year olds. Methods/design The Children, Parents, and Pets Exercising Together Study is an exploratory, assessor-blinded, randomised controlled trial as defined in the UK MRC Framework on the development and evaluation of complex interventions in public health. The trial will follow CONSORT guidance. Approximately 40 dog-owning families will be allocated randomly in a ratio of 1.5:1 to receive a simple behavioural intervention lasting for 10 weeks or to a 'waiting list' control group. The primary outcome is change in objectively measured child physical activity using Actigraph accelerometry. Secondary outcomes in the child, included in part to shape a future more definitive randomised controlled trial, are: total time spent sedentary and patterning of sedentary behaviour (Actigraph accelerometry; body composition and bone health from dual energy x-ray absorptiometry; body weight, height and BMI; and finally, health-related quality of life using the PedsQL. Secondary outcomes in parents and dogs are: changes in body weight; changes in Actigraph accelerometry measured physical activity and sedentary behaviour. Process evaluation will consist of assessment of simultaneous child, parent, and dog accelerometry data and brief interviews with participating families. Discussion The Children, Parents, and Pets Exercising Together trial should be the first randomised controlled study to establish and evaluate an intervention aimed at dog-based physical

  14. Rationale and design of INTERSTROKE: a global case-control study of risk factors for stroke

    DEFF Research Database (Denmark)

    O'Donnell, M; Serpault, Damien Xavier; Diener, C;

    2010-01-01

    Stroke is a major global health problem. It is the third leading cause of death and the leading cause of adult disability. INTERHEART, a global case-control study of acute myocardial infarction in 52 countries (29,972 participants), identified nine modifiable risk factors that accounted for >90...... with a first stroke within 72 h of hospital presentation in whom CT or MRI is performed. Proxy respondents are used for cases unable to communicate. Etiological and topographical stroke subtype is documented for all cases. Controls are hospital- and community-based, matched for gender, ethnicity and age (+/-5...

  15. The health outcomes and physical activity in preschoolers (HOPP study: rationale and design

    Directory of Open Access Journals (Sweden)

    Timmons Brian W

    2012-04-01

    Full Text Available Abstract Background The early years are the period of growth for which we know the least about the impact of physical activity. In contrast, we know that more than 90 % of school-aged Canadian children, for example, are not meeting physical activity recommendations. Such an activity crisis is a major contributor to recent trends in childhood obesity, to which preschoolers are not immune. The World Health Organization estimated that more than 42 million children under the age of 5 years were overweight world-wide in 2010. If an activity crisis exists during the preschool years, we should also be concerned about its broader impact on health. Unfortunately, the relationship between physical activity and health during the early years is poorly understood. The goal of the Health Outcomes and Physical activity in Preschoolers (HOPP study is to describe how the prevalence and patterns of physical activity in preschoolers are associated with indices of health. Methods The HOPP study is a prospective cohort study. We aim to recruit 400 3- to 5-year-old children (equal number of boys and girls and test them once per year for 3 years. Each annual assessment involves 2 laboratory visits and 7 consecutive days of physical activity monitoring with protocols developed in our pilot work. At visit 1, we assess body composition, aerobic fitness, short-term muscle power, motor skills, and have the parents complete a series of questionnaires related to their child’s physical activity, health-related quality of life and general behaviour. Over 7 consecutive days each child wears an accelerometer on his/her waist to objectively monitor physical activity. The accelerometer is programmed to record movement every 3 s, which is needed to accurately capture the intensity of physical activity. At visit 2, we assess vascular structure and function using ultrasound. To assess the associations between physical activity and health outcomes, our primary analysis will involve

  16. Impact of emerging health insurance arrangements on diabetes outcomes and disparities: rationale and study design.

    Science.gov (United States)

    Wharam, J Frank; Soumerai, Steve; Trinacty, Connie; Eggleston, Emma; Zhang, Fang; LeCates, Robert; Canning, Claire; Ross-Degnan, Dennis

    2013-01-01

    Consumer-directed health plans combine lower premiums with high annual deductibles, Internet-based quality-of-care information, and health savings mechanisms. These plans may encourage members to seek better value for health expenditures but may also decrease essential care. The expansion of high-deductible health plans (HDHPs) represents a natural experiment of tremendous proportion. We designed a pre-post, longitudinal, quasi-experimental study to determine the effect of HDHPs on diabetes quality of care, outcomes, and disparities. We will use a 13-year rolling sample (2001-2013) of members of an HDHP and members of a control group. To reduce selection bias, we will limit participants to those whose employers mandate a single health insurance type. The study will measure rates of monthly hemoglobin A1c, lipid, and albuminuria testing; availability of blood glucose test strips; and rates of retinal examinations, high-severity emergency department visits, and preventable hospitalizations. Results could be used to design health plan features that promote high-quality care and better outcomes among people who have diabetes.

  17. Hypertrophic Cardiomyopathy Registry: The rationale and design of an international, observational study of hypertrophic cardiomyopathy.

    Science.gov (United States)

    Kramer, Christopher M; Appelbaum, Evan; Desai, Milind Y; Desvigne-Nickens, Patrice; DiMarco, John P; Friedrich, Matthias G; Geller, Nancy; Heckler, Sarahfaye; Ho, Carolyn Y; Jerosch-Herold, Michael; Ivey, Elizabeth A; Keleti, Julianna; Kim, Dong-Yun; Kolm, Paul; Kwong, Raymond Y; Maron, Martin S; Schulz-Menger, Jeanette; Piechnik, Stefan; Watkins, Hugh; Weintraub, William S; Wu, Pan; Neubauer, Stefan

    2015-08-01

    Hypertrophic cardiomyopathy (HCM) is the most common monogenic heart disease with a frequency as high as 1 in 200. In many cases, HCM is caused by mutations in genes encoding the different components of the sarcomere apparatus. Hypertrophic cardiomyopathy is characterized by unexplained left ventricular hypertrophy, myofibrillar disarray, and myocardial fibrosis. The phenotypic expression is quite variable. Although most patients with HCM are asymptomatic, serious consequences are experienced in a subset of affected individuals who present initially with sudden cardiac death or progress to refractory heart failure. The Hypertrophic Cardiomyopathy Registry study is a National Heart, Lung, and Blood Institute-sponsored 2,750-patient, 44-site, international registry and natural history study designed to address limitations in extant evidence to improve prognostication in HCM (NCT01915615). In addition to the collection of standard demographic, clinical, and echocardiographic variables, patients will undergo state-of-the-art cardiac magnetic resonance for assessment of left ventricular mass and volumes as well as replacement scarring and interstitial fibrosis. In addition, genetic and biomarker analyses will be performed. The Hypertrophic Cardiomyopathy Registry has the potential to change the paradigm of risk stratification in HCM, using novel markers to identify those at higher risk.

  18. Association between prescribing patterns of anti-asthmatic drugs and clinically uncontrolled asthma: a cross-sectional study

    DEFF Research Database (Denmark)

    Davidsen, Jesper Rømhild; Hallas, Jesper; Søndergaard, Jens;

    2011-01-01

    Studies based on prescription data have shown that many asthmatics tend to use large quantities of inhaled beta-2-agonists, suggesting poorly controlled disease. The aim of the present study was to investigate the association between clinically uncontrolled asthma and prescribing patterns of anti...

  19. Design, rationale, and baseline demographics of SEARCH I: a prospective cluster-randomized study

    Directory of Open Access Journals (Sweden)

    Albers F

    2012-07-01

    Full Text Available Frank Albers,1 Asif Shaikh,2 Ahmar Iqbal,31Medical Affairs Respiratory, 2Clinical Development and Medical Affairs, Field Based Medicine-Respiratory, Boehringer Ingelheim Pharmaceuticals, Inc, Ridgefield, CT, USA; 3Respiratory Medical Affairs, Pfizer Inc, New York, NY, USAAbstract: Questionnaires are available to identify patients at risk for several chronic diseases, including COPD, but are infrequently utilized in primary care. COPD is often underdiagnosed, while at the same time the US Preventive Services Task Force recommends against spirometric screening for COPD in asymptomatic adults. Use of a symptom-based questionnaire and subsequent handheld spirometric device depending on the answers to the questionnaire is a promising approach to identify patients at risk for COPD. Screening, Evaluating and Assessing Rate CHanges of diagnosing respiratory conditions in primary care 1 (SEARCH I was a prospective cluster-randomized study in 168 US primary care practices evaluating the effect of the COPD-Population Screener (COPD-PS™ questionnaire. The effect of this questionnaire alone or sequentially with the handheld copd-6TM device was evaluated on new diagnoses of COPD and on respiratory diagnostic practice patterns (including referrals for pulmonary function testing, referrals to pulmonologists, new diagnoses of COPD, and new respiratory medication prescriptions. Participating practices entered a total of 9704 consecutive consenting subjects aged ≥ 40 years attending primary care clinics. Study arm results were compared for new COPD diagnosis rates between usual care and (1 COPD-PS plus copd-6 and (2 COPD-PS alone. A cluster-randomization design allowed comparison of the intervention effects at the practice level instead of individuals being the subjects of the intervention. Regional principal investigators controlled the flow of study information to sub-investigators at participating practices to reduce observation bias (Hawthorne effect. The

  20. Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints (ALTITUDE): rationale and study design

    DEFF Research Database (Denmark)

    Parving, Hans-Henrik; Brenner, Barry M; McMurray, John J V;

    2009-01-01

    , resuscitated death, myocardial infarction, stroke, unplanned hospitalization for heart failure, onset of end-stage renal disease or doubling of baseline serum creatinine concentration. Secondary endpoints include a composite CV endpoint and a composite renal endpoint. CONCLUSION: ALTITUDE will determine...... the residual renal and cardiovascular risk still remains high. Aliskiren a novel oral direct renin inhibitor that unlike ACEi and ARBs, lowers plasma renin activity, angiotensin I and angiotensin II levels, may thereby provide greater benefit compared to ACEi or ARB alone. METHODS: The primary objective...... of the ALTITUDE trial is to determine whether aliskiren 300 mg once daily, reduces cardiovascular and renal morbidity and mortality compared with placebo when added to conventional treatment (including ACEi or ARB). ALTITUDE is an international, randomized, double-blind, placebo-controlled, parallel-group study...

  1. Relationship between volition, physical activity and weight loss maintenance: Study rationale, design, methods and baseline characteristics

    DEFF Research Database (Denmark)

    Jørgensen, Sune Dandanell; Elbe, Anne-Marie; Pfister, Gertrud Ursula

    2017-01-01

    ) for an interdisciplinary prospective study with follow-up. The change in lifestyle and weight loss is promoted via a 3-month intensive lifestyle intervention at a private health school. The intervention consists of supervised training (1–3 hours/day), a healthy hypo-caloric diet (−500 to −700 kCal/day) and education...... in healthy lifestyle in classes/groups. The participants’ body weight and composition (Dual Energy X-ray absorptiometry), volitional skills (questionnaire), physical activity level (heart rate accelerometer / questionnaire) and maximal oxygen uptake (indirect calorimetry) are to be monitored before, after...... maintenance. Conclusions: If specific volitional skills are identified as predictors of adherence to physical activity and success in clinical weight loss maintenance, these can be trained in future intensive lifestyle interventions in order to optimize the success rate....

  2. A family smoking index to capture genetic influence in smoking: rationale and two validation studies.

    Science.gov (United States)

    Drobes, David J; Munafò, Marcus R; Leigh, Fiona; Saladin, Michael E

    2005-02-01

    Despite a growing appreciation that genetic factors may impart vulnerability toward smoking behavior, only a modest consensus has been created about the specific genetic mechanisms that may underlie various aspects of smoking. A core feature of genetic contribution toward any complex human behavior is familial resemblance. Most previous attempts to index familial smoking have classified individuals into discrete categories, based on the number of smokers in a family. We discuss the development of a continuous measure of familial smoking, the Family Smoking Index (FSI), which is based on the proportion of smokers in first- and second-degree family members and provides a more precise weighting according to genetic proximity. We present the psychometric characteristics of the FSI as well as initial validation data from two studies. We also describe current and future directions for continued FSI validation and application.

  3. Children with Asthma and Sports

    Directory of Open Access Journals (Sweden)

    Selda Yuzer

    2014-06-01

    Full Text Available Asthma is one of the chronic diseases which have are widely seen among the children. The disease has recently been in the increase all over the world and affects many children. In a study conducted with International Study of Asthma and Allergies in Childhood (ISAAC method, it was found out that prevalence of childhood asthma was 17.1%. Participation in sportive activities by the children with asthma, which is today considered as a part of asthma treatment program, makes contributions to their physical, mental and psychological development and increases their quality of life. The most recommended sports for the children with asthma are swimming and water sports. Sports like tennis and volleyball are too advised. Choice of sports depends on severity of asthma, child and #8217;s choice and whether or not asthma is kept under control. Nursing approaches for the children with asthma include correction of symptoms, training of children and their families, assistance with disease adaptation, continuing asthma care at home and interventions to make children lead healthy activities of daily life of children. With protective measures to be taken by families and children; children should be encourage for sportive activities. [TAF Prev Med Bull 2014; 13(3.000: 241-244

  4. The role of prenatal, perinatal and postnatal factors in the explanation of socioeconomic inequalities in preschool asthma symptoms: The generation R study

    NARCIS (Netherlands)

    Hafkamp-de Groen, E.; Rossem, L. van; Jongste, J.C. de; Mohangoo, A.D.; Moll, H.A.; Jaddoe, V.W.V.; Hofman, A.; Mackenbach, J.P.; Raat, H.

    2012-01-01

    Background The authors assessed whether socioeconomic inequalities in asthma symptoms were already present in preschool children and to what extent prenatal, perinatal and postnatal risk factors for asthma symptoms mediate the effect of socioeconomic status (SES). Methods The study included 3136 Dut

  5. Neuroimaging studies of factors related to exercise: rationale and design of a 9 month trial.

    Science.gov (United States)

    Herrmann, Stephen D; Martin, Laura E; Breslin, Florence J; Honas, Jeffery J; Willis, Erik A; Lepping, Rebecca J; Gibson, Cheryl A; Befort, Christie A; Lambourne, Kate; Burns, Jeffrey M; Smith, Bryan K; Sullivan, Debra K; Washburn, Richard A; Yeh, Hung-Wen; Donnelly, Joseph E; Savage, Cary R

    2014-01-01

    The prevalence of obesity is high resulting from chronic imbalances between energy intake and expenditure. On the expenditure side, regular exercise is associated with health benefits, including enhanced brain function. The benefits of exercise are not immediate and require persistence to be realized. Brain regions associated with health-related decisions, such as whether or not to exercise or controlling the impulse to engage in immediately rewarding activities (e.g., sedentary behavior), include reward processing and cognitive control regions. A 9 month aerobic exercise study will be conducted in 180 sedentary adults (n = 90 healthy weight [BMI = 18.5 to 26.0 kg/m(2)]; n = 90 obese [BMI = 29.0 to 41.0 kg/m(2)) to examine the brain processes underlying reward processing and impulse control that may affect adherence in a new exercise regimen. The primary aim is to use functional magnetic resonance imaging (fMRI) to examine reward processing and impulse control among participants that adhere (exercise >80% of sessions) and those that do not adhere to a nine-month exercise intervention with secondary analyses comparing sedentary obese and sedentary healthy weight participants. Our results will provide valuable information characterizing brain activation underlying reward processing and impulse control in sedentary obese and healthy weight individuals. In addition, our results may identify brain activation predictors of adherence and success in the exercise program along with measuring the effects of exercise and improved fitness on brain activation.

  6. The Congenital Heart Disease Genetic Network Study: rationale, design, and early results.

    Science.gov (United States)

    Gelb, Bruce; Brueckner, Martina; Chung, Wendy; Goldmuntz, Elizabeth; Kaltman, Jonathan; Kaski, Juan Pablo; Kim, Richard; Kline, Jennie; Mercer-Rosa, Laura; Porter, George; Roberts, Amy; Rosenberg, Ellen; Seiden, Howard; Seidman, Christine; Sleeper, Lynn; Tennstedt, Sharon; Kaltman, Jonathan; Schramm, Charlene; Burns, Kristin; Pearson, Gail; Rosenberg, Ellen

    2013-02-15

    Congenital heart defects (CHD) are the leading cause of infant mortality among birth defects, and later morbidities and premature mortality remain problematic. Although genetic factors contribute significantly to cause CHD, specific genetic lesions are unknown for most patients. The National Heart, Lung, and Blood Institute-funded Pediatric Cardiac Genomics Consortium established the Congenital Heart Disease Genetic Network Study to investigate relationships between genetic factors, clinical features, and outcomes in CHD. The Pediatric Cardiac Genomics Consortium comprises 6 main and 4 satellite sites at which subjects are recruited, and medical data and biospecimens (blood, saliva, cardiovascular tissue) are collected. Core infrastructure includes an administrative/data-coordinating center, biorepository, data hub, and core laboratories (genotyping, whole-exome sequencing, candidate gene evaluation, and variant confirmation). Eligibility includes all forms of CHD. Annual follow-up is obtained for probands age is 5.5 years. The one third enrolled at age <1 year are contacted annually for follow-up information. The distribution of CHD favors more complex lesions. Approximately, 11% of probands have a genetic diagnosis. Adequate DNA is available from 97% and 91% of blood and saliva samples, respectively. Genomic analyses of probands with heterotaxy, atrial septal defects, conotruncal, and left ventricular outflow tract obstructive lesions are underway. The scientific community's use of Pediatric Cardiac Genomics Consortium resources is welcome.

  7. Rationale and design of the EXenatide Study of Cardiovascular Event Lowering (EXSCEL) trial.

    Science.gov (United States)

    Holman, Rury R; Bethel, Mary Angelyn; George, Jyothis; Sourij, Harald; Doran, Zoë; Keenan, Joanne; Khurmi, Nardev S; Mentz, Robert J; Oulhaj, Abderrahim; Buse, John B; Chan, Juliana C; Iqbal, Nayyar; Kundu, Sudeep; Maggioni, Aldo P; Marso, Steven P; Öhman, Peter; Pencina, Michael J; Poulter, Neil; Porter, Lisa E; Ramachandran, Ambady; Zinman, Bernard; Hernandez, Adrian F

    2016-04-01

    Exenatide once-weekly is an extended release formulation of exenatide, a glucagon-like peptide-1 receptor agonist, which can improve glycemic control, body weight, blood pressure, and lipid levels in patients with type 2 diabetes mellitus (T2DM). The EXenatide Study of Cardiovascular Event Lowering (EXSCEL) will compare the impact of adding exenatide once-weekly to usual care with usual care alone on major cardiovascular outcomes. EXSCEL is an academically led, phase III/IV, double-blind, pragmatic placebo-controlled, global trial conducted in 35 countries aiming to enrol 14,000 patients with T2DM and a broad range of cardiovascular risk over approximately 5 years. Participants will be randomized (1:1) to receive exenatide once-weekly 2 mg or matching placebo by subcutaneous injections. The trial will continue until 1,360 confirmed primary composite cardiovascular end points, defined as cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke, have occurred. The primary efficacy hypothesis is that exenatide once-weekly is superior to usual care with respect to the primary composite cardiovascular end point. EXSCEL is powered to detect a 15% relative risk reduction in the exenatide once-weekly group, with 85% power and a 2-sided 5% alpha. The primary safety hypothesis is that exenatide once-weekly is noninferior to usual care with respect to the primary cardiovascular composite end point. Noninferiority will be concluded if the upper limit of the CI is <1.30. EXSCEL will assess whether exenatide once-weekly can reduce cardiovascular events in patients with T2DM with a broad range of cardiovascular risk. It will also provide long-term safety information on exenatide once-weekly in people with T2DM. ClinicalTrials.gov Identifier: NCT01144338.

  8. PROspective Multicenter Imaging Study for Evaluation of Chest Pain: Rationale and Design of the PROMISE Trial

    Science.gov (United States)

    Douglas, Pamela S.; Hoffmann, Udo; Lee, Kerry L.; Mark, Daniel B.; Al-Khalidi, Hussein R.; Anstrom, Kevin; Dolor, Rowena J.; Kosinski, Andrzej; Krucoff, Mitchell W.; Mudrick, Daniel W.; Patel, Manesh R.; Picard, Michael H.; Udelson, James E.; Velazquez, Eric J.; Cooper, Lawton

    2014-01-01

    Background Suspected coronary artery disease (CAD) is one of the most common, potentially life threatening diagnostic problems clinicians encounter. However, no large outcome-based randomized trials have been performed to guide the selection of diagnostic strategies for these patients. Methods The PROMISE study is a prospective, randomized trial comparing the effectiveness of two initial diagnostic strategies in patients with symptoms suspicious for CAD. Patients are randomized to either: 1) functional testing (exercise electrocardiogram, stress nuclear imaging, or stress echocardiogram); or 2) anatomic testing with >=64 slice multidetector coronary computed tomographic angiography. Tests are interpreted locally in real time by subspecialty certified physicians and all subsequent care decisions are made by the clinical care team. Sites are provided results of central core lab quality and completeness assessment. All subjects are followed for ≥1 year. The primary end-point is the time to occurrence of the composite of death, myocardial infarction, major procedural complications (stroke, major bleeding, anaphylaxis and renal failure) or hospitalization for unstable angina. Results Over 10,000 symptomatic subjects were randomized in 3.2 years at 193 US and Canadian cardiology, radiology, primary care, urgent care and anesthesiology sites. Conclusion Multi-specialty community practice enrollment into a large pragmatic trial of diagnostic testing strategies is both feasible and efficient. PROMISE will compare the clinical effectiveness of an initial strategy of functional testing against an initial strategy of anatomic testing in symptomatic patients with suspected CAD. Quality of life, resource use, cost effectiveness and radiation exposure will be assessed. Clinical trials.gov identifier NCT01174550 PMID:24890527

  9. Danish pain specialists' rationales behind the choice of fentanyl transdermal patches and oral transmucosal systems-A Delphi study

    DEFF Research Database (Denmark)

    Jacobsen, Ramune; Møldrup, Claus; Christrup, Lona

    2009-01-01

    survey. Response rates were 45% in the brainstorming and 88% in the rating phases, respectively. Statistical analysis with SPSS for Windows 15.00 included descriptive statistics and factor analysis. Results. The most important rationale to choose fentanyl patches was that patients' clinical condition did...

  10. Study design, objectives, hypotheses, main findings, health consequences for the population exposed, rationale of future research

    Energy Technology Data Exchange (ETDEWEB)

    Trnovec, T.; Kocan, A. [Slovak Medical Univ., Bratislava (Slovakia); Bencko, V. [Charles Univ., Prague (Czech Republic); Langer, P. [Institute of Experimental Endocrinology SAS, Bratislava (Slovakia); Berg, M. van den [Rijksuniversiteit Utrecht (Netherlands); Bergman, A. [Stockholm Univ. (Sweden); Hustak, M. [Air Force Military Hospital, Kosics (Slovakia)

    2004-09-15

    In Slovakia, the Chemko Chemical Company, based in Strazske, in the Michalovce district, produced PCBs between 1959 and 1984, in the amount of more than 21,000 tons of commercial mixtures (Delor 103, 104, 105, 106, Delotherm DK and DH, Hydelor 137). PCBs were used for similar industrial purposes as in the west. Improper disposal from the Chemko plant via release of effluent directly into the Laborec River resulted in long-term contamination of sediment. As a result eastern Slovakia, the Michalovce district in particular, is recognized as one of the areas all over the world most heavily polluted with PCBs. Historical studies show that blood and adipose PCB levels were higher in Czechoslovakia than elsewhere in the 1970's and 1980's. Current data indicate that persons who eat locally raised food - pork, beef, poultry, eggs - in this district have elevated serum concentrations of PCBs. Environmental exposure to organochlorines in the Michalovce district indicate association with higher rates of certain cancers, but an inverse association with risk of breast cancer. An increased prevalence of thyroid disorders in the polluted area was also reported. This ''experimental setting in nature'' has attracted international scientific teams and two projects in the area are ongoing: Evaluating Human Health Risk from Low-dose and Long-term PCB Exposure, 5{sup th} FP Project QLK4-2000-00488, 2001- 2004; PCBRISK (http://www.pcbrisk.sk/) and Early Childhood Development and PCB Exposures in Slovakia, NCI/NIH, R01-CA96525 University of California, Davis, USA. This paper is serving as an introduction to papers of a session reporting on various health outcomes associated with PCB exposure. The objectives of the PCBRISK project were targeted at an evaluation of the human health risks of low-dose and long-term exposure to a group of persistent organochlorine pollutants, including polychlorinated biphenyls (PCBs) and their metabolites, organochlorine

  11. Occupational irritants and asthma: an Estonian cross-sectional study of 34,000 adults.

    Science.gov (United States)

    Dumas, Orianne; Laurent, Emeline; Bousquet, Jean; Metspalu, Andres; Milani, Lili; Kauffmann, Francine; Le Moual, Nicole

    2014-09-01

    Occupational exposures make important contributions to asthma morbidity. The role of low/moderate level irritant exposures remains unclear. We aimed to determine which occupational exposures are associated with asthma in an eastern European country with low asthma prevalence. The Estonian Genome Center of University of Tartu collected data from 50 077 adults in 2002-2011. Asthma was assessed through a questionnaire regarding diagnosed diseases, current health status and medication. Exposures to 22 agents during the current and longest held jobs were estimated using an asthma-specific job-exposure matrix. Analyses included 34 015 subjects (aged 18-65 years, 67.0% females), of which 1209 (3.6%) reported asthma (608 with physician-confirmed diagnosis). After adjusting for age, sex and smoking habits, lifetime occupational exposure to known asthmagens (20.4%) was significantly associated with physician-diagnosed asthma (OR 1.28, 95% CI 1.03-1.59), especially high molecular weight agents (flour: OR 2.36, 95% CI 1.31-4.27; animals: OR 1.62, 95% CI 1.00-2.60). Exposure to low/moderate levels of irritants (17.4%) was associated with physician-diagnosed asthma (OR 1.88, 95% CI 1.48-2.37). More pronounced associations were observed in subjects reporting current treated asthma. Beyond confirming the effect of known asthmagens (which are well-known, mostly from observations in western countries), the results provide evidence for a role of low/moderate exposure to irritants. This finding, observed in a country with a low prevalence of asthma and atopy, provides new insight into the understanding of asthma heterogeneity.

  12. [Asthma, obesity and diet].

    Science.gov (United States)

    Barranco, P; Delgado, J; Gallego, L T; Bobolea, I; Pedrosa, Ma; García de Lorenzo, A; Quirce, S

    2012-01-01

    Asthma and obesity have a considerable impact on public health and their prevalence has increased in recent years. Numerous studies have linked both disorders. Most prospective studies show that obesity is a risk factor for asthma and have found a positive correlation between baseline body mass index (BMI) and the subsequent development of asthma, although these results are not conclusive when studying the association between airway hyperresponsiveness with BMI. Furthermore, several studies suggest that whereas weight gain increases the risk of asthma, weight loss improves the course of the illness. Different factors could explain this association. Obesity is capable of reducing pulmonary compliance, lung volumes and the diameter of peripheral respiratory airways as well as affecting the volume of blood in the lungs and the ventilation-perfusion relationship. Furthermore, the increase in the normal functioning of adipose tissue in obese subjects leads to a systemic proinflammatory state, which produces a rise in the serum concentrations of several cytokines, the soluble fractions of their receptors and chemokines. Many of these mediators are synthesized and secreted by cells from adipose tissue and receive the generic name of adipokines, including IL-6, IL-10, eotaxin, TNF-α, TGF- 1, PCR, leptin y adiponectin. Finally, specific regions of the human genome which are related to both asthma and obesity have been identified. Most studies point out that obesity is capable of increasing the prevalence and incidence of asthma, although this effect appears to be modest. The treatment of obese asthmatics must include a weight control program.

