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Sample records for asthma-related environmental fungus

  1. Genetic and environmental influence on asthma

    DEFF Research Database (Denmark)

    Skadhauge, L.R.; Christensen, Kaare; Kyvik, Kirsten Ohm

    1999-01-01

    The aim of this study was to estimate the relative influence of genetic and environmental factors on the aetiology of asthma. The classic twin study design was used to analyse data on self-reported asthma obtained by a questionnaire mailed to 34,076 individuals, aged 12-41 yrs and originating from...... in the monozygotic than in the dizygotic twins. Using biometric modelling, a model including additive genetic and nonshared environmental effects provided the best overall fit to the data. According to this model, 73% of the variation in liability to asthma was explained by genetic factors. No sex difference or age......-dependency in the magnitude of genetic effects was observed. The biometric analysis emphasized a major influence of genetic factors in the aetiology of asthma. However, a substantial part of the variation in liability to asthma is due to the impact of environmental factors specific to the individual. There is no evidence...

  2. Environmental and Personal Factors Related to Asthma Severity among Children: Hospital Based Study, Egypt

    Directory of Open Access Journals (Sweden)

    Omaima Ibrahim AboElkheir

    2016-09-01

    Full Text Available Background: Childhood asthma is a complex disorder in which many environmental and personal factors play a role. However, the contribution of these factors to asthma severity is poorly understood. This study aims to determine the relationship between environmental exposures, personal factors and asthma severity among asthmatic children. Methods: This cross-sectional hospital based study was conducted on 180 asthmatic children; they were divided into mild, moderate and severe asthma according to forced expiratory volume in first second. Environmental factors (indoor and outdoor, food allergy, history of other allergic diseases, family history of allergic disorders, time trend of attacks as well as asthma outcome were reported. Results: Children with severe asthma were younger than those with mild or moderate asthma. Severe asthma was significantly linked to family history of allergy, presence of co-morbid allergic diseases, fish, egg and milk allergy, as well as exposure to passive smoking (73.7% and poor housing conditions. Also, it was significantly linked to presence of unauthorized factories in residential area (31.6 %, p=0.001. As well as, contact with pets (42.1%. Children with severe asthma had more limitations of physical activities (73.7%, missed school days (81.5%, with poor school performance (p=0.04 than those with mild moderate or asthma. Conclusion: Severe asthma was linked to female gender and younger age, co-morbid allergic diseases, family history of atopy and food allergy. It was higher among children residing in places with unauthorized factories and living in substandard housing condition. Children with severe asthma had poor asthma outcome.

  3. Do indoor environments influence asthma and asthma-related symptoms among adults in homes? A review of the literature

    Directory of Open Access Journals (Sweden)

    Yu Jie

    2011-09-01

    Full Text Available This review summarizes the results of epidemiological studies focusing on the detrimental effects of home environmental factors on asthma morbidity in adults. We reviewed the literature on indoor air quality (IAQ, physical and sociodemographic factors, and asthma morbidity in homes, and identified commonly reported asthma, allergic, and respiratory symptoms involving the home environment. Reported IAQ and asthma morbidity data strongly indicated positive associations between indoor air pollution and adverse health effects in most studies. Indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke. Environmental exposure may increase an adult’s risk of developing asthma and also may increase the risk of asthma exacerbations. Evaluation of present IAQ levels, exposure characteristics, and the role of exposure to these factors in relation to asthma morbidity is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity.

  4. Detrimental effects of environmental tobacco smoke in relation to asthma severity.

    Directory of Open Access Journals (Sweden)

    Suzy A A Comhair

    2011-05-01

    Full Text Available Environmental tobacco smoke (ETS has adverse effects on the health of asthmatics, however the harmful consequences of ETS in relation to asthma severity are unknown.In a multicenter study of severe asthma, we assessed the impact of ETS exposure on morbidity, health care utilization and lung functions; and activity of systemic superoxide dismutase (SOD, a potential oxidative target of ETS that is negatively associated with asthma severity.From 2002-2006, 654 asthmatics (non-severe 366, severe 288 were enrolled, among whom 109 non-severe and 67 severe asthmatics were routinely exposed to ETS as ascertained by history and validated by urine cotinine levels. ETS-exposure was associated with lower quality of life scores; greater rescue inhaler use; lower lung function; greater bronchodilator responsiveness; and greater risk for emergency room visits, hospitalization and intensive care unit admission. ETS-exposure was associated with lower levels of serum SOD activity, particularly in asthmatic women of African heritage.ETS-exposure of asthmatic individuals is associated with worse lung function, higher acuity of exacerbations, more health care utilization, and greater bronchial hyperreactivity. The association of diminished systemic SOD activity to ETS exposure provides for the first time a specific oxidant mechanism by which ETS may adversely affect patients with asthma.

  5. How many deaths will it take? A death from asthma associated with work-related environmental tobacco smoke.

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    Stanbury, Martha; Chester, Debra; Hanna, Elizabeth A; Rosenman, Kenneth D

    2008-02-01

    Despite epidemiologic, experimental and observational data on the association of environmental tobacco smoke (ETS) and adverse health effects, bar and restaurant workers remain exposed to ETS in the majority of states and countries. Three public health surveillance systems were used to identify and conduct a follow-up investigation of a reported acute asthma death of a young waitress in a bar. The waitress collapsed at the bar where she worked and was declared dead shortly thereafter. Evaluation of the circumstances of her death and her medical history concluded that her death was from acute asthma due to environmental tobacco smoke at work. This is the first reported acute asthma death associated with work-related ETS. Recent studies of asthma among bar and restaurant workers before and after smoking bans support this association. This death dramatizes the need to enact legal protections for workers in the hospitality industry from secondhand smoke.

  6. Asthma-Related School Absenteeism, Morbidity, and Modifiable Factors.

    Science.gov (United States)

    Hsu, Joy; Qin, Xiaoting; Beavers, Suzanne F; Mirabelli, Maria C

    2016-07-01

    Asthma is a leading cause of chronic disease-related school absenteeism. Few data exist on how information on absenteeism might be used to identify children for interventions to improve asthma control. This study investigated how asthma-related absenteeism was associated with asthma control, exacerbations, and associated modifiable risk factors using a sample of children from 35 states and the District of Columbia. The Behavioral Risk Factor Surveillance System Child Asthma Call-back Survey is a random-digit dial survey designed to assess the health and experiences of children aged 0-17 years with asthma. During 2014-2015, multivariate analyses were conducted using 2006-2010 data to compare children with and without asthma-related absenteeism with respect to clinical, environmental, and financial measures. These analyses controlled for sociodemographic and clinical characteristics. Compared with children without asthma-related absenteeism, children who missed any school because of asthma were more likely to have not well controlled or very poorly controlled asthma (prevalence ratio=1.50; 95% CI=1.34, 1.69) and visit an emergency department or urgent care center for asthma (prevalence ratio=3.27; 95% CI=2.44, 4.38). Mold in the home and cost as a barrier to asthma-related health care were also significantly associated with asthma-related absenteeism. Missing any school because of asthma is associated with suboptimal asthma control, urgent or emergent asthma-related healthcare utilization, mold in the home, and financial barriers to asthma-related health care. Further understanding of asthma-related absenteeism could establish how to most effectively use absenteeism information as a health status indicator. Published by Elsevier Inc.

  7. Asthma-related health services and asthma control among women in Puerto Rico

    Science.gov (United States)

    Ortiz-Rivera, María Calixta

    2018-01-01

    Objectives: This study evaluates social, behavioral, and environmental determinants to differentiate between active and inactive asthma and how predisposing, enabling, and need factors elucidate asthma-related health services and asthma control among women in Puerto Rico. Methods: This study analyzed secondary cross-sectional data from a subsample of 625 adult females who participated in the Asthma Call Back Survey in Puerto Rico. Logistic and multinomial regression analyses were conducted to examine associations between explanatory variables and asthma outcomes. Results: In total, 63% of women reported active asthma, from which 37.9% have not well controlled or very poorly controlled asthma. Women with active asthma were significantly more likely to be out of work, have middle income (US$25,000–asthma were significantly associated with increased units of physician urgent visits and emergency room visits. Conclusion: The findings confirmed significant determinants for active asthma and adds information on odds ratio for sensitive subgroups that utilize asthma-related health services in higher proportion than their counterparts. These associations suggest a development of asthma management plan targeting women to control the condition and reduce health-care utilization.

  8. Work-related asthma, financial barriers to asthma care, and adverse asthma outcomes: asthma call-back survey, 37 states and District of Columbia, 2006 to 2008.

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    Knoeller, Gretchen E; Mazurek, Jacek M; Moorman, Jeanne E

    2011-12-01

    Proper asthma management and control depend on patients having affordable access to healthcare yet financial barriers to asthma care are common. To examine associations of work-related asthma (WRA) with financial barriers to asthma care and adverse asthma outcomes. Cross-sectional, random-digit-dial survey conducted in 37 states and District of Columbia. A total of 27,927 ever-employed adults aged ≥18 years with current asthma. Prevalence ratios (PR) for the associations of WRA with financial barriers to asthma care and of WRA with adverse asthma outcomes stratified by financial barriers. Persons with WRA were significantly more likely than those with non-WRA to have at least 1 financial barrier to asthma care [PR, 1.66; 95% confidence interval (CI), 1.43-1.92]. Individuals with WRA were more likely to experience adverse asthma outcomes such as asthma attack (PR, 1.31; 95% CI, 1.22-1.40), urgent treatment for worsening asthma (PR, 1.57; 95% CI, 1.39-1.78), asthma-related emergency room visit (PR, 1.69; 95% CI, 1.41-2.03), and very poorly controlled asthma (PR, 1.54; 95% CI: 1.36-1.75). After stratifying for financial barriers to asthma care, the associations did not change. Financial barriers to asthma care should be considered in asthma management, and individuals with WRA are more likely to experience financial barriers. However, individuals with WRA are more likely to experience adverse asthma outcomes than individuals with non-WRA, regardless of financial barriers. Additional studies are needed to identify medical, behavioral, occupational, or environmental factors associated with adverse asthma outcomes among individuals with WRA.

  9. Environmental Management of Pediatric Asthma: Guidelines for Health Care Providers

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    Roberts, James R.; McCurdy, Leyla Erk

    2005-01-01

    These guidelines are the product of a new Pediatric Asthma Initiative aimed at integrating environmental management of asthma into pediatric health care. This document outlines competencies in environmental health relevant to pediatric asthma that should be mastered by primary health care providers, and outlines the environmental interventions…

  10. National Environmental Leadership Award in Asthma Management

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    The National Asthma Awards recognizes health plans, healthcare providers and communities in action that demonstrate an environmental component to address asthma triggers, collaborate with others and save healthcare dollars with their programming.

  11. Environmental tobacco smoke and childhood asthma

    Directory of Open Access Journals (Sweden)

    Dae Jin Song

    2010-02-01

    Full Text Available In recent years, environmental tobacco smoke (ETS has become an important worldwide public health issue. Children are particularly vulnerable to ETS because they are still developing. ETS exposure causes a wide range of adverse health effects on childhood asthma. There is convincing evidence that ETS exposure is causally associated with an increased prevalence of asthma, increased severity of asthma and worsening asthma control in children who already have the disease, even though a causal relationship with asthma onset is not yet established for asthma incidence. Mechanisms underlying these adverse effects of ETS are not clearly elucidated but e studies on this issue suggest that genetic susceptibility, impaired lung function, and augmented airway inflammation and remodeling may be involved. Children with asthma are just as likely to be exposed to ETS as children in general and there is no risk-free level of exposure. Therefore, providing a smoke-free environment may be of particular importance to the asthmatic children exposed to ETS who have adverse asthma outcomes, as well as to children with genetic susceptibility who are at increased risk of developing asthma upon exposure to ETS in early childhood.

  12. Sparse modeling of spatial environmental variables associated with asthma.

    Science.gov (United States)

    Chang, Timothy S; Gangnon, Ronald E; David Page, C; Buckingham, William R; Tandias, Aman; Cowan, Kelly J; Tomasallo, Carrie D; Arndt, Brian G; Hanrahan, Lawrence P; Guilbert, Theresa W

    2015-02-01

    Geographically distributed environmental factors influence the burden of diseases such as asthma. Our objective was to identify sparse environmental variables associated with asthma diagnosis gathered from a large electronic health record (EHR) dataset while controlling for spatial variation. An EHR dataset from the University of Wisconsin's Family Medicine, Internal Medicine and Pediatrics Departments was obtained for 199,220 patients aged 5-50years over a three-year period. Each patient's home address was geocoded to one of 3456 geographic census block groups. Over one thousand block group variables were obtained from a commercial database. We developed a Sparse Spatial Environmental Analysis (SASEA). Using this method, the environmental variables were first dimensionally reduced with sparse principal component analysis. Logistic thin plate regression spline modeling was then used to identify block group variables associated with asthma from sparse principal components. The addresses of patients from the EHR dataset were distributed throughout the majority of Wisconsin's geography. Logistic thin plate regression spline modeling captured spatial variation of asthma. Four sparse principal components identified via model selection consisted of food at home, dog ownership, household size, and disposable income variables. In rural areas, dog ownership and renter occupied housing units from significant sparse principal components were associated with asthma. Our main contribution is the incorporation of sparsity in spatial modeling. SASEA sequentially added sparse principal components to Logistic thin plate regression spline modeling. This method allowed association of geographically distributed environmental factors with asthma using EHR and environmental datasets. SASEA can be applied to other diseases with environmental risk factors. Copyright © 2014 Elsevier Inc. All rights reserved.

  13. Linking Asthma Exacerbation and Air Pollution Data: A Step Toward Public Health and Environmental Data Integration

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    Faruque, Fazlay; Finley, Richard; Marshall, Gailen; Brackin, Bruce; Li, Hui; Williams, Worth; Al-Hamdan, Mohammad; Luvall, Jeffrey; Rickman, Doug; Crosson, Bill

    2006-01-01

    Studies have shown that reducing exposure to triggers such as air pollutants can reduce symptoms and the need for medication in asthma patients. However, systems that track asthma are generally not integrated with those that track environmental hazards related to asthma. Tlvs lack of integration hinders public health awareness and responsiveness to these environmental triggers. The current study is a collaboration between health and environmental professionals to utilize NASA-derived environmental data to develop a decision support system (DSS) for asthma prediction, surveillance, and intervention. The investigators link asthma morbidity data from the University of Mississippi Medical Center (UMMC) and Mississippi Department of Health (MDH) with air quality data from the Mississippi Department of Environmental Quality (MDEQ) and remote sensing data from NASA. Daily ambient environmental hazard data for PM2.5 and ozone are obtained from the MDEQ air quality monitoring locations and are combined with remotely sensed data from NASA to develop a state-wide spatial and time series profile of environmental air quality. These data are then used to study the correlation of these measures of air quality variation with the asthma exacerbation incidence throughout the state over time. The goal is to utilize these readily available measures to allow real-time risk assessment for asthma exacerbations. GeoMedStat, a DSS previously developed for biosurveillance, will integrate these measures to monitor, analyze and report the real-time risk assessment for asthma exacerbation throughout the state.

  14. [The comparison of the indoor environmental factors associated with asthma and related allergies among school-child between urban and suburban areas in Beijing].

    Science.gov (United States)

    Lü, Hai-bo; Deng, Fu-rong; Sun, Ji-dong; Wu, Shao-wei; Sun, Xiu-ming; Wang, Xin; Zhao, Yan-hua; Guo, Xin-biao

    2010-07-01

    To study the indoor environmental factors associated with the prevalence of asthma and related allergies among school children. A cluster sampling method was used and the ISAAC questionnaire was conducted. A total of 4612 elementary students under Grade Five of 7 schools were enrolled in the survey for the impact of indoor environmental factors on the prevalence of asthma and related allergies in several urban and suburban schools of Beijing. A total of 4060 sample were finally analyzed including 1992 urban and 2068 suburban. The prevalence of wheeze, allergic rhinoconjunctivitis and atopic eczema in the past 12 months was 3.1% (61/1992), 5.3% (106/1992), 1.1% (22/1992) among urban children while 1.3% (27/2068), 3.1% (65/2068), 1.0% (22/2068) among suburban children respectively. The prevalence of wheeze and allergic rhinoconjunctivitis of the past 12 months in urban were both significantly higher than that in suburban (χ(2) = 14.77, 11.93, P children (5.3% (105/1992), 29.4% (586/1992)) were significantly (χ(2) = 39.03, 147.22, P interior decoration had different influence on the prevalence of asthma and related allergies among school children in the two areas. The significant impact of passive smoking on having asthma ever among suburban children was observed (OR = 2.70, 95%CI = 1.17 - 6.23) while no significant result in urban (OR = 1.06, 95%CI = 0.71 - 1.58); the percentage of interior decoration was 84.0% (1673/1992) among urban children and 80.0% (1655/2068) among suburban children, there was significant impact of interior decoration on the prevalence of having eczema ever among urban children (OR = 1.57, 95%CI = 1.17 - 2.10) but no significant results were found in suburban sample (OR = 1.06, 95%CI = 0.76 - 1.48). The prevalence of asthma and related allergies among school children is much higher in urban areas than that in suburban areas and the indoor environmental factors such as passive smoking and interior decoration may differently explain the

  15. Environmental risk factors of childhood asthma in urban centers.

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    Malveaux, F J; Fletcher-Vincent, S A

    1995-09-01

    Asthma morbidity and mortality are disproportionately high in urban centers, and minority children are especially vulnerable. Factors that contribute to this dilemma include inadequate preventive medical care for asthma management, inadequate asthma knowledge and management skills among children and their families, psychosocial factors, and environmental exposure to allergens or irritants. Living in substandard housing often constitutes excess exposure to indoor allergens and pollutants. Allergens associated with dust mites (DM) and cockroaches (CR) are probably important in both onset and worsening of asthma symptoms for children who are chronically exposed to these agents. Young children spend a great deal of time on or near the floor where these allergens are concentrated in dust. Of children (2 to 10 years of age) living in metropolitan Washington, DC, 60% were found to be sensitive to CR and 72% were allergic to DM. Exposure to tobacco smoke contributes to onset of asthma earlier in life and is a risk factor for asthma morbidity. Since disparity of asthma mortality and morbidity among minority children in urban centers is closely linked to socioeconomic status and poverty, measures to reduce exposure to environmental allergens and irritants and to eliminate barriers to access to health care are likely to have a major positive impact. Interventions for children in urban centers must focus on prevention of asthma symptoms and promotion of wellness.

  16. Environmental triggers and avoidance in the management of asthma

    Directory of Open Access Journals (Sweden)

    Gautier C

    2017-03-01

    Full Text Available Clarisse Gautier,1 Denis Charpin1,2 1Department of Pulmonology and Allergy, North Hospital, 2Faculty of Medicine, Aix-Marseille University, Marseille, France Abstract: Identifying asthma triggers forms the basis of environmental secondary prevention. These triggers may be allergenic or nonallergenic. Allergenic triggers include indoor allergens, such as house dust mites (HDMs, molds, pets, cockroaches, and rodents, and outdoor allergens, such as pollens and molds. Clinical observations provide support for the role of HDM exposure as a trigger, although avoidance studies provide conflicting results. Molds and their metabolic products are now considered to be triggers of asthma attacks. Pets, dogs, and especially cats can undoubtedly trigger asthmatic symptoms in sensitized subjects. Avoidance is difficult and rarely adhered to by families. Cockroach allergens contribute to asthma morbidity, and avoidance strategies can lead to clinical benefit. Mouse allergens are mostly found in inner-city dwellings, but their implication in asthma morbidity is debated. In the outdoors, pollens can induce seasonal asthma in sensitized individuals. Avoidance relies on preventing pollens from getting into the house and on minimizing seasonal outdoor exposure. Outdoor molds may lead to severe asthma exacerbations. Nonallergenic triggers include viral infections, active and passive smoking, meteorological changes, occupational exposures, and other triggers that are less commonly involved. Viral infection is the main asthma trigger in children. Active smoking is associated with higher asthma morbidity, and smoking cessation interventions should be personalized. Passive smoking is also a risk factor for asthma exacerbation. The implementation of public smoking bans has led to a reduction in the hospitalization of asthmatic children. Air pollution levels have been linked with asthmatic symptoms, a decrease in lung function, and increased emergency room visits and

  17. Environmental risk factors of childhood asthma in urban centers.

    OpenAIRE

    Malveaux, F J; Fletcher-Vincent, S A

    1995-01-01

    Asthma morbidity and mortality are disproportionately high in urban centers, and minority children are especially vulnerable. Factors that contribute to this dilemma include inadequate preventive medical care for asthma management, inadequate asthma knowledge and management skills among children and their families, psychosocial factors, and environmental exposure to allergens or irritants. Living in substandard housing often constitutes excess exposure to indoor allergens and pollutants. Alle...

  18. Something new in the air: Paying for community-based environmental approaches to asthma prevention and control.

    Science.gov (United States)

    Tschudy, Megan M; Sharfstein, Joshua; Matsui, Elizabeth; Barnes, Charles S; Chacker, Stacey; Codina, Rosa; Cohn, John R; Sandel, Megan; Wedner, H James

    2017-11-01

    Despite the recommendation in national asthma guidelines to target indoor environmental exposures, most insurers generally have not covered the outreach, education, environmental assessments, or durable goods integral to home environmental interventions. However, emerging payment approaches offer new potential for coverage of home-based environmental intervention costs. These opportunities are becoming available as public and private insurers shift reimbursement to reward better health outcomes, and their key characteristic is a focus on the value rather than the volume of services. These new payment models for environmental interventions can be divided into 2 categories: enhanced fee-for-service reimbursement and set payments per patient that cover asthma-related costs. Several pilot programs across the United States are underway, and as they prove their value and as payment increasingly becomes aligned with better outcomes at lower cost, these efforts should have a bright future. Physicians should be aware that these new possibilities are emerging for payment of the goods and services needed for indoor environmental interventions for their patients with asthma. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Forecasting asthma-related hospital admissions in London using negative binomial models.

    Science.gov (United States)

    Soyiri, Ireneous N; Reidpath, Daniel D; Sarran, Christophe

    2013-05-01

    Health forecasting can improve health service provision and individual patient outcomes. Environmental factors are known to impact chronic respiratory conditions such as asthma, but little is known about the extent to which these factors can be used for forecasting. Using weather, air quality and hospital asthma admissions, in London (2005-2006), two related negative binomial models were developed and compared with a naive seasonal model. In the first approach, predictive forecasting models were fitted with 7-day averages of each potential predictor, and then a subsequent multivariable model is constructed. In the second strategy, an exhaustive search of the best fitting models between possible combinations of lags (0-14 days) of all the environmental effects on asthma admission was conducted. Three models were considered: a base model (seasonal effects), contrasted with a 7-day average model and a selected lags model (weather and air quality effects). Season is the best predictor of asthma admissions. The 7-day average and seasonal models were trivial to implement. The selected lags model was computationally intensive, but of no real value over much more easily implemented models. Seasonal factors can predict daily hospital asthma admissions in London, and there is a little evidence that additional weather and air quality information would add to forecast accuracy.

  20. NIAID, NIEHS, NHLBI, and MCAN Workshop Report: The indoor environment and childhood asthma-implications for home environmental intervention in asthma prevention and management.

    Science.gov (United States)

    Gold, Diane R; Adamkiewicz, Gary; Arshad, Syed Hasan; Celedón, Juan C; Chapman, Martin D; Chew, Ginger L; Cook, Donald N; Custovic, Adnan; Gehring, Ulrike; Gern, James E; Johnson, Christine C; Kennedy, Suzanne; Koutrakis, Petros; Leaderer, Brian; Mitchell, Herman; Litonjua, Augusto A; Mueller, Geoffrey A; O'Connor, George T; Ownby, Dennis; Phipatanakul, Wanda; Persky, Victoria; Perzanowski, Matthew S; Ramsey, Clare D; Salo, Päivi M; Schwaninger, Julie M; Sordillo, Joanne E; Spira, Avrum; Suglia, Shakira F; Togias, Alkis; Zeldin, Darryl C; Matsui, Elizabeth C

    2017-10-01

    Environmental exposures have been recognized as critical in the initiation and exacerbation of asthma, one of the most common chronic childhood diseases. The National Institute of Allergy and Infectious Diseases; National Institute of Environmental Health Sciences; National Heart, Lung, and Blood Institute; and Merck Childhood Asthma Network sponsored a joint workshop to discuss the current state of science with respect to the indoor environment and its effects on the development and morbidity of childhood asthma. The workshop included US and international experts with backgrounds in allergy/allergens, immunology, asthma, environmental health, environmental exposures and pollutants, epidemiology, public health, and bioinformatics. Workshop participants provided new insights into the biologic properties of indoor exposures, indoor exposure assessment, and exposure reduction techniques. This informed a primary focus of the workshop: to critically review trials and research relevant to the prevention or control of asthma through environmental intervention. The participants identified important limitations and gaps in scientific methodologies and knowledge and proposed and prioritized areas for future research. The group reviewed socioeconomic and structural challenges to changing environmental exposure and offered recommendations for creative study design to overcome these challenges in trials to improve asthma management. The recommendations of this workshop can serve as guidance for future research in the study of the indoor environment and on environmental interventions as they pertain to the prevention and management of asthma and airway allergies. Published by Elsevier Inc.

  1. Evaluation of the Environmental Scoring System in Multiple Child Asthma Intervention Programs in Boston, Massachusetts.

    Science.gov (United States)

    Dong, Zhao; Nath, Anjali; Guo, Jing; Bhaumik, Urmi; Chin, May Y; Dong, Sherry; Marshall, Erica; Murphy, Johnna S; Sandel, Megan T; Sommer, Susan J; Ursprung, W W Sanouri; Woods, Elizabeth R; Reid, Margaret; Adamkiewicz, Gary

    2018-01-01

    To test the applicability of the Environmental Scoring System, a quick and simple approach for quantitatively measuring environmental triggers collected during home visits, and to evaluate its contribution to improving asthma outcomes among various child asthma programs. We pooled and analyzed data from multiple child asthma programs in the Greater Boston Area, Massachusetts, collected in 2011 to 2016, to examine the association of environmental scores (ES) with measures of asthma outcomes and compare the results across programs. Our analysis showed that demographics were important contributors to variability in asthma outcomes and total ES, and largely explained the differences among programs at baseline. Among all programs in general, we found that asthma outcomes were significantly improved and total ES significantly reduced over visits, with the total Asthma Control Test score negatively associated with total ES. Our study demonstrated that the Environmental Scoring System is a useful tool for measuring home asthma triggers and can be applied regardless of program and survey designs, and that demographics of the target population may influence the improvement in asthma outcomes.

  2. 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

  3. Geospatial Modeling of Asthma Population in Relation to Air Pollution

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    Kethireddy, Swatantra R.; Tchounwou, Paul B.; Young, John H.; Luvall, Jeffrey C.; Alhamdan, Mohammad

    2013-01-01

    Current observations indicate that asthma is growing every year in the United States, specific reasons for this are not well understood. This study stems from an ongoing research effort to investigate the spatio-temporal behavior of asthma and its relatedness to air pollution. The association between environmental variables such as air quality and asthma related health issues over Mississippi State are investigated using Geographic Information Systems (GIS) tools and applications. Health data concerning asthma obtained from Mississippi State Department of Health (MSDH) for 9-year period of 2003-2011, and data of air pollutant concentrations (PM2.5) collected from USEPA web resources, and are analyzed geospatially to establish the impacts of air quality on human health specifically related to asthma. Disease mapping using geospatial techniques provides valuable insights into the spatial nature, variability, and association of asthma to air pollution. Asthma patient hospitalization data of Mississippi has been analyzed and mapped using quantitative Choropleth techniques in ArcGIS. Patients have been geocoded to their respective zip codes. Potential air pollutant sources of Interstate highways, Industries, and other land use data have been integrated in common geospatial platform to understand their adverse contribution on human health. Existing hospitals and emergency clinics are being injected into analysis to further understand their proximity and easy access to patient locations. At the current level of analysis and understanding, spatial distribution of Asthma is observed in the populations of Zip code regions in gulf coast, along the interstates of south, and in counties of Northeast Mississippi. It is also found that asthma is prevalent in most of the urban population. This GIS based project would be useful to make health risk assessment and provide information support to the administrators and decision makers for establishing satellite clinics in future.

  4. Surveillance of work-related asthma in new york state.

    Science.gov (United States)

    Tice, Cori J; Cummings, Karen R; Gelberg, Kitty H

    2010-04-01

    The objective of this paper is to determine the percent of adults with asthma attributable to work and describe characteristics of the work-related asthma population in New York State. Sociodemographic and control characteristics of those with and without work-related asthma are compared. Data from three population-based surveys and one case-based surveillance system were analyzed. Work-relatedness of asthma was determined by self-report for the population-based surveys and by physician report for the case-based system. Self-reported sociodemographic and control characteristics were analyzed for the population-based surveys by work-relatedness. The percent of work-relatedness among adults with current asthma in New York State ranged from 10.6% to 44.5%. Significantly more adults with work-related asthma had poorly controlled asthma than those without work-related asthma. More adults with work-related asthma also tended to be employed in the manufacturing, educational services, and public administration industries than the general population. The most frequently reported exposure was dust. Adults with work-related asthma have decreased control and adverse socioeconomic impacts compared to those with asthma that is not work-related. Increased recognition and physician reporting is necessary to further prevent the impact of work-related exposures.

  5. Farm work-related asthma among US primary farm operators.

    Science.gov (United States)

    Mazurek, Jacek M; White, Gretchen E; Rodman, Chad; Schleiff, Patricia L

    2015-01-01

    The objective of this study was to estimate the prevalence of current asthma and the proportion of current asthma that is related to work on the farm among primary farm operators. The 2011 Farm and Ranch Safety Survey data were used to produce estimates and prevalence odds ratios. An estimated 5.1% of farm operators had asthma. Of these, 15.4% had farm work-related asthma. Among operators with farm work-related asthma, 54.8% (95% confidence interval [CI]: 41.8%-68.2%) had an asthma attack in the prior 12 months and 33.3% (95% CI: 21.2%-45.4%) had an asthma attack that occurred while doing farm work. Of those who had an asthma attack that occurred while doing farm work, 65.0% associated their asthma attack with plant/tree materials. This study provides updated information on asthma and the proportion of current asthma that is related to work on the farm and identifies certain groups of farm operators that might benefit from workplace asthma prevention intervention.

  6. Asthma morbidity in adult Chicago public housing residents.

    Science.gov (United States)

    Lambertino, Anissa; Turyk, Mary E; Curtis, Luke; Persky, Victoria W

    2009-03-01

    Residents of public housing can experience socioeconomic disadvantages, inadequate access to health care, and particularly substandard indoor air quality due to inadequate building maintenance. This study investigates demographic, medical management, severity, and household factors associated with asthma-related emergency department visits and hospitalizations. A total of 103 adult participants with asthma from four Chicago housing developments completed surveys and underwent household inspections. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related emergency department visits: asthma controller medication use, not keeping an asthma-related doctor's appointment, and frequent nocturnal wheeze episodes. Using stepwise multivariate logistic regression, we identified independent predictors of asthma-related hospitalizations: peeling paint, plaster, or wallpaper, environmental tobacco smoke, written action plan for an asthma-related doctor or emergency department visit, and frequent nocturnal wheeze episodes. In multivariate models, factors related to clinical severity and asthma management were related to both emergency department visits and hospitalizations while household conditions were related only to hospitalizations. Interventions to address both asthma management and household environmental triggers may be needed to reduce asthma morbidity in low-income populations.

  7. Cost-consequence analysis of multimodal interventions with environmental components for pediatric asthma in the state of Maryland.

    Science.gov (United States)

    Jassal, Mandeep S; Diette, Gregory B; Dowdy, David W

    2013-08-01

    Applied environmental strategies for asthma control are often expensive, but may save longer-term healthcare costs. Whether these savings outweigh additional costs of implementing these strategies is uncertain. We conducted a systematic review to estimate the expenditures and savings of environmental interventions for asthma in the state of Maryland. Direct costs included hospitalizations, emergency room, and clinic visits. Indirect expenditures included costs of lost work productivity and travel incurred during the usage of healthcare services. We used decision analysis, assuming a hypothetical cohort of the approximated 49,290 pediatric individuals in Maryland with persistent asthma, to compare costs and benefits of environmental asthma interventions against the standard of care (no intervention) from the societal perspective. Three interventions among nine articles met the inclusion criteria for the systematic review: 1) environmental education using medical professionals; 2) education using non-medical personnel; and 3) multi-component strategy involving education with non-medical personnel, allergen-impermeable covers, and pest management. All interventions were found to be cost-saving relative to the standard of care. Home environmental education using non-medical professionals yielded the highest net savings of $14.1 million (95% simulation interval (SI): $-.283 million, $19.4 million), while the multi-component intervention resulted in the lowest net savings of $8.1 million (95% SI: $-4.9 million, $15.9 million). All strategies were most sensitive to the baseline number of hospitalizations in those not receiving targeted interventions for asthma. Limited environmental reduction strategies for asthma are likely to be cost-saving to the healthcare system in Maryland and should be considered for broader scale-up in other economically similar settings.

  8. Work-Related Asthma in Korea - Findings from the Korea Work-Related Asthma Surveillance (KOWAS) program, 2004-2009.

    Science.gov (United States)

    Kwon, Soon-Chan; Song, Jaechul; Kim, Yong-Kyu; Calvert, Geoffrey M

    2015-01-01

    To determine the incidence and epidemiological characteristics of work-related asthma in Korea. During 2004-2009, the Korea Work-Related Asthma Surveillance (KOWAS) program collected data on new cases of work-related asthma from occupational physicians, allergy and chest physicians, regional surveillance systems, and workers' compensation schemes. The incidence was calculated on the basis of industry, occupation, sex, age, and region. In addition, the distribution of causal agents was determined. During the study period, 236 cases of work-related asthma were reported, with 77 cases from more than 1 source. A total of 22.0% (n=52) were reported by occupational physicians, 52.5% (n=124) by allergy and chest physicians, 24.2% (n=57) by regional surveillance systems, and 43.2% (n=102) by workers' compensation schemes. The overall average annual incidence was 3.31 cases/million workers, with a rate of 3.78/million among men and 2.58/million among women. The highest incidence was observed in the 50-59-year age group (7.74/million), in the Gyeonggi/Incheon suburb of Seoul (8.50/million), in the furniture and other instrument manufacturing industries (67.62/million), and among craft and related trades workers (17.75/million). The most common causal agents were isocyanates (46.6%), flour/grain (8.5%), metal (5.9%), reactive dyes (5.1%), and solvents (4.2%). The incidence of work-related asthma in Korea was relatively low, and varied according to industry, occupation, gender, age, and region. Data provided by workers' compensation schemes and physician reports have been useful for determining the incidence and causes of work-related asthma.

  9. Decreased importance of environmental risk factors for childhood asthma from 1996 to 2006.

    Science.gov (United States)

    Bjerg, A; Hedman, L; Perzanowski, M; Wennergren, G; Lundbäck, B; Rönmark, E

    2015-01-01

    The large increase in asthma prevalence continues in several, but not all areas. Despite the individual risk factors that have been identified, the reasons for the observed trends in prevalence are largely unknown. This study sought to characterize what trends in risk factors accompanied trends in asthma prevalence. Two population-based cohorts of 7- to 8-year-old children from the same Swedish study areas examined by expanded International Study of Asthma and Allergy in Childhood questionnaires were compared 10 years apart. In 1996 and 2006, 3430 (97% participation) and 2585 (96% participation) questionnaires were completed, respectively. A subset was skin-prick-tested: in 1996 and 2006, 2148 (88% participation) and 1700 (90% participation) children, respectively. The adjusted population-attributable fraction (aPAF) was calculated using the prevalence and multivariate odds ratio of each risk factor. The prevalence of current asthma and wheeze was similar in 1996 and 2006. Allergic sensitization, however, increased from 21% to 30%. The prevalence of parental asthma increased from 17% to 24%, while respiratory infections and maternal smoking decreased (60% to 29% and 32% to 16%, respectively). The aPAFs of non-environmental risk factors for current asthma increased in 1996-2006: allergic sensitization from 35% to 41%, parental asthma from 27% to 45% and male sex from 20% to 25%. Conversely, the aPAFs of environmental risk factors decreased: respiratory infections from 36% to 32% and damp home and maternal smoking from 14% and 19%, respectively, to near zero in 2006. From 1996 to 2006, the non-environmental risk factors parental asthma, allergic sensitization and male sex had an increasing or constant importance for current asthma in 7- to 8-year-old children. The importance of the environmental exposures damp home, respiratory infections and maternal smoking decreased. This counterbalancing in risk factors may explain the level of prevalence of current asthma.

  10. [Guidelines on asthma in extreme environmental conditions].

    Science.gov (United States)

    Drobnic, Franchek; Borderías Clau, Luis

    2009-01-01

    Asthma is a highly prevalent chronic disease which, if not properly controlled, can limit the patient's activities and lifestyle. In recent decades, owing to the diffusion of educational materials, the application of clinical guidelines and, most importantly, the availability of effective pharmacological treatment, most patients with asthma are now able to lead normal lives. Significant social changes have also taken place during the same period, including more widespread pursuit of sporting activities and tourism. As a result of these changes, individuals with asthma can now participate in certain activities that were inconceivable for these patients only a few years ago, including winter sports, underwater activities, air flight, and travel to remote places with unusual environmental conditions (deserts, high mountain environments, and tropical regions). In spite of the publication of several studies on this subject, our understanding of the effects of these situations on patients with asthma is still limited. The Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) has decided to publish these recommendations based on the available evidence and expert opinion in order to provide information on this topic to both doctors and patients and to avert potentially dangerous situations that could endanger the lives of these patients.

  11. Asthma and respiratory symptoms in hospital workers related to dampness and biological contaminants.

    Science.gov (United States)

    Cox-Ganser, J M; Rao, C Y; Park, J-H; Schumpert, J C; Kreiss, K

    2009-08-01

    The National Institute for Occupational Safety and Health investigated respiratory symptoms and asthma in relation to damp indoor environments in employees of two hospitals. A cluster of six work-related asthma cases from one hospital department, whose symptoms arose during a time of significant water incursions, led us to conduct a survey of respiratory health in 1171/1834 employees working in the sentinel cases hospital and a nearby hospital without known indoor environmental concerns. We carried out observational assessment of dampness, air, chair, and floor dust sampling for biological contaminants, and investigation of exposure-response associations for about 500 participants. Many participants with post-hire onset asthma reported diagnosis dates in a period of water incursions and renovations. Post-hire asthma and work-related lower respiratory symptoms were positively associated with the dampness score. Work-related lower respiratory symptoms showed monotonically increasing odds ratios with ergosterol, a marker of fungal biomass. Other fungal and bacterial indices, particle counts, cat allergen and latex allergen were associated with respiratory symptoms. Our data imply new-onset of asthma in relation to water damage, and indicate that work-related respiratory symptoms in hospital workers may be associated with diverse biological contaminants. In healthcare facilities with indoor dampness and microbial contamination, possible associations between such conditions and respiratory health effects should be considered. Good building maintenance and housekeeping procedures should lead to improvements in employee respiratory health.

  12. The management of work-related asthma guidelines: a broader perspective

    NARCIS (Netherlands)

    Baur, X.; Aasen, T.B.; Burge, P.S.; Heederik, D.

    2012-01-01

    The aim of the European Respiratory Society work-related asthma guidelines is to present the management and prevention options of work-related asthma and their effectiveness. Work-related asthma accounts for 5-25% of all adult asthma cases and is responsible for a significant socioeconomic burden.

  13. The effects of indoor environmental exposures on pediatric asthma: a discrete event simulation model

    Directory of Open Access Journals (Sweden)

    Fabian M Patricia

    2012-09-01

    Full Text Available Abstract Background In the United States, asthma is the most common chronic disease of childhood across all socioeconomic classes and is the most frequent cause of hospitalization among children. Asthma exacerbations have been associated with exposure to residential indoor environmental stressors such as allergens and air pollutants as well as numerous additional factors. Simulation modeling is a valuable tool that can be used to evaluate interventions for complex multifactorial diseases such as asthma but in spite of its flexibility and applicability, modeling applications in either environmental exposures or asthma have been limited to date. Methods We designed a discrete event simulation model to study the effect of environmental factors on asthma exacerbations in school-age children living in low-income multi-family housing. Model outcomes include asthma symptoms, medication use, hospitalizations, and emergency room visits. Environmental factors were linked to percent predicted forced expiratory volume in 1 second (FEV1%, which in turn was linked to risk equations for each outcome. Exposures affecting FEV1% included indoor and outdoor sources of NO2 and PM2.5, cockroach allergen, and dampness as a proxy for mold. Results Model design parameters and equations are described in detail. We evaluated the model by simulating 50,000 children over 10 years and showed that pollutant concentrations and health outcome rates are comparable to values reported in the literature. In an application example, we simulated what would happen if the kitchen and bathroom exhaust fans were improved for the entire cohort, and showed reductions in pollutant concentrations and healthcare utilization rates. Conclusions We describe the design and evaluation of a discrete event simulation model of pediatric asthma for children living in low-income multi-family housing. Our model simulates the effect of environmental factors (combustion pollutants and allergens

  14. [Satellite symposium: Asthma in the World. Asthma among children in Latin America].

    Science.gov (United States)

    Mallol, J

    2004-01-01

    The prevalence of respiratory symptoms related to asthma in children from Latin America has been largely ignored. This region participated in phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC) with 17 participating centers in phase I and 78 centers in phase III. Data were obtained on asthma, rhinitis and eczema from countries and centers with markedly different climactic, cultural and environmental conditions and socioeconomic development. The results for phase I are presented herein because data from phase III are currently being revised at the ISAAC international data control center and will be officially available in the second half of 2004. Phase I provided important information on the prevalence of asthma in the participating countries and demonstrated wide variation among centers in the same country and among countries. The participating Latin American countries are all developing countries and share more or less the same problems related to low socioeconomic status. Therefore, the results and figures should be analyzed within that context. The range for accumulative and current asthma symptoms in children from the Latin American countries that participated in phase I (89,000) were as follows: the prevalence of asthma ranged from 5.5% to 28% in children aged 13-14 years and from 4.1% to 26.9% in children aged 6-7 years. The prevalence of wheezing in the previous 12 months ranged from 6.6% to 27% in children aged 13-14 years and from 8.6% to 32.1% in children aged 6-7 years. The high figures for asthma in a region with a high level of gastrointestinal parasites infestation, a high burden of acute respiratory and gastrointestinal infections occurring early in life, severe environmental and hygiene problems, suggest that these factors, considered as protective in other (developed) regions of the world, do not have the same effect in this region. Furthermore, those aggressive environmental conditions acting together from very

  15. Asthma control and productivity loss in those with work-related asthma: A population-based study.

    Science.gov (United States)

    Wong, Alyson; Tavakoli, Hamid; Sadatsafavi, Mohsen; Carlsten, Chris; FitzGerald, J Mark

    2017-06-01

    In Canada, asthma is the third leading cause of work loss, yet little is known about the associated productivity loss. The goal of this study was to look at the relationship between asthma control and productivity loss, particularly contrasting those with work-related asthma (WRA) and non-work-related asthma (NWRA). A population-based random sample of adults with asthma in British Columbia, Canada, was prospectively recruited. Asthma control was graded according to Global Initiative for Asthma classification, while productivity loss and presence of WRA was assessed using questionnaires. Ordinal regression models were then used to associate WRA with asthma control. Generalized linear models were applied to estimate the average productivity loss associated with different levels of asthma control among those with WRA and NWRA. The study included 300 employed adults. Sixty (20%) had WRA. The odds of being controlled were significantly lower in those with WRA (OR = 0.23, 95% CI: 0.09, 0.56; P asthma had a significant difference in productivity loss due to presenteeism ($659.1 [95% CI: 12.9, 1581.5; P = 0.04]), but not absenteeism ($88.7 [95% CI: -86.5, 279.6; P = 0.35]), when compared to those with NWRA and uncontrolled asthma. There was no significant difference when a similar comparison was made for those with controlled or partially controlled asthma. WRA is associated with worse asthma control and increased productivity loss. Presenteeism makes a significant contribution to productivity loss and should be considered when evaluating the overall economic burden of asthma, particularly WRA.

  16. Imaging diagnosis of bronchial asthma and related diseases

    International Nuclear Information System (INIS)

    Sakai, Fumikazu; Fujimura, Mikihiko; Kimura, Fumiko; Fujimura, Kaori; Hayano, Toshio; Nishii, Noriko; Machida, Haruhiko; Toda, Jo; Saito, Naoko

    2002-01-01

    We describe imaging features of bronchial asthma and related diseases. The practical roles of imaging diagnosis are the evaluation of severity and complications of bronchial asthma and differential diagnosis of diseases showing asthmatic symptoms other than bronchial asthma. (author)

  17. Pediatric Obesity-Related Asthma: The Role of Metabolic Dysregulation.

    Science.gov (United States)

    Vijayakanthi, Nandini; Greally, John M; Rastogi, Deepa

    2016-05-01

    The burden of obesity-related asthma among children, particularly among ethnic minorities, necessitates an improved understanding of the underlying disease mechanisms. Although obesity is an independent risk factor for asthma, not all obese children develop asthma. Several recent studies have elucidated mechanisms, including the role of diet, sedentary lifestyle, mechanical fat load, and adiposity-mediated inflammation that may underlie the obese asthma pathophysiology. Here, we review these recent studies and emerging scientific evidence that suggest metabolic dysregulation may play a role in pediatric obesity-related asthma. We also review the genetic and epigenetic factors that may underlie susceptibility to metabolic dysregulation and associated pulmonary morbidity among children. Lastly, we identify knowledge gaps that need further exploration to better define pathways that will allow development of primary preventive strategies for obesity-related asthma in children. Copyright © 2016 by the American Academy of Pediatrics.

  18. 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.

  19. A twin study of early-childhood asthma in Puerto Ricans.

    Directory of Open Access Journals (Sweden)

    Supinda Bunyavanich

    Full Text Available The relative contributions of genetics and environment to asthma in Hispanics or to asthma in children younger than 3 years are not well understood.To examine the relative contributions of genetics and environment to early-childhood asthma by performing a longitudinal twin study of asthma in Puerto Rican children ≤ 3 years old.678 twin infants from the Puerto Rico Neo-Natal Twin Registry were assessed for asthma at age 1 year, with follow-up data obtained for 624 twins at age 3 years. Zygosity was determined by DNA microsatellite profiling. Structural equation modeling was performed for three phenotypes at ages 1 and 3 years: physician-diagnosed asthma, asthma medication use in the past year, and ≥ 1 hospitalization for asthma in the past year. Models were additionally adjusted for early-life environmental tobacco smoke exposure, sex, and age.The prevalences of physician-diagnosed asthma, asthma medication use, and hospitalization for asthma were 11.6%, 10.8%, 4.9% at age 1 year, and 34.1%, 40.1%, and 8.5% at 3 years, respectively. Shared environmental effects contributed to the majority of variance in susceptibility to physician-diagnosed asthma and asthma medication use in the first year of life (84%-86%, while genetic effects drove variance in all phenotypes (45%-65% at age 3 years. Early-life environmental tobacco smoke, sex, and age contributed to variance in susceptibility.Our longitudinal study in Puerto Rican twins demonstrates a changing contribution of shared environmental effects to liability for physician-diagnosed asthma and asthma medication use between ages 1 and 3 years. Early-life environmental tobacco smoke reduction could markedly reduce asthma morbidity in young Puerto Rican children.

  20. Work-related asthma | Jeebhay | Continuing Medical Education

    African Journals Online (AJOL)

    Occupational lung diseases such as asthma, COPD and pneumoconioses caused by exposure to airborne particulates are a major contributor to mortality and disability globally. However, work-related asthma remains under-recognised, poorly managed and inadequately compensated.

  1. Asthma and Environmental Factors in Children

    Directory of Open Access Journals (Sweden)

    Mirzadeh M.

    2016-10-01

    Full Text Available Asthma is one of the most prevalent atopic diseases in childhood. It is characterized by inflammation of conductive airways and bronchial hyperresponsiveness. Environmental factors introduced to child in early years of life may have a protective or harmful role in developing atopic diseases. To evaluate the influence of some environmental factors such as cat or dog ownership, smoking of mother or father and environmental pollution on prevalence of wheezing in children. Subjects and methods: This was a cross sectional retrospective study. A questionnaire was designed based on International Study of Asthma and Allergies in Childhood (ISAAC. Parents of the subjects were asked to fill in the questionnaires. Children’s wheezing association with keeping cats and dogs, smoking mother and father and frequency of truck passing in place of residence was investigated. 545 children were recruited in our study. Prevalence of wheezing was 9%. Keeping cats in first year of life and last year was associated with less wheezing. But the latter association was not statistically significant. Keeping dogs was so scarce in area of our study, so we could not perform a rightful analysis. Frequency of truck passing was significantly higher in those with wheezing. Keeping cats in first year of life was a significant protective factor, whereas residence in an area with frequent truck passing increased wheezing in children. Results of our study can emphasize the need to keep children away from polluted areas. Further studies are needed to investigate whether keeping a pet in household can benefit children regarding all possible concerns and benefits.

  2. Development and Pilot Testing of a Bilingual Environmental Health Assessment Tool to Promote Asthma-friendly Childcares.

    Science.gov (United States)

    Evans-Agnew, Robin A; Postma, Julie; Camacho, Ariana Ochoa; Hershberg, Rachel M; Trujilio, Elsa; Tinajera, Maria

    2018-01-01

    Childhood marks the highest risk for allergic sensitization to asthma triggers. Hispanic/Latino children are at higher risk for hospitalization for asthma than non-Hispanic White children. Childcare providers lack knowledge about reducing asthma triggers. The purpose of this paper is to describe a community-based participatory research (CBPR) initiative aimed at developing and pilot testing a bilingual walk-through assessment tool for asthma-friendly childcare environments. Ten Latina mothers of children with asthma living in the Pacific Northwest collaborated with research partners to develop and pilot test a Childcare Environmental Health (CEH) assessment walk-through survey.Results and Lessons Learned: The women innovated the survey with photography and structural examinations of stress and provision of basic needs. The survey tool identified environmental threats to asthma in all three childcares surveyed. Parents are well-positioned to build trust with childcare providers, assess asthma triggers, and recommend practical mitigation strategies.

  3. A Nonlinear differential equation model of Asthma effect of environmental pollution using LHAM

    Science.gov (United States)

    Joseph, G. Arul; Balamuralitharan, S.

    2018-04-01

    In this paper, we investigated a nonlinear differential equation mathematical model to study the spread of asthma in the environmental pollutants from industry and mainly from tobacco smoke from smokers in different type of population. Smoking is the main cause to spread Asthma in the environment. Numerical simulation is also discussed. Finally by using Liao’s Homotopy analysis Method (LHAM), we found that the approximate analytical solution of Asthmatic disease in the environmental.

  4. Social and environmental stressors in the home and childhood asthma.

    Science.gov (United States)

    Suglia, Shakira Franco; Franco Suglia, Shakira; Duarte, Cristiane S; Sandel, Megan T; Wright, Rosalind J

    2010-07-01

    Both physical environmental factors and chronic stress may independently increase susceptibility to asthma; however, little is known on how these different risks may interact. The authors examined the relationship between maternal intimate partner violence (IPV), housing quality and asthma among children in the Fragile Families and Child Wellbeing Study (N=2013). Maternal reports of IPV were obtained after the child's birth and at 12 and 36 months. At the 36-month assessment, interviewers rated indoor housing conditions, regarding housing deterioration (ie, peeling paint, holes in floor, broken windows) and housing disarray (ie, dark, cluttered, crowded or noisy house). At the same time, mothers reported on housing hardships (ie, moving repeatedly, and hardships in keeping house warm). Maternal-report of physician-diagnosed asthma by age 36 months which was active in the past year was the outcome. Asthma was diagnosed in 10% of the children. In an adjusted analysis, an increased odds of asthma was observed in children of mothers experiencing IPV chronically (OR 1.8, 95% CI 1.0 to 3.5) and in children experiencing housing disarray (OR 1.5, 95% CI 1.1 to 2.0) compared with those not exposed to these risks. In stratified analyses, a greater effect of IPV on asthma was noted among children living in disarrayed or deteriorated housing or among children whose mothers were experiencing housing hardship. IPV and housing disarray are associated with increased early childhood asthma. Exposure to cumulative or multiple stressors (ie, IPV and poor housing quality) may increase children's risk of developing asthma more than a single stressor.

  5. Development of a web-based, work-related asthma educational tool for patients with asthma

    OpenAIRE

    Ghajar-Khosravi, Shadi; Tarlo, Susan M; Liss, Gary M; Chignell, Mark; Ribeiro, Marcos; Levinson, Anthony J; Gupta, Samir

    2013-01-01

    BACKGROUND: Asthma is a common chronic condition. Work-related asthma (WRA) has a large socioeconomic impact and is increasing in prevalence but remains under-recognized. Although international guidelines recommend patient education, no widely available educational tool exists.OBJECTIVE: To develop a WRA educational website for adults with asthma.METHODS: An evidence-based database for website content was developed, which applied evidence-based website design principles to create a website pr...

  6. Immigration and acculturation-related factors and asthma morbidity in Latino children.

    Science.gov (United States)

    Koinis-Mitchell, Daphne; Sato, Amy F; Kopel, Sheryl J; McQuaid, Elizabeth L; Seifer, Ronald; Klein, Robert; Esteban, Cynthia; Lobato, Debra; Ortega, Alexander N; Canino, Glorisa; Fritz, Gregory K

    2011-01-01

    This article presents a summary of findings from asthma studies focusing on immigration and acculturation-related factors. A study examining associations between these processes, family cohesion and social support networks, and asthma morbidity in a sample of Dominican and Puerto Rican caregivers residing in the mainland U.S., is also described. Latino children with asthma (n = 232), ages 7-16 (49% female) and their caregivers completed interview-based questionnaires on immigration and acculturation-related processes, family characteristics, and asthma morbidity. The frequency of ED use due to asthma may be higher for children of caregivers born in Puerto Rico. Acculturative stress levels were higher for Puerto Rican born caregivers residing in the mainland U.S. Asthma-related educational and intervention programs for Latino children and families should be tailored to consider the effects that the immigration and acculturation experience can have on asthma management. Specific family-based supports focused on decreasing stress related to the acculturation process, and increasing social and family support around the asthma treatment process may help to reduce asthma morbidity in Latino children.

  7. Relative Importance and Additive Effects of Maternal and Infant Risk Factors on Childhood Asthma.

    Science.gov (United States)

    Wu, Pingsheng; Feldman, Amy S; Rosas-Salazar, Christian; James, Kristina; Escobar, Gabriel; Gebretsadik, Tebeb; Li, Sherian Xu; Carroll, Kecia N; Walsh, Eileen; Mitchel, Edward; Das, Suman; Kumar, Rajesh; Yu, Chang; Dupont, William D; Hartert, Tina V

    2016-01-01

    Environmental exposures that occur in utero and during early life may contribute to the development of childhood asthma through alteration of the human microbiome. The objectives of this study were to estimate the cumulative effect and relative importance of environmental exposures on the risk of childhood asthma. We conducted a population-based birth cohort study of mother-child dyads who were born between 1995 and 2003 and were continuously enrolled in the PRIMA (Prevention of RSV: Impact on Morbidity and Asthma) cohort. The individual and cumulative impact of maternal urinary tract infections (UTI) during pregnancy, maternal colonization with group B streptococcus (GBS), mode of delivery, infant antibiotic use, and older siblings at home, on the risk of childhood asthma were estimated using logistic regression. Dose-response effect on childhood asthma risk was assessed for continuous risk factors: number of maternal UTIs during pregnancy, courses of infant antibiotics, and number of older siblings at home. We further assessed and compared the relative importance of these exposures on the asthma risk. In a subgroup of children for whom maternal antibiotic use during pregnancy information was available, the effect of maternal antibiotic use on the risk of childhood asthma was estimated. Among 136,098 singleton birth infants, 13.29% developed asthma. In both univariate and adjusted analyses, maternal UTI during pregnancy (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.18, 1.25; adjusted OR [AOR] 1.04, 95%CI 1.02, 1.07 for every additional UTI) and infant antibiotic use (OR 1.21, 95%CI 1.20, 1.22; AOR 1.16, 95%CI 1.15, 1.17 for every additional course) were associated with an increased risk of childhood asthma, while having older siblings at home (OR 0.92, 95%CI 0.91, 0.93; AOR 0.85, 95%CI 0.84, 0.87 for each additional sibling) was associated with a decreased risk of childhood asthma, in a dose-dependent manner. Compared with vaginal delivery, C

  8. Relative Importance and Additive Effects of Maternal and Infant Risk Factors on Childhood Asthma.

    Directory of Open Access Journals (Sweden)

    Pingsheng Wu

    Full Text Available Environmental exposures that occur in utero and during early life may contribute to the development of childhood asthma through alteration of the human microbiome. The objectives of this study were to estimate the cumulative effect and relative importance of environmental exposures on the risk of childhood asthma.We conducted a population-based birth cohort study of mother-child dyads who were born between 1995 and 2003 and were continuously enrolled in the PRIMA (Prevention of RSV: Impact on Morbidity and Asthma cohort. The individual and cumulative impact of maternal urinary tract infections (UTI during pregnancy, maternal colonization with group B streptococcus (GBS, mode of delivery, infant antibiotic use, and older siblings at home, on the risk of childhood asthma were estimated using logistic regression. Dose-response effect on childhood asthma risk was assessed for continuous risk factors: number of maternal UTIs during pregnancy, courses of infant antibiotics, and number of older siblings at home. We further assessed and compared the relative importance of these exposures on the asthma risk. In a subgroup of children for whom maternal antibiotic use during pregnancy information was available, the effect of maternal antibiotic use on the risk of childhood asthma was estimated.Among 136,098 singleton birth infants, 13.29% developed asthma. In both univariate and adjusted analyses, maternal UTI during pregnancy (odds ratio [OR] 1.2, 95% confidence interval [CI] 1.18, 1.25; adjusted OR [AOR] 1.04, 95%CI 1.02, 1.07 for every additional UTI and infant antibiotic use (OR 1.21, 95%CI 1.20, 1.22; AOR 1.16, 95%CI 1.15, 1.17 for every additional course were associated with an increased risk of childhood asthma, while having older siblings at home (OR 0.92, 95%CI 0.91, 0.93; AOR 0.85, 95%CI 0.84, 0.87 for each additional sibling was associated with a decreased risk of childhood asthma, in a dose-dependent manner. Compared with vaginal delivery, C

  9. Occupational exposures associated with work-related asthma and work-related wheezing among U.S. workers.

    Science.gov (United States)

    Arif, Ahmed A; Delclos, George L; Whitehead, Lawrence W; Tortolero, Susan R; Lee, Eun S

    2003-10-01

    National estimates of occupational asthma (OA) in the United States are sparse. Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, we analyzed associations between occupation and work-related asthma and work-related wheezing among U.S. workers. This study identified several occupations that were at risk of developing work-related asthma and/or wheezing, with cleaners and equipment cleaners showing the highest risks. Other major occupations identified were farm and agriculture; entertainment; protective services; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock, and material movers; and motor vehicle operators. The population attributable risks for work-related asthma and work-related wheezing were 26% and 27%, respectively. This study adds evidence to the literature that identifies work-related asthma as an important public health problem. Several occupations are targeted for additional evaluation and study. Of particular interest are cleaners, which are being increasingly reported as a risk group for asthma. Future intervention strategies need to be developed for effective control and prevention of asthma in the workplace. Copyright 2003 Wiley-Liss, Inc.

  10. Asthma-related productivity losses in Alberta, Canada

    Directory of Open Access Journals (Sweden)

    Nguyen X Thanh

    2009-03-01

    Full Text Available Nguyen X Thanh, Arto Ohinmaa, Charles YanInstitute of Health Economics, Edmonton, Alberta, CanadaObjectives: To estimate the number and cost of asthma-related productivity loss days due to absenteeism and presenteeism (at work but not fully functioning in Alberta in 2005.Methods: Using data from the 2005 Canadian Community Health Survey, this study focused on people of working age (18–64 years, who reported having an asthma diagnosis. Total asthma-related disability days, including in-bed days and activity-restricted days, were estimated by multiplying the difference in the means of total disability days between asthmatics and nonasthmatics adjusted for sociodemographic characteristics and other health conditions by a multiple linear regression, with the number of asthmatics in the population. Number of productivity loss days was a sum between the number of in-bed days (absenteeism and the number of activity-restricted days multiplied by a reduction in functional level (presenteeism, adjusted for five working days per week. Other data from Alberta or Canadian published literature, such as a reduction in functional level of 20%–30%, a labor participation rate of 73%, and an average wage of $158 per day in 2005, were also used for analyses.Results: The prevalence of asthma was estimated at 8.5% among approximately 2.1 million people of working age in Alberta in 2005. The difference in the means of total disability days between asthmatics and nonasthmatics was 0.487 (95% CI: 0.286–0.688 in a period of two weeks or 12.7 (7.5–17.9 in one year. With the reduction in functional level of 20%–30%, the number of asthma-related productivity loss days was estimated from 442 (259–624 to 533 (313–753 thousand, respectively. The corresponding cost was from $70 ($41–$99 to $84 ($49–$119 million. Of these, the presenteeism accounted for 42% to 52%.Conclusions: The results suggest that an improvement in the controlling of asthma could have a

  11. Immigration and Acculturation-Related Factors and Asthma Morbidity in Latino Children*

    Science.gov (United States)

    Sato, Amy F.; Kopel, Sheryl J.; McQuaid, Elizabeth L.; Seifer, Ronald; Klein, Robert; Esteban, Cynthia; Lobato, Debra; Ortega, Alexander N.; Canino, Glorisa; Fritz, Gregory K.

    2011-01-01

    Objective This article presents a summary of findings from asthma studies focusing on immigration and acculturation-related factors. A study examining associations between these processes, family cohesion and social support networks, and asthma morbidity in a sample of Dominican and Puerto Rican caregivers residing in the mainland U.S., is also described. Methods Latino children with asthma (n = 232), ages 7–16 (49% female) and their caregivers completed interview-based questionnaires on immigration and acculturation-related processes, family characteristics, and asthma morbidity. Results The frequency of ED use due to asthma may be higher for children of caregivers born in Puerto Rico. Acculturative stress levels were higher for Puerto Rican born caregivers residing in the mainland U.S. Conclusion Asthma-related educational and intervention programs for Latino children and families should be tailored to consider the effects that the immigration and acculturation experience can have on asthma management. Specific family-based supports focused on decreasing stress related to the acculturation process, and increasing social and family support around the asthma treatment process may help to reduce asthma morbidity in Latino children. PMID:21745811

  12. Change in the manifestations of asthma and asthma-related traits in childhood: a latent transition analysis.

    Science.gov (United States)

    Garden, Frances L; Simpson, Judy M; Mellis, Craig M; Marks, Guy B

    2016-02-01

    It is known that asthma is a heterogeneous entity whose manifestations vary with age. Our objective was to examine changes in the manifestation of asthma and asthma-related traits in childhood by defining empirically derived childhood asthma phenotypes and examining their transitions over time.To define the phenotypes we used data on respiratory symptoms, healthcare utilisation, medications, spirometry, airway hyperresponsiveness (AHR), exhaled nitric oxide concentration and atopy from a birth cohort recruited on the basis of having a first-degree relative with asthma. Data were acquired at ages 1.5-11.5 years and analysed using latent transition analysis.In a study population of 370 participants, we classified subjects into four phenotypes: 1) nonatopic, few symptoms (prevalence range from 1.5 to 5 years: 52-60%), 2) atopic, few symptoms (3-21%), 3) nonatopic, asthma and rhinitis symptoms (13-35%), and 4) atopic, asthma and rhinitis symptoms (2-14%) in early childhood; and 1) nonatopic, no respiratory disease (prevalence range from 8 to 11.5 years: 41-46%), 2) atopic, no respiratory disease (23-33%), 3) nonatopic, asthma symptoms, no AHR or airway inflammation (8-12%) and 4) atopic asthma (19%) in mid-childhood. Transitioning between phenotypes was common in early childhood, but less common in later childhood.This analysis represents the first attempt to incorporate longitudinal patterns of several manifestations of asthma into a single model to simultaneously define phenotypes and examine their transitions over time. It provides quantitative support for the view that asthma is a heterogeneous entity, and that some children with wheeze and other respiratory symptoms in early life progress to asthma in mid-childhood, while others become asymptomatic. Copyright ©ERS 2016.

  13. Incidence of rhinitis and asthma related to welding in Northern Europe.

    NARCIS (Netherlands)

    Storaas, T.; Zock, J.P.; Morano, A.E; Holm, M.; Bjornsson, E.; Forsberg, B.; Janson, C.; Norbäck, D.; Omenass, E.; Schlünssen, V.; Torén, K.; Svanes, C.