  13. Korean Asthma Guideline 2014: Summary of Major Updates to the Korean Asthma Guideline 2014.

    Science.gov (United States)

    Kim, Deog Kyeom; Park, Yong Bum; Oh, Yeon-Mok; Jung, Ki-Suck; Yoo, Ji Hong; Yoo, Kwang-Ha; Kim, Kwan Hyung

    2016-07-01

    Asthma is a prevalent and serious health problem in Korea. Recently, the Korean Asthma Guideline has been updated by The Korean Academy of Tuberculosis and Respiratory Diseases (KATRD) in an effort to improve the clinical management of asthma. This guideline focuses on adult patients with asthma and aims to deliver up to date scientific evidence and recommendations to general physicians for the management of asthma. For this purpose, this guideline was updated following systematic review and meta-analysis of recent studies and adapting some points of international guidelines (Global Initiative for Asthma [GINA] report 2014, National Asthma Education and Prevention Program [NAEPP] 2007, British Thoracic Society [BTS/SIGN] asthma guideline 2012, and Canadian asthma guideline 2012). Updated issues include recommendations derived using the population, intervention, comparison, and outcomes (PICO) model, which produced 20 clinical questions on the management of asthma. It also covers a new definition of asthma, the importance of confirming various airflow limitations with spirometry, the epidemiology and the diagnostic flow of asthma in Korea, the importance and evidence for inhaled corticosteroids (ICS) and ICS/formoterol as a single maintenance and acute therapy in the stepwise management of asthma, assessment of severity of asthma and management of exacerbation, and an action plan to cope with exacerbation. This guideline includes clinical assessments, and treatment of asthma-chronic obstructive pulmonary disease overlap syndrome, management of asthma in specific conditions including severe asthma, elderly asthma, cough variant asthma, exercise-induced bronchial contraction, etc. The revised Korean Asthma Guideline is expected to be a useful resource in the management of asthma.

  14. A case for consideration of cultural diversity in heart failure management--Part 1: Rationale for the DISCOVER Study.

    Science.gov (United States)

    Davidson, Patricia M; Macdonald, Peter; Ang, Esther; Paull, Glenn; Choucair, Sam; Daly, John; Moser, Debra K; Dracup, Kathleen

    2004-10-01

    Heart failure is a condition increasing in prevalence and responsible for high health care utilization, morbidity and mortality. Randomised controlled trials of nurse-coordinated interventions have determined self-care and the incorporation of the patient and their family in care planning as critical elements of service delivery. Coping with a chronic illness, such as heart failure, forces the individual to adjust to changed physical, social and emotional functioning and to modify their lifestyle accordingly. Clinicians increasingly use models of care that focus care delivery on the community setting. In order to develop strategies to assist patients and their families with self-care it is important that clinicians understand the health-care seeking behaviours of all individuals targeted in the community. Australia is a culturally diverse nation, yet evaluations of models of care have been undertaken largely in individuals from predominately Anglo-Celtic origins. The end result of this approach is failure to understand the full range of diverse perspectives that individuals hold that can have an impact on self-care behaviours. Consideration of cultural diversity should extend beyond language to a broader appreciation of cultural values, health seeking beliefs and engagement of culturally unique communities. The 'Understanding the cultural experiences of individuals with chronic heart failure (CHF) in South East Health (DISCOVER) Study' seeks to uncover information on the health patterns, information needs and the adjustment process for overseas-born individuals with heart failure. Such information will assist clinicians to tailor health care service delivery and ensure the delivery of appropriate, quality care. This manuscript provides the background, rationale and methods for this study.

  15. Evaluation of Agreement Between Video and Written Questionnaires for Asthma Symptoms Among Children of Tehran: ISAAC Study

    Directory of Open Access Journals (Sweden)

    MR Masjedi

    2008-07-01

    Full Text Available Introduction: International study on asthma was conducted to study the prevalence of Asthma symptoms among 13-14 year old children using written and video questionnaires during the early 90's. The aim of the present study (ISAAC was to evaluate the agreement between the two questionnaires which were self-completed by the children. Methods: This study, which was a part of the third phase of International Study of Asthma and Allergy in Childhood (ISAAC and performed exactly similar to phase1, was performed by National Research Institute of Tuberculosis and Lung Diseases (NRITLD in two cities of Iran; Rasht and Tehran. All stages of the study were performed in accordance with ISAAC protocol. The present study discusses data related to children of Tehran. A total of 3100 school children aged 13-14 years were questioned about asthma symptoms using written and video questionnaires of ISAAC study. For statistical analysis, initially a descriptive study of the available data was performed. Thereafter, chance corrected agreement between the two questionnaires was evaluated using Cohen’s Kappa co-efficiency. Results: Of the total of 3100 children, 52.4% were male and 47.6% female, with a mean age of 13.6 years. Although the questions discussed in the two questionnaires were not exactly similar, the results of the video questionnaires showed a statistically significant lower positive response to asthma symptoms as compared to the written version. Kappa co-efficiency ranged between 0.06- 0.21 (mean=0.12, which is considered poor for all variables. Conclusion: Positive responses to having asthma symptoms were significantly higher using the written questionnaire compared to the video questionnaire. Similar to previous studies, agreement between the two was considered poor for all variables. Although factors such as language, culture, dwelling area, e.t.c. have special effects on results of these questionnaires, results indicate that the two questionnaires

  16. Adherence to asthma guidelines in general practices.

    Science.gov (United States)

    Roghmann, M C; Sexton, M

    1999-06-01

    Adherence to asthma practice guidelines is low. Improved compliance could potentially improve care of patients with asthma. The purpose of this study was to determine if patients managed in a general practice with an associated asthma clinic are more likely to use asthma medications according to clinical practice guidelines than patients managed in the general surgery of the practice. A cross-sectional study of adult asthmatics, aged 18-55 years, was conducted in six British general practices. Prescription data on all asthma medication was collected for a 6-month period. Information on asthma clinic attendance, age, sex, employment status, other medical illness, and how patients used their inhaled beta2-agonist was collected through questionnaire. The prescription data for asthma medication and patient use of inhaled beta2-agonist were compared to the British Thoracic Society's (BTS) Guidelines for Management of Asthma in Adults to determine if the patient's asthma medication regimen was appropriate. There was no significant association found between appropriate asthma medication and asthma clinic attendance or other patient characteristics. Adherence to the BTS guidelines was low. Fifty-eight percent of the asthma patients used asthma medication regimens that were not consistent with the BTS guidelines published 1 year earlier. Adherence to the BTS guidelines was low regardless of patient characteristics, including asthma clinic attendance, age, sex, employment status, other medical illness, or individual practice. These findings underscore the need to document the utility of clinical practice guidelines which may improve physician compliance.

  17. Coexistence of asthma and polycystic ovary syndrome

    DEFF Research Database (Denmark)

    Zierau, Louise; Gade, Elisabeth Juul; Lindenberg, Svend;

    2016-01-01

    Asthma may be associated with polycystic ovary syndrome (PCOS), and possibly patients with PCOS have a more severe type of asthma. The purpose of this systematic literature review is to summarize evidence of a coexistense of PCOS and asthma using the available literature. The search was completed...... on 01.01.2016. English language articles were retrieved using the search terms 'Asthma' AND 'PCOS', 'Asthma' AND 'systemic inflammation', 'Asthma' AND 'metabolic syndrome', 'asthma' AND 'gynaecology', 'PCOS' AND 'systemic inflammation', 'PCOS' AND 'metabolic syndrome', 'PCOS' AND 'allergy'. Five papers...... meeting prespecified search criteria were found of which two were registry studies of relevance. The current literature supports a coexistense of PCOS and asthma and gives us an indication of the causes for the possible link between PCOS and asthma. Further research in the area must be conducted...

  18. Childhood Exposure to Ambient Air Pollutants and the Onset of Asthma: An Administrative Cohort Study in Québec

    Science.gov (United States)

    Tétreault, Louis-Francois; Doucet, Marieve; Gamache, Philippe; Fournier, Michel; Brand, Allan; Kosatsky, Tom; Smargiassi, Audrey

    2016-01-01

    pollutants and the onset of asthma: an administrative cohort study in Québec. Environ Health Perspect 124:1276–1282; http://dx.doi.org/10.1289/ehp.1509838 PMID:26731790

  19. Selling falsehoods? A cross-sectional study of Canadian naturopathy, homeopathy, chiropractic and acupuncture clinic website claims relating to allergy and asthma

    Science.gov (United States)

    Murdoch, Blake; Carr, Stuart; Caulfield, Timothy

    2016-01-01

    Objective To identify the frequency and qualitative characteristics of marketing claims made by Canadian chiropractors, naturopaths, homeopaths and acupuncturists relating to the diagnosis and treatment of allergy and asthma. Design Cross-sectional study. Setting Canada. Data set 392 chiropractic, naturopathic, homeopathic and acupuncture clinic websites located in 10 of the largest metropolitan areas in Canada, as identified using 400 Google search results. Duplicates were not excluded from data analysis. Main outcome measures Mention of allergy, sensitivity or asthma, claim of ability to diagnose allergy, sensitivity or asthma, claim of ability to treat allergy, sensitivity or asthma, and claim of allergy, sensitivity or asthma treatment efficacy. Tests and treatments promoted were noted as qualitative examples. Results Naturopath clinic websites have the highest rates of advertising at least one of diagnosis, treatment or efficacy for allergy or sensitivity (85%) and asthma (64%), followed by acupuncturists (68% and 53%, respectively), homeopaths (60% and 54%) and chiropractors (33% and 38%). Search results from Vancouver, British Columbia were most likely to advertise at least one of diagnosis, treatment or efficacy for allergy or sensitivity (72.5%) and asthma (62.5%), and results from London, Ontario were least likely (50% and 40%, respectively). Of the interventions advertised, few are scientifically supported; the majority lack evidence of efficacy, and some are potentially harmful. Conclusions The majority of alternative healthcare clinics studied advertised interventions for allergy and asthma. Many offerings are unproven. A policy response may be warranted in order to safeguard the public interest. PMID:27986744

  20. Fixed airflow obstruction in asthma: a descriptive study of patient profiles and effect on treatment responses

    OpenAIRE

    Tashkin, Donald P.; Chipps, Bradley E.; Trudo,Frank; Zangrilli, James G

    2014-01-01

    Background The role of fixed airflow obstruction (FAO) in asthma is unclear. Objective: To assess the relationship between FAO and clinical features of asthma and the effect of FAO on treatment response. Methods: Post hoc descriptive analysis of data stratified by FAO category (screening post-albuterol FEV1/FVC

  1. Are operating room nurses at higher risk of severe persistent asthma? The Nurses' Health Study.

    NARCIS (Netherlands)

    Moual, N. le; Varraso, R.; Zock, J.P.; Henneberger, P.; Speizer, F.E.; Kauffmann, F.; Camargo, C.A.

    2013-01-01

    Objective: To assess the associations between operating room (OR) nursing, a category of health care workers at high risk of exposure to various inhaled agents, and asthma severity/control among women with asthma. Methods: The level of severity/control in nurses with prevalent doctor-diagnosed asthm

  2. Fetal and Infant Origins of Childhood Asthma: The Generation R Study

    NARCIS (Netherlands)

    A.M.M. van der Sonnenschein-Voort (Agnes)

    2014-01-01

    markdownabstract__Abstract__ Asthma is a chronic inflammatory disorder of the airways. Accumulating evidence suggest that childhood asthma has at least part of its origins in fetal life and infancy. The developmental plasticity hypothesis suggests that adverse exposures in early life lead to develo

  3. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study : Design and first results

    NARCIS (Netherlands)

    Brunekreef, B; Smit, J; de Jongste, J; Neijens, H; Gerritsen, J; Postma, D; Aalberse, R; Koopman, L; Kerkhof, M; Wijga, A; van Strien, R

    2002-01-01

    The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study was initiated in 1996. Children born to allergic mothers were enrolled in a double-blind placebo-controlled trial for evaluating the use of mite-impermeable mattress and pillow covers. Children born to allergic and no

  4. Individual traffic-related air pollution and new onset adult asthma: A GIS-based pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Sherson, D.; Lysbeck Hansen, C. (Hospital of Vejle, Dept. of Occupational and Environmental Medicine, (Denmark)); Solvang Jensen, S.; Hertel, O. (Univ. of Aarhus, National Environmental Research Institute (Denmark)); Baelum, J. (Odense Univ. Hospital, Dep. of Occupational and Environmental Medicine (Denmark)); Skadhauge, L. (Haderslev Hospital, Dep. of Occupational and Environmental Medicine (Denmark)); Siersted, H.C. (Odense Univ. Hospital, Dep. of Respiratory Medicine (Denmark)); Omland, OE. (Aalborg Hospital, Dep. of Occupational Medicine (Denmark)); Thomsen, G. (South-West Jutland Hospital Esbjerg, Dep. of Occupational and Environmental Medicine (Denmark)); Sigsgaard, T. (Univ. of Aarhus, Institute of Occupational and Environmental Medicine (Denmark))

    2008-03-15

    The objective of this pilot study is to investigate the relation between asthma and wheeze debut and individually estimated exposure to traffic-related air pollutants with a validated exposure system (AirGIS). A non-smoking cohort with recently acquired asthma or wheeze as well as matched controls was identified from a large cross-sectional study. All residential and working addresses with corresponding time periods for a 10 year period were successfully identified for all study participants (N=33) and exposure estimated for both urban background and street level. Individual levels of air pollutants in the years preceding debut of asthma or wheeze were analyzed using survival analysis. No significant correlations between exposure levels and onset of disease or symptom were demonstrated. A tendency towards higher levels of nitrogen oxides exposure during the year prior to debut was seen in wheeze cases. Substantial problems in determining time of onset were encountered. It is recommended that the analytic methods developed in this pilot study are used in a larger prospective cohort to investigate individual trafficrelated air pollutants as a risk factor for the development of new asthma and wheeze. (au)

  5. Traffic-related air pollution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden

    Directory of Open Access Journals (Sweden)

    Nihlén Ulf

    2009-01-01

    Full Text Available Abstract Background There is growing evidence that air pollution from traffic has adverse long-term effects on chronic respiratory disease in children, but there are few studies and more inconclusive results in adults. We examined associations between residential traffic and asthma and COPD in adults in southern Sweden. A postal questionnaire in 2000 (n = 9319, 18–77 years provided disease status, and self-reported exposure to traffic. A Geographical Information System (GIS was used to link geocoded residential addresses to a Swedish road database and an emission database for NOx. Results Living within 100 m of a road with >10 cars/minute (compared with having no heavy road within this distance was associated with prevalence of asthma diagnosis (OR = 1.40, 95% CI = 1.04–1.89, and COPD diagnosis (OR = 1.64, 95%CI = 1.11–2.4, as well as asthma and chronic bronchitis symptoms. Self-reported traffic exposure was associated with asthma diagnosis and COPD diagnosis, and with asthma symptoms. Annual average NOx was associated with COPD diagnosis and symptoms of asthma and chronic bronchitis. Conclusion Living close to traffic was associated with prevalence of asthma diagnosis, COPD diagnosis, and symptoms of asthma and bronchitis. This indicates that traffic-related air pollution has both long-term and short-term effects on chronic respiratory disease in adults, even in a region with overall low levels of air pollution.

  6. Difficult asthma: assessment and management, Part 1.

    Science.gov (United States)

    Long, Aidan A; Fanta, Christopher H

    2012-01-01

    A minority of asthma patients have disease that proves difficult to control with usual medications and experience ongoing symptoms, poor quality of life, and limitations in activity and/or frequent asthma exacerbations. This group of patients accounts for much of the expense associated with asthma care and is the focus of national and international collaborative study groups. Distinguishing between "difficult-to-manage asthma" and truly "therapy-resistant asthma" is helpful and promotes a systematic consideration of contributory factors. Critical evaluation of factors contributing to difficult-to-manage asthma including adverse environment, comorbidities, nonadherence, and incorrect diagnosis is recommended in a systematic fashion in Part 1 of this contribution.

  7. Childhood Asthma Management and Environmental Triggers.

    Science.gov (United States)

    Hollenbach, Jessica P; Cloutier, Michelle M

    2015-10-01

    Asthma is the most common chronic disease among children. It cannot be prevented but can be controlled. Industrialized countries experience high lifetime asthma prevalence that has increased over recent decades. Asthma has a complex interplay of genetic and environmental triggers. Studies have revealed complex interactions of lung structure and function genes with environmental exposures such as environmental tobacco smoke and vitamin D. Home environmental strategies can reduce asthma morbidity in children but should be tailored to specific allergens. Coupled with education and severity-specific asthma therapy, tailored interventions may be the most effective strategy to manage childhood asthma.

  8. Individual-level socioeconomic status is associated with worse asthma morbidity in patients with asthma

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    Bouchard Anne

    2009-12-01

    Full Text Available Abstract Background Low socioeconomic status (SES has been linked to higher morbidity in patients with chronic diseases, but may be particularly relevant to asthma, as asthmatics of lower SES may have higher exposures to indoor (e.g., cockroaches, tobacco smoke and outdoor (e.g., urban pollution allergens, thus increasing risk for exacerbations. Methods This study assessed associations between adult SES (measured according to educational level and asthma morbidity, including asthma control; asthma-related emergency health service use; asthma self-efficacy, and asthma-related quality of life, in a Canadian cohort of 781 adult asthmatics. All patients underwent a sociodemographic and medical history interview and pulmonary function testing on the day of their asthma clinic visit, and completed a battery of questionnaires (Asthma Control Questionnaire, Asthma Quality of Life Questionnaire, and Asthma Self-Efficacy Scale. General Linear Models assessed associations between SES and each morbidity measure. Results Lower SES was associated with worse asthma control (F = 11.63, p Conclusions Results suggest that lower SES (measured according to education level, is associated with several indices of worse asthma morbidity, particularly worse asthma control, in adult asthmatics independent of disease severity. Results are consistent with previous studies linking lower SES to worse asthma in children, and add asthma to the list of chronic diseases affected by individual-level SES.

  9. Dose-response study of sodium cromoglycate in exercise-induced asthma.

    Science.gov (United States)

    Patel, K R; Berkin, K E; Kerr, J W

    1982-01-01

    Ten patients with exercise-induced asthma participated in a single-blind dose-response study comparing the protective effect of inhaled sodium cromoglycate in increasing concentrations from 2 to 40 mg/ml. Saline was used as a control. Effects were assessed from the mean maximal percentage fall in forced expiratory volume in one second (FEV1) after the patients had run on a treadmill for eight minutes. There was slight bronchodilation evident from the increase in baseline FEV1 after inhalation of sodium cromoglycate, the difference reaching statistical significance with the highest concentration (5.7%, p less than 0.05). After exercise the maximal percentage falls in FEV1 (means and SEM) after saline and after sodium cromoglycate at 2, 10, 20, and 40 mg/ml were 37.3 +/- 4.7, 17.3 +/- 4.1, 10 +/- 3.3, 7.6 +/- 2.4, and 12 +/- 2.9. Sodium cromoglycate inhibited the exercise-induced fall in FEV1 at all the concentrations used in the study (p less than 0.001) and its inhibitory effect increased from 2 to 20 mg/ml. The mean FEV1 returned to baseline values within 15 minutes at higher concentrations of sodium cromoglycate (20 and 40 mg/ml) and a small bronchodilator effect was noted at 30 minutes. The findings suggest that the protective effect of sodium cromoglycate in exercise asthma is dose related. At higher concentration the drug suppresses chemical mediator release from the lung mast cells and may also modify the bronchial reactivity to release mediators. PMID:6818707

  10. What drives prescribing of asthma medication to preschool wheezing children? A primary care study.

    Science.gov (United States)

    Montella, Silvia; Baraldi, Eugenio; Bruzzese, Dario; Mirra, Virginia; Di Giorgio, Angela; Santamaria, Francesca

    2013-12-01

    There is limited information on which data primary care pediatricians (PCPs) use to decide whether to prescribe or not asthma maintenance treatment, and what drives prescribing a specific therapy. The study aim was to investigate how prescribing anti-asthma maintenance treatment to preschool wheezing children is influenced by patient, family, environmental, and PCP characteristics. We conducted a cross-sectional study at 32 PCPs sites in Campania, Italy. Medical, family, and environmental information of 376 preschool wheezy children, and characteristics of the enrolled PCPs were collected. Main outcome measures of multilevel multivariate logistic regression analyses were the prescribing of maintenance treatment, and the prescription of a combined therapy as opposed to monotherapy. Variables significantly associated with long-term inhaled corticosteroids (ICS) and/or leukotriene modifiers prescription included frequent wheezing (OR = 7.19), emergency department (ED) visits (OR = 2.21), personal allergic diseases (OR = 8.49), day-care/kindergarten attendance (OR = 2.67), a high PCP prescribing volume (OR = 2.74), and a low proportion of 0- to 5-year-old patients with wheezing diagnosis (OR = 1.16). Leukotriene modifiers plus ICS were much more likely prescribed than ICS or leukotriene modifiers alone to older children (OR = 1.06) and to patients experiencing frequent wheezing (OR = 3.00), ED visits (OR = 3.12), or tobacco smoke exposure during the first 2 years of life (OR = 2.04). Finally, PCP's characteristics significantly associated with ICS plus leukotriene modifiers prescription were group practice (OR = 4.16) and a high prescribing volume (OR = 1.45). Our findings suggest that child characteristics alone are not sufficient to explain how PCPs decide to prescribe maintenance treatment and which therapy to assign, but variables associated to PCPs are crucial as well.

  11. A retrospective cohort study of cancer mortality in employees of a Russian chrysotile asbestos mine and mills: study rationale and key features.

    Science.gov (United States)

    Schüz, J; Schonfeld, S J; Kromhout, H; Straif, K; Kashanskiy, S V; Kovalevskiy, E V; Bukhtiyarov, I V; McCormack, V

    2013-08-01

    Chrysotile, a serpentine asbestos fibre, is the only type of asbestos produced and consumed in the world today. It is an established human carcinogen. We have begun fieldwork on a retrospective cohort study of employees of one of the world's largest chrysotile mine and mills, situated in Asbest, Russia. The primary aim of the study is to better characterize and quantify the risk of cancer mortality in terms of (i) the dose-response relationship of exposure with risk; (ii) the range of cancer sites affected, including female-specific cancers; and (iii) effects of duration of exposure and latency periods. This information will expand our understanding of the scale of the impending cancer burden due to chrysotile, including if chrysotile use ceased worldwide forthwith. Herein we describe the scientific rationale for conducting this study and the main features of its study design.

  12. Asthma pharmacotherapy.

    Science.gov (United States)

    Schofield, Minka L

    2014-02-01

    Asthma is a chronic inflammatory disease of the airway that leads to airway obstruction via bronchoconstriction, edema, and mucus hypersecretion. The National Asthma Education and Prevention Program has outlined evidence-based guidelines to standardize asthma therapy and improve outcomes. The initial recommendation of choice for persistent asthmatic patients is an inhaled corticosteroid (ICS). Long-acting beta-2 agonists in combination with ICS, oral corticosteroids, leukotriene modifiers, and anti-IgE therapeutic options can be considered for patients with persistent or worsening symptoms. Many novel therapies are being developed, with an emphasis on anti-inflammatory mechanisms, gene expression, and cytokine modification.

  13. Assessment of satisfaction with different dry powder inhalation devices in Greek patients with COPD and asthma: the ANASA study

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    Zervas E

    2016-08-01

    Full Text Available Eleftherios Zervas, Konstantinos Samitas, Mina Gaga 7th Respiratory Department and Asthma Center, Athens Chest Hospital “Sotiria”, Athens, Greece Background: Poor adherence to inhaled therapy is common in patients with asthma and COPD. An inhaler selection based on patients’ preference could be beneficial to adherence and treatment effectiveness. Properly designed questionnaires can assess patients’ satisfaction with their medication devices. The aim of this study was to estimate, using the Feeling of Satisfaction with Inhaler (FSI-10 questionnaire, the ease of use and satisfaction of patients regarding three different marketed dry powder inhalers (DPIs: Diskus® (DK, Elpenhaler® (EH, and Turbuhaler® (TH. The FSI-10 is a self-completed questionnaire to assess patients’ opinions regarding ease of use, portability, and usability of devices, irrespective of the drug used.Patients and methods: We performed a 4-week, open, noninterventional, multicenter, parallel clinical study in 560 asthmatic and 561 COPD patients. During the first visit, patients were classified into three groups according to the DPI they were already using. Patients were regularly receiving their treatments (Seretide DK, Rolenium EH, and Symbicort TH and agreed to complete the FSI-10 questionnaire in the second visit.Results: A total of 517 COPD and 523 asthma patients completed the study. All DPIs tested received satisfactory results, while the EH obtained consistently higher scores in the FSI-10 in both COPD and asthma patients (44.7 and 44.1 vs 41.5 and 43 for TH, 40.8 and 41.4 for DK, P<0.001 and P<0.01, respectively. TH was rated better than DK by asthma patients. Patients suffering with severe COPD tended to express higher feeling of satisfaction than those with moderate or mild disease, irrespective of the device used.Conclusion: All DPIs tested were highly acceptable by asthma and COPD patients of different ages; nevertheless, EH received significantly higher

  14. Changes of Airway Reactivity after Mycoplasma Pneumoniae Infection in Children: A Study for Early Precautions against Pediatric Asthma.

    Science.gov (United States)

    Zhang, Han; Lv, Gaomei; Shang, Yunxiao; Liu, Liyun; Xiang, Yun; Feng, Jing; Wang, Zhijia

    2015-10-01

    The relationship between Mycoplasma pneumoniae (MP) infection and asthma has rarely been explored through examination of airway reactivity. The aim of this study was to determine airway reactivity changes after MP infection in children. First, 106 children were divided into four groups according to the existence of MP infection and/or asthma. Then children with only MP belonged to the MP group; children who had both MP infection and asthma belonged to the MP+A group; children with asthma but not MP infection belonged to the non-MP+A group; normal children were classified as normal control (NC) group. Each subject underwent a bronchial provocation test (BPT) after effectively controlling the symptoms. Airway hyperresponsiveness (AHR) parameters were compared among the groups. BPT positive rates were also calculated and compared. All AHR parameters decreased following MP infection, with a more significant decrease of small airway reactivity related indexes. The BPT-positive rate in the MP+A group was significantly higher than that in the MP group. Large airway reactivity showed no significant differences between the MP+A and non-MP+A groups, while the small airway reactivity augmented more significantly in the MP+A group. MP infection caused increased reactivity of both large and small airways in lungs, and BPT-positive identification in some patients.

  15. A Pilot Study: Effects of Dietary Supplementation with α-Linolenic Acid-Enriched Perilla Seed Oil on Bronchial Asthma

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    Kozo Ashida

    1997-01-01

    Full Text Available N-3 fatty acids, such as fish oil, have been reported to have some beneficial effects in patients with bronchial asthma. The effects of dietary supplementation with perilla seed oil rich in a-linolenic acid (α-LNA, parent n-3 fatty acid, were studied in five patients with asthma. The symptoms of asthma and mean peak flow rates (PFR both early in the morning and in the evening were improved 2 weeks after dietary supplementation and the increases in PFR were significant (P<0.05. The generation of leukotriene B4 (LTB4 by peripheral leukocytes stimulated with the Ca2+ ionophore A23187 was significantly suppressed from 77.6 to 41.6 ng/5Xl06 cells by dietary supplementation (P<0.05. The generation of leukotriene C4 (LTC4 by leukocytes was also significantly suppressed from 64.0 to 38.8 ng/5x106 cells after supplementation with perilla seed oil (P<0.05. These results suggest that dietary supplementation with perilla seed oil is beneficial for the treatment of asthma.

  16. Causes and consequences of cerebral small vessel disease. The RUN DMC study: a prospective cohort study. Study rationale and protocol

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    van der Vlugt Maureen J

    2011-02-01

    Full Text Available Abstract Background Cerebral small vessel disease (SVD is a frequent finding on CT and MRI scans of elderly people and is related to vascular risk factors and cognitive and motor impairment, ultimately leading to dementia or parkinsonism in some. In general, the relations are weak, and not all subjects with SVD become demented or get parkinsonism. This might be explained by the diversity of underlying pathology of both white matter lesions (WML and the normal appearing white matter (NAWM. Both cannot be properly appreciated with conventional MRI. Diffusion tensor imaging (DTI provides alternative information on microstructural white matter integrity. The association between SVD, its microstructural integrity, and incident dementia and parkinsonism has never been investigated. Methods/Design The RUN DMC study is a prospective cohort study on the risk factors and cognitive and motor consequences of brain changes among 503 non-demented elderly, aged between 50-85 years, with cerebral SVD. First follow up is being prepared for July 2011. Participants alive will be included and invited to the research centre to undergo a structured questionnaire on demographics and vascular risk factors, and a cognitive, and motor, assessment, followed by a MRI protocol including conventional MRI, DTI and resting state fMRI. Discussion The follow up of the RUN DMC study has the potential to further unravel the causes and possibly better predict the consequences of changes in white matter integrity in elderly with SVD by using relatively new imaging techniques. When proven, these changes might function as a surrogate endpoint for cognitive and motor function in future therapeutic trials. Our data could furthermore provide a better understanding of the pathophysiology of cognitive and motor disturbances in elderly with SVD. The execution and completion of the follow up of our study might ultimately unravel the role of SVD on the microstructural integrity of the white

  17. Childhood asthma in Beijing, China: A population-based case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, T.Z.; Niu, S.R.; Lu, B.Y.; Fan, X.E.; Sun, F.Y.; Wang, J.P.; Zhang, Y.W.; Zhang, B.; Owens, P.; Hao, L.Y.; Li, Y.D.; Leaderer, B. [Yale School of Medicine, New Haven, CT (United States). Dept. of Epidemiology & Public Health

    2002-11-15

    A population-based case-control study was conducted in Shunyi County, People's Republic of China, in January 1999 and March 2001 to investigate the risk factors for childhood asthma. An increased risk of childhood asthma was associated with smoking by relatives in front of the mother while she was pregnant with the child (odds ratio (OR) = 1.3, 95% confidence interval (CI): 1.0, 1.6) and with smoking by relatives in front of the child (OR = 1.4, 95% CI: 1.1, 1.9). The risk increased with the increasing number of smokers and the total minutes of smoking by relatives in front of both the child and the mother while she was pregnant with the child. An increased risk was observed for use of coal for heating (OR = 1.5, 95% CI: 1.1, 1.9). Those who reported using coal for cooking without ventilation also had an increased risk (OR = 2.3, 95% CI: 1.5, 3.5). An increased risk was observed for those who reported having molds or fungi on the ceilings of their houses (OR = 1.8, 95% CI: 1.1, 2.9) or inside the child's room (OR 1.8, 95% CI: 1.0, 3.2). An increased risk was also found for those having both a dog and a cat as pets (OR 1.5, 95% CI: 1.0, 2.3) or for finding both cockroaches and rats inside their houses (OR = 1.8, 95% CI: 1.2, 2.8).

  18. Pediatric asthma controller therapy.

    Science.gov (United States)

    Anselmo, Mark

    2011-02-01

    The treatment of children with asthma has historically relied upon expert opinion using data extrapolated from adult studies. Over the past few years, landmark studies have been completed providing healthcare professionals with evidence on which a reasonable approach can be made for children suffering from this common and serious disease. Asthmatic phenotype in children, unlike adults, tends to differ according to age, which must be taken into account as well as triggers, severity, and level of control. The care of the child with asthma is complex, but accumulating data have demonstrated that we are on the right path for optimizing control while reducing the burden of side effects. The newest Global Initiative for Asthma (GINA) guidelines, as well as recent updates from the landmark CAMP (Childhood Asthma Management Program) study and information from the PACT (Pediatric Asthma Control Trial) and budesonide/formoterol controller and reliever studies, along with recent comparisons of higher dose inhaled corticosteroids (ICS), and ICS/long-acting β(2)-adrenoceptor agonist (LABA) combination and leukotriene receptor antagonist (LTRA) therapies in children have clarified a few of the big questions in pediatric asthma. For children with asthma aged 5 years and older, the CAMP trial demonstrated that regular use of ICS reduces the frequency of symptoms; however, height was adversely affected and there is no evidence for altering the natural history of asthma. In patients aged 6 years and over whose asthma is uncontrolled on ICS alone, combination therapy with ICS and a LABA has been recently compared with the use of higher dose ICS and the addition of an LTRA in pediatric patients. The addition of a LABA statistically will be of most benefit; however, some children will have optimal control with doubling the baseline dose of ICS or addition of an LTRA. Use of budesonide/formoterol as a controller and reliever therapy extends the time to first exacerbation versus

  19. The association of intrafamilial violence against children with symptoms of atopic and non-atopic asthma: A cross-sectional study in Salvador, Brazil.

    Science.gov (United States)

    Bonfim, Camila Barreto; dos Santos, Darci Neves; Barreto, Maurício Lima

    2015-12-01

    This study aims to describe the types of intrafamilial violence perpetrated against children according to living conditions, family factors, and child characteristics, and to identify the association between types of intrafamilial violence and asthma symptoms in atopic and non-atopic children. A cross-sectional study was carried out with 1,370 caregivers as part of the Social Changes, Asthma and Allergy in Latin America (SCAALA) study, conducted in 2006 in Brazil. The study population was selected by random sampling. The main outcome measures were atopic and non-atopic asthma. We investigate the association between intrafamilial violence and asthma symptoms in atopic and non-atopic children. A backward multivariate logistic polytomous regression was performed to verify the main association. Nonviolent discipline (NVD) and maltreatment nonviolent discipline (MNVD) were positively associated with non-atopic asthma symptoms (NVD: odds ratio (OR)=1.95/95% confidence interval (CI)=1.17-3.25; MNVD: OR=1.95/95% CI=1.19-3.20). However, for the most severe intrafamilial violence, this association was not found after control of potential confounders. This study demonstrates the effect of types of intrafamilial violence on non-atopic asthma. Intrafamilial violence against children represents one more component in the determination of non-atopic asthma in Latin America.

  20. Exercise and Asthma

    Science.gov (United States)

    ... Español Text Size Email Print Share Exercise and Asthma Page Content Article Body Almost every child (and ... of Pediatrics about asthma and exercise. What is asthma Asthma is the most common chronic medical problem ...

  1. Asthma and Hispanic Americans

    Science.gov (United States)

    ... and Data > Minority Population Profiles > Hispanic/Latino > Asthma Asthma and Hispanic Americans In 2014, 2.1 million Hispanics reported that they currently have asthma. Puerto Rican Americans have almost twice the asthma ...

  2. Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study

    Directory of Open Access Journals (Sweden)

    Jöbsis Quirijn

    2009-06-01

    Full Text Available Abstract Background Asthma is the most common chronic disease in childhood, characterized by chronic airway inflammation. There are problems with the diagnosis of asthma in young children since the majority of the children with recurrent asthma-like symptoms is symptom free at 6 years, and does not have asthma. With the conventional diagnostic tools it is not possible to differentiate between preschool children with transient symptoms and children with asthma. The analysis of biomarkers of airway inflammation in exhaled breath is a non-invasive and promising technique to diagnose asthma and monitor inflammation in young children. Moreover, relatively new lung function tests (airway resistance using the interrupter technique have become available for young children. The primary objective of the ADEM study (Asthma DEtection and Monitoring study, is to develop a non-invasive instrument for an early asthma diagnosis in young children, using exhaled inflammatory markers and early lung function measurements. In addition, aetiological factors, including gene polymorphisms and gene expression profiles, in relation to the development of asthma are studied. Methods/design A prospective case-control study is started in 200 children with recurrent respiratory symptoms and 50 control subjects without respiratory symptoms. At 6 years, a definite diagnosis of asthma is made (primary outcome measure on basis of lung function assessments and current respiratory symptoms ('golden standard'. From inclusion until the definite asthma diagnosis, repeated measurements of lung function tests and inflammatory markers in exhaled breath (condensate, blood and faeces are performed. The study is registered and ethically approved. Discussion This article describes the study protocol of the ADEM study. The new diagnostic techniques applied in this study could make an early diagnosis of asthma possible. An early and reliable asthma diagnosis at 2–3 years will have

  3. Childhood Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  4. Occupational Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  5. Asthma Quiz

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  6. A population-based study of asthma, quality of life, and occupation among elderly Hispanic and non-Hispanic whites: a cross-sectional investigation

    Directory of Open Access Journals (Sweden)

    Delclos George L

    2005-09-01

    Full Text Available Abstract Background The U.S. population is aging and is expected to double by the year 2030. The current study evaluated the prevalence of asthma and its correlates in the elderly Hispanic and non-Hispanic white population. Methods Data from a sample of 3021 Hispanics and non-Hispanic White subjects, 65 years and older, interviewed as part of an ongoing cross-sectional study of the elderly in west Texas, were analyzed. The outcome variable was categorized into: no asthma (reference category, current asthma, and probable asthma. Polytomous logistic regression analysis was used to assess the relationship between the outcome variable and various socio-demographic measures, self-rated health, asthma symptoms, quality of life measures (SF-12, and various occupations. Results The estimated prevalence of current asthma and probable asthma were 6.3% (95%CI: 5.3–7.2 and 9.0% (95%CI: 7.8–10.1 respectively. The majority of subjects with current asthma (Mean SF-12 score 35.8, 95%CI: 34.2–37.4 or probable asthma (35.3, 34.0–36.6 had significantly worse physical health-related quality of life as compared to subjects without asthma (42.6, 42.1–43.1. In multiple logistic regression analyses, women had a 1.64 times greater odds of current asthma (95%CI: 1.12–2.38 as compared to men. Hay fever was a strong predictor of both current and probable asthma. The odds of current asthma were 1.78 times (95%CI: 1.24–2.55 greater among past smokers; whereas the odds of probable asthma were 2.73 times (95%CI: 1.77–4.21 greater among current smokers as compared to non-smokers. Similarly fair/poor self rated health and complaints of severe pain were independently associated with current and probable asthma. The odds of current and probable asthma were almost two fold greater for obesity. When stratified by gender, the odds were significantly greater among females (p-value for interaction term = 0.038. The odds of current asthma were significantly greater for

  7. Traffic exposure associated with allergic asthma and allergic rhinitis in adults. A cross-sectional study in southern Sweden

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    Montnémery Peter

    2009-05-01

    Full Text Available Abstract Background There is conflicting evidence that traffic-related air pollution is a risk factor for allergic conditions. Few studies have investigated this in adults. In adults, a high proportion of asthma, rhinitis and eczema is triggered by non-allergic factors. We investigated traffic as a risk factor for allergic versus non-allergic asthma and rhinitis, and eczema, in adults. A questionnaire from 2000 (n = 9319, 18–77 years provided individual data about disease outcome and self-reported traffic exposure. Additional exposure assessments were obtained using Geographical Informations Systems (GIS. Residential addresses were linked to the national Swedish Road Database and to a pollutant database with modelled annual means of NOx (Nitrogen Oxids. Results Living within 100 m from a road with a traffic intensity of >10 cars/min (24 hour mean was associated with prevalence of current asthma reported to be triggered by allergic factors (OR = 1.83, 95% CI = 1.23–2.72 and with allergic rhinitis (OR = 1.30, 95%CI = (1.05–1.61. No relation was seen with asthma or rhinitis triggered by other factors. Living within 100 m of a road with >10 cars/min was also associated with hand-eczema during the last 12 months (OR = 1.63, 95% CI = 1.19–2.23, but not with allergic eczema or diagnosed hand-eczema. Consistent results were seen using self-reported traffic, but the associations with NOx were less consistent. Conclusion Exposure to traffic was associated with a higher prevalence of allergic asthma and allergic rhinitis, but not with asthma or rhinitis triggered by non-allergic factors. This difference was suggested by the overall pattern, but only clear using GIS-measured traffic intensity as a proxy for traffic exposure. An association was also found with hand-eczema during the last 12 months. We suggest that asthma and rhinitis should not be treated as homogenous groups when estimating effects from traffic in adults.

  8. Moderating effect of gender on the prospective relation of physical activity with psychosocial outcomes and asthma control in adolescents: a longitudinal study

    NARCIS (Netherlands)

    Tiggelman, D.; Ven, M.O.M. van de; Schayck, O.C.P. van; Engels, R.C.M.E.

    2014-01-01

    Objective: Adolescents with asthma experience more psychosocial and physiological problems compared to their healthy peers. Physical activity (PA) might decrease these problems. This study was the first observational longitudinal study to examine whether habitual PA could predict changes in psychoso

  9. Rationale, design, methodology and sample characteristics for the family partners for health study: a cluster randomized controlled study

    Directory of Open Access Journals (Sweden)

    Berry Diane C

    2012-03-01

    Full Text Available Abstract Background Young children who are overweight are at increased risk of becoming obese and developing type 2 diabetes and cardiovascular disease later in life. Therefore, early intervention is critical. This paper describes the rationale, design, methodology, and sample characteristics of a 5-year cluster randomized controlled trial being conducted in eight elementary schools in rural North Carolina, United States. Methods/Design The first aim of the trial is to examine the effects of a two-phased intervention on weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy in overweight or obese 2nd, 3 rd, and 4th grade children and their overweight or obese parents. The primary outcome in children is stabilization of BMI percentile trajectory from baseline to 18 months. The primary outcome in parents is a decrease in BMI from baseline to 18 months. Secondary outcomes for both children and parents include adiposity, nutrition and exercise health behaviors, and self-efficacy from baseline to 18 months. A secondary aim of the trial is to examine in the experimental group, the relationships between parents and children's changes in weight status, adiposity, nutrition and exercise health behaviors, and self-efficacy. An exploratory aim is to determine whether African American, Hispanic, and non-Hispanic white children and parents in the experimental group benefit differently from the intervention in weight status, adiposity, health behaviors, and self-efficacy. A total of 358 African American, non-Hispanic white, and bilingual Hispanic children with a BMI ≥ 85th percentile and 358 parents with a BMI ≥ 25 kg/m2 have been inducted over 3 1/2 years and randomized by cohort to either an experimental or a wait-listed control group. The experimental group receives a 12-week intensive intervention of nutrition and exercise education, coping skills training and exercise (Phase I, 9 months of continued monthly contact

  10. Recognizing asthma mimics and asthma complications.

    Science.gov (United States)

    Amundson, Dennis; Seda, Gilbert; Daheshia, Massoud

    2011-10-01

    Asthma is a chronic inflammatory disorder of the airways characterized by airflow obstruction, bronchial hyperreactivity, and underlying inflammation. Two common reasons asthmatics fail standard therapy are incorrect diagnosis and failure to recognize underlying contributing factors. A correct diagnosis of asthma is of great importance to military practitioners since misdiagnosis or uncontrolled asthma affects an individual's operational readiness or determines whether one can receive a medical waiver to enlist in military service. This article presents four cases of patients with dyspnea that have conditions which mimic asthma or complicate asthma management: vocal cord dysfunction misdiagnosed as asthma, respiratory bronchiolitis interstitial lung disease mistaken as asthma, difficult-to-control asthma because of bronchiectasis and allergic bronchopulmonary aspergillosis, and difficult and fatal asthma. Asthma is contrasted to other respiratory disorders, and an outlined approach to asthma diagnosis and management is presented using the Global Initiative for Asthma guidelines.

  11. Asthma in patients with psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, A S; Skov, L; Skytthe, A;

    2015-01-01

    We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan [1]. The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...

  12. Association of Different Human Rhinovirus Species with Asthma in Children: A Preliminary Study

    Directory of Open Access Journals (Sweden)

    Min Zhao

    2016-01-01

    Conclusions: Our data revealed a high prevalence of HRVs in children in China, regardless of clinical status. HRV-C was the dominant species and may be one of the key factors in the association of HRVs with asthma.

  13. Causal direction between respiratory syncytial virus bronchiolitis and asthma studied in monozygotic twins

    DEFF Research Database (Denmark)

    Poorisrisak, Porntiva; Halkjaer, Liselotte Brydensholt; Thomsen, Simon Francis;

    2010-01-01

    Respiratory syncytial virus (RSV) bronchiolitis has been associated with later development of asthma, wheezing, abnormal pulmonary function, and sensitization. Our aim was to determine the differential effect within monozygotic (MZ) twin pairs discordant for severe RSV bronchiolitis in infancy...

  14. Long-term studies of the natural history of asthma in childhood

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Bønnelykke, Klaus

    2010-01-01

    ). Prospective identification of endophenotypes allowing accurate prediction of the clinical course is currently not possible. The variability of the clinical course remains an enigma and difficult to predict. Three of 4 school-aged children with asthma have outgrown disease by midadulthood. The risk......Segmentation of children with asthma and other wheezy disorders remains the main research challenge today, as it was when described 2 centuries ago. Early childhood wheezy disorders follow different temporal trajectories, probably representing different underlying mechanisms (endophenotypes...... of persistence increases with severity, sensitization, smoking, and female sex. Genetic risk variants might help disentangle the heterogeneity of asthma and other wheezy disorders. At early school age, children with asthma have reduced lung function. It is an important and unresolved question whether the airflow...

  15. Regular use of non-steroidal anti-inflammatory drugs increases the risk of adult-onset asthma: a population-based follow-up study

    DEFF Research Database (Denmark)

    Thomsen, Simon Francis; Kyvik, Kirsten Ohm; Skadhauge, Lars Rauff;

    2009-01-01

    BACKGROUND: Little is known about the relation between regular use of non-steroidal anti-inflammatory drugs (NSAIDs) and the risk of asthma at the population level. The aim of this study was to examine a possible association between intake of NSAIDs and risk of adult-onset asthma. METHODS: Using...... data from two multidisciplinary postal questionnaire surveys concerning health and lifestyle, we prospectively studied 19 349 adult twins enrolled in the nationwide Danish Twin Registry. RESULTS: We found a higher prevalence of new-onset asthma in subjects who used NSAIDs (other than aspirin) regularly...

  16. Preliminary studies: differences in microRNA expression in asthma and chronic obstructive pulmonary disease

    OpenAIRE

    Pietrusińska, Małgorzata; Pająk, Aneta; Górski, Paweł; Kuna, Piotr; Szemraj, Janusz; Goździńska-Nielepkowicz, Agnieszka; Pietras, Tadeusz

    2016-01-01

    Introduction The asthma- and chronic obstructive pulmonary disease (COPD)-related morbidity has been increasing during the recent years. Both asthma and COPD are diseases of inflammatory etiology. The increasing interest in the pathomechanisms involved in the development of obstructive pulmonary diseases seems to be fully justified. Recent research has attempted to determine the associations of microRNA with the pathogenesis of pulmonary diseases. Aim To assess the expression of microRNA in t...

  17. Asthma and COPD in cystic fibrosis intron-8 5T carriers. A population-based study

    DEFF Research Database (Denmark)

    Dahl, Morten; Tybjaerg-Hansen, Anne; Lange, Peter;

    2005-01-01

    Carriers of cystic fibrosis intron-8 5T alleles with high exon-9 skipping could have increased annual lung function decline and increased risk for asthma or chronic obstructive pulmonary disease (COPD).......Carriers of cystic fibrosis intron-8 5T alleles with high exon-9 skipping could have increased annual lung function decline and increased risk for asthma or chronic obstructive pulmonary disease (COPD)....

  18. Suicidal ideation and suicide attempts among asthma

    OpenAIRE

    2016-01-01

    Background The present study aimed to investigate the mental health status in patients with asthma and assess the effects of asthma on suicidal ideation and attempts using a representative sample from Korea. Methods Individual-level data were obtained from 228,744 participants (6372 with asthma and 222,372 without asthma) of the 2013 Korean Community Health Survey. Demographic characteristics, socioeconomic status, physical health status, and mental health status were compared between patient...

  19. Obesity-related asthma in adults.

    Science.gov (United States)

    Bhatt, Nikunj A; Lazarus, Angeline

    2016-08-01

    Obesity as a risk factor for asthma has been identified in previous studies. Additionally, a disproportionate number of patients with severe or difficult-to-control asthma are obese. Patients with obesity-related asthma tend to have worse asthma control and quality of life disproportionate to their pulmonary function tests, are less responsive to corticosteroid therapy, and are more likely to have obesity-related comorbidities such as obstructive sleep apnea and gastroesophageal disease that complicate asthma treatment. With the increasing prevalence of obesity, the prevalence of asthma is anticipated to grow proportionally. Addressing weight loss and encouraging activity is essential in the management of obesity-related asthma. This article briefly overviews the epidemiology, unique distinguishing features, potential mechanisms, and approach to management of patients with obesity-related asthma in adults.

  20. Adolescent boys with asthma – a pilot study on embodied gendered habits

    Directory of Open Access Journals (Sweden)

    Westergren T

    2012-11-01

    Full Text Available Thomas Westergren,1 Ulla-Britt Lilleaas21Faculty of Health and Sport Science, Department of Health and Nursing Science, University of Agder, Grimstad, Norway; 2Faculty of Humanities and Education, Centre for Gender and Equality, University of Agder, Kristiansand, NorwayPurpose: Asthma is a common chronic disease with gender differences in terms of severity and quality of life. This study aimed to understand the gendered practices of male asthmatic adolescents in terms of living with and managing their chronic disease. The study applied a sociological perspective to identify the gender-related practices of participants and their possible consequences for health and disease.Patients and methods: The study used a combined ethnomethodology and grounded theory design, which was interpreted using Bourdieu's theory of practice. We aimed to discover how participants interpreted their social worlds to create a sense of meaning in their everyday lives. The study was based on multistage focus group interviews with five adolescent participants at a specialist center for asthmatic children and youths. We took necessary precautions to protect the participants, according to the principles of the Declaration of Helsinki. The study protocol was approved by the Regional Committee for Medical Research Ethics and the hospital's research department.Results: The core concept for asthmatic male adolescents was being men. They were focused on being nonasthmatic, and exhibited ambivalence towards the principles of the health services. Physical activity supported their aim of being men and being nonasthmatic, as well as supported their treatment goals. Being fearless, unconcerned, “cool,” and dependent also supported the aim of being men and being nonasthmatic, but not the health service principle of regular medication. Occasionally, the participants were asthmatic when they were not able to or gained no advantages from being nonasthmatic. Their practice of being men

  1. Hanford waste-form release and sediment interaction: A status report with rationale and recommendations for additional studies

    Energy Technology Data Exchange (ETDEWEB)

    Serne, R.J. (Pacific Northwest Lab., Richland, WA (USA)); Wood, M.I. (Westinghouse Hanford Co., Richland, WA (USA))

    1990-05-01

    This report documents the currently available geochemical data base for release and retardation for actual Hanford Site materials (wastes and/or sediments). The report also recommends specific laboratory tests and presents the rationale for the recommendations. The purpose of this document is threefold: to summarize currently available information, to provide a strategy for generating additional data, and to provide recommendations on specific data collection methods and tests matrices. This report outlines a data collection approach that relies on feedback from performance analyses to ascertain when adequate data have been collected. The data collection scheme emphasizes laboratory testing based on empiricism. 196 refs., 4 figs., 36 tabs.

  2. Taking ACTion for better control of asthma

    Institute of Scientific and Technical Information of China (English)

    SUN Yong-chang

    2007-01-01

    @@ The global prevalence of asthma ranges from 1% to 18% of the population in different countries.1 In China, while national data of asthma prevalence are still lacking, an epidemiological study in Beijing showed that the prevalence of asthma in occupational populations was 1.25%.2

  3. Adult Asthma Consensus Guidelines Update 2003

    Directory of Open Access Journals (Sweden)

    Catherine Lemière

    2004-01-01

    Full Text Available BACKGROUND: Several sets of Canadian guidelines for the diagnosis and management of asthma have been published over the past 15 years. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies have highlighted the need to incorporate new information into the asthma guidelines.

  4. Self-reported asthma and allergies in top athletes compared to the general population - results of the German part of the GA2LEN-Olympic study 2008

    Directory of Open Access Journals (Sweden)

    Thomas Silke

    2010-11-01

    Full Text Available Abstract Background Prevalence of asthma and allergies in top athletes is high. However, most previous studies did not include a general population comparison group. We aimed to compare the prevalence of asthma, allergies and medical treatment in different groups of German top athletes to the general population. Methods Prior to the 2008 Summer Olympic Games, 291 German candidates for participation (65% completed a questionnaire on respiratory and allergic symptoms. Results were compared to those of a general population study in Germany (n = 2425, response 68%. Furthermore, associations between types of sports and the self-reported outcomes were calculated. All models were adjusted for age, sex, level of education and smoking. Results Athletes reported significantly more doctors' diagnosed asthma (17% vs. 7%, more current use of asthma medication (10% vs. 4% and allergic rhinitis (25% vs. 17% compared to the general population. After adjustment, top athletes only had an increased Odds Ratio for doctor's diagnosed asthma (OR: 1.6; 95% CI 1.1-2.5. Compared to the general population, athletes in endurance sports had an increased OR for doctor's diagnosed asthma (2.4; 1.5-3.8 and current use of asthma medication (1.8; 1.0-3.4. In this group, current wheeze was increased when use of asthma medication was taken into account (1.8; 1.1-2.8. For other groups of athletes, no significantly increased ORs were observed. Conclusions Compared to the general population, an increased risk of asthma diagnosis and treatment was shown for athletes involved in endurance sports. This might be due to a better medical surveillance and treatment of these athletes.

  5. Quality of life in children with undiagnosed and diagnosed asthma

    NARCIS (Netherlands)

    van Gent, R.; van Essen, L.E.; Rovers, M.M.; Kimpen, J.L.; van der Ent, C.K.; de Meer, G.

    2007-01-01

    This study describes the impact of undiagnosed and diagnosed asthma on quality of life in schoolchildren aged 7-10 years and their caregivers in a cross-sectional community-based study. Diagnosed asthma was defined as the parents' confirmation of a physician's diagnosis of asthma. Undiagnosed asthma

  6. Genome-Wide Association Study Identifies Novel Loci Associated With Diisocyanate-Induced Occupational Asthma

    Science.gov (United States)

    Yucesoy, Berran; Kaufman, Kenneth M.; Lummus, Zana L.; Weirauch, Matthew T.; Zhang, Ge; Cartier, André; Boulet, Louis-Philippe; Sastre, Joaquin; Quirce, Santiago; Tarlo, Susan M.; Cruz, Maria-Jesus; Munoz, Xavier; Harley, John B.; Bernstein, David I.