    2015-01-01

    Welding-related asthma is well recognised but less is known about rhinitis in relation to welding. The aim here, was to study associations between welding, rhinitis and asthma in a general population sample, and factors influencing selection into and out of a welding occupation. Adult-onset asthma

  14. Environmental Air Pollutants as Risk Factors for Asthma Among Children Seen in Pediatric Clinics in UKMMC, Kuala Lumpur.

    Science.gov (United States)

    Idris, Idayu Badilla; Ghazi, Hasanain Faisal; Zhie, Khor Hui; Khairuman, Khairul Aliff; Yahya, Siti Kasuma; Abd Zaim, Farah Azureen; Nam, Chok Wai; Abdul Rasid, Hazwan Zuhairi; Isa, Zaleha Md

    2016-01-01

    The prevalence of asthma is increasing, especially among children in Malaysia, with environmental factors as one of the main preventable contributors. The aim of this study was to determine the association between environmental air pollutants and the occurrence of asthma among children seen in pediatric clinics in Universiti Kebangsaan Malaysia Medical Center (UKMMC), Kuala Lumpur. An unmatched case control study among children who attended the pediatric clinic was carried out from May to August 2015. A total of 223 children who were diagnosed with asthma (105 cases) and who did not have asthma (118 controls) were included in this study. Their parents or caregivers were interviewed using questionnaires modified from the International Study of Asthma and Allergies in Childhood. Data obtained were analyzed using SPSS software version 20. There was a higher risk of asthma in those who had carpet at home (OR = 2.15 CI [1.25-3.68]), those who lived within 200 m of heavy traffic (OR = 1.72 CI [1.01-2.93]), and those who were exposed to lorry fumes (OR = 2.61. CI [1.38-4.93]). Environmental air pollutants increased the risk of asthma among children in Malaysia. Exposure to congested roads, lorry fumes, and indoor carpet were associated with asthma among children in this study. Parents or caretakers of children with asthma should be given adequate education on the prevention of asthmatic attack among these children. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Environmental and mucosal microbiota and their role in childhood asthma.

    Science.gov (United States)

    Birzele, L T; Depner, M; Ege, M J; Engel, M; Kublik, S; Bernau, C; Loss, G J; Genuneit, J; Horak, E; Schloter, M; Braun-Fahrländer, C; Danielewicz, H; Heederik, D; von Mutius, E; Legatzki, A

    2017-01-01

    High microbial diversity in the environment has been associated with lower asthma risk, particularly in children exposed to farming. It remains unclear whether this effect operates through an altered microbiome of the mucosal surfaces of the airways. DNA from mattress dust and nasal samples of 86 school age children was analyzed by 454 pyrosequencing of the 16S rRNA gene fragments. Based on operational taxonomic units (OTUs), bacterial diversity and composition were related to farm exposure and asthma status. Farm exposure was positively associated with bacterial diversity in mattress dust samples as determined by richness (P = 8.1 × 10 -6 ) and Shannon index (P = 1.3 × 10 -5 ). Despite considerable agreement of richness between mattress and nasal samples, the association of richness with farming in nasal samples was restricted to a high gradient of farm exposure, that is, exposure to cows and straw vs no exposure at all. In mattress dust, the genera Clostridium, Facklamia, an unclassified genus within the family of Ruminococcaceae, and six OTUs were positively associated with farming. Asthma was inversely associated with richness [aOR = 0.48 (0.22-1.02)] and Shannon index [aOR = 0.41 (0.21-0.83)] in mattress dust and to a lower extent in nasal samples [richness aOR 0.63 = (0.38-1.06), Shannon index aOR = 0.66 (0.39-1.12)]. The stronger inverse association of asthma with bacterial diversity in mattress dust as compared to nasal samples suggests microbial involvement beyond mere colonization of the upper airways. Whether inhalation of metabolites of environmental bacteria contributes to this phenomenon should be the focus of future research. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Prevalence and Occupational and Environmental Risk Factors of Self-Reported Asthma: Evidence from a Cross-Sectional Survey in Seven Chinese Cities.

    Science.gov (United States)

    Fu, Qing-Ling; Du, Yue; Xu, Geng; Zhang, Hua; Cheng, Lei; Wang, Yan-Jun; Zhu, Dong-Dong; Lv, Wei; Liu, Shi-Xi; Li, Pei-Zhong; Shi, Jian-Bo; Ou, Chun-Quan

    2016-11-04

    Asthma is one of the most common chronic diseases and associated with significant morbidity and mortality. However, few data on occupational and environmental risk factors of asthma are available, particularly in Asian adults. Based on a national cross-sectional survey, we assessed the prevalence and risk factors of asthma in Chinese adults. A total of 9974 participants aged 15 years and over in seven Chinese cities were selected using a stratified four-stage random sampling. All participants were interviewed face-to-face in their homes using a standardized self-administered questionnaire. Multivariate logistic regression analyses were adopted to determine various risk factors for asthma. The prevalence of self-reported lifetime asthma was 2.46% among the entire adult population, 3.02% among males and 1.93% among females. The prevalence varied by age group, ethnicity, marital status, education, and floor space per person ( p occupational and environmental determinants of asthma, including a clearance-related job (OR = 2.28, 95%CI: 1.07-4.89), occupational exposure to industrial or occupational poisonous gas (OR = 4.21, 95%CI: 2.43-7.30), having large amounts of carpet in the workplace (OR = 2.61, 95%CI: 1.20-5.69) and using coal for cooking (OR = 2.65, 95%CI: 1.26-5.57). Asthma is a serious public health problem in China. Our study provides important updated information on the prevalence of asthma and its associated risk factors, which may help us better understand the epidemiology of asthma and prevent this disorder.

  17. Health Benefits of Green Public Housing: Associations With Asthma Morbidity and Building-Related Symptoms.

    Science.gov (United States)

    Colton, Meryl D; Laurent, Jose Guillermo Cedeno; MacNaughton, Piers; Kane, John; Bennett-Fripp, Mae; Spengler, John; Adamkiewicz, Gary

    2015-12-01

    We examined associations of several health outcomes with green and conventional low-income housing, where the prevalence of morbidities and environmental pollutants is elevated. We used questionnaires and a visual inspection to compare sick building syndrome (SBS) symptoms and asthma-related morbidity among residents in multifamily units in Boston, Massachusetts, between March 2012 and May 2013. Follow-up was approximately 1 year later. Adults living in green units reported 1.35 (95% confidence interval [CI] = 0.66, 2.05) fewer SBS symptoms than those living in conventional (control) homes (P green homes experienced substantially lower risk of asthma symptoms (odds ratio [OR] = 0.34; 95% CI = 0.12, 1.00), asthma attacks (OR = 0.31; 95% CI = 0.11, 0.88), hospital visits (OR = 0.24; 95% CI = 0.06, 0.88), and asthma-related school absences (OR = 0.21; 95% CI = 0.06, 0.74) than children living in conventional public housing. Participants living in green homes had improved health outcomes, which remained consistent over the study period. Green housing may provide a significant value in resource-poor settings where green construction or renovation could simultaneously reduce harmful indoor exposures, promote resident health, and reduce operational costs.

  18. 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.

  19. Socioeconomic and environmental determinants of adolescent asthma in urban Latin America: an ecological analysis

    Directory of Open Access Journals (Sweden)

    Gisel Lorena Fattore

    2015-11-01

    Full Text Available Abstract The prevalence of asthma is high in urban areas of many Latin-American countries where societies show high levels of inequality and different levels of development. This study aimed to examine the relationship between asthma symptoms prevalence in adolescents living in Latin American urban centers and socioeconomic and environmental determinants measured at the ecological level. Asthma prevalence symptoms were obtained from the International Study of Asthma and Allergies in Childhood (ISAAC phase III. A hierarchical conceptual framework was defined and the explanatory variables were organized in three levels: distal, intermediate, proximal. Linear regression models weighed by sample size were undertaken between asthma prevalence and the selected variables. Asthma prevalence was positively associated with Gini index, water supply and homicide rate, and inversely associated with the Human Development Index, crowding and adequate sanitation. This study provides evidence of the potential influence of poverty and social inequalities on current wheezing in adolescents in a complex social context like Latin America.

  20. Impact evaluation of environmental factors on respiratory function of asthma patients living in urban territory.

    Science.gov (United States)

    Veremchuk, Lyudmila V; Tsarouhas, Konstantinos; Vitkina, Tatyana I; Mineeva, Elena E; Gvozdenko, Tatyana A; Antonyuk, Marina V; Rakitskii, Valeri N; Sidletskaya, Karolina A; Tsatsakis, Aristidis M; Golokhvast, Kirill S

    2018-04-01

    Environmental pollution, local climatic conditions and their association with the prevalence and exacerbation of asthma are topics of intense current medical investigation. Air pollution in the area of Vladivostock was estimated both by the index of emission volumes of "air gaseous components" (nitrogen oxide and nitrogen dioxide, formaldehyde, hydrogen sulfide, carbon monoxide) in urban atmosphere and by mass spectrometric analysis of precipitates in snow samples. A total of 172 local asthma patients (101 controlled-asthma patients-CAP and 71 non-controlled asthma patients - nCAP) were evaluated with the use of spirometry and body plethysmography. Airway obstruction reversibility was evaluated with the use of an inhaled bronchodilator. Using discriminant analysis the association of environmental parameters with clinical indices of asthma patients is explored and thresholds of impact are established. CAP presented high sensitivity to large-size suspended air particles and to several of the studied climatic parameters. Discriminant analysis showed high values of Wilks' lambda index (α = 0.69-0.81), which implies limited influence of environmental factors on the respiratory parameters of CAP. nCAP were more sensitive and susceptible to the majority of the environmental factors studied, including air suspended toxic metals particles (Cr, Zn and Ni). Air suspended particles showed higher tendency for pathogenicity in nCAP population than in the CAP, with a wider range of particle sizes being involved. Dust fractions ranging from 0 to 1 μm and from 50 to 100 μm were additionally implicated compared to CAP group. Considerably lowest thresholds levels of impact are calculated for nCAP. Copyright © 2017. Published by Elsevier Ltd.

  1. Prevalence and Occupational and Environmental Risk Factors of Self-Reported Asthma: Evidence from a Cross-Sectional Survey in Seven Chinese Cities

    Directory of Open Access Journals (Sweden)

    Qing-Ling Fu

    2016-11-01

    Full Text Available Objective: Asthma is one of the most common chronic diseases and associated with significant morbidity and mortality. However, few data on occupational and environmental risk factors of asthma are available, particularly in Asian adults. Based on a national cross-sectional survey, we assessed the prevalence and risk factors of asthma in Chinese adults. Methods: A total of 9974 participants aged 15 years and over in seven Chinese cities were selected using a stratified four-stage random sampling. All participants were interviewed face-to-face in their homes using a standardized self-administered questionnaire. Multivariate logistic regression analyses were adopted to determine various risk factors for asthma. Results: The prevalence of self-reported lifetime asthma was 2.46% among the entire adult population, 3.02% among males and 1.93% among females. The prevalence varied by age group, ethnicity, marital status, education, and floor space per person (p < 0.05. After adjusting for socio-demographic variables and smoking, we found independent occupational and environmental determinants of asthma, including a clearance-related job (OR = 2.28, 95%CI: 1.07–4.89, occupational exposure to industrial or occupational poisonous gas (OR = 4.21, 95%CI: 2.43–7.30, having large amounts of carpet in the workplace (OR = 2.61, 95%CI: 1.20–5.69 and using coal for cooking (OR = 2.65, 95%CI: 1.26–5.57. Conclusions: Asthma is a serious public health problem in China. Our study provides important updated information on the prevalence of asthma and its associated risk factors, which may help us better understand the epidemiology of asthma and prevent this disorder.

  2. Emotionally triggered asthma and its relationship to panic disorder, ataques de nervios, and asthma-related death of a loved one in Latino adults.

    Science.gov (United States)

    Vazquez, Karinna; Sandler, Jonathan; Interian, Alejandro; Feldman, Jonathan M

    2017-02-01

    Research has demonstrated high comorbidity between asthma and panic disorder (PD). Less is known about the relationship between asthma and the Latino cultural idiom of distress of ataques de nervios, as well as the role that psychosocial stressors play. The current study tested the hypotheses that Latino asthma patients who experience PD, ataques de nervios, and/or asthma-related death of a loved one endorse greater psychological triggers of asthma, greater perceived impact of asthma triggers, and greater difficulty controlling such triggers than do those without these conditions. Data originated from an interview conducted prior to a randomized controlled trial in which 292 Latino adults with self-reported asthma were recruited from outpatient clinics in the Bronx, NY. The PRIME-MD Patient Health Questionnaire (PHQ) was used to screen for PD symptoms, while the Structured Clinical Interview for DSM-IV (SCID-I) was used to confirm diagnosis of PD. Lifetime history of ataques de nervios and asthma-related death of a loved one were based upon self-report. Asthma triggers were examined using the Asthma Trigger Inventory (ATI). PD, ataques de nervios, and asthma-related death of a loved one each predicted a higher frequency of psychological asthma triggers, controlling for gender and comorbid medical conditions. Participants with PD also reported greater impact of asthma triggers than those without PD, while no significant differences in perceived control were observed. Providers should screen for PD, ataques de nervios, and asthma-related death of a loved one in Latino asthma patients, given their observed association with emotionally triggered asthma. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. NIAID, NIEHS, NHLBI, and MCAN Workshop Report : The indoor environment and childhood asthma-implications for home environmental intervention in asthma prevention and management

    NARCIS (Netherlands)

    Gold, Diane R; Adamkiewicz, Gary; Arshad, Syed Hasan; Celedón, Juan C; Chapman, Martin D; Chew, Ginger L; Cook, Donald N; Custovic, Adnan; Gehring, Ulrike; Gern, James E; Johnson, Christine C; Kennedy, Suzanne; Koutrakis, Petros; Leaderer, Brian; Mitchell, Herman E; Litonjua, Augusto A; Mueller, Geoffrey A; O'Connor, George T; Ownby, Dennis; Phipatanakul, Wanda; Persky, Victoria; Perzanowski, Matthew S; Ramsey, Clare D; Salo, Päivi M; Schwaninger, Julie M; Sordillo, Joanne E; Spira, Avrum; Suglia, Shakira F; Togias, Alkis; Zeldin, Darryl C; Matsui, Elizabeth C

    2017-01-01

    Environmental exposures have been recognized as critical in the initiation and exacerbation of asthma, one of the most common chronic childhood diseases. The National Institute of Allergy and Infectious Diseases; National Institute of Environmental Health Sciences; National Heart, Lung, and Blood

  4. Flavonoids and Asthma

    Science.gov (United States)

    Tanaka, Toshio; Takahashi, Ryo

    2013-01-01

    Asthma is a chronic disease, characterized by airway inflammation, airflow limitation, hyper-reactivity and airway remodeling. It is believed that asthma is caused by the interaction between genetic and environmental factors. The prevalence of allergic diseases, including asthma, has increased worldwide during the past two decades. Although the precise reasons that have caused this increase remain unknown, dietary change is thought to be one of the environmental factors. Flavonoids, which are polyphenolic plant secondary metabolites ubiquitously present in vegetables, fruits and beverages, possess antioxidant and anti-allergic traits, as well as immune-modulating activities. Flavonoids are powerful antioxidants and anti-allergic nutrients that inhibit the release of chemical mediators, synthesis of Th2 type cytokines, such as interleukin (IL)-4 and IL-13, and CD40 ligand expression by high-affinity immunoglobulin E (IgE) receptor-expressing cells, such as mast cells and basophils. They also inhibit IL-4-induced signal transduction and affect the differentiation of naïve CD4+ T cells into effector T-cells through their inhibitory effect on the activation of the aryl hydrocarbon receptor. Various studies of flavonoids in asthmatic animal models have demonstrated their beneficial effects. The results of several epidemiological studies suggest that an increase in flavonoid intake is beneficial for asthma. Moreover, clinical trials of flavonoids have shown their ameliorative effects on symptoms related to asthma. However, these human studies are currently limited; further validation is required to clarify whether an appropriate intake of flavonoids may constitute dietary treatment and for part of a preventive strategy for asthma. PMID:23752494

  5. An official American Thoracic Society proceedings: work-related asthma and airway diseases. Presentations and discussion from the Fourth Jack Pepys Workshop on Asthma in the Workplace.

    Science.gov (United States)

    Tarlo, Susan M; Malo, Jean-Luc

    2013-08-01

    Work-related asthma is a common occupational lung disease. The scope of the Fourth Jack Pepys Workshop that was held in May 2010 went beyond asthma to include discussion of other occupational airway diseases, in particular occupationally related chronic obstructive pulmonary disease (COPD) and bronchiolitis. Aspects explored included public health considerations, environmental aspects, outcome after diagnosis, prevention and surveillance, and other work-related obstructive airway diseases. Consistent methods are needed to accurately estimate the comparative burden of occupation-related airway diseases among different countries. Challenges to accomplishing this include variability in health care delivery, compensation systems, cultural contexts, and social structures. These factors can affect disease estimates, while heterogeneity in occupations and workplace exposures can affect the underlying true prevalence of morbidity. Consideration of the working environment included discussion of practical methods of limiting exposure to respiratory sensitizers, methods to predict new sensitizers before introduction into workplaces, the role of legislated exposure limits, and models to estimate relative validity of various ameliorative measures when complete avoidance of the sensitizer is not feasible. Other strategies discussed included medical surveillance measures and education, especially for young individuals with asthma and new workers about to enter the workforce. Medical outcomes after development of sensitizer-induced occupational asthma are best following earlier diagnosis and removal from further exposure, but a subset may be able to continue working safely provided that exposure is reduced under close follow-up monitoring. It was recognized that occupationally related COPD is common but underappreciated, deserving further study and prevention efforts.

  6. Advances in pediatric asthma and atopic dermatitis.

    Science.gov (United States)

    Foroughi, Shabnam; Thyagarajan, Ananth; Stone, Kelly D

    2005-10-01

    Allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, food allergy, and urticaria are common in general pediatric practice. This review highlights several significant advances in pediatric allergy over the past year, focusing on asthma and atopic dermatitis. With increasing options for the treatment of allergic diseases, much work is now focused on methods for individualizing treatments to a patient's phenotype and genotype. Progress over the past year includes the characterization of effects of regular albuterol use in patients with genetic variations in the beta-adrenergic receptor. Maintenance asthma regimens for children in the first years of life are also an ongoing focus. The relation between upper airway allergic inflammation and asthma has continued to accumulate support and now extends to the middle ear. Environmental influences on asthma and interventions have been described, including environmental controls for asthma and the role of air pollution on lung development in children. Finally, concerns have been raised regarding the use of topical immunomodulators in young children with atopic dermatitis. Progress continues in the care of children with atopic diseases. Attention to treatment with appropriate medications, patient-individualized environmental controls, and extensive education are the keys to successfully treating atopic children. This review highlights several recent advances but is not intended to be a comprehensive review.

  7. 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

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

    International Nuclear Information System (INIS)

    Liu, Fan; Zhao, Yang; Liu, Yu-Qin; Liu, Yang; Sun, Jing; Huang, Mei-Meng; Liu, Yi; Dong, Guang-Hui

    2014-01-01

    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 10 ), sulfur dioxide (SO 2 ), nitrogen dioxides (NO 2 ), and ozone (O 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 3 increase in PM 10 , 1.23 (95%CI, 1.14–1.32) per 21 μg/m 3 increase in SO 2 , 1.25 (95%CI, 1.16–1.36) per 10 μg/m 3 increase in NO 2 , and 1.31 (95%CI, 1.21–1.41) per 23 μg/m 3 increase in O 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, and pet were associated with increased ORs of asthma

  9. Integrating Demographic, Clinical,and Environmental Exposure Information to Identify Genomic Biomarkers Associated With Subtypes of Childhood Asthma

    Science.gov (United States)

    Childhood asthma is a multifactorial disease with a disturbingly high incidence in urbanized areas. The pathogenesis of asthma is poorly understood due to the complex relationship between genetic susceptibility and modulating environmental factors. The Mechanistic Indicators of C...

  10. Obese and Allergic Related Asthma Phenotypes Among Children Across the United States.

    Science.gov (United States)

    Ross, Mindy K; Romero, Tahmineh; Sim, Myung S; Szilagyi, Peter G

    2018-04-19

    Pediatric asthma is heterogeneous with phenotypes that reflect differing underlying inflammation and pathophysiology. Little is known about the national prevalence of certain obesity and allergy related asthma phenotypes or associated characteristics. We therefore assessed the national prevalence, risk factors, and parent-reported severity of four asthma phenotypes: not-allergic-not-obese, allergic-not-obese, obese-not-allergic, and allergic-and-obese. We analyzed data from the 2007-2008 National Survey of Children's Health (NSCH) of 10-17 year-olds with parent-reported asthma. We described sociodemographic and health risk factors of each phenotype and then applied logistic and ordinal regression models to identify associated risk factors and level of severity of the phenotypes. Among 4,427 children with asthma in this NSCH cohort, the association between race and phenotype is statistically significant (p<0.0001); white children with asthma were most likely to have allergic-not-obese asthma while black and Hispanic children with asthma were most likely to have the obese-non-allergic phenotype (p<0.001). ADD/ADHD was more likely to be present in allergic-not-obese children (OR 1.50, CI 1.14-1.98, p = 0.004). The phenotype with the highest risk for more severe compared to mild asthma was the obese-and-allergic asthma phenotype (OR 3.34, CI 2.23-5.01, p<0.001). Allergic-not-obese asthma comprised half of our studied asthma phenotypes, while obesity-related asthma (with or without allergic components) comprised one-fifth of asthma phenotypes in this cohort representative of the U.S. Children with both obese and allergic asthma are most likely to have severe asthma. Future management of childhood asthma might consider more tailoring of treatment and management plans based upon different childhood asthma phenotypes.

  11. Exhaled breath condensate nitrates, but not nitrites or FENO, relate to asthma control.

    Science.gov (United States)

    Malinovschi, Andrei; Pizzimenti, Stefano; Sciascia, Savino; Heffler, Enrico; Badiu, Iuliana; Rolla, Giovanni

    2011-07-01

    Asthma is a chronic respiratory disease, characterised by airways inflammation, obstruction and hyperresponsiveness. Asthma control is the goal of asthma treatment, but many patients have sub-optimal control. Exhaled NO and exhaled breath condensate (EBC) NO metabolites (nitrites and nitrates) measurements are non-invasive tools to assess airways inflammation. Our aim was to investigate the relationships between asthma control and the above-named biomarkers of airways inflammation. Thirty-nine non-smoking asthmatic patients (19 women) aged 50 (21-80) years performed measurements of exhaled NO (FENO), EBC nitrates, nitrites and pH, and answered Asthma Control Questionnaire (ACQ) and Asthma Control Test (ACT)-questionnaire. The ACT and ACQ score were strongly interrelated (ρ = -0.84, p 0.05). EBC nitrates were negatively related to ACT score (ρ = -0.34, p = 0.03) and positively related to ACQ score (ρ = 0.41, p = 0.001) while no relation of EBC nitrites to either ACQ or ACT score was found (p>0.05). EBC nitrates were the only biomarker that was significantly related to asthma control. This suggests that nitrates, but not nitrites or FENO, reflect an aspect of airways inflammation that is closer related to asthma symptoms. Therefore there is a potential role for EBC nitrates in objective assessment of asthma control. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. 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

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    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.

  13. Risk Assessment and Community Participation Model for Environmental Asthma Management in an Elementary Public School: A Case Study in Puerto Rico

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    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

  14. Monitoring asthma in childhood: management-related issues

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    Bart L. Rottier

    2015-06-01

    Full Text Available Management-related issues are an important aspect of monitoring asthma in children in clinical practice. This review summarises the literature on practical aspects of monitoring including adherence to treatment, inhalation technique, ongoing exposure to allergens and irritants, comorbid conditions and side-effects of treatment, as agreed by the European Respiratory Society Task Force on Monitoring Asthma in Childhood. The evidence indicates that it is important to discuss adherence to treatment in a non-confrontational way at every clinic visit, and take into account a patient's illness and medication beliefs. All task force members teach inhalation techniques at least twice when introducing a new inhalation device and then at least annually. Exposure to second-hand tobacco smoke, combustion-derived air pollutants, house dust mites, fungal spores, pollens and pet dander deserve regular attention during follow-up according to most task force members. In addition, allergic rhinitis should be considered as a cause for poor asthma control. Task force members do not screen for gastro-oesophageal reflux and food allergy. Height and weight are generally measured at least annually to identify individuals who are susceptible to adrenal suppression and to calculate body mass index, even though causality between obesity and asthma has not been established. In cases of poor asthma control, before stepping up treatment the above aspects of monitoring deserve closer attention.

  15. Asthma Research

    Science.gov (United States)

    EPA is working to explore the role of common air pollutants in the development and exacerbation of asthma at different life stages as well as other environmental and genetic factors that might make a person more sensitive to developing asthma.

  16. Air pollution and children's asthma-related emergency hospital visits in southeastern France.

    Science.gov (United States)

    Mazenq, Julie; Dubus, Jean-Christophe; Gaudart, Jean; Charpin, Denis; Nougairede, Antoine; Viudes, Gilles; Noel, Guilhem

    2017-06-01

    Children's asthma is multifactorial. Environmental factors like air pollution exposure, meteorological conditions, allergens, and viral infections are strongly implicated. However, place of residence has rarely been investigated in connection with these factors. The primary aim of our study was to measure the impact of particulate matter (PM), assessed close to the children's homes, on asthma-related pediatric emergency hospital visits within the Bouches-du-Rhône area in 2013. In a nested case-control study on 3- to 18-year-old children, each control was randomly matched on the emergency room visit day, regardless of hospital. Each asthmatic child was compared to 15 controls. PM 10 and PM 2.5 , meteorological conditions, pollens, and viral data were linked to ZIP code and analyzed by purpose of emergency visit. A total of 68,897 visits were recorded in children, 1182 concerning asthma. Short-term exposure to PM 10 measured near children's homes was associated with excess risk of asthma emergency visits (adjusted odds ratio 1.02 (95% CI 1.01-1.04; p = 0.02)). Male gender, young age, and temperature were other risk factors. Conversely, wind speed was a protective factor. PM 10 and certain meteorological conditions near children's homes increased the risk of emergency asthma-related hospital visits in 3- to 18-year-old children in Bouches-du-Rhône. What is Known: • A relationship between short-term exposure to air pollution and increase in emergency room visits or hospital admissions as a result of increased pollution levels has already been demonstrated. What is New: • This study confirms these results but took into account confounding factors (viral data, pollens, and meteorological conditions) and is based on estimated pollution levels assessed close to the children's homes, rather than those recorded at the hospital. • The study area, the Mediterranean, is favorable to creation of secondary pollutants in these sunny and dry seasons.

  17. Urban vs. rural factors that affect adult asthma.

    Science.gov (United States)

    Jie, Yu; Isa, Zaleha Md; Jie, Xu; Ju, Zhang Long; Ismail, Noor Hassim

    2013-01-01

    In this review, our aim was to examine the influence of geographic variations on asthma prevalence and morbidity among adults, which is important for improving our understanding, identifying the burden, and for developing and implementing interventions aimed at reducing asthma morbidity. Asthma is a complex inflammatory disease of multifactorial origin, and is influenced by both environmental and genetic factors. The disparities in asthma prevalence and morbidity among the world's geographic locations are more likely to be associated with environmental exposures than genetic differences. In writing this article, we found that the indoor factors most consistently associated with asthma and asthma-related symptoms in adults included fuel combustion, mold growth, and environmental tobacco smoke in both urban and rural areas. Asthma and asthma-related symptoms occurred more frequently in urban than in rural areas, and that difference correlated with environmental risk exposures, SES, and healthcare access. Environmental risk factors to which urban adults were more frequently exposed than rural adults were dust mites,high levels of vehicle emissions, and a westernized lifestyle.Exposure to indoor biological contaminants in the urban environment is common.The main risk factors for developing asthma in urban areas are atopy and allergy to house dust mites, followed by allergens from animal dander. House dust mite exposure may potentially explain differences in diagnosis of asthma prevalence and morbidity among adults in urban vs. rural areas. In addition, the prevalence of asthma morbidity increases with urbanization. High levels of vehicle emissions,Western lifestyles and degree of urbanization itself, may affect outdoor and thereby indoor air quality. In urban areas, biomass fuels have been widely replaced by cleaner energy sources at home, such as gas and electricity, but in most developing countries, coal is still a major source of fuel for cooking and heating

  18. Development of a web-based, work-related asthma educational tool for patients with asthma.

    Science.gov (United States)

    Ghajar-Khosravi, Shadi; Tarlo, Susan M; Liss, Gary M; Chignell, Mark; Ribeiro, Marcos; Levinson, Anthony J; Gupta, Samir

    2013-01-01

    Asthma is a common chronic condition. Work-related asthma (WRA) has a large socioeconomic impact and is increasing in prevalence but remains under-recognized. Although international guidelines recommend patient education, no widely available educational tool exists. To develop a WRA educational website for adults with asthma. An evidence-based database for website content was developed, which applied evidence-based website design principles to create a website prototype. This was subsequently tested and serially revised according to patient feedback in three moderated phases (one focus group and two interview phases), followed by face validation by asthma educators. Patients (n=10) were 20 to 28 years of age; seven (70%) were female, three (30%) were in university, two (20%) were in college and five (50%) were currently employed. Key format preferences included: well-spaced, bulleted text; movies (as opposed to animations); photos (as opposed to cartoons); an explicit listing of website aims on the home page; and an exploding tab structure. Participants disliked integrated games and knowledge quizzes. Desired informational content included a list of triggers, prevention⁄control methods, currently available tools and resources, a self-test for WRA, real-life scenario presentations, compensation information, information for colleagues on how to react during an asthma attack and a WRA discussion forum. The website met the perceived needs of young asthmatic patients. This resource could be disseminated widely and should be tested for its effects on patient behaviour, including job choice, workplace irritant⁄allergen avoidance and⁄or protective equipment, asthma medication use and physician prompting for management of WRA symptoms.

  19. Asthma in childhood: a complex, heterogeneous disease

    Directory of Open Access Journals (Sweden)

    Hai Lee Chung

    2011-01-01

    Full Text Available Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheezing phenotypes in young children and about potential mechanisms and risk factors for the development of chronic asthma. The goal of these studies was to provide a better insight into the causes and natural course of childhood asthma. It is well-known that complicated interactions between genes and environmental factors contribute to the development of asthma. Because childhood is a period of rapid growth in both the lungs and the immune system, developmental factors should be considered in the pathogenesis of childhood asthma. The pulmonary system continues to grow and develop until linear growth is completed. Longitudinal studies have reported significant age-related immune development during postnatal early life. These observations suggest that the phenotypes of childhood asthma vary among children and also in an individual child over time. Improved classification of heterogeneous conditions of the disease will help determine novel strategies for primary and secondary prevention and for the development of individualized treatment for childhood asthma.

  20. [Asthma control status in children and related factors in 29 cities of China].

    Science.gov (United States)

    Zhao, Jing

    2013-02-01

    To investigate the status of asthma control in the city and severity of asthma in children and to identify related factors. This study was conducted in one children's hospital or tertiary hospital in each of the 29 provinces except Xinjiang and Xizang Autonomous Regions. Totally, 2960 parents with asthmatic children ages 0 to 14 years, and all had been diagnosed with asthma at least 3 months ago and the course was more than 12 months, who visited those hospitals were selected for the knowledge, attitude, and practice (KAP) questionnaire survey, and separated into the controlled asthma group and uncontrolled asthma group according to children's asthma conditions in the past 12 months. Multivariate analysis was carried out based on the answers to 28 tested factors; 2485 of 2960 questionnaires from 29 provinces were valid. Of the 2485 valid questionnaires, 66.0% asthmatic children had asthma attacks in the past 12 months, 26.8% asthmatic children had visited the emergency department, 16.2% asthmatic children had been hospitalized. The total cost was significantly higher in the uncontrolled group than in contro group (χ² = 23.14, P asthma control, knowledge of "3 or more times recurrent wheezing suggesting asthma", knowledge of "cough lasting for more than 4 weeks suggesting asthma", knowledge of "cough improved with bronchodilators suggesting asthma", knowledge of "awareness of using short-acting β₂ agonist for acute attack", avoiding contact with plush toys, adhere to use nasal steroid, inhaled corticosteroids/composite preparation, age of children and course of asthma in children are protective factors that affect asthma control and severity of asthma in children. Food allergies, eczema and family history of asthma are risk factors. Asthma in many children was poorly controlled. Factors that affect asthma control and severity include parents' knowledge about asthma, exposure to adverse environment, the compliance with medication and regular visits for asthma

  1. Environmental Determinants of Bronchial Asthma among Saudi School Children in Southwestern Saudi Arabia

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    Jobran M. Alqahtani

    2016-12-01

    Full Text Available The aim here was to study the possible environmental and dietary determinants of asthma among school-aged children in Southwestern Saudi Arabia. In a cross-sectional study on a representative sample in Najran in Southwestern Saudi Arabia using an Arabic version of the modified ISAAC Phase III, parent-administered questionnaire data were collected. Skin prick tests (SPTs were performed. The study included 1700 school children, out of them 468 (27.5% were diagnosed with, cases of bronchial asthma and 20.8% (353 reported a 12-month nocturnal cough (as a proxy of severe asthma. In multivariable analysis, the study identified the following risk factors for having asthma or severe asthma: having dogs in the house, being male, being exposed to dense truck traffic on the street, using wood as a cooking fuel, conducting vigorous exercise, consuming eggs, consuming vegetables, having an allergic sensitization to dog hair, and being exposed to Cladosporium, pigweed, and Bermuda grass. On the other hand, the following food stuffs were found to be protective: seafood, fruit, and dairy products. Comprehensive school educational programs for both children and their parents should be adopted to prevent the use of wood in cooking and heating, to ensure that house pets are properly cared for, and to encourage proper dietary habits. Physicians should be informed of the patterns of allergens in order to improve asthma diagnosis and management.

  2. Wireless Sensor-Dependent Ecological Momentary Assessment for Pediatric Asthma mHealth Applications.

    Science.gov (United States)

    Buonocore, Chris M; Rocchio, Rosemary A; Roman, Alfonso; King, Christine E; Sarrafzadeh, Majid

    2017-07-01

    Pediatric asthma is a prevalent chronic disease condition that can benefit from wireless health systems through constant symptom management. In this paper, we propose a smart watch based wireless health system that incorporates wireless sensing and ecological momentary assessment (EMA) to determine an individual's asthma symptoms. Since asthma is a multifaceted disease, this approach provides individualized symptom assessments through various physiological and environmental wireless sensor based EMA triggers specific to common asthma exacerbations. Furthermore, the approach described here improves compliance to use of the system through insightful EMA scheduling related to sensor detected environmental and physiological changes, as well as the patient's own schedule. After testing under several real world conditions, it was found that the system is sensitive to both physiological and environmental conditions that would cause asthma symptoms. Furthermore, the EMA questionnaires that were triggered based on these changes were specific to the asthma trigger itself, allowing for invaluable context behind the data to be collected.

  3. Pattern of airway inflammation and remodelling in mild persistent atopic asthma and in mild persistent asthma related to gastroesophageal reflux.

    Science.gov (United States)

    Dal Negro, R W; Guerriero, M; Micheletto, C

    2012-12-01

    The increase of basement membrane thickness (BMAT) represents a structural feature described as commonly characterizing airway remodelling in asthma, even if the non-atopic condition had been investigated only episodically from this point of view. Gastrooesophageal-reflux is a pathological condition which can frequently cause and/or sustain asthma in non-atopic individuals. The aim of the study was to measure BMT; some inflammatory mediators in BAL; cys-leucotrienes (LTE4) in urine; e-NO, and BHR to Methacholine (MCh) in mild atopic and in mild non-atopic, GER-related asthma. After their informed consent, 25 mild atopic (40.9 years +/- 13.1 sd, FEV1 = 95.9% pred. +/- 12.9 sd) and 39 non-atopic, GER-related asthmatics (57.3 years +/- 14.2 ds, FEVY1 = 101.3% pred. +/- 12.2 sd), nonsmoker and of a comparable asthma duration, underwent measurements of basal lung function and bronchial response to MCh (PD20 FEV1); endobronchial biopsies and BAL (in the right middle lobe), and a 24-h gastroesophageal pHmetry. Atopic GER-related asthma showed two distinct patterns of airway inflammation. The eosinophilic contribution to airway inflammation was systematically prevailing in the former group, such as: EOS = 10.7% +/- 13.4 sd vs 2.0% +/- 2.8 sd, p = 0.001; ECP = 344.9 mcg/l +/- 635.9 sd vs 59.2 mcg/l +/- 75.1 sd, p = 0.001. Data from the present study are suggesting that persistent mild atopic and mild GER-related asthma seem to represent two distinct phenotypes of asthma in terms of airway remodelling, and in particular of BMT involvement.

  4. Enhancing Pediatric Asthma Care and Nursing Education Through an Academic Practice Partnership.

    Science.gov (United States)

    McClure, Natasha; Lutenbacher, Melanie; O'Kelley, Ellen; Dietrich, Mary S

    Home environmental assessments and interventions delivered via academic practice partnerships (APP) between clinics and schools of nursing may be a low or no cost delivery model of pediatric asthma care and professional education. Patients receive enhanced clinical resources that can improve self-management and healthcare utilization. Additionally, students can practice chronic disease management skills in actual patient encounters. To describe outcomes of the implementation of an APP between a school of nursing and a pediatric asthma specialty clinic (PASC) to deliver a home visit program (HVP). The HVP was designed to reduce emergency department visits and asthma related hospitalizations in PASC patients and provide clinical experiences for nursing students. PASC referred patients to the HVP based on their level of asthma control. Students provided an individualized number of home visits to 17 participants over a nine month period. A 12-month pre- and post-HVP comparison of emergency department visits and asthma related hospitalizations was conducted. Additional information was gathered from stakeholders via an online survey, and interviews with APP partners and HVP families. Children had fewer asthma related hospitalizations post HVP. Findings suggest a reduction in exposure to environmental triggers, improved patient and family management of asthma, and increased PASC knowledge of asthma triggers in the home and increased student knowledge and skills related to asthma management. Multiple clinical and educational benefits may be realized through the development of APPs as an infrastructure supporting targeted interventions in home visits to pediatric asthma patients and their families. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Integrating Environmental Management of Asthma into Pediatric Health Care: What Worked and What Still Needs Improvement?

    Science.gov (United States)

    Roberts, James R; Newman, Nicholas; McCurdy, Leyla E; Chang, Jane S; Salas, Mauro A; Eskridge, Bernard; De Ybarrondo, Lisa; Sandel, Megan; Mazur, Lynnette; Karr, Catherine J

    2016-12-01

    The National Environmental Education Foundation (NEEF) launched an initiative in 2005 to integrate environmental management of asthma into pediatric health care. This study, a follow-up to a 2013 study, evaluated the program's impact and assessed training results by 5 new faculty champions. We surveyed attendees at training sessions to measure knowledge and the likelihood of asking about and managing environmental triggers of asthma. To conduct the program evaluation, a workshop was held with the faculty champions and NEEF staff in which we identified major program benefits, as well as challenges and suggestions for the future. Trainee baseline knowledge of environmental triggers was low, but they reported robust improvement in environmental triggers knowledge and intention to recommend environmental management. The program has a broad, national scope, reaching more than 12 000 physicians, health care providers, and students, and some faculty champions successfully integrated materials into health record. Program barriers and future endeavors were identified.

  6. Statin Exposure Is Associated with Decreased Asthma-related Emergency Department Visits and Oral Corticosteroid Use

    Science.gov (United States)

    Li, Lingling; Butler, Melissa G.; Fung, Vicki; Kharbanda, Elyse O.; Larkin, Emma K.; Vollmer, William M.; Miroshnik, Irina; Rusinak, Donna; Weiss, Scott T.; Lieu, Tracy; Wu, Ann Chen

    2013-01-01

    Rationale: Statins, or HMG-CoA reductase inhibitors, may aid in the treatment of asthma through their pleiotropic antiinflammatory effects. Objectives: To examine the effect of statin therapy on asthma-related exacerbations using a large population-based cohort. Methods: Statin users aged 31 years or greater with asthma were identified from the Population-Based Effectiveness in Asthma and Lung population, which includes data from five health plans. Statin exposure and asthma exacerbations were assessed over a 24-month observation period. Statin users with a statin medication possession ratio greater than or equal to 80% were matched to non–statin users by age, baseline asthma therapy, site of enrollment, season at baseline, and propensity score, which was calculated based on patient demographics and Deyo-Charlson conditions. Asthma exacerbations were defined as two or more oral corticosteroid dispensings, asthma-related emergency department visits, or asthma-related hospitalizations. The association between statin exposure and each of the three outcome measures was assessed using conditional logistic regression. Measurements and Main Results: Of the 14,566 statin users, 8,349 statin users were matched to a nonuser. After adjusting for Deyo-Charlson conditions that remained unbalanced after matching, among statin users, statin exposure was associated with decreased odds of having asthma-related emergency department visits (odds ratio [OR], 0.64; 95% confidence interval [CI], 0.53–0.77; P statin users with asthma, statin exposure was associated with decreased odds of asthma-related emergency department visits and oral corticosteroid dispensings. PMID:24093599

  7. 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 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.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.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.

  8. A Health-Related Quality of Life Measure for Older Adolescents With Asthma: Child Health Survey for Asthma-T (Teen Version).

    Science.gov (United States)

    O'Laughlen, Mary C; Hollen, Patricia J; Rance, Karen; Rovnyak, Virginia; Hinton, Ivora; Hellems, Martha A; Radecki, Linda

    2015-01-01

    Although adolescent substance use can have direct effects on asthma symptoms and interact with medications used to treat asthma, no validated health-related quality of life (HRQL) instrument exists for adolescents 17 to 19 years of age with asthma. The American Academy of Pediatric's HRQL instrument, the Child Health Survey for Asthma (CHSA)-Child version, was modified with a substance use subscale to address outcomes specific to adolescents ages 17 to 19 years with asthma. Two cohorts (N = 70) were recruited for instrument testing at pediatric primary care practices and two university clinics. A small methodological study with 24 adolescents was conducted to obtain initial support of the psychometric properties for the CHSA-Teen version at baseline, day 14, and day 16. A follow-up study included 46 teens to provide further support. The psychometric properties of the CHSA-Teen version were good and comparable with the CHSA-Child version for feasibility, reliability, and validity. Health care providers need to be aware of each adolescent's substance use to personalize counseling related to asthma medications. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  9. Infant origins of childhood asthma associated with specific molds.

    Science.gov (United States)

    Reponen, Tiina; Lockey, James; Bernstein, David I; Vesper, Stephen J; Levin, Linda; Khurana Hershey, Gurjit K; Zheng, Shu; Ryan, Patrick; Grinshpun, Sergey A; Villareal, Manuel; Lemasters, Grace

    2012-09-01

    The specific cause or causes of asthma development must be identified to prevent this disease. Our hypothesis was that specific mold exposures are associated with childhood asthma development. Infants were identified from birth certificates. Dust samples were collected from 289 homes when the infants were 8 months of age. Samples were analyzed for concentrations of 36 molds that comprise the Environmental Relative Moldiness Index (ERMI) and endotoxin, house dust mite, cat, dog, and cockroach allergens. Children were evaluated at age 7 years for asthma based on reported symptoms and objective measures of lung function. Host, environmental exposure, and home characteristics evaluated included a history of parental asthma, race, sex, upper and lower respiratory tract symptoms, season of birth, family income, cigarette smoke exposure, air conditioning, use of a dehumidifier, presence of carpeting, age of home, and visible mold at age 1 year and child's positive skin prick test response to aeroallergens and molds at age 7 years. Asthma was diagnosed in 24% of the children at age 7 years. A statistically significant increase in asthma risk at age 7 years was associated with high ERMI values in the child's home in infancy (adjusted relative risk for a 10-unit increase in ERMI value, 1.8; 95% CI, 1.5-2.2). The summation of levels of 3 mold species, Aspergillus ochraceus, Aspergillus unguis, and Penicillium variabile, was significantly associated with asthma (adjusted relative risk, 2.2; 95% CI, 1.8-2.7). In this birth cohort study exposure during infancy to 3 mold species common to water-damaged buildings was associated with childhood asthma at age 7 years. Copyright © 2012 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  10. Prevalence of Asthma, Asthma Attacks, and Emergency Department Visits for Asthma Among Working Adults - National Health Interview Survey, 2011-2016.

    Science.gov (United States)

    Mazurek, Jacek M; Syamlal, Girija

    2018-04-06

    In 2010, an estimated 8.2% of U.S. adults had current asthma, and among these persons, 49.1% had had an asthma attack during the past year (1). Workplace exposures can cause asthma in a previously healthy worker or can trigger asthma exacerbations in workers with current asthma* (2). To assess the industry- and occupation-specific prevalence of current asthma, asthma attacks, and asthma-related emergency department (ED) visits among working adults, CDC analyzed 2011-2016 National Health Interview Survey (NHIS) data for participants aged ≥18 years who, at the time of the survey, were employed at some time during the 12 months preceding the interview. During 2011-2016, 6.8% of adults (11 million) employed at any time in the past 12 months had current asthma; among those, 44.7% experienced an asthma attack, and 9.9% had an asthma-related ED visit in the previous year. Current asthma prevalence was highest among workers in the health care and social assistance industry (8.8%) and in health care support occupations (8.8%). The increased prevalence of current asthma, asthma attacks, and asthma-related ED visits in certain industries and occupations might indicate increased risks for these health outcomes associated with workplace exposures. These findings might assist health care and public health professionals in identifying workers in industries and occupations with a high prevalence of current asthma, asthma attacks, and asthma-related ED visits who should be evaluated for possible work-related asthma. Guidelines intended to promote effective management of work-related asthma are available (2,3).

  11. Health-Related Quality of Life of Children with Asthma: Self and Parental Perceptions.

    Science.gov (United States)

    Kalyva, Efrosini; Eiser, Christine; Papathanasiou, Aikaterini

    2016-12-01

    This study aimed to explore whether age, gender, asthma severity, asthma duration, and exposure to parental smoking were associated with levels of asthma-specific health-related quality of life (HRQoL) among Greek children with asthma and to identify any differences between self- and proxy ratings of asthma-specific HRQoL. One hundred and seventy-three (173) children with asthma (8-12 years old) and their parents completed the Pediatric Quality of Life Asthma Module self- and proxy measures. Asthma severity, age, and asthma duration explained almost half of the variance in asthma-specific HRQoL scores according to self- and proxy reports. Older male children with more severe asthma who were diagnosed for a longer period of time and had at least one smoking parent reported lower asthma-specific HRQoL according to self- and proxy reports. Although children and their parents seemed to agree in their views of asthma-specific HRQoL, there were significant differences in ratings of specific parameters of asthma-specific HRQoL. This study identifies the factors that account for a significant variance in asthma-specific HRQoL scores according to self- and proxy reports and is among the first to record the effect of parental smoking on children's and parents' perceptions of asthma-specific HRQoL.

  12. Quality of life of patients with asthma related to damp and moldy work environments.

    Science.gov (United States)

    Karvala, Kirsi; Uitti, Jukka; Luukkonen, Ritva; Nordman, Henrik

    2013-01-01

    Long-term outcomes of asthma related to exposure to workplace dampness are not well known. The aim of this study was to evaluate the quality of life (QOL) of patients with asthma related to damp and moldy workplaces and characterize factors influencing QOL. Using a questionnaire, we followed 1267 patients previously examined for suspected occupational respiratory disease related to exposure to damp and moldy indoor environments. In addition to demographic and other background data, the questionnaire included sections on current employment status, QOL, anxiety and depression, somatization, hypochondria, and asthma medication. We compared the QOL of patients with occupational asthma (OA) with that of patients with work-exacerbated asthma (WEA) or symptoms without asthma. Impaired QOL was found among patients diagnosed with OA when they were compared with patients in corresponding environments with WEA or symptoms only. Not working and greater use of asthma medication were major determinants of worse QOL. Psychological factors did not explain the differences between the groups. OA induced by exposure to workplace moisture and molds is associated with QOL deterioration. The impairment is related to being unemployed (due to disability, retirement, job loss or other reasons) and the need for medication.

  13. Prenatal exposure to environmental chemical contaminants and asthma and eczema in school-age children

    DEFF Research Database (Denmark)

    Smit, Lidwien A M; Lenters, Virissa; Høyer, Birgit Bjerre

    2015-01-01

    BACKGROUND: Emerging evidence suggests that prenatal or early-life exposures to environmental contaminants may contribute to an increased risk of asthma and allergies in children. We aimed to the explore associations of prenatal exposures to a large set of environmental chemical contaminants...... asthma, eczema, and wheeze. We applied principal components analysis (PCA) to sixteen contaminants in maternal serum sampled during pregnancy, including perfluoroalkyl substances (PFASs), metabolites of diethylhexyl (DEHP) and diisononyl (DiNP) phthalates, PCB-153, and p,p'-DDE. Scores of five principal...... components (PCs) explaining 70% of the variance were included in multiple logistic regression models. RESULTS: In a meta-analysis that included both populations, the PC2 score, reflecting exposure to DiNP, was negatively associated with current eczema (OR 0.71, 95% CI 0.52-0.96). Other associations were...

  14. Identifying Individual, Cultural and Asthma-Related Risk and Protective Factors Associated With Resilient Asthma Outcomes in Urban Children and Families

    Science.gov (United States)

    McQuaid, Elizabeth L.; Jandasek, Barbara; Kopel, Sheryl J.; Seifer, Ronald; Klein, Robert B.; Potter, Christina; Fritz, Gregory K.

    2012-01-01

    Objective The goal of this study is to identify individual, family/cultural, and illness-related protective factors that may minimize asthma morbidity in the context of multiple urban risks in a sample of inner-city children and families. Methods Participating families are from African-American (33), Latino (51) and non-Latino white (47) backgrounds. A total of 131 children with asthma (56% male), ages 6–13 years and their primary caregivers were included. Results Analyses supported the relationship between cumulative risks and asthma morbidity across children of the sample. Protective processes functioned differently by ethnic group. For example, Latino families exhibited higher levels of family connectedness, and this was associated with lower levels of functional limitation due to asthma, in the context of risks. Conclusions This study demonstrates the utility of examining multilevel protective processes that may guard against urban risks factors to decrease morbidity. Intervention programs for families from specific ethnic groups can be tailored to consider individual, family-based/cultural and illness-related supports that decrease stress and enhance aspects of asthma treatment. PMID:22408053

  15. Active and passive smoking impacts on asthma with quantitative and temporal relations: A Korean Community Health Survey.

    Science.gov (United States)

    Kim, So Young; Sim, Songyong; Choi, Hyo Geun

    2018-06-05

    This study aimed to evaluate the relations of smoking with asthma and asthma-related symptoms, considering quantitative and temporal influences. The 820,710 Korean adults in the Korean Community Health Survey in 2009, 2010, 2011, and 2013 were included and classified as non-smoker, past smoker or current smoker. Total smoking years, total pack-years, and age at smoking onset were assessed. Information on wheezing, exercise wheezing, and aggravation of asthma in the past 12 months and asthma diagnosis history and current treatment was collected. Multiple logistic regression analysis with complex sampling was used. Current and former smokers showed significant positive relations with wheezing, exercise wheezing, asthma ever, current asthma, and asthma aggravation. Current smokers demonstrated higher adjusted odd ratios (AORs) for wheezing, exercise wheezing, and asthma aggravation than former smokers. Former smokers showed higher AORs than current smokers for current asthma treatment. Longer passive smoking was related to wheezing and exercise wheezing. Greater age at smoking onset and duration since cessation were negatively related to wheezing, exercise wheezing, and current asthma; total pack-years demonstrated proportional associations with these symptoms. Former, current, and passive smoking was positively correlated with wheezing and exercise wheezing. Total pack-years and early initiation were increasingly related to asthma.

  16. Age-related prevalence of chronic rhinosinusitis and nasal polyps and their relationships with asthma onset.

    Science.gov (United States)

    Won, Ha-Kyeong; Kim, Young-Chan; Kang, Min-Gyu; Park, Han-Ki; Lee, Seung-Eun; Kim, Min-Hye; Yang, Min-Suk; Chang, Yoon-Seok; Cho, Sang-Heon; Song, Woo-Jung

    2018-04-01

    Chronic rhinosinusitis (CRS) is a major disease condition with high morbidity and can influence lower airway disease status in adults. However, its associations with adult asthma onset and activity have not been examined in detail in a general adult population. To investigate relationships between CRS with nasal polyps (CRSwNP) and asthma characteristics. A cross-sectional data set of 17,506 adult participants (≥18 years old) in the Korean National Health and Nutrition Examination Survey from 2010 through 2012 was analyzed. CRS was defined using structured questionnaires according to the international guideline, and presence of nasal polyps was objectively assessed using nasal endoscopy. Presence of asthma and its onset and current activity were assessed using structured questionnaires. CRS was significantly related to asthma, but the relationships were distinct by CRS and asthma status. CRSwNP was significantly associated with adult-onset asthma (onset after 18 years of age) or late-onset asthma (onset after 40 years of age), whereas CRS without nasal polyps was related to childhood-onset asthma (onset before 18 years) or early-onset asthma (onset before 40 years) in adults. The 2 CRS subgroups showed significant associations with current asthma but not with past asthma. However, the comorbid asthma rate was lower than 10% among subjects with CRS. This study found distinct age-related patterns of CRSwNP and asthma and demonstrated their significant associations in a general population. However, the low prevalence of asthma in CRSwNP is in sharp contrast to findings in Western populations, which warrants further investigation for ethnic or regional differences in relationships between CRSwNP and asthma. Copyright © 2018 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  17. The association between phthalate exposure and asthma

    Directory of Open Access Journals (Sweden)

    Ming-Ju Tsai

    2012-07-01

    Full Text Available Asthma is a chronic inflammatory disorder of the airway, characterized by airway hyperresponsiveness. It is a disabling disease with an increasing prevalence, resulting in heavy social and economic burdens worldwide. Humans are extensively exposed to phthalates, and many epidemiological studies have shown a relationship between phthalate exposure and asthma in recent decades. Earlier experimental studies focused on inflammatory cells, demonstrating the adjuvant effects, immunomodulatory effects, or immunosuppressive effects related to phthalate exposure. Recent studies have shown that phthalates may have a direct effect on airway epithelial cells and contribute to airway remodeling, which is the cardinal pathologic characteristic of chronic asthma, with a high correlation with disease severity. Through these efforts, phthalates have been recognized as important environmental factors in the pathogenesis of asthma, but further studies are still required to elucidate the detailed mechanism. This review discusses the current status of human exposure to phthalates in Taiwan and summarizes the epidemiological and experimental evidence related to the roles of phthalate exposure in the development of asthma and associated diseases.

  18. Work-related asthma

    African Journals Online (AJOL)

    occupational exposure is 16% and for work-exacerbated asthma around 10%.3,4 ... Mohamed Jeebhay is a Professor of Occupational Medicine at the University of Cape Town. He convenes .... (obtain material safety data sheets. (MSDs) for ...

  19. Mechanistic Indicators of Childhood Asthma (MICA): piloting an integrative design for evaluating environmental health

    Science.gov (United States)

    Background: Modem methods in molecular biology and advanced computational tools show promise in elucidating complex interactions that occur between genes and environmental factors in diseases such as asthma; however appropriately designed studies are critical for these methods to...

  20. Asthma prevalence and risk factors in early childhood at Northern Portugal

    Directory of Open Access Journals (Sweden)

    P.T.B.S. Branco

    2016-05-01

    Full Text Available Asthma is the commonest and most important chronic non-infectious disease in childhood and it has become more prevalent in recent years. There is a shortage of studies in relation to early childhood and so, as part of the INAIRCHILD project, this cross-sectional study aimed to assess the prevalence of asthma and its associated risk factors, namely demographic, environmental, psychosocial and clinical factors for infants and preschoolers living in Northern Portugal. Data concerning asthma prevalence were collected through questionnaires based on those from the International Study of Asthma and Allergies in Childhood (ISAAC-derived, the questionnaires were distributed to 1042 children attending the 17 nurseries involved in the INAIRCHILD project (10 in urban and suburban context, and 7 in rural context. The response rate was 48%. Prevalence of asthma based on symptomatology and odds ratio was calculated. Around 52% of the studied children presented at least one of the respiratory symptoms investigated (wheeze, dyspnea and cough in the absence of upper respiratory infections. The prevalence of asthma was 10.7%, comparable to the figures for Portuguese schoolchildren (6–7 years old reported by the national Directorate-General of Health, thus showing that an early diagnosis might be possible and helpful for the mitigation of childhood asthma. Environmental context (urban, suburban or rural, gender and family asthma history showed clear associations with asthma prevalence, namely non-rural location, male gender, and having an asthmatic parent were found to be risk factors. Keywords: Asthma, Children, Demographic, Environmental, Psychosocial and clinical risk factors

  1. The relation between paracetamol use and asthma

    DEFF Research Database (Denmark)

    Shaheen, S; Potts, J; Gnatiuc, L

    2008-01-01

    Studies from the UK and the USA suggest that frequent use of paracetamol (acetaminophen) may increase the risk of asthma, but data across Europe are lacking.As part of a multi-centre case-control study organised by the GA(2)LEN network we have examined whether frequent paracetamol use is associated...... with adult asthma across Europe. The network compared 521 cases with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 507 controls with no diagnosis of asthma and no asthmatic symptoms in the last 12 months across 12 European centres. All cases and controls were selected from...... the same population defined by age (20-45 years) and place of residence.In a random effects meta-analysis, after controlling for confounders, the adjusted odds ratio for asthma associated with weekly use of paracetamol, compared with less frequent use, was 2.87 (95% CI: 1.49 to 5.37), P=0...

  2. Lipoxin Generation Is Related to Soluble Epoxide Hydrolase Activity in Severe Asthma

    Science.gov (United States)

    Ono, Emiko; Dutile, Stefanie; Kazani, Shamsah; Wechsler, Michael E.; Yang, Jun; Hammock, Bruce D.; Douda, David Nobuhiro; Tabet, Yacine; Khaddaj-Mallat, Rayan; Sirois, Marco; Sirois, Chantal; Rizcallah, Edmond; Rousseau, Éric; Martin, Richard; Sutherland, E. Rand; Castro, Mario; N. Jarjour, Nizar; Israel, Elliot

    2014-01-01

    Rationale: Severe asthma is characterized by airway inflammatory responses associated with aberrant metabolism of arachidonic acid. Lipoxins (LX) are arachidonate-derived pro-resolving mediators that are decreased in severe asthma, yet mechanisms for defective LX biosynthesis and a means to increase LXs in severe asthma remain to be established. Objectives: To determine if oxidative stress and soluble epoxide hydrolase (sEH) activity are linked to decreased LX biosynthesis in severe asthma. Methods: Aliquots of blood, sputum, and bronchoalveolar lavage fluid were obtained from asthma subjects for mediator determination. Select samples were exposed to t-butyl-hydroperoxide or sEH inhibitor (sEHI) before activation. Peripheral blood leukocyte–platelet aggregates were monitored by flow cytometry, and bronchial contraction was determined with cytokine-treated human lung sections. Measurements and Main Results: 8-Isoprostane levels in sputum supernatants were inversely related to LXA4 in severe asthma (r = −0.55; P = 0.03) and t-butyl-hydroperoxide decreased LXA4 and 15-epi-LXA4 biosynthesis by peripheral blood leukocytes. LXA4 and 15-epi-LXA4 levels were inversely related to sEH activity in sputum supernatants and sEHIs significantly increased 14,15-epoxy-eicosatrienoic acid and 15-epi-LXA4 generation by severe asthma whole blood and bronchoalveolar lavage fluid cells. The abundance of peripheral blood leukocyte–platelet aggregates was related to asthma severity. In a concentration-dependent manner, LXs significantly inhibited platelet-activating factor–induced increases in leukocyte–platelet aggregates (70.8% inhibition [LXA4 100 nM], 78.3% inhibition [15-epi-LXA4 100 nM]) and 15-epi-LXA4 markedly inhibited tumor necrosis factor-α–induced increases in bronchial contraction. Conclusions: LX levels were decreased by oxidative stress and sEH activity. Inhibitors of sEH increased LXs that mediated antiphlogistic actions, suggesting a new therapeutic approach

  3. The international school nurse asthma project: barriers related to asthma management in schools.

    Science.gov (United States)

    Svavarsdottir, Erla Kolbrun; Garwick, Ann W; Anderson, Lori S; Looman, Wendy S; Seppelt, Ann; Orlygsdottir, Brynja

    2013-05-01

    This article is a report of an international study of barriers to asthma care from the perspectives of school nurses in Reykjavik, Iceland and St. Paul, Minnesota, in the context of their schools, communities and countries. Globally, asthma affects the health and school performance of many adolescents. School nurses play a key role by providing care to adolescents with asthma in school settings. Understanding universal barriers to asthma management in schools is important for developing interventions that are effective in multiple societal contexts. Exploratory, descriptive study. Parallel studies were conducted from September 2008-January 2009, through six focus groups among school nurses (n = 32, in Reykjavik n = 17 and St. Paul n = 15) who were managing asthma in adolescents. Focus groups were audio-recorded and transcribed verbatim in English or Icelandic. The Icelandic transcripts were translated into English. Descriptive content analytic techniques were used to systematically identify and categorize types of barriers to asthma care. School nurses in both countries identified common barriers, such as time constraints, communication challenges and school staff barriers. The primary difference was that St. Paul school nurses identified more socio-economic and health access barriers than school nurses in Reykjavik. Greater cultural and linguistic diversity and socio-economic differences in the student population in St. Paul and lack of universal healthcare coverage in the US contributed to school nurses' need to focus more on asthma management than school nurses in Reykjavik, who were able to focus more on asthma prevention and education. © 2012 Blackwell Publishing Ltd.

  4. Prevalence of asthma symptoms among adults aged 20-44 years in Canada

    DEFF Research Database (Denmark)

    Manfreda, J; Becklake, M R; Sears, M R

    2001-01-01

    Reported prevalence rates of asthma vary within and between countries around the world. These differences suggest environmental factors in addition to genetic factors in the cause of the disease and may provide clues for preventive strategies. We examined the variability of asthma-related symptom...

  5. Does health-related quality of life in asthma patients correlate with ...

    African Journals Online (AJOL)

    Background: Assessment of health-related quality of life (HRQOL) has been shown to be more relevant to patients who have chronic diseases such as asthma, as achieving the best possible quality of life is the paramount objective in the management of such patients. This study assessed the quality of life of asthma patients ...

  6. The role of trait mindfulness in quality of life and asthma control among adolescents with asthma.

    Science.gov (United States)

    Cillessen, Linda; van de Ven, Monique O; Karremans, Johan C

    2017-08-01

    The current study focused on the role of trait mindfulness in asthma-related quality of life (QoL) and asthma control in adolescent asthma patients. Furthermore, potential underlying mechanisms (general and asthma-specific stress) of this relationship were investigated. In this cross-sectional study, questionnaire data of 94 adolescents with asthma that were prescribed daily asthma medication were included. Two Structural Equation Models (SEMs), a direct model and an indirect model, were tested. We found that trait mindfulness was directly related to asthma-related QoL, but not to asthma control. The relationship between trait mindfulness and asthma-related QoL was explained by asthma-specific, but not by general stress. Furthermore, an indirect relation from mindfulness to asthma control via asthma-specific stress was found. Cross-sectional evidence for a relation between mindfulness and asthma-related QoL is found. These findings may point to the possibility that an intervention aimed at increasing mindfulness could be a promising tool to improve asthma-related QoL in adolescents via a decrease in asthma-specific stress. Copyright © 2017. Published by Elsevier Inc.

  7. Two cases of Schizophyllum asthma: is this a new clinical entity or a precursor of ABPM?

    Science.gov (United States)

    Ogawa, Haruhiko; Fujimura, Masaki; Takeuchi, Yasuo; Makimura, Koichi

    2011-10-01

    There is a close link between fungal sensitization and asthma severity. Although Schizophyllum commune (S. commune, "suehirotake" in Japanese), one of the basidiomycetous (BM) fungi, is a fungus that can cause allergic bronchopulmonary mycosis (ABPM) and allergic fungal sinusitis (AFS), whether the fungus causes or sensitizes subjects to asthma is unclear. The bronchial provocation test using S. commune antigen was performed in two asthmatics who had demonstrated positive skin reactions to the S. commune antigen, and low dose of itraconazole (50 mg/day) was prescribed as an adjunctive therapy for 2 weeks. The allergological features and clinical manifestations of these patients are herein evaluated and discussed. Case 1 was a 71-year-old female, and case 2 was a 69-year-old male. Both patients demonstrated positive reactions to the inhalation test. A diagnosis of AFS or ABPM was excluded in both patients because of the lack of a history of pulmonary infiltrates, central bronchiectasis, a history of expectoration of brown plugs or flecks, or sinusoidal findings. Although the efficacy of itraconazole in our cases was unclear, the elevated titer of the specific IgG-for S. commune in case 2 gradually decreased during the period of antifungal therapy. The two patients described herein were diagnosed to have bronchial asthma caused by S. commune; so-called Schizophyllum asthma. S. commune may also be a causative fungal antigen of bronchial asthma. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Managing problematic severe asthma: beyond the guidelines.

    Science.gov (United States)

    Pike, Katharine C; Levy, Mark L; Moreiras, John; Fleming, Louise

    2018-04-01

    This review discusses issues related to managing problematic severe asthma in children and young people. A small minority of children have genuinely severe asthma symptoms which are difficult to control. Children with genuinely severe asthma need investigations and treatments beyond those described within conventional guidelines. However, the majority of children with poor symptom control despite high-intensity treatment achieve improvement in their asthma control once attention has been paid to the basics of asthma management. Basic asthma management requires optimisation of inhaler technique and treatment adherence, avoidance of environmental triggers and self-management education. It is also important that clinicians recognise risk factors that predispose patients to asthma exacerbations and potentially life-threatening attacks. These correctable issues need to be tackled in partnership with children and young people and their families. This requires a coordinated approach between professionals across healthcare settings. Establishing appropriate infrastructure for coordinated asthma care benefits not only those with problematic severe asthma, but also the wider asthma population as similar correctable issues exist for children with asthma of all severities. Investigation and management of genuine severe asthma requires specialist multidisciplinary expertise and a systematic approach to characterising patients' asthma phenotypes and delivering individualised care. While inhaled corticosteroids continue to play a leading role in asthma therapy, new treatments on the horizon might further support phenotype-specific therapy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Comprehensive genetic assessment of a functional TLR9 promoter polymorphism: no replicable association with asthma or asthma-related phenotypes

    Directory of Open Access Journals (Sweden)

    Celedón Juan C

    2011-02-01

    Full Text Available Abstract Background Prior studies suggest a role for a variant (rs5743836 in the promoter of toll-like receptor 9 (TLR9 in asthma and other inflammatory diseases. We performed detailed genetic association studies of the functional variant rs5743836 with asthma susceptibility and asthma-related phenotypes in three independent cohorts. Methods rs5743836 was genotyped in two family-based cohorts of children with asthma and a case-control study of adult asthmatics. Association analyses were performed using chi square, family-based and population-based testing. A luciferase assay was performed to investigate whether rs5743836 genotype influences TLR9 promoter activity. Results Contrary to prior reports, rs5743836 was not associated with asthma in any of the three cohorts. Marginally significant associations were found with FEV1 and FVC (p = 0.003 and p = 0.008, respectively in one of the family-based cohorts, but these associations were not significant after correcting for multiple comparisons. Higher promoter activity of the CC genotype was demonstrated by luciferase assay, confirming the functional importance of this variant. Conclusion Although rs5743836 confers regulatory effects on TLR9 transcription, this variant does not appear to be an important asthma-susceptibility locus.

  10. Meteorological factors, aeroallergens and asthma-related visits inKuwait: a 12-month retrospective study

    International Nuclear Information System (INIS)

    Qasem, Jafar A.; Al-Sherfyee, A.; Al-Mathkouri, Samirah A.; Nasrallah, H.; Al-Khalaf, Bader N.; Al-Sharifi, F.; Al-Saraf, H.

    2008-01-01

    The increasing prevalence of asthma in many countries has been related toweather factors and aerllergen concentrations, but this has not been studiedin Kuwait. We evaluated the effect of meteorological factors and theoccurrence of aerobiologicals on the number of asthma cases in Kuwait. Thenumber of daily asthma visits to the allergy center and emergency departmentat Al-Sabha Hospital for 1 year were examined on a monthly basis forcorrelation with major meteorological factors (temperature, relativehumidity, rain, wind speed and direction). Spore and pollen counts werecollected hourly. A total of 4353 patients received asthma treatment duringthe year. The highest pollen count was in the month of September with amaximum relative humidity of 47% and no precipitation, but with a high meantemperature of 39.7C. Pollen counts were higher in the late summer(September) and occurred with a high patient visit to the allergy center.Fungal spore counts were significantly higher in early winter (December). Thehigh fungal spore count seemed related to with high relative humidity andhigh precipitation with a low mean average temperature of 19.7C. The increasenumber of patients with bronchial asthma visiting an emergency clinic duringDecember was significantly associated with high aerial counts for fungalspores (P<0.3) and the months of September and October were more significantfor pollen. This study indicates that meteorological factors, aeroallergenconcentrations and asthma-related visits were interrelated. The results mayprove useful in the generation of hypotheses and development of designs formore comprehensive, individual-based epidemiological studies. (author)

  11. Xerostomia relates to the degree of asthma control.

    Science.gov (United States)

    Alcázar Navarrete, Bernardino; Gómez-Moreno, Gerardo; Aguilar-Salvatierra, Antonio; Guardia, Javier; Romero Palacios, Pedro José

    2015-04-01

    Few studies have assessed the relationships between xerostomia and the use of inhaled corticosteroids (ICS). The main objective of this study was to investigate the prevalence of xerostomia in a respiratory outpatient clinic and its relationship with bronchial asthma and ICS use. A cross-sectional observational study of patients recruited in an outpatient setting divided them according to previous diagnoses of bronchial asthma. Data about pulmonary function, concomitant medication, medical comorbidities, Xerostomia Inventory test (XI test), and the degree of asthma control by ACT (asthma control test) were collected for each patient. A linear regression model was applied, using the XI score as dependent variable and the ACT score as independent variable. The 57 patients were divided into asthmatics (40 patients, 70.2%) and control group without asthma (17, 29.8%). The prevalence of xerostomia was 87.7% (50 patients), with no differences between the study groups or current dose of ICS. In the asthmatic group, patients with uncontrolled asthma had worse XI scores than those with partially or totally controlled asthma (30.43 ± 8.71 vs. 24.92 ± 8.08; P Xerostomia is a common symptom in the ambulatory setting. There is a moderate relationship between the degree of asthma control and the severity of xerostomia. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. [Biochemical basis of tolerance to osmotic stress in phytopathogenic fungus: The case of Macrophomina phaseolina (Tassi) Goid.

    Science.gov (United States)

    Martínez-Villarreal, Rodolfo; Garza-Romero, Tamar S; Moreno-Medina, Víctor R; Hernández-Delgado, Sanjuana; Mayek-Pérez, Netzahualcoyotl

    Fungus Macrophomina phaseolina (Tassi) Goid. is the causative agent of charcoal rot disease which causes significant yield losses in major crops such as maize, sorghum, soybean and common beans in Mexico. This fungus is a facultative parasite which shows broad ability to adapt itself to stressed environments where water deficits and/or high temperature stresses commonly occur. These environmental conditions are common for most cultivable lands throughout Mexico. Here we describe some basic facts related to the etiology and epidemiology of the fungus as well as to the importance of responses to stressed environments, particularly to water deficits, based on morphology and growth traits, as well as on physiology, biochemistry and pathogenicity of fungus M. phaseolina. To conclude, we show some perspectives related to future research into the genus, which emphasize the increasing need to improve the knowledge based on the application of both traditional and biotechnological tools in order to elucidate the mechanisms of resistance to environmental stress which can be extrapolated to other useful organisms to man. Copyright © 2016 Asociación Argentina de Microbiología. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Meteorological factors, aeroallergens and asthma-related visits in Kuwait : A 12-month retrospective study

    International Nuclear Information System (INIS)

    Jafar A Qasem

    2010-01-01

    The increasing prevalence of asthma in many countries has been related to weather factors and aeroallergen concentrations , but this has not been studied in Kuwait. We evaluated the effect of meteorological factors and the occurrence of aerobiologicals on the number of asthma cases in Kuwait.The number of daily asthma visits to the allergy center and emergency department at Al-Sabha Hospital for 1 year were examined on a monthly basis for correlation with major metereological factors (temperature , relative humidity , rain , wind speed and direction). Spore and pollen counts were collected hourly. Results: A total of 4353 patients received asthma treatment during the year. The highest pollen count was in the month of September with a maximum relative humidity of 47% and no precipitation , but with a high mean temperature of 39.7 0 C. . Pollen counts were higher in the late summer (September) and occurred with a high patient visit to the allergy center. Fungal spore counts were significantly higher in early winter (December). The high fungal spore count seemed related to with high relative humidity and high precipitation with a low mean average temperature of 19.7 0 C. The increase number of patients with bronchial asthma visiting an emergency clinic during December was significantly associated with high aerial counts for fungal spores (P<.03) , and the months of September and October were more significant for pollen.This study indicates that meteorological factors , aeroallergen concentrations and asthma related visits are interrelated. The results may prove useful in the generation of hypotheses and development of designs for more comprehensive , individual-based epidemiological studies (Author).

  14. A case-control study of the relation between plasma selenium and asthma in European populations

    DEFF Research Database (Denmark)

    Burney, P; Potts, J; Makowska, J

    2008-01-01

    BACKGROUND: There is evidence that selenium levels are relatively low in Europe and may be falling. Low levels of selenium or low activity of some of the enzymes dependent on selenium have been associated with asthma. METHODS: The GA(2)LEN network has organized a multicentre case-control study...... in Europe to assess the relation of plasma selenium to asthma. The network compared 569 cases in 14 European centres with a diagnosis of asthma and reporting asthma symptoms in the last 12 months with 576 controls from the same centres with no diagnosis of asthma and no asthmatic symptoms in the last 12......-analysis of the results from the centres showed no overall association between asthma and plasma selenium [odds ratio (OR)/10 microg/l increase in plasma selenium: 1.04; 95% confidence interval (CI): 0.89-1.21] though there was a significantly protective effect in Lodz (OR: 0.48; 95% CI: 0.29-0.78) and a marginally...

  15. Mitochondrial Dysfunction and Oxidative Stress in Asthma: Implications for Mitochondria-Targeted Antioxidant Therapeutics

    Directory of Open Access Journals (Sweden)

    P. Hemachandra Reddy

    2011-02-01

    Full Text Available Asthma is a complex, inflammatory disorder characterized by airflow obstruction of variable degrees, bronchial hyper-responsiveness, and airway inflammation. Asthma is caused by environmental factors and a combination of genetic and environmental stimuli. Genetic studies have revealed that multiple loci are involved in the etiology of asthma. Recent cellular, molecular, and animal-model studies have revealed several cellular events that are involved in the progression of asthma, including: increased Th2 cytokines leading to the recruitment of inflammatory cells to the airway, and an increase in the production of reactive oxygen species and mitochondrial dysfunction in the activated inflammatory cells, leading to tissue injury in the bronchial epithelium. Further, aging and animal model studies have revealed that mitochondrial dysfunction and oxidative stress are involved and play a large role in asthma. Recent studies using experimental allergic asthmatic mouse models and peripheral cells and tissues from asthmatic humans have revealed antioxidants as promising treatments for people with asthma. This article summarizes the latest research findings on the involvement of inflammatory changes, and mitochondrial dysfunction/oxidative stress in the development and progression of asthma. This article also addresses the relationship between aging and age-related immunity in triggering asthma, the antioxidant therapeutic strategies in treating people with asthma.

  16. Epigenetics of human asthma and allergy: promises to keep.

    Science.gov (United States)

    Devries, Avery; Vercelli, Donata

    2013-09-01

    The interest in asthma epigenetics is high because epigenetic mechanisms likely contribute to the environmental origins of the disease and its phenotypic variability. This review presents the main findings of asthma epigenetics and the challenges that still delay progress. We examined the current literature on asthma epigenetics (31 reviews and 25 original data publications). We focused on DNA methylation studies in populations. Both genome-wide and candidate gene studies have explored DNA methylation in allergic disease. Genome-wide studies ask whether and which regions of the genome are differentially methylated in relation to the phenotype of interest. Identification of such regions provides clues about the identity of the genes, pathways and networks underpinning a phenotype and connects these networks to the phenotype through epigenetic mechanisms. Candidate gene studies examine DNA methylation in genes chosen because of their known or hypothesized role in immunity, responses to environmental stimuli or disease pathogenesis. Most existing studies in asthma and allergy focused on candidate genes involved in the response to environmental pollutants. Asthma epigenetics is still in its infancy. The paucity of primary literature originates from methodological and analytical challenges of genome-wide studies, the difficulties in interpreting small differences in DNA methylation, and the need to develop robust bioinformatic tools for pathway, network and system analyses of epigenetic data. Once these challenges have been overcome, epigenetic studies will likely provide important insights about the inception and pathogenesis of allergic disease and will help define disease endotypes.

  17. Asthma Medications and Pregnancy

    Science.gov (United States)

    ... Asthma Associated Conditions Asthma & Pregnancy Asthma & Pregnancy: Medications Asthma & Pregnancy: Medications Make an Appointment Refer a Patient ... make sure you are using it correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) ...

  18. 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

    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...... system (AirGIS). The project applied the following methodology. A non-smoking cohort with recently acquired asthma or wheeze as well as matched controls were 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). 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...

  19. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

    Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients with ast......Cigarette smoking is a well-known health hazard, probably not least for patients suffering from asthma. This review gives a short overview of the effects of passive and active smoking on the inception and outcome with of longitudinal changes in the lung function and mortality of patients...... with asthma. Substantial evidence suggests that smoking affects asthma adversely. Exposure to environmental tobacco smoke, especially maternal smoking in children, may be a significant risk factor for asthma. Such exposure in patients with established asthma is not only associated with more severe symptoms......, but also with a poorer quality of life, reduced lung function, and increased utilisation of health care including hospital admissions. Active smoking does not appear to be a significant risk factor for asthma, but is associated with a worse outcome with regard to both longitudinal changes in lung function...

  20. Association between environmental factors and current asthma, rhinoconjunctivitis and eczema symptoms in school-aged children from Oropeza Province--Bolivia: a cross-sectional study.

    Science.gov (United States)

    Solis-Soto, María Teresa; Patiño, Armando; Nowak, Dennis; Radon, Katja

    2013-11-05

    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. A cross-sectional study was performed in 2340 children attending the fifth grade in 36 randomly selected elementary schools in Oropeza province. The prevalence of symptoms was determined using the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Environmental factors were assessed by the ISAAC environmental questionnaire including questions related to exposure to pets, farm animals, indoor and outdoor pollution, presence of disease vectors at home and precarious household conditions. Generalized linear mixed-effects models were adjusted for age, sex and place of living. Thirty seven percent of children reported that at least one of their parents smoked at home. Wood or coal was used as cooking fuel in 19% of the homes and 29% reported intense truck traffic on the street where they lived. With respect to hygiene conditions, 86% reported exposure to dogs, 59% exposure to cats and 36% regular contact to farm animals. More than one precarious household condition was reported by 8% of children. In the adjusted model exposure to dog (adjusted OR 1.4; CI 95% 1.0-1.9), cat (1.2; 1.0-1.5), farm animals (1.5; 1.2-1.8); intense truck traffic (1.3; 1.0-1.6), parents smoking at home (1.2; 1.0-1.5), presence of disease vectors at home (fourth quartile vs. first quartile: 1.6; 1.2-2.3) and two or more precarious household conditions (1.5; 1.0-2.2) were significantly associated with rhinoconjunctivitis symptoms. The associations were similar for asthma and eczema symptoms; however it did not reach the level of statistical

  1. Sub-optimal patient and physician communication in primary care consultations: its relation to severe and difficult asthma

    NARCIS (Netherlands)

    Moffat, M.; Cleland, J.; Van der Molen, T.; Price, D.

    2006-01-01

    Introduction: Asthma control can be influenced by a range of non-medical issues, including psychosocial factors. Little is known about the views of patients, particularly those with severe and/or difficult asthma, towards their asthma control and their asthma-related primary care consultations. Aims

  2. Effect of nutrition and environmental factors on the endoparasitic fungus Esteya vermicola, a biocontrol agent against pine wilt disease.

    Science.gov (United States)

    Xue, Jianjie; Zhang, Yongan; Wang, Chunyan; Wang, Yuzhu; Hou, Jingang; Wang, Zhen; Wang, Yunbo; Gu, Lijuan; Sung, Changkeun

    2013-09-01

    The nematophagous fungus Esteya vermicola has tremendous potential for biological control. This species exhibits strong infectious activity against pinewood nematodes, whereas the study on the effect of nutrition and environmental factors is still of paucity. Carbon (C), nitrogen (N), pH value, temperature, and water activity have great impact on the fungal growth, sporulation, and germination. In nutrition study, the greatest number of conidia (2.36 × 10(9) per colony) was obtained at the C:N ratio of 100:1 with a carbon concentration 32 g l(-1). In addition, the germination rate and radial growth of E. vermicola were used to evaluate the effects of environmental conditions and they were optimized as following: pH 5.5, 26 °C and water activity of 0.98. Our results also confirmed that variation of environmental factors has a detrimental influence on the efficacy of active conidia and growth of fungus. Moreover, under above optimal condition, the biocontrol efficacy was significantly improved in regard to the increase of adhesive and mortality rate, which highlight the study on the application of E. vermicola as pine wilt disease biocontrol agent.

  3. [Epigenetics in allergic diseases and asthma].

    Science.gov (United States)

    Castro-Rodríguez, José A; Krause, Bernardo J; Uauy, Ricardo; Casanello, Paola

    2016-01-01

    Allergic diseases and asthma are the result of complex interactions between genetic predisposition and environmental factors. Asthma is one of the most prevalent chronic disease among children. In this article we review some environmental factors like: allergen exposition, tobacco, bacteria, microbial components, diet, obesity and stress, which influences during intrauterine and infancy life in the epigenetic regulation of asthma and allergic diseases. The review has been done in three models: in-vitro, animal and human. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Regional variations in risk factors for asthma in school children.

    Science.gov (United States)

    Lawson, Joshua A; Rennie, Donna C; Senthilselvan, Ambikaipakan; Cockcroft, Donald W; McDuffie, Helen H

    2005-09-01

    The authors have previously reported an increased prevalence of asthma in Estevan, Saskatchewan (21.4%) compared with Swift Current, Saskatchewan (16.2%). To determine the association between asthma and personal and indoor environmental risk factors in these communities. A population-based cross-sectional study was conducted in January 2000. A questionnaire was distributed to school children in grades 1 to 6 for completion by a parent. Multivariate logistic regression was used to examine associations between various risk factors and physician-diagnosed asthma. Asthma was associated with respiratory allergy (adjusted OR [adjOR]=8.85, 95% CI 6.79 to 11.54), early respiratory illness (adjOR=2.81, 95% CI 1.96 to 4.03) and family history of asthma (adjOR=2.37, 95% CI 1.67 to 3.36). Several environmental factors varied with asthma by town. In Estevan, asthma was associated with home mould or dampness (adjOR=1.82, 95% CI 1.23 to 2.69) and was inversely associated with air conditioning (adjOR=0.56, 95% CI 0.37 to 0.85). The risk of asthma was increased if the child had previous exposure to environmental tobacco smoke from the mother in both communities (Swift Current: OR=1.87, 95% CI 1.06 to 3.30; Estevan: OR=2.00, 95% CI 1.17 to 3.43), and there was an inverse association with current exposure to environmental tobacco smoke from the mother in Estevan (OR=0.64, 95% CI 0.40 to 1.00). When multivariate analyses were stratified by sex, the relationship between home mould or dampness and asthma was most prominent in girls in Estevan. Despite a similar regional location, different risk factors for asthma were identified in each community. Local environmental factors are important to consider when interpreting findings and planning asthma care.

  5. Shiitake mushroom (Lentinus edodes: A poorly known allergen in Western countries responsible for severe work-related asthma

    Directory of Open Access Journals (Sweden)

    Valerio Pravettoni

    2014-10-01

    Full Text Available Objectives: The aim of this study was to investigate the IgE-mediated pathogenesis of severe asthma presented by a patient only after handling shiitake (Lentinus edodes mushrooms (SM. Material and Methods: Skin tests were performed using in-house extracts from mushrooms that the patient usually handled, i.e., shiitake, porcini, oyster and black fungus mushroom varieties. Specific IgE to champignons and various molds were determined. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE immunoblotting was performed to detect IgE-binding components. Four negative controls were included in the study. Results: Skin prick tests performed with in-house mushroom extracts from varieties other than shiitake were completely negative, in contrast to the positive test obtained for shiitake mushrooms. Serum specific IgE levels for common molds and champignons were all negative. SDS-PAGE revealed many protein bands in the four mushroom extracts. Immunoblotting using the patient’s serum showed allergenic bands at about 15 and 24 kDa exclusively for SM that were not shared with negative controls. Another faint band was detectable at approximately 37 kDa for SM and porcini varieties. Conclusions: Here, we present the first European case of SM-induced occupational asthma, a disease more frequently occurring in Asia. Asthma attacks stopped when the patient avoided contact with shiitake mushrooms. No skin reactions and no IgE-binding proteins by immunoblotting were detectable with the other mushrooms tested. The positive skin test with shiitake mushrooms and IgE-binding components in the shiitake extract confirmed the IgE-mediated etiology of the reaction.

  6. Comprehensive Neighborhood Portraits and Child Asthma Disparities.

    Science.gov (United States)

    Kranjac, Ashley W; Kimbro, Rachel T; Denney, Justin T; Osiecki, Kristin M; Moffett, Brady S; Lopez, Keila N

    2017-07-01

    Objectives Previous research has established links between child, family, and neighborhood disadvantages and child asthma. We add to this literature by first characterizing neighborhoods in Houston, TX by demographic, economic, and air quality characteristics to establish differences in pediatric asthma diagnoses across neighborhoods. Second, we identify the relative risk of social, economic, and environmental risk factors for child asthma diagnoses. Methods We geocoded and linked electronic pediatric medical records to neighborhood-level social and economic indicators. Using latent profile modeling techniques, we identified Advantaged, Middle-class, and Disadvantaged neighborhoods. We then used a modified version of the Blinder-Oaxaca regression decomposition method to examine differences in asthma diagnoses across children in these different neighborhoods. Results Both compositional (the characteristics of the children and the ambient air quality in the neighborhood) and associational (the relationship between child and air quality characteristics and asthma) differences within the distinctive neighborhood contexts influence asthma outcomes. For example, unequal exposure to PM 2.5 and O 3 among children in Disadvantaged and Middle-class neighborhoods contribute to asthma diagnosis disparities within these contexts. For children in Disadvantaged and Advantaged neighborhoods, associational differences between racial/ethnic and socioeconomic characteristics and asthma diagnoses explain a significant proportion of the gap. Conclusions for Practice Our results provide evidence that differential exposure to pollution and protective factors associated with non-Hispanic White children and children from affluent families contribute to asthma disparities between neighborhoods. Future researchers should consider social and racial inequalities as more proximate drivers, not merely as associated, with asthma disparities in children.

  7. Johns Hopkins Center for Childhood Asthma in the Urban Environment

    Data.gov (United States)

    Federal Laboratory Consortium — The long term goals of the Center for Childhood Asthma in the Urban Environment are to examine how exposures to environmental pollutants and allergens may relate to...

  8. Childhood asthma-predictive phenotype.

    Science.gov (United States)

    Guilbert, Theresa W; Mauger, David T; Lemanske, Robert F

    2014-01-01

    Wheezing is a fairly common symptom in early childhood, but only some of these toddlers will experience continued wheezing symptoms in later childhood. The definition of the asthma-predictive phenotype is in children with frequent, recurrent wheezing in early life who have risk factors associated with the continuation of asthma symptoms in later life. Several asthma-predictive phenotypes were developed retrospectively based on large, longitudinal cohort studies; however, it can be difficult to differentiate these phenotypes clinically as the expression of symptoms, and risk factors can change with time. Genetic, environmental, developmental, and host factors and their interactions may contribute to the development, severity, and persistence of the asthma phenotype over time. Key characteristics that distinguish the childhood asthma-predictive phenotype include the following: male sex; a history of wheezing, with lower respiratory tract infections; history of parental asthma; history of atopic dermatitis; eosinophilia; early sensitization to food or aeroallergens; or lower lung function in early life. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. DNA methylation levels associated with race and childhood asthma severity.

    Science.gov (United States)

    Chan, Marcia A; Ciaccio, Christina E; Gigliotti, Nicole M; Rezaiekhaligh, Mo; Siedlik, Jacob A; Kennedy, Kevin; Barnes, Charles S

    2017-10-01

    Asthma is a common chronic childhood disease worldwide. Socioeconomic status, genetic predisposition and environmental factors contribute to its incidence and severity. A disproportionate number of children with asthma are economically disadvantaged and live in substandard housing with potential indoor environmental exposures such as cockroaches, dust mites, rodents and molds. These exposures may manifest through epigenetic mechanisms that can lead to changes in relevant gene expression. We examined the association of global DNA methylation levels with socioeconomic status, asthma severity and race/ethnicity. We measured global DNA methylation in peripheral blood of children with asthma enrolled in the Kansas City Safe and Healthy Homes Program. Inclusion criteria included residing in the same home for a minimum of 4 days per week and total family income of less than 80% of the Kansas City median family income. DNA methylation levels were quantified by an immunoassay that assessed the percentage of 5-methylcytosine. Our results indicate that overall, African American children had higher levels of global DNA methylation than children of other races/ethnicities (p = 0.029). This difference was more pronounced when socioeconomic status and asthma severity were coupled with race/ethnicity (p = 0.042) where low-income, African American children with persistent asthma had significantly elevated methylation levels relative to other races/ethnicities in the same context (p = 0.006, Hedges g = 1.14). Our study demonstrates a significant interaction effect among global DNA methylation levels, asthma severity, race/ethnicity, and socioeconomic status.

  10. The healthy worker effect in asthma: work may cause asthma, but asthma may also influence work.

    Science.gov (United States)

    Le Moual, Nicole; Kauffmann, Francine; Eisen, Ellen A; Kennedy, Susan M

    2008-01-01

    Despite the increasing attention to the relationship between asthma and work exposures, occupational asthma remains underrecognized and its population burden underestimated. This may be due, in part, to the fact that traditional approaches to studying asthma in populations cannot adequately take into account the healthy worker effect (HWE). The HWE is the potential bias caused by the phenomenon that sicker individuals may choose work environments in which exposures are low; they may be excluded from being hired; or once hired, they may seek transfer to less exposed jobs or leave work. This article demonstrates that population- and workplace-based asthma studies are particularly subject to HWE bias, which leads to underestimates of relative risks. Our objective is to describe the HWE as it relates to asthma research, and to discuss the significance of taking HWE bias into account in designing and interpreting asthma studies. We also discuss the importance of understanding HWE bias for public health practitioners and for clinicians. Finally, we emphasize the timeliness of this review in light of the many longitudinal "child to young adult" asthma cohort studies currently underway. These prospective studies will soon provide an ideal opportunity to examine the impact of early workplace environments on asthma in young adults. We urge occupational and childhood asthma epidemiologists collaborate to ensure that this opportunity is not lost.

  11. Prevalence of Work-Related Asthma and its Impact in Primary Health Care.

    Science.gov (United States)

    Vila-Rigat, Rosa; Panadès Valls, Rafael; Hernandez Huet, Enric; Sivecas Maristany, Joan; Blanché Prat, Xavier; Muñoz-Ortiz, Laura; Torán Monserrat, Pere; Rabell Santacana, Ventura

    2015-09-01

    To determine the prevalence of occupational asthma (OA) and work-exacerbated asthma (WEA) among asthmatic patients diagnosed in Primary Health Care (PHC). To analyze the impact at PHC level caused by under-diagnosis and inappropriate referral of OA. A descriptive, cross-sectional multicenter study in patients aged between 16 and 64years diagnosed with asthma, according to their medical record; all were working or had worked, and were assigned to one of 16 PHC centers in a healthcare district. Based on the responses to the questionnaire completed at the study visit, which included a thorough review of the subject's entire working history, patients were classified into three categories by an expert in occupational asthma: OA, WEA or common asthma (CA). Three hundred and sixty-eight patients completed the questionnaire. The prevalence of OA was 18.2% (25% in men and 14.6% in women, P=.046), and 54 patients (14.7%) were classified as WEA. The proportion of patients with work-related asthma (WRA) was therefore 32.9%. Asthmatic patients with WRA took more sick leave than CA patients (P<.001). A high prevalence of WRA was found, mostly treated in PHC. Under-diagnosis of WRA is widespread in PHC. Copyright © 2014 SEPAR. Published by Elsevier Espana. All rights reserved.

  12. Perceived food hypersensitivity relates to poor asthma control and quality of life in young non-atopic asthmatics.

    Science.gov (United States)

    Johnson, Jennifer; Borres, Magnus P; Nordvall, Lennart; Lidholm, Jonas; Janson, Christer; Alving, Kjell; Malinovschi, Andrei

    2015-01-01

    The relationship between perceived food hypersensitivity in asthmatics, food allergen sensitization, asthma control and asthma-related quality of life has not been studied. Our aim was to study the prevalence of perceived food hypersensitivity in a cohort of young asthmatics, its relation to food allergen sensitization, and any correlation to asthma control and asthma-related quality of life. Perceived food hypersensitivity, as well as IgE sensitization to common food allergens, levels of exhaled nitric oxide (FeNO), and blood eosinophil counts (B-Eos) were assessed in 408 subjects (211 women) with asthma, aged (mean ± SEM) 20.4 ± 0.3 years. Subjects filled out the Asthma Control Test (ACT) and the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ). Inflammation was assessed by means of FeNO and B-Eos. Fifty-three per cent of subjects reported food hypersensitivity. A corresponding food allergen sensitization was found in 68% of these subjects. Non-atopic subjects with perceived food hypersensitivity (n = 31) had lower ACT (19 (15 - 22) vs. 21 (20 - 23), p < 0.001) and Mini-AQLQ -scores (5.3 (4.3 - 6.1) vs. 6.1 (5.5 - 6.5), p < 0.001) than subjects with no food hypersensitivity (n = 190), despite lower levels of FeNO and B-Eos (p < 0.05). Food hypersensitivity was commonly reported among young asthmatics. In a majority of cases, a corresponding food allergen sensitization was found. A novel and clinically important finding was that non-atopic subjects with perceived food hypersensitivity were characterized by poorer asthma control and asthma-related quality of life.

  13. Asthma prevalence and risk factors in early childhood at Northern Portugal.

    Science.gov (United States)

    Branco, P T B S; Nunes, R A O; Alvim-Ferraz, M C M; Martins, F G; Ferraz, C; Vaz, L G; Sousa, S I V

    2016-01-01

    Asthma is the commonest and most important chronic non-infectious disease in childhood and it has become more prevalent in recent years. There is a shortage of studies in relation to early childhood and so, as part of the INAIRCHILD project, this cross-sectional study aimed to assess the prevalence of asthma and its associated risk factors, namely demographic, environmental, psychosocial and clinical factors for infants and preschoolers living in Northern Portugal. Data concerning asthma prevalence were collected through questionnaires based on those from the International Study of Asthma and Allergies in Childhood (ISAAC-derived), the questionnaires were distributed to 1042 children attending the 17 nurseries involved in the INAIRCHILD project (10 in urban and suburban context, and 7 in rural context). The response rate was 48%. Prevalence of asthma based on symptomatology and odds ratio was calculated. Around 52% of the studied children presented at least one of the respiratory symptoms investigated (wheeze, dyspnea and cough) in the absence of upper respiratory infections. The prevalence of asthma was 10.7%, comparable to the figures for Portuguese schoolchildren (6-7 years old) reported by the national Directorate-General of Health, thus showing that an early diagnosis might be possible and helpful for the mitigation of childhood asthma. Environmental context (urban, suburban or rural), gender and family asthma history showed clear associations with asthma prevalence, namely non-rural location, male gender, and having an asthmatic parent were found to be risk factors. Copyright © 2015 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

  14. Asthma Heredity, Cord Blood IgE and Asthma-Related Symptoms and Medication in Adulthood: A Long-Term Follow-Up in a Swedish Birth Cohort.

    Directory of Open Access Journals (Sweden)

    Hartmut Vogt

    Full Text Available Cord blood IgE has previously been studied as a possible predictor of asthma and allergic diseases. Results from different studies have been contradictory, and most have focused on high-risk infants and early infancy. Few studies have followed their study population into adulthood. This study assessed whether cord blood IgE levels and a family history of asthma were associated with, and could predict, asthma medication and allergy-related respiratory symptoms in adults. A follow-up was carried out in a Swedish birth cohort comprising 1,701 consecutively born children. In all, 1,661 individuals could be linked to the Swedish Prescribed Drug Register and the Medical Birth Register, and 1,227 responded to a postal questionnaire. Cord blood IgE and family history of asthma were correlated with reported respiratory symptoms and dispensed asthma medication at 32-34 years. Elevated cord blood IgE was associated with a two- to threefold increased risk of pollen-induced respiratory symptoms and dispensed anti-inflammatory asthma medication. Similarly, a family history of asthma was associated with an increased risk of pollen-induced respiratory symptoms and anti-inflammatory medication. However, only 8% of the individuals with elevated cord blood IgE or a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication at follow-up. In all, 49 out of 60 individuals with dispensed anti-inflammatory asthma medication at 32-34 years of age had not been reported having asthma at previous check-ups of the cohort during childhood. Among those, only 5% with elevated cord blood IgE and 6% with a family history of asthma in infancy could be linked to current dispensation of anti-inflammatory asthma medication as adults. Elevated cord blood IgE and a positive family history of asthma were associated with reported respiratory symptoms and dispensed asthma medication in adulthood, but their predictive power was poor

  15. TLR-related pathway analysis : novel gene-gene interactions in the development of asthma and atopy

    NARCIS (Netherlands)

    Reijmerink, N. E.; Bottema, R. W. B.; Kerkhof, M.; Gerritsen, J.; Stelma, F. F.; Thijs, C.; van Schayck, C. P.; Smit, H. A.; Brunekreef, B.; Koppelman, G. H.; Postma, D. S.

    P>Background: The toll-like receptor (TLR)-related pathway is important in host defence and may be crucial in the development of asthma and atopy. Numerous studies have shown associations of TLR-related pathway genes with asthma and atopy phenotypes. So far it has not been investigated whether

  16. Asthma prevalence and school-related hazardous air pollutants in the US-México border area.

    Science.gov (United States)

    Carrillo, Genny; Perez Patron, Maria J; Johnson, Natalie; Zhong, Yan; Lucio, Rose; Xu, Xiaohui

    2018-04-01

    Asthma is the most common chronic disease in children and has been linked to high levels of ambient air pollution and certain hazardous air pollutants (HAPs). Outdoor pollutants such as benzene, released by car emissions, and organic chemicals found in diesel exhaust, as well as particles and irritant gases, including nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), and ozone (O 3 ), contribute to an increased prevalence of respiratory diseases such as asthma. The objectives of this study were to: 1) conduct a screening survey to identify high risk for asthma among school-age children in Hidalgo County, and, 2) study the potential health impact of school-related exposure to HAPs pertaining to asthma risk. We carried out a quantitative cross-sectional study combining a school-based asthma screening survey across 198 schools in Hidalgo County, Texas, with information on school neighborhood environments, including census tract-level information on hazardous air pollutants (HAPs) and socioeconomic status (SES) in the respective school neighborhoods. HAPs levels were assessed based on the EPA 2011 National-Scale Air Toxics Assessment (NATA) while SES information was assessed using data from the 2010-2014 American Community Survey. 2930 students completed the asthma screening survey and results showed an overall asthma prevalence of 9.4%, slightly higher than the national and state prevalence. Participants in the 14-18 years old age group showed a much higher asthma prevalence of 16.7%. When assessing school-neighborhood characteristics, our results revealed no significant differences in asthma prevalence across census tracts with different SES levels. For HAPs, in the single-pollutant model, chlorine levels showed a significant linear trend for prevalence of asthma (p=0.03) while hydrochloric acid had a marginally significant linear trend (p=0.08). The association with chlorine remained significant in the multi-pollutant model. Asthma prevalence among school

  17. Fragrances and work-related asthma-California surveillance data, 1993-2012.

    Science.gov (United States)

    Weinberg, Justine Lew; Flattery, Jennifer; Harrison, Robert

    2017-12-01

    Fragrance chemicals are used in a large array of products. Workers may be exposed to these chemicals in the workplace directly when used as air fresheners, or indirectly in personal care products used by coworkers or others. This study characterizes work-related asthma (WRA) cases associated with fragrance exposures in California workplaces from 1993 through 2012. We used the California Work-Related Asthma Prevention Program's surveillance database to identify individuals with physician-diagnosed WRA associated with the use of air fresheners and scented personal care products (perfumes, colognes, etc.). Cases were classified using previously published, standardized surveillance methods. Perfume was the ninth most common exposure identified from 1993 through 2012. A total of 270 WRA cases associated with fragrance exposure were reported during this period, representing 3.8% of all confirmed cases. These 270 cases included 242 associated with perfume or cologne, 32 associated with air freshener, and 4 associated with both. Similar to non-fragrance cases, nearly a quarter of fragrance-associated cases were classified as new-onset asthma. Fragrance-associated cases were significantly more likely to be in office, health, and education jobs than non-fragrance-associated cases. When compared to non-fragrance cases, fragrance cases were significantly more likely to be female (94% vs 62%) and be classified as having work-aggravated asthma (38% vs 20%), yet had similar outcomes compared with cases associated with other exposures. Our surveillance data show that fragrance use in the workplace is associated with WRA. Prevention methods include employee education, enforced fragrance-free policies, well-designed ventilation systems, and good building maintenance.

  18. Occupational Asthma

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  19. Childhood Asthma

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  20. The Regional Asthma Disease Management Program (RADMP) for low income underserved children in rural western North Carolina: a National Asthma Control Initiative Demonstration Project.

    Science.gov (United States)

    Shuler, Melinda S; Yeatts, Karin B; Russell, Donald W; Trees, Amy S; Sutherland, Susan E

    2015-01-01

    A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI). This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management. Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month pre-intervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p < 0.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25-75 increased by 7.2%, 13.2% and 21.1%, respectively (all p < 0.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882,021. The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

  1. Perceived food hypersensitivity relates to poor asthma control and quality of life in young non-atopic asthmatics.

    Directory of Open Access Journals (Sweden)

    Jennifer Johnson

    Full Text Available The relationship between perceived food hypersensitivity in asthmatics, food allergen sensitization, asthma control and asthma-related quality of life has not been studied.Our aim was to study the prevalence of perceived food hypersensitivity in a cohort of young asthmatics, its relation to food allergen sensitization, and any correlation to asthma control and asthma-related quality of life.Perceived food hypersensitivity, as well as IgE sensitization to common food allergens, levels of exhaled nitric oxide (FeNO, and blood eosinophil counts (B-Eos were assessed in 408 subjects (211 women with asthma, aged (mean ± SEM 20.4 ± 0.3 years. Subjects filled out the Asthma Control Test (ACT and the Mini Asthma Quality of Life Questionnaire (Mini-AQLQ. Inflammation was assessed by means of FeNO and B-Eos.Fifty-three per cent of subjects reported food hypersensitivity. A corresponding food allergen sensitization was found in 68% of these subjects. Non-atopic subjects with perceived food hypersensitivity (n = 31 had lower ACT (19 (15 - 22 vs. 21 (20 - 23, p < 0.001 and Mini-AQLQ -scores (5.3 (4.3 - 6.1 vs. 6.1 (5.5 - 6.5, p < 0.001 than subjects with no food hypersensitivity (n = 190, despite lower levels of FeNO and B-Eos (p < 0.05.Food hypersensitivity was commonly reported among young asthmatics. In a majority of cases, a corresponding food allergen sensitization was found. A novel and clinically important finding was that non-atopic subjects with perceived food hypersensitivity were characterized by poorer asthma control and asthma-related quality of life.

  2. Relation of the Timing of Onset of Rhinitis and Cough to Asthma Attack in Children.

    Science.gov (United States)

    Sugimura, Tetsu; Ozaki, Yukiko; Tananari, Yoshifumi; Yamakawa, Rumi; Hirata, Rumiko

    2016-01-01

    If the risk of progression to asthma could be predicted in patients with rhinitis, prevention of asthma might become possible. The purpose of this study was to clarify the relationship between the duration of rhinitis symptoms and acute asthma attacks in children with a history of asthma who were not on treatment for asthma. In 94 children with a history of asthma who were asymptomatic after completing asthma treatment, we investigated the onset and duration of nasal discharge and cough related to allergic rhinitis. Then the children were followed up for 2 weeks and were classified into either an asthma attack group (Group A) or non-asthma group(Group B). A total of 78 subjects were evaluated after 16 were excluded. The duration of nasal discharge was significantly shorter in Group A than in Group B (5.5±1.9 days vs. 10.4±3.1 days, Pasthma attack may be higher when the onset of cough precedes nasal discharge or when nasal discharge has a short duration and cough shows an early onset. These results may provide assistance when selecting patients for early anti-allergy therapy from among those presenting with upper respiratory tract symptoms.

  3. Perinatal and Early Childhood Environmental Factors Influencing Allergic Asthma Immunopathogenesis

    Science.gov (United States)

    Gaffin, Jonathan M.; Kanchongkittiphon, Watcharoot; Phipatanakul, Wanda

    2014-01-01

    Background The prevalence of asthma has increased dramatically over the past several decades. While hereditary factors are highly important, the rapid rise outstrips the pace of genomic variation. Great emphasis has been placed on potential modifiable early life exposures leading to childhood asthma. Methods We reviewed the recent medical literature for important studies discussing the role of the perinatal and early childhood exposures and the inception of childhood asthma. Results and Discussion Early life exposure to allergens (House dust mite (HDM), furred pets, cockroach, rodent and mold)air pollution (nitrogen dioxide (NO2), ozone (O3), volatile organic compounds (VOCs), and particulate matter (PM)) and viral respiratory tract infections (Respiratory syncytial virus (RSV) and human rhinovirus (hRV)) have been implicated in the development of asthma in high risk children. Conversely, exposure to microbial diversity in the perinatal period may diminish the development of atopy and asthma symptoms. PMID:24952205

  4. An asthma-related quality of life instrument is unable to identify asthmatic children with major psychosocial problems.

    NARCIS (Netherlands)

    Tibosch, M.M.; Reidsma, C.; Landstra, A.; Hugen, C.A.C.; Gerrits, P.; Brouwer, M.; Gent, R. van; Merkus, P.J.F.M.; Verhaak, C.M.

    2010-01-01

    Evidence shows that psychosocial problems among children and adolescents with asthma interfere with adherence to treatment and therefore need attention in asthma care. It is unknown whether the already frequently implemented asthma-related quality of life (QoL) instruments reflect psychosocial

  5. Risk factors associated with allergic and non-allergic asthma in adolescents.

    Science.gov (United States)

    Janson, Christer; Kalm-Stephens, Pia; Foucard, Tony; Alving, Kjell; Nordvall, S Lennart

    2007-07-01

    Risk factors for asthma have been investigated in a large number of studies in adults and children, with little progress in the primary and secondary prevention of asthma. The aim of this investigation was to investigate risk factors associated with allergic and non-allergic asthma in adolescents. In this study, 959 schoolchildren (13-14 years old) answered a questionnaire and performed exhaled nitric oxide (NO) measurements. All children (n = 238) with reported asthma, asthma-related symptoms and/or increased NO levels were invited to a clinical follow-up which included a physician evaluation and skin-prick testing. Asthma was diagnosed in 96 adolescents, whereof half had allergic and half non-allergic asthma. Children with both allergic and non-allergic asthma had a significantly higher body mass index (BMI) (20.8 and 20.7 vs. 19.8 kg/m(2)) (p < 0.05) and a higher prevalence of parental asthma (30% and 32% vs. 16%) (p < 0.05). Early-life infection (otitis and croup) [adjusted odds ratio (OR) (95% confidence interval (CI)): 1.99 (1.02-3.88) and 2.80 (1.44-5.42), respectively], pets during the first year of life [2.17 (1.16-4.04)], window pane condensation [2.45 (1.11-5.40)] and unsatisfactory school cleaning [(2.50 (1.28-4.89)] was associated with non-allergic but not with allergic asthma. This study indicates the importance of distinguishing between subtypes of asthma when assessing the effect of different risk factors. While the risk of both allergic and non-allergic asthma increased with increasing BMI, associations between early-life and current environmental exposure were primarily found in relation to non-allergic asthma.

  6. Diagnosis of bronchial asthma in sensitization to yeast-like fungus candida ablicans

    International Nuclear Information System (INIS)

    Burnasheva, R.Kh.; Gumerova, A.M.; Glushko, N.I.; Rakhmatullina, N.M.

    1994-01-01

    The peculiarities of bronchial asthma caused by hypersensitivity to antigens Candida albicans are studied. The allergen Candida albicans developed in the Kazan SIEM is used in the specific diagnosis. The various types of reactions in skin and provocative inhalation tests are analyzed, the role of specific immunoglobulins E is stressed

  7. Modification of Traffic-related Respiratory Response by Asthma Control in a Population of Car Commuters

    Science.gov (United States)

    Mirabelli, Maria C.; Golan, Rachel; Greenwald, Roby; Raysoni, Amit U.; Holguin, Fernando; Kewada, Priya; Winquist, Andrea; Flanders, W. Dana; Sarnat, Jeremy A.

    2015-01-01

    Background Effects of traffic-related exposures on respiratory health are well documented, but little information is available about whether asthma control influences individual susceptibility. We analyzed data from the Atlanta Commuter Exposure study to evaluate modification of associations between rush-hour commuting, in-vehicle air pollution, and selected respiratory health outcomes by asthma control status. Methods Between 2009 and 2011, 39 adults participated in Atlanta Commuter Exposure, and each conducted two scripted rush-hour highway commutes. In-vehicle particulate components were measured during all commutes. Among adults with asthma, we evaluated asthma control by questionnaire and spirometry. Exhaled nitric oxide, forced expiratory volume in 1 second (FEV1), and other metrics of respiratory health were measured precommute and 0, 1, 2, and 3 hours postcommute. We used mixed effects linear regression to evaluate associations between commute-related exposures and postcommute changes in metrics of respiratory health by level of asthma control. Results We observed increased exhaled nitric oxide across all levels of asthma control compared with precommute measurements, with largest postcommute increases observed among participants with below-median asthma control (2 hours postcommute: 14.6% [95% confidence interval {CI} = 5.7, 24.2]; 3 hours postcommute: 19.5% [95% CI = 7.8, 32.5]). No associations between in-vehicle pollutants and percent of predicted FEV1 were observed, although higher PM2.5 was associated with lower FEV1 % predicted among participants with below-median asthma control (3 hours postcommute: −7.2 [95% CI = −11.8, −2.7]). Conclusions Level of asthma control may influence respiratory response to in-vehicle exposures experienced during rush-hour commuting. PMID:25901844

  8. Efficacy of Entomopathogenic Fungus Beauveria Bassiana and Gamma Irradiation Against the Greater Date Moth, Arenipses Sabella

    International Nuclear Information System (INIS)

    Mikhaiel, A.A.; Abul Fadl, H.A.A.

    2011-01-01

    The fungus Beauveria bassiana (Bals.) was isolated locally from dead larvae of the greater date moth, Arenipses sabella (Hampson) (Lepidoptera: Pyralidae). The effect of three exposure methods and two environmental factors (temperature and relative humidity) on pathogenicity of the fungus with different concentrations to A. sabella second instar larvae were examined. The study demonstrated that the entomopathogenic fungus was most efficient in the control of second instar larvae at 25 degree C and 100% humidity and the percent of mortality was increased when increasing the concentration of fungus. The mode of exposure of fungus to larvae directly sprayed, larvae exposed to the treated dates or larvae both sprayed and exposed to the treated dates showed 56.66, 26.66 and 75% mortality, respectively, at concentration 1x10 10 spores/ml and three days post-treatment. The F1 larvae resulting from irradiated male pupae with 150 Gy were more susceptible to pathogenic fungus at low concentration ((1x10 8 spores/ml) than non-irradiated ones. The scanning electron microscope was used to delineate the morphological stages of fungus to the germinated conidia and the hyphae penetrating the larva cuticle.

  9. Asthma as a disruption in iron homeostasis | Science ...

    Science.gov (United States)

    Over several decades, asthma has evolved from being recognized as a single disease to include a diverse group of phenotypes with dissimilar natural histories, pathophysiologies, responses to treatment, and distinctive molecular pathways. With the application of Occam’s razor to asthma, it is proposed that there is one cause underlying the numerous phenotypes of this disease and that the responsible molecular pathway is a deficiency of iron in the lung tissues. This deficiency can be either absolute (e.g. asthma in the neonate and during both pregnancy and menstruation) or functional (e.g. asthma associated with infections, smoking, and obesity). Comparable associations between asthma co-morbidity (e.g. eczema, urticaria, restless leg syndrome, and pulmonary hypertension) with iron deficiency support such a shared mechanistic pathway. Therapies directed at asthma demonstrate a capacity to impact iron homeostasis, further strengthening the relationship. Finally, pathophysiologic events producing asthma, including inflammation, increases in Th2 cells, and muscle contraction, can correlate with iron availability. Recognition of a potential association between asthma and an absolute and/or functional iron deficiency suggests specific therapeutic interventions including inhaled iron. Asthma is a public health issue that has environmental triggers. Iron homeostasis is an essential mechanism whereby the body manages the impact of environmental agents on overall

  10. Severe asthma in childhood

    International Nuclear Information System (INIS)

    Ciznar, P.

    2013-01-01

    Patients with severe asthma are clinically, physiologically and biologically a heterogeneous group. About half of children referred for medical examination for severe asthma have true severe, therapy resistant asthma. The rest of referred patients have difficult to treat asthma. Symptoms persist mostly due to drug non-compliance, inappropriate inhalation technique, persistent environmental exposures or co-morbid conditions. Compared with adults have children more frequently atopic form of severe asthma. This is associated with eosinophilia in peripheral blood and sensitization to inhaled allergens. The IgE levels are high. Therapy of co-morbidities and improvement of treatment compliance lead in most cases to full asthma control. Proportion of children will benefit from biologics like anti-IgE monoclonal antibody, administered by subcutaneous injections in 2 to 4 week intervals. By this therapy it is not only possible to suppress symptoms, but also decrease the total steroid dose and the risk of adverse effects associated with its long-term administration. By achieving a full asthma control we lower future risk of exacerbations and probably improve long-term prognosis of disease, frequently persisting for the rest of life. (author)

  11. Socio-demographic factors related to under-diagnosis of childhood asthma in Upper Silesia, Poland.

    Science.gov (United States)

    Zejda, Jan E; Farnik, Małgorzata; Smółka, Irena; Lawson, Joshua; Brożek, Grzegorz M

    2017-06-07

    Introduction. The presented study of 4,535 children aged 7-17 years in the Upper Silesian region of Poland yielded 186 cases of previously known asthma, and 44 children with newly diagnosed asthma. The aim of the presented study was to identify non-medical factors that could explain why children with a newly established diagnosis ('undiagnosed asthma') had not been diagnosed in the past. Materials and method. The study was performed according to a case-control design. Parents of the children answered questionnaires on socio-economic status and family-related factors. Statistical determinants of undiagnosed asthma were explored using raw (OR) and logistic odds ratios with their 95% confidence intervals (logOR, 95%CI). Results. Children with undiagnosed asthma were younger compared to the group with previously known asthma (11.3±2.1 vs. 12.6±2.5 years; p=0.0008). Newly diagnosed cases were more frequent in children who had less parental attention (less than 1 hour/day spent by parent with child - OR=4.36; 95%CI: 1.76-10.81) and who were not registered with specialized health care (OR=2.20; 95%CI: 0.95-5.06). Results of logistic regression analysis suggest that under-diagnosis of asthma is related to age below 12 years - logOR = 3.59 (95%CI: 1.28-10.36), distance to a health centre > 5 km - logOR = 3.45 (95%CI: 1.05-11.36), time spent with child Conclusion. Among non-medical determinants of undiagnosed asthma the age of a child plays a major role. Another factors of importance is the large distance between residence and health centre, and low parental attention at home.

  12. Environmental conditions, immunologic phenotypes, atopy, and asthma: new evidence of how the hygiene hypothesis operates in Latin America.

    Science.gov (United States)

    Figueiredo, Camila Alexandrina; Amorim, Leila D; Alcantara-Neves, Neuza M; Matos, Sheila M A; Cooper, Philip J; Rodrigues, Laura C; Barreto, Mauricio L

    2013-04-01

    It has been proposed that improved hygiene and reduced experience of infections in childhood influences the development of allergic diseases. The mechanisms by which the hygiene operates are not well established but are underpinned by two apparently incompatible immunologic paradigms, the balance of TH1 versus TH2 cytokines and IL-10-mediated regulation of TH2 cytokines. This study defined immunologic phenotypes with the use of latent class analysis and investigated their associations with environmental factors, markers of allergy and asthma, in a Latin American population. We studied 1127 children living in urban Brazil. Data on wheeze and environmental exposures were collected with standardized questionnaires. Atopy was measured by specific IgE in serum and skin prick test reactivity to aeroallergens. Cytokines were measured in culture after the stimulation of peripheral blood leukocytes with mitogen. Infections with pathogens were assessed by serology and stool examinations. Children were classified as having high or low burden of infection. Latent class analysis was used to identify immune phenotypes on the basis of cytokine production. Logistic regression was used to evaluate the adjusted effects of environment and burden of infection on the immunologic phenotypes and the effect of the phenotypes on atopy and asthma. Three phenotypes were identified, labeled underresponsive, intermediate, and responsive. Children of more educated mothers, living in improved environmental conditions, and with a low burden of infection were significantly more likely to have the responsive phenotype. The responsive phenotype was significantly associated with an increased prevalence of atopy but not asthma. Our findings contribute to a better understanding of the immune mechanisms by which the hygiene hypothesis operates in urban Latin America. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  13. Obesity, Asthma, and the Microbiome

    OpenAIRE

    Cho, Youngji; Shore, Stephanie A.

    2016-01-01

    Obesity is a risk factor for asthma, but standard asthma drugs have reduced efficacy in the obese. Obesity alters the gastrointestinal microbial community structure. This change in structure contributes to some obesity-related conditions and also could be contributing to obesity-related asthma. Although currently unexplored, obesity may also be altering lung microbiota. Understanding the role of microbiota in obesity-related asthma could lead to novel treatments for these patients.

  14. Effects of regular exercise on asthma control in young adults.

    Science.gov (United States)

    Heikkinen, Sirpa A M; Mäkikyrö, Elina M S; Hugg, Timo T; Jaakkola, Maritta S; Jaakkola, Jouni J K

    2017-08-28

    According to our systematic literature review, no previous study has assessed potential effects of regular exercise on asthma control among young adults. We hypothesized that regular exercise improves asthma control among young adults. We studied 162 subjects with current asthma recruited from a population-based cohort study of 1,623 young adults 20-27 years of age. Asthma control was assessed by the occurrence of asthma-related symptoms, including wheezing, shortness of breath, cough, and phlegm production, during the past 12 months. Asthma symptom score was calculated based on reported frequencies of these symptoms (range: 0-12). Exercise was assessed as hours/week. In Poisson regression, adjusting for gender, age, smoking, environmental tobacco smoke exposure, and education, the asthma symptom score reduced by 0.09 points per 1 hour of exercise/week (95% CI: 0.00 to 0.17). Applying the "Low exercise" quartile as the reference, "Medium exercise" reduced the asthma symptom score by 0.66 (-0.39 to 1.72), and "High exercise" reduced it significantly by 1.13 (0.03 to 2.22). The effect was strongest among overweight subjects. Our results provide new evidence that regular exercising among young adults improves their asthma control. Thus, advising about exercise should be included as an important part of asthma self-management in clinical practice.

  15. Cow milk induced allergies (CMA) and asthma in new born.

    Science.gov (United States)

    Wang, W; Wu, H-W; Liu, J-F

    2016-01-01

    The prevalence of asthma and allergic diseases in childhood has increased in several industrialized countries since the second half of the twentieth century. In some countries, the prevalence is still rising, although in others it seems to have plateaued or even decreased. It has been suggested that environmental factors operating prenatally and in early life affect the development of asthma and allergic diseases. Particularly changes in microbial exposure are proposed to play an important role in the development and maturation of the immune system. Thus, the factors that affect microbial exposure, such as mode of delivery and the use of antibiotics, may influence the development of asthma and allergic diseases. Several studies have explored the associations between perinatal factors and children's use of antibiotics and the risk of asthma, with inconsistent findings. The present review article will be focused on the important findings related with factors responsible for above allergic reactions along with asthma in young infants. Also, the influence of cow milk intake will also be taken in account to cover the aspect of cow milk induced allergies and asthma in infants.

  16. A comparison of some of the characteristics of patients with occupational and non-occupational asthma.

    Science.gov (United States)

    Axon, E J; Beach, J R; Burge, P S

    1995-04-01

    Occupational asthma is the most frequently diagnosed occupational lung disease reported to the SWORD (Surveillance of Work-related and Occupational Respiratory Disease) scheme. However, diagnosing occupational asthma is not straightforward, and establishing a link with work may be difficult. This study was undertaken to determine the differences between patients with occupational asthma and those with non-occupational asthma which might help in their diagnosis. Information was collected using a self-completed questionnaire. Questionnaires were distributed to 30 subjects aged 18-65 years at each of two clinics--one for patients with occupational asthma and one for those with cryptogenic and environmental asthma. Replies were received from 26 patients with occupational asthma (87%) and 29 patients with non-occupational asthma (97%). The age of onset was significantly higher for those with occupational asthma (42.6 vs 20.7 years). Significantly more subjects with occupational asthma reported improvement on holiday, whereas no significant difference was found in the numbers reporting worsening of symptoms on work days. Those with occupational asthma were less likely to report seasonal variation in symptoms, exacerbation by allergies, pets and stress, or a family history of asthma. Subjects with occupational asthma were more likely to become unemployed (50% vs 3%). Recognition of some of these features in a patient's history may help in the difficult task of differentiating occupational from non-occupational asthma, potentially avoiding the need for exhaustive investigations in some patients. The high prevalence of holiday improvement among subjects with non-occupational asthma suggested that domestic or environmental allergies arising outside the workplace may have been making an important contribution to ongoing symptoms in these subjects.

  17. The frequency of asthma exacerbations and healthcare utilization in patients with asthma from the UK and USA.

    Science.gov (United States)

    Suruki, Robert Y; Daugherty, Jonas B; Boudiaf, Nada; Albers, Frank C

    2017-04-27

    Asthma exacerbations are frequent in patients with severe disease. This report describes results from two retrospective cohort studies describing exacerbation frequency and risk, emergency department (ED)/hospital re-admissions, and asthma-related costs by asthma severity in the US and UK. Patients with asthma in the US-based Clinformatics™ DataMart Multiplan IMPACT (2010-2011; WEUSKOP7048) and the UK-based Clinical Practice Research Datalink (2009-2011; WEUSKOP7092) databases were categorized by disease severity (Global Initiative for Asthma [GINA]; Step and exacerbation history) during the 12 months pre-asthma medical code (index date). Outcomes included: frequency of exacerbations (asthma-related ED visit, hospitalization, or oral corticosteroid use with an asthma medical code recorded within ±2 weeks) 12 months post-index, asthma-related ED visits/hospitalization, and asthma-related costs 30 days post-index. Risk of a subsequent exacerbation was determined by proportional hazard model. Of the 222,817 and 211,807 patients with asthma included from the US and UK databases, respectively, 12.5 and 8.4% experienced ≥1 exacerbation during the follow-up period. Exacerbation frequency increased with disease severity. Among the 5,167 and 2,904 patients with an asthma-related ED visit/hospitalization in the US and UK databases, respectively, 9.2 and 4.7% had asthma-related re-admissions within 30 days. Asthma-related re-admission rates and costs increased with disease severity, approximately doubling between GINA Step 1 and 5 and in patients with ≥2 versus <2 exacerbations in the previous year. Risk of a subsequent exacerbation increased 32-35% for an exacerbation requiring ED visit/hospitalization versus oral corticosteroids. Increased disease severity was associated with higher exacerbation frequency, ED/hospitalization re-admission, costs and risk of subsequent exacerbation, indicating that these patients require high-intensity post-exacerbation management.

  18. Asthma in goldminers

    African Journals Online (AJOL)

    Objectives. To detennine whether asthma in goldminers is caused by or contributed to by their working environment. Design. A case-control stUdy in which men with asthma working underground in goldmines were compared with underground goldminers without asthma in relation to their age, duration of exposure to the ...

  19. Illness appraisals and health-related quality of life in adolescents and young adults with allergies and asthma.

    Science.gov (United States)

    Hullmann, Stephanie E; Eddington, Angelica R; Molzon, Elizabeth S; Mullins, Larry L

    2013-01-01

    The current study sought to: 1) assess differences in levels of physical and mental health-related quality of life (HRQOL), illness uncertainty, and intrusiveness in adolescents and young adults (AYAs) with allergies and asthma, as well as 2) examine the effect of illness appraisals on HRQOL. Participants were undergraduate students with self-reported allergies (n=74) and asthma (n=74) who completed the Mishel Uncertainty in Illness Scale (MUIS), the Illness Intrusiveness Scale (IIS), and the SF-36 Health Survey Questionnaire. Paired t-tests indicated that AYAs with allergies reported higher levels of illness uncertainty and poorer mental HRQOL than AYAs with asthma; the groups did not differ on reported levels of illness intrusiveness or physical HRQOL. Hierarchical regressions were conducted to examine the relationship between illness appraisals and HRQOL. Results revealed that poorer mental HRQOL was associated with higher illness uncertainty in AYAs with allergies and higher illness intrusiveness in AYAs with asthma. Poorer physical HRQOL was associated with higher illness uncertainty in AYAs with asthma and higher illness intrusiveness in AYAs with allergies and asthma. The current examination suggests that illness appraisals may be differentially related to HRQOL in AYAs with allergies compared to those with asthma.

  20. Alveolar and exhaled NO in relation to asthma characteristics--effects of correction for axial diffusion.

    Science.gov (United States)

    Heijkenskjöld-Rentzhog, C; Nordvall, L; Janson, C; Borres, M P; Alving, K; Malinovschi, A

    2014-08-01

    Inflammation in the small airways might contribute to incomplete asthma disease control despite intensive treatment in some subgroups of patients. Exhaled NO (FeNO) is a marker of inflammation in asthma and the estimated NO contribution from small airways (CalvNO ) is believed to reflect distal inflammation. Recent studies recommend adjustments of CalvNO for trumpet model and axial diffusion (TMAD-adj). This study aimed to investigate the clinical correlates of CalvNO , both TMAD-adjusted and unadjusted. Asthma symptoms, asthma control, lung function, bronchial responsiveness, blood eosinophils, atopy and treatment level were assessed in 410 subjects, aged 10-35 years. Exhaled NO was measured at different flow-rates and CalvNO calculated, with TMAD-adjustment according to Condorelli. Trumpet model and axial diffusion-adjusted CalvNO was not related to daytime wheeze (P = 0.27), FEF50 (P = 0.23) or bronchial responsiveness (P = 0.52). On the other hand, unadjusted CalvNO was increased in subjects with daytime wheeze (P < 0.001), decreased FEF50 (P = 0.02) and with moderate-to-severe compared to normal bronchial responsiveness (P < 0.001). All these characteristics correlated with increased FeNO (all P < 0.05). Unadjusted CalvNO was positively related to bronchial NO flux (J'awNO ) (r = 0.22, P < 0.001) while TMAD-adjCalvNO was negatively related to J'awNO (r = -0.38, P < 0.001). Adjusted CalvNO was not associated with any asthma characteristics studied in this large asthma cohort. However, both FeNO and unadjusted CalvNO related to asthma symptoms, lung function and bronchial responsiveness. We suggest a potential overadjustment by current TMAD-corrections, validated in healthy or unobstructed asthmatics. Further studies assessing axial diffusion in asthmatics with different degrees of airway obstruction and the validity of proposed TMAD-corrections are warranted. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Seizure-related hospital admissions, readmissions and costs: Comparisons with asthma and diabetes in South Australia.