    2015-01-01

    Diisocyanates, reactive chemicals used to produce polyurethane products, are the most common causes of occupational asthma. The aim of this study is to identify susceptibility gene variants that could contribute to the pathogenesis of diisocyanate asthma (DA) using a Genome-Wide Association Study (GWAS) approach. Genome-wide single nucleotide polymorphism (SNP) genotyping was performed in 74 diisocyanate-exposed workers with DA and 824 healthy controls using Omni-2.5 and Omni-5 SNP microarrays. We identified 11 SNPs that exceeded genome-wide significance; the strongest association was for the rs12913832 SNP located on chromosome 15, which has been mapped to the HERC2 gene (p = 6.94 × 10−14). Strong associations were also found for SNPs near the ODZ3 and CDH17 genes on chromosomes 4 and 8 (rs908084, p = 8.59 × 10−9 and rs2514805, p = 1.22 × 10−8, respectively). We also prioritized 38 SNPs with suggestive genome-wide significance (p < 1 × 10−6). Among them, 17 SNPs map to the PITPNC1, ACMSD, ZBTB16, ODZ3, and CDH17 gene loci. Functional genomics data indicate that 2 of the suggestive SNPs (rs2446823 and rs2446824) are located within putative binding sites for the CCAAT/Enhancer Binding Protein (CEBP) and Hepatocyte Nuclear Factor 4, Alpha transcription factors (TFs), respectively. This study identified SNPs mapping to the HERC2, CDH17, and ODZ3 genes as potential susceptibility loci for DA. Pathway analysis indicated that these genes are associated with antigen processing and presentation, and other immune pathways. Overlap of 2 suggestive SNPs with likely TF binding sites suggests possible roles in disruption of gene regulation. These results provide new insights into the genetic architecture of DA and serve as a basis for future functional and mechanistic studies. PMID:25918132

  7. Prevalence of asthma and other allergic conditions in Colombia 2009–2010: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Dennis Rodolfo J

    2012-07-01

    Full Text Available Abstract Background While it is suggested that the prevalence of asthma in developed countries may have stabilized, this is not clear in currently developing countries. Current available information for both adults and children simultaneously on the burden and impact of allergic conditions in Colombia and in many Latin American countries is limited. The objectives of this study were to estimate the prevalence for asthma, allergic rhinitis (AR, atopic eczema (AE, and atopy in six colombian cities; to quantify costs to the patient and her/his family; and to determine levels of Immunoglobulin E (IgE in asthmatic and healthy subjects. Methods We conducted a cross-sectional, population-based study in six cities during the academic year 2009–2010. We used a school-based design for subjects between 5–17 years old. We carried out a community-based strategy for subjects between 1–4 years old and adults between 18–59 years old. Serum samples for total and antigen-specific (IgE levels were collected using a population-based, nested, case–control design. Results We obtained information on 5978 subjects. The largest sample of subjects was collected in Bogotá (2392. The current prevalence of asthma symptoms was 12% (95% CI, 10.5-13.7, with 43% (95% CI, 36.3-49.2 reporting having required an emergency department visit or hospitalization in the past 12 months. Physician diagnosed asthma was 7% (95% CI, 6.1-8.0. The current prevalence of AR symptoms was 32% (95% CI, 29.5-33.9, and of AE symptoms was 14% (95% CI, 12.5-15.3. We collected blood samples from 855 subjects; 60.2% of asthmatics and 40.6% of controls could be classified as atopic. Conclusions In Colombia, symptom prevalence for asthma, AR and AE, as well as levels of atopy, are substantial. Specifically for asthma, symptom severity and absence from work or study due to symptoms are important. These primary care sensitive conditions remain an unmet public health burden in developing

  8. BENEFIT OF ASTHMA ACTION PLAN

    Directory of Open Access Journals (Sweden)

    Pagadpally

    2015-09-01

    Full Text Available AIM: The aim of this study was to evaluate the role of asthma action plan on asthma control, reducing unscheduled hospital visits of children with asthma. The study also was to know if the instructions regarding management are being documented in the patient notes. METHOD: It was a retrospective study. The data was collected from a random sample of 100 patients with asthma between Jan . 2012 to Dec . 2014 who were admitted as in - patients to the children’s ward in our hospital. RESULTS: Children who received asthma action plan had fewer exacerbations and fewer lost school days. Good documentation of symptoms led to better compliance and outcome in the child KEYWORDS: A sthma; A ction plan.

  9. Mobile phone-based asthma self-management aid for adolescents (mASMAA: a feasibility study

    Directory of Open Access Journals (Sweden)

    Rhee H

    2014-01-01

    Full Text Available Hyekyun Rhee,1 James Allen,2 Jennifer Mammen,1 Mary Swift21School of Nursing, 2Department of Computer Science, University of Rochester, Rochester, NY, USAPurpose: Adolescents report high asthma-related morbidity that can be prevented by adequate self-management of the disease. Therefore, there is a need for a developmentally appropriate strategy to promote effective asthma self-management. Mobile phone-based technology is portable, commonly accessible, and well received by adolescents. The purpose of this study was to develop and evaluate the feasibility and acceptability of a comprehensive mobile phone-based asthma self-management aid for adolescents (mASMAA that was designed to facilitate symptom monitoring, treatment adherence, and adolescent–parent partnership. The system used state-of-the-art natural language-understanding technology that allowed teens to use unconstrained English in their texts, and to self-initiate interactions with the system.Materials and methods: mASMAA was developed based on an existing natural dialogue system that supports broad coverage of everyday natural conversation in English. Fifteen adolescent–parent dyads participated in a 2-week trial that involved adolescents' daily scheduled and unscheduled interactions with mASMAA and parents responding to daily reports on adolescents' asthma condition automatically generated by mASMAA. Subsequently, four focus groups were conducted to systematically obtain user feedback on the system. Frequency data on the daily usage of mASMAA over the 2-week period were tabulated, and content analysis was conducted for focus group interview data.Results: Response rates for daily text messages were 81%–97% in adolescents. The average number of self-initiated messages to mASMAA was 19 per adolescent. Symptoms were the most common topic of teen-initiated messages. Participants concurred that use of mASMAA improved awareness of symptoms and triggers, promoted treatment adherence and

  10. Patterns, predictors and outcomes of asthma control and exacerbations during pregnancy: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Luke E. Grzeskowiak

    2016-02-01

    Full Text Available There exists a paucity of data for socially disadvantaged populations describing patterns and predictors of asthma control status and exacerbations during pregnancy, and their relationship to adverse perinatal outcomes. Asthmatic women (n=189 were followed prospectively during pregnancy, with visits at 12, 20, 28 and 36 weeks gestation. Data on loss of control, recurrent uncontrolled asthma and moderate/severe exacerbations were collected at each visit and their relationship to perinatal outcomes examined following stratification for fetal sex. 50% of asthmatic women experienced a loss of control or moderate/severe exacerbation during pregnancy, with 22% of women experiencing a moderate/severe exacerbation. Factors associated with an increased risk of women experiencing recurrent uncontrolled asthma during pregnancy included smoking (relative risk 2.92, 95% CI 1.53–5.58, inhaled corticosteroid use at the beginning of pregnancy (relative risk 2.40, 95% CI 1.25–4.60 and increasing maternal age (relative risk 1.06, 95% CI 1.01–1.11. No factors were associated with moderate/severe exacerbations. Asthma control rather than exacerbations during pregnancy appeared to be most strongly correlated with perinatal outcomes. Following stratification by fetal sex, the presence of recurrent uncontrolled asthma was associated with an increased risk of being small for gestational age in women pregnant with females (33.3% versus 9.5%; p=0.018. In contrast, there was a nonsignificant increased risk of preterm birth in women with recurrent uncontrolled asthma that were pregnant with males (25.0% versus 11.8%; p=0.201 These results suggest that the key to improving perinatal outcomes lies in improving asthma control as early as possible in pregnancy and monitoring throughout pregnancy, rather than focusing on preventing exacerbations alone.

  11. Association between environmental factors and current asthma, rhinoconjunctivitis and eczema symptoms in school-aged children from Oropeza Province – Bolivia: a cross-sectional study

    OpenAIRE

    Solis-Soto, Maria Teresa; Patino, Armando; Nowak, Dennis; Radon, Katja

    2013-01-01

    Background: In recent years, the prevalence of asthma, rhinoconjunctivitis and eczema symptoms in childhood has considerably increased in developing countries including Bolivia, possibly due to changes in lifestyle, environmental and domestic factors. This study aimed to assess the association between environmental factors and asthma, rhinoconjuctivitis and eczema symptoms in school-aged children from Oropeza Province in Chuquisaca, Bolivia. Methods: A cross-sectional study was performed in 2...

  12. Environment and asthma in adults.

    Science.gov (United States)

    Le Moual, Nicole; Jacquemin, Bénédicte; Varraso, Raphaëlle; Dumas, Orianne; Kauffmann, Francine; Nadif, Rachel

    2013-09-01

    The present review addresses recent advances and especially challenging aspects regarding the role of environmental risk factors in adult-onset asthma, for which the causes are poorly established. In the first part of the review, we discuss aspects regarding some environmental risk factors for adult-onset asthma: air pollution, occupational exposures with a focus on an emerging risk represented by exposure to cleaning agents (both at home and in the workplace), and lifestyle and nutrition. The second part is focused on perspectives and challenges, regarding relevant topics on which research is needed to improve the understanding of the role of environmental factors in asthma. Aspects of exposure assessment, the complexity of multiple exposures, the interrelationships of the environment with behavioral characteristics and the importance of studying biological markers and gene-environment interactions to identify the role of the environment in asthma are discussed. We conclude that environmental and lifestyle exposures play an important role in asthma or related phenotypes. The changes in lifestyle and the environment in recent decades have modified the specific risk factors in asthma even for well-recognized risks such as occupational exposures. To better understand the role of the environment in asthma, the use of objective (quantitative measurement of exposures) or modern tools (bar code, GPS) and the development of multidisciplinary collaboration would be very promising. A better understanding of the complex interrelationships between socio-economic, nutritional, lifestyle and environmental conditions might help to study their joint and independent roles in asthma.

  13. AsthmaVent – Effect of Ventilation on Asthma Control

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    Background House dust mite (HDM) allergy is a frequent cause of allergic asthma among children. Children spend 14 hours of their time indoor everyday in aberage, where they are exposed to different components in the indoor air. These components are children with asthma and HDM allergy specially...... air quality and thereby asthma symptoms and quality of life, in children with house dust mite allergy and asthma. Materials and Methods Randomized double-blind placebo-controlled intervention study, including 80 children from 3 Danish Pediatric outpatient clinics, with: Verified asthma, requiring...... a minimum of 400 µg of inhaled steroid daily Verified HDM allergy Verified exposure to HDMallergene No pet- or birch allergy A ventilation system will be placed in to the child’s bedroom, ventilating the room with a rate of 2-3 air changes per hour for 9 months during the winter season. We monitor indoor...

  14. Efficacy of the I Can Control Asthma and Nutrition Now (ICAN) Pilot Program on Health Outcomes in High School Students with Asthma

    Science.gov (United States)

    Kouba, Joanne; Velsor-Friedrich, Barbarba; Militello, Lisa; Harrison, Patrick R.; Becklenberg, Amy; White, Barb; Surya, Shruti; Ahmed, Avais

    2013-01-01

    Asthma is the most prevalent chronic illness in childhood affecting 7 million youth. Many youth with asthma face another risk factor in obesity. Obesity, in turn, increases disorders such as asthma. Studies have recommended that asthma programs also address weight management in youth. Taking this into consideration, the I Can Control Asthma and…

  15. Barriers to Asthma Management as Identified by School Nurses

    Science.gov (United States)

    Quaranta, Judith E.; Spencer, Gale A.

    2016-01-01

    Asthma rates are increasing in children. School nurses have opportunities to care for children with asthma but need to overcome barriers impacting their ability to manage asthma in the school setting. This study (a) assessed barriers present in the school setting, (b) determined the impact of barriers on performance of asthma management behaviors,…

  16. Low Magnesium Concentration in Erythrocytes of Children with Acute Asthma

    Directory of Open Access Journals (Sweden)

    Mostafa Sedighi

    2006-12-01

    These results indicate that intracellular Mg level may be a more accurate method to assess Mg level in patients with asthma. Hence, determination of Mg concentration in erythrocytes may be used in evaluation of asthma pathophysiology. There are recommendations for using intravenous Mg sulfate in acute asthma, and this study supports the rational for using it in emergency departments for acute severe asthma.

  17. Risk Assessment and Community Participation Model for Environmental Asthma Management in an Elementary Public School: A Case Study in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Alberto Rivera-Rentas

    2006-03-01

    Full Text Available Asthma is a rapidly growing chronic disease in the general population of the world, mostly in children. Puerto Ricans have the highest prevalence of children with asthma among the Hispanic community in the US and its territories. Asthma and air quality are becoming a significant and potentially costly public health issue in Puerto Rico. The CDC has reported that in Puerto Rico, 320,350 adults have asthma and this number represents 11.5% of the island adult population. The north east municipality of Carolina, Puerto Rico, has the highest asthma prevalence in the 0 to 17 year old range (2001 data. In this study, we address the potential relationship between anthropogenic and naturally occurring environmental factors, and asthma prevalence in an urban elementary public school in Carolina in an effort to empower and engage communities to work on their environmental health issues. We integrated geographic information systems (GIS data of anthropogenic activities near the school as well as the natural resources and geomorphology of the region. We found that as Carolina is close by to Caribbean National Forest (El Yunque, this together with the temperature and precipitation cycles in the zone creates the ideal environmental conditions for increased humidity and pollen, mold and fungi development through out the year. We also collected health and socio economic data to generate an asthma profile of the students, employees and parents from the school community, and through a survey we identified perceptions on environmental asthma triggers, and indoor air quality in the school and homes of the students and employees. Finally, we implemented a workshop on indoor air quality designed to engage the school community in managing asthma triggers and the school environment. Our results showed that nearly 30 % of its student’s population has asthma, and from this group 58% are males and 42% are female students. Of all asthmatic children, only 43

  18. Studies on bronchial hyperreactivity, allergic responsiveness, and asthma in rural and urban children of the highlands of Papua New Guinea.

    Science.gov (United States)

    Turner, K J; Dowse, G K; Stewart, G A; Alpers, M P

    1986-04-01

    The prevalence of asthma and allergic responsiveness in rural and urban children of the highlands of Papua New Guinea was studied. Bronchial provocation studies with histamine demonstrated significant bronchial hyperreactivity in 0.5% (1 in 195) rural and 1.7% (1 in 59) urban children, rates which were significantly lower than those observed in corresponding adult populations (7%). Urban children demonstrated a higher incidence of skin test reactivity toward Dermatophagoides pteronyssinus, Aspergillus fumigatus, and dog dander than did the rural children. However, there were no significant differences between these populations with regard to total serum IgE levels, the degree of parasitism as judged by stool examination, or allergic responses to Ascaris suum, plantain, and coffee bean husk. A more detailed study demonstrated age- and sex-related differences in total IgE and mite-specific RAST scores in the rural but not the urban population. These data suggest an active suppression of the capacity of children to mount an IgE response to environmental allergens such as the mite manifesting itself as low asthma prevalence. The data also indicate that, although the underlying defect of bronchial hyperreactivity in asthma may be genetically inherited, it is not revealed until the lung has received an allergen-induced inflammatory insult.

  19. Ion channels in asthma.

    Science.gov (United States)

    Valverde, Miguel A; Cantero-Recasens, Gerard; Garcia-Elias, Anna; Jung, Carole; Carreras-Sureda, Amado; Vicente, Rubén

    2011-09-23

    Ion channels are specialized transmembrane proteins that permit the passive flow of ions following their electrochemical gradients. In the airways, ion channels participate in the production of epithelium-based hydroelectrolytic secretions and in the control of intracellular Ca(2+) levels that will ultimately activate almost all lung cells, either resident or circulating. Thus, ion channels have been the center of many studies aiming to understand asthma pathophysiological mechanisms or to identify therapeutic targets for better control of the disease. In this minireview, we focus on molecular, genetic, and animal model studies associating ion channels with asthma.

  20. RELATIONSHIP BETWEEN PSYCHOPATHOLOGY & SOCIO-DEMOGRAPHIC AND CLINICAL VARIABLES IN COPD AND BRONCHIAL ASTHMA: A COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Mayank

    2014-11-01

    Full Text Available This is a cross sectional comparative case control study assessing the Relationship between psychopathology and socio demographic and clinical variables in chronic obstructive pulmonary disease (COPD and Bronchial Asthma in comparison to healthy individuals. The investigation reveals that there is psychopathology in all the three groups. The psychopathology is significantly more in patients with COPD. Psychopathology in COPD patients is related to age, duration, severity of illness and steroid medication. It is found that psychopathology in bronchial asthma patients are more than those of healthy controls but there is no significant difference. The psychopathology is significantly related to relate to age, marital status, occupational status, and smoking. Duration severity of illness and steroid medication.

  1. Oral pulsatile delivery: rationale and chronopharmaceutical formulations.

    Science.gov (United States)

    Maroni, Alessandra; Zema, Lucia; Del Curto, Maria Dorly; Loreti, Giulia; Gazzaniga, Andrea

    2010-10-15

    Oral pulsatile/delayed delivery systems are designed to elicit programmable lag phases preceding a prompt and quantitative, repeated or prolonged release of drugs. Accordingly, they draw increasing interest because of the inherent suitability for accomplishing chronotherapeutic goals, which have recently been highlighted in connection with a number of widespread chronic diseases with typical night or early-morning recurrence of symptoms (e.g. bronchial asthma, cardiovascular disease, rheumatoid arthritis, early-morning awakening). In addition, time-based colonic release can be attained when pulsatile delivery systems are properly adapted to overcome unpredictable gastric emptying and provide delay phases that would approximately match the small intestinal transit time. Oral pulsatile delivery is pursued by means of a variety of release platforms, namely reservoir, capsular and osmotic devices. The aim of the present review is to outline the rationale and main formulation strategies behind delayed-release dosage forms intended for the pharmacological treatment of chronopathologies.

  2. Bronchial asthma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008049 Activation ralated genes of memory CD+4 T cells in asthma patients. PI Weifeng(皮卫峰),et al. Dept Respir Med, Xinhua Hosp, Sch Med, Shanghai Jiaotong Univ, Shanghai 200092. Chin J Tuberc Respir Dis 2007;30(12):932-935. Objective To screen and identify the genes of activated memory CD+4 T cells in asthma. Methods Differential display polymerase chain reaction(DDPCR) was utilized to identify genes of memory CD+4 T cells after activation from asthmatic patients and normal individuals,

  3. Prenatal Stress, Prematurity, and Asthma.

    Science.gov (United States)

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced "premature asthma." Prenatal stress may cause not only abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring TH2 (allergic) immune responses characteristic of atopic asthma: interleukin 6 (IL-6), which has been associated with premature labor, can promote TH2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing "premature asthma." If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health.

  4. Pilot Study on Genetic Polymorphisms CYP1A2*1F on Asthma Patients and Nonasthma in Indonesia

    Directory of Open Access Journals (Sweden)

    Doddy de Queljoe

    2015-03-01

    Full Text Available Genetic polymorphisms of CYP1A2 is related to the theophylline metabolism that may affect drug levels in the blood, which can also affect incidence of adverse drug reaction (ADR and clinical outcomes of asthma therapy. The frequency of CYP1A2 polymorphism is known to vary among ethnic. Allegedly the Indonesian population has high frequency of gene variants of CYP1A2*1F. This study aims to determine the profile of CYP1A2*1F gene polymorphism in a sample of nonasthma and asthma in Indonesia with other populations based on the literature. Data were taken on January–June 2014. Blood samples were obtained from 29 nonasthma samples and 16 patients with asthma. After extraction of genomic DNA, CYP1A2*1F gene polymorphisms determined by PCR-RFLP. The results of this study indicate that the CYP1A2*1F gene polymorphism in nonasthma samples was 10.35% (3/29 for C/C, 37.93% (11/29 for the C/A, and 51.72% (15/29 for A/A. The asthmatics genotype have a frequency distribution of C/A genotype of 81.25% (13/16 and A/A of 18.75% (3/16. There was no significant difference (p=0.276 allele frequencies between samples of nonasthma and asthma patients. The frequency of CYP1A2*1F gene in Indonesian population is higher than the population of Egypt, Japan, and UK, but lower compared to Malaysia. It can be concluded that there is no difference in frequency.

  5. Asthma symptoms in obese adults

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli

    2016-01-01

    The association between asthma and obesity is well-described, but not straightforward, and according to current guidelines asthma control is more difficult to achieve in obese patients. The currently available studies evaluating response to pharmacological asthma therapy in obese patients show...... that these patients have an altered, in general less favorable, response to both reliever and controller medication compared to normal weight patients. However, at present, the limited available evidence precludes evidence-based recommendations. The 'obesity-related asthma' phenotype has different characteristics......, including association with atopy and type of airway inflammation, compared to 'classic' asthma. Furthermore, weight loss in patients with this phenotype leads to an improvement in symptoms, lung function, and airway responsiveness, as well as a reduction in medication utilization and hospital admissions...

  6. B-Glucan exacerbates allergic asthma independent of fungal ...

    Science.gov (United States)

    BackgroundAllergic sensitization to fungi has been associated with asthma severity. As a result, it has been largely assumed that the contribution of fungi to allergic disease is mediated through their potent antigenicity.ObjectiveWe sought to determine the mechanism by which fungi affect asthma development and severity.MethodsWe integrated epidemiologic and experimental asthma models to explore the effect of fungal exposure on asthma development and severity.ResultsWe report that fungal exposure enhances allergen-driven TH2 responses, promoting severe allergic asthma. This effect is independent of fungal sensitization and can be reconstituted with β-glucan and abrogated by neutralization of IL-17A. Furthermore, this severe asthma is resistant to steroids and characterized by mixed TH2 and TH17 responses, including IL-13+IL-17+CD4+ double-producing effector T cells. Steroid resistance is dependent on fungus-induced TH17 responses because steroid sensitivity was restored in IL-17rc−/− mice. Similarly, in children with asthma, fungal exposure was associated with increased serum IL-17A levels and asthma severity.ConclusionOur data demonstrate that fungi are potent immunomodulators and have powerful effects on asthma independent of their potential to act as antigens. Furthermore, our results provide a strong rationale for combination treatment strategies targeting IL-17A for this subgroup of fungus-exposed patients with difficult-to-treat asthma. To describe th

  7. Do the residents in the emergency department appropriately manage patients with acute asthma attack? A study of self-criticism.

    Science.gov (United States)

    Akoglu, Sebahat; Topacoglu, Hakan; Karcioglu, Ozgur; Cimrin, Arif Hikmet

    2004-01-01

    The objective of this study was to investigate the management of patients with asthma attack admitted to the emergency department (ED) in terms of compliance with international guidelines. The records of patients with asthma who were admitted to a university-based ED between December 2001 and December 2002 were evaluated. A total of 72 cases with available data were evaluated retrospectively. Twenty-six patients (36.1%) were admitted more than once during the study period. The number of multiple admissions ranged from 2 (15 patients, 20.0%) to 11 (2 patients, 2.8%). Peak expiratory flow (PEF) measurements were recorded in 17 patients (23.6%) on presentation. Pulse and respiratory rates were recorded in 70 (97.0%) and 67 patients (93.0%), respectively. Thirty-four patients (47.2%) underwent chest x-ray; results were normal in most patients. Salbutamol was the most commonly used drug as first-line therapy. Ipratropium bromide (inhaled) and systemic corticosteroids were added to the salbutamol in 47 (65.2%), 42 (58.4%), and 32 patients (44%), respectively. Pulmonologists were consulted in only 7 cases (9.7%). Thirty patients (43.4%) were prescribed corticosteroids on discharge. The role of functional parameters in determining asthma severity and monitoring treatment effects should be emphasized in clinical practice. Finally, more prevalent use of management guidelines will help determine their usefulness.

  8. Experimental study on onset of asthma like symptoms by diesel exhausts particles (DEP); Diesel haiki biryushi (DEP) ni yoru zensoku yo byotai no hassho ni kansuru jikkenteki kenkyu

    Energy Technology Data Exchange (ETDEWEB)

    Sagai, M. [National Research Inst. for Environmental Studies, Tsukuba (Japan)

    1995-03-10

    By experiments using mice, facts which suggest that diesel exhaust particles (DEP) produce a large amount of superoxide (O2{sup -})by chemical or biochemical reaction and this superoxide causes lung injury with a result of asthma like symptoms. It is verified, by the use of mice, that four fundamental symptoms of the onset of asthma like symptoms, i.e. rise of blood vessel permeability, mucus hypersecretion, inflammation accompanying chronic eosinophil infiltration, and airway hyperresponsiveness, are caused by DEP. It can be derived from the fact that mankind asthma may also be caused by DEP. The knowledge obtained by this experiment, which indicates that DEP causes chronic inflammation accompanying eosinophil infiltration, may add important information to the study on the causal relationship of DEP with asthma symptoms. 31 refs., 15 figs., 1 tab.

  9. Asthma Risk Profiles of Children Participating in an Asthma Education and Management Program

    Science.gov (United States)

    Wilson, Candice; Rapp, Kristi Isaac; Jack, Leonard, Jr.; Hayes, Sandra; Post, Robert; Malveaux, Floyd

    2015-01-01

    Background: Focused risk assessment is essential in the effective management of asthma. Purpose: This study identified and examined correlations among areas of pediatric asthma risk and determined associations between these risks and demographic characteristics. Methods: This exploratory study identified risk factors that affect asthma management…

  10. Significance of Haemodynamic and Haemostatic Factors in the Course of Different Manifestations of Cerebral Small Vessel Disease: The SHEF-CSVD Study—Study Rationale and Protocol

    Directory of Open Access Journals (Sweden)

    Jacek Staszewski

    2013-01-01

    Full Text Available Rationale. This paper describes the rationale and design of the SHEF-CSVD Study, which aims to determine the long-term clinical and radiological course of cerebral small vessel disease (CSVD and to evaluate haemostatic and haemodynamic prognostic factors of the condition. Design. This single-centre, prospective, non-interventional cohort study will follow 150 consecutive patients with different clinical manifestations of CSVD (lacunar ischaemic stroke, vascular dementia, vascular parkinsonism or spontaneous deep, intracerebral haemorrhage and 50 age- and sex-matched controls over a period of 24 months. The clinical and radiological course will be evaluated basing on a detailed neurological, neuropsychological and MRI examinations. Haemodynamic (cerebral vasoreactivity, 24 h blood pressure control and haemostatic factors (markers of endothelial and platelet dysfunction, brachial artery flow-mediated dilatation test will be determined. Discussion. The scheduled study will specifically address the issue of haemodynamic and haemostatic prognostic factors and their course over time in various clinical manifestations of CSVD. The findings may aid the development of prophylactic strategies and individualised treatment plans, which are critical during the early stages of the disease.

  11. Rationale and design of the plate or pin (pop study for dislocated midshaft clavicular fractures: study protocol for a randomised controlled trial

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    Meylaerts Sven AG

    2011-07-01

    Full Text Available Abstract Background To describe the rationale and design of a future study comparing results of plate fixation and Elastic Stable Intramedullary Nailing (ESIN with a Titanium Elastic Nail (TEN for adults with a dislocated midshaft clavicular fracture. Methods/Design Prospective randomized multicenter clinical trial in two level 1 and one level 2 trauma centers. 120 patients between 18 and 65 years of age will be included. They are randomized to either plate fixation or ESIN with a TEN with a one year follow-up. Sixty patients will be treated with plate fixation and 60 patients will be treated with ESIN. Primary outcome parameter is the Disabilities of the Arm, Shoulder and Hand score after 6 months. Secondary outcome parameters are Constant Shoulder Score, complications, experienced pain, radiologic consolidation and cosmetics after both procedures. Discussion Prospective randomized studies comparing operative techniques for treatment of dislocated midshaft clavicular fracture are lacking. By studying shoulder function, complications, quality of life, radiographic union, cosmetics as well as experienced pain, a complete efficacy assessment of both procedures will be performed. Trial registration The POP study is registered in the Dutch Trial Register (NTR NTR2438.