    Science.gov (United States)

    Bellon, Michelle L; Barton, Christopher; McCaffrey, Nikki; Parker, Denise; Hutchinson, Claire

    2017-08-01

    Seizures are listed as an Ambulatory Care Sensitive Condition (ACSC), where, in some cases, hospitalisation may be avoided with appropriate preventative and early management in primary care. We examined the frequencies, trends and financial costs of first and subsequent seizure-related hospital admissions in the adult and paediatric populations, with comparisons to bronchitis/asthma and diabetes admissions in South Australia between 2012 and 2014. De-identified hospital separation data from five major public hospitals in metropolitan South Australia were analysed to determine the number of children and adults admitted for the following Australian Refined Diagnosis Related Groups: seizure related conditions; bronchitis/asthma; and diabetes. Additional data included length of hospital stay and type of admission. Demographic data were analysed to identify whether social determinants influence admission, and a macro costing approach was then applied to calculate the financial costs to the Health Care System. The rate of total seizure hospitalizations was 649 per 100,000; lower than bronchitis/asthma (751/100,000), yet higher than diabetes (500/100,000). The highest proportions of subsequent separations were recorded by children with seizures regardless of complexity (47% +CSCC; 17% -CSCC) compared with asthma (11% +CSCC; 14% -CSCC) or diabetes (14% +CSCC; 13% -CSCC), and by adults with seizures with catastrophic or severe complications/comorbidity (25%), compared with diabetes (22%) or asthma (14%). The mean cost per separation in both children and adults was highest for diabetes (AU$4438/$7656), followed by seizures (AU$2408/$5691) and asthma (AU$2084/$3295). Following the lead of well-developed and resourced health promotion initiatives in asthma and diabetes, appropriate primary care, community education and seizure management services (including seizure clinics) should be targeted in an effort to reduce seizure related hospitalisations which may be avoidable

  2. Virus detection and cytokine profile in relation to age among acute exacerbations of childhood asthma.

    Science.gov (United States)

    Kato, Masahiko; Suzuki, Kazuo; Yamada, Yoshiyuki; Maruyama, Kenichi; Hayashi, Yasuhide; Mochizuki, Hiroyuki

    2015-09-01

    Little information is available regarding eosinophil activation and cytokine profiles in relation to age in virus-induced bronchial asthma. We therefore explored the association between age, respiratory viruses, serum eosinophil cationic protein (ECP), and cytokines/chemokines in acute exacerbations of childhood asthma. We investigated viruses in nasal secretions from 88 patients with acute exacerbation of childhood asthma by using antigen detection kits and/or RT-PCR, followed by direct DNA sequencing analysis. We also measured peripheral eosinophil counts, and the serum levels of ECP and 27 types of cytokines/chemokines in 71 virus-induced acute asthma cases and 13 controls. Viruses were detected in 71(80.7%) of the 88 samples. The three major viruses detected were rhinoviruses, RS viruses, and enteroviruses; enteroviruses were found to be dominant in patients aged ≥3 years. There was no change in the levels of rhinoviruses and RS viruses between the two age groups, defined as children aged asthma cases compared with controls. Serum ECP values were significantly higher in patients with virus-induced asthma at age ≥3 years compared with those aged asthma in patients childhood asthma. Copyright © 2015 The Authors. Production and hosting by Elsevier B.V. All rights reserved.

  3. Asthma among mink workers

    DEFF Research Database (Denmark)

    Grøntved, Berit; Carstensen, Ole; Petersen, Rolf

    2014-01-01

    We report two cases of asthma among mink workers. The first case is about a mink farmer who had asthma that was difficult to treat. In the medical history there was no clear relation to work, and no conclusive work relation with peak flow monitoring. He had a positive histamine release test to mink...... urine. The second case is about a mink farm worker, who had an asthma attack when handling mink furs. Peak flow monitoring showed a clear relation to this work, but there were no signs of allergy. We conclude that these two cases suggest an increased risk of asthma among mink workers....

  4. A NONLINEAR MATHEMATICAL MODEL FOR ASTHMA: EFFECT OF ENVIRONMENTAL POLLUTION

    Directory of Open Access Journals (Sweden)

    NARESHA RAM

    2009-04-01

    Full Text Available In this paper, we explore a nonlinear mathematical model to study the spread of asthma due to inhaled pollutants from industry as well as tobacco smoke from smokers in a variable size population. The model is analyzed using stability theory of differential equations and computer simulation. It is shown that with an increase in the level of air pollutants concentration, the asthmatic (diseased population increases. It is also shown that along with pollutants present in the environment, smoking (active or passive also helps in the spread of asthma. Moreover, with the increase in the rate of interaction between susceptibles and smokers, the persistence of the spread of asthma is higher. A numerical study of the model is also performed to see the role of certain key parameters on the spread of asthma and to support the analytical results.

  5. Relationship between Pesticide Metabolites, Cytokine Patterns, and Asthma-Related Outcomes in Rural Women Workers

    Directory of Open Access Journals (Sweden)

    Hussein H. Mwanga

    2016-09-01

    Full Text Available The objective of this study was to investigate the relationship between exposure to organophosphate (OP and pyrethroid (PYR pesticides with serum cytokine patterns and asthma-related outcomes among rural women workers. A cross-sectional study was conducted among rural women (n = 211, including those working and living on farms and nearby town dwellers. Pesticide exposure was assessed using urinary metabolite concentrations of OP and PYR pesticides. Health outcome assessment was ascertained through the European Community Respiratory Health Survey (ECRHS questionnaire, fractional exhaled nitric oxide (FeNO, and serum cytokines associated with asthma. The prevalence of doctor-diagnosed asthma was 11%, adult-onset asthma 9%, and current asthma 6%. In this population, the proportion of T helper type 2 (Th2 cytokines (interleukin (IL-4, IL-5, and IL-13 detectable in subjects was between 18% and 40%, while the proportion of non-Th2 cytokines (IL-6, IL-8, IL-10, IL-17, and interferon gamma was between 35% and 71%. Most Th2 and non-Th2 cytokines were positively associated with either OP or PYR metabolites. Non-Th2 cytokines showed much stronger associations with OP metabolites (Dimethyl phosphate OR = 4.23; 95% CI: 1.54–11.65 than Th2 cytokines (Dimethyl phosphate OR = 1.69; 95% CI: 0.83–3.46. This study suggests that exposure to most OP and some PYR pesticides may be associated with asthma-related cytokines, with non-Th2 cytokines demonstrating consistently stronger relationships.

  6. How does race/ethnicity influence pharmacological response to asthma therapies?

    Science.gov (United States)

    Cazzola, Mario; Calzetta, Luigino; Matera, Maria Gabriella; Hanania, Nicola A; Rogliani, Paola

    2018-04-01

    Our understanding of whether and/or how ethnicity influences pharmacological response to asthma therapies is still very scarce. A possible explanation for the increased asthma treatment failures observed in ethnic and racial minorities receiving asthma therapies is that some of these groups may have a pharmacogenomic predisposition to either nonresponse or to adverse response with a specific class of drugs. However, the effects of ethnicity on pharmacological response to asthma therapies are also, and mainly, determined by socioeconomic and environmental factors to a varying extent, depending on the ethnic groups. Areas covered: Genetic, socioeconomic and environmental factors that can affect the pharmacotherapeutic responses to asthma medications and their link(s) to race/ethnicity have been examined and critically discussed. Expert opinion: Differences in genetic ancestry are definitely non-modifiable factors, but socioeconomic and environmental disadvantages are all factors that can be modified. It is likely that improved outcomes may be achieved when tailored and multifaceted approaches that include home, school, and clinician-based interventions are implemented. Consequently, it is critical to determine if a clinical intervention programme combined with implementation strategies that attempt to reduce inequalities can reduce asthma disparities, including the influence of ethnicity and race on pharmacological response to asthma therapies.

  7. Inhaled Asthma Medications

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  8. 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....

  9. The nematophagous fungus Monacrosporium thaumasium and its nematicidal activity on Angiostrongylus vasorum.

    Science.gov (United States)

    Soares, Filippe Elias de Freitas; Braga, Fabio Ribeiro; de Araújo, Jackson Victor; Lima, Walter dos Santos; de Queiroz, José Humberto

    2015-01-01

    The dog acts as a reservoir and environmental disseminator of potentially zoonotic parasites. The objective of this work was to study the fungus Monacrosporium thaumasium regarding its nematicidal potential in laboratory trials and its proteolytic profile. The in vitro test was carried out through two assays (A and B). In assay A, conidia of the fungus N34a were added in positive coprocultures for Angiostrongylus vasorum. In assay B, crude extract (treated group) and distilled water (control group) were added to coprocultures. Next, the proteolytic profile of crude extract of the nematophagous fungus M. thaumasium (NF34a) was revealed by performing a zymogram. There was a reduction (p<0.01) in the averages of larvae recovered from the treated groups (conidia and crude extract) in relation to control groups. The zymogram suggested that the nematophagous fungus M. thaumasium produces a protease of approximately 40 kDa. The results of this work confirm that the conidia as well as the crude extract of the fungus M. thaumasium may be used to control A. vasorum L1. The proteolytic profile suggested the presence of one protease (Mt1) of approximately 40 kDa that in the future may be used in biological control of L1 of this nematode. Copyright © 2013 Revista Iberoamericana de Micología. Published by Elsevier Espana. All rights reserved.

  10. Caffeine for asthma

    OpenAIRE

    Welsh, EJ; Bara, A; Barley, E; Cates, CJ

    2010-01-01

    Background\\ud \\ud Caffeine has a variety of pharmacological effects; it is a weak bronchodilator and it also reduces respiratory muscle fatigue. It is chemically related to the drug theophylline which is used to treat asthma. It has been suggested that caffeine may reduce asthma symptoms and interest has been expressed in its potential role as an asthma treatment. A number of studies have explored the effects of caffeine in asthma, this is the first review to systematically examine and summar...

  11. Infection with Mycoplasma pneumoniae is not related to asthma control, asthma severity, and location of airway obstruction

    Directory of Open Access Journals (Sweden)

    Khalil Ansarin,Siavoush Abedi,Reza Ghotaslou

    2010-12-01

    Full Text Available Khalil Ansarin1, Siavoush Abedi1, Reza Ghotaslou1, Mohammad Hossein Soroush1, Kamyar Ghabili1, Kenneth R Chapman21Tuberculosis and Lung Disease Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; 2Asthma and Airway Centre, Toronto Western Hospital, University Health Network, Toronto, ON, CanadaBackground: Mycoplasma pneumoniae is an organism that reportedly has a strong relationship to asthma. However, asthma severity and location of airway obstruction have not been compared between asthmatic patients with and without evidence for remote mycoplasma infection.Objectives: The aim of this research was to study the relationship between previous M. pneumoniae infections in asthmatic patients and presence of any predilection for the involvement of central or peripheral airways, the severity of the disease, and asthma control.Methods: Sixty-two patients with asthma were assessed by a validated asthma control test (ACT. All patients underwent spirometry and lung volume studies by body plethysmography. The forced expiratory volume in 1 second (FEV1, forced vital capacity (FVC, total lung capacity (TLC, residual volume (RV, and functional residual capacity (FRC were measured. An oropharyngeal swab was obtained for polymerase chain reaction analysis to detect the mycoplasma antigen. Moreover, blood samples were obtained to measure the titration of antimycoplasma immunoglobulin M (IgM and IgG antibodies. The asthmatic patients with a positive IgG for mycoplasma and negative PCR and negative IgM antibody were considered to have remote history of mycoplasma infection. The relationship between the asthma control using ACT score and pulmonary function variables were compared in patients with and without evidence for remote mycoplasma infection.Results: The incidence of postnasal drip was higher among the patients with asthma who had no evidence for remote mycoplasma infection (61.3% vs 32%, P = 0.035. The median ACT score was 16.5 (11–22 and

  12. Prevention of asthma: where are we in the 21st century?

    Science.gov (United States)

    Propp, Phaedra; Becker, Allan

    2013-12-01

    Asthma is the most common chronic disease of childhood and, in the latter part of the 20th century, reached epidemic proportions. Asthma is generally believed to result from gene-environment interactions. There is consensus that a 'window of opportunity' exists during pregnancy and early in life when environmental factors may influence its development. We review multiple environmental, biologic and sociologic factors that may be important in the development of asthma. Meta-analyses of studies have demonstrated that multifaceted interventions are required in order to develop asthma prevention. Multifaceted allergen reduction studies have shown clinical benefits. Asthma represents a dysfunctional interaction with our genes and the environment to which they are exposed, especially in fetal and early infant life. The increasing prevalence of asthma also may be an indication of increased population risk for the development of other chronic non-communicable autoimmune diseases. This review will focus on the factors which may be important in the primary prevention of asthma. Better understanding of the complex gene-environment interactions involved in the development of asthma will provide insight into personalized interventions for asthma prevention.

  13. Assessing the Association Between Asthma and Air Quality in the Presence of Wildfires

    Science.gov (United States)

    Young, L. J.; Al-Hamdan, M. Z.; Lopiano, K. K.; Crosson, W. L.; Gotway, C. A.; DuClos, C.; Jordan, M.; Estes, M. G.; Luvall, J. C.; Estes, S. M.; Xu, X.; Holt, N. M.; Leary, E.

    2012-12-01

    Asthma hospital/emergency room (patient) data are used as the foundation for creating a health outcome indicator of human response to environmental air quality. Daily U.S. Environmental Protection Agency (EPA) Air Quality System (AQS) fine particulates (PM2.5) ground data and the U.S. National Aeronautical Space Administration (NASA) MODIS aerosol optical depth (AOD) data were acquired and processed for years of 2007 and 2008. Figure 1 shows the PM2.5 annual mean composite of all the 2007 B-spline daily surfaces. Initial models for predicting the number of weekly asthma cases within a Florida county has focused on environmental variables. Weekly maximums of PM2.5, relative humidity, and the proportions of the county with smoke and fire were the environmental variables included in the model. Cosine and sine functions of time were used to account for seasonality in asthma cases. Counties were considered to be random effects, thereby adjusting for differences in socio-demographics and other factors. The 2007 predictions for Miami-Dade county when using B-splines PM2.5 are displayed in Figures 2.; PM2.5 annual mean composite of all the 2007 daily surfaces developed using Al-Hamdan et al (2009) B-spline fitting algorithm ; Predicted and observed weekly asthma cases presenting to hospitals or emergency rooms in Miami-Dade county in Florida during 2007

  14. Work-related psychosocial stress as a risk factor for asthma, allergy, and respiratory infections in the Swedish workforce.

    Science.gov (United States)

    Runeson-Broberg, Roma; Norbäck, Dan

    2014-04-01

    This study examined the association between work-related psychosocial stress and asthma, atopy, and respiratory infections. 532 randomly selected occupationally active people (272 men, 260 women; M age = 41 yr., SD = 13) in Sweden participated. Information on history of asthma, atopy, and respiratory infections was collected by a postal self-report questionnaire. Work stress was assessed based on the demands-control-support model. Current asthma and respiratory infections were associated with work-related psychosocial stress. When stratified for sex, these associations were only found in men. Associations between low control, low support, and current asthma were found among young participants ( 40 years) low supervisor support was associated with frequent respiratory infections.

  15. 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

    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......-66 years with recent-onset mild asthma (11 years] or 200 mug [patients aged 2 symptom days/week; further divided into 0-1, >1-2 symptom days/week). RESULTS: Overall, 7138 patients were included (budesonide, n=3577; placebo, n=3561). At baseline, symptom frequency was 0-1 symptom days/week for 2184 (30...... even in patients with the lowest baseline asthma symptom frequency (0-1 days/week). (Figure Presented)....

  16. Peri-adolescent asthma symptoms cause adult anxiety-related behavior and neurobiological processes in mice.

    Science.gov (United States)

    Caulfield, Jasmine I; Caruso, Michael J; Michael, Kerry C; Bourne, Rebecca A; Chirichella, Nicole R; Klein, Laura C; Craig, Timothy; Bonneau, Robert H; August, Avery; Cavigelli, Sonia A

    2017-05-30

    Human and animal studies have shown that physical challenges and stressors during adolescence can have significant influences on behavioral and neurobiological development associated with internalizing disorders such as anxiety and depression. Given the prevalence of asthma during adolescence and increased rates of internalizing disorders in humans with asthma, we used a mouse model to test if and which symptoms of adolescent allergic asthma (airway inflammation or labored breathing) cause adult anxiety- and depression-related behavior and brain function. To mimic symptoms of allergic asthma in young BALB/cJ mice (postnatal days [P] 7-57; N=98), we induced lung inflammation with repeated intranasal administration of house dust mite extract (most common aeroallergen for humans) and bronchoconstriction with aerosolized methacholine (non-selective muscarinic receptor agonist). Three experimental groups, in addition to a control group, included: (1) "Airway inflammation only", allergen exposure 3 times/week, (2) "Labored breathing only", methacholine exposure once/week, and (3) "Airway inflammation+Labored breathing", allergen and methacholine exposure. Compared to controls, mice that experienced methacholine-induced labored breathing during adolescence displayed a ∼20% decrease in time on open arms of the elevated plus maze in early adulthood (P60), a ∼30% decrease in brainstem serotonin transporter (SERT) mRNA expression and a ∼50% increase in hippocampal serotonin receptor 1a (5Htr1a) and corticotropin releasing hormone receptor 1 (Crhr1) expression in adulthood (P75). This is the first evidence that experimentally-induced clinical symptoms of adolescent asthma alter adult anxiety-related behavior and brain function several weeks after completion of asthma manipulations. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Assessing asthma control and associated risk factors among persons with current asthma - findings from the child and adult Asthma Call-back Survey.

    Science.gov (United States)

    Zahran, Hatice S; Bailey, Cathy M; Qin, Xiaoting; Moorman, Jeanne E

    2015-04-01

    Monitoring the level of asthma control is important in determining the effectiveness of current treatment which may decrease the frequency and intensity of symptoms and functional limitations. Uncontrolled asthma has been associated with decreased quality of life and increased health care use. The objectives of this study were to assess the level of asthma control and identify related risk factors among persons with current asthma. Using the 2006 to 2010 BRFSS child and adult Asthma Call-back Survey, asthma control was classified as well-controlled or uncontrolled (not-well-controlled or very-poorly-controlled) using three impairment measures: daytime symptoms, night-time symptoms, and taking short-acting β2-agonists for symptom control. Multivariate logistic regression identified predictors of asthma control. Fifty percent of adults and 38.4% of children with current asthma had uncontrolled asthma. About 63% of children and 53% of adults with uncontrolled asthma were on long-term asthma control medications. Among children, uncontrolled asthma was significantly associated with being younger than 5 years, having annual household income asthma (low educational attainment, low income, cigarette smoking, and co-morbid conditions including obesity and depression) could improve asthma control.

  18. Allergy in severe asthma.

    Science.gov (United States)

    Del Giacco, S R; Bakirtas, A; Bel, E; Custovic, A; Diamant, Z; Hamelmann, E; Heffler, E; Kalayci, Ö; Saglani, S; Sergejeva, S; Seys, S; Simpson, A; Bjermer, L

    2017-02-01

    It is well recognized that atopic sensitization is an important risk factor for asthma, both in adults and in children. However, the role of allergy in severe asthma is still under debate. The term 'Severe Asthma' encompasses a highly heterogeneous group of patients who require treatment on steps 4-5 of GINA guidelines to prevent their asthma from becoming 'uncontrolled', or whose disease remains 'uncontrolled' despite this therapy. Epidemiological studies on emergency room visits and hospital admissions for asthma suggest the important role of allergy in asthma exacerbations. In addition, allergic asthma in childhood is often associated with severe asthma in adulthood. A strong association exists between asthma exacerbations and respiratory viral infections, and interaction between viruses and allergy further increases the risk of asthma exacerbations. Furthermore, fungal allergy has been shown to play an important role in severe asthma. Other contributing factors include smoking, pollution and work-related exposures. The 'Allergy and Asthma Severity' EAACI Task Force examined the current evidence and produced this position document on the role of allergy in severe asthma. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. The relation of innate and adaptive immunity with viral-induced acute asthma attacks: Focusing on IP-10 and cathelicidin.

    Science.gov (United States)

    Arikoglu, T; Akyilmaz, E; Yildirim, D D; Batmaz, S B; Ulger, S T; Aslan, G; Kuyucu, S

    Despite growing evidence suggesting potential association between innate and adaptive immunity in viral-induced acute asthma, there is paucity of data in this area. This study aimed to investigate the association of innate and adaptive immunity with acute asthma attacks by analysing the role of IFN-γ-inducible protein 10 (IP-10), TLR2, cathelicidin, vitamin D and cytokines. This prospective study included 33 patients with viral-induced acute asthma and 30 children with controlled asthma. Nasopharyngeal swab samples were collected for virus identification and asthma attack scores assessed in acute asthma group. Blood sampling for IP-10, TLR2, cathelicidin, vitamin D levels, and spirometric indices were employed. Serum IP-10 and cathelicidin levels of acute asthma group were significantly higher and vitamin D levels were lower than controlled asthma group (IP-10; p=0.006, cathelicidin; p=0.002, vitamin D; pasthma attack severity (p=0.03) in acute asthma group. Higher cathelicidin values showed significant positive relation to IP-10 (beta coefficient: 33, p=0.02). Serum IP-10 levels higher than 38.9pg/ml (sensitivity: 85%, specificity: 47%, p=0.002) were predictive of virus-induced asthma. Serum IP-10 and vitamin D levels were found to be significantly related to viral-asthma attacks (IP-10; aOR: 8.93, p=0.03 and vitamin D; aOR: 0.82, p=0.001). Innate immunity biomarkers such as serum IP-10 and cathelicidin can be used to predict viral-induced acute asthma. These biomarkers may provide potential new treatment targets for acute asthma. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  20. Effect of the anti-IL-17 antibody on allergic inflammation in an obesity-related asthma model.

    Science.gov (United States)

    Liang, Lin; Hur, Jung; Kang, Ji Young; Rhee, Chin Kook; Kim, Young Kyoon; Lee, Sook Young

    2018-04-19

    The co-occurrence of obesity aggravates asthma symptoms. Diet-induced obesity increases helper T cell (TH) 17 cell differentiation in adipose tissue and the spleen. The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor pravastatin can potentially be used to treat asthma in obese patients by inhibiting interleukin 17 (IL-17) expression. This study investigated the combined effects of pravastatin and anti-IL-17 antibody treatment on allergic inflammation in a mouse model of obesity-related asthma. High-fat diet (HFD)-induced obesity was induced in C57BL/6 mice with or without ovalbumin (OVA) sensitization and challenge. Mice were administered the anti-IL-17 antibody, pravastatin, or both, and pathophysiological and immunological responses were analyzed. HFD exacerbated allergic airway inflammation in the bronchoalveolar lavage fluid of HFD-OVA mice as compared to OVA mice. Blockading of the IL-17 in the HFD-OVA mice decreased airway hyper-responsiveness (AHR) and airway inflammation compared to the HFD-OVA mice. Moreover, the administration of the anti-IL-17 antibody decreased the leptin/adiponectin ratio in the HFD-OVA but not the OVA mice. Co-administration of pravastatin and anti-IL-17 inhibited airway inflammation and AHR, decreased goblet cell numbers, and increased adipokine levels in obese asthmatic mice. These results suggest that the IL-17-leptin/adiponectin axis plays a key role in airway inflammation in obesity-related asthma. Our findings suggest a potential new treatment for IL-17 as a target that may benefit obesity-related asthma patients who respond poorly to typical asthma medications.

  1. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Surveillance Most Recent Asthma Data Most Recent Asthma State or Territory Data AsthmaStats Asthma as the Underlying ... Links Asthma’s Impact on the Nation Fact Sheet State Data Profiles (2011) Work-related Asthma NCHS Asthma ...

  2. Association Between Antibiotic Exposure, Bronchiolitis, and TLR4 (rs1927911) Polymorphisms in Childhood Asthma

    Science.gov (United States)

    Lee, Eun; Kwon, Ji-Won; Kim, Hyo-Bin; Yu, Ho-Sung; Kang, Mi-Jin; Hong, Kyungmo; Yang, Song I; Jung, Young Ho; Lee, Seung-Hwa; Choi, Kil Young; Shin, Hye Lim; Hong, Seo Ah; Kim, Hyung Young; Seo, Ju-Hee; Kim, Byoung-Ju; Lee, So Yeon; Song, Dae Jin; Kim, Woo-Kyung; Jang, Gwang Cheon; Shim, Jung Yeon

    2015-01-01

    Purpose The complex interplay between environmental and genetic factors plays an important role in the development of asthma. Several studies have yielded conflicting results regarding the 2 asthma-related risk factors: antibiotic usage during infancy and/or a history of bronchiolitis during early life and the development of asthma. In addition to these risk factors, we also explored the effects of Toll-like receptor 4 (TLR4) polymorphism on the development of childhood asthma. Methods This cross-sectional study involved 7,389 middle school students who were from 8 areas of Seoul, Korea, and completed the International Study of Asthma and Allergies in Childhood questionnaire. The TLR4 polymorphism rs1927911 was genotyped in 1,395 middle school students from two areas using the TaqMan assay. Results Bronchiolitis in the first 2 years of life, antibiotic exposure during the first year of life, and parental history of asthma were independent risk factors for the development of asthma. When combined, antibiotic use and a history of bronchiolitis increased the risk of asthma (adjusted odds ratio [aOR]: 4.64, 95% confidence interval [CI]: 3.09-6.97, P value for interaction=0.02). In subjects with CC genotype of TLR4, antibiotic exposure and a history of bronchiolitis during infancy, the risk of asthma was increased, compared to subjects without these risk factors (aOR: 5.72, 95% CI: 1.74-18.87). Conclusions Early-life antibiotic exposures and a history of bronchiolitis are risk factors for asthma in young adolescents. Polymorphisms of TLR4 modified the influence of these environmental factors. Reducing antibiotic exposure and preventing bronchiolitis during infancy may prevent the development of asthma, especially in genetically susceptible subjects. PMID:25729624

  3. Factors associated with allergen sensitizations in patients with asthma and/or rhinitis in China.

    Science.gov (United States)

    Li, Jing; Huang, Ying; Lin, Xiaoping; Zhao, Deyu; Tan, Guolin; Wu, Jinzhun; Zhao, Changqing; Zhao, Jing; Spangfort, Michael D; Lai, Xuxin; Zhong, Nanshan

    2012-01-01

    Allergen sensitization is influenced by genetic and environmental factors; however, the factors related to sensitizations in patients with rhinitis and asthma in China are largely unknown. This study investigated the factors associated with allergen sensitizations in patients with asthma and rhinitis in China. A cross-sectional survey was performed in 6304 patients with asthma and/or rhinitis from four regions of China. Patients completed a standardized questionnaire related to respiratory and allergic symptoms, family history of allergic diseases, smoking history, environmental exposure, and eating behaviors. They underwent skin-prick tests (SPTs) with 13 common aeroallergens. Blood samples were collected from 2268 of patients for specific IgE (sIgE) measurements against 16 common aeroallergens. Patients with both asthma and rhinitis had higher prevalence of SPT and sIgE positivity to most allergens than those with asthma or rhinitis alone (p history of allergic rhinitis, air-conditioner usage, sleeping on a mattress, and frequently eating meat were associated with increased risk of SPT and sIgE positivity. Using air-conditioner and sleeping on a mattress were further found to be associated with sIgE positivity to mites and molds. However, increased age and fish, fruit, and raw vegetable intake decreased the risk of SPT and sIgE positivity. Family history of allergic rhinitis, male gender, using an air conditioner, sleeping on a mattress, and frequent meat consumption are risk factors for allergen sensitizations, whereas increased age and frequent fish, fruit, and raw vegetable consumption may protect patients with asthma and/or rhinitis from developing sensitizations in China.

  4. Parents' asthma information needs and preferences for school-based asthma support.

    Science.gov (United States)

    Al Aloola, Noha Abdullah; Nissen, Lisa; Alewairdhi, Huda Abdullaziz; Al Faryan, Nawaf; Saini, Bandana

    2017-11-01

    This study sought to investigate parents' needs and preferences for school-based asthma support in Saudi Arabian primary schools. Semi-structured qualitative interviews were conducted in the period between November 2015 and February 2016, with a convenience sample that comprised Saudi parents and carers of children with asthma. Recruitment of participants was primarily driven through Saudi primary schools; passive snowballing and social networks were used to boost participation rates further. Interviews were audio-recorded, transcribed verbatim, translated and data were thematically organised using a latent content analysis approach. Twenty interviews were conducted. Six themes emerged from the interviews and were grouped into three major categories: (1) general asthma management issues; (2) school-based asthma management issues; and (3) communication dissatisfaction. Participants expressed concern at schools' social and physical environments and a lack of confidence in the ability of schools to manage their child's asthma, especially when their child was ill. Most of the participants advocated for staff training and school community engagement to improve the management of asthma in Saudi primary schools. This research clearly describes a need for school-based asthma support, including asthma-related policies, procedures and education on asthma and first aid in Saudi primary schools.

  5. Farm exposure and time trends in early childhood may influence DNA methylation in genes related to asthma and allergy.

    Science.gov (United States)

    Michel, S; Busato, F; Genuneit, J; Pekkanen, J; Dalphin, J-C; Riedler, J; Mazaleyrat, N; Weber, J; Karvonen, A M; Hirvonen, M-R; Braun-Fahrländer, C; Lauener, R; von Mutius, E; Kabesch, M; Tost, J

    2013-03-01

    Genetic susceptibility and environmental influences are important contributors to the development of asthma and atopic diseases. Epigenetic mechanisms may facilitate gene by environment interactions in these diseases. We studied the rural birth cohort PASTURE (Protection against allergy: study in rural environments) to investigate (a) whether epigenetic patterns in asthma candidate genes are influenced by farm exposure in general, (b) change over the first years of life, and (c) whether these changes may contribute to the development of asthma. DNA was extracted from cord blood and whole blood collected at the age of 4.5 years in 46 samples per time point. DNA methylation in 23 regions in ten candidate genes (ORMDL1, ORMDL2, ORMDL3, CHI3L1, RAD50, IL13, IL4, STAT6, FOXP3, and RUNX3) was assessed by pyrosequencing, and differences between strata were analyzed by nonparametric Wilcoxon-Mann-Whitney tests. In cord blood, regions in ORMDL1 and STAT6 were hypomethylated in DNA from farmers' as compared to nonfarmers' children, while regions in RAD50 and IL13 were hypermethylated (lowest P-value (STAT6) = 0.001). Changes in methylation over time occurred in 15 gene regions (lowest P-value (IL13) = 1.57*10(-8)). Interestingly, these differences clustered in the genes highly associated with asthma (ORMDL family) and IgE regulation (RAD50, IL13, and IL4), but not in the T-regulatory genes (FOXP3, RUNX3). In this first pilot study, DNA methylation patterns change significantly in early childhood in specific asthma- and allergy-related genes in peripheral blood cells, and early exposure to farm environment seems to influence methylation patterns in distinct genes. © 2013 John Wiley & Sons A/S. Published by Blackwell Publishing Ltd.

  6. Changing adherence-related beliefs about ICS maintenance treatment for asthma: feasibility study of an intervention delivered by asthma nurse specialists.

    Science.gov (United States)

    Chapman, Sarah C E; Barnes, Neil; Barnes, Mari; Wilkinson, Andrea; Hartley, John; Piddock, Cher; Weinman, John; Horne, Rob

    2015-06-05

    The Necessity-Concerns Framework (NCF) posits that non-adherence to inhaled corticosteroids (ICS) in asthma is influenced by doubts about the necessity for ICS and concerns about their potential adverse effects. This feasibility study examined whether these beliefs could be changed by briefing asthma nurse specialists on ways of addressing necessity beliefs and concerns within consultations. Pre-post intervention study. Secondary care. Patients with a diagnosis of moderate to severe asthma who were prescribed daily ICS were recruited to either a hospital care group (n=79; 71.0% female) or intervention group (n=57; 66.7% female). Asthma nurse specialists attended a 1.5-day NCF briefing. Beliefs about ICS (primary outcome) and self-reported adherence were measured preconsultation and 1 month postconsultation. Participants also rated their satisfaction with their consultations immediately after the consultation. Consultation recordings were coded to assess intervention delivery. After the NCF briefing, nurse specialists elicited and addressed beliefs about medicine more frequently. The frequency of using the NCF remained low, for example, open questions eliciting adherence were used in 0/59 hospital care versus 14/49 (28.6%) intervention consultations. Doubts about personal necessity for, and concerns about, ICS were reduced at 1 month postbriefing (pchanged nurse consultations, but not sufficiently enough to fully address non-adherence or adherence-related ICS beliefs (necessity and concerns). More effective techniques are needed to support nurse specialists and other practitioners to apply the intervention in hospital asthma review consultations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  7. 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

  8. Asthma-Related Outcomes in Patients Initiating Extrafine Ciclesonide or Fine-Particle Inhaled Corticosteroids

    Science.gov (United States)

    Postma, Dirkje S.; Dekhuijzen, Richard; van der Molen, Thys; Martin, Richard J.; van Aalderen, Wim; Roche, Nicolas; Guilbert, Theresa W.; Israel, Elliot; van Eickels, Daniela; Khalid, Javaria Mona; Herings, Ron M.C.; Overbeek, Jetty A.; Miglio, Cristiana; Thomas, Victoria; Hutton, Catherine; Hillyer, Elizabeth V.

    2017-01-01

    Purpose Extrafine-particle inhaled corticosteroids (ICS) have greater small airway deposition than standard fine-particle ICS. We sought to compare asthma-related outcomes after patients initiated extrafine-particle ciclesonide or fine-particle ICS (fluticasone propionate or non-extrafine beclomethasone). Methods This historical, matched cohort study included patients aged 12-60 years prescribed their first ICS as ciclesonide or fine-particle ICS. The 2 cohorts were matched 1:1 for key demographic and clinical characteristics over the baseline year. Co-primary endpoints were 1-year severe exacerbation rates, risk-domain asthma control, and overall asthma control; secondary endpoints included therapy change. Results Each cohort included 1,244 patients (median age 45 years; 65% women). Patients in the ciclesonide cohort were comparable to those in the fine-particle ICS cohort apart from higher baseline prevalence of hospitalization, gastroesophageal reflux disease, and rhinitis. Median (interquartile range) prescribed doses of ciclesonide and fine-particle ICS were 160 (160-160) µg/day and 500 (250-500) µg/day, respectively (P<0.001). During the outcome year, patients prescribed ciclesonide experienced lower severe exacerbation rates (adjusted rate ratio [95% CI], 0.69 [0.53-0.89]), and higher odds of risk-domain asthma control (adjusted odds ratio [95% CI], 1.62 [1.27-2.06]) and of overall asthma control (2.08 [1.68-2.57]) than those prescribed fine-particle ICS. The odds of therapy change were 0.70 (0.59-0.83) with ciclesonide. Conclusions In this matched cohort analysis, we observed that initiation of ICS with ciclesonide was associated with better 1-year asthma outcomes and fewer changes to therapy, despite data suggesting more difficult-to-control asthma. The median prescribed dose of ciclesonide was one-third that of fine-particle ICS. PMID:28102056

  9. 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

    2008-12-01

    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 designed by health educators and local students, which teaches asthma physiology and asthma self-management techniques to middle and high school students in Oakland, CA. Eligible students were identified through an in-class asthma case identification survey. Approximately 10-15 students identified as asthmatic were recruited for each series of the Kickin' Asthma intervention. The curriculum was delivered by an asthma nurse in a series of four 50-minute sessions. Students completed a baseline and a 3-month follow-up survey that compared symptom frequency, health care utilization, activity limitations, and medication use. Of the 8488 students surveyed during the first 3 years of the intervention (2003-2006), 15.4% (n = 1309) were identified as asthmatic; approximately 76% of eligible students (n = 990) from 15 middle schools and 3 high schools participated in the program. Comparison of baseline to follow-up data indicated that students experienced significantly fewer days with activity limitations and significantly fewer nights of sleep disturbance after participation in the intervention. For health care utilization, students reported significantly less frequent emergency department visits or hospitalizations between the baseline and follow-up surveys. A school-based asthma curriculum designed specifically for urban students has been shown to reduce symptoms, activity limitations, and health care utilization for intervention participants.

  10. Microbiota in allergy and asthma and the emerging relationship with the gut microbiome.

    Science.gov (United States)

    Fujimura, Kei E; Lynch, Susan V

    2015-05-13

    Asthma and atopy, classically associated with hyper-activation of the T helper 2 (Th2) arm of adaptive immunity, are among the most common chronic illnesses worldwide. Emerging evidence relates atopy and asthma to the composition and function of the human microbiome, the collection of microbes that reside in and on and interact with the human body. The ability to interrogate microbial ecology of the human host is due in large part to recent technological developments that permit identification of microbes and their products using culture-independent molecular detection techniques. In this review we explore the roles of respiratory, gut, and environmental microbiomes in asthma and allergic disease development, manifestation, and attenuation. Though still a relatively nascent field of research, evidence to date suggests that the airway and/or gut microbiome may represent fertile targets for prevention or management of allergic asthma and other diseases in which adaptive immune dysfunction is a prominent feature. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Full-chain health impact assessment of traffic-related air pollution and childhood asthma.

    Science.gov (United States)

    Khreis, Haneen; de Hoogh, Kees; Nieuwenhuijsen, Mark J

    2018-05-01

    Asthma is the most common chronic disease in children. Traffic-related air pollution (TRAP) may be an important exposure contributing to its development. In the UK, Bradford is a deprived city suffering from childhood asthma rates higher than national and regional averages and TRAP is of particular concern to the local communities. We estimated the burden of childhood asthma attributable to air pollution and specifically TRAP in Bradford. Air pollution exposures were estimated using a newly developed full-chain exposure assessment model and an existing land-use regression model (LUR). We estimated childhood population exposure to NO x and, by conversion, NO 2 at the smallest census area level using a newly developed full-chain model knitting together distinct traffic (SATURN), vehicle emission (COPERT) and atmospheric dispersion (ADMS-Urban) models. We compared these estimates with measurements and estimates from ESCAPE's LUR model. Using the UK incidence rate for childhood asthma, meta-analytical exposure-response functions, and estimates from the two exposure models, we estimated annual number of asthma cases attributable to NO 2 and NO x in Bradford, and annual number of asthma cases specifically attributable to traffic. The annual average census tract levels of NO 2 and NO x estimated using the full-chain model were 15.41 and 25.68 μg/m 3 , respectively. On average, 2.75 μg/m 3 NO 2 and 4.59 μg/m 3 NO x were specifically contributed by traffic, without minor roads and cold starts. The annual average census tract levels of NO 2 and NO x estimated using the LUR model were 21.93 and 35.60 μg/m 3 , respectively. The results indicated that up to 687 (or 38% of all) annual childhood asthma cases in Bradford may be attributable to air pollution. Up to 109 cases (6%) and 219 cases (12%) may be specifically attributable to TRAP, with and without minor roads and cold starts, respectively. This is the first study undertaking full-chain health impact assessment

  12. Identification of Immunity-Related Genes in Dialeurodes citri against Entomopathogenic Fungus Lecanicillium attenuatum by RNA-Seq Analysis.

    Directory of Open Access Journals (Sweden)

    Shijiang Yu

    Full Text Available Dialeurodes citri is a major pest in citrus producing areas, and large-scale outbreaks have occurred increasingly often in recent years. Lecanicillium attenuatum is an important entomopathogenic fungus that can parasitize and kill D. citri. We separated the fungus from corpses of D. citri larvae. However, the sound immune defense system of pests makes infection by an entomopathogenic fungus difficult. Here we used RNA sequencing technology (RNA-Seq to build a transcriptome database for D. citri and performed digital gene expression profiling to screen genes that act in the immune defense of D. citri larvae infected with a pathogenic fungus. De novo assembly generated 84,733 unigenes with mean length of 772 nt. All unigenes were searched against GO, Nr, Swiss-Prot, COG, and KEGG databases and a total of 28,190 (33.3% unigenes were annotated. We identified 129 immunity-related unigenes in transcriptome database that were related to pattern recognition receptors, information transduction factors and response factors. From the digital gene expression profile, we identified 441 unigenes that were differentially expressed in D. citri infected with L. attenuatum. Through calculated Log2Ratio values, we identified genes for which fold changes in expression were obvious, including cuticle protein, vitellogenin, cathepsin, prophenoloxidase, clip-domain serine protease, lysozyme, and others. Subsequent quantitative real-time polymerase chain reaction analysis verified the results. The identified genes may serve as target genes for microbial control of D. citri.

  13. Identification of Immunity-Related Genes in Dialeurodes citri against Entomopathogenic Fungus Lecanicillium attenuatum by RNA-Seq Analysis.

    Science.gov (United States)

    Yu, Shijiang; Ding, Lili; Luo, Ren; Li, Xiaojiao; Yang, Juan; Liu, Haoqiang; Cong, Lin; Ran, Chun

    2016-01-01

    Dialeurodes citri is a major pest in citrus producing areas, and large-scale outbreaks have occurred increasingly often in recent years. Lecanicillium attenuatum is an important entomopathogenic fungus that can parasitize and kill D. citri. We separated the fungus from corpses of D. citri larvae. However, the sound immune defense system of pests makes infection by an entomopathogenic fungus difficult. Here we used RNA sequencing technology (RNA-Seq) to build a transcriptome database for D. citri and performed digital gene expression profiling to screen genes that act in the immune defense of D. citri larvae infected with a pathogenic fungus. De novo assembly generated 84,733 unigenes with mean length of 772 nt. All unigenes were searched against GO, Nr, Swiss-Prot, COG, and KEGG databases and a total of 28,190 (33.3%) unigenes were annotated. We identified 129 immunity-related unigenes in transcriptome database that were related to pattern recognition receptors, information transduction factors and response factors. From the digital gene expression profile, we identified 441 unigenes that were differentially expressed in D. citri infected with L. attenuatum. Through calculated Log2Ratio values, we identified genes for which fold changes in expression were obvious, including cuticle protein, vitellogenin, cathepsin, prophenoloxidase, clip-domain serine protease, lysozyme, and others. Subsequent quantitative real-time polymerase chain reaction analysis verified the results. The identified genes may serve as target genes for microbial control of D. citri.

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Asthma-related Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with Current Asthma Asthma Severity among Children with Current Asthma Overuse of quick-relief medication among persons with active asthma Use of long-term control ...

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

    Science.gov (United States)

    Sama, Susan R; Hunt, Phillip R; Cirillo, C I H Priscilla; Marx, Arminda; Rosiello, Richard A; Henneberger, Paul K; Milton, Donald K

    2003-08-07

    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. 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. 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%. Computerized HMO records can be successfully used to identify AOA. Manual review of these records is important to confirm case status and is useful in evaluation of

  16. Allergy and asthma prevention 2014

    DEFF Research Database (Denmark)

    Nieto, Antonio; Wahn, Ulrich; Bufe, Albrecht

    2014-01-01

    Asthma and allergic diseases have become one of the epidemics of the 21st century in developed countries. Much of the success of other areas of medicine, such as infectious diseases, lies on preventive measures. Thus, much effort is also being placed lately in the prevention of asthma and allergy....... This manuscript reviews the current evidence, divided into four areas of activity. Interventions modifying environmental exposure to allergens have provided inconsistent results, with multifaceted interventions being more effective in the prevention of asthma. Regarding nutrition, the use of hydrolyzed formulas...... that antiviral vaccines could be useful in the future. Allergen-specific immunotherapy is effective for the treatment of allergic patients with symptoms; the study of its value for primary and secondary prevention of asthma and allergy is in its very preliminary phases. The lack of success in the prevention...

  17. Review of family relational stress and pediatric asthma: the value of biopsychosocial systemic models.

    Science.gov (United States)

    Wood, Beatrice L; Miller, Bruce D; Lehman, Heather K

    2015-06-01

    Asthma is the most common chronic disease in children. Despite dramatic advances in pharmacological treatments, asthma remains a leading public health problem, especially in socially disadvantaged minority populations. Some experts believe that this health gap is due to the failure to address the impact of stress on the disease. Asthma is a complex disease that is influenced by multilevel factors, but the nature of these factors and their interrelations are not well understood. This paper aims to integrate social, psychological, and biological literatures on relations between family/parental stress and pediatric asthma, and to illustrate the utility of multilevel systemic models for guiding treatment and stimulating future research. We used electronic database searches and conducted an integrated analysis of selected epidemiological, longitudinal, and empirical studies. Evidence is substantial for the effects of family/parental stress on asthma mediated by both disease management and psychobiological stress pathways. However, integrative models containing specific pathways are scarce. We present two multilevel models, with supporting data, as potential prototypes for other such models. We conclude that these multilevel systems models may be of substantial heuristic value in organizing investigations of, and clinical approaches to, the complex social-biological aspects of family stress in pediatric asthma. However, additional systemic models are needed, and the models presented herein could serve as prototypes for model development. © 2015 Family Process Institute.

  18. Asthma Morbidity, Comorbidities, and Modifiable Factors Among Older Adults.

    Science.gov (United States)

    Hsu, Joy; Chen, Jessica; Mirabelli, Maria C

    Asthma morbidity is increased among older adults, especially older adult women. Interventions to improve asthma control in this population are not well described. The objective of this study was to identify risk factors (including modifiable factors) associated with asthma-related hospitalizations and emergency department or urgent care center visits (ED/UCV) among older adults. A secondary objective was to investigate sex differences in variables relevant to asthma control. Data were obtained from 14,076 older adults ≥65 years with active asthma participating in the 2006-2010 Behavioral Risk Factor Surveillance System Asthma Call-back Survey (a random-digit dialed survey) in 40 US states, the District of Columbia, and Puerto Rico, representative of >2.6 million persons. Weighted, adjusted logistic regression was conducted. One or more asthma-related hospitalizations in the past year were reported by 5.7% (95% confidence interval [95% CI] = 5.0% to 6.4%) of participants; 10.6% (95% CI = 9.7% to 11.5%) reported ≥1 asthma-related ED/UCV. Compared with older adults without asthma-related hospitalizations, adjusted odds were higher among those with ≥1 asthma-related hospitalization for chronic obstructive pulmonary disease (COPD), coronary artery disease, depression, cockroaches or mold in the home, and cost barriers to asthma-related health care or medication. All these factors, except for cockroaches, were associated with asthma-related ED/UCV. Compared with males, adjusted odds were higher among females for COPD, depression, obesity, and cost barriers to asthma-related health care or medication. Among older adults, asthma-related hospitalizations and ED/UCV were associated with clinical comorbidities, mold in the home, and financial barriers to asthma-related health care. Interventions addressing modifiable factors could reduce asthma morbidity among older adults. Published by Elsevier Inc.

  19. Asthma Home Environment Checklist

    Science.gov (United States)

    This checklist guides home care visitors in identifying environmental asthma triggers most commonly found in homes. It includes sections on the building, home interior and room interior and provides low-cost action steps for remediation.

  20. Glucagon-like peptide 1: A potential anti-inflammatory pathway in obesity-related asthma.

    Science.gov (United States)

    Nguyen, Dan-Vinh; Linderholm, Angela; Haczku, Angela; Kenyon, Nicholas

    2017-12-01

    Alterations in arginine metabolism and accelerated formation of advanced glycation end-products (AGEs), crucial mechanisms in obesity-related asthma, can be modulated by glucagon-like peptide 1 (GLP-1). l-arginine dysregulation in obesity promotes inflammation and bronchoconstriction. Prolonged hyperglycemia, dyslipidemia, and oxidative stress leads to production of AGEs, that bind to their receptor (RAGE) further potentiating inflammation. By binding to its widely distributed receptor, GLP-1 blunts the effects of RAGE activation and arginine dysregulation. The GLP-1 pathway, while comprehensively studied in the endocrine and cardiovascular literature, is under-recognized in pulmonary research. Insights into GLP-1 and the lung may lead to novel treatments for obesity-related asthma. Published by Elsevier Inc.

  1. MECHANISTIC INDICATORS OF CHILDHOOD ASTHMA (MICA): A SYSTEMS BIOLOGY APPROACH FOR THE INTEGRATION OF MULTIFACTORIAL EXPOSURE AND ENVIRONMENTAL HEALTH DATA

    Science.gov (United States)

    Modem methods in molecular biology and advanced computational tools show promise in elucidating complex interactions that occur between genes and environmental factors in diseases such as asthma. However, appropriately designed studies are critical for these methods to reach the...

  2. Asthma, Allergies and Pregnancy

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  3. Explaining Racial Disparities in Child Asthma Readmission Using a Causal Inference Approach.

    Science.gov (United States)

    Beck, Andrew F; Huang, Bin; Auger, Katherine A; Ryan, Patrick H; Chen, Chen; Kahn, Robert S

    2016-07-01

    Childhood asthma is characterized by disparities in the experience of morbidity, including the risk for readmission to the hospital after an initial hospitalization. African American children have been shown to have more than 2 times the hazard of readmission when compared with their white counterparts. To explain why African American children are at greater risk for asthma-related readmissions than white children. This study was completed as part of the Greater Cincinnati Asthma Risks Study, a population-based, prospective, observational cohort. From August 2010 to October 2011, it enrolled 695 children, aged 1 to 16 years, admitted for asthma or wheezing who identified as African American (n = 441) or white (n = 254) in an inpatient setting of an urban, tertiary care children's hospital. The main outcome was time to asthma-related readmission and race was the predictor. Biologic, environmental, disease management, access, and socioeconomic hardship variables were measured; their roles in understanding racial readmission disparities were conceptualized using a directed acyclic graphic. Inverse probability of treatment weighting balanced African American and white children with respect to key measured variables. Racial differences in readmission hazard were assessed using weighted Cox proportional hazards regression and Kaplan-Meier curves. The sample was 65% male (n = 450), and the median age was 5.4 years. African American children were 2.26 times more likely to be readmitted than white children (95% CI, 1.56-3.26). African American children significantly differed with respect to nearly every measured biologic, environmental, disease management, access, and socioeconomic hardship variable. Socioeconomic hardship variables explained 53% of the observed disparity (hazard ratio, 1.47; 95% CI, 1.05-2.05). The addition of biologic, environmental, disease management, and access variables resulted in 80% of the readmission disparity being explained. The

  4. Allergic asthma biomarkers using systems approaches

    Directory of Open Access Journals (Sweden)

    Gaurab eSircar

    2014-01-01

    Full Text Available Asthma is characterized by lung inflammation caused by complex interaction between the immune system and environmental factors such as allergens and inorganic pollutants. Recent research in this field is focused on discovering new biomarkers associated with asthma pathogenesis. This review illustrates updated research associating biomarkers of allergic asthma and their potential use in systems biology of the disease. We focus on biomolecules with altered expression, which may serve as inflammatory, diagnostic and therapeutic biomarkers of asthma discovered in human or experimental asthma model using genomic, proteomic and epigenomic approaches for gene and protein expression profiling. These include high-throughput technologies such as state of the art microarray and proteomics Mass Spectrometry (MS platforms. Emerging concepts of molecular interactions and pathways may provide new insights in searching potential clinical biomarkers. We summarized certain pathways with significant linkage to asthma pathophysiology by analyzing the compiled biomarkers. Systems approaches with this data can identify the regulating networks, which will eventually identify the key biomarkers to be used for diagnostics and drug discovery.

  5. Age at asthma onset and asthma self-management education among adults in the United States.

    Science.gov (United States)

    Mirabelli, Maria C; Beavers, Suzanne F; Shepler, Samantha H; Chatterjee, Arjun B

    2015-01-01

    Asthma self-management education improves asthma-related outcomes. We conducted this analysis to evaluate variation in the percentages of adults with active asthma reporting components of asthma self-management education by age at asthma onset. Data from 2011 to 2012 Asthma Call-back Surveys were used to estimate percentages of adults with active asthma reporting six components of asthma self-management education. Components of asthma self-management education include having been taught to what to do during an asthma attack and receiving an asthma action plan. Differences in the percentages of adults reporting each component and the average number of components reported across categories of age at asthma onset were estimated using linear regression, adjusted for age, education, race/ethnicity, sex, smoking status, and years since asthma onset. Overall, an estimated 76.4% of adults with active asthma were taught what to do during an asthma attack and 28.7% reported receiving an asthma action plan. Percentages reporting each asthma self-management education component declined with increasing age at asthma onset. Compared with the referent group of adults whose asthma onset occurred at 5-14 years of age, the percentage of adults reporting being taught what to do during an asthma attack was 10% lower among those whose asthma onset occurred at 65-93 years of age (95% CI: -18.0, -2.5) and the average number of components reported decreased monotonically across categories of age at asthma onset of 35 years and older. Among adults with active asthma, reports of asthma self-management education decline with increasing age at asthma onset.

  6. 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)

  7. Factors related to the incorrect use of inhalers by asthma patients

    Directory of Open Access Journals (Sweden)

    Paulo de Tarso Roth Dalcin

    2014-01-01

    Full Text Available OBJECTIVE: To evaluate inhaler technique in outpatients with asthma and to determine associations between the correctness of that technique and the level of asthma control. METHODS: This was a cross-sectional study involving patients > 14 years of age with physician-diagnosed asthma. The patients were recruited from the Asthma Outpatient Clinic of the Hospital de Clínicas de Porto Alegre, in the city of Porto Alegre, Brazil. The patients completed two questionnaires (a general questionnaire and an asthma control questionnaire based on the 2011 Global Initiative for Asthma guidelines, demonstrated their inhaler technique, and performed pulmonary function tests. Incorrect inhaler technique was defined as the incorrect execution of at least two of the predefined steps. RESULTS: We included 268 patients. Of those, 81 (30.2% showed incorrect inhaler technique, which was associated with poor asthma control (p = 0.002. Logistic regression analysis identified the following factors associated with incorrect inhaler technique: being widowed (OR = 5.01; 95% CI, 1.74-14.41; p = 0.003; using metered dose inhalers (OR = 1.58; 95% CI, 1.35-1.85; p 2 comorbidities (OR = 3.80; 95% CI, 1.03-14.02; p = 0.045. CONCLUSIONS: In the sample studied, incorrect inhaler technique was associated with poor asthma control. Widowhood, use of metered dose inhalers, low socioeconomic level, and the presence of > 2 comorbidities were associated with incorrect inhaler technique.

  8. The National Asthma Survey--New York State: association of the home environment with current asthma status.

    Science.gov (United States)

    Nguyen, Trang; Lurie, Melissa; Gomez, Marta; Reddy, Amanda; Pandya, Kruti; Medvesky, Michael

    2010-01-01

    The National Asthma Survey--New York State (NYS), a telephone survey of NYS residents, was conducted in 2002-2003 to further understand the burden of asthma among adults and children and to identify health, socioeconomic, behavioral, and environmental factors associated with asthma. A total of 1,412 households with at least one member with current asthma and 2,290 control households answered questions about their home environment (e.g., presence of asthma triggers and practices that promote or reduce common asthma triggers). RESULTS; For children younger than 18 years of age, we found statistically significant positive associations between current asthma and the presence of mold (adjusted odds ratio [AOR] = 2.1, 95% confidence interval [CI] 1.3, 3.3), air cleaners (AOR = 1.5, 95% CI 1.1, 2.1), dehumidifiers (AOR = 2.0, 95% CI 1.4, 2.7), and humidifiers (AOR = 1.6, 95% CI 1.1, 2.3). For adults, there were statistically significant positive associations with the presence of mold (AOR = 2.5, 95% CI 1.8, 3.4), air cleaners (AOR = 2.2, 95% CI 1.7, 2.8), and humidifiers (AOR = 1.4, 95% CI 1.1, 1.8). There were no statistically significant associations with the presence of cockroaches, pets, or tobacco smoke, while use of a wood-burning stove or fireplace was significantly more prevalent in control homes. Asthma guidelines emphasize the importance of reducing triggers in the home as part of a multifaceted approach to asthma control. Despite these guidelines, many asthma triggers (specifically, mold) were as prevalent or more so in the homes of New Yorkers with asthma as compared with control households. Public health interventions in NYS should focus on educating households about potential asthma triggers and their sources and teach methods to prevent, reduce, or eliminate them.

  9. Rural Asthma: Current Understanding of Prevalence, Patterns, and Interventions for Children and Adolescents.

    Science.gov (United States)

    Estrada, Robin Dawson; Ownby, Dennis R

    2017-06-01

    Asthma is the most common chronic illness of children and adolescents in the USA. While asthma has been understood to disproportionately affect urban dwellers, recent investigations have revealed rural pediatric asthma prevalence to be very similar to urban and to be more closely correlated with socioeconomic and environmental factors than geographic location or population density. Rural children experience factors unique to location that impact asthma development and outcomes, including housing quality, cigarette smoke exposure, and small/large-scale farming. Additionally, there are challenging barriers to appropriate asthma care that frequently are more severe for those living in rural areas, including insurance status, lack of primary care providers and pulmonary specialists, knowledge deficits (both patient and provider), and a lack of culturally tailored asthma interventions. Interventions designed to address rural pediatric asthma disparities are more likely to be successful when targeted to specific challenges, such as the use of school-based services or telemedicine to mitigate asthma care access issues. Continued research on understanding the complex interaction of specific rural environmental factors with host factors can inform future interventions designed to mitigate asthma disparities.

  10. Clearing the air and breathing freely: the health politics of air pollution and asthma.

    Science.gov (United States)

    Brown, Phil; Mayer, Brian; Zavestoski, Stephen; Luebke, Theo; Mandelbaum, Joshua; McCormick, Sabrina

    2004-01-01

    This study examines the growing debate around environmental causes of asthma in the context of federal regulatory disputes, scientific controversy, and environmental justice activism. A multifaceted form of social discovery of the effect of air pollution on asthma has resulted from multipartner and multiorganizational approaches and from intersectoral policy that deals with social inequality and environmental justice. Scientists, activists, health voluntary organizations, and some government agencies and officials have identified various elements of the asthma and air pollution connection. To tackle these issues, they have worked through a variety of collaborations and across different sectors of environmental regulation, public health, health services, housing, transportation, and community development. The authors examine the role of activist groups in discovering the increased rates of asthma and framing it as a social and environmental issue; give an overview of the current knowledge base on air pollution and asthma, and the controversies within science; and situate that science in the regulatory debate, discussing the many challenges to the air quality researchers. They then examine the implications of the scientific and regulatory controversies over linking air pollution to increases in asthma. The article concludes with a discussion of how alliances between activists and scientists lead to new research strategies and innovations.

  11. Factors affecting fungus-induced larval mortality in Anopheles gambiae and Anopheles stephensi

    Directory of Open Access Journals (Sweden)

    Takken Willem

    2010-01-01

    Full Text Available Abstract Background Entomopathogenic fungi have shown great potential for the control of adult malaria vectors. However, their ability to control aquatic stages of anopheline vectors remains largely unexplored. Therefore, how larval characteristics (Anopheles species, age and larval density, fungus (species and concentration and environmental effects (exposure duration and food availability influence larval mortality caused by fungus, was studied. Methods Laboratory bioassays were performed on the larval stages of Anopheles gambiae and Anopheles stephensi with spores of two fungus species, Metarhizium anisopliae and Beauveria bassiana. For various larval and fungal characteristics and environmental effects the time to death was determined and survival curves established. These curves were compared by Kaplan Meier and Cox regression analyses. Results Beauveria bassiana and Metarhizium anisopliae caused high mortality of An. gambiae and An. stephensi larvae. However, Beauveria bassiana was less effective (Hazard ratio (HR Metarhizium anisopliae. Anopheles stephensi and An. gambiae were equally susceptible to each fungus. Older larvae were less likely to die than young larvae (HR Conclusions This study shows that both fungus species have potential to kill mosquitoes in the larval stage, and that mortality rate depends on fungus species itself, larval stage targeted, larval density and amount of nutrients available to the larvae. Increasing the concentration of fungal spores or reducing the exposure time to spores did not show a proportional increase and decrease in mortality rate, respectively, because the spores clumped together. As a result spores did not provide uniform coverage over space and time. It is, therefore, necessary to develop a formulation that allows the spores to spread over the water surface. Apart from formulation appropriate delivery methods are also necessary to avoid exposing non-target organisms to fungus.

  12. Early-life home environment and risk of asthma among inner-city children.

    Science.gov (United States)

    O'Connor, George T; Lynch, Susan V; Bloomberg, Gordon R; Kattan, Meyer; Wood, Robert A; Gergen, Peter J; Jaffee, Katy F; Calatroni, Agustin; Bacharier, Leonard B; Beigelman, Avrahman; Sandel, Megan T; Johnson, Christine C; Faruqi, Ali; Santee, Clark; Fujimura, Kei E; Fadrosh, Douglas; Boushey, Homer; Visness, Cynthia M; Gern, James E

    2018-04-01

    Environmental exposures in early life appear to play an important role in the pathogenesis of childhood asthma, but the potentially modifiable exposures that lead to asthma remain uncertain. We sought to identify early-life environmental risk factors for childhood asthma in a birth cohort of high-risk inner-city children. We examined the relationship of prenatal and early-life environmental factors to the occurrence of asthma at 7 years of age among 442 children. Higher house dust concentrations of cockroach, mouse, and cat allergens in the first 3 years of life were associated with lower risk of asthma (for cockroach allergen: odds ratio per interquartile range increase in concentration, 0.55; 95% CI, 0.36-0.86; P < .01). House dust microbiome analysis using 16S ribosomal RNA sequencing identified 202 and 171 bacterial taxa that were significantly (false discovery rate < 0.05) more or less abundant, respectively, in the homes of children with asthma. A majority of these bacteria were significantly correlated with 1 of more allergen concentrations. Other factors associated significantly positively with asthma included umbilical cord plasma cotinine concentration (odds ratio per geometric SD increase in concentration, 1.76; 95% CI, 1.00-3.09; P = .048) and maternal stress and depression scores. Among high-risk inner-city children, higher indoor levels of pet or pest allergens in infancy were associated with lower risk of asthma. The abundance of a number of bacterial taxa in house dust was associated with increased or decreased asthma risk. Prenatal tobacco smoke exposure and higher maternal stress and depression scores in early life were associated with increased asthma risk. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  13. Increased ultrafine particles and carbon monoxide concentrations are associated with asthma exacerbation among urban children

    Science.gov (United States)

    Evans, Kristin A.; Halterman, Jill S.; Hopke, Philip K.; Fagnano, Maria; Rich, David Q.

    2014-01-01

    % CI=1.03–2.59). Relative odds estimates were larger among children receiving school-based inhaled corticosteroid treatment. We observed no such associations with accumulation mode particles, black carbon, fine particles (≤ 2.5 μm), or sulfur dioxide. Ozone concentrations were inversely associated with the relative odds of a pediatric asthma visit. Conclusions These findings suggest a response to markers of traffic pollution among urban asthmatic children. Effects were strongest among children receiving preventive medications through school, suggesting that this group of children was particularly sensitive to environmental triggers. Medication adherence alone may be insufficient to protect the most vulnerable from environmental asthma triggers. However, further research is necessary to confirm this finding. PMID:24528997

  14. Prevalence of asthma and asthma-like symptoms in inner-city schoolchildren.

    Science.gov (United States)

    Mvula, Mosanda; Larzelere, Michele; Kraus, Marjorie; Moisiewicz, Kathleen; Morgan, Connie; Pierce, Stephanie; Post, Robert; Nash, Theresa; Moore, Cleveland

    2005-02-01

    This study investigates the prevalence of asthma and asthma-related symptoms in New Orleans inner-city schoolchildren. A cross-sectional survey of 1535 elementary, middle, and high school children (aged 5-18) was conducted by using the International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire. Lifetime prevalence of wheezing was 39.4%, and lifetime prevalence of asthma was 24.4%. Wheezing during the previous 12 months was reported by 25.7% of the sample. Twenty-one percent of respondents reported having one or more attacks of wheezing per year, with 5.6% reporting four or more attacks per year. Many participants reported sleep disturbance (15.4%), with 6.2% reporting sleep disturbance more than once a week. The 12-month rate of speech limitation due to asthma exacerbation was 6.6%. Exercise-induced asthma was reported by 16.9% of the students, and nocturnal cough (not associated with cold) was reported by 27.3%. Overall, boys reported higher rates of symptoms than girls, and younger children (aged 6-7) reported greater symptoms than older children (aged 13-14). These findings show that prevalence of asthma in this population is elevated, and the ISAAC written questionnaire successfully identified inner-city children at risk for asthma in New Orleans.

  15. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School and Childcare Providers CDC Publications on Asthma National Asthma Control Program ...

  16. Asthma and allergic rhinitis in adoptees and their adoptive parents.

    Science.gov (United States)

    Smith, J M; Cadoret, R J; Burns, T L; Troughton, E P

    1998-08-01

    Since the highest risk for the development of atopic disease is in early life, environmental risk factors need to be separated from the genetic component in this high risk period. Adoptees removed at birth and placed in adoptive families present a way to separate environmental and genetic factors at this early susceptible age. An opportunity for a pilot study of asthma and allergic rhinitis in adoptive families was presented when a psychiatrist (RC) was planning a behavioral study of young adult adoptees and their adoptive parents. A detailed questionnaire about allergic rhinitis and asthma was added after the psychiatrists' interview. Placement was not influenced by a history of allergy in adoptive or natural parents. The adoptee and at least one adoptive parent completed questionnaires in 367 families. The adoptees had been removed at birth and placed in the adoptive family within 3 months (83% within 1 month). Compared with adoptive families without asthma or allergic rhinitis, an adoptive mother with asthma or rhinitis, when the adoptive father was not affected, increased the risk for asthma in the adoptee (OR = 3.2, P adoptive mother alone (OR = 3.2, P Adoptive father asthma or allergic rhinitis showed a trend toward increased asthma in the adoptee (OR = 1.9, P adoption by parents with asthma or allergic rhinitis suggests that further well planned adoptee studies should be made.