  12. Current asthma contributes as much as smoking to chronic bronchitis in middle age: a prospective population-based study

    Directory of Open Access Journals (Sweden)

    Dharmage SC

    2016-08-01

    Full Text Available Shyamali C Dharmage,1 Jennifer L Perret,1,2, John A Burgess,1 Caroline J Lodge,1 David P Johns,3 Paul S Thomas,4 Graham G Giles,1,5 John L Hopper,1,6 Michael J Abramson,7,8 E Haydn Walters,3,9, Melanie C Matheson1 1Allergy and Lung Health Unit, Center for Epidemiology and Biostatistics, The University of Melbourne, 2Institute for Breathing and Sleep (IBAS, Melbourne, VIC, 3“Breathe Well” Center of Research Excellence for Chronic Respiratory Disease and Lung Ageing, School of Medicine, University of Tasmania, Hobart, TAS, 4Inflammation and Infection Research, Faculty of Medicine, University of New South Wales, Sydney, NSW, 5Cancer Epidemiology Center, Cancer Council Victoria, Melbourne, VIC, Australia; 6Department of Public Health, Seoul National University, Seoul, South Korea; 7Allergy, Immunology and Respiratory Medicine, The Alfred Hospital, Melbourne, 8School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 9School of Medicine, University of Tasmania, Hobart, TAS, Australia Background and objective: Personal smoking is widely regarded to be the primary cause of chronic bronchitis (CB in adults, but with limited knowledge of contributions by other factors, including current asthma. We aimed to estimate the independent and relative contributions to adult CB from other potential influences spanning childhood to middle age.Methods: The population-based Tasmanian Longitudinal Health Study cohort, people born in 1961, completed respiratory questionnaires and spirometry in 1968 (n=8,583. Thirty-seven years later, in 2004, two-thirds responded to a detailed postal survey (n=5,729, from which the presence of CB was established in middle age. A subsample (n=1,389 underwent postbronchodilator spirometry between 2006 and 2008 for the assessment of chronic airflow limitation, from which nonobstructive and obstructive CB were defined. Multivariable and multinomial logistic regression models were used to estimate

  13. Are asthma-like symptoms in elite athletes associated with classical features of asthma?

    DEFF Research Database (Denmark)

    Lund, T.K.; Pedersen, L.; Anderson, S.D.;

    2009-01-01

    Background: Asthma is frequent in elite athletes and clinical studies in athletes have found increased airway inflammation. Objective: To investigate asthma-like symptoms, airway inflammation, airway reactivity (AR) to mannitol and use of asthma medication in Danish elite athletes. Methods......: The study group consisted of 54 elite athletes (19 with doctor-diagnosed asthma), 22 non-athletes with doctor-diagnosed asthma (steroid naive for 4 weeks before the examination) and 35 non-athletes without asthma; all aged 18-35 years. Examinations (1 day): questionnaires, exhaled nitric oxide (e......NO) in parts per billion, spirometry, skin prick test, AR to mannitol and blood samples. Induced sputum was done in subjects with asthma. Results: No significant difference was found in values for eNO, AR and atopy between 42 elite athletes with and 12 without asthma-like symptoms. Elite athletes with doctor...

  14. Comparison of oral montelukast with oral zileuton in acute asthma: A randomized, double-blind, placebo-controlled study

    Science.gov (United States)

    Magazine, Rahul; Shahul, Hameed Aboobackar; Chogtu, Bharti; Kamath, Asha

    2016-01-01

    Background: Leukotriene modifiers have an established role in the management of chronic asthma but their role in acute asthma is still under evaluation. Objective: To study and compare the effects of oral montelukast with oral zileuton in acute asthma. Materials and Methods: This study included 120 asthmatics and was conducted from September 2012 to March 2014. Patients were randomized into three different groups to receive montelukast or zileuton or placebo in addition to standard treatment for asthma exacerbation. Peak expiratory flow rate (PEFR) values, details of rescue medication and vital signs were recorded at 6 h, 12 h, 24 h, and 48 h of drug or placebo administration and at discharge. Additional recording was done in the morning (8–10 am) following admission. The primary endpoint was the mean PEFR of each group at these time points; the secondary end point being the need for rescue medications. Results: The mean PEFR recordings of the three study groups – placebo, montelukast, and zileuton – respectively, at various time points were as follows: at 6 h (223.25 ± 90.40, 199.00 ± 82.52, 233.75 ± 84.05; P = 0.240); at 12 h (271.00 ± 109.38, 251.50 ± 101.44, 309.50 ± 129.63; P = 0.048); at 24 h (288.25 ± 114.26, 269.00 ± 107.51, 324.50 ± 127.88; P = 0.080); and at 48 h (295.00 ± 114.80, 293.50 ± 113.24, 344.75 ± 119.91; P = 0.015); discharge (305.00 ± 118.56, 305.25 ± 119.51, 361.25 ± 119.70; P = 0.010). The mean PEFR for the three study groups at 8–10 am on the morning following admission was 268.75 ± 111.43, 252.50 ± 99.99, 306.75 ± 114.44; P = 0.047. Total rescue doses needed were 10, 1, and 0, respectively (P = 0.049). Conclusion: Zileuton is better than montelukast as an additional drug in acute asthma and results in significant improvement in lung function, and reduction in the need for rescue medications. PMID:27185992

  15. Comparison of oral montelukast with oral zileuton in acute asthma: A randomized, double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Rahul Magazine

    2016-01-01

    Full Text Available Background: Leukotriene modifiers have an established role in the management of chronic asthma but their role in acute asthma is still under evaluation. Objective: To study and compare the effects of oral montelukast with oral zileuton in acute asthma. Materials and Methods: This study included 120 asthmatics and was conducted from September 2012 to March 2014. Patients were randomized into three different groups to receive montelukast or zileuton or placebo in addition to standard treatment for asthma exacerbation. Peak expiratory flow rate (PEFR values, details of rescue medication and vital signs were recorded at 6 h, 12 h, 24 h, and 48 h of drug or placebo administration and at discharge. Additional recording was done in the morning (8-10 am following admission. The primary endpoint was the mean PEFR of each group at these time points; the secondary end point being the need for rescue medications. Results: The mean PEFR recordings of the three study groups - placebo, montelukast, and zileuton - respectively, at various time points were as follows: at 6 h (223.25 ± 90.40, 199.00 ± 82.52, 233.75 ± 84.05; P = 0.240; at 12 h (271.00 ± 109.38, 251.50 ± 101.44, 309.50 ± 129.63; P = 0.048; at 24 h (288.25 ± 114.26, 269.00 ± 107.51, 324.50 ± 127.88; P = 0.080; and at 48 h (295.00 ± 114.80, 293.50 ± 113.24, 344.75 ± 119.91; P = 0.015; discharge (305.00 ± 118.56, 305.25 ± 119.51, 361.25 ± 119.70; P = 0.010. The mean PEFR for the three study groups at 8-10 am on the morning following admission was 268.75 ± 111.43, 252.50 ± 99.99, 306.75 ± 114.44; P = 0.047. Total rescue doses needed were 10, 1, and 0, respectively (P = 0.049. Conclusion: Zileuton is better than montelukast as an additional drug in acute asthma and results in significant improvement in lung function, and reduction in the need for rescue medications.

  16. Early incidence of occupational asthma among young bakers, pastry-makers and hairdressers: design of a retrospective cohort study

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    Guéant-Rodriguez Rosa-Maria

    2010-04-01

    Full Text Available Abstract Background Occupational exposures are thought to be responsible for 10-15% of new-onset asthma cases in adults, with disparities across sectors. Because most of the data are derived from registries and cross-sectional studies, little is known about incidence of occupational asthma (OA during the first years after inception of exposure. This paper describes the design of a study that focuses on this early asthma onset period among young workers in the bakery, pastry making and hairdressing sectors in order to assess early incidence of OA in these "at risk" occupations according to exposure duration, and to identify risk factors of OA incidence. Methods/Design The study population is composed of subjects who graduated between 2001 and 2006 in these sectors where they experience exposure to organic or inorganic allergenic or irritant compounds (with an objective of 150 subjects by year and 250 young workers with no specific occupational exposure. A phone interview focusing on respiratory and 'Ear-Nose-Throat' (ENT work-related symptoms screen subjects considered as "possibly OA cases". Subjects are invited to participate in a medical visit to complete clinical and lung function investigations, including fractional exhaled nitric oxide (FENO and carbon monoxide (CO measurements, and to collect blood samples for IgE (Immunoglobulin E measurements (total IgE and IgE for work-related and common allergens. Markers of oxidative stress and genetic polymorphisms exploration are also assessed. A random sample of 200 "non-cases" (controls is also visited, following a nested case-control design. Discussion This study may allow to describ a latent period between inception of exposure and the rise of the prevalence of asthma symptoms, an information that would be useful for the prevention of OA. Such a time frame would be suited for conducting screening campaigns of this emergent asthma at a stage when occupational hygiene measures and adapted

  17. Asthma and obesity: does weight loss improve asthma control? a systematic review

    Directory of Open Access Journals (Sweden)

    Juel CTB

    2012-06-01

    Full Text Available Caroline Trunk-Black Juel,1 Zarqa Ali,1 Lisbeth Nilas,2 Charlotte Suppli Ulrik11Respiratory Section, Internal Medicine Unit, 2Department of Obstetrics and Gynaecology, Hvidovre Hospital and University of Copenhagen, Hvidovre, DenmarkAim and methods: Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma.Results: Weight loss in obese individuals with doctor-diagnosed asthma is associated with a 48%–100% remission of asthma symptoms and use of asthma medication. Published studies, furthermore, reveal that weight loss in obese asthmatics improves asthma control, and that especially surgically induced weight loss results in significant improvements in asthma severity, use of asthma medication, dyspnoea, exercise tolerance, and acute exacerbations, including hospitalizations due to asthma. Furthermore, weight loss in obese asthmatics is associated with improvements in level of lung function and airway responsiveness to inhaled methacholine, whereas no significant improvements have been observed in exhaled nitric oxide or other markers of eosinophilic airway inflammation.Conclusion: Overweight and obese adults with asthma experience a high symptomatic remission rate and significant improvements in asthma control, including objective measures of disease activity, after weight loss. Although these positive effects of weight loss on asthma-related health outcomes seem not to be accompanied by remission or improvements in markers of eosinophilic airway inflammation, it has potentially important implications for the future burden of asthma.Keywords: asthma, weight loss, diet, bariatric surgery, asthma control

  18. Comparison of clinical effects of beclomethasone dipropionate & budesonide in treatment of children with mild persistent asthma: A double-blind, randomized, controlled study

    Science.gov (United States)

    Singh, Anju; Nandan, Devki; Dewan, Vivek; Sankar, Jhuma

    2016-01-01

    Background & objectives: Various inhaled corticosteroids (ICSs) are available to control the symptoms of asthma. Although beclomethasone dipropionate (BDP) and budesonide (BUD) are one of the oldest ICSs, their wide availability and low cost make them attractive options in developing countries. Due to lack of consensus on which of the two drugs is better for controlling mild persistent asthma, we undertook this study to compare the efficacy of these two drugs by measuring the change in percentage predicted forced expiratory volume in one second (FEV1) from baseline in children with mild persistent asthma. Methods: A double-blind, randomized, parallel group study was conducted in children 7-15 yr of age with newly diagnosed asthma. Of the 85 cases of mild persistent asthma, 42 received BUD while 43 received BDP at a dose of 400 µg/day using pressurized metered-dose inhaler with valved spacer for two months. The outcomes measured were change in FEV1, symptom scores and side effects. Results: There was a significant (P management of children with mild persistent asthma. [CTRI No: CTRI/2013/03/003495]. PMID:27934805

  19. Home versus Office blood pressure MEasurements : Reduction of Unnecessary treatment Study: Rationale and Study design of the HOMERUS Trial

    NARCIS (Netherlands)

    Verberk, WJ; Kroon, AA; Kessels, AGH; Dirksen, C; Nelemans, PJ; Lenders, JWM; Thien, TABM; van Montfrans, GA; Smit, AJ; de Leeuw, PW

    2003-01-01

    The Home versus Office MEasurements, Reduction of Unnecessary treatment Study (HOMERUS) is a multicentre prospective study, primarily designed to examine in subjects with mild to moderate hypertension whether treatment decisions based on home blood pressure measurements can lead to reduction in the

  20. Population-based multicase-control study in common tumors in Spain (MCC-Spain: rationale and study design

    Directory of Open Access Journals (Sweden)

    Gemma Castaño-Vinyals

    2015-07-01

    Discussion: This study, conducted within the Spanish Consortium for Biomedical Research in Epidemiology & Public Health (CIBERESP, is a unique initiative to evaluate etiological factors for common cancers and will promote cancer research and prevention in Spain.

  1. Antibiotic exposure in the first year of life and later treated asthma, a population based birth cohort study of 143,000 children.

    Science.gov (United States)

    Pitter, Gisella; Ludvigsson, Jonas Filip; Romor, Pierantonio; Zanier, Loris; Zanotti, Renzo; Simonato, Lorenzo; Canova, Cristina

    2016-01-01

    Several epidemiological studies reported an association between antibiotic consumption in the first year of life and later asthma, but results are conflicting and affected by potential biases. We examined this controversial issue in a population-based birth cohort. Using administrative data, we identified 143,163 children born in 1995-2011 in Friuli-Venezia Giulia (Italy) (median follow-up 5.25 years, 927,350 person-years). Antibiotic prescriptions in the first year of life and subsequent treated asthma (defined as ≥2 anti-asthmatic drug prescriptions within a 12-month period) were retrieved from drug prescription records. We estimated incidence rate ratios (IRR) using Poisson regression models, adjusted for perinatal variables and for hospitalizations for infections in the first year of life. We identified 34,957 new-onset asthma cases. Antibiotic consumption in the first year of life increased the risk of new-onset asthma [IRR 1.51, 95% confidence interval (CI) 1.48-1.54] with a dose-response relationship (p-trend asthma identified at 13-35 months of life (IRR 2.07, 95% CI 2.00-2.14), but remained statistically significant for asthma identified at 36-71 months (IRR 1.17, 95% CI 1.14-1.21) and at ≥72 months (IRR 1.15, 95% CI 1.08-1.22). Antibiotics increased the risk of current asthma at ≥6 years (IRR 1.35, 95% CI 1.30-1.41) and at ≥13 years of age (IRR 1.19, 95% CI 1.08-1.33). Antibiotic exposure in infancy is associated with an increased risk of asthma up to adolescence. The association detected at older ages is not explained by reverse causation; however, confounding by respiratory infections not leading to hospital admission cannot be excluded.

  2. Current Control and Future Risk in Asthma Management

    OpenAIRE

    2011-01-01

    Despite international and national guidelines, poor asthma control remains an issue. Asthma exacerbations are costly to both the individual, and the healthcare provider. Improvements in our understanding of the therapeutic benefit of asthma therapies suggest that, in general, while long-acting bronchodilator therapy improves asthma symptoms, the anti-inflammatory activity of inhaled corticosteroids reduces acute asthma exacerbations. Studies have explored factors which could be predictive of ...

  3. Asthma changes at a Pediatric Intensive Care Unit after 10 years: Observational study

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    Ayman A Al-Eyadhy

    2015-01-01

    Full Text Available Objectives: To describe the change in the management, and outcome of children with acute severe asthma (ASA admitted to Pediatric Intensive Care Unit (PICU at tertiary institute, as compared to previously published report in 2003. Methods : This is a retrospective observational study. All consecutive pediatric ASA patients who were admitted to PICU during the study period were included. The data were extracted from PICU database and medical records. The Cohort in this study (2013 Cohort was compared with the Cohort of ASA, which was published in 2003 from the same institution (2003 Cohort. Results: In comparison to previous 2003 Cohort, current Cohort (2013 revealed higher mean age (5.5 vs. 3.6 years; P ≤ 0.001, higher rate of PICU admission (20.3% vs. 3.6%; P ≤ 0.007, less patients who received maintenance inhaled steroids (43.3% vs. 62.4%; P ≤ 0.03, less patients with pH <7.3 (17.9% vs. 42.9%; P ≤ 0.001. There were more patients in 2013 Cohort who received: Inhaled Ipratropium bromide (97% vs. 68%; P ≤ 0.001, intravenous magnesium sulfate (68.2% vs. none, intravenous salbutamol (13.6% vs. 3.6%; P ≤ 0.015, and noninvasive ventilation (NIV (35.8% vs. none while no patients were treated with theophylline (none vs. 62.5%. The median length of stay (LOS was 2 days while mean LOS was half a day longer in the 2013 Cohort. None of our patients required intubation, and there was no mortality. Conclusion: We observed slight shift toward older age, considerably increased the rate of PICU admission, increased utilization of Ipratropium bromide, magnesium sulfate, and NIV as important modalities of treatment.

  4. Determinação de escore e nota de corte do módulo de asma do International Study of Asthma and Allergies in Childhood para discriminação de adultos asmáticos em estudos epidemiológicos Determining the score and cut-off point that would identify asthmatic adults in epidemiological studies using the asthma module of the International Study of Asthma and Allergies in Childhood questionnaire

    Directory of Open Access Journals (Sweden)

    Elayne de Fátima Maçãira

    2005-12-01

    Full Text Available OBJETIVO: Validar o questionário padronizado escrito do International Study of Asthma and Allergies in Childhood, módulo sobre asma, para pesquisa de prevalência de asma, estabelecendo seu escore e a nota de corte para discriminação de adultos asmáticos. MÉTODOS: Entrevistamos pacientes ambulatoriais adultos, 40 asmáticos e 38 controles, pareados por sexo e idade, utilizando o módulo de asma do International Study of Asthma and Allergies in Childhood, composto por oito aspectos dicotômicos de asma. Determinamos o escore e a nota de corte para discriminação de asmáticos, definindo sua sensibilidade, especificidade e índice de Youden. Validamos o método em contraposição ao diagnóstico clínico e funcional. A reprodutibilidade das questões individuais foi testada por meio de reentrevistas de metade dos pacientes após algumas semanas. RESULTADOS: O escore variou de 0 a 14 pontos. Um escore = 5 pontos permitiu discriminar pacientes asmáticos (sensibilidade = 93%, especificidade = 100% e índice de Youden = 0,93. A maioria das questões apresentou boa reprodutibilidade, observada em reentrevista após 48,2 ± 11,1 dias (Kappa e Kappa ponderado variando de 0,43 a 1,00 para as questões individuais. CONCLUSÃO: A validação de uma nota de corte permite uma interpretação alternativa às informações fornecidas pelo módulo de asma do International Study of Asthma and Allergies in Childhood, levando em conta o conjunto das informações e não somente as respostas individuais de cada questão em estudos de prevalência de asma em adultos.OBJECTIVE: To validate, for use in asthma prevalence studies, the asthma module of the standardized written questionnaire developed for use in the International Study of Asthma and Allergies in Childhood, establishing the score and cut-off point that would identify asthmatic adults. METHODS: We interviewed 78 adult outpatients (40 adult asthmatics and 38 age-matched and gender-matched controls

  5. GSTP1 and TNF Gene Variants and Associations between Air Pollution and Incident Childhood Asthma : The Traffic, Asthma and Genetics (TAG) Study

    NARCIS (Netherlands)

    MacIntyre, Elaina A.; Brauer, Michael; Melen, Erik; Bauer, Carl Peter; Bauer, Mario; Berdel, Dietrich; Bergstroem, Anna; Brunekreef, Bert; Chan-Yeung, Moira; Kluemper, Claudia; Fuertes, Elaine; Gehring, Ulrike; Gref, Anna; Heinrich, Joachim; Herbarth, Olf; Kerkhof, Marjan; Koppelman, Gerard H.; Kozyrskyj, Anita L.; Pershagen, Goran; Postma, Dirkje S.; Thiering, Elisabeth; Tiesler, Carla M. T.; Carlsten, Christopher

    2014-01-01

    Background: Genetics may partially explain observed heterogeneity in associations between traffic-related air pollution and incident asthma. Objective: Our aim was to investigate the impact of gene variants associated with oxidative stress and inflammation on associations between air pollution and i

  6. A comparative and descriptive study of asthma in chronic rhinosinusitis with nasal polyps

    DEFF Research Database (Denmark)

    Håkansson, Kåre; Thomsen, Simon Francis; Konge, Lars;

    2014-01-01

    BACKGROUND: Chronic rhinosinusitis (CRS) is a common health problem that is subclassified as CRS with nasal polyps (CRSwNPs) or CRS without NPs (CRSsNP). In accordance with the united airways concept, CRSwNPs frequently coexists with asthma but to date, this association remains unexplained and its...

  7. A population-based prescription study of asthma drugs during pregnancy

    DEFF Research Database (Denmark)

    Olesen, Charlotte; Thrane, Nana; Nielsen, G.L.

    2001-01-01

    . Methods: The Birth Registry was used to identify all 15,756 primiparous women who gave birth in the County of North Jutland between 1991 and 1996. According to the North Jutland Prescription Database, 303 of these women received prescriptions for asthma drugs during pregnancy. Women who did not purchase...

  8. Risk factors for asthma in young adults: a co-twin control study

    DEFF Research Database (Denmark)

    Thomsen, SF; Ulrik, Charlotte Suppli; Kyvik, KO;

    2006-01-01

    . Pairs in which only one twin developed asthma -- discordant pairs -- were identified and conditional logistic regression was applied to detect effects of risk factors. RESULTS: A total of 126 monozygotic (MZ) and 273 dizygotic (DZ) discordant twin pairs were identified. In MZ twins hay fever (OR = 3.......16, 95% CI: 1.29-7.73, P = 0.007) and exercise (OR for inactivity = 0.35, 95% CI: 0.13-0.91, P = 0.023) were significantly associated with asthma, whereas in DZ twins, hay fever (OR = 2.44, 95% CI: 1.44-4.13, P = 0.001), eczema (OR = 1.96, 95% CI: 1.02-3.78, P = 0.040), female sex (OR between males...... and females = 0.54, 95% CI: 0.36-0.80, P = 0.002), and increasing levels of body mass index (BMI; OR per unit = 1.11, 95% CI: 1.02-1.20, P = 0.009) were significant predictors of asthma. CONCLUSIONS: Hay fever, eczema, female sex, exercise and increasing levels of BMI were risk factors for asthma in young...

  9. The Prevalence of Severe Asthma and Low Asthma Control Among Danish Adults

    DEFF Research Database (Denmark)

    von Bülow, Anna; Kriegbaum, Margit; Backer, Vibeke;

    2014-01-01

    BACKGROUND: The prevalence of severe asthma is unknown. However, international expert statements estimate that severe asthma represents 5% to 10 % of the entire asthma population. OBJECTIVE: Based on register data from a nationwide population, we wanted to investigate the prevalence of severe...... asthma, the extent of asthma control, and contact with specialist care. METHODS: A descriptive cross-sectional register study was performed. By using a nationwide prescription database, we identified current patients with asthma (age, 18-44 years) in 2010. Severity was classified as severe versus mild......-moderate asthma according to the level of antiasthma treatment. We investigated prescription drug use, hospitalizations, emergency department visits, and outpatient clinic visits according to severity. RESULTS: Among a nationwide population, we identified 61,583 current patients with asthma. Based on the level...

  10. Challenges of Asthma Management for School Nurses in Districts with High Asthma Hospitalization Rates

    Science.gov (United States)

    Liberatos, Penny; Leone, Jennifer; Craig, Ann Marie; Frei, Elizabeth Mary; Fuentes, Natalie; Harris, India Marie

    2013-01-01

    Background: School nurses play a central role in assisting elementary school children in managing their asthma, especially those in higher-risk school districts that are at increased risk of uncontrolled asthma. Study purposes are to (1) identify barriers to asthma management by school nurses in higher-risk school districts; and (2) assess the…

  11. Scheduled asthma management in general practice generally improve asthma control in those who attend

    DEFF Research Database (Denmark)

    Backer, Vibeke; Bornemann, Maja; Knudsen, Anja Dorte Brandt;

    2012-01-01

    Successful asthma management involves guideline-based treatment and regular follow-up. We aimed to study the level of disease control in asthmatic individuals managed by their GP and a dedicated nurse when using a systematic asthma consultation guide based on Global Initiative of Asthma guideline...

  12. Obesity and asthma: impact on severity, asthma control, and response to therapy.

    Science.gov (United States)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-05-01

    Asthma is more prevalent in obese, compared with normal weight, subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy. Several studies have shown that overweight and obesity is associated with more severe asthma and impaired quality of life, compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy, with regard to symptoms, level of FEV1, fraction of exhaled nitric oxide, and airway responsiveness. Some studies suggest that asthma in the obese patient might be more responsive to leukotriene modifiers, orchestrated by leptin and/or adiponectin derived from adipose tissue, than to inhaled corticosteroids, possibly reflecting differences in the underlying airway inflammation in obese versus non-obese asthmatics. In conclusion, overweight and obesity is associated with poorer asthma control and, very importantly, overall poorer response to asthma therapy, compared with normal weight individuals.

  13. Helpful Hints: Caregiver-Generated Asthma Management Strategies and Their Relation to Pediatric Asthma Symptoms and Quality of Life

    OpenAIRE

    2012-01-01

    Objective This mixed-methods study examined the relation between caregiver-generated asthma management strategies and asthma severity in a sample of 200 children with persistent asthma (ages 5–12 years). Methods Caregivers were interviewed about asthma management strategies they found helpful in controlling their child's symptoms. A qualitative content analysis was used to identify household strategies. Indicators of asthma severity included lung functioning (FEV1) and functional severity (FS...

  14. The Danish National Database for Asthma

    DEFF Research Database (Denmark)

    Backer, Vibeke; Lykkegaard, Jesper; Bodtger, Uffe;

    2016-01-01

    AIM OF THE DATABASE: Asthma is the most prevalent chronic disease in children, adolescents, and young adults. In Denmark (with a population of 5.6 million citizens), >400,000 persons are prescribed antiasthmatic medication annually. However, undiagnosed cases, dubious diagnoses, and poor asthma...... management are probably common. The Danish National Database for Asthma (DNDA) was established in 2015. The aim of the DNDA was to collect the data on all patients treated for asthma in Denmark and to monitor asthma occurrence, the quality of diagnosis, and management. STUDY POPULATION: Persons above the age...... year, the inclusion criteria are a second purchase of asthma prescription medicine within a 2-year period (National Prescription Registry) or a diagnosis of asthma (National Patient Register). Patients with chronic obstructive pulmonary disease are excluded, but smokers are not excluded. DESCRIPTIVE...

  15. Elastin in asthma

    NARCIS (Netherlands)

    Reddel, Caroline J; Weiss, Anthony S; Burgess, Janette K

    2012-01-01

    Extracellular matrix is generally increased in asthma, causing thickening of the airways which may either increase or decrease airway responsiveness, depending on the mechanical requirements of the deposited matrix. However, in vitro studies have shown that the altered extracellular matrix produced

  16. Using the Health Belief Model to Understand School Nurse Asthma Management

    Science.gov (United States)

    Quaranta, Judith E.; Spencer, Gale A.

    2015-01-01

    Ten million children in the United States have asthma. Since children are in school about 6 hr a day, school nurses are positioned to intervene and influence asthma outcomes. A descriptive correlational study was designed to investigate performance of school nurses' asthma management behaviors in relationship to asthma knowledge, asthma attitude,…

  17. Diagnosing asthma in general practice with portable exhaled nitric oxide measurement – results of a prospective diagnostic study

    Directory of Open Access Journals (Sweden)

    Laux Gunter

    2009-03-01

    Full Text Available Abstract Background To evaluate the sensitivity, specificity and predictive values of fractional exhaled nitric oxide (FENO for the diagnosis of asthma in general practice. Methods Prospective diagnostic study with 160 patients attending 10 general practices for the first time with complaints suspicious of obstructive airway disease (OAD. Patients were referred to a lung function laboratory for diagnostic investigation. The index test was FENO measured with a portable FENO analyser based on electrochemical sensor. The reference standard was the Tiffeneau ratio (FEV1/VC as received by spirometric manoeuvre and/or results of bronchial provocation. Bronchial provocation with methacholine was performed to determine bronchial hyper-responsiveness (BHR in the event of inconclusive spirometric results. Results 88 (55% were female; their average age was 43.9 years. 75 (46.9% patients had asthma, 25 (15.6% had COPD, 8 (5.0% had an overlap of COPD and asthma, and 52 (32.5% had no OAD. At a cut-off level of 46 parts per billion (ppb (n = 30; 18.8%, sensitivity was 32% (95%CI 23–43%, specificity 93% (95%CI 85–97%, positive predictive value (PPV 80% (95%CI 63–91%, negative predictive value (NPV 61% (95%CI 52–69% when compared with a 20% fall in FEV1 from the baseline value (PC20 after inhaling methacholine concentration ≤ 16 mg/ml. At 76 ppb (n = 11; 6.9% specificity was 100% (95%CI 96–100% and PPV was 100% (95%CI 72–100. At a cut-off level of 12 ppb (n = 34; 21.3%, sensitivity was 90% (95%CI 79–95%, specificity 25% (95%CI 17–34%, PPV 40% (95%CI 32–50, NPV 81% (95%CI 64–91% when compared with a 20% fall of FEV1 after inhaling methacholine concentration ≤ 4 mg/ml. Three patients with unsuspicious spirometric results have to be tested with FENO to save one bronchial provocation test. Conclusion Asthma could be ruled in with FENO > 46 ppb. Mild and moderate to severe asthma could be ruled out with FENO ≤ 12 ppb. FENO measurement with

  18. Case study research as bridge builder between science and the society. The rationale behind the ASTRA 2005 winter storm study

    Energy Technology Data Exchange (ETDEWEB)

    Haanpaeae, S.; Peltonen, L.