  17. Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma

    DEFF Research Database (Denmark)

    Prescott, E; Lange, P; Vestbo, J

    1997-01-01

    BACKGROUND: Women are more often admitted to hospital for asthma than men. A study was undertaken to determine whether this is caused by gender differences in the prevalence or severity of the disease. METHODS: Admissions to hospital for asthma in 13,540 subjects were followed from 1977 to 1993....... RESULTS: At baseline 315 subjects (2.3%) reported asthma, 2.2% of women and 2.5% of men. During follow up 160 subjects were admitted to hospital for asthma. After controlling for self-reported asthma and smoking, women had a higher risk of being admitted to hospital than men (relative risk 1.7, 95...

  18. Work-related stress, inability to relax after work and risk of adult asthma: a population-based cohort study.

    Science.gov (United States)

    Loerbroks, A; Gadinger, M C; Bosch, J A; Stürmer, T; Amelang, M

    2010-10-01

    There is an extensive literature linking stressful work conditions to adverse health outcomes. Notwithstanding, the relationship with asthma has not been examined, although various other measures of psychological stress have been associated with asthma. Therefore, we aimed to investigate the relation between work stress and asthma prevalence and incidence. We used data from a population-based cohort study (n = 5114 at baseline in 1992-1995 and n = 4010 at follow-up in 2002/2003). Asthma was measured by self-reports. Two scales that assessed psychologically adverse work conditions were extracted from a list of work-condition items by factor analysis (these scales were termed 'work stress' and 'inability to relax after work'). For each scale, the derived score was employed both as continuous z-score and as categorized variable in analyses. Associations with asthma were estimated by prevalence ratios (PRs) and risk ratios (RRs) using Poisson regression with a log-link function adjusting for demographics, health-related lifestyles, body mass index and family history of asthma. Analyses were restricted to those in employment (n = 3341). Work stress and inability to relax z-scores were positively associated with asthma prevalence (PR = 1.15, 95%CI = 0.97, 1.36 and PR = 1.43, 95%CI = 1.12, 1.83, respectively). Prospective analyses using z-scores showed that for each 1 standard deviation increase in work stress and inability to relax, the risk of asthma increased by approximately 40% (RR for work stress = 1.46, 95%CI = 1.06, 2.00; RR for inability to relax = 1.39, 95%CI = 1.01, 1.91). Similar patterns of associations were observed in analyses of categorized exposures. This is the first study to show a cross-sectional and longitudinal association of work stress with asthma.

  19. Racial disparities in health-related quality of life in a cohort of very-low-birth-weight 2- and 3-year-olds with and without asthma.

    Science.gov (United States)

    McManus, Beth Marie; Robert, Stephanie; Albanese, Aggie; Sadek-Badawi, Mona; Palta, Mari

    2012-07-01

    Children born very low birth weight (VLBW) are at risk for low health-related quality of life (HRQoL), compared with normal-birth-weight peers, and racial disparities may compound the difference. Asthma is the most pervasive health problem among VLBW children and is also more common among black than white children, partly due to unfavourable environmental exposures. This study explores racial disparities in HRQoL among VLBW children and examines whether potential disparities can be explained by asthma and neighbourhood disadvantage. The study population was the Newborn Lung Project, a cohort of infants (n=660) born VLBW in 2003-2004 in Wisconsin, USA, who were followed up at age 2-3. Multilevel linear regression models were used to examine the contributions of asthma, neighbourhood disadvantage, and other child and family socio-demographic covariates, to racial disparities in HRQoL at age 2-3. A child's HRQoL was measured using the Paediatric Quality of Life Inventory 4.0. VLBW, black, non-Hispanic children, on average, score nearly 4 points lower (p0.05). The authors found no evidence that the relationship between asthma and HRQoL differs by race. The interaction between neighbourhood disadvantage and asthma is statistically significant, with further examination suggesting that racial disparities are particularly pronounced in the most advantaged neighbourhoods. The authors found that the black disadvantage in HRQoL among 2-3-year-old VLBW children likely stems from a high prevalence of asthma. Neighbourhood attributes did not further explain the disparity, as the racial difference was particularly pronounced in advantaged neighbourhoods.

  20. Genetics of asthma: a molecular biologist perspective

    OpenAIRE

    Ghosh Balaram; Kumar Amrendra

    2009-01-01

    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 biologica...

  1. Proteomic Analysis Reveals the Deregulation of Inflammation-Related Proteins in Acupuncture-Treated Rats with Asthma Onset

    Directory of Open Access Journals (Sweden)

    Yu-Dong Xu

    2012-01-01

    Full Text Available Although the beneficial effects of acupuncture in asthma treatment have been well documented, little is known regarding the biological basis of this treatment. Changes in the lung proteome of acupuncture-treated rats with asthma onset were comparatively analyzed using a two-dimensional gel electrophoresis (2DE and mass-spectrometry- (MS- based proteomic approach. Acupuncture on specific acupuncture points appeared to improve respiratory function and reduce the total number of leukocytes and eosinophils in bronchoalveolar lavage fluid in OVA-induced asthma onset. Image analysis of 2DE gels revealed 32 differentially expressed acupuncture-specific protein spots in asthma onset; 30 of which were successfully identified as 28 unique proteins using LC-MS/MS. Bioinformatic analyses indicated that these altered proteins are most likely involved in inflammation-related biological functions, and the functional associations of these proteins result in an inflammation signaling pathway. Acupuncture regulates the pathway at different levels by regulating several key nodal proteins, including downregulating of proinflammatory proteins (e.g., S100A8, RAGE, and S100A11 and upregulating of anti-inflammatory proteins (e.g., CC10, ANXA5, and sRAGE. These deregulated inflammation-related proteins may mediate, at least in part, the antiasthmatic effect of acupuncture. Further functional investigation of these acupuncture-specific effector proteins could identify new drug candidates for the prophylaxis and treatment of asthma.

  2. 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

  3. The Child Opportunity Index and Disparities in Pediatric Asthma Hospitalizations Across One Ohio Metropolitan Area, 2011-2013.

    Science.gov (United States)

    Beck, Andrew F; Huang, Bin; Wheeler, Kathryn; Lawson, Nikki R; Kahn, Robert S; Riley, Carley L

    2017-11-01

    To determine whether the Child Opportunity Index (COI), a nationally available measure of relative educational, health/environmental, and social/economic opportunity across census tracts within metropolitan areas, is associated with population- and patient-level asthma morbidity. This population-based retrospective cohort study was conducted between 2011 and 2013 in a southwest Ohio county. Participants included all children aged 1-16 years with hospitalizations or emergency department visits for asthma or wheezing at a major pediatric hospital. Patients were identified using discharge diagnosis codes and geocoded to their home census tract. The primary population-level outcome was census tract asthma hospitalization rate. The primary patient-level outcome was rehospitalization within 12 months of the index hospitalization. Census tract opportunity was characterized using the COI and its educational, health/environmental, and social/economic domains. Across 222 in-county census tracts, there were 2539 geocoded hospitalizations. The median asthma-related hospitalization rate was 5.0 per 1000 children per year (IQR, 1.9-8.9). Median hospitalization rates in very low, low, moderate, high, and very high opportunity tracts were 9.1, 7.6, 4.6, 2.1, and 1.8 per 1000, respectively (P asthma morbidity. The details provided by the COI may inform interventions aimed at increasing opportunity and reducing morbidity across regions. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Rhinitis, Asthma and Respiratory Infections among Adults in Relation to the Home Environment in Multi-Family Buildings in Sweden

    Science.gov (United States)

    Wang, Juan; Engvall, Karin; Smedje, Greta; Norbäck, Dan

    2014-01-01

    Risk factors for rhinitis, asthma and respiratory infections in the home environment were studied by a questionnaire survey. Totally 5775 occupants (≥18 years old) from a stratified random sample of multi-family buildings in Sweden participated (46%). 51.0% had rhinitis in the last 3 months (current rhinitis); 11.5% doctor diagnosed asthma; 46.4% respiratory infections in the last 3 months and 11.9% antibiotic medication for respiratory infections in the last 12 months. Associations between home environment and health were analyzed by multiple logistic regression, controlling for gender, age and smoking and mutual adjustment. Buildings constructed during 1960–1975 were risk factors for day time breathlessness (OR = 1.53, 95%CI 1.03–2.29). And those constructed during 1976–1985 had more current rhinitis (OR = 1.43, 95%CI 1.12–1.84) and respiratory infections (OR = 1.46, 95%CI 1.21–1.78). Cities with higher population density had more current rhinitis (p = 0.008) and respiratory infections (pBuilding dampness was a risk factor for wheeze (OR = 1.42, 95%CI 1.08–1.86) and day time breathlessness (OR = 1.57, 95%CI 1.09–2.27). Building dampness was a risk factor for health among those below 66 years old. Odor at home was a risk factor for doctor diagnosed asthma (OR = 1.49, 95%CI 1.08–2.06) and current asthma (OR = 1.52, 95%CI 1.03–2.24). Environmental tobacco smoke (ETS) was a risk factor for current asthma (OR = 1.53, 95%CI 1.09–2.16). Window pane condensation was a risk factor for antibiotic medication for respiratory infections (OR = 1.41, 95%CI 1.10–1.82). In conclusion, rhinitis, asthma and respiratory infections were related to a number of factors in the home environment. Certain building years (1961–1985), building dampness, window pane condensation and odor in the dwelling may be risk factors. PMID:25136984

  5. Phthalate-induced oxidative stress and association with asthma-related airway inflammation in adolescents

    DEFF Research Database (Denmark)

    Franken, Carmen; Lambrechts, Nathalie; Govarts, Eva

    2017-01-01

    Background In Belgium, around 8.5% of the children have asthmatic symptoms. Increased asthma risk in children has been reported in relation to exposure to phthalate plasticizers but the underlying mechanisms are largely unknown. Aim The aim of this study was to identify if oxidative stress......BP) and mono-ethyl phthalate (MEP). Analysis of 8-OHdG in urine was used as a sensitive biomarker of oxidative stress at the level of DNA. The presence of doctor-diagnosed asthma was elicited by a self-administered questionnaire. Associations were assessed using multiple linear and logistic regression models...

  6. Sibship and self-esteem in children with asthma

    Directory of Open Access Journals (Sweden)

    Concetta Polizzi

    2016-06-01

    Full Text Available This study has explored the valence of sibship that may empower the self-esteem of children with asthma at the interpersonal, environmental control competence, emotionality management, and body-image levels. It has been assumed that the relationship between siblings may have a moderating effect on the negative impact that asthma has on child’s development. Seventy children suffering from chronic asthma have been involved: 40 children with siblings (experimental group and 30 sibling-free children (control group. The children with asthma have exhibited higher levels of self-esteem in comparison with the sibling-free children. The results of the study, at the clinical significance level, highlight how meaningful could be the involvement of healthy siblings to support the development, and to ease the compliance of children suffering from asthma. The outcomes have confirmed the supportive valence of sibship for the self-esteem of the children with asthma.

  7. Sibship and Self-esteem in Children with Asthma.

    Science.gov (United States)

    Polizzi, Concetta; Fontana, Valentina; Carollo, Antonio; Bono, Alessandra; Burgio, Sofia; Perricone, Giovanna

    2016-06-15

    This study has explored the valence of sibship that may empower the self-esteem of children with asthma at the interpersonal, environmental control competence, emotionality management, and body-image levels. It has been assumed that the relationship between siblings may have a moderating effect on the negative impact that asthma has on child's development. Seventy children suffering from chronic asthma have been involved: 40 children with siblings (experimental group) and 30 sibling-free children (control group). The children with asthma have exhibited higher levels of self-esteem in comparison with the sibling-free children. The results of the study, at the clinical significance level, highlight how meaningful could be the involvement of healthy siblings to support the development, and to ease the compliance of children suffering from asthma. The outcomes have confirmed the supportive valence of sibship for the self-esteem of the children with asthma.

  8. Atopy, asthma, and lung function in relation to folate and vitamin B(12) in adults

    DEFF Research Database (Denmark)

    Thuesen, B H; Husemoen, L L N; Ovesen, L

    2010-01-01

    Recent studies suggested low serum folate and impaired folate metabolism as potential risk factors for development of asthma and atopic disease, but the results are inconsistent. The aim of this study was to investigate the relations of markers of folate and vitamin B12 (B12) deficiency with diff......Recent studies suggested low serum folate and impaired folate metabolism as potential risk factors for development of asthma and atopic disease, but the results are inconsistent. The aim of this study was to investigate the relations of markers of folate and vitamin B12 (B12) deficiency...

  9. Longitudinal patterns of predominant asthma disease activity in pediatric patients enrolled in an asthma-specific disease management program.

    Science.gov (United States)

    Scott, Lyne; Nichols, Breck; Choi Kwong, Kenny Yat; Morphew, Tricia; Jones, Craig A

    2008-08-01

    To determine if patterns of predominant asthma disease activity are more closely related than baseline asthma severity to measures of morbidity (acute asthma attack, emergency room visit/hospitalization, missed school days, and/or steroid burst). Retrospective analysis was performed for inner-city Los Angeles asthmatic children (3 to 18 years of age) during their first year of enrollment in an asthma-specific disease management program. All measures of morbidity were more closely related to patterns of predominant disease activity than baseline severity. We conclude that patterns of predominant disease activity are a more significant predictor of asthma morbidity than is baseline severity.

  10. Overall and peripheral lung function assessment by spirometry and forced oscillation technique in relation to asthma diagnosis and control.

    Science.gov (United States)

    Heijkenskjöld Rentzhog, C; Janson, C; Berglund, L; Borres, M P; Nordvall, L; Alving, K; Malinovschi, A

    2017-12-01

    Classic spirometry is effort dependent and of limited value in assessing small airways. Peripheral airway involvement, and relation to poor control, in asthma, has been highlighted recently. Forced oscillation technique (FOT) offers an effort-independent assessment of overall and peripheral lung mechanics. We studied the association between lung function variables, obtained either by spirometry or multifrequency (5, 11 and 19 Hz) FOT, and asthma diagnosis and control. Spirometry measures, resistance at 5 (R5) and 19 Hz (R19), reactance at 5 Hz (X5), resonant frequency (f res ), resistance difference between 5-19 Hz (R5-R19) and Asthma Control Test scores were determined in 234 asthmatic and 60 healthy subjects (aged 13-39 years). We used standardized lung function variables in logistic regression analyses, unadjusted and adjusted for age, height, gender and weight. Lower FEV 1 /FVC (OR [95% CI] 0.47 [0.32, 0.69]) and FEF 50 (0.62 [0.46, 0.85]) per standard deviation increase, and higher R5 (3.31 [1.95, 5.62]) and R19 (2.54 [1.65, 3.91]) were associated with asthma diagnosis. Independent predictive effects of FEV 1 /FVC and R5 or R19, respectively, were found for asthma diagnosis. Lower FEV 1 /FVC and altered peripheral FOT measures (X5, f res and R5-R19) were associated with uncontrolled asthma (P-values < .05). Resistance FOT measures were equally informative as spirometry, related to asthma diagnosis, and, furthermore, offered additive information to FEV 1 /FVC, supporting a complementary role for FOT. Asthma control was related to FOT measures of peripheral airways, suggesting a potential use in identifying such involvement. Further studies are needed to determine a clinical value and relevant reference values in children, for the multifrequency FOT measurements. © 2017 John Wiley & Sons Ltd.

  11. Herbal Medicine Cordyceps sinensis Improves Health-Related Quality of Life in Moderate-to-Severe Asthma

    OpenAIRE

    Wang, Ningqun; Li, Jie; Huang, Xiaobo; Chen, Wenqiang; Chen, Yujing

    2016-01-01

    Moderate-to-severe asthma has a substantial impact on the health-related quality of life (HR-QOL) of the patients. Cordyceps sinensis is a traditional Chinese medicine that is evaluated clinically for the treatment of many diseases, such as chronic allograft nephropathy, diabetic kidney disease, and lung fibrosis. In order to investigate the effects of Cordyceps sinensis on patients with moderate-to-severe persistent asthma, 120 subjects were randomized to receive Corbin capsule containing Co...

  12. Prevalence of and Risk Factors for Asthma in Off-Reserve Aboriginal Children and Adults in Canada

    Directory of Open Access Journals (Sweden)

    Hsiu-Ju Chang

    2012-01-01

    Full Text Available Only a few studies have investigated asthma morbidity in Canadian Aboriginal children. In the present study, data from the 2006 Aboriginal Peoples Survey were used to determine the prevalence and risk factors for asthma in Canadian Aboriginal children six to 14 years of age and adults 15 to 64 years of age living off reserve. The prevalence of asthma was 14.3% in children and 14.0% in adults. Children and adults with Inuit ancestry had a significantly lower prevalence of asthma than those with North American Indian and Métis ancestries. Factors significantly associated with ever asthma in children included male sex, allergy, low birth weight, obesity, poor dwelling conditions and urban residence. In adults, factors associated with ever asthma varied among Aboriginal groups; however, age group, sex and urban residence were associated with ever asthma in all four Aboriginal groups. The prevalence of asthma was lower in Aboriginal children and higher in Aboriginal adults compared with that reported for the Canadian population. Variation in the prevalence of and risk factors for asthma among Aboriginal ancestry groups may be related to genetic and environmental factors that require further investigation.

  13. A multifaceted community-based asthma intervention in Chicago: effects of trigger reduction and self-management education on asthma morbidity.

    Science.gov (United States)

    Turyk, Mary; Banda, Elizabeth; Chisum, Gay; Weems, Dolores; Liu, Yangyang; Damitz, Maureen; Williams, Rhonda; Persky, Victoria

    2013-09-01

    Home-based, multifaceted interventions have been effective in reducing asthma morbidity in children. However, identification of independent components that contribute to outcomes and delineating effectiveness by level of asthma symptoms would help to refine the intervention and target appropriate populations. A community health educator led asthma intervention implemented in a low-income African-American neighborhood included asthma management education, individually tailored low-cost asthma home trigger remediation, and referrals to social and medical agencies, when appropriate. Changes in asthma morbidity measures were assessed in relation to implementation of individual intervention components using multivariable logistic regression. Among the 218 children who completed the year-long program, there were significant reductions in measures of asthma morbidity, including symptoms, urgent care visits, emergency department (ED) visits, hospitalizations, missed school days, and missed work days for caretakers. We also found significant decreases in the prevalence of many home asthma triggers and improvements in asthma management practices. Improvement in caretaker's ability to manage the child's asthma was associated with reduction in ED visits for asthma and uncontrolled asthma. Specific home interventions, such as repair of water leaks and reduced exposure to plants, dust, clutter and stuffed toys, may be related to reduction in asthma morbidity. This program was effective in reducing asthma morbidity in low-income African-American children and identified specific interventions as possible areas to target in future projects. Furthermore, the intervention was useful in children with persistent asthma symptoms as well as those with less frequent asthma exacerbations.

  14. Exploring asthma in the workplace: A triangulation of perspectives from management, employees and people with asthma.

    Science.gov (United States)

    Zhao, Denise H; Cheung, Janet M Y; Smith, Lorraine; Saini, Bandana

    2017-08-31

    People with asthma spend a significant amount of time in the workplace but little is known about the current state of disease management in such contexts. The aim of the current study is to explore the experiences, attitudes and perceptions of asthma across different stakeholders in the workplace to help inform potential recommendations for workplace asthma policies. Using purposive and convenience sampling methods, in-depth semi-structured interviews were conducted in Australia with 5 human resource personnel, 10 employees with asthma and 10 employees without asthma. Interviews were guided by a schedule of questions focusing on attitudes and experiences of people with asthma in the workplace, which were audio recorded, transcribed verbatim and thematically analysed. Analysis of the qualitative dataset revealed three key themes: Beliefs and Attitudes about Asthma, Asthma Solutions in the Workplace and Workplace Obstacles. Findings suggest that employees with asthma experience problems managing their asthma at work and there is a lack of workplace support in relation to asthma emergency management. Key recommendations for workplace asthma policies have been made to provide better support for employees with asthma. However, further investigation into the experience of managing asthma is required in a wider variety of occupations and work experiences to inform the development of a workplace asthma policy.

  15. Nest enlargement in leaf-cutting ants: relocated brood and fungus trigger the excavation of new chambers.

    Directory of Open Access Journals (Sweden)

    Daniela Römer

    Full Text Available During colony growth, leaf-cutting ants enlarge their nests by excavating tunnels and chambers housing their fungus gardens and brood. Workers are expected to excavate new nest chambers at locations across the soil profile that offer suitable environmental conditions for brood and fungus rearing. It is an open question whether new chambers are excavated in advance, or will emerge around brood or fungus initially relocated to a suitable site in a previously-excavated tunnel. In the laboratory, we investigated the mechanisms underlying the excavation of new nest chambers in the leaf-cutting ant Acromyrmex lundi. Specifically, we asked whether workers relocate brood and fungus to suitable nest locations, and to what extent the relocated items trigger the excavation of a nest chamber and influence its shape. When brood and fungus were exposed to unfavorable environmental conditions, either low temperatures or low humidity, both were relocated, but ants clearly preferred to relocate the brood first. Workers relocated fungus to places containing brood, demonstrating that subsequent fungus relocation spatially follows the brood deposition. In addition, more ants aggregated at sites containing brood. When presented with a choice between two otherwise identical digging sites, but one containing brood, ants' excavation activity was higher at this site, and the shape of the excavated cavity was more rounded and chamber-like. The presence of fungus also led to the excavation of rounder shapes, with higher excavation activity at the site that also contained brood. We argue that during colony growth, workers preferentially relocate brood to suitable locations along a tunnel, and that relocated brood spatially guides fungus relocation and leads to increased digging activity around them. We suggest that nest chambers are not excavated in advance, but emerge through a self-organized process resulting from the aggregation of workers and their density

  16. Obesity and asthma

    Directory of Open Access Journals (Sweden)

    Pranab Baruwa

    2013-01-01

    Full Text Available Asthma is a chronic disorder affecting millions of people worldwide. The prevalence of asthma is around 300 million and is expected to increase another 100 million by 2025. Obesity, on the other hand, also affects a large number of individuals. Overweight in adults is defined when body mass index (BMI is between 25 to 30 kg/m 2 and obesity when the BMI >30 kg/m 2 . It has been a matter of interest for researchers to find a relation between these two conditions. This knowledge will provide a new insight into the management of both conditions. At present, obese asthma patients may be considered a special category and it is important to assess the impact of management of obesity on asthma symptoms.

  17. Indoor environmental exposures for children with asthma enrolled in the HEAL study, post-Katrina New Orleans.

    Science.gov (United States)

    Grimsley, L Faye; Chulada, Patricia C; Kennedy, Suzanne; White, LuAnn; Wildfire, Jeremy; Cohn, Richard D; Mitchell, Herman; Thornton, Eleanor; El-Dahr, Jane; Mvula, Mosanda M; Sterling, Yvonne; Martin, William J; Stephens, Kevin U; Lichtveld, Maureen

    2012-11-01

    Rain and flooding from Hurricane Katrina resulted in widespread growth of mold and bacteria and production of allergens in New Orleans, Louisiana, which may have led to increased exposures and morbidity in children with asthma. The goal of the Head-off Environmental Asthma in Louisiana (HEAL) study was to characterize post-Katrina exposures to mold and allergens in children with asthma. The homes of 182 children with asthma in New Orleans and surrounding parishes were evaluated by visual inspection, temperature and moisture measurements, and air and dust sampling. Air was collected using vacuum-pump spore traps and analyzed for > 30 mold taxa using bright field microscopy. Dust was collected from the children's beds and bedroom floors and analyzed for mouse (Mus m 1), dust mite (Der p 1), cockroach (Bla g 1), and mold (Alternaria mix) allergens using ELISA. More than half (62%) of the children were living in homes that had been damaged by rain, flooding, or both. Geometric mean indoor and outdoor airborne mold levels were 501 and 3,958 spores/m3, respectively. Alternaria antigen was detected in dust from 98% of homes, with 58% having concentrations > 10 µg/g. Mus m 1, Der p 1, and Bla g 1 were detected in 60%, 35%, and 20% of homes, respectively, at low mean concentrations. Except for Alternaria antigen in dust, concentrations of airborne mold (ratio of indoor to outdoor mold) and dust allergens in the homes of HEAL children were lower than measurements found in other studies, possibly because of extensive post-Katrina mold remediation and renovations, or because children moved into cleaner homes upon returning to New Orleans.

  18. Diagnosis of asthma - new theories.

    Science.gov (United States)

    Löwhagen, Olle

    2015-01-01

    Recent studies have shown a remarkably high frequency of poorly controlled asthma. Several reasons for this treatment failure have been discussed, however, the basic question of whether the diagnosis is always correct has not been considered. Follow-up studies have shown that in many patients asthma cannot be verified despite ongoing symptoms. Mechanisms other than bronchial obstruction may therefore be responsible. The current definition of asthma may also include symptoms that are related to mechanisms other than bronchial obstruction, the clinical hallmark of asthma. Based on a review of the four cornerstones of asthma - inflammation, hyperresponsiveness, bronchial obstruction and symptoms - the aim was to present some new aspects and suggestions related to the diagnosis of adult non-allergic asthma. Recent studies have indicated that "classic" asthma may sometimes be confused with asthma-like disorders such as airway sensory hyperreactivity, small airways disease, dysfunctional breathing, non-obstructive dyspnea, hyperventilation and vocal cord dysfunction. This confusion may be one explanation for the high proportion of misdiagnosis and treatment failure. The current diagnosis, focusing on bronchial obstruction, may be too "narrow". As there may be common mechanisms a broadening to include also non-obstructive disorders, forming an asthma syndrome, is suggested. Such broadening requires additional diagnostic steps, such as qualitative studies with analysis of reported symptoms, non-effort demanding methods for determining lung function, capsaicin test for revealing airway sensory hyperreactivity, careful evaluation of the therapeutic as well as diagnostic effect of corticosteroids and testing of suggested theories.

  19. Long-term control medication use and asthma control status among children and adults with asthma.

    Science.gov (United States)

    Zahran, Hatice S; Bailey, Cathy M; Qin, Xiaoting; Johnson, Carol

    2017-12-01

    Uncontrolled asthma decreases quality of life and increases health care use. Most people with asthma need daily use of long-term control (LTC) medications for asthma symptoms and to prevent asthma attacks. Ongoing assessment of a person's level of asthma control and medication use is important in determining the effectiveness of current treatment to decrease the frequency and intensity of symptoms and functional limitations. To assess the use of LTC medication among children and adults with current asthma and identify contributing factors for LTC medication use. We used the 2006-2010 Behavioral Risk Factor Surveillance System (BRFSS) child and adult Asthma Call-back Survey (ACBS) data to assess the level of asthma control and LTC medication use. Asthma control was classified as well controlled and uncontrolled using guideline-based measures. We used multivariable logistic regression models to identify contributing factors for LTC medication use and having uncontrolled asthma. Among persons with current asthma, 46.0% of children and 41.5% of adults were taking LTC medications and 38.4% of children and 50.0% of adults had uncontrolled asthma. Among children who had uncontrolled asthma (38.4%), 24.1% were taking LTC medications and 14.3% were not taking LTC medications. Among adults who had uncontrolled asthma (50.0%), 26.7% were taking LTC medications and 23.3% were not taking LTC medications. Using BRFSS ACBS data to assess the level of asthma control and LTC medication use can identify subpopulations of persons with asthma who receive suboptimal treatment, for which better asthma-related medical treatment and management are needed.

  20. Asthma: a major pediatric health issue

    Directory of Open Access Journals (Sweden)

    Smyth Rosalind L

    2002-06-01

    Full Text Available Abstract The incidence, prevalence, and mortality of asthma have increased in children over the past three to four decades, although there has been some decline in the most recent decade. These trends are particularly marked and of greatest concern in preschool children. Internationally, there are huge variations among countries and continents, as demonstrated by the International Study of Asthma and Allergies in Childhood. In general, asthma rates were highest in English-speaking countries (UK, New Zealand, Australia, and North America and some Latin American countries (Peru and Costa Rica, and lowest in South Korea, Russia, Uzbekistan, Indonesia, and Albania. There is currently no unifying hypothesis to explain these trends or any associated risk factors. Environmental factors that may lead to asthma include air pollution; genetic factors, the hygiene hypothesis, and lifestyle differences also play potentially causative roles. Asthma may develop as a result of persistent activation of the immune system alone or in combination with physiologic airway remodeling in early childhood. Further studies are needed to confirm this hypothesis.

  1. Bronchial asthma among workers in Alexandria and its association ...

    African Journals Online (AJOL)

    Introduction: Many workers in Alexandria are exposed to a variety of occupational and environmental allergens and/or irritants that predispose them to the development of bronchial asthma. The present study was conducted to determine the role of occupational exposure as a determinant of occurrence of bronchial asthma ...

  2. Teaching Your Child about Asthma

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  3. Herbal Medicine Cordyceps sinensis Improves Health-Related Quality of Life in Moderate-to-Severe Asthma

    Directory of Open Access Journals (Sweden)

    Ningqun Wang

    2016-01-01

    Full Text Available Moderate-to-severe asthma has a substantial impact on the health-related quality of life (HR-QOL of the patients. Cordyceps sinensis is a traditional Chinese medicine that is evaluated clinically for the treatment of many diseases, such as chronic allograft nephropathy, diabetic kidney disease, and lung fibrosis. In order to investigate the effects of Cordyceps sinensis on patients with moderate-to-severe persistent asthma, 120 subjects were randomized to receive Corbin capsule containing Cordyceps sinensis for 3 months (treatment group, n=60, whereas the control group (n=60 did not receive treatment with Corbin capsule. Inhaled corticosteroid and as-needed β-agonists were used in the treatment of both groups. HR-QOL was measured with the Juniper’s Asthma Quality of Life Questionnaire (AQLQ. The incidence of asthma exacerbation, pulmonary function testing, and serum measurements of inflammatory mediators were also evaluated. The results showed that the treatment group indicated a significant increase in AQLQ scores and lung function compared with the control group. The expression levels of the inflammation markers IgE, ICAM-1, IL-4, and MMP-9 in the serum were decreased and IgG increased in the treatment group compared with the control group. Therefore, the conclusion was reached that a formulation of Cordyceps sinensis improved the HR-QOL, asthma symptoms, lung function, and inflammatory profile of the patients with moderate-to-severe asthma. This trial is registered with ChiCTR-IPC-16008730.

  4. Herbal Medicine Cordyceps sinensis Improves Health-Related Quality of Life in Moderate-to-Severe Asthma.

    Science.gov (United States)

    Wang, Ningqun; Li, Jie; Huang, Xiaobo; Chen, Wenqiang; Chen, Yujing

    2016-01-01

    Moderate-to-severe asthma has a substantial impact on the health-related quality of life (HR-QOL) of the patients. Cordyceps sinensis is a traditional Chinese medicine that is evaluated clinically for the treatment of many diseases, such as chronic allograft nephropathy, diabetic kidney disease, and lung fibrosis. In order to investigate the effects of Cordyceps sinensis on patients with moderate-to-severe persistent asthma, 120 subjects were randomized to receive Corbin capsule containing Cordyceps sinensis for 3 months (treatment group, n = 60), whereas the control group ( n = 60) did not receive treatment with Corbin capsule. Inhaled corticosteroid and as-needed β -agonists were used in the treatment of both groups. HR-QOL was measured with the Juniper's Asthma Quality of Life Questionnaire (AQLQ). The incidence of asthma exacerbation, pulmonary function testing, and serum measurements of inflammatory mediators were also evaluated. The results showed that the treatment group indicated a significant increase in AQLQ scores and lung function compared with the control group. The expression levels of the inflammation markers IgE, ICAM-1, IL-4, and MMP-9 in the serum were decreased and IgG increased in the treatment group compared with the control group. Therefore, the conclusion was reached that a formulation of Cordyceps sinensis improved the HR-QOL, asthma symptoms, lung function, and inflammatory profile of the patients with moderate-to-severe asthma. This trial is registered with ChiCTR-IPC-16008730.

  5. A twin study of perfume-related respiratory symptoms

    DEFF Research Database (Denmark)

    Elberling, J; Lerbaek, A; Kyvik, K O

    2009-01-01

    Respiratory symptoms from environmental perfume exposure are main complaints in patients with multiple chemical sensitivities and often coincide with asthma and or eczema. In this population-based twin study we estimate the heritability of respiratory symptoms related to perfume and if co......-occurrences of the symptoms in asthma, atopic dermatitis, hand eczema or contact allergy are influenced by environmental or genetic factors common with these diseases. In total 4,128 twin individuals (82%) responded to a questionnaire. The heritability of respiratory symptoms related to perfume is 0.35, 95%CI 0.......14-0.54. Significant associations (prespiratory symptoms and asthma, atopic dermatitis, hand eczema or contact allergy are not attributable to shared genetic or shared environmental/familial factors, except possibly for atopic dermatitis where genetic pleiotropy with respiratory symptoms...

  6. Association of maternal diabetes and child asthma.

    Science.gov (United States)

    Azad, Meghan B; Becker, Allan B; Kozyrskyj, Anita L

    2013-06-01

    Perinatal programming is an emerging theory for the fetal origins of chronic disease. Maternal asthma and environmental tobacco smoke (ETS) are two of the best-known triggers for the perinatal programming of asthma, while the potential role of maternal diabetes has not been widely studied. To determine if maternal diabetes is associated with child asthma, and if so, whether it modifies the effects of ETS exposure and maternal asthma. We studied 3,574 Canadian children, aged 7-8 years, enrolled in a population-based birth cohort. Standardized questionnaires were completed by the children's parents, and data were analyzed by multivariable logistic regression. Asthma was reported in 442 children (12.4%). Compared to those without asthma, asthmatic children were more likely to have mothers (P = 0.003), but not fathers (P = 0.89), with diabetes. Among children without maternal history of diabetes, the likelihood of child asthma was 1.4-fold higher in those exposed to ETS (adjusted odds ratio, 1.40; 95% confidence interval, 1.13-1.73), and 3.6-fold higher in those with maternal asthma (3.59; 2.71-4.76). Among children born to diabetic mothers, these risks were amplified to 5.7-fold (5.68; 1.18-27.37) and 11.3-fold (11.30; 2.26-56.38), respectively. In the absence of maternal asthma or ETS, maternal diabetes was not associated with child asthma (0.65, 0.16-2.56). Our findings suggest that maternal diabetes may contribute to the perinatal programming of child asthma by amplifying the detrimental effects of ETS exposure and maternal asthma. Copyright © 2012 Wiley Periodicals, Inc.

  7. Risk factors for hospitalization among adults with asthma: the influence of sociodemographic factors and asthma severity

    Directory of Open Access Journals (Sweden)

    Eisner Mark D

    2000-12-01

    Full Text Available Abstract Background The morbidity and mortality from asthma have markedly increased since the late 1970s. The hospitalization rate, an important marker of asthma severity, remains substantial. Methods In adults with health care access, we prospectively studied 242 with asthma, aged 18–50 years, recruited from a random sample of allergy and pulmonary physician practices in Northern California to identify risk factors for subsequent hospitalization. Results Thirty-nine subjects (16% reported hospitalization for asthma during the 18-month follow-up period. On controlling for asthma severity in multiple logistic regression analysis, non-white race (odds ratio [OR], 3.1; 95% confidence interval [CI], 1.1–8.8 and lower income (OR, 1.1 per $10,000 decrement; 95% CI, 0.9–1.3 were associated with a higher risk of asthma hospitalization. The severity-of-asthma score (OR, 3.4 per 5 points; 95%, CI 1.7–6.8 and recent asthma hospitalization (OR, 8.3; 95%, CI, 2.1–33.4 were also related to higher risk, after adjusting for demographic characteristics. Reliance on emergency department services for urgent asthma care was also associated with a greater likelihood of hospitalization (OR, 3.2; 95% CI, 1.0–9.8. In multivariate analysis not controlling for asthma severity, low income was even more strongly related to hospitalization (OR, 1.2 per $10,000 decrement; 95% CI, 1.02–1.4. Conclusion In adult asthmatics with access to health care, non-white race, low income, and greater asthma severity were associated with a higher risk of hospitalization. Targeted interventions applied to high-risk asthma patients may reduce asthma morbidity and mortality.

  8. Parental asthma education and risks for nonadherence to pediatric asthma treatments.

    Science.gov (United States)

    Delgado, Eva M; Cho, Christine S; Gildengorin, Ginny; Leibovich, Sara A; Morris, Claudia R

    2014-11-01

    Targeted parental education reduces acute visits for pediatric asthma. Whether the use of education sources readily available to parents relates to nonadherence to asthma treatments is uncertain. This study describes asthma education sources and assesses for a relationship to risks for nonadherence. Caregivers of children with asthma completed a cross-sectional survey at 2 sites: a pediatric emergency department (ED) and an asthma clinic (AC). Measured items included the use of 7 education sources (primary care, ED, AC, friends/family, TV, internet, and printed materials), scores of child asthma morbidity, parental asthma knowledge, and risks for nonadherence, the primary outcome. Recruitment site, preferred language (English/Spanish), and demographics were recorded. Descriptive statistics, bivariate analyses, and multivariate regressions were performed. A total of 260 participants, 158 from ED and 102 from AC, used a variety of education sources. They reported 4.1 (2.0) of 13 risk factors for nonadherence, with more risks in ED parents than AC parents (4.8 vs 3.9, P The ED parents worried more about medications and had worse access to primary care. The regression did not show a significant relationship between education sources and risks for nonadherence, but ED recruitment, Spanish language, and worse morbidity contributed to higher risks. The use of more asthma education sources was not associated with reduced risks for nonadherence. Of the education sources, a primary care provider may benefit ED parents, who also need refills and education about medications. Spanish-speaking parents report more risks for nonadherence, warranting further study of Spanish-language asthma education.

  9. Advances in asthma in 2016: Designing individualized approaches to management.

    Science.gov (United States)

    Anderson, William C; Apter, Andrea J; Dutmer, Cullen M; Searing, Daniel A; Szefler, Stanley J

    2017-09-01

    In this year's Advances in Asthma review, we discuss viral infections in asthmatic patients and potential therapeutic agents, the microbiome, novel genetic associations with asthma, air quality and climate effects on asthma, exposures during development and long-term sequelae of childhood asthma, patient-centered outcomes research, and precision medicine. In addition, we discuss application of biomarkers to precision medicine and new information on asthma medications. New evidence indicates that rhinovirus-triggered asthma exacerbations become more severe as the degree of sensitization to dust mite and mouse increase. The 2 biggest drivers of asthma severity are an allergy pathway starting with allergic sensitization and an environmental tobacco smoke pathway. In addition, allergic sensitization and blood eosinophils can be used to select medications for management of early asthma in young children. These current findings, among others covered in this review, represent significant steps toward addressing rapidly advancing areas of knowledge that have implications for asthma management. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. A twin study of perfume-related respiratory symptoms.

    Science.gov (United States)

    Elberling, J; Lerbaek, A; Kyvik, K O; Hjelmborg, J

    2009-11-01

    Respiratory symptoms from environmental perfume exposure are main complaints in patients with multiple chemical sensitivities and often coincide with asthma and or eczema. In this population-based twin study we estimate the heritability of respiratory symptoms related to perfume and if co-occurrences of the symptoms in asthma, atopic dermatitis, hand eczema or contact allergy are influenced by environmental or genetic factors common with these diseases. In total 4,128 twin individuals (82%) responded to a questionnaire. The heritability of respiratory symptoms related to perfume is 0.35, 95%CI 0.14-0.54. Significant associations (pperfume-related respiratory symptoms and asthma, atopic dermatitis, hand eczema or contact allergy are not attributable to shared genetic or shared environmental/familial factors, except possibly for atopic dermatitis where genetic pleiotropy with respiratory symptoms to perfume is suggested by an estimated genetic correlation of 0.39, 95%CI 0.09-0.72.

  11. Asthma in inner city children: recent insights: United States.

    Science.gov (United States)

    Dutmer, Cullen M; Kim, Haejin; Searing, Daniel A; Zoratti, Edward M; Liu, Andrew H

    2018-04-01

    Children living in US inner cities experience disparate burdens of asthma, especially in severity, impairment, exacerbations, and morbidity. Investigations seeking to better understand the factors and mechanisms underlying asthma prevalence, severity, and exacerbation in children living in these communities can lead to interventions that can narrow asthma disparities and potentially benefit all children with asthma. This update will focus on recent (i.e. late 2016-2017) advances in the understanding of asthma in US inner city children. Studies published in the past year expand understanding of asthma prevalence, severity, exacerbation, and the outcomes of guidelines-based management of these at-risk children, including: asthma phenotypes in US inner city children that are severe and difficult-to-control; key environmental determinants and mechanisms underlying asthma severity and exacerbations (e.g. allergy-mediated exacerbation susceptibility to rhinovirus); the importance of schools as a place for provocative exposures (e.g. mouse allergen, nitrogen dioxide) as well as a place where asthma care and outcomes can be improved; and the development and validation of clinically useful indices for gauging asthma severity and predicting exacerbations. These recent studies provide a trove of actionable findings that can improve asthma care and outcomes for these at-risk children.

  12. Relating small airways to asthma control by using impulse oscillometry in children.

    Science.gov (United States)

    Shi, Yixin; Aledia, Anna S; Tatavoosian, Ahramahzd V; Vijayalakshmi, Shruthi; Galant, Stanley P; George, Steven C

    2012-03-01

    Previous reports suggest that the peripheral airways are associated with asthma control. Patient history, although subjective, is used largely to assess asthma control in children because spirometric results are many times normal values. Impulse oscillometry (IOS) is an objective and noninvasive measurement of lung function that has the potential to examine independently both small- and large-airway obstruction. We sought to determine the utility of IOS in assessing asthma control in children. Asthmatic and healthy children (6-17 years) were enrolled in the study. Spirometric and IOS (resistance of the respiratory system at 5 Hz [R5] and 20 Hz [R20], reactance of the respiratory system at 5 Hz [X5], resonant frequency of reactance [Fres], and area under the reactance curve between 5 Hz and Fres [reactance area {AX}]) values were collected in triplicate before and after a bronchodilator was administered. The physicians were blinded to the IOS measurements and assessed asthma control using American Thoracic Society guidelines. Small-airway IOS measurements, including the difference of R5 and R20 [R5-20], X5, Fres, and AX, of children with uncontrolled asthma (n = 44) were significantly different from those of children with controlled asthma (n = 57) and healthy children (n = 14), especially before the administration of a bronchodilator. However, there was no difference in large-airway IOS values (R20). No differences were found between children with controlled asthma and healthy children in any of the end points. Receiver operating characteristic analysis showed cut points for baseline R5-20 (1.5 cm H(2)O · L(-1) · s) and AX (9.5 cm H(2)O · L(-1)) that effectively discriminated controlled versus uncontrolled asthma (area under the curve, 0.86 and 0.84) and correctly classified more than 80% of the population. Uncontrolled asthma is associated with small-airways dysfunction, and IOS might be a reliable and noninvasive method to assess asthma control in children

  13. Polycyclic aromatic hydrocarbons, tobacco smoke, and epigenetic remodeling in asthma

    Science.gov (United States)

    Klingbeil, E. C.; Hew, K. M.; Nygaard, U. C.; Nadeau, K. C.

    2014-01-01

    Environmental determinants including aerosolized pollutants such as polycyclic aromatic hydrocarbons (PAHs) and tobacco smoke have been associated with exacerbation and increased incidence of asthma. The influence of aerosolized pollutants on the development of immune dysfunction in asthmatics has been suggested to be mediated through epigenetic remodeling. Genome accessibility and transcription are regulated primarily through DNA methylation, histone modification, and microRNA transcript silencing. Epigenetic remodeling has been shown in studies to be associated with Th2 polarization and associated cytokine and chemokine regulation in the development of asthma. This review will present evidence for the contribution of the aerosolized pollutants PAH and environmental tobacco smoke to epigenetic remodeling in asthma. PMID:24760221

  14. Environmental Factors Affecting Asthma and Allergies: Predicting and Simulating Downwind Exposure to Airborne Pollen

    Science.gov (United States)

    Luvall, Jeffrey; Estes, Sue; Sprigg, William A.; Nickovic, Slobodan; Huete, Alfredo; Solano, Ramon; Ratana, Piyachat; Jiang, Zhangyan; Flowers, Len; Zelicoff, Alan

    2009-01-01

    This slide presentation reviews the environmental factors that affect asthma and allergies and work to predict and simulate the downwind exposure to airborne pollen. Using a modification of Dust REgional Atmosphere Model (DREAM) that incorporates phenology (i.e. PREAM) the aim was to predict concentrations of pollen in time and space. The strategy for using the model to simulate downwind pollen dispersal, and evaluate the results. Using MODerate-resolution Imaging Spectroradiometer (MODIS), to get seasonal sampling of Juniper, the pollen chosen for the study, land cover on a near daily basis. The results of the model are reviewed.

  15. Tacit and transitionary: an exploration of patients' and primary care health professionals' goals in relation to asthma.

    Science.gov (United States)

    Williams, Brian; Steven, Karen; Sullivan, Frank M

    2011-04-01

    Goal setting is recommended in UK health policy to make health care more patient-centred, to enhance the likelihood of behaviour change and to improve health outcomes. Patient-centred care is thought to be particularly important in the management of long term conditions such as asthma. We therefore explored and compared the asthma goals of both health professionals and people with asthma within the primary care clinical consultation, and identified the potential barriers to achieving shared goals and more patient-centred care provision. We conducted a qualitative study based on semi-structured interviews with 15 people with asthma, 7 general practitioners and 6 primary care asthma nurses from Tayside, UK. The data were analysed using the 'Framework' methodology. Four potential barriers to the identification of goals were located. The first stemmed from the status and nature of patients' goals, while the remaining three related to the beliefs and practices of health professionals. These findings are discussed in relation to relevant sociological literature around the potential tensions between lay and professional knowledge, and also tensions in the relationship between knowledge and values. We conclude that barriers need to be recognised and addressed where possible before the achievement of shared asthma goals can become common practice. In particular, health professionals may require training in how to elicit goals with patients and how to differentiate between end states and goals that are in fact assumed to mediate the achievement of such desired end states. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Physical inactivity and obesity: relation to asthma and chronic obstructive pulmonary disease?

    Science.gov (United States)

    ten Hacken, Nick H T

    2009-12-01

    Physical inactivity and obesity are modifiable risk factors for many chronic diseases, including cardiovascular disease, diabetes mellitus, osteoporosis, osteoarthritis, and depression. Both physical inactivity and obesity are associated with low-grade systemic inflammation that may contribute to the inflammatory processes present in many chronic diseases. In asthma, almost no studies are available in which physical inactivity has been studied using performance-based instruments. In contrast, the association between obesity and a higher prevalence of asthma has often been suggested in a large number of studies. In chronic obstructive pulmonary disease (COPD) physical inactivity has been demonstrated in a few studies that used performance-based instruments; this was associated with the higher COPD Global Initiative on Obstructive Lung Disease (GOLD) stages and a higher degree of systemic inflammation, independent of body mass index. In contrast to physical inactivity, obesity in COPD is associated with the lower GOLD stages. Additionally, obesity is associated with the chronic obstructive phenotype and features of the metabolic syndrome. To elucidate the independent relation of physical inactivity and obesity with systemic inflammation, performance-based studies of physical inactivity in asthma and COPD are highly needed.

  17. Prevalence of asthma symptoms and associated factors in schoolchildren from Brazilian Amazon islands.

    Science.gov (United States)

    Freitas, Marly S; Monteiro, Julius Caesar S; Camelo-Nunes, Inês C; Solé, Dirceu

    2012-08-01

    To determine the prevalence of asthma symptoms among schoolchildren living on two different Brazilian Amazon islands and to identify the risk factors related to this condition. A cross-sectional study of 400 schoolchildren (5-8 years old) using written questionnaires produced by the International Study of Asthma and Allergies in Childhood, a skin prick test (allergic sensitization), and a stool examination (for helminthic infection). Nonparametric tests were carried out, and the risk factors were identified by logistic regression. The prevalence of active asthma symptoms was markedly higher in children living on Outeiro Island (OI) than those living on Combú Island (CBI) (30.5% and 16.5%, respectively). The logistic regression identified several risk factors of asthma symptoms on CBI: parental history of asthma, night coughing in the past year, and "currently have a cat". On OI, the major risk factors were parental history of asthma, personal history of eczema, having two or more older siblings, and night coughing in the past year. The risk factors in common on both the islands were night coughing in the past year and parental history of asthma. The prevalence of asthma symptoms was higher in those with a lifestyle closer to that observed in urban areas (i.e., better sanitation and hygiene), reinforcing the protective effect of a rural environment. Different risk factors were associated with asthma symptoms in schoolchildren living on OI and on CBI. This fact may reflect the environmental individuality and particularities of each island.

  18. Dimensions of Socioeconomic Status and Childhood Asthma Outcomes: Evidence for Distinct Behavioral and Biological Associations.

    Science.gov (United States)

    Chen, Edith; Shalowitz, Madeleine U; Story, Rachel E; Ehrlich, Katherine B; Levine, Cynthia S; Hayen, Robin; Leigh, Adam K K; Miller, Gregory E

    The objective of this study was to investigate 2 key dimensions of socioeconomic status (SES)-prestige and resources-and their associations with immune, behavioral, and clinical outcomes in childhood asthma. Children ages 9 to 17 years with a physician's diagnosis of asthma (N = 150), and one of their parents participated in this study. Children and parents completed interviews and questionnaires about SES (prestige = parent education; resources = family assets), environmental exposures, and clinical asthma measures. Spirometry was conducted to assess children's pulmonary function, and blood was collected to measure cytokine production in response to nonspecific stimulation, allergen-specific stimulation, and microbial stimulation. Higher scores on both dimensions of childhood SES were associated with better clinical outcomes in children (β's from |.18 to .27|, p values childhood family environments have different implications for behavioral and immunological processes relevant to childhood asthma. They also suggest that childhood SES relates to multiple aspects of immunologic regulation of relevance to the pathophysiology of asthma.

  19. The Importance of Asthma and Health Programs in Improving Academic Performance

    Science.gov (United States)

    School air quality has a major impact on asthma and other respiratory illnesses. Airborne allergens or irritants frequently trigger asthma attacks, yet environmental assessments demonstrate that schools often harbor allergen levels at or close to the th

  20. Determination of blood ET-1 and related cytokines in pediatric patients with bronchial asthma

    International Nuclear Information System (INIS)

    Qian Jiangang; Ling Wanli; Ma Yunbao; Zhang Xiaoyi

    2005-01-01

    Objective: To explore the role of endothelin and related cytokines (IL-5, IL-6, IL-8) in the development of bronchial asthma in pediatric patients. Methods: Plasma ET-1 (with RIA) and serum IL-5 (with ELISA), IL-6, IL-8 (with RIA) levels were measured in 42 pediatric patients with bronchial asthma and 30 controls. Results: The plasma ET-1 levels in the patients during acute attack (n=22) were significantly higher than those in patients during remission (n=20) as well as in controls (P 0.05). Levels of ET-1 were positively correlated with those of IL-5 (during attack, r=0.560, P<0.01; during remission, r=0.435, P<0.01). Conclusion: ET and the cytokines IL-5, IL-6, IL-8 participated in the pathogenesis of bronchial asthma through different mechanisms and dynamic determination of which could reflect the progression of the disease. (authors)

  1. Asthma in Children: Risk Factors, Clinical Features and Prevention

    Directory of Open Access Journals (Sweden)

    Serap Balci

    2010-02-01

    Full Text Available Asthma is the most common chronic disease of childhood. It is known that asthma prevalence has increased significantly especially in children in last 20 years. To stop this increase in asthma, causes and prevention measures should be known better. For the management of the illness, control of environmental and trigger factors causing asthma attack are extremely important. Asthmatic children and family should be informed by health staff about changes in their life and measures to prevent the attacks. Through this information asthmatic children and their families can be supported for a better quality of life. [TAF Prev Med Bull 2010; 9(1.000: 79-86

  2. Relation of DNA methylation of 5'-CpG island of ACSL3 to transplacental exposure to airborne polycyclic aromatic hydrocarbons and childhood asthma.

    Directory of Open Access Journals (Sweden)

    Frederica Perera

    Full Text Available In a longitudinal cohort of approximately 700 children in New York City, the prevalence of asthma (>25% is among the highest in the US. This high risk may in part be caused by transplacental exposure to traffic-related polycyclic aromatic hydrocarbons (PAHs but biomarkers informative of PAH-asthma relationships is lacking. We here hypothesized that epigenetic marks associated with transplacental PAH exposure and/or childhood asthma risk could be identified in fetal tissues. Mothers completed personal prenatal air monitoring for PAH exposure determination. Methylation sensitive restriction fingerprinting was used to analyze umbilical cord white blood cell (UCWBC DNA of 20 cohort children. Over 30 DNA sequences were identified whose methylation status was dependent on the level of maternal PAH exposure. Six sequences were found to be homologous to known genes having one or more 5'-CpG island(s (5'-CGI. Of these, acyl-CoA synthetase long-chain family member 3 (ACSL3 exhibited the highest concordance between the extent of methylation of its 5'-CGI in UCWBCs and the level of gene expression in matched fetal placental tissues in the initial 20 cohort children. ACSL3 was therefore chosen for further investigation in a larger sample of 56 cohort children. Methylation of the ACSL3 5'-CGI was found to be significantly associated with maternal airborne PAH exposure exceeding 2.41 ng/m(3 (OR = 13.8; p<0.001; sensitivity = 75%; specificity = 82% and with a parental report of asthma symptoms in children prior to age 5 (OR = 3.9; p<0.05. Thus, if validated, methylated ACSL3 5'CGI in UCWBC DNA may be a surrogate endpoint for transplacental PAH exposure and/or a potential biomarker for environmentally-related asthma. This exploratory report provides a new blueprint for the discovery of epigenetic biomarkers relevant to other exposure assessments and/or investigations of exposure-disease relationships in birth cohorts. The results support the emerging theory of

  3. Leveraging gene-environment interactions and endotypes for asthma gene discovery

    DEFF Research Database (Denmark)

    Bønnelykke, Klaus; Ober, Carole

    2016-01-01

    , such as childhood asthma with severe exacerbations, and on relevant exposures that are involved in gene-environment interactions (GEIs), such as rhinovirus infections, will improve detection of asthma genes and our understanding of the underlying mechanisms. We will discuss the challenges of considering GEIs......Asthma is a heterogeneous clinical syndrome that includes subtypes of disease with different underlying causes and disease mechanisms. Asthma is caused by a complex interaction between genes and environmental exposures; early-life exposures in particular play an important role. Asthma is also...... heritable, and a number of susceptibility variants have been discovered in genome-wide association studies, although the known risk alleles explain only a small proportion of the heritability. In this review, we present evidence supporting the hypothesis that focusing on more specific asthma phenotypes...

  4. Diet and Asthma: Is It Time to Adapt Our Message?

    Directory of Open Access Journals (Sweden)

    Laurent Guilleminault

    2017-11-01

    Full Text Available Asthma is a chronic respiratory disorder which is associated with airway inflammation. Environmental factors, in association with genetic susceptibility, play a critical role in asthma pathophysiology. Inhaled allergens, smoke exposure, indoor and outdoor air pollution are common triggers of asthma symptoms. Although the role of diet has clearly established mechanisms in diseases such as cardiovascular disease, type 2 diabetes, and cancer, it is not commonly identified as a causal factor in asthma. However, some dietary patterns, such as the Western diet, which includes a high intake of refined grains, processed and red meats, and desserts, have pro-inflammatory effects. On the contrary, the Mediterranean diet, with high intake of fruits and vegetables has anti-inflammatory properties. The influence of food on asthma outcomes is of growing interest, but dietary habits of asthma patients are not commonly investigated in clinical practice. In this review, we focus on the impact of diet on asthma risk and asthma control. We also detail the influence of diet on obese patients with asthma.

  5. Exacerbations of asthma during pregnancy

    DEFF Research Database (Denmark)

    Ali, Z; Hansen, A V; Ulrik, C S

    2016-01-01

    Asthma is common among pregnant women, and the incidence of asthma exacerbations during pregnancy is high. This literature review provides an overview of the impact of exacerbations of asthma during pregnancy on pregnancy-related complications. The majority of published retrospective studies reveal...... 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...... to these outcomes. In conclusion, asthma exacerbations during pregnancy are associated with complications of pregnancy, labour and delivery. Prevention of exacerbations is essential to reduce the risk of complications and poor outcome....

  6. Impact of air pollution on respiratory diseases in children with recurrent wheezing or asthma.

    Science.gov (United States)

    Esposito, Susanna; Galeone, Carlotta; Lelii, Mara; Longhi, Benedetta; Ascolese, Beatrice; Senatore, Laura; Prada, Elisabetta; Montinaro, Valentina; Malerba, Stefano; Patria, Maria Francesca; Principi, Nicola

    2014-08-07

    Air pollution has many negative health effects on the general population, especially children, subjects with underlying chronic disease and the elderly. The aims of this study were to evaluate the effects of traffic-related pollution on the exacerbation of asthma and development of respiratory infections in Italian children suffering from asthma or wheezing compared with healthy subjects and to estimate the association between incremental increases in principal pollutants and the incidence of respiratory symptoms. This prospective study enrolled 777 children aged 2 to 18 years (375 with recurrent wheezing or asthma and 402 healthy subjects). Over 12 months, parents filled out a daily clinical diary to report information about respiratory symptoms, type of medication used and healthcare utilization. Clinical data were combined with the results obtained using an air pollution monitoring system of the five most common pollutants. Among the 329 children with recurrent wheezing or asthma and 364 healthy subjects who completed follow-up, children with recurrent wheezing or asthma reported significantly more days of fever (p=0.005) and cough (ppollution and the development of asthma exacerbations and respiratory infections in children born to atopic parents and in those suffering from recurrent wheezing or asthma. These findings suggest that environmental control may be crucial for respiratory health in children with underlying respiratory disease.

  7. Approach to asthma in adults

    African Journals Online (AJOL)

    Introduction. Asthma is a chronic inflammatory disease of the airways, ... of the airway, constriction of the airway via smooth muscle ... Avoiding these factors can help to reduce asthma exacerbations .... Nutritional and exercise-related factors.

  8. Severe exacerbations and decline in lung function in asthma

    DEFF Research Database (Denmark)

    O'Byrne, Paul M; Pedersen, Søren; Lamm, Carl Johan

    2009-01-01

    RATIONALE: To evaluate the association between asthma exacerbations and the decline in lung function, as well as the potential effects of an inhaled corticosteroid, budesonide, on exacerbation-related decline in patients with asthma. OBJECTIVES: To determine whether severe asthma exacerbations...... with low-dose inhaled budesonide prevents severe asthma-related events (exacerbations requiring hospitalization or emergency treatment) and decline in lung function. MEASUREMENTS AND MAIN RESULTS: There were 315 patients who experienced at least one severe asthma exacerbation, of which 305 were analyzable...... of reduction afforded by budesonide, in patients who experienced at least one severe asthma-related event compared with those who did not, was statistically significant (P = 0.042). CONCLUSIONS: Severe asthma exacerbations are associated with a more rapid decline in lung function. Treatment with low doses...

  9. Advances in asthma 2015: Across the lifespan.

    Science.gov (United States)

    Liu, Andrew H; Anderson, William C; Dutmer, Cullen M; Searing, Daniel A; Szefler, Stanley J

    2016-08-01

    In 2015, progress in understanding asthma ranged from insights to asthma inception, exacerbations, and severity to advancements that will improve disease management throughout the lifespan. 2015's insights to asthma inception included how the intestinal microbiome affects asthma expression with the identification of specific gastrointestinal bacterial taxa in early infancy associated with less asthma risk, possibly by promoting regulatory immune development at a critical early age. The relevance of epigenetic mechanisms in regulating asthma-related gene expression was strengthened. Predicting and preventing exacerbations throughout life might help to reduce progressive lung function decrease and disease severity in adulthood. Although allergy has long been linked to asthma exacerbations, a mechanism through which IgE impairs rhinovirus immunity and underlies asthma exacerbations was demonstrated and improved by anti-IgE therapy (omalizumab). Other key molecular pathways underlying asthma exacerbations, such as cadherin-related family member 3 (CDHR3) and orosomucoid like 3 (ORMDL3), were elucidated. New anti-IL-5 therapeutics, mepolizumab and reslizumab, were US Food and Drug Administration approved for the treatment of patients with severe eosinophilic asthma. In a clinical trial the novel therapeutic inhaled GATA3 mRNA-specific DNAzyme attenuated early- and late-phase allergic responses to inhaled allergen. These current findings are significant steps toward addressing unmet needs in asthma prevention, severity modification, disparities, and lifespan outcomes. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  10. How to manage a child with difficult asthma?

    Science.gov (United States)

    Saglani, Sejal; Fleming, Louise

    2016-08-01

    Children with difficult asthma have significant morbidity and fail to achieve asthma control despite being prescribed high dose maintenance treatment. If control remains poor after diagnostic confirmation, detailed assessments of the reasons for asthma being difficult-to-control are needed. Underlying modifiable factors including non-adherence to medication, persistent environmental exposures that trigger asthma symptoms and psychosocial factors contribute to poor control in these patients. The focus of this review is to provide a practical approach to the diagnosis and management of difficult asthma including an overview of long term assessments to identify potential progression to true, severe asthma. A multi-disciplinary team is critical to enable modifiable factors to be identified and addressed. Significant resources are required to manage paediatric difficult asthma optimally and only specialist centres should be tasked with the assessment of these patients. Although this may have an impact on healthcare resources, long term benefits for lung health are significant. Expert commentary: The management of paediatric difficult asthma is not simple and involves numerous professionals with varied expertise. However, if it is not undertaken with the appropriate skills, there is a significant risk of children receiving inappropriate invasive investigations and therapies that will have no impact on morbidity.

  11. Diet and Asthma: Vitamins and Methyl Donors

    Science.gov (United States)

    Han, Yueh-Ying; Blatter, Josh; Brehm, John M.; Forno, Erick; Litonjua, Augusto A; Celedón, Juan C.

    2014-01-01

    SUMMARY Dietary changes may partly explain the high burden of asthma in industrialized nations. Experimental studies have motivated a significant number of observational studies of the relation between vitamins (A, C, D, and E) or nutrients acting as methyl donors (folate, vitamin B12, and choline) and asthma. Because observational studies are susceptible to several sources of bias, well-conducted randomized controlled trials (RCTs) remain the “gold standard” to determine whether a vitamin or nutrient has an effect on asthma. Evidence from observational studies and/or relatively few RCTs most strongly justify ongoing and future RCTs of: 1) vitamin D to prevent or treat asthma, 2) choline supplementation as adjuvant treatment for asthma, and 3) vitamin E to prevent the detrimental effects of air pollution in subjects with asthma. At this time, there is insufficient evidence to recommend supplementation with any vitamin or nutrient acting as a methyl donor to prevent or treat asthma. PMID:24461761

  12. Asthma: NHLBI Workshop on the Primary Prevention of Chronic Lung Diseases

    Science.gov (United States)

    Hartert, Tina V.; Martinez, Fernando D.; Weiss, Scott T.; Fahy, John V.

    2014-01-01

    Asthma is a common disease with enormous public health costs, and its primary prevention is an ambitious and important goal. Understanding of how host and environmental factors interact to cause asthma is incomplete, but persistent questions about mechanisms should not stop clinical research efforts aimed at reducing the prevalence of childhood asthma. Achieving the goal of primary prevention of asthma will involve integrated and parallel sets of research activities in which mechanism-oriented studies of asthma inception proceed alongside clinical intervention studies to test biologically plausible prevention ideas. For example, continued research is needed, particularly in young children, to uncover biomarkers that identify asthma risk and provide potential targets of intervention, and to improve understanding of the role of microbial factors in asthma risk and disease initiation. In terms of clinical trials that could be initiated now or in the near future, we recommend three interventions for testing: (1) preventing asthma through prophylaxis against respiratory syncytial virus and human rhinovirus infections of the airway; (2) immune modulation, using prebiotics, probiotics, and bacterial lysates; and (3) prevention of allergen sensitization and allergic inflammation, using anti-IgE. These interventions should be tested while other, more universal prevention measures that may promote lung health are also investigated. These potential universal lung health measures include prevention of preterm delivery; reduced exposure of the fetus and young infant to environmental pollutants, including tobacco smoke; prevention of maternal and child obesity; and management of psychosocial stress. PMID:24754822

  13. Long-term CPAP treatment improves asthma control in patients with asthma and obstructive sleep apnoea.

    Science.gov (United States)

    Kauppi, Paula; Bachour, Patrick; Maasilta, Paula; Bachour, Adel

    2016-12-01

    Both asthma and obstructive sleep apnoea cause sleep disturbance, daytime sleepiness and diminished quality of life. Continuous positive airway pressure (CPAP) is efficient in reducing symptoms related to sleep apnoea. Here we report the impact of long-term use of CPAP on asthma symptoms. A survey questionnaire was distributed to all of our obstructive sleep apnoea patients with CPAP therapy in 2013. We used the Finnish version of the Asthma Control Test™ (ACT) and a visual analogue scale (0 = no symptoms, 100 = severe asthma symptoms). Asthma was defined as self-reported physician-diagnosed disease and a special reimbursement for asthma medication by the Social Insurance Institution. We sent 2577 questionnaires and received 1586 answers (61 %). One hundred ninety-seven patients were asthmatics with a prevalence of asthma among CPAP users of 13 %. We studied 152 patients (58 females) whose CPAP therapy was initiated after starting asthma medication. Their mean (SD) age was 62 (10) years, duration of CPAP 5.7 (4.7) years and their CPAP daily use was 6.3 (2.4) h. Self-reported asthma severity decreased significantly from 48.3 (29.6) to 33.1 (27.4) (p CPAP (P CPAP in patients with both asthma and obstructive sleep apnoea.

  14. Estimated cost of asthma in outpatient treatment: a real-world study

    Science.gov (United States)

    Costa, Eduardo; Caetano, Rosangela; Werneck, Guilherme Loureiro; Bregman, Maurício; Araújo, Denizar Vianna; Rufino, Rogério

    2018-01-01

    ABSTRACT OBJECTIVE To estimate the cost of diagnosis and treatment of asthma. METHODS We used the perspective of society. We sequentially included for 12 months, in 2011-2012, 117 individuals over five years of age who were treated for asthma in the Pneumology and Allergy-Immunology Services of the Piquet Carneiro Polyclinic, Universidade do Estado do Rio de Janeiro. All of them were interviewed twice with a six-month interval for data collection, covering 12 months. The cost units were identified and valued according to defined methods. We carried out a sensitivity analysis and applied statistical methods with a significance level of 5% for cost comparisons between subgroups. RESULTS The study consisted of 108 patients, and 73.8% of them were women. Median age was 49.5 years. Rhinitis was present in 83.3% of the individuals, and more than half were overweight or obese. Mean family income was U$915.90/month (SD = 879.12). Most workers and students had absenteeism related to asthma. Total annual mean cost was U$1,291.20/patient (SD = 1,298.57). The cost related to isolated asthma was U$1,155.43/patient-year (SD = 1,305.58). Obese, severe, and uncontrolled asthmatic patients had higher costs than non-obese, non-severe, and controlled asthmatics, respectively. Severity and control level were independently associated with higher cost (p = 0.001 and 0.000, respectively). The direct cost accounted for 82.3% of the estimated total cost. The cost of medications for asthma accounted for 62.2% of the direct costs of asthma. CONCLUSIONS Asthma medications, environmental control measures, and long-term health leaves had the greatest potential impact on total cost variation. The results are an estimate of the cost of treating asthma at a secondary level in the Brazilian Unified Health System, assuming that the treatment used represents the ideal approach to the disease. PMID:29641652

  15. Prematurity, atopy, and childhood asthma in Puerto Ricans.

    Science.gov (United States)

    Rosas-Salazar, Christian; Ramratnam, Sima K; Brehm, John M; Han, Yueh-Ying; Boutaoui, Nadia; Forno, Erick; Acosta-Pérez, Edna; Alvarez, María; Colón-Semidey, Angel; Canino, Glorisa; Celedón, Juan C

    2014-02-01

    Puerto Rican children share a disproportionate burden of prematurity and asthma in the United States. Little is known about prematurity and childhood asthma in Puerto Rican subjects. We sought to examine whether prematurity is associated with asthma in Puerto Rican children. We performed a case-control study of 678 children aged 6 to 14 years with (n = 351) and without (n = 327) asthma living in San Juan, Puerto Rico. Prematurity was defined by parental report for our primary analysis. In a secondary analysis, we only included children whose parents reported prematurity that required admission to the neonatal intensive care unit. Asthma was defined as physician-diagnosed asthma and wheeze in the prior year. We used logistic regression for analysis. All multivariate models were adjusted for age, sex, household income, atopy (≥1 positive IgE level to common allergens), maternal history of asthma, and early-life exposure to environmental tobacco smoke. In a multivariate analysis there was a significant interaction between prematurity and atopy on asthma (P = .006). In an analysis stratified by atopy, prematurity was associated with a nearly 5-fold increased odds of asthma in atopic children (adjusted odds ratio, 4.7; 95% CI, 1.5-14.3; P = .007). In contrast, there was no significant association between prematurity and asthma in nonatopic children. Similar results were obtained in our analysis of prematurity requiring admission to the neonatal intensive care unit and asthma. Our results suggest that atopy modifies the estimated effect of prematurity on asthma in Puerto Rican children. Prematurity might explain, in part, the high prevalence of atopic asthma in this ethnic group. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  16. 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. METHO...

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Asthma control in Latin America: the Asthma Insights and Reality in Latin America (AIRLA) survey.

    Science.gov (United States)

    Neffen, Hugo; Fritscher, Carlos; Schacht, Francisco Cuevas; Levy, Gur; Chiarella, Pascual; Soriano, Joan B; Mechali, Daniel

    2005-03-01

    The aims of this survey were (1) to assess the quality of asthma treatment and control in Latin America, (2) to determine how closely asthma management guidelines are being followed, and (3) to assess perception, knowledge and attitudes related to asthma in Latin America. We surveyed a household sample of 2,184 adults or parents of children with asthma in 2003 in 11 countries in Latin America. Respondents were asked about healthcare utilization, symptom severity, activity limitations and medication use. Daytime asthma symptoms were reported by 56% of the respondents, and 51% reported being awakened by their asthma at night. More than half of those surveyed had been hospitalized, attended a hospital emergency service or made unscheduled emergency visits to other healthcare facilities for asthma during the previous year. Patient perception of asthma control did not match symptom severity, even in patients with severe persistent asthma, 44.7% of whom regarded their disease as being well or completely controlled. Only 2.4% (2.3% adults and 2.6% children) met all criteria for asthma control. Although 37% reported treatment with prescription medications, only 6% were using inhaled corticosteroids. Most adults (79%) and children (68%) in this survey reported that asthma symptoms limited their activities. Absence from school and work was reported by 58% of the children and 31% of adults, respectively. Asthma control in Latin America falls short of goals in international guidelines, and in many aspects asthma care and control in Latin America suffer from the same shortcomings as in other areas of the world.

  19. Asthma in children in relation to pre-term birth and fetal growth restriction.

    Science.gov (United States)

    Koshy, Gibby; Akrouf, Kafya A S; Kelly, Yvonne; Delpisheh, Ali; Brabin, Bernard J

    2013-08-01

    To assess the impact of parental asthma on risk of pre-term birth (PTB) and intrauterine growth restriction, and their subsequent association with childhood asthma. Three sequential cross-sectional surveys were conducted in 1993 (3,746), 1998 (1,964) and 2006 (1,074) in the same 15 schools among 5-11 year old children in Merseyside using the same respiratory health questionnaire completed by parents (sample size in brackets). Between 1993 and 2006, prevalence of PTB varied between 12.4 and 15.2 %, and of small for gestational age (SGA or growth restricted) babies between 2.1 and 4.6 %, and maternal asthma prevalence between 8.1 and 13.4 %. For the combined surveys mothers with asthma were more likely to have a PTB than non-asthmatic mothers (OR 1.39, 95 % CI 1.10-1.95, p PTBs of asthmatic mothers developed doctor diagnosed asthma compared to 34.3 % for term babies (adjusted OR 1.65, 1.34-2.04, p < 0.001). The corresponding estimates for the symptom triad of cough, wheeze and breathlessness were 19.4 and 17.6 % (adjusted OR 1.78, 0.79-3.98). Conversely SGA babies were less likely to develop doctor diagnosed asthma (adjusted OR 0.49, 0.27-0.90, p < 0.021), or the symptom triad of cough, wheeze and breathlessness (adjusted OR 0.22, 0.05-0.97, p < 0.043), whether or not the mother was asthmatic. Maternal asthma is an independent risk factor for PTB which predisposes to childhood asthma. Intrauterine growth restriction was protective against childhood asthma.

  20. [Warning symptoms of asthma attack and asthma self-management: a national asthma control survey from China].

    Science.gov (United States)

    Lin, J T; Wang, W Q; Zhou, X; Wang, C Z; Huang, M; Cai, S X; Chen, P; Lin, Q C; Zhou, J Y; Gu, Y H; Yuan, Y D; Sun, D J; Yang, X H; Yang, L; Huo, J M; Chen, Z C; Jiang, P; Zhang, J; Ye, X W; Liu, H G; Tang, H P; Liu, R Y; Liu, C T; Zhang, W; Hu, C P; Chen, Y Q; Liu, X J; Dai, L M; Zhou, W; Huang, Y J; Xu, J Y

    2017-08-08

    Objective: To investigate warning symptoms of asthma attack and evaluate asthma self-management status of asthma patients in urban China. Methods: A multi-center, cross-sectional, questionnaire-based survey was carried out from 30 general hospitals dispersed in 30 provinces of mainland China (except for Tibet) during Oct 2015 to May 2016. Information of frequency and warning symptoms of asthma attack, the time from warning symptoms to asthma attack, the impact of asthma attack and asthma self-management were collected from asthma patients of outpatient department. Results: Altogether 3 875 asthmatic outpatients were recruited. 78.1% (3 026/3 875) of the patients reported restriction of exercise and daily activities during asthma exacerbation. 82.5% (3 160/3 829) of the patients had warning symptoms before asthma attack, the most common warning symptoms were cough, chest tightness and shortness of breath. The median time from warning symptoms to asthma attack was 2 h, the mean time was 90 h. Only 4.4% (167/3 829) of the patients had definite confidence to control asthma when symptoms deteriorated. 76.7% (2 937/3 828) of the patients used medications to control asthma when asthma symptoms deteriorated. Medication choice: inhaled corticosteroid (ICS) + formoterol 45.8% (1 776/3 875), short-acting beta-agonist (SABA) 23.9% (927/3 875). Conclusions: Most asthma patients have warning symptoms before asthma attack, the most common symptoms are cough, chest tightness and shortness of breath. The proportion of patients conducting effective asthma self-management remains low.

  1. Development of a questionnaire to evaluate asthma control in Japanese asthma patients.

    Science.gov (United States)

    Tohda, Yuji; Hozawa, Soichiro; Tanaka, Hiroshi

    2018-01-01

    The asthma control questionnaires used in Japan are Japanese translations of those developed outside Japan, and have some limitations; a questionnaire designed to optimally evaluate asthma control levels for Japanese may be necessary. The present study was conducted to validate the Japan Asthma Control Survey (JACS) questionnaire in Japanese asthma patients. A total of 226 adult patients with mild to severe persistent asthma were enrolled and responded to the JACS questionnaire, asthma control questionnaire (ACQ), and Mini asthma quality of life questionnaire (Mini AQLQ) at Weeks 0 and 4. The reliability, validity, and sensitivity/responsiveness of the JACS questionnaire were evaluated. The intra-class correlation coefficients (ICCs) were within the range of 0.55-0.75 for all JACS scores, indicating moderate/substantial reproducibility. For internal consistency, Cronbach's alpha coefficients ranged from 0.76 to 0.92 in total and subscale scores, which were greater than the lower limit of internal consistency. As for factor validity, the cumulative contribution ratio of four main factors was 0.66. For criterion-related validity, the correlation coefficients between the JACS total score and ACQ5, ACQ6, and Mini AQLQ scores were -0.78, -0.78, and 0.77, respectively, showing a significant correlation (p asthma control status in a higher number of patients. UMIN000016589. Copyright © 2017 Japanese Society of Allergology. Production and hosting by Elsevier B.V. All rights reserved.

  2. Interaction between retinoid acid receptor-related orphan receptor alpha (RORA and neuropeptide S receptor 1 (NPSR1 in asthma.

    Directory of Open Access Journals (Sweden)

    Nathalie Acevedo

    Full Text Available Retinoid acid receptor-related Orphan Receptor Alpha (RORA was recently identified as a susceptibility gene for asthma in a genome-wide association study. To investigate the impact of RORA on asthma susceptibility, we performed a genetic association study between RORA single nucleotide polymorphisms (SNPs in the vicinity of the asthma-associated SNP (rs11071559 and asthma-related traits. Because the regulatory region of a previously implicated asthma susceptibility gene, Neuropeptide S receptor 1 (NPSR1, has predicted elements for RORA binding, we hypothesized that RORA may interact biologically and genetically with NPSR1. 37 RORA SNPs and eight NPSR1 SNPs were genotyped in the Swedish birth cohort BAMSE (2033 children and the European cross-sectional PARSIFAL study (1120 children. Seven RORA SNPs confined into a 49 kb region were significantly associated with physician-diagnosed childhood asthma. The most significant association with rs7164773 (T/C was driven by the CC genotype in asthma cases (OR = 2.0, 95%CI 1.36-2.93, p = 0.0003 in BAMSE; and 1.61, 1.18-2.19, p = 0.002 in the combined BAMSE-PARSIFAL datasets, respectively, and strikingly, the risk effect was dependent on the Gln344Arg mutation in NPSR1. In cell models, stimulation of NPSR1 activated a pathway including RORA and other circadian clock genes. Over-expression of RORA decreased NPSR1 promoter activity further suggesting a regulatory loop between these genes. In addition, Rora mRNA expression was lower in the lung tissue of Npsr1 deficient mice compared to wildtype littermates during the early hours of the light period. We conclude that RORA SNPs are associated with childhood asthma and show epistasis with NPSR1, and the interaction between RORA and NPSR1 may be of biological relevance. Combinations of common susceptibility alleles and less common functional polymorphisms may modify the joint risk effects on asthma susceptibility.

  3. Effectiveness of Evidence-Based Asthma Interventions.

    Science.gov (United States)

    Kennedy, Suzanne; Bailey, Ryan; Jaffee, Katy; Markus, Anne; Gerstein, Maya; Stevens, David M; Lesch, Julie Kennedy; Malveaux, Floyd J; Mitchell, Herman

    2017-06-01

    Researchers often struggle with the gap between efficacy and effectiveness in clinical research. To bridge this gap, the Community Healthcare for Asthma Management and Prevention of Symptoms (CHAMPS) study adapted an efficacious, randomized controlled trial that resulted in evidence-based asthma interventions in community health centers. Children (aged 5-12 years; N = 590) with moderate to severe asthma were enrolled from 3 intervention and 3 geographically/capacity-matched control sites in high-risk, low-income communities located in Arizona, Michigan, and Puerto Rico. The asthma intervention was tailored to the participant's allergen sensitivity and exposure, and it comprised 4 visits over the course of 1 year. Study visits were documented and monitored prospectively via electronic data capture. Asthma symptoms and health care utilization were evaluated at baseline, and at 6 and 12 months. A total of 314 intervention children and 276 control children were enrolled in the study. Allergen sensitivity testing (96%) and home environmental assessments (89%) were performed on the majority of intervention children. Overall study activity completion (eg, intervention visits, clinical assessments) was 70%. Overall and individual site participant symptom days in the previous 4 weeks were significantly reduced compared with control findings (control, change of -2.28; intervention, change of -3.27; difference, -0.99; P asthma in these high-need populations. Copyright © 2017 by the American Academy of Pediatrics.

  4. 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...

  5. The Epidemiology of Childhood Asthma in Red Deer and Medicine Hat, Alberta

    Directory of Open Access Journals (Sweden)

    Patrick A Hessel

    2001-01-01

    Full Text Available OBJECTIVES: To document the prevalence of asthma among school-aged children in two Alberta communities, to understand host and indoor environmental factors associated with asthma, and to compare these factors between the two communities.

  6. Comparing a disease-specific and a generic health-related quality of life instrument in subjects with asthma from the general population

    Directory of Open Access Journals (Sweden)

    Rochat Thierry

    2008-02-01

    Full Text Available Abstract Background Few epidemiologic studies have assessed health-related quality of life (HRQL of asthma patients from a general population and it is unclear which instrument is best suitable for this purpose. We investigated the validity of the Asthma Quality of Life Questionnaire (AQLQ and the SF-36 completed by individuals with asthma from the population-based SAPALDIA (Swiss study on air pollution and lung diseases in adults cohort. Methods The study included 258 participants with a physician-diagnosed asthma who had completed the AQLQ and SF-36. We assessed floor and ceiling effects, internal consistency reliability and cross-sectional validity with a priori hypotheses that correlations between the specific HRQL domains (e.g. "symptoms" or "physical functioning" and the corresponding external validation measures (respiratory symptoms, need for doctor visits, limitation in activities due to asthma and lung function would capture similar aspects and be correlated moderately (≥ 0.3 to strongly (≥ 0.5, whereas non-corresponding domains be correlated weakly with each other ( Results The AQLQ showed pronounced ceiling effects with all median domain scores above 6 (scores varied from 1–7. For the SF-36, ceiling effects were present in 5 out of 8 domains. Cronbach's alpha was >0.7 for all AQLQ and SF-36 domains. Correlations between the AQLQ domains "respiratory symptoms", "activity limitation" and "environmental exposure", and the validation measures ranged from 0.29–0.57. Correlations between the "emotional function" domain and the validation measures were also in this range (0.31–0.55 and not as low as we hypothesized. For the SF-36, correlations between "physical functioning" and "role physical", and the validation measures ranged from 0.25–0.56, whereas "role emotional" and "mental health" correlated with these measures from 0.01–0.23. Conclusion The AQLQ and the SF-36 showed fairly good internal consistency. Both instruments

  7. Virus-induced exacerbations in asthma and COPD

    Directory of Open Access Journals (Sweden)

    Daisuke eKurai

    2013-10-01

    Full Text Available Chronic obstructive pulmonary disease (COPD is characterized by chronic airway inflammation and/or airflow limitation due to pulmonary emphysema. Chronic bronchitis, pulmonary emphysema, and bronchial asthma may all be associated with airflow limitation; therefore, exacerbation of asthma may be associated with the pathophysiology of COPD. Furthermore, recent studies have suggested that the exacerbation of asthma, namely virus-induced asthma, may be associated with a wide variety of respiratory viruses.COPD and asthma have different underlying pathophysiological processes and thus require individual therapies. Exacerbation of both COPD and asthma, which are basically defined and diagnosed by clinical symptoms, is associated with a rapid decline in lung function and increased mortality. Similar pathogens, including human rhinovirus, respiratory syncytial virus, influenza virus, parainfluenza virus and coronavirus, are also frequently detected during exacerbation of asthma and/or COPD. Immune response to respiratory viral infections, which may be related to the severity of exacerbation in each disease, varies in patients with both COPD and asthma. In this regard, it is crucial to recognize and understand both the similarities and differences of clinical features in patients with COPD and/or asthma associated with respiratory viral infections, especially in the exacerbative stage.In relation to definition, epidemiology, and pathophysiology, this review aims to summarize current knowledge concerning exacerbation of both COPD and asthma by focusing on the clinical significance of associated respiratory virus infections.

  8. Asthma and COPD: Differences and Similarities

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  9. [The role of the microbial environment for the development of childhood asthma and allergies].

    Science.gov (United States)

    Braun-Fahrländer, Charlotte

    2013-12-01

    Asthma and allergies are among the most frequent chronic diseases in childhood. Their prevalence has increased during the second half of the twentieth century but seem to stabilize in recent years in many Western European countries such as Switzerland. Although the genetic background is known to have a strong impact on an individual's risk to develop asthma or allergy it seems likely that environmental factors are mostly responsible for the increase in prevalence over time. Much research has been devoted to environmental risk factors promoting the development of asthma and allergies. Yet, there is increasing interest in environmental factors which might protect from the development of these diseases and which might have been reduced along with the development of a "Western lifestyle". The role of environmental allergens, the hygiene hypothesis and the role of the farm environment on the development of asthma and allergies are discussed. An emphasis is put on the microbial environment as encountered in the farming environment which has been shown to confer protection from the development of asthma and allergies. It is likely that among other factors the development of a "Western lifestyle" went along with a marked change of the microbial environment children are exposed to.

  10. Asthma Is More Severe in Older Adults

    Science.gov (United States)

    Dweik, Raed A.; Comhair, Suzy A.; Bleecker, Eugene R.; Moore, Wendy C.; Peters, Stephen P.; Busse, William W.; Jarjour, Nizar N.; Calhoun, William J.; Castro, Mario; Chung, K. Fan; Fitzpatrick, Anne; Israel, Elliot; Teague, W. Gerald; Wenzel, Sally E.; Love, Thomas E.; Gaston, Benjamin M.

    2015-01-01

    Background Severe asthma occurs more often in older adult patients. We hypothesized that the greater risk for severe asthma in older individuals is due to aging, and is independent of asthma duration. Methods This is a cross-sectional study of prospectively collected data from adult participants (N=1130; 454 with severe asthma) enrolled from 2002 – 2011 in the Severe Asthma Research Program. Results The association between age and the probability of severe asthma, which was performed by applying a Locally Weighted Scatterplot Smoother, revealed an inflection point at age 45 for risk of severe asthma. The probability of severe asthma increased with each year of life until 45 years and thereafter increased at a much slower rate. Asthma duration also increased the probability of severe asthma but had less effect than aging. After adjustment for most comorbidities of aging and for asthma duration using logistic regression, asthmatics older than 45 maintained the greater probability of severe asthma [OR: 2.73 (95 CI: 1.96; 3.81)]. After 45, the age-related risk of severe asthma continued to increase in men, but not in women. Conclusions Overall, the impact of age and asthma duration on risk for asthma severity in men and women is greatest over times of 18-45 years of age; age has a greater effect than asthma duration on risk of severe asthma. PMID:26200463

  11. 331 Asthma Management in Latin America: Learnings from the Latin America Asthma Insight and Management (LA AIM) Survey of Patients

    OpenAIRE

    Maspero, Jorge; Jardim, Jose; González-Díaz, Sandra; Aranda, Alvaro; Tassinari, Paolo

    2012-01-01

    Background In 2003, the Asthma Insights and Reality in Latin America (AIRLA) survey assessed, in part, perception, knowledge, and attitudes related to asthma.1 In 2011 the Latin America Asthma Insight and Management (LA AIM) survey was designed to ascertain the realities of living with asthma, disconnect between expectations in asthma management and patient experience, and unmet needs. Using results from our survey, we investigated the advances made in asthma care and the challenges that rema...

  12. Draft Genome Sequence of the Dimorphic Fungus Sporothrix pallida, a Nonpathogenic Species Belonging to Sporothrix, a Genus Containing Agents of Human and Feline Sporotrichosis

    NARCIS (Netherlands)

    D'Alessandro, Enrico; Giosa, Domenico; Huang, Lilin; Zhang, Jing; Gao, Wenchao; Brankovics, Balázs; Oliveira, Manoel Marques Evangelista; Scordino, Fabio; Lo Passo, Carla; Criseo, Giuseppe; van Diepeningen, Anne D; Huang, Huaiqiu; de Hoog, G Sybren; Romeo, Orazio

    2016-01-01

    Sporothrix pallidais considered to be a mostly avirulent environmental fungus, phylogenetically closely related to the well-known pathogenSporothrix schenckii Here, we present the first assembly of its genome, which provides a valuable resource for future comparative genomic studies between

  13. Identification and Function of a Novel Candidate Gene for Asthma:ADAM 33

    Directory of Open Access Journals (Sweden)

    John W. Holloway

    2005-01-01

    Full Text Available Asthma is a complex disorder of inflammation and remodelling largely restricted to the conducting airways. It is a disorder where there are major genetics and environmental factors that interact together to initiate and propagate the disease into a chronic relapsing disorder. Until recently the genetic factors involved in disease pathogenesis have been restricted to variants in known molecules involved in the inflammatory or remodelling pathways. In this review evidence is presented for a new susceptibility gene for asthma, ADAM 33, that was identified by positional cloning. It is suggested that ADAM 33 plays a key role in predisposing to reduced lung function and bronchial hyperresponsiveness characteristic of asthma. Through an understanding of the disease-related SNPs(in ADAM 33it may be possible, not only to identify a gene based diagnostic test, but also to focus attention on developing a new treatment that reverses remodelling changes.

  14. The Relationship between Environmental Relative Moldiness Index Values and Asthma

    Data.gov (United States)

    U.S. Environmental Protection Agency — No data generated. This dataset is not publicly accessible because: There was no new data generated. It can be accessed through the following means: None available....

  15. Asthma management in rural New South Wales: perceptions of health care professionals and people with asthma.

    Science.gov (United States)

    Cvetkovski, Biljana; Armour, Carol; Bosnic-Anticevich, Sinthia

    2009-08-01

    To investigate the perceptions and attitudes towards asthma management of general practitioners, pharmacists and people with asthma in a rural area. Qualitative semistructured interviews. Small rural centre in New South Wales. General practitioners, pharmacists and people with asthma in a rural area. General practitioners perceived that the patient provided a barrier to the implementation of optimal asthma services. They were aware that other health care professionals had a role in asthma management but were not aware of the details, particularly in relation to that of the pharmacist and would like to improve communication methods. Pharmacists also perceived the patient to be a barrier to the delivery of optimal asthma management services and would like to improve communication with the general practitioner. The impact of the rural environment for the health care professionals included workforce shortages, availability of support services and access to continuing education. People with asthma were satisfied with their asthma management and the service provided by the health care professionals and described the involvement of family members and ambulance officers in their overall asthma management. The rural environment was an issue with regards to distance to the hospital during an emergency. General practitioners and pharmacists confirmed their existing roles in asthma management while expressing a desire to improve communication between the two professions to help overcome barriers and optimise the asthma service delivered to the patient. The patient described minimal barriers to optimising asthma management, which might suggest that they might not have great expectations of asthma care.

  16. Cough during infancy and subsequent childhood asthma.

    Science.gov (United States)

    Oren, E; Rothers, J; Stern, D A; Morgan, W J; Halonen, M; Wright, A L

    2015-09-01

    Wheezing in infancy has been associated with subsequent asthma, but whether cough similarly influences asthma risk has been little studied. We sought to determine whether prolonged cough and cough without cold in the first year of life are associated with childhood asthma. Participants in the Infant Immune Study, a non-selected birth cohort, were surveyed 7 times in the first 9 months of life regarding the presence of wheeze and cough. Cough for more than 28 days was defined as prolonged. Parents were asked at 1 year if the child ever coughed without a cold. Asthma was defined as parental report of physician diagnosis of asthma, with symptoms or medication use between 2 and 9 years. Logistic regression was used to assess adjusted odds for asthma associated with cough characteristics. A total of 24% (97) of children experienced prolonged cough and 23% (95) cough without cold in the first 9 months, respectively. Prolonged cough was associated with increased risk of asthma relative to brief cough (OR 3.57, CI: 1.88, 6.76), with the risk being particularly high among children of asthmatic mothers. Cough without cold (OR 3.13, 95% CI: 1.76, 5.57) was also independently associated with risk of childhood asthma. Both relations persisted after adjustment for wheeze and total IgE at age 1. Prolonged cough in infancy and cough without cold are associated with childhood asthma, independent of infant wheeze. These findings suggest that characteristics of cough in infancy are early markers of asthma susceptibility, particularly among children with maternal asthma. © 2015 John Wiley & Sons Ltd.

  17. Food diversity in infancy and the risk of childhood asthma and allergies.

    Science.gov (United States)

    Nwaru, Bright I; Takkinen, Hanna-Mari; Kaila, Minna; Erkkola, Maijaliisa; Ahonen, Suvi; Pekkanen, Juha; Simell, Olli; Veijola, Riitta; Ilonen, Jorma; Hyöty, Heikki; Knip, Mikael; Virtanen, Suvi M

    2014-04-01

    Recently, the bacterial diversity of the intestinal flora and the diversity of various environmental factors during infancy have been linked to the development of allergies in childhood. Food is an important environmental exposure, but the role of food diversity in the development of asthma and allergies in childhood is poorly defined. We studied the associations between food diversity during the first year of life and the development of asthma and allergies by age 5 years. In a Finnish birth cohort we analyzed data on 3142 consecutively born children. We studied food diversity at 3, 4, 6, and 12 months of age. Asthma, wheeze, atopic eczema, and allergic rhinitis were measured by using the International Study of Asthma and Allergies in Childhood questionnaire at age 5 years. By 3 and 4 months of age, food diversity was not associated with any of the allergic end points. By 6 months of age, less food diversity was associated with increased risk of allergic rhinitis but not with the other end points. By 12 months of age, less food diversity was associated with increased risk of any asthma, atopic asthma, wheeze, and allergic rhinitis. Less food diversity during the first year of life might increase the risk of asthma and allergies in childhood. The mechanisms for this association are unclear, but increased dietary antigen exposure might contribute to this link. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  18. Factors associated with asthma expression in adolescents

    Directory of Open Access Journals (Sweden)

    Silvia de Souza Campos Fernandes

    Full Text Available ABSTRACT Objective: To evaluate risk factors associated with asthma symptoms in adolescents in the 13- to 14-year age bracket. Methods: This was a cross-sectional study involving adolescents enrolled in randomly selected public schools in the city of Belo Horizonte, Brazil, and conducted with the use of the International Study of Asthma and Allergies in Childhood (ISAAC questionnaire and its supplementary module for risk factor assessment. The ISAAC questionnaire was completed by the students themselves, whereas the supplementary questionnaire was completed by their parents or legal guardians. Variables showing p ≤ 0.25 in the univariate analysis were included in the multivariate analysis. Stepwise regression with backward elimination was used for variable selection. Results: We evaluated 375 adolescents, 124 (33.1% of whom had asthma symptoms. The final multivariate analysis model revealed that asthma symptoms were associated with birth weight < 2,500 g (p < 0.001, day care center or nursery attendance (p < 0.002, maternal history of asthma (p < 0.001, contact with animals during the first year of life (p < 0.027, current contact with animals outside the home (dogs, cats, or farm animals; p < 0.005, and more than 20 cigarettes per day smoked by parents or other household members (p < 0.02. Conclusions: Exposure to animals in and outside the home is associated with asthma symptoms, as is environmental tobacco smoke exposure. Families, health professionals, and administrators of health care facilities should take that into account in order to prevent asthma and reduce asthma morbidity.

  19. The neonatal methylome as a gatekeeper in the trajectory to childhood asthma.

    Science.gov (United States)

    DeVries, Avery; Vercelli, Donata

    2017-04-01

    Asthma is a heterogeneous group of conditions that typically begin in early life and result in recurrent, reversible bronchial obstruction. The role played by epigenetic mechanisms in the pathogenesis of childhood asthma is understood only in part. Here we discuss asthma epigenetics within a developmental perspective based on our recent demonstration that the epigenetic trajectory to childhood asthma begins at birth. We next discuss how this trajectory may be affected by prenatal environmental exposures. Finally, we examine in vitro studies that model the impact of asthma-associated exposures on the epigenome. All of these studies specifically surveyed human DNA methylation and involved a genome-wide component. In combination, their results broaden our understanding of asthma pathogenesis and the role the methylome plays in this process.

  20. Is asthma associated with cognitive impairments? A meta-analytic review.

    Science.gov (United States)

    Irani, Farzin; Barbone, Jordan Mark; Beausoleil, Janet; Gerald, Lynn

    2017-12-01

    Asthma is a chronic disease with significant health burden and socioeconomic and racial/ethnic disparities related to diagnosis and treatment. Asthma primarily affects the lungs, but can impact brain function through direct and indirect mechanisms. Some studies have suggested that asthma negatively impacts cognition, while others have failed to identify asthma-related cognitive compromise. We aimed to conduct a meta-analysis of cognition in individuals with asthma compared to that in healthy controls. We also examined the impact of some key potential moderators. Data on cognitive outcome measures and sociodemographic, illness-related, and study-related variables were extracted from studies reporting cognitive test performance in individuals with asthma compared to that in controls. There was no evidence of publication bias. A random-effects model examining differences in task performance between 2017 individuals with asthma and 2131 healthy controls showed significant effects in the small to medium range. Cognitive deficits associated with asthma were global, with strongest effects on broader measures involving academic achievement and executive functioning, but with additional impact on processing speed, global intellect, attention, visuospatial functioning, language, learning, and memory. Severity of asthma was a key moderator, with greatest cognitive deficits associated with severe asthma. Cognitive burden was also greatest in asthma patients who were younger, males, from low socioeconomic backgrounds, and from racial/ethnic minorities. Effects were independent of type of population (child versus adult), type of study (norm-referenced versus control-referenced), or reported use of oral or inhaled corticosteroid medications. There is cognitive burden associated with asthma, particularly among vulnerable groups with severe asthma. This could be due to increased risk of intermittent cerebral hypoxia in severe asthma. The clinical need to assess cognition in

  1. Pediatric Asthma

    Science.gov (United States)

    ... Science Education & Training Home Conditions Asthma (Pediatric) Asthma (Pediatric) Make an Appointment Refer a Patient Ask a ... meet the rising demand for asthma care. Our pediatric asthma team brings together physicians, nurses, dietitians, physical ...

  2. Pediatric asthma and ambient pollutant levels in industrializing nations.

    Science.gov (United States)

    Jassal, Mandeep S

    2015-01-01

    Asthma is one of the most common chronic diseases in childhood and its prevalence has been increasing within industrializing nations. The contribution of ambient pollutants to asthma symptomatology has been explored in some countries through epidemiological investigations, molecular analysis and monitoring functional outcomes. The health effects of rising environmental pollution have been of increasing concern in industrializing nations with rising urbanization patterns. This review article provides an overview of the link between pediatric asthma and exposure to rising sources of urban air pollution. It primarily focuses on the asthma-specific effects of sulfur dioxide, nitrogen dioxide, ozone and particulate matter. Worldwide trends of asthma prevalence are also provided which detail the prominent rise in asthma symptoms in many urban areas of Africa, Latin America and Asia. The molecular and functional correlation of ambient pollutants with asthma-specific airway inflammation in the pediatric population are also highlighted. The final aspect of the review considers the correlation of motor vehicle, industrial and cooking energy sources, ascribed as the major emitters among the pollutants in urban settings, with asthma epidemiology in children. © The Author 2014. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. The puzzle of immune phenotypes of childhood asthma.

    Science.gov (United States)

    Landgraf-Rauf, Katja; Anselm, Bettina; Schaub, Bianca

    2016-12-01

    Asthma represents the most common chronic childhood disease worldwide. Whereas preschool children present with wheezing triggered by different factors (multitrigger and viral wheeze), clinical asthma manifestation in school children has previously been classified as allergic and non-allergic asthma. For both, the underlying immunological mechanisms are not yet understood in depth in children. Treatment is still prescribed regardless of underlying mechanisms, and children are not always treated successfully. This review summarizes recent key findings on the complex mechanisms of the development and manifestation of childhood asthma. Whereas traditional classification of childhood asthma is primarily based on clinical symptoms like wheezing and atopy, novel approaches to specify asthma phenotypes are under way and face challenges such as including the stability of phenotypes over time and transition into adulthood. Epidemiological studies enclose more information on the patient's disease history and environmental influences. Latest studies define endotypes based on molecular and cellular mechanisms, for example defining risk and protective single nucleotide polymorphisms (SNPs) and new immune phenotypes, showing promising results. Also, regulatory T cells and recently discovered T helper cell subtypes such as Th9 and Th17 cells were shown to be important for the development of asthma. Innate lymphoid cells (ILC) could play a critical role in asthma patients as they produce different cytokines associated with asthma. Epigenetic findings showed different acetylation and methylation patterns for children with allergic and non-allergic asthma. On a posttranscriptional level, miRNAs are regulating factors identified to differ between asthma patients and healthy controls and also indicate differences within asthma phenotypes. Metabolomics is another exciting chapter important for endotyping asthmatic children. Despite the development of new biomarkers and the discovery of

  4. A genome-wide search for linkage to asthma phenotypes in the genetics of asthma international network families : evidence for a major susceptibility locus on chromosome 2p

    NARCIS (Netherlands)

    Pillai, SG; Chiano, MN; White, NJ; Speer, M; Barnes, KC; Carlsen, K; Gerritsen, Jorrit; Helms, P; Lenney, W; Silverman, M; Sly, P; Sundy, J; Tsanakas, J; von Berg, A; Whyte, M; Varsani, S; Skelding, P; Hauser, M; Vance, J; Pericak-Vance, M; Burns, DK; Middleton, LT; Brewster, [No Value; Anderson, WH; Riley, JH

    Asthma is a complex disease and the intricate interplay between genetic and environmental factors underlies the overall phenotype of the disease. Families with at least two siblings with asthma were collected from Europe, Australia and the US. A genome scan using a set of 364 families with a panel

  5. Asthma and obesity in three-year-old urban children: role of sex and home environment.

    Science.gov (United States)

    Suglia, Shakira Franco; Chambers, Earle C; Rosario, Andres; Duarte, Cristiane S

    2011-07-01

    To examine whether the relationship between obesity and asthma in young girls and boys can be explained by social and physical characteristics of the home environment. We examined the relationship between asthma and obesity in children in the Fragile Families and Child Wellbeing Study (n=1815). Asthma was determined through maternal report of asthma diagnosis by a doctor (active in past 12 months). Weight and height of child was measured during an in-home visit. Data on home social (maternal depression, intimate partner violence) and physical environmental factors (housing quality, tobacco exposure) were collected via questionnaire. Ten percent of children had active asthma, 19% of children were overweight, and 17% of children were obese. In fully adjusted models, obese children had twice the odds of having asthma (OR, 2.3; 95% CI, 1.5-3.3) compared with children of normal body weight. In stratified analyses, overweight boys, but not overweight girls, had increased of odds of asthma. Obese boys and girls had increased odds of asthma compared with boys and girls of normal body weight. The relationship between asthma and obesity is present in boys and girls as young as 3 years of age; a relationship between being overweight and asthma is only present among boys. This relationship is not attributable to shared social and environmental factors of the children's home. Copyright © 2011 Mosby, Inc. All rights reserved.

  6. The effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to 18 years diagnosed with asthma: a systematic review protocol.

    Science.gov (United States)

    Walter, Helen; Sadeque-Iqbal, Fatema; Ulysse, Rose; Castillo, Doreen; Fitzpatrick, Aileen; Singleton, Joanne

    2015-10-01

    The objective of this review is to identify the best available quantitative evidence related to the effectiveness of school-based family asthma educational programs on the quality of life and number of asthma exacerbations of children aged five to18 years with a diagnosis of asthma. Asthma is a serious public health issue globally and nationally. The World Health Organization (WHO) Global Asthma Report 2014 estimates that 334 million people worldwide currently suffer from asthma. In the United States, asthma currently affects about 25 million people. Although asthma can occur at any age, it most often begins early in life, and is the most common non-communicable disease among children. Approximately 14% of the world's children have asthma. In the United States, 7.1 million children have asthma. Globally, the burden of asthma, measured by disability and premature death, is greatest in children approaching adolescence (ages 10-14). Asthma is also a serious economic concern in primary health care worldwide. In the United States, the estimated total cost of asthma to society was US$56 billion in 2007, or US$3259 per person. In 2008 asthma caused 10.5 million missed days from school and 14.2 missed days from work for caregivers. The estimated total cost of loss of productivity resulting from missed school or work days is US$3.8 billion per year, and premature death US$2.1 billion per year. Globally, asthma ranks 14 in terms of disability adjusted life years (DALYs), which are the number of years lost to ill health, disability or death attributed to asthma. According to a 2011 European study, the estimated total cost of asthma was €19.3 billion among people aged 15 to 64 years. A study conducted in the Asia-Pacific region reported that the direct and indirect costs of asthma per person ranged from US$184 in Vietnam to US$1189in Hong Kong in 2000. A Canadian study showed that C$184 loss of productivity during one week was attributed to asthma in 2012. In Australia, AU

  7. Asthma mortality in Uruguay, 1984-1998.

    Science.gov (United States)

    Baluga, J C; Sueta, A; Ceni, M

    2001-08-01

    Asthma mortality rates have increased worldwide during the past several years despite the increased availability of new and effective medications. Few studies show reliable data from Latin American countries. To determine asthma mortality rates from 1984 to 1998 and to relate mortality to sales of asthma medications. We conducted a retrospective epidemiologic study in the total population of Uruguay. Data were obtained from the Department of Statistics of the Ministry of Public Health. Trends in mortality rates were analyzed using linear regression procedures. Spearman rank correlations were used to relate mortality rates to sales of asthma medications. The mean overall mortality rate was 5.10 per 100,000 during the period 1984 to 1998, (range 6.08 to 3.39) and showed a decreasing trend (P = 0.001). During the period 1995 to 1998, a more pronounced decrease was observed (mean mortality rate, 4.10 per 100,000). In the 5- to 34-year-old age group the mean mortality rate was 0.43 (range 0.65 to 0.13). Similarly, the mortality rate in this age group decreased particularly in the 1994 to 1998 period (mean 0.19; P = 0.005). Finally, the mortality rate was inversely correlated with sales of inhaled corticosteroids; for the overall mortality rate, p = -0.71, P = 0.003; for 5- to 34-year-old age group, p = -0.63, P = 0.01. Although mortality attributable to asthma seems to be decreasing, the overall mortality rate is still high compared with more economically developed countries. A more pronounced decrease in asthma mortality has been seen in the 5- to 34-year-old group. At present, Uruguay is a Latin American country with a low rate of asthma mortality. This is probably related to the use of new therapies to treat asthma.

  8. Isolation and identification of iron ore-solubilising fungus

    Directory of Open Access Journals (Sweden)

    Damase Khasa

    2010-09-01

    Full Text Available Potential mineral-solubilising fungi were successfully isolated from the surfaces of iron ore minerals. Four isolates were obtained and identified by molecular and phylogenetic methods as close relatives of three different genera, namely Penicillium (for isolate FO, Alternaria (for isolates SFC2 and KFC1 and Epicoccum (for isolate SFC2B. The use of tricalcium phosphate (Ca3(PO42in phosphate-solubilising experiments confirmed isolate FO as the only phosphate solubiliser among the isolated fungi. The bioleaching capabilities of both the fungus and its spent liquid medium were tested and compared using two types of iron ore materials, conglomerate and shale, from the Sishen Iron Ore Mine as sources of potassium (K and phosphorus (P. The spent liquid medium removed more K (a maximum of 32.94% removal, from conglomerate, than the fungus (a maximum of 21.36% removal, from shale. However, the fungus removed more P (a maximum of 58.33% removal, from conglomerate than the spent liquid medium (a maximum of 29.25% removal, from conglomerate. The results also indicated a potential relationship between the removal of K or P and the production of organic acids by the fungus. A high production of gluconic acid could be related to the ability of the fungus to reduce K and P. Acetic, citric and maleic acids were also produced by the fungus, but in lower quantities. In addition, particle size and iron ore type were also shown to have significant effects on the removal of potassium and phosphorus from the iron ore minerals. We therefore conclude that the spent liquid medium from the fungal isolate FO can potentially be used for biobeneficiation of iron ore minerals.

  9. Asthma

    Directory of Open Access Journals (Sweden)

    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.

  10. Travel Tips for People with Asthma

    Centers for Disease Control (CDC) Podcasts

    2012-02-22

    This podcast will assist health care providers in supporting asthma patients so they can be symptom-free and fully active while traveling.  Created: 2/22/2012 by National Center for Environmental Health.   Date Released: 2/22/2012.

  11. Experiences addressing health-related financial challenges with disease management among African American women with asthma

    Science.gov (United States)

    Patel, Minal R.; Caldwell, Cleopatra H.; Id-Deen, Effat; Clark, Noreen M.

    2018-01-01

    Objective Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. Methods In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Results Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Conclusions Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available. PMID:24471517

  12. Experiences addressing health-related financial challenges with disease management among African American women with asthma.

    Science.gov (United States)

    Patel, Minal R; Caldwell, Cleopatra H; Id-Deen, Effat; Clark, Noreen M

    2014-06-01

    Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available.

  13. Association of Youth and Caregiver Anxiety and Asthma Care Among Urban Young Adolescents.

    Science.gov (United States)

    Bruzzese, Jean-Marie; Reigada, Laura C; Lamm, Alexandra; Wang, Jing; Li, Meng; Zandieh, Stephanie O; Klein, Rachel G

    To examine the association of adolescent asthma-related anxiety, social anxiety, separation anxiety, and caregiver asthma-related anxiety with asthma care by urban adolescents. Participants were 386 ethnic minority adolescents (mean age 12.8 years) with persistent asthma and their caregivers. Adolescents reported what they do to prevent asthma symptoms and to manage acute symptoms, and if they or their caregiver is responsible for their asthma care. Adolescents completed the Youth Asthma-Related Anxiety Scale, and the social and separation anxiety subscales of the Screen for Child Anxiety and Emotional Disorders (SCARED); caregivers completed the Parent Asthma-Related Anxiety Scale. Linearity of the associations was assessed by generalized additive models. When there was no evidence for nonlinearity, linear mixed effects models were used to evaluate the effects of the predictors. Adolescent asthma-related anxiety had a strong curvilinear relationship with symptom prevention (P Adolescents took more prevention steps as their anxiety increased, with a plateau at moderate anxiety. There was a linear relationship of adolescent asthma-related anxiety to symptom management (β = 0.03, P = .021) and to asthma responsibility (β = 0.11, P = .015), and of caregiver asthma-related anxiety to adolescent symptom prevention (β = 0.04, P = .001). Adolescent social and separation anxiety had weak to no relationship with asthma care. Results remained consistent when controlling for each of the other anxieties. Asthma-related anxiety plays an important, independent role in asthma care. When low, adolescents may benefit from increased support from caregivers and awareness of the consequences of uncontrolled asthma. When elevated, health providers should ensure the adolescents are not assuming responsibility for asthma care prematurely. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  14. Land cover and air pollution are associated with asthma hospitalisations: A cross-sectional study.

    Science.gov (United States)

    Alcock, Ian; White, Mathew; Cherrie, Mark; Wheeler, Benedict; Taylor, Jonathon; McInnes, Rachel; Otte Im Kampe, Eveline; Vardoulakis, Sotiris; Sarran, Christophe; Soyiri, Ireneous; Fleming, Lora

    2017-12-01

    There is increasing policy interest in the potential for vegetation in urban areas to mitigate harmful effects of air pollution on respiratory health. We aimed to quantify relationships between tree and green space density and asthma-related hospitalisations, and explore how these varied with exposure to background air pollution concentrations. Population standardised asthma hospitalisation rates (1997-2012) for 26,455 urban residential areas of England were merged with area-level data on vegetation and background air pollutant concentrations. We fitted negative binomial regression models using maximum likelihood estimation to obtain estimates of asthma-vegetation relationships at different levels of pollutant exposure. Green space and gardens were associated with reductions in asthma hospitalisation when pollutant exposures were lower but had no significant association when pollutant exposures were higher. In contrast, tree density was associated with reduced asthma hospitalisation when pollutant exposures were higher but had no significant association when pollutant exposures were lower. We found differential effects of natural environments at high and low background pollutant concentrations. These findings can provide evidence for urban planning decisions which aim to leverage health co-benefits from environmental improvements. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Asthma Basics

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Asthma KidsHealth / For Parents / Asthma What's in this article? ... I Know? Print en español Asma What Is Asthma? Asthma is a condition that causes breathing problems. ...

  16. Timing and Duration of Traffic-related Air Pollution Exposure and the Risk for Childhood Wheeze and Asthma.

    Science.gov (United States)

    Brunst, Kelly J; Ryan, Patrick H; Brokamp, Cole; Bernstein, David; Reponen, Tiina; Lockey, James; Khurana Hershey, Gurjit K; Levin, Linda; Grinshpun, Sergey A; LeMasters, Grace

    2015-08-15

    The timing and duration of traffic-related air pollution (TRAP) exposure may be important for childhood wheezing and asthma development. We examined the relationship between TRAP exposure and longitudinal wheezing phenotypes and asthma at age 7 years. Children completed clinical examinations annually from age 1 year through age 4 years and age 7 years. Parental-reported wheezing was assessed at each age, and longitudinal wheezing phenotypes (early-transient, late-onset, persistent) and asthma were defined at age 7 years. Participants' time-weighted exposure to TRAP, from birth through age 7 years, was estimated using a land-use regression model. The relationship between TRAP exposure and wheezing phenotypes and asthma was examined. High TRAP exposure at birth was significantly associated with both transient and persistent wheezing phenotypes (adjusted odds ratio [aOR] = 1.64; 95% confidence interval [CI], 1.04-2.57 and aOR = 2.31; 95% CI, 1.28-4.15, respectively); exposure from birth to age 1 year and age 1 to 2 years was also associated with persistent wheeze. Only children with high average TRAP exposure from birth through age 7 years were at significantly increased risk for asthma (aOR = 1.71; 95% CI, 1.01-2.88). Early-life exposure to TRAP is associated with increased risk for persistent wheezing, but only long-term exposure to high levels of TRAP throughout childhood was associated with asthma development.

  17. The First 1000 Days of Life Factors Associated with "Childhood Asthma Symptoms": Brisa Cohort, Brazil.

    Science.gov (United States)

    Nascimento, Joelma Ximenes Prado Teixeira; Ribeiro, Cecilia Claudia Costa; Batista, Rosângela Fernandes Lucena; de Britto Alves, Maria Teresa Seabra Soares; Simões, Vanda Maria Ferreira; Padilha, Luana Lopes; Cardoso, Viviane Cunha; Vianna, Elcio Oliveira; Bettiol, Heloisa; Barbieri, Marco Antonio; Silva, Antônio Augusto Moura Da

    2017-11-22

    This prospective study used data from the BRISA Cohort, São Luís, Brazil (n = 1140) and analyzed associations between environmental factors up to the first 1000 days of life and "Childhood Asthma Symptoms". "Childhood Asthma Symptoms" was a latent variable based on the number of wheezing episodes, emergency care visit due to wheezing, diagnosis of asthma and diagnosis of rhinitis. A theoretical model that included prenatal factors (socioeconomic status, pregestational body mass index-BMI, soft drink and junk food consumption), birth factors (gestational age, smoking and diseases during pregnancy, birth weight and type of delivery), first year of life factors (breastfeeding, environmental aeroallergens and respiratory diseases) and BMI z-score in the second year of life, was analyzed by structural equation modeling. High pregestational BMI, high soft drink consumption, cesarean section without labor, chill in the first three months of life, carpeted floor and child's exposure to tobacco were associated with higher values of "Childhood Asthma Symptoms". In contrast, high birth weight, breastfeeding and infant's age were associated with lower values of "Childhood Asthma Symptoms". These findings support the hypothesis that environmental factors that are present before conception and up to the first 1000 days of life are associated with asthma.

  18. Social determinants of childhood asthma symptoms: an ecological study in urban Latin America.

    Science.gov (United States)

    Fattore, Gisel L; Santos, Carlos A T; Barreto, Mauricio L

    2014-04-01

    Asthma is an important public health problem in urban Latin America. This study aimed to analyze the role of socioeconomic and environmental factors as potential determinants of asthma symptoms prevalence in children from Latin American (LA) urban centers. We selected 31 LA urban centers with complete data, and an ecological analysis was performed. According to our theoretical framework, the explanatory variables were classified in three levels: distal, intermediate, and proximate. The association between variables in the three levels and prevalence of asthma symptoms was examined by bivariate and multivariate linear regression analysis weighed by sample size. In a second stage, we fitted several linear regression models introducing sequentially the variables according to the predefined hierarchy. In the final hierarchical model Gini Index, crowding, sanitation, variation in infant mortality rates and homicide rates, explained great part of the variance in asthma prevalence between centers (R(2) = 75.0 %). We found a strong association between socioeconomic and environmental variables and prevalence of asthma symptoms in LA urban children, and according to our hierarchical framework and the results found we suggest that social inequalities (measured by the Gini Index) is a central determinant to explain high prevalence of asthma in LA.

  19. Diagnostic approach in cases with suspected work-related asthma

    Science.gov (United States)

    2013-01-01

    Background Work-related asthma (WRA) is a major cause of respiratory disease in modern societies. The diagnosis and consequently an opportunity for prevention are often missed in practice. Methods Based on recent studies and systematic reviews of the literature methods for detection of WRA and identification of specific causes of allergic WRA are discussed. Results and Conclusions All workers should be asked whether symptoms improve on days away from work or on holidays. Positive answers should lead to further investigation. Spirometry and non-specific bronchial responsiveness should be measured, but carefully performed and validly analysed serial peak expiratory flow or forced expiratory volume in one second (FEV1) measurements are more specific and confirm occupational asthma in about 82% of those still exposed to the causative agent. Skin prick testing or specific immunoglobulin E assays are useful to document allergy to high molecular weight allergens. Specific inhalational challenge tests come closest to a gold standard test, but lack standardisation, availability and sensitivity. Supervised workplace challenges can be used when specific challenges are unavailable or the results non-diagnostic, but methodology lacks standardisation. Finally, if the diagnosis remains unclear a follow-up with serial measurements of FEV1 and non-specific bronchial hyperresponsiveness should detect those likely to develop permanent impairment from their occupational exposures. PMID:23768266

  20. Asthma Among Employed Adults, by Industry and Occupation - 21 States, 2013.

    Science.gov (United States)

    Dodd, Katelynn E; Mazurek, Jacek M

    2016-12-02

    Workers in various industries and occupations are at risk for work-related asthma* (1). Data from the 2006-2007 adult Behavioral Risk Factor Surveillance System (BRFSS) Asthma Call-back Survey (ACBS), an in-depth asthma survey conducted with respondents who report an asthma diagnosis, from 33 states indicated that up to 48% of adult current asthma might be related to work and could therefore potentially be prevented (2). Identification of the industries and occupations with increased prevalence of asthma might inform work-related asthma intervention and prevention efforts. To assess the industry-specific and occupation-specific proportions of adults with current asthma by state, CDC analyzed data from the 2013 BRFSS industry and occupation module, collected from 21 states for participants aged ≥18 years who, at the time of the survey interview, were employed or had been out of work for industry and occupation were observed. By state, current asthma prevalence was highest among workers in the information industry (18.0%) in Massachusetts and in health care support occupations (21.5%) in Michigan. Analysis of BRFSS industry and occupation and optional asthma modules can be used to identify industries and occupations to assess for asthma among workers, identify workplace exposures, and guide the design and evaluation of effective work-related asthma prevention and education programs (1).

  1. 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.

    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

  2. Relations of Change in Condition Severity and School Self-Concept To Change in Achievement-Related Behavior in Children with Asthma or Epilepsy.

    Science.gov (United States)

    Huberty, Thomas J.; Austin, Joan K.; Huster, Gertrude A.; Dunn, David W.

    2000-01-01

    Explores relation of gender, change in condition of severity, and change in school self-concept, to change in teachers' ratings of academic-related behaviors in children with asthma or epilepsy. Tests showed that these children were near population mean in academic-related behaviors, except students with high-severity epilepsy. (Author/JDM)

  3. 'Relax and take a deep breath': print media coverage of asthma and air pollution in the United States.

    Science.gov (United States)

    Mayer, Brian

    2012-09-01

    The media are an important social actor in the construction of the public's understanding of the complex relationships between the environment and their health. This paper explores the print media's coverage of the relationship between asthma and air pollution, focusing on the portrayal of causal certainty between exposure to various forms of air pollution and the etiology and exacerbation of the disease. By examining twenty years of newspaper articles from the New York Timeş Los Angeles Times, and the Washington Post, this paper presents findings on trends across time, within papers, and across key themes. Although the print media's coverage of asthma and its environmental correlates has increased over time, this paper finds relatively little coherence in whether asthma is portrayed as directly caused by air pollution or triggered by exposures. In terms of coverage, outdoor sources of air pollution are covered more frequently - but with less certainty in the discussion of specific relationships. This lack of coherence and specificity in the portrayal of asthma as an environmental disease may weaken regulators' ability to act in passing air pollution reforms by lowering the public's interest and concern. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. Perinatal Programming of Asthma: The Role of Gut Microbiota

    Directory of Open Access Journals (Sweden)

    Meghan B. Azad

    2012-01-01

    Full Text Available Perinatal programming, a dominant theory for the origins of cardiovascular disease, proposes that environmental stimuli influence developmental pathways during critical periods of prenatal and postnatal development, inducing permanent changes in metabolism. In this paper, we present evidence for the perinatal programming of asthma via the intestinal microbiome. While epigenetic mechanisms continue to provide new explanations for the programming hypothesis of asthma development, it is increasingly apparent that the intestinal microbiota plays an independent and potentially interactive role. Commensal gut bacteria are essential to immune system development, and exposures disrupting the infant gut microbiota have been linked to asthma. This paper summarizes the recent findings that implicate caesarean delivery, breastfeeding, perinatal stress, probiotics, and antibiotics as modifiers of infant gut microbiota in the development of asthma.

  5. Life style and home environment are associated with racial disparities of asthma and allergy in Northeast Texas children

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Yuexia, E-mail: ysun@engr.psu.edu [Texas Institute of Allergy, Indoor Environment and Energy (TxAIRE), University of Texas at Tyler, 3900 University Blvd, Tyler, Tx 75799 (United States); Architecture Engineering Department, Pennsylvania State University, 104 Engineering Unit A, State College, PA 16802 (United States); Sundell, Jan, E-mail: ja.sundell@gmail.com [Dept of Building Science, Tsinghua University, Haidian District, Beijing City 100084 (China); The Faculty of Urban Construction and Environmental Engineering, Chongqing University, Shapingba District, Chongqing City 400030 (China)

    2011-09-15

    A high prevalence and racial disparities in asthma and allergy have been observed in American children. This study aimed to identify risk factors for asthma and allergy among children, and their contribution to racial disparities in allergy prevalence. A population-based cross-sectional study was carried out among children aged 1-8 years in Northeast Texas 2008-2009. The health conditions, life style and home environment of 3766 children were surveyed by parental questionnaires through e.g. daycares, elementary school, and medical clinics. Among participants who indicated their ethnicity, 255 were Mexican-Americans, 178 Afro-Americans and 969 Caucasians. Afro-American children had a significantly higher prevalence of asthma and eczema. Caucasian had the highest prevalence of rhinitis. Compared to Mexican-American children, Afro-American and Caucasian children were breast fed shorter time, more often went to day care center, had pets and environmental tobacco smoke exposure at home more often. For all children, being at a day care center, being exposed to dampness and environmental tobacco smoke at home were strong risk factors for asthma and allergy. Central air conditioning system was associated with an increased prevalence of wheeze among Mexican-American children, while pets were associated with an increased risk of rhinitis among Afro-American and Caucasian children. Caucasian children were generally not healthier than relatively poor Mexican-American children. Differences in the prevalence of asthma and allergy between races cannot be explained by socioeconomic status only. Life style and home environmental exposures are important risk factors for asthma and allergy in Northeast Texas children. - Highlights: {yields} This is a general population cross-sectional study in Northeast Texas. {yields} Racial disparity of allergy cannot be explained by socioeconomic status only. {yields} Life style and home environment caused racial disparity of allergy in children

  6. Life style and home environment are associated with racial disparities of asthma and allergy in Northeast Texas children

    International Nuclear Information System (INIS)

    Sun, Yuexia; Sundell, Jan

    2011-01-01

    A high prevalence and racial disparities in asthma and allergy have been observed in American children. This study aimed to identify risk factors for asthma and allergy among children, and their contribution to racial disparities in allergy prevalence. A population-based cross-sectional study was carried out among children aged 1-8 years in Northeast Texas 2008-2009. The health conditions, life style and home environment of 3766 children were surveyed by parental questionnaires through e.g. daycares, elementary school, and medical clinics. Among participants who indicated their ethnicity, 255 were Mexican-Americans, 178 Afro-Americans and 969 Caucasians. Afro-American children had a significantly higher prevalence of asthma and eczema. Caucasian had the highest prevalence of rhinitis. Compared to Mexican-American children, Afro-American and Caucasian children were breast fed shorter time, more often went to day care center, had pets and environmental tobacco smoke exposure at home more often. For all children, being at a day care center, being exposed to dampness and environmental tobacco smoke at home were strong risk factors for asthma and allergy. Central air conditioning system was associated with an increased prevalence of wheeze among Mexican-American children, while pets were associated with an increased risk of rhinitis among Afro-American and Caucasian children. Caucasian children were generally not healthier than relatively poor Mexican-American children. Differences in the prevalence of asthma and allergy between races cannot be explained by socioeconomic status only. Life style and home environmental exposures are important risk factors for asthma and allergy in Northeast Texas children. - Highlights: → This is a general population cross-sectional study in Northeast Texas. → Racial disparity of allergy cannot be explained by socioeconomic status only. → Life style and home environment caused racial disparity of allergy in children. → Daycare

  7. International trends in admissions and drug sales for asthma.

    Science.gov (United States)

    Gupta, R; Anderson, H R; Strachan, D P; Maier, W; Watson, L

    2006-02-01

    To test whether national patterns of asthma drug use, particularly inhaled corticosteroids (ICS), are related to the rate of acute severe asthma exacerbations. The relation of international trends in hospital admissions for asthma with asthma drug sales was examined using country-specific regressions over the period 1990-1999. Pooled estimates of the regression coefficients were calculated using random effects models. Data on asthma admissions and asthma drug sales (including the sub-category ICS) were obtained from 11 countries. There was a negative relationship between falling admissions and rising sales of respiratory drugs and ICS in 9 of these 11 countries. A pooled estimate of the change in asthma admission rate per 10,000 associated with a unit increase in sales rate was -6.3 (95% CI -10.4 - -2.3) for all asthma drugs and -11.2 (95% CI -19.7 - -2.8) for ICS. At the national level, there is good evidence that over the last decade, increased sales of asthma drugs, and ICS in particular, were associated with a decline in rates of hospital admission for asthma. This is consistent with a beneficial effect of increasing use of asthma drugs, but other explanations such as decreasing prevalence could also be responsible.

  8. Acute viral bronchiolitis and risk of asthma in schoolchildren: analysis of a Brazilian newborn cohort.

    Science.gov (United States)

    Brandão, Heli V; Vieira, Graciete O; Vieira, Tatiana O; Cruz, Álvaro A; Guimarães, Armênio C; Teles, Carlos; Camargos, Paulo; Cruz, Constança M S

    To verify whether the occurrence of acute viral bronchiolitis in the first year of life constitutes a risk factor for asthma at age 6 considering a parental history of asthma. Cross-sectional study in a cohort of live births. A standardized questionnaire of the International Study of Asthma and Allergies in Childhood was applied to the mothers to identify asthma in children at the age of 6 years. Acute viral bronchiolitis diagnosis was performed by maternal report of a medical diagnosis and/or presence of symptoms of coryza accompanied by cough, tachypnea, and dyspnea when participants were 3, 6, 9, and 12 months. Socioeconomic, environmental data, parental history of asthma, and data related to pregnancy were collected in the first 72h of life of the newborn and in prospective home visits by trained interviewers. The association between acute viral bronchiolitis and asthma was evaluated by logistic regression analysis and potential modifier effect of parental history was verified by introducing an interaction term into the adjusted logistic regression model. Prevalence of acute viral bronchiolitis in the first year of life was 68.6% (461). The occurrence of acute viral bronchiolitis was a risk factor for asthma at 6 years of age in children with parental history of asthma OR: 2.66, 95% CI (1.10-6.40), modifier effect p=0.002. Parental history of asthma OR: 2.07, 95% CI (1.29-3.30) and male gender OR: 1.69, 95% CI, (1.06-2.69) were other identified risk factors for asthma. Acute viral bronchiolitis in the first year of life is a risk factor for asthma in children with parental history of asthma. Copyright © 2016. Published by Elsevier Editora Ltda.

  9. Acute viral bronchiolitis and risk of asthma in schoolchildren: analysis of a Brazilian newborn cohort,

    Directory of Open Access Journals (Sweden)

    Heli V. Brandão

    Full Text Available Abstract Objective: To verify whether the occurrence of acute viral bronchiolitis in the first year of life constitutes a risk factor for asthma at age 6 considering a parental history of asthma. Methods: Cross-sectional study in a cohort of live births. A standardized questionnaire of the International Study of Asthma and Allergies in Childhood was applied to the mothers to identify asthma in children at the age of 6 years. Acute viral bronchiolitis diagnosis was performed by maternal report of a medical diagnosis and/or presence of symptoms of coryza accompanied by cough, tachypnea, and dyspnea when participants were 3, 6, 9, and 12 months. Socioeconomic, environmental data, parental history of asthma, and data related to pregnancy were collected in the first 72 h of life of the newborn and in prospective home visits by trained interviewers. The association between acute viral bronchiolitis and asthma was evaluated by logistic regression analysis and potential modifier effect of parental history was verified by introducing an interaction term into the adjusted logistic regression model. Results: Prevalence of acute viral bronchiolitis in the first year of life was 68.6% (461. The occurrence of acute viral bronchiolitis was a risk factor for asthma at 6 years of age in children with parental history of asthma OR: 2.66, 95% CI (1.10-6.40, modifier effect p = 0.002. Parental history of asthma OR: 2.07, 95% CI (1.29-3.30 and male gender OR: 1.69, 95% CI, (1.06-2.69 were other identified risk factors for asthma. Conclusion: Acute viral bronchiolitis in the first year of life is a risk factor for asthma in children with parental history of asthma.

  10. Prevention of Allergies and Asthma in Children

    Science.gov (United States)

    American Academy of Allergy Asthma & Immunology Menu Search Main navigation Skip to content Conditions & Treatments Allergies Asthma Primary Immunodeficiency Disease Related Conditions Drug Guide Conditions Dictionary Just ...

  11. A Cost-Benefit Analysis of a State-Funded Healthy Homes Program for Residents With Asthma: Findings From the New York State Healthy Neighborhoods Program.

    Science.gov (United States)

    Gomez, Marta; Reddy, Amanda L; Dixon, Sherry L; Wilson, Jonathan; Jacobs, David E

    Despite considerable evidence that the economic and other benefits of asthma home visits far exceed their cost, few health care payers reimburse or provide coverage for these services. To evaluate the cost and savings of the asthma intervention of a state-funded healthy homes program. Pre- versus postintervention comparisons of asthma outcomes for visits conducted during 2008-2012. The New York State Healthy Neighborhoods Program operates in select communities with a higher burden of housing-related illness and associated risk factors. One thousand households with 550 children and 731 adults with active asthma; 791 households with 448 children and 551 adults with asthma events in the previous year. The program provides home environmental assessments and low-cost interventions to address asthma trigger-promoting conditions and asthma self-management. Conditions are reassessed 3 to 6 months after the initial visit. Program costs and estimated benefits from changes in asthma medication use, visits to the doctor for asthma, emergency department visits, and hospitalizations over a 12-month follow-up period. For the asthma event group, the per person savings for all medical encounters and medications filled was $1083 per in-home asthma visit, and the average cost of the visit was $302, for a benefit to program cost ratio of 3.58 and net benefit of $781 per asthma visit. For the active asthma group, per person savings was $613 per asthma visit, with a benefit to program cost ratio of 2.03 and net benefit of $311. Low-intensity, home-based, environmental interventions for people with asthma decrease the cost of health care utilization. Greater reductions are realized when services are targeted toward people with more poorly controlled asthma. While low-intensity approaches may produce more modest benefits, they may also be more feasible to implement on a large scale. Health care payers, and public payers in particular, should consider expanding coverage, at least for

  12. What is new since the last (1999) Canadian Asthma Consensus Guidelines?

    Science.gov (United States)

    Boulet, L P; Bai, T R; Becker, A; Bérubé, D; Beveridge, R; Bowie, D M; Chapman, K R; Côté, J; Cockcroft, D; Ducharme, F M; Ernst, P; FitzGerald, J M; Kovesi, T; Hodder, R V; O'Byrne, P; Rowe, B; Sears, M R; Simons, F E; Spier, S

    2001-01-01

    The objective of the present document is to review the impact of new information on the recommendations made in the last (1999) Canadian Asthma Consensus Guidelines. It includes relevant published studies and observations or comments regarding what are considered to be the main issues in asthma management in children and adults in office, emergency department, hospital and clinical settings. Asthma is still insufficiently controlled in a large number of patients, and practice guidelines need to be integrated better with current care. This report re-emphasises the need for the following: objective measures of airflow obstruction to confirm the diagnosis of asthma suggested by the clinical evaluation; identification of contributing factors; and the establishment of a treatment plan to rapidly obtain and maintain optimal asthma control according to specific criteria. Recent publications support the essential role of asthma education and environmental control in asthma management. They further support the role of inhaled corticosteroids as the mainstay of anti-inflammatory therapy of asthma, and of both long acting beta2-agonists and leukotriene antagonists as effective means to improve asthma control when inhaled corticosteroids are insufficient. New developments, such as combination therapy, and recent major trials, such as the Children's Asthma Management Project (CAMP) study, are discussed.

  13. What Is New Since the Last (1999 Canadian Asthma Consensus Guidelines?

    Directory of Open Access Journals (Sweden)

    Louis-Philippe Boulet

    2001-01-01

    Full Text Available The objective of the present document is to review the impact of new information on the recommendations made in the last (1999 Canadian Asthma Consensus Guidelines. It includes relevant published studies and observations or comments regarding what are considered to be the main issues in asthma management in children and adults in office, emergency department, hospital and clinical settings. Asthma is still insufficiently controlled in a large number of patients, and practice guidelines need to be integrated better with current care. This report re-emphasises the need for the following: objective measures of airflow obstruction to confirm the diagnosis of asthma suggested by the clinical evaluation; identification of contributing factors; and the establishment of a treatment plan to rapidly obtain and maintain optimal asthma control according to specific criteria. Recent publications support the essential role of asthma education and environmental control in asthma management. They further support the role of inhaled corticosteroids as the mainstay of anti-inflammatory therapy of asthma, and of both long acting beta2-agonists and leukotriene antagonists as effective means to improve asthma control when inhaled corticosteroids are insufficient. New developments, such as combination therapy, and recent major trials, such as the Children’s Asthma Management Project (CAMP study, are discussed.

  14. The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil.

    Science.gov (United States)

    Urrutia-Pereira, Marilyn; Avila, Jennifer; Solé, Dirceu

    2016-01-01

    To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents ( 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.

  15. The Program for the Prevention of Childhood Asthma: a specialized care program for children with wheezing or asthma in Brazil

    Directory of Open Access Journals (Sweden)

    Marilyn Urrutia-Pereira

    2016-02-01

    Full Text Available Objective : To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma and the characteristics of the patients followed in this program. Methods : Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents ( 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%, occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. Conclusions : A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood.

  16. Epidemiological study of school performance and asthma ...

    African Journals Online (AJOL)

    Ehab

    Original article. Background: Childhood asthma is a major health problem in Egypt and worldwide. ... and environmental barriers like indoor and outdoor air pollution, tobacco ..... medical therapy and its utilization for the benefit of the asthmatic ...

  17. Posttraumatic stress disorder following asthma attack (post-asthma attack PTSD) and psychiatric co-morbidity: the impact of alexithymia and coping.

    Science.gov (United States)

    Chung, Man Cheung; Rudd, Hannah; Wall, Natalie

    2012-05-30

    This study investigated the prevalence of post-asthma attack posttraumatic stress disorder (PTSD) and the severity of psychiatric co-morbidity among a group of college students and whether alexithymia and coping strategies would relate to health outcomes. This is a cross-sectional study in which 156 college students who had previously experienced asthma attack were recruited. They completed a demographic page, Asthma Symptom Checklist, PTSD Checklist, General Health Questionnaire-28, Toronto Alexithymia Scale and the COPE. They were also matched with 141 students without asthma. The results showed that 3% met the criteria for full-PTSD, 44% for partial and 53% for no-PTSD. There were no significant differences between the asthma and control groups in severity of psychiatric co-morbid symptoms. Path analyses showed that asthma severity was significantly correlated with PTSD and psychiatric co-morbidity. It was also correlated with alexithymia which was in turn associated with psychiatric co-morbidity but not PTSD. Coping strategies were not correlated with health outcomes. To conclude, people can develop PTSD symptoms and degrees of psychiatric co-morbid symptoms after suffering asthma attack. The severity of these symptoms relates to people's perceptions of asthma severity and alexithymia. Copyright © 2012 Elsevier Ltd. All rights reserved.

  18. TIPE2 Inhibits the Expression of Asthma-Related Inflammatory Factors in Hyperstretched Bronchial Epithelial Cells Through the Wnt/β-Catenin Pathway.

    Science.gov (United States)

    Sun, Xinrong; Chen, Lu; Yan, Wen

    2017-06-01

    Childhood asthma, an airway inflammatory disease, is a serious threat to the child's quality of life. Recently, TIPE2 expression was reported to be decreased in children with asthma. Therefore, additional studies focusing on TIPE2 might provide an approach for treating childhood asthma. In this study, we found that TIPE2 was poorly expressed in hyperstretched human bronchial epithelial cells (BEAS-2B). TIPE2 overexpression also significantly suppressed the stretch-induced secretion of asthma-related inflammatory factors (TNF-α, TSLP, MMP-9, and VEGF). In contrast, TIPE2 inhibition significantly promoted the secretion of TNF-α, TSLP, MMP-9, and VEGF. Furthermore, overexpression of TIPE2 remarkably inhibited the activation of Wnt/β-catenin in hyperstretched BEAS-2B cells, while siTIPE2 activated Wnt/β-catenin in hyperstretched BEAS-2B cells. Further analysis showed that the Wnt/β-catenin signal inhibitor Dkk-1 could further enhance the TIPE2-induced suppression of Wnt/β-catenin signaling, which also suppressed the siTIPE2-induced secretion of TNF-α, TSLP, MMP-9, and VEGF in hyperstretched BEAS-2B cells. Dkk-1 reversed the effects of siRNA-TIPE2 on Wnt/β-catenin signaling and inflammatory cytokines. In summary, we have exhibited that TIPE2 inhibited the expression of asthma-related inflammatory factors in hyperstretched BEAS-2B cells by suppressing the Wnt/β-catenin signaling pathway. TIPE2 may be involved in airway inflammation during asthma attack, and it may be used as a potential therapeutic target for bronchial epithelial inflammation in childhood asthma.

  19. Work stress, asthma control and asthma-specific quality of life: Initial evidence from a cross-sectional study.

    Science.gov (United States)

    Hartmann, Bettina; Leucht, Verena; Loerbroks, Adrian

    2017-03-01

    Research has suggested that psychological stress is positively associated with asthma morbidity. One major source of stress in adulthood is one's occupation. However, to date, potential links of work stress with asthma control or asthma-specific quality of life have not been examined. We aimed to address this knowledge gap. In 2014/2015, we conducted a cross-sectional study among adults with asthma in Germany (n = 362). For the current analyses that sample was restricted to participants in employment and reporting to have never been diagnosed with chronic obstructive pulmonary disease (n = 94). Work stress was operationalized by the 16-item effort-reward-imbalance (ERI) questionnaire, which measures the subcomponents "effort", "reward" and "overcommitment." Participants further completed the Asthma Control Test and the Asthma Quality of Life Questionnaire-Sydney. Multivariable associations were quantified by linear regression and logistic regression. Effort, reward and their ratio (i.e. ERI ratio) did not show meaningful associations with asthma morbidity. By contrast, increasing levels of overcommitment were associated with poorer asthma control and worse quality of life in both linear regression (ß = -0.26, p = 0.01 and ß = 0.44, p work-related overcommitment with asthma control and asthma-specific quality of life. Longitudinal studies with larger samples are needed to confirm our findings and to disentangle the potential causality of associations.

  20. Exercise-Induced Asthma

    Science.gov (United States)

    ... Videos for Educators Search English Español Exercise-Induced Asthma KidsHealth / For Parents / Exercise-Induced Asthma What's in ... Exercise-Induced Asthma Print What Is Exercise-Induced Asthma? Most kids and teens with asthma have symptoms ...

  1. 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

    . Elite athletes with physician-diagnosed asthma seem to have less airway reactivity and fewer sputum eosinophils than non-athletes with physician-diagnosed asthma, but more studies are needed to further investigate if and how the asthma phenotype of elite athletes differs from that of classical asthma....

  2. Cleaning and asthma characteristics in women.

    NARCIS (Netherlands)

    Dumas, O.; Siroux, V.; Luu, F.; Nadif, R.; Zock, J.P.; Kauffmann, F.; Moual, N. le

    2014-01-01

    Background We aimed to assess the associations between occupational exposure to cleaning products, a gender-related exposure, and asthma characteristics, considering clinical, mmunological and inflammatory aspects. Methods Analyses were conducted in 391 women (73 with adult-onset asthma) from the

  3. Increase in the heritability of asthma from 1994 to 2003 among adolescent twins

    DEFF Research Database (Denmark)

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

    2011-01-01

    BACKGROUND: Over the past decades the prevalence of asthma has increased in most parts of the world, and widespread changes in lifestyle and environment have been postulated as the primary cause for this. We examined whether the extent to which genetic and environmental factors influence suscepti......BACKGROUND: Over the past decades the prevalence of asthma has increased in most parts of the world, and widespread changes in lifestyle and environment have been postulated as the primary cause for this. We examined whether the extent to which genetic and environmental factors influence...... was compared between the two cohorts. RESULTS: The prevalence of asthma increased from 7.1% in 1994 to 10.8% in 2003, p ...

  4. A population based time series analysis of asthma hospitalisations in Ontario, Canada: 1988 to 2000

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2001-08-01

    Full Text Available Abstract Background Asthma is a common yet incompletely understood health problem associated with a high morbidity burden. A wide variety of seasonally variable environmental stimuli such as viruses and air pollution are believed to influence asthma morbidity. This study set out to examine the seasonal patterns of asthma hospitalisations in relation to age and gender for the province of Ontario over a period of 12 years. Methods A retrospective, population-based study design was used to assess temporal patterns in hospitalisations for asthma from April 1, 1988 to March 31, 2000. Approximately 14 million residents of Ontario eligible for universal healthcare coverage during this time were included for analysis. Time series analyses were conducted on monthly aggregations of hospitalisations. Results There is strong evidence of an autumn peak and summer trough seasonal pattern occurring every year over the 12-year period (Fisher-Kappa (FK = 23.93, p > 0.01; Bartlett Kolmogorov Smirnov (BKS = 0.459, p Conclusions A clear and consistent seasonal pattern was observed in this study for asthma hospitalisations. These findings have important implications for the development of effective management and prevention strategies.

  5. Diagnosis of asthma: diagnostic testing.

    Science.gov (United States)

    Brigham, Emily P; West, Natalie E

    2015-09-01

    Asthma is a heterogeneous disease, encompassing both atopic and non-atopic phenotypes. Diagnosis of asthma is based on the combined presence of typical symptoms and objective tests of lung function. Objective diagnostic testing consists of 2 components: (1) demonstration of airway obstruction, and (2) documentation of variability in degree of obstruction. A review of current guidelines and literature was performed regarding diagnostic testing for asthma. Spirometry with bronchodilator reversibility testing remains the mainstay of asthma diagnostic testing for children and adults. Repetition of the test over several time points may be necessary to confirm airway obstruction and variability thereof. Repeated peak flow measurement is relatively simple to implement in a clinical and home setting. Bronchial challenge testing is reserved for patients in whom the aforementioned testing has been unrevealing but clinical suspicion remains, though is associated with low specificity. Demonstration of eosinophilic inflammation, via fractional exhaled nitric oxide measurement, or atopy, may be supportive of atopic asthma, though diagnostic utility is limited particularly in nonatopic asthma. All efforts should be made to confirm the diagnosis of asthma in those who are being presumptively treated but have not had objective measurements of variability in the degree of obstruction. Multiple testing modalities are available for objective confirmation of airway obstruction and variability thereof, consistent with a diagnosis of asthma in the appropriate clinical context. Providers should be aware that both these characteristics may be present in other disease states, and may not be specific to a diagnosis of asthma. © 2015 ARS-AAOA, LLC.

  6. 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.

  7. Updated prevalences of asthma, allergy, and airway symptoms, and a systematic review of trends over time for childhood asthma in Shanghai, China.

    Directory of Open Access Journals (Sweden)

    Chen Huang

    Full Text Available The prevalence of asthma among Shanghai children has increased over time. This increase might be associated with changes in environmental exposures. Investigation of the time-trend of asthma and current prevalences is essential to understanding the causes.To estimate the current prevalences of asthma, allergies and other respiratory symptoms among Shanghai preschool children, and to investigate the time-trend of childhood asthma prevalence of from 1990 to 2011.From April 2011 to April 2012, the CCHH (China, Children, Homes, Health cross-sectional study was conducted in Shanghai. Questionnaires were distributed to 17,898 parents or guardians of preschool children from 72 kindergartens in 5 districts. Previous similar studies were also summarized by a systematic literature review.From a total of 14,884 questionnaires for 3-7 year old children, prevalences of the following diseases and symptoms were calculated: asthma 10.2%, wheeze (ever 28.1%, pneumonia (ever 33.5%, otitis media 11.0%, rhinitis (ever 54.1%, hay fever 12.2%, eczema (ever 22.7%, and food allergy 15.7%. Urban children had higher prevalences of most symptoms than suburban children. The prevalence of asthma has increased significantly, almost five-fold, from 2.1% in 1990 to 10.2% in the present study. The prevalence of asthma in boys was higher than in girls in the present study and in all reviewed studies.Asthma, allergy and airway symptoms are common among preschool children in Shanghai. The prevalence of childhood asthma in Shanghai has increased rapidly from 1990 to 2011.

  8. Patterns of genomic variation in the poplar rust fungus Melampsora larici-populina identify pathogenesis-related factors

    Directory of Open Access Journals (Sweden)

    Antoine ePersoons

    2014-09-01

    Full Text Available Melampsora larici-populina is a fungal pathogen responsible for foliar rust disease on poplar trees, which causes damage to forest plantations worldwide, particularly in Northern Europe. The reference genome of the isolate 98AG31 was previously sequenced using a whole genome shotgun strategy, revealing a large genome of 101 megabases containing 16,399 predicted genes, which included secreted protein genes representing poplar rust candidate effectors. In the present study, the genomes of 15 isolates collected over the past 20 years throughout the French territory, representing distinct virulence profiles, were characterized by massively parallel sequencing to assess genetic variation in the poplar rust fungus. Comparison to the reference genome revealed striking structural variations. Analysis of coverage and sequencing depth identified large missing regions between isolates related to the mating type loci. More than 611,824 single-nucleotide polymorphism (SNP positions were uncovered overall, indicating a remarkable level of polymorphism. Based on the accumulation of non-synonymous substitutions in coding sequences and the relative frequencies of synonymous and non-synonymous polymorphisms (i.e. PN/PS, we identify candidate genes that may be involved in fungal pathogenesis. Correlation between non-synonymous SNPs in genes encoding secreted proteins and pathotypes of the studied isolates revealed candidate genes potentially related to virulences 1, 6 and 8 of the poplar rust fungus.

  9. Risk Factors for Asthma Exacerbation and Treatment Failure in Adults and Adolescents with Well-Controlled Asthma during Continuation and Step Down Therapy.

    Science.gov (United States)

    DiMango, Emily; Rogers, Linda; Reibman, Joan; Gerald, Lynn B; Brown, Mark; Sugar, Elizabeth A; Henderson, Robert; Holbrook, Janet T

    2018-06-04

    Although national and international guidelines recommend reduction of asthma controller therapy or 'step-down" therapy in patients with well controlled asthma, it is expected that some individuals may experience worsening of asthma symptoms or asthma exacerbations during step-down. Characteristics associated with subsequent exacerbations during step-down therapy have not been well defined. The effect of environmental tobacco smoke (ETS) exposure on risk of treatment failure during asthma step down therapy has not been reported. To identify baseline characteristics associated with treatment failure and asthma exacerbation during maintenance and guideline-based step-down therapy. The present analysis uses data collected from a completed randomized controlled trial of optimal step-down therapy in patients with well controlled asthma taking moderate dose combination inhaled corticosteroids/long acting beta agonists. Participants were 12 years or older with physician diagnosed asthma and were enrolled between December 2011 and May 2014. An Emergency Room visit in the previous year was predictive of a subsequent treatment failure (HR 1.53 (1.06, 2.21 CI). For every 10% increase in baseline forced expiratory volume in one second percent predicted, the hazard for treatment failure was reduced by 14% (95% CI: 0.74-0.99). There was no difference in risk of treatment failure between adults and children, nor did duration of asthma increase risk of treatment failure. Age of asthma onset was not associated with increased risk of treatment failure. Unexpected emergency room visit in the previous year was the only risk factor significantly associated with subsequent asthma exacerbations requiring systemic corticosteroids. Time to treatment failure or exacerbation did not differ in participants with and without self-report of ETS exposure. The present findings can help clinicians identify patients more likely to develop treatment failures and exacerbations and who may therefore

  10. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... the Nation Fact Sheet State Data Profiles (2011) Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals ...

  11. Pharmacogenetics of asthma

    Science.gov (United States)

    Lima, John J.; Blake, Kathryn V.; Tantisira, Kelan G.; Weiss, Scott T.

    2009-01-01

    Purpose of review Patient response to the asthma drug classes, bronchodilators, inhaled corticosteroids and leukotriene modifiers, are characterized by a large degree of heterogeneity, which is attributable in part to genetic variation. Herein, we review and update the pharmacogenetics and pharmaogenomics of common asthma drugs. Recent findings Early studies suggest that bronchodilator reversibility and asthma worsening in patients on continuous short-acting and long-acting β-agonists are related to the Gly16Arg genotype for the ADRB2. More recent studies including genome-wide association studies implicate variants in other genes contribute to bronchodilator response heterogeneity and fail to replicate asthma worsening associated with continuous β-agonist use. Genetic determinants of the safety of long-acting β-agonist require further study. Variants in CRHR1, TBX21, and FCER2 contribute to variability in response for lung function, airways responsiveness, and exacerbations in patients taking inhaled corticosteroids. Variants in ALOX5, LTA4H, LTC4S, ABCC1, CYSLTR2, and SLCO2B1 contribute to variability in response to leukotriene modifiers. Summary Identification of novel variants that contribute to response heterogeneity supports future studies of single nucleotide polymorphism discovery and include gene expression and genome-wide association studies. Statistical models that predict the genomics of response to asthma drugs will complement single nucleotide polymorphism discovery in moving toward personalized medicine. PMID:19077707

  12. Advances in asthma and allergy genetics in 2007.

    Science.gov (United States)

    Vercelli, Donata

    2008-08-01

    This review discusses the main advances in the genetics of asthma and allergy published in the Journal in 2007. The association studies discussed herein addressed 3 main topics: the effect of the environment and gene-environment interactions on asthma/allergy susceptibility, the contribution of T(H)2 immunity gene variants to allergic inflammation, and the role of filaggrin mutations in atopic dermatitis and associated phenotypes. Other articles revealed novel, potentially important candidate genes or confirmed known ones. Collectively, the works published in 2007 reiterate that allergy and asthma are typical complex diseases; that is, they are disorders in which intricate interactions among environmental and genetic factors modify disease susceptibility by altering the fundamental structural and functional properties of target organs at critical developmental windows.

  13. Asthma Burden in the Hospitalized Patients in North of Iran

    Directory of Open Access Journals (Sweden)

    Javad Ghaffari

    2014-10-01

    Full Text Available Introduction: Asthma is a chronic inflammatory airway disease. Genetic and environmental factors have been important role in the induction of asthma. It's estimated that asthma affect 2.7 to 35.4% of child (in average 13.4% in Iran. The aims of this study to assess the costs of asthma patients admitted in Boali hospital in Sari in the north of Iran. Patients and Methods: This descriptive study was carried out in asthma patients 1 to 20 years old that admitted in the Boali hospital in Sari from 2008 to2012. Out of 455 folders, 22 folders excluded because incomplete registrations.Results: Out of 432 patients, 280 patients (64.81% were male. 349 patients were 1-5 years old (80.78%. Average annual cost in our asthmatic patients was 1219064 Rials(Iran currency ($ 121.9 per patient, 1183655 ($ 118.3 and 1284789($ 128.5 Rials per male and per female patient respectively. Conclusions: Our study showed asthma disease has been significantly cost for patient, family

  14. 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...

  15. Asthma in pregnancy: association between the Asthma Control Test and the Global Initiative for Asthma classification and comparisons with spirometry.

    Science.gov (United States)

    de Araujo, Georgia Véras; Leite, Débora F B; Rizzo, José A; Sarinho, Emanuel S C

    2016-08-01

    The aim of this study was to identify a possible association between the assessment of clinical asthma control using the Asthma Control Test (ACT) and the Global Initiative for Asthma (GINA) classification and to perform comparisons with values of spirometry. Through this cross-sectional study, 103 pregnant women with asthma were assessed in the period from October 2010 to October 2013 in the asthma pregnancy clinic at the Clinical Hospital of the Federal University of Pernambuco. Questionnaires concerning the level of asthma control were administered using the Global Initiative for Asthma classification, the Asthma Control Test validated for asthmatic expectant mothers and spirometry; all three methods of assessing asthma control were performed during the same visit between the twenty-first and twenty-seventh weeks of pregnancy. There was a significant association between clinical asthma control assessment using the Asthma Control Test and the Global Initiative for Asthma classification (pspirometry. This study shows that both the Global Initiative for Asthma classification and the Asthma Control Test can be used for asthmatic expectant mothers to assess the clinical control of asthma, especially at the end of the second trimester, which is assumed to be the period of worsening asthma exacerbations during pregnancy. We highlight the importance of the Asthma Control Test as a subjective instrument with easy application, easy interpretation and good reproducibility that does not require spirometry to assess the level of asthma control and can be used in the primary care of asthmatic expectant mothers. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. 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

  17. 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

  18. Link between environmental air pollution and allergic asthma: East meets West.

    Science.gov (United States)

    Zhang, Qingling; Qiu, Zhiming; Chung, Kian Fan; Huang, Shau-Ku

    2015-01-01

    With the levels of outdoor air pollution from industrial and motor vehicle emissions rising rapidly in the fastly-industrializing countries of South East Asia, the prevalence of asthma and allergic diseases has also been increasing to match those in the West. Epidemiological and experimental exposure studies indicate a harmful impact of outdoor air pollution from vehicles and factories both on the development of allergic diseases and asthma and the increase in asthma symptoms and exacerbations. The level of outdoor pollution in Asia is much higher and more diverse than those encountered in Western countries. This may increase the impact of outdoor pollution on health, particularly lung health in Asia. This review discusses the constituents of air pollution in Asia with a special focus on studies in mainland China and Taiwan where the levels of pollution have reached high levels and where such high levels particularly in winter can cause a thick haze that reduces visibility. The onus remains on regulatory and public health authorities to curb the sources of pollution so that the health effects on the population particularly those with lung and cardiovascular diseases and with increased susceptibility can be mitigated.

  19. Perinatal programming of childhood asthma: early fetal size, growth trajectory during infancy, and childhood asthma outcomes.

    Science.gov (United States)

    Turner, Steve

    2012-01-01

    The "fetal origins hypothesis" or concept of "developmental programming" suggests that faltering fetal growth and subsequent catch-up growth are implicated in the aetiology of cardiovascular disease. Associations between reduced birth weight, rapid postnatal weight gain, and asthma suggest that there are fetal origins to respiratory disease. The present paper first summarises the literature relating birth weight and post natal growth trajectories to asthma outcomes. Second, issues regarding the interpretation of antenatal fetal ultrasound measurements are discussed. Finally, recent reports linking antenatal measurement and growth trajectory to early childhood asthma outcomes are discussed. Understanding the nature and timing of factors which influence antenatal growth may give important insight into the antecedents of early-onset asthma with implications for interventions.

  20. Correlation of light transmittance with asthma attack: fine water particles as a possible inducing factor of asthma.

    Science.gov (United States)

    Kanaya, Kazuo; Okamoto, Koji; Shimbo, Shinichiro; Ikeda, Masayuki

    2011-01-01

    It has been postulated that air-borne fine water particles (or mist) can induce asthma attacks in asthmatic children. To date, no attempt has been made to quantify the density of air-borne fine water particles with the aim of relating particle density to the etiology of asthma among children. The aim of this study was to investigate the relation of asthma attack frequency and the particle density evaluated in terms of light transmittance. The density of fine water particles was quantified by measuring reductions in light transmittance at 250, 365 and 580 nm at an outdoor location when the surroundings were in darkness. The measurements were made at distances varying from 1 to 3 m from the light sources and performed every morning and evening for 1 year. Each day was separated into two half-day units [i.e., morning (from midnight to noon) and afternoon (from noon to midnight)]. The number of asthma attacks among 121 enrolled asthmatic children was counted for each unit. A possible correlation between the transmittance reduction and frequency of asthma attacks was assessed. A significant difference was observed in the extent of reduction in light transmittance at 365 nm between the units with asthma attacks and those without attacks. Furthermore, the reduction in the transmittance was more evident when more asthma attacks were recorded among the patients. No difference was detected in the reduction in light transmittance at 250 or 580 nm. These results support the hypothesis that air-borne fine water particles are among the etiological factors that induce asthma attacks in asthmatic children.

  1. Hypothalamic digoxin and hemispheric chemical dominance in relation to the pathogenesis of bronchial asthma.

    Science.gov (United States)

    Kurup, Ravi Kumar; Kurup, Parameswara Achutha

    2003-08-01

    The isoprenoid pathway produces three key metabolites--digoxin (membrane sodium-potassium ATPase inhibitor and regulator of neurotransmitter transport), dolichol (regulator of N-glycosylation of proteins), and ubiquinone (free radical scavenger). The isoprenoid pathway was assessed in patients with bronchial asthma. The pathway was also assessed in patients with right hemispheric, left hemispheric, and bihemispheric dominance to find out the role of hemispheric dominance in the pathogenesis of bronchial asthma. The pathway was upregulated with increase in digoxin synthesis in bronchial asthma. There was an increase in tryptophan catabolites and a reduction in tyrosine catabolites in patients with bronchial asthma. The ubiquinone levels were low and lipid peroxidation increased in these patients. There was increase in dolichol and glycoconjugate levels and reduction in lysosomal stability in these patients. The cholesterol:phospholipid ratio was increased and glycoconjugate levels were reduced in the membranes of these patients. The patterns noticed in bronchial asthma were similar to those in patients with right hemispheric chemical dominance. Bronchial asthma occurs in right hemispheric chemically dominant individuals. Ninety percent of the patients with bronchial asthma were right-handed and left hemispheric dominant by the dichotic listening test. But their biochemical patterns were similar to those obtained in right hemispheric chemical dominance. Hemispheric chemical dominance is a different entity and has no correlation with handedness or the dichotic listening test.

  2. Asthma and Air Quality in the Presence of Fires - A Foundation for Public Health Policy in Florida

    Science.gov (United States)

    Crosson, William; Al-Hamdan, Mohammad; Estes, Maurice, Jr.; Estes, Sue; Luvall, Jeffrey; Sifford, Cody; Young, Linda

    2012-01-01

    Outdoor air quality and its associated impacts on respiratory problems in Florida are of public health significance. Air quality in Florida can be poor during the extended wildfire season, threatening persons with compromised respiratory systems each year. Studies have demonstrated that particulate matter, which is generally elevated in the vicinity of wildfires, is associated with increases in hospital admissions and occurrences of acute asthma exacerbations. However, few studies have examined the modifying effect of socio-demographic characteristics of cities or regional areas on the relationship between air quality and health outcomes. In an ongoing university/multi-agency project, asthma hospital/emergency room (patient) data are being used to create a health outcome indicator of human response to environmental air quality. Environmental data are derived from satellite measurements, with special attention being given to the effect of wildfires and prescribed burns on air quality. This presentation will focus on the environmental data sets particulate matter, location of fires, smoke plumes that are being collected and processed for linkage with health data. After this linkage has been performed, space-time models of asthma rates as a function of air quality data and socio-demographic variables will be developed and validated. The Florida Department of Health (FDOH) will work with county health department staff and representatives from the medical community to establish a protocol with triggers for issuing public health advisories/alerts based on the developed and validated health outcome indicators. From this effort, a science-based policy for issuing public health advisories/alerts for asthma relating to air quality will be developed, giving FDOH the ability to (1) predict, with stated levels of uncertainty, case load of hospital admissions based on air quality, (2) reduce asthma exacerbations by forewarning asthmatics to limit outside activities on poor air

  3. Asthma in goldminers | Cowie | South African Medical Journal

    African Journals Online (AJOL)

    Objectives. To detennine whether asthma in goldminers is caused by or contributed to by their working environment. Design. A case-control stUdy in which men with asthma working underground in goldmines were compared with underground goldminers without asthma in relation to their age, duration of exposure to the ...

  4. Mitochondrial Dysfunction in Metabolic Syndrome and Asthma

    Science.gov (United States)

    Mabalirajan, Ulaganathan; Ghosh, Balaram

    2013-01-01

    Though severe or refractory asthma merely affects less than 10% of asthma population, it consumes significant health resources and contributes significant morbidity and mortality. Severe asthma does not fell in the routine definition of asthma and requires alternative treatment strategies. It has been observed that asthma severity increases with higher body mass index. The obese-asthmatics, in general, have the features of metabolic syndrome and are progressively causing a significant burden for both developed and developing countries thanks to the westernization of the world. As most of the features of metabolic syndrome seem to be originated from central obesity, the underlying mechanisms for metabolic syndrome could help us to understand the pathobiology of obese-asthma condition. While mitochondrial dysfunction is the common factor for most of the risk factors of metabolic syndrome, such as central obesity, dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, the involvement of mitochondria in obese-asthma pathogenesis seems to be important as mitochondrial dysfunction has recently been shown to be involved in airway epithelial injury and asthma pathogenesis. This review discusses current understanding of the overlapping features between metabolic syndrome and asthma in relation to mitochondrial structural and functional alterations with an aim to uncover mechanisms for obese-asthma. PMID:23840225

  5. Prevalence of Asthma in School Children on the Arizona-Sonora Border.

    Science.gov (United States)

    Carr, Tara F; Beamer, Paloma I; Rothers, Janet; Stern, Debra A; Gerald, Lynn B; Rosales, Cecilia B; Van Horne, Yoshira Ornelas; Pivniouk, Oksana N; Vercelli, Donata; Halonen, Marilyn; Gameros, Mercedes; Martinez, Fernando D; Wright, Anne L

    Mexican-born children living in the United States have a lower prevalence of asthma than other US children. Although children of Mexican descent near the Arizona (AZ)-Sonora border are genetically similar, differences in environmental exposures might result in differences in asthma prevalence across this region. The objective of this study was to determine if the prevalence of asthma and wheeze in these children varies across the AZ-Sonora border. The International Study of Asthma and Allergy in Children written and video questionnaires were administered to 1753 adolescents from 5 middle schools: Tucson (school A), Nogales, AZ (schools B, C), and Nogales, Sonora, Mexico (schools D, E). The prevalence of asthma and symptoms was compared, with analyses in the AZ schools limited to self-identified Mexican American students. Compared with the Sonoran reference school E, the adjusted odds ratio (OR) for asthma was significantly higher in US schools A (OR 4.89, 95% confidence interval [CI] 2.72-8.80), B (OR 3.47, 95% CI 1.88-6.42), and C (OR 4.12, 95% CI 1.78-9.60). The adjusted OR for wheeze in the past year was significantly higher in schools A (OR 2.19, 95% CI 1.20-4.01) and B (OR 2.67, 95% CI 1.42-5.01) on the written questionnaire and significantly higher in A (OR 2.13, 95% CI 1.22-3.75), B (OR 1.95, 95% CI 1.07-3.53), and Sonoran school D (OR 2.34, 95% CI 1.28-4.30) on the video questionnaire compared with school E. Asthma and wheeze prevalence differed significantly between schools and was higher in the United States. Environmental factors that may account for these differences could provide insight into mechanisms of protection from asthma. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  6. Are recreational SCUBA divers with asthma at increased risk?

    Science.gov (United States)

    Ustrup, Amalie S; Ulrik, Charlotte S

    2017-10-01

    Asthma has traditionally been regarded as a contraindication to self-contained underwater breathing apparatus (SCUBA) diving, although large numbers of patients with asthma dive. The aim of the review is to provide an update on current knowledge on potential disease-related hazards in SCUBA divers with asthma. Systematic literature review based on the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Seven studies met the criteria for inclusion in the review (comprising a total of 560 subjects). Five studies reported an increased risk for developing diving-related injuries in divers with asthma, based on case reports (n = 1), case history combined with objective assessment (n = 1), and dives and/or simulated dives (n = 3). The remaining studies (n = 2) were based on self-reported diving habits in divers suffering from asthma, obtained from anonymous questionnaires in diving magazines, reported no diving-related injuries among respondents. Due to limited evidence it is difficult to draw valid conclusions, but there are indications that recreational divers with asthma may be at increased risk for diving-related injuries compared to non-asthmatic divers. However, it is of at most importance to obtain further evidence from large-scale, well-designed studies.

  7. Lung function, asthma symptoms, and quality of life for children in public housing in Boston: a case-series analysis

    Directory of Open Access Journals (Sweden)

    Steinbach Suzanne

    2004-12-01

    Full Text Available Abstract Background Children in urban public housing are at high risk for asthma, given elevated environmental and social exposures and suboptimal medical care. For a multifactorial disease like asthma, design of intervention studies can be influenced by the relative prevalence of key risk factors. To better understand risk factors for asthma morbidity in the context of an environmental intervention study, we conducted a detailed baseline evaluation of 78 children (aged 4–17 years from three public housing developments in Boston. Methods Asthmatic children and their caregivers were recruited between April 2002 and January 2003. We conducted intake interviews that captured a detailed family and medical history, including questions regarding asthma symptom severity, access to health care, medication usage, and psychological stress. Quality of life was evaluated for both the child and caregiver with an asthma-specific scale. Pulmonary function was measured with a portable spirometer, and allergy testing for common indoor and outdoor allergens was conducted with skin testing using the prick puncture method. Exploratory linear and logistic regression models evaluating predictors of respiratory symptoms, quality of life, and pulmonary function were conducted using SAS. Results We found high rates of obesity (56% and allergies to indoor contaminants such as cockroaches (59% and dust mites (59%. Only 36% of children with persistent asthma reported being prescribed any daily controller medication, and most did not have an asthma action plan or a peak flow meter. One-time lung function measures were poorly correlated with respiratory symptoms or quality of life, which were significantly correlated with each other. In multivariate regression models, household size, body mass index, and environmental tobacco smoke exposure were positively associated with respiratory symptom severity (p Conclusion Given the elevated prevalence of multiple risk factors

  8. Relation of Immunologic Mechanism of Asthma and Air Pollution

    Directory of Open Access Journals (Sweden)

    Carlos Iván Falcón-Rodríguez

    2017-04-01

    Conclusions: Th1 response could cause low or no association between exposure to pollution and the development of asthma in different cities, which constitutes another limitation in epidemiological studies.

  9. Mechanistic Indicators of Childhood Asthma (MICA) Study

    Science.gov (United States)

    The Mechanistic Indicators of Childhood Asthma (MICA) Study has been designed to incorporate state-of-the-art technologies to examine the physiological and environmental factors that interact to increase the risk of asthmatic responses. MICA is primarily a clinically-bases obser...

  10. [Asthma and professional life (author's transl)].

    Science.gov (United States)

    Gervais, P; Diamant-Berger, O; Gervais, A

    1979-01-01

    In world industry and agriculture as a whole, the number of people with asthma and complex pneumopathies related to chemical and organic pollution seems important. Indeed, subjects with an atopic inclination are often the first to be jeoparized. However, it must be stressed that occurrence of asthma in relation with work should always lead to investigate an anomaly in professional hygiene. For other workers this latter eventuality constitutes in the long run a threat of precipitin pneumopathy, chronic bronchitis, pulmonary fibrosis, or even cancer (in the case of nickel). Selection upon hiring is an unsatisfactory measure. The improvement of the atmospheric conditions at work should always be sought for. In some professional asthma cases, we were able to confirm that medication provides efficient protection. This solution, however, seems only slightly satisfactory since the subject is still left in contact with substances which have harmful effects other than asthma. It is therefore important that doctors track down and explore the cases of professional asthma, declaring their existence to social security and work inspection organizations, in order to establish an epidemiological knowledge, regularly updated, which would provide an indispensable basis for any prevention through improvement of working conditions.

  11. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Impact on the Nation Fact Sheet State Data Profiles (2011) Work-related Asthma NCHS Asthma FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School ...

  12. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Visits to a Health Care Provider(s) among Children Health Care Coverage among Children Asthma-related Missed School Days among Children aged 5–17 Years Asthma Severity among Adults with ...

  13. New Asthma Guidelines What You Should Know

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section New Asthma Guidelines: What You Should Know Past Issues / Fall ... on. If you or a relative suffers from asthma, it is important to know that quality care ...

  14. Asthma and obesity among 3 year old urban children: The role of sex and the home environment

    Science.gov (United States)

    Suglia, Shakira Franco; Chambers, Earle; Rosario, Andres; Duarte, Cristiane S.

    2011-01-01

    Objective To examine whether the relationship between obesity and asthma in young girls and boys can be explained by social and physical characteristics of the home environment. Study design We examined the relationship between asthma and obesity among children in the Fragile Families and Child Wellbeing study (N=1815). Asthma was determined through maternal report of asthma diagnosis by a doctor (active in past 12 months). Weight and height of child was measured during an in-home visit. Data on home social (maternal depression, intimate partner violence) and physical environmental factors (housing quality, tobacco exposure) were collected by questionnaire. Results Ten percent of children had active asthma, 19% were overweight and 17% were obese. In fully adjusted models, obese children had twice the odds of having asthma (OR 2.3 95%CI 1.5, 3.3) compared with children of normal body weight. In stratified analyses overweight boys, but not overweight girls, had an increased of odds of asthma. Obese boys and girls had an increased odds of asthma compared with boys and girls of normal body weight. Conclusion The relationship between asthma and obesity is present in boys and girls as young as 3 years of age, a relationship between being overweight and asthma is only present among boys. This relationship is not attributable to shared social and environmental factors of the children’s home. PMID:21392787

  15. Obesity and asthma

    OpenAIRE

    Pranab Baruwa; Kripesh Ranjan Sarmah

    2013-01-01

    Asthma is a chronic disorder affecting millions of people worldwide. The prevalence of asthma is around 300 million and is expected to increase another 100 million by 2025. Obesity, on the other hand, also affects a large number of individuals. Overweight in adults is defined when body mass index (BMI) is between 25 to 30 kg/m 2 and obesity when the BMI >30 kg/m 2 . It has been a matter of interest for researchers to find a relation between these two conditions. This knowledge will provide a ...

  16. Effect of cat and daycare exposures on the risk of asthma in children with atopic dermatitis.

    Science.gov (United States)

    Gaffin, Jonathan M; Spergel, Jonathan M; Boguniewicz, Mark; Eichenfield, Lawrence F; Paller, Amy S; Fowler, Joseph F; Dinulos, James G; Tilles, Stephen A; Schneider, Lynda C; Phipatanakul, Wanda

    2012-01-01

    Atopic dermatitis (AD) in young children is often followed by the development of asthma (atopic march). The role of environmental exposures is unclear in this high-risk population. We aimed to determine the predictive relationship between indoor allergen exposures, particularly pets, rodents, and cockroaches, to the development of asthma in a prospective pediatric cohort. Children with AD and a family history of allergy were followed prospectively with questionnaire ascertainment of environmental exposure to cats, dogs, cockroaches, rats, and mice. Asthma was diagnosed by study physicians based on caregiver reports of symptoms continually assessed over the course of the study period. Fifty-five of the 299 children developed asthma by the end of the study. Cat exposure had a strong and independent effect to reduce the risk of developing asthma across all analyses (odds ratio [OR], 0.16; 95% confidence interval [CI], 0.05-0.53). Dog, mouse, rat, and cockroach exposures did not significantly influence the development of asthma. Daycare exposure had the largest risk reduction for the development of asthma (OR, 0.08; 95% CI, 0.03-0.19). Maternal asthma (OR, 2.93; 95% CI, 1.29-6.67), baseline body mass index (OR, 1.23; 95% CI, 1.08-1.42), and specific immunoglobulin E to house-dust mix at 3 years were each independent risk factors for the development of asthma. In children with AD, cat and daycare exposure may reduce the risk of developing early childhood asthma.

  17. 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.

  18. Asthma Treatments for Children and Adolescents: Strategies for a Global Approach

    Directory of Open Access Journals (Sweden)

    Robert L Thivierge

    1995-01-01

    Full Text Available Strategies for a global approach to the management of asthma in children and adolescents are described. Such an approach requires the physician to explain to the patient the pathophysiology of asthma, to evaluate and, whenever possible, change predisposing environmental factors, to establish a written plan of action and to maintain a close follow-up of the patient to ensure compliance.

  19. Genetic polymorphisms and asthma: findings from a case-control study in the Madeira island population.

    Science.gov (United States)

    Berenguer, Anabela Gonçalves; Fernandes, Ana Teresa; Oliveira, Susana; Rodrigues, Mariana; Ornelas, Pedro; Romeira, Diogo; Serrão, Tânia; Rosa, Alexandra; Câmara, Rita

    2014-09-04

    Asthma is a complex disease influenced by multiple genetic and environmental factors. While Madeira has the highest prevalence of asthma in Portugal (14.6%), the effect of both genetic and environmental factors in this population has never been assessed. We categorized 98 asthma patients according to the Global Initiative for Asthma (GINA) guidelines, established their sensitization profile, and measured their forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) indexes. Selected single nucleotide polymorphisms (SNPs) were analysed as potential markers for asthma susceptibility and severity in the interleukin 4 (IL4), interleukin 13 (IL13), beta-2-adrenergic receptor (ADRB2), a disintegrin and metalloprotease 33 (ADAM33), gasdermin-like (GSDML) and the signal transducer and activator of transcription 6 (STAT6) genes comparatively to a population reference set. Although mites are the major source of allergic sensitization, no significant difference was found amongst asthma severity categories. IL4-590*CT/TT and IL4-RP2*253183/183183 were found to predict the risk (2-fold) and severity (3 to 4-fold) of asthma and were associated with a lower FEV1 index. ADRB2-c.16*AG is a risk factor (3.5-fold), while genotype GSDML-236*TT was protective (4-fold) for moderate-severe asthma. ADAM33-V4*C was associated to asthma and mild asthma by the transmission disequilibrium test (TDT). Finally, ADAM33-V4*CC and STAT6-21*TT were associated with higher sensitization (mean wheal size ≥10 mm) to house dust (1.4-fold) and storage mite (7.8-fold). In Madeira, IL4-590C/T, IL4-RP2 253/183, GSDML-236C/T and ADAM33-V4C/G SNPs are important risk factors for asthma susceptibility and severity, with implications for asthma healthcare management.

  20. Early Life and Environmental Risk Factors Modify the Effect of Acculturation on Hispanic Children's Asthma.

    Science.gov (United States)

    Chavez-Payan, Paola; Grineski, Sara E; Collins, Timothy W

    2015-01-01

    Acculturation tends to erode Hispanic immigrants' initial health advantage. Using a more nuanced conceptualization of acculturation than previous studies, we explore the associations between acculturation and Hispanic children's asthma. Data came from an observational mail survey of caretakers of Hispanic schoolchildren in El Paso, Texas (N = 1,513). Results from generalized linear models (GzLMs) demonstrate that acculturation was a significant positive predictor of asthma. The addition of interaction terms revealed that prenatal smoking, low birth weight, breastfeeding, and pest exposure significantly modified the effect of acculturation on asthma. Results suggest that although higher levels of acculturation were detrimental overall, the effects were not equally damaging for all Hispanic children. Findings foster an understanding of how the effect of acculturation on Hispanic children's asthma is intensified or attenuated by distinct individual-level risk factors.

  1. Role of urbanization and air pollution in adolescent asthma: a mass screening in Taiwan.

    Science.gov (United States)

    Lin, R S; Sung, F C; Huang, S L; Gou, Y L; Ko, Y C; Gou, H W; Shaw, C K

    2001-10-01

    The prevalence of asthma in school children in Taiwan is increasing. This study used mass screening among middle school children in Taiwan to determine the prevalence of asthma and related factors. Data were collected from parents using a self-reported questionnaire and from children using the International Study of Asthma and Allergies in Childhood (ISAAC) video questionnaire. Six study teams conducted the survey nationwide in 1995-1996, with the assistance of middle school nurses and teachers. Among the 1,018,031 students at 795 middle schools who returned questionnaires, 8.5% had a history of asthma (ranging in prevalence from 4.2% to 13% in 25 areas). The prevalence of asthma was higher in boys than in girls (10.0% vs 7%) and was highest in more urbanized areas (11.2%), followed by moderately urbanized areas (7.4%) and less urbanized and rural areas (6.5%). Controlling for age, family smoking, family incense burning, and parental education level, multivariate logistic regression models indicated that children living in an area with heavy air pollution were more likely to have asthma than those in an area with no or light pollution (odds ratio, OR = 2.01 and 95% confidence interval, CI = 1.94-2.09 based on parental ranking of pollution level, or OR = 1.30 and 95% CI = 1.18-1.42 based on pollution level reported by the Environmental Protection Administration). Adolescent asthma in Taiwan is most prevalent in the most urbanized areas and decreases in prevalence in less urbanized areas. This study also found that higher parental education level and higher area air pollution were associated with higher adolescent asthma prevalence.

  2. Traffic-related air pollution exposure is associated with allergic sensitization, asthma, and poor lung function in middle age.

    Science.gov (United States)

    Bowatte, Gayan; Lodge, Caroline J; Knibbs, Luke D; Lowe, Adrian J; Erbas, Bircan; Dennekamp, Martine; Marks, Guy B; Giles, Graham; Morrison, Stephen; Thompson, Bruce; Thomas, Paul S; Hui, Jennie; Perret, Jennifer L; Abramson, Michael J; Walters, Haydn; Matheson, Melanie C; Dharmage, Shyamali C

    2017-01-01

    Traffic-related air pollution (TRAP) exposure is associated with allergic airway diseases and reduced lung function in children, but evidence concerning adults, especially in low-pollution settings, is scarce and inconsistent. We sought to determine whether exposure to TRAP in middle age is associated with allergic sensitization, current asthma, and reduced lung function in adults, and whether these associations are modified by variants in Glutathione S-Transferase genes. The study sample comprised the proband 2002 laboratory study of the Tasmanian Longitudinal Health Study. Mean annual residential nitrogen dioxide (NO 2 ) exposure was estimated for current residential addresses using a validated land-use regression model. Associations between TRAP exposure and allergic sensitization, lung function, current wheeze, and asthma (n = 1405) were investigated using regression models. Increased mean annual NO 2 exposure was associated with increased risk of atopy (adjusted odds ratio [aOR], 1.14; 95% CI, 1.02-1.28 per 1 interquartile range increase in NO 2 [2.2 ppb]) and current wheeze (aOR, 1.14; 1.02-1.28). Similarly, living less than 200 m from a major road was associated with current wheeze (aOR, 1.38; 95% CI, 1.06-1.80) and atopy (aOR, 1.26; 95% CI, 0.99-1.62), and was also associated with having significantly lower prebronchodilator and postbronchodilator FEV 1 and prebronchodilator forced expiratory flow at 25% to 75% of forced vital capacity. We found evidence of interactions between living less than 200 m from a major road and GSTT1 polymorphism for atopy, asthma, and atopic asthma. Overall, carriers of the GSTT1 null genotype had an increased risk of asthma and allergic outcomes if exposed to TRAP. Even relatively low TRAP exposures confer an increased risk of adverse respiratory and allergic outcomes in genetically susceptible individuals. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  3. Asthma education

    African Journals Online (AJOL)

    2011-01-01

    ). Allergy and Asthma Clinic, Red Cross War Memorial Hospital. Mike Levin runs a secondary level asthma/ allergy clinic and does a tertiary allergy session once a week, focusing on difficult asthma and food allergies. He has ...

  4. Suppression of a methionine synthase by calmodulin under environmental stress in the entomopathogenic fungus Beauveria bassiana.

    Science.gov (United States)

    Kim, Jiyoung; Oh, Junsang; Yoon, Deok-Hyo; Sung, Gi-Ho

    2017-10-01

    Methionine synthase (MetE, EC 2.1.1.14) catalyses the final step in the methionine biosynthetic pathway. Methionine biosynthesis plays a major role in protein biogenesis and is the source of S-adenosyl methionine (SAM), the universal donor of methyl groups. In this study, we demonstrated that BbMetE acts as a typical MetE enzyme in the entomopathogenic fungus Beauveria bassiana. In addition, we found that BbMetE binds to calmodulin (CaM) in vitro and in vivo. The functional role of CaM binding to BbMetE was to negatively regulate BbMetE activity in B. bassiana. Our proton-nuclear magnetic resonance data revealed that CaM inhibitor W-7 increases methionine content in B. bassiana, suggesting that CaM negatively regulates the BbMetE activity. Environmental stress stimuli such as salt, H 2 O 2 and heat suppressed BbMetE activity in B. bassiana. W-7 reversed this effect, suggesting that the inhibitory mechanism is mediated through stimulation of CaM activity. Therefore, this work suggests that BbMetE plays an important role in methionine biosynthesis, which is mediated by environmental stress stimuli via the CaM signalling pathway. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  5. Severe angina pectoris in asthma attack: a case report.

    Science.gov (United States)

    Nabavizadeh, Seyed Hesamedin; Farahbakhsh, Nazanin; Fazel, Ali; Mosavat, Fereshteh; Anushiravani, Amir

    2016-06-01

    Asthma is a chronic inflammatory disorder of the airways related to the obstruction of reversible airflow. Asthma presents as recurrent attacks of cough and dyspnea. Poor control causes recurrent admissions to the ICU, and mortality is related to poor drug compliance and follow-up. Angina pectoris is a syndrome of recurrent chest discomfort related to myocardial ischemia. The presence of these two disorders rarely has been reported. We reported a 12-year-old boy who was referred with exacerbation of asthma and developed angina pectoris during hospitalization. He had labored breathing and diffuse wheezing. During treatment of the asthma, the patient developed severe chest pain due to shunt formation and coronary hypoxia, caused by the sole administration of ventolin, since oxygen had been disconnected. After receiving appropriate therapy, both his asthma and angina recovered, and, to date, he has not experienced angina pectoris again.

  6. Outdoor fungi and child asthma health service attendances.

    Science.gov (United States)

    Tham, Rachel; Dharmage, Shyamali C; Taylor, Philip E; Katelaris, Constance H; Vicendese, Don; Abramson, Michael J; Erbas, Bircan

    2014-08-01

    Asthma is a significant global public health issue. Severe asthma exacerbations can be triggered by environmental factors and require medical care from health services. Although it is known that fungal exposure may lead to allergic sensitization, little is understood about its impact on asthma exacerbations. This review aims to examine whether outdoor fungi play a significant role in child asthma exacerbations. Systematic search of seven electronic databases and hand searching for peer-reviewed studies published in English, up to 31 August 2013. Inclusion criteria were study population aged asthma, attended a health service; outdoor fungi exposure was reported. Quality and risk of bias assessments were conducted. Due to significant heterogeneity, meta-analysis was not conducted. Of the 1896 articles found, 15 were eligible. Findings were not consistent, possibly due to methodological variations in exposure classifications, statistical methods and inclusion of confounders. Cross-sectional studies found no or weak associations. All but one time series studies indicated an association that varied between fungal species. Increasing evidence indicates that asthmatic children are susceptible to asthma exacerbations when exposed to outdoor fungal spores. There is limited understanding of the contributions of different fungal species. Research is needed to investigate interactions of outdoor fungi with pollen, air pollutants and respiratory viruses. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Direct health care costs associated with asthma in British Columbia

    Science.gov (United States)

    Sadatsafavi, Mohsen; Lynd, Larry; Marra, Carlo; Carleton, Bruce; Tan, Wan C; Sullivan, Sean; FitzGerald, J Mark

    2010-01-01

    BACKGROUND: A better understanding of health care costs associated with asthma would enable the estimation of the economic burden of this increasingly common disease. OBJECTIVE: To determine the direct medical costs of asthma-related health care in British Columbia (BC). METHODS: Administrative health care data from the BC Linked Health Database and PharmaNet database from 1996 to 2000 were analyzed for BC residents five to 55 years of age, including the billing information for physician visits, drug dispensations and hospital discharge records. A unit cost was assigned to physician/emergency department visits, and government reimbursement fees for prescribed medications were applied. The case mix method was used to calculate hospitalization costs. All costs were reported in inflation-adjusted 2006 Canadian dollars. RESULTS: Asthma resulted in $41,858,610 in annual health care-related costs during the study period ($331 per patient-year). The major cost component was medications, which accounted for 63.9% of total costs, followed by physician visits (18.3%) and hospitalization (17.8%). When broader definitions of asthma-related hospitalizations and physician visits were used, total costs increased to $56,114,574 annually ($444 per patient-year). There was a statistically significant decrease in the annual per patient cost of hospitalizations (P<0.01) over the study period. Asthma was poorly controlled in 63.5% of patients, with this group being responsible for 94% of asthma-related resource use. CONCLUSION: The economic burden of asthma is significant in BC, with the majority of the cost attributed to poor asthma control. Policy makers should investigate the reason for lack of proper asthma control and adjust their policies accordingly to improve asthma management. PMID:20422063

  8. Perinatal Programming of Childhood Asthma: Early Fetal Size, Growth Trajectory during Infancy, and Childhood Asthma Outcomes

    Directory of Open Access Journals (Sweden)

    Steve Turner

    2012-01-01

    Full Text Available The “fetal origins hypothesis” or concept of “developmental programming” suggests that faltering fetal growth and subsequent catch-up growth are implicated in the aetiology of cardiovascular disease. Associations between reduced birth weight, rapid postnatal weight gain, and asthma suggest that there are fetal origins to respiratory disease. The present paper first summarises the literature relating birth weight and post natal growth trajectories to asthma outcomes. Second, issues regarding the interpretation of antenatal fetal ultrasound measurements are discussed. Finally, recent reports linking antenatal measurement and growth trajectory to early childhood asthma outcomes are discussed. Understanding the nature and timing of factors which influence antenatal growth may give important insight into the antecedents of early-onset asthma with implications for interventions.

  9. Induction of Asthma and the Environment: What We Know and Need to Know

    Science.gov (United States)

    Selgrade, MaryJane K.; Lemanske, Robert F.; Gilmour, M. Ian; Neas, Lucas M.; Ward, Marsha D.W.; Henneberger, Paul K.; Weissman, David N.; Hoppin, Jane A.; Dietert, Rodney R.; Sly, Peter D.; Geller, Andrew M.; Enright, Paul L.; Backus, Gillian S.; Bromberg, Philip A.; Germolec, Dori R.; Yeatts, Karin B.

    2006-01-01

    The prevalence of asthma has increased dramatically over the last 25 years in the United States and in other nations as a result of ill-defined changes in living conditions in modern society. On 18 and 19 October 2004 the U.S. Environmental Protection Agency and the National Institute of Environmental Health Sciences sponsored the workshop “Environmental Influences on the Induction and Incidence of Asthma” to review current scientific evidence with respect to factors that may contribute to the induction of asthma. Participants addressed two broad questions: a) What does the science suggest that regulatory and public health agencies could do now to reduce the incidence of asthma? and b) What research is needed to improve our understanding of the factors that contribute to the induction of asthma and our ability to manage this problem? In this article (one of four articles resulting from the workshop), we briefly characterize asthma and its public health and economic impacts, and intervention strategies that have been successfully used to prevent induction of asthma in the workplace. We conclude with the findings of seven working groups that focus on ambient air, indoor pollutants (biologics), occupational exposures, early life stages, older adults, intrinsic susceptibility, and lifestyle. These groups found strong scientific support for public health efforts to limit in utero and postnatal exposure to cigarette smoke. However, with respect to other potential types of interventions, participants noted many scientific questions, which are summarized in this article. Research to address these questions could have a significant public health and economic impact that would be well worth the investment. PMID:16581555

  10. 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 ...

  11. Effect of Exercise on Cardiorespiratory Function in Obese Children with Asthma in Different Moisture Levels

    Directory of Open Access Journals (Sweden)

    S Pouyan Majd

    2014-09-01

    Methods: The present case-control study was carried out with ten obese asthmatic children and fifteen healthy children who performed an exercise protocol in different environments (relative humidity 65 ± 5% versus 35 ± 5%. During exercise, cardiorespiratory parameters were controlled using K4B2. Heart rate, systolic blood pressure and double product were measured with a digital sphygmomanometer and stethoscope polar. Data were analyzed with dependent T test and ANOVA with repeated measures analysis. Results: A significant increase was detected in the markers of HR, SP and DP after exercise in obese children with asthma and healthy children (P< 0.005. However, indexes of cardiorespiratory and exhaustion was significantly higher in obese children with asthma and healthy during exercise in the environment with 65 ± 5% relative humidity, as compared to 35 ± 5% relative humidity. Conclusion: These results indicated that cardiorespiratory function in children with asthma and healthy children were different. Cardiorespiratory responses to exercise in children are influenced by environmental conditions such as humidity, so that humidity has a negative impact on the duration of the activity and load on the heart muscle.

  12. "Asthma can take over your life but having the right support makes that easier to deal with." Informing research priorities by exploring the barriers and facilitators to asthma control: a qualitative analysis of survey data.

    Science.gov (United States)

    Normansell, Rebecca; Welsh, Emma

    2015-01-01

    Involving patients and the public in research prioritisation is important. Cochrane Airways works with authors to produce systematic reviews of evidence related to chronic airways disease. Cochrane Airways has undertaken activities to identify research priorities, including workshops with stakeholders and consultation with experts. We present the findings of an online survey, designed to align our work with the priorities of people affected by asthma. We promoted a survey comprising open-ended questions via social media to people affected by asthma. We compiled the free-text responses and conducted an exploratory thematic analysis to identify important barriers and facilitators to asthma control. We triangulated findings with other research prioritisation activities to produce new review questions. We received 57 survey responses. Eight main themes emerged, most encompassing both facilitators and barriers: attitudes and knowledge; financial costs; environmental factors and triggers; healthcare systems; lifestyle factors; medication; self-care; and support. Barriers were more frequently mentioned than facilitators and many related to healthcare systems. These findings offer valuable insights into the challenges faced by individuals affected by asthma in the UK, and possibly further afield. We developed a list of priority reviews based on what was said by people in this survey and at a workshop. This demonstrates the real impact that people affected by asthma have on the research agenda of Cochrane Airways. Over the next 2-3 years we will produce reviews that address some of these questions hopefully leading to health benefits.

  13. School and Asthma

    Science.gov (United States)

    ... Videos for Educators Search English Español School and Asthma KidsHealth / For Kids / School and Asthma Print en ... Let's find out. Why Do I Need an Asthma Action Plan? When you're dealing with asthma, ...

  14. Mechanical ventilation for severe asthma.

    Science.gov (United States)

    Leatherman, James

    2015-06-01

    Acute exacerbations of asthma can lead to respiratory failure requiring ventilatory assistance. Noninvasive ventilation may prevent the need for endotracheal intubation in selected patients. For patients who are intubated and undergo mechanical ventilation, a strategy that prioritizes avoidance of ventilator-related complications over correction of hypercapnia was first proposed 30 years ago and has become the preferred approach. Excessive pulmonary hyperinflation is a major cause of hypotension and barotrauma. An appreciation of the key determinants of hyperinflation is essential to rational ventilator management. Standard therapy for patients with asthma undergoing mechanical ventilation consists of inhaled bronchodilators, corticosteroids, and drugs used to facilitate controlled hypoventilation. Nonconventional interventions such as heliox, general anesthesia, bronchoscopy, and extracorporeal life support have also been advocated for patients with fulminant asthma but are rarely necessary. Immediate mortality for patients who are mechanically ventilated for acute severe asthma is very low and is often associated with out-of-hospital cardiorespiratory arrest before intubation. However, patients who have been intubated for severe asthma are at increased risk for death from subsequent exacerbations and must be managed accordingly in the outpatient setting.

  15. Asthma, surgery, and general anesthesia: a review.

    Science.gov (United States)

    Tirumalasetty, Jyothi; Grammer, Leslie C

    2006-05-01

    Over 20 million Americans are affected with asthma. Many will require some type of surgical procedure during which their asthma management should be optimized. Preoperative assessment of asthma should include a specialized history and physical as well as pulmonary function testing. In many asthmatic patients, treatment with systemic corticosteroids and bronchodilators is indicated to prevent the inflammation and bronchoconstriction associated with endotracheal intubation. The use of corticosteroids has not been shown to adversely affect wound healing or increase the rate of infections postoperatively. Preoperative systemic corticosteroids may be used safely in the majority of patients to decrease asthma-related morbidity.

  16. 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

  17. The integrated care of asthma in Switzerland (INCAS)-study: Patients' perspective of received asthma care and their interest in asthma education.

    Science.gov (United States)

    Dürr, Selina; Hersberger, Kurt E; Zeller, Andreas; Scheuzger, Jonas; Miedinger, David; Gregoriano, Claudia; Leuppi, Jörg D; Steurer-Stey, Claudia

    2016-11-01

    For successful long-term asthma care, self-management education is a cornerstone. Little is known about associations between patients' interest in education, asthma control and care delivery. We compared patients' characteristics, asthma control and patients' perspective about asthma care in subjects with and without interest in asthma education. Moreover, we assessed reasons, why patients denied participating in asthma education. Baseline data of 223 patients with asthma (age 43 ± 12 years, 38% male, 58% non-smokers, 13% current smokers), who participated in a multicentre longitudinal controlled study, are reported. At baseline, patients completed the Asthma Control Test (ACT), the Patient Assessment Chronic Illness Care questionnaire (PACIC 5A) and stated their interest in an asthma education programme. Overall, 34% of all participants showed uncontrolled asthma. One hundred and twenty-five (56%) patients were interested in education. Compared to patients without interest, they were characterised by male gender (p = 0.013), worse asthma control (p < 0.001), and perception of lower quality of chronic asthma care delivery, in particular lower self-management support (p < 0.001). Main reasons for rejecting asthma education were having sufficient asthma knowledge, having only mild asthma, receiving adequate medical support and lack of time. More than half of the patients were interested in asthma education. Interest was associated with worse asthma control and lower receipt of care according to the Chronic Care Model. Considering these aspects, this approach may help to improve care quality and allow targeting interventions to those patients who are interested in becoming active participants in their care and who might benefit most.

  18. Mismatch between asthma symptoms and spirometry: implications for managing asthma in children.

    Science.gov (United States)

    Schifano, Elizabeth D; Hollenbach, Jessica P; Cloutier, Michelle M

    2014-11-01

    To examine the concordance between spirometry and asthma symptoms in assessing asthma severity and beginning therapy by the general pediatrician. Between 2008 and 2012, spirometry testing was satisfactorily performed in 894 children (ages 5-19 years) whose asthma severity had been determined by their pediatrician using asthma guideline-based clinical criteria. Spirometry-determined asthma severity using national asthma guidelines and clinician-determined asthma severity were compared for concordance using weighted Kappa coefficients. Thirty percent of participants had clinically determined intermittent asthma; 32%, 33%, and 5% had mild, moderate, and severe, persistent asthma, respectively. Increasing disease severity was associated with decreases in the forced expiratory volume in 1 second/forced vital capacity (FVC) ratio (P spirometry-determined severity. Concordance was 0.16 (95% CI 0.10, 0.23), and when adjusted for bias and prevalence, was 0.20 (95% CI 0.17, 0.23). When accounting for age, sex, exposure to smoke, and insurance type, only spirometry-determined asthma severity was a significant predictor of agreement (P spirometry-determined severity increased. Concordance between spirometry and asthma symptoms in determining asthma severity is low even when guideline-based clinical assessment tools are used. Because appropriate therapy reduces asthma morbidity and is guided by disease severity, results from spirometry testing could better guide pediatricians in determining appropriate therapy for their patients with asthma. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Forecasting peak asthma admissions in London: an application of quantile regression models

    Science.gov (United States)

    Soyiri, Ireneous N.; Reidpath, Daniel D.; Sarran, Christophe

    2013-07-01

    Asthma is a chronic condition of great public health concern globally. The associated morbidity, mortality and healthcare utilisation place an enormous burden on healthcare infrastructure and services. This study demonstrates a multistage quantile regression approach to predicting excess demand for health care services in the form of asthma daily admissions in London, using retrospective data from the Hospital Episode Statistics, weather and air quality. Trivariate quantile regression models (QRM) of asthma daily admissions were fitted to a 14-day range of lags of environmental factors, accounting for seasonality in a hold-in sample of the data. Representative lags were pooled to form multivariate predictive models, selected through a systematic backward stepwise reduction approach. Models were cross-validated using a hold-out sample of the data, and their respective root mean square error measures, sensitivity, specificity and predictive values compared. Two of the predictive models were able to detect extreme number of daily asthma admissions at sensitivity levels of 76 % and 62 %, as well as specificities of 66 % and 76 %. Their positive predictive values were slightly higher for the hold-out sample (29 % and 28 %) than for the hold-in model development sample (16 % and 18 %). QRMs can be used in multistage to select suitable variables to forecast extreme asthma events. The associations between asthma and environmental factors, including temperature, ozone and carbon monoxide can be exploited in predicting future events using QRMs.

  20. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... and Publications Related Articles, Publications, and Links Asthma’s Impact on the Nation Fact Sheet State Data Profiles ( ... How to Use Your Asthma Inhaler Recommend on Facebook Tweet Share Compartir You can control your asthma ...

  1. Reporting to parents on children's exposures to asthma triggers in low-income and public housing, an interview-based case study of ethics, environmental literacy, individual action, and public health benefits.

    Science.gov (United States)

    Perovich, Laura J; Ohayon, Jennifer Liss; Cousins, Elicia Mayuri; Morello-Frosch, Rachel; Brown, Phil; Adamkiewicz, Gary; Brody, Julia Green

    2018-05-21

    Emerging evidence about the effects of endocrine disruptors on asthma symptoms suggests new opportunities to reduce asthma by changing personal environments. Right-to-know ethics supports returning personal results for these chemicals to participants, so they can make decisions to reduce exposures. Yet researchers and institutional review boards have been reluctant to approve results reports in low-income communities, which are disproportionately affected by asthma. Concerns include limited literacy, lack of resources to reduce exposures, co-occurring stressors, and lack of models for effective reporting. To better understand the ethical and public health implications of returning personal results in low-income communities, we investigated parents' experiences of learning their children's environmental chemical and biomonitoring results in the Green Housing Study of asthma. The Green Housing Study measured indoor chemical exposures, allergens, and children's asthma symptoms in "green"-renovated public housing and control sites in metro-Boston and Cincinnati in 2011-2013. We developed reports for parents of children in the study, including results for their child and community. We observed community meetings where results were reported, and metro-Boston residents participated in semi-structured interviews in 2015 about their report-back experience. Interviews were systematically coded and analyzed. Report-back was positively received, contributed to greater understanding, built trust between researchers and participants, and facilitated action to improve health. Sampling visits and community meetings also contributed to creating a positive study experience for participants. Participants were able to make changes in their homes, such as altering product use and habits that may reduce asthma symptoms, though some faced roadblocks from family members. Participants also gained access to medical resources, though some felt that clinicians were not responsive

  2. School variation in asthma: compositional or contextual?

    Directory of Open Access Journals (Sweden)

    Tracy K Richmond

    2009-12-01

    Full Text Available 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.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.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.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.

  3. Childhood asthma and indoor allergens in Native Americans in New York

    Directory of Open Access Journals (Sweden)

    Tarbell Alice

    2006-07-01

    Full Text Available Abstract Background The objective of this study was to assess the correlation between childhood asthma and potential risk factors, especially exposure to indoor allergens, in a Native American population. Methods A case-control study of St. Regis Mohawk tribe children ages 2–14 years, 25 diagnosed with asthma and 25 controls was conducted. Exposure was assessed based on a personal interview and measurement of mite and cat allergens (Der p 1, Fel d 1 in indoor dust. Results A non-significant increased risk of childhood asthma was associated with self-reported family history of asthma, childhood environmental tobacco smoke exposure, and air pollution. There was a significant protective effect of breastfeeding against current asthma in children less than 14 years (5.2 fold lower risk. About 80% of dust mite and 15% of cat allergen samples were above the threshold values for sensitization of 2 and 1 μg/g, respectively. The association between current asthma and exposure to dust mite and cat allergens was positive but not statistically significant. Conclusion This research identified several potential indoor and outdoor risk factors for asthma in Mohawks homes, of which avoidance may reduce or delay the development of asthma in susceptible individuals.

  4. How should treatment approaches differ depending on the severity of asthma?

    Science.gov (United States)

    Kupczyk, Maciej; Kuna, Piotr

    2017-12-01

    Asthma is nowadays regarded as a syndrome of various overlapping phenotypes with defined clinical characteristics, different underlying inflammatory mechanisms, identifiable genetic background, environmental risk factors and possible biomarkers. There are no doubts that due to the diversity of asthma, a 'one size fits all' management of the disease is no longer valid. Areas covered: Nowadays asthma management is based on the control of the disease, and the goals of asthma treatment are defined as good symptom control, decreased future risk of exacerbations, fixed airflow limitation, and side-effects of treatment. Alternative strategies for adjusting asthma treatment such as sputum or exhaled nitric oxide guided protocols have been evaluated and despite some effectiveness, are regarded as impractical in every-day clinical conditions. Further studies in the field of asthma phenotypes/endotypes and biomarkers are warranted with the main goal to define which of those possible subgroups will be useful in clinical practice in regards to the potential allocation of successful treatment. Expert commentary: Despite the availability of guidelines on the diagnosis and management of asthma, it seems that the disease is still not optimally controlled. Addressing unmet needs in every day care, improving education, adherence/compliance and inhalation technique may significantly improve asthma control across all severities of the disease.

  5. Characterization of additional components of the environmental pH-sensing complex in the pathogenic fungus Cryptococcus neoformans.

    Science.gov (United States)

    Pianalto, Kaila M; Ost, Kyla S; Brown, Hannah E; Alspaugh, J Andrew

    2018-05-16

    Pathogenic microorganisms must adapt to changes in their immediate surroundings, including alterations in pH, to survive the shift from the external environment to that of the infected host. In the basidiomycete fungal pathogen Cryptococcus neoformans , these pH changes are primarily sensed by the fungal-specific, alkaline pH-sensing Rim/Pal pathway. The C. neoformans Rim pathway has diverged significantly from that described in ascomycete fungi. We recently identified the C. neoformans putative pH sensor Rra1, which activates the Rim pathway in response to elevated pH. In this study, we probed the function of Rra1 by analyzing its cellular localization and performing protein co-immunoprecipitation to identify potential Rra1 interactors. We found that Rra1 does not strongly colocalize or interact with immediate downstream Rim pathway components. However, these experiments identified a novel Rra1 interactor, the previously uncharacterized C. neoformans nucleosome assembly protein 1 (Nap1), which was required for Rim pathway activation. We observed that Nap1 specifically binds to the C-terminal tail of the Rra1 sensor, likely promoting Rra1 protein stability. This function of Nap1 is conserved in fungi closely related to C. neoformans that contain Rra1 orthologs, but not in the more distantly-related ascomycete fungus Saccharomyces cerevisiae In conclusion, our findings have revealed the sophisticated, yet distinct, molecular mechanisms by which closely and distantly related microbial phyla rapidly adapt to environmental signals and changes such as alterations in pH. Published under license by The American Society for Biochemistry and Molecular Biology, Inc.

  6. Novel monoclonal treatments in severe asthma

    DEFF Research Database (Denmark)

    Meteran, Howraman; Meteran, Hanieh; Porsbjerg, Celeste

    2017-01-01

    articles published in English since 2000 were considered. The search identified 29 studies; 8 additional studies were found by hand search, generating 37 studies. RESULTS: Of the 37 studies investigating biological treatments of asthma, 5 were on the effects of anti-IgE (omalizumab); 12 on anti-IL-5; 8...... TSLP, IL-9, and TNF-α lacked convincing effectiveness. CONCLUSION: Research on the biological treatment of asthma shows promising results. While anti-IgE (omalizumab) has been used in the treatment of asthma for some years, anti-IL-5 has recently been approved for use. The efficacy of results of other...... large studies with a longer duration is needed to draw a firm conclusion. Such studies should not only focus on clinical outcomes, but also consider asthma-related quality of life. Knowledge on the asthma phenotypes and identification of biomarkers associated with these will be useful for physicians...

  7. 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

    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...... asthma and low asthma control were not managed by specialist care. Patients with severe asthma with specialist contact more frequently had impaired asthma control compared with subjects not treated by a specialist (44.4% vs 33.1%, P

  8. Interaction between rhinitis and asthma: state of the art.

    Science.gov (United States)

    Frieri, Marianne

    2003-01-01

    Rhinitis and asthma are very prevalent allergic disorders with comorbid features, similar risk factors, and environmental triggers. Pathophysiological processes are linked via tissue histopathology, immunologic pathway, and inflammatory mediators. Allergen challenge of the upper airway can increase lower-airway responsiveness and allergen challenge of the lower airway can lead to upper-airway inflammation. Both allergic rhinitis and asthma exert a high social and economic burden in significant loss of work and school days as well as impairment for children and adults.

  9. 17q21 gene variation is not associated with asthma in adulthood

    DEFF Research Database (Denmark)

    Kreiner-Møller, E.; Strachan, D P; Linneberg, A

    2015-01-01

    BACKGROUND: 17q21 gene variants are the strongest known genetic determinants for childhood asthma and have been reported to interact with environmental tobacco smoke exposure in childhood. It remains unclear whether individuals with 17q21 risk variants have increased risk of asthma or reduced lung....... This contrasts the findings in children and suggests that this locus is associated with a childhood-specific asthma endotype....... function in adulthood. The aim was to examine the association between the 17q21 region and current adult asthma and lung function, and interaction with active smoking. METHODS: We investigated the single nucleotide polymorphism rs7216389 at the 17q21 locus in 3471 adults from the Health2006 cross...

  10. Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT)

    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

    Several tools are useful in detecting uncontrolled asthma in children. The aim of this study was to compare Global Initiative for Asthma (GINA) guidelines with the Childhood Asthma Control Test (C-ACT) and the Asthma Control Test (ACT) in detecting uncontrolled asthma in children. 145 children with

  11. Datasheet: Pseudogymnoascus destructans (white-nose syndrome fungus)

    Science.gov (United States)

    Blehert, David; Lankau, Emily W.

    2017-01-01

    Pseudogymnoascus destructans is a psychrophilic (cold-loving) fungus that causes white-nose syndrome (WNS), an emerging disease of North American bats that has caused unprecedented population declines. The fungus is believed to have been introduced to North America from Europe or Asia (where it is present but does not cause significant mortality), but the full extent of its native range is unknown. The route of introduction is also unknown. In North America, hibernating bats become infected with P. destructans when body temperature decreases during winter torpor into the range permissive for growth of this fungus. Infected bats may develop visible fungal growth on the nose or wings, awaken more frequently from torpor, and experience a cascade of physiologic changes that result in weight loss, dehydration, electrolyte imbalances, and death. P. destructans persists in the environments of underground bat hibernation sites (hibernacula) and is believed to spread primarily by natural movements of infected bats. The first evidence of WNS in North America is from a photograph of a hibernating bat taken during winter of 2005-2006 in a hibernaculum near Albany, New York. P. destructans subsequently spread rapidly from the northeastern United States throughout much of the eastern portions of the United States and Canada, and most recently (as of May 2017) was detected in Washington State. It has killed millions of bats, threatening some species with regional extirpation and putting at risk the valuable environmental services that bats provide by eating harmful insects.

  12. Signs of an asthma attack

    Science.gov (United States)

    ... resources Asthma - children Patient Instructions Asthma and school Asthma - child - discharge Asthma - control drugs Asthma - quick-relief drugs Asthma - what to ask the doctor - adult Asthma - what to ask your doctor - child Exercise-induced asthma Exercising and asthma at school ...

  13. Follow up investigation of workers in synthetic fibre plants with humidifier disease and work related asthma

    NARCIS (Netherlands)

    Pal, TM; de Monchy, JGR; Groothoff, JW; Post, D

    Objective-To investigate the clinical and sociomedical outcome in patients with various clinical manifestations of humidifier disease and work related asthma after removal from further exposure. Methods-Follow up investigation (range 1-13 years) of respiratory symptoms, spirometry, airway

  14. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Health Care Coverage among Children Asthma-related Missed School Days among Children aged 5–17 Years Asthma ... FastStats Survey Questions Resources for Health Professionals and Schools Healthcare Professionals Public Health Professionals School and Childcare ...

  15. Evaluation of a pharmacist-managed asthma clinic in an Indian Health Service clinic.

    Science.gov (United States)

    Pett, Ryan G; Nye, Shane

    2016-01-01

    To observe whether American Indian and Alaskan Native (AI/AN) patients at the Yakama Indian Health Service seen at the pharmacist-managed asthma clinic improved asthma outcomes. Retrospective chart review, single group, preintervention and postintervention. Pharmacist-managed asthma clinic at an Indian Health Service ambulatory care clinic. Sixty-one AI/AN patients who were seen at least once in the asthma clinic from 2010 to 2014. Pharmacist-provided asthma education and medication management. Asthma-related hospitalizations and emergency department or urgent care (ED) visits. The total number of asthma-related hospitalizations and ED visits between the 12-month periods preceding and following the initial asthma clinic visit were 11 versus 2 hospitalizations (P = 0.02) and 43 versus 25 ED visits (P = 0.02), respectively. Over the same period, asthma-related oral corticosteroid use showed a nonsignificant decrease in the number of prescriptions filled (n = 59, P = 0.08). In contrast, inhaled corticosteroid prescription fills significantly increased (n = 42, P = 0.01). A reduction of asthma-related hospitalizations and ED visits were observed during the course of the intervention. Increased access to formal asthma education and appropriate asthma care benefit the Yakama AI/AN people. A controlled trial is needed to confirm that the intervention causes the intended effect. Published by Elsevier Inc.

  16. Managing Asthma in Pregnancy (MAP) trial: FENO levels and childhood asthma.

    Science.gov (United States)

    Morten, Matthew; Collison, Adam; Murphy, Vanessa E; Barker, Daniel; Oldmeadow, Christopher; Attia, John; Meredith, Joseph; Powell, Heather; Robinson, Paul D; Sly, Peter D; Gibson, Peter G; Mattes, Joerg

    2018-03-08

    The single-center double-blind, randomized controlled Managing Asthma in Pregnancy (MAP) trial in Newcastle, Australia, compared a treatment algorithm using the fraction of exhaled nitric oxide (FENO) in combination with asthma symptoms (FENO group) against a treatment algorithm using clinical symptoms only (clinical group) in pregnant asthmatic women (Australian New Zealand Clinical Trials Registry, no. 12607000561482). The primary outcome was a 50% reduction in asthma exacerbations during pregnancy in the FENO group. However, the effect of FENO-guided management on the development of asthma in the offspring is unknown. We sought to investigate the effect of FENO-guided asthma management during pregnancy on asthma incidence in childhood. A total of 179 mothers consented to participate in the Growing into Asthma (GIA) double-blind follow-up study with the primary aim to determine the effect of FENO-guided asthma management on childhood asthma incidence. A total of 140 children (78%) were followed up at 4 to 6 years of age. FENO-guided as compared to symptoms-only approach significantly reduced doctor-diagnosed asthma (25.9% vs 43.2%; odds ratio [OR], 0.46, 95% CI, 0.22-0.96; P = .04). Furthermore, frequent wheeze (OR, 0.27; 95% CI, 0.09-0.87; P = .03), use of short-acting β-agonists (OR, 0.49; 95% CI, 0.25-0.97; P = .04), and emergency department visits for asthma (OR, 0.17; 95% CI, 0.04-0.76; P = .02) in the past 12 months were less common in children born to mothers from the FENO group. Doctor-diagnosed asthma was associated with common risk alleles for early onset asthma at gene locus 17q21 (P = .01 for rs8069176; P = .03 for rs8076131), and higher airways resistance (P = .02) and FENO levels (P = .03). A causal mediation analysis suggested natural indirect effects of FENO-guided asthma management on childhood asthma through "any use" and "time to first change in dose" of inhaled corticosteroids during the MAP trial (OR: 0.83; 95% CI: 0

  17. 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.

  18. Improving asthma-related health outcomes among low-income, multiethnic, school-aged children: results of a demonstration project that combined continuous quality improvement and community health worker strategies.

    Science.gov (United States)

    Fox, Patrick; Porter, Patricia G; Lob, Sibylle H; Boer, Jennifer Holloman; Rocha, David A; Adelson, Joel W

    2007-10-01

    The purpose of this work was to improve asthma-related health outcomes in an ethnically and geographically disparate population of economically disadvantaged school-aged children by using a team-based approach using continuous quality improvement and community health workers. A demonstration project was conducted with 7 community clinics treating approximately 3000 children with asthma 5 to 18 years of age. The overall clinic population with asthma was assessed for care-process changes through random cross-sectional chart reviews at baseline and 24 months (N = 560). A subset of patients with either moderate or severe persistent asthma or poorly controlled asthma (N = 405) was followed longitudinally for specific asthma-related clinical outcomes, satisfaction with care, and confidence managing asthma by family interview at baseline and at 12 or 24 months. Patient-centered and care-process outcomes included patient/parent assessment of quality of care and confidence in self-management, asthma action plan review, and documentation of guideline-based indicators of quality of care. Direct clinical outcomes included daytime and nighttime symptoms, use of rescue medications, acute care and emergency department visits, hospitalizations, and missed school days. Each clinic site's degree of adherence to the intervention model was evaluated and ranked to examine the correlation between model adherence and outcomes. Cross-sectional data showed clinic-wide improvements in the documentation of asthma severity, review of action plans, health services use, and asthma symptoms. At follow-up in the longitudinal sample, fewer patients reported acute visits, emergency department visits, hospitalizations, frequent daytime and nighttime symptoms, and missed school days compared with baseline. More patients reported excellent or very good quality of care and confidence in asthma self-management. Linear regression analysis of the clinical sites' model adherence ranks against site

  19. Identifying biomarkers for asthma diagnosis using targeted metabolomics approaches.

    Science.gov (United States)

    Checkley, William; Deza, Maria P; Klawitter, Jost; Romero, Karina M; Klawitter, Jelena; Pollard, Suzanne L; Wise, Robert A; Christians, Uwe; Hansel, Nadia N

    2016-12-01

    The diagnosis of asthma in children is challenging and relies on a combination of clinical factors and biomarkers including methacholine challenge, lung function, bronchodilator responsiveness, and presence of airway inflammation. No single test is diagnostic. We sought to identify a pattern of inflammatory biomarkers that was unique to asthma using a targeted metabolomics approach combined with data science methods. We conducted a nested case-control study of 100 children living in a peri-urban community in Lima, Peru. We defined cases as children with current asthma, and controls as children with no prior history of asthma and normal lung function. We further categorized enrollment following a factorial design to enroll equal numbers of children as either overweight or not. We obtained a fasting venous blood sample to characterize a comprehensive panel of targeted markers using a metabolomics approach based on high performance liquid chromatography-mass spectrometry. A statistical comparison of targeted metabolites between children with asthma (n = 50) and healthy controls (n = 49) revealed distinct patterns in relative concentrations of several metabolites: children with asthma had approximately 40-50% lower relative concentrations of ascorbic acid, 2-isopropylmalic acid, shikimate-3-phosphate, and 6-phospho-d-gluconate when compared to children without asthma, and 70% lower relative concentrations of reduced glutathione (all p  13 077 normalized counts/second and betaine ≤ 16 47 121 normalized counts/second). By using a metabolomics approach applied to serum, we were able to discriminate between children with and without asthma by revealing different metabolic patterns. These results suggest that serum metabolomics may represent a diagnostic tool for asthma and may be helpful for distinguishing asthma phenotypes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Patterns of functional enzyme activity in fungus farming ambrosia beetles.

    Science.gov (United States)

    De Fine Licht, Henrik H; Biedermann, Peter H W

    2012-06-06

    In wood-dwelling fungus-farming weevils, the so-called ambrosia beetles (Curculionidae: Scolytinae and Platypodinae), wood in the excavated tunnels is used as a medium for cultivating fungi by the combined action of digging larvae (which create more space for the fungi to grow) and of adults sowing and pruning the fungus. The beetles are obligately dependent on the fungus that provides essential vitamins, amino acids and sterols. However, to what extent microbial enzymes support fungus farming in ambrosia beetles is unknown. Here we measure (i) 13 plant cell-wall degrading enzymes in the fungus garden microbial consortium of the ambrosia beetle Xyleborinus saxesenii, including its primary fungal symbionts, in three compartments of laboratory maintained nests, at different time points after gallery foundation and (ii) four specific enzymes that may be either insect or microbially derived in X. saxesenii adult and larval individuals. We discovered that the activity of cellulases in ambrosia fungus gardens is relatively small compared to the activities of other cellulolytic enzymes. Enzyme activity in all compartments of the garden was mainly directed towards hemicellulose carbohydrates such as xylan, glucomannan and callose. Hemicellulolytic enzyme activity within the brood chamber increased with gallery age, whereas irrespective of the age of the gallery, the highest overall enzyme activity were detected in the gallery dump material expelled by the beetles. Interestingly endo-β-1,3(4)-glucanase activity capable of callose degradation was identified in whole-body extracts of both larvae and adult X. saxesenii, whereas endo-β-1,4-xylanase activity was exclusively detected in larvae. Similar to closely related fungi associated with bark beetles in phloem, the microbial symbionts of ambrosia beetles hardly degrade cellulose. Instead, their enzyme activity is directed mainly towards comparatively more easily accessible hemicellulose components of the ray

  1. 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...

  2. Defining asthma and assessing asthma outcomes using electronic health record data: a systematic scoping review.

    Science.gov (United States)

    Al Sallakh, Mohammad A; Vasileiou, Eleftheria; Rodgers, Sarah E; Lyons, Ronan A; Sheikh, Aziz; Davies, Gwyneth A

    2017-06-01

    There is currently no consensus on approaches to defining asthma or assessing asthma outcomes using electronic health record-derived data. We explored these approaches in the recent literature and examined the clarity of reporting.We systematically searched for asthma-related articles published between January 1, 2014 and December 31, 2015, extracted the algorithms used to identify asthma patients and assess severity, control and exacerbations, and examined how the validity of these outcomes was justified.From 113 eligible articles, we found significant heterogeneity in the algorithms used to define asthma (n=66 different algorithms), severity (n=18), control (n=9) and exacerbations (n=24). For the majority of algorithms (n=106), validity was not justified. In the remaining cases, approaches ranged from using algorithms validated in the same databases to using nonvalidated algorithms that were based on clinical judgement or clinical guidelines. The implementation of these algorithms was suboptimally described overall.Although electronic health record-derived data are now widely used to study asthma, the approaches being used are significantly varied and are often underdescribed, rendering it difficult to assess the validity of studies and compare their findings. Given the substantial growth in this body of literature, it is crucial that scientific consensus is reached on the underlying definitions and algorithms. Copyright ©ERS 2017.

  3. Saharan dust, climate variability, and asthma in Grenada, the Caribbean.

    Science.gov (United States)

    Akpinar-Elci, Muge; Martin, Francis E; Behr, Joshua G; Diaz, Rafael

    2015-11-01

    Saharan dust is transported across the Atlantic and interacts with the Caribbean seasonal climatic conditions, becoming respirable and contributing to asthma presentments at the emergency department. This study investigated the relationships among dust, climatic variables, and asthma-related visits to the emergency room in Grenada. All asthma visits to the emergency room (n = 4411) over 5 years (2001-2005) were compared to the dust cover and climatic variables for the corresponding period. Variation in asthma was associated with change in dust concentration (R(2) = 0.036, p asthma was positively correlated with rainfall (R(2) = 0.055, p asthma visits were inversely related to mean sea level pressure (R(2) = 0.123, p = 0.006) and positively correlated with relative humidity (R(2) = 0.593, p = 0.85). Saharan dust in conjunction with seasonal humidity allows for inhalable particulate matter that exacerbates asthma among residents in the Caribbean island of Grenada. These findings contribute evidence suggesting a broader public health impact from Saharan dust. Thus, this research may inform strategic planning of resource allocation among the Caribbean public health agencies.

  4. Urinary Eosinophil Protein X in Childhood Asthma: Relation with Changes in Disease Control and Eosinophilic Airway Inflammation

    Directory of Open Access Journals (Sweden)

    Marianne Nuijsink

    2013-01-01

    ; at 2 years: r=-0.21,P=0.03. Within-patient changes from baseline of uEPX correlated with changes in % eos. No relations were found between uEPX and symptoms. Conclusion. In this population of children with atopic asthma, uEPX correlated with FEV1 and % eos, and within-subjects changes in uEPX correlated with changes in FEV1 and % eos. As the associations were weak and the scatter of uEPX wide, it seems unlikely that uEPX will be useful as a biomarker for monitoring asthma control in the individual child.

  5. A Brazilian social bee must cultivate fungus to survive.

    Science.gov (United States)

    Menezes, Cristiano; Vollet-Neto, Ayrton; Marsaioli, Anita Jocelyne; Zampieri, Davila; Fontoura, Isabela Cardoso; Luchessi, Augusto Ducati; Imperatriz-Fonseca, Vera Lucia

    2015-11-02

    The nests of social insects provide suitable microenvironments for many microorganisms as they offer stable environmental conditions and a rich source of food [1-4]. Microorganisms in turn may provide several benefits to their hosts, such as nutrients and protection against pathogens [1, 4-6]. Several examples of symbiosis between social insects and microorganisms have been found in ants and termites. These symbioses have driven the evolution of complex behaviors and nest structures associated with the culturing of the symbiotic microorganisms [5, 7, 8]. However, while much is known about these relationships in many species of ants and termites, symbiotic relationships between microorganisms and social bees have been poorly explored [3, 4, 9, 10]. Here, we report the first case of an obligatory relationship between the Brazilian stingless bee Scaptotrigona depilis and a fungus of the genus Monascus (Ascomycotina). Fungal mycelia growing on the provisioned food inside the brood cell are eaten by the larva. Larvae reared in vitro on sterilized larval food supplemented with fungal mycelia had a much higher survival rate (76%) compared to larvae reared under identical conditions but without fungal mycelia (8% survival). The fungus was found to originate from the material from which the brood cells are made. Since the bees recycle and transport this material between nests, fungus would be transferred to newly built cells and also to newly founded nests. This is the first report of a fungus cultivation mutualism in a social bee. Copyright © 2015 Elsevier Ltd. All rights reserved.

  6. The burden of severe asthma in childhood and adolescence

    DEFF Research Database (Denmark)

    Fleming, Louise; Murray, Clare; Bansal, Aruna T

    2015-01-01

    U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches. A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53...... in the severe wheeze cohort. Almost all participants in each cohort were atopic and had a normal body mass index. Asthma-related quality of life, as assessed by the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and the Paediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ), was worse...... and mild/moderate cohorts were clinically very similar. Children with severe preschool wheeze or severe asthma are usually atopic and have impaired quality of life that is associated with poor control and airflow limitation: a very different phenotype from adult severe asthma. In-depth phenotyping...

  7. Air pollution and asthma severity in adults

    Science.gov (United States)

    Rage, Estelle; Siroux, Valérie; Künzli, Nino; Pin, Isabelle; Kauffmann, Francine

    2009-01-01

    Objectives There is evidence that exposure to air pollution affects asthma, but the effect of air pollution on asthma severity has not been addressed. The aim was to assess the relation between asthma severity during the past 12 months and home outdoor concentrations of air pollution. Methods Asthma severity over the last 12 months was assessed in two complementary ways among 328 adult asthmatics from the French Epidemiological study on the Genetics and Environment of Asthma (EGEA) examined between 1991 and 1995. The 4-class severity score integrated clinical events and type of treatment. The 5-level asthma score is based only on the occurrence of symptoms. Nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3) concentrations were assigned to each residence using two different methods. The first was based on the closest monitor data from 1991–1995. The second consisted in spatial models that used geostatistical interpolations and then assigned air pollutants to the geo-coded residences (1998). Results Higher asthma severity score was significantly related to the 8-hour average of ozone during April-September (O3-8hr) and the number of days (O3-days) with 8-hour ozone averages above 110 μg.m−3 (for a 36-day increase, equivalent to the inter quartile range, in O3-days, odds ratio (95% confidence interval) 2.22 (1.61–3.07) for one class difference in score). Adjustment for age, sex, smoking habits, occupational exposure, and educational level did not alter results. Asthma severity was unrelated to NO2. Both exposure assessment methods and severity scores resulted in very similar findings. SO2 correlated with severity but reached statistical significance only for the model based assignment of exposure. Conclusions The observed associations between asthma severity and air pollution, in particular O3, support the hypothesis that air pollution at levels far below current standards increases asthma severity. PMID:19017701

  8. Environmental and mucosal microbiota and their role in childhood asthma

    NARCIS (Netherlands)

    Birzele, L T; Depner, M.; Ege, M.J.; Engel, M; Kublik, S; Bernau, C; Loss, G J; Genuneit, J.; Horak, E.; Schloter, M; Braun-Fahrländer, C.; Danielewicz, H.; Heederik, D; von Mutius, E.; Legatzki, A

    BACKGROUND: High microbial diversity in the environment has been associated with lower asthma risk, particularly in children exposed to farming. It remains unclear whether this effect operates through an altered microbiome of the mucosal surfaces of the airways. METHODS: DNA from mattress dust and

  9. Plasma adrenomedullin levels in children with asthma: any relation with atopic dermatitis?

    Science.gov (United States)

    Kucukosmanoglu, E; Keskin, O; Karcin, M; Cekmen, M; Balat, A

    2012-01-01

    Asthma is a chronic, inflammatory disease of the airway, and adrenomedullin (ADM) may have some effects against bronchoconstriction. However, the role(s) of ADM in asthmatic children have not been evaluated yet. The aims of this study were to determine if there are any changes in plasma ADM levels during acute asthma attack, and to search for any association between allergen sensitivity and ADM level in asthmatic children. Twenty-seven children with acute asthma attack, ranging in age from 5 to 15 years were investigated and compared with 20 controls. Plasma ADM levels (ng/mL) were measured by ELISA method. No significant difference was found in ADM levels between the controls and patients in either the acute attack or remission period. Plasma ADM levels were significantly higher in the acute attack (p=0.043) compared to the remission period in patients who were considered as having a "severe attack" according to GINA (Global Initiative for Asthma) classification. There were statistically significant correlations between the patients' AlaTOP and Food Panel 7 levels and plasma ADM levels in the acute attack period (p=0.010, p=0.001, respectively). The ADM levels in patients with a history of atopic dermatitis were significantly higher in the acute attack period compared to those without a history of atopic dermatitis (p=0.007). We speculate that ADM may have a role in children with atopic dermatitis, and may also have a role in the immuno-inflammatory process of asthma. Copyright © 2011 SEICAP. Published by Elsevier Espana. All rights reserved.

  10. Asthma in General practice: risk factors and asthma control.

    NARCIS (Netherlands)

    Nieuwenhof, L. van den

    2009-01-01

    Asthma is a chronic, inflammatory, pulmonary disease with a significant impact on patients, their families, and society. When symptomatic asthma is diagnosed, often irreversible changes in the airways have occurred. Therefore it is important to detect persons at high risk of asthma as early as

  11. Mechanisms of aspirin-sensitive asthma

    Directory of Open Access Journals (Sweden)

    Sun Ying

    2004-01-01

    Full Text Available It is now widely accepted that aspirin, along with other non-steroidal anti-inflammatory drugs (NSAIDs, may precipitate asthma attacks in a minority of susceptible individuals. The syndrome is part of a mucosal inflammatory disease that typically affects the nasal, as well as the bronchial, mucosa and sometimes the gut and skin also. Although the mucosal cellular infiltrate in aspirin-sensitive asthma and rhinitis resembles that of asthma and rhinitis in general, there is evidence of increased expression of asthma-relevant cytokines, such as interleukin-5 and granulocyte–macrophage colony stimulating factor, and a more intense infiltrate of mast cells and eosinophils. One key feature of aspirin-sensitive asthma is thought to be the overproduction of cysteinyl leukotrienes, principally by these local mast cells and eosinophils, but whether this represents a fundamental abnormality or is simply a consequence of greater numbers and activation of inflammatory cells is unclear. Genetic polymorphisms of the leukotriene C4 synthase gene, which result in elevated expression of this enzyme, may also play a role. In addition, overexpression of cysteinyl leukotriene receptors, particularly CysLT1, may contribute to an enhanced response of local inflammatory and structural cells to cysteinyl leukotrienes. Aspirin challenge in these patients is accompanied by acute further elevation of the already elevated baseline cysteinyl leukotriene synthesis, a phenomenon that is most closely related to the ability of aspirin and related NSAIDs to inhibit the cyclooxygenase enzyme COX-1. The reason for this is unknown, although it has been suggested that the COX-1 product prostaglandin E2 (PGE2 serves as a ‘brake’ to leukotriene synthesis and that somehow this mechanism is deficient in aspirin-sensitive asthmatics. A better understanding of the pathogenesis of aspirin-sensitive asthma will undoubtedly lead to better approaches to treatment. Aside from the use of

  12. A GIS-based assessment of environmental influences on allergy development in children.

    Science.gov (United States)

    Lam, Agnes; Wong, Gary W K; Poon, Chin Man; Lee, Shui Shan

    2014-11-01

    This study aims to assess potential environmental influences on allergy development in children. Based on a parent-completed questionnaire survey administered in Hong Kong in 2003 in accordance with the International Study of Asthma and Allergies in Childhood protocol, the prevalence and incidence of asthma and rhinoconjunctivitis of 508 preschool children aged 4 to 6 years in Yuen Long District were determined and a range of indoor and outdoor environmental factors were assessed. Exposure to moisture and mold in the first year of life increased the risk of asthma (adjusted odds ratio [aOR] = 2.56; 95% confidence interval [CI] = 1.40-4.68) and rhinoconjunctivitis (aOR = 2.09; 95% CI = 1.15-3.80). Current maternal smoking was also associated with a higher prevalence of asthma (aOR = 2.00; 95% CI = 1.04-3.84). No association was observed between outdoor traffic-related air pollutants and the prevalence of the allergic conditions. Indoor home environments had a stronger influence on allergy development, whereas exposure to traffic-related external environment gave a variable effect, the significance of which would be difficult to be substantiated. © 2011 APJPH.

  13. Airway contractility and remodeling : Links to asthma symptoms

    NARCIS (Netherlands)

    West, Adrian R.; Syyong, Harley T.; Siddiqui, Sana; Pascoe, Chris D.; Murphy, Thomas M.; Maarsingh, Harm; Deng, Linhong; Maksym, Geoffrey N.; Bosse, Ynuk

    Respiratory symptoms are largely caused by obstruction of the airways. In asthma, airway narrowing mediated by airway smooth muscle (ASM) contraction contributes significantly to obstruction. The spasmogens produced following exposure to environmental triggers, such as viruses or allergens, are

  14. Transcriptome of an entomophthoralean fungus (Pandora formicae) shows molecular machinery adjusted for successful host exploitation and transmission

    DEFF Research Database (Denmark)

    Malagocka, Joanna; Grell, Morten Nedergaard; Lange, Lene

    2015-01-01

    Pandora formicae is an obligate entomopathogenic fungus from the phylum Entomophthoromycota, known to infect only ants from the genus Formica. In the final stages of infection, the fungus induces the so-called summit disease syndrome, manipulating the host to climb up vegetation prior to death......, but the fungus had not grown out through the cuticle and (2) when the fungus was growing out from host cadaver and producing spores. These phases mark the switch from within-host growth to reproduction on the host surface, after fungus outgrowth through host integument. In this first de novo transcriptome...... of an entomophthoralean fungus, we detected expression of many pathogenicity-related genes, including secreted hydrolytic enzymes and genes related to morphological reorganization and nutrition uptake. Differences in expression of genes in these two infection phases were compared and showed a switch in enzyme expression...

  15. Single parent households and increased child asthma morbidity.

    Science.gov (United States)

    Moncrief, Terri; Beck, Andrew F; Simmons, Jeffrey M; Huang, Bin; Kahn, Robert S

    2014-04-01

    To characterize whether single parent households are associated with pediatric asthma-related repeat healthcare utilization and to examine family-level psychosocial variables that may explain this relationship. We analyzed a prospective cohort of 526 children aged 1-16 years hospitalized for asthma or bronchodilator-responsive wheezing whose caregivers self-reported their marital status. Those reporting being "single" were considered the at-risk category. The outcome was repeat asthma-related utilization (emergency room (ER) revisit or hospital readmission) within 12 months. We assessed, a priori, four psychosocial variables (household income, caregiver risk of psychological distress, ratio of in-home children to adults, and regular attendance at childcare or a secondary home). Among all children enrolled in the cohort, 40% returned to the ER or hospital for asthma within 12 months. Of all caregivers, 59% self-identified as single. Single status was significantly associated with each psychosocial variable. Children in households with lower incomes and higher ratios of children to adults were both more likely to return to the ER or hospital than children with higher incomes and lower ratios, respectively (each p asthma from single parent households were more likely to have asthma-related reutilization within 12 months than children from homes with married parents. This was driven, in large part, by underlying differences in household income.

  16. Functional variant in the autophagy-related 5 gene promotor is associated with childhood asthma.

    Directory of Open Access Journals (Sweden)

    Lisa J Martin

    Full Text Available Autophagy is a cellular process directed at eliminating or recycling cellular proteins. Recently, the autophagy pathway has been implicated in immune dysfunction, the pathogenesis of inflammatory disorders, and response to viral infection. Associations between two genes in the autophagy pathway, ATG5 and ATG7, with childhood asthma were investigated.Using genetic and experimental approaches, we examined the association of 13 HapMap-derived tagging SNPs in ATG5 and ATG7 with childhood asthma in 312 asthmatic and 246 non-allergic control children. We confirmed our findings by using independent cohorts and imputation analysis. Finally, we evaluated the functional relevance of a disease associated SNP.We demonstrated that ATG5 single nucleotide polymorphisms rs12201458 and rs510432 were associated with asthma (p = 0.00085 and 0.0025, respectively. In three independent cohorts, additional variants in ATG5 in the same LD block were associated with asthma (p<0.05. We found that rs510432 was functionally relevant and conferred significantly increased promotor activity. Furthermore, Atg5 expression was increased in nasal epithelium of acute asthmatics compared to stable asthmatics and non-asthmatic controls.Genetic variants in ATG5, including a functional promotor variant, are associated with childhood asthma. These results provide novel evidence for a role for ATG5 in childhood asthma.

  17. Asthma in children in relation to pre-term birth and fetal growth restriction

    NARCIS (Netherlands)

    Koshy, Gibby; Akrouf, Kafya A. S.; Kelly, Yvonne; Delpisheh, Ali; Brabin, Bernard J.

    2013-01-01

    To assess the impact of parental asthma on risk of pre-term birth (PTB) and intrauterine growth restriction, and their subsequent association with childhood asthma. Three sequential cross-sectional surveys were conducted in 1993 (3,746), 1998 (1,964) and 2006 (1,074) in the same 15 schools among

  18. 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....

  19. The Airway Microbiome in Severe Asthma: Associations with Disease Features and Severity

    Science.gov (United States)

    Huang, Yvonne J.; Nariya, Snehal; Harris, Jeffrey M.; Lynch, Susan V.; Choy, David F.; Arron, Joseph R.; Boushey, Homer

    2015-01-01

    Background Asthma is heterogeneous, and airway dysbiosis is associated with clinical features in mild-moderate asthma. Whether similar relationships exist among patients with severe asthma is unknown. Objective To evaluate relationships between the bronchial microbiome and features of severe asthma. Methods Bronchial brushings from 40 participants in the BOBCAT study (Bronchoscopic Exploratory Research Study of Biomarkers in Corticosteroid-refractory Asthma) were evaluated using 16S rRNA-based methods. Relationships to clinical and inflammatory features were analyzed among microbiome-profiled subjects. Secondarily, bacterial compositional profiles were compared between severe asthmatics, and previously studied healthy controls (n=7), and mild-moderate asthma subjects (n=41). Results In severe asthma, bronchial bacterial composition was associated with several disease-related features, including body-mass index (BMI; Bray-Curtis distance PERMANOVA, p < 0.05), changes in Asthma Control Questionnaire (ACQ) scores (p < 0.01), sputum total leukocytes (p = 0.06) and bronchial biopsy eosinophils (per mm2; p = 0.07). Bacterial communities associated with worsening ACQ and sputum total leukocytes (predominantly Proteobacteria) differed markedly from those associated with BMI (Bacteroidetes/Firmicutes). In contrast, improving/stable ACQ and bronchial epithelial gene expression of FKBP5, an indicator of steroid responsiveness, correlated with Actinobacteria. Mostly negative correlations were observed between biopsy eosinophils and Proteobacteria. No taxa were associated with a T-helper type 2-related epithelial gene expression signature, but expression of Th17-related genes was associated with Proteobacteria. Severe asthma subjects, compared to healthy controls or mild-moderate asthmatics, were significantly enriched in Actinobacteria, although the largest differences observed involved a Klebsiella genus member (7.8 fold-increase in severe asthma, padj < 0.001) Conclusions

  20. Multiomics Data Triangulation for Asthma Candidate Biomarkers and Precision Medicine.

    Science.gov (United States)

    Pecak, Matija; Korošec, Peter; Kunej, Tanja

    2018-06-01

    Asthma is a common complex disorder and has been subject to intensive omics research for disease susceptibility and therapeutic innovation. Candidate biomarkers of asthma and its precision treatment demand that they stand the test of multiomics data triangulation before they can be prioritized for clinical applications. We classified the biomarkers of asthma after a search of the literature and based on whether or not a given biomarker candidate is reported in multiple omics platforms and methodologies, using PubMed and Web of Science, we identified omics studies of asthma conducted on diverse platforms using keywords, such as asthma, genomics, metabolomics, and epigenomics. We extracted data about asthma candidate biomarkers from 73 articles and developed a catalog of 190 potential asthma biomarkers (167 human, 23 animal data), comprising DNA loci, transcripts, proteins, metabolites, epimutations, and noncoding RNAs. The data were sorted according to 13 omics types: genomics, epigenomics, transcriptomics, proteomics, interactomics, metabolomics, ncRNAomics, glycomics, lipidomics, environmental omics, pharmacogenomics, phenomics, and integrative omics. Importantly, we found that 10 candidate biomarkers were apparent in at least two or more omics levels, thus promising potential for further biomarker research and development and precision medicine applications. This multiomics catalog reported herein for the first time contributes to future decision-making on prioritization of biomarkers and validation efforts for precision medicine in asthma. The findings may also facilitate meta-analyses and integrative omics studies in the future.

  1. Clustering patterns of LOD scores for asthma-related phenotypes revealed by a genome-wide screen in 295 French EGEA families.

    Science.gov (United States)

    Bouzigon, Emmanuelle; Dizier, Marie-Hélène; Krähenbühl, Christine; Lemainque, Arnaud; Annesi-Maesano, Isabella; Betard, Christine; Bousquet, Jean; Charpin, Denis; Gormand, Frédéric; Guilloud-Bataille, Michel; Just, Jocelyne; Le Moual, Nicole; Maccario, Jean; Matran, Régis; Neukirch, Françoise; Oryszczyn, Marie-Pierre; Paty, Evelyne; Pin, Isabelle; Rosenberg-Bourgin, Myriam; Vervloet, Daniel; Kauffmann, Francine; Lathrop, Mark; Demenais, Florence

    2004-12-15

    A genome-wide scan for asthma phenotypes was conducted in the whole sample of 295 EGEA families selected through at least one asthmatic subject. In addition to asthma, seven phenotypes involved in the main asthma physiopathological pathways were considered: SPT (positive skin prick test response to at least one of 11 allergens), SPTQ score being the number of positive skin test responses to 11 allergens, Phadiatop (positive specific IgE response to a mixture of allergens), total IgE levels, eosinophils, bronchial responsiveness (BR) to methacholine challenge and %predicted FEV(1). Four regions showed evidence for linkage (Pasthma and lung function screens, 6q14 appears to be a new region potentially linked to %FEV(1). To determine which of these various asthma phenotypes are more likely to share common genetic determinants, a principal component analysis was applied to the genome-wide LOD scores. This analysis revealed clustering of LODs for asthma, SPT and Phadiatop on one axis and clustering of LODs for %FEV(1), BR and SPTQ on the other, while LODs for IgE and eosinophils appeared to be independent from all other LODs. These results provide new insights into the potential sharing of genetic determinants by asthma-related phenotypes.

  2. Educating young children about asthma: comparing the effectiveness of a developmentally appropriate asthma education video tape and picture book.

    Science.gov (United States)

    Holzheimer, L; Mohay, H; Masters, I B

    1998-01-01

    Asthma self-management programmes have been shown to increase children's knowledge about asthma and improve their management practices and health status. However, existing programmes have rarely addressed the unique learning needs of very young children. This study aimed to develop and assess the effectiveness of a video tape and picture book designed to teach children about the prevention and management of acute episodes of asthma. The information content of the educational resources was determined by analysis of relevant medical information and asthma management skills. Social Learning Theory and consideration of the developmental stage of the target population informed the format and style of presentation of the resources. Eighty children aged between 2 and 5 years who had been diagnosed with asthma by their medical practitioner and who required daily asthma medication participated in a controlled experimental study. The study evaluated the impact of the asthma education resources on children's knowledge about asthma, compliance with medication regimens and health status. Children were randomly allocated to one of three experimental groups. Children in these groups were exposed to either the video tape alone, the book alone or both the video tape and book, or to a control group who viewed materials unrelated to asthma. The results for the three experimental groups were compared with the control group who did not receive exposure to any of the asthma education resources. The results showed that children in each experimental group had significantly greater gains in asthma-related knowledge than children in the control group and children exposed to both resources showed the greatest increases in knowledge. Children in each of the three experimental groups also had better compliance and health than children in the control group. These findings indicate that carefully designed asthma education resources are useful for providing even the youngest children with

  3. The course of asthma in young adults: a population-based nine-year follow-up on asthma remission and control.

    Directory of Open Access Journals (Sweden)

    Lucia Cazzoletti

    Full Text Available BACKGROUND: Only few longitudinal studies on the course of asthma among adults have been carried out. OBJECTIVE: The aim of the present prospective study, carried out between 2000 and 2009 in Italy, is to assess asthma remission and control in adults with asthma, as well as their determinants. METHODS: All the subjects with current asthma (21-47 years identified in 2000 in the Italian Study on Asthma in Young Adults in 6 Italian centres were followed up. Asthma remission was assessed at follow-up in 2008-2009 (n = 214, asthma control at baseline and follow-up. Asthma remission and control were related to potential determinants by a binomial logistic and a multinomial logistic model. Separate models for remission were used for men and women. RESULTS: The estimate of the proportion of subjects who were in remission was 29.7% (95%CI: 14.4%;44.9%. Men who were not under control at baseline had a very low probability of being in remission at follow-up (OR = 0.06; 95%CI:0.01;0.33 when compared to women (OR = 0.40; 95%CI:0.17;0.94. The estimates of the proportion of subjects who were under control, partial control or who were not under control in our sample were 26.3% (95%CI: 21.2;31.3%, 51.6% (95%CI: 44.6;58.7% and 22.1% (95%CI: 16.6;27.6%, respectively. Female gender, increasing age, the presence of chronic cough and phlegm and partial or absent asthma control at baseline increased the risk of uncontrolled asthma at follow-up. CONCLUSION: Asthma remission was achieved in nearly 1/3 of the subjects with active asthma in the Italian adult population, whereas the proportion of the subjects with controlled asthma among the remaining subjects was still low.

  4. Characteristics of patients making serious inhaler errors with a dry powder inhaler and association with asthma-related events in a primary care setting

    Science.gov (United States)

    Westerik, Janine A. M.; Carter, Victoria; Chrystyn, Henry; Burden, Anne; Thompson, Samantha L.; Ryan, Dermot; Gruffydd-Jones, Kevin; Haughney, John; Roche, Nicolas; Lavorini, Federico; Papi, Alberto; Infantino, Antonio; Roman-Rodriguez, Miguel; Bosnic-Anticevich, Sinthia; Lisspers, Karin; Ställberg, Björn; Henrichsen, Svein Høegh; van der Molen, Thys; Hutton, Catherine; Price, David B.

    2016-01-01

    Abstract Objective: Correct inhaler technique is central to effective delivery of asthma therapy. The study aim was to identify factors associated with serious inhaler technique errors and their prevalence among primary care patients with asthma using the Diskus dry powder inhaler (DPI). Methods: This was a historical, multinational, cross-sectional study (2011–2013) using the iHARP database, an international initiative that includes patient- and healthcare provider-reported questionnaires from eight countries. Patients with asthma were observed for serious inhaler errors by trained healthcare providers as predefined by the iHARP steering committee. Multivariable logistic regression, stepwise reduced, was used to identify clinical characteristics and asthma-related outcomes associated with ≥1 serious errors. Results: Of 3681 patients with asthma, 623 (17%) were using a Diskus (mean [SD] age, 51 [14]; 61% women). A total of 341 (55%) patients made ≥1 serious errors. The most common errors were the failure to exhale before inhalation, insufficient breath-hold at the end of inhalation, and inhalation that was not forceful from the start. Factors significantly associated with ≥1 serious errors included asthma-related hospitalization the previous year (odds ratio [OR] 2.07; 95% confidence interval [CI], 1.26–3.40); obesity (OR 1.75; 1.17–2.63); poor asthma control the previous 4 weeks (OR 1.57; 1.04–2.36); female sex (OR 1.51; 1.08–2.10); and no inhaler technique review during the previous year (OR 1.45; 1.04–2.02). Conclusions: Patients with evidence of poor asthma control should be targeted for a review of their inhaler technique even when using a device thought to have a low error rate. PMID:26810934

  5. Autoimmune diseases in asthma.

    Science.gov (United States)

    Tirosh, Amir; Mandel, Dror; Mimouni, Francis B; Zimlichman, Eyal; Shochat, Tzippora; Kochba, Ilan

    2006-06-20

    Previous research has suggested an inverse relationship between T-helper 2-related atopic disorders, such as asthma, and T-helper 1-related autoimmune diseases. One controversial hypothesis postulates that asthma provides a protective effect for the development of autoimmune-related disorders. To assess the rate of newly diagnosed autoimmune disorders in a large cohort of young adults. Using cross-sectional data from the Israeli Defense Force database, the authors analyzed the prevalence of autoimmune disorders in asthmatic and nonasthmatic military personnel between 1980 and 2003. A follow-up study traced newly diagnosed autoimmune disorders among asthmatic and nonasthmatic individuals from the time of enrollment in military service until discharge (22 and 36 months for women and men, respectively). General community. 307,367 male and 181,474 female soldiers in compulsory military service who were between 18 and 21 years of age. Cases of type 1 diabetes mellitus, vasculitis, immune thrombocytopenic purpura, inflammatory bowel disease, rheumatoid arthritis, and the antiphospholipid syndrome. Of 488,841 participants at enrollment, significantly more women than men had autoimmune disorders. Compared with asthmatic women, nonasthmatic women had a significantly higher prevalence of all autoimmune disorders except for the antiphospholipid syndrome. Type 1 diabetes mellitus, vasculitis, and rheumatoid arthritis were less prevalent in men with asthma than in those without. During the follow-up period, vasculitis and rheumatoid arthritis were more frequently diagnosed in nonasthmatic persons of both sexes. There was a significantly higher incidence of immune thrombocytopenic purpura, inflammatory bowel disease, and the antiphospholipid syndrome in nonasthmatic women and a statistically significantly higher incidence of type 1 diabetes mellitus in nonasthmatic men. The study was limited to a population of young military recruits; therefore, its findings are not necessarily

  6. Work-related allergy and asthma in spice mill workers - The impact of processing dried spices on IgE reactivity patterns.

    Science.gov (United States)

    van der Walt, Anita; Lopata, Andreas L; Nieuwenhuizen, Natalie E; Jeebhay, Mohamed F

    2010-01-01

    Three spice mill workers developed work-related allergy and asthma after prolonged exposure to high levels (>10 mg/m(3)) of inhalable spice dust. Patterns of sensitization to a variety of spices and putative allergens were identified. Work-related allergy and asthma were assessed on history, clinical evaluation, pulmonary function and fractional exhaled nitric oxide. Specific IgE reactivity to a range of common inhalant, food and spice allergens was evaluated using ImmunoCAP and allergen microarray. The presence of non-IgE-mediated reactions was determined by basophil stimulation (CAST-ELISA). Specific allergens were identified by immunoblotting to extracts of raw and dried processed garlic, onion and chili pepper. Asthma was confirmed in all 3 subjects, with work-related patterns prominent in worker 1 and 3. Sensitization to multiple spices and pollen was observed in both atopic workers 1 and 2, whereas garlic and chili pepper sensitization featured in all 3 workers. Microarray analysis demonstrated prominent profilin reactivity in atopic worker 2. Immunoblotting demonstrated a 50-kDa cross-reactive allergen in garlic and onion, and allergens of approximately 40 and 52 kDa in chili pepper. Dry powdered garlic and onion demonstrated greater IgE binding. This study demonstrated IgE reactivity to multiple spice allergens in workers exposed to high levels of inhalable spice dust. Processed garlic and onion powder demonstrated stronger IgE reactivity than the raw plant. Atopy and polysensitization to various plant profilins, suggesting pollen-food syndrome, represent additional risk factors for sensitizer-induced work-related asthma in spice mill workers. 2010 S. Karger AG, Basel.

  7. The impact of asthma medication guidelines on asthma controller use and on asthma exacerbation rates comparing 1997-1998 and 2004-2005.

    Science.gov (United States)

    Rank, Matthew A; Liesinger, Juliette T; Ziegenfuss, Jeanette Y; Branda, Megan E; Lim, Kaiser G; Yawn, Barbara P; Shah, Nilay D

    2012-01-01

    The relationship between asthma controller medication use and exacerbation rates over time is unclear at the population level. To estimate the change in asthma controller medication use between 2 time periods as measured by the controller-to-total asthma medication ratio and its association with changes in asthma exacerbation rates between 1997-1998 and 2004-2005. The study design was a cross-sectional population-level comparison between individuals from 1997-1998 and 2004-2005. Study participants were individuals aged 5 to 56 years identified as having asthma in the Medical Expenditure Panel Survey (MEPS). The main outcome measures were a controller-to-total asthma medication ratio greater than 0.5 and asthma exacerbation rates (dispensing of systemic corticosteroid or emergency department visit/hospitalization for asthma) in 1997-1998 compared with 2004-2005. The proportion of individuals with a controller-to-total asthma medication ratio greater than 0.5, when adjusted for other demographic factors, has improved by 16.1% (95% CI: 10.8%, 21.3%) for all individuals from 1997-1998 to 2004-2005. Annual asthma exacerbation rates did not change significantly in any group from 1997-1998 to 2004-2005 (0.27/year to 0.23/year). African American and Hispanic individuals with asthma had higher asthma exacerbation rates and a lower proportion with a controller-to-total asthma medication ratio greater than 0.5 than whites in both 1997-1998 and 2004-2005; however, these differences were not statistically significant. An increase in asthma controller-to-total medication ratio in a sample reflective of the US population was not associated with a decreased asthma exacerbation rate comparing 1997-1998 and 2004-2005. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. The Integrated Care of Asthma in Switzerland (INCAS) Study: Changes in Asthma Control and Perception of Health Care through Asthma Education.

    Science.gov (United States)

    Dürr, Selina; Hersberger, Kurt E; Zeller, Andreas; Scheuzger, Jonas; Miedinger, David; Gregoriano, Claudia; Joos Zellweger, Ladina; Steurer-Stey, Claudia; Leuppi, Jörg Daniel

    2017-01-01

    Despite great efforts in establishing optimal asthma management, asthma may remain uncontrolled. To effectively manage chronic diseases, such as asthma, it is important to train patients in self-management skills. The aim of this study was to assess the potential benefit of standardised asthma education in Switzerland for asthma control and patients' perception of received asthma care and of self-management support. For this multicentre longitudinal controlled study, asthma patients were recruited in Switzerland. The Asthma Control Test (ACT) was used to assess asthma control. The Patient Assessment of Chronic Illness Care questionnaire (PACIC 5A) was applied to evaluate received health-care services and self-management support. Patients were offered the possibility to attend asthma education sessions conducted by the Swiss Lung League and Swiss Allergy Centre. After 1 year, attenders and non-attenders completed the questionnaires again. Changes in ACT and PACIC 5A scores were analysed using dependent t tests. Overall, 223 patients with asthma were investigated (mean age 43 ± 12 years, 38% male, 13% current smokers, 29% ex-smokers). Sixty-one (27%) patients attended education sessions. Both groups had improved asthma control at follow-up (attenders: t(56) = -3.2, r = 0.4 [medium effect size], p = 0.002; non-attenders: t(141) = -2.6, r = 0.2 [small effect size], p = 0.010). Attenders improved in PACIC and 5A sum scores (t(50) = -3.6, r = 0.5 [medium effect size], p = 0.001). A comprehensive self-management asthma education programme in Switzerland improved asthma control and patients' perception of received asthma care and of self-management support. Professionals should motivate patients to attend asthma education in order to become active partners in managing their disease. © 2017 S. Karger AG, Basel.

  9. Sustainable Benefits of a Community Hospital-Based Paediatric Asthma Clinic.

    Science.gov (United States)

    Kuzik, Brian A; Chen, Chee P; Hansen, Miriam J; Montgomery, Paula L

    2017-01-01

    In 2011, we reported that our paediatric asthma clinic (PAC) appeared to significantly reduce the burden of paediatric asthma in our community. Supported by these results, the PAC underwent a gradual threefold expansion while maintaining the same model of care. We now report on the outcome of that expansion and demonstrate that our PAC continues to significantly reduce the burden of paediatric asthma in our community. As previously, newly enrolled PAC patients continue to show a 12-month reduction in asthma-related emergency department (ED) visits and admissions exceeding 60% and 80%, respectively. This consistent short-term benefit, coupled with clinic expansion, has contributed to a significant improvement in our rate of paediatric asthma-related ED visits or hospitalizations when compared to other Ontario hospitals.

  10. Exposure to gun violence and asthma among children in Puerto Rico.

    Science.gov (United States)

    Ramratnam, Sima K; Han, Yueh-Ying; Rosas-Salazar, Christian; Forno, Erick; Brehm, John M; Rosser, Franziska; Marsland, Anna L; Colón-Semidey, Angel; Alvarez, María; Miller, Gregory E; Acosta-Pérez, Edna; Canino, Glorisa; Celedón, Juan C

    2015-08-01

    Although community violence may influence asthma morbidity by increasing stress, no study has assessed exposure to gun violence and childhood asthma. We examined whether exposure to gun violence is associated with asthma in children, particularly in those reporting fear of leaving their home. Case-control study of 466 children aged 9-14 years with (n = 234) and without (n = 232) asthma in San Juan, Puerto Rico. Lifetime exposure to gun violence was defined as hearing a gunshot more than once. We also assessed whether the child was afraid to leave his/her home because of violence. Asthma was defined as physician-diagnosed asthma and wheeze in the prior year. We used logistic regression for the statistical analysis. All multivariate models were adjusted for age, gender, household income, parental asthma, environmental tobacco smoke, prematurity and residential distance from a major road. Cases were more likely to have heard a gunshot more than once than control subjects (n = 156 or 67.2% vs. n = 122 or 52.1%, P violence, those who had heard a gunshot more than once and were afraid to leave their home due to violence had 3.2 times greater odds of asthma (95% CI for OR = 2.2-4.4, P violence is associated with asthma in Puerto Rican children, particularly in those afraid to leave their home. Stress from such violence may contribute to the high burden of asthma in Puerto Ricans. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Chemically armed mercenary ants protect fungus-farming societies

    DEFF Research Database (Denmark)

    Adams, Rachelle Martha Marie; Liberti, Joanito; Illum, Anders A.

    2013-01-01

    guest ants are sufficient to kill raiders that invariably exterminate host nests without a cohabiting guest ant colony. We also show that the odor of guest ants discourages raider scouts from recruiting nestmates to host colonies. Our results imply that Sericomyrmex fungus-growers obtain a net benefit......The ants are extraordinary in having evolved many lineages that exploit closely related ant societies as social parasites, but social parasitism by distantly related ants is rare. Here we document the interaction dynamics among a Sericomyrmex fungus-growing ant host, a permanently associated...... parasitic guest ant of the genus Megalomyrmex, and a raiding agro-predator of the genus Gnamptogenys. We show experimentally that the guest ants protect their host colonies against agro-predator raids using alkaloid venom that is much more potent than the biting defenses of the host ants. Relatively few...

  12. A pharmacy asthma service achieves a change in patient responses from increased awareness to taking responsibility for their asthma.

    Science.gov (United States)

    Naik-Panvelkar, Pradnya; Saini, Bandana; LeMay, Kate S; Emmerton, Lynne M; Stewart, Kay; Burton, Deborah L; Bosnic-Anticevich, Sinthia Z; Krass, Ines; Smith, Lorraine D; Armour, Carol L

    2015-06-01

    If novel health services are to be implemented and sustained in practice, the perceptions and views of patients form a critical part of their evaluation. The aims of this study were to explore patient's perceptions and experiences with a pharmacy asthma service and to investigate if there was a change over time. Interviews and focus groups were conducted with patients participating in the asthma service at three time points. Data were transcribed verbatim and thematically analyzed using a framework approach. The service led to an enhanced awareness and understanding of asthma