    2007-07-01

    The challenge of climate change as a complex global issue is that it demands locally grounded solutions that bring together actors from various fields. As a 'wicked' problem climate change adaptation demands deliberation between different subsystems of society, including scientific research. While answering the complex needs of the society, it has to be re-evaluated what 'good' science means. This brings about a need for socially robust knowledge. The need for contextualisation of scientific knowledge is supported by theoretical development in the fields of policy analysis and risk governance. It also entails an epistemic shift away from the 'quest for certainty' towards a pragmatist understanding of knowledge. The underlying request is to integrate expert knowledge with the needs of other stakeholders - to bring in the people to add to the policy formation a notion of emotional knowledge. As a research method, case studies readily contextualise scientific information and therefore offer valuable insights into the underlying social values of the problems at hand. As locally grounded narratives they can offer a shortcut to the formation of a new kind of expertise needed as the demands from the society reform the claims on scientific information. It is argued that developing the science-policy interface and risk communication can both benefit from a contextual research approach using case studies. Such studies have critical and persuasive functions, and they provide a basis for further case-based learning exercises with opportunities for awareness raising, institutional capacity building and practical adaptation measures. (orig.)

  19. Childhood asthma prediction models: a systematic review.

    Science.gov (United States)

    Smit, Henriette A; Pinart, Mariona; Antó, Josep M; Keil, Thomas; Bousquet, Jean; Carlsen, Kai H; Moons, Karel G M; Hooft, Lotty; Carlsen, Karin C Lødrup

    2015-12-01

    Early identification of children at risk of developing asthma at school age is crucial, but the usefulness of childhood asthma prediction models in clinical practice is still unclear. We systematically reviewed all existing prediction models to identify preschool children with asthma-like symptoms at risk of developing asthma at school age. Studies were included if they developed a new prediction model or updated an existing model in children aged 4 years or younger with asthma-like symptoms, with assessment of asthma done between 6 and 12 years of age. 12 prediction models were identified in four types of cohorts of preschool children: those with health-care visits, those with parent-reported symptoms, those at high risk of asthma, or children in the general population. Four basic models included non-invasive, easy-to-obtain predictors only, notably family history, allergic disease comorbidities or precursors of asthma, and severity of early symptoms. Eight extended models included additional clinical tests, mostly specific IgE determination. Some models could better predict asthma development and other models could better rule out asthma development, but the predictive performance of no single model stood out in both aspects simultaneously. This finding suggests that there is a large proportion of preschool children with wheeze for which prediction of asthma development is difficult.

  20. Allergies, asthma, and dust

    Science.gov (United States)

    Reactive airway disease - dust; Bronchial asthma - dust; Triggers - dust ... Things that make allergies or asthma worse are called triggers. Dust is a common trigger. When your asthma or allergies become worse due to dust, you are ...

  1. Allergies, asthma, and molds

    Science.gov (United States)

    Reactive airway - mold; Bronchial asthma - mold; Triggers - mold; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. Mold is a common trigger. When your asthma or allergies become worse due to mold, you are ...

  2. Asthma: Basic Information

    Science.gov (United States)

    ... Air Pollution & Respiratory Health Learn How to Control Asthma Language: English Español (Spanish) Recommend on Facebook Tweet ... Treated? Select a Language Español (Spanish) What Is Asthma? Asthma is a disease that affects your lungs. ...

  3. Asthma in Children

    Science.gov (United States)

    ... have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience wheezing, coughing, chest tightness, ...

  4. Asthma triggers (image)

    Science.gov (United States)

    ... things make your asthma worse. These are called asthma "triggers". Avoiding them is your first step toward feeling better. The most common asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors ...

  5. Anxiety, depression and self-esteem in children with well-controlled asthma : case-control study

    NARCIS (Netherlands)

    Letitre, Sarah L.; de Groot, Eric P.; Draaisma, Eelco; Brand, Paulus

    2014-01-01

    Objective Although asthma has been linked to psychological morbidity, this relationship may be confounded by poor asthma control. We aimed to compare the prevalence of anxiety, depression and low level of self-esteem in children with well-controlled asthma with that of healthy peers. Setting Dedicat

  6. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik;

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The obj......BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents...... and extracted data from original articles that met the inclusion criteria. Summary odds ratios (ORs) and confidence intervals (CIs) were used to express the results of the meta-analysis (forest plot). We explored heterogeneity using funnel plots and the Graphic Appraisal Tool for Epidemiology (GATE). RESULTS......: We retrieved 1,571 titles and selected 11 articles describing three cohort and eight cross-sectional studies for inclusion. A meta-analysis of the cohort studies revealed a risk of new-onset asthma in children with low PA (OR [95 % CI] 1.32 [0.95; 1.84] [random effects] and 1.35 [1.13; 1.62] [fixed...

  7. Validity of Asthma Control Test in Chinese patients

    Institute of Scientific and Technical Information of China (English)

    ZHOU Xin; LI Jing; WANG Chang-zheng; DING Feng-ming; LIN Jiang-tao; YIN Kai-sheng; CHEN Ping; HE Quan-ying; SHEN Hua-hao; WAN Huan-ying; LIU Chun-tao

    2007-01-01

    Background So far, in China, there has been no effective or easy procedure to define the control of asthma. This study assesses the validity of Asthma Control Test in Chinese patients.Methods Three questionnaires (Asthma Control Test, Asthma Control Questionnaire and the 30 second asthma test)were administered to 305 asthma patients from 10 teaching hospitals across China. Spirometry was also used. Asthma specialists rated the control of asthma according to patients' symptoms, medications and forced expiratory volume in first second. The patients were divided into noncontrolled group and controlled group according to the specialists' rating.Reliability, empirical validity and screening accuracy were conducted for Asthma Control Test scores. Screening accuracy was compared among 3 questionnaires. The patients' self rating and the specialists' rating were also compared.Results The internal consistency reliability of the 5-item Asthma Control Test was 0.854. The correlation coefficient between Asthma Control Test and the specialists' rating was 0.729, which was higher than other instruments. Asthma Control Test scores discriminated between groups of patients differing in the percent predicted forced expiratory volume in first second (F=26.06, P<0.0001), the specialists' rating of asthma control (F=88.24, P<0.0001) and the Asthma Control Questionnaire scores (F=250.57, P<0.0001). Asthma Control Test showed no significant difference with Asthma Control Questionnaire in the percent correctly classified, while the percent correctly classified by Asthma Control Test was much higher than 30 second asthma test. The patients' self rating was the same as assessment of the specialists (t=0.65, P=0.516).Conclusion The Asthma Control Test is an effective and practicable method for assessing asthma control in China.

  8. Rationale and design of a study using a standardized locally procured macronutrient supplement as adjunctive therapy to HIV treatment in Kenya.

    Science.gov (United States)

    Sztam, Kevin A; Ndirangu, Murugi; Sheriff, Muhsin; Arpadi, Stephen M; Hawken, Mark; Rashid, Juma; Deckelbaum, Richard J; El Sadr, Wafaa M

    2013-01-01

    Poor nutritional status at initiation of antiretroviral therapy (ART) is predictive of mortality. Decreased dietary intake is a major determinant of weight loss in HIV. Despite a biological rationale to treat undernutrition in adults receiving ART, few studies have provided data on feasibility, safety, effectiveness, and sustainability of specific macronutrient supplements with HIV treatment in adults, especially supplements such as a food basket, a supplement approach seldom evaluated in spite of its wide use. We present the rationale and design for a study of a locally procured macronutrient supplement given to HIV-infected patients initiating ART with a body mass index (BMI) ≤20.0 kg/m(2). The objective was to determine feasibility of procurement, distribution, safety and to obtain preliminary effectiveness data for a locally procured supplement. The design was a comparative study for 200 adult participants at two Kenya government-supported clinics. The primary outcome was BMI at 24 weeks. Supplement duration was 24 weeks, total follow-up was 48 weeks, and the study included a comparison site. Novel aspects of this study include use of a standardized macronutrient supplement to protect the participant against household food sharing, and a complementary micronutrient supplement. Comprehensive data collected included dietary intake, HIV-related quality-of-life, food security, neuropsychiatric assessments, laboratory studies, and household geomapping. Assessments were made at baseline, at 24 weeks, and at 48 weeks post-ART initiation. Challenges included establishing a partnership with local millers, distribution from the HIV clinic, food safety, and tracking of participants. These findings will help inform nutrition support programming in Kenya and similar settings, and provide needed data regarding use of macronutrient supplements as an adjunctive intervention with ART.

  9. Stress and asthma

    Directory of Open Access Journals (Sweden)

    Shoji Nagata

    1999-01-01

    Full Text Available Three factors in recent medical research and treatment (advances in the field of psychoneuroimmunology, epidemiological evidence regarding important interaction between psychosocial factors and development of disease, and the recognition of the importance of patient education for self-management of asthma have led clinicians and researchers to reconsider the role of psychosocial stress in asthma. There are many reports suggesting that stressful life events, family problems and a behavior pattern that increases psychological conflict may influence the development or relapse of asthma and influence its clinical course. Depression is known as one of the risk factors of fatal asthmatic attack. In laboratory studies, about 20% of asthmatics were considered reactors who showed an airway change after exposure to emotional stress. Studies regarding the pathway of stress effect on allergy and asthma are reviewed and discussed from the standpoint of psychoneuroimmunology; for example, the enhancement of IgE production and increased susceptibility to respiratory infection by stress, conditioned anaphylaxis and nerve/mast cell interaction, the effect of stress on various bronchial responses and the inhibition of the immediate and late asthmatic response by anterior hypothalamic lesioning.

  10. Asthma essentials

    Directory of Open Access Journals (Sweden)

    Timothy Greene

    2013-12-01

    Full Text Available Asthma is a chronic, reversible obstructive disease that when in exacerbation can present to the emergency department in a spectrum of severity. Prompt recognition of the potentially severely ill asthmatic requires a careful history and physical exam while considering alternative diagnoses for the presenting symptoms. Early administration of salbutamol and corticosteroids is indicated in almost all patients with other medications such as ipratropium and magnesium and supportive modalities like BiPAP reserved for sicker patients. The global impact of asthma is increasing, especially amongst children. While the benign clinical presentation is most common and mortality has decreased in recent decades due to improved recognition and care, the ubiquity of the condition and frequent lack of regular outpatient management contribute to the disease claiming 250,000 lives worldwide annually. The emergency physician must be prepared to assess and appropriately manage both the young child with a mild wheeze and the adult in respiratory failure.

  11. Indoor Domestic environment and asthma

    Directory of Open Access Journals (Sweden)

    Papadimitriou E.

    2010-01-01

    Full Text Available Introduction: Genesis and development of asthma are greatly affected by the indoor environmental quality. Duringrecent years, it is noted an important increase in asthma cases worldwide which is mainly caused by the effects ofpollutants in indoor environments. Purpose: In this study, there has been an effort to show the impact of indoorenvironment on asthma development. Methodology: Reviewing bibliography by information retrieval from thePubmed and TRIP Database.Conclusion: Indoor air pollution is an interdisciplinary subject. The great number ofpollutants, their variety on structure and action, the conditions under which they are developed as well as theirdifferent and disparate ways of treatment and control require knowledge from many scientific fields. By assuming newdimensions in world climate changes, increasing sensitization in allergens, using respiratory irritants, such aspesticides and compounds and chemicals of industrial origin, and at the same time the poor home indoor air qualityand the family history of asthma lead to new asthma cases worldwide. An important number of asthma cases in afamily could be avoided by implementing a better environmental policy inside our homes. Finally, by understandingbetter the link between environment and asthma as well as by explaining the involved gene action, they will bedelivered more effective prevention and treatment programs.

  12. Environmental factors and childhood asthma.

    Science.gov (United States)

    Phipatanakul, Wanda

    2006-09-01

    Indoor allergens are potent triggers for acute and chronic pediatric asthma. Environmental control measures of these allergens should be considered first-line treatment measures. Allergen avoidance can produce changes in disease activity and symptoms that can be beneficial before any medical intervention is implemented. In addition to allergen avoidance, studies evaluating other exposures, such as endotoxin and diet, in the pathogenesis of asthma are in progress. Understanding the complex relationships between exposure and allergy/asthma development is vitally important to the development of potentially more effective primary and secondary prevention strategies.

  13. Cluster Analysis and Clinical Asthma Phenotypes

    Science.gov (United States)

    Shaw, Dominic E.; Berry, Michael A.; Thomas, Michael; Brightling, Christopher E.; Wardlaw, Andrew J.

    2014-01-01

    Rationale Heterogeneity in asthma expression is multidimensional, including variability in clinical, physiologic, and pathologic parameters. Classification requires consideration of these disparate domains in a unified model. Objectives To explore the application of a multivariate mathematical technique, k-means cluster analysis, for identifying distinct phenotypic groups. Methods We performed k-means cluster analysis in three independent asthma populations. Clusters of a population managed in primary care (n = 184) with predominantly mild to moderate disease, were compared with a refractory asthma population managed in secondary care (n = 187). We then compared differences in asthma outcomes (exacerbation frequency and change in corticosteroid dose at 12 mo) between clusters in a third population of 68 subjects with predominantly refractory asthma, clustered at entry into a randomized trial comparing a strategy of minimizing eosinophilic inflammation (inflammation-guided strategy) with standard care. Measurements and Main Results Two clusters (early-onset atopic and obese, noneosinophilic) were common to both asthma populations. Two clusters characterized by marked discordance between symptom expression and eosinophilic airway inflammation (early-onset symptom predominant and late-onset inflammation predominant) were specific to refractory asthma. Inflammation-guided management was superior for both discordant subgroups leading to a reduction in exacerbation frequency in the inflammation-predominant cluster (3.53 [SD, 1.18] vs. 0.38 [SD, 0.13] exacerbation/patient/yr, P = 0.002) and a dose reduction of inhaled corticosteroid in the symptom-predominant cluster (mean difference, 1,829 μg beclomethasone equivalent/d [95% confidence interval, 307–3,349 μg]; P = 0.02). Conclusions Cluster analysis offers a novel multidimensional approach for identifying asthma phenotypes that exhibit differences in clinical response to treatment algorithms. PMID:18480428

  14. Genome-wide association study of body mass index in 23,000 individuals with and without asthma

    Science.gov (United States)

    Melén, Erik; Granell, Raquel; Kogevinas, Manolis; Strachan, David; Gonzalez, Juan R.; Wjst, Matthias; Jarvis, Debbie; Ege, Markus; Braun-Fahrländer, Charlotte; Genuneit, Jon; Horak, Elisabeth; Bouzigon, Emmanuelle; Demenais, Florence; Kauffmann, Francine; Siroux, Valérie; Michel, Sven; von Berg, Andrea; Heinzmann, Andrea; Kabesch, Michael; Probst-Hensch, Nicole M.; Curjuric, Ivan; Imboden, Medea; Rochat, Thierry; Henderson, John; Sterne, Jonathan A.C.; McArdle, Wendy L.; Hui, Jennie; James, Alan L.; Musk, A. William; Palmer, Lyle J.; Becker, Allan; Kozyrskyj, Anita L.; Chan-Young, Moira; Park, Julie E.; Leung, Andy; Daley, Denise; Freidin, Maxim B.; Deev, Ivan A.; Ogorodova, Ludmila M.; Puzyrev, Valery P.; Celedón, Juan C.; Brehm, John M.; Cloutier, Michelle M.; Canino, Glorisa; Acosta-Pérez, Edna; Soto-Quiros, Manuel; Avila, Lydiana; Bergström, Anna; Magnusson, Jessica; Söderhäll, Cilla; Kull, Inger; Scholtens, Salome; Boezen, H. Marike; Koppelman, Gerard H.; Wijga, Alet H.; Marenholz, Ingo; Esparza-Gordillo, Jorge; Lau, Susanne; Lee, Young-Ae; Standl, Marie; Tiesler, Carla M. T.; Flexeder, Claudia; Heinrich, Joachim; Myers, Rachel A.; Ober, Carole; Nicolae, Dan L.; Farrall, Martin; Kumar, Ashish; Moffatt, Miriam F.; Cookson, William O.C.M.; Lasky-Su, Jessica

    2012-01-01

    Background Both asthma and obesity are complex disorders that are influenced by environmental and genetic factors. Shared genetic factors between asthma and obesity have been proposed to partly explain epidemiological findings of co-morbidity between these conditions. Objective To identify genetic variants that are associated with body mass index (BMI) in asthmatic children and adults, and to evaluate if there are differences between the genetics of BMI in asthmatics and healthy individuals. Methods In total, 19 studies contributed with genome-wide analysis study (GWAS) data from more than 23,000 individuals with predominantly European descent, of whom 8,165 are asthmatics. Results We report associations between several DENND1B variants (p=2.2×10−7 for rs4915551) on chromosome 1q31 and BMI from a meta-analysis of GWAS data using 2,691 asthmatic children (screening data). The top DENND1B SNPs were next evaluated in seven independent replication data sets comprising 2,014 asthmatics, and rs4915551 was nominally replicated (p<0.05) in two of the seven studies and of borderline significance in one (p=0.059). However, strong evidence of effect heterogeneity was observed and overall, the association between rs4915551 and BMI was not significant in the total replication data set, p=0.71. Using a random effects model, BMI was overall estimated to increase by 0.30 kg/m2 (p=0.01 for combined screening and replication data sets, N=4,705) per additional G allele of this DENND1B SNP. FTO was confirmed as an important gene for adult and childhood BMI regardless of asthma status. Conclusions and Clinical Relevance DENND1B was recently identified as an asthma susceptibility gene in a GWAS on children, and here we find evidence that DENND1B variants may also be associated with BMI in asthmatic children. However, the association was overall not replicated in the independent data sets and the heterogeneous effect of DENND1B points to complex associations with the studied diseases

  15. Persistent cough: is it asthma?

    OpenAIRE

    Faniran, A; Peat, J; Woolcock, A

    1998-01-01

    The aim of this study was to determine if children in the community with persistent cough can be considered to have asthma. A validated questionnaire was given to the parents of 1245 randomly selected children aged 6-12 years. Atopy was measured with skin prick tests. Children with persistent cough had less morbidity and less atopy compared with children with wheeze. Although the syndrome commonly referred to as "cough variant asthma" could not be shown in this study, a sign...

  16. Secular trends of allergic asthma in Danish adults. The Copenhagen Allergy Study

    DEFF Research Database (Denmark)

    Linneberg, A; Nielsen, N H; Madsen, F

    2001-01-01

    .6%, odds ratio 1.45, 95% CI 1.17-1.79), and house dust (7.8% vs. 10.2%, odds ratio 1.35, 95% CI 1.12-1.61). The validation of these symptoms showed that the positive predictive values were reasonably stable over time, which may support that a true increase in allergic asthma has occurred. In conclusion...

  17. Asthma in Hispanics. An 8-year update.

    Science.gov (United States)

    Rosser, Franziska J; Forno, Erick; Cooper, Philip J; Celedón, Juan C

    2014-06-01

    This review provides an update on asthma in Hispanics, a diverse group tracing their ancestry to countries previously under Spanish rule. A marked variability in the prevalence and morbidity from asthma remains among Hispanic subgroups in the United States and Hispanic America. In the United States, Puerto Ricans and Mexican Americans have high and low burdens of asthma, respectively (the "Hispanic Paradox"). This wide divergence in asthma morbidity among Hispanic subgroups is multifactorial, likely reflecting the effects of known (secondhand tobacco smoke, air pollution, psychosocial stress, obesity, inadequate treatment) and potential (genetic variants, urbanization, vitamin D insufficiency, and eradication of parasitic infections) risk factors. Barriers to adequate asthma management in Hispanics include economic and educational disadvantages, lack of health insurance, and no access to or poor adherence with controller medications such as inhaled corticosteroids. Although considerable progress has been made in our understanding of asthma in Hispanic subgroups, many questions remain. Studies of asthma in Hispanic America should focus on environmental or lifestyle factors that are more relevant to asthma in this region (e.g., urbanization, air pollution, parasitism, and stress). In the United States, research studies should focus on risk factors that are known to or may diverge among Hispanic subgroups, including but not limited to epigenetic variation, prematurity, vitamin D level, diet, and stress. Clinical trials of culturally appropriate interventions that address multiple aspects of asthma management in Hispanic subgroups should be prioritized for funding. Ensuring high-quality healthcare for all remains a pillar of eliminating asthma disparities.

  18. Exposure to psychosocial job strain during pregnancy and odds of asthma and atopic dermatitis among 7-year old children - a prospective cohort study

    DEFF Research Database (Denmark)

    Larsen, Ann Dyreborg; Schlünssen, Vivi; Christensen, Berit Hvass;

    2014-01-01

    during pregnancy and asthma as well as AD among 7-year-old children. METHODS: The study is based on the Danish National Birth Cohort and includes prospective data from 32 104 pregnancies. Job strain was assessed early in pregnancy by use of two questions on demands and control. We categorized...... participants into four job strain categories: low strain (low demands, high control), active (high demands, high control), passive (low demands, low control), and high strain (high demands, low control). Information on asthma and AD until age seven was collected using maternal self-report. Multinomial logistic......OBJECTIVES: Few epidemiological studies have studied maternal stress exposure during pregnancy and odds of asthma and atopic dermatitis (AD) among offspring, and none have extended the focus to psychosocial job strain. The aim of this study was to assess the association between maternal job strain...

  19. Montelukast improves air trapping, not airway remodeling, in patients with moderate-to-severe asthma: a pilot study

    Institute of Scientific and Technical Information of China (English)

    GAO Jin-ming; CAI Feng; PENG Min; MA Yi; WANG Bin

    2013-01-01

    Background Evidence has demonstrated that the distal lung,which includes airways of <2 mm in diameter and lung parenchyma,constitutes an important component of asthma pathology.Cysteinyl leukotrienes (CysLTs) are potent proinflammatory mediators and bronchoconstrictors involved in the asthmatic process.Guidelines recommend the leukotriene-modifying agents for asthma treatment.We hypothesized that a leukotriene receptor antagonist with an inhaled corticosteroid (ICS) and long-acting β2 agonist (LABA) combination would improve small airways function in moderate-tosevere asthmatics evaluated by physiological tests and high-resolution computed tomography (HRCT) analysis.This study was performed at a tertiary university hospital in Beijing.Methods This was a randomized,double-blind,parallel study performed in 38 patients with moderate-to-severe asthma treated with salmeterol/fluticasone (SFC) plus montelukast (SFC+M) or SFC plus placebo over 24 weeks.Small airway function was assessed by physiological studies and HRCT image analysis.Results Montelukast significantly improved air trapping as expressed by the residual volume (RV)/total lung capacity (TLC).Over 24 weeks of treatment,RV/TLC was improved by (15.41±6.67)% in patients receiving SFC+M while RV/TLC was decreased by (8.57±10.26)% in patients receiving SFC alone,the difference between the two groups was significant (P=0.02).There was a trend towards a significant difference in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) in the SFC+M group compared to that in the SFC group ((17.87±8.17)% vs.(12.28±9.20)%,P=0.056).There was no significant change in percentage wall area (WA%) after 24 weeks of add-on treatment with montelukast.Patients receiving SFC+M showed significant improvement in the ratio of CT-determined values at full expiration to those at full inspiration (E/I ratio) (0.894±0.005 vs.0.871±0.003,P=0.002).Conclusion We have shown,using lung function tests

  20. Ethical and policy issues in cluster randomized trials: rationale and design of a mixed methods research study

    Directory of Open Access Journals (Sweden)

    Chaudhry Shazia H

    2009-07-01

    Full Text Available Abstract Background Cluster randomized trials are an increasingly important methodological tool in health research. In cluster randomized trials, intact social units or groups of individuals, such as medical practices, schools, or entire communities – rather than individual themselves – are randomly allocated to intervention or control conditions, while outcomes are then observed on individual cluster members. The substantial methodological differences between cluster randomized trials and conventional randomized trials pose serious challenges to the current conceptual framework for research ethics. The ethical implications of randomizing groups rather than individuals are not addressed in current research ethics guidelines, nor have they even been thoroughly explored. The main objectives of this research are to: (1 identify ethical issues arising in cluster trials and learn how they are currently being addressed; (2 understand how ethics reviews of cluster trials are carried out in different countries (Canada, the USA and the UK; (3 elicit the views and experiences of trial participants and cluster representatives; (4 develop well-grounded guidelines for the ethical conduct and review of cluster trials by conducting an extensive ethical analysis and organizing a consensus process; (5 disseminate the guidelines to researchers, research ethics boards (REBs, journal editors, and research funders. Methods We will use a mixed-methods (qualitative and quantitative approach incorporating both empirical and conceptual work. Empirical work will include a systematic review of a random sample of published trials, a survey and in-depth interviews with trialists, a survey of REBs, and in-depth interviews and focus group discussions with trial participants and gatekeepers. The empirical work will inform the concurrent ethical analysis which will lead to a guidance document laying out principles, policy options, and rationale for proposed guidelines. An

  1. Comparison of stayers, dropouts, and newcomers in a longitudinal population study of asthma and bronchial hyperresponsiveness: introduction of bias?

    Science.gov (United States)

    Ulrik, C S

    1995-01-01

    A random sample of children and adolescents from the general population in Copenhagen, Denmark, has been examined twice (6 years apart) with respect to asthma, allergy, and nonspecific bronchial hyperresponsiveness. To investigate potential bias resulting from loss of baseline subjects at follow-up (dropout bias) and bias resulting from subjects entering the study at the follow-up stage (newcomer bias), stayers (subjects who participated in both examinations) were compared to dropouts and newcomers, respectively. The sample consisted of 983 subjects (aged 7-17 years at the time of the baseline study), of whom 408 (199 boys) participated in both examinations (stayers), 119 (62 boys) in the baseline study only (dropouts), and 257 (124 boys in the follow-up study only (newcomers). Thus, a total of 784 subjects (80% of the sample) were examined either once or twice. At baseline dropouts did not differ from stayers with respect to anthropometric data, smoking habits, pulmonary function, or prevalence of positive skin prick tests, bronchial hyperresponsiveness, asthma, and allergic diseases. Likewise, these variables for newcomers were not different from those of the stayers apart from a significantly higher smoking rate in newcomers (45% vs. 32%, p = 0.003). Based on these findings and the high overall response rate, it seems reasonable to assume that the group of stayers is representative of the whole sample, apart from an underestimation of the number of smokers and, therefore, an underestimation of the risks associated with smoking.(ABSTRACT TRUNCATED AT 250 WORDS)

  2. Obese individuals experience wheezing without asthma but not asthma without wheezing

    DEFF Research Database (Denmark)

    Çolak, Yunus; Shoaib, Afzal; Lange, Peter;

    2016-01-01

    BACKGROUND: Observational studies suggest that obesity is associated with increased risk of asthma. However, it is unknown whether this could be explained by wheezing. We tested the hypothesis that high body mass index (BMI) observationally and genetically is associated with high risk of wheezing...... and asthma, and that the association between high BMI and asthma is explained by wheezing. METHODS: We genotyped 85 437 individuals aged 20-100 years from the Copenhagen General Population Study for FTO (rs9939609), MC4R (rs17782313), TMEM18 (rs6548238) GNPDA2 (rs10938397) and BDNF (rs10767664); 14 500...... individuals experienced wheezing and 5406 had asthma. Wheezing was self-reported, and asthma was ascertained through self-report, hospital contacts with asthma, and/or receiving medication for asthma. BMI was calculated as measured weight divided by measured height squared (kg/m(2)). RESULTS: In observational...

  3. The pharmacogenetics and pharmacogenomics of asthma therapy

    OpenAIRE

    Tse, Sze Man; Tantisira, Kelan; Weiss, Scott Tillman

    2011-01-01

    Despite the availability of several classes of asthma medications and their overall effectiveness, a significant portion of patients fail to respond to these therapeutic agents. Evidence suggests that genetic factors may partly mediate the heterogeneity in asthma treatment response. This review discusses important findings in asthma pharmacogenetics and pharmacogenomics studies conducted to date, examines limitations of these studies and finally, proposes future research directions in this fi...

  4. Exacerbations of asthma during pregnancy

    DEFF Research Database (Denmark)

    Ali, Z; Hansen, A V; Ulrik, C S

    2016-01-01

    that asthma exacerbations during pregnancy increase the risk of pre-eclampsia, gestational diabetes, placental abruption and placenta praevia. Furthermore, these women also have higher risk for breech presentation, haemorrhage, pulmonary embolism, caesarean delivery, maternal admission to the intensive care...... unit and longer postpartum hospital stay. Asthma has been associated with increased risk of intrauterine growth retardation, small-for-gestational age, low birth weight, infant hypoglycaemia and preterm birth, but more recent prospective studies have not revealed significant associations with regard...

  5. Respiratory Reviews in Asthma 2013

    OpenAIRE

    Kim, Tae-Hyung

    2014-01-01

    From January 2012 up until March 2013, many articles with huge clinical importance in asthma were published based on large numbered clinical trials or meta-analysis. The main subjects of these studies were the new therapeutic plan based on the asthma phenotype or efficacy along with the safety issues regarding the current treatment guidelines. For efficacy and safety issues, inhaled corticosteroid tapering strategy or continued long-acting beta agonists use was the major concern. As new thera...

  6. Prescription of asthma medications before and during pregnancy in France

    DEFF Research Database (Denmark)

    Beau, Anna-Belle; Didier, Alain; Hurault-Delarue, Caroline;

    2016-01-01

    OBJECTIVE: Asthma affects between 3 to 8% of pregnant women. Previous studies have suggested that women's prescriptions for asthma medication change during pregnancy. The aim was to describe the prescription of asthma medications before and during pregnancy in France. METHODS: Women from the EFEM......OBJECTIVE: Asthma affects between 3 to 8% of pregnant women. Previous studies have suggested that women's prescriptions for asthma medication change during pregnancy. The aim was to describe the prescription of asthma medications before and during pregnancy in France. METHODS: Women from...

  7. Study of the correlations between fractional exhaled nitric oxide in exhaled breath and atopic status, blood eosinophils, FCER2 mutation, and asthma control in Vietnamese children

    Directory of Open Access Journals (Sweden)

    Nguyen-Thi-Bich H

    2016-09-01

    Full Text Available Hanh Nguyen-Thi-Bich,1 Huong Duong-Thi-Ly,2 Vu Thi Thom,2 Nhung Pham-Thi-Hong,2 Long Doan Dinh,2 Huong Le-Thi-Minh,1 Timothy John Craig,3 Sy Duong-Quy3,4 1Department of Immunology, Allergology, and Rheumatology, National Hospital of Pediatrics, Hanoi, Vietnam; 2School of Medicine and Pharmacy, Vietnam National University Hanoi, Vietnam; 3Department of Medicine, Penn State University, Hershey, PA, USA; 4Department of Respiratory Diseases, Lam Dong Medical College, Dalat, Vietnam Introduction: Fractional exhaled nitric oxide (FENO is a biomarker of airway inflammation in asthma. The measurement of FENO is utilized to assist in the diagnosis and treatment of children with asthma, especially for those treated with inhaled corticosteroids. Objectives: The aims of this study were to evaluate the correlations between FENO and atopic status, blood eosinophil levels, FCER2 mutation, and asthma control in Vietnamese children. Subjects and methods: This was a prospective and descriptive study approved by the local Ethical Board. All children with uncontrolled asthma, seen in the National Hospital of Pediatrics (Hanoi, Vietnam, were included. Exhaled breath FENO, blood eosinophils, skin prick test, total IgE, asthma control test (ACT, and FCER2 gene polymorphism were performed at inclusion. They were followed up at 3 months to evaluate clinical status, FENO levels, and ACT. Results: Forty-two children with uncontrolled asthma with a mean age of 10±3 years (6–16 years were included. The male/female ratio was 2.5/1. The mean FENO levels were 26±25 ppb. FENO was significantly higher in patients with a positive skin prick test for respiratory allergens (P<0.05. FENO was significantly correlated with blood eosinophil levels (r=0.5217; P=0.0004. Five of the 32 subjects (15.6% had a mutation of FCER2 gene (rs28364072 SNP. In this group, the levels of FENO were highest (37±10 ppb; P<0.05. The levels of FENO were significantly decreased after 3 months of

  8. Asthma and obesity

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ali, Zarqa; Nilas, Lisbeth

    2012-01-01

    Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma....

  9. 2003 Canadian Asthma Consensus Guidelines Executive Summary

    Directory of Open Access Journals (Sweden)

    Becker Allan

    2006-03-01

    Full Text Available Abstract Background Guidelines for the diagnosis and management of asthma have been published over the last 15 years; however, there has been little focus on issues relating to asthma in childhood. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies, particularly in children, have highlighted the need to incorporate new information into the asthma guidelines. The objectives of this article are to review the literature on asthma published between January 2000 and June 2003 and to evaluate the influence of new evidence on the recommendations made in the 1999 Canadian Asthma Consensus Report and its 2001 update, with a major focus on pediatric issues. Methods The diagnosis of asthma in young children and prevention strategies, pharmacotherapy, inhalation devices, immunotherapy, and asthma education were selected for review by small expert resource groups. The reviews were discussed in June 2003 at a meeting under the auspices of the Canadian Network For Asthma Care and the Canadian Thoracic Society. Data published through December 2004 were subsequently reviewed by the individual expert resource groups. Results This report evaluates early-life prevention strategies and focuses on treatment of asthma in children, emphasizing the importance of early diagnosis and preventive therapy, the benefits of additional therapy, and the essential role of asthma education. Conclusion We generally support previous recommendations and focus on new issues, particularly those relevant to children and their families. This document is a guide for asthma management based on the best available published data and the opinion of health care professionals, including asthma experts and educators.

  10. School variation in asthma: compositional or contextual?

    Directory of Open Access Journals (Sweden)

    Tracy K Richmond

    Full Text Available BACKGROUND: Childhood asthma prevalence and morbidity have been shown to vary by neighborhood. Less is known about between-school variation in asthma prevalence and whether it exists beyond what one might expect due to students at higher risk of asthma clustering within different schools. Our objective was to determine whether between-school variation in asthma prevalence exists and if so, if it is related to the differential distribution of individual risk factors for and correlates of asthma or to contextual influences of schools. METHODS: Cross-sectional analysis of 16,640 teens in grades 7-12 in Wave 1 (data collected in 1994-5 of the National Longitudinal Study of Adolescent Health. Outcome was current diagnosis of asthma as reported by respondents' parents. Two-level random effects models were used to assess the contribution of schools to the variance in asthma prevalence before and after controlling for individual attributes. RESULTS: The highest quartile schools had mean asthma prevalence of 21.9% compared to the lowest quartile schools with mean asthma prevalence of 7.1%. In our null model, the school contributed significantly to the variance in asthma (sigma(u0(2 = 0.27, CI: 0.20, 0.35. Controlling for individual, school and neighborhood attributes reduced the between-school variance modestly (sigma(u0(2 = 0.19 CI: 0.13-0.29. CONCLUSION: Significant between-school variation in current asthma prevalence exists even after controlling for the individual, school and neighborhood factors. This provides evidence for school level contextual influences on asthma. Further research is needed to determine potential mechanisms through which schools may influence asthma outcomes.

  11. The relation of airway obstruction to asthma, chronic rhinosinusitis and age

    DEFF Research Database (Denmark)

    Obaseki, D; Potts, J; Joos, G;

    2014-01-01

    RATIONALE: There is conflicting evidence on whether patients with asthma experience an accelerated decline in lung function with age. We examined the association between postbronchodilator lung function, asthma, chronic rhinosinusitis (CRS), and atopy with age using a large European sample. METHODS...... history, atopy, and treatment. Multiple regression was used to assess the interactive effects of age and diagnostic group on decline in postbronchodilator ventilatory function. RESULTS: A total of 3337 participants provided adequate data (778 with asthma, 399 with CRS, 244 with both asthma and CRS...

  12. Prevalence of symptoms of asthma, rhinitis and eczema in 13- to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III.

    Science.gov (United States)

    Ait-Khaled, N; Odhiambo, J; Pearce, N; Adjoh, K S; Maesano, I A; Benhabyles, B; Bouhayad, Z; Bahati, E; Camara, L; Catteau, C; El Sony, A; Esamai, F O; Hypolite, I E; Melaku, K; Musa, O A; Ng'ang'a, L; Onadeko, B O; Saad, O; Jerray, M; Kayembe, J M; Koffi, N B; Khaldi, F; Kuaban, C; Voyi, K; M'Boussa, J; Sow, O; Tidjani, O; Zar, H J

    2007-03-01

    Phase I of the International Study of Asthma and Allergies in Childhood has provided valuable information regarding international prevalence patterns and potential risk factors in the development of asthma, allergic rhinoconjunctivitis and eczema. However, in Phase I, only six African countries were involved (Algeria, Tunisia, Morocco, Kenya, South Africa and Ethiopia). Phase III, conducted 5-6 years later, enrolled 22 centres in 16 countries including the majority of the centres involved in Phase I and new centres in Morocco, Tunisia, Democratic Republic of Congo, Togo, Sudan, Cameroon, Gabon, Reunion Island and South Africa. There were considerable variations between the various centres of Africa in the prevalence of the main symptoms of the three conditions: wheeze (4.0-21.5%), allergic rhinoconjunctivitis (7.2-27.3%) and eczema (4.7-23.0%). There was a large variation both between countries and between centres in the same country. Several centres, including Cape Town (20.3%), Polokwane (18.0%), Reunion Island (21.5%), Brazzaville (19.9%), Nairobi (18.0%), Urban Ivory Coast (19.3%) and Conakry (18.6%) showed relatively high asthma symptom prevalences, similar to those in western Europe. There were also a number of centres showing high symptom prevalences for allergic rhinoconjunctivitis (Cape Town, Reunion Island, Brazzaville, Eldoret, Urban Ivory Coast, Conakry, Casablanca, Wilays of Algiers, Sousse and Eldoret) and eczema (Brazzaville, Eldoret, Addis Ababa, Urban Ivory Coast, Conakry, Marrakech and Casablanca).

  13. The placebo effect in asthma.

    Science.gov (United States)

    Dutile, Stefanie; Kaptchuk, Ted J; Wechsler, Michael E

    2014-08-01

    The placebo effect is a complex phenomenon occurring across a variety of clinical conditions. While much placebo research has been conducted in diseases defined by self-report such as depression, chronic pain, and irritable bowel syndrome (IBS), asthma has been proposed as a useful model because of its easily measured objective outcomes. Studies examining the placebo response in asthma have not only contributed to an understanding of the mechanisms behind the placebo response but also shed an interesting light on the current treatment and diagnosis of asthma. This paper will review current literature on placebos in general and specifically on the placebo response in asthma. It focuses on what we know about the mechanisms behind the placebo effect, whether there is a specific portion of the population who responds to placebos, which patient outcomes are influenced by the placebo effect, and whether the effect can be augmented.

  14. Association of polymorphisms of the CHI3L1 gene with asthma and atopy: a populations-based study of 6514 Danish adults

    DEFF Research Database (Denmark)

    Rathcke, Camilla Noelle; Holmkvist, Johan; Husmoen, Lise Lotte N;

    2009-01-01

    and lung function in a large population-based sample of adults. METHODS/PRINCIPAL FINDINGS: Eleven single nucleotide polymorphisms (SNPs) of CHI3L1 including rs4950928 were genotyped in 6514 individuals. Asthma was defined as self-reported history of physician-diagnosed asthma. Total IgE and specific Ig......BACKGROUND: YKL-40 is a chitinase-like glycoprotein encoded by the chitinase 3-like 1 gene, CHI3L1, localized at chromosome 1q32.1. Increased levels of serum YKL-40 have been reported to be a biomarker for asthma and a reduced lung function. Interestingly, the C-allele of the -131 C-->G (rs4950928......) polymorphism of CHI3L1 has been shown to associate with bronchial hyperresponsiveness and reduced lung function suggesting that variations in CHI3L1 may influence risk of asthma. The objective of the present study was to investigate the association of common variation in the CHI3L1 locus with asthma, atopy...

  15. Evaluation of acute bacterial rhino sinusitis in asthma patients based on clinical parameters and imaging studies, together with ear, nose and throat examination

    Energy Technology Data Exchange (ETDEWEB)

    Faure, Alecsandra Calil Moises; Santoro, Ilka Lopes; Lederman, Henrique Manoel; Fernandes, Ana Luisa Godoy [Federal University of Sao Paulo (UNIFESP/EPM), SP (Brazil). School of Medicine from Sao Paulo. Dept. of Internal Medicine]. E-mail: analgf@terra.com.br; analuisa@pneumo.epm.br; Weckx, Luc Louis Maurice [Federal University of Sao Paulo (UNIFESP/EPM), SP (Brazil). School of Medicine from Sao Paulo. Otorhinolaryngology; Fernandes, Artur da Rocha Correa [Federal University of Sao Paulo (UNIFESP/EPM), SP (Brazil). School of Medicine from Sao Paulo. Dept. of Diagnostic Imaging

    2008-06-15

    Objective: To evaluate paranasal sinuses in patients with stable or acute asthma in order to determine the prevalence of acute bacterial rhinosinusitis. Methods: A cross-sectional study including 30 patients with acute asthma (73% females) treated in the emergency room and 30 patients with stable asthma (80% females) regularly monitored as outpatients. All patients completed a questionnaire on respiratory signs and symptoms and were submitted to ear, nose and throat (ENT) examination, as well as to X-ray and computed tomography (CT) imaging of the sinuses. Results: Based on the clinical diagnosis, the prevalence of acute bacterial rhinosinusitis was 40% in the patients with acute asthma and 3% in those with stable asthma. The ENT examination findings and the imaging findings in isolation were not useful to confirm the diagnosis. Conclusions: In themselves, ENT examination findings, X-ray findings and CT findings were not useful for the diagnosis of acute bacterial rhinosinusitis. Our results provide further evidence that a clinical diagnosis of bacterial rhinosinusitis should be made with caution. (author)

  16. Rationale for Student Dress Codes: A Review of School Handbooks

    Science.gov (United States)

    Freeburg, Elizabeth W.; Workman, Jane E.; Lentz-Hees, Elizabeth S.

    2004-01-01

    Through dress codes, schools establish rules governing student appearance. This study examined stated rationales for dress and appearance codes in secondary school handbooks; 182 handbooks were received. Of 150 handbooks containing a rationale, 117 related dress and appearance regulations to students' right to a non-disruptive educational…

  17. Asthma in elite athletes: how do we manage asthma-like symptoms and asthma in elite athletes?

    DEFF Research Database (Denmark)

    Lund, Thomas Kromann

    2009-01-01

    INTRODUCTION: Asthma is frequent in elite athletes and the high prevalence of asthma might be associated with specific types of sport. It has been suggested that chronic endurance training might increase the number of neutrophils in the airways, and this may reflect airway injury. The use of anti......-asthmatic medication in elite athletes is also currently under scrutiny in order to reduce the risk of under-treatment or over treatment. OBJECTIVES: Determine the use of anti-asthmatic medication and the prevalence of asthma-like symptoms and asthma in Danish elite athletes. Further, to determine whether elite...... survey of elite athletes (N = 418); and (iii) a clinical study of elite athletes. A total of 54 elite athletes (19 with physician-diagnosed asthma) participated together with two control groups: (i) 22 non-athletes with physician-diagnosed asthma (steroid naïve for 4 weeks before the examination) and (ii...

  18. Occupational allergies and asthma.

    OpenAIRE

    Tarlo, S.M.

    1999-01-01

    OBJECTIVE: To review aspects of occupational allergies and asthma for primary care physicians recognizing, diagnosing, and managing patients with these conditions. QUALITY OF EVIDENCE: Studies in the medical literature mainly provide level 2 evidence, that is, from at least one well-designed clinical trial without randomization, from cohort or case-control analytical studies, from multiple time series, or from dramatic results in uncontrolled experiments. MAIN MESSAGE: Occupational allergies ...

  19. Asthma and Obstructive Sleep Apnea

    Institute of Scientific and Technical Information of China (English)

    Yi-Xian Qiao; Yi Xiao

    2015-01-01

    Objective:To get a comprehensive understanding about the relationship between obstructive sleep apnea (OSA) and asthma by reviewing the epidemiology,pathophysiology,and clinical manifestation and then summarizing the latest progress on diagnosis and treatment.Data Sources:Articles referred in this review were mainly collected from a comprehensive search of the PubMed published in English from 1990 to 2015 with the terms "OSA" and “asthma'" as the main keywords.Highly regarded older publications were also included.Study Selection:Information about the features of the two diseases in common,the pathophysiologic association between them and their current treatments from the literature search were identified,retrieved,and summarized.Results:Both OSA and asthma are very prevalent conditions.The incidences of them have kept on rising in recent years.Asthma is often accompanied by snoring and apnea,and OSA often combines with asthma,as well.They have many predisposing and aggravating factors in common.Possible shared direct mechanistic links between them include mechanical effects,intermittent hypoxia,nerve reflex,inflammation,leptin,etc.Indirect mechanistic links include medication,nose diseases,smoking,obesity,and gastroesophageal reflux disease.Since OSA presents many similar features with nocturnal asthma,some scholars termed them as a sole syndrome "alternative overlap syndrome,"and proved that asthma symptoms in those patients could be improved through the treatment of continuous positive airway pressure.Conclusions:OSA and asthma are closely associated in pathogenesis,symptoms,and therapies.With the growing awareness of the relationship between them,we should raise our vigilance on the coexistence of OSA in those difficult-to-control asthmatic patients.Further studies are still needed to guide the clinical works.

  20. Impact of self-reported symptoms of allergic rhinitis and asthma on sleep disordered breathing and sleep disturbances in the elderly with polysomnography study

    Science.gov (United States)

    Kim, Sae-Hoon; Won, Ha-Kyeong; Moon, Sung-Do; Kim, Byung-Keun; Chang, Yoon-Seok; Kim, Ki-Woong; Yoon, In-Young

    2017-01-01

    Background Sleep disordered breathing (SDB) and sleep disturbances have been reported to be associated with allergic rhinitis and asthma. However, population-based studies of this issue in the elderly are rare. Objective To investigate the impact of self-reported rhinitis and asthma on sleep apnea and sleep quality using polysomnography in an elderly Korean population. Methods A total of 348 elderly subjects who underwent one-night polysomnography study among a randomly selected sample were enrolled. Study subjects underwent anthropometric and clinical evaluations. Simultaneously, the prevalence and co-morbid status of asthma and allergic rhinitis, and subjective sleep quality were evaluated using a self-reported questionnaire. Results Ever-diagnosis of allergic rhinitis was significantly more prevalent in subjects with SDB compared with those without SDB. Subjects with an ever-diagnosis of allergic rhinitis showed a higher O2 desaturation index and mean apnea duration. Indices regarding sleep efficiency were affected in subjects with a recent treatment of allergic rhinitis or asthma. Waking after sleep onset was longer and sleep efficiency was lower in subjects who had received allergic rhinitis treatment within the past 12 months. Subjects who had received asthma treatment within the past 12 months showed significantly lower sleep efficiency than others. Conclusion Our study indicates that a history of allergic rhinitis is associated with increased risk of SDB in the elderly. Sleep disturbance and impaired sleep efficiency were found in the subjects who had received recent treatment of allergic rhinitis or asthma. Physicians should be aware of the high risk of sleep disorders in older patients with respiratory allergic diseases. PMID:28245272

  1. Occupational asthma in Japan

    OpenAIRE

    Dobashi, Kunio

    2012-01-01

    Research into occupational asthma (OA) in Japan has been led by the Japanese Society of Occupational and Environmental Allergy. The first report about allergic OA identified konjac asthma. After that, many kinds of OA have been reported. Cases of some types of OA, such as konjac asthma and sea squirt asthma, have been dramatically reduced by the efforts of medical personnel. Recently, with the development of new technologies, chemical antigen-induced asthma has increased in Japan. Due to adva...

  2. Atopy is a risk factor for adult asthma in urban community of Southwestern Nigeria

    Directory of Open Access Journals (Sweden)

    O M Ige

    2012-01-01

    Full Text Available Rationale: Factors affecting asthma course are not clearly elucidated in urban communities in developing countries. Furthermore, the interaction between factors such as atopy, environmental exposure, urbanization, and helminthic infections in modulating asthma have not been well investigated. Objectives: To determine factors, which affect asthma in adults being evaluated at urban tertiary health center of Southwestern part of Nigeria. Materials and Methods: A random sample of 24 (12 males, 12 females consecutive asthmatics seen in the Outpatient Pulmonary Clinic of University College Hospital of Ibadan and 27 (13 males, 14 females age and gender-matched controls underwent evaluation, which included blood tests for eosinophils, serum IgE, allergy skin tests to eight common environmental allergens, and spirometry. The modified version of the questionnaire of the International study of Asthma and Allergies in Children (ISAAC Phase III used by the same study group of researchers in Nigeria was used to assess the asthma symptoms. Wilcoxon sign-rank tests were used to compare eosinophil counts, percentage eosinophils, and allergic skin test between the two groups, while paired t test was used to compare spirometry variables. Results: Asthmatics had significantly more positive skin reaction to house dust mite and mould than controls (P<0.05. Total serum IgE was also significantly higher in asthmatics than in controls (mean 210 vs 60 IU/mL; P=0.003. However, no significant differences were observed in total eosinophil counts. No significant difference in the degree of intestinal helminthes infection in the two groups, which means stool parasitism was similar. FEV 1 % was significantly lower in asthmatics (P=0.02 but FEV 1 was similar between the two groups (P=0.02. Conclusion: The elevated levels of IgE and positive skin reactions to some of the common environmental allergens suggests an important role of atopy in the expression of asthma in this

  3. Rationale Management Challenges in Requirements Engineering

    NARCIS (Netherlands)

    Liang, Peng; Avgeriou, Paris; He, Keqing

    2010-01-01

    Rationale and rationale management have been playing an increasingly prominent role in software system development mainly due to the knowledge demand during system evaluation, maintenance, and evolution, especially for large and complex systems. The rationale management for requirements engineering,

  4. Differences in fungi present in induced sputum samples from asthma patients and non-atopic controls: a community based case control study

    Directory of Open Access Journals (Sweden)

    van Woerden Hugo Cornelis

    2013-02-01

    Full Text Available Abstract Background There is emerging evidence for the presence of an extensive microbiota in human lungs. It is not known whether variations in the prevalence of species of microbiota in the lungs may have aetiological significance in respiratory conditions such as asthma. The aim of the study was to undertake semi-quantitative analysis of the differences in fungal species in pooled sputum samples from asthma patients and controls. Methods Induced sputum samples were collected in a case control study of asthma patients and control subjects drawn from the community in Wandsworth, London. Samples from both groups were pooled and then tested for eukaryotes. DNA was amplified using standard PCR techniques, followed by pyrosequencing and comparison of reads to databases of known sequences to determine in a semi-quantitative way the percentage of DNA from known species in each of the two pooled samples. Results A total of 136 fungal species were identified in the induced sputum samples, with 90 species more common in asthma patients and 46 species more common in control subjects. Psathyrella candolleana, Malassezia pachydermatis, Termitomyces clypeatus and Grifola sordulenta showed a higher percentage of reads in the sputum of asthma patients and Eremothecium sinecaudum, Systenostrema alba, Cladosporium cladosporioides and Vanderwaltozyma polyspora showed a higher percentage of reads in the sputum of control subjects. A statistically significant difference in the pattern of fungi that were present in the respective samples was demonstrated using the Phylogenetic (P test (P  Conclusion This study is novel in providing evidence for the widespread nature of fungi in the sputum of healthy and asthmatic individuals. Differences in the pattern of fungi present in asthma patients and controls merit further investigation. Of particular interest was the presence of Malassezia pachydermatis, which is known to be associated with atopic dermatitis.

  5. A comparative study of efficacy and safety of arformoterol and salbutamol nebulization as rescue therapy in acute non-severe asthma

    Directory of Open Access Journals (Sweden)

    Sibes K Das

    2011-01-01

    Full Text Available Arformoterol, a long-acting beta-2 agonist, has a rapid onset and long duration of action. Its role as rescue medication in acute asthma attack is undetermined. To compare the efficacy and tolerability of arformoterol with salbutamol nebulization, a study was conducted among 50 patients with acute non-severe asthma. Patients were randomly assigned to group 1 (n = 25 and group 2 (n = 25 who received three doses of salbutamol and arformoterol nebulization, respectively, at 20-min intervals. The peak expiratory flow rate (PEFR was measured at the baseline and 5 min after each dose. The demographics and baseline characteristics were comparable between the two groups. The mean PEFR significantly increased in both these groups when compared with the baseline. The increases in the PEFR in two groups were similar after the third dose. The adverse effects in both these groups were minor. Arformoterol was as effective and safe as salbutamol in acute non-severe asthma.

  6. Asthma affects time to pregnancy and fertility

    DEFF Research Database (Denmark)

    Gade, Elisabeth J; Thomsen, Simon F; Lindenberg, Svend;

    2014-01-01

    Coexistence of infertility and asthma has been observed clinically. Therefore, we investigated the association between asthma and delayed pregnancy in a nationwide population-based cohort of twins. A cohort of 15 250 twins living in Denmark (aged 12-41 years) participated in a questionnaire study...... including questions about the presence of asthma and fertility. Differences in time to pregnancy and pregnancy outcome were analysed in subjects with asthma, allergy and in healthy individuals using multiple regression analysis. Asthma was associated with an increased time to pregnancy, the percentage...... in those >30 years of age (32.2% versus 24.9%, OR (95% CI) 1.44 (1.1-1.9); p=0.04). Untreated asthmatics had a significant increased risk of prolonged time to pregnancy compared to healthy individuals (OR (95% CI) 1.79 (1.20-2.66); p=0.004), while asthmatics receiving any kind of treatment for asthma...

  7. Childhood asthma in low income countries

    DEFF Research Database (Denmark)

    Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K

    2012-01-01

    Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts...... and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing...... in under-5s without fever, which suggests the diagnosis of asthma/wheezing rather than bacterial pneumonia. Ultimately, underlying asthma may have contributed to malnutrition and fatal bacterial pneumonia. In conclusion, preschool asthma in low-income countries may be significantly under...

  8. The treatment of asthma in obesity.

    Science.gov (United States)

    Dixon, Anne

    2012-06-01

    The world is facing an unprecedented epidemic of obesity. This epidemic has led to major changes in the epidemiology of common diseases such as asthma. Obesity is a major risk factor for new-onset asthma. This article will discuss the role of mechanical and metabolic factors, as well as obesity-related comorbidities, in both causing airway disease and also affecting response to therapy in obese asthmatics. Asthma in obese individuals probably includes a spectrum of disease with at least two distinct phenotypes: early-onset allergic disease complicated by obesity and late-onset disease developing in the setting of obesity. Both phenotypes are distinct from asthma in lean individuals. Treatment of asthma in obesity needs to consider altered response to controller therapy, and the fact that mechanical factors, metabolic inflammation and other comorbidities are probably contributing to airway disease. Future studies should focus on the development of therapies specifically tailored towards the treatment of asthma in obesity.

  9. A double-blind study on the effect of inhaled corticosteroids on plasma protein exudation in asthma.

    Science.gov (United States)

    Nocker, R E; Weller, F R; Out, T A; de Riemer, M J; Jansen, H M; van der Zee, J S

    1999-05-01

    Plasma protein exudation into the airways is an important pathophysiological event in asthma. The effect of 12 wk of treatment with inhaled fluticasone propionate (FP; 250 microgram twice a day) or salbutamol (Sb; 400 microgram twice a day) on plasma protein leakage was compared in a double-blind, randomized parallel-group study of 30 patients with asthma. Primary outcomes were plasma protein leakage and size selectivity of the blood-airway lumen barrier, cell differentials in BAL fluid, and bronchial responsiveness to histamine (PC20histamine). Two independent procedures to account for the effect of variable dilution of BAL on the levels of albumin (Alb) and alpha2-macroglobulin (A2M) in BAL fluid consisted of correction based on urea levels and on the application of the relative coefficient of excretion [RCE = ([A2M] in BAL fluid/[A2M] in serum)/([Alb] in BAL fluid/[Alb] in serum)]. In the FP group a significant decrease was found in the A2M level and the RCE, and in the percentage of eosinophils in BAL fluid. The PC20histamine increased significantly (mean increase, 2.4 doubling doses), whereas PC20histamine decreased in the Sb group. Differences between groups were significant except for the decrease in eosinophils. We conclude that 12 wk of FP (250 microgram twice a day) decreased the permeability of the blood-airway lumen barrier, in particular for high molecular weight proteins.

  10. Use of a total traffic count metric to investigate the impact of roadways on asthma severity: a case-control study

    Directory of Open Access Journals (Sweden)

    deVos Annemarie JBM

    2011-06-01

    Full Text Available Abstract Background This study had two principal objectives: (i to investigate the relationship between asthma severity and proximity to major roadways in Perth, Western Australia; (ii to demonstrate a more accurate method of exposure assessment for traffic pollutants using an innovative GIS-based measure that fully integrates all traffic densities around subject residences. Methods We conducted a spatial case-control study, in which 'cases' were defined as individuals aged under 19 years of age with more severe asthma (defined here as two or more emergency department contacts with asthma in a defined 5-year period versus age- and gender-matched 'controls' with less severe asthma (defined here as one emergency department contact for asthma. Traffic exposures were measured using a GIS-based approach to determine the lengths of the roads falling within a buffer area, and then multiplying them by their respective traffic counts. Results We examined the spatial relationship between emergency department contacts for asthma at three different buffer sizes: 50 metres, 100 metres and 150 metres. No effect was noted for the 50 metre buffer (OR = 1.07; 95% CI: 0.91-1.26, but elevated odds ratios were observed with for crude (unadjusted estimates OR = 1.21 (95% CI: 1.00-1.46 for 100 metre buffers and OR = 1.25 (95% CI: 1.02-1.54 for 150 metre buffers. For adjusted risk estimates, only the 150 metre buffer yielded a statistically significant finding (OR = 1.24; 95% CI:1.00-1.52. Conclusions Our study revealed a significant 24% increase in the risk of experiencing multiple emergency department contacts for asthma for every log-unit of traffic exposure. This study provides support for the hypothesis that traffic related air pollution increases the frequency of health service contacts for asthma. This study used advanced GIS techniques to establish traffic-weighted buffer zones around the geocoded residential location of subjects to provide an accurate

  11. Assessment of association of exposure to polycyclic aromatic hydrocarbons with bronchial asthma and oxidative stress in children: A case control study

    Directory of Open Access Journals (Sweden)

    Suresh Ram

    2009-01-01

    Full Text Available Background: Polycyclic aromatic hydrocarbons (PAH originate from the incomplete combustion of organic matter and ambient air pollution by these is increasing. There is also an increase in the global prevalence of asthma, for which environmental pollution has been recognized as one of the important factors. Exposure to pollutants and other allergens induces chronic airway inflammation by generation of reactive oxygen species, causing oxidative stress. Therefore, the objective of the present study was to assess association, if any, between exposure to PAH and asthma as well as oxidative stress in children. Method: In this hospital-based case control study, cases of bronchial asthma aged 1-14 years and healthy matched controls were included. Oxidative stress was measured by assessing the levels of enzymes catalase, superoxide dismutase, malondialdehyde (MDA, and reduced glutathione (GSH. Results : Forty-two cases and 20 controls were enrolled. Mean blood level of phenanthrene, a PAH, was 63.11 ppb ± 115.62 and 4.20 ppb ± 10.68 ppb in cases and controls, respectively ( P = 0.02. Mean blood levels of GSH was significantly lower in cases and controls (27.39 mg/ml ± 11.09 versus 47.39 g/ml ± 13.83; P -value = 0.001. Likewise, mean blood level of MDA in nanomole/ml was significantly higher in asthma as compared with controls (12.85 ± 5.40 versus 8.19 ± 5.16; P -value = 0.002, suggestive of increased oxidative stress. Conclusions: Because elevated blood level of phenanthrene is associated with bronchial asthma as well as with oxidative stress, measures to reduce exposure to PAH may possibly lead to reduced incidence and severity of bronchial asthma.

  12. Time in bed, sleep quality and associations with cardiometabolic markers in children : the Prevention and Incidence of Asthma and Mite Allergy birth cohort study

    NARCIS (Netherlands)

    Berentzen, Nina E.; Smit, Henriette A.; Bekkers, Marga B. M.; Brunekreef, Bert; Koppelman, Gerard H.; De Jongste, Johan C.; Kerkhof, Marjan; Van Rossem, Lenie; Wijga, Alet H.

    2014-01-01

    We investigated associations of time in bed and multiple sleep quality characteristics with cardiometabolic markers in children. Data from the prevention and incidence of asthma and mite allergy study, a population-based prospective birth-cohort study started in 1996-1997 in the Netherlands, were an

  13. Alternative Treatment for Asthma: Case Study of Success of Traditional Chinese Medicine Treatment of Children from Urban Areas with Different Levels of Environmental Pollution

    Science.gov (United States)

    Kopnina, Helen

    2012-01-01

    The present study examined efficacy of traditional Chinese medicine (TCM) treatment in Dutch children with asthma in areas with differing air pollution. The study results indicate that TCM treatment of children living in more polluted urban area is less successful then that of children living in cleaner air area. PMID:23724242

  14. Kids' Asthma Flareups Fall Off After No-Smoking Laws

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_162952.html Kids' Asthma Flareups Fall Off After No-Smoking Laws Researchers ... adopted indoor smoking bans, fewer children need emergency asthma treatment, a new study finds. ER visits for ...

  15. Early Virus Raises Asthma Risk in Certain Kids

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_160651.html Early Virus Raises Asthma Risk in Certain Kids: Study Infants ... Topics Asthma in Children Genetic Testing Respiratory Syncytial Virus Infections About MedlinePlus Site Map FAQs Contact Us ...

  16. Consequences of asthma on job absenteeism and job retention

    DEFF Research Database (Denmark)

    Hansen, Carl Lysbeck; Baelum, Jesper; Skadhauge, Lars Rauff;

    2012-01-01

    Various social and economic effects are associated with asthma. This quantitative study describes the effects of current asthma on work life evaluated from the number of weeks receiving transfer incomes....

  17. Helicobacter pylori Seropositivity in Children With Asthma

    OpenAIRE

    Yousefichaijan; Mosayebi; Sharafkhah; Kahbazi; Heydarbagi; Rafiei

    2016-01-01

    Background Some studies have reported an association between Helicobacter pylori (H. pylori) colonization and the occurrence of asthma or other allergies. However, data are inconsistent, and few studies have been performed in children. Objectives The current study aimed to investigate H. pylori seropositivity in children with and without asthma. Patients and Methods This cross-sect...

  18. Prevalência de sintomas de asma, rinite e eczema atópico entre crianças e adolescentes brasileiros identificados pelo International Study of Asthma and Allergies (ISAAC: fase 3 Prevalence of symptoms of asthma, rhinitis, and atopic eczema among Brazilian children and adolescents identified by the International Study of Asthma and Allergies in Childhood (ISAAC: phase 3

    Directory of Open Access Journals (Sweden)

    Dirceu Solé

    2006-10-01

    Full Text Available OBJETIVO: Determinar a prevalência de sintomas relacionados à asma, rinite e eczema atópico em escolares (EC entre 6 e 7 anos e adolescentes (AD entre 13 e 14 anos, residentes em 20 cidades brasileiras, empregando o questionário escrito padronizado do ISAAC, e avaliar a sua associação com a latitude, altitude e temperatura média anual dos centros de residência. MÉTODOS: Participaram do estudo EC e AD das cinco regiões do Brasil, totalizando 23.422 questionários ISAAC respondidos pelos pais de EC e 58.144 pelos próprios AD. Os índices de latitude, altitude e temperatura média anual foram obtidos do Instituto Brasileiro de Geografia e Estatística. RESULTADOS: As prevalências médias para os EC e AD, respectivamente, foram: asma ativa, 24,3 e 19,0%; rinoconjuntivite, 12,6 e 14,6%; e eczema flexural, 8,2 e 5,0%. Associação significante e negativa foi observada entre latitude e prevalência de asma diagnosticada por médico para os EC, asma grave, asma diagnosticada por médico, eczema e eczema flexural para os AD. Não houve associação com a altitude dos centros. CONCLUSÃO: A prevalência de asma, rinite e eczema atópico no Brasil foi variável. Valores mais altos, sobretudo de asma e eczema, foram observados nos centros localizados mais próximos ao Equador.OBJECTIVE: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema among schoolchildren aged 6 to 7 years and adolescents aged 13 to 14 years in 20 Brazilian cities by using the standardized ISAAC written questionnaire, and to assess the association of this prevalence with latitude, altitude and average annual temperature of collaborating centers. METHODS: Schoolchildren and adolescents from five Brazilian regions participated in the study, totaling 23,422 ISAAC questionnaires answered by schoolchildren's parents and 58,144 questionnaires answered by adolescents. The values for latitude, altitude and average annual temperature were obtained from the

  19. Ways of coping with asthma in everyday life: validation of the Asthma Specific Coping Scale

    DEFF Research Database (Denmark)

    Aalto, Anna-Mari; Härkäpää, Kristiina; Aro, Arja R;

    2002-01-01

    OBJECTIVE: This study examines the validity of the Asthma Specific Coping Scale. METHODS: Study samples were comprised of persons with drug-treated asthma (n=3464) drawn from the Drug Reimbursement Registry and asthma rehabilitation participants [brief (n=278) and comprehensive (n=316) intervention...... also showed sensitivity to change after rehabilitation. CONCLUSION: Though further longitudinal studies are needed, this scale seems to be a promising instrument to be used in surveys and outcome studies....

  20. Parental Perceptions and Practices toward Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Amani K. Abu-Shaheen

    2016-01-01

    Full Text Available Introduction. Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective. To investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods. Using a self-administered questionnaire, a two-stage cross-sectional survey of parents of children aged between 3 and 15 years, was conducted from schools located in Riyadh province in central Saudi Arabia. Results. During the study interval, 2000 parents were asked to participate in the study; 1450 parents responded, of whom 600 (41.4% reported that their children had asthma, dyspnea, or chest allergy (recurrent wheezing or coughing, while 478 (32.9% of the parents reported that their children were diagnosed earlier with asthma by a physician. Therefore, the final statistical analyses were performed with 600 participants. Furthermore, 321 (53.5% respondents believed that asthma is solely a hereditary disease. Interestingly, 361 (60.3% were concerned about side effects of inhaled corticosteroids and 192 (32% about the development of dependency on asthma medications. Almost 76% of parents had previously visited a pediatric emergency department during an asthma attack. Conclusions. Parents had misperceptions regarding asthma and exhibited ineffective practices in its management. Therefore, improving asthma care and compliance requires added parental education.

  1. Genetics of asthma: a molecular biologist perspective

    Directory of Open Access Journals (Sweden)

    Ghosh Balaram

    2009-05-01

    Full Text Available Abstract Asthma belongs to the category of classical allergic diseases which generally arise due to IgE mediated hypersensitivity to environmental triggers. Since its prevalence is very high in developed or urbanized societies it is also referred to as "disease of civilizations". Due to its increased prevalence among related individuals, it was understood quite long back that it is a genetic disorder. Well designed epidemiological studies reinforced these views. The advent of modern biological technology saw further refinements in our understanding of genetics of asthma and led to the realization that asthma is not a disorder with simple Mendelian mode of inheritance but a multifactorial disorder of the airways brought about by complex interaction between genetic and environmental factors. Current asthma research has witnessed evidences that are compelling researchers to redefine asthma altogether. Although no consensus exists among workers regarding its definition, it seems obvious that several pathologies, all affecting the airways, have been clubbed into one common category called asthma. Needless to say, genetic studies have led from the front in bringing about these transformations. Genomics, molecular biology, immunology and other interrelated disciplines have unearthed data that has changed the way we think about asthma now. In this review, we center our discussions on genetic basis of asthma; the molecular mechanisms involved in its pathogenesis. Taking cue from the existing data we would briefly ponder over the future directions that should improve our understanding of asthma pathogenesis.

  2. What's an Asthma Action Plan?

    Science.gov (United States)

    ... to 2-Year-Old What's an Asthma Action Plan? KidsHealth > For Parents > What's an Asthma Action Plan? ... normal everyday activities without having asthma symptoms. Action Plans Are Unique Each person's experience with asthma is ...

  3. Stay away from asthma triggers

    Science.gov (United States)

    Asthma triggers - stay away from; Asthma triggers - avoiding; Reactive airway disease - triggers; Bronchial asthma - triggers ... to them. Have someone who does not have asthma cut the grass, or wear a facemask if ...

  4. Reassociation of dreams. II. An LSD study of sexual conflicts in eczema and asthma.

    Science.gov (United States)

    Abramson, H A

    1976-07-01

    This second paper on the reassociation of dreams confirms 1. the value of reassociating a key dream (The Beetle Bug Dream) and 2. the use of lysergic acid diethyl amide (LSD) as an adjunct to psychoanalytic therapy. The patient (Joyce) was a young mother whose very severe eczema and asthma were accompanied by an incapacitating depression. The following summary of the three interviews indicate briefly the psychodynamic materials developed which helped Joyce uncover her confused sexual identifications and fear of lesbianism. In Interview 96 the initial Beetle Bug Dream was studied cautiously. On analysis the tentacles of the Beetle Bugs symbolically represented the hands of a man mauling a girl's skin. A sexual approach by a man is considered an attack. "Bugs get under the skin. If Jack (my husband) touches my skin, that spot itches." A second Beetle Bug is described. The special aspect of this unique Bug is that it was not threatening. This Bug is discussed in terms of the transference: the silent analyst and a father who responded to her childhood travail by silence are compared. Reassociation of the Beetle Bug Dream without LSD took place one year later. The session (Interview 235) lasted about 45 minutes and the verbatim recording occupied 12 typewritten pages. Free association led to the realization that the patient was programmed in part to identify with her father--a silent, passive individual. It was apparent that a psychological struggle for femininity, induced by the confused identification led to a threat of penetration by the sting of the Beetle Bug and, where a man was involved, penetration by the penis. Interview 236 (three days later) was conducted under LSD 25. The Beetle Bug Dream again formed the basis of this interview, which lasted four hours and occupied 46 pages of typewritten, verbatim material. A new feeling of independence from maternal influence is felt. "It used to be if I just thought of her, I could start scratching." The relationship

  5. [Dynamics of functional parameters in different schemes for bronchial asthma therapy: results of the STRELA-ACT multicentre study].

    Science.gov (United States)

    Ogorodova, L M; Kulikov, E S; Deev, I A; Cherniak, B A; Fassakhov, R S

    2011-01-01

    Different strategies for disease control in real clinical practice are compared in terms of dynamics of functional parameters in patients with persistent bronchial asthma. This prospective multicentre surveillance study was carried out in 19 Russian clinics using the common protocol. The patients were divided in 3 groups in accordance with the changes of basal antiinflammatory therapy during the study period. Group A--stepwise increase in the extent of combined salmoterol/fluticason therapy, group B--long-term stable-dose salmoterol/fluticason therapy, group C--salmoterol/fluticason therapy with gradual decrease of the dose and/or transition to an alternative variant. Statistical analysis using Statistica 6.0 program included data from 543 patients. The results suggest that the two first modalities increased the level of control (ACT test) and improved characteristics of external respiration throughout the study period. Strategy 3 was associated with a decrease in the external respiration function and the level of control.

  6. Novel Gentic Variations Contributing to Asthma Susceptability in Saudi Arabia

    Science.gov (United States)

    2014-04-13

    Collection of Clinical Data That Will be Used in This Study and Will Form a Data Bank for Asthma in Saudi Arabia; Identify Known and NOVEL Genetic Risk Factors Contributing to Asthma Susceptibility; Study the Mechanistic Roles of the Genetic Variants Within Major Asthma Susceptibility Genes

  7. Determinants of asthma phenotypes in supermarket bakery workers.

    NARCIS (Netherlands)

    Baatjies, R.; Lopata, A.L.; Sander, I.; Raulf-Heimsoth, M.; Bateman, E.D.; Meijster, T.; Heederik, D.J.J.; Robins, T.G.; Jeebhay, M.F.

    2009-01-01

    While baker's asthma has been well described, various asthma phenotypes in bakery workers have yet to be characterised. Our study aims to describe the asthma phenotypes in supermarket bakery workers in relation to host risk factors and self-reported exposure to flour dust. A cross-sectional study of

  8. Determinants of asthma phenotypes in supermarket bakery workers

    NARCIS (Netherlands)

    Baatjies, R.; Lopata, A.L.; Sander, I.; Raulf-Heimsoth, M.; Batemane, E.D.; Meijster, T.; Heederik, D.; Robins, T.G.; Jeebhay, M.F.

    2009-01-01

    While baker's asthma has been well described, various asthma phenotypes in bakery workers have yet to be characterised. Our study aims to describe the asthma phenotypes in supermarket bakery workers in relation to host risk factors and self-reported exposure to flour dust. A cross-sectional study of

  9. Ethnic disparities in quality of care for children with asthma.

    NARCIS (Netherlands)

    Laar, J.J.N. van; Stronk, K.; Devillé, W.

    2004-01-01

    Studies from the UK and USA found ethnic disparities in asthma treatment for children. Little is known about ethnic disparities in asthma treatment for chidlren in the Netherlands. The aim of this study is to gain insight into ethnic disparities in asthma care for children living in the Nederlands.

  10. Study rationale and design of OPTIMISE, a randomised controlled trial on the effect of benchmarking on quality of care in type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Hermans Michel P

    2011-09-01

    Full Text Available Abstract Background To investigate the effect of physician- and patient-specific feedback with benchmarking on the quality of care in adults with type 2 diabetes mellitus (T2DM. Methods Study centres in six European countries were randomised to either a benchmarking or control group. Physicians in both groups received feedback on modifiable outcome indicators (glycated haemoglobin [HbA1c], glycaemia, total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein [LDL]-cholesterol and triglycerides for each patient at 0, 4, 8 and 12 months, based on the four times yearly control visits recommended by international guidelines. The benchmarking group also received comparative results on three critical quality indicators of vascular risk (HbA1c, LDL-cholesterol and systolic blood pressure [SBP], checked against the results of their colleagues from the same country, and versus pre-set targets. After 12 months of follow up, the percentage of patients achieving the pre-determined targets for the three critical quality indicators will be assessed in the two groups. Results Recruitment was completed in December 2008 with 3994 evaluable patients. Conclusions This paper discusses the study rationale and design of OPTIMISE, a randomised controlled study, that will help assess whether benchmarking is a useful clinical tool for improving outcomes in T2DM in primary care. Trial registration NCT00681850

  11. Perimenstrual asthma: from pathophysiology to treatment strategies.

    Science.gov (United States)

    Graziottin, Alessandra; Serafini, Audrey

    2016-01-01

    The prevalence of asthma is about 9,7 % in women and 5,5 % in men. Asthma can deteriorate during the perimenstrual period, a phenomenon known as perimenstrual asthma (PMA), which represents a unique, highly symptomatic asthma phenotype. It is distinguished from traditional allergic asthma by aspirin sensitivity, less atopy, and lower lung capacity. PMA incidence is reported to vary between 19 and 40 % of asthmatic women. The presence of PMA has been related to increases in asthma-related emergency department visits, hospitalizations and emergency treatment including intubations. It is hypothesized that hormonal status may influence asthma in women, focusing on the role of sex hormones, and specifically on the impact of estrogens' fluctuations at ovulation and before periods. This paper will focus on the pathophysiology of hormone triggered cycle related inflammatory/allergic events and their relation with asthma. We reviewed the scientific literature on Pubmed database for studies on PMA. Key word were PMA, mastcells, estrogens, inflammation, oral contraception, hormonal replacement therapy (HRT), and hormone free interval (HFI). Special attention will be devoted to the possibility of reducing the perimenstrual worsening of asthma and associated symptoms by reducing estrogens fluctuations, with appropriate hormonal contraception and reduced HFI. This novel therapeutical approach will be finally discussed.

  12. Smoking among upper secondary pupils with asthma: reasons for their smoking behavior: a population-based study

    DEFF Research Database (Denmark)

    Precht, Dorthe Hansen; Keiding, Lis; Nielsen, Gert Allan;

    2006-01-01

    We compared why adolescent pupils with and without asthma started smoking and currently smoke. Girls with asthma started smoking less often because of friends smoking, and asthmatics started more often because of pressure, especially asthmatic boys. Fewer asthmatics smoked currently for social...

  13. Does traffic exhaust contribute to the development of asthma and allergic sensitization in children: findings from recent cohort studies

    Directory of Open Access Journals (Sweden)

    Forsberg Bertil

    2009-04-01

    Full Text Available Abstract The aim of this review was to assess the evidence from recent prospective studies that long-term traffic pollution could contribute to the development of asthma-like symptoms and allergic sensitization in children. We have reviewed cohort studies published since 2002 and found in PubMed in Oct 2008. In all, 13 papers based on data from 9 cohorts have evaluated the relationship between traffic exposure and respiratory health. All surveys reported associations with at least some of the studied respiratory symptoms. The outcome varied, however, according to the age of the child. Nevertheless, the consistency in the results indicates that traffic exhaust contributes to the development of respiratory symptoms in healthy children. Potential effects of traffic exhaust on the development of allergic sensitization were only assessed in the four European birth cohorts. Long-term exposure to outdoor air pollutants had no association with sensitization in ten-year-old schoolchildren in Norway. In contrast, German, Dutch and Swedish preschool children had an increased risk of sensitization related to traffic exhaust despite fairly similar levels of outdoor air pollution as in Norway. Traffic-related effects on sensitization could be restricted to individuals with a specific genetic polymorphism. Assessment of gene-environment interactions on sensitization has so far only been carried out in a subgroup of the Swedish birth cohort. Further genetic association studies are required and may identify individuals vulnerable to adverse effects from traffic-related pollutants. Future studies should also evaluate effects of traffic exhaust on the development and long term outcome of different phenotypes of asthma and wheezing symptoms.

  14. Knowledge and attitudes towards genetic testing: a two year follow-up study in patients with asthma, diabetes mellitus and cardiovascular disease

    NARCIS (Netherlands)

    Calsbeek, Hiske; Morren, M.; Rijken, M.; Bensing, J.

    2007-01-01

    Adequate knowledge and personal attitudes towards DNA-testing are major determinants of optimal utilization of genetic testing. This study aims to (1) assess the genetic knowledge and attitude towards genetic testing of patients with asthma, diabetes mellitus type II and cardiovascular diseases, (2)

  15. Exposure to animals and the risk of allergic asthma: a population-based cross-sectional study in Finnish and Russian children

    Directory of Open Access Journals (Sweden)

    Pushkarev Vadim

    2008-06-01

    Full Text Available Abstract Background There is little information on potential differences in animal exposure between Finland and Russia and particularly on the effects of animal exposure on asthma among Russian children. The aim of the study was to compare the pet and farm animal exposures and to assess the relations of pre- and postnatal animal exposures to the occurrence of allergic asthma in Finnish and Russian school children. Methods We conducted a population-based cross-sectional study in neighbour towns on either side of the Finnish-Russian border; Imatra in Finland and Svetogorsk in Russia. The study population consisted of 512 Finnish and 581 Russian school children aged 7–16 years (response rate 79%. Multivariate logistic regression analysis was used to estimate adjusted odds ratios (OR and 95% confidence intervals (CI related to each exposure. Results Current indoor exposure to pets was more frequent among school children in Svetogorsk than in Imatra (67.5% vs. 56.0%, P Conclusion Exposure to pets and farm animals during childhood differed significantly between Finland and Russia. Our study provides evidence that early-life exposure to cats increases the risk of asthma whereas exposure to dogs is protective. Our findings suggest that intermittent fetal and early-life exposure to farm animals increases the risk of allergic asthma in urban children visiting farms.

  16. Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma : Bidirectional case-crossover study using the general practice research database

    NARCIS (Netherlands)

    Hak, Eelko; Mulder, Bianca; Schuiling-Veninga, Nynke C. M.; De Vries, Tjalling W.; Jick, Susan S.

    2013-01-01

    Background: Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. Objectives: To assess the association between the use of acid-suppre

  17. Use of Acid-Suppressive Drugs in Pregnancy and the Risk of Childhood Asthma : Bidirectional Crossover Study using the General Practice Research Database

    NARCIS (Netherlands)

    Hak, Eelko; Mulder, Bianca; Schuiling-Veninga, Catharina C. M.; de Vries, Tjalling W.; Jick, Susan S.

    2013-01-01

    Background Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. Objective We assessed the association between the use of acid-suppres

  18. Comorbidity of eczema, rhinitis, and asthma in IgE-sensitised and non-IgE-sensitised children in MeDALL : a population-based cohort study

    NARCIS (Netherlands)

    Pinart, Mariona; Benet, Marta; Annesi-Maesano, Isabella; von Berg, Andrea; Berdel, Dietrich; Carlsen, Karin C. L.; Carlsen, Kai-Halon; Bindslev-Jensen, Carsten; Eller, Esben; Fantini, Maria P.; Lenzi, Jacopo; Gehring, Ulrike; Heinrich, Joachim; Hohmann, Cynthia; Just, Jocelyne; Keil, Thomas; Kerkhof, Marjan; Kogevinas, Manolis; Koletzko, Sibylle; Koppelman, Gerard H.; Kull, Inger; Lau, Susanne; Meien, Erik; Mamas, Isabelle; Porta, Daniela; Postma, Dirkje; Ranciere, Fanny; Smit, Henriette A.; Stein, Renato T.; Tischer, Christina G.; Torrent, Maties; Wickman, Magnus; Wijga, Alert H.; Bouquest, Jean; Sunyer, Jordi; Basagaina, Xavier; Guerra, Stefano; Garcia-Aymerich, Judith; Anto, Josep M.

    2014-01-01

    Background Eczema, rhinitis, and asthma often coexist (comorbidity) in children, but the proportion of comorbidity not attributable to either chance or the role of IgE sensitisation is unknown. We assessed these factors in children aged 4-8 years. Methods In this prospective cohort study, we assesse

  19. Asthma and PM10

    Directory of Open Access Journals (Sweden)

    Gilmour M Ian

    2000-07-01

    Full Text Available Abstract PM10 (the mass of particles present in the air having a 50% cutoff for particles with an aerodynamic diameter of 10 μm is the standard measure of particulate air pollution used worldwide. Epidemiological studies suggest that asthma symptoms can be worsened by increases in the levels of PM10. Epidemiological evidence at present indicates that PM10 increases do not raise the chances of initial sensitisation and induction of disease, although further research is warranted. PM10 is a complex mixture of particle types and has many components and there is no general agreement regarding which component(s could lead to exacerbations of asthma. However pro-inflammatory effects of transition metals, hydrocarbons, ultrafine particles and endotoxin, all present to varying degrees in PM10, could be important. An understanding of the role of the different components of PM10 in exacerbating asthma is essential before proper risk assessment can be undertaken leading to advice on risk management for the many asthmatics who are exposed to air pollution particles.

  20. Asthma and obesity.

    Science.gov (United States)

    Boulet, L-P

    2013-01-01

    The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients.