WorldWideScience

Sample records for asthmatic children clinicians

  1. Cotinine Levels in Asthmatic Children

    Directory of Open Access Journals (Sweden)

    A Delpisheh

    2005-10-01

    Full Text Available Introduction: Asthmatic children are more at risk to environmental tobacco smoke exposure (ETS due to impaired lower airway function. Objective: To investigate the association of low socio-economic status and ETS exposure in asthmatic children. Design: A cross-sectional study on 425 primary school children (aged 5-11years in Merseyside, using a parent completed questionnaire and childrens’ saliva samples. Results: 25.9 % of children had doctor diagnosed asthma and 12 % had a history of hospital admission for respiratory illnesses. The symptom triad of cough, wheeze and breathlessness were reported for 8.5% of children. Mean cotinine level was 2.1 ng/ml (±0.6 SD. 45.6% of children were ETS exposed (cotinine levels >1.0 ng/ml. Asthmatic children and those from disadvantaged households were more likely to be ETS exposed, compared to non-asthmatic and those from advantaged households [OR=1.7 (95%CI=1.1-2.4] and [OR=2.1(1.8-3.2 respectively]. A synergic effect of parental asthma, deprivation and high cotinine levels on childhood asthma was observed in multivariate analysis. Conclusions: A high cotinine level was significantly associated with an increased risk of asthma in children particularly amongst disadvantaged households. Interventions aimed at limiting ETS exposure particularly among disadvantaged groups with asthmatic children are needed.

  2. [The prognosis of asthmatic children with status asthmatics in early childhood].

    Science.gov (United States)

    Komatsu, Masaki; Ikematsu, Kaori; Tachimoto, Hiroshi; Shukuya, Akinori; Ebisawa, Motohiro

    2002-07-01

    To clarify the prognosis of asthmatic children with status asthmatics in early childhood, we retrospectively investigated 113 patients (boys: 62, girls: 51) who had been treated as status asthmatics since 1995 through 2000 in National Sagamihara Hospital. In this study, the frequency of admission was decreased year by year, 62.8% (1st year), 29.2% (3rd year), and 5% (5th year). All patients were evaluated as severe or moderate patients during the 1st year from the episode of status asthmatics. Three years after the episode, 38% of patients were evaluated as severe or moderate patients. Five years later, only 20% of patients were evaluated as severe or moderate patients and 35% became free from treatment and asthma attack. Most of the patients were treated by DSCG inhalation and RTC therapy. Nine patients needed BDI therapy in addition to DSCG and RTC. With appropriate and careful treatment, the prognosis of the patients who had experienced status asthmatics in the early childhood was kept relatively well. PMID:12201171

  3. Steroid Phobia among Parents of Asthmatic Children: Myths and Truth

    Directory of Open Access Journals (Sweden)

    Magdy M Zedan

    2010-09-01

    Full Text Available Asthma is one of the most common chronic diseases of childhood. Inhaled corticosteroids (ICS are the recommended controller drug for asthma treatment. The aim of our study was to determine concerns and fears of parents of children with asthma towards the use of ICS. One hundred parents of asthmatic children were interviewed using structural questionnaire. Airway inflammation was reported by only 6% of interviewed parents, whereas airway narrowing was addressed by 34%. Interesting data, 71% of parents were concerned with the role of steroids in asthma treatment, but more than half (53% of them addressed fears from side effects. Apparent gaps were found in knowledge of parents of asthmatic children about ICS as controller asthma medication. So, physician and health providers should explain to asthmatic parents that airway inflammation is the core for asthma management. This may remove fears about ICS and thus improve adherence to treatment.

  4. CD4(+), CD25(+), FOXP3 (+) T Regulatory Cell Levels in Obese, Asthmatic, Asthmatic Obese, and Healthy Children.

    Science.gov (United States)

    Donma, Metin; Karasu, Erkut; Ozdilek, Burcu; Turgut, Burhan; Topcu, Birol; Nalbantoglu, Burcin; Donma, Orkide

    2015-08-01

    The aim of this prospective case control study is to determine CD4(+), CD25(+), and FoxP3(+) T regulatory cells (Tregs) and T helper cells (Ths) in obese, asthmatic, asthmatic obese, and healthy children. Obese (n = 40), asthmatic (n = 40), asthmatic obese (n = 40), and healthy children (n = 40) were included in this study. Blood samples collected from children were marked with CD4, CD25, ve Foxp3 in order to detect Tregs and Ths by flow cytometric method. Statistical analyses were performed. p ≤ 0.05 was chosen as meaningful threshold. Tregs exhibiting anti-inflammatory nature were significantly lower in obese (0.16 %; p ≤ 0.001), asthmatic (0.25 %; p ≤ 0.01), and asthmatic obese (0.29 %; p ≤ 0.05) groups than control group (0.38 %). Ths were counted higher in asthma group than control (p ≤ 0.01) and obese (p ≤ 0.001) groups. T cell immunity plays important roles in chronic inflammatory diseases such as obesity and asthma pathogeneses. Decreased numbers of Tregs found in obese, asthmatic, and asthmatic obese children might represent a challenge of these cells. PMID:25655390

  5. Characterization of the immune inflammatory profile in obese asthmatic children.

    Science.gov (United States)

    Magrone, Thea; Simone, Maria; Altamura, Maria; Munno, Irene

    2014-01-01

    Asthma and obesity are two common disorders often associated in children and characterized by an inflammatory status. Growing evidences support a connection between obesity and asthma since weight reduction can improve asthmatic symptoms. In this study, we have enrolled eighty children: 17 non asthmatics and non obese, 19 obese, 28 asthmatics-obese and, 16 asthmatics non-obese, respectively. In all participants, respiratory functional tests and body mass index (BMI) were calculated. Moreover, systemic inflammation of biomarkers such as T helper (h)1-type, Th2-type and T regulatory-type serum cytokines along with major adipokines was determined. Data will show that the association between asthma and obesity leads to a predominant Th1-type response with an increase in pro-inflammatory cytokines. This inflammatory profile in asthmatics-obese children is sustained by elevated serum levels of leptin and visfatin, while adiponectin concentration is rather diminished. Finally, levels of systemic inflammatory biomarkers positively correlate with the increase in BMI values in all population subgroups.

  6. Bronchoconstrictive effect of ultrasonic nebulized distilled water on asthmatic children.

    Science.gov (United States)

    Baba, Y; Hayashida, M; Yasunami, J; Takamatsu, I; Adachi, K; Toyoshima, K

    1989-01-01

    We studied the airway responsiveness of asthmatic and normal children to ultrasonic nebulized distilled water (UNDW inhalation test). It was found that this stimulus induced a fall in FEV1 (forced expiratory volume in 1 s) in asthmatic children, but little fall in normal children. This airway response was shown to be reproducible at about 2-week intervals. The more severe the asthma, the higher the percentage of the responders to the UNDW inhalation test, and the greater the fall in FEV1. The results of the UNDW inhalation test did not correlate with that of acetylcholine inhalation test or of exercise-induced asthma (EIA). UNDW-induced bronchoconstriction was inhibited by premedication with disodium cromoglycate (DSCG) (20 mg) or inhaled ipratropium bromide (40 micrograms). Jet-nebulized distilled water induced little fall in FEV1 in asthmatic children. These data suggest that UNDW-induced bronchoconstriction may involve the release of chemical mediators from the mast cells and cholinergic pathways. We conclude that UNDW inhalation test is a safe, less burdensome, and rather convenient method to evaluate clinically nonspecific airway hyperresponsiveness in asthmatic children. PMID:2534983

  7. Pollution effects on asthmatic children in Europe: the PEACE study.

    NARCIS (Netherlands)

    Roemer, W.

    1998-01-01

    This thesis is based upon the 'Pollution Effects on Asthmatic Children in Europe (PEACE)' study. The PEACE study is a multi-centre study of the acute effects of particles with a 50% cut-off aerodynamic diameter of 10 µm (PM 10 ), Black Smoke (BS), SO 2 and NO 2 on re

  8. Attitudes of asthmatic and nonasthmatic children to physical exercise

    Directory of Open Access Journals (Sweden)

    Dimitrakaki V

    2013-01-01

    Full Text Available Vithleem Dimitrakaki,1 Konstantinos Porpodis,2 Evangelos Bebetsos,1 Paul Zarogoulidis,2 Antonis Papaiwannou,2 Theodora Tsiouda,2 Hlias Tsioulis,2 Konstantinos Zarogoulidis21Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece; 2Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreecePurpose: The aim of this study was to examine the physical activity of children with and without asthma in Greece, the factors affecting their intention to exercise, and the influence of gender.Method: The study involved 50 children with asthma and 50 children without asthma, aged 9–14-years old. We used the leisure time exercise questionnaire to assess the frequency and intensity of exercise. The planned behavior scale examined seven factors affecting physical activity: attitude, intention, self-identity, attitude strength, social role model, information, and knowledge.Results: Asthmatic children did not differ significantly in mild, moderate, and overall level of physical activity from children without asthma but they participated less in intense and systematic exercise. The two asthmatic groups did not differ in any of the planned behavior factors. Significant differences between genders occurred with respect to self-identity and social role model. Boys appeared to exercise more regularly and intensely compared to girls.Conclusion: Asthmatic children did not systematically participate in physical activity, preferring mostly mild and moderate intensity activities. Children with and without asthma had comparable positive attitudes and intentions toward exercise.Keywords: planned behavior theory, asthma, sports, health behavior

  9. DRUG THERAPY IN ASTHMATIC CHILDREN: SURVEY IN MASHHAD

    Directory of Open Access Journals (Sweden)

    M.H Karimi

    2000-03-01

    Full Text Available Introduction. For future health planning of our country, the type and amount of drugs used for treatment of chronic diseases should be known. Therefore, in the present study the treatment regimen of asthmatic children in the city of Mashhad was studied. Methods. To study the different types of drugs in the treatment regimen of asthmatic children in the city of Mashhad, we evaluated the treatment regimen of 366 primary school children with asthma disease. Starting, maximum and duration of action of three different bronchodilators (salbutamol inhaler, salbutamol syrup, and theophylline syrup were compared. Findings. The results of the first part of this study showed that only 31.6 percent of asthmatic children had history of treatment and only 10.6 percent had current medication. In addition, most of the treated children (38.8 percent had only bronchodilator (salbutamol syrup in their treatment regimen. The effect of salbutamol inhaler on lung function tests starts in 5 min, salbutamol syrup in 15 min and theophylline syrup at 30 min after administration. The maximum response to salbutamol inhaler, salbutamol syrup, and theophylline syrup occurred 15 min, 4 hr and 3 hr after administration, respectively. The reduction of response to salbutamol inhaler occurs after 3 hr, but there was no any reduction in response to salbutamol and theophylline syrup during study period. Conclusion. The prevalence of asthma among children in the city of Mashhad is relatively high, but most of asthmatic children are not treated. Although the oral bronchodilator in mild asthma is effective, salbutamol inhaler is needed for emergency use.

  10. Nocturnal symptoms and sleep disturbances in clinically stable asthmatic children.

    Science.gov (United States)

    Chugh, Inder Mohan; Khanna, Puneet; Shah, Ashok

    2006-01-01

    Presence of nocturnal symptoms is related to asthma severity. Clinically stable asthmatic children, too, report frequent nocturnal symptoms and sleep disturbances. The study determined these parameters in stable, asthmatic children, in their home environment. This case-control, questionnaire-based study in 70 school-going children comprised 40 asthmatics (Group 1) and 30, age/gender matched, healthy children (Group 2). Parents maintained peak expiratory flow (PEF) and sleep diaries for one week. Group 1 had significantly lower mean morning (250.3 vs. 289.1 I/minute) and mean evening PEF values (261.7 vs. 291.3 I/minute). Group 1 (38.95%), reported frequent nocturnal symptoms like cough (36.90%), breathlessness (32.80%), wheeze (27.68%) and chest tightness (14.35%). Sleep disturbances, significant in Group 1 (38, 95% vs. 14.35%), included daytime sleepiness (24.60%), daytime tiredness (20.50%), difficulty in maintaining sleep (15.38%), early morning awakening (14.35%), struggle against sleep during daytime (12.30%), and involuntarily falling asleep (17.43%). On a scale of 1-6, Group 1 scored significant sleep disturbances/patient (3 vs. 0.8); lethargy/tiredness in morning (2.9 vs. 2.2), poorer sleep quality (4.7 vs. 5.4), less parents' satisfaction with child's sleep (4.5 vs. 5.5) and daytime fitness (4.1 vs. 5.3). Group 1, when exposed to environmental tobacco smoke (22, 55%), reported significant nocturnal symptoms (18/22, 81%) and reduced mean morning and evening PEF values (17/22, 77%). It is concluded that clinically stable, asthmatic children reported increased nocturnal symptoms, sleep disturbances and poorer sleep quality. Lack of awareness of asthma-sleep association and its clinical implications could lead to poor asthma control and impaired daytime activity. PMID:17136879

  11. Determinants of lung function and airway hyperresponsiveness in asthmatic children

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Anhøj, J;

    2007-01-01

    Genetic Study (SAGA). RESULTS: The primary analysis studied the association between the lung function and delay of inhaled corticosteroids (ICS) after asthma diagnosis among asthmatic children and young adults with a history of regular ICS treatment (N=919). FEV(1) percent predicted (FEV(1)% pred) was 0......BACKGROUND: Asthma patients exhibit an increased rate of loss of lung function. Determinants to such decline are largely unknown and the modifying effect of steroid therapy is disputed. This cross-sectional study aimed to elucidate factors contributing to such decline and the possible modifying...... effect of steroid treatment. METHODS: We analyzed determinants of lung function and airway hyperresponsiveness (AHR) in a Scandinavian study of 2390 subjects from 550 families. Families were selected for the presence of two or more asthmatic children as part of a genetic study, Scandinavian Asthma...

  12. Ventilation-perfusion (V/Q) scan in asthmatic children

    International Nuclear Information System (INIS)

    Full text: A V/Q scan provides quantitative information of regional lung function. Chronic asthmatic children stabilised on inhalation therapy were studied using the above method to know its role in management of asthma. 47 asthmatic children who were on salbutamol and steroid inhalation therapy were included in this study. V/Q scans were done using 99mTc labelled aerosol and 99mTc-MAA, respectively, x-rays and PFTs were also done. 18 out of 47(38%) asthmatic children showed abnormal V/Q scans of which 3 were matched and 15 were mismatched defects. Out of the 15 mismatched defects, 13 had normal ventilation and normal perfusion, 1 had abnormal ventilation and normal perfusion and 1 had abnormal ventilation and abnormal perfusion in different areas. The perfusion defect can be explained on the basis of hypoxia secondary to hypo ventilation. However, normal ventilation with persistent abnormal perfusion in 13 out of 18 abnormal scans (72%) could be due to the fact that defect in perfusion takes longer time to reverse than ventilation defects as in our study. One patient improved in perfusion after 9 months, 3 patients who underwent repeat scan after 6 months, however, showed no significant predictable change. The cause for poor ventilation and perfusion at different stages of asthma is poorly understood and should be looked into

  13. The Experiences of Mothers with Asthmatic Children: A Content Analysis

    Directory of Open Access Journals (Sweden)

    Mohadeseh Mohsenpour

    2012-08-01

    Full Text Available Introduction: Having children with chronic diseases such as asthma creates conditions that cause emotional and behavioral problems in parents. In most families, the mother tends to have the first role in caring for her child and therefore mothers endure greater psychological pressure than other family members. These mothers' experiences and problems are different due to cultural and economic differences and the health services they receive. This study aimed to explore the experiences of mothers of an asthmatic child. Methods: In this qualitative study data was collected through unstructured, in-depth interviews with 10 mothers who had an asthmatic child. The Graneheim and Lundman's qualitative content analysis method was used for analyzing the data. Results: The analysis of data showed five main themes including constant concern, feel-ing of having an unusual life, the need for help from others, feeling of guilt, and the de-sire to constantly monitor the child. Conclusion: The mothers of asthmatic children ex-pressed feelings and experiences that demonstrated their need for support and empathy. Therefore, in addition to the necessity of developing strategies to support these mothers, future studies aiming to reveal methods to provide them with support are also required.

  14. Adrenal function in asthmatic children treated with inhaled budesonide

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Damkjaer Nielsen, M;

    1991-01-01

    The effect of the inhaled topical steroid budesonide on adrenal function was evaluated in 33 children (aged 7-15 years) with moderate bronchial asthma. The trial was designed as a prospective single-blind study of the effect of budesonide in daily doses of 200 microgram through 400 microgram to 800...... significantly during treatment with 800 microgram budesonide as compared to treatment with 200 microgram budesonide (95% confidence interval: 74%-112%). It is concluded, that budesonide is a topical steroid with a favourable ratio between topical and systemic effects in asthmatic children....

  15. Effect of an intranasal corticosteroid on exercise induced bronchoconstriction in asthmatic children

    NARCIS (Netherlands)

    Kersten, Elin T. G.; van Leeuwen, Janneke C.; Brand, Paul L. P.; Duiverman, Eric J.; de Jongh, Frans H. C.; Thio, Bernard J.; Driessen, Jean M. M.

    2012-01-01

    Rationale Allergic rhinitis and exercise induced bronchoconstriction (EIB) are common in asthmatic children. The aim of this study was to investigate whether treatment of allergic rhinitis with an intranasal corticosteroid protects against EIB in asthmatic children. Methods: This was a double-blind,

  16. Effect of an intranasal conrticosteroid on exercide induced bronchocostriction in asthmatic children

    NARCIS (Netherlands)

    Kersten, E.T.; Leeuwen, J.C. van; Brand, P.L.; Duiverman, E.J.; Jongh, de F.H.C.; Thio, B.J.; Driessen, J.M.

    2012-01-01

    Rationale: Allergic rhinitis and exercise induced bronchoconstriction (EIB) are common in asthmatic children. The aim of this study was to investigate whether treatment of allergic rhinitis with an intranasal corticosteroid protects against EIB in asthmatic children. Methods: This was a double-blin

  17. [Exercise-induced airway obstruction in asthmatic children and adolescents].

    Science.gov (United States)

    Zapletal, A; Zbojan, J; Pohanka, V

    1992-03-01

    In 115 asymptomatic asthmatic children and adolescents (age 6-18 years) there was studied the magnitude of airway obstruction, induced by various physical efforts and assessed from the recording of maximum expiratory flow-volume curves and in some patients by "specific" airway conductance measurement in a body plethysmograph. The effects of 5 minutes free running outdoors, 5 minutes of exercise on a bicycle ergometer (2 watts/kg of body weight), routine swimming training in swimming pool and of forced expiration maneuver on the magnitude of airway obstruction were assessed. The most frequent and largest degree of airway obstruction was observed after 5 min. free running outdoors (heart rate after running 160-200/min). The obstruction was revealed in 80-100% asthmatics in various groups. The chosen lung function parameters showed exercise-induced airway obstruction in the same patients in various proportions as well as the magnitude of the obstruction. Following free running outdoors the values of maximum expiratory flow at 25% of vital capacity and "specific" airway conductance were most reduced. Spontaneous retreat of obstruction was observed in the course of 2 hours. The physical exercise on a bicycle ergometer was a small stimulus in inducing of airway obstruction. The swimming in a pool did not provoke any obstruction. In 10% of our asthmatics airway obstruction was observed following forced expiration maneuver. Airway obstruction induced by 5 minutes free running outdoors and assessed best by flow-volume curves appeared as a suitable test in the assessment of airway hyperresponsiveness. PMID:1591810

  18. Pneumomediastinum, subcutaneous emphysema and pneumorrhachis in asthmatic children.

    Science.gov (United States)

    Colavita, L; Cuppari, C; Pizzino, M R; Sturiale, M; Mondello, B; Monaco, F; Barone, M; Salpietro, C

    2016-01-01

    Pneumomediastinum (PM), subcutaneous emphysema (SE) and pneumorrhachis (also known as epidural air (EDA) or epidural emphysema) are very rare findings in children. PM is defined as the passage of air from intra-alveolar space to interstitium and, later, to the mediastinum. From the mediastinum, the air may catch up subcutaneous tissue (usually of the neck) and/or epidural space via the cervical fascial planes and neural foramina, forming respectively SE and EDA. The PM can be divided in spontaneous (or idiopathic) and secondary PM. Only few studies have evaluated the exact incidence of PM and its complications in children, and to define the correct diagnostic work up, treatment and outpatient follow-up. We report the case of a 9-year-old child with undiagnosed asthma that, during severe asthmatic flare secondary to acute infection of high airway, developed PM, SE and EDA. PMID:27358152

  19. Ethnic and migrant differences in the use of anti-asthmatic medication for children

    DEFF Research Database (Denmark)

    Cantarero-Arévalo, Lourdes; Ersbøll, Annette Kjaer; Holstein, Bjørn E;

    2014-01-01

    Ethnic differences in the use of anti-asthmatic medication have been reported, with ethnic minorities being at a higher risk of suboptimal asthma control. As contextual socioeconomic characteristics may play a role, we analysed whether ethnic differences in the use of anti-asthmatic medication...... among children residing in the Capital Region of Denmark varied by place of residence....

  20. Predicted Aerobic Capacity of Asthmatic Children: A Research Study from Clinical Origin

    Directory of Open Access Journals (Sweden)

    Lene Lochte

    2012-01-01

    Full Text Available Objective. To compare longitudinally PAC of asthmatic children against that of healthy controls during ten months. Methods. Twenty-eight asthmatic children aged 7–15 years and 27 matched controls each performed six submaximal exercise tests on treadmill, which included a test of EIA (exercise-induced asthma. Predicted aerobic capacity (mLO2/min/kg was calculated. Spirometry and development were measured. Physical activity, medication, and “ever asthma/current asthma” were reported by questionnaire. Results. Predicted aerobic capacity of asthmatics was lower than that of controls (P=0.0015 across observation times and for both groups an important increase in predicted aerobic capacity according to time was observed (P<0.001. FEV1 of the asthmatic children was within normal range. The majority (86% of the asthmatics reported pulmonary symptoms to accompany their physical activity. Physical activity (hours per week showed important effects for the variation in predicted aerobic capacity at baseline (F=2.28, P=0.061 and at the T4 observation (F=3.03, P=0.027 and the analyses showed important asthma/control group effects at baseline, month four, and month ten. Physical activity of the asthmatics correlated positively with predicted aerobic capacity. Conclusion. The asthmatic children had consistently low PAC when observed across time. Physical activity was positively associated with PAC in the asthmatics.

  1. HRCT findings of asthmatic children under maintenance therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Hyun Sook; Park, Jai Soung; Goo, Dong Erk; Lee, Hae Kyung; Kwon, Kui Hyang; Choi, Deuk Lin; Pyun, Bok Yang [Soonchunhyang University Hospital, Seoul (Korea, Republic of)

    2000-05-01

    The purpose of this study was to evaluate the HRCT findings of bronchial asthma during maintenance bronchodilator therapy and to determine whether there were irreversible bronchial changes occurred in pediatric patients with this condition. HRCT findings of the lung in 21 asthmatic children (14 boys and 7 girls aged between 3.5 and 13.8 (mean: 7.7) years) who were receiving maintenance bronchodilator therapy were retrospectively studied. At the time of CT examination, 16 were receiving nonsteroid bronchodilator therapy only, and five were receiving both bronchodilator and steroid therapy. Thirteen patients were defined as allergic and eight were nonallergic. The clinical severity of chronic asthma was graded as severe in seven cases, and moderate in 14. The duration of the disease ranged from 4 months to 6 years (mean 3.2 years). HRCT was performed in 19 cases for evaluation of the atelectasis, hyperinflation, and prominent bronchovascular bundles seen on plain radiographs, and in two cases for evaluation following acute exacerbation. A CT W-2000 scanner (Hitachi Medical Co. Tokyo, Japan) was used during the end inspiratory phase, and in addition, ten patients were scanned during the expiratory phase. Scans were reviewed for evidence of bronchial thickening, bronchiectasis, emphysema, abnormal density, mucus plugs, and other morphological abnormalities. The presence of bronchial wall thickening or air trapping was evaluated according to the duration, severity and type of asthma. Among the 21 patients, 7 (33.3%) had normal HRCT findings, while in 14 (66.7%), bronchial wall thickening was demonstrated. Eleven of the 14 patients with bronchial wall thickening(78.6%) also had air trapping. No patient was suffering from bronchiectasis or emphysema. There were no statistically significant correlations between the presence of bronchial wall thickening or air trapping and the duration of the disease, its severity, or type of asthma. There was, however, a statistically

  2. Environmental Health: Children׳s Health, a Clinician׳s Dilemma.

    Science.gov (United States)

    McClafferty, Hilary

    2016-06-01

    Few pediatricians receive training in environmental health, yet accumulating research shows that a disproportionate burden of exposure from environmental toxicants (man-made contaminants) is borne by children, adolescents, and the developing fetus. This is explained in part because of children׳s vulnerability to environmental-toxicants based on socioeconomic status, body surface area, metabolism, and potential transfers via placenta and breast milk. Public concern about toxicants affecting children in air, land, water, food, and beverages places pediatricians in the challenging position of being expected to knowledgably answer questions about environmental exposures while lacking sufficient training in the field. Surveys show pediatricians have high interest in environmental topics, yet feel a low sense of self-efficacy regarding patient education and lack evidence-based treatment guidelines and other effective educational tools. The goal of this article is to provide an overview of selected toxicants relevant to pediatric health, review practical suggestions to reduce or eliminate children's exposures, and introduce resources for taking an environmental health history to better prepare pediatricians and other clinicians caring for children to decrease harmful exposures in infants, children, and adolescents.

  3. Asthmatic Children And Immunological Effects Of BCG Vaccine Key words: Asthmatic children, BCG vaccine

    International Nuclear Information System (INIS)

    A TH2 screwed immune response is known to play a crucial role in the pathogenesis of allergy, so, preventing the differentiation of TH cells. The TH2 cells are appeared as a logical therapeutic approach to atopic asthma. The purpose of TH1 study was to determine the possible role of BCG vaccine on asthma and whether a TH1 type immune response elicited by BCG immunization could suppress the allergic sensitization in childhood asthma. Seventy asthmatic patients (50 atopic and 20 non-atopic) and fifty healthy individuals were subjected to TH1 study. Tuberculin test was performed for all groups then subjects with positive tuberculin test were excluded. The BCG vaccine was given for all groups with assessment of TH1 and TH2 cytokine response by measuring total IgE, IL-4 (for TH2 response) and INF-γ (for TH1 response). Significant reduction in IgE and IL-4, and elevation in INF-γ were determined in group I (atopic asthma) following BCG vaccination. There was non-significant change observed in IgE and IL-4 levels of group II while significant reduction in IL-4 and significant increase in INF-γ was observed after BCG vaccine

  4. Oral health status in preschool asthmatic children in Iran.

    Directory of Open Access Journals (Sweden)

    Sara Ehsani

    2013-09-01

    Full Text Available Asthma is a chronic inflammatory disorder of the airways, which is diagnosed by periodic symptoms of inflammation, bronchial spasm, and increased mucosal secretions. It has higher incidence among the preschool children. There are many contradictory reports based on the effect of asthma on oral health, however it has been hypothesized that asthma could lead to poor oral health. The objective of the present study was to investigate oral health indices in 44 preschool children of three to six years old with mild to moderate asthma and 46 matched healthy children in Tehran Children's Respiratory Center.Dental plaque, gingival inflammation, mouth breathing, and dental caries were evaluated by one trained examiner according to World Health Organization [WHO] criteria. Culture and colony counting of streptococcus mutans and lactobacillus species were carried out in saliva specimens of the patients. The effects of different factors on the colony counts were statistically analyzed using linear regression analysis.The level of mother’s education and preexisting asthma disease in children had significant effect  on  the  colony counts  of  streptococcus  species whereas no  factor  was found  to influence the number of lactobacillus counts significantly. The results indicated no significant differences between the children with asthma and those without asthma regarding (decayed, missing, filled, teeth dmft index (mean of 3.34 in asthmatic children and 3.0 in the control group.Therefore, it can be deduced that the presence of asthma disease did not increase the probability of tooth decay.

  5. Predicted Aerobic Capacity of Asthmatic Children: A Research Study from Clinical Origin

    OpenAIRE

    Lene Lochte

    2012-01-01

    Objective. To compare longitudinally PAC of asthmatic children against that of healthy controls during ten months. Methods. Twenty-eight asthmatic children aged 7–15 years and 27 matched controls each performed six submaximal exercise tests on treadmill, which included a test of EIA (exercise-induced asthma). Predicted aerobic capacity (mLO2/min/kg) was calculated. Spirometry and development were measured. Physical activity, medication, and “ever asthma/current asthma” were reported by questi...

  6. Pulmonary ventilation studies of asthmatic children with Kr-81m

    International Nuclear Information System (INIS)

    Krypton-81 m gas was eluted from the 81Rb-sup(81m)Kr generator by using compressed air or oxygen as an eluting agent. The continuous inhalation of mixed gas of sup(81m)Kr and air or oxygen with the use of a scintillation camera produced a pulmonary image of which density was proportional to regional ventilation. Because of short half life of sup(81m)Kr (13 seconds), exhaled gas was not necessary to be trapped by the charcoal filter, and the several pulmonary views of a patient could readily be available in a short period of time. The great advantage of sup(81m)Kr generator was found in use for the studies of small children who were not usually cooperative to medical examination. Thirty seven patients with bronchial asthma of any state were so far studied. Their ages ranged from 3 to 15 years old. Studies revealed the definite ventilation defects in scans of patients with asthmatic attack. Re-scans right after the use of bronchodilators showed marked improvement of the ventilation defects. Exercise-induced asthma (EIA) was easily identified by the sup(81m)Kr ventilation study. After premedications for EIA with disodium cromoglicate, the next exercises produced less or no ventilation defects, and the preventive effect could be individually examined. The sup(81m)Kr ventilation study was also used for estimating the patient's sensitivity to provokative substances of bronchial asthma. House dust was continuously inhaled with sup(81m)Kr gas by patients. The threshold dose of house dust of disclosing ventilation defects in scans was definitely less than that of provokating the symptom of asthmatic attack. The sensitive sup(81m)Kr ventilation study could be another provokative test which induces no clinical symptoms. (author)

  7. Salivary cortisol monitoring: determination of reference values in healthy children and application in asthmatic children.

    Science.gov (United States)

    Nagakura, Toshikazu; Tanaka, Toshiaki; Arita, Masahiko; Nishikawa, Kiyoshi; Shigeta, Makoto; Wada, Noriyuki; Matsumoto, Tsutomu; Hiraba, Kazumi; Fukuda, Norimasa

    2012-01-01

    Venipuncture testing of adrenocortical function in asthmatic infants and young children receiving inhaled corticosteroids can raise cortisol levels and mask physiological responses. This study aimed to establish reference ranges for salivary cortisol levels and evaluate the safety and effects of jet-nebulized budesonide inhalation suspension (BIS) on salivary cortisol levels and patient outcomes in infants and young children with mild or persistent asthma. Reference salivary cortisol levels were determined in healthy children aged 6 months to 4 years old. A 12-week multicenter, randomized, parallel-group, open-label study was performed involving 53 age-matched asthmatic children who received either 0.5 mg/day of BIS or 40-60 mg/day of cromolyn sodium inhalation suspension (CIS) via compressor nebulizer. The effective measuring range of salivary cortisol concentration in asthmatic children was 0.12-3.00 micrograms/dL. The upper and lower limits of the reference range were 0.827 and 0.076 micrograms/dL, respectively. No significant difference was seen from baseline through week 12 in the CIS and BIS groups. BIS was safe in these patients, with no inhibitory effects on adrenocortical function. Salivary cortisol measurement offers a useful and accurate tool for testing adrenocortical function in infants and young children. Longer-term studies that incorporate testing of the hypothalamic-pituitary-adrenal axis are warranted to confirm our findings.

  8. Superoxide dismutase levels and peak expiratory flow in asthmatic children

    Directory of Open Access Journals (Sweden)

    Arie Kurniasih

    2015-09-01

    Full Text Available Background Asthma is a chronic inflammatory process which involve variety of cells such as inflammatory mediators, reactive oxygen species (ROS, and cytokines. The inflammatory process would be exacerbated in the presence of oxidative stress. Superoxide dismutase (SOD is the first important enzyme to protect the respiratory tract against oxidative stress. The decreased of SOD has a correlation with increased of airway obstruction and bronchospasm. Objective To assess for a correlation between superoxide dismutase (SOD levels and peak expiratory flow, as well as to determine the impact of SOD levels for predicting asthma attacks. Methods We conducted a prospective cohort study at Dr. Sardjito Hospital, Yogyakarta, between February and April 2011 involving asthmatic children aged 5-18 years. Subjects’ serum SOD levels and peak expiratory flow were measured at the same time point. We then performed a prospective study following up on the same subjects to find out if they had a recurrent asthma attack within one month of the tests. We also reassessed their peak expiratory flow one month after blood specimens were obtained. Results Thirty-nine patients were enrolled in this study. There was no significant correlation between SOD level and peak expiratory flow [r=0.289; 95%CI -0.025 to 0.47; P=0.074]. However, older age was significantly associated with higher peak expiratory flow (=0.5; 95%CI 3.10 to 11.57; P=0.01. Lower levels of SOD increased the risk of asthma attacks in a month following the initial measurements (RR=5.5; 95%CI 1.6 to 18.9; P=0.009. Conclusion Superoxide dismutase (SOD level is not significantly associated with peak expiratory flow. However, we find a relationship between older age and higher peak expiratory flow and a relationship between lower SOD levels and risk of asthma attacks within one month following the tests.

  9. Heterogeneity of FeNO response to inhaled steroid in asthmatic children

    DEFF Research Database (Denmark)

    Buchvald, F; Eiberg, H; Bisgaard, H

    2003-01-01

    synthethase 1 (NOS1) gene were studied in a double-blind, placebo-controlled crossover comparison of budesonide (BUD) Turbohaler 1600 mcg daily vs. placebo in asthmatic schoolchildren. RESULTS: Forty children were included in the study from a screening of 184 asthmatic children with moderately persistent......BACKGROUND: Nitric oxide in exhaled air is regarded as an inflammation marker, and may be used to monitor the anti-inflammatory control from inhaled corticosteroids (ICSs). However, this response to ICSs exhibits a heterogeneous pattern. OBJECTIVE: The study aimed to describe the independent...... raised in 15 children. Allergy and BHR, but none of the other independent variables under study were significantly related to FeNO after BUD1600. CONCLUSION: Exhaled nitric oxide exhibited a heterogeneous response to ICS in asthmatic schoolchildren. Allergy and BHR were driving FeNO level independently...

  10. Oximetry Signal Processing Identifies REM Sleep-Related Vulnerability Trait in Asthmatic Children

    Science.gov (United States)

    Perez, Geovanny F.; Gutierrez, Maria J.; Huseni, Shehlanoor; Pancham, Khrisna; Rodriguez-Martinez, Carlos E.; Nino, Cesar L.; Nino, Gustavo

    2013-01-01

    Rationale. The sleep-related factors that modulate the nocturnal worsening of asthma in children are poorly understood. This study addressed the hypothesis that asthmatic children have a REM sleep-related vulnerability trait that is independent of OSA. Methods. We conducted a retrospective cross-sectional analysis of pulse-oximetry signals obtained during REM and NREM sleep in control and asthmatic children (n = 134). Asthma classification was based on preestablished clinical criteria. Multivariate linear regression model was built to control for potential confounders (significance level P ≤ 0.05). Results. Our data demonstrated that (1) baseline nocturnal respiratory parameters were not significantly different in asthmatic versus control children, (2) the maximal % of SaO2 desaturation during REM, but not during NREM, was significantly higher in asthmatic children, and (3) multivariate analysis revealed that the association between asthma and REM-related maximal % SaO2 desaturation was independent of demographic variables. Conclusion. These results demonstrate that children with asthma have a REM-related vulnerability trait that impacts oxygenation independently of OSA. Further research is needed to delineate the REM sleep neurobiological mechanisms that modulate the phenotypical expression of nocturnal asthma in children. PMID:24288619

  11. Endothelin-1 As A Biochemical Marker in Asthmatic Children Using Induced Sputum Method

    International Nuclear Information System (INIS)

    Endothelin-1 is a physiological normal potent bronchoconstrictor peptide produced in the respiratory airways and increase excessively their inflammation. Endothelin-1 (Et-1) level was measured by radioimmunoassay (RIA) in saliva, sputum and plasma of thirty children suffering from mild to moderate asthma with age ranged from 6-12 years. Ten healthy children of matching age and sex were used as control group. The patients were further classified according to previous regular treatment into 21 steroid dependent and 9 non-steroid dependent. The results revealed that the saliva, sputum and plasma levels of ET-1 in asthmatic patients were significantly higher than that of control children. In both control and asthmatic children, ET-1 levels were more pronounced in the order of saliva>sputum>plasma. On the other hand, the saliva, sputum and plasma levels of ET-1 were significantly lower in steroid dependent asthmatic children than that of the non-steroid dependent ones. High levels of ET-1 in mild to moderate asthmatic children clarify the implication of this biochemical mediator marker in the pathology of the disease. The regular inhaled steroid therapy reduced the level of this mediator but did not return to the basal levels of controls, so, ET-1 antagonist may be useful in management of bronchial asthma in children. Moreover, ET-1 in sputum was more valuable biochemical indicator to monitor airway inflammation than in plasma

  12. Transcriptional characteristics of CD4+ T cells in young asthmatic children: RORC and FOXP3 axis

    Directory of Open Access Journals (Sweden)

    Hamzaoui A

    2011-11-01

    Full Text Available Agnes Hamzaoui1,2,*, Haïfa Maalmi1,*, Anissa Berraïes1,2, Hanadi Abid1,2, Jamel Ammar1,2, Kamel Hamzaoui11Department of Pediatrics and Respiratory Disease, Homeostasis and Cell Dysfunction Unit Research, Abderrahman Mami Hospital, Ariana, Tunisia; 2Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia *These authors contributed to this work equallyBackground: Asthma is a chronic inflammatory disorder, hypothetically caused by autoreactive Th2 cells, whereas Th1 and regulatory T cells may confer protection. The development of Th subpopulations is dependent on the expression of lineage-specific transcription factors.Purpose: This study aimed to assess the balance of CD4+ T cell populations in asthmatic children.Methods: Peripheral blood mononuclear cells (PBMC mRNA expression was assessed in 30 asthmatic children (18 patients with mild asthma and 12 with moderate asthma. Real-time polymerase chain reaction (RT-PCR quantified TBX21, GATA-3, RORC, FOXP3, and EBI3 mRNA expression. Intracellular cytokine expression of IL-2, IL-4, IL-10, and IFN-γ in CD4+ T cells in asthmatic children was measured by flow cytometry. IL-6 and IL-17 cytokines were assessed in serum by enzyme-linked immunosorbent assay (ELISA.Results: A significant increase was found in the percentage of CD4+ and CD8+ T cell-producing IL-4, IL-6, and IL-17. A decreased percentage of CD4+ producing IFN-γ in asthmatic children was found. Expression of GATA-3 (Th2, retinoid-related orphan receptor C (RORC (Th17, and EBI3 were increased in asthmatic patients compared to healthy controls. Expression of FOXP3 (Treg and TBX21 (Th1 were decreased (P < 0.0001 and P < 0.0001 in asthmatic children. Analysis of transcription factor ratios revealed an increase in the RORC/FOXP3 (P = 0.0001, and a significant decrease of TBX21/GATA-3 (P = 0.0001 ratios in patients with asthma.Conclusion: Young asthmatics were characterized by increased IL-4 production and low IFN-γ synthesis. The

  13. Clinical effectiveness of conventional influenza vaccination in asthmatic children

    NARCIS (Netherlands)

    Smits, A J; Hak, E; Stalman, W A B; van Essen, G A; Hoes, A W; Verheij, Th J M

    2002-01-01

    Influenza immunization rates among young asthmatics remain unsatisfactory due to persistent concern about the impact of influenza and the benefits of the vaccine. We assessed the effectiveness of the conventional inactivated trivalent sub-unit influenza vaccine in reducing acute respiratory disease

  14. Modification of the late asthmatic reaction by hyposensitization in asthmatic children allergic to house dust mite (Dermatophagoides pteronyssinus) or grass pollen.

    Science.gov (United States)

    Van Bever, H P; Bosmans, J; De Clerck, L S; Stevens, W J

    1988-07-01

    The frequency and severity of the late asthmatic reaction (LAR) was studied in asthmatic children allergic to house dust mite (HDM) or grass pollen (GP) with and without hyposensitization (HS). The four groups were comparable according to their severity of asthma. All children were allergic to HDM (Dermatophagoides pteronyssinus) or GP according to history, skin testing and specific IgE determination via the RAST. The LAR occurred less frequently (29% versus 73%) (P less than 0.001) and was less severe in children receiving HS. The difference was significant between the children allergic to HDM as well as between children allergic to GP. The immediate asthmatic reaction (IAR) was also less severe in children allergic to HDM who received HS, compared to those who never received HS, (P = 0.033) although the PD20 of the HDM challenge (PD20HDM) was not different between the two groups. In children allergic to GP, there was no difference in PD20 of the GP challenge (PD20GP) or in severity of the IAR, whether the children received HS or not. There was no difference between the PD20HDM in patients who developed a LAR and in patients who did not. There was no relation between the type of asthmatic reaction following the allergen provocation test and the level of circulating immune complexes (CIC) and the level of house dust mite-specific IgG (IgGHDM) or grass pollen-specific IgE (IgGGP) in the different groups, determined before the challenge. There was a decrease in the level of IgG containing CIC (IgGCIC) during the LAR. It is concluded that the LAR occurs less frequently and is less severe in asthmatic children who receive HS. PMID:3414914

  15. 522 Association between Eosinophilic Airway Inflammation and Persistent Airflow Limitation in Asthmatic Children

    OpenAIRE

    Lee, Yong Ju; Lee, Hyun Hee; Kim, Kyung Won; Sohn, Myung Hyun; Kim, Kyu-Earn

    2012-01-01

    Background Eosinophilic airway inflammation contributes to persistent airflow limitation in adults with severe asthma. We aimed to evaluate the association between eosinophilic inflammation in induced sputum and pulmonary function, and persistent airflow limitation in children. Methods A total of 92 asthmatic children and 72 control children were enrolled in this study. Eosinophil count (%) and eosinophil cationic protein (ECP) levels were measured in induced sputum. We performed spirometry a...

  16. Agreement between spirometry and tracheal auscultation in assessing bronchial responsiveness in asthmatic children

    NARCIS (Netherlands)

    Sprikkelman, AB; Schouten, JP; Lourens, MS; Heymans, HSA; van Aalderen, WMC

    1999-01-01

    We have recently found that changes in lung sounds correspond well with a 20% fall in the forced expiratory volume in 1 s (FEV1) after methacholine challenge in asthmatic children. Up to now, little was known about the agreement between a 20% fall in FEV1 and a change in lung sounds after repeated b

  17. Asthmatic symptoms, physical activity, and overweight in young children: A cohort study

    NARCIS (Netherlands)

    Eijkemans, M.; Mommers, M.; Vries, S.I. de; Buuren, S. van; Stafleu, A.; Bakker, I.; Thijs, C.

    2008-01-01

    OBJECTIVE. Prevalence of asthma and overweight has increased simultaneously during the past decades. Several studies have reported an association between these two health problems, but it is unclear whether this relation is causal. We hypothesize that children with asthmatic symptoms are less physic

  18. Exhaled nitric oxide predicts exercise-induced bronchoconstriction in asthmatic school children

    DEFF Research Database (Denmark)

    Buchvald, Frederik; Hermansen, Mette N; Nielsen, Kim G;

    2005-01-01

    used in routine monitoring of pediatric asthma control. The fractional concentration of exhaled nitric oxide (FeNO) also reflects uncontrolled asthma. We hypothesized that FeNO may be used for prescreening of asthmatic children to exclude those with good asthma control unlikely to have EIB, thereby...

  19. Effect of age and eosinophil number on fractional exhaled nitric oxide level in non-asthmatic children in shanghai.

    OpenAIRE

    Wei Liu; Jizhi Chu; Li Sun; Zhiqin Shen; Yan Liu; Qing Peng; Xiwen Gao

    2014-01-01

    This study aimed to identify the relationship between fractional exhaled nitric oxide (FeNO) level and potential factors in non-asthmatic children from Shanghai, China. From March to April 2012, the school-aged children fulfilling the inclusion criteria were recruited. The FeNO levels of non-asthmatic children were detected by the Nano Coulomb nitric oxide analyzer. Questionnaires were recorded, including personal data, family illness history and daily habits. In addition, not only the number...

  20. IgE anti Hepatitis B virus surface antigen antibodies detected in serum from inner city asthmatic and non asthmatic children.

    Science.gov (United States)

    Smith-Norowitz, Tamar A; Tam, Elizabeth; Norowitz, Kevin B; Chotikanatis, Kobkul; Weaver, Diana; Durkin, Helen G; Bluth, Martin H; Kohlhoff, Stephan

    2014-04-01

    Viral Hepatitis type B (HBV) is a public health concern, but has not been linked to asthma. Immunoglobulin (Ig) G is involved in HBV immune responses; less is known about IgE antibodies (Abs) against HBV in asthma. Given the importance of HBV, we sought to determine whether HBV vaccine contributes to asthma in children, by stimulating specific IgE production. Total IgE, IgE- or IgG-anti-HBVs Abs were studied in vaccinated pediatric asthmatics and non asthmatics. We found: (1) total IgE was higher in asthmatics; (2) total IgE did not correlate with IgE anti-HBVs; (3) IgE anti-HBVs did correlate with IgG-anti-HBVs in all subjects; (4)IgE- and IgG-HBVs Abs were similar in both groups; (5) IgE- or IgG anti-HBVs Abs did not correlate with age. Our findings indicate that HBV vaccination induces IgE responses in asthmatics and non asthmatics. PMID:24374043

  1. Relation between nocturnal symptoms and changes in lung function on lying down in asthmatic children.

    OpenAIRE

    A. Greenough; Everett, L.; Pool, J; Price, J.F.

    1991-01-01

    Nocturnal symptoms are common in young asthmatic children. Such symptoms may be caused by increased impairment of lung function when they adopt the supine posture. Thirty one children aged 2.8-8.3 years were studied, of whom 20 had asthma (10 with frequent nocturnal symptoms) and 11 had no respiratory problems (control subjects). Peak expiratory flow (PEF) was measured with a Wright's peak flow meter and functional residual capacity (FRC) by a helium gas dilution technique after 30 minutes of...

  2. Fibroblast-myofibroblast transition is differentially regulated by bronchial epithelial cells from asthmatic children

    OpenAIRE

    Reeves, Stephen R; Kolstad, Tessa; Lien, Tin-Yu; Herrington-Shaner, Sarah; Debley, Jason S.

    2015-01-01

    Background Airway remodeling is a proposed mechanism that underlies the persistent loss of lung function associated with childhood asthma. Previous studies have demonstrated that human lung fibroblasts (HLFs) co-cultured with primary human bronchial epithelial cells (BECs) from asthmatic children exhibit greater expression of extracellular matrix (ECM) components compared to co-culture with BECs derived from healthy children. Myofibroblasts represent a population of differentiated fibroblasts...

  3. Factors attributable to the level of exhaled nitric oxide in asthmatic children

    Directory of Open Access Journals (Sweden)

    Banovcin P

    2009-12-01

    Full Text Available Abstract Background Asthma is a heterogeneous disease with variable symptoms especially in children. Exhaled nitric oxide (FeNO has proved to be a marker of inflammation in the airways and has become a substantial part of clinical management of asthmatic children due to its potential to predict possible exacerbation and adjust the dose of inhalant corticosteroids. Objectives We analyzed potential factors that contribute to the variability of nitric oxide in various clinical and laboratory conditions. Materials and methods Study population consisted of 222 asthmatic children and 27 healthy control subjects. All children underwent a panel of tests: fractioned exhaled nitric oxide, exhaled carbon monoxide, asthma control test scoring, blood sampling, skin prick tests, and basic spirometry. Results FeNO and other investigated parameters widely changed according to clinical or laboratory characteristics of the tested children. Asthmatics showed increased levels of FeNO, exhaled carbon monoxide, total serum IgE, and higher eosinophilia. Boys had higher FeNO levels than girls. We found a significant positive correlation between FeNO levels and the percentage of blood eosinophils, %predicted of forced vital capacity, total serum IgE levels, and increasing age. Conclusions Various phenotypes of children's asthma are characterized by specific pattern of the results of clinical and laboratory tests. FeNO correlates with total serum IgE, blood eosinophilia, age, and some spirometric parameters with different strength. Therefore, the coexistence of atopy, concomitant allergic rhinitis/rhinoconjunctivitis, and some other parameters should be considered in critical evaluation of FeNO in the management of asthmatic children.

  4. Understanding Environmental Tobacco Smoke Exposure and Effects in Asthmatic Children through Determination of Urinary Cotinine and Targeted Metabolomics of Plasma

    Science.gov (United States)

    Understanding Environmental Tobacco Smoke Exposure and Effects in Asthmatic Children through Determination of Urinary Cotinine and Targeted Metabolomics of Plasma Introduction Asthma is a complex disease with multiple triggers and causal factors, Exposure to environmental tob...

  5. Regulatory T cells in induced sputum of asthmatic children: association with inflammatory cytokines

    Directory of Open Access Journals (Sweden)

    Hamzaoui Agnès

    2010-02-01

    Full Text Available Abstract Background and objective CD4+CD25+ regulatory T (Treg cells play an essential role in maintaining immune homeostasis. In this study, we investigated whether the induced sputum (IS pool and the function of CD4+CD25+ Treg cells are altered in asthma pediatric patients. Methods Treg activity was studied in the IS of 40 asthmatic children. CD3+ cells were analyzed for the expression of FoxP3 mRNA by real time reverse transcription-polymerase chain reaction (RT-PCR. IS cells from asthmatics and controls were stained for Treg markers and analyzed by flow cytometry. We also studied the ability of Treg cells to differentiate monocytes toward alternatively activated macrophages (AAM, and to suppress proinflammatory cytokines. Results (i Mild and moderate asthmatics had significantly decreased expression of FoxP3/β-actin mRNA and decreased proportions of CD4+CD25highFoxP3+ cells compared to healthy children; (ii patients with moderate asthma had even lower proportions of FoxP3 expression compared to mild asthmatic patients; (iii monocytes cultured with Treg cells displayed typical features of AAM, including up-regulated expression of CD206 (macrophage mannose receptor and CD163 (hemoglobin scavenger receptor, and an increased production of chemokine ligand 18 (CCL18. In addition, Treg cells from asthmatics have a reduced capacity to suppress LPS-proinflammatory cytokine production from monocytes/macrophages (IL-1, IL-6 and TNF-α. Conclusion Asthma pediatric patients display a decreased bronchial Treg population. The impaired bronchial Treg activity is associated with disease severity.

  6. Effects of Montelukast on free radical production in whole blood and isolated human polymorphonuclear neutrophils (PMNs) in asthmatic children

    Science.gov (United States)

    Al Saadi, Muslim M.; Meo, Sultan Ayoub; Mustafa, Ali; Shafi, Ahmed; Tuwajri, Ali S. Al

    2011-01-01

    Montelukast is a highly selective leukotriene-receptor antagonist (LTRA). It is widely used in the treatment of bronchial asthma, primarily as an adjunct to corticosteroids. Reactive oxygen species (ROSs) play an important role in the pathogenesis of asthma and oxidative stress contributing to the initiation and worsening of inflammatory respiratory disorders, such as asthma. Antioxidant drugs may have a role in minimizing or preventing damage in asthmatic children. The aim of this study was to assess the antioxidant effect of montelukast on the production of free radicals in the whole blood and polymorphonuclear neutrophils (PMNs) in asthmatic children. A group of 48 (38 males and 10 females), apparently healthy asthmatic children were recruited with ages ranging between 6 and 14 years. In asthmatic children, base line (premedication) and post medication free radicals activity in the whole blood and polymorphonuclear neutrophils (PMNs) was determined by measuring chemiluminescence (CL) response through chemiluminescence luminometer. Free radical productions were significantly decreased in the whole blood, when stimulated with Phorbol Myristate Acetate (p < 0.04) and Opsonised Zymosan (p < 0.05). The free radicals were also significantly decreased in isolated polymorphonuclear neutrophils (PMNs) when stimulated with Opsonised Zymosan (p < 0.05) after the post medication treatment of montelukast in asthmatic children. Montelukast decreased the reactive oxygen species production, both in the whole blood as well as isolated PMNs in asthmatic children. PMID:23960762

  7. Cardiorespiratory fitness of asthmatic children and validation of predicted aerobic capacity

    DEFF Research Database (Denmark)

    Lochte, Lene; Angermann, Marie; Larsson, Benny

    2009-01-01

    ). Physical activity level and subjective health showed no differences between groups, or level and categories, respectively. CONCLUSION: The asthmatic participants presented with lower aerobic capacity than controls in both PAC and MAC; therefore, results confirmed the validity of the PAC method. Data......INTRODUCTION: Predicted aerobic capacity (PAC) was estimated by submaximal exercise test and compared with monitored aerobic capacity (MAC) measured by laboratory conditions [maximal oxygen uptake (VO(2peak))] in 18 children and adolescents, 10 asthmatics and 8 matched controls. Objectives...... for statistical evaluation; the method of Bland and Altman estimated the agreement between PAC and MAC; P mean difference between PAC and MAC at follow-up was -1.0 mLO(2)/min...

  8. Variability of pulmonary function test in healthy children, asthmatic and with chronicle lung disease

    International Nuclear Information System (INIS)

    Comparison of sequential pulmonary function tests in the same individual can be used to assess progression of a disease, response to therapy, or response to bronchial provocation. These types of comparisons require an understanding of the factors influencing the variability normally in repeat measurements of lung function. To avoid misleading conclusions about changes in serial measurements, the degree of variability of each test must be considered in their interpretation. The purpose of this study was to examine the degree of intrasubject variability for pulmonary function testing in healthy, asthmatic and children with chronic lung disease (CLD). The tests examined were spirometry, and body plethysmography determination of lung volumes. We studied 21 healthy children, 19 asthmatic patients and 19 children with CLD, testing were done on nine occasions, three times within a day, on three different days, over a period of two months. Short-term variability was defined as the coefficient of variation for the s ix measurements made on days 1 and 2, and the long-term variability as the CV of the nine measurements made on days 1, 2 and 3. Based on the CV measures, children with CLD had significantly more variability in all spirometric values compared with healthy and asthmatic children, except for PEF (P< 0.05) children with CLD had a significantly lower CV for TGV and FRC compared with the other two groups (p < 0.05). Asthmatic children had a significantly higher CV for RV and RV/TLC compared with healthy and children with CLD (p < 0.05). We propose a method to consider changes in pulmonary function tests as significant. The degree of variability and an estimate of the percent change for significance of spirometric and plethysmographic tests must be considered in the interpretation of data to avoid misleading conclusions. The variability of spirometric pulmonary function data in healthy subjects was smaller than that for patients with pulmonary disease, so larger

  9. Adherence to preventive medications in asthmatic children at a tertiary care teaching hospital in Malaysia

    Directory of Open Access Journals (Sweden)

    Md Redzuan A

    2014-02-01

    Full Text Available Adyani Md Redzuan, Meng Soon Lee, Noraida Mohamed Shah Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia Purpose: Asthma affects an estimated 300 million people worldwide. Poor adherence to prescribed preventive medications, especially among children with asthma, leads to increased mortality and morbidity. The purpose of this study was to assess the adherence and persistence levels of asthmatic children at the Universiti Kebangsaan Malaysia Medical Center (UKMMC, a tertiary care teaching hospital, and to determine the factors that influence adherence to prescribed preventive medications. Patients and methods: Participants were asthmatic patients aged 18 years and younger with at least one prescription for a preventive medication refilled between January and December 2011. Refill records from the pharmacy dispensing database were used to determine the medication possession ratio (MPR and continuous measure of gaps (CMG, measures of adherence and persistence levels, respectively. Results: The sample consisted of 218 children with asthma from the General and Respiratory pediatric clinics at UKMMC. The overall adherence level was 38% (n=83; MPR ≥80%, and the persistence level was 27.5% (n=60; CMG ≤20%. We found a significant association between the adherence and persistence levels (r=0.483, P<0.01. The presence of comorbidities significantly predicted the adherence (odds ratio [OR] =16.21, 95% confidence interval [CI]: 7.76–33.84, P<0.01 and persistence level (OR=2.63, 95% CI: 0.13–52.79, P<0.01. Other factors, including age, sex, ethnicity, duration of asthma diagnosis, and number of prescribed preventive medications did not significantly affect adherence or persistence (P>0.05. Conclusion: In conclusion, the adherence level among children with asthma at UKMMC was low. The presence of comorbidities was found to influence adherence towards preventive medications in asthmatic children. Keywords: asthma, persistence

  10. The Efficacy of Montelukast Monotherapy in Moderate Persistent Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Mahir Igde

    2009-09-01

    Full Text Available Although current guidelines place single leukotriene receptor antagonists use as a therapeutic option in mild persistent asthma, there is still uncertainty about its place. In this study efficiency of montelukast monotherapy in children with moderate persistent asthma was evaluated. Children (age 6 to 16 with persistent moderate asthma were treated prospectively with budesonide combined with montelukast (n=20, or only montelukast (n=15 during six months. Asthma symptoms and exacerbations were obtained from diary data. This study suggests that both treatments were effective and well tolerated. It could be concluded that sole montelukast treatment in children with moderate persistent asthma is effective.

  11. Sensitization to neumoallergens influence in mothers of asthmatic children.

    Science.gov (United States)

    Sánchez Palacios, A; Schamann, F; García, J A; Sánchez, M A; Rodríguez, A

    1996-01-01

    Allergy diseases in our province have the characteristic of early appearance of asthma and predominant monosensitization to domestic dust mites due to the climatic condition. In this work we study the influence in allergic children. We selected 1028 mothers that brought their children to hospital for the first time. We divided them in two groups. One was comprised of 459 mothers of atopic children (MA) and another of 569 mothers of non atopic children (MC). All mothers were skin-prick tested (Phazet). The papula area, the mothers with aeroallergen sensitization, were 180 (17.5%) between MA 126 (27.4%) and MC 54 (9.5%). The diagnosis of allergic mothers was higher in MA than in MC. Asthma 8.39%, Rhinitis 4.75% and dermatitis 2%. 53.31% lived on the coast. 51.45% had house moulds. 31% had animals. 34.9% were smokers. There were more adverse drug reactions in MA than in MC. 180 mothers presented sensitization. D. pteronyssinus 66.3%, D. farinae 65.5% Lolium P. 14.55%, Cats 11.6% (MA > MC), Artemisia Vulgaris 6.25% and Cladosporium Herbarum 0.6%. There was no correlation between skin sensitization and domestic animals. There was no influence between children's IgE and mothers with skin sensitization. Skin sensitization to grass pollen correlated with the mother who was living in another country. The mothers who have been living more than five years in our province presented more skin sensitization to aero-allergens.

  12. Sensitization to neumoallergens influence in mothers of asthmatic children.

    Science.gov (United States)

    Sánchez Palacios, A; Schamann, F; García, J A; Sánchez, M A; Rodríguez, A

    1996-01-01

    Allergy diseases in our province have the characteristic of early appearance of asthma and predominant monosensitization to domestic dust mites due to the climatic condition. In this work we study the influence in allergic children. We selected 1028 mothers that brought their children to hospital for the first time. We divided them in two groups. One was comprised of 459 mothers of atopic children (MA) and another of 569 mothers of non atopic children (MC). All mothers were skin-prick tested (Phazet). The papula area, the mothers with aeroallergen sensitization, were 180 (17.5%) between MA 126 (27.4%) and MC 54 (9.5%). The diagnosis of allergic mothers was higher in MA than in MC. Asthma 8.39%, Rhinitis 4.75% and dermatitis 2%. 53.31% lived on the coast. 51.45% had house moulds. 31% had animals. 34.9% were smokers. There were more adverse drug reactions in MA than in MC. 180 mothers presented sensitization. D. pteronyssinus 66.3%, D. farinae 65.5% Lolium P. 14.55%, Cats 11.6% (MA > MC), Artemisia Vulgaris 6.25% and Cladosporium Herbarum 0.6%. There was no correlation between skin sensitization and domestic animals. There was no influence between children's IgE and mothers with skin sensitization. Skin sensitization to grass pollen correlated with the mother who was living in another country. The mothers who have been living more than five years in our province presented more skin sensitization to aero-allergens. PMID:8882754

  13. Characterization of a “high” TNF-α phenotype in moderate-to-severe asthmatic children

    OpenAIRE

    Brown, Sheena D.; Brown, Lou Ann; Stephenson, Susan; Dodds, Jennifer C.; Douglas, Shaneka L.; Hongyan QU; Fitzpatrick, Anne M.

    2015-01-01

    Systemic TNF-α expression is increased in a subset of children with moderate-to-severe asthma despite aggressive corticosteroid treatment and is associated with poor asthma control. Phenotypic-directed TNF-α inhibition may be of benefit in some asthmatic children.

  14. Characterization of a “high” TNF-α phenotype in moderate-to-severe asthmatic children

    Science.gov (United States)

    Brown, Sheena D.; Brown, Lou Ann; Stephenson, Susan; Dodds, Jennifer C.; Douglas, Shaneka L.; Qu, Hongyan; Fitzpatrick, Anne M.

    2015-01-01

    Summary Systemic TNF-α expression is increased in a subset of children with moderate-to-severe asthma despite aggressive corticosteroid treatment and is associated with poor asthma control. Phenotypic-directed TNF-α inhibition may be of benefit in some asthmatic children. PMID:25725987

  15. Seropositivity for Chlamydia Pneumoniae and Mycoplasma Pneumoniae in Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Murat Tutanc

    2014-03-01

    Full Text Available Acute respiratory tract infections may trigger acute asthma attacks and may be held responsible for etiopathogenesis in children with asthma. Although bacterial infections attract a limited amount of attention, recently Chlamydia pneumoniae (CP and Mycoplasma pneumoniae (MP, in particular, are reported to be the possible factors. IgM and IgG seroprevalence was investigated in 66 children patients with bronchial asthma (between the ages of 3 and 14 for CP and Mycoplasma pneumoniae. In a total of 66 cases, 18 (27.2% patients were detected with IgG positivity for CP whereas 27 of them (40.9% were detected with IgG positivity for MP. IgG positivity was determined in 6 patients (13.0% in the control group for CP, and in 6 patients (10.8% in the control group for MP. The rate of the asthma patients with IgG seropositivity for MP was 4 times higher than that of the control group. It was seen that IgG antibody seropositivity for CP was higher in those with more frequent attacks. No such difference was observed in terms of IgG antibody seropositivity for M. pneumoniae. There are many studies indicating that CP and MP infections take an importance place in the etiology of bronchial asthma and asthma attacks in children. The results obtained reveal the effect of both microorganisms on the etiopathogenesis of the bronchial asthma and the increased number of asthma attacks.

  16. Regulatory T cells in induced sputum of asthmatic children: association with inflammatory cytokines

    OpenAIRE

    Hamzaoui Agnès; Ammar Jamel; Hamzaoui Kamel

    2010-01-01

    Abstract Background and objective CD4+CD25+ regulatory T (Treg) cells play an essential role in maintaining immune homeostasis. In this study, we investigated whether the induced sputum (IS) pool and the function of CD4+CD25+ Treg cells are altered in asthma pediatric patients. Methods Treg activity was studied in the IS of 40 asthmatic children. CD3+ cells were analyzed for the expression of FoxP3 mRNA by real time reverse transcription-polymerase chain reaction (RT-PCR). IS cells from asthm...

  17. THE EFFICIENCY OF PHYSICAL THERAPY IN OPTIMIZING THE RESPIRATORY FUNCTION FOR ASTHMATIC CHILDREN

    Directory of Open Access Journals (Sweden)

    Rata Marinela

    2013-12-01

    Full Text Available The purpose of this paper is to highlight the role of physical therapy in the field of respiratory pathology in children, mainly in bronchial asthma. By the hypothesis we want to prove that the intervention through physical therapy applied based on structured programs according to the needs of the subject and implemented by a specific methodology is able to optimize the functionality of asthmatic children. Material. The subjects of the study were three in number, aged 4-6 years, diagnosed with infantile asthma around the age of three years old. The experimental methods were selected based on objective clinical and functional assessment and intervention methods were chosen according with specific objectives, exemplifying respiratory exercises, games with objects and equipment, respiratory flow modulation techniques. Sessions were conducted three times a week totaling an amount of 36 sessions over three months. We obtained favorable results for all evaluated parameters, which were also influenced by the severity and number of occurrences of crises, the precocity of diagnosis and the moment when the treatment program started, the consistency of treatment sessions, the conditions of their entire activity and permanent collaboration between physician, physical therapist and parents. In conclusion, the experiment confirms the effectiveness of respiratory physiotherapy to optimize functionality in asthmatic children. Performing breathing exercises significantly reduces the occurrence of wheezing and improves effort capacity.

  18. Reduction in exhaled nitric oxide immediately after methacholine challenge in asthmatic children

    Science.gov (United States)

    Piacentini, G; Bodini, A; Peroni, D; Del Giudice, M M.; Costella, S; Boner, A

    2002-01-01

    Background: The measurement of exhaled nitric oxide (NO) has recently been proposed as a useful technique for the evaluation of airway inflammation in asthma. The purpose of this study was to determine the effect of methacholine bronchial provocation on the levels of exhaled NO in asthmatic children. Method: Exhaled NO was measurement immediately before and after methacholine provocation in 51 children with mild to moderate asthma. Results: A significant decrease occurred in the level of exhaled NO (p<0.0001) after methacholine bronchial provocation which was not correlated with the percentage fall in forced expiratory volume in 1 second (FEV1). Conclusions: The methacholine test should not be used immediately before measurement of exhaled NO in children with asthma. PMID:12200520

  19. A systematic review of lung function testing in asthmatic young children.

    Science.gov (United States)

    Ioan, Iulia; Varechova, Silvia; Marchal, François; Pleşca, Doina-Anca

    2015-01-01

    Asthma diagnosis is difficult in young children being mainly based on clinical signs and parents' history, which is sometimes difficult to obtain. Lung function testing may improve asthma diagnosis by objectively assessing its main features, airway obstruction, spontaneously reversible or after use of a bronchodilator drug, ventilation inhomogeneity during an acute bronchoconstriction and airway hyperresponsiveness. In young children that cannot cope with classical tests, it is important to use and develop simple, short lasting methods, made in spontaneous ventilation without active cooperation. Such techniques are a measurement of respiratory resistance by forced oscillations or the interrupter technique, of specific airway resistance by plethysmography and capnography. All these parameters are sensitive to the presence of an airway obstruction and to a bronchodilator or bronchoconstrictor agent, but their cutoff values in differentiating between asthmatic and healthy children as well as their specific indications in asthma management remain to be established. PMID:26506667

  20. THEOPHYLLINE-INDUCED ALTERATION IN SERUM ELECTROLYTES AND URIC ACID OF ASTHMATIC CHILDREN

    Directory of Open Access Journals (Sweden)

    R. Amin

    2003-03-01

    Full Text Available Theophylline, (1,3-dimethylxanthine is widely used as a smooth muscle relaxant, myocardial stimulant and a diuretic agent. The most frequent use of theophylline is in treatment of acute and chronic asthma as a bronchodilator.To determine the effect of Theophylline on serum electrolyte and uric acid, 21 asthmatic children (age range 1,5-7 years with severe acute asthma and 25 patients with chronic asthma (5-15 years who were being treated with slow-release theophylline were enrolled in this study. Fifty age and sex matched normal children took part as control. Blood samples (5ml were withdrawn before, during and after completion of the course of intravenous theophylline treatment (0.05-0.70 mg/kg/ hr. Sera obtained were used for analysis of K+, Na+, phosphorus, calcium and uric acid by RA-1000 automated analyzer and the following results were obtained:(1 After treatment, total serum calcium in acute asthmatic patients decreased significantly compared with controls (PWe conclude that the serum levels of phosphate, potassium, calcium and uric acid should be monitored in patient receiving theophylline especially during prolonged use and critical emergency cases.

  1. Effects of nebulized terbutaline on oxygen saturation in acute asthmatic children.

    Science.gov (United States)

    Lin, Y Z; Hsieh, K H; Shih, T Y; Chen, W; Wu, K W

    1994-01-01

    To evaluate the paradoxical effect of oxygen desaturation following beta-2 bronchodilator nebulization treatment in acute asthmatic children, a total of 47 patients, aged between 1.8 and 14 years, 27 males and 20 females, were studied. Twenty ml of nebulized normal saline (NS), followed by 10 mg (4 ml) of terbutaline sulphate solution (TSS) in 20 ml NS, were delivered by an ultrasonic nebulizer in 10 min to each patient through a connecting air tube placed in front of the nose and mouth. Oxygen saturation (SaO2) and pulse rate were monitored, using a pulse oximeter, before study and every two minutes until the end of the study. The clinical severity score and peak expiratory flow rate (PEFR) were checked before the study, at the end of inhalation of NS, and at the end of inhalation of TSS. SaO2 was increased both after nebulized NS and TSS when compared with the pre-study data (p 0.9). No SaO2 decrease after nebulized TSS was observed in any of the seven severe asthmatic children with a prestudy SaO2 < or = 90%. The clinical severity score and PEFR were also significantly improved both after nebulized NS and TSS (p < 0.0001 and p < 0.001, respectively for NS, and both p < 0.0001 for TSS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7942023

  2. Superoxide dismutase levels and peak expiratory flow in asthmatic children

    Directory of Open Access Journals (Sweden)

    Arie Kurniasih

    2016-11-01

    Full Text Available involvevariety of cells such as inflammatory mediators, reactive oxygenspecies (ROS, and cytokines. The inflammatory process would beexacerbated in the presence of oxidative stress. Superoxide dismutase(SOD is the first important enzyme to protect the respiratory tractagainst oxidative stress. The decreased of SOD has a correlation withincreased of airway obstruction and bronchospasm.Objective To assess for a correlation between superoxide dismutase(SOD levels and peak expiratory flow, as well as to determinethe impact of SOD levels for predicting asthma attacks.Methods We conducted a prospective cohort study at Dr. SardjitoHospital, Yogyakarta, between February and April 2011 involvingasthmatic children aged 5-18 years. Subjects’ serum SOD levelsand peak expiratory flow were measured at the same time point.We then performed a prospective study following up on the samesubjects to find out if they had a recurrent asthma attack withinone month of the tests. We also reassessed their peak expiratoryflow one month after blood specimens were obtained.Results Thirty-nine patients were enrolled in this study. Therewas no significant correlation between SOD level and peakexpiratory flow [r=0.289; 95%CI -0.025 to 0.47; P=0.074].However, older age was significantly associated with higher peakexpiratory flow (=0.5; 95%CI 3.10 to 11.57; P=0.01. Lowerlevels of SOD increased the risk of asthma attacks in a monthfollowing the initial measurements (RR=5.5; 95%CI 1.6 to 18.9;P=0.009.Conclusion Superoxide dismutase (SOD level is not significantlyassociated with peak expiratory flow. However, we find arelationship between older age and higher peak expiratory flowand a relationship between lower SOD levels and risk of asthmaattacks within one month following the tests. [

  3. Prevalence of DSM IV anxiety and affective disorders in a pediatric population of asthmatic children and adolescents.

    Science.gov (United States)

    Vila, G; Nollet-Clemençon, C; de Blic, J; Mouren-Simeoni, M C; Scheinmann, P

    2000-06-01

    A series of 82 children and adolescents with moderate and severe persistent asthma was studied. Their psychopathological problems were compared to those of 82 healthy subjects, matched for age, sex and socio-economic status. The patients completed the Child Depression Inventory, an inventory of fears and anxiety (ECAP) and the Coopersmith Self Esteem Inventory. Parents of asthmatic children filled in the Child Behavior Check List to assess their social competence. The patients were examined with the revised Kiddie Schedule for Affective Disorders and Schizophrenia. There were more anxiety symptoms in the asthmatic group than in the control group. Asthmatics were not significantly more depressed than controls and their self-esteem was as good. We found 29 anxiety disorders, four affective disorders and four disruptive behavior disorders. Generalized anxiety disorder was the main diagnosis (n=24). The asthmatic subgroup presenting anxiety and affective disorders had poorer self esteem, fewer activities and worse social competence than other asthmatics and controls. Adolescents did not seem to have more emotional disturbances than younger patients. Girls did not have more DSM IV anxiety or affective disorders than boys. PMID:10802131

  4. Serum Leptin and Adiponectin Levels in Obese and Nonobese Asthmatic School Children in relation to Asthma Control

    Directory of Open Access Journals (Sweden)

    Atqah Abdul Wahab

    2013-01-01

    Full Text Available There is growing evidence of a positive correlation between asthma and obesity in children and adults. Leptin and adiponectin regulate several metabolic and inflammatory functions. This study aims to evaluate serum leptin and adiponectin concentrations in asthmatic school children to investigate their association with obesity and the degree of asthma control. Obese asthmatic (OA and nonobese asthmatic (NOA children, aged 7 to 14, were randomly enrolled in this prospective study. Data on demographic, anthropometric, serum lipids, and spirometric measures and allergy status were collected and analyzed. Serum leptin was significantly higher (25.8±11.1 versus 8.7±11.1; P<0.0001 and adiponectin levels were lower (2.5±1.2 versus 5.4±2.9; P<0.0001 in OA compared to NOA children. The uncontrolled group had higher leptin and lower adiponectin levels compared to well and partially controlled asthma. BMI was positively correlated with leptin (r=0.79; P<0.001 and negatively with adiponectin (r=-0.73; P<0.001. Mean BMI and leptin levels were observed to be higher in girls compared to boys. Stepwise multiple linear regression analysis showed that higher BMI and female gender had significant effect on serum leptin levels. Among asthmatic children higher serum leptin and lower adiponectin levels were significantly associated with obesity and showed no significant association with degree of asthma controls.

  5. [Controlled study of the effect of sports training on cardiopulmonary functions in asthmatic children and adolescents].

    Science.gov (United States)

    Rothe, T; Köhl, C; Mansfeld, H J

    1990-09-01

    The influence of physical training on the cardiopulmonary system and on lung function of asthmatic children was determined in a controlled study. The children were all indoor patients of the Hochgebirgsklinik Davos, Switzerland. 36 children at the age of 10 to 16 years entered the study. They were placed into either a "free running group", a "swimming group" or a "control group." The children of the training groups underwent a training of at least 10 units of 30 minutes each in 3 weeks. The control group did not participate in any regular physical training. Heart rate was measured before and after a bicycle ergometer exercise of 5 minutes at 2.5 watts/kg body weight. This was repeated at the end of the study. In the "free running group" a significant decrease of the heart rate at rest (p less than 0.05) and at the end of bicycle ergometer exercise (p less than 0.01) could be seen. In the "swimming group" the decrease of the latter was significant (p less than 0.05). In both groups an increase in work tolerance could be demonstrated, but not in the "control group." In all three groups an improvement of lung function (IVC, FEV1) was found, but it was not significant in any of the groups. The small improvement might be due to a reduction in allergen exposure and better medical treatment. The study confirms the possibility of physical training of children with asthma even if exercise-induced asthmatic signs and symptoms are present. PMID:2263585

  6. Effect of plastic spacer handling on salbutamol lung deposition in asthmatic children

    DEFF Research Database (Denmark)

    Lipworth, Brian J; Lee, Daniel K C; Anhøj, Jacob;

    2002-01-01

    AIMS: To study the effects of electrostatics in a plastic spacer on the lung deposition of salbutamol in asthmatic children. METHODS: Twenty-five children (5-12 years) with mild asthma were given salbutamol hydrofluoroalkane pressurized metered dose inhaler 400 micro g via a 750 ml plastic spacer...... on separate days. Blood samples were taken for plasma salbutamol at 5, 10, 15 and 20 min after inhalation to measure lung bioavailability as a surrogate for relative lung dose. With immediate inhalation following actuation, a new rinsed spacer (NewRinsed ) was compared with a used spacer after repeated daily...... use (Used ), a spacer rinsed after repeated use (UsedRinsed ) and a spacer primed with benzalkonium chloride to avoid electrostatics (Primed1). In addition, spacers were evaluated using a 15 s inhalation delay following actuation with primed (PrimedDelay) and rinsed (RinsedDelay) spacers. Data were...

  7. Association between allergic rhinitis and hospital resource use among asthmatic children in Norway

    DEFF Research Database (Denmark)

    Sazonov Kocevar, V; Thomas, J; Jonsson, L;

    2005-01-01

    of concomitant allergic rhinitis on asthma-related hospital resource utilization among children below 15 years of age with asthma in Norway. METHODS: A population-based retrospective cohort study of children (aged 0-14 years) with asthma was conducted using data from a patient-specific public national database......BACKGROUND: Preliminary evidence suggests that inadequately controlled allergic rhinitis in asthmatic patients can contribute towards increased asthma exacerbations and poorer symptom control, which may increase medical resource use. The objective of this study was therefore to assess the effect...... of hospital admissions during a 2-year period, 1998-1999. Multivariate linear regression, adjusting for risk factors including age, gender, year of admission, urban/rural residence and severity of asthma episode, estimated the association between allergic rhinitis and total hospital days. A multivariate Cox...

  8. Lung function response to cold air challenge in asthmatic and healthy children of 2-5 years of age

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2000-01-01

    The aim of the study was to assess feasibility, sensitivity, specificity, predictive value, and repeatability of cold, dry air challenge (CACh) as a diagnostic test for asthma in young children 2 to 5 yr of age. Response to a 4-min single-step isocapnic CACh was measured in 38 asthmatics and 29...

  9. Severe and Moderate Asthma Exacerbations in Asthmatic Children and Exposure to Ambient Air Pollutants

    Science.gov (United States)

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

    2016-01-01

    Background: It is well established that short-term exposure to ambient air pollutants can exacerbate asthma, the role of early life or long-term exposure is less clear. We assessed the association between severe asthma exacerbations with both birth and annual exposure to outdoor air pollutants with a population-based cohort of asthmatic children in the province of Quebec (Canada). Method: Exacerbations of asthma occurring between 1 April 1996 and 31 March 2011 were defined as one hospitalization or emergency room visit with a diagnosis of asthma for children (<13 years old) already diagnosed with asthma. Annual daily average concentrations of ozone (O3) and nitrogen dioxide (NO2) were estimated at the child’s residential postal code. Satellite based levels of fine particulate (PM2.5) estimated for a grid of 10 km by 10 km were also assigned to postal codes of residence for the whole province. Hazard ratios (HRs) were estimated from Cox models with a gap time approach for both birth and time-dependant exposure. Results: Of the 162,752 asthmatic children followed (1,020,280 person-years), 35,229 had at least one asthma exacerbation. The HRs stratified by age groups and adjusted for the year of birth, the ordinal number of exacerbations, sex, as well as material and social deprivation, showed an interquartile range increase in the time-dependant exposure to NO2 (4.95 ppb), O3 (3.85 ppb), and PM2.5 (1.82 μg/m3) of 1.095 (95% CI 1.058–1.131), 1.052 (95% CI 1.037–1.066) and 1.025 (95% CI 1.017–1.031), respectively. While a positive association was found to PM2.5, no associations were found between exposure at birth to NO2 or O3. Conclusions: Our results support the conclusion, within the limitation of this study, that asthma exacerbations in asthmatic children are mainly associated with time dependent residential exposures less with exposure at birth. PMID:27490556

  10. Skin Test Reactivity to Fungal Aeroallergens in Asthmatic Children in Southern Iran

    Directory of Open Access Journals (Sweden)

    Reza Amin

    2010-06-01

    Full Text Available The development of asthma appears to involve interplay between host factors and environmental exposures. The most important environmental factors are viral respiratory infections and airborne allergens in consist of sensitization to fungal aeroallergens [1]. Exposure to fungal aeroallergens was reported to be a cause of asthma in many parts of the world.There are few data on the prevalence of allergy to molds in Iran. This study was performed to determine the positive skin prick test to molds and their related risk factors in asthmatic children in Shiraz, southern Iran (Table 1.Skin prick test was done in two hundred and thirty asthmatic children with five types of common fungal aeroallergens (Aspergillus fumigatus, Caldosporium herbarum, Penicillium, Alternaria and Rhizopus.Out of 230 asthmatic children (175 boys, 55 girls with mean age 6.34±3 years, 25 (10.9% had positive skin test to molds. In other studies this rate was reported to be different between 2% to 80%[2]. Of 25 children with positive skin test to molds, the common fungal aeroallergen was Aspergillus followed by Cladosporium, Alternaria, Penicillium and Rhizopus. Amin R et al studied airborne fungal spores in Shiraz. The most important fungi, in order of numbers, had been Altenaria, Aspergilus, Rhizopus and Penicillium[3]. With regard to results of skin prick test in our study, it seems that Alternia is the most common outdoor fungus, but Aspergillus could be the most important indoor fungus.Another study showed in asthmatic patients that main skin test reactivity to fungi was for Aspergillus but most frequent cultured fungus was Cladosporium[4].Of 25 subjects with positive skin test to molds, 5 (20% were females, 20 (80% were residents of urban areas and 4 (56% lived in homes older than ten years. There was no significant correlation between the prevalence of mold skin test positivity in males and females, rural and urban habitats and age of homes.There was no difference in the

  11. Evaluation of new sensitizations in asthmatic children monosensitized to house dust mite by specific immunotherapy.

    Science.gov (United States)

    Harmanci, Koray; Razi, Cem H; Toyran, Muge; Kanmaz, Gozde; Cengizlier, Mehmet R

    2010-03-01

    Specific immunotherapy (SIT) is one of the treatment modalities recomended for the management of asthma and allergic rhinitis by international guidelines. A potential benefit of immunotherapy (IT) is to prevent the development of sensitisation to new allergens. There is stil no conclusion on this subject. One hundred twenty-two children 8-18 years old with intermittent asthma, with or without allergic rhinitis, all of whom were monosensitised to house dust mite (HDM) were selected. Sixty two of these children accepted to receive SIT with HDM extract for 4 years and the remaining 60 did not accept SIT and were treated with asthma medications only. This second group of children served as the control group. At the end of the 4-year study period, 36 of the 53 patients (67.9%) in the SIT group showed no new sensitizations, compared to 38 of 52 (73.0%) in the control group (p = 0.141). The most frequent new sensitizations at the end of the study were pollens, grasses and olive polen, followed by animal dander, alternaria and cockroach. In conclusion, SIT may not prevent the onset of new sensitizations in asthmatic children monosensitized to house dust mites. Further investigation is required to clarify the immunologic mechanisms and other factors by which SIT reduces or not the development of new sensitizations in monosensitized children. PMID:20527510

  12. Lung function and short-term outcome in young asthmatic children

    DEFF Research Database (Denmark)

    Klug, B; Bisgaard, H

    1999-01-01

    technique. Rint, sRaw, Xrs,5 and Rrs,5 were suggestive of impaired lung function in 44%, 14%, 11% and 7.5% of the children, respectively, with a predominance of children aged 2-3 yrs. Sixty-five per cent were treated with inhaled steroids, and 35% were treated only with beta2-agonists as needed; lung......The aims of this study were to investigate lung function in 2-5-yr-old stable asthmatic children consecutively referred from general practitioners and to analyse the outcome on the basis of their requirement for antiasthmatic treatment and symptoms after 1.6-4.5 yrs. Lung function was measured...... in 110 children with a mean+/-SD age of 3.8+/-1.0 yrs using the interruptor technique (resistance assessed using the interruptor technique (Rint)), whole body plethysmography (specific airway resistance (sRaw) and respiratory resistance (Rrs,5)and reactance at 5 Hz (Xrs,5) using the impulse oscillation...

  13. Genetic polymorphism of GSTM1 and antioxidant supplementation influence lung function in relation to ozone exposure in asthmatic children in Mexico City

    OpenAIRE

    Romieu, I; Sienra-Monge, J; Ramirez-Aguilar, M; Moreno-Macias, H; Reyes-Ruiz, N; d Estela,; Hernandez-Avila, M.; London, S.

    2004-01-01

    Background: We recently reported that antioxidant supplementation with vitamins C and E mitigated ozone related decline in forced expiratory flow (FEF25–75) in 158 asthmatic children in an area with high ozone exposure in Mexico City.

  14. The parenting attitudes and the stress of mothers predict the asthmatic severity of their children: a prospective study

    Directory of Open Access Journals (Sweden)

    Sudo Nobuyuki

    2010-10-01

    Full Text Available Abstract Objective To examine relationships between a mother's stress-related conditions and parenting attitudes and their children's asthmatic status. Methods 274 mothers of an asthmatic child 2 to 12 years old completed a questionnaire including questions about their chronic stress/coping behaviors (the "Stress Inventory", parenting attitudes (the "Ta-ken Diagnostic Test for Parent-Child Relationship, Parent Form", and their children's disease status. One year later, a follow-up questionnaire was mailed to the mothers that included questions on the child's disease status. Results 223 mothers (81% responded to the follow-up survey. After controlling for non-psychosocial factors including disease severity at baseline, multiple linear regression analysis followed by multiple logistic regression analysis found chronic irritation/anger and emotional suppression to be aggravating factors for children aged Conclusions Different types of parental stress/coping behaviors and parenting styles may differently predict their children's asthmatic status, and such associations may change as children grow.

  15. Life quality related to health in asthmatic children and their caretaker.

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Gómez Baute

    2005-11-01

    Full Text Available Fundament: In present days it is known that sanitary assistance should not only be focused on patient’s survival (life quantity, but also in the life quality. Objective: to evaluate health-related life quality in children with asthma and their caretakers through 4 measurement devices. Methods: Analytic-prospective-descriptive study to evaluate life quality of children and their caretakers. There was a universe of 72 asthmatic children from the number 32, 37, and 49 clinics of Palmira. For life quality estimation three questionnaires were used. We calculated the standard deviation and measure of the variables. The variations in measurement were evaluated through minimum change difference. Three measurements were realized in one month interval. Results: The 61.8% of patients evaluated with the American college quality test had bad life quality. The evaluation of life quality using the questionnaire of the Mc Master the Juniper University threw a moderate life quality, being the emotive sphere the most affected. The evaluation of life quality in caretakers showed a deterioration.

  16. Influence of housing characteristics on bacterial and fungal communities in homes of asthmatic children.

    Science.gov (United States)

    Dannemiller, K C; Gent, J F; Leaderer, B P; Peccia, J

    2016-04-01

    Variations in home characteristics, such as moisture and occupancy, affect indoor microbial ecology as well as human exposure to microorganisms. Our objective was to determine how indoor bacterial and fungal community structure and diversity are associated with the broader home environment and its occupants. Next-generation DNA sequencing was used to describe fungal and bacterial communities in house dust sampled from 198 homes of asthmatic children in southern New England. Housing characteristics included number of people/children, level of urbanization, single/multifamily home, reported mold, reported water leaks, air conditioning (AC) use, and presence of pets. Both fungal and bacterial community structures were non-random and demonstrated species segregation (C-score, P children, and pets) characteristics. Occupant density measures were associated with beneficial bacterial taxa, including Lactobacillus johnsonii as measured by qPCR. A more complete knowledge of indoor microbial communities is useful for linking housing characteristics to human health outcomes. Microbial assemblies in house dust result, in part, from the building's physical and occupant characteristics. PMID:25833176

  17. Bronchodilation and bronchoprotection in asthmatic preschool children from formoterol administered by mechanically actuated dry-powder inhaler and spacer

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2001-01-01

    resistance (sRaw) in a whole body plethysmograph. Hyperventilation of cold, dry air was used as bronchial challenge, and the responsiveness was estimated as change in sRaw. The bronchoprotective effect of formoterol Turbohaler 9 microg was compared with salbutamol 200 microg and placebo at 15 min, 4 and 8 h......We evaluated the bronchodilatory and the bronchoprotective effect of the long-acting beta(2)-agonist formoterol administered as dry powder from a mechanically actuated dry-powder inhaler (DPI) using spacer in 12 asthmatic children 2 to 5 yr of age. Lung function was measured as the specific airway...... than 4 h. In conclusion, formoterol administered as dry powder in a single dose provided rapid and sustained bronchodilation and clinically significant bronchoprotection for at least 8 h in 2- to 5-yr-old asthmatic children. Furthermore, this study suggests that mechanical actuation of DPI using...

  18. Effects of Montelukast on free radical production in whole blood and isolated human polymorphonuclear neutrophils (PMNs) in asthmatic children

    OpenAIRE

    Al Saadi, Muslim M.; Meo, Sultan Ayoub; MUSTAFA, Ali; Shafi, Ahmed; Tuwajri, Ali S. Al

    2011-01-01

    Montelukast is a highly selective leukotriene-receptor antagonist (LTRA). It is widely used in the treatment of bronchial asthma, primarily as an adjunct to corticosteroids. Reactive oxygen species (ROSs) play an important role in the pathogenesis of asthma and oxidative stress contributing to the initiation and worsening of inflammatory respiratory disorders, such as asthma. Antioxidant drugs may have a role in minimizing or preventing damage in asthmatic children. The aim of this study was ...

  19. [Effects of procaterol on arterial blood gas and pulmonary function in asthmatic children].

    Science.gov (United States)

    Obata, T; Masaki, T; Iikura, Y

    1990-12-01

    We examined the changes in arterial blood gas, FEV1 and V50 after the inhalation of procaterol on 19 occasions in 16 asthmatic children. The initial value of PaO2 had statistically significant correlation with the initial values of %FEV1 and %V50. PaO2 fell down in 11 out of 19 (57.9%) and remarkably decreased more than 5 mmHg in 6 out of 19 (31.6%). The fall in PaO2 was most significant at 5 min after the inhalation in almost subjects. The changes in PaO2 after the inhalation had good correlation with the initial value of %FEV1 and %V50. The initial values were quite lower in the patients with decreased PaO2 more than 5 mmHg than those with increased PaO2. Severe patients showed statistically low values of the initial PaO2 and %V50 and showed a fall in PaO2 after inhalation compared with moderate patients. An increase in A-aDO2 elicited that deteriorations of V/Q ratio caused a decrease in PaO2 after inhalation. There were no significant changes in heart rates and no complaints of nausea, headache or tremor.

  20. Innovative approach to laser acupuncture therapy of acute obstruction in asthmatic children

    Directory of Open Access Journals (Sweden)

    Nedeljković Miroslav

    2008-01-01

    Full Text Available Introduction A prospective randomized study encompassed 100 patients with asthma in the stage of acute bronchial obstruction, 7 to 17 years of age, of both sexes and with the similar rate of attack seventy. The patients were spirometrically monitored (FVC, FEVl, PEF and FEF 25-75% by a pediatrician-pulmonologist for 12 days. Fifty patients were subjected to conservative drug therapy, whereas other 50 patients additionally underwent the Su Jok therapy according to the 6-Ki principles, applying laser ray at the acupuncture points in the hand. After 12 days of treatment the group, in which both therapy methods were applied, reached the range of referent values for all investigated parameters. In the same period of time the group undergoing only conservative drug therapy retained values below the reference ones for the given age for 3 (FEVl, PEFR and FEF 25-75% out of 5 investigated parameters. The obtained results differed from the group subjected to the combined therapy with the high rate of statistical significance. On the basis of the obtained results the efficacy of the 6-Ki technique of Su Jok therapy was confirmed as the therapeutic method supplementary to the conservative drug therapy in the treatment of acute bronchial obstruction in asthmatic children, provided that therapy is carried out in stationary conditions and under constant spirometric surveillance of the patient.

  1. The relationship between serum vitamin D level and asthma severity in asthmatic children (aged 1-15 years) in Ardabil, 2012-13

    OpenAIRE

    Farzad Ahmadabadi; Mehrdad Mirzarahimi; Manouchehr Barak; Adel Ahadi; Rasoul Alipour

    2015-01-01

    Background: Vitamin D plays an important role in many immune and allergic diseases, and its deficiency is more in areas with low solar radiation. Asthma is a common disease in children of Ardabil city. The present study was designed to evaluate vitamin D levels in asthmatic children in Ardabil. Methods: A total of 100 asthmatic children (40% boys and 60% girls) with a mean age of 5.7 +/- 3.46 years (1-15 years) and who visited the Bou-Ali pediatric hospital were included. Vitamin D levels...

  2. Usefulness of a Clinician Rating Scale in Identifying Preschool Children with ADHD

    Science.gov (United States)

    Gopin, Chaya; Healey, Dione; Castelli, Katia; Marks, David; Halperin, Jeffrey M.

    2010-01-01

    Objective: To ascertain the psychometric properties and clinical utility of the Behavioral Rating Inventory for Children (BRIC), a novel clinician inventory for preschoolers. Method: Completion of the BRIC for 214 preschoolers follows 2 evaluation sessions, generally separated by less than 2 weeks. Items are submitted to a Principal Components…

  3. Indoor allergens and microbial bio-contaminants in homes of asthmatic children in central Taiwan.

    Science.gov (United States)

    Wu, Francis Fu-Sheng; Siebers, Robert; Chang, Chin-Fu; Hsieh, Shu-Wen; Wu, Mei-Wen; Chen, Chi-Ying; Pierse, Nevil; Crane, Julian

    2009-09-01

    Indoor allergens and microbial bio-contaminants play a significant role in asthma symptoms. The aim of the study was to determine levels of house dust mite allergens, bacterial endotoxin, and fungal beta-glucan in homes of 120 asthmatic children in central Taiwan. Dust samples from 120 mattresses (67 double-sided) were analyzed for house dust mite allergens (Der p 1, Der f 1, and Blo t 5), endotoxin, and beta-glucan. Pillows (n = 118) were analyzed for house dust mite allergens only. Kitchen dust samples were analyzed for the cockroach allergen, Bla g 1. Blo t 5 was detected in 9.3% pillows and 82.2% mattresses, Der p 1 in 95.8% pillows and 93.2% mattresses, and Der f 1 in 82.2% pillows and 83.1% mattresses. Geometric mean levels (95% confidence interval) of endotoxin and beta-glucan in mattresses were 108.4 Eu/mg (81.4-144.2) and 25.2 microg/g (22.7-28.0), respectively. House dust mite allergens and endotoxin levels were significantly lower on the bamboo side of 67 mattresses, compared to the inner sprung mattress side. Geometric mean of kitchen Bla g 1 was 0.61 U/g (95% CI: 0.43-0.85). Given the presence of Der p 1, Der f 1 and Blo t 5 in central Taiwan, it is advised to measure allergens of all three house dust mite species to obtain a true index of allergen exposure. Bamboo sides of mattresses had significantly lower house dust mite allergens and endotoxin levels. PMID:19728217

  4. Effect of house dust mite immunotherapy on interleukin-10-secreting regulatory T cells in asthmatic children

    Institute of Scientific and Technical Information of China (English)

    WANG Wei; XIANG Li; LIU Yong-ge; WANG Yong-hong; SHEN Kun-ling

    2010-01-01

    Background Subcutaneous specific immunotherapy has been demonstrated to be capable of inducing T-cell regulatory response.Interleukin-10 (IL-10) plays a crucial role in inducing allergen-specific tolerance.However the reports of the changes of IL-10 in house dust mite (HDM)-specific immunotherapy were varied.The aim of this study was to evaluate the function of IL-10-secreting regulatory T cells in asthma children successfully treated with HDM immunotherapy.Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 27 patients following 1.5--2 years of HDM-specific immunotherapy (SIT, SIT group) and from 27 matched treated asthmatic children allergic to HDM (asthmagroup).After 48 hours of in vitro stimulation with HDM extracts, IL-10-secreting regulatory T cells were measured by four colour flow cytometry.Sera were tested for allergen-specific IgG4 and IgE using the Immuno CAP 100 assay.Results PBMCs from children undergoing immunotherapy following HDM extracts stimuli produced significantly more IL-10 compared with the asthma group.The frequency of iTreg cells and aTreg cells increased in SIT group after HDM stimulation, while it was not affected in the asthma group.Among the iTreg cells and aTreg cells, the frequency of CD4+CD25-Foxp3-IL-10+ Treg cells increased the most which was 2 times higher than that in unstimulated cultures in SIT group.The levels of HDM-specific IgG4 of SIT group was significiently higher compared with asthma group, but there was no correlation of the levels of HDM-specific IgG4 and IL-10 secreting Treg cells.Conclusions HDM-specific immunotherapy can successfully upregulate the frequency of IL-10-secreting Treg cells.CD4+CD25-Foxp3-IL-10+ Treg cells may play a key role in inducing the immune tolerance in HDM-specific immunotherapy.

  5. "Assessment of Quality of Life in Iranian Asthmatic Children,Young Adults and Their Caregivers "

    Directory of Open Access Journals (Sweden)

    Fariborz Zieh

    2006-06-01

    The questionnaires after statically analysis showed good levels of both longitudinal and cross sectional correlations with the conventional asthma indices and with general quality of life. We found that consistently QOL in boys were more disturbed than females, a good relevancy between severity of asthma and QOL scores and more disturbances of QOL in caregivers of male asthmatic patients than caregivers of female asthmatic patients. We could not find any significant relevancy between FEV1 percentage of predicted and overall scores of QOL. Smaller airways, and higher airway resistance and more activity of males than females may explain why boys have more disturbed life style than females.

  6. Preparation of Mental Health Clinicians to Work with Children with Co-Occurring Autism Spectrum Disorders and Mental Health Needs

    Science.gov (United States)

    Williams, Marian E.; Haranin, Emily C.

    2016-01-01

    Up to 70% of children with autism spectrum disorders (ASD) have a co-occurring mental health disorder; however, many clinicians feel unprepared to serve children with complex co-occurring conditions. This study surveyed 64 mental health clinicians working in 21 publically-funded mental health agencies in a large urban setting to explore their…

  7. The impact of vitamin D deficiency on immune T cells in asthmatic children: a case-control study

    Directory of Open Access Journals (Sweden)

    Maalmi H

    2012-05-01

    Full Text Available Haïfa Maalmi,1,2 Anissa Berraïes,1,2,3 Eya Tangour,1,2,3 Jamel Ammar,1,2,3 Hanadi Abid,1,2,3 Kamel Hamzaoui,1,2 Agnes Hamzaoui1,2,31Department of Basic Sciences, Medicine School of Tunis, University Tunis El Manar, Tunis; 2Unit Research, Homeostasis and Cell Dysfunction, Ariana; 3Department of Pneumopediatry, A Mami Hospital, Ariana, Tunisia Background: Vitamin D exerts profound effects on both adaptive and innate immune functions involved in the development and course of autoimmune and inflammatory diseases. As the incidence of vitamin D insufficiency is surprisingly high in the general population, experimental studies have started to investigate whether vitamin D levels (measured as serum 25 hydroxy vitamin D-25[OH]D are correlated with immune cells and clinical parameters.Purpose: The aim of the present research was to investigate serum vitamin D status in a case-control study in children with asthma and to study associations between vitamin D levels and certain immunological parameters.Materials and methods: A case control study of thirty-nine children with clinically controlled asthma was enrolled to assess the relationship between serum vitamin D concentrations and disease activity. Vitamin D was assayed with a radioimmunoassay kit. We evaluated the relationship between vitamin D concentrations and forced vital capacity (FVC, forced expiratory volume in 1 second (FEV1, and the FEV1/FVC ratio. Correlations between inflammatory mediators, Th1, Th2, Th17, and regulatory T cells (Treg and vitamin D were investigated.Results: Only 15.38% of our asthmatic children had a sufficient serum 25(OHD (≥30 ng/mL whereas 80% of healthy children expressed sufficient levels. Deficient values of vitamin D (<20 ng/mL were observed in 17 (43.59% asthmatic patients (14.40 ± 3.30 ng/mL; P = 0.0001. Deficiency was not observed in controls. Th1/Th2 ratio was significantly correlated to 25(OHD level (r = 0.698; P = 0.0001. A significant negative correlation

  8. Relationship between Emotion, Severity of Illness and the Effect on IL-8 in Asthmatic Children%儿童情绪与哮喘病情的关系及对IL-8的影响

    Institute of Scientific and Technical Information of China (English)

    牛轶; 程自立; 王高华; 姜毅

    2002-01-01

    Objective: To examine the emotional states o f asthmatic children wit h different degrees of severity, as well as the effects of emotion on change of cytokines in airway. Methods: Asthmatic children were divi ded into two groups ac cording to the degrees of severity: moderate and mild. Their emotional states we re measured and results were compared. Correlation analysis was conducted betwee n scores on emotional scales and sputum levels of IL-8.Results: Total scores on anxiety and depression were higher in the moderate group than in the mild group. Negative correlation was found between levels of anxiety and IL-8 during acute exacerbation of asthmatic condition. Conclusion: Emotional distress was found to be increased with severity of asthmatic condition in children. Anxiety contribu ted to the decreased concentration of IL-8 in asthmatic children's airway.

  9. Effect of age and eosinophil number on fractional exhaled nitric oxide level in non-asthmatic children in shanghai.

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2014-10-01

    Full Text Available This study aimed to identify the relationship between fractional exhaled nitric oxide (FeNO level and potential factors in non-asthmatic children from Shanghai, China. From March to April 2012, the school-aged children fulfilling the inclusion criteria were recruited. The FeNO levels of non-asthmatic children were detected by the Nano Coulomb nitric oxide analyzer. Questionnaires were recorded, including personal data, family illness history and daily habits. In addition, not only the number of leukocytes and eosinophils but also the level of hemoglobin in peripheral blood, were measured via the automated blood cell analyzer. All data were statistically analyzed with SPSS version 17.0 software and the correlation of these potential factors with FeNO level was calculated via Kendall's rank correlation. A total of 132 healthy children (aging 6-13 years were enrolled in Minhang District, Shanghai, China. The mean value of FeNO level was 15.05 ppb. The correlation analyses revealed that age (R=0.190, p=0.029 and eosinophil number (R=0.575, p=0.000 were significantly and positively correlated with FeNO levels. The FeNO levels of individuals aged 10-13 years was significantly higher than those of the individuals aged 6-9 years (22.65 ± 18.82 ppb vs. 15.28 ± 9.78 ppb, p<0.05. However, other potential factors were not significantly correlated with FeNO level. The FeNO levels in healthy school-aged children may reflect airway eosinophilic inflammation levels, and was affected by eosinophil count and age significantly.

  10. Effects of dermatophagoides pteronyssinus allergen-specific immunotherapy on the serum interleukin-13 and pulmonary functions in asthmatic children

    Institute of Scientific and Technical Information of China (English)

    CHEN Zhuang-gui; LI Ming; CHEN Yan-feng; JI Jing-zhi; LI Ya-ting; CHEN Wei; CHEN Fen-hua; CHEN Hong

    2009-01-01

    Background Airway remodeling is the specific pathological characteristics of asthma, which is related to the clinical symptoms, pulmonary function, and airway hyperreactivity. This study aimed at exploring the effects of dermatophagoides pteronyssinus allergen-specific immunotherapy (SIT) on the serum interleukin (IL)-13 and pulmonary functions in asthmatic children.Methods Fifty-eight pediatric asthma patients allergic to dust mite participated in this study. Thirty-five children received SIT with a standardized dermatophagoides pteronyssinus extract for one year (SIT group), and the other 23 children treated with inhaled corticosteroids (ICS group) according to the Global Initiative for Asthma (GINA) for one year. Serum levels of IL-13, IL-4 and interferon (IFN)-y were examined and the pulmonary functions were checked before and after the treatment.Results After the treatment, the number of emergency visiting for asthma attack in SIT group was significantly less than that in ICS group. The serum levels of IL-4 and IL-13 were clearly reduced, IFN-γ and the ratio of IFN-γ/IL-4 were significantly increased, the pulmonary functions (forced vital capacity (FVC), forced expiratory volume in one second percentage (FEV1%) and peak expiratory flow percentage (PEF%) were significantly improved in the SIT group.Meanwhile, IFN-y and the ratio of IFN-γ/IL-4 were greatly increased, but serum levels of IL-4 and IL-13 had less changes,the pulmonary functions (FVC, FEV1% and PEF%) were poorly improved in ICS group. The basic pulmonary functions in both groups were at the same level, which had made more improvement in SIT group than in ICS group one year later.Conclusions One year of dermatophagoides pteronyssinus SIT can significantly reduce the frequencies of emergency visiting for asthma attack and improve the pulmonary functions of children with allergic asthma, and that is attributed to SIT, which can reduce the levels of IL-4 and IL-13 and regulate the imbalance of the

  11. Yoga as a Complementary Therapy for Children and Adolescents: A Guide for Clinicians

    OpenAIRE

    Kaley-Isley, Lisa C.; Peterson, John; Fischer, Colleen; Peterson, Emily

    2010-01-01

    Yoga is being used by a growing number of youth and adults as a means of improving overall health and fitness. There is also a progressive trend toward use of yoga as a mind-body complementary and alternative medicine intervention to improve specific physical and mental health conditions. To provide clinicians with therapeutically useful information about yoga, the evidence evaluating yoga as an effective intervention for children and adolescents with health problems is reviewed and summarize...

  12. Discriminative capacity of bronchodilator response measured with three different lung function techniques in asthmatic and healthy children aged 2 to 5 years

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2001-01-01

    as compared with placebo in healthy control subjects. Lung function improved to a significantly greater extent in asthmatic children than in control subjects as reflected by all methods. sRaw provided the best discriminative power of such a bronchodilator response, with a sensitivity of 66% and specificity...

  13. ASSESSING ASTHMATIC CHILDREN'S EXPOSURES TO TOXIC AIR POLLUTANTS AND THE POTENTIAL INHALED DOSES USING TIME ACTIVITY INFORMATION AND ENERGY EXPENDITURE DATA

    Science.gov (United States)

    Accurately quantifying human exposures and the potential doses of various populations to environmental pollutants is critical for the U.S. Environmental Protection Agency to assess and manage human health risks. The Tampa Asthmatic Children's Study (TACS) was a pilot research stu...

  14. Comparative efficacy of terbutaline sulphate delivered by Turbuhaler dry powder inhaler or pressurised metered dose inhaler with Nebuhaler spacer in children during an acute asthmatic episode

    OpenAIRE

    Drblik, S; Lapierre, G; Thivierge, R; Turgeon, J; Gaudreault, P; Cummins-McManus, B; Verdy, I; Haddon, J; Lee, J.; Spier, S

    2003-01-01

    Aims: To compare the efficacy of terbutaline sulphate delivered via Turbuhaler with a pressurised metered dose inhaler (pMDI) connected to Nebuhaler spacer in a population of asthmatic children presenting to emergency departments because of an acute episode of asthma.

  15. 哮喘儿童行为异常的心理社会因素分析%Analysis the influence factor of asthmatic children's behavioral problems

    Institute of Scientific and Technical Information of China (English)

    王德颖; 孙月吉; 阎楠; 林媛; 赵广东; 景淑君; 张忠鲁; 陈锦波; 宋超英

    2008-01-01

    目的 探讨哮喘儿童的行为问题与哮喘儿童的气质、个性及父母教养方式之间的关系.方法 随机抽取45例儿童哮喘患者与69例正常儿童,应用自制哮喘儿童问卷、Achenbach儿童行为量表(CBCL)、儿童艾森克个性测试(EPQ)、儿童气质问卷、父母教养方式问卷(EMBU)进行调查分析.结果 1.儿童行为:哮喘儿童组与正常对照组在总粗分、学习能力、分裂性、交往不良和强迫性因子上差异有显著性(t=2.778~3.805,P<0.05).2.儿童气质:4~7岁哮喘组与正常对照组儿童在规律性因子上差异有显著性(t=2.602,P<0.05).哮喘儿童气质的活动水平与哮喘儿童的行为问题的总粗分、分裂性、强迫性、攻击性和违纪因子存在正相关(r=0.451~0.804,P<0.05).反应强度与分裂性因子呈正相关(r=0.444,P<0.05).3.儿童人格(EPQ):8~14岁哮喘儿童和正常对照儿童人格差异无显著性(P>0.05).4.父母教养方式:哮喘组与正常对照组只在父偏爱和母偏爱两个维度上差异有显著性(t=2.946,2.997,P<0.05).哮喘儿童的行为问题与哮喘儿童父母的教养方式之间无相关性(P>0.05).5.多元线性回归显示哮喘儿童行为问题与儿童气质的活动水平,规律性及父母教养方式的母拒绝有关.结论 哮喘儿童与正常对照儿童相比存在更多的行为问题;哮喘儿童的行为问题与哮喘儿童的气质相关,与儿童人格和父母教养方式无相关性.%Objective To explore the relationship between asthmatic children's behavioral problems and asthmatic children's temperaments,personalities,their EMBU. Methods 45 outpatient cases of asthmatic children and 69 cases of non-asthmatic children were investigated with Eysenck's personality Questionaire (EPQ), Egma Minnen av Bardndosnaupp for stran (EMBU), Child Behavior Checklist (CBCL) and Children Temperament Questionnaire. Results ⑴Behavior:5 items had significant different between asthmatic and

  16. Pharmacokinetic Comparison of Inhaled Fixed Combination vs. the Free Combination of Beclomethasone and Formoterol pMDIs in Asthmatic Children

    DEFF Research Database (Denmark)

    Chawes, Bo; Piccinno, A; Kreiner-Møller, E;

    2013-01-01

    and adverse events were monitored. RESULTS: 20 subjects were evaluable. The systemic exposure of B17MP and Formoterol administered as fixed combination did not exceed the free combination: B17MP AUC(0-t) (hours(2) pg/mL) ratio Test/Reference [90% CI], 0.81 [0.697-0.948] and Formoterol AUC(0-t) (hours(2) pg......AIM: The fixed combination of Beclomethasone (BDP) and Formoterol pMDI (Foster®, Chiesi Farmaceutici) is being developed in the lower strength (BDP/Formoterol: 50/6μg) to provide an appropriate dosage in children with asthma. The aim of this work was to investigate the systemic bioavailability of B......17MP (active metabolite of BDP) and Formoterol after single inhalation of Foster® pMDI 50/6μg vs. the free combination of BDP and Formoterol pMDIs in asthmatic children. METHODS: 5-11-year-old children inhaled BDP 200μg and Formoterol 24μg as fixed vs. free combination in an open label, randomized, 2...

  17. Comparisons of the complementary effect on exhaled nitric oxide of salmeterol vs montelukast in asthmatic children taking regular inhaled budesonide

    DEFF Research Database (Denmark)

    Buchvald, Frederik; Bisgaard, Hans

    2003-01-01

    . OBJECTIVE: To compare the control of FeNO provided by salmeterol or montelukast add-on therapy in asthmatic children undergoing regular maintenance treatment with a daily dose of 400 microg of budesonide. METHODS: The study included children with increased FeNO despite regular treatment with budesonide, 400...... microg/d, and normal lung function. Montelukast, 5 mg/d, salmeterol, 50 microg twice daily, or placebo was compared as add-on therapy to budesonide, 400 microg, in a randomized, double-blind, double-dummy, crossover study. RESULTS: Twenty-two children completed the trial. The geometric mean FeNO level...... was 20 ppb (95% confidence interval [CI], 15-27 ppb) after salmeterol, which was significantly higher than after montelukast (mean, 15 ppb; 95% CI, 11-18 ppb; P = 0.002) and placebo (mean, 15 ppb; 95% CI, 10-21 ppb; P = 0.03). There was no difference in FeNO between the montelukast and placebo groups...

  18. A multi-strain Synbiotic may reduce viral respiratory infections in asthmatic children: a randomized controlled trial

    Science.gov (United States)

    Ahanchian, Hamid; Jafari, Seyed Ali; Ansari, Elham; Ganji, Toktam; Kiani, Mohammad Ali; Khalesi, Maryam; Momen, Tooba; Kianifar, Hamidreza

    2016-01-01

    Background and objective Asthma is a growing problem worldwide. Acute exacerbations impose considerable morbidity, mortality, and increased cost. Viral respiratory infections are the most common cause (80–85%) of pediatric asthma exacerbations and admissions to the hospital. The aim of this study was to determine the effect of a new synbiotic Lactocare® on viral respiratory infections and asthma exacerbations in asthmatic children. Methods In this double blind, placebo-controlled, randomized clinical trial, 72 children with mild persistent asthma, aged between 6 and 12 years, were randomized to receive either Lactocare®, a Synbiotic containing 1 billion CFU/Capsule of Lactobacillus casei, Lactobacillus rhamnosus, Streptococcus thermophilus, Bifidobacterium breve, Lactobacillus acidophilus, Bifidobacterium infantis, Lactobacillus bulgaricus, and Fructooligosacharide (Zist Takhmir, Tehran, Iran) or placebo daily for 60 days. The primary outcome was the number of viral respiratory infections, and secondary outcomes were school absence, salbutamol and prednisolone usage, outpatient visits, and hospital admission for asthma. The outcomes were compared among study groups using the SPSS 11.5 program and the Mann Whitney and Fisher exact tests. Results Of the 72 children who were enrolled with mild persistent asthma, 36 were assigned randomly to be treated with synbiotic and 36 with placebo. The number of viral respiratory infections was significantly higher in placebo group than the synbiotic group during the first month of intervention (0.74 ± 0.12 vs. 0.44 ± 0.1, p < 0.007) but not during the second month (0.5 ± 0.8 vs. 0.5 ± 0.8, p < 0.641). Considering the total duration of the study (two months), infection episodes also were significantly lower in the synbiotic group (0.92 ± 0.15 vs. 0.69 ± 0.11, p < 0.046). Salbutamol consumption was significantly lower in the synbiotic group, but there were no significant differences in school absenteeism, oral

  19. Association of Body Mass Index with Asthma Severity and Pulmonary Function among Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Rasuol Nasiri Kalmarzi

    2016-09-01

    Full Text Available Background Asthma is a chronic inflammatory disease in respiratory system and obesity is another inflammatory disease which incidence rate is increasing. Although, many studies have been conducted on severity of asthma and its relationship with obesity, but different results have been obtained. This study aimed to determine a relationship between asthma severity, Body Mass Index (BMI and pulmonary function in Kurdistan province, Iran. Materials and Methods: In this cross sectional study 90 asthmatic patients referred to referral hospital in Kurdistan, North West of Iran, were selected by simple random method. BMI was calculated by dividing weight by height.Pulmonary Function Test (PFT and bronchial-stimulation-test were used for confirmation and investigation of asthma severity. Data were analyzed using SPSS-15 and Chi-square and spearman correlation coefficient tests. Results: Relationship between BMI and severity of asthma (mild, medium and severe was evaluated, there was a relationship and positive relationship between them (P

  20. [Continuous nebulization with terbutaline sulfate under tent inhalation. Evaluation of the efficacy in children 2 to 5 years of age in asthmatic crises].

    Science.gov (United States)

    Lotufo, J P; Ejzenberg, B; Vieira, S; Mukai, L; Macedo, H; Yamashita, C; Ventura, G; Baldacci, E R; Okay, Y

    1998-06-01

    This study investigated the efficacy of a system for continuous nebulization of terbutaline sulphate in the treatment of acute asthmatic crises in children. The equipment consisted of a condensation nebulizer attached to a 40 liter acrylic tent placed around the patient's head. A prospective, randomized and open clinical trial was conducted. Twenty eight children, 2 to 5 year-old, in acute asthmatic crises were selected. Fourteen were nebulized with terbutaline sulphate while in the control group the aerosolization was proceeded only with half diluted physiologic serum. All patients were administered aminophyline intravenously. The parameter used to evaluate the efficacy of the terbutaline sulphate nebulizing system was clinical improvement measured by the Wood-Downes Score. Two additional parameters indicating terbutaline sulphate absorption were used: reduction of potassium seric levels and positive chronotropic effect. The group treated with terbutaline sulphate showed greater clinical improvement than control group at the 12 hour protocol evaluation as well as lower seric potassium level. A positive chronotropic effect was also observed at the final protocol evaluation. The data showed, preliminarily, that (a) the system for continuous nebulization of terbutaline sulphate was effective in treatment of children's acute asthmatic crises, and (b) there was evidence attesting to the absorption of terbutaline sulphate by the children treatment with it. PMID:9677633

  1. Screening for Social Determinants of Health Among Children and Families Living in Poverty: A Guide for Clinicians.

    Science.gov (United States)

    Chung, Esther K; Siegel, Benjamin S; Garg, Arvin; Conroy, Kathleen; Gross, Rachel S; Long, Dayna A; Lewis, Gena; Osman, Cynthia J; Jo Messito, Mary; Wade, Roy; Shonna Yin, H; Cox, Joanne; Fierman, Arthur H

    2016-05-01

    Approximately 20% of all children in the United States live in poverty, which exists in rural, urban, and suburban areas. Thus, all child health clinicians need to be familiar with the effects of poverty on health and to understand associated, preventable, and modifiable social factors that impact health. Social determinants of health are identifiable root causes of medical problems. For children living in poverty, social determinants of health for which clinicians may play a role include the following: child maltreatment, child care and education, family financial support, physical environment, family social support, intimate partner violence, maternal depression and family mental illness, household substance abuse, firearm exposure, and parental health literacy. Children, particularly those living in poverty, exposed to adverse childhood experiences are susceptible to toxic stress and a variety of child and adult health problems, including developmental delay, asthma and heart disease. Despite the detrimental effects of social determinants on health, few child health clinicians routinely address the unmet social and psychosocial factors impacting children and their families during routine primary care visits. Clinicians need tools to screen for social determinants of health and to be familiar with available local and national resources to address these issues. These guidelines provide an overview of social determinants of health impacting children living in poverty and provide clinicians with practical screening tools and resources. PMID:27101890

  2. Screening of the FcεRI-β-Gene in a Swiss Population of Asthmatic Children: No Association with E237G and Identification of New Sequence Variations

    Directory of Open Access Journals (Sweden)

    M. Rohrbach

    1998-01-01

    Full Text Available Background: The gene of the beta subunit of the high affinity receptor for IgE (FcεRI-β encoded on chromosome 11q13 has recently been identified as a candidate gene for asthma and atopy. Two coding variations, E237G and I181L have been described as being associated with asthma and atopy. Our aim was to investigate a Swiss population of atopic and asthmatic children for variations in this gene.

  3. 哮喘患儿和非哮喘儿童血中抗肺炎链球菌荚膜多糖IgG水平的差异%The difference of anti-pneumococcal capsular polysaccharide IgG levels in plasma of asthmatic and non-asthmatic children

    Institute of Scientific and Technical Information of China (English)

    陈蒙; 田曼; 陆悦倩; 赵德育

    2013-01-01

    Objectives To explore the humoral immunologic mechanisms of the susceptibility to invasive pneumococcal diseases (IPD) in asthmatic children. Methods Plasma samples were collected from 43 asthmatic and 20 non-asthmatic chil-dren. Anit-pneumococcal capsular polysaccharide (PPS)-IgG concentrations were measured by enzyme-linked immunosorbent assays. Results The mean concentrations of anti-PPS 14, 19A and 23F-IgG were signiifcantly higher in asthmatic children than in non-asthmatic children (P<0.05). The ratios of the asthmatic children who had anti-PPS 14, 19A and 23F-IgG concentrations higher than the protective antibody level (≥0.2 µg/ml ) were 100%for all the serotypes. Conclusions The immune responses of producing anti-PPS IgG to defense IPD were normal in asthmatic children. Asthmatic children may be more susceptive to pneumococcal infection or colonization than non-asthmatic children.%目的:探讨哮喘患儿对侵袭性肺炎链球菌疾病(IPD)易感性的体液免疫机制。方法收集43例哮喘患儿和20例非哮喘择期手术患儿的血浆标本,用酶联免疫吸附法(ELISA)测定并比较两组血中抗肺炎链球菌荚膜多糖(PPS)IgG水平。结果哮喘患儿血中抗PPS-14、19A及23F 3种血清型IgG水平均高于非哮喘儿童,差异有统计学意义(P均<0.05);其3型IgG水平达到保护性抗体水平(≥0.2µg/ml)以上的比例均为100%。结论哮喘患儿体内防御IPD的抗PPS-IgG免疫功能正常,但哮喘患儿可能比非哮喘儿童更容易发生肺炎链球菌感染或定植。

  4. Airway resistance measurements in pre-school children with asthmatic symptoms : The interrupter technique

    NARCIS (Netherlands)

    Kooi, EMW; Schokker, S; van der Molen, T; Duiverman, EJ

    2006-01-01

    Measuring airway resistance in pre-school children with the interrupter technique has proven to be feasible and reliable in daily clinical practice and research settings. Whether it contributes to diagnosing asthma in pre-schoot children still remains uncertain. From the results of previous studies

  5. Perception of parenting stress in mothers of asthmatic children%哮喘患儿母亲亲职压力的调查研究

    Institute of Scientific and Technical Information of China (English)

    黎雅婷; 陈虹; 陈壮桂

    2013-01-01

    目的:对比哮喘患儿母亲亲职压力与健康儿童母亲的亲职压力的异同。方法分别对64位支气管哮喘患儿母亲及98位健康儿童母亲进行一般情况资料问卷及亲职压力短式量表调查并进行评分。结果哮喘患儿母亲在亲职压力总分(93.34±19.23)及各个维度上得分(32.97±7.42,28.41±8.18,31.97±7.39)均高于对照组(76.21±12.35,26.52±5.28,23.88±5.55,25.82±5.73),差异有统计学意义(P<0.01);哮喘患儿母亲亲职压力“高”的比例(56.3%)高于对照组(21.4%),差异有统计学意义(P<0.01)结论哮喘患儿母亲亲职压力高于健康儿童母亲。%Objective To investigate the parenting stress in mothers of asthmatic children. Methods The study adopted the case-control study design with the random sampling method. 64 mothers of asthmatic children participated in the research group, while 98 mothers with healthy children serve as a comparison group. Data were collected with general information questionnaire, Parenting Stress Index-Short Form Chinese Version(PSI-SF Chinese Version) in each group. Results The scores of the whole scale and three dimensions of PSI-SF Chinese version in mothers with asthmatic children were (93.34±19.23,32.97±7.42,28.4 1±8.18,31.97±7.39), significantly higher than those in the mothers with health children(the scores were:(76.21 ±12.35,26.52±5.28,23.88±5.55,25.82±5.73). Conclusion Mothers of asthmatic children experienced higher parenting stress than the mothes with health children.

  6. Demographic and psychosocial characteristics of asthmatic children in a Canadian rehabilitation setting.

    Science.gov (United States)

    Hambley, J; Brazil, K; Furrow, D; Chua, Y Y

    1989-01-01

    This study investigated the demographic and psychosocial characteristics of patients attending a residential treatment program for children with asthma. Measures of background information and standardized psychosocial variables were administered to 54 inpatients over an 18-month period. Typically, our patients presented with moderate to severe chronic asthma, mostly diagnosed before 3 years of age and often associated with atopic dermatitis. The families exhibited normal levels of emotional bonding and flexibility in response to stress. Psychosocially, most children were experiencing behavioral and school-related problems, with 6-11-year-old boys exhibiting global social competency problems as well. Girls exhibited lower self-esteem. Locus of control was within the normal range for all age groups. Half the children had not previously attended an asthma education program and two-thirds of the family members either smoked and/or had a pet. The treatment implications of these characteristics of our asthma population were considered. PMID:2702227

  7. Daily home measurements of exhaled nitric oxide in asthmatic children during natural birch pollen exposure

    DEFF Research Database (Denmark)

    Vahlkvist, Signe; Sinding, Marianne; Skamstrup, Kirsten;

    2006-01-01

    the feasibility, repeatability, accuracy, sensitivity, and biologic plausibility of new handheld equipment for FENO measurements. We studied day-to-day home measurements of FENO during the birch pollen season in children with allergy to birch pollen and a history of mild asthma and rhinoconjunctivitis during......BACKGROUND: Fractional exhaled nitric oxide (FENO) is a sensitive marker of eosinophilic airway inflammation in asthma. Available methods have restricted measurements to the clinic, giving only a snapshot of the disease, which by nature is highly variable. OBJECTIVES: We sought to investigate...... this season, as well as in nonatopic children. METHODS: Eleven children with mild asthma and allergy to birch pollen, performed daily home measurements of FENO for 6 weeks before and during the birch pollen season by using a handheld FENO monitor (NIOX MINO). Additionally, FENO (chemiluminescence equipment...

  8. NO in exhaled air of asthmatic children is reduced by the leukotriene receptor antagonist montelukast

    DEFF Research Database (Denmark)

    Bisgaard, H; Loland, L; Oj, J A

    1999-01-01

    maintenance treatment with inhaled steroids during the study (mean daily dose, 273 microgram), whereas the other 15 used only inhaled beta(2)-agonists as required. The within-subject coefficient of variation of FENO over a 2-wk interval for the 26 children was 38%. FENO was significantly reduced by 20% after...

  9. Use of tracheal auscultation for the assessment of bronchial responsiveness in asthmatic children

    NARCIS (Netherlands)

    Sprikkelman, AB; Grol, MH; Lourens, MS; Gerritsen, J; Heymans, HSA; vanAalderen, WMC

    1996-01-01

    Background - It can be difficult to assess bronchial responsiveness in children because of their inability to perform spirometric tests reliably. In bronchial challenges lung sounds could be used to detect the required 20% fall in the forced expiratory volume in one second (FEV(1)). A study was unde

  10. Coarse Fraction Particle Matter and Exhaled Nitric Oxide in Non-Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Hanne Krage Carlsen

    2016-06-01

    Full Text Available Coarse particle matter, PMcoarse, is associated with increased respiratory morbidity and mortality. The aim of this study was to investigate the association between short-term changes in PMcoarse and sub-clininal airway inflammation in children. Healthy children aged 11 years from two northern Swedish elementary schools underwent fraction of exhaled nitrogen oxide (FENO measurements to determine levels of airway inflammation twice weekly during the study period from 11 April–6 June 2011. Daily exposure to PMcoarse, PM2.5, NO2, NOx, NO and O3 and birch pollen was estimated. Multiple linear regression was used. Personal covariates were included as fixed effects and subjects were included as a random effect. In total, 95 children participated in the study, and in all 493 FENO measurements were made. The mean level of PMcoarse was 16.1 μg/m3 (range 4.1–42.3, and that of O3 was 75.0 μg/m3 (range: 51.3–106.3. That of NO2 was 17.0 μg/m3 (range: 4.7–31.3, NOx was 82.1 μg/m3 (range: 13.3–165.3, and NO was 65 μg/m3 (range: 8.7–138.4 during the study period. In multi-pollutant models an interquartile range increase in 24 h PMcoarse was associated with increases in FENO by between 6.9 ppb (95% confidence interval 0.0–14 and 7.3 ppb (95% confidence interval 0.4–14.9. PMcoarse was associated with an increase in FENO, indicating sub-clinical airway inflammation in healthy children.

  11. Coarse Fraction Particle Matter and Exhaled Nitric Oxide in Non-Asthmatic Children

    Science.gov (United States)

    Carlsen, Hanne Krage; Boman, Peter; Björ, Bodil; Olin, Anna-Carin; Forsberg, Bertil

    2016-01-01

    Coarse particle matter, PMcoarse, is associated with increased respiratory morbidity and mortality. The aim of this study was to investigate the association between short-term changes in PMcoarse and sub-clininal airway inflammation in children. Healthy children aged 11 years from two northern Swedish elementary schools underwent fraction of exhaled nitrogen oxide (FENO) measurements to determine levels of airway inflammation twice weekly during the study period from 11 April–6 June 2011. Daily exposure to PMcoarse, PM2.5, NO2, NOx, NO and O3 and birch pollen was estimated. Multiple linear regression was used. Personal covariates were included as fixed effects and subjects were included as a random effect. In total, 95 children participated in the study, and in all 493 FENO measurements were made. The mean level of PMcoarse was 16.1 μg/m3 (range 4.1–42.3), and that of O3 was 75.0 μg/m3 (range: 51.3–106.3). That of NO2 was 17.0 μg/m3 (range: 4.7–31.3), NOx was 82.1 μg/m3 (range: 13.3–165.3), and NO was 65 μg/m3 (range: 8.7–138.4) during the study period. In multi-pollutant models an interquartile range increase in 24 h PMcoarse was associated with increases in FENO by between 6.9 ppb (95% confidence interval 0.0–14) and 7.3 ppb (95% confidence interval 0.4–14.9). PMcoarse was associated with an increase in FENO, indicating sub-clinical airway inflammation in healthy children. PMID:27338437

  12. Coarse Fraction Particle Matter and Exhaled Nitric Oxide in Non-Asthmatic Children.

    Science.gov (United States)

    Carlsen, Hanne Krage; Boman, Peter; Björ, Bodil; Olin, Anna-Carin; Forsberg, Bertil

    2016-01-01

    Coarse particle matter, PMcoarse, is associated with increased respiratory morbidity and mortality. The aim of this study was to investigate the association between short-term changes in PMcoarse and sub-clininal airway inflammation in children. Healthy children aged 11 years from two northern Swedish elementary schools underwent fraction of exhaled nitrogen oxide (FENO) measurements to determine levels of airway inflammation twice weekly during the study period from 11 April-6 June 2011. Daily exposure to PMcoarse, PM2.5, NO₂, NOx, NO and O₃ and birch pollen was estimated. Multiple linear regression was used. Personal covariates were included as fixed effects and subjects were included as a random effect. In total, 95 children participated in the study, and in all 493 FENO measurements were made. The mean level of PMcoarse was 16.1 μg/m³ (range 4.1-42.3), and that of O₃ was 75.0 μg/m³ (range: 51.3-106.3). That of NO₂ was 17.0 μg/m³ (range: 4.7-31.3), NOx was 82.1 μg/m³ (range: 13.3-165.3), and NO was 65 μg/m³ (range: 8.7-138.4) during the study period. In multi-pollutant models an interquartile range increase in 24 h PMcoarse was associated with increases in FENO by between 6.9 ppb (95% confidence interval 0.0-14) and 7.3 ppb (95% confidence interval 0.4-14.9). PMcoarse was associated with an increase in FENO, indicating sub-clinical airway inflammation in healthy children. PMID:27338437

  13. Effects of air pollution on the respiratory health of asthmatic children living in Mexico City.

    Science.gov (United States)

    Romieu, I; Meneses, F; Ruiz, S; Sienra, J J; Huerta, J; White, M C; Etzel, R A

    1996-08-01

    The relation between air pollution and the exacerbation of childhood asthma was studied in a panel of 71 children (aged 5 to 7 yr) with mild asthma who resided in the northern part of mexico City. During the follow-up, ambient measures of particulate matter less than 10 microns (PM10, 24-h average) and ozone (1-h maximum) frequently exceeded the Mexican standards for these contaminants. The peak expiratory flow rate (PEFR) was strongly associated with PM10 levels and marginally with ozone levels. Respiratory symptoms (coughing, phlegm production, wheezing, and difficulty breathing) were associated with both PM10 and ozone levels. An increase of 20 micrograms/m3 of PM10 was related to an 8% increase in lower respiratory illness (LRI) among children on the same day (95% confidence interval [CI] = 1.04-1.15), and an increase of 10 micrograms/m3 in the weekly mean of particulate matter less than 2.5 microns (PM2.5) was related to a 21% increase in LRI (95% CI = 1.08-1.35). A 50 parts per billion (ppb) increase in ozone was associated with a 9% increase in LRI (95% CI = 1.03-1.15) on the same day. We concluded that children with mild asthma are affected by the high ambient levels of particulate matter and ozone observed in the northern part of Mexico City.

  14. Radiology services for children in HIV- and TB-endemic regions: scope for greater collaboration between radiologists and clinicians caring for children

    International Nuclear Information System (INIS)

    There is limited literature documenting the interaction between radiologists and clinicians caring for children, especially in regions where HIV and tuberculosis (TB) are endemic. The dual burden of these diseases in resource-limited settings creates unique challenges for radiographic interpretation and utilization. This review aims to heighten awareness of issues confronting radiologists and clinicians caring for children and to encourage greater collaboration between these two disciplines in HIV- and TB-endemic regions. The Child-Friendly Healthcare Initiative is discussed, emphasizing opportunities to promote child friendliness in radiology services. (orig.)

  15. 哮喘儿童肺通气功能检测的临床分析%Clinical analysis of parameter of pulmonary ventilation function in asthmatic children

    Institute of Scientific and Technical Information of China (English)

    陈泓伶; 谢庆玲; 贺海兰; 黎重清; 温志红

    2014-01-01

    目的:通过监测哮喘儿童急性发作期与缓解期肺通气功能各指标变化情况,了解其在儿童哮喘病情评估及指导治疗中的作用。方法应用德国Jaeger Master Screen肺功能仪对43例5~12岁哮喘急性发作期和经治疗后进入缓解期的哮喘儿童进行肺通气功能检测,包括大气道指标( FVC、FEVl、FEV1/FVC、PEF)及小气道指标( FEF25、FEF50、FEF75、MMEF75/25),同时收集哮喘患儿病史资料和治疗情况。结果哮喘急性发作期患儿肺功能指标FVC、FEV1、FEV1/FVC、PEF与缓解期及健康对照组儿童比较,差异有统计学意义( P<0.01);哮喘缓解期患儿的FVC、FEV1、PEF与健康对照组比较,差异无统计学意义( P>0.05)。小气道功能指标FEF25、FEF50、FEF75、MMEF75/25在哮喘急性发作期患儿中均明显降低,与缓解期组及健康对照组儿童相比差异有统计学意义( P<0.01);哮喘治疗缓解期组中FEF25、FEF50、FEF75、MMEF75/25仍低于健康对照组,差异有统计学意义( P<0.05)。哮喘急性发作期不同严重程度患儿的肺通气功能指标( FVC%pred、FEV1%pred、PEF%pred、FEF25%pred、FEF50%pred、FEF75%pred、MMEF75/25%pred )随哮喘严重程度增加各指标越低,差异有统计学意义( P<0.05)。结论哮喘急性发作期肺通气功能受损,治疗缓解后小气道肺功能指标仍低于正常。肺通气功能的小气道功能指标在儿童哮喘的病情评估及治疗监测指导中意义更大。%Objective To study the role of parameters of pulmonary ventilation function in assessing asth-matic status and instructing treatment by measuring parameter of pulmonary ventilation function in children with asth -ma in acute exacerbation and remission .Methods Forty three(5 to 12 years old) children with asthma both in acute exacerbation and in remission after treatment were studied .Pulmonary ventilation function

  16. Calidad de vida en el niño asmático y su cuidador Quality of life in the asthmatic children and their caregiver

    Directory of Open Access Journals (Sweden)

    ALBERTO VIDAL G

    2007-09-01

    Full Text Available Introducción: Medir la calidad de vida en asma es importante para su tratamiento. Objetivo: El propósito del estudio fue conocer la calidad de vida del niño asmático y su cuidador. Método: Se aplicaron dos cuestionarios de calidad de vida en asma de Juniper. El cuestionario de calidad de vida para pacientes pediátricos con asma (PAQLQ fue respondido por 267 niños asmáticos persistentes de 7 a 15 años de La Unidad de Enfermedades Respiratorias del Hospital Roberto del Río. El cuestionario de calidad de vida para la persona encargada del cuidado del niño con asma (PACQLQ fue respondido por sus respectivos cuidadores. Se consideró como alteración significativa de calidad de vida un promedio menor de 5 puntos. Se analizó el impacto de la severidad y duración del asma en la calidad de vida del niño asmático y su cuidador. Para el análisis estadístico se utilizó Chi cuadrado considerando como significativo un p Introduction: To measure quality of life in asthma is important for its treatment. Objective: The purpose of this study was to know the quality of life of the asthmatic child and his her caregiver. Method: Two questionnaires of quality of life in asthma of Juniper were applied. The pediatric asthma quality of life questionnaire (PAQLQ was responded by 267 persistent asthmatic children, 7 to 15 years old from our Unit of Respiratory Diseases of a public children hospital. The pediatric asthma caregiver quality of life questionnaire (PACQLQ was applied to their respective caregivers. An average of less than 5 points was considered as a significant alteration in quality of life. The impact of the severity and duration of the asthma in the quality of life of the asthmatic children and their caregivers was analyzed. For the statistical analysis the test of Chi square was used and a p < 0.05 was considered significant. Results: A global average of quality of global life less than 5 was found in 39.7% of the asthmatic group and in

  17. Extended nitric oxide analysis may improve personalized anti-inflammatory treatment in asthmatic children with intermediate F(E)NO50.

    Science.gov (United States)

    Thornadtsson, A; Neerincx, A H; Högman, M; Hugen, C; Sintnicolaas, C; Harren, F J M; Merkus, P J F M; Cristescu, S M

    2015-12-01

    Exhaled nitric oxide (F(E)NO) is elevated in asthma, and a clinical practice guideline has been published with recommendations for anti-inflammatory treatment. It summarizes that a F(E)NO at an expiratory flow rate of 50 ml s(-1) (F(E)NO50) above 35 ppb in children indicates eosinophilic inflammation, and the most likely response is to use inhaled corticosteroids. Intermediate F(E)NO50 between 20-35 ppb should be interpreted cautiously. The aim of the study was to investigate this guideline in a small group of asthmatic children. Thirty-seven asthmatic children; 23 boys and 14 girls, visited the outpatient clinic, and provided exhaled breath samples for offline NO measurement. These samples were analysed with chemiluminescence techniques. Three flow rates, namely 16, 90 and 230 ml s(-1) were used for the extended NO analysis (Högman-Meriläinen algorithm, HMA) to estimate the alveolar concentration (C(A)NO), diffusion rate of the airway wall (D(aw)NO) and airway wall content (C(aw)NO). For accuracy of the HMA, the estimated value of F(E)NO at 50 ml s(-1) (F(E)NO50) was compared with measured F(E)NO50. In nine children the difference was more than 5 ppb and the data were therefore excluded. Five children with F(E)NO50   35 ppb had an allergy and had F(E)NO50 of 56 (47;60) ppb and C(aw)NO of 140 (121;172) ppb. Thirteen children with allergies, with intermediate F(E)NO50, had F(E)NO50 of 27 (25;30) ppb with a wide range of C(aw)NO. In five of these children, values were comparable to healthy children, 44 (43;50) ppb while eight children had elevated C(aw)NO values of 108 (95;129) ppb. Our data indicate the clinical potential use of extended NO analysis to determine the personal target value of F(E)NO50 for monitoring the treatment outcome. Furthermore, for children with intermediate F(E)NO50 more than half of them could possibly benefit from an adjustment of inhaled corticosteroids if the C(aw)NO value was considered. PMID:26670199

  18. Correlation between psychosomatic symptoms in asthmatic children's mothers and parental rearing patterns%哮喘儿童母亲心理健康状况及其与父母养育方式的相关性

    Institute of Scientific and Technical Information of China (English)

    王莉华; 郭庆辉; 李朝霞; 马宇; 王育龙

    2013-01-01

    [Objective] To explore the correlation between psychosomatic symptoms in asthmatic children’s mothers and parental rearing patterns.[Methods] Egna Minnen Barndoms Uppfostran(EMBU) was applied to 50 asthmatic children and 31 healthy children.State-Trait Anxiety Inventory(STAI-form Y),Self-Rating Depression Scale (SDS) were applied to their mothers.[Results] The scores of state anxiety,trait anxiety,depression in asthmatic children's mothers were significantly higher than in healthy children's mothers (P all<0.01).The parental rearing patterns between asthmatic children and healthy children were almost the same.The asthmatic children's mothers with lower educational degree had stronger tendency of punishment and sternness.The asthmatic children's fathers with higher educational degree had stronger tendency of excessive interference.The state anxiety and trait anxiety in asthmatic children's mothers were negatively related to emotional warmth and understanding (mother and father).Depression in asthmatic children's mothers was negatively related to emotional warmth and understanding (father).[Conclusion] Pediatricians should pay attention to psychological help and support of asthmatic children's mothers,improving parental rearing patterns and the life's quality of children and their mothers.%[目的]探讨哮喘儿童母亲心理健康状况特点、哮喘儿童父母养育方式及两者之间的相关性. [方法]采用父母养育方式评价量表测查50例哮喘患儿,并与31例健康儿童对照,采用状态-特质焦虑问卷、自评抑郁量表对上述儿童母亲进行测查. [结果]哮喘儿童母亲状态焦虑、特质焦虑、抑郁分值显著高于健康儿童母亲(P均<0.01).哮喘儿童与健康儿童父母养育方式基本一致.受教育程度低的哮喘儿童母亲对子女有更多惩罚严厉倾向,受教育程度高的哮喘儿童父亲有更多过分干涉倾向.哮喘儿童母亲状态焦虑、特质焦虑与父亲情感温暖与

  19. Influential factors and difference analysis for self-management behavior levels of asthmatic children%哮喘儿童自我管理行为水平的影响因素及差异性分析

    Institute of Scientific and Technical Information of China (English)

    胡平; 张际; 黄英; 袁小平; 蒋永惠; 王倩

    2011-01-01

    目的 了解哮喘儿童自我管理行为水平的影响因素并分析其差异性,为儿童哮喘防治健康教育提供依据.方法 采用自行设计的哮喘儿童自我管理量表调查2009年12月至2010年6月到我院哮喘中心就诊的492例哮喘儿童(≥7岁)的自我管理行为水平,并对年龄、性别、居住地等可能对其产生影响的因素进行分析.结果 年龄不同、主要照顾者文化程度不同、病程不同的哮喘儿童自我管理水平存在明显的差异(P<0.05),家族史仅在哮喘儿童总体自我管理及疾病医学管理上差异有统计学意义(P<0.05),教养方式在哮喘儿童总体自我管理、疾病医学管理和社会心理管理上差异有统计学意义(P <0.05):10~12岁组与13 ~17岁组的哮喘儿童自我管理行为水平明显高于7~9岁组;照顾者文化程度为大学组、高中组哮喘儿童自我管理行为水平明显高于小学、初中组;病程≥5年的哮喘儿童自我管理行为处于最高水平;有家族史的患儿在总体自我管理水平和疾病医学管理上明显高于无家族史的(P<0.05);采用一方打骂,一方溺爱的家庭教养方式的哮喘儿童在总体自我管理水平及疾病医学管理水平、社会心理管理水平显著低于说服教育及打骂教育(P<0.05).结论 年龄、主要照顾者的文化程度、病程、家族史、教养方式是影响哮喘儿童自我管理水平的显著因素.%Objective To investigate influential factors of self-management behavior levels of asthmatic children and analyze the difference, and to provide the evidence for sound education for the prevention and treatment of children asthma. Methods Totally 492 asthmatic children (7-17 years old) who visited our hospital between Dec. 2009 to Jun. 2010 were enrolled and their self-management behavior level were studied with a self-designed scale. Potential influential factors including age, sex, and habitation were analyzed

  20. [Possibilities for a reduction of long-term steroid treatment in asthmatic children during a stay in northsea climate (author's transl)].

    Science.gov (United States)

    Schütze, G

    1976-07-01

    1. 40 children with Asthma bronchiale under long-term Cortisone therapy were admitted as in-patients of a clinic in the climate of the Northsea. 37 children needed Cortisone therapy because of serious attacks of Asthma bronchiale, and 3 children because of disturbing neurodermitis constitutionalis. -- 2. Corticoids were discontinued abruptly, immediately after admission. a) In 34 children the discontinuation had no adverse effect the following 6 to 8 weeks, or even longer, there was no need for Cortisone therapy. b) In 4 children during the first 2 weeks and in 2 further children during the 5th or 6th week, the asthmatic disorder deteriorated to such a degree that Cortisone therapy had to be re-introduced. -- 3. On the base of the reported observation, it is concluded that under the conditions of the Northsea climate it is of advantage for children with Asthma bronchiale and Neurodermitis to discontinue abruptly Cortisone therapy because a) this type of therapy which involves the potential risk of unwanted side effects can be shortened and b) the specific positive effect of climatic changes during the first couple of weeks is utilized to a greater extent. The gradual reduction of steroid therapy would diminish this particular stimulation. However, this kind of treatment requires close clinical observation to anticipate an acute "Addison-Crises". -- 4. All children with serious dispuce already during the first days of their stay in the clinic clearly need continuation of steroid therapy. -- Otherwise, even previous steroid therapy for more than one year is no contradiction for the recommended procedure as long as the clinical condition of the patient allows for it.

  1. Clinical Practice Experiences in Diagnosis and Treatment of Traumatic Brain Injury in Children: A Survey among Clinicians at 9 Large Hospitals in China.

    Science.gov (United States)

    Di, Fei; Gao, Qi; Xiang, Joe; Zhang, Di; Shi, Xiuquan; Yan, Xueqiang; Zhu, Huiping

    2015-01-01

    Proper diagnosis and treatment of traumatic brain injury (TBI) in children is becoming an increasingly problematic issue in China. This study investigated Chinese clinicians to provide information about their knowledge and experiences in diagnosis and treatment of pediatric TBI. We conducted a questionnaire survey among clinicians in the emergency departments and neurosurgery departments at 9 major hospitals in China. The questionnaire included demographic information, and knowledge and experiences regarding the diagnosis and treatment of pediatric TBI. A total of 235 clinicians completed questionnaires. 43.8% of the surveyed clinicians reported children with only scalp hematoma without any other signs and symptoms of concussion as TBI cases. Most clinicians (85.1%) reported no existing uniform diagnostic criteria for children with TBI in China. The majority of clinicians (91.9%) reported that CT scans were performed in all patients with suspected head injury as a routine procedure in their hospitals. Only 20.9% of clinicians believed that radiation from CT scanning may increase cancer risk in children. About 33.6% of the clinicians reported that they ordered CT scans to investigate suspected head injury due to the poor doctor-patient relationship in China, and to protect themselves against any medical lawsuits in the future. About 80% of the clinicians reported that there are no existing pediatric TBI treatment guidelines in China. Instead a senior doctor's advice is the most reported guidelines regarding treating pediatric TBI (66.0%). All of the surveyed clinicians reported that the lack of diagnosis and/or treatment standard is the biggest problem in effectively diagnosing and treating pediatric TBI in China. Developing guidelines for the diagnosis and treatment of children with TBI is a high priority in China. The extremely high usage of CT for pediatric TBI in China suggests that it is important to establish evidence-based clinical decision rules to help

  2. Dose-dependent relationship between prenatal exposure to fine particulates and exhaled carbon monoxide in non-asthmatic children. A population-based birth cohort study

    Directory of Open Access Journals (Sweden)

    Wiesław A. Jędrychowski

    2013-02-01

    Full Text Available Objectives: The main goal of the study was to assess possible association between fetal exposure to fi ne particulate matter (PM2.5 and exhaled carbon monoxide (eCO measured in non-asthmatic children. Material and Methods: The subjects include 118 children taking part in an ongoing population-based birth cohort study in Kraków. Personal samplers of PM2.5 were used to measure fi ne particle mass in the fetal period and carbon monoxide (CO in exhaled breath from a single exhalation effort at the age of 7. In the statistical analysis of the effect of prenatal PM2.5 exposure on eCO, a set of potential confounders, such as environmental tobacco smoke (ETS, city residence area, sensitization to house dust allergens and the occurrence of respiratory symptoms monitored over the seven-year follow-up was considered. Results: The level of eCO did not correlate with the self-reported ETS exposure recorded over the follow-up, however, there was a positive signifi cant relationship with the prenatal PM2.5 exposure (non-parametric trend p = 0.042. The eCO mean level was higher in atopic children (geometric mean = 2.06 ppm, 95% CI: 1.58–2.66 ppm than in non-atopic ones (geometric mean = 1.57 ppm, 95% CI: 1.47–1.73 ppm and the difference was statistically signifi cant (p = 0.036. As for the respiratory symptoms, eCO values were associated positively only with the cough severity score recorded in the follow-up (nonparametric trend p = 0.057. In the nested multivariable linear regression model, only the effects of prenatal PM2.5 and cough severity recorded in the follow-up were related to eCO level. The prenatal PM2.5 exposure represented 5.1%, while children’s cough represented only 2.6% of the eCO variability. Conclusion: Our study suggests that elevated eCO in non-asthmatic children may result from oxidative stress experienced in the fetal period and that heme oxygenase (HO activity in body tissues may be programmed in the fetal period by the exposure to

  3. Can asthmatic subjects dive?

    Directory of Open Access Journals (Sweden)

    Yochai Adir

    2016-06-01

    Full Text Available Recreational diving with self-contained underwater breathing apparatus (scuba has grown in popularity. Asthma is a common disease with a similar prevalence in divers as in the general population. Due to theoretical concern about an increased risk for pulmonary barotrauma and decompression sickness in asthmatic divers, in the past the approach to asthmatic diver candidates was very conservative, with scuba disallowed. However, experience in the field and data in the current literature do not support this dogmatic approach. In this review the theoretical risk factors of diving with asthma, the epidemiological data and the recommended approach to the asthmatic diver candidate will be described.

  4. THE USE OF SUPEROXIDE DISMUTASE IN ACCELERATING SYMPTOM RELIEF IN ASTHMATIC AND HOUSE DUST MITE ALLERGIC CHILDREN RECEIVING HOUSE DUST MITE IMMUNOTHERAPY: DOUBLE BLIND RANDOMIZED CONTROLLED CLINICAL TRIAL

    Directory of Open Access Journals (Sweden)

    Anang Endaryanto

    2015-09-01

    Full Text Available Objective: To evaluate the efficacy of superoxide dismutase (SOD in lung function (FEV1 reversibility and respiratory symptoms (drug scores, symptoms scores in asthmatic and house dust mite allergic children receiving house dust mites immunotherapy. Methods: Forty subjects aged 6–17 years old with asthma, tested positive for house dust mite allergy on skin prick test, and received immunotherapy were enrolled in this study. All subjects completed clinical based assessments and diary-based assessments for drug and symptom scores. Following a four-week baseline assessment, all subjects were randomized to receive SOD or placebo. Respiratory symptoms (drug and symptoms score and FEV1 were evaluated at the end of the 1st, 2nd, 3rd, and 4th weeks after randomization. Drug score, symptoms score, and FEV1 reversibility test results were analyzed using a Paired t test and repeated measure of ANOVA. Results: There was a significant difference in drug scores, symptoms score, and FEV1 reversibility test outcomes between SOD and placebo. SOD group showed a significant decrease in all outcome measures compared to those in placebo group. Conclusions: The use of SOD as antioxidants is effective in accelerating symptom relief for children with asthma and house dust mite allergy receiving house dust mite immunotherapy.

  5. Clinical effect of Diskus dry-powder inhaler at low and high inspiratory flow-rates in asthmatic children

    DEFF Research Database (Denmark)

    Nielsen, K G; Auk, I L; Bojsen, K;

    1998-01-01

    at low (30 L x min[-1]) and high (90 L x min[-1]) flow rates. A pilot study in 129 children aged 3-10 yrs demonstrated that 99% of children of 3 yrs and above can generate a flow > or = 30 L x min(-1) through the device, while 26% performed > or = 90 L x min(-1). Eighteen children aged 8-15 yrs...... clinical effect at low and high flow rates in children....

  6. Perfil del niño y adolescente asmático en Atención Primaria Profile of asthmatic children and adolescents in Primary Care

    Directory of Open Access Journals (Sweden)

    A. Bercedo Sanz

    2009-01-01

    asthmatic children were men. Concerning family antecedents, we must take into account that in some of the children´s parents we have found the presence of asthma in 30.5%, of allergic rhinitis in 40.3%, atopic dermatitis in 27.1% and habit smoking in 52.9%, with 55.3% of asthmatic children affected by passive smoking. 55.3% of the patients had suffered from bronchiolitis. 61% of the asthmatic ones associated allergic rhinitis and a 48.8% atopic dermatitis. Regarding the severity of asthma we found that 68.5% were occasional episodic asthma, 18.7% frequent episodic asthma, 12.5% moderate persistent asthma and 0.3% severe persistent asthma. 24.7% of the asthmatic children required emergency services during last year. September and October are the months with a higher prevalence of asthma attacks and we find another rise of asthma attacks in May. 59.6% did not have base treatment, 16.9% used inhaled corticoids, 22% combined treatment (‚2 of long action and inhaled corticoid, 2.4% montelukast and a 10.5% inmmunotherapy. 78.3% of the studied patients were atopics, 68.5% were allergic to dust mites and a 34.6% to grass pollen. Breastfeeding period of time of the population studied was of 90 days, the more the breastfeeding lasts, the more severe asthma was (120 days of persistent asthma against 60 days of occasional episodic asthma, (p=0,08. Only a 29.2% of the asthmatic children had made the spirometry and a 9.5% were sent to pneumology against the 30.5% who were sent to allergology The level of severity of asthma was associated with the presence of asthma in the father (OR=2,65, p=0,03, asthma in the brothers (OR=3,88, p< 0.001 and the antecedent of to have suffered bronquiolitis (OR=1,75, p=0,05. Also, the smaller age of the children was the only found factor that it predicted going to urgencies (OR=1,12, p=0,03.
    Conclusions: The knowledge of the clinical-epidemiological profile of asthma in PHC will allow to improve the handling of this disease, to know its real

  7. Measurement of lung function in awake 2-4-year-old asthmatic children during methacholine challenge and acute asthma

    DEFF Research Database (Denmark)

    Klug, B; Bisgaard, H

    1996-01-01

    This study evaluated three techniques for testing of lung function in young awake children. We compared measurements by the forced or impulse oscillation technique (IOS), the interrupter technique (IT), and transcutaneous measurements of oxygen (tcPo2) with concomitant measurements of specific ai...... function. The techniques are non-invasive, are not dependent on the active co-operation or sedation of the subjects, and therefore are well suited for routine use in young children....

  8. Histórias de criança: as narrativas de crianças asmáticas no brincar Children's stories: asthmatic children's narratives in play

    Directory of Open Access Journals (Sweden)

    Cláudia Maria Teixeira Goulart

    2003-01-01

    Full Text Available Este estudo examinou como crianças com asma constroem significados sobre sua doença e informações que recebem a este respeito. Levou-se a efeito três estudos de caso com crianças participantes de um Programa de Educação em Asma, utilizando uma abordagem cultural que usa as narrativas como um meio de buscar significações. Foram realizadas observações no ambiente hospitalar e entrevistas com mães. Usou-se as narrativas do brincar, já que este permite ampliar o estudo da subjetividade infantil. A análise das narrativas fundamentaram-se no modelo estrutural de Todorov e os resultados evidenciaram que as narrativas no brincar apresentam uma estrutura peculiar, explicada pelas particularidades psíquicas destas crianças. Elementos da cultura estiveram presentes nas narrativas, permitindo a análise de como a criança negocia seus significados pessoais e familiares com os significados da cultura médico-hospitalar. Discutiu-se as implicações do tipo de abordagem educacional que informa as crianças a respeito de sua doença.This study examined how asthmatic children construct meanings about asthma and the information given to them. A case-study design was used with three subjects involved in a Program of Asthma. A cultural approach which assumes the use of narratives was used to search for children's meanings. Observations in the hospital and interviews with the children's mothers were carried out. Narratives of play were examined to investigate children's subjectivity. These narratives were analysed using Todorov' s structural model. Results showed structural alterations in narratives generated in play which may be explained by asthmatic children's psychological particularities. Culture features were strongly present allowing for the analysis of how children negotiate their personal and familiar meanings with the meanings of the medical culture in which they are embedded. The educational approach which informs children about their

  9. The parental management and the life quality of asthmatic children%父母管理与支气管哮喘儿童的生活质量

    Institute of Scientific and Technical Information of China (English)

    袁方; 徐婉婷; 张建华; 李建军; 郭盛; 吴良霞; 盛锦云

    2013-01-01

    目的 评估父母对哮喘的认知、态度、健康理念、自我效能、自控能力及外部资源与父母管理策略应用的相关性;分析父母管理行为中,不同程度自控能力与哮喘疗效间的关系.方法 采取横断面研究设计,共纳入151份哮喘患儿及其家长的有效调查问卷.结果 父母的外部资源、自我效能、自控能力是父母坚持日常预防及哮喘规范化治疗的重要影响因素.父母管理行为与患儿哮喘治疗的疗效呈中度相关.患儿父母的管理策略越多元化,其子女拥有的体能、学习能力及生活质量就越好.家庭不同阶段自控能力与患儿肺功能及生活质量呈显著的线性关系.结论 对父母自我效能及自控能力的干预,可有效提高学龄期哮喘儿童的生活质量.%Objective To examine how knowledge, attitudes, beliefs, self-efficacy, self-regulation and external resources are related to parental use of management strategies. To determine the relationship of management behaviors of parents with different levels of self-regulation and main asthma outcomes. Methods Using a cross-sectional design, a total of 151 parent-child pairs completed take-home questionnaires were analyzed. Results Main findings revealed that external resources, self-efficacy and self-regulation were significant predictors of parental use of daily prevention and parental reported medication adherence. Parental management behaviors were found to be moderately related to main asthma outcomes. The more parents used management strategies, the better physical and school performance and the higher quality of life their children had. Trend analysis of family phase differences revealed a significant positive linear correlation between children's pulmonary functioning and quality of life. Conclusions Intervention focused on parental self-efficacy and self-regulation can improve the quality of life of asthmatic children in primary school children.

  10. Use of Hypnotic Techniques in Children and Adolescents with Chronic Pain: Do the Ages of Patients or Years of Practice and Theoretical Orientation of Clinicians Matter?

    Science.gov (United States)

    Tomé-Pires, Catarina; Solé, Ester; Racine, Mélanie; de la Vega, Rocío; Castarlenas, Elena; Jensen, Mark P; Miró, Jordi

    2016-01-01

    Hypnosis is known to be effective in the treatment of pediatric pain. To better understand which strategies might be most useful, more knowledge is needed regarding the strategies that are actually used by experienced clinicians and the factors that influence their use. To address this knowledge gap, 35 health care professionals completed an online survey on the use of hypnosis in the management of pediatric chronic pain. The findings indicate that clinicians vary their use of hypnotic strategies primarily as a function of a patient's age but not as a function of theoretical orientation or amount of experience. The findings may be useful for guiding clinicians in their selection of strategies and suggestions when working with children with pain. PMID:27585730

  11. Impact of Market Competition on Continuity of Care and Hospital Admissions for Asthmatic Children: A Longitudinal Analysis of Nationwide Health Insurance Data 2009-2013.

    Directory of Open Access Journals (Sweden)

    Kyoung Hee Cho

    Full Text Available Ambulatory care-sensitive conditions, including asthma, can be managed with timely and effective outpatient care, thereby reducing the need for hospitalization.This study assessed the relationship between market competition, continuity of care (COC, and hospital admissions in asthmatic children according to their health care provider.A longitudinal design was employed with a 5-year follow-up period, between 2009 and 2013, under a Korean universal health insurance program. A total of 253 geographical regions were included in the analysis, according to data from the Korean Statistical Office. Data from 9,997 patients, aged ≤ 12 years, were included. We measured the COC over a 5-year period using the Usual Provider Continuity (UPC index. Random intercept models were calculated to assess the temporal and multilevel relationship between market competition, COC, and hospital admission rate.Of the 9,997 patients, 243 (2.4% were admitted to the hospital in 2009. In the multilevel regression analysis, as the Herfindahl-Hirschman Index increased by 1,000 points (denoting decreased competitiveness, UPC scores also increased (ß = 0.001; p < 0.0001. In multilevel logistic regression analysis, the adjusted odds ratio (OR for hospital admissions for individuals with lower COC scores (≥ 2 ambulatory visits and a UPC index score of < 1 was 3.61 (95% CI: 2.98-4.38 relative to the reference group (≥ 2 ambulatory visits and a UPC index score of 1.Market competition appears to reduce COC; decreased COC was associated with a higher OR for hospital admissions.

  12. 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 probl

  13. The insulin-like growth factor axis and collagen turnover in asthmatic children treated with inhaled budesonide

    DEFF Research Database (Denmark)

    Wolthers, O D; Juul, A; Hansen, M;

    1995-01-01

    ) and the amino terminal propeptide of type III procollagen (PIIINP) were studied in 14 prepubertal children with asthma (mean age 9.7 years) during treatment with inhaled budesonide. The study design was a randomized, crossover trial with two double-blind treatment periods (200 and 800 micrograms) and one open...

  14. 小儿哮喘持续状态68例的临床护理体会%The nursing experience of 68 cases of children status asthmatics

    Institute of Scientific and Technical Information of China (English)

    王茜; 贾入

    2012-01-01

      目的总结小儿哮喘持续状态下的临床护理措施以及护理体会,为后期相关临床护理工作提供有力的参考性依据。方法我院收治小儿哮喘持续状态患者68例,对其采取行之有效的支持性治疗以及综合护理。结果我院接受治疗的小儿哮喘持续状态患者的病情均获得了极大程度上的改善,其中出现了一例由于患有严重先天性心脏病最终抢救无效死亡的患者。结论强化小儿哮喘持续状态患者的临床护理工作是保证患儿最终获得康复的前提保证,能够改善患儿的生命健康质量以及家属的满意度状态。%  Objective: To discuss methods and experience of nursing for children status asthmatics to provide envidence in future work. Methods: Treated 68 cases of children status asthmatics to use comprehensive nursing methods. Resutls: Al the patients received comprehensive improved quickly, but 1 case dead because of serious congenital heart disease. Conclusion:Strengthen nursing work to children status asthmatics is the key to ensure their recovery and improve their life quality and parents' satisfaction.

  15. Effects of a self-management asthma educational program in Taiwan based on PRECEDE-PROCEED model for parents with asthmatic children.

    Science.gov (United States)

    Chiang, Li-Chi; Huang, Jing-Long; Yeh, Kuo-Wei; Lu, Chang-Ming

    2004-04-01

    This study was conducted to evaluate the comparative effectiveness of two different asthma educational programs. One was self-management asthma education based on the PRECEDE-PROCEED model to change the influential factors based on a previous need assessment study in Taiwan. The other consisted of regular outpatient asthma education. The purposes were: 1) to compare differences in the asthma knowledge, self-efficacy, perceived effectiveness, children's cooperation, doctor-patient communication, and self-management behaviors in the experimental and control groups before education, and 2 weeks, 3 months, and 6 months after education; and 2) to compare differences in drug use, medication utilization, asthma severity, signs/symptoms of asthma, school absenteeism, and exercise ability before education, and 2 weeks, 3 months, and 6 months after education. Parents of asthmatic children were recruited from among outpatients of Chang Gung Children's Hospital, Taoyuan, Taiwan. They were grouped by registration number: those with even numbers were assigned to the experimental group, and those with odd numbers were assigned to the control group. Measurements were collected four times from all parents by means of a questionnaire and chart review. The General Linear Model: Repeat Measurement was used to compare variance differences. The following results were found. 1) Asthma knowledge, self-efficacy, perceived effectiveness, children's cooperation, and self-management behaviors significantly improved after the self-management asthma educational program based on PRECEDE-PROCEED. Except for perceived effectiveness, all variables still had good effectiveness after 6 months of follow-up. The experimental group was better than the control group in knowledge, children's cooperation, and self-management behaviors at the 3-month follow up, as well as in knowledge and children's cooperation at the 6-month follow-up. 2) In both the experimental and control groups, the educational program

  16. The insulin-like growth factor axis and collagen turnover in asthmatic children treated with inhaled budesonide

    DEFF Research Database (Denmark)

    Wolthers, O D; Juul, A; Hansen, M;

    1995-01-01

    ) and the amino terminal propeptide of type III procollagen (PIIINP) were studied in 14 prepubertal children with asthma (mean age 9.7 years) during treatment with inhaled budesonide. The study design was a randomized, crossover trial with two double-blind treatment periods (200 and 800 micrograms) and one open......, non-randomized treatment period (400 micrograms). All periods were 18 days' duration. Budesonide treatment was associated with a dose-related suppressive trend in serum concentrations of PIIINP when the 400 micrograms period was included (p

  17. Pico do fluxo expiratório no acompanhamento de crianças asmáticas Peak expiratory flow monitoring in asthmatic children

    Directory of Open Access Journals (Sweden)

    Ana Cristina C. F. Fonseca

    2006-12-01

    months. Seventy-five patients (96.1% were selected by simple randomization and monitored for 3 months, via a clinical severity scale and pulmonary function tests (PEF and VEF1. Results were analyzed using Pearson's coefficient. RESULTS: Correlations between absolute and percentage PEF figures and clinical severity score, were negative and very close to zero, signifying a weak correlation with no statistical significance. The same relationship was observed between VEF1 and clinical severity score. The correlation between VEF1 and PEF had a positive value with statistical significance (p = 0.000. CONCLUSIONS: Since the best parameter for evaluating airway obstruction is VEF1, the finding that there is a positive correlation between this measure and absolute PEF reinforces the importance of its use and allows for the recommendation that PEF be measured as part of the management of asthmatic children, particularly in severe cases.

  18. Parent Training with Asthmatic Children.

    Science.gov (United States)

    Olson, Roberta A.; Chaney, John M.

    To examine the effects of an 8-week parent/child cognitive behavioral treatment intervention on physiological, symptomatic, and behavioral indices of asthma, a comparison was made of results on 1-year pre-intervention and 1-year post-intervention assessments. The first year of the study involved a retrospective collection of medical data for 18…

  19. Cysteinyl leukotriene and 8-isoprostane in exhaled breath condensate of asthmatic children%哮喘患儿呼出气冷凝液中半胱氨酰白三烯和8-异前列腺素的研究

    Institute of Scientific and Technical Information of China (English)

    丁俊丽; 王亚亭; 周登余; 刘晓静; 魏丽华; 李鑫

    2015-01-01

    Objective To analyze the change of cysteinyl leukotriene ( Cys-LTs) levels and 8-Isopros-tane (8-iso-PG) levels in the exhaled breath condensate (EBC) of asthmatic children from acute exacerbation to clinical remission, and investigate the role of the detection of Cys-LTs and 8-iso-PG in EBC in its severity and pathogenesis , and explore the relationship between the Cys-LTs and 8-iso-PG through measuring Cys-LTs levels and 8-iso-PG levels in the EBC of asthmatic children. Methods The outpatient or inpatient asthmatic children of the pediatrics and a group of healthy children were studied. All subjects′ EBC were collected by the R-Tube produced by American Respiratory Research. The concentration of Cys-LTs and 8-iso-PG in EBC were measured by enzyme-linked immunosorbent assay (ELISA), and compared among children in asthmatic exacerbation, asthmatic remission, and healthy condition. The relevance of their change would be explored at the same time. Results (1) Cys-LTs levels in EBC were higher in asthma exacerbation, compared to healthy controls (P0. 05 ) . ( 2 ) 8-iso-PG levels was higher in asthmatic exacerbation compared to asth-matic remission ( P0.05)。(2) EBC中的8-iso-PG水平发作组较缓解组高( P<0.05);缓解组较健康对照组高( P<0.05)。(3)对三组EBC中Cys-LTs和8-iso-PG分别进行相关性分析,发作组中Cys-LTs与8-iso-PG有显著相关性( n1=35, r1=0.61, P<0.05),缓解组中两者无显著相关性。结论哮喘患儿EBC中8-iso-PG水平与哮喘严重程度有关,可作为疗效监测的客观指标。 Cys-LTs水平与哮喘恶化有关。两种标志物在哮喘发作时有相关性,提示此时气道氧化应激与炎症反应有一定关联。

  20. Relationship between behavioral problems of asthmatic children and emotional state of their mothers%哮喘儿童行为问题与母亲心理情绪状态的关系

    Institute of Scientific and Technical Information of China (English)

    王莉华; 郭庆辉; 李朝霞; 马宇; 张太娥; 乔艳红; 王育龙

    2014-01-01

    目的:探讨哮喘患儿行为问题与母亲心理情绪状态的关系,为制定相应干预措施提供依据。方法选择2010年12月至2011年10月在山东大学第二医院陪同就诊的44例哮喘儿童的母亲为研究组,并和济南市某小学29例健康儿童的母亲对照。采用状态-特质焦虑问卷、自评抑郁量表、Rutter儿童行为问卷-父母问卷进行调查及分析。结果哮喘组儿童行为总分较高,对照组儿童行为总分较低,两者比较差异具有统计学意义(t=4.12,P<0.01)。哮喘组行为问题阳性检出率高于对照组,差异具有统计学意义(χ2=13.50,P<0.001)。男性患儿行为问题总阳性检出率高于女性患儿,差异具有统计学意义(χ2=4.05,P<0.05)。哮喘组以下常见的单项行为问题检出率均高于对照组,包括不能静坐、心烦、发呆、易怒、忧伤、睡眠困难(χ2值分别为7.28、12.28、6.15、6.43、8.17、4.54,均P<0.05)。哮喘患儿母亲的状态焦虑、特质焦虑和抑郁分值均高于对照组( t值分别为3.29、3.67、4.71,均P<0.05)。哮喘患儿行为分值与母亲状态焦虑分值呈正相关(r=0.389,P<0.01),差异有统计学意义。哮喘患儿行为分值与母亲特质焦虑分值无相关(r=0.244,P>0.05),与母亲抑郁分值无相关(r=0.230,P>0.05)。结论总结哮喘儿童行为特征和其母亲心理情绪状态特点及制定相应干预措施是控制哮喘发作、提高哮喘儿童生活质量的有效方法。%Objective To study the relationship between behavioral problems of asthmatic children and emotional state of their mothers ,so as to provide basis for intervention measures .Methods During the period of December 2010 to October 2011 44 mothers of asthmatic children visiting the Second Hospital of Shandong University were enrolled in the study , and they were

  1. 哮喘儿童心理行为问题特征及应对方式研究%Features of Psychological Behavioral Problems in Asthmatic Children and Their Copping Styles

    Institute of Scientific and Technical Information of China (English)

    王倩; 张际; 梅其霞; 黄英; 袁小平; 蒋永蕙; 胡平

    2011-01-01

    Objective To investigate the psychological behavioral features of school children with asthma in order to provide reference for clinical mental intervention. Methods Achenbach Child Behavior Checklist ( CBCL ) and Coping with a Disease ( CODI ) were used to investigate the hehavior problems and coping styles of 143 children with asthma aged 8 - 16 , and Self - compiled Questionnaire was taken fro investigation of their psycho - social factors. Results The rate of abnormal behavior was significantly higher in asthmatic children ( 33. 57 % ) than that in healthy children ( 12. 97% ) ( P < 0. 01 ). Behavioral prohlems mainly manifested as social withdrawal tendencies, decreased social acceptability, poor interpersonal communication,compulsivity, anxiety, over - dependence, and so on. Behavioral problems and coping styles were different in asthmatic children of different ages, family structures, and education methods. Conclusion Bronchial asthma is a psychosomatic disease,and asthmatic children have some deficiencies m social interaction capacity, the higher incidence of behavioral problems, and immature coping styles. The medical professionals should give them customized psychological counseling and treatment for caregivers in order to prevent and correct bad behaviors, improve mental coping capability, cultivate good character, and promote physical and mental development in children with asthma.%目的 调查哮喘儿童心理和行为特点,为临床心理行为干预治疗提供参考依据.方法 采用Achenbach 儿童行为评定量表(Achenbach Child Behavior Checklist,CBCL)和慢性病儿童应对方式量表(Coping With a Disease,CODI)对143 例在重庆医科大学附属儿童医院哮喘中心确诊并系统管理的8-16岁哮喘儿童行为问题和应对方式进行测试,同时采用一般情况调查表对其社会心理行为因素进行了调查.结果 哮喘儿童行为异常率为33.57%,显著高于全国常模(12.97%),

  2. 北京市哮喘儿童家长知信行问卷调查%Survey on knowledge, attitude and practices in asthmatic children's parents in Beijing

    Institute of Scientific and Technical Information of China (English)

    张国卿; 赵京; 申昆玲; 向莉; 夏光明; 杨雪秋; 鲍慧玲

    2009-01-01

    Objectives To study the knowledge,attitude and practice(KAP)concerning asthma in parents of children with asthma and the related factors.Method Questionnaire survey was conducted by using the multi-center research methods in twenty hospitals with asthmatic clinic or pediatric clinic in Beijing from August to October in 2008.The investigation focused on Beijing permanent residents with children who have been diagnosed as asthma for more than 6 months.Result Totally 390 parents of asthmatic children were investigated among whom 351 provided valid questionnaires,the response rate reached 90.0%;75.2% of the parents knew that the nature of asthma is a chronic allergic airway inflammatory disease;54.4% of parents think that even if the child is in a state of asthma control he/she can participate in only mild exercise;88.4% of parents consider that the long-term use of inhaled corticosteroid would have a mild effect on growth and development of children.Of the asthmatic children.32.5% adhered to use inhaled corticosteroid prescription;47.2% adhered to Use leukotriene receptor modulator;45.3% of parents of children with acute asthma attack will add antibiotics;18.1% of parents would choose short-acting β2-agonist.The multi-factors Logistic regression suggested that the parents' educational background and the frequency of referral in children with asthma under control may have an influences on the parents' KAP(P1).Conclusion The general understanding of asthma in asthmatic children's parents in Beijing area is good,the higher the parents' educational background and revisit frequency of asthmatic children whose disease is under control,the better the Parents' KAP.%目的 了解北京市哮喘儿童家长哮喘知信行现状及影响因素.方法 2008年8-10月,采取多中心问卷调查的方法,在北京市20家医院的哮喘专科或儿科门诊,对北京市常住居民中诊断为哮喘6个月以上的就诊患儿家长进行调查.结果 共调查390

  3. Validez en el registro del pico espiratorio máximo de niños asmáticos de la Ciudad de México Validity of peak flow record in asthmatic children residing in Mexico City

    Directory of Open Access Journals (Sweden)

    Diana Jiménez-Millán

    2007-06-01

    Full Text Available OBJETIVO: Determinar la concordancia entre el pico espiratorio forzado (PEF registrado por padres de niños asmáticos y el PEF electrónico que es el almacenado en el AirWatch (PEFe. MATERIAL Y MÉTODOS: Se obtuvo el PEF de 42 niños de 5 a 15 años de edad del Hospital Infantil de México Federico Gómez de la Ciudad de México entre octubre de 1998 y 1999. Los padres registraron el valor máximo del PEF en un diario de salud. Se calculó la correlación de Spearman entre el PEFe y el PEFr. Utilizamos un modelo logístico de efectos mixtos. RESULTADOS: La correlación del PEFe y el PEFr fue r= 0.96 (pOBJECTIVE: To determine the concordance between maximum peak expiratory flow records (PEFr reported by the parents of asthmatic children and the electronic values stored by the AirWatch device (PEFe. MATERIAL AND METHODS: Records of PEF measurements between October 1998 and 1999 were obtained from 42 asthmatic children 5 to 15 years of age recruited at the Hospital Infantil de Mexico Federico Gomez, in Mexico City. Parents recorded the maximum value in the health diary. Spearman correlation was calculated between PEFe and PEFr and a mixed-effects logistic model was used. RESULTS: The correlation between PEFe and PEFr was r=0.96 (p<0.05 among children with a diagnosis of moderate or severe asthma and r=0.40 (p<0.05 among children diagnosed with mild asthma. Follow-up time, asthma severity, gender and age of the child and their interactions were predictors of the differences between PEFe and PEFr. CONCLUSIONS: Parents of children with moderate or severe asthma from 6 to 8 years of age report PEF values with greater accuracy during follow-up than others.

  4. 哮喘患儿吸入糖皮质激素治疗5年后过敏原变化观察%Allergen sensitization changes in asthmatic children receiving inhaled corticosteroid therapy for five years

    Institute of Scientific and Technical Information of China (English)

    汤正珍; 郑跃杰; 王和平; 宋萍; 刘晓莉; 刘萍; 白大明; 王莉

    2012-01-01

    目的 了解哮喘患儿吸入糖皮质激素(ICS)治疗5年后的过敏原变化情况.方法 对2003-2004年在深圳市儿童医院哮喘门诊登记且登记时均行皮肤点刺实验(SPT)并给予ICS治疗的133例哮喘患儿,进行现场回顾性调查.现场调查包括填写调查表和复查SPT.结果 133例哮喘患儿完成了5年前后的2次SPT检测,5年前121例(91%)SPT阳性,12例(9%)SPT阴性;5年后133例中119例 (89.5%)SPT检测阳性,14例(10.5%)SPT阴性,与5年前比较,差异无统计学意义(P>0.05).5年后吸入性过敏原和食物过敏原的阳性率均无明显变化,但蟑螂和树花粉明显增加(P>0.05),牛奶、鸡蛋明显减少(P>0.05).结论 哮喘患儿5年后过敏率变化不大,吸入性过敏有所增加,食物过敏有减少趋势.屋尘螨和粉尘螨仍然是主要过敏原.ICS治疗与否对过敏情况无明显影响.%Objective To assess the allergen -sensitization changes in asthmatic children receiving inhaled corticosteroid (ICS) therapy for 5 years. Methods . The retrospective study was carried out in 133 asthmatic children receiving treatment of ICS from 2003-2004 in Shenzhen Children' s Hospital. The patients were assessed by questionnaire and skin prick tests (SPT).Results Totally 133 patients finished the SPT before and after five years. The positive rate of SPT in 133 cases was 91% before five years,which was not significantly different(P > 0.05)from that of the patients (89.5%)af-ter five years . There was no significant increase in food and inhalant hypersensitivity (P > 0.05) ,but Cockroach and Tree-pollen increased obviously, and milk and eggs were reduced significantly.Conclusions Allergen sensitization changes in asthmatic children received inhaled corticosteroid therapy for five years are small.Inhalant allergens increase obviously, but the tendency of food hypersensitivity is reduced.Dermatophagoldes pteronyssinus and Dermatophagoides farina are still the main allergen.

  5. Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Aguocha Chinyere M

    2009-09-01

    Full Text Available Abstract Background There may be need to assess intelligent quotient (IQ scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition (ICD - 10 criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Methods Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. Results A total of forty-four (44 children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001. First order correlation controlling for the chronological age of the children

  6. The impact of health education and standard treatments on the life quality of asthmatic children%健康教育与规范治疗对哮喘儿童生命质量的影响

    Institute of Scientific and Technical Information of China (English)

    胡琴; 连金媚; 陈晓玲

    2013-01-01

    Objective To investigate the impact of health education and standard treatments on the life quality of asthmatic children.Methods We conducted clinic treatments of 110 cases of asthmatic children lasting for 6 months,which were divided into standard treatment and health education group with 60 cases and group without standard treatment and health education with 50 cases.We emphasized the education management on cases in experimental group,which strictly obeyed the Global Initiative for Asthma (GINA) to formulate classified treatments as well as regular follow-up.Control group received the same treatments as experimental group yet without emphasizing health education about asthma on parents,which was accompanied with irregular follow-up.We compared the before-treatment and after-treatment life-quality and lung functions of asthmatic children.Moreover,we used Pediatric Asthma Quality of Life Questionnaire (PAQLQ) to evaluate the before-treatment and after-treatment life quality of asthmatic children.Results After follow-up lasting for 6 months,the treatments of experiment group had obvious improvements (P <0.01).The improvements of peak expiratory flow (PEF) of lung function test and timed vital capacity of the first second (FEV1) of experimental group were also better than the improvements of these two metrics of control group (P < 0.01).In addition,after 6 months,in both all dimensions of PAQLQ and total score,the differences between before and after treatment of experimental group were significant (P < 0.01,P < 0.05) ; and the differences between experimental group and control group were also significant in both all dimensions of PAQLQ score (12.4 ±2.1) and total score comparing to the control group (8.1 ±2.3),and the differences are also significant (t =2.5,P < 0.01).Conclusions Health education and standard treatments significantly improved the life quality of asthmatic children with a good compliance of treatment and a low recurrence rate,which is

  7. A survey on the knowledge and behavior in asthmatic children's parents in Tianjin%天津市哮喘患儿家长哮喘知识及行为调查

    Institute of Scientific and Technical Information of China (English)

    王峥; 刘长山; 阮小玲; 王雪艳; 张奕; 李霞; 杨静

    2010-01-01

    目的 调查天津市哮喘患儿家长对哮喘知识的了解程度及其对治疗的依从性.方法 随机抽取2009年6月1日至7月31日期间哮喘专科门诊就诊的93名哮喘患儿家长(患儿均在我哮喘专科门诊规范治疗半年以上)进行问卷调查.结果 接受调查的家长中,72.04%知晓哮喘本质是气道慢性炎症性疾病;100%患儿遵医嘱规律使用吸入激素55.91%或吸入激素与长效β2受体激动荆联合制剂44.09%作为长期维持治疗药物;74.68%认为患儿病情控制后可以正常参加各项运动.>5岁患儿中分别有93.55%及97.85%未使用过峰流速仪及"儿童哮喘控制测试(CACT)"监测病情;哮喘急性发作时,25.81%首选吸入速效β2受体激动剂作为自我紧急处理措施,19.35%及11.83%仍分别选择加用抗生素及束手无措;43.01%认为即使遵从医嘱规律使用吸入激素,对孩子生长发育仍有影响.结论 经规范治疗的天津市哮喘患儿家长对哮喘的认知普遍较好,但仍存在薄弱环节.哮喘知识的宣传教育可帮助患儿及其家长了解哮喘知识,树立对疾病及其防治的正确认识,增加治疗依从性,应长期坚持进行.%Objective To investigate the understanding level of asthma related knowledge and the treatment compliance in parents of children with asthma in Tianjin. Methods Questionnaire survey was given to 93 randomly selected parents of children with asthma at our asthmatic clinic ,whose children began to receive regularly asthmatic administration for at least 6 months from June to July in 2009. Results 72.04% of the parents included into the survey knew that asthma was a chronic airway inflammatory disease; 100% of them adhered to use prescription inhaled corticosteroid (55.91%) or inhaled corticosteroid combined with an inhaled long-acting β2-agonist (44. 09% ) ;74. 68% of them believed that if the child is in a well control state, he/she could participate in exercise as healthy children. There were

  8. Pregnancy Outcomes in Asthmatic Women

    Directory of Open Access Journals (Sweden)

    Mehran Karimi

    2008-06-01

    Full Text Available Asthma is considered to be the most common respiratory disorder complicating pregnancy. Seventy-six asthmatic and 152 non-asthmatic pregnant women were studied. Maternal asthma was significantly associated with adverse infant outcomes, including prematurity, low birth weight and the need for Cesarean delivery. The results of this study could indicate that pregnant women with asthma were at substantially increased risk for adverse infant outcomes and suggest the need for extra attention to mothers with asthma before and during pregnancy.

  9. The Effect of Rapid Antigen Detection Test on Antibiotic Prescription Decision of Clinicians and Reducing Antibiotic Costs in Children with Acute Pharyngitis.

    Science.gov (United States)

    Kose, Engin; Sirin Kose, Seda; Akca, Deniz; Yildiz, Kerem; Elmas, Cengizhan; Baris, Mustafa; Anil, Murat

    2016-08-01

    We aimed to investigate the effect of rapid antigen detection test (RADT) in the diagnosis of streptococcal pharyngitis, its impact on antibiotic prescription decision of pediatricians and influence on reduction of antibiotic treatment costs in children with pharyngitis. The study group consisted of 223 patients who were diagnosed with pharyngitis by pediatricians. The sensitivity and specificity of RADT were 92.1% (95% Cl: 78.6-98.3%) and 97.3% (95% Cl: 93.8-99.1%), respectively. In the first assessment, before performing RADT, pediatricians decided to prescribe antibiotics for 178 (79.8%) patients with pharyngitis. After learning RADT results, pediatricians finally decided to prescribe antibiotics for 83 (37.2%) patients with pharyngitis, and antibiotic prescription decreased by 42.6%. Antibiotic costs in non-Group A streptococcus pharyngitis, Group A streptococcus pharyngitis and all subjects groups decreased by 80.8%, 48%, and 76.4%, respectively. Performing RADT in children with pharyngitis has an important impact on treatment decision of clinicians, reduction of unnecessary antibiotic prescriptions and antibiotic costs. PMID:26999012

  10. Efecto de budesonida sobre la densidad y el metabolismo óseo en niños asmáticos Effect of budesonide on bone density and bone metabolism of asthmatic children

    Directory of Open Access Journals (Sweden)

    Mariela Paoli de Valeri

    2000-08-01

    conducted in 38 prepubertal children aged 6 to 11 years, selected from the pediatric chest outpatient clinic of the Instituto Autónomo Hospital Universitario de Los Andes, Mérida, Venezuela. Three study groups were assembled: 9 asthmatic children treated with inhaled budesonide (300 µg/day for over 6 months (Group A; 14 asthmatic children not treated with inhaled corticosteroids (Group B; and 15 non-asthmatic children (Group C. All of them underwent testing of bone formation and resorption markers, and measurement of bone mineral density (DMO and content (CMO. Statistical analysis consisted of central tendency and dispersion measures, analysis of variance, and Fisher and Scheffe tests for comparison of means. RESULTS: In the groups studied (A, B, and C calcium serum levels were 9.1±0.3; 9.6±0.4; 9.3±0.6 mg/ml, respectively; osteocalcine levels were 14.8±4.6; 13.0±2.5; 11.9±3.4 ng/dl; the type I collagen carboxyterminal telopeptide (ICTP levels were 19.6±16.5; 14.2±15.4; 13.0±18.3 µg/l; the DMO levels were 0.67±0.06; 0.68±0.06; 0.69±0.06 g/cm²; and the CMO levels were 1 158.8±217.4; 1 106.4±256.1; 1 176.5±240.5 g, respectively. No statistically significant differences were observed between the groups. CONCLUSIONS: The administration of 100-400 µg/day of inhaled budesonide for a period of six months, did not change the bone mineral density and metabolism of asthmatic children.

  11. 小儿喘息性支气管炎雾化吸入治疗的护理措施%Discussion of care measures in children with asthmatic bronchitis inhalation therapy

    Institute of Scientific and Technical Information of China (English)

    李红; 李艳

    2015-01-01

    Objective:To understand the clinical effect of children with asthmatic bronchitis inhalation therapy care measures. Methods:100 patients with application in the treatment of inhalation asthmatic bronchitis were selected from 2011 to 2014. According to the nursing program they were divided into the control group and the observation group,50 cases in each group.The control group were received routine treatment and nursing,and the observation group accepted for treatment and nursing of atomizing inhalation.The two groups were compared for the clinical efficacy.Results:The observation group with clinical treatment of the total efficiency of 92%,significantly better than the control group the total efficiency of 78%,and there was statistically significant(P<0.05).The observation group with parents on the satisfaction degree of nursing intervention to the control group was significant superiority,and there was statistically significant(P<0.05).Conclusion:The main clinical treatment of children with asthmatic bronchial is inhalation.Nursing intervention measures detailed in the course of treatment can guarantee the better therapeutic effects,the greatest extent to reduce the impact of disease on the life quality of patients.It is worthy of clinical popularization and promotion.%目的:了解雾化吸入治疗喘息性支气管炎小儿患儿的护理措施及其临床价值。方法:2011年-2014年收治应用雾化吸入方案治疗喘息性支气管炎患儿100例,根据护理方案将其分为对照组与观察组,每组50例。对照组接受常规治疗护理,观察组接受针对性雾化吸入治疗护理。对比两组患儿临床治疗效果。结果:观察组临床治疗总有效率92.0%,显著优于对照组总有效率78.0%,差异有统计学意义(P<0.05);观察组患儿家长对护理干预满意程度相对于对照组患儿家长有显著优越性,差异有统计学意义(P<0.05)。结论:对喘息性支气管患儿主要临床

  12. 父母认知及管理对支气管哮喘患儿治疗依从性的影响%Effect of parental management and cognition of related knowledge on asthmatic children's compliance to ;therapy

    Institute of Scientific and Technical Information of China (English)

    魏然; 叶依娜; 龚享锋; 石就家; 谭丹

    2016-01-01

    Objective To investigate the effect of parental management and cognition of related knowledge on asthmatic children's compliance to therapy. Methods A total of 86 cases of asthmatic children admitted to Department of Pediatrics of our hospital from October 2013 to October 2015, were selected as research objects. Clinical data of these children were collected and a questionnaire was developed. Based on the behavior of children with glucocorticoids dur-ing treatment, all these children were divided into the compliance group (34 cases) and the non-compliant group (52 cas-es). The general information questionnaire, parental knowledge, parental management, medication compliance question-naires and drug inhalation technique questionnaire survey were compared with statistical methods. Results General in-formation on two groups of children and parents showed that the compliance group of children had the lower frequency of outbreak and better educated parents (P<0.05). The cognition score of disease in the compliance group parents was (18.6 ± 2.6) points, significantly higher than the non-compliant group of (12.5 ± 2.1) points (P<0.05). The management score of in the compliance group parents was (119 ± 7) points, significantly lower than the control group of (145 ± 8) points (P<0.05). The children's inhalation technology score of in the compliance group was (5.2±0.8) points, significant-ly higher than that in the control group of (2.1 ± 1.3) points (P<0.05). Logistic regression analysis showed that parental cognition [OR=1.04, 95% CI (1.00~1.13), P=0.02], parental management [OR=0.06, 95%CI (0.50~0.92), P=0.01] and children with inhalation technique [OR=2.68, 95% CI (1.52~6.53), P=0.01] were the influencing factors of treatment compliance in asthmatic children (P<0.01). Conclusion To improve parents' cognition and management can improve medication compliance and symptoms of children with bronchial asthma, and reduce the incidence frequency.%目的:探讨父母认

  13. HT. A clinician demurs.

    Science.gov (United States)

    Speroff, Leon

    2003-10-01

    The ongoing challenge to clinicians is to make medical judgments that are suitable for patients as individuals with unique combinations of medical needs. The cancellation of the WHI study's estrogen/progestin arm leaves unanswered questions that will affect clinicians' medical decisions.

  14. Clinical Nursing Care of Patients with Severe Asthmatic Suffocating Pneumonia in Children%小儿重型喘憋性肺炎临床护理效果观察

    Institute of Scientific and Technical Information of China (English)

    王文英

    2014-01-01

    目的:研究并观察小儿重型喘憋性肺炎临床护理效果。方法本组研究的研究对象主要为我院2009年12月~2012年7月共收治的82例小儿重型喘憋性肺炎患者护理。结果所有的82例小儿重型喘憋性肺炎患者在经过科学的治疗以及系统的护理之后,均康复出院。结论对于小儿重型喘憋性肺炎的患者而言,临床治疗固然重要,然而,系统与科学的护理亦不可忽视。护理人员应该了解小儿重型喘憋性肺炎的基本理论以及护理方法,认真观察患者的病情,运用正确的护理方式,以最大限度的保障患者的临床疗效。%Objective To study and observation of severe asthma in children with pneumonia clinical nursing ef ect. Methods The research object of this group as the main study in our hospital from 2009 December to 2012 July were treated 82 cases of severe asthma children hold nursing of patients with pneumonia. Results Al the 82 cases severe asthma in children with pneumonia patients after the treatment and nursing science system, have recovered and been discharged. Conclusion For severe asthma in children with asthmatic pneumonia patients, clinical treatment is important, however, the nursing system and science should not be ignored. Nursing staf should understand the basic theory of severe asthma in children with pneumonia and nursing methods, careful y observe the patient's condition, the cor ect way to use nursing, clinical ef icacy in patients with maximum protection.

  15. Corticosteróides inalatórios e crescimento em crianças asmáticas ambulatoriais Inhaled corticosteroid treatment and growth of asthmatic children seen at outpatient clinics

    Directory of Open Access Journals (Sweden)

    Elisete E. Arend

    2006-06-01

    Full Text Available OBJETIVO: Verificar o efeito do uso de corticosteróides inalatórios no aumento estatural e ponderal de crianças asmáticas tratadas ambulatorialmente MÉTODOS: Foi realizado um estudo de coorte prospectivo de 1 ano, no qual 124 crianças asmáticas com 3 a 16 anos de idade que haviam recebido prescrição para uso de corticosteróides inalatórios há pelo menos 12 meses foram avaliadas quanto aos escore z altura/idade, peso/idade, índice de massa corporal e altura alvo parental estimada para a idade atual. Os critérios de exclusão foram: peso de nascimento menor que 2.500 g, desnutrição, doenças crônicas e uso de corticóide sistêmico por mais de 7 dias consecutivos. RESULTADOS: A média ± desvio padrão dos escores z altura/idade inicial e final foi, respectivamente, de 0,06±1,2 e 0,01±1,2, (IC95% 0,05-0,11; dos escores z peso/idade inicial e final foi de 0,6±1,5 e 0,5±1,5, respectivamente (IC95% 1,84-6,6. Esses valores não diferiram significativamente (p = 0,199 e p = 0,808. Quando estratificados em grupos bem e mal controlados da asma, púberes e não-púberes, também não houve perda estatural. CONCLUSÃO: Em relação às curvas NCHS (National Center for Health Statistics, não houve prejuízo na estatura e peso corporal de crianças/adolescentes que utilizaram corticosteróides inalatórios por mais de 1 ano nas doses preconizadas para prevenir asma.OBJECTIVE: To ascertain the effect of inhaled corticosteroid use on gain in height and weight of asthmatic pediatric outpatients. METHODS: A one-year prospective cohort study was carried out with 124 asthmatic children aged 3 to 16 years who were prescribed inhaled corticosteroids for at least 12 months, evaluating z-scores for height/age, weight/age, body mass index and parental target height for current age. Exclusion criteria were: birth weight less than 2,500 g, malnutrition, chronic diseases and systemic corticoid use for more than 7 consecutive days. RESULTS: The mean

  16. What can we learn from chest radiographs in hypoxemic asthmatics?

    International Nuclear Information System (INIS)

    Background: Chest radiographs (X-rays) are frequently obtained on children with asthma exacerbations who remain hypoxemic after therapy eventhough their utility has not been evaluated. Objective: To compare X-rays in hypoxemic and non-hypoxemic asthmatic children. Methods: Over 21 months, X-rays were obtained on all persistently hypoxemic asthmatics (1-17 years, oxygen saturation <93% in room air), and some non-hypoxemic asthmatics. A pediatric radiologist blinded to the patients' symptoms evaluated each X-ray for lung size, extravascular lung fluid, and atelectasis. Clinical outcomes including duration of hypoxemia, length of hospital stay, and admission to the PICU were assessed through chart audit after hospital discharge. Results: A total of 445 patients were enrolled and stratified into four groups based on initial and post-treatment pulse oximetry measurements. Hypoxemic groups I and II were more likely to have large or small lungs (P<0.05), severe interstitial fluid (P<0.01), and atelectasis (P<0.01) compared to non-hypoxemic group IV. Group I was more likely to have fluid in the alveolar space compared to all other groups (P<0.01). Within hypoxemic group I, there was no association between any radiographic findings and our clinical outcomes. (orig.)

  17. Study on the characters of the asthmatic children's behavior and the psychological status of their mothers%支气管哮喘患儿行为特征及其与母亲心理健康状况相关性研究

    Institute of Scientific and Technical Information of China (English)

    林菊清; 黄春香; 张立岗

    2011-01-01

    目的 探讨支气管哮喘患儿行为特征及其母亲心理健康状况,为临床治疗及早期干预提供依据.方法 以2007年10月至2009年2月长治医学院附属和济医院、附属和平医院确诊的4~12岁支气管哮喘患儿96例为支气管哮喘组,采用Achenhach儿童行为评定量表(cBcL)对支气管哮喘组及96名正常儿童(对照组)进行评估.采用症状自评量表(SCL-90)对所有研究对象的母亲进行评估.结果 支气管哮喘组患儿社会能力低于对照组,行为问题总检出率为38.5%,明显高于对照组(15.7%),差异有统计学意义(P<0.005);在躯体主诉、抑郁、焦虑、内向性行为、社交退缩、违纪等方面得分高于对照组,差异均有统计学意义(P<0.05).支气管哮喘组患儿母亲在焦虑、抑郁、敌对、恐怖、精神病性等方面得分均高于对照组儿童母亲,差异有统计学意义(P<0.05).结论 支气管哮喘患儿较正常儿童表现出更多的行为问题,且支气管哮喘患儿母亲较正常儿童的母亲更易出现一些心理问题,故在对支气管哮喘患儿进行规范的药物治疗基础上,应配合适当的心理行为干预.%Objective To study the characters of the asthmatic children' s behavior and the psychological status of their mothers, and to provide the evidence for the synthesis treatment and the early intervention in the clinical practice.Methods Totally 96 children with astthma and 96 healthy children were investigated about their psychological behavior with Achenbach Children Behavioral Scale (CBCL) ;their mothers were investigated about their psychological status with Symptom Checklist 90 (SCL-90). Results The oecurrence rate of behavioral problems was 38.5% in the asthmatic children, which was higher than the normal children's 15.7%;the difference was significant (P < 0.005 ). The scores of the asthmatic children in the somatization, dumps, anxiety, social intercourse flinch and disobeying were higher than

  18. Susceptibility of asthmatic children to respiratory infection Susceptibilidade de crianças asmáticas a infecções respiratórias

    Directory of Open Access Journals (Sweden)

    Júlio C. R. Pereira

    1997-10-01

    Full Text Available OBJECTIVE: A case-control study of patients with pneumonia was conducted to investigate whether wheezing diseases could be a risk factor. METHODS: A random sample was taken from a general university hospital in S. Paulo City between March and August 1994 comprising 51 cases of pneumonia paired by age and sex to 51 non-respiratory controls and 51 healthy controls. Data collection was carried out by two senior paediatricians. Diagnoses of pneumonia and presence of wheezing disease were independently established by each paediatrician for both cases and controls. Pneumonia was radiologically confirmed and repeatability of information on wheezing diseases was measured. Logistic regression analysis was used to identify risk factors. RESULTS: Wheezing diseases, interpreted as proxies of asthma, were found to be an important risk factor for pneumonia with an odds ratio of 7.07 (95%CI= 2.34-21.36, when the effects of bedroom crowding (odds ratio = 1.49 per person, 95%CI= 0.95-2.32 and of low family income (odds ratio = 5.59 against high family income, 95%CI= 1.38-22.63 were controlled. The risk of pneumonia attributable to wheezing diseases is tentatively calculated at 51.42%. CONCLUSION: It is concluded that at practice level asthmatics should deserve proper surveillance for infection and that at public health level pneumonia incidence could be reduced if current World Health Organisation's guidelines were reviewed as to include comprehensive care for this illness.OBJETIVO: Investigar, através de um estudo caso-controle de pacientes com pneumonia, se as doenças chiadoras poderiam constituir-se em fator de risco. MÉTODOS: De um hospital universitário, na cidade de São Paulo, Brasil, entre março e agosto de 1994, foi tomada uma amostra de 51 casos de pneumonia pareados por sexo e idade a 51 controles sadios e 51 controles não respiratórios. O diagnóstico de pneumonia e a presença de doença chiadora foram investigados de forma independente por

  19. Analysis on the effects of the subjective living-quality and the social adaptive behavior in asthmatic children%哮喘儿童的主观生活质量及社会适应能力评定分析

    Institute of Scientific and Technical Information of China (English)

    张玲; 江忠; 徐静

    2012-01-01

    [Objective]To know the quality of life and the social of adaptive behavior in asthmatic children. [Methods] The subjective quality of life and the social adaptive behavior of 68 moderate or severe asthmatic children aged 7 ~ 12. 5 years were measured by means of ISLQ and SAB scales in remission stage. [Results]The scores of subjective quality of life in asthma group were lower than that in control group(P<0. 05 or <0. 01). The adaptive deviation quotient of asthma group was lower than that of control group(P<0. 05). Particularly social/self-direction factor was significantly low-er than in control group(P<0. 001). [Conclusions] The two parties of subjective living quality and social of adaptive behavior in asthmatic children are lower than in normal children. In order to improve the quality of life and the social adaptive behavior,the comprehensive intervention should be made according to different psychological characteristics in asthmatic children.%[目的]了解哮喘患儿主观生活质量及社会适应能力,为提高患儿的主观生活质量及社会适应能力提供指导依据. [方法]采用ISLQ及SAB量表,对68例年龄7~12.5岁的中、重度处于缓解期的哮喘患儿进行主观生活质量及社会适应能力的心理测试. [结果]反映主观生活质量的8个维度中哮喘患儿有6个维度得分明显低于对照组(P<0.05或<0.01);社会适应商数低于对照组(P<0.05),尤其以社会/自制因子与对照组差异极显著(P<0.001).[结论]哮喘患儿主观生活质量和社会适应能力明显低于对照儿童,应针对患儿不同的心理特点进行综合干预,力求提高生活质量和适应能力.

  20. 25例小儿支气管哮喘并肺部感染的治疗体会%Treating bronchial asthmatic children by combining Montelukast Sodium Chewable Tablets and Budesonide Suspension for Inhalation plus Terbutaline Sulphate Solution for Nebulisation

    Institute of Scientific and Technical Information of China (English)

    朱至明; 陈建华; 吴思雨

    2010-01-01

    目的 观察顺尔宁联用普米克令舒+博利康尼氧驱动雾化吸入治疗小儿支气管哮喘的疗效.方法 对收住的25例支气管哮喘并肺部感染患儿的临床资料进行回顾性分析.结果 顺尔宁联用普米克令舒+博利康尼雾化吸入治疗小儿支气管哮喘并肺部感染的半年复发率为0,单纯用普米克令舒+博利康尼氧驱动雾化吸入治疗小儿支气管哮喘并肺部感染的半年复发率为46.7%.结论 顺尔宁联用普米克令舒+博利康尼氧驱动雾化吸入治疗小儿支气管哮喘并肺部感染疗效显著,值得临床推广应用.%Objective To observe the therapeutic effects of montelukast sodium chewable tablets and budesonide suspension for inhalation plus terbutaline sulphate solution for nebulisation in bronchial asthmatic children. Method Proceed with the review analysis of 25 examples of bronchial asthmatic children. Result Bronchial asthmatic children with the treatment of montelukast sodium chewable tablets and budesonide suspension for inhalation plus terbutaline sulphate solution for nebulisation, whose halfyearly setback rate is 0.Conclusions Those without montelukast sodium chewable tablets whose halfyearly setback rate is 46.7%.

  1. Barriers to Prescribing Controller Anti-Inflammatory Medication Among Puerto Rican Asthmatic Children with Public Insurance: Results of National Survey of Pediatricians

    OpenAIRE

    Canino, Glorisa; Vila, Doryliz; CABANA, MICHAEL; Quiñones, Amarilis; Otero, Mirla; Acosta, Edna; Pabón-Cruz, Karen; Colón, Frances M.; Rand, Cynthia

    2010-01-01

    There are substantial disparities in dispensing patterns of long-term control medications for asthma among children in Puerto Rico with public insurance compared to those with private insurance. Public health insurance policy in Puerto Rico includes the cost of medications in the capitation paid to the primary care physicians and clinics. Survey questionnaires were mailed to all pediatricians enrolled in the Puerto Rico College of Physicians (N = 798) in addition to some pediatricians not enr...

  2. The effect of inhaled budesonide on symptoms, lung function, and cold air and methacholine responsiveness in 2- to 5-year-old asthmatic children

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2000-01-01

    ) with moderately severe asthma in a single-center, randomized, double-blind, parallel-group, placebo-controlled study involving 8 wk of treatment. Budesonide (BUD) 400 microgram twice daily was administered via a pressurized metered-dose inhaler and metal spacer device. Symptom scores (SSc) and use of short......-acting beta(2)-agonist were monitored with diary cards. LF in awake children was measured as the specific airway resistance (sRaw), using whole-body plethysmography; as resistance by the interrupter technique (Rint); and as resistance and reactance at 5 Hz (Rrs5, Xrs5) by the impulse oscillation technique...

  3. Cumulative high doses of inhaled formoterol have less systemic effects in asthmatic children 6-11 years-old than cumulative high doses of inhaled terbutaline

    DEFF Research Database (Denmark)

    Kaae, Rikke; Agertoft, Lone; Pedersen, Sören;

    2004-01-01

    OBJECTIVES: To evaluate high dose tolerability and relative systemic dose potency between inhaled clinically equipotent dose increments of formoterol and terbutaline in children. METHODS: Twenty boys and girls (6-11 years-old) with asthma and normal ECGs were studied. Ten doses of formoterol (Oxis...... pressure (BP), ECG, plasma potassium, glucose, lactate, and adverse events were monitored up to 10 h to assess tolerability and relative systemic dose potency. RESULTS: Formoterol and terbutaline had significant beta2-adrenergic effects on most outcomes. Apart from the effect on systolic BP, QRS duration...... and PR interval, the systemic effects were significantly more pronounced with terbutaline than with formoterol. Thus, mean minimum plasma potassium, was suppressed from 3.56 (95% confidence interval, CI: 3.48-3.65) mmol l(-1) on the day of no treatment to 2.98 (CI: 2.90-3.08) after 10 x F4.5 and 2...

  4. Effectiveness of heating, ventilation and air conditioning system with HEPA filter unit on indoor air quality and asthmatic children's health

    Energy Technology Data Exchange (ETDEWEB)

    Xu, Ying; Raja, Suresh; Ferro, Andrea R.; Jaques, Peter A.; Hopke, Philip K. [Clarkson University, 8 Clarkson Avenue, Center for Air Resources Engineering and Science, Potsdam, NY 13699 (United States); Gressani, Cheryl; Wetzel, Larry E. [Air Innovations, Inc, 7000 Performance Drive, North Syracuse, NY 13212 (United States)

    2010-02-15

    Poor indoor air quality has been linked to the exacerbation of asthma symptoms in children. Because people spend most of their time indoors, improving indoor air quality may provide some relief to asthma sufferers. A study was conducted to assess whether operating an air cleaning/ventilating unit (HEPAiRx {sup registered}) in a child's bedroom can improve his/her respiratory health. Thirty children diagnosed with asthma were randomly split into two groups. For the first six weeks, group A had the air cleaning/ventilating unit (HEPAiRx {sup registered}) running in the bedrooms of the participants and group B did not; for the second six weeks, both groups had the cleaners running in the bedrooms; and, for the final six weeks, group A turned the cleaners off and group B kept theirs running. Indoor air quality parameters, including temperature, relative humidity, particulate matter (PM 0.5-10 {mu}m), carbon monoxide, carbon dioxide and total volatile organic compound (TVOC) concentrations, were monitored in each bedroom using an AirAdvice indoor air quality multi-meter. As a measure of pulmonary inflammation, exhaled breath condensate (EBC) was collected every sixth day and analyzed for nitrate and pH. Peak expiratory flow (PEF) was also measured. PM and TVOC concentrations decreased with operation of the HEPAiRx an average of 72% and 59%, respectively. The EBC nitrate concentrations decreased significantly and the EBC pH and PEF values increased significantly with operation of the unit (p < 0.001 when comparing on/off sample means). These results indicate that air cleaning in combination with ventilation can effectively reduce symptoms for asthma sufferers. (author)

  5. Effects of Dietary Induced Weight Loss on Exercise-Induced Bronchoconstriction in Overweight and Obese Children

    NARCIS (Netherlands)

    van Leeuwen, Janneke C.; Hoogstrate, Mira; Duiverman, Eric J.; Thio, Boony J.

    2014-01-01

    RationalePrevious studies showed that obesity in asthmatic children is associated with more severe exercise-induced bronchoconstriction (EIB), compared with non-obese asthmatic children. This study investigates the effect of weight loss on EIB in overweight and obese asthmatic children. MethodsIn th

  6. Clinical Decision-Making in Community Children's Mental Health: Using Innovative Methods to Compare Clinicians with and without Training in Evidence-Based Treatment

    Science.gov (United States)

    Baker-Ericzén, Mary J.; Jenkins, Melissa M.; Park, Soojin; Garland, Ann F.

    2015-01-01

    Background: Mental health professionals' decision-making practice is an area of increasing interest and importance, especially in the pediatric research and clinical communities. Objective: The present study explored the role of prior training in evidence-based treatments (EBTs) on clinicians' assessment and treatment formulations using…

  7. The clinician's guide to autism.

    Science.gov (United States)

    Harrington, John W; Allen, Korrie

    2014-02-01

    On the basis of the most recent epidemiologic research, Autism Spectrum Disorder (ASD) affects approximately 1% to 2% of all children. (1)(2) On the basis of some research evidence and consensus, the Modified Checklist for Autism in Toddlers isa helpful tool to screen for autism in children between ages 16 and 30 months. (11) The Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, changes to a 2-symptom category from a 3-symptom category in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition(DSM-5): deficits in social communication and social interaction are combined with repetitive and restrictive behaviors, and more criteria are required per category. The DSM-5 subsumes all the previous diagnoses of autism (classic autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified) into just ASDs. On the basis of moderate to strong evidence, the use of applied behavioral analysis and intensive behavioral programs has a beneficial effect on language and the core deficits of children with autism. (16) Currently, minimal or no evidence is available to endorse most complementary and alternative medicine therapies used by parents, such as dietary changes (gluten free), vitamins, chelation, and hyperbaric oxygen. (16) On the basis of consensus and some studies, pediatric clinicians should improve their capacity to provide children with ASD a medical home that is accessible and provides family-centered, continuous, comprehensive and coordinated, compassionate, and culturally sensitive care. (20)

  8. The clinician's guide to autism.

    Science.gov (United States)

    Harrington, John W; Allen, Korrie

    2014-02-01

    On the basis of the most recent epidemiologic research, Autism Spectrum Disorder (ASD) affects approximately 1% to 2% of all children. (1)(2) On the basis of some research evidence and consensus, the Modified Checklist for Autism in Toddlers isa helpful tool to screen for autism in children between ages 16 and 30 months. (11) The Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, changes to a 2-symptom category from a 3-symptom category in the Diagnostic Statistical Manual of Mental Disorders, Fifth Edition(DSM-5): deficits in social communication and social interaction are combined with repetitive and restrictive behaviors, and more criteria are required per category. The DSM-5 subsumes all the previous diagnoses of autism (classic autism, Asperger syndrome, and pervasive developmental disorder not otherwise specified) into just ASDs. On the basis of moderate to strong evidence, the use of applied behavioral analysis and intensive behavioral programs has a beneficial effect on language and the core deficits of children with autism. (16) Currently, minimal or no evidence is available to endorse most complementary and alternative medicine therapies used by parents, such as dietary changes (gluten free), vitamins, chelation, and hyperbaric oxygen. (16) On the basis of consensus and some studies, pediatric clinicians should improve their capacity to provide children with ASD a medical home that is accessible and provides family-centered, continuous, comprehensive and coordinated, compassionate, and culturally sensitive care. (20) PMID:24488830

  9. Avaliação do crescimento linear de crianças e adolescentes com asma Linear growth evaluation of asthmatic children

    Directory of Open Access Journals (Sweden)

    MARIA ÂNGELA G. MONTEIRO-ANTONIO

    2002-06-01

    Full Text Available OBJETIVO: Estudar a influência da asma atópica sobre a estatura e a velocidade de crescimento em crianças e adolescentes brasileiros, considerando as condições socioeconômicas, a história natural da doença e o crescimento individual. MÉTODOS: Foram acompanhados 66 pacientes do Ambulatório de Imunologia, Alergia e Pneumologia do Hospital das Clínicas da Universidade Estadual de Campinas (HC/Unicamp, com idade entre 4 e 14 anos completos. A altura foi medida ao início do estudo e a cada três meses, e a idade óssea realizada uma vez durante o período de observação. Os pacientes foram divididos em dois grupos de acordo com o desenvolvimento puberal: pré-púbere e púbere. RESULTADOS: Nos 40 pacientes do grupo pré-púbere, com seguimento de 0,5 - 1,3 anos, a média dos escores z da altura/idade foi 0,028±0,978 e a da velocidade de crescimento foi 0,045±1,110. Os 26 pacientes do grupo púbere, com seguimento de 0,6 - 1,5 anos, tiveram a média dos escores z da altura/idade de -0,170±1,209 e a da velocidade de crescimento de -0,042±2,321. No grupo pré-púbere, os pacientes que tiveram uma ou mais pneumonias, apresentaram menor média do escore z da velocidade de crescimento (p=0,04, enquanto nos pacientes púberes, o mesmo se observou em relação ao uso de corticosteróides em dose alta (p=0,02. CONCLUSÕES: O manejo correto da asma, associado ao controle das infecções e à condições de vida favoráveis, permitem que as crianças e adolescentes cresçam normalmente, atingindo seu potencial genético pleno.OBJETIVE: The aim was to assess the effect of atopic asthma on the stature and growth velocity of Brazilian adolescents and children, taking into consideration their socioeconomic conditions, natural disease history and individual growth .METHODS: 66 patients had been seen at the Pneumology, Immunology and Allergy Ambulatory, Unicamp, University Hospital. Their height and weight were measured every 3 months and the bone

  10. Life quality related to health in asthmatic children and their caretaker. Calidad de vida relacionada con salud en niños asmáticos y sus cuidadores.

    Directory of Open Access Journals (Sweden)

    Roberto Travieso Peña

    2005-12-01

    Full Text Available

    Fundament: In present days it is known that sanitary assistance should not only be focused on patient’s survival (life quantity, but also in the life quality. Objective: to evaluate health-related life quality in children with asthma and their caretakers through 4 measurement devices. Methods: Analytic-prospective-descriptive study to evaluate life quality of children and their caretakers. There was a universe of 72 asthmatic children from the number 32, 37, and 49 clinics of Palmira. For life quality estimation three questionnaires were used. We calculated the standard deviation and measure of the variables. The variations in measurement were evaluated through minimum change difference. Three measurements were realized in one month interval. Results: The 61.8% of patients evaluated with the American college quality test had bad life quality. The evaluation of life quality using the questionnaire of the Mc Master the Juniper University threw a moderate life quality, being the emotive sphere the most affected. The evaluation of life quality in caretakers showed a deterioration.

    Fundamento: En nuestros días se reconoce que la asistencia sanitaria no sólo debe focalizarse en la supervivencia del paciente (cantidad de vida, sino también en la calidad de vida. Objetivo: Evaluar la calidad de vida relacionada con salud en niños con asma y sus cuidadores a través de 4 herramientas de medición. Métodos: Estudio descriptivo prospectivo analítico para evaluar la calidad de vida de niños y sus cuidadores. Para ello se tomó el universo de 72 niños asmáticos de los consultorios 32, 37, 49 de Palmira. Para la estimación de la calidad de vida se emplearon tres cuestionarios. A las variables se les calculó media y desviación estándar. Las variaciones en las mediciones se evaluaron por medio de la

  11. Safety of specific immunotherapy with standardized house-dust mite vaccine in asthmatic children%标准化屋尘螨提取液治疗儿童支气管哮喘的安全性研究

    Institute of Scientific and Technical Information of China (English)

    郝创利; 陶慧; 沈美菊; 侯政

    2008-01-01

    目的 通过观察进行标准化屋尘螨特异性免疫治疗(脱敏治疗)的支气管哮喘(简称哮喘)患儿,在脱敏治疗过程中出现的不良反应,评价脱敏治疗的安全性.方法 对在苏州大学附属儿童医院哮喘专科门诊临床确诊的110例哮喘患儿,应用(丹麦ALK-Abell(o)公司安脱达)标准化屋尘螨提取液进行皮下注射脱敏治疗.观察每次注射后不良反应发生情况,统计脱敏治疗的不良反应发生率.结果 在110例患儿共接受免疫注射2332人次,发生局部不良反应291人次(发生率12.48%),其中速发型局部不良反应146人次(6.26%),迟发型局部不良反应145人次(6.22%).局部不良反应在20~800SQU、2000~80 000SQU、100 000 SQU阶段的发生率分别是:1.05%(6/569)、12.05%(97/805)和19.62%(188/958),差异有统计学意义.发生全身不良反应79人次(3.39%),1例次为3级非致命性全身反应,其余均为轻度全身反应(包括哮喘、过敏性鼻炎,过敏性结膜炎、过敏性皮炎),其中速发型全身不良反应49人次(2.10%).迟发型全身不良反应为30人次(1.29%).全身不良反应在20~800 SQU、2 000~80 000 SQU、100 000 SQU阶段的发生率分别是:0.35%(2/569)、6.71%(54/805)和2.51%(24/958),差异有统计学意义.结论 哮喘患儿对标准化屋尘螨提取液特异性免疫治疗耐受性良好.绝大多数局部不良反应为轻度,其发生率随注射提取物浓度增高而增高.全身不良反应绝大多数为轻度,以发生在2 000~80 000 SQU剂量明显上升阶段为最多,在此阶段多加注意.全身不良反应以注射浓度2 000~80 000 SQU为最高.而局部不良反应以100 000 SQU组为最高,提示局部不良反应和全身不良反应不平行.局部不良反应发生不提示全身不良反应发生.%Objective To evaluate the safety of specific immunotherapy(SIT)with standardized house dust mite(HDM)vaccine on allergic asthmatic children.Methods 110 patients with mild to moderate

  12. Directional secretory response of double stranded RNA-induced thymic stromal lymphopoetin (TSLP and CCL11/eotaxin-1 in human asthmatic airways.

    Directory of Open Access Journals (Sweden)

    Gustavo Nino

    Full Text Available BACKGROUND: Thymic stromal lymphoproetin (TSLP is a cytokine secreted by the airway epithelium in response to respiratory viruses and it is known to promote allergic Th2 responses in asthma. This study investigated whether virally-induced secretion of TSLP is directional in nature (apical vs. basolateral and/or if there are TSLP-mediated effects occurring at both sides of the bronchial epithelial barrier in the asthmatic state. METHODS: Primary human bronchial epithelial cells (HBEC from control (n = 3 and asthmatic (n = 3 donors were differentiated into polarized respiratory tract epithelium under air-liquid interface (ALI conditions and treated apically with dsRNA (viral surrogate or TSLP. Sub-epithelial effects of TSLP were examined in human airway smooth muscle cells (HASMC from normal (n = 3 and asthmatic (n = 3 donors. Clinical experiments examined nasal airway secretions obtained from asthmatic children during naturally occurring rhinovirus-induced exacerbations (n = 20 vs. non-asthmatic uninfected controls (n = 20. Protein levels of TSLP, CCL11/eotaxin-1, CCL17/TARC, CCL22/MDC, TNF-α and CXCL8 were determined with a multiplex magnetic bead assay. RESULTS: Our data demonstrate that: 1 Asthmatic HBEC exhibit an exaggerated apical, but not basal, secretion of TSLP after dsRNA exposure; 2 TSLP exposure induces unidirectional (apical secretion of CCL11/eotaxin-1 in asthmatic HBEC and enhanced CCL11/eotaxin-1 secretion in asthmatic HASMC; 3 Rhinovirus-induced asthma exacerbations in children are associated with in vivo airway secretion of TSLP and CCL11/eotaxin-1. CONCLUSIONS: There are virally-induced TSLP-driven secretory immune responses at both sides of the bronchial epithelial barrier characterized by enhanced CCL11/eotaxin-1 secretion in asthmatic airways. These results suggest a new model of TSLP-mediated eosinophilic responses in the asthmatic airway during viral-induced exacerbations.

  13. Information management for clinicians.

    Science.gov (United States)

    Mehta, Neil B; Martin, Stephen A; Maypole, Jack; Andrews, Rebecca

    2016-08-01

    Clinicians are bombarded with information daily by social media, mainstream television news, e-mail, and print and online reports. They usually do not have much control over these information streams and thus are passive recipients, which means they get more noise than signal. Accessing, absorbing, organizing, storing, and retrieving useful medical information can improve patient care. The authors outline how to create a personalized stream of relevant information that can be scanned regularly and saved so that it is readily accessible. PMID:27505880

  14. Radiosensitivity and the clinician

    Energy Technology Data Exchange (ETDEWEB)

    1985-07-06

    The existence of differences in cellular radiosensitivity in individuals with different disorders has implications for the clinician from the points of view of diagnosis and therapy. Comments are made on the abnormal response of lymphocytes from patients with various disorders such as ataxia-telangiectasis, Friedreich's ataxia, familial retinoblastoma, multiple sclerosis, Rothmund-Thomson syndrome, tuberous sclerosis, Huntington's disease, and auto-immune diseases such as rheumatoid arthritis and polymyosotis. The possibility of using the variations in radiation response as a means of identification of A-T heterozygotes and Huntington's disease carriers is raised.

  15. Patient-clinician conflict: causes and compromises.

    Science.gov (United States)

    Lask, Bryan

    2003-03-01

    Conflict is an everyday phenomenon, a part of everyday life. It is hardly surprising that it also occurs in a clinical setting, not only between clinicians and within teams, but also between patients, their families and clinicians. This is all the more the likely in a setting that deals with a chronic disease such as CF. The physical, emotional, social and practical burdens of the illness are such that coping mechanisms are stretched to their limits. Disagreements, misunderstandings, impaired trust and different expectations may all challenge the patient-clinician relationship. In a context in which children and adolescents form at least half the clientele, the potential for conflict is intensified because of the involvement of parents. This paper emphasises the normality of such conflicts, and using case illustrations, explains the reasons for conflicts and explores how best to resolve them. The basic principles of conflict-resolution are outlined, and useful techniques, readily applicable in everyday practice, are described. PMID:15463846

  16. Identification of a core set of exercise tests for children and adolescents with cerebral palsy : a Delphi survey of researchers and clinicians

    NARCIS (Netherlands)

    Verschuren, Olaf; Ketelaar, Marjolijn; Keefer, Daniel; Wright, Virginia; Butler, Jane; Ada, Louise; Maher, Carol; Reid, Siobhan; Wright, Marilyn; Dalziel, Blythe; Wiart, Lesley; Fowler, Eileen; Unnithan, Viswanath; Maltais, Desiree B.; Van Den Berg-Emons, Rita; Takken, Tim

    2011-01-01

    AIM Evidence-based recommendations regarding which exercise tests to use in children and adolescents with cerebral palsy (CP) are lacking. This makes it very difficult for therapists and researchers to choose the appropriate exercise-related outcome measures for this group. This study aimed to ident

  17. Undifferentiated bronchial fibroblasts derived from asthmatic patients display higher elastic modulus than their non-asthmatic counterparts.

    Directory of Open Access Journals (Sweden)

    Michal Sarna

    Full Text Available During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive research efforts, these properties remain unknown. Importantly, the role of undifferentiated HBFs in the asthmatic process was systematically omitted. Specifically, biomechanical properties of undifferentiated HBFs have not been considered in either FMT or airway remodeling in vivo. Here, we combine atomic force spectroscopy with fluorescence microscopy to compare mechanical properties and actin cytoskeleton architecture of HBFs derived from asthmatic patients and non-asthmatic donors. Our results demonstrate that asthmatic HBFs form thick and aligned 'ventral' stress fibers accompanied by enlarged focal adhesions. The differences in cytoskeleton architecture between asthmatic and non-asthmatic cells correlate with higher elastic modulus of asthmatic HBFs and their increased predilection to TGF-β-induced FMT. Due to the obvious links between cytoskeleton architecture and mechanical equilibrium, our observations indicate that HBFs derived from asthmatic bronchi can develop considerably higher static tension than non-asthmatic HBFs. This previously unexplored property of asthmatic HBFs may be potentially important for their myofibroblastic differentiation and bronchial wall remodeling during asthma development.

  18. Undifferentiated bronchial fibroblasts derived from asthmatic patients display higher elastic modulus than their non-asthmatic counterparts.

    Science.gov (United States)

    Sarna, Michal; Wojcik, Katarzyna A; Hermanowicz, Pawel; Wnuk, Dawid; Burda, Kvetoslava; Sanak, Marek; Czyż, Jarosław; Michalik, Marta

    2015-01-01

    During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT) can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs) derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive research efforts, these properties remain unknown. Importantly, the role of undifferentiated HBFs in the asthmatic process was systematically omitted. Specifically, biomechanical properties of undifferentiated HBFs have not been considered in either FMT or airway remodeling in vivo. Here, we combine atomic force spectroscopy with fluorescence microscopy to compare mechanical properties and actin cytoskeleton architecture of HBFs derived from asthmatic patients and non-asthmatic donors. Our results demonstrate that asthmatic HBFs form thick and aligned 'ventral' stress fibers accompanied by enlarged focal adhesions. The differences in cytoskeleton architecture between asthmatic and non-asthmatic cells correlate with higher elastic modulus of asthmatic HBFs and their increased predilection to TGF-β-induced FMT. Due to the obvious links between cytoskeleton architecture and mechanical equilibrium, our observations indicate that HBFs derived from asthmatic bronchi can develop considerably higher static tension than non-asthmatic HBFs. This previously unexplored property of asthmatic HBFs may be potentially important for their myofibroblastic differentiation and bronchial wall remodeling during asthma development. PMID:25679502

  19. Epidemiology of Depression for Clinicians.

    Science.gov (United States)

    Bromberger, Joyce T.; Costello, Elizabeth Jane

    1992-01-01

    Reviews epidemiology of depression and ways this information can be useful for clinicians. Defines frequently used epidemiological terms; presents prevalence rates and risk factors; discusses impact and consequences of depression; and suggests arenas for prevention, early intervention, and treatment that can help clinicians in their everyday work.…

  20. Analysis of Therapeutic Effect of Asthma-relieving Manipulation for Children with Acute Asthmatic Exacerbation by Lung Sound Spectrum%从肺音频谱分析平喘摩按法治疗儿童哮喘急性发作的效果

    Institute of Scientific and Technical Information of China (English)

    倪玉婷; 孙素涛; 张晶洁; 冯海音; 唐君; 徐荣谦

    2014-01-01

    Objective By using lung sound spectrum analysis, the clinical efficacy of asthma -relieving manipulation, which is a gentle massage therapy mainly on the acupoints, on acute exacerbation of children asthma was evaluated. Methods We collected the lung sound of 11 children with acute asthmatic attack before and after asthma-relieving manipulation, and then input to the computer for obtaining lung sound spectrum signal data. The sound intensity, average respiratory muscle strength ( RMS) power, total RMS power and the volume of every 25 Hz frequency spectrum were extracted for comparison. Results After asthma-relieving manipulation, the sound intensity, average RMS power, and total RMS power of the children with acute asthmatic attack were significantly lower than those before the manipulation (P0.05). Conclusion Lung sound spectrum analysis can be applied to monitor lung function of asthmatic children objectively and quantitatively, and it is a new sensitive method for clinical detection. Asthma-relieving manipulation shows certain effect on acute exacerbation of children asthma.%【目的】采用肺音频谱分析,评价平喘摩按法对儿童哮喘急性发作的疗效。【方法】采集11例儿童哮喘急性发作患者在实施平喘摩按法手法治疗前后的呼吸音,输入电脑导出肺音频谱信号数据,对声音强度(LSI)、平均有效功率(average RMS power)、总有效功率(total RMS power)及频率谱每隔25 Hz的音量大小进行比较。【结果】哮喘急性发作患儿在实施平喘摩按法手法治疗后,呼吸音强度、平均有效功率、总有效功率显著降低,与手法治疗前比较差异有统计学意义(P<0.01)。肺音频谱分析显示:手法治疗后,频率在300 Hz以下音量显著降低,与手法治疗前比较差异有统计学意义(P<0.05);而频率在300 Hz以上手法治疗前后音量大小差异无统计学意义(P>0.05)。【结论】肺音频谱

  1. EVALUATING ANTI-ASTHMATIC EFFECT OF POLYHERBAL AYURVEDIC DRUG BHARANGYADI ON RESPIRATORY MECHANICS USING MATLAB

    OpenAIRE

    Kajaria Divya; Kajaria Ankit; Tripathi J.S.; Tiwari S.K

    2013-01-01

    Asthma is one of the most prevalent chronic inflammatory lung diseases among children and adults. A lot of work had been done in various field (including both modern and Ayurvedic) on anti-asthmatic drugs to evaluate their action on lungs. The parameters chosen for assessing the properties of drug is mainly based on clinical improvement and improvement in pulmonary function test. These all method employed so far are indirect method for assessment of action of drug on lungs as change in pulmon...

  2. Risk factors in pediatric asthmatic patients. Cases and control studies.

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Gómez Baute

    2003-04-01

    Full Text Available Background: Asthma constitutes the first disease among chronic diseases in children. The morbid-mortality promoted to continue being elevated in spite of the new therapies. For this reason it is a disease with high priority for investigation in pediatric ages. Method: A control and case group study was carried out. The samples was composed by 72 asthmatic children from three General Comprehensive doctor offices from Palmira health area located in Cienfuegos Province, Cuba; and a control group of 72 children apparently healthy from the same population. A questionnaire with the different risk variables was elaborated. Odds ratio technique was used to estimate the risk. Results: low weight at birth, family history of asthma, brochiolitis antecedent and the excessive usage of antibiotics in children under 1 year old were the main risks found. Conclusions: It is conclusive that the exposure to home allergen plus a genetic favorable factor, the prematurity, and brochiolitis constituted the most outstanding elements to suffer from asthma in the population studied.

  3. The systemic family assessment system: its validity with asthmatic children and their families Evaluación familiar sistémica: su validez con niños asmáticos y sus familias Avaliação familiar sistêmica: sua validade com crianças asmáticas e suas famílias

    Directory of Open Access Journals (Sweden)

    Dóris Lieth Peçanha

    2007-12-01

    Full Text Available The construct and concurrent validity of the Systemic Family Assessment (SFA system was tested. Participants were 11 asthmatic and 14 healthy Brazilian children (aged 5 to 9 along with their intact families. Measures included the SFA, the Family Colored Drawing Test with children (FCDT, and a semi-structured interview with parents (PI. Comparisons between families of asthmatic and healthy children yielded significant differences for all family dimensions of the SFA. The most affected dimensions for families of asthmatic children were the individuation process within the family, family conflicts, family integration and cohesion, roles, and quality of leadership within the family. Significative correlation between the SFA and the two independent measures were found. Results support the construct and concurrent validity of the SFA.La validez de constructo y la validad coexistente do protocolo de Evaluación Familiar Sistémica (EFS fue establecida. El estudio fue realizado en Brasil con familias intactas, y observó 11 niños con asma y 14 saludables, con edades de 5 a 9 años. Las medidas analizadas incluyeron el EFS, el Test del Dibujo Coloreado de la Familia aplicado a los niños (TDCF, y una entrevista semi-estructurada aplicada a los padres (EP. Las comparaciones entre las familias de niños asmáticos y saludables apuntaron diferencias significativas en todas las dimensiones familiares de la EFS. En las familias de niños asmáticos las dimensiones más afectadas fueron el proceso de la individuación dentro de la familia, los conflictos familiares, la integración familiar y la cohesión, los papeles y la calidad de liderazgo dentro de la familia. Se encontró una correlación significativa entre el EFS y las dos medidas independientes. Los resultados prueban la validez del constructo y la validad coexistente del EFS.Foi testada a validade de construto e a validade concorrente do protocolo de Avaliação Familiar Sistêmica (AFS. Os

  4. The effect of endurance running training on asthmatic adults.

    OpenAIRE

    Freeman, W; Nute, M G; Williams, C.

    1989-01-01

    Nine mild to moderate asthmatic adults (three males, six females) and six non-asthmatics (one male, five females) underwent endurance running training three times per week for five weeks, at self selected running speeds on a motorized treadmill. After training, the asthmatic group had a significantly higher maximum oxygen uptake, significantly lower blood lactate and heart rate in submaximal running, and significantly reduced time to complete a two mile treadmill run, partly attributable to t...

  5. Does drug compliance change in asthmatic patients during pregnancy?

    OpenAIRE

    Yilmaz, Insu; Erkekol, Ferda Oner; Celen, Sevki; Karaca, Mujdegul Zayifoglu; Aydin, Omur; Celik, Gulfem; Misirligil, Zeynep; Mungan, Dilsad

    2013-01-01

    Background Pregnant women with asthma are recommended to maintain optimal therapeutic management during pregnancy. Uncontrolled, symptomatic asthma may increase the risk of adverse peri-natal outcomes; thus adequate regular anti-asthmatic treatment must be given to provide optimal asthma control during pregnancy. However, doubts about the safety of asthmatic drugs can affect pregnant asthmatic patients’ drug compliance. The aim of this study was to assess behavioral differences in drug compli...

  6. Correlación entre la espirometría y la resistencia y reactancia respiratoria medida por oscilometría de impulso en niños asmáticos CORRELATION BETWEEN SPIROMETRY AND RESPIRATORY RESISTANCE AND REACTANCE MEASURED BY IMPULSE OSCILLOMETRY IN ASTHMATIC CHILDREN

    Directory of Open Access Journals (Sweden)

    MARCELA LINARES P.

    2002-04-01

    Full Text Available La oscilometría de impulso (IOS es una técnica a través de la cual se mide la resistencia (Rrs y la reactancia respiratoria (Xrs a varias frecuencias simultaneas, a través de la interpretación de impulsos oscilatorios sobrepuestos a la ventilación corriente. Es un método que se realiza en forma rápida, no invasiva, y requiere una cooperación mínima por parte del paciente. Tres de los índices más sensibles para evaluar obstrucción periférica son la resistencia y la reactancia a 5 hertz (Rrs5 y Xrs5, y la frecuencia de resonancia (FR. El objetivo de este trabajo fue correlacionar distintos índices de la espirometría y la oscilometría de impulso (IOS, en niños asmáticos. Durante 6 meses, desde diciembre de 1999, se realiza en forma correlativa IOS y espirometría a todo niño asmático mayor de 6 años de la Unidad de Respiratorio Infantil del Hospital Padre Hurtado, con un equipo Jaeger Masterscreen IOS. Para el análisis de los resultados sólo fueron aceptadas aquellas curvas que cumplieron con los criterios de aceptabilidad y reproducibilidad determinados internacionalmente. Se obtuvo 98 pruebas aceptables para los dos exámenes en 40 niñas y 58 niños, con una edad promedio de 9,3 años (6 a 15 años. Se correlacionó VEF1, FEF25-75 , FEF25, FEF50, y FEF75 con Xrs5, Rrs5 y FR. Los coeficientes de correlación encontrados oscilaron entre 0,5 y 0,73 (p Impulse oscillometry (IOS is a technique that measures respiratory resistance (Rrs and reactance (Xrs at several frequencies, through the interpretation of oscillatory impulses overlapping spontaneous breathing. It is a non-invasive, fast and easy to perform technique that requires minimal patient cooperation. Three of the most sensitive parameters to evaluate peripheral airways obstruction are resistance and reactance at 5 Hertz (Rrs5 and Xrs5, and resonance frequency (RF. The aim of this study was to evaluate the correlation between spirometry and IOS, in asthmatic children

  7. Following-up study on efficacy of different preventive montelukast sodium programs in the prevention of wheezing and asthma of atopic children with asthmatic bronchitis%不同孟鲁司特钠方案预防特应质喘息性支气管炎患儿发作的研究

    Institute of Scientific and Technical Information of China (English)

    郭玉兰; 郦银芳; 张莉

    2015-01-01

    Objective To observe and explore the clinical efficacy of different preventive montelukast sodi-um programs in the prevention of wheezing and asthma of atopic children with asthmatic bronchitis. Methods 150 atopic children with asthmatic bronchitis from Jan. 2012 to June. 2014 were selected and randomly divided into the 3-month preventive medicine group ( group A ) , the 6-month preventive medicine group ( group B ) and the control group, 50 cases in each group. The 3-month preventive medicine group was treated with montelukast sodium for 3 months to prevent wheezing and asthma, and the 6-month preventive medicine group was treated with montelukast so-dium for 6 months, while the control group was not given preventive medicine intervention. After 6 months of follow-up, the blood serum IgE, leukotriene E4 and other inflammatory mediators were examined, and the incidence of wheezing and asthma of the 3 groups during follow-up were compared. Results After 6 months' follow-up, the serum levels of IgE, LTE4, IL-4, IL-8 and IL-10 were significantly different from each group (P0. 05). Conclusion Stable atopic asthmatic bronchitis children with preventive montelukast sodium programs can effectively reduce the incidence of wheezing and asthma, and the 6-month program has comparative advantages.%目的:观察并探讨不同孟鲁司特钠服药方案预防特异质喘息性支气管炎患儿喘息及哮喘发作的临床疗效。方法入选2012年1月~2014年6月收治的150例喘息性支气管炎患儿为研究对象,患儿治疗稳定后根据随机数字表分为3个月服药组、6个月服药组和对照组,每组各50例,3个月服药组给予口服孟鲁司特钠3个月预防性服药方案,6个月服药组给予口服孟鲁司特钠6个月服药方案,对照组不给于药物干预,随访6个月后采血检测血清IgE、白三烯E4等炎性介质,比较三组随访期间喘息及哮喘发生率。结果随访6个月后三组患儿血清IgE、LTE4、IL-4、IL-8

  8. EVALUATING ANTI-ASTHMATIC EFFECT OF POLYHERBAL AYURVEDIC DRUG BHARANGYADI ON RESPIRATORY MECHANICS USING MATLAB

    Directory of Open Access Journals (Sweden)

    Kajaria Divya

    2013-02-01

    Full Text Available Asthma is one of the most prevalent chronic inflammatory lung diseases among children and adults. A lot of work had been done in various field (including both modern and Ayurvedic on anti-asthmatic drugs to evaluate their action on lungs. The parameters chosen for assessing the properties of drug is mainly based on clinical improvement and improvement in pulmonary function test. These all method employed so far are indirect method for assessment of action of drug on lungs as change in pulmonary function may appear without any relevant change in lungs mechanics. In present study we assess the anti-asthmatic effect of drug directly on respiratory parameter by using MATLAB lung mechanics modeling. Administration of drug is equally distributed throughout lungs and produces significant increase in lung volume which is attributed to the decrease in airways resistance and increase in lung compliance.

  9. Changes of Th17 cells and CD4+CD25+ regulatory T cells in peripheral blood of asthmatic children and their relationship with the situation of asthma.%哮喘患儿外周血Th17细胞CD4+CD25+调节性细胞变化及其与病情相关分析

    Institute of Scientific and Technical Information of China (English)

    马秋莉; 彭韶; 梁鹏; 李会娟; 张曼

    2011-01-01

    Objective To observe the levels of Thl7 cells, CD4+CD25+ regulatory T cells in the asthmatic children and relationship between the two types of cells and children' s condition. Methods Flow cytometry was used to detect the percentages of the Thl7 cells and CD4+CD25+ regulatory T cells in the peripheral blood of acute asthma children (asthma group, n - 60) .alleviated period asthma children (n = 30) and healthy children (healthy control group, n = 30).Acute asthma children were divided into 3 groups: mild, moderate and severe asthmatic patients. Results Compared with the healthy control group (1.02% ± 0.28%) and alleviated period asthma children (1.65% ± 0.38%), the numbers of CD4+ cells (Thl7) expressing IL-17 in peripheral blood of acute asthma(2.24% ± 1.02%) were increased, and the differences were statistically significant (P<0.05). The levels of CD4+CD25+T cells in peripheral blood of acute asthma and alleviated period asthma children (5.37% ± 0.80% ; 6.05% ± 0.87%) were significantly lower than those of healthy children (7.11% ± 0.89%) (P < 0.05). Thl7 cells were positively correlated with the course of childhood asthma(r = 0.649, P < 0.05).CD4+CD25+ regulatory T cells were negatively correlated with the course of childhood asthma (r =-0.599, P < 0.05). Conclusion The immunization response of Thl7 cells in peripheral blood of asthmatic children is strengthened, but the immune function of CD4+CD25+regulatory T cells is decresed. The severity of asthma is closely related to the inbal-ance of Th71ATreg cellular immunity.%目的 探讨支气管哮喘患儿外周血中辅助T细胞(Th) 17细胞和CD4+ CD25+调节性T细胞(Treg)的变化与儿童哮喘病情的相关性.方法 收集2009年月5月至2010年4月于郑州大学第一附属医院就诊的患儿,均为首次确诊哮喘或规范吸入激素停用>3个月后复发及近1个月内无明显感染者.采用流式细胞仪测定患儿外周血中Th17细胞及CD4+CD25+Treg比例的变化.结果 Th

  10. Sensitization and exposure to pet allergens in asthmatics versus non-asthmatics with allergic rhinitis.

    Science.gov (United States)

    Henriksen, A H; Holmen, T L; Bjermer, L

    2001-02-01

    In sensitized subjects with allergic rhinitis (AR) or asthma, allergen exposure provokes symptoms. Among non-asthmatics with AR, an association between allergen sensitization, pollen season and lower airway inflammation has been demonstrated. Our aims were to compare AR and asthma with regard to patterns of allergen sensitization, the degree of airway hyperresponsiveness (AHR) and levels of exhaled nitric oxide (ENO). Finally, we wanted to relate our findings to previous or current exposure to household pets. Four hundred and thirty-one adolescents with different clinical phenotypes were randomly selected from a large-scale epidemiological survey. They were investigated with allergy screening, measurements of ENO and a methacholine bronchoprovocation test. Sensitization to pet allergens (cat, dog and horse) was associated with increased AHR and ENO both in asthmatics and non-asthmatics with AR. The risk of being sensitized to cat allergens was significantly reduced in those who had kept cats vs. those who had never kept them. Keeping dogs or horses did not influence the risk of being sensitized to the respective allergens. Only in steroid-naive, non-smoking asthmatics, a trend towards increased ENO in those sensitized and exposed to cat or dog allergens was seen. Although sensitization towards pet allergens was associated with inflammation in the lower airways irrespective of clinical phenotype, keeping pets did not increase the risk of being sensitized to pet allergens. PMID:11217908

  11. Discriminant analysis of pulmonary function parameters. Healthy adults versus mild asthmatics and moderate asthmatics.

    Directory of Open Access Journals (Sweden)

    Meguro,Tadamichi

    1982-08-01

    Full Text Available Volume-time (V-T and flow-volume (F-V curves were measured in all the subjects of nonsmoking young males (mean value 26.3 yrs. of age, healthy and asthmatics. Eleven parameters of pulmonary function tests composed of two V-T, six F-V, and three mean time constant (MTC parameters, were calculated from the curves. These parameters were used in the two analyses through the all possible selection procedure (APSP discriminating between healthy adults and mild asthmatics and also between healthy and moderate. Flow rate at 75% of FVC (V75 proved to be the most useful parameter and V50 the next best in both analyses. The probability of misclassification using all eleven parameters was 19.64% in the analysis of healthy adults and mild asthmatics, and 4.29% in the analysis of healthy adults and moderate asthmatics. There was a little difference in the parameters selected at every step. The discriminant analysis proved that the flow-volume patterns were different according to the severity of bronchial asthma. Thus flow-volume recognition was considered to be important in analyzing the severity of bronchial asthma.

  12. A STUDY OF OXIDANTS-ANTIOXIDANTS BALANCE IN ASTHMATIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Lokendra

    2014-06-01

    Full Text Available : This study was done to observe the serum/plasma oxidant-antioxidant status among asthmatic patients. Plasma MDA (Malon-di-aldehyde, an oxidant and Serum SOD (superoxide dismutase, an antioxidant, were assayed among asthmatic patients and their mean values were compared with healthy volunteer controls. Values were also observed in different age groups. The difference in mean pMDA level was found statistically significantly among cases and control, higher among asthmatic patients. Likewise, s-SOD level was significantly reduced among asthmatic patients. Clearly, there was an imbalance between oxidants and antioxidants levels among asthmatic patients and this consideration may be helpful in proper planning of basket of anti-asthma interventions. Future studies are recommended.

  13. β2-Adrenoreceptor Polymorphisms in Asthmatic Patients

    OpenAIRE

    Binaei, Saeed; Rashed, Sahar M.; Christensen, Michael L.

    2003-01-01

    β2-adrenergic receptors (β2AR) are GTP-binding protein (G-protein) coupled receptors widely distributed in human tissue. Inhaled β2-agonist drugs exert their primary effect on the β2AR of bronchial smooth muscles, causing relaxation and bronchial dilatation. Polymorphisms in the β2AR gene have been identified, which may affect responsiveness to β2-agonists and disease severity in asthmatics. Nine single nucleotide polymorphisms (SNPs) within the coding region and eight SNPs within in the 5′ u...

  14. Pharmacokinetics of nebulized and oral procaterol in asthmatic and non-asthmatic subjects in relation to doping analysis

    DEFF Research Database (Denmark)

    Krogh, Nanna; Backer, Vibeke; Rzeppa, Sebastian;

    2016-01-01

    The purpose of the present study was to investigate pharmacokinetics of procaterol in asthmatics and non-asthmatics after nebulized and oral administration in relation to doping. Ten asthmatic and ten non-asthmatic subjects underwent two pharmacokinetic trials. At first trial, 4 μg procaterol was...... after nebulized administration. For doping control purposes, our observations indicate that it is possible to differentiate therapeutic nebulized administration of procaterol from proh ib ited use of oral procaterol.......The purpose of the present study was to investigate pharmacokinetics of procaterol in asthmatics and non-asthmatics after nebulized and oral administration in relation to doping. Ten asthmatic and ten non-asthmatic subjects underwent two pharmacokinetic trials. At first trial, 4 μg procaterol...... was administered as nebulization. At second trial, 100 μg procaterol was administered orally. Serum and urine samples were collected before and after administration of procaterol. Samples were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Serum and urine concentrations of procaterol were...

  15. Tobacco control for clinicians who treat adolescents.

    Science.gov (United States)

    Sargent, James D; DiFranza, Joseph R

    2003-01-01

    Smoking remains the most common preventable cause of death in the developed world, and is rapidly becoming an important cause of death in the developing world. Nicotine is a powerfully addictive substance, and the tobacco industry spends billions annually promoting it in the United States. It is therefore important for clinicians to understand why people smoke, to address smoking in patients of all ages, and to lobby for health-preserving tobacco control policies at the community level. Children take up smoking in response to social influences: smoking by friends, parents, and family, and through exposure to smoking in media. Parents who smoke not only model the behavior, but also often make the product available by leaving cigarettes around the house. Media influences include the dollar 10 billion spent per year on tobacco marketing, but more importantly, the modeling of the behavior on screen by movie and television stars. Once children start smoking, many rapidly lose autonomy over the behavior. Youth can get hooked after smoking just a few cigarettes. The most effective community efforts for reducing tobacco use are: raising the price of tobacco; halting the sale of tobacco to minors; enforcing strict school tobacco policies; and making public places smoke free through local ordinances. Working with individuals, clinicians should support cessation in all smokers, including parents of children and adolescents. They should screen children for smoking risk factors beginning at age 10. They should teach parents to maintain smoke-free households, to set nonsmoking expectations early on, and to monitor adolescents for signs of smoking. Parents should limit exposure to adult media (e.g., R-rated movies) and use family television time to discuss the effect of seeing screen depictions of smoking on adolescent behavior. Adolescents who smoke should be assessed for signs of nicotine dependence and counseled about quitting. Clinicians are effective community voices; they

  16. Focused bedside ultrasonography by clinicians

    DEFF Research Database (Denmark)

    Hillingsø, Jens; Svendsen, Lars Bo; Nielsen, Michael Bachmann

    2008-01-01

    OBJECTIVE: Ultrasonography (US) performed by clinicians might shorten workout time and diminish the workload of simple diagnostic procedures for physicians specialized in US. The purpose of this follow-up study was to evaluate the effect of an introductory course in US on participants' clinical b...

  17. The role of technology in clinician-to-clinician communication.

    Science.gov (United States)

    McElroy, Lisa M; Ladner, Daniela P; Holl, Jane L

    2013-12-01

    Incomplete, fragmented and poorly organised communications contribute to more than half the errors that lead to adverse and sentinel events. Meanwhile, communication software and devices with expanding capabilities are rapidly proliferating and being introduced into the healthcare setting. Clinicians face a large communication burden, which has been exacerbated by the additional challenge of selecting a mode of communication. In addition to specific communication devices, some hospitals have implemented advanced technological systems to assist with communication. However, few studies have provided empirical evidence of the specific advantages and disadvantages of the different devices used for communication. Given the increasing quantities of information transmitted to and by clinicians, evaluations of how communication methods and devices can improve the quality, safety and outcomes of healthcare are needed.

  18. STUDY OF AIRBORNE INSECT ALLERGEN IN ASTHMATIC PATIENTS

    Institute of Scientific and Technical Information of China (English)

    孙秀珍; 刘云; 周玎

    2004-01-01

    Objective To study the variety of airborne allergenic insects and its sensibility in asthmatic patients. Methods 300 asthmatic patients and 100 normal controls underwent skin prick test (SPT) with 13 kinds of superior airborne insect vaccine, and sera sIgE of those whose SPT results were positive were tested by BSA-ELISA. Results The total positive rate of SPT with 13 kinds of insect vaccine in asthmatic patients was 58%, and it was significantly higher than that of normal control (P<0.01). The results of SPT with Stayridae, Heliothis armigera, Psilgramma menephorn and other 7 kinds of insects were more than 30% in asthmatic patients which meant these 10 kinds of insects were main allergenic insects to asthmatic patients. The positive rate of sIgE in asthmatic patients was more than 85%, while the normal control was only 6.0%. There was significant difference between two groups (P<0.01). Conclusion Stayridae, Heliothis armigera, Psilgramma menephorn and other 7 kinds of insects were main allergenic insects to asthmatic patients and perhaps they were the main allergens to the onset of asthma at the end summer or the early autumn.

  19. Neural plasticity occurs in the adrenal medulla of asthmatic rats

    Institute of Scientific and Technical Information of China (English)

    FENG Jun-tao; LI Xiao-zhao; HU Cheng-ping; WANG Jun; NIE Hua-ping

    2010-01-01

    Background Airway symptoms in asthma are related to decrease of epinephrine secretion, which may be ascribed to elevated nerve growth factor (NGF) in the organism.The aim of this study was to monitor the neuroendocrine alteration in the adrenal medulla of asthmatic rats.Methods Sixteen rats were randomly divided into two groups (n=8), control group and asthma group, and the asthmatic rats were sensitized and challenged with ovalbumin (OVA).The levels of NGF, epinephrine and norepinephrine in serum were detected by enzyme linked immunosorbent assay (ELISA), the NGF expression in adrenal medulla was detected by immunohistochemistry, and the changes in the ultrastructure of the adrenal medulla was observed by electron microscopy.Results The NGF expression was increased in asthmatic rats compared with control rats.Compared with control rats,the results indicated that the epinephrine level was decreased in asthmatic rats, but no significant difference was found in norepinephrine levels.We found more ganglion cells in the adrenal medulla of asthmatic rats than in control rats, with NGF immunostaining mainly located in these ganglion cells.Electron microscopic images showed the density of chromaffin granula decreased and there was shrunken nucleolemma in the adrenal medullary cells of asthmatic rats.Conclusion The innervation of the adrenal medulla is changed in asthmatic rats, and it may contribute to the epinephrine decrease in asthma.

  20. Broncoprovocação com solução salina hipertônica em crianças asmáticas Brocoprovocación con solución salina hipertónica en niños asmáticos Bronchoprovocation with hypertonic saline solution in asthmatic children

    Directory of Open Access Journals (Sweden)

    Cínthia Maria X. Costa

    2012-09-01

    ,5%, considerándose el resultado positivo como la reducción del volumen espiratorio forzado en el primer segundo (VEF1 ≥20%. RESULTADOS: Sesenta individuos eran atópicos. La frecuencia de positividad de la prueba de broncoprovocación fue mayor en el Grupo MG que en el IL (93 versus 65%. El tiempo necesario para la reducción de 20% del VEF1 para el grupo de atópicos fue menor en el MG cuando comparado al IL, 90 (30 a 330 versus 210 (30 a 690 segundos, con pOBJECTIVE: To verify if the bronchoprovocation test with 4.5% hypertonic saline solution allows to detect the gradient of response in asthmatic children and adolescents, according to asthma severity. METHODS: 75 asthmatic patients aged six to 18 years-old were evaluated in this cross-sectional study. They were classified according to asthma severity in: intermittent or mild persistent (IM and moderate or severe persistent (MS. They were also classified according to sensitization to inhaled allergens in atopics: positive skin prick test to Dermatophagoides pteronyssinus, D. farinae and Blomia tropicalis; or non- atopic with negative skin prick tests. All patients underwent a bronchoprovocation test with 4.5% hypertonic saline solution. The result of the bronchoprovocation test was considerd positive if at least a reduction of 20% in the forced expiratory volume in one second (FEV1 was noted. RESULTS: 60 individuals were atopic. The bronchoprovocation test was positive more frequently in the MS group than in the IM one (93 versus 65%. Less time was needed for a 20% fall of FEV1 in the MG compared to the IL group [90 (30 - 330 versus 210 (30 - 690 seconds; p<0.05]. The percentage of FEV1 fall was higher in the MG group than in the IL one [26,4% (14 - 63 versus 20% (0 - 60; p<0.05]. CONCLUSIONS: The 4.5% hypertonic saline solution bronchoprovocation test is safe and easy to perform. It detects a gradient of response in asthmatic children and adolescents regarding asthma severity. Higher frequency of positive tests, shorter

  1. Help wanted: developing clinician leaders

    OpenAIRE

    Stoller, James K

    2014-01-01

    Because healthcare faces challenges, such as ensuring quality and access and controlling cost, effective leadership is needed at every level of healthcare organizations. Yet, physicians are trained in clinical and scientific skills but not in leadership competencies. Furthermore, clinicians often feel ill-prepared to assume managerial and leadership roles. To close this gap, training in leadership competencies, such as emotional intelligence, communication, teamwork, and change management, is...

  2. Diffusion imaging concepts for clinicians.

    Science.gov (United States)

    Neil, Jeffrey J

    2008-01-01

    This review covers the fundamentals of diffusion tensor imaging. It is written with the clinician in mind and assumes the reader has a passing familiarity with magnetic resonance imaging (MRI). Topics covered include comparison of diffusion MRI with conventional MRI, water apparent diffusion coefficient (ADC), diffusion anisotropy, tract tracing, and changes of water apparent diffusion in response to injury. The discussion centers primarily on applications to the central nervous system, but examples from other tissues are included. PMID:18050325

  3. Buccal health in asthmatic patients. Salud bucal en pacientes asmáticos.

    Directory of Open Access Journals (Sweden)

    Joel González Beriao

    2003-05-01

    Full Text Available Background: Buccal health as integral and determinant part of general health makes us find different ways and methods to elevate life quality in the population. Objective: To establish the risk of suffering from dental cavities in asthmatic patients. Methods: A non match case and control study constituted by 100 children selected at simple random from the universe of asthmatic patients belonging to the General Comprehensive doctor offices number 7,9,10, 11, 43, and 44 from Area II in Cienfuegos municipality. The controlled group was selected in the same offices but from the universe of non asthmatic children. The age in both groups was from 6 to 15 years old. Visits to the children´s home were carried out for the record of the information through health oral dental and buccal health knowledge surveys. Results: The index of cavities, lost, and obturated permanent teeth was higher (3, 28 than in the control group (0, 44. The buccal hygiene indexes and the level of knowledge in both groups did not show significant differences. The most used drugs in asthma therapy were salbutamol and ketotifeno which change the buccal milieu. The odds ratio technique between asthmatic and non asthmatic patients showed 4, 9 times more at risk of suffering from dental cavities in the first group. Finally, it can be stated that the asthmatic patients are more at risk of suffering from cavities than the non asthmatic ones, so a program for buccal health in these patients should be performed.

    Fundamento: La salud bucal como parte integrante y determinante de la salud general del hombre, nos obliga cada vez con mayor rigor y nivel científico a la búsqueda de diferentes vías y métodos para elevar la calidad de vida de la población. Objetivo: Establecer el riesgo de padecer caries dental de los pacientes asmáticos. Métodos: Estudio de casos y

  4. Tim-3 mRNA Expression in Peripheral Blood Mononuclear Cells and Its Relationship with CD4+CD25+ Regulatory T Cells from Asthmatic Children%哮喘儿童外周血单个核细胞Tim-3mRNA的表达及其与CD4+CD25+调节性T细胞的关系

    Institute of Scientific and Technical Information of China (English)

    陆小霞

    2011-01-01

    目的 观察哮喘患儿外周血单个核细胞(PBMC)中Tim-3 mRNA的表达及其与CD4+CD25+调节性T细胞(Treg)的关系,探讨Tim-3在哮喘发生发展中的作用.方法 收集哮喘门诊或住院患儿73例,其中哮喘缓解期38例(缓解组),轻至中度急性发作期35例(发作组).利用RT-PCR检测哮喘患儿PBMC中Tim-3 mRNA的表达并做半定量分析,流式细胞术检测PBMC中的CD4+CD25+ Treg的水平(CD4+CD25+ Treg占CD4+T细胞的百分比).利用酶联免疫吸附试验(ELISA)检测血浆中白细胞介素6(IL-6)、转化生长因子β(TGF-β)的水平,并分析Tim-3 mRNA与CD4+CD25+ Treg、IL-6水平的相关性.结果 哮喘发作组PBMC中Tim-3 mRNA吸光度值为(0.86±0.17),与缓解组(0.39±0.11)和正常对照组(0.06±0.03)比较,差异具有统计学意义(均P<0.05),并且缓解组与正常对照组比较差异亦具有统计学意义(P<0.05).哮喘发作组外周血CD4+CD25+ Treg百分率为(8.35±1.67)%,与缓解组[(10.21±2.04)%]和正常对照组[(12.43±2.58)%]比较,差异均具有统计学意义(P<0.05),并且缓解组与正常对照组比较差异亦具有统计学意义(P<0.05);哮喘发作组血浆中IL-6水平为(78.35±14.59)pg/mL,与缓解组[(36.48±9.18)pg/mL]和正常对照组[(10.24±3.57)pg/mL]比较,差异均具有统计学意义(P<0.05),缓解组与正常对照组比较差异亦有统计学意义(P<0.05).3组血浆中TGF-β水平没有明显差异;哮喘发作组和缓解组PBMC中Tim-3 mRNA的表达水平与CD4+CD25+ Treg百分率均呈负相关(r=-0.81,-0.79,均P<0.05),与IL-6的水平呈正相关(r=0.87,0.83,均P<0.01).结论 哮喘患儿PBMC中Tim-3 mRNA表达增高参与哮喘的发生与发展,其机制可能与升高血浆IL-6,抑制CD4+CD25+ Treg的生成有关.%Objective To detect the expression of T cell immunoglobulin mucin 3 ( Tim-3)mRNA in pcripheral blood mono nuclear cells(PBMC)isolated from asthmatic children and analyze its rclationship with CD4+ CD25+ rcgulatory T cells

  5. Compliance of asthmatic families with a primary prevention programme of asthma and effectiveness of measures to reduce inhalant allergens--a randomized trial.

    NARCIS (Netherlands)

    Schonberger, H.J.; Maas, T.; Dompeling, E.C.; Knottnerus, J.A.; Weel, C. van; Schayck, C.P. van

    2004-01-01

    BACKGROUND: Compliance to and the effect of pre- and post-natal exposure reduction measures to prevent asthma in high-risk children from asthmatic families were studied. METHOD: Families were randomized to a special care group (n=222) and a control group (n=221). Educational advice on measures to re

  6. Bone marrow-derived mesenchymal stem cells regulate the function of Th17/Treg in peripheral blood of severe asthmatic children%骨髓间充质干细胞对重症哮喘患儿外周血Th17/Treg 的免疫调节作用

    Institute of Scientific and Technical Information of China (English)

    黄雪琼; 檀卫平; 吴葆菁; 蓝丹; 吴海飞; 麦贤弟

    2014-01-01

    目的:探讨骨髓间充质干细胞( MSCs )在体外对重度哮喘患儿外周血辅助性T细胞17( Th17)和CD4+CD25+调节性T细胞(Treg)的免疫调节作用。方法:体外分离、培养和鉴定MSCs。 MSCs经丝裂霉素处理后按不同比例(1∶1、1∶2、1∶10和1∶20)与哮喘患儿外周血T淋巴细胞(TLC)直接接触共培养,检测各组MSCs 对TLC的增殖调节作用。选取上述1∶2比例共培养体系和单独TLC培养体系,ELISA法分别检测Th17的效应分子白细胞介素17( IL-17)和Treg效应分子转化生长因子β( TGF-β)水平,qRT-PCR法检测转录因子维甲酸相关孤儿核受体(RORC)及叉头框蛋白3(Foxp3)mRNA表达水平。结果: MSCs 可显著抑制重度哮喘患儿TLC增殖,且随着MSCs数量的增加,抑制作用增强。 MSCs +TLC共培养组Th17转录因子RORC mRNA和效应因子IL-17表达较TLC组下降,同时TGF-β表达增高,而Treg细胞调控基因Foxp3 mRNA表达无明显改变。结论: MSCs在体外可能通过抑制Th17分化及IL-17的分泌,同时上调TGF-β的表达,进而有效改善哮喘患儿的Th17/Treg失衡状态。%AIM: To investigate the regulatory function of bone marrow-derived mesenchymal stem cells (MSCs) on T helper 17 cells (Th17) and regulatory T cells (Treg) in peripheral blood of severe asthmatic children . METHODS:MSCs were isolated , cultured and identified in vitro.MSCs digested with mitomycin were cocultured with T lymphocytes (TLC) at different ratios (1∶1, 1∶2, 1∶10 and 1∶20) from severe asthmatic children for 72 h.The prolifera-tion of TLC was measured by CCK-8 method.In the coculture system of the 1∶2 ratio and the single TLC system , the super-natant levels of interleukin-17 (IL-17) and transforming growth factor-β(TGF-β) were measured by ELISA.The mRNA expression of retinoic acid-related orphan nuclear receptor C (RORC) and forkhead box protein 3 (Foxp3) in TLC was de-tected by

  7. Airway responses to NO2 and allergen in asthmatics

    OpenAIRE

    Barck, Charlotte

    2005-01-01

    Nitrogen dioxide (N02), a gas produced by combustion, is a common environmental air pollutant. Individuals with asthma are more sensitive to N02 exposure than healthy subjects, according to results from controlled human-exposure studies. N02 can enhance the asthmatic response to inhaled allergen. The mechanisms for N02's enhancing effect on the asthmatic reaction to allergen appear to be related to an increased inflammatory reaction in the airways. The general aim of the ...

  8. Nerve growth factor levels and localisation in human asthmatic bronchi.

    Science.gov (United States)

    Olgart Höglund, C; de Blay, F; Oster, J P; Duvernelle, C; Kassel, O; Pauli, G; Frossard, N

    2002-11-01

    Nerve growth factor (NGF) has recently been suggested to be an important mediator of inflammation. In support of this, serum levels of NGF have been shown to be enhanced in asthmatics. However, it has not yet been shown whether the levels of NGF are also altered locally in asthmatic airways, when compared with healthy subjects, and the localisation of potential sources of NGF in the human bronchus have not yet been described. The aim of the present study was to assess NGF levels in bronchoalveolar lavage fluid (BALF) from asthmatics and to compare them to those of control subjects. Furthermore, the authors wanted to localise potential sources of NGF in bronchial tissue, and to number NGF-immunopositive infiltrating cells in the bronchial submucosa. BALF and bronchial biopsies were obtained from seven control subjects and seven asthmatic patients by fibreoptic bronchoscopy. NGF protein levels were quantified by enzyme-linked immunosorbent assay in BALF. NGF localisation was examined by immunohistochemistry on bronchial biopsy sections. The asthmatics exhibited significantly enhanced NGF levels in BALF. Intense NGF-immunoreactivity was observed in bronchial epithelium, smooth muscle cells and infiltrating inflammatory cells in the submucosa, and to a lesser extent in the connective tissue. The asthmatics exhibited a higher number of NGF-immunoreactive infiltrating cells in the bronchial submucosa than control subjects. This study provides evidence that nerve growth factor is locally produced in the airways, and shows that this production is enhanced in asthmatics. These findings suggest that nerve growth factor is produced by both structural cells and infiltrating inflammatory cells in human bronchus in vivo, and the authors suggest that the increase in nerve growth factor protein in bronchoalveolar lavage fluid observed in asthmatic patients may originate both from structural cells, producing increased nerve growth factor levels in inflammatory conditons, and from

  9. 自我管理行为干预对使用糖皮质激素的哮喘患儿健康状况的影响%Effects of Self-Management Behaviors Intervention on Health Status in Asthmatic Children with Using Glucocorticoid

    Institute of Scientific and Technical Information of China (English)

    张亚丽; 周新

    2014-01-01

    Objective To investigate the effects of the self-management behaviors intervention on the related indexes of health status in children patients with asthma treated by inhaled glucocorticoid. Methods 84 asthmatic children patients with using inhaled glucocorti-coid were randomly divided into the control group and the experimental group according to the random number table,42 cases in each group. The control group received the routine treatment and nursing care. On this basis,the experimental group received the self-man-agement behaviors intervention. The health related indexes were compared between the two groups. Results Compared with before inter-vention,the health related indexes after 1-week and 3-month intervention in the experimental group were significantly improved, moreover which were obviously superior to those in the control group( P < 0. 05). Conclusion The self-management behaviors inter-vention can effectively improve the health status in astnmatic children with using inhaled glucocorticoid,which is worthy of promotion.%目的:探讨自我管理行为干预对使用吸入型糖皮质激素的哮喘患儿健康状况的影响。方法选取84例哮喘患儿,按随机数字表法分为试验组与对照组,各42例。对照组接受常规的诊治及护理,试验组在此基础上接受自我管理行为干预,比较两组患者健康状况相关指标。结果与干预前比较,干预1周及3个月后试验组健康状况相关指标评均有明显改善,均明显优于对照组( P<0.05)。结论自我管理行为干预可有效改善使用吸入型糖皮质激素的哮喘患儿的健康状况相关指标,值得推广。

  10. The In fluence of Sla meterol Fluticasone Joint with Montelukast on the IL-4 IN F-γIgE EOS of Asthmatic Children%沙美特罗替卡松联合孟鲁斯特对哮喘患儿IL-4 INF-γIgE EOS 影响研究

    Institute of Scientific and Technical Information of China (English)

    王艳军

    2015-01-01

    Ob jective:To investigate the clinical efficacy and immune function of salmeterol fluticasone joint with montelukast on asthmatic children .Method:From January 2011 to December 2013, 102 cases of asthmatic children were divided into test group and control group according to different treatment methods , each had 51 cases.The control group accepted salmeterol fluticasone inhalants ,while the test group accepted montelukast on the basis of control group .Result:The total effective rate of test group was 96.1%,while the control group was 82.4%,the difference was statistically significant ( P 0.05) . But at he treatment of 3 months and after 3 months,the compliance rates of lung function of text group were all better than the control group ( P IgE,EOS between the two groups before the treatment (P>0.05).But at he treatment of 3 months and after 3 months,the levels of IL-4,IgE and EOS of two groups were all lower than before ,and the levels of the INF-γwas higher than before ( P<0.05) .The difference was statistically significant between the two groups ( P<0. 05).Con clusion:The treatment of salmeterol fluticasone joint with montelukast on asthmatic children have significant effect , good safety .It is worthy of being popularizing on clinical .%目的:探讨沙美特罗替卡松联合孟鲁斯特治疗支气管哮喘患儿对临床疗效、免疫功能的影响。方法:选取我院自2011年1月至2013年12月收治的哮喘患儿102例,按治疗方法的不同分为试验组及对照组,各51例。对照组患儿给予沙美特罗替卡松粉吸入剂,试验组在此基础上给予口服孟鲁司特钠。观察患儿治疗前后临床疗效及免疫功能的情况。结果:试验组患儿治疗总有效率为96.1%,对照组患儿治疗后总有效率为82.4%,试验组患儿治疗后总有效率显著优于对照组,差异有统计学意义(P<0.05)。两组患儿治疗前肺功能达标率,差异无统计学意义(P>0.05

  11. Haematological and lipid profile assays in Nigerian asthmatics

    Institute of Scientific and Technical Information of China (English)

    Caroline E Omotil; Egbagbe Eruke Elizabeth

    2009-01-01

    Objective: To assess the haematological and lipid profile assays in asthmatics. Methods: Eighty asthmatic subjects were prospectively studied in a major referral centre serving the Niger Delta region of Nigeria for 12 months (2006-2007). Clinico-haematological and serum lipid total cholesterol (TC), triglyceride (TG), and lipoproteins concentration were analyzed after adjusting for age, cigarette smoking, alcohol ingestion, hypertension and diabetes mellitus. Results: Eighty patients (34 males and 46 females) were seen with female predominating in the various age groups (M∶ F ratio, 0.7∶ 1). Total cholesterol and low density lipoproteins-cholesterol for the asthmatics was significantly higher than the controls (P2.3mmol/L) and a significant hypercholesterolemia (HC, >5.2mmol/L) according to the Adult Treatment Panel III definition in asthmatics thereby putting them at increased risk for the development of cardiovascular disease as well as other disorders related to excess lipids. There was a significant thrombocytopenia (P<0.000 1) which may accompany allergen exposure and this persists for 24 h; that asthmatics of African descent showed a significantly increased total leucocyte count (P=0.001) similar to other studies in the Western countries. Conclusion: Hyperlipidaemia is a prevalent medical problem among asthmatics; hence screening for fasting serum lipid levels to identify those who need early intervention is recommended.

  12. Platelets from Asthmatic Individuals Show Less Reliance on Glycolysis.

    Science.gov (United States)

    Xu, Weiling; Cardenes, Nayra; Corey, Catherine; Erzurum, Serpil C; Shiva, Sruti

    2015-01-01

    Asthma, a chronic inflammatory airway disease, is typified by high levels of TH2-cytokines and excessive generation of reactive nitrogen and oxygen species, which contribute to bronchial epithelial injury and airway remodeling. While immune function plays a major role in the pathogenesis of the disease, accumulating evidence suggests that altered cellular metabolism is a key determinant in the predisposition and disease progression of asthma. Further, several studies demonstrate altered mitochondrial function in asthmatic airways and suggest that these changes may be systemic. However, it is unknown whether systemic metabolic changes can be detected in circulating cells in asthmatic patients. Platelets are easily accessible blood cells that are known to propagate airway inflammation in asthma. Here we perform a bioenergetic screen of platelets from asthmatic and healthy individuals and demonstrate that asthmatic platelets show a decreased reliance on glycolytic processes and have increased tricarboxylic acid cycle activity. These data demonstrate a systemic alteration in asthma and are consistent with prior reports suggesting that oxidative phosphorylation is more efficient asthmatic individuals. The implications for this potential metabolic shift will be discussed in the context of increased oxidative stress and hypoxic adaptation of asthmatic patients. Further, these data suggest that platelets are potentially a good model for the monitoring of bioenergetic changes in asthma. PMID:26147848

  13. Platelets from Asthmatic Individuals Show Less Reliance on Glycolysis.

    Directory of Open Access Journals (Sweden)

    Weiling Xu

    Full Text Available Asthma, a chronic inflammatory airway disease, is typified by high levels of TH2-cytokines and excessive generation of reactive nitrogen and oxygen species, which contribute to bronchial epithelial injury and airway remodeling. While immune function plays a major role in the pathogenesis of the disease, accumulating evidence suggests that altered cellular metabolism is a key determinant in the predisposition and disease progression of asthma. Further, several studies demonstrate altered mitochondrial function in asthmatic airways and suggest that these changes may be systemic. However, it is unknown whether systemic metabolic changes can be detected in circulating cells in asthmatic patients. Platelets are easily accessible blood cells that are known to propagate airway inflammation in asthma. Here we perform a bioenergetic screen of platelets from asthmatic and healthy individuals and demonstrate that asthmatic platelets show a decreased reliance on glycolytic processes and have increased tricarboxylic acid cycle activity. These data demonstrate a systemic alteration in asthma and are consistent with prior reports suggesting that oxidative phosphorylation is more efficient asthmatic individuals. The implications for this potential metabolic shift will be discussed in the context of increased oxidative stress and hypoxic adaptation of asthmatic patients. Further, these data suggest that platelets are potentially a good model for the monitoring of bioenergetic changes in asthma.

  14. Risk for asthma in offspring of asthmatic mothers versus fathers: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Robert H Lim

    Full Text Available BACKGROUND: Many human epidemiologic studies demonstrate that maternal asthma confers greater risk of asthma to offspring than does paternal disease. However, a handful have shown the opposite. Given this disparity, a meta-analysis is necessary to determine the veracity and magnitude of the "maternal effect." METHODOLOGY/PRINCIPAL FINDINGS: We screened the medical literature from 1966 to 2009 and performed a meta-analysis to compare the effect of maternal asthma vs. paternal asthma on offspring asthma susceptibility. Aggregating data from 33 studies, the odds ratio for asthma in children of asthmatic mothers compared with non-asthmatic mothers was significantly increased at 3.04 (95% confidence interval: 2.59-3.56. The corresponding odds ratio for asthma in children of asthmatic fathers was increased at 2.44 (2.14-2.79. When comparing the odds ratios, maternal asthma conferred greater risk of disease than did paternal asthma (3.04 vs. 2.44, p = 0.037. When analyzing the studies in which asthma was diagnosed by a physician the odds ratios were attenuated and no significant differences were observed (2.85 vs. 2.48, N = 18, p = 0.37. Similarly, no significant differences were observed between maternal and paternal odds ratios when analyzing the studies in which the patient population was 5 years or older (3.15 vs. 2.60, p = 0.14. However, in all cases the trend remained the same, that maternal asthma was a greater risk factor for asthma than paternal. CONCLUSIONS/SIGNIFICANCE: The results show that maternal asthma increases offspring disease risk to a greater extent than paternal disease.

  15. Effect of Dust Mite Allergen-Specific Immunotherapy Combined with Standardized Management on Prognosis of Asthmatic Children%粉尘螨特异性免疫治疗联合规范化防治在哮喘控制中的作用

    Institute of Scientific and Technical Information of China (English)

    谭永强; 曹兰芳; 沈瑾; 陈柳; 叶桂云; 徐决平

    2011-01-01

    Objective To evaluate the effect of dust mite allergen - specific immunotherapy combined with standardized management on prevention and therapeutic effect in children with asthma. Methods Ninety - five children with established diagnosis of allergic asthma to dust mite were enrolled in this study from Apr. 2005 to Jun. 2010 ,of whom 54 children received treatment with specific immunotherapy(SIT)combined with standardized management (treatment group)for 2- 3 years,and the other 41 cases served as the control group, who received only standardized management( inhaled corticosteroids) at the same time. The clinical symptom and acute episode of the asthmatic children,peak expiratory flow(PEF) and children asthma control test (Ch -CACT), the frequency of respiratory tract infection were detected before and after the treatment,especially the season with high attack rate in 1 year afar the treatment. The data were analyzed by SPSS 15.0 software. Results Compared with control group, the frequency of acute episode, the degree of stable phase of asthma, the dose of inhaled corticosteroids in treatment group after treatment for 1 year were significantly decreased. The PEF and Ch - CACT in both groups were obviously improved and the frequency of respiratory tract infection in both groups after treatment for 1 year were obviously decreased. But the PEF and Ch - CACT in control group were obviously dropped in the season with high attack rate after treatment for 1 year and the average duration of respiratory tract infection in control group were obviously prolonged. Conclusions The dust mite allergen - specific immunotherapy combined with standar-dized management can obviously reduce the frequency and degree of acute episode of asthma, improve the pulmonary function of asthmatic children ,decrease the the frequency and the average duration of respiratory tract infection.%目的 评价粉尘螨特异性免疫治疗联合规范化防治在儿童支气管哮喘(

  16. Assessment of personal exposure to ozone in asthmatic children residing in Mexico City Evaluación de la exposición personal a ozono en niños asmáticos de la Ciudad de México

    Directory of Open Access Journals (Sweden)

    Matiana Ramírez-Aguilar

    2008-02-01

    Full Text Available OBJECTIVE: A study was conducted to evaluate personal ozone exposure (O3p among asthmatic children residing in Mexico City. MATERIAL AND METHODS: A total of 158 chil-dren were recruited from December 1998 to April 2000. On average, three O3p measurements were obtained per child using passive badges. Time-activity patterns were recorded in a diary. Daily ambient ozone measurements (O3a were obtained from the fixed station, according to children’s residence. Levels of O3a and ozone, weighted by time spent in different micro-environments (O3w, were used as independent variables in order to model O3p concentrations using a mixed-effects model. RESULTS: Mean O3p was 7.8 ppb. The main variables in the model were: time spent indoors, distance between residence and fixed station, follow-up group, and two interaction terms (overall R²=0.50, pOBJETIVO: Realizamos este estudio para evaluar la exposición personal a ozono (O3p en niños asmáticos de la Ciudad de México. MATERIAL Y MÉTODOS: Se incluyeron 158 niños entre diciembre de 1998 y abril de 2000. En promedio se obtuvieron tres mediciones por niño, utilizando filtros pasivos para medir O3p. Se caracterizaron los patrones de actividad y las concentraciones ambientales diarias de ozono (O3a se obtuvieron de estaciones fijas cercanas a la residencia del niño. Los niveles promedio de O3a y las concentraciones ponderadas por el tiempo en diferentes microambientes (O3w fueron usados como variables independientes para modelar las concentraciones de O3p, utilizando modelos de efectos mixtos. RESULTADOS: La media de O3p fue 7.8 ppb. Las principales variables en el modelo fueron: tiempo en exteriores, distancia, periodo de seguimiento y dos términos de interacción (R²=0.50, p<0.05. CONCLUSIONES: Las concentraciones de O3w pueden usarse como "proxi" de O3p, tomando en cuenta patrones de actividad y lugar de residencia.

  17. Exhaled carbon monoxide in asthmatics: a meta-analysis

    Directory of Open Access Journals (Sweden)

    Huang Mao

    2010-04-01

    Full Text Available Abstract Background The non-invasive assessment of airway inflammation is potentially advantageous in asthma management. Exhaled carbon monoxide (eCO measurement is cheap and has been proposed to reflect airway inflammation and oxidative stress but current data are conflicting. The purpose of this meta-analysis is to determine whether eCO is elevated in asthmatics, is regulated by steroid treatment and reflects disease severity and control. Methods A systematic search for English language articles published between 1997 and 2009 was performed using Medline, Embase and Cochrane databases. Observational studies comparing eCO in non-smoking asthmatics and healthy subjects or asthmatics before and after steroid treatment were included. Data were independently extracted by two investigators and analyzed to generate weighted mean differences using either a fixed or random effects meta-analysis depending upon the degree of heterogeneity. Results 18 studies were included in the meta-analysis. The eCO level was significantly higher in asthmatics as compared to healthy subjects and in intermittent asthma as compared to persistent asthma. However, eCO could not distinguish between steroid-treated asthmatics and steroid-free patients nor separate controlled and partly-controlled asthma from uncontrolled asthma in cross-sectional studies. In contrast, eCO was significantly reduced following a course of corticosteroid treatment. Conclusions eCO is elevated in asthmatics but levels only partially reflect disease severity and control. eCO might be a potentially useful non-invasive biomarker of airway inflammation and oxidative stress in nonsmoking asthmatics.

  18. Auditoria Médica: atendimento de crianças com asma em uma Unidade de Saúde da Família, Pelotas, RS Medical Auditing: care to asthmatic children in a Family Health Unit, Pelotas, RS

    Directory of Open Access Journals (Sweden)

    Ana Maria Siga Stephan

    2009-06-01

    Full Text Available Descrição do processo de atendimento médico às crianças com asma, mediante auditoria realizada concomitantemente a estudo transversal, conduzido em crianças da área de cobertura de uma Unidade de Saúde da Família, para verificar a prevalência de asma e avaliar o conhecimento materno sobre a doença. Utilizaram-se como fonte de dados os prontuários de família das crianças com asma que se consultaram nos últimos 12 meses. Das 258 crianças com asma identificadas no estudo, 69 (26,7% tinham registros de consultas devido à doença. Havia registros de peso em 76,8% dos prontuários, de frequência respiratória em 26,1%, de tiragem intercostal em 21,7%, de cianose em 1,4% e de orientações sobre o uso da medicação em 33,3%. A frequência de registros de orientações sobre os sinais e sintomas de gravidade e o manejo das crises foi de 15,9% e sobre os fatores desencadeantes, modificações ambientais e comportamentais, 14,5%. Foram encontrados registros de prescrição de broncodilatador para 55,1% das crianças, e de corticoesteroide mais broncodilatador para 42,0%. Os baixos percentuais de registros sobre orientações evidenciam as deficiências no atendimento médico realizado na Unidade de Saúde da Família, sobretudo no que se refere à educação em saúde.This is a description of the process of medical care to children with asthma, through an audit carried out concomitantly with a cross-sectional study with children living in the catchment area of a Family Health Unit, to find the prevalence of asthma and to assess maternal knowledge about the disease. Medical records of families whose children had asthma and visited doctors in the previous 12 months were used as sources of data. Of the 258 children identified with asthma, 69 (26.7% had visited the unit because of the disease. Weight was recorded in 76.8% of the medical records, respiratory frequency in 26.1%, intercostal retractions in 21.7%, cyanosis in 1.4%, and

  19. Application of Orem’ s self-care model for asthmatic children%Orem自理模式在儿童支气管哮喘护理中的应用

    Institute of Scientific and Technical Information of China (English)

    崔艳梅

    2015-01-01

    Objective To investigate the application of Orem’ s self-care model in the self-care of children with asthma. Methods 120 children with asthma were randomly divided into control and experimental groups. The pa-tients in the control group received routine nursing. The patients in the experimental group received self-care education which included improvement of self-care ability, self-care responsibility and health knowledge. Patients in the experi-mental group were visited in their homes eight times and those in the control group were visited two times. Results The Orem's self-care skills of medicine usage, peak expiratory flow meter usage, applying an asthma action plan, keeping a daily follow-up schedule, and protecting against triggering factors differed significantly between the first and last visits in the experimental group, whereas the self-care skills of adolescents in the control group did not change. Conclusion Applying Orem’ s self-care model can increase the self-care skills of children with asthma.%目的:探讨Orem自理模式在儿童支气管哮喘护理中的应用。方法将120例哮喘患儿随机分为实验组和对照组,对照组患者采用常规的健康教育,实验组哮喘患儿采用个体化自护教育,实验组家访8次,对照组家访2次。结果首次和末次家访中,实验组患儿5种自我护理技能:正确使用药物、PEF仪,坚持每日计划表,应用哮喘行动计划以及避免哮喘诱因显著提高。对照组自我护理技能没有明显改变。结论 Orem自理模式可以提高哮喘患儿自我护理技能。

  20. The Effects of Triple Inhalation Therapy of Budesonide, Terbutaline Sulphate and Ipratropium Bromide in Children with Asthmatic Bronchitis%布地奈德、硫酸特布他林、异丙托溴铵气雾剂三联气泵雾化吸入治疗小儿喘息性支气管炎疗效观察

    Institute of Scientific and Technical Information of China (English)

    魏向阳; 滕永华

    2012-01-01

    Objective:To observe the effects of triple inhalation therapy of budesonide, terbutaline sulphate and ipratropium bromide in children with asthmatic bronchitis. Methods: Randomly 122 cases of asthmatic bronchitis were divided into a treatment group of 62 patients, and a control group of 60 patients. Treatment group was treated with budesonide, terbutaline sulphate and ipratropium bromide inhalation. Patients weighing less than 10 kg received Pulmicort 1 mL, Bricanyl 0.5 mL, and Atrovenl 0. 25 mL 2 to 3 limes daily; while those weighting greater than 10 kg received Pulmicort 1 mL, Bricanyl 1 mL, and Atrovent 0.5 mL 2 to 3 times dairy. In each inhalation 2 mL of normal saline was mixed into aerosol pump. Symptoms and signs before and after treatment, and the course of disease were compared. Results: The clinical symptoms disappearance time and pulmonary rales disappearance time of the treatment group were shorter than those of the control group ( P<0.01). The treatment group's total effective rate was 95.6% 09 opposed to the control group (with a total effective rate of 75.0%); the difference was statistically significant (P<0.01). Conclusions: Budesonide, terbutaline sulphate and ipratropium bromide combined inhalation therapy can shorten the course of asthmatic bronchitis, increase the cure rate, and decrease adverse reactions.%目的:观察布地奈德、硫酸特布他林、异丙托溴铵气雾剂联合雾化吸入治疗喘息性支气管炎的临床疗效.方法:将122例喘息性支气管炎患儿随机分为治疗组62例、对照组60例,两组采用相同的抗感染、止咳、平喘等综合治疗.治疗组加用布地奈德、硫酸特布他林、异丙托溴铵气雾剂雾化吸入,体重小于10 kg者,予布地奈德1 mL、硫酸特布他林0.5mL、异丙托溴铵气雾剂0.25 mL;体重大于10 kg者予布地奈德1 mL、硫酸特布他林1 mL、异丙托溴铵气雾剂0.5 mL,均加生理盐水2 mL混合后放雾化器中经压力雾化泵吸入,每

  1. Paraoxonase 1 phenotype and paraoxonase activity in asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Nurhan Sarioglu

    2015-02-01

    Full Text Available Oxidative stress is involved in the pathogenesis of asthma. Paraoxonase 1 (PON1 and arylesterase are esterase enzymes displaying antioxidant characteristics. PON1 activity varies widely among individuals and ethnic groups, partly related to polymorphisms. The aim of this study was to determine the activities of PON1 and arylesterase including the phenotype distribution of PON1 in asthmatic patients and healthy subjects. Forty-nine asthmatic patients and 41 healthy people were included in this study. Serum PON1 and arylesterase activities were determined by spectrophotometric assays, as well as the lipid profiles. The PON1 ratio (salt stimulated paraoxonase/arylesterase was trimodally distributed and this ratio was used to determine the individual phenotypes of all subjects. The PON1 activity in the asthmatic patients was significantly lower (p=0.024 when compared to the healthy control group, however no significant difference in the activity of arylesterase was observed between the two groups. The prevalence of the PON1 phenotypes in the asthmatic population were 26.5%, 16.3% and 57.2 % for QQ, QR and RR, respectively. PON1 activity was significantly lower in asthmatic patients; in addition, the results of this investigation indicated that PON1 RR phenotype may be an important risk factor in asthma disease.

  2. Noninvasive positive pressure ventilation in acute asthmatic attack

    Directory of Open Access Journals (Sweden)

    A. Soroksky

    2010-03-01

    Full Text Available Asthma is characterised by reversible airway obstruction. In most patients, control of disease activity is easily achieved. However, in a small minority, asthma may be fatal. Between the two extremes lie patients with severe asthmatic attacks, refractory to standard treatment. These patients are at an increased risk of recurrent severe attacks, with respiratory failure, and mechanical ventilation. Invasive mechanical ventilation of the asthmatic patient is associated with a higher risk of complications and, therefore, is a measure of last resort. Noninvasive positive pressure ventilation (NPPV is another treatment modality that may be beneficial in patients with severe asthmatic attack who are at an increased risk of developing respiratory failure. These patients have the potential to benefit from early respiratory support in the form of NPPV. However, reports of NPPV in asthmatic patients are scarce, and its usage in asthmatic attacks is, therefore, still controversial. Only a few reports of NPPV in asthma have been published over the last decade. These studies mostly involve small numbers of patients and those who have problematic methodology. In this article we review the available evidence for NPPV in asthma and try to formulate our recommendations for NPPV application in asthma based on the available evidence and reports.

  3. Immunometabolism in Obese Asthmatics: Are We There Yet?

    Directory of Open Access Journals (Sweden)

    Lisa G. Wood

    2013-09-01

    Full Text Available Obesity is now recognised as a worldwide epidemic. The recent International Association for the Study of Obesity/International Obesity Taskforce (IASO/IOTF analysis estimates that approximately 1.0 billion adults are currently overweight and a further 475 million are obese. Obesity has huge psychosocial impact with obese children and adolescents facing discrimination and stigmatization in many areas of their lives leading to body dissatisfaction, low self-esteem and depression. Indeed, obesity is recognised as an important risk factor for the development of several chronic diseases such as hypertension, cancer, asthma and metabolic syndrome. Chronic low grade systemic inflammation is considered as a hallmark of obesity and may possibly explain the link between obesity and chronic disease, in particular the increased incidence, prevalence and severity of asthma in obese individuals. There is now strong evidence for infiltration of immune and inflammatory cells into adipose tissue that drives systemic inflammation and subsequent end organ damage. In addition to adipocytes, the key adipose tissue resident immune cells are macrophages and mast cells. Immunometabolism, as an emerging field of investigation, explores the pivotal role of these immune cells in translating immunological changes to metabolic effects in obesity. Abundance of free fatty acids, along with other inflammatory cytokines shift the balance of metabolic homeostasis to pro-inflammatory status by influencing the development of inflammatory cell lineage, which, further exhibits distinct functional phenotypes. There is emerging evidence for macrophage activation and functional polarization of an anti-inflammatory M2 phenotype towards a pro-inflammatory M1 phenotype of macrophages in obese adipose tissue. Similarly, studies in both obese humans and murine models reveal the pathognomic presence of an increased number of mast cells in visceral adipose tissue. These suggest a possible

  4. 哮喘儿童照顾者家庭疾病管理体验的质性研究%Disease management experiences of family caregivers of asthmatic children: a qualitative research

    Institute of Scientific and Technical Information of China (English)

    顾希茜; 段红梅; 侯小妮; 向莉

    2014-01-01

    目的 了解我国哮喘儿童照顾者家庭疾病管理的照顾体验,为提供适合患儿照顾者家庭需求的疾病管理内容和发展个体化健康教育服务奠定基础.方法 应用质性研究中的现象学研究方法,对15名哮喘儿童家长进行半结构式深入访谈,采用Colaizzi现象学分析法进行资料分析.结果 分析出哮喘儿童照顾者家庭疾病管理体验的4个主题:得知诊断后心理感受复杂;陪伴治疗时经历疾病管理困难;遭遇疾病负面影响;渴望社会、医疗、家庭支持.结论 哮喘儿童照顾者在疾病管理过程中承受着心理、生理的沉重负担,在疾病管理过程中遭遇了各种困难及负面影响.需要为其提供专业的个体化健康教育服务,构建更完善的疾病支持系统,减轻家庭照顾压力.%Objective To find out and understand the feeling of caregivers who had children with asthma in order to provide proper family-care contents and develop individual nursing care by medical professionals.Methods Totals of fifteen parents of children with asthma were interviewed with open-ended questions.The data collected from the interviews were analyzed with Colaizzi.Results These parents had complex feeling after the asthma diagnosis and desired for social,medical,family support.Disease management difficulties and its negative impact were found in the study.Conclusions These caregivers undergo the psychological and physiological burden and suffered many difficulties and negative effects in asthma management.Health professionals should provide individual nursing care and establish better support system to help them cope with stress.

  5. The influence of glucocorticoid inhalation on serum IgE of asthmatic children%吸入糖皮质激素对哮喘儿童血清IgE的影响

    Institute of Scientific and Technical Information of China (English)

    李云; 钟礼立; 黄寒; 王涛; 易红玲; 梁沫; 陈敏; 王娟

    2009-01-01

    目的 探讨哮喘儿童吸入糖皮质激素(ICS)治疗前后血清总IgE的变化及意义.方法 哮喘儿童520例,均给予ICS治疗.≤3岁142例,4~5岁169例,均给予储雾罐吸入丙酸氟替卡松气雾剂治疗;6~14岁209例,选用沙美特罗替卡松粉吸入剂治疗;剂量为200~375μg/d.治疗前与治疗后3个月复查IgE.结果 520例患儿治疗前IgE为(496.12±24.75)kU/L,治疗后IgE为(390.71±18.71)kU/L,差异有统计学意义(t=7.337,P300 kU/L 260例,45例(16.15%,45/260)治疗后血清总IgE升高,差异有统计学意义(χ=37.789,P=0.000).结论 ICS使IgE下降,IgE的检测有利于哮喘患者诊治过程中的病情观察.%Objective To discuss the significance of serum IgE before and after inhale glucocorticoid treat-ment of children's asthma. Methods 520 children with asthma were seleceted from the outpatient. Different type of fluticasone propionate were given to different age groups: Aerosol type by a spacer in less than 5 years old,and in-halant (Seretide) 5 years and the above. The dosage was between 200 μg/day to 375 μg/day. IgE was tested before and 3 months after the treatment. Results Serum IgE decreased significantly in 3 months treatment [ from (496.12±24.75) kU/L to (390.71±18.71) kU/L] (t=7.337,P=37.789,P=0.000). Conclusion Inhale glucocorticoid can make the level of IgE decreased.

  6. Efectos del entrenamiento físico en piscina climatizada sobre la capacidad aeróbica de un grupo de niños asmáticos. (Effects of the physical training in a warm-water pool on the aerobic power of a group of asthmatic children.

    Directory of Open Access Journals (Sweden)

    Juan David Fernández Villada

    2009-07-01

    Full Text Available ResumenObjetivo: Observar cambios en la capacidad aeróbica de un grupo de niños asmáticos después de un entrenamiento físico en piscina climatizada (EFPC. Método: 22 niños asmáticos, se dividieron en grupo experimental (GE y grupo control (GC de 11 cada uno. El GE se sometió a un EFPC durante 18 semanas de manera controlada, mientras el GC solo hacía sus actividades cotidianas. A ambos grupos se les realizó pruebas de esfuerzo en banda rodante para determinar el máximo consumo de oxígeno en METS y la frecuencia cardiaca máxima (FCM. Se midió en cada sesión de EFPC si los niños presentaban asma inducida por esfuerzo (AIE. Resultados: Al iniciar el estudio, el promedio de METS y de la FCM fueron similares en ambos grupos (Anova METS p = 0.5568; Anova FCM p = 0.5198; METS: GE 11.61 ± 2.33 DS, GC 11.05 ± 2.08 DS; FCM: GE 165.09 ± 13.85 DS, GC 161.46 ± 12.12 DS. Al finalizar, sólo el GE mejoró en los promedios de los METS de la diferencia pre-post según la prueba de observaciones apareadas (METS GE 6.65 ± 3.46 DS; Anova p = 0.0006. La FCM también aumentó, siendo significativa en el GE (FCM: GE 22.45 ± 19.04 DS; Anova FCM p = 0.0823. Solo el 6,06% de las mediciones presentaron AIE. Conclusión: Se encontró aumento significativo de la capacidad aeróbica en el GE, comparado con el GC. Se sugiere que utilizar piscina climatizada para el entrenamiento físico del asmático puede disminuir el AIE.Abstract Objective: To observe changes in the aerobic power in a group of asthmatic children after of a physical training in warm-water pool (EFPC. Method: 22 asthmatic children, who were divided in to an experimental group (GE and a control group (GC of 11 each. The GE was submitted to an EFPC for 18 weeks in a controlled way, while the GC only did their daily activities. Treadmill ergometer testing were conducted to both groups, to determine the maximal oxygen consumption in MET and the maximum heart rate (FCM. Each section of the

  7. Impact of socioeconomic status on the use of inhaled corticosteroids in young adult asthmatics

    DEFF Research Database (Denmark)

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

    2011-01-01

    OBJECTIVE: The aim of this population-based longitudinal study was to examine the associations between socioeconomic status (SES) and anti-asthmatic treatment with inhaled corticosteroids (ICS) among young Danish adult asthmatics, and to investigate whether these associations were consistent over...... use in young adult asthmatics. To encourage ICS use, special attention should be paid to asthmatics with low educational level and low income. Further studies are needed to elucidate underlying mechanisms for this socioeconomic inequality....

  8. Home Visiting Programs: What the Primary Care Clinician Should Know.

    Science.gov (United States)

    Finello, Karen Moran; Terteryan, Araksi; Riewerts, Robert J

    2016-04-01

    Responsibilities for primary care clinicians are rapidly expanding ascomplexities in families' lives create increased disparities in health and developmental outcomes for young children. Despite the demands on primary care clinicians to promote health in the context of complex family and community factors, most primary care clinicians are operating in an environment of limited training and a shortage of resources for supporting families. Partnerships with evidence-based home visiting programs for very young children and their families can provide a resource that will help to reduce the impact of adverse early childhood experiences and facilitate health equity. Home visiting programs in the United States are typically voluntary and designed to be preventative in nature, although families are usually offered services based on significant risk criteria since the costs associated with universal approaches have been considered prohibitive. Programs may be funded within the health (physical orbehavioral/mental health), child welfare, early education, or early intervention systems or by private foundation dollars focused primarily on oneof the above systems (e.g., health), with a wide range of outcomes targeted by the programs and funders. Services may be primarily focused on the child, the parent, or parent-child interactions. Services include the development of targeted and individualized intervention strategies, better coaching of parents, and improved modeling of interactions that may assist struggling families. This paper provides a broad overview ofthe history of home visiting, theoretical bases of home visiting programs, key components of evidence-based models, outcomes typically targeted, research on effectiveness, cost information, challenges and benefits of home visiting, and funding/sustainability concerns. Significance for primary care clinicians isdescribed specifically and information relevant for clinicians is emphasized throughout the paper. PMID:26872870

  9. Bone mineral density in asthmatic patients on inhaled corticosteroids in a developing country

    Directory of Open Access Journals (Sweden)

    Yeh Chunn Kuan

    2012-01-01

    Conclusion: The risk factors for osteoporosis and osteopenia among asthmatic patients were older age and lower BMI, but not the cumulative dose of ICS. Asthmatic patients on ICS have no added risk of osteoporosis or osteopenia as compared with non-asthmatic subjects.

  10. Relationship between airway pathophysiology and airway inflammation in older asthmatics

    DEFF Research Database (Denmark)

    Porsbjerg, Celeste M; Gibson, Peter G; Pretto, Jeffrey J;

    2013-01-01

    BACKGROUND AND OBJECTIVE: Asthma-related morbidity is greater in older compared with younger asthmatics. Airway closure is also greater in older asthmatics, an observation that may be explained by differences in airway inflammation. We hypothesized that in older adult patients with asthma......, neutrophil airway inflammation increases airway closure during bronchoconstriction, while eosinophil airway inflammation increases airway hyperresponsiveness (AHR). METHODS: Asthmatic subjects (n = 26), aged ≥55 years (68% female), were studied, and AHR to 4.5% saline challenge was measured by the response......-dose ratio (%fall in forced expiratory volume in 1 s (FEV1 )/mg saline). Airway closure was assessed during bronchoconstriction percent change in forced vital capacity (FVC)/percent change in FEV1 (i.e. Closing Index). Airway inflammation was assessed by induced sputum and exhaled nitric oxide (eNO). RESULTS...

  11. Effect of inhalation of Glucocorticoids on the levels of serum NO﹑IL-8 and GM-CSF in Bronchial Asthmatic children%吸入糖皮质激素对支气管哮喘患儿血清NO、IL-8和GM-CSF水平的影响

    Institute of Scientific and Technical Information of China (English)

    温晓春; 蔡爱东

    2014-01-01

    目的:观察支气管哮喘患儿血清IL-6﹑IL-8和GM-CSF水平的变化。方法:采用化学法和放射免疫法分析,先对31例支气管哮喘患儿进行了吸入糖皮质激素前后血清NO﹑IL-8和GM-CSF水平检测,并与35名正常健康儿作比较。结果:支气管哮喘患儿在吸入糖皮质激素前血清NO﹑IL-8和GM-CSF水平均非常显著的高于正常儿组( P<0.01),经吸入糖皮质激素2个月后与正常人比较仍有显著差异( P<0.05)且血清N O水平与I L-8﹑G M-C S F水平呈显著正相关(r=0.5134,0.6012,P<0.01)。结论:吸入糖皮质激素是治疗支气管哮喘的重要手段,其治疗作用与下调NO﹑IL-8和GM-CSF水平有关。%objective: To observe the effect of inhalation of glucocorticoids on the levels of serum NO﹑IL-8 and GM-CSF in Bronchial Asthmatic children. Methods : Serum NO(with chemistry) serum IL-8﹑GM-CSF(with RIA) levels were determined in 31 patients and compared 35 controls. Results: before inhalation of glucocorticoids , the serum NO﹑IL-8 and GM-CSF levels were significantly higher than those in controls(P<0.01).after 2mouths of inhalation of glucocorticoids the serum NO﹑IL-8 and GM-CSF levels though dropped markedly but remained apparently higher than those in controls(P<0.05).Serum NO levels were positively correlated with serum NO﹑IL-8 and GM-CSF levels(r=0.5134,0.6012,P<0.01).Conclusions:Inhalation of glucocorticoids is an important means for bronchial asthma and the therapeutic effects closely related to the down regulation of levels NO﹑IL-8 and GM-CSF.

  12. Effect of Inhalation of Glucocorticoids on the Levels of Serum NO,NOS and GM-CSF in Bronchial Asthmatic Children%吸入糖皮质激素对支气管哮喘患儿血清NO、NOS和GM-CSF水平的影响江

    Institute of Scientific and Technical Information of China (English)

    龚成香; 赵庆琪; 姚加平

    2013-01-01

    目的:观察支气管哮喘患儿血清NO、NOS和GM-CSF水平的变化.并探讨其吸入糖皮质激素后对支气管哮喘患儿血清NO、NOS和GM-CSF水平的影响.方法:采用化学法和放射免疫分析对36例支气管哮喘患儿进行了吸入糖皮质激素前后NO、NOS和GM-CSF检测,并与35名正常健康儿作比较.结果:支气管哮喘患儿在吸入糖皮质激素前血清NO、NOS和GM-CSF水平均非常显著地高于正常儿组(P<0.01),经吸入糖皮质激素治疗3个月后与正常儿组比较仍有显著性差异(P<0.05).结论:吸入糖皮质激素是治疗支气管哮喘的重要手段,其治疗作用与下调NO、NOS和GM-CSF水平有关.%Objective To observe the effect of inhalation of glucocorticoids on the levels of serum NO, NOS and GM-CSF in bronchial asthmatic children. Methods Serum NO, NOS (with chemistry) , serum GM-CSF (with BIA) levels were determined in 36 patients and compared with 35 normal controls. Results Before inhalation of glucocorticoids the serum NO, NOS and GM-CSF levels were significantly higher than those in the controls(P<0.01). After 3 months of inhalation glucocorticoids. the serum NO,NOS and GM-CSF levels though dropped markedly but remained apparently higher than those in the oontrols( P < 0.05). Conclusion Inhalation of glucocorticoids is an important means for bronchial asthma and the therapeutic effects closely related to the down regulation of levels of NO, NOS and GM-CSF.

  13. Differential deposition of fibronectin by asthmatic bronchial epithelial cells.

    Science.gov (United States)

    Ge, Qi; Zeng, Qingxiang; Tjin, Gavin; Lau, Edmund; Black, Judith L; Oliver, Brian G G; Burgess, Janette K

    2015-11-15

    Altered ECM protein deposition is a feature in asthmatic airways. Fibronectin (Fn), an ECM protein produced by human bronchial epithelial cells (HBECs), is increased in asthmatic airways. This study investigated the regulation of Fn production in asthmatic or nonasthmatic HBECs and whether Fn modulated HBEC proliferation and inflammatory mediator secretion. The signaling pathways underlying transforming growth factor (TGF)-β1-regulated Fn production were examined using specific inhibitors for ERK, JNK, p38 MAPK, phosphatidylinositol 3 kinase, and activin-like kinase 5 (ALK5). Asthmatic HBECs deposited higher levels of Fn in the ECM than nonasthmatic cells under basal conditions, whereas cells from the two groups had similar levels of Fn mRNA and soluble Fn. TGF-β1 increased mRNA levels and ECM and soluble forms of Fn but decreased cell proliferation in both cells. The rate of increase in Fn mRNA was higher in nonasthmatic cells. However, the excessive amounts of ECM Fn deposited by asthmatic cells after TGF-β1 stimulation persisted compared with nonasthmatic cells. Inhibition of ALK5 completely prevented TGF-β1-induced Fn deposition. Importantly, ECM Fn increased HBEC proliferation and IL-6 release, decreased PGE2 secretion, but had no effect on VEGF release. Soluble Fn had no effect on cell proliferation and inflammatory mediator release. Asthmatic HBECs are intrinsically primed to produce more ECM Fn, which when deposited into the ECM, is capable of driving remodeling and inflammation. The increased airway Fn may be one of the key driving factors in the persistence of asthma and represents a novel, therapeutic target. PMID:26342086

  14. Dyphylline aerosol can induce bronchospasm in human asthmatics.

    Science.gov (United States)

    Lawyer, C; Auer, S; Brottem, J; Bardana, E; Hirshman, C; Lynn, R; Downes, H

    1982-01-01

    Dihydroxypropyl theophylline (dyphylline) was administered by aerosol in a single dose of 250 mg aerosolized over five minutes to two asthmatic volunteers and in a single dose of 375 mg aerosolized over ten minutes to two other asthmatic volunteers. Serial spirometry was then performed. Marked bronchospasm occurred within ten minutes in two of the subjects, and developed more slowly in another. One subject demonstrated no significant change. Aerosolized dyphylline solution was not an effective bronchodilator, using the methods described in this study. PMID:6957527

  15. Serum 25 Hydroxy Vitamin D Levels In Adult Asthmatic Patients

    OpenAIRE

    Mostafa M. Shaaban*, Manal Hashem

    2012-01-01

    Purpose: Patients with chronic lung disease as asthma appear to be at increased risk for vitamin D deficiency for reasons that are not clear. Methods: A cross sectional study including 75 asthmatic adults aged older than 18 years and 75 adults healthy control aged older than 18 years (35 males and 40 females for both groups) assessing the relationship between serum 25 hydroxy vitamin D levels and lung function. Result: In our study only (12٫31%) of our asthmatic adults had sufficient vitamin...

  16. Suicide Survivors' Perceptions of the Treating Clinician.

    Science.gov (United States)

    Peterson, Erin M.; Luoma, Jason B.; Dunne, Edward

    2002-01-01

    Examines survivors' attitudes and perceptions of the clinicians who treated their loved one at the time of death. The 71 respondents were relatives or friends of individuals who had died of suicide. Only 11% reported that clinicians attempted to contact them before the death. Discusses implications of findings for clinical practice, legal issues,…

  17. Functional phenotype of airway myocytes from asthmatic airways

    NARCIS (Netherlands)

    Wright, David B.; Trian, Thomas; Siddiqui, Sana; Pascoe, Chris D.; Ojo, Oluwaseun O.; Johnson, Jill R.; Dekkers, Bart G. J.; Dakshinamurti, Shyamala; Bagchi, Rushita; Burgess, Janette K.; Kanabar, Varsha

    2013-01-01

    In asthma, the airway smooth muscle (ASM) cell plays a central role in disease pathogenesis through cellular changes which may impact on its microenvironment and alter ASM response and function. The answer to the long debated question of what makes a 'healthy' ASM cell become 'asthmatic' still remai

  18. Viral bronchiolitis for the clinician.

    Science.gov (United States)

    Fitzgerald, Dominic A

    2011-04-01

    Viral bronchiolitis is common, and about 98-99% of infants are managed in the home. Because about 95% of infants < 2 years old are infected with respiratory syncytial virus, however, bronchiolitis is the commonest reason for admission to hospital in the first 6 months of life. It is usually a self-limiting condition lasting around a week in previously well children. About 1% of infants are admitted to hospital, and about 10% of hospitalised infants will require admission to the intensive care unit. Respiratory syncytial virus is isolated from about 70% of infants hospitalised with bronchiolitis. The emphasis of hospital treatment is to ensure adequate hydration and oxygenation. Other than supplemental oxygen, little in the way of pharmacological treatment has been demonstrated to alter the course of the illness or the risk of wheezing in the months following bronchiolitis.

  19. Social-economic profile of asthmatic patients assisted at a Nucleus of Integrated Medical Assistance - doi:10.5020/18061230.2008.p180

    Directory of Open Access Journals (Sweden)

    Anisia Torquilho Praxedes

    2012-01-01

    Full Text Available Objective: To determine the social-economic profile of asthmatic patients who use the health services rendered by the Nucleus of Integrated Medical Assistance (NAMI, in Fortaleza- Ce. Methods: This descriptive, retrospective and cross-sectional study, of a quantitative approach, had a sample comprised by 40 asthmatic patients assisted at NAMI during the period of April to May, 2006. The data collection was accomplished by means of a standard semi-structured interview, with open and closed questions. Results: The age range between 0 to 5 years old represented the greater percentage of patients, thus obtaining 60.0% of the answered questionnaires. According to social-economic conditions, 55.0% were illiterate or were learning to read, 75.0% were using some drug prescribed at NAMI, 72.5% fully ignored the disease, 52.5% recognized the factors that triggered the asthmatic crisis and 55.0% said having often crisis. Seventy per cent (70.0% of the interviewed showed some difficulty related to the use of the drugs; 47.5% referred having different problems related to the access to the medications. Conclusion: By the analysis of the determined social-economic profile of asthmatics patients assisted at NAMI, it is concluded that great part of them are people with little instruction, due to the social exclusion in which they are found; being the majority of them children of female gender. NCT00722657

  20. A study of airway smooth muscle in asthmatic and non-asthmatic airways using PS-OCT (Conference Presentation)

    Science.gov (United States)

    Adams, David C.; Holz, Jasmin A.; Szabari, Margit V.; Hariri, Lida P.; Harris, R. Scott; Cho, Jocelyn L.; Hamilos, Daniel L.; Luster, Andrew D.; Medoff, Benjamin D.; Suter, Melissa J.

    2016-03-01

    Present understanding of the pathophysiological mechanisms of asthma has been severely limited by the lack of an imaging modality capable of assessing airway conditions of asthma patients in vivo. Of particular interest is the role that airway smooth muscle (ASM) plays in the development of asthma and asthma related symptoms. With standard Optical Coherence Tomography (OCT), imaging ASM is often not possible due to poor structural contrast between the muscle and surrounding tissues. A potential solution to this problem is to utilize additional optical contrast factors intrinsic to the tissue, such as birefringence. Due to its highly ordered structure, ASM is strongly birefringent. Previously, we demonstrated that Polarization Sensitive OCT(PS-OCT) has the potential to be used to visualize ASM as well as easily segment it from the surrounding (weakly) birefringent tissue by exploiting a property which allows it to discriminate the orientation of birefringent fibers. We have already validated our technology with a substantial set of histological comparisons made against data obtained ex vivo. In this work we present a comprehensive comparison of ASM distributions in asthmatic and non-asthmatic human volunteers. By isolating the ASM we parameterize its distribution in terms of both thickness and band width, calculated volumetrically over centimeters of airway. Using this data we perform analyses of the asthmatic and non-asthmatic airways using a broad number and variety and subjects.

  1. Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa

    OpenAIRE

    Aguocha Chinyere M; Okoroikpa Ifeoma N; Ubochi Vincent N; Bakare Muideen O; Ebigbo Peter O

    2009-01-01

    Abstract Background There may be need to assess intelligent quotient (IQ) scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intell...

  2. Bronchoprotection with a leukotriene receptor antagonist in asthmatic preschool children

    DEFF Research Database (Denmark)

    Bisgaard, H; Nielsen, K G

    2000-01-01

    receiving regular treatment with budesonide delivered by an inhaler with a spacer in a mean daily dose of 350 microg, but the bronchoprotection provided by montelukast was independent of concurrent steroid treatment. There was no convincing evidence of failure to respond, and the protective effect...

  3. Increased proinflammatory responses from asthmatic human airway smooth muscle cells in response to rhinovirus infection

    Directory of Open Access Journals (Sweden)

    King Nicholas JC

    2006-05-01

    Full Text Available Abstract Background Exacerbations of asthma are associated with viral respiratory tract infections, of which rhinoviruses (RV are the predominant virus type. Airway smooth muscle is important in asthma pathogenesis, however little is known about the potential interaction of RV and human airway smooth muscle cells (HASM. We hypothesised that rhinovirus induction of inflammatory cytokine release from airway smooth muscle is augmented and differentially regulated in asthmatic compared to normal HASM cells. Methods HASM cells, isolated from either asthmatic or non-asthmatic subjects, were infected with rhinovirus. Cytokine production was assayed by ELISA, ICAM-1 cell surface expression was assessed by FACS, and the transcription regulation of IL-6 was measured by luciferase activity. Results RV-induced IL-6 release was significantly greater in HASM cells derived from asthmatic subjects compared to non-asthmatic subjects. This response was RV specific, as 5% serum- induced IL-6 release was not different in the two cell types. Whilst serum stimulated IL-8 production in cells from both subject groups, RV induced IL-8 production in only asthmatic derived HASM cells. The transcriptional induction of IL-6 was differentially regulated via C/EBP in the asthmatic and NF-κB + AP-1 in the non-asthmatic HASM cells. Conclusion This study demonstrates augmentation and differential transcriptional regulation of RV specific innate immune response in HASM cells derived from asthmatic and non-asthmatics, and may give valuable insight into the mechanisms of RV-induced asthma exacerbations.

  4. Effect of Long-term Inhalation of Glucocorticoids on the Level of Leptin, IL-13 and IL-2 in Bronchial Asthmatic Children%长期吸入糖皮质激素对支气管哮喘患者血清leptin、IL-13和IL-2水平的影响

    Institute of Scientific and Technical Information of China (English)

    潘炯伟

    2011-01-01

    目的:观察支气管哮喘患者血清leptin、IL-13和IL-2水平的变化并探讨长期吸入糖皮质激素后对支气管哮喘患者血清leptin、IL-13和IL-2的影响.方法:4采用酶联免疫吸附法(ELISA),分别检测70例支气管哮喘患者采用吸入糖皮质激素治疗前、治疗3、6、12个月后及60例对照者血清IL-13和IL-2水平;采用放射免疫分析血清leptin浓度.结果:支气管哮喘患者血清leptin、IL-13和IL-2水平显著高于正常对照组.吸入糖皮质激素治疗3个月后支气管哮喘患者血清leptin、IL-13和IL-2浓度与治疗前比较下降(P均<0.05),治疗6个月和12个月后显著低于治疗前(P均<0.01),且治疗12个月后各个炎症指标与对照组相比无显著性差异(P>0.05).结论:长期吸入糖皮质激素是治疗支气管哮喘的重要手段,其治疗作用与下调血清leptin、IL-13和IL-2水平有关.%Objective To determine the effect of long-term inhalation of glucocorticoids on the level of leptin, IL-13, and H-2 in bronchial asthmatic patient. Methods End/me-linked immunosorbent assay ( ELISA ) was used to detect the serum IL-13 and IL-2 level in 60 healthy persons ( normal control group ) and 70 bronchial asthma patients untreated and 3, 6, 12 months pest-treatment, meanwhile leptin was determined by radio immunoassay. Results The serum levels of leptin, IL-13, and IL-2 in were significantly increased in patient with bronchial asthma compared with that in the normal control group. The serum levels of leptin, IL-13, and IL 2 in children with asthma were clem'eased gradually after inhaling gineccortieoids for 3 months ( P < 0.05 ). The treatment of inhaled glucocortieoids for 6 and 12 months can attenuate the elevation of leptin, IL-13, and IL-2 compared with that before the treatment. Conclusion Long-term inhaled glucoeortieoid is an important means for asthma, and the effects are related to the decrease of level of leptin, IL-13, and IL-2.

  5. Child Health Disparities: What Can a Clinician Do?

    Science.gov (United States)

    Cheng, Tina L; Emmanuel, Mickey A; Levy, Daniel J; Jenkins, Renee R

    2015-11-01

    Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity.

  6. Child Health Disparities: What Can a Clinician Do?

    Science.gov (United States)

    Cheng, Tina L; Emmanuel, Mickey A; Levy, Daniel J; Jenkins, Renee R

    2015-11-01

    Pediatric primary and specialty practice has changed, with more to do, more regulation, and more family needs than in the past. Similarly, the needs of patients have changed, with more demographic diversity, family stress, and continued health disparities by race, ethnicity, and socioeconomic status. How can clinicians continue their dedicated service to children and ensure health equity in the face of these changes? This article outlines specific, practical, actionable, and evidence-based activities to help clinicians assess and address health disparities in practice. These tools may also support patient-centered medical home recognition, national and state cultural and linguistic competency standards, and quality benchmarks that are increasingly tied to payment. Clinicians can play a critical role in (1) diagnosing disparities in one's community and practice, (2) innovating new models to address social determinants of health, (3) addressing health literacy of families, (4) ensuring cultural competence and a culture of workplace equity, and (5) advocating for issues that address the root causes of health disparities. Culturally competent care that is sensitive to the needs, health literacy, and health beliefs of families can increase satisfaction, improve quality of care, and increase patient safety. Clinical care approaches to address social determinants of health and interrupting the intergenerational cycle of disadvantage include (1) screening for new health "vital signs" and connecting families to resources, (2) enhancing the comprehensiveness of services, (3) addressing family health in pediatric encounters, and (4) moving care outside the office into the community. Health system investment is required to support clinicians and practice innovation to ensure equity. PMID:26459644

  7. Florida Red Tide Toxins (Brevetoxins) and Longitudinal Respiratory Effects in Asthmatics

    OpenAIRE

    Bean, Judy A.; Fleming, Lora E.; Kirkpatrick, Barbara; Backer, Lorraine C.; Nierenberg, Kate; Reich, Andrew; Cheng, Yung Sung; Wanner, Adam; Benson, Janet; Naar, Jerome; Pierce, Richard; Abraham, William M.; Kirkpatrick, Gary; Hollenbeck, Julie; Zaias, Julia

    2011-01-01

    Having demonstrated significant and persistent adverse changes in pulmonary function for asthmatics after 1 hour exposure to brevetoxins in Florida red tide (Karenia brevis bloom) aerosols, we assessed the possible longer term health effects in asthmatics from intermittent environmental exposure to brevetoxins over 7 years. 125 asthmatic subjects were assessed for their pulmonary function and reported symptoms before and after 1 hour of environmental exposure to Florida red tide aerosols for ...

  8. Undifferentiated Bronchial Fibroblasts Derived from Asthmatic Patients Display Higher Elastic Modulus than Their Non-Asthmatic Counterparts

    OpenAIRE

    Sarna, Michal; Wojcik, Katarzyna A.; Hermanowicz, Pawel; Wnuk, Dawid; Burda, Kvetoslava; Sanak, Marek; Czyż, Jarosław; Michalik, Marta

    2015-01-01

    During asthma development, differentiation of epithelial cells and fibroblasts towards the contractile phenotype is associated with bronchial wall remodeling and airway constriction. Pathological fibroblast-to-myofibroblast transition (FMT) can be triggered by local inflammation of bronchial walls. Recently, we have demonstrated that human bronchial fibroblasts (HBFs) derived from asthmatic patients display some inherent features which facilitate their FMT in vitro. In spite of intensive rese...

  9. Efficacy and safety of influenza vaccination in children with asthma.

    Science.gov (United States)

    Patria, Maria Francesca; Tenconi, Rossana; Esposito, Susanna

    2012-04-01

    The mean global prevalence of asthma among children is approximately 12%, making it the most common chronic disease in children. Influenza infection has been associated with complications such as exacerbations of wheezing and asthma, increased airway hyper-reactivity and hospitalization. Although influenza vaccination is recommended for asthmatic patients by all health authorities, vaccination coverage remains significantly lower than expected and is lowest of all in children. Compliance is affected by the uncertainty of parents and physicians concerning the clinical risk of influenza in asthmatic subjects, the benefits of influenza vaccination in preventing asthma exacerbations and the safety of immunization. The aim of this review is to analyze the rationale for using influenza vaccine, discuss the relationship between influenza and the severity of asthmatic episodes and document the efficacy and safety of influenza vaccination in the pediatric asthmatic population.

  10. Dialogue on Separation: Clinicians as Educators.

    Science.gov (United States)

    Boss, Pauline Grossenbacher; Whitaker, Carl

    1979-01-01

    This dialogue on separation by three clinicians took place in a family relations class at the University of Wisconsin-Madison. It emphasizes the point that psychological separation, more than physical separation, is the essence of individuation, and that for students to understand the concept of individuation they must experience as well as study…

  11. Environmental Effects on Fractional Exhaled Nitric Oxide in Allergic Children

    Directory of Open Access Journals (Sweden)

    Stefania La Grutta

    2012-01-01

    Full Text Available Fractional exhaled nitric oxide (FeNO is a non-invasive marker of airway inflammation in asthma and respiratory allergy. Environmental factors, especially indoor and outdoor air quality, may play an important role in triggering acute exacerbations of respiratory symptoms. The authors have reviewed the literature reporting effects of outdoor and indoor pollutants on FeNO in children. Although the findings are not consistent, urban and industrial pollution—mainly particles (PM2.5 and PM10, nitrogen dioxide (NO2, and sulfur dioxide (SO2—as well as formaldehyde and electric baseboard heating have been shown to increase FeNO, whilst ozone (O3 tends to decrease it. Among children exposed to Environmental Tobacco Smoke (ETS with a genetic polymorphisms in nitric oxide synthase genes (NOS, a higher nicotine exposure was associated with lower FeNO levels. Finally, although more studies are needed in order to better investigate the effect of gene and environment interactions which may affect the interpretation of FeNO values in the management of children with asthma, clinicians are recommended to consider environmental exposures when taking medical histories for asthma and respiratory allergy. Further research is also needed to assess the effects of remedial interventions aimed at reducing/abating environmental exposures in asthmatic/allergic patients.

  12. Exhaled nitric oxide and inducible nitric oxide synthase gene polymorphism in Japanese asthmatics

    Directory of Open Access Journals (Sweden)

    Suguru Sato

    2016-07-01

    Conclusions: The number of CCTTT repeats in the iNOS promoter region was associated with FeNO levels in asthmatics before treatment, suggesting the importance of iNOS genotype in the clinical application of FeNO for asthmatics.

  13. Florida Red Tide Toxins (Brevetoxins) and Longitudinal Respiratory Effects in Asthmatics.

    Science.gov (United States)

    Bean, Judy A; Fleming, Lora E; Kirkpatrick, Barbara; Backer, Lorraine C; Nierenberg, Kate; Reich, Andrew; Cheng, Yung Sung; Wanner, Adam; Benson, Janet; Naar, Jerome; Pierce, Richard; Abraham, William M; Kirkpatrick, Gary; Hollenbeck, Julie; Zaias, Julia; Mendes, Eliana; Baden, Daniel G

    2011-09-01

    Having demonstrated significant and persistent adverse changes in pulmonary function for asthmatics after 1 hour exposure to brevetoxins in Florida red tide (Karenia brevis bloom) aerosols, we assessed the possible longer term health effects in asthmatics from intermittent environmental exposure to brevetoxins over 7 years. 125 asthmatic subjects were assessed for their pulmonary function and reported symptoms before and after 1 hour of environmental exposure to Florida red tide aerosols for upto 11 studies over seven years. As a group, the asthmatics came to the studies with normal standardized percent predicted pulmonary function values. The 38 asthmatics who participated in only one exposure study were more reactive compared to the 36 asthmatics who participated in ≥4 exposure studies. The 36 asthmatics participating in ≥4 exposure studies demonstrated no significant change in their standardized percent predicted pre-exposure pulmonary function over the 7 years of the study. These results indicate that stable asthmatics living in areas with intermittent Florida red tides do not exhibit chronic respiratory effects from intermittent environmental exposure to aerosolized brevetoxins over a 7 year period. PMID:22053149

  14. Association of School Social Networks' Influence and Mass Media Factors with Cigarette Smoking among Asthmatic Students

    Science.gov (United States)

    Kanamori, Mariano; Beck, Kenneth H.; Carter-Pokras, Olivia

    2015-01-01

    Background: Around 10% of adolescent students under 18 years have current asthma. Asthmatic adolescents smoke as much or more than non-asthmatic adolescents. We explored the association between exposure to mass media and social networks' influence with asthmatic student smoking, and variations of these exposures by sex. Methods: This study…

  15. Attenuated response to repeated daily ozone exposures in asthmatic subjects

    Energy Technology Data Exchange (ETDEWEB)

    Gong, H. Jr.; Linn, W.S. [Rancho Low Amigos Medical Center, Downey, CA (United States); McManus, M.S. [Univ. of California, Los Angeles, CA (United States)

    1997-01-01

    The development of attenuated response ({open_quotes}tolerance{close_quotes}) to daily ozone (O{sub 3}) exposures in the laboratory is well established in healthy adult volunteers. However, the capability of asthmatics to develop tolerance during multiday ozone exposures in unclear. We exposed 10 adult volunteers with mild asthma to 0.4 ppm O{sub 3} in filtered air for 3 h/d on 5 consecutive d. Two similar filtered-air exposures during the preceding week served as controls. Follow-up O{sub 3} exposures were performed 4 and 7 d after the most recent consecutive exposure. All exposures were performed in an environmental chamber at 31 {degrees}C and 35% relative humidity. The subjects performed moderate exercise (mean ventilation rate of 32 l/min) for 15 min of each half-hour. Responses were measured with spirometry and symptom evaluations before and after each exposure, and a bronchial reactivity test (methacholine challenge) was conducted after each exposure. All response measurements showed clinically and statistically significant day-to-day variation. Symptom and forced-expiratory-volume-in-1-s responses were similarly large on the 1st and 2nd O{sub 3} exposure days, after which they diminished progressively, approaching filtered air response levels by the 5th consecutive O{sub 3} day. This tolerance was partially lost 4 and 7 d later. Bronchial reactivity peaked after the first O{sub 3} exposure and remained somewhat elevated after all subsequent O{sub 3} exposures, relative to its control level following filtered-air exposures. Individual responses varied widely; more severe initial responses to O{sub 3} predicted less rapid attenuation. We concluded that asthmatics can develop tolerance to frequent high-level O{sub 3} exposures in much the same manner as normal subjects, although the process may be slower and less fully effective in asthmatics. 27 refs., 3 figs., 4 tabs.

  16. Language Sampling, Analysis and Training: A Handbook for Teachers and Clinicians.

    Science.gov (United States)

    Tyack, Dorothy; Gottsleben, Robert

    Intended for teachers and speech clinicians, the handbook and accompanying worksheets describe research-based psycholinguistic procedures for needs assessment and individualized instruction of language-delayed children, including aphasics. Four main chapters explain how to collect a language sample (a systematic transcription of the student's…

  17. Vicarious Trauma: Predictors of Clinicians' Disrupted Cognitions about Self-Esteem and Self-Intimacy

    Science.gov (United States)

    Way, Ineke; VanDeusen, Karen; Cottrell, Tom

    2007-01-01

    This study examined vicarious trauma in clinicians who provide sexual abuse treatment (N = 383). A random sample of clinical members from the Association for the Treatment of Sexual Abusers and American Professional Society on the Abuse of Children were surveyed. Vicarious trauma was measured using the Trauma Stress Institute Belief Scale…

  18. Clinical Photography: A Guide for the Clinician

    Directory of Open Access Journals (Sweden)

    Nayler J

    2003-01-01

    Full Text Available Clinicians might not always have available the services of a professional medical photographer, but if a standardised approach is followed those who take their own clinical photographs can achieve acceptable results. This article offers guidance to the clinician on consistent lighting, exposure, patient positioning, linear scale, perspective, depth of field, and background. Advice is given on equipment and materials, including digital and conventional cameras, flash (strobe, films, and processing choices. Consistency of approach is emphasised - it is not acceptable to use photographic tricks to enhance the appearance of clinical outcomes. Rather, care should be taken to ensure that the only changes among clinical photographs taken over time are in the patient. Photographs should be stored and presented appropriately for their use and images for publication should be prepared according to the instructions to authors. Digital images for publication should be sized appropriately for the final reproduction size.

  19. How can clinician-educator training programs be optimized to match clinician motivations and concerns?

    Directory of Open Access Journals (Sweden)

    McCullough B

    2015-01-01

    Full Text Available Brendan McCullough, Gregory E Marton, Christopher J Ramnanan Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada Background: Several medical schools have implemented programs aimed at supporting clinician-educators with formal mentoring, training, and experience in undergraduate medical teaching. However, consensus program design has yet to be established, and the effectiveness of these programs in terms of producing quality clinician-educator teaching remains unclear. The goal of this study was to review the literature to identify motivations and perceived barriers to clinician-educators, which in turn will improve clinician-educator training programs to better align with clinician-educator needs and concerns. Methods: Review of medical education literature using the terms “attitudes”, “motivations”, “physicians”, “teaching”, and “undergraduate medical education” resulted in identification of key themes revealing the primary motivations and barriers involved in physicians teaching undergraduate medical students. Results: A synthesis of articles revealed that physicians are primarily motivated to teach undergraduate students for intrinsic reasons. To a lesser extent, physicians are motivated to teach for extrinsic reasons, such as rewards or recognition. The key barriers deterring physicians from teaching medical students included: decreased productivity, lack of compensation, increased length of the working day, patient concerns/ethical issues, and lack of confidence in their own ability. Conclusion: Our findings suggest that optimization of clinician-educator training programs should address, amongst other factors, time management concerns, appropriate academic recognition for teaching service, and confidence in teaching ability. Addressing these issues may increase the retention of clinicians who are active and proficient in medical education. Keywords: clinician-educators, teaching, undergraduate medical

  20. Exercise-Induced Wheezing among Japanese Pre-School Children and Pupils

    Directory of Open Access Journals (Sweden)

    Yoko Murakami

    2014-01-01

    Conclusions: EIW was not rare among current asthmatic children. An increased risk for EIW was in accordance with increasing severity of current asthma and this relation was mitigated with leukotriene receptor antagonist daily use among kindergartners.

  1. An observational study of patient versus parental perceptions of health-related quality of life in children and adolescents with a chronic pain condition: who should the clinician believe?

    Directory of Open Access Journals (Sweden)

    Vetter Thomas R

    2012-07-01

    Full Text Available Abstract Background Previous pediatric studies have observed a cross-informant variance in patient self-reported health-related quality of life (HRQoL versus parent proxy-reported HRQoL. This study assessed in older children and adolescents with a variety of chronic pain conditions: 1 the consistency and agreement between pediatric patients’ self-report and their parents’ proxy-report of their child’s HRQoL; 2 whether this patient-parent agreement is dependent on additional demographic and clinical factors; and 3 the relationship between pediatric patient HRQoL and parental reported HRQoL. Methods The 99 enrolled patients (mean age 13.2 years, 71% female, 81% Caucasian and an accompanying parent completed the PedsQLTM 4.0 and 36-Item Short-Form Health Survey Version 2 (SF-36v2 at the time of their initial appointment in a pediatric chronic pain medicine clinic. Patients’ and parents’ total, physical, and psychosocial HRQoL scores were analyzed via an intra-class correlation coefficient, Spearman’s correlation coefficient, Wilcoxon signed rank test, and Bland-Altman plot. A multivariable linear regression model was used to evaluate the association between clinical and demographic variables and the difference in patient and proxy scores for the Total Scale Score on the PedsQL™. Results With the exception of the psychosocial health domain, there were no statistically significant differences between pediatric patients’ self-report and their parents’ proxy-report of their child’s HRQoL. However, clinically significant patient-parent variation in pediatric HRQoL was observed. Differences in patient-parent proxy PedsQL™ Total Scale Score Scores were not significantly associated with patient age, gender, race, intensity and duration of patient’s pain, household income, parental marital status, and the parent’s own HRQoL on the SF-36v2. No significant relationship existed among patients’ self-reported HRQoL (Peds

  2. Mechanisms of BDNF regulation in asthmatic airway smooth muscle.

    Science.gov (United States)

    Aravamudan, Bharathi; Thompson, Michael A; Pabelick, Christina M; Prakash, Y S

    2016-08-01

    Brain-derived neurotrophic factor (BDNF), a neurotrophin produced by airway smooth muscle (ASM), enhances inflammation effects on airway contractility, supporting the idea that locally produced growth factors influence airway diseases such as asthma. We endeavored to dissect intrinsic mechanisms regulating endogenous, as well as inflammation (TNF-α)-induced BDNF secretion in ASM of nonasthmatic vs. asthmatic humans. We focused on specific Ca(2+) regulation- and inflammation-related signaling cascades and quantified BDNF secretion. We find that TNF-α enhances BDNF release by ASM cells, via several mechanisms relevant to asthma, including transient receptor potential channels TRPC3 and TRPC6 (but not TRPC1), ERK 1/2, PI3K, PLC, and PKC cascades, Rho kinase, and transcription factors cAMP response element binding protein and nuclear factor of activated T cells. Basal BDNF expression and secretion are elevated in asthmatic ASM and increase further with TNF-α exposure, involving many of these regulatory mechanisms. We conclude that airway BDNF secretion is regulated at multiple levels, providing a basis for autocrine effects of BDNF under conditions of inflammation and disease, with potential downstream influences on contractility and remodeling. PMID:27317689

  3. Mechanism of hypothalamic paraventricular nucleus in regulating asthmatic attack

    Institute of Scientific and Technical Information of China (English)

    Jia Liu; Rong Dong; Jian Xiao; Nina Liu

    2006-01-01

    BACKGROUD: It has been confirmed that c-fos expession increased markedly in hypothalamic paraventricular nucleus(PVN)during asthmatic attack in rats,and PVN has extensive physiological functions,involving in the regulation of respiratory system,etc.OBJECTIVE: To observe the alteration of electroencephalogram(EEG)and power spectra in PVN during the asthmatic attack,and the alteraiton of lung function and diaphragmatic muscle discharge after bilateral PVN lesion in asthmatic rats.DESIGN:A randomized control study.SETTING: Laboratory of Physiology and Pharmacology,School of Basic Medical Sciences,Southeast University.MATERIALS: Forty-eight male adult SD rats of 260-300g were used.The rats were randomly divided into 6 groups(n=8):control group,asthma group,electrolytic lesion of PVN group,KA-induced lesion of PVN group,sham electrolytic lesion of PVN group and sham kainic acid(KA)-induced lesion of PVN group.KA,chicken ovalbumin and aluminum hydroxide were purchased from American Sigma Company.Bordetella pertrssis vaccine (Institute of Biological Products of Shanghai);stereotaxic apparartus (Jianwan Ⅱ,China);Iesion-producing device (YC-2 programmable stimulato,Chengdu Iustrument Company);MD2000 signal processing system(Nanjing Medical School); data acquisition system (RM6240B,Chengdu Instrument Company).METHODS:The experiments were carried out in the Laboratory of Physiology and Pharmacology,School of Basic Medical Sciences,Southeast University from January to August in 2006.①Rats except for control group were sensitized with an intraperitoneal injection of 100 mg chicken ovalbumin and 100 mg aluminum hydroxide and Bordetella pertussis vaccine containing 5×109 heat-killed in 1 mL of sterile saline.From the fifteenth to seventeenth days rats received three times aerosolized ovalbumin challenge. In rats of the control group and asthma group three steel electrodes were placed into the left PVN(AP-1.8 mm,LR 0.4 mm,OH-7.9 mm).parietal cortex and subcutaneous tissue in

  4. β2-Agonist induced cAMP is decreased in asthmatic airway smooth muscle due to increased PDE4D.

    Directory of Open Access Journals (Sweden)

    Thomas Trian

    Full Text Available BACKGROUND AND OBJECTIVE: Asthma is associated with airway narrowing in response to bronchoconstricting stimuli and increased airway smooth muscle (ASM mass. In addition, some studies have suggested impaired β-agonist induced ASM relaxation in asthmatics, but the mechanism is not known. OBJECTIVE: To characterize the potential defect in β-agonist induced cAMP in ASM derived from asthmatic in comparison to non-asthmatic subjects and to investigate its mechanism. METHODS: We examined β(2-adrenergic (β(2AR receptor expression and basal β-agonist and forskolin (direct activator of adenylyl cyclase stimulated cAMP production in asthmatic cultured ASM (n = 15 and non-asthmatic ASM (n = 22. Based on these results, PDE activity, PDE4D expression and cell proliferation were determined. RESULTS: In the presence of IBMX, a pan PDE inhibitor, asthmatic ASM had ∼50% lower cAMP production in response to isoproterenol, albuterol, formoterol, and forskolin compared to non-asthmatic ASM. However when PDE4 was specifically inhibited, cAMP production by the agonists and forskolin was normalized in asthmatic ASM. We then measured the amount and activity of PDE4, and found ∼2-fold greater expression and activity in asthmatic ASM compared to non-asthmatic ASM. Furthermore, inhibition of PDE4 reduced asthmatic ASM proliferation but not that of non-asthmatic ASM. CONCLUSION: Decreased β-agonist induced cAMP in ASM from asthmatics results from enhanced degradation due to increased PDE4D expression. Clinical manifestations of this dysregulation would be suboptimal β-agonist-mediated bronchodilation and possibly reduced control over increasing ASM mass. These phenotypes appear to be "hard-wired" into ASM from asthmatics, as they do not require an inflammatory environment in culture to be observed.

  5. Respiratory functions in asthmatic and normal women during different phases of menstrual cycle

    International Nuclear Information System (INIS)

    Menstrual cycle is an integral part of life of women. There is widespread agreement that changes in the levels of oestrogen and progesterone associated with menstrual cycle also affect different systems of the body besides reproductive system. Levels of oestrogen and progesterone are maximum in the secretory phase and minimum just before the menstruation .Bronchial asthma is one of the commonest chronic respiratory diseases. Premenstrual worsening of asthma symptoms has been reported to affect 33-40% of asthmatic women. This exacerbation of asthma symptoms has been correlated with the oestrogen and progesterone levels. The association between menstrual cycle and lung functions in normal females has also been recognised. The pathophysiology of this process is still not proved. The purpose of our study was to confirm the probable effects of the female hormones on lung functions in normal and asthmatic women in different phases of menstrual cycle and to compare them. Methods: The study was done on 40 normal and 40 asthmatic females in the age group of 15-45 years. Pulmonary function tests were done in three phases of menstrual cycle i.e. follicular, secretory and menstrual in all the subjects. Results: The mean value of lung functions, i.e., FVC, FEV, PEFR, FEF25-75%, FEF 200-1200 were significantly lower in asthmatic females than normal ones (p<0.01) in all three phases. The lung functions of both asthmatic and non-asthmatic females in secretory phase were significantly higher than in menstrual phase (p<0.005). The PFTs in menstrual phase were even lower than the follicular phase (p<0.04). Conclusion: Respiratory parameters of both asthmatic and non-asthmatic women in reproductive age group show significant variation in different phases of menstrual cycle. The smooth muscle relaxant effect of progesterone and probably oestrogen might have contributed to it. The lung function parameters in asthmatics were of lower value compared to normal women. (author)

  6. Increased Expression of PI-3K in Asthmatic Rat T Lymphocytes

    Institute of Scientific and Technical Information of China (English)

    LIU Jin; ZHOU Shixin; XIONG Shengdao; XU Yongjian; ZHANG Zhenxiang; XIONG Weining

    2007-01-01

    In order to explore the expression of PI-3K in T lymphocytes of asthmatic rats and the relationship between PI-3K and activation of T lymphocytes, 24 Wistar rats were randomly divided into 4 groups: normal control group, asthmatic one-week group, asthmatic two-week group and asthmatic four-week group. T cells were purified from blood of each rat and the expression of PI-3K was observed by immunocytochemical fluorescence staining, the semiquantitative fluorescence intensity was measured by HPIAS-2000 analytic software, and the expression of IL-4 in supernatants was detected by ELISA. The results showed that the fluorescence intensity of T lymphocytes in asthmatic groups was significantly higher than that in normal control (P<0.001), indicating that the expression of PI-3K in T lymphocytes of asthmatic rats was significantly higher than that in those of normal controls, and the difference between acute and chronic stage asthmatic groups was significant (P<0.05). The expression levels of IL-4 protein in supernatants of asthmatic T lymphocytes were significantly higher than those in the normal controls (P<0.05). There was a significant positive correlation between the expression of PI-3K in T lymphocytes and the IL-4 protein expression in supernatants (r=0.583, P<0.01). It was suggested that PI-3K signal pathway may participate in the processes of activation and other cytological effects of asthmatic T lymphocytes, thus may play an important roles in the pathogenesis of asthma.

  7. Air pollution and respiratory health of children: the PEACE panel study in Teplice, Czech Republic.

    NARCIS (Netherlands)

    Kotesovec, F.; Vitnerova, N.; Leixner, M.; Benes, I.; Skoorkovsky, J.; Roemer, W.

    1998-01-01

    As part of a multicentre study (the Pollution Effects on Asthmatic Children in Europe (PEACE) project) the acute effects of air pollution on the health of susceptible children was investigated. Eighty nine children in the urban and 77 children in the rural area were followed during the study period

  8. Air pollution and respiratory health of children: the PEACE panel study in Umea., Sweden.

    NARCIS (Netherlands)

    Forsberg, B.; Segerstedt, B.; Stjernberg, N.; Roemer, W.

    1998-01-01

    The Pollution Effects on Asthmatic Children in Europe (PEACE) study examined the acute effects of short-term changes in air pollution on symptomatic children. We were one of 14 research centres in Europe that used a common study protocol. Seventy five children in an urban panel and 72 children in a

  9. Effects of a communication course for clinicians on parents' perception of care - a randomized controlled trial

    DEFF Research Database (Denmark)

    Ammentorp, Jette; Sabroe, Svend; Kofoed, Poul-Erik;

    2009-01-01

    in communication skills training has primarily focused on the behavioural changes of clinicians, and only few studies have investigated the effect from the perspective of the user. Method: A randomized controlled trial including medical doctors and nurses from paediatric outpatients' clinics was carried out....... The intervention group completed a 5-day communication course, whereas the control group had no intervention. The intervention was evaluated using questionnaires measuring parents' perception of the communication and their satisfaction. The questionnaires were filled out by parents to children consulting....... There were no significant differences between the satisfaction of parents visiting clinicians from the intervention group and those visiting clinicians from the control group; however, the proportion of parents who had a positive perception of the communication was up to 9.8% higher in the intervention group...

  10. Cyberbullying Education for Parents: A Guide for Clinicians

    Directory of Open Access Journals (Sweden)

    Margaret Hannah

    2010-01-01

    Full Text Available 536Cyberbullying is a problem that is growing rapidly,. current estimates indicate that at least 20-35% of children and adolescents experience cyberbullying. Clinicians need to be equipped with a framework to help parents in the role they play with their children and the cyberworld. This paper will guide professionals as they advise parents in navigating the world of cyberbullying. It is based on research on parenting, child development and cyberbullying. Parents today typically feel ill-equipped to respond to cyberbullying. They may be convinced that they were born a generation too late to relate to current online etiquette or to know what behaviors are appropriate. Many teens, as they try to separate themselves from authority figures, make it their mission to keep their online world-with all its positive and frightening attributes-�their own�. While bullying has now taken on a new dimension, the behavior itself is ancient. Parents should not feel powerless; instead, they should feel confident about responding in ways that are familiar and in concert with their own well-established parenting values and style. As challenging as it is to guide parents today around electronic issues such as cyberbullying, three basic principles can help guide you in your conversations with the parents you are seeking to educate. Remind parents to rely upon the basic strategies they successfully employ on a day-to-day basis: NURTURE children, provide STRUCTURE that is developmentally sound and JOIN children in their world in appropriate ways. This article provides details on how to help parents successfully achieve these three goals."

  11. Peer Support for Clinicians: A Programmatic Approach.

    Science.gov (United States)

    Shapiro, Jo; Galowitz, Pamela

    2016-09-01

    Burnout is plaguing the culture of medicine and is linked to several primary causes including long work hours, increasingly burdensome documentation, and resource constraints. Beyond these, additional emotional stressors for physicians are involvement in an adverse event, especially one that involves a medical error, and malpractice litigation. The authors argue that it is imperative that health care institutions devote resources to programs that support physician well-being and resilience. Doing so after adverse and other emotionally stressful events, such as the death of a colleague or caring for victims of a mass trauma, is crucial as clinicians are often at their most vulnerable during such times. To this end, the Center for Professionalism and Peer Support at Brigham and Women's Hospital redesigned the peer support program in 2009 to provide one-on-one peer support. The peer support program was one of the first of its kind; over 25 national and international programs have been modeled off of it. This Perspective describes the origin, structure, and basic workings of the peer support program, including important components for the peer support conversation (outreach call, invitation/opening, listening, reflecting, reframing, sense-making, coping, closing, and resources/referrals). The authors argue that creating a peer support program is one way forward, away from a culture of invulnerability, isolation, and shame and toward a culture that truly values a sense of shared organizational responsibility for clinician well-being and patient safety.

  12. Peer Support for Clinicians: A Programmatic Approach.

    Science.gov (United States)

    Shapiro, Jo; Galowitz, Pamela

    2016-09-01

    Burnout is plaguing the culture of medicine and is linked to several primary causes including long work hours, increasingly burdensome documentation, and resource constraints. Beyond these, additional emotional stressors for physicians are involvement in an adverse event, especially one that involves a medical error, and malpractice litigation. The authors argue that it is imperative that health care institutions devote resources to programs that support physician well-being and resilience. Doing so after adverse and other emotionally stressful events, such as the death of a colleague or caring for victims of a mass trauma, is crucial as clinicians are often at their most vulnerable during such times. To this end, the Center for Professionalism and Peer Support at Brigham and Women's Hospital redesigned the peer support program in 2009 to provide one-on-one peer support. The peer support program was one of the first of its kind; over 25 national and international programs have been modeled off of it. This Perspective describes the origin, structure, and basic workings of the peer support program, including important components for the peer support conversation (outreach call, invitation/opening, listening, reflecting, reframing, sense-making, coping, closing, and resources/referrals). The authors argue that creating a peer support program is one way forward, away from a culture of invulnerability, isolation, and shame and toward a culture that truly values a sense of shared organizational responsibility for clinician well-being and patient safety. PMID:27355784

  13. Being an Effective Teacher Five Tips for Busy Clinicians.

    Science.gov (United States)

    Szostek, Jason

    2016-01-01

    Teaching is challenging, and most clinicians have little-to-no formal training on how to teach. For many, the extent of their experience has been limited to teaching medical students during residency. Many clinicians would benefit from learning about effective teaching practices. This article offers practical tips to help busy clinicians who teach medical trainees of all levels. PMID:27323523

  14. The Relationship of Clinicians' Values to Therapy Outcome Ratings.

    Science.gov (United States)

    Mitchell, Cary L.

    1993-01-01

    Explored interpersonal values of 69 experienced clinical psychologists and investigated clinician ratings of hypothetical, value-based therapy outcome vignettes. Clinicians showed greater endorsement of independence and lower endorsement of conformity in Survey of Interpersonal Values. Clinicians' own values were positively correlated with their…

  15. Acute quadriparesis in an asthmatic treated with atracurium.

    Science.gov (United States)

    Tousignant, C P; Bevan, D R; Eisen, A A; Fenwick, J C; Tweedale, M G

    1995-03-01

    An 18-yr-old male asthmatic was paralyzed with atracurium for a period of seven days to facilitate mechanical pulmonary ventilation. After withdrawal of the muscle relaxant, train-of-four neuromuscular monitoring demonstrated rapid recovery of normal function. Three days later he developed acute quadriparesis without respiratory compromise. Electrophysiological studies showed normal conduction velocities, low compound muscle action potential amplitudes and evidence of denervation. Most cases of post-ventilatory weakness in the ICU involve the use of vecuronium and pancuronium. It has been suggested that the steroid nucleus in these muscle relaxants may be responsible. Our patient developed generalised weakness after treatment with atracurium, a benzylisoquinolinium muscle relaxant. Thus, it appears that the steroid nucleus of vecuronium and pancuronium is not essential in causing post-ventilatory weakness. PMID:7743575

  16. Molecular mechanism of icariin on rat asthmatic model

    Institute of Scientific and Technical Information of China (English)

    XU Chang-qing; LE Jing-jing; DUAN Xiao-hong; DU Wei-jing; LIU Bao-jun; WU Jing-feng; CAO Yu-xue; DONG Jing-cheng

    2011-01-01

    Background Effects of icariin on airway inflammation in asthmatic rats and the intervention of LPS induced inflammation are interfered with the machanism of icariin. Our study aimed to observe the effect of icariin on ovalbumin-induced imbalance of Th1/Th2 cytokine expression and its mechanism.Methods Sixty male SD rats were randomly divided into control group (PBS), asthma group (ovalbumin (OVA)-induced),dexamethasone group, and OVA+icariin low, medium and high dose groups (5, 10, 20 mg/kg, respectively). Each group had ten rats. The model of OVA sensitization was a rat asthma model. Enzyme-linked immunosorbent assay (ELISA)method was used to observe the effects of icariin on interleukin-4 (IL-4) and inerferon Y (IFN-Y) in rats' lung tissue.Immunohistochemical staining was applied to detect the intervention effects of icariin on T cells (T-bet) and gatabinding protein 3 (GATA-3) in rat pulmonary tissue. Realtime RT-PCR was used to observe the intervention effects of icariin on T-bet and GATA-3 mRNA expression in rat pulmonary tissue and spleen lymphocytes. Western blotting was used to observe the icariin intervention effects on T-bet, GATA-3 and nuclear factor-Kappa B (NF-κB) p65 protein expressions in rat pulmonary tissue.Results The ELISA results from pulmonary tissue showed that IL-4 expression was significantly reduced (P <0.05),while the IFN-y expression increased but not significantly when we compared OVA+icariin medium and high dose groups with the asthma group. Immunohistochemical staining of pulmonary tissue showed that the GATA-3 decreased significantly while the T-bet staining did not change in the OVA+icariin high dose group. In pulmonary tissue and spleen lymphocytes T-bet and GATA-3 mRNA expressions were significantly reduced (P <0.05) in icariin treatment groups compared with the asthma model group. GATA-3 and T-bet mRNA in rat spleen lymphocytes in the asthma group were higher than in the control group. GATA-3 mRNA expression in pulmonary

  17. Integrating virtual reality video games into practice: clinicians' experiences.

    Science.gov (United States)

    Levac, Danielle E; Miller, Patricia A

    2013-10-01

    The Nintendo Wii is a popular virtual reality (VR) video gaming system in rehabilitation practice and research. As evidence emerges related to its effectiveness as a physical therapy training method, clinicians require information about the pragmatics of its use in practice. The purpose of this descriptive qualitative study is to explore observations and insights from a sample of physical therapists (PTs) working with children with acquired brain injury regarding practical implications of using the Wii as a physical therapy intervention. Six PTs employed at a children's rehabilitation center participated in semi-structured interviews, which were transcribed and analyzed using content analysis. Two themes summarize the practical implications of Wii use: 1) technology meets clinical practice; and 2) onus is on the therapist. Therapists described both beneficial and challenging implications arising from the intersection of technology and practice, and reported the personal commitment required to orient oneself to the gaming system and capably implement this intervention. Findings include issues that may be relevant to professional development in a broader rehabilitation context, including suggestions for the content of educational initiatives and the need for institutional support from managers in the form of physical resources for VR implementation.

  18. The presence of radiological features on chest radiographs: How well do clinicians agree?

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, M. [Department of Child Health, School of Medicine, Cardiff University (United Kingdom); Lawson, Z. [Department of Child Health, School of Medicine, Cardiff University (United Kingdom); Department of Primary Care and Public Health, School of Medicine, Cardiff University (United Kingdom); Morris, S.; Evans, A.; Harrison, S.; Isaac, R. [Department of Paediatric Radiology, University Hospital of Wales, Cardiff (United Kingdom); Crocker, J. [Department of Primary Care and Public Health, School of Medicine, Cardiff University (United Kingdom); Powell, C., E-mail: powellc7@cardiff.ac.uk [Department of Child Health, School of Medicine, Cardiff University (United Kingdom)

    2012-07-15

    Aim: To compare levels of agreement amongst paediatric clinicians with those amongst consultant paediatric radiologists when interpreting chest radiographs (CXRs). Materials and methods: Four paediatric radiologists used picture archiving and communication system (PACS) workstations to evaluate the presence of five radiological features of infection, independently in each of 30 CXRs. The radiographs were obtained over 1 year (2008) from children with fever and signs of respiratory distress, aged 6 months to <16 years. The same CXRs were interpreted a second time by the paediatric radiologists and by 21 clinicians with varying experience levels, using the Web 1000 viewing system and a projector. Intra- and interobserver agreement within groups, split by grade and specialty, were analysed using free-marginal multi-rater kappa. Results: Normal CXRs were identified consistently amongst all 25 participants. The four paediatric radiologists showed high levels of intraobserver agreement between methods (kappa scores between 0.53 and 1.00) and interobserver agreement for each method (kappa scores between 0.67 and 0.96 for PACS assessment). The 21 clinicians showed varying levels of agreement from 0.21 to 0.89. Conclusion: Paediatric radiologists showed high levels of agreement for all features. In general, the clinicians had lower levels of agreement than the radiologists. This study highlights the need for improved training in interpreting CXRs for clinicians and the timely reporting of CXRs by radiologists to allow appropriate patient management.

  19. AMBIENT COARSE PARTICULATE MATTER ASSOCIATED WITH HEMATOLOGIC FACTORS IN ADULT ASTHMATICS

    Science.gov (United States)

    Introduction: The elderly and those with cardiovascular disease are susceptible to particulate matter (PM) exposures. Asthmatics are thought to be primarily affected by PM via airway inflammation. We investigated whether factors in blood hemostasis change in response to fluctuat...

  20. Plasminogen activator inhibitor-1 in sputum and nasal fluids increases in asthmatics during common colds

    Science.gov (United States)

    Cho, Seong H.; Hong, Seung J.; Chen, Haimei; Habib, Ali; Cho, David; Lee, Sun H.; Kang, Joseph; Ward, Theresa; Boushey, Homer A.; Schleimer, Robert P.; Avila, Pedro C.

    2014-01-01

    Capsule Summary This study showed that sputum and nasal lavage levels of plasminogen activator inhibitor-1 (PAI-1) rise during a common cold in asthmatic patients. This rise may contribute to the progression of airway remodeling. PMID:24373352

  1. Influenza enhances caspase-1 in bronchial epithelial cells from asthmatic volunteers and is associated with pathogenesis

    Science.gov (United States)

    Background: The leading cause of asthma exacerbation is respiratory viral infection. Innate antiviral defense pathways are altered in the asthmatic epithelium, yet involvement of inflammasome signaling in virus-induced asthma exacerbation is not known. Objective: This study com...

  2. Repeated Nitrogen Dioxide Exposures and Eosinophilic Airway Inflammation in Asthmatics: A Randomized Crossover Study

    OpenAIRE

    Ezratty, Véronique; Guillossou, Gaëlle; Neukirch, Catherine; Dehoux, Monique; Koscielny, Serge; Bonay, Marcel; Cabanes, Pierre-André; Samet, Jonathan M; Mure, Patrick; Ropert, Luc; Tokarek, Sandra; Lambrozo, Jacques; Aubier, Michel

    2014-01-01

    Background: Nitrogen dioxide (NO2), a ubiquitous atmospheric pollutant, may enhance the asthmatic response to allergens through eosinophilic activation in the airways. However, the effect of NO2 on inflammation without allergen exposure is poorly studied. Objectives: We investigated whether repeated peaks of NO2, at various realistic concentrations, induce changes in airway inflammation in asthmatics. Methods: Nineteen nonsmokers with asthma were exposed at rest in a double-blind, crossover s...

  3. Effect of inhaled endotoxin on induced sputum in normal, atopic, and atopic asthmatic subjects

    OpenAIRE

    Nightingale, J.; Rogers, D.; Hart, L.; Kharitonov, S; Chung, K.(The University of Iowa, Iowa City, U.S.A); Barnes, P.

    1998-01-01

    BACKGROUND—Inhalation of lipopolysaccharide (LPS) causes an inflammatory response in the lungs. To explore this response, inflammatory indices were measured in induced sputum from atopic asthmatic patients and compared with atopic and non-atopic subjects after inhalation of LPS.
METHODS—The effects of inhaled LPS (60 µg) or placebo (0.9% saline) were examined in a randomised, double blind, crossover trial in 11 non-atopic normal subjects, seven atopic, non-asthmatic indiv...

  4. Serum IL-17 & eotaxin levels in asthmatic patients with allergic rhinitis

    OpenAIRE

    Lv, Hong; Lu, Bing; Qian, Xing-jia; Huang, Jian-An; Qiu, Tie-feng

    2016-01-01

    Objective: To investigate the serum levels of Interleukin (IL)-17 and eotaxin levels and the relationship between serum IL-17, eotaxin and pulmonary function in asthmatic patients with allergic rhinitis. Methods: Serum IL-17 and eotaxin levels in asthmatic patients with allergic rhinitis during attacking and remission and in healthy control subjects were measured using enzyme-linked immunosorbent assay (ELISA) kits. Then we studied the correlation between the serum IL-17, eotaxin levels and p...

  5. Within-breath analysis of respiratory mechanics in asthmatic patients by forced oscillation

    OpenAIRE

    Juliana Veiga; Agnaldo José Lopes; José Manoel Jansen; Pedro Lopes de Melo

    2009-01-01

    INTRODUCTION: The within-breath analysis of respiratory mechanics by the monofrequency Forced Oscillation Technique (mFOT) is of great interest in both physiopathology studies and the diagnosis of respiratory diseases. However, there are limited data on the use of this technique in the analysis of asthma. This study evaluates within-breath mechanics of asthmatic individuals and the contribution of the mFOT in the asthma diagnosis. METHODS: Twenty-two healthy and twenty-two asthmatic subjects,...

  6. Bayes’ Rule for Clinicians: An Introduction

    Directory of Open Access Journals (Sweden)

    Chris F Westbury

    2010-11-01

    Full Text Available Bayes’ Rule is a way of calculating conditional probabilities. It is difficult to find an explanation of its relevance that is both mathematically comprehensive and easily accessible to all readers. This article tries to fill that void, by laying out the nature of Bayes’ Rule and its implications for clinicians in a way that assumes little or no background in probability theory. It builds on Meehl & Rosen’s (1955 classic paper, by laying out algebraic proofs that they simply allude to, and by providing extremely simple and intuitively accessible examples of the concepts that they assumed their reader understood, and provides examples of how the rule applies in a variety of clinical settings.

  7. A clinician-driven home care delivery system.

    Science.gov (United States)

    August, D A; Faubion, W C; Ryan, M L; Haggerty, R H; Wesley, J R

    1993-12-01

    The financial, entrepreneurial, administrative, and legal forces acting within the home care arena make it difficult for clinicians to develop and operate home care initiatives within an academic setting. HomeMed is a clinician-initiated and -directed home care delivery system wholly owned by the University of Michigan. The advantages of a clinician-directed system include: Assurance that clinical and patient-based factors are the primary determinants of strategic and procedural decisions; Responsiveness of the system to clinician needs; Maintenance of an important role for the referring physician in home care; Economical clinical research by facilitation of protocol therapy in ambulatory and home settings; Reduction of lengths of hospital stays through clinician initiatives; Incorporation of outcome analysis and other research programs into the mission of the system; Clinician commitment to success of the system; and Clinician input on revenue use. Potential disadvantages of a clinician-based system include: Entrepreneurial, financial, and legal naivete; Disconnection from institutional administrative and data management resources; and Inadequate clinician interest and commitment. The University of Michigan HomeMed experience demonstrates a model of clinician-initiated and -directed home care delivery that has been innovative, profitable, and clinically excellent, has engendered broad physician, nurse, pharmacist, and social worker enthusiasm, and has supported individual investigator clinical protocols as well as broad outcomes research initiatives. It is concluded that a clinician-initiated and -directed home care program is feasible and effective, and in some settings may be optimal. PMID:8242586

  8. Do clinicians use more question marks?

    Science.gov (United States)

    Otte, Willem M; van’t Klooster, Maryse A; van Diessen, Eric; Leijten, Frans SS; Sander, Josemir W

    2015-01-01

    Objective To quantify the use of question marks in titles of published studies. Design and setting Literature review. Participants All Pubmed publications between 1 January 2013 and 31 December 2013 with an available abstract. Papers were classified as being clinical when the search terms clin*, med* or patient* were found anywhere in the paper’s title, abstract or the journal’s name. Other papers were considered controls. As a verification, clinical journals were compared to non-clinical journals in two different approaches. Also, 50 highest impact journals were explored for publisher group dependent differences. Main outcome measure Total number of question marks in titles. Results A total of 368,362 papers were classified as clinical and 596,889 as controls. Clinical papers had question marks in 3.9% (95% confidence interval 3.8–4.0%) of titles and other papers in 2.3% (confidence interval 2.3–2.3%; p < 0.001). These findings could be verified for clinical journals compared to non-clinical journals. Different percentages between four publisher groups were found (p < 0.01). Conclusion We found more question marks in titles of clinical papers than in other papers. This could suggest that clinicians often have a question-driven approach to research and scientists in more fundamental research a hypothesis-driven approach. An alternative explanation is that clinicians like catchy titles. Publishing groups might have pro- and anti-question mark policies. PMID:26085937

  9. TSLP directly impairs pulmonary Treg function: association with aberrant tolerogenic immunity in asthmatic airway

    Directory of Open Access Journals (Sweden)

    Nguyen Khoa D

    2010-03-01

    Full Text Available Abstract Background Even though thymic stromal lymphopoietin (TSLP has been implicated in the development of allergic inflammation, its influence on immune tolerance mediated by regulatory T cells (Treg have not been explored. We aimed to dissect the influence of TSLP on immunosuppressive activities of Treg and its potential consequences in human allergic asthma. Methods In vitro culture system was utilized to study the effects of TSLP on human Treg. The functional competency of pulmonary Treg from a cohort of 15 allergic asthmatic, 15 healthy control, and 15 non-allergic asthmatic subjects was also evaluated by suppression assays and flow cytometric analysis. Results Activated pulmonary Treg expressed TSLP-R and responded to TSLP-mediated activation of STAT5. TSLP directly and selectively impaired IL-10 production of Treg and inhibited their suppressive activity. In human allergic asthma, pulmonary Treg exhibited a significant decrease in suppressive activity and IL-10 production compared to healthy control and non-allergic asthmatic counterparts. These functional alterations were associated with elevated TSLP expression in bronchoaveolar lavage fluid (BAL of allergic asthmatic subjects. Furthermore, allergic asthmatic BAL could suppress IL-10 production by healthy control pulmonary Treg in a TSLP-dependent manner. Conclusions These results provide the first evidences for a direct role of TSLP in the regulation of suppressive activities of Treg. TSLP mediated inhibition of Treg function might present a novel pathologic mechanism to dampen tolerogenic immune responses in inflamed asthmatic airway.

  10. 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

  11. Cross-national reliability of clinician-rated outcome measures in child and adolescent mental health services

    DEFF Research Database (Denmark)

    Hanssen-Bauer, Ketil; Gowers, Simon; Aalen, Odd O;

    2007-01-01

    Clinician-rated measures are in extensive use as routine outcome measures in child and adolescent mental health services. We investigated cross-national differences and inter-rater reliability of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA), the Children's Global...... Assessment Scale (CGAS) and the Global Assessment of Psychosocial Disability (GAPD). Thirty clinicians from 5 nations independently rated 20 written vignettes. The national groups afterwards established national consensus ratings. There were no cross-national differences in independent scores, but there were...

  12. COMPASSION SATISFACTION AND BURNOUT AMONGST CLINICIANS OF VADODARA CITY, GUJARAT

    Directory of Open Access Journals (Sweden)

    Anupsinh H

    2014-10-01

    Full Text Available INTRODUCTION: Clinicians are the one who are involved in most stressful events. Compassion fatigue comprises of two components-burnout and secondary traumatic stress. Up to one third of practicing clinicians could be expected to be suffering from burn out if assessed cross sectional. More importantly there has been an increasing trend in the emotional exhaustion of clinicians over the years. There is paucity of literature in this area, especially in the Indian setting. AIM: Identifying ‘burn out’ and ‘compassion fatigue’ among clinicians involved in care of individuals suffering from medical illness. MATERIAL AND METHODS: A total of 100 clinicians were included in the study. A semi structured questionnaire was administered to gather information related to personal & professional details of the study participants. Professional Quality of Life Scale (Pro QoL Version V was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS. RESULTS: Females had higher compassion satisfaction (CS & less burn out (BO compared to males. Clinicians working with both teaching and non-teaching institute had higher CS compared to clinicians working only in private practice or associated with teaching institute. Clinicians from dental field had higher CS compared to clinicians from medical field. Clinicians from non-surgical field had higher CS compared to surgeons. Increase in the number of hours spent in clinical practice decreases CS & increases BO. CONCLUSION: Clinicians are the first contact for any patients & gets affected by their physical as well as mental trauma. Clinicians are exposed to great level of stress & traumatic events in their day to day activity & handle the burden of disease & deceased. Thus it is necessary to know the level of burden a clinician is carrying & find out the way to improve the life style & the patient care.

  13. Media literacy for clinicians and parents.

    Science.gov (United States)

    Villani, V Susan; Olson, Cheryl K; Jellinek, Michael S

    2005-07-01

    Families and children are in the midst of a media revolution. Television, Internet access, instant messaging, cell phones, and interactive video games are delivering more information for more hours than ever in history. Exposure is occurring at younger and younger ages, often without parental oversight or interpretation. The impact on children is just beginning to be studied. Does media exposure prepare children for the world in which they live or deprive them of critical developmental opportunities? Does the steady display of violence contribute to violent behavior? This article presents a developmental context, discusses the research conducted to date, reviews the recommendations of major organizations, and tries to take a balanced perspective in the midst of a rising tide of media, technology, commercialism, and controversy. PMID:15936672

  14. Facilitating the professional development role of clinicians: evaluating the impact of the clinician-trainer program.

    Science.gov (United States)

    Happell, Brenda

    2004-06-01

    The professionalisation of nursing has been accompanied by recognition of the need for ongoing professional development. Continuing education is considered as an important method in maintaining professional development. Despite this recognition there is a paucity of literature addressing either the problems experienced in accessing and utilising continuing education or innovative programs designed to overcome these problems. This paper describes the impact evaluation of the clinician-trainer program, developed by the Centre for Psychiatric Nursing Research and Practice (CPNRP). This program was developed with a view to equip experienced psychiatric/mental health clinicians with the skills to provide workplace professional development to nursing colleagues. The evaluation suggests that for most participants (n=21), the program has lead to an increase in the delivery of continuing education sessions.

  15. Multi-pollutant exposures in an asthmatic cohort

    Science.gov (United States)

    Williams, Ron; Rappold, Ana G.; Case, Martin; Schmitt, Mike; Stone, Susan; Jones, Paul; Thornburg, Jonathan; Devlin, Robert B.

    2012-12-01

    An investigation of personal fine and coarse particulate matter (PM2.5, PM10-2.5), nitrogen dioxide (NO2), and ozone (O3) exposures was conducted with an adult asthmatic cohort as part of the U.S. Environmental Protection Agency's Moderate and Severe Asthmatics and their Environment Study (MASAES). The overall goal of the MASAES was to determine the association of particulate matter on the degree of resulting lung inflammation, with those having severe asthma hypothesized to be more highly susceptible to such outcomes. The primary exposure objective was to determine the spatial (personal versus ambient) and temporal relationships associated with the aforementioned air pollutants and establish the precision of a new dual PM2.5, PM10-2.5 monitor (CPEM) for personal exposure monitoring. A total of 16 non-smoking adults of various asthma severities were monitored over the course of a 14 month period during 2008-2009. Participants were monitored for 24 continuous hours each monitoring day with a maximum of five events per participant. Median personal PM2.5 and PM10-2.5 exposures were 16.5 and 10.1 μg m-3, respectively. Daily ambient mass concentrations accounted for less than 1% of the observed variability in personal PM2.5 or PM10-2.5 exposures. Duplicate personal measures yielded R2 values of 0.92 PM2.5 and 0.77 PM10-2.5, respectively. Maximum daily personal exposures of 17.0 ppb NO2 and 21.7 ppb O3 occurred with respective mean exposures of 5.8 and 3.4 ppb. Ambient NO2 and O3 measures were observed to be poorly associated with personal exposures (R2 independent of the participant. The poor correlation between personal and ambient concentrations of PM as well as the various gaseous copollutants indicates the complexity of the multi-pollutant environment and the impact of non-ambient sources on these pollutants relative to total personal exposures.

  16. Analysis of Clinicians' Perceptual Cough Evaluation.

    Science.gov (United States)

    Laciuga, Helena; Brandimore, Alexandra E; Troche, Michelle S; Hegland, Karen W

    2016-08-01

    This study examined the relationships between subjective descriptors and objective airflow measures of cough. We hypothesized that coughs with specific airflow characteristics would share common subjective perceptual descriptions. Thirty clinicians (speech-language pathologists, otolaryngologists, and neurologists) perceptually evaluated ten cough audio samples with specific airflow characteristics determined by peak expiratory flow rate, cough expired volume, cough duration, and number of coughs in the cough epoch. Participants rated coughs by strength, duration, quality, quantity, and overall potential effectiveness for airway protection. Perception of cough strength and effectiveness was determined by the combination of presence of pre-expulsive compression phase, short peak expiratory airflow rate rise time, high peak expiratory flow rates, and high cough volume acceleration. Perception of cough abnormality was defined predominantly by descriptors of breathiness and strain. Breathiness was characteristic for coughs with either absent compression phases and relatively high expiratory airflow rates or coughs with significantly low expired volumes and reduced peak flow rates. In contrast, excessive strain was associated with prolonged compression phases and low expiratory airflow rates or the absence of compression phase with high peak expiratory rates. The study participants reached greatest agreement in distinguishing between single and multiple coughs. Their assessment of cough strength and effectiveness was less consistent. Finally, the least agreement was shown in determining the quality categories. Modifications of cough airflow can influence perceptual cough evaluation outcomes. However, the inconsistency of cough ratings among our participants suggests that a uniform cough rating system is required. PMID:27115759

  17. Myeloid Sarcoma: The Clinician's Point of View

    Directory of Open Access Journals (Sweden)

    M. Malagola

    2011-01-01

    Full Text Available Myeloid Sarcoma may occur in patients with an acute or chronic myeloproliferative disorder as well as de novo, with no apparent sign or symptom of concomitant haematological disease. The patients are preferentially young male and the site of disease localization may vary from central nervous system to pleura and thorax, with a common involvement of the reticuloendothelial system. The disease often shows chromosomal rearrangements, involving chromosomes 7, 8 and 3 and sometimes a complex karyotype (more than 3 abnormalities is detected at diagnosis. The prognosis of this disease is dismal and only high-dose chemotherapy with autologous or allogeneic stem cells transplantation (auto or allo-SCT may be potentially curative. In the absence of definitive elements that can define the prognosis of extra-medullary localization of “standard risk” AML, Clinicians should pursue the collection of data from different Centres and design of homogeneous treatment strategies, that could integrate standard chemotherapy with specific approaches, such as radiotherapy, transplant procedures or, in selected cases (such as those displaying molecular abnormalities involving protein tyrosine-kinases, molecularly targeted therapies.

  18. Interpretation of data by the clinician.

    Science.gov (United States)

    Goldzieher, J W

    The cardinal challenges to every practicing physician are to interpret clinical data correctly and to place them in proper perspective. Clinical investigations frequently lack the rigidly controlled conditions and the careful experimental designs usually found in preclinical animal studies, and this deficiency is partially attributable to the inherent complexities of clinical medicine. Consequently, a great deal of controversy results from conflicting interpretations, extrapolations and overextension of limited data that are often equivocal. More careful appraisal of data and increased awareness of the well-known pitfalls found in retrospective and prospective studies, in which biostatistical design and clinical relevance are often incompatible, are emphasized, and personal biases and the flagrant sensationalism expounded by the media are condemned. The clinician is cautioned to sift through the data, consider the benefit/risk ratio for each patient and then to subordinate the role of critical scientist and assume the role of physician, exercising good judgment in light of the existing evidence and the immediate problems at hand. PMID:39823

  19. Gaps in pediatric clinician communication and opportunities for improvement.

    Science.gov (United States)

    Woods, Donna M; Holl, Jane L; Angst, Denise B; Echiverri, Susan C; Johnson, Daniel; Soglin, David F; Srinivasan, Gopal; Amsden, Laura B; Barnathan, Julia; Hason, Teri; Lamkin, Leonard; Weiss, Kevin B

    2008-01-01

    Teamwork and good communication are central to the provision of high-quality care. A standardized focus-group protocol was used. Analysis assessed emergent themes of patient safety-related effective and problematic clinician communication. Sixty-three focus groups were conducted with clinicians from five Chicago Pediatric Patient Safety Consortium hospitals. Effective and problematic clinician-to-clinician communication themes were described in all focus groups and at each participating hospital. Problematic communication contexts included the communication process for orders, consultations, acuity assessment, management of surgical and medical patients, and the discharge process. Organizational policies and systems leading to patient safety risk included a lack of clear responsibilities and expectations for clinicians and for clinical communication, as well as a lack of a clear chain of responsibility for communication when hierarchical communication barriers affected safe patient care. Results of this investigation highlighted gaps in pediatric clinician communication and opportunities for improvement. PMID:18831476

  20. The Expression of microRNA-1 and microRNA-126 in Peripheral Blood of Asthmatic Children with Acute Episode of Bronchial Asthma and its Correlation with the Onset of the Disease%microRNA-1与microRNA-126在支气管哮喘急性发作期患儿外周血中的表达及诊断价值

    Institute of Scientific and Technical Information of China (English)

    颜世军; 潘秋莎; 周炳文; 孙雨

    2016-01-01

    .78)ng/L and(77.05±17.21)ng/L, the difference was significant (P < 0.05). The levels of microRNA-1,microRNA-126 in asthma group were(2.15±0.97) and(7.34±1.26), the levels of microRNA-1,microR-NA-126 in control group were(5.81±1.29) and(3.66±0.91), the difference was significant (P <0.05). The sensitivity and specificity of microRNA-126 and microRNA-1 in peripheral blood of children with acute attack of bronchial asthma were 85.42%, 78.85%, 79.17% and 73.08% respectively, and the area under the ROC curve was 0.917 and 0.865 respectively. Conclusion:The level of microRNA-126 in peripheral blood of asth-matic children with acute attack of bronchial asthma is increased, and the level of microRNA-1 is deereased, and both can be used as an objective indicator of acute attack of bronchial asthma in children.

  1. COMPASSION SATISFACTION AND BURNOUT AMONGST CLINICIANS OF VADODARA CITY, GUJARAT

    OpenAIRE

    Anupsinh H; Sandip H.; Lakhan R; De, Kajal; Raghav; Nisarg

    2014-01-01

    INTRODUCTION: Clinicians are the one who are involved in most stressful events. Compassion fatigue comprises of two components-burnout and secondary traumatic stress. Up to one third of practicing clinicians could be expected to be suffering from burn out if assessed cross sectional. More importantly there has been an increasing trend in the emotional exhaustion of clinicians over the years. There is paucity of literature in this area, especially in the Indian setting. AIM...

  2. Bioethics for clinicians: 25. Teaching bioethics in the clinical setting

    OpenAIRE

    McKneally, Martin F.; Peter A Singer

    2001-01-01

    BIOETHICS IS NOW TAUGHT IN EVERY CANADIAN MEDICAL SCHOOL. Canada needs a cadre of teachers who can help clinicians learn bioethics. Our purpose is to encourage clinician teachers to accept this important responsibility and to provide practical advice about teaching bioethics to clinicians as an integral part of good clinical medicine. We use 5 questions to focus the discussion: Why should I teach? What should I teach? How should I teach? How should I evaluate? How should I learn?

  3. Evaluation of the medical assistance to asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Margarita Roméu Escobar

    2005-11-01

    Full Text Available Fundament: The evaluation and perfeccioning of assistance quality in Health services are objectives of permanent interest. Bronquial asthma is a high frequency desease, and it requires an evaluated attention. Objective: to evaluate the medical attention to the asthmatic patient in the Area III polyclinic of Cienfuegos. Methods: Transversal and descriptive study that included 150 patients randomly selected from the dispensary records of the Area III Educational Polyclinic of Cienfuegos, in December 2001. Medical records were checked and the patients were interviewed. Results: differences were found among the classifications (light, persistent and moderate reflected in medical records and the evaluation the authors made. Only 12 % of the Medical Records had good quality. The 80 % of patients have adequate knowledge about their desease, but most of them do not follow inter-crisis treatment. The place more used for treatment of the crisis was the polyclinic. There is a high level of satisfaction with medical services. Conclusion: The medical care of patient with bronchial asthma can be improved, being more systematic in inter-crisis treatment based on previous evaluation of each patient and in the sequential use of different therapeutic options, particularly in the practice of correct life styles.

  4. Increased amount of nitric oxide in exhaled air of asthmatics.

    Science.gov (United States)

    Alving, K; Weitzberg, E; Lundberg, J M

    1993-10-01

    The presence of nitric oxide (NO) in the exhaled air of humans has recently been described. We wanted to assess at what level exhaled NO originates in normal airways, and to determine whether airway inflammation induces changes in the levels of exhaled NO. Exhaled NO was continuously measured by chemiluminescence technique during normal tidal breathing through the nose or mouth, with a detection limit of 1 part per billion (ppb). Twelve control subjects were compared to eight patients with mild atopic asthma and rhinitis caused by occupational allergen. In control subjects, the major part of NO in exhaled air (up to 30 ppb) seemed to originate in the nasal airways, with only minor contribution from the lower airways and the oral cavity. However, in mild asthmatics, the level of exhaled NO during oral breathing, indicating the involvement of the lower airways, was increased 2-3 fold. Since increased production of NO in the lower airways may involve activated macrophages or neutrophils, we suggest that exhaled NO may be used to instantly monitor ongoing bronchial inflammation, at least when involving inducible NO synthase. PMID:7507065

  5. The Difficult-to-Control Asthmatic: A Systematic Approach

    Directory of Open Access Journals (Sweden)

    Le Annie V

    2006-09-01

    Full Text Available Abstract With the judicious use of inhaled corticosteroids, β2 agonists, and leukotriene modifiers, most patients with asthma are easily controlled and managed. However, approximately 5% of asthmatics do not respond to standard therapy and are classified as "difficult to control." 1 Typically, these are patients who complain of symptoms interfering with daily living despite long-term treatment with inhaled corticosteroids in doses up to 2,000 μg daily. Many factors can contribute to poor response to conventional therapy, and especially for these patients, a systematic approach is needed to identify the underlying causes. First, the diagnosis of asthma and adherence to the medication regimen should be confirmed. Next, potential persisting exacerbating triggers need to be identified and addressed. Concomitant disorders should be discovered and treated. Lastly, the impact and implications of socioeconomic and psychological factors on disease control can be significant and should be acknowledged and discussed with the individual patient. Less conventional and novel strategies for treating corticosteroid-resistant asthma do exist. However, their use is based on small studies that do not meet evidence-based criteria; therefore, it is essential to sort through and address the above issues before reverting to other therapy.

  6. Arsenic poisoning from anti-asthmatic herbal preparations.

    Science.gov (United States)

    Tay, C H; Seah, C S

    1975-09-13

    Arsenic poisoning, a disease of the past, was recently found in 74 patients in Singapore over a 15-month period. Most victims (70%) had a chronic form of poisoning and 64% of the cases were caused by a local anti-asthmatic herbal preparation containing 12,000 ppm of inorganic arsenic sulphide. The other patients were poisoned by six other brands of herbal preparations used for the treatment of asthma and a variety of other illnesses. Subsequent investigations revealed another 22 other brands of Chinese herbal preparations containing high concentrations of inorganic arsenic ranging from 25 to 107,000 ppm, of which most were imported. Nearly 40% of the patients had taken the medicine for less than six months, but the others had a longer history of exposure ranging from one to 15 years. Systemic involvement was confined mainly to the skin (91%), nervous system (51%), gastrointestinal system (23%) and blood (23%). Malignancy of the skin was present in six patients, and of the visceral samples, toxicological confirmation was found in half of the cases investigated. There was no correlation between the clinical status of the patients and their tissue arsenic content. The importance of arsenic poisoning by herbal preparations is discussed, as there are no known reports of their association.

  7. Efficacy of steroid treatments in the asthmatic preschool child

    DEFF Research Database (Denmark)

    Bisgaard, H

    2002-01-01

    Asthma represents the most common chronic disease in preschool children. Hospital admission for wheezy disorders is the most common paediatric chronic disease causing hospital admission and more common in young children than later in life....

  8. Adolescent autonomy revisited: clinicians need clearer guidance.

    Science.gov (United States)

    Brierley, Joe; Larcher, Victor

    2016-08-01

    In 1996, Brazier and Bridge raised the question 'is adolescent autonomy truly dead and buried' following judicial decisions which had seemed to reverse the Gillick-inspired trend for greater child autonomy in healthcare. Subsequent decisions by the courts have reinforced the view that those below 18 years in England and Wales remain children with limited rights to refuse treatment compared with adults. This is at variance with the daily experience of those working with young people who increasingly seek to actively involve them in making freely informed decisions about their healthcare, in accordance with the principles enunciated in the UN Convention of the Rights of the Child and the UK Children Acts. We review the derivation of the law in England and Wales in this area, in the light of another recent family court judgement enforcing treatment on a 'competent' child without his or her consent and ask: 'How can the Common Law and the ethical practice of those caring for young people have diverged so far?' Either young people can decide whether to have a recommended treatment, or they cannot. Given Ian McEwan's book, the Children Act, has stimulated wider social debate in this area might this be an opportune moment to seek public policy resolution with regards to healthcare decision making by young people? We argue that events since the Gillick case have underlined the need for a comprehensive review of legal policy and practice in this area. While absolute autonomy and freedom of choice are arguably inconsistent with the protection rights that society has agreed are owed to children, healthcare practitioners need clarity over the circumstances in which society expects that autonomous choices of adolescents can be overridden. PMID:27003419

  9. Adolescent autonomy revisited: clinicians need clearer guidance.

    Science.gov (United States)

    Brierley, Joe; Larcher, Victor

    2016-08-01

    In 1996, Brazier and Bridge raised the question 'is adolescent autonomy truly dead and buried' following judicial decisions which had seemed to reverse the Gillick-inspired trend for greater child autonomy in healthcare. Subsequent decisions by the courts have reinforced the view that those below 18 years in England and Wales remain children with limited rights to refuse treatment compared with adults. This is at variance with the daily experience of those working with young people who increasingly seek to actively involve them in making freely informed decisions about their healthcare, in accordance with the principles enunciated in the UN Convention of the Rights of the Child and the UK Children Acts. We review the derivation of the law in England and Wales in this area, in the light of another recent family court judgement enforcing treatment on a 'competent' child without his or her consent and ask: 'How can the Common Law and the ethical practice of those caring for young people have diverged so far?' Either young people can decide whether to have a recommended treatment, or they cannot. Given Ian McEwan's book, the Children Act, has stimulated wider social debate in this area might this be an opportune moment to seek public policy resolution with regards to healthcare decision making by young people? We argue that events since the Gillick case have underlined the need for a comprehensive review of legal policy and practice in this area. While absolute autonomy and freedom of choice are arguably inconsistent with the protection rights that society has agreed are owed to children, healthcare practitioners need clarity over the circumstances in which society expects that autonomous choices of adolescents can be overridden.

  10. Activated p38 MAPK in Peripheral Blood Monocytes of Steroid Resistant Asthmatics.

    Directory of Open Access Journals (Sweden)

    Ling-Bo Li

    Full Text Available Steroid resistance is a significant problem in management of chronic inflammatory diseases, including asthma. Accessible biomarkers are needed to identify steroid resistant patients to optimize their treatment. This study examined corticosteroid resistance in severe asthma. 24 asthmatics with forced expiratory volume in one second of less then 80% predicted were classified as steroid resistant or steroid sensitive based on changes in their lung function following a week of treatment with oral prednisone. Heparinised blood was collected from patients prior to oral prednisone administration. Phosphorylated mitogen activated kinases (MAPK (extracellular regulated kinase (ERK, p38 and jun kinase (JNK were analyzed in whole blood samples using flow cytometry. Activation of phospho-p38 MAPK and phospho-mitogen- and stress-activated protein kinase 1 (MSK1 in asthmatics' peripheral blood mononuclear cells (PBMC were confirmed by Western blot. Dexamethasone suppression of the LPS-induced IL-8 mRNA production by steroid resistant asthmatics PBMC in the presence of p38 and ERK inhibitors was evaluated by real time PCR. Flow cytometry analysis identified significantly stronger p38 phosphorylation in CD14+ monocytes from steroid resistant than steroid sensitive asthmatics (p = 0.014, whereas no difference was found in phosphorylation of ERK or JNK in CD14+ cells from these two groups of asthmatics. No difference in phosphorylated p38, ERK, JNK was detected in CD4+, CD8+ T cells, B cells and NK cells from steroid resistant vs. steroid sensitive asthmatics. P38 MAPK pathway activation was confirmed by Western blot, as significantly higher phospho-p38 and phospho-MSK1 levels were detected in the PBMC lysates from steroid resistant asthmatics. P38 inhibitor significantly enhanced DEX suppression of LPS-induced IL-8 mRNA by PBMC of steroid resistant asthmatics. This is the first report demonstrating selective p38 MAPK pathway activation in blood monocytes of

  11. DETERMINATION OF THE HABITS OF ASTHMATIC PATIENTS ABOUT USING SUBSTANCE CONTAINING PERFUME

    Directory of Open Access Journals (Sweden)

    Ercan GOCGELDI

    2005-06-01

    Full Text Available Introduction: Air pollution, perfume, aerosol substances, odors of paint and detergent are the most important non-specific irritants stimulating the asthmatic attack. The odors of these substances exist for long time and form the serious risk for the asthmatic patients. This study was planned to determine the frequency of using perfume and substance containing perfume and the sensitivities to the substances among the asthmatic patients using inhaling steroid and b2-mimetic ant asthmatic drugs. Methods: This is a descriptive study and conducted among patients who applied to the Allergic Diseases outpatient service of Gulhane Military Medical Academia in October-December 2004. 83 asthmatic patients who accepted to participate to the study filled out a questionnaire that including patients habits relating perfume, cleaners with perfume, perfume for living room, toilets and bathrooms, and having dyspnea or not when exposed any kind of perfumes and using any b2-mimetik or not. Results: 73.5% (n=61 of participants were male, and 26.5 % (n=22 were women. Their ages were from 18 to 57 years. 79.5% (n=66 of participants expressed that they were sensitive to the odors mentioned and experienced the respiratory problems when they were at the surroundings by odour and 26.5% (n=22 of participants sometimes used the B2-mimetic antiasthmatic drugs for this reason. On the other hand; It was found that 68.7% (n=57 of participants regularly used the perfume for themselves everyday, 85.5% (n=71 of participants washed their clothings by using cleaners and/or softeners with perfume, 44.6% (n=37 of participants used the perfume for their rooms frequently, 62.7% (n=52 of participants used substance with perfume in their toilets and bathrooms. Conclusion: We conclude that the asthmatic patients have not sufficient knowledge about non-spesific irritants stimulating the asthmatic attack, and don’t behave sensitive. It’s important to plan properly the medical

  12. Asthma in children : origins and outcomes

    NARCIS (Netherlands)

    Zomer - Kooijker, K.

    2014-01-01

    Asthma is one of the most common chronic diseases in the world. At school age, 4-7% of all children is experiencing asthmatic symptoms. Improvement of asthma control and health related quality of life (HRQOL) may lower the huge burden of this disease. This requires insight into the determinants of a

  13. Relation of circulating T cell profiles to airway inflammation and asthma control in asthmatic pregnancy.

    Science.gov (United States)

    Eszes, N; Bohács, A; Cseh, A; Toldi, G; Bikov, A; Ivancsó, I; Müller, V; Horváth, I; Rigó, J; Vásárhelyi, B; Losonczy, Gy; Tamási, L

    2012-09-01

    Asthmatic inflammation during pregnancy poses a risk for maternal and fetal morbidities. Circulating T cell immune phenotype is known to correlate with airway inflammation (detectable by fractional concentration of nitric oxide present in exhaled breath (FENO)) in non-pregnant allergic asthmatics. The aim of this study was to assess the relationship of peripheral T cell phenotype to FENO and clinical variables of asthma during pregnancy.We examined 22 pregnant women with allergic asthma in the 2nd/3rd trimester. The prevalence of Th1, Th2, regulatory T (Treg) and natural killer (NK) cell subsets was identified with flow cytometry using cell-specific markers. FENO, Asthma Control Test (ACT) total score and lung function were evaluated.Peripheral blood Th1, Th2, Treg, and NK cell prevalence were not significantly correlated to airway inflammation assessed by FENO in asthmatic pregnant women (all cells p > 0.05; study power > 75%). However, an inverse correlation was detected between Th2 cell prevalence and ACT total scores (p = 0.03) in asthmatic pregnancy.Blunted relationship between T cell profile and airway inflammation may be the result of pregnancy induced immune tolerance in asthmatic pregnancy. On the other hand, increased Th2 response impairs disease control that supports direct relationship between symptoms and cellular mechanisms of asthma during pregnancy. PMID:22982718

  14. Study of isolation of Mycoplasma pneumoniae in asthmatics by sputum culture

    Directory of Open Access Journals (Sweden)

    Acharya Vishak

    2005-01-01

    Full Text Available Background : Mycoplasma pneumoniae is implicated in acute exacerbations of bronchial asthma and is also a factor in the chronicity of asthma. This study was conducted to determine the significance of this association and to estimate the incidence of M.pneumoniae in the airways of asthmatics by isolation of the organism in sputum by culture method. Methods: In our study we have tried to isolate M.pneumoniae in sputum specimen samples by culture technique in one hundred asthmatic patients and fifty non-asthmatics who served as controls. Results : In our study we were able to isolate M.pneumoniae by sputum culture in 18% of the asthmatics. Among the culture positive patients, 16% had acute exacerbation of asthma. Conclusions : Our study compares favorably with the earlier studies done using serology and PCR in the diagnosis of M.pneumoniae infections in asthma emphasizing the usefulness of sputum cluture as a reliable investigative tool for isolation of M.pneumoniae in asthmatics. It also suggests a role for broader therapeutic implications in treatment of asthma. Lung India 2005; 22 : 50-53

  15. [Oropharyngeal bacteria in asthmatic patients in the city of Maracaibo, Venezuela].

    Science.gov (United States)

    Arocha-Sandoval, Francisco; Parra-Quevedo, Katynna

    2002-09-01

    Bronchial asthma is an intercurrent disease that affects a major portion of the population. Neither its etiopathogenesis nor its complications have been fully established. The purpose of this study was to determine the composition of oropharyngeal bacterial flora in asthmatic patients and compare it with oropharyngeal bacterial flora in a group of healthy patients in order to establish its relationship with the pathogenesis of asthma and its complications. A sample consisting of 116 pharyngeal swabs was analysed from march 1995 to december 1996. 58 of the total amount of pharyngeal swabs corresponded to asthmatic patients (during asthmatic crisis), while the other 58 corresponded to healthy subjects. Common bacteriological culture techniques were carried out in order to obtain the bacteriological diagnosis. The results showed that isolation of transitory flora bacteria in asthmatic patients was 75.8%, which was significantly higher (p crisis. This data must be considered when applying empiric therapy in asthmatic patients complicated with pneumonia. The possibility that certain infectious agents, including bacteria, could play a role in asthma pathogenesis is one of the questions that should be answered in future studies on this topic. PMID:12229277

  16. The Relationship between Clinicians' Confidence and Accuracy, and the Influence of Child Characteristics, in the Screening of Autism Spectrum Disorder

    Science.gov (United States)

    Hedley, Darren; Brewer, Neil; Nevill, Rose; Uljarevic, Mirko; Butter, Eric; Mulick, James A.

    2016-01-01

    The study examined the confidence accuracy relationship, and the influence of child characteristics on clinician confidence, when predicting a diagnosis of Autism Spectrum Disorder during screening of 125 referred children aged under 3.5 years. The diagnostic process included observation, interview, language and developmental testing. Clinical…

  17. Measuring Sensory Reactivity in Autism Spectrum Disorder: Application and Simplification of a Clinician-Administered Sensory Observation Scale

    Science.gov (United States)

    Tavassoli, Teresa; Bellesheim, Katherine; Siper, Paige M.; Wang, A. Ting; Halpern, Danielle; Gorenstein, Michelle; Grodberg, David; Kolevzon, Alexander; Buxbaum, Joseph D.

    2016-01-01

    Sensory reactivity is a new DSM-5 criterion for autism spectrum disorder (ASD). The current study aims to validate a clinician-administered sensory observation in ASD, the Sensory Processing Scale Assessment (SPS). The SPS and the Short Sensory Profile (SSP) parent-report were used to measure sensory reactivity in children with ASD (n = 35) and…

  18. Organizational culture, job satisfaction, and clinician turnover in primary care.

    Science.gov (United States)

    Hall, Charles B; Brazil, Kevin; Wakefield, Dorothy; Lerer, Trudy; Tennen, Howard

    2010-04-01

    The purpose of this study is to examine how organizational culture and job satisfaction affect clinician turnover in primary care pediatric practices. One hundred thirty clinicians from 36 primary care pediatric practices completed the Primary Care Organizational Questionnaire (PCOQ), which evaluates interactions among members of the practice and job-related attributes measuring 8 organizational factors, along with a separate 3-item instrument measuring job satisfaction. Random effects logistic models were used to assess the associations between job satisfaction, the organizational factors from the PCOQ, and clinician turnover over the subsequent year. All 8 measured organizational factors from the PCOQ, particularly perceived effectiveness, were associated with job satisfaction. Five of the 8 organizational factors were also associated with clinician turnover. The effects of the organizational factors on turnover were substantially reduced in a model that included job satisfaction; only 1 organizational factor, communication between clinicians and nonclinicians, remained significant (P = .05). This suggests that organizational culture affects subsequent clinician turnover primarily through its effect on job satisfaction. Organizational culture, in particular perceived effectiveness and communication, affects job satisfaction, which in turn affects clinician turnover in primary care pediatric practices. Strategies to improve job satisfaction through changes in organizational culture could potentially reduce clinician turnover. PMID:23804066

  19. Bronchiolitis: what the clinician should know

    Directory of Open Access Journals (Sweden)

    Roberto Antonucci

    2015-10-01

    Full Text Available Bronchiolitis is an acute infection of the lower respiratory tract affecting infants and young children, with Respiratory Syncytial Virus (RSV being the most common pathogen. Bronchiolitis is generally a mild disease, but may present with severe signs and symptoms requiring hospitalization. Risk factors including prematurity, bronchopulmonary dysplasia, immunodeficiency and congenital heart defects may predispose patients to develop a severe disease. The diagnosis should be based on clinical evaluation, without supportive radiographic and laboratory studies. Etiological diagnosis may be helpful to decrease the hospital transmission of virus and to avoid inappropriate use of antibiotics.The mainstay of therapy for bronchiolitis is supportive care, which should be directed at maintaining adequate oxygenation, ensuring a proper respiratory toilet, and meeting the requirements of fluids and nutrition. The use of nebulized hypertonic saline should be limited to hospitalized patients. Severe respiratory failure may require mechanical ventilatory support. Neither corticosteroids nor antibiotics offer consistent benefit in the treatment of bronchiolitis, and thus should not be used. A trial of a bronchodilator may be appropriate, but should be continued exclusively if a prompt favorable response occurs. Effective interventions to prevent the spread of RSV infection include hand washing or disinfection by caregivers and contact isolation. The use of palivizumab, a monoclonal antibody directed against RSV, is a safe prophylactic option, but should be restricted to children at high-risk for severe RSV disease, during the epidemic period. Current evidence suggests that early RSV bronchiolitis predisposes children to recurrent wheezing and asthma in the first decade of life.Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios

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

    DEFF Research Database (Denmark)

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

    2011-01-01

    Studies based on prescription data have shown that many asthmatics tend to use large quantities of inhaled beta-2-agonists, suggesting poorly controlled disease. The aim of the present study was to investigate the association between clinically uncontrolled asthma and prescribing patterns of anti......-asthmatic drugs with a primary focus on short-acting beta-2-agonists (SABA)....

  1. Serum interferon-gamma is associated with longitudinal decline in lung function among asthmatic patients : the Normative Aging Study

    NARCIS (Netherlands)

    Litonjua, AA; Sparrow, D; Guevarra, L; O'Connor, GT; Weiss, ST; Tollerud, DJ

    2003-01-01

    Background: Cytokines are important mediators of the asthmatic response. A retrospective pilot study showed that serum levels of interleukin (IL)-5 and interferon (IFN)-gamma were related to lung function decline among asthmatic patients over the preceding 3 years. To confirm these findings, we test

  2. [The role of the pharmacist in the educational charge of the asthmatic patient].

    Science.gov (United States)

    Courdent, L; Sonneville, A; Narcisse, G; Faure, N; Ernouf, D; Mor, B

    2000-10-01

    The problem of educative charge of the asthmatic patient has mobilised general physicians, specialists and kinesitherapists for many years. The first mutual aid associations for asthmatic patients, created at the initiative of pneumologists and allergists or their patients date back for a score or so of years and their principal objectives are the adaption of educational measures, in transmission of clear information and in the loan of surveillance equipment, to ensure that inhalation equipment is adapted appropriately to the case. Since, the mediatisation has reinforced this action in all directions, in the interests of and for the great benefit of asthmatic patients; and so the role of the pharmacist has also become essential not only in the field of information but also in that of control of the self-evaluation of the patient; three inseparable aspects are thus emphasized: information aspect, technical aspect, initiation of surveillance of the illness.

  3. Cessation of dexamethasone exacerbates airway responses to methacholine in asthmatic mice.

    Science.gov (United States)

    Stengel, Peter W; Nickell, Laura E; Wolos, Jeffrey A; Snyder, David W

    2007-06-01

    In asthmatic mice, dexamethasone (30.0 mg/kg) was administered orally once daily on Days 24-27. One hour after dexamethasone on Day 25-27, the mice were exposed to ovalbumin aerosols. Twenty-eight days after the initial ovalbumin immunization, we found that dexamethasone reduced methacholine-induced pulmonary gas trapping and inhibited bronchoalveolar lavage eosinophils and neutrophils. However, five days after the last dose of dexamethasone and last ovalbumin aerosol exposure in other asthmatic mice, the airway obstructive response to methacholine was exacerbated in dexamethasone-treated mice compared to vehicle-treated mice on Day 32. Further, eosinophils, but not neutrophils, were still inhibited after cessation of dexamethasone. Thus, discontinuing dexamethasone worsened methacholine-induced pulmonary gas trapping of asthmatic mice in the absence of eosinophilic airway inflammation.

  4. Quantifying the shape of maximal expiratory flow-volume curves in healthy humans and asthmatic patients.

    Science.gov (United States)

    Dominelli, Paolo B; Molgat-Seon, Yannick; Foster, Glen E; Dominelli, Giulio S; Haverkamp, Hans C; Henderson, William R; Sheel, A William

    2016-01-01

    Differences in the absolute flow and volume of maximal expiratory flow-volume (MEFV) curves have been studied extensively in health and disease. However, the shapes of MEFV curves have received less attention. We questioned if the MEFV curve shape was associated with (i) expiratory flow limitation (EFL) in health and (ii) changes in bronchial caliber in asthmatics. Using the slope-ratio (SR) index, we quantified MEFV curve shape in 84 healthy subjects and 8 matched asthmatics. Healthy subjects performed a maximal exercise test to assess EFL. Those with EFL during had a greater SR (1.15 ± 0.20 vs. 0.85 ± 0.20, p0.05). Asthmatics average SR was greater than the healthy subjects (1.35 ± 0.03 vs. 0.90 ± 0.11, pEFL and this metric could aid in discriminating between groups known to differ in the absolute size of MEFV curves. PMID:26388199

  5. Childhood discipline: challenges for clinicians and parents.

    Science.gov (United States)

    Banks, J Burton

    2002-10-15

    Although childhood discipline is an important issue for parents, this topic is seldom emphasized by family physicians during well-child examinations. Behavior problems are relatively common but frequently under-recognized by physicians. Opportunities to counsel parents about safe, effective methods of discipline are therefore missed. Discipline should be instructive and age-appropriate and should include positive reinforcement for good behavior. Punishment is only one aspect of discipline and, in order to be effective, it must be prompt, consistent, and fair. Time-out is frequently used to correct younger children, but because it is often enforced improperly, it loses its effectiveness. Corporal punishment is a controversial but common form of discipline that is less effective than some other types of punishment. Its use is linked to child and spouse abuse, as well as to future substance use, violent crime, poor self-esteem, and depression. Despite the possible negative effects of corporal punishment, it is still widely accepted in our society. Since discipline plays an important role in the social and emotional development of children, physicians should be trained to discuss this issue with parents during routine well-child examinations. PMID:12408419

  6. [Intermittent or persistent rhinitis in children and adolescents with Asthma: «the Swiss LARA paediatrics survey»].

    Science.gov (United States)

    Leuppi, J D; Wildhaber, J H; Spertini, F; Helbling, A

    2011-10-01

    Asthma and allergic rhinitis are chronic inflammatory airway diseases which often occur concomitantly. The objective of the LARA program was to identify the comorbidities and characteristics of asthma (A), intermittent or persistent rhinitis (IPR) and physician defined atopic dermatitis (AD) in 6- to 16-year old asthmatic Swiss children and adolescents. Overall, 126 general practitioners and paediatricians collected the data of 670 asthmatics. Approximately one third of the asthmatic children in Switzerland had well-controlled asthma. Almost two thirds of these asthmatics suffered from concomitant IPR. The latter presented with significantly less symptoms while the treatment rates with inhaled corticosteroids (approximately 90%) and leukotriene-receptorantagonists (approximately 50%) were comparable. However, there were almost twice as many passive smokers in the less well-controlled group. The prevalence of AD was similar in both groups. IPR and AD may play an important role as risk factors in the future development of asthma. PMID:21971616

  7. Exhaled nitric oxide collected with two different mouthpieces: a study in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Leme A.S.

    2002-01-01

    Full Text Available Techniques for collecting exhaled nitric oxide (ENO recommend the use of antibacterial filters of 0.3 µm. The aim of the present study was to compare the measurements of ENO obtained with two different filtering devices. Air samples from 17 asthmatic and 17 non-asthmatic subjects were collected by a recommended off-line technique using two different mouthpieces: 1 the Sievers disposable tool (A under a breathing pressure of 18 cmH2O, and 2 a mouthpiece containing a HEPA filter (B under a breathing pressure of 12 cmH2O. The nitric oxide samples were collected into an impermeable reservoir bag. Values for ENO were compared using two-way repeated measures ANOVA followed by the Tukey test. Agreement was assessed by Bland-Altman analysis. ENO values obtained with mouthpieces A and B were comparable for asthmatic (mean ± SEM, 42.9 ± 6.9 vs 43.3 ± 6.6 ppb and non-asthmatic (13.3 ± 1.3 vs 13.7 ± 1.1 ppb subjects. There was a significant difference in ENO between asthmatics and non-asthmatics using either mouthpiece A (P<0.001 or B (P<0.001. There was a positive correlation between mouthpiece A and mouthpiece B for both groups. The Bland-Altman limits of agreement were considered to be acceptable. Mouthpiece B was less expensive than A, and these data show that it can be used without compromising the result. Our data confirm reports of higher ENO values in the presence of airway inflammation.

  8. A Pedagogical Note: Use of Telepractice to Link Student Clinicians to Diverse Populations.

    Science.gov (United States)

    Cassel, Stacy Gallese; Hadley Edd, Amy J

    2016-01-01

    Telepractice is the application of telecommunications technology to the delivery of telehealth services via the online connection of clinicians, clients, and patients for assessment, intervention, or consultation. This article describes a pilot project in which speech-language pathology students in a university training program gained experience in working with culturally diverse preschool students using telepractice technology. The preschool students benefited by making gains in communication skills, while the university students acquired competency in the use of telepractice and in working with children whose cultural and linguistic backgrounds were outside of their experience. To assess the training experience, a Likert-scale survey administered to student clinicians revealed a high degree of satisfaction and improved familiarity with the use of telepractice, and an increased comfort level working with multi-cultural populations. PMID:27563390

  9. Why MIC matters? Microbiologists vs. clinicians

    Directory of Open Access Journals (Sweden)

    Corrado Girmenia

    2013-07-01

    Full Text Available Several mechanisms of resistance may interfere with the patients’ healing from a fungal infection. However, in premature children fungi are generally susceptible to antifungal agents, except in case of vertical transmission from the mother. In vitro sensitivity tests have been recently harmonized between American and European standards, after years of unhomogeneity: to date, the interpretation of epidemiological cut-off of wild-type population and clinical cut-off are common, and are often updated. Sensitivity tests are difficult to perform, but luckily new commercial tests approvedby FDA are available. Sometimes, knowing the intrinsic sensitivities and resistances of every fungal species and subspecies may be enough in the clinical practice, since few resistances are acquired.http://dx.doi.org/rhc.v4i1S.863

  10. Air pollution and respiratory health of children: the PEACE panel study in Hettstedt and Zerbst., Eastern Germany.

    NARCIS (Netherlands)

    Beyer, U.; Franke, K.; Cyrus, J.; Peters, A.; Heinrich, J.; Wichmann, H.E.; Brunekreef, B.

    1998-01-01

    A multicentre study (Pollution Effects on Asthmatic Children in Europe (PEACE) study) investigated the relationship between the daily variation of respiratory health and air pollution in children with chronic respiratory symptoms. Data were collected for 75 children in Hettstedt (polluted) and 63 ch

  11. Randomised clinical trials with clinician-preferred treatment.

    Science.gov (United States)

    Korn, E L; Baumrind, S

    1991-01-19

    The standard design for randomised clinical trials may be inappropriate when the clinician believes that one of the treatments being tested is superior for the patient, or when the clinician has a preference for one of the treatments. For such instances the suggestion is that the patient is randomly allocated to treatment only when there is clinical disagreement about treatment of choice for that patient, and then the patient is assigned to a clinician who had thought that the regimen allocated is the one most appropriate for that patient.

  12. How clinicians manage access to opioid replacement therapy.

    Science.gov (United States)

    Harlow, Warren; Happell, Brenda; Browne, Graeme

    2014-10-01

    In Australia, people wait to access opioid replacement therapy (ORT). The aim of this study was to examine how clinicians (n = 35) prioritize consumers for opioid replacement therapy (ORT). The study used a methodology informed by a constructivist approach to grounded theory. Based on a scenario related to two consumers seeking admission to opioid replacement therapy (ORT), participants were asked to prioritize one for preferential admission and questioned about their decision-making. Clinicians were neither confident nor unanimous in their decision-making. Team involvement and work experience influenced their judgment. Differences between clinicians in regard to understanding risks and protective factors were identified. To support uniformity in managing treatment requests, clearer policy direction to gui clinician practice, and further exploration of how models of care and team involvement influence consumer outcomes, are recommended.

  13. Oral health in children with asthma

    OpenAIRE

    Marković Dejan; Perić Tamara; Sovtić Aleksandar; Minić Predrag; Petrović Vanja

    2015-01-01

    Introduction. It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. Objective. The aim of the study was to determine the oral health status of children with asthma and to evaluate the oral health parameters according to the medications and severity of the disease. Methods. The study group consisted of 158 children with asthma and 100 healthy control subje...

  14. Effects of Ramadan Fasting on Spirometric Values and Clinical Symptoms in Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-07-01

    Full Text Available Introduction: Ramadan is the 9th Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset. The effect of Ramadan intermittent fasting on asthma control is controversial. The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study. The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting. Among spirometric variables, only peak expiratory flow improved after Ramadan (p <0.05. There was a reduction in the mean peak expiratory flow variability from 13% at the first week of fasting to 10% at the fourth week (p <0.05. Conclusion: In well-controlled asthmatic patients, Ramadan fasting resulted in improvement in peak expiratory flow and peak expiratory flow variability.

  15. Correlations of Flow Structure and Particle Deposition with Structural Alterations in Severe Asthmatic Lungs

    Science.gov (United States)

    Choi, Sanghun; Miyawaki, Shinjiro; Choi, Jiwoong; Hoffman, Eric A.; Wenzel, Sally; Lin, Ching-Long

    2014-11-01

    Severe asthmatics are characterized by alterations of bifurcation angle, hydraulic diameter, circularity of the airways, and local shift of air-volume functional change. The characteristics altered against healthy human subjects can affect flow structure and particle deposition. A large-eddy-simulation (LES) model for transitional and turbulent flows is utilized to study flow characteristics and particle deposition with representative healthy and severe asthmatic lungs. For the subject-specific boundary condition, local air-volume changes are derived with two computed tomography images at inspiration and expiration. Particle transport simulations are performed on LES-predicted flow fields. In severe asthmatics, the elevated air-volume changes of apical lung regions affect the increased particle distribution toward upper lobes, especially for small particles. The constricted airways are significantly correlated with high wall shear stress, leading to the increased pressure drop and particle deposition. The structural alterations of bifurcation angle, circularity and hydraulic diameter in severe asthmatics are associated with the increase of particle deposition, wall shear stress and wall thickness. NIH Grants: U01-HL114494, R01-HL094315 and S10-RR022421. Computer time: XSEDE.

  16. PULMONARY FUNCTION, AIRWAY RESPONSIVENSS, AND RESPIRATORY SYMPTOMS IN ASTHMATICS FOLLOWING EXERCISE IN NO2

    Science.gov (United States)

    Asthmatics performed three l0-min moderate exercises while exposed to 0.00 and 0.30 NO2. ollowing the initial exercise, FEV1 decreased to a greater extent (pFEV1 and FVC and increases in SRaw were ...

  17. Hookah Smoking and Harm Perception among Asthmatic Adolescents: Findings from the Florida Youth Tobacco Survey

    Science.gov (United States)

    Martinasek, Mary P.; Gibson-Young, Linda; Forrest, Jamie

    2014-01-01

    Background: Hookah tobacco smoking has increased in prevalence among Florida adolescents and is often viewed as a safer alternative to cigarette smoking by young adults. Asthmatic adolescents are at increased risk of the negative health effects of hookah smoking. The purpose of this study is to examine if hookah use and harm perception vary by…

  18. Adolescent asthmatics' needs and preferences regarding medication counseling: results from online focus groups.

    NARCIS (Netherlands)

    Koster, E.S.; Philbert, D.; Dijk, L. van; Vries, T.W. de; Bouvy, M.L.

    2014-01-01

    Background: In adolescents, non-adherence is a major problem and leads to uncontrolled disease. Objectives: To assess adolescents needs and preferences regarding counseling and support with focus on use of new media. Methods: Asthmatic adolescents needs and preferences were examined by means of mode

  19. Comparison of normal and asthmatic subjects' responses to sulfate pollutant aerosols

    Energy Technology Data Exchange (ETDEWEB)

    Utell, M.J.; Morrow, P.E.; Hyde, R.W.

    1980-01-01

    Epidemiological studies support an association between elevated levels of sulfates and acute respiratory disease. To determine if these pollutants produce airway hyperreactivity, 16 normal and 17 asthmatic subjects inhaled a control NaCl aerosol and the following sulfates: ammonium sulfate, sodium bisulfate, ammonium bisulfate, and sulfuric acid. A Lovelace generator produced particles with an average MMAD of approx. 1.0 ..mu..m (sigma/sub g/ approx. = 2.0) and concentrations of 0.1 and 1.0 mg/m/sup 3/. By double-blind randomization, all subjects breathed these aerosols for a 16-minute period. To determine if sulfate inhalation caused increased reactivity to a known bronchoconstrictor, all subjects inhaled carbachol following each 16-minute exposure. Before, during, and after exposure, pulmonary function studies were performed. When compared to NaCl, sulfate (1 mg/m/sup 3/) produced significant reductions in airway conductance and flow rates in asthmatics. The two most sensitive asthmatics demonstrated changes even at 0.1 mg/m/sup 3/ sulfate. To a far more significant degree, the bronchoconstrictor action of carbachol was potentiated by sulfates more or less in relation to their acidity in normals and asthmatics.

  20. The Expression and Activity of Cathepsins D, H and K in Asthmatic Airways

    NARCIS (Netherlands)

    Faiz, Alen; Tjin, Gavin; Harkness, Louise; Weckmann, Markus; Bao, Shisan; Black, Judith L.; Oliver, Brian G. G.; Burgess, Janette K.

    2013-01-01

    Tumstatin is an anti-angiogenic collagen IV alpha 3 fragment, levels of which are reduced in the airways of asthmatics. Its reduction may be due to the degradation by extracellular matrix (ECM) proteases. Cathepsins play a role in ECM remodelling, with cathepsin D, H and K (CTSD, CTSH and CTSK) bein

  1. The effect of inhaled glucocorticoid therapy on serum proteomics of asthmatic patients

    Institute of Scientific and Technical Information of China (English)

    姜洪娟

    2014-01-01

    Objective To screen the biomarkers which may play important roles in the pathogenesis and therapy of asthmaby using serum comparative proteomics.Methods From June 2011 to September 2012,30 chronic persistent asthmatic patients(asthma group)and 30 healthy controls(control group)were selected for study in our hospi-

  2. Adolescent asthmatics' needs and preferences regarding medication counseling: Results from online focus groups

    NARCIS (Netherlands)

    Koster, Ellen S.; Philbert, Daphne; Van Dijk, Liset L.; De Vries, Tjalling W.; Bouvy, Marcel L.

    2014-01-01

    Background: In adolescents, non-adherence is a major problem and leads to uncontrolled disease. Objectives: To assess adolescents needs and preferences regarding counseling and support with focus on use of new media. Methods: Asthmatic adolescents needs and preferences were examined by means of mode

  3. The cultural divide: exploring communication barriers between scientists and clinicians

    OpenAIRE

    Restifo, Linda L; Phelan, Gerald R.

    2011-01-01

    Summary Despite remarkable advances in basic biomedical science that have led to improved patient care, there is a wide and persistent gap in the abilities of researchers and clinicians to understand and appreciate each other. In this Editorial, the authors, a scientist and a clinician, discuss the rift between practitioners of laboratory research and clinical medicine. Using their first-hand experience and numerous interviews throughout the United States, they explore the causes of this ‘...

  4. Compassion Fatigue and Burnout Amongst Clinicians: A Medical Exploratory Study

    OpenAIRE

    Jaikrit Bhutani; Sukriti Bhutani; Yatan Pal Singh Balhara; Sanjay Kalra

    2012-01-01

    Background: Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying ′burnout′ and ′compassion fatigue′ among clinicians involved in care of individuals suffering from medical illness. Materials and Methods: A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile o...

  5. Fascia Research from a Clinician/Scientist’s Perspective

    OpenAIRE

    Findley, Thomas W.

    2011-01-01

    The upcoming Third International Fascia Research Congress will have much exciting information for the clinician, as well as for the clinical and basic science researcher. This paper provides a perspective from a clinician/scientist, including the fascial network of body-wide connections between and within individual cells, and sharing of loads between muscle and fascia. Basic studies of fibroblast cell shape show the impact of manual therapy, acupuncture, and yoga-like stretching at the cellu...

  6. Cardiovascular magnetic resonance physics for clinicians: part I

    OpenAIRE

    Ridgway John P

    2010-01-01

    Abstract There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR) techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR) techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinician...

  7. Air trapping on HRCT in asthmatics: correlation with pulmonary function test

    International Nuclear Information System (INIS)

    To evaluate on the basis of the pulmonary function test the correlation between the extent of air trapping on HRCT with the severity of airway obstruction and also to identify the prognostic effect of the extent of air trapping after treatment of asthma. Thirty five patients with clinically diagnosed bronchial asthma and air trapping, as seen on HRCT, were included in this study. We quantitatively analysed on HRCT the extent of air trapping and then statistically compared this with the clinical parameters of the pulmonary function test. We classified the patients into two groups on the basis of the pulmonary function test and clinical status : Group 1 (N=35), the total number of asthmatic patients; Group 2 (N=18), relatively stable asthmatics without acute asthmatic attack who showed FEV1 of more than 80% of the predicted value. Using the functional paramenters of PEFR, one of the obijective indicators of improvement in airway obstruction, we also classified the patients into three groups on the basis of interval between treatment and clinical improvement. The result of this was as follows : group 1, asymptomatic group (initial PEFR within normal limit, N=7); group 2, early responder (improvement of PEFR within three hospital days, N=18); group 3, late responder (improvement of PEFR within fourteen hospital days should there be a number here). Using HRCT, we then statistically analysed the differences between the three groups in the extent of air trapping. Among the total of 35 asthmatics, the extent of air trapping on HRCT showed significant correlation with FEV1 (r= -0.6161, p < 0.001) and MEFR (r= -0.6012, p < 0.001). Among the relatively stable asthmatics who showed FEV1 more than 80% of the predicted value, MEFR (r= -0.7553, p < 0.001) and FEF75 (r= -0.7529, p=0.012) showed statistically significant correlation with the extent of air trapping on HRCT, but there was no significant correlation between air trapping on HRCT and FEV1. In the three groups of

  8. Role of Low Dosage Arsenic Trioxide on Pulmonary Dendritic Cells in Asthmatic Mice

    Institute of Scientific and Technical Information of China (English)

    周林福; 殷凯生; 周智敏

    2003-01-01

    Objective: To investigate the distribution and recruitment of pulmonary dendritic cells (DCs) and the influence of low dosage arsenic trioxide (As2O3) on them in the airway of asthmatic mice. Methods: Thirty BALB/c mice were randomly divided into 3 groups: the control group, the asthmatic group and the As2O3 treated group. The mice asthmatic model was induced via sensitizing with peritoneal injection of ovalbumin (OVA) for two times and then provocated with aerosol inhalation of OVA for a week. The treated group was peritoneally injected with 0.2 ml solution of As2O3 (4mg/kg) 0.5h after each provocation. The immunohistochemistry and computerised image analysis were applied to detect quantitatively the DCs in the lung and airway of mice. Results: All intraepithelial nonlymphoid dendritic cells-145 (NLDC-145) throughout the respiratory tree in the mice of the control group formed a network with the density of DCs varying from (575±54) cells/mm2 epithelial surface in the large airway, to (68±12) cells/mm2 epithelial surface in the small airway. The distribution of airway NLDC-145+ in the asthmatic group was similar to that in the control group, but its density was significantly upregulated (P<0.01). The distribution of airway NLDC-145 in the treated group was similar to that in the asthmatic group, only its density was significantly downregulated (P<0.01). Conclusion: There is an integral network of NLDC-145+ throughout the respiratory tree. To downregulate the density but not change the distribution of pulmonary DCs could be an important therapeutic mechanism of low dosage As2O3 in treating asthma.

  9. Asthmatics exhibit altered oxylipin profiles compared to healthy individuals after subway air exposure.

    Directory of Open Access Journals (Sweden)

    Susanna L Lundström

    Full Text Available BACKGROUND: Asthma is a chronic inflammatory lung disease that causes significant morbidity and mortality worldwide. Air pollutants such as particulate matter (PM and oxidants are important factors in causing exacerbations in asthmatics, and the source and composition of pollutants greatly affects pathological implications. OBJECTIVES: This randomized crossover study investigated responses of the respiratory system to Stockholm subway air in asthmatics and healthy individuals. Eicosanoids and other oxylipins were quantified in the distal lung to provide a measure of shifts in lipid mediators in association with exposure to subway air relative to ambient air. METHODS: Sixty-four oxylipins representing the cyclooxygenase (COX, lipoxygenase (LOX and cytochrome P450 (CYP metabolic pathways were screened using liquid chromatography-tandem mass spectrometry (LC-MS/MS of bronchoalveolar lavage (BAL-fluid. Validations through immunocytochemistry staining of BAL-cells were performed for 15-LOX-1, COX-1, COX-2 and peroxisome proliferator-activated receptor gamma (PPARγ. Multivariate statistics were employed to interrogate acquired oxylipin and immunocytochemistry data in combination with patient clinical information. RESULTS: Asthmatics and healthy individuals exhibited divergent oxylipin profiles following exposure to ambient and subway air. Significant changes were observed in 8 metabolites of linoleic- and α-linolenic acid synthesized via the 15-LOX pathway, and of the COX product prostaglandin E(2 (PGE(2. Oxylipin levels were increased in healthy individuals following exposure to subway air, whereas asthmatics evidenced decreases or no change. CONCLUSIONS: Several of the altered oxylipins have known or suspected bronchoprotective or anti-inflammatory effects, suggesting a possible reduced anti-inflammatory response in asthmatics following exposure to subway air. These observations may have ramifications for sensitive subpopulations in urban areas.

  10. Relationship of circulating hyaluronic acid levels to disease control in asthma and asthmatic pregnancy.

    Science.gov (United States)

    Eszes, Noémi; Toldi, Gergely; Bohács, Anikó; Ivancsó, István; Müller, Veronika; Rigó, János; Losonczy, György; Vásárhelyi, Barna; Tamási, Lilla

    2014-01-01

    Uncontrolled asthma is a risk factor for pregnancy-related complications. Hyaluronic acid (HA), a potential peripheral blood marker of tissue fibrosis in various diseases, promotes eosinophil survival and plays a role in asthmatic airway inflammation as well as in physiological processes necessary to maintain normal pregnancy; however the level of circulating HA in asthma and asthmatic pregnancy is unknown. We investigated HA levels in asthmatic patients (N = 52; asthmatic pregnant (AP) N = 16; asthmatic non-pregnant (ANP) N = 36) and tested their relationship to asthma control. Serum HA level was lower in AP than in ANP patients (27 [24.7-31.55] vs. 37.4 [30.1-66.55] ng/mL, p = 0.006); the difference attenuated to a trend after its adjustment for patients' age (p = 0.056). HA levels and airway resistance were positively (r = 0.467, p = 0.004), HA levels and Asthma Control Test (ACT) total score inversely (r = -0.437, p = 0.01) associated in ANP patients; these relationships remained significant even after their adjustments for age. The potential value of HA in the determination of asthma control was analyzed using ROC analysis which revealed that HA values discriminate patients with ACT total score ≥20 (controlled patients) and asthma control, as it correlates with airway resistance and has good sensitivity in the detection of impaired asthma control. Decrease of HA level in pregnancy may be the consequence of pregnancy induced immune tolerance.

  11. Nutritional status and physical inactivity in moderated asthmatics: A pilot study.

    Science.gov (United States)

    Bruno, Andreina; Uasuf, Carina Gabriela; Insalaco, Giuseppe; Barazzoni, Rocco; Ballacchino, Antonella; Gjomarkaj, Mark; Pace, Elisabetta

    2016-08-01

    Preservation of nutritional status and of fat-free mass (FFM) and/or preventing of fat mass (FM) accumulation have a positive impact on well-being and prognosis in asthma patients. Physical inactivity is identified by World Health Organization as the fourth leading risk factor for global mortality. Physical activity (PA) may contribute to limit FM accumulation, but little information is available on the interactions between habitual PA and body composition and their association with disease severity in asthma severity.Associations between habitual PA, FM, FFM, and pulmonary function were investigated in 42 subjects (24 patients with mild-moderate asthma and 18 matched control subjects). Sensewear Armband was used to measure PA and metabolic equivalent of tasks (METs) continuously over 4 days, while body composition was measured by bioelectrical impedance analysis. Respiratory functions were also assessed in all study participants.FM and FFM were comparable in mild-moderate asthmatics and controls, but PA was lower in asthmatics and it was negatively correlated with FM and positively with the FFM marker body cell mass in all study subjects (P < 0.05). Among asthmatics, treated moderate asthmatics (ICS, n = 12) had higher FM and lower PA, METs, steps number/die, and forced expiratory volume in the 1st second (FEV1)/forced vital capacity (FVC) than in untreated intermittent asthmatics (UA, n = 12).This pilot study assesses that in mild-moderate asthma patients, lower PA is associated with higher FM and higher disease severity. The current results support enhancement of habitual PA as a potential tool to limit FM accumulation and potentially contribute to preserve pulmonary function in moderate asthma, considering the physical inactivity a strong risk factor for asthma worsening. PMID:27495092

  12. The transcription factor PU.1 promotes alternative macrophage polarization and asthmatic airway inflammation.

    Science.gov (United States)

    Qian, Feng; Deng, Jing; Lee, Yong Gyu; Zhu, Jimmy; Karpurapu, Manjula; Chung, Sangwoon; Zheng, Jun-Nian; Xiao, Lei; Park, Gye Young; Christman, John W

    2015-12-01

    The transcription factor PU.1 is involved in regulation of macrophage differentiation and maturation. However, the role of PU.1 in alternatively activated macrophage (AAM) and asthmatic inflammation has yet been investigated. Here we report that PU.1 serves as a critical regulator of AAM polarization and promotes the pathological progress of asthmatic airway inflammation. In response to the challenge of DRA (dust mite, ragweed, and Aspergillus) allergens, conditional PU.1-deficient (PU/ER(T)(+/-)) mice displayed attenuated allergic airway inflammation, including decreased alveolar eosinophil infiltration and reduced production of IgE, which were associated with decreased mucous glands and goblet cell hyperplasia. The reduced asthmatic inflammation in PU/ER(T)(+/-) mice was restored by adoptive transfer of IL-4-induced wild-type (WT) macrophages. Moreover, after treating PU/ER(T)(+/-) mice with tamoxifen to rescue PU.1 function, the allergic asthmatic inflammation was significantly restored. In vitro studies demonstrate that treatment of PU.1-deficient macrophages with IL-4 attenuated the expression of chitinase 3-like 3 (Ym-1) and resistin-like molecule alpha 1 (Fizz-1), two specific markers of AAM polarization. In addition, PU.1 expression in macrophages was inducible in response to IL-4 challenge, which was associated with phosphorylation of signal transducer and activator of transcription 6 (STAT6). Furthermore, DRA challenge in sensitized mice almost abrogated gene expression of Ym-1 and Fizz-1 in lung tissues of PU/ER(T)(+/-) mice compared with WT mice. These data, all together, indicate that PU.1 plays a critical role in AAM polarization and asthmatic inflammation.

  13. Airway protease/antiprotease imbalance in atopic asthmatics contributes to increased Influenza A virus cleavage and replication

    Directory of Open Access Journals (Sweden)

    Kesic Matthew J

    2012-09-01

    Full Text Available Abstract Asthmatics are more susceptible to influenza infections, yet mechanisms mediating this enhanced susceptibility are unknown. Influenza virus hemagglutinin (HA protein binds to sialic acid residues on the host cells. HA requires cleavage to allow fusion of the viral HA with host cell membrane, which is mediated by host trypsin-like serine protease. We show data here demonstrating that the protease:antiprotease ratio is increased in the nasal mucosa of asthmatics and that these changes were associated with increased proteolytic activation of influenza. These data suggest that disruption of the protease balance in asthmatics enhances activation and infection of influenza virus.

  14. Cost effectiveness of guideline advice for children with asthma : a literature review

    NARCIS (Netherlands)

    Feenstra, Talitha L; Rutten-Van Mölken, Maureen P M H; Jager, Johannes C; Van Essen-Zandvliet, Liesbeth E M

    2002-01-01

    Asthma is an important chronic disease among children. This study reviews the cost effectiveness of interventions in the long-term care of asthmatic children and compares these results with treatment advice in four current guidelines. Cost-effectiveness studies were searched for in Medline, Embase,

  15. What Drives Prescribing of Asthma Medication to Children? A Multilevel Population-Based Study

    NARCIS (Netherlands)

    Zuidgeest, Mira G. P.; van Dijk, Liset; Spreeinvenberg, Peter; Smit, Henriette A.; Brunekreef, Bert; Arets, Hubertus G. M.; Bracke, Madelon; Leufkens, Hubert G. M.

    2009-01-01

    PURPOSE Diagnosing asthma in children with asthmatic symptoms remains a challenge, particularly in preschool children. This challenge creates an opportunity for variability in prescribing. The aim of our study was to investigate how and to what degree patient, family, and physician characteristics i

  16. What drives prescribing of asthma medication to children? A population based cohort study.

    NARCIS (Netherlands)

    Zuidgeest, M.G.P.; Dijk, L. van; Spreeuwenberg, P.; Smit, H.A.; Brunekreef, B.; Arets, H.G.; Bracke, M.; Leufkens, H.G.M.

    2008-01-01

    Background: Diagnosing children with asthmatic symptoms remains a challenge, particularly in preschool children. This creates space for variability in prescribing, as has been found in previous studies. Objectives: To investigate how and to what degree patient, family and physician influence prescri

  17. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    Energy Technology Data Exchange (ETDEWEB)

    McQueen, A.S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)], E-mail: andrewmcqueen7@hotmail.com; Worthy, S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom); Keir, M.J. [Department of Medical Physics, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)

    2008-06-15

    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

  18. Change of Regulatory Treg Cells Levels in Asthmatic Children Allergic to House Dust Mite and Its Clinical Significance%屋尘螨过敏的支气管哮喘患儿调节性T淋巴细胞水平变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    王炜; 李芳; 段国威; 吴晓玲; 宋青

    2012-01-01

    Objective To investigate the changes of frequency and function of CD4 + CD25 + Foxp3 +Treg cells and their roles in the evaluation of severity in children with asthma allergic to house dust mite( HDM). Methods Sixty children sensitive to HDM with asthma were divided into mild asthma group,moderate asthma group and severe asthma group according to their clinical features,and 20 healthy children were enrolled as the healthy control group. Peripheral Mood monouctear cells ( PBMC) were isolated from the subjects. After 48 hours of in vitro stimulation with HDM extracts, CD4 + CD25+ Foxp3 + regulatory T cells and CD4+ CD25 + Foxp3 + IL - 10+ regulatory T cells were measured by using flow cytometry. Results The frequency of CD4 + CD25+ Foxp3 + Treg cells had no statistical significance between the mild asthma group and moderate asthma group(P, >0.05) .but significantly decreased in the severe asthma group compared with the healthy control group(P <0.001). The frequency of IL - 10 - secreting - CD4 + CD25+ Foxp3 + Treg cells was also decreased significantly in the asthma group compared with that in the healthy control group( P <0.001). The frequency of IL - 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells was significantly lower in the moderate asthma group compared with that in the mild asthma group(P<0.05) ,and the IL- 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells in the severe asthma group were hardly found. The. frequency of IL - 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells was significantly lower in the severe asthma group compared with that in the moderate asthma group( P<0.01). There was a remarkably negative correlation between IL - 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells level and the asthma severity(r= -0. 637,P<0.05). Conclusions In the mild asthma children and moderate asthma children, there are quantitative but functional insufficiency of regulatory T cells. And in severe asthma group there are both quantitative and functional

  19. Compassion Fatigue and Burnout Amongst Clinicians: A Medical Exploratory Study

    Directory of Open Access Journals (Sweden)

    Jaikrit Bhutani

    2012-01-01

    Full Text Available Background: Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying ′burnout′ and ′compassion fatigue′ among clinicians involved in care of individuals suffering from medical illness. Materials and Methods: A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0. Results: The mean age of clinicians was 46.68±11.06 (range 26-67 years. Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction. Conclusion: The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.

  20. From leader to leadership: clinician managers and where to next?

    Science.gov (United States)

    Fulop, Liz; Day, Gary E

    2010-08-01

    Individual clinician leadership is at the forefront of health reforms in Australia as well as overseas with many programs run by health departments (and hospitals) generally focus on the development of individual leaders. This paper argues, along with others, that leadership in the clinician management context cannot be understood from an individualistic approach alone. Clinician managers, especially in the ranks of doctors, are usually described as 'hybrid-professional managers' as well as reluctant leaders for whom most leadership theories do not easily apply. Their experiences of leadership development programs run by health departments both in Australia and internationally are likely to be based on an individual leader-focussed approach that is driving health care reforms. These approaches work from three key assumptions: (1) study and fix the person; (2) give them a position or title; and (3) make them responsible for results. Some would argue that the combination of these three approaches equates to heroic and transformational leadership. Several alternative approaches to leadership development are presented to illustrate how reforms in healthcare, and notably in hospitals, must incorporate alternative approaches, such as those based on collective and relational forms of leadership. This does not mean eschewing individual approaches to leadership but rather, thinking of them differently and making them more relevant to the daily experiences of clinician managers. We conclude by highlighting several significant challenges facing leadership development for clinician managers that arise from these considerations. PMID:20797368

  1. The preventive effect of Brassica napus L. oil on pathophysiological changes of respiratory system in experimental asthmatic rat

    Directory of Open Access Journals (Sweden)

    Mehdi Kabiri rad

    2012-12-01

    Results: Eosinophil numbers in the submucosal layer, as well as smooth muscle layer thicknesses were significantly lower in the rat group treated with 0.75 mg/kg B. napus oil as compared with asthmatic group (p

  2. Evaluation of Asthmatic Patients Referred to Jahrom Hospital and Clinic

    Directory of Open Access Journals (Sweden)

    Soheila Alyasin

    2004-09-01

    Full Text Available Asthma is the most common chronic respiratory disease of children in the world. Serial studies in the world have showed an increased prevalence of bronchial asthma. In this study, the children younger than 12 years old referred to Jahrom hospital and clinic due to asthma were selected. We issued 100 questionnaires, according to International Study of Asthma and Allergies in Childhood (ISAAC criteria and were completed by the physicians. The ratio of male to female was 1 to 9. The patients who were under the age of 4, 3 and 1 year were 82%, 60% and 15% respectively. Passive smoking was present in 56% of the patients, and 22% had pets at home like cat, dog or bird. Home dampness was present in 33%. Ninety percent of patients had used breast feeding during the first year of life. Seventy percent of patients had family history of asthma. Food allergy was present and could trigger asthma in 15%. The result of ISSAC questionnaire showed that during the last year wheezing was present in 10%, 6% had 1-3 attacks and 4% had 4-12 attacks. Sleep disturbance by wheezing had occurred in 5% but cough in 16%. Thirteen percent of patients had wheezing after exercise. In Jahrom town the climate is warm and dry. In this town asthma in children is more common among the children who are younger than 4 years old. The risk factor like smoking at home, pets and home dampness should be eliminated from their environment.

  3. Adaptação e validação do Pediatric Asthma Quality of Life Questionnaire (PAQLQ-A em crianças e adolescentes brasileiros com asma Adaptation and validation of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ in Brazilian asthmatic children and adolescents

    Directory of Open Access Journals (Sweden)

    Cintia S. K. La Scala

    2005-02-01

    Full Text Available OBJETIVOS: Traduzir e adaptar ao português (cultura brasileira o Pediatric Asthma Quality of Life Questionnaire (PAQLQ para uso em crianças e adolescentes com asma e validar a versão adaptada (PAQLQ-A. MÉTODOS: Crianças e adolescentes (7 a 17 anos com asma foram entrevistados e responderam o PAQLQ-A à admissão, sendo avaliados por escore clínico de gravidade. Segundo o escore clínico de gravidade, os pacientes foram classificados em leves ( 2. Eles foram reavaliados em pelo menos mais duas ocasiões, com intervalo de 2 a 4 semanas. RESULTADOS: Durante o seguimento, alguns se mantiveram sem mudança no escore clínico de gravidade e foram identificados como estáveis; já os que variaram foram identificados como instáveis. A reprodutibilidade do PAQLQ-A foi avaliada entre os estáveis comparando-se as médias dos domínios sintomas, emoções, atividades e total e do escore clínico de gravidade em dois tempos predeterminados (15 a 30 dias de intervalo, sem diferenças entre elas. A avaliação da suscetibilidade à alteração foi feita entre os pacientes instáveis. As médias dos domínios e o total em dois tempos foram significantemente diferentes, assim como o escore clínico de gravidade. A validação do instrumento foi realizada pela aplicação do teste de confiabilidade de Cronbach (a = 0,909. CONCLUSÕES: A tradução do PAQLQ para a língua portuguesa não modificou estruturalmente o questionário original; o PAQLQ-A é de fácil aplicação, reprodutível, capaz de detectar mudanças e constitui-se em instrumento valioso para a avaliação da qualidade de vida em crianças e adolescentes com asma.OBJECTIVES: To translate the Pediatric Asthma Quality of Life Questionnaire (PAQLQ into Portuguese and adapt it to the Brazilian context, for use in children and adolescents with asthma and to validate the adapted version of the questionnaire (PAQLQ-A. METHODS: Children and adolescents (7 to 17 years old with asthma answered the

  4. Comparison of circadian variations using FEV1 and peak expiratory flow rates among normal and asthmatic subjects.

    OpenAIRE

    Troyanov, S; Ghezzo, H; Cartier, A; Malo, J.L.

    1994-01-01

    BACKGROUND--Most studies that describe circadian variations in asthma have used maximum rate of peak expiratory flow (PEF) rather than forced expiratory volume in one second (FEV1) to assess airway calibre. This study was designed to assess circadian variations in PEF and FEV1 measured simultaneously and to compare variations in these measurements in normal and asthmatic subjects in a stable clinical state. METHODS--Twenty nine subjects (nine asthmatic subjects on bronchodilators, 10 on inhal...

  5. Perceived Food Hypersensitivity Relates to Poor Asthma Control and Quality of Life in Young Non-Atopic Asthmatics

    OpenAIRE

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

    2015-01-01

    Background The relationship between perceived food hypersensitivity in asthmatics, food allergen sensitization, asthma control and asthma-related quality of life has not been studied. Objective 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. Methods Perceived food hypersensitivity, as well as IgE sensitization to common ...

  6. HIV/AIDS Clinician Training Needs in China: A Review

    Institute of Scientific and Technical Information of China (English)

    Joseph D. Tucker

    2002-01-01

    @@ THE URGENCY OF the HIV epidemic in China hascreated substantial interest in the prevention, treatment,care, and advocacy of HIV and AIDS.1 China hasinvested large portions of its public health structure tocurb the spread of the HIV epidemic within its borders.However, training and education of physicians has beentraditionally less emphasized, stalled at the intersectionbetween health education, clinical science, and publichealth.2 The emerging HIV/AIDS clinician trainingneeds must be revisited in light of the historical andbiological context of HIV in China. This brief review ofthe clinician training needs in China will examine thehistory of STDs in China, the biological corollariesimportant to training, and the endpoints of recent studiesassessing Chinese HIV and sexually transmitted diseases(STI) clinician training.

  7. Educação permanente com agentes comunitários de saúde: uma proposta de cuidado com crianças asmáticas Continuing education with community health agents: a proposal for care of asthmatic children

    Directory of Open Access Journals (Sweden)

    Maria Wanderleya de Lavor Coriolano

    2012-06-01

    Full Text Available O uso de metodologias ativas nos processos de formação dos trabalhadores de saúde é uma diretriz recomendada na Política Nacional de Educação Permanente em Saúde (PNEPS para trabalhadores do Sistema Único de Saúde (SUS. Neste estudo, formulou-se uma intervenção educativa para agentes comunitários de saúde (ACS sobre cuidados dirigidos a crianças/famílias com asma. O objetivo é descrever uma ação educativa com agentes comunitários de saúde sobre conhecimentos relacionados à asma, adotando as diretrizes da PNEPS no contexto da atenção primária. Tratase de estudo 'quantiqualitativo', com avaliação préteste e pósteste autopreenchida pelos agentes comunitários de saúde, além de metodologias ativas em três grupos focais vivenciais, que tiveram sua trajetória gravada e transcrita para posterior análise de dados, com uso da técnica análise de conteúdo na modalidade temática proposta por Bardin. Os conhecimentos dos ACS sobre mitos relacionados à asma apontaram acréscimo após a ação educativa. Dos grupos focais emergiram as temáticas: Educação em saúde para prevenção das doenças respiratórias; Significado atribuído à asma; Bombinhas: desmistificando conceitos; Fatores desencadeantes para asma; Adaptando cuidados preventivos; Avaliando os conhecimentos construídos. A utilização de metodologias ativas favoreceu o desenvolvimento de competências por parte dos ACS, despertando motivação na abordagem educativa junto às crianças/famílias com asma.The use of active methods in the health worker training process is a guideline that is recommended under the National Continuing Education in Health Policy (PNEPS for National Health System (SUS employees. In this study, the authors created an educational intervention for community health agents (CHA regarding care aimed at children/families with asthma. The aim is to describe an educational action involving community health workers about asthmarelated

  8. Efeito do índice de massa corpórea na gravidade da asma e na reatividade brônquica induzida pelo exercício em crianças asmáticas com sobrepeso e obesas Effect of body mass index on asthma severity and exercise-induced bronchial reactivity in overweight and obese asthmatic children

    Directory of Open Access Journals (Sweden)

    Joaquim Carlos Rodrigues

    2007-09-01

    Full Text Available OBJETIVO: Analisar a relação entre o grau de obesidade ou sobrepeso medido pelo índice de massa corpórea (IMC de crianças e adolescentes asmáticos com a gravidade clínica e funcional da doença e com a intensidade do broncoespasmo induzido pelo exercício (BIE. MÉTODOS: 20 pacientes com idade entre seis e 18 anos, asma persistente e sobrepeso ou obesidade foram submetidos ao teste padronizado com exercício em bicicleta ergométrica e avaliação seriada dos parâmetros espirométricos, realizada aos 3, 6, 10, 15, 20 e 30 minutos após o exercício. BIE foi definido como a queda do volume expiratório forçado no primeiro segundo (VEF1 >10% e/ou do fluxo médio expiratório forçado medido entre 25 e 75% da capacidade vital forçada (FEF25-75% >26% em relação aos valores pré-teste. Foram avaliadas as freqüências de positividade do teste e as maiores quedas de VEF1 e FEF25-75% após o término do exercício. RESULTADOS: A gravidade clínica da asma foi considerada leve, moderada e grave em dez, cinco e cinco pacientes, respectivamente. Houve BIE em 50% dos pacientes testados. Não houve correlação significativa entre os seguintes parâmetros confrontados: valores de IMC e valores basais do VEF1 e FEF25-75% percentuais em relação ao previsto; valores do IMC e as maiores quedas do VEF1 e do FEF25-75% em relação aos valores basais; valores do IMC e gravidade da asma. A melhor correlação ocorreu entre o IMC e as maiores quedas do FEF25-75% em relação ao basal. CONCLUSÕES: O IMC não teve influência no grau de hiperresponsividade brônquica induzida pelo exercício em crianças asmáticas com sobrepeso e obesas e na gravidade da obstrução basal medida pelo VEF1 e FEF25-75%.OBJECTIVE: To analyze the association between the degree of obesity or overweight measured by the body mass index (BMI in children and adolescents with asthma and the clinical and functional severity of the disease and the intensity of exercise

  9. Analysis of the dynamic states of pulmonary ventilation and perfusion in bronchial asthmatics using 133Xe gas ventilation scintigraphy and 99mTc-MAA lung perfusion scintigraphy

    International Nuclear Information System (INIS)

    To clarify the organic changes and pathophysiology of the lungs in intractable asthmatics, the dynamic states of pulmonary ventilation and perfusion were analyzed in 15 bronchial asthmatics in the stable state using 133Xe gas ventilation scintigraphy and 99mTc-MAA lung perfusion scintigraphy, respectively. Dysfunction of pulmonary ventilation and impairment of pulmonary perfusion were significantly severer in intractable asthmatics than in non-intractable asthmatics (p<0.01, p<0.05, respectively) and those of asthma caused by aging. Late onset asthmatics with a long duration of disease tended to show severe impairment of pulmonary perfusion. Above all, the longer the duration of the disease, the severer became the impairment of pulmonary perfusion in late onset intractable asthmatics (LOIA). These findings suggest that the progression of irreversible organic changes of lungs in LOIA is involved in the severity of bronchial asthma. (author)

  10. Multiple bronchoceles in a non-asthmatic patient with allergic bronchopulmonary aspergillosis.

    Science.gov (United States)

    Amin, Muhammad Umar; Mahmood, Rabia

    2008-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction due to a fungus, Aspergillus fumigatus. It is typically seen in patients with long-standing asthma. Our patient was a non-asthmatic 18 years old male who presented with chronic cough for 2 years. Peripheral blood eosinophilia and elevated scrum IgE were observed. His x-ray chest revealed v-shaped opacity in the left upper lobe close to the hilum. High resolution computed tomographic scan of the chest revealed multiple dilated bronchi filled with mucous (bronchoceles) and central bronchiectasis (CB) involving main segmental bronchi. Central bronchiectasis (CB) was typical of ABPA but bronchocele formation was a rare manifestation of the disease. The patient was managed with oral prednisolone and was relieved of his symptoms. Occurrence of ABPA in non-asthmatics is very rare and deserves reporting. PMID:18846804

  11. Inhaled corticosteroid effects both eosinophilic and non-eosinophilic inflammation in asthmatic patients.

    OpenAIRE

    2004-01-01

    AIM: To determine induced sputum cell counts and interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-alpha) and leukotriene B4 (LTB4) levels as markers of neutrophilic inflammation in moderate persistent asthma, and to evaluate the response to inhaled steroid therapy. METHODS: Forty-five moderate asthmatic patients and 10 non-smoker controls were included in this study. All patients received inhaled corticosteroid (800 microg of budesonide) for 12 weeks. Before and after treatment pulmonar...

  12. Prostaglandin I2 enhances cough reflex sensitivity to capsaicin in the asthmatic airway

    OpenAIRE

    Ishiura, Yoshihisa; Fujimura, Masaki; Nobata, Kouichi; Oribe, Yoshitaka; Abo, Miki; Myou, Shigeharu

    2007-01-01

    Inflammatory mediators are involved in the pathogenesis of airway inflammation, but the role of prostaglandin I2 (PGI2) remains obscure. This study was designed to investigate the role of PGI2 in cough reflex sensitivity of the asthmatic airway, which is characterized by chronic eosinophilic airway inflammation. The effect of beraprost, a chemically and biologically stable analogue of PGI2, on cough response to inhaled capsaicin was examined in 21 patients with stable asthma in a randomized, ...

  13. Network analysis of quantitative proteomics on asthmatic bronchi: effects of inhaled glucocorticoid treatment

    Directory of Open Access Journals (Sweden)

    Sihlbom Carina

    2011-09-01

    Full Text Available Abstract Background Proteomic studies of respiratory disorders have the potential to identify protein biomarkers for diagnosis and disease monitoring. Utilisation of sensitive quantitative proteomic methods creates opportunities to determine individual patient proteomes. The aim of the current study was to determine if quantitative proteomics of bronchial biopsies from asthmatics can distinguish relevant biological functions and whether inhaled glucocorticoid treatment affects these functions. Methods Endobronchial biopsies were taken from untreated asthmatic patients (n = 12 and healthy controls (n = 3. Asthmatic patients were randomised to double blind treatment with either placebo or budesonide (800 μg daily for 3 months and new biopsies were obtained. Proteins extracted from the biopsies were digested and analysed using isobaric tags for relative and absolute quantitation combined with a nanoLC-LTQ Orbitrap mass spectrometer. Spectra obtained were used to identify and quantify proteins. Pathways analysis was performed using Ingenuity Pathway Analysis to identify significant biological pathways in asthma and determine how the expression of these pathways was changed by treatment. Results More than 1800 proteins were identified and quantified in the bronchial biopsies of subjects. The pathway analysis revealed acute phase response signalling, cell-to-cell signalling and tissue development associations with proteins expressed in asthmatics compared to controls. The functions and pathways associated with placebo and budesonide treatment showed distinct differences, including the decreased association with acute phase proteins as a result of budesonide treatment compared to placebo. Conclusions Proteomic analysis of bronchial biopsy material can be used to identify and quantify proteins using highly sensitive technologies, without the need for pooling of samples from several patients. Distinct pathophysiological features of asthma can be

  14. Effect of Different Positions on FVC and FEV1 Measurements of Asthmatic Patients

    OpenAIRE

    Melam, Ganeswara Rao; Buragadda, Syamala; Alhusaini, Adel; Alghamdi, Mohammed Abdulrahman; Alghamdi, Mansour Saleh; Kaushal, Parmveer

    2014-01-01

    [Purpose] The purpose of our study was to investigate the effect of different positions on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) of asthmatic patients .[Subjects and Methods] Thirty subjects with severe asthma aged between 20–39 years were enrolled after they had signed a written consent. Subjects were selected using the inclusion criteria, and PFT were randomly administered. Spirometer measurements (FVC, FEV...

  15. Reported Respiratory Symptom Intensity in Asthmatics During Exposure to Aerosolized Florida Red Tide Toxins

    OpenAIRE

    Milian, Alexyz; Nierenberg, Kate; Fleming, Lora E.; Bean, Judy A.; Wanner, Adam; Reich, Andrew; Backer, Lorraine C.; Jayroe, David; Kirkpatrick, Barbara

    2007-01-01

    Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation. Symptoms of brevetoxin inhalation include: eye, nose, and throat irritation, coughing, wheezing, chest tightness, and shortness of breath. Asthmatics appear t...

  16. Effects of the inhaled treatment of liriope radix on an asthmatic mouse model.

    Science.gov (United States)

    Kim, Ki-Suk; Cho, Dong-Hyuk; Yang, Hea Jung; Choi, Eun-Kyeong; Shin, Min Hee; Kim, Kang-Hoon; Ahn, Kwang Seok; Ha, In Jin; Na, Yun-Cheol; Um, Jae Young; Chung, Won Seok; Jung, Hee-Jae; Jung, Sung-Ki; Jang, Hyeung-Jin

    2015-01-01

    As a treatment for allergic asthma, inhaled treatments such as bronchodilators that contain β2-agonists have an immediate effect, which attenuates airway obstructions and decreases airway hypersensitivity. However, bronchodilators only perform on a one off basis, but not consistently. Asthma is defined as a chronic inflammatory disease of the airways accompanying the overproduction of mucus, airway wall remodeling, bronchial hyperreactivity and airway obstruction. Liriope platyphylla radix extract (LPP), a traditional Korean medicine, has been thoroughly studied and found to be an effective anti-inflammatory medicine. Here, we demonstrate that an inhaled treatment of LPP can attenuate airway hyperresponsiveness (AHR) in an ovalbumin-induced asthmatic mouse model, compared to the saline-treated group (p < 0.01). Moreover, LPP decreases inflammatory cytokine levels, such as eotaxin (p < 0.05), IL-5 (p < 0.05), IL-13 (p < 0.001), RANTES (p < 0.01), and TNF-α (p < 0.05) in the bronchoalveolar lavage (BAL) fluid of asthmatic mice. A histopathological study was carried out to determine the effects of LPP inhalation on mice lung tissue. We performed UPLC/ESI-QTOF-MS, LC/MS, and GC/MS analyses to analyze the chemical constituents of LPP, finding that these are ophiopogonin D, spicatoside A, spicatoside B, benzyl alcohol, and 5-hydroxymethylfurfural. This study demonstrates the effect of an inhaled LPP treatment both on airway AHR and on the inflammatory response in an asthmatic mouse model. Hence, LPP holds significant promise as a nasal inhalant for the treatment of asthmatic airway disease. PMID:25967662

  17. Superoxide Dismutase Inactivation in Pathophysiology of Asthmatic Airway Remodeling and Reactivity

    OpenAIRE

    Comhair, Suzy A.A.; Xu, Weiling; Ghosh, Sudakshina; Thunnissen, Frederik B. J. M.; Almasan, Alexandru; Calhoun, William J.; Janocha, Allison J.; Zheng, Lemin; Hazen, Stanley L.; Erzurum, Serpil C.

    2005-01-01

    Airway hyperresponsiveness and remodeling are defining features of asthma. We hypothesized that impaired superoxide dismutase (SOD) antioxidant defense is a primary event in the pathophysiology of hyperresponsiveness and remodeling that induces apoptosis and shedding of airway epithelial cells. Mechanisms leading to apoptosis were studied in vivo and in vitro. Asthmatic lungs had increased apoptotic epithelial cells compared to controls as determined by terminal dUTP nick-end labeling-positiv...

  18. Inhibition of methoxamine-induced bronchoconstriction by ipratropium bromide and disodium cromoglycate in asthmatic subjects.

    OpenAIRE

    Black, J.; Vincenc, K; Salome, C.

    1985-01-01

    We compared the effects of pretreatment with saline, ipratropium bromide, and disodium cromoglycate (DSCG) on bronchoconstriction induced by methoxamine--an alpha-adrenoceptor agonist, in asthmatic subjects. All 12 patients bronchoconstricted in response to methoxamine after saline. The PD20 (the dose of methoxamine causing a 20% fall in forced expiratory volume in 1 s [FEV1]) ranged from 0.3-18 mumol. Ipratropium bromide (200 micrograms administered by aerosol) significantly inhibited (P les...

  19. Stereoselective total synthesis of the potent anti-asthmatic compound CMI-977 (LDP-977)

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Luiz Carlos; Farina, Lui Strambi; Ferreira, Marco Antonio Barbosa, E-mail: ldias@iqm.unicamp.br [Universidade de Campinas (UNICAMP), SP (Brazil). Instituto de Quimica

    2013-02-15

    A short and efficient stereoselective total synthesis of CMI-977 (LDP-977), a potent and orally active anti-asthmatic compound, was developed. The key steps involve a highly diastereoselective Mukaiyama oxidative cyclization, which provides the trans-THF (tetrahydrofuran) unit and a Seyferth-Gilbert homologation to construct the triple bond in the target molecule. The synthesis of the key chiral building block was performed using Jacobsen hydrolytic kinetic resolution. (author)

  20. Eicosanoid Mediators in the Airway Inflammation of Asthmatic Patients: What is New?

    Science.gov (United States)

    Sanak, Marek

    2016-11-01

    Lipid mediators contribute to inflammation providing both pro-inflammatory signals and terminating the inflammatory process by activation of macrophages. Among the most significant biologically lipid mediators, these are produced by free-radical or enzymatic oxygenation of arachidonic acid named "eicosanoids". There were some novel eicosanoids identified within the last decade, and many of them are measurable in clinical samples by affordable chromatography-mass spectrometry equipment or sensitive immunoassays. In this review, we present some recent advances in understanding of the signaling by eicosanoid mediators during asthmatic airway inflammation. Eicosanoid profiling in the exhaled breath condensate, induced sputum, or their metabolites measurements in urine is complementary to the cellular phenotyping of asthmatic inflammation. Special attention is paid to aspirin-exacerbated respiratory disease, a phenotype of asthma manifested by the most profound changes in the profile of eicosanoids produced. A hallmark of this type of asthma with hypersensitivity to non-steroid anti-inflammatory drugs (NSAIDs) is to increase biosynthesis of cysteinyl leukotrienes on the systemic level. It depends on transcellular biosynthesis of leukotriene C₄ by platelets that adhere to granulocytes releasing leukotriene A₄. However, other abnormalities are also reported in this type of asthma as a resistance to anti-inflammatory activity of prostaglandin E₂ or a robust eosinophil interferon-γ response resulting in cysteinyl leukotrienes production. A novel mechanism is also discussed in which an isoprostane structurally related to prostaglandin E₂ is released into exhaled breath condensate during a provoked asthmatic attack. However, it is concluded that any single eicosanoid or even their complex profile can hardly provide a thorough explanation for the mechanism of asthmatic inflammation. PMID:27582398

  1. Within-breath analysis of respiratory mechanics in asthmatic patients by forced oscillation

    Directory of Open Access Journals (Sweden)

    Juliana Veiga

    2009-01-01

    Full Text Available INTRODUCTION: The within-breath analysis of respiratory mechanics by the monofrequency Forced Oscillation Technique (mFOT is of great interest in both physiopathology studies and the diagnosis of respiratory diseases. However, there are limited data on the use of this technique in the analysis of asthma. This study evaluates within-breath mechanics of asthmatic individuals and the contribution of the mFOT in the asthma diagnosis. METHODS: Twenty-two healthy and twenty-two asthmatic subjects, including patients with mild (n=8, moderate (n=8, and severe (n=6 obstruction, were studied. Forced Oscillation Technique data were interpreted using the mean respiratory impedance (Zt, the impedance during inspiration (Zi, expiration (Ze, at the beginning of inspiration (Zii, and at expiration (Zie. The peakto-peak impedance (Zpp was also calculated by the subtraction of Zii from Zie. Receiver operating characteristic curves were used to determine the sensitivity (Se and specificity (Sp of m Forced Oscillation Technique parameters in identifying asthma. RESULTS: Respiratory impedance values were significantly higher in asthmatics: Zt (p<0.001, Zi (p<0.001, Ze (p<0.001, Zii (p<0.001, Zie (p<0.001, and Zpp (p<0.003. The best parameters for detecting asthma were Zi, Zii, and Zie (Se=90.9%, Sp=90.9%, followed by Zt and Ze. These results are in close agreement with recently published theories and pathophysiological fundamentals. CONCLUSIONS: mFOT permits a non-invasive and detailed analysis in different phases of the respiratory cycle, providing parameters that are adequate for the diagnosis of asthma with high accuracy. These results confirm the high clinical and scientific potential of this methodology in the evaluation of asthmatic patients.

  2. Investigating the Effects of Asthma Medication on the Cognitive and Psychosocial Functioning of Primary School Children with Asthma

    Science.gov (United States)

    Naude, H.; Pretorius, E.

    2003-01-01

    The effects of asthma medication on the cognitive and psychosocial functioning of primary school children with asthma are investigated. A questionnaire survey was conducted in a primary school in Stellenbosch (South Africa) with a population of six hundred and thirty-five students. Among these students, fifty-nine asthmatic children were…

  3. Colonic Diverticula and Diverticular Disease: 10 Facts Clinicians Should Know.

    Science.gov (United States)

    Peery, Anne F

    2016-01-01

    Diverticular disease accounts for substantial health care utilization and costs. Despite this public health burden, clinical practice has been largely based on poor-quality evidence. Fortunately, there is growing interest in this neglected disease. Based on recent work, clinicians should be familiar with the following 10 facts about diverticula and diverticular disease.

  4. Smartphone and mobile phone security for the clinician.

    Science.gov (United States)

    Barber, Harry

    2016-08-01

    Smartphones are near ubiquitous and widely used by doctors in discussing patients. In all communication doctors should take steps to protect confidentiality, yet there is a paucity of available information on how clinicians can bolster cyber security and minimize risk when using their mobile phone. PMID:27487057

  5. Using clinicians' search query data to monitor influenza epidemics.

    Science.gov (United States)

    Santillana, Mauricio; Nsoesie, Elaine O; Mekaru, Sumiko R; Scales, David; Brownstein, John S

    2014-11-15

    Search query information from a clinician's database, UpToDate, is shown to predict influenza epidemics in the United States in a timely manner. Our results show that digital disease surveillance tools based on experts' databases may be able to provide an alternative, reliable, and stable signal for accurate predictions of influenza outbreaks.

  6. Research on recurrent pregnancy complications: a clinician's perspective.

    Science.gov (United States)

    Smulian, John C

    2007-07-01

    Research on recurrent pregnancy complications is essential to help clinicians provide appropriate counselling and guide the management of patients with a history of adverse pregnancy outcomes. However, recurrence research is complex, in both its execution and interpretation. The paucity of appropriate data sets accessible for study of recurrent pregnancy outcomes presents significant challenges in performing recurrence research. This is further compounded by the different perspectives on recurrence between epidemiologists and clinicians. The interpretation of risk, whether it is absolute risk, relative risk or population-attributable fraction, underlies the often opposing perspectives of researchers and clinicians. Because clinicians acutely feel the need to provide appropriate counselling and management strategies when there has been a previous pregnancy complication, it is necessary that all those involved in research and care for these women work together to address gaps in our knowledge for recurrent pregnancy outcomes. In this way, we can develop a better understanding of disease processes, counsel patients better, design management plans and, ultimately, achieve better outcomes for our patients.

  7. Smartphone and mobile phone security for the clinician.

    Science.gov (United States)

    Barber, Harry

    2016-08-01

    Smartphones are near ubiquitous and widely used by doctors in discussing patients. In all communication doctors should take steps to protect confidentiality, yet there is a paucity of available information on how clinicians can bolster cyber security and minimize risk when using their mobile phone.

  8. Attitudes of clinicians following large-scale pharmacogenomics implementation.

    Science.gov (United States)

    Peterson, J F; Field, J R; Shi, Y; Schildcrout, J S; Denny, J C; McGregor, T L; Van Driest, S L; Pulley, J M; Lubin, I M; Laposata, M; Roden, D M; Clayton, E W

    2016-08-01

    Clinician attitudes toward multiplexed genomic testing may be vital to the success of translational programs. We surveyed clinicians at an academic medical center about their views on a large pharmacogenomics implementation, the PREDICT (Pharmacogenomic Resource for Enhanced Decisions in Care and Treatment) program. Participants were asked about test ordering, major factors influencing use of results, expectations of efficacy and responsibility for applying results to patient care. Virtually all respondents (99%) agreed that pharmacogenomics variants influence patients' response to drug therapy. The majority (92%) favored immediate, active notification when a clinically significant drug-genome interaction was present. However, clinicians were divided on which providers were responsible for acting on a result when a prescription change was indicated and whether patients should be directly notified of a significant result. We concluded genotype results were valued for tailoring prescriptions, but clinicians do not agree on how to appropriately assign clinical responsibility for actionable results from a multiplexed panel.The Pharmacogenomics Journal advance online publication, 11 August 2015; doi:10.1038/tpj.2015.57. PMID:26261062

  9. Perception of adults' smile esthetics among orthodontists, clinicians and laypeople

    Directory of Open Access Journals (Sweden)

    Enio Ribeiro Cotrim

    2015-02-01

    Full Text Available OBJECTIVE: Smile esthetics has become a major concern among patients and orthodontists. Therefore, the aim of this study was: (1 To highlight differences in perception of smile esthetics by clinicians, orthodontists and laypeople; (2 To assess factors such as lip thickness, smile height, color gradation, tooth size and crowding, and which are associated with smile unpleasantness. METHODS: To this end, edited photographs emphasizing the lower third of the face of 41 subjects were assessed by three groups (orthodontists, laypeople and clinicians who graded the smiles from 1 to 9, highlighting the markers that evince smile unpleasantness. Kruskall-Wallis test supplemented by Bonferroni test was used to assess differences among groups. Additionally, the prevailing factors in smile unpleasantness were also described. RESULTS: There was no significant difference (P = 0.67 among groups rates. However, the groups highlighted different characteristics associated with smile unpleasantness. Orthodontists emphasized little gingival display, whereas laypeople emphasized disproportionate teeth and clinicians emphasized yellow teeth. CONCLUSION: Orthodontists, laypeople and clinicians similarly assess smile esthetics; however, noticing different characteristics. Thus, the orthodontist must be careful not to impose his own perception of smile esthetics.

  10. Clinicians' information sources for new substance abuse treatment.

    Science.gov (United States)

    Arfken, Cynthia L; Agius, Elizabeth; Dickson, Marcus W

    2005-09-01

    Little is known about clinicians' information sources for new treatments or ways to improve dissemination of that information. We analyzed 163 clinicians' responses to a checklist of where and how frequently they obtain information on new treatment approaches. They reported at least yearly use of a median of four cosmopolite categories (e.g., journals or books, Internet) and a median of three local categories (e.g., co-workers, personal experience) with interpersonal contact with co-workers (89%) and seminars/conferences (86%) being the most frequently endorsed responses for at least yearly use. In response to the hypothetical scenario of receiving monthly e-mail summaries of journal articles, 59% of the clinicians rated the strategy as "very helpful". If continuing education credits were offered, more clinicians (from 50-80%) would read the relevant articles. Information dissemination may improve with expanded Internet access at programs and short e-mailed summaries carrying links to full articles coupled with the incentive of earning continuing education credits.

  11. Effects of systemic glucocorticosteroids on peripheral neutrophil functions in asthmatic subjects: an ex vivo study

    Directory of Open Access Journals (Sweden)

    P. L. Paggiaro

    1995-01-01

    Full Text Available In 21 asthmatic subjects, several functions of isolated peripheral neutrophils (chemokinesis and chemotaxis toward 10% E. coli; superoxide anion generation after PMA; leukotriene B4 (LTB4 release from whole blood and isolated neutrophtls, before and after different stimuli were evaluated during an acute exacerbation of asthma, and after 14 – 54 days of treatment with systemic glucocorticosteroids (GCS. During acute exacerbation, superoxide anion generation was higher in asthmatics than in eleven normal subjects (39.2 ± 14.1 vs. 25.2 ± 7.3 nmol, p 20% after GCS treatment (from 131 ± 18 to 117 ± 21 μm, p = 0.005. Chemokinesis sicantly decreased in all subjects, and the changes significantly correlated with an arbitrary score of the total administered dose of GCS (r = 0.57, p < 0.05. These data suggest that neutrophil activation plays a minor role in asthma, and that treatment with GCS is not able to modify most functions of peripheral neutrophils in asthmatic subjects; chemotaxis seems to be related only to the severity of the asthma and it could reflect the improvement of the disease.

  12. Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-03-01

    Full Text Available Introduction: Ramadan is the 9th  Islamic lunar month during which Muslims avoid eating and drinking from sunrise to sunset.  The effect of Ramadan intermittent fasting on asthma control is controversial.  The aim of this study was to investigate the effects of Ramadan fasting on the spirometric variables and clinical symptoms on well-controlled asthmatic patients during Ramadan. Material and Methods: a cohort study was conducted in Mashhad, Khorasan Razavi, Iran. Twenty-nine (19 females and 10 males well-controlled asthmatic patients aged 47 (12 years completed the study.  The average duration of fasting was 26.5 days. Assessment of spirometric variables (daily peak expiratory flow, peak expiratory flow variability, peak expiratory flow home monitoring as well as asthma clinical symptoms including dyspnea, cough, wheezing, and chest tightness were carried out. Results: No significant changes in clinical symptoms were reported in asthmatic patients at the end of Ramadan fasting.  Among spirometric variables, only peak expiratory flow improved after Ramadan (p

  13. Reported respiratory symptom intensity in asthmatics during exposure to aerosolized Florida red tide toxins.

    Science.gov (United States)

    Milian, Alexyz; Nierenberg, Kate; Fleming, Lora E; Bean, Judy A; Wanner, Adam; Reich, Andrew; Backer, Lorraine C; Jayroe, David; Kirkpatrick, Barbara

    2007-09-01

    Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation. Symptoms of brevetoxin inhalation include: eye, nose, and throat irritation, coughing, wheezing, chest tightness, and shortness of breath. Asthmatics appear to be more sensitive to the effects of inhaled brevetoxin. This study examined data from 97 asthmatics exposed at the beach for 1 hour during K. brevis blooms, and on separate occasions when no bloom was present. In conjunction with extensive environmental monitoring, participants were evaluated utilizing questionnaires and pulmonary function testing before and after a 1-hour beach walk. A modified Likert scale was incorporated into the questionnaire to create respiratory symptom intensity scores for each individual pre- and post-beach walk. Exposure to Florida red tide significantly increased the reported intensity of respiratory symptoms; no significant changes were seen during an unexposed period. This is the first study to examine the intensity of reported respiratory symptoms in asthmatics after a 1-hour exposure to Florida red tide. PMID:17885863

  14. Dynamics of eosinophil infiltration in the bronchial mucosa before and after the late asthmatic reaction.

    Science.gov (United States)

    Aalbers, R; de Monchy, J G; Kauffman, H F; Smith, M; Hoekstra, Y; Vrugt, B; Timens, W

    1993-06-01

    We wanted to determine whether changes in bronchial hyperresponsiveness (BHR) following allergen challenge show a time relationship with inflammatory events in the airways of allergic asthmatic subjects. Lavage was performed and endobronchial biopsies were taken via the fiberoptic bronchoscope, before, and 3 and 24 h after, allergen challenge, on separate occasions, in nine dual asthmatic responders. The numbers of activated eosinophils, identified by immunohistochemistry, using the monoclonal anti-eosinophil cationic protein antibody, EG2, were significantly increased both at 3 h and at 24 h in the submucosa and bronchial lavage. A significant negative correlation was found between the number of EG2+ cells in the submucosa and in the bronchial lavage 24 h after the allergen challenge (r = -0.70). At 24 h, the amount of eosinophil cationic protein (ECP) was increased in the bronchial lavage. A significant correlation was observed between the amount of ECP at 3 h and the log provocative dose of house dust mite producing a 20% fall in forced expiratory volume in one second (PD20 HDM) (r = -0.63). The results suggest a recruitment of activated eosinophils to the submucosa and, further, to the epithelial lining, followed by degranulation. This process has already started 3 h after allergen challenge, and lasts for at least 24 h, which may result in mucosal damage and subsequent allergen-induced increase in BHR, before and after the late asthmatic reaction. PMID:8339804

  15. Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants

    Directory of Open Access Journals (Sweden)

    Díaz-Sánchez David

    2009-12-01

    Full Text Available Abstract Introduction Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function in asthmatic children. Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants. Methods A total of 158 asthmatic children recruited at the Children's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks. Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks. Dietary intake was evaluated using a 108-item food frequency questionnaire and a fruit and vegetable index (FVI and a Mediterranean diet index (MDI were constructed. The impact of these indices on lung function and interleukin-8 (IL-8 and their interaction with air pollutants were determined using mixed regression models with random intercept and random slope. Results FVI was inversely related to IL-8 levels in nasal lavage (p 1 (test for trend p 1 and FVC as was with MDI and ozone for FVC. No effect of diet was observed among healthy children. Conclusion Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City.

  16. What motivates senior clinicians to teach medical students?

    Science.gov (United States)

    Dahlstrom, Jane; Dorai-Raj, Anna; McGill, Darryl; Owen, Cathy; Tymms, Kathleen; Watson, D Ashley R

    2005-01-01

    Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia). Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24%) were female and 57 (76%) were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%), 41–55 years = 46 participants (61.3%) and >55 years = 13 participants (17.3%). Most participants (n = 48, 64%) were staff specialists and 27 (36%) were visiting medical officers. Half of the participants were internists (n = 39, 52%), 12 (16%) were surgeons, and 24 (32%) were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce. PMID:16022738

  17. What motivates senior clinicians to teach medical students?

    Directory of Open Access Journals (Sweden)

    Owen Cathy

    2005-07-01

    Full Text Available Abstract Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia. Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24% were female and 57 (76% were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%, 41–55 years = 46 participants (61.3% and >55 years = 13 participants (17.3%. Most participants (n = 48, 64% were staff specialists and 27 (36% were visiting medical officers. Half of the participants were internists (n = 39, 52%, 12 (16% were surgeons, and 24 (32% were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce.

  18. Special considerations for adolescent athletic and asthmatic patients

    Directory of Open Access Journals (Sweden)

    Wuestenfeld JC

    2013-01-01

    Full Text Available Jan C Wuestenfeld,1,2 Bernd Wolfarth1,21Department of Preventive and Rehabilitative Sports Medicine, Technical University Munich (TUM, Munich, Germany; 2Institute for Applied Training Science (IAT, Leipzig, GermanyAbstract: Asthma is defined as a chronic inflammatory disorder of the airways with bronchial hyperresponsiveness and variable bronchoconstriction, and is one of the most common diseases in childhood and adolescence. Exercise-induced asthma-like symptoms and asthma are also frequently seen in highly trained athletes. Exercise-induced asthma (EIA and exercise-induced bronchoconstriction (EIB are found in 8%–10% of healthy school-aged children and in 35% of children with asthma. Highly increased ventilation, inhalation of cold, dry air and air pollutants (eg, chlorine are thought to be important triggers for EIA and EIB. EIA is often experienced concurrently with vocal cord dysfunction, which needs to be considered during the differential diagnosis. The pharmacological treatment of EIA is similar to the treatment of asthma in nonexercising adolescents. The therapy is based on anti-inflammatory drugs (eg, inhaled glucocorticosteroids and bronchodilators (eg, β2-agonists. The treatment of EIB is comparable to the treatment of EIA and leukotriene modifiers offer a new and promising treatment option, particularly in EIB. Generally, athletes may not use β2-agonists according to the prohibited list of the World Anti-Doping Agency (WADA. However, the WADA list contains specific β2-agonistic substances that are permitted to be used by inhalation.Keywords: exercise-induced asthma, exercise-induced bronchospasm, adolescents, asthma, athletes

  19. Oral health in children with asthma

    Directory of Open Access Journals (Sweden)

    Marković Dejan

    2015-01-01

    Full Text Available Introduction. It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. Objective. The aim of the study was to determine the oral health status of children with asthma and to evaluate the oral health parameters according to the medications and severity of the disease. Methods. The study group consisted of 158 children with asthma and 100 healthy control subjects aged 2-18 years. The diagnosis of dental caries was performed using the Decayed, Missing, and Filled Teeth (DMFT/dmft criteria. The oral hygiene, periodontal status and gingival health were assessed with the Simplified Oral Hygiene Index (Greene-Vermillion, Community Periodontal Index of Treatment Needs and Gingival Index (Löe-Silness, respectively. Results. Thirty (19% patients with asthma and 43 (43% healthy children were caries-free (p<0.001. There were no significant differences between asthmatic and control children in caries experience (for children with asthma mean DMFT=2.1±1.8, mean dmft=4.2±3.3; for healthy children mean DMFT=2.5±0.9, mean dmft=5.2±1.3. Level of asthma control did not have influence on dental health, while dose of inhaled corticosteroid had impact on primary dentition. Periodontal status and gingival health did not differ between asthmatic and control children. However, children with asthma had poorer oral hygiene (p<0.001. Conclusion. Results of the study do not show a relationship between asthma and oral diseases. However, further improvement could be made in educating children and parents on the importance of good oral hygiene and prevention of oral diseases.

  20. Fetal Alcohol Spectrum Disorders and Challenges Faced by Caregivers: Clinicians' Perspectives.

    Science.gov (United States)

    Baskin, Jonathan; Delja, Jolie R; Mogil, Catherine; Gorospe, Clarissa M; Paley, Blair

    2016-01-01

    BackgroundThere is a notable absence of evidence based early interventions for young children with FASD.  ObjectiveThis study examines clinicians' perspectives regarding the needs of caregivers of children with FASD and how such perspectives informed the development of a family-centered early intervention for young children with prenatal alcohol exposure.  Method19 professionals who work with children with prenatal alcohol exposure and / or in out-of-home care were recruited to participate in focus groups. The facilitator used a semi-structured topic guide to elicit feedback from participants. These data were transcribed, coded, and categorized to reflect themes in a manner informed by a grounded theory approach. A second investigator repeated the process. Codes were chosen and assigned to data by consensus.   ResultsThe coded data yielded five distinct perceived challenges faced by caregivers: (1) seeking and possibly receiving a diagnosis; (2) processing emotions and coming to terms with the child's difficulties; (3) seeking support and belonging within a knowledgeable community; (4) developing a new understanding of the child's behavior; and (5) becoming an educator, advocate, and expert on the child and FASD.   ConclusionProfessionals believe specific capacities are essential insofar as the human service systems that caregivers engage are perceived to be under-equipped to respond to the distinct set of challenges faced by children with FASD and their families. Findings are discussed in terms of how the proposed intervention was designed to address such challenges and to cultivate those key capacities in order for families to meet their children's needs. PMID:27462878

  1. Conflict of Interest in Research--The Clinician Scientist's Perspective.

    Science.gov (United States)

    Kong, Nicole H Y; Chow, Pierce K H

    2013-11-01

    Conflict of interest (COI) in research represents situations that pose risks of undue influence on scientific objectivity and judgment because of secondary interests. This is complex but is inherent to biomedical research. The role of a clinician scientist can be conflicted when scientific objectivity is perceived to compete with scientific success (publications, grants), partiality to patients (clinical trials), obligations to colleagues (allowing poor scholarship to pass), research sponsors (industry), and financial gains (patents, royalties). While there are many ways which COIs can occur in research, COI mitigations remain reliable. Collaborations between investigators and industry are valuable to the development of novel therapies and undue discouragement of these relationships may inadvertently harm the advancement of healthcare. As a result, proper management of COI is fundamental and crucial to the maintenance of long-term, mutually beneficial relationships between industry and academia. The nature of COI in research and methods of mitigation are discussed from the perspective of a clinician scientist. PMID:24356664

  2. The cultural divide: exploring communication barriers between scientists and clinicians

    Directory of Open Access Journals (Sweden)

    Linda L. Restifo

    2011-07-01

    Despite remarkable advances in basic biomedical science that have led to improved patient care, there is a wide and persistent gap in the abilities of researchers and clinicians to understand and appreciate each other. In this Editorial, the authors, a scientist and a clinician, discuss the rift between practitioners of laboratory research and clinical medicine. Using their first-hand experience and numerous interviews throughout the United States, they explore the causes of this ‘cultural divide’. Members of both professions use advanced problem-solving skills and typically embark on their career paths with a deeply felt sense of purpose. Nonetheless, differences in classroom education, professional training environments, reward mechanisms and sources of drive contribute to obstacles that inhibit communication, mutual respect and productive collaboration. More than a sociological curiosity, the cultural divide is a significant barrier to the bench-to-bedside goals of translational medicine. Understanding its roots is the first step towards bridging the gap.

  3. [The clinician-scientist: proposal for a new paradigm].

    Science.gov (United States)

    Leibovici, Leonard; Paul, Mical

    2010-10-01

    The decline in the attraction and prestige of the clinician-scientist paradigm is due to the dissonance between clinical work and conducting research in basic science. Medicine entails alleviating distress and prolonging life. Thus, medical research deals directly with the questions: what ails our patients and what shortens their lives? How can it be prevented? How can we alleviate suffering and prolong life? Research designs that fit these questions are: researcher (or patient) initiated randomized controlled trials; systematic reviews and meta-analysis; high-quality observational studies that address risk factors, natural history of disease, side-effects, and efficiency of treatment; research in ethics; and qualitative research. The clinician-scientist should perform medical research. Investing in this paradigm wilt encourage young doctors to conduct research directly oriented to benefit their patients.

  4. Clinician acceptance is the key factor for sustainable telehealth services.

    Science.gov (United States)

    Wade, Victoria A; Eliott, Jaklin A; Hiller, Janet E

    2014-05-01

    Telehealth, the delivery of health care services at a distance using information and communications technology, has been slow to be adopted and difficult to sustain. Researchers developing theories concerning the introduction of complex change into health care usually take a multifactorial approach; we intentionally sought a single point of intervention that would have maximum impact on implementation. We conducted a qualitative interview study of 36 Australian telehealth services, sampled for maximum variation, and used grounded theory methods to develop a model from which we chose the most important factor affecting the success of telehealth. We propose that clinician acceptance explains much of the variation in the uptake, expansion, and sustainability of Australian telehealth services, and that clinician acceptance could, in most circumstances, overcome low demand, technology problems, workforce pressure, and lack of resourcing. We conclude that our model offers practical advice to those seeking to implement change with limited resources.

  5. A qualitative analysis of EHR clinical document synthesis by clinicians.

    Science.gov (United States)

    Farri, Oladimeji; Pieckiewicz, David S; Rahman, Ahmed S; Adam, Terrence J; Pakhomov, Serguei V; Melton, Genevieve B

    2012-01-01

    Clinicians utilize electronic health record (EHR) systems during time-constrained patient encounters where large amounts of clinical text must be synthesized at the point of care. Qualitative methods may be an effective approach for uncovering cognitive processes associated with the synthesis of clinical documents within EHR systems. We utilized a think-aloud protocol and content analysis with the goal of understanding cognitive processes and barriers involved as medical interns synthesized patient clinical documents in an EHR system to accomplish routine clinical tasks. Overall, interns established correlations of significance and meaning between problem, symptom and treatment concepts to inform hypotheses generation and clinical decision-making. Barriers identified with synthesizing EHR documents include difficulty searching for patient data, poor readability, redundancy, and unfamiliar specialized terms. Our study can inform recommendations for future designs of EHR clinical document user interfaces to aid clinicians in providing improved patient care. PMID:23304398

  6. How is health economics relevant to transplant clinicians?

    Science.gov (United States)

    Wong, Germaine; Howard, Kirsten; Webster, Angela C; Morton, Rachael L; Chapman, Jeremy R; Craig, Jonathan C

    2014-07-27

    Decision making is complex and difficult in clinical practice. Clinicians are often faced with a large range of possible alternative decision options, each with their own consequences and trade-offs. Health economics methods enable informed decision making on how best to allocate limited resources that could lead to most health gains. Economic evaluation in particular is highly relevant in transplantation medicine. Transplantation is an expensive intervention, but it improves the quality of life and survival of people with chronic diseases. The balance between health care resource use and the optimal health gains is useful not only to decision-makers, but also to consumers, clinicians, and researchers. This article is an overview of the concepts of economic evaluation in the setting of transplantation and highlights the applicability of these concepts in clinical transplantation.

  7. Bioethics for clinicians: 5. Substitute decision-making.

    OpenAIRE

    Lazar, N M; Greiner, G G; Robertson, G; Singer, P A

    1996-01-01

    Substitute decision-making is a means of making health care decisions on behalf of people who are incapable of making these decisions for themselves. It is based on the ethical principle of respect for autonomy. Substitute decision-making poses two main questions: Who-should make the decision for the incapable person, and, How should the decision be made? Because the applicable statutory and common law varies across Canada, clinicians should become familiar with the legal requirements of thei...

  8. Clinician-Educators as Dual Professionals: A Contemporary Reappraisal.

    Science.gov (United States)

    Stoddard, Hugh A; Brownfield, Erica D

    2016-07-01

    Physicians who teach face unique responsibilities and expectations because they must educate learners while simultaneously caring for patients. Recently this has become even more difficult as the environment for clinician-educators has been undermined by public antipathy toward both the education profession and the medicine profession.Erosion of public confidence in both professions is evidenced by three trends. First, the democratizing nature of the Internet and the availability of technical knowledge to laypeople have encroached on the domain of professional knowledge. Second, the responsibility of a professional to make decisions has been undercut by legal interpretations regarding how physicians are paid for patient care and how teachers are evaluated on performance. And finally, altruistic motivations in both professions have been called into question by external forces promoting "accountability" rather than trusting professionals to act for the best interest of their patients or students.In this climate of increasing accountability and decreasing trust for professionals, clinician-educators can best serve patients and learners through transdisciplinary collaboration with professional educators. Clinician-educators should rely on professional educators for judgment and specialized knowledge in the field of education rather than embodying both professions by themselves. Health care practice has become more team oriented; health care education should do likewise to counteract the social and political trends eroding public confidence in medicine and education. Relying on collaboration with education professionals constitutes a substantial change to how clinician-educators define themselves, but it holds the best promise for medical training in the current social milieu. PMID:27119327

  9. Emergency contraception review: evidence-based recommendations for clinicians

    OpenAIRE

    Cleland, Kelly; Raymond, Elizabeth G.; Westley, Elizabeth; Trussell, James

    2014-01-01

    Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile and availability. The most effective emergency contraceptive is the copper IUD, followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, while ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Althoug...

  10. Biosimilar insulins: guidance for data interpretation by clinicians and users

    OpenAIRE

    Heinemann, L.; Home, P D; Hompesch, M.

    2015-01-01

    Biosimilar insulins are approved copies of insulins outside patent protection. Advantages may include greater market competition and potential cost reduction, but clinicians and users lack a clear perspective on ‘biosimilarity’ for insulins. The manufacturing processes for biosimilar insulins are manufacturer‐specific and, although these are reviewed by regulators there are few public data available to allow independent assessment or review of issues such as intrinsic quality or batch‐to‐batc...

  11. Cardiovascular magnetic resonance physics for clinicians: part II

    OpenAIRE

    Biglands John D; Radjenovic Aleksandra; Ridgway John P

    2012-01-01

    Abstract This is the second of two reviews that is intended to cover the essential aspects of cardiovascular magnetic resonance (CMR) physics in a way that is understandable and relevant to clinicians using CMR in their daily practice. Starting with the basic pulse sequences and contrast mechanisms described in part I, it briefly discusses further approaches to accelerate image acquisition. It then continues by showing in detail how the contrast behaviour of black blood fast spin echo and bri...

  12. Clinician experiences assessing work disability related to mental disorders

    OpenAIRE

    Dewa, Carolyn S; Hiske Hees; Lucy Trojanowski; Schene, Aart H

    2015-01-01

    OBJECTIVE: Medical certification is one of the basic administrative mechanisms used by social policies aimed at income protection. The assessment of work disability is central to the income protection application. Yet, there is evidence suggesting that determining work disability related to mental disorders is challenging. Although essential to the disability application process, few studies have looked at physician and other clinician experiences with the process. However, this type of infor...

  13. Crew resource management training--clinicians' reactions and attitudes.

    Science.gov (United States)

    France, Daniel J; Stiles, Renee; Gaffney, E Andrew; Seddon, Margaret R; Grogan, Eric L; Nixon, William R; Speroff, Theodore

    2005-08-01

    Many health care organizations are adopting crew resource management (CRM) training from the aviation industry as a patient safety practice. Although CRM has high face validity, its effects have not been thoroughly evaluated in aviation or health care. Its potential to improve team communication, coordination, and patient safety, however, makes efforts to study CRM necessary and worthwhile. This article evaluates clinicians' attitudes about and reactions to CRM after they participated in an eight-hour, commercially developed training program.

  14. Reliability of adverse symptom event reporting by clinicians

    Science.gov (United States)

    Li, Yuelin; Coffey, Charles W.; Sit, Laura; Shaw, Mary; Lavene, Dawn; Bennett, Antonia V.; Fruscione, Mike; Rogak, Lauren; Hay, Jennifer; Gönen, Mithat; Schrag, Deborah; Basch, Ethan

    2013-01-01

    Purpose Adverse symptom event reporting is vital as part of clinical trials and drug labeling to ensure patient safety and inform risk–benefit decision making. The purpose of this study was to assess the reliability of adverse event reporting of different clinicians for the same patient for the same visit. Methods A retrospective reliability analysis was completed for a sample of 393 cancer patients (42.8% men; age 26–91, M = 62.39) from lung (n = 134), prostate (n = 113), and Ob/Gyn (n = 146) clinics. These patients were each seen by two clinicians who independently rated seven Common Terminology Criteria for Adverse Events (CTCAE) symptoms. Twenty-three percent of patients were enrolled in therapeutic clinical trials. Results The average time between rater evaluations was 68 min. Intraclass correlation coefficients were moderate for constipation (0.50), diarrhea (0.58), dyspnea (0.69), fatigue (0.50), nausea (0.52), neuropathy (0.71), and vomiting (0.46). These values demonstrated stability over follow-up visits. Two-point differences, which would likely affect treatment decisions, were most frequently seen among symptomatic patients for constipation (18%), vomiting (15%), and nausea (8%). Conclusion Agreement between different clinicians when reporting adverse symptom events is moderate at best. Modification of approaches to adverse symptom reporting, such as patient self-reporting, should be considered. PMID:21984468

  15. Clinician's Attitudes to the Introduction of Routine Weighing in Pregnancy

    Science.gov (United States)

    Beckmann, Michael M.; Wilkinson, Shelley A.

    2016-01-01

    Background. Excessive gestational weight gain poses significant short- and long-term health risks to both mother and baby. Professional bodies and health services increasingly recommend greater attention be paid to weight gain in pregnancy. A large Australian tertiary maternity hospital plans to facilitate the (re)introduction of routine weighing of all women at every antenatal visit. Objective. To identify clinicians' perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Method. Forty-four maternity staff from three professional groups were interviewed in four focus groups. Staff included midwives; medical staff; and dietitians. Transcripts underwent qualitative content analysis to identify and examine barriers and enablers to the routine weighing of women throughout pregnancy. Results. While most staff supported routine weighing, various concerns were raised. Issues included access to resources and staff; the ability to provide appropriate counselling and evidence-based interventions; and the impact of weighing on patients and the therapeutic relationship. Conclusion. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were also identified. Implementation strategies will be tailored to the discrete professional groups and will address identified gaps in knowledge, resources, and clinician skills and confidence. PMID:27446614

  16. Prevalence of Asthma in Children of Chemical Warfare Victims

    Science.gov (United States)

    Mirsadraee, Majid; Mozaffari, Abolfazl; Attaran, Davood

    2011-01-01

    Objective Exposure of DNA to sulfur mustard gas may increase the inheritance of asthma in chemical warfare victims' (CWV) offspring. The objective of this study was to determine the prevalence of asthma in children of CWV and compare it to asthmatic children in the general population. Methods Four hundred and nine children from 130 CWV fathers and 440 children from 145 asthmatic parents from two cities in Iran participated in this study. The prevalence of asthma was determined by standard questionnaire released for epidemiological survey of asthma in children and compared between two groups. Findings The prevalence of asthma in the CWV group was 15%; this was not significantly different from the control group (12.5%). The children of the CWV group reported a significantly greater incidence of wheezing (1.2±3.1 attacks) per year, but the control group reported more severe attacks leading to speech difficulties (3%) and coughing (7%). Regression analysis showed that with increasing family size in the control group, the number of subjects suffering from asthmatic symptoms decreases significantly (r=0.86, P=0.001). Conclusion Chemical agents may increase the prevalence of asthma in the offspring of CWV. PMID:23056804

  17. Studying forced expiratory volume at 1 second over menstrual segments in asthmatic and non-asthmatic women: assessing protocol feasibility

    Directory of Open Access Journals (Sweden)

    Wegienka Ganesa

    2012-07-01

    Full Text Available Abstract Background Sex hormones may play an important role in observed gender differences in asthma incidence and severity, as well as in the observed changes in asthma symptoms during times of hormonal fluctuation (i.e.; premenstrual, pregnancy, etc.. This pilot study sought to demonstrate the feasibility of data collection methods to investigate the effects of sex hormones on lung function in women. Findings A cohort of 13 women (6 with and 7 without prior asthma diagnoses who were having menstrual periods and were not taking hormones collected urine samples daily for measurement of estrogen (estrone E1C and progesterone (Pregnanediol-glucuronide PDG metabolites over the course of a menstrual segment (bleeding episode plus the following bleeding-free interval. Hormones were used to estimate menstrual segment phase (follicular versus luteal based on a published algorithm. Daily bleeding and FEV1 measurements were recorded and percent predicted FEV1 was calculated. Percent predicted FEV1 decreased over the course of the follicular but not the luteal phase. More specifically, among women without a prior asthma diagnosis, the E1C/PDG ratio and E1C and PDG were individually associated with FEV1 in the follicular phase. No associations were found between hormones and percent predicted FEV1 in the luteal phase or among asthmatic women. E1C was associated with FEV1 in the five days before bleeding onset only among non-asthmatic women. Discussion A study of contiguous daily hormones and symptoms over menstrual segments from a large group of women with and without asthma is needed to better determine within-woman cyclicity of the observed patterns.

  18. The impact of passive smoking on the respiratory system in children Invited Editor

    OpenAIRE

    Keskinoğlu, Pembe; Aksakoğlu, Gazanfer

    2007-01-01

    Passive smoking environmental tobacco smoke is an important public health problem causing several adverse effects on the health outcomes of children Adverse effects of passive smoking occur from conception through adolescence Exposure to passive smoking in children is associated especially with increased upper and lower respiratory infection and increased asthmatic symptoms Globally including Turkey the percentage of children exposed to environmental tobacco smoke is considerably high Exposur...

  19. iAIDS: HIV-related internet resources for the practicing clinician.

    Science.gov (United States)

    Krakower, Douglas; Kwan, Candice K; Yassa, David S; Colvin, Richard A

    2010-10-01

    In this review, we collate 25 clinically useful human immunodeficiency virus (HIV)-related Web sites to facilitate efficient access to online resources according to themes of clinical inquiry: (1) comprehensive clinical information, (2) opportunistic infections, (3) antiretroviral drug interactions, (4) care of HIV-infected women and children, and (5) continuing medical education. We evaluated these Web sites for clinical content and quality using criteria including the currency of information, inclusion of references, sponsors, whether the site is useful in resource-limited settings, ease of navigation, and content specific for each theme. Using the specified criteria, we provided overall ratings for each Web site. We conclude that the Web sites listed in this review can help extend knowledge about best practices and provide real-time patient care support to clinicians. PMID:20738185

  20. AIR POLLUTION AND RESPIRATORY HEALTH AMONG CHILDREN WITH ASTHMATIC OR COUGH SYMPTOMS. (R825265)

    Science.gov (United States)

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  1. Airflow limitation in asthmatic children assessed with a non-invasive EMG technique

    NARCIS (Netherlands)

    Maarsingh, EJW; van Eykern, LA; de Haan, RJ; Griffioen, RW; Hoekstra, MO; van Aalderen, WMC

    2002-01-01

    The aim of the study was to investigate the association between electromyography (EMG) of the diaphragm and intercostal muscles and the forced expiratory volume in 1 s (FEV1) at different levels of histamine-induced airflow limitation, and the response to salbutamol. Moreover, we assessed the reprod

  2. Transcriptional characteristics of CD4+ T cells in young asthmatic children: RORC and FOXP3 axis

    OpenAIRE

    Hamzaoui A; Maalmi H; Berraïes A; Abid H; Ammar J; Hamzaoui K

    2011-01-01

    Agnes Hamzaoui1,2,*, Haïfa Maalmi1,*, Anissa Berraïes1,2, Hanadi Abid1,2, Jamel Ammar1,2, Kamel Hamzaoui11Department of Pediatrics and Respiratory Disease, Homeostasis and Cell Dysfunction Unit Research, Abderrahman Mami Hospital, Ariana, Tunisia; 2Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia *These authors contributed to this work equallyBackground: Asthma is a chronic inflammatory disorder, hypothetically caused by autoreactive Th2 cells, whereas...

  3. Different breathing patterns in healthy and asthmatic children : Responses to an arithmetic task

    NARCIS (Netherlands)

    Fokkema, DS; Maarsingh, EJW; van Eykern, LA; van Aalderen, WMC

    2006-01-01

    Asthma patients have been reported to be sensitive to breathlessness, independent of the degree of airway obstruction. Paying attention and task performance may induce changes in breathing pattern and these in turn may mediate such a feeling. The present experiment investigates whether strained brea

  4. The impact of discussing exercise test results of young asthmatic children on adherence to maintenance medication

    NARCIS (Netherlands)

    Visser, R.; Brusse-Keizer, M.; Palen, van der J.; Klok, T.; Thio, B.J.

    2015-01-01

    Objective: Parents’ awareness of their child’s asthma may improve by discussing an exercise challenge test (ECT) result with them. We investigated the influence of discussing an ECT result with parents on adherence to inhaled maintenance medication, parental illness perceptions and medication belief

  5. [Social media monitoring of asthmatic children treated in a specialized program: Parents and caregivers expectations].

    Science.gov (United States)

    Urrutia-Pereira, Marilyn; Ávila, Jennifer Bg; Cherrez-Ojeda, Ivan; Ivancevich, Juan Carlos; Solé, Dirceu

    2015-01-01

    Antecedentes: las redes sociales se utilizan para el apoyo de los pacientes con asma; sin embargo, no se conocen las expectativas de los padres y los cuidadores de los pacientes con respecto al uso de estas redes. Objetivo: evaluar las expectativas de los padres y los cuidadores de niños asmáticos atendidos en el Programa de Prevención del Asma Infantil (PIPA, Uruguaiana, RS) con respecto al uso de las redes sociales. Material y método: estudio observacional, descriptivo, de corte transversal, en el que padres y cuidadores de niños tratados en el Programa de Prevención del Asma Infantil respondieron a un cuestionario escrito acerca del uso de las nuevas tecnologías y las diversas aplicaciones para mejorar la información acerca del asma. Resultados: participaron 210 padres o cuidadores (mediana de edad: 25 años; intervalo de edad: 18-42 años) de pacientes con edad promedio de 7.3 años (intervalo de edad: 2 a 18 años) y duración del asma de 4.7 años; 65% de los padres o cuidadores tuvo menos de ocho años de grado de escolaridad. La mayoría de ellos (72%) no tenía acceso a Internet a través de sus teléfonos y sólo 18% obtenía información activamente acerca del asma por Internet; 87% refirió su interés por recibir información a través de las redes sociales. Conclusión: los padres o cuidadores de niños atendidos en el Programa de Prevención del Asma Infantil expresaron gran interés en el uso de redes sociales, pero pocos las usan para controlar la enfermedad de los niños. Aunque las redes sociales proporcionan un gran beneficio para la salud, esta información debe ser vigilarse en relación con su fiabilidad y calidad. La privacidad de los usuarios (médicos y pacientes) debe ser preservada y debe facilitarse su acceso a Internet.

  6. Morning-evening changes in airway responsiveness to methacholine in normal and asthmatic subjects: analysis using partial flow-volume curves.

    OpenAIRE

    Heaton, R W; Gillett, M K; Snashall, P. D.

    1988-01-01

    In eight normal and eight asthmatic subjects airway responsiveness to methacholine was measured by means of partial flow-volume loops at 0800 and 1800 hours on the same day. Airway responsiveness was lower in the evening in both normal and asthmatic subjects.

  7. YKL-40 and genetic status of CHI3L1 in a large group of asthmatics

    DEFF Research Database (Denmark)

    Hansen, Jakob W; Thomsen, Simon F; Porsbjerg, Celeste;

    2015-01-01

    SNP (-131 C/G, rs4950928). METHODS: In this study, 1,137 patients with asthma, 415 with rhinitis only, and 275 non-asthmatic controls were included. Assessment included a clinical interview concerning the diagnosis of asthma, severity of asthma, and asthma treatment as well as clinical tests to assess...... asthma and rhinitis. Serum YKL-40 was measured, and genotyping for the SNP (-131 C/G) was conducted. RESULTS: No significant difference in the serum concentration of YKL-40 was found between patients with asthma, patients with rhinitis, and non-asthmatic controls; however, YKL-40 was increased in.......0001). CONCLUSION: There was no association between polymorphisms of SNP (-131 C/G) and asthma. The highest serum YKL-40 concentrations were seen in severe asthmatics. Individuals with less severe asthma showed a smaller difference against controls, limiting its clinical usefulness. More research is needed to...

  8. Gastroesophageal reflux episodes in asthmatic patients and their temporal relation with sleep architecture

    Directory of Open Access Journals (Sweden)

    L. Mello-Fujita

    2008-02-01

    Full Text Available Gastroesophageal reflux (GER is common in asthma patients and can contribute to sleep disruption. The aim of the present study was to determine the time-related distribution of GER events together with their impact on sleep in asthmatic subjects with GER disease symptoms. The inclusion criteria were: 18-65 years, controlled moderate to severe asthma and GER-compatible clinical evidence. The exclusion criteria were: chronic obstructive lung disease, smoking, infections of the upper airways, use of oral corticosteroids, other co-morbidities, pregnancy, sleep-related disorders, night-time shift work, and the use of substances with impact on sleep. Asthmatic patients with nocturnal symptoms were excluded. All-night polysomnography and esophageal pH monitoring were recorded simultaneously. Of the 147 subjects selected, 31 patients and 31 controls were included. Seventeen patients were classified as DeMeester positive and 14 as DeMeester negative. Both groups displayed similar outcomes when general variables were considered. Sleep stage modification one minute prior to GER was observed in the DeMeester-positive group. Awakening was the most frequent occurrence at GER onset and during the 1-min period preceding 38% of the nocturnal GER. Sleep stage 2 was also prevalent and preceded 36% of GER events. In the DeMeester-negative group, awakening was the most frequent response before and during GER. Modifications in sleep stages, arousals or awakenings were associated with 75% of the total GER events analyzed during the period of one minute before and after the fall of esophageal pH below 4 in the DeMeester-positive group. These data provide evidence that sleep modifications precede the GER events in asthmatic patients.

  9. Alteration of airway responsiveness mediated by receptors in ovalbumin-induced asthmatic E3 rats

    Institute of Scientific and Technical Information of China (English)

    Jing-wen LONG; Xu-dong YANG; Lei CAO; She-min LU; Yong-xiao CAO

    2009-01-01

    Aim:Airway hyperresponsiveness is a constant feature of asthma.The aim of the present study was to investigate airway hyperreactivity mediated by contractile and dilative receptors in an ovalbumin (OVA)-induced model of rat asthma.Methods:Asthmatic E3 rats were prepared by intraperitoneal injection with OVA/aluminum hydroxide and then challenged with intranasal instillation of OVA-PBS two weeks later.The myograph method was used to measure the responses of constriction and dilatation in the trachea,main bronchi and lobar bronchi.Results:In asthmatic E3 rata,β2 adrenoceptor-mediated relaxation of airway smooth muscle pre-contracted with 5-HT was inhibited,and there were no obvious difference in relaxation compared with normal E3 rats.Contraction of lobar bronchi mediated by 5-HT and sarafotoxin 6c was more potent than in the trachea or main bronchi.Airway contractions mediated by the endothelin (ET)A receptor,ETB receptor and M3 muscarinic receptor were augmented,and the augmented contraction was most obvious in lobar bronchi.The order of efficacy of contraction for lobar bronchi induced by agonists was ET-1,sarafotoxin 6c>ACh>5-HT.OX8 (an antibody against CD8+ T cells) strongly shifted and 0X35 (an antibody against CD4+ T cells) modestly shifted isoprenaline-induced concentration-relaxation curves in a nonparallel fashion to the left with an increased Rmax in asthmatic rats and sarafotoxin 6c-induced concentration-contractile curves to the right with a decreased Emax.Conclusion:The inhibition of airway relaxation and the augmentation of contraction mediated by receptors contribute to airway hyperresponsiveness and involve CD8+ and CD4+ T cells.

  10. Effect of omeprazole and domperidone on adult asthmatics with gastroesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    Bhavneesh Sharma; Manisha Sharma; Mradul Kumar Daga; Gopal Krishan Sachdev; Elliott Bondi

    2007-01-01

    AIM: To study the effect of combined omeprazole(Ome) and domperidone(Dom) therapy on asthma symptoms and pulmonary function in asthmatics with gastroesoph ageal reflux.METHODS: We selected 198 asthmatics with gastro esophageal reflux diagnosed by 24-h esophageal pH moni toring to receive Ome 20 mg twice daily and Dom 10 mg three times daily or placebo for 16 wk (1:1 double-blind randomization). Spirometry was done at baseline and af ter 16 wk of treatment. The primary outcome measures were: mean daily daytime and nighttime asthma symp tom scores. Mean daily reflux symptom scores, albuterol use as rescue medication (number of puffs), daytime and nighttime peak expiratory flow rate (PEFR), postbroncho dilator forced expiratory volume in 1 second (FEV1) and postbronchodilator forced vital capacity (FVC) were sec ondary outcome measures.RESULTS: Comparison of mean change from baseline between antireflux therapy and placebo groups revealed significant reduction in daytime asthma symptom score (17.4% vs 8.9 %), nighttime asthma symptom score (19.6% vs 5.4%), reflux symptom score (8.7% vs 1.6%) and rescue medication use (23.2% vs 3.1%) after antire flux therapy compared to mean change in placebo group (P < 0.001). There was significant improvement in morn ing PEFR (7.9% vs 0.2%), evening PEFR (9.8% vs 0.5%), FEV1 (11.1% vs 3.78%) and FVC (9.3% vs 1.52%) in the antireflux therapy group compared to placebo on comparing the mean change from baseline after 16 wk (P < 0.01).CONCLUSION: Combined therapy with Ome and Dom in adult asthmatics with gastroesophageal reflux may be beneficial by reducing asthma symptoms, rescuing medi cation use, and improving pulmonary function.

  11. Assessment of asthmatic inflammation using hybrid fluorescence molecular tomography-x-ray computed tomography

    Science.gov (United States)

    Ma, Xiaopeng; Prakash, Jaya; Ruscitti, Francesca; Glasl, Sarah; Stellari, Fabio Franco; Villetti, Gino; Ntziachristos, Vasilis

    2016-01-01

    Nuclear imaging plays a critical role in asthma research but is limited in its readings of biology due to the short-lived signals of radio-isotopes. We employed hybrid fluorescence molecular tomography (FMT) and x-ray computed tomography (XCT) for the assessment of asthmatic inflammation based on resolving cathepsin activity and matrix metalloproteinase activity in dust mite, ragweed, and Aspergillus species-challenged mice. The reconstructed multimodal fluorescence distribution showed good correspondence with ex vivo cryosection images and histological images, confirming FMT-XCT as an interesting alternative for asthma research.

  12. Expression of Interleukin-17 in Lung and Peripheral Blood of Asthmatic Rats and the Influence of Dexamethasone

    Institute of Scientific and Technical Information of China (English)

    XIONG Weining; ZENG Daxiong; XU Yongjian; FANG Huijuan; CAO Yong; SONG Qingfeng; CAO Chao

    2007-01-01

    The expression of interleukin-17 (IL-17) in lung and peripheral blood of asthmatic rats and the influence of dexamethasone, and the role of IL-17 in the pathogenesis of asthma were inves-tigated. Thirty Sprague-Dawley (SD) adult rats were randomly divided into three groups (n=10 in each group): normal group, asthmatic group, and dexamethasone-interfered group. Rat asthmatic model was established by intraperitoneal (I.p.) injection of 10% ovalbumin (OVA) and challenge with 1% OVA via inhalation. Rats in dexamethasone-interfered group were pretreated with dexa-methasone (2 mg/kg, I.p.) 30 rain before each challenge. The expression of IL-17 protein in serum and bronchoalveolar lavage fluid (BALF) was detected by ELISA. The expression of IL-17 mRNA in peripheral blood mononuclear cells (PBMC) and BALF cells was semi-quantitatively detected by RT-PCR. The expression of IL-17 protein in serum and BALF of asthmatic rats was significantly elevated as compared with normal rats and dexamethsone-interfered rats (P<0.01), and there was sig- nificant difference between normal rats and dexamethsone-interfered rats (P<0.05). The expression of IL-17 mRNA in PBMC and BALF cells of asthmatic rats was markedly increased as compared with normal rats and dexamethsone-interfered rats (P<0.01), and significant difference was found between normal rats and dexamethsone-interfered rats (P<0.05). It was concluded that the expression of IL-17 was increased significantly in asthmatic rats and could be inhibited partly by dexamethasone, sug-gesting that IL-17 might play an important role in the pathogenesis of asthma as an inflammation regulation factor.

  13. Role of extracellular signal-regulated kinase in regulating expression of interleukin 13 in lymphocytes from an asthmatic rat model

    Institute of Scientific and Technical Information of China (English)

    LI Yuan-yuan; LIU Xian-sheng; LIU Chang; XU Yong-jian; XIONG Wei-xing

    2010-01-01

    Background The extracellular signal-regulated kinase (ERK) is widely expressed in mammal cells and involved in airway proliferation and remodeling in asthma. In this study, we intend to explore the role of ERK in the expression of the Th2 cytokine, interleukin 13 (IL-13) in lymphocytes in asthma.Methods Forty Sprague-Dawley rats were randomly divided into two groups: normal control and asthmatic groups. Peripheral blood lymphocytes were isolated and purified from the blood of each rat and divided into five groups: control, asthmatic lymphocytes, asthmatic cells stimulated with ERK activator epidermal growth factor (EGF), or with ERK inhibitor PD98059, or with EGF and PD98059 together. The expression of phosphorylated-ERK (p-ERK) was observed by immunocvtochemical staining, the expression of ERK mRNA was determined by reverse transcriptase-PCR, IL-13 protein in supernatants was measured by ELISA.Results (1) The ERK mRNA level and the percentage of cells with p-ERK in lymphocytes from asthmatic rats were significantly higher than those in normal controls, and were significantly increased by EGF administration. This effect of EGF was significantly inhibited by PD98059 pretreatment. (2) IL-13 protein in supematants of asthmatic lymphocytes was higher than that produced by normal control lymphocytes, and was significantly increased by EGF treatment. This EGF effect was partly blocked by PD98059 pretreatment. (3) There was a significant positive correlation between the percentage of cells with p-ERK in peripheral blood lymphocytes and IL-13 protein in supematants of lymphocytes from asthmatic rats.Conclusions In asthma the ERK expression and activation levels were increased, as was the protein level of IL-13. The ERK signaling pathway may be involved in the increased expression of the Th2 cytokine IL-13 in asthma.

  14. Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey

    Science.gov (United States)

    Ozkaya, Emin; Sogut, Ayhan; Küçükkoç, Mehmet; Eres, Mustafa; Acemoglu, Hamit; Yuksel, Hasan; Murat, Naci

    2015-11-01

    Variability in children's allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6-15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [ p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67-6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [ p = 0.00, OR 2.6 (CI 1.79-3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma.

  15. Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey.

    Science.gov (United States)

    Ozkaya, Emin; Sogut, Ayhan; Küçükkoç, Mehmet; Eres, Mustafa; Acemoglu, Hamit; Yuksel, Hasan; Murat, Naci

    2015-11-01

    Variability in children's allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6-15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67-6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [p = 0.00, OR 2.6 (CI 1.79-3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma.

  16. What Clinicians Need to Know about Bilingual Development.

    Science.gov (United States)

    Hoff, Erika; Core, Cynthia

    2015-05-01

    Basic research on bilingual development suggests several conclusions that can inform clinical practice with children from bilingual environments. They include the following: (1) Dual language input does not confuse children. (2) It is not necessary for the two languages to be kept separate in children's experience to avoid confusion. (3) Learning two languages takes longer than learning one; on average, bilingual children lag behind monolingual children in single language comparisons. (4) A dominant language is not equivalent to an only language. (5) A measure of total vocabulary provides the best indicator of young bilingual children's language learning capacity. (6) Bilingual children can have different strengths in each language. (7) The quantity and quality of bilingual children's input in each language influence their rates of development in each language. (8) Immigrant parents should not be discouraged from speaking their native language to their children. (9) Bilingual environments vary enormously in the support they provide for each language, with the result that bilingual children vary enormously in their dual language skills. Empirical findings in support of each conclusion are presented.

  17. Long-term asthma treatment guided by airway hyperresponsiveness in children : a randomised controlled trial

    NARCIS (Netherlands)

    Nuijsink, M.; Hop, W. C. J.; Sterk, P. J.; Duiverman, E. J.; de Jorgste, J. C.

    2007-01-01

    Management plans for childhood asthma show limited success in optimising asthma control. The aim of the present study was to assess whether a treatment strategy guided by airway hyperresponsiveness (AHR) increased the number of symptom-free days and improved lung function in asthmatic children, comp

  18. Exhaled nitric oxide predicts airway hyper-responsiveness to hypertonic saline in children that wheeze

    NARCIS (Netherlands)

    de Meer, G; van Amsterdam, JGC; Janssen, NAH; Meijer, E; Brunekreef, B; STEERENBERG, PA

    2005-01-01

    Background: Exhaled nitric oxide (eNO) has shown good validity for the assessment of airway inflammation in asthmatic children. In large-scale epidemiological studies, this method would be preferred above airway challenge tests, because it is a quick and easy applicable tool. Objective: In this stud

  19. Selection of suitable housekeeping genes for real-time quantitative PCR in CD4(+ lymphocytes from asthmatics with or without depression.

    Directory of Open Access Journals (Sweden)

    Ting Wang

    Full Text Available OBJECTIVE: No optimal housekeeping genes (HKGs have been identified for CD4(+ T cells from non-depressive asthmatic and depressive asthmatic adults for normalizing quantitative real-time PCR (qPCR assays. The aim of present study was to select appropriate HKGs for gene expression analysis in purified CD4(+ T cells from these asthmatics. METHODS: Three groups of subjects (Non-depressive asthmatic, NDA, n = 10, Depressive asthmatic, DA, n = 11, and Healthy control, HC, n = 10 respectively were studied. qPCR for 9 potential HKGs, namely RNA, 28S ribosomal 1 (RN28S1, ribosomal protein, large, P0 (RPLP0, actin, beta (ACTB, cyclophilin A (PPIA, glyceraldehyde-3-phosphate dehydrogenase (GAPDH, phosphoglycerate kinase 1 (PGK1, beta-2-microglobulin (B2M, glucuronidase, beta (GUSB and ribosomal protein L13a (RPL13A, was performed. Then the data were analyzed with three different applications namely BestKeeper, geNorm, and NormFinder. RESULTS: The analysis of gene expression data identified B2M and RPLP0 as the most stable reference genes and showed that the level of PPIA was significantly different among subjects of three groups when the two best HKGs identified were applied. Post-hoc analysis by Student-Newman-Keuls correction shows that depressive asthmatics and non-depressive asthmatics exhibited lower expression level of PPIA than healthy controls (p<0.05. CONCLUSIONS: B2M and RPLP0 were identified as the most optimal HKGs in gene expression studies involving human blood CD4(+ T cells derived from normal, depressive asthmatics and non-depressive asthmatics. The suitability of using the PPIA gene as the HKG for such studies was questioned due to its low expression in asthmatics.

  20. Inhaled corticosteroid treatment modulates ZNF432 gene variant's effect on bronchodilator response in asthmatics

    Science.gov (United States)

    Wu, Ann C.; Himes, Blanca E.; Lasky-Su, Jessica; Litonjua, Augusto; Peters, Stephen P.; Lima, John; Kubo, Michiaki; Tamari, Mayumi; Nakamura, Yusuke; Qiu, Weiliang; Weiss, Scott T.; Tantisira, Kelan

    2013-01-01

    Background Single nucleotide polymorphisms (SNPs) influence a patient's response to inhaled corticosteroids and β2-agonists, and the effect of treatment with inhaled corticosteroids is synergistic with the effect of β2-agonists. We hypothesized that use of inhaled corticosteroids could influence the effect of SNPs associated with bronchodilator response. Objective To assess whether, among asthma subjects, the association of SNPs with bronchodilator response is different between those treated with inhaled corticosteroids vs. those on placebo. Methods A genome-wide association analysis was conducted using 581 white subjects from the Childhood Asthma Management Program (CAMP). Using data for 449,540 SNPs, we conducted a gene by environment analysis in PLINK with inhaled corticosteroid treatment as the environmental exposure and bronchodilator response as the outcome measure. We attempted to replicate the top 12 SNPs in the Leukotriene Modifier Or Corticosteroid or Corticosteroid-Salmeterol (LOCCS) Trial. Results The combined P-value for the CAMP and LOCCS populations was 4.81E-08 for rs3752120, which is located in the zinc finger protein gene ZNF432, and has unknown function. Conclusions Inhaled corticosteroids appear to modulate the association of bronchodilator response with variant(s) in the ZNF432 gene among adults and children with asthma. Clinical Implications Clinicians who treat asthma patients with inhaled corticosteroids should be aware that the patient's genetic makeup likely influences response as measured in lung function. Capsule Summary Our study suggests that inhaled corticosteroids could influence the effect of multiple SNPs associated with bronchodilator response across the genome. PMID:24280104

  1. Turnaround Time (TAT): Difference in Concept for Laboratory and Clinician.

    Science.gov (United States)

    Pati, Hara P; Singh, Gurmeet

    2014-06-01

    Lab investigations are essential in patient management and qualities of the tests reports are emphasized. But there is another aspect of quality which is often overlooked and that is timeliness which is expressed as turnaround time (TAT). Mostly the laboratory services are directed at providing a rapid, reliable report at a reasonable cost. However, most laboratories put undue stress on only reliability, where as the clinician gives more stress on how soon (TAT) a report would be available to them. There is no clear definition of TAT, as to which period should be included in determining TAT for a specific test. For laboratory personnel, it would be from the time of receipt of sample in laboratory till report is generated. However, for a clinician, it would appropriate from the time of his/her requisition of a test till the report reaches him/her. The TAT would not be similar for routine tests versus in STAT/urgent tests. TAT would be different for ICU/emergency services. The causes of poor satisfaction level from lab users includes stat and routine test TAT and stat test TAT is considered by majority as the most important indicator of laboratories functioning. Hospital computerization with record of time from test request, sample collection, report generation and receipt of report by clinician would help in generating TAT. Analyzing outliers in TAT in a lab gives insight of causes delay in TAT and the areas need improvement. Laboratories in developing countries are yet to use TAT and analyze them for laboratory improvement. PMID:24839360

  2. The Translation Evidence Mechanism. The Compact between Researcher and Clinician.

    Science.gov (United States)

    Bauer, Janet G; Chiappelli, Francesco

    2010-01-01

    Currently, best evidence is a concentrated effort by researchers. Researchers produce information and expect that clinicians will implement their advances in improving patient care. However, difficulties exist in maximizing cooperation and coordination between the producers, facilitators, and users (patients) of best evidence outcomes. The Translational Evidence Mechanism is introduced to overcome these difficulties by forming a compact between researcher, clinician and patient. With this compact, best evidence may become an integral part of private practice when uncertainties arise in patient health status, treatments, and therapies. The mechanism is composed of an organization, central database, and decision algorithm. Communication between the translational evidence organization, clinicians and patients is through the electronic chart. Through the chart, clinical inquiries are made, patient data from provider assessments and practice cost schedules are collected and encrypted (HIPAA standards), then inputted into the central database. Outputs are made within a timeframe suitable to private practice and patient flow. The output consists of a clinical practice guideline that responds to the clinical inquiry with decision, utility and cost data (based on the "average patient") for shared decision-making within informed consent. This shared decision-making allows for patients to "game" treatment scenarios using personal choice inputs. Accompanying the clinical practice guideline is a decision analysis that explains the optimized clinical decision. The resultant clinical decision is returned to the central database using the clinical practice guideline. The result is subsequently used to update current best evidence, indicate the need for new evidence, and analyze the changes made in best evidence implementation. When updates in knowledge occur, these are transmitted to the provider as alerts or flags through patient charts and other communication modalities. PMID

  3. End points in dermatologic clinical trials: A review for clinicians.

    Science.gov (United States)

    Wei, Erin X; Kirsner, Robert S; Eaglstein, William H

    2016-07-01

    Clinical trials are critical for the development of new therapies in dermatology, and their results help determine US Food and Drug Administration (FDA) approval and guide care. Of special relevance is the clinical trial efficacy end point, the metric from which statistically significant outcome is derived. Clinicians' understanding of a clinical trial's end point is necessary for critical analysis of the trial results and for applying those results to daily practice. This review provides practical knowledge and critical evaluation of end points used in treatment approvals by the FDA. The end points for actinic keratosis, acne vulgaris, atopic dermatitis, onychomycosis, and cutaneous ulcer serve as examples. PMID:26936300

  4. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

    Institute of Scientific and Technical Information of China (English)

    Bong; Sik; Matthew; Kim; Bob; T; Li; Alexander; Engel; Jaswinder; S; Samra; Stephen; Clarke; Ian; D; Norton; Angela; E; Li

    2014-01-01

    Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is notapparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.

  5. Correlation among regional ventilation, airway resistance and particle deposition in normal and severe asthmatic lungs

    Science.gov (United States)

    Choi, Sanghun; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

    2012-11-01

    Computational fluid dynamic simulations are performed to investigate flow characteristics and quantify particle deposition with normal and severe asthmatic lungs. Continuity and Navier-Stokes equations are solved with unstructured meshes and finite element method; a large eddy simulation model is adopted to capture turbulent and/or transitional flows created in the glottis. The human airway models are reconstructed from CT volumetric images, and the subject-specific boundary condition is imposed to the 3D ending branches with the aid of an image registration technique. As a result, several constricted airways are captured in CT images of severe asthmatic subjects, causing significant pressure drop with high air speed because the constriction of airways creates high flow resistance. The simulated instantaneous velocity fields obtained are then employed to track transport and deposition of 2.5 μm particles. It is found that high flow resistance regions are correlated with high particle-deposition regions. In other words, the constricted airways can induce high airway resistance and subsequently increase particle deposition in the regions. This result may be applied to understand the characteristics of deposition of pharmaceutical aerosols or bacteria. This work was supported in part by NIH grants R01-HL094315 and S10-RR022421.

  6. Montelukast modulates lung CysLT1 receptor expression and eosinophilic inflammation in asthmatic mice

    Institute of Scientific and Technical Information of China (English)

    Yan-jun ZHANG; Lei ZHANG; Shao-bin WANG; Hua-hao SHEN; Er-qing WEI

    2004-01-01

    AIM: To determine the expressions of cysteinyl leukotriene receptors, CysLT1 and CysLT2, in airway eosinophilic inflammation of OVA-induced asthmatic mice and the modulation by montelukast, a CysLT1 receptor antagonist.METHODS: Asthma model was induced by chronic exposure to ovalbumin (OVA) in C57BL/6 mice. The eosinophils in bronchoalveolar lavage (BAL) fluid and lung tissues were counted, IL-5 level in BAL fluid was measured,and CysLT1 and CysLT2 receptor mRNA expressions were detected by semi-quantitative RT-PCR. RESULTS:Montelukast (6 mg/kg, once per day for 20 d) significantly suppressed the increased eosinophils in BAL fluid and lung tissue, and increased IL-5 level in BAL fluid in OVA challenged mice. OVA challenge increased CysLT1 but decreased CysLT2 receptor mRNA expression. Montelukast inhibited the increased CysLT1 but not the reduced CysLT2 expression after OVA challenge. CONCLUSION: CysLT receptors are modulated immunologically, and montelukast inhibits up-regulation of CysLT1 receptor and airway eosinophilic inflammation in asthmatic mice.

  7. Leucocyte kinesis in blood, bronchoalveoli and nasal cavities during late asthmatic responses in guinea-pigs.

    Science.gov (United States)

    Nabe, T; Shinoda, N; Yamashita, K; Yamamura, H; Kohno, S

    1998-03-01

    Recently, we reported a reproducible model of asthma in guinea-pigs in vivo, which developed a late asthmatic response (LAR) as well as an early response. In this study, time-related changes in the occurrence of the LAR and leucocyte kinesis were assessed. Furthermore, the state of the activation of eosinophils that migrated into the lower airways was characterized in vitro. Guinea-pigs were alternately sensitized/challenged by inhalation with aerosolized ovalbumin adsorbed on aluminium hydroxide and ovalbumin alone, once every 2 weeks. At defined times before and after the fifth challenge, airway resistance was measured, blood was drawn and bronchoalveolar lavage (BAL) and nasal cavity lavage (NCL) were performed. Superoxide anion (.O2-) production of eosinophils was measured with cytochrome c. Occurrence of LAR and considerable increases in circulating eosinophils coincided with each other 5-7 h after the challenge. After 7 h, eosinophil infiltrations into bronchoalveolar spaces were observed. The capacity of eosinophils from the sensitized animals to produce .O2- was higher than those from the non-sensitized ones, when eosinophils were stimulated by platelet-activating factor. Although an increased number of eosinophils in the NCL fluid was observed, it was much less than that in the BAL fluid. Thus, it has been concluded that eosinophilia in the blood and the lung may participate in the occurrence of the late asthmatic response, which is thought to be preferentially evoked in the lower airways in guinea-pigs in vivo.

  8. Transformation of adrenal medullary chromaffin cells increases asthmatic susceptibility in pups from allergen-sensitized rats

    Directory of Open Access Journals (Sweden)

    Feng Jun-Tao

    2012-11-01

    Full Text Available Abstract Background Studies have shown that epinephrine release is impaired in patients with asthma. The pregnancy of female rats (dams with asthma promotes in their pups the differentiation of adrenal medulla chromaffin cells (AMCCs into sympathetic neurons, mediated by nerve growth factor, which leads to a reduction in epinephrine secretion. However, the relatedness between the alteration of AMCCs and increased asthma susceptibility in such offspring has not been established. Methods In this study, we observed the effects of allergization via ovalbumin on rat pups born of asthmatic dams. Results Compared to the offspring of untreated controls, bronchial hyperreactivity and airway inflammation were more severe in the pups from sensitized (asthmatic dams. In pups exposed to nerve growth factor (NGF in utero these effects were aggravated further, but the effects were blocked in pups whose dams had been treated with anti-NGF. Furthermore, alterations in AMCC phenotype corresponded to the degree of bronchial hyperreactivity and lung lesions of the different treatment groups. Such AMCC alterations included degranulation of chromaffin granules, reduction of epinephrine and phenylethanolamine-n-methyl transferase, and elevation of NGF and peripherin levels. Conclusions Our results present evidence that asthma during the pregnancy of rat dams promotes asthma susceptibility in their offspring, and that the transformation of AMCCs to neurons induced by NGF plays an important role in this process.

  9. Is Health-Related Quality of Life Associated with Upper and Lower Airway Inflammation in Asthmatics?

    Directory of Open Access Journals (Sweden)

    Nicola Scichilone

    2013-01-01

    Full Text Available Background. Allergic diseases impair health-related quality of life (HR-QoL. However, the relationship between airway inflammation and HR-QoL in patients with asthma and rhinitis has not been fully investigated. We explored whether the inflammation of upper and lower airways is associated with HR-QoL. Methods. Twenty-two mild allergic asthmatics with concomitant rhinitis (10 males, 38 ± 17 years were recruited. The Rhinasthma was used to identify HR-QoL, and the Asthma Control Test (ACT was used to assess asthma control. Subjects underwent lung function and exhaled nitric oxide (eNO test, collection of exhaled breath condensate (EBC, and nasal wash. Results. The Rhinasthma Global Summary score (GS was 25 ± 11. No relationships were found between GS and markers of nasal allergic inflammation (% eosinophils: , ; ECP: , or bronchial inflammation (pH of the EBC: , ; bronchial NO: , ; alveolar NO: , . The mean ACT score was 18. When subjects were divided into controlled (ACT ≥ 20 and uncontrolled (ACT < 20, the alveolar NO significantly correlated with GS in uncontrolled asthmatics (, . Conclusions. Upper and lower airways inflammation appears unrelated to HR-QoL associated with respiratory symptoms. These preliminary findings suggest that, in uncontrolled asthma, peripheral airway inflammation could be responsible for impaired HR-QoL.

  10. Metabolism in vitro of leukotriene B4 in blood of normal subjects and asthmatic patients

    International Nuclear Information System (INIS)

    The metabolism of exogenous leukotriene B4 (LTB4) was investigated in venous blood obtained from normal and asthmatic subjects. Using specific radioimmunoassay (RIA) and reverse-phase high performance liquid chromatography (RP-HPLC) techniques we have demonstrated that LTB4 is relatively stable during a 2 hr incubation period at 37 degrees C in our system in vitro. Nevertheless, chromatographic analysis revealed the presence of two products which had retention times identical to 20-hydroxy LTB4 (20-0H LTB4) and 20-carboxy LTB4 (20-C00H LTB4) in which the dicarboxylic derivative was the main metabolite present after 15 min incubation. The amount of LTB4 and its w-oxidation products observed after a 2 hr incubation period was 73% and 24% respectively. There was no basal release of LTB4 from blood. The appearance of these oxidative products was totally suppressed at 4 degrees C and with incubations performed with either venous plasma or Hartmann's control. No significant difference was observed in substrate metabolism between normal and asthmatic subjects. Our results demonstrate that LTB4 is slowly degraded in human whole blood through a cellular dependent process of w-oxidation which may be an important pathway for regulating the availability of this potent biologically active substance

  11. The biotransformation in vitro of cysteinyl leukotrienes in blood of normal and asthmatic subjects

    Energy Technology Data Exchange (ETDEWEB)

    Zakrzewski, J.T.; Sampson, A.P.; Evans, J.M.; Barnes, N.C.; Piper, P.J.; Costello, J.F. (King' s College School of Medicine and Dentistry, Denmark Hill, London (England))

    1989-04-01

    The metabolism of exogenous leukotriene C4 (LTC4), LTD4 and LTE4 (10(-8) M) was studied in vitro in blood of normal and asthmatic subjects for up to 2 hr by reverse-phase high performance liquid chromatography. In whole blood, incubation of LTC4 (T1/2 = 11.5 min) resulted in the formation of LTD4 and LTE4 whose biosynthesis was inhibited by serine borate (30 mM). Similar experiments performed with LTD4 (T1/2 = 5 min) produced a single metabolite (LTE4) which was inhibited by L-cysteine (10 mM). On the other hand, LTE4 represented a highly stable product in our in vitro system. The bioconversion of LTC4 or LTD4 was slower in plasma but this effect appeared more pronounced for the cysteinylglycinyl derivative. The bioconversion of LTD4 in whole blood or plasma was almost twice as rapid as LTC4. Experiments performed with asthmatic blood showed no significant difference in the survival of LTC4. These results suggest that blood may play a role in regulating the bioavailability of cysteinyl-containing LTs which could be of relevance to their excretion in man.

  12. Requirements for the formal representation of pathophysiology mechanisms by clinicians.

    Science.gov (United States)

    de Bono, B; Helvensteijn, M; Kokash, N; Martorelli, I; Sarwar, D; Islam, S; Grenon, P; Hunter, P

    2016-04-01

    Knowledge of multiscale mechanisms in pathophysiology is the bedrock of clinical practice. If quantitative methods, predicting patient-specific behaviour of these pathophysiology mechanisms, are to be brought to bear on clinical decision-making, the Human Physiome community and Clinical community must share a common computational blueprint for pathophysiology mechanisms. A number of obstacles stand in the way of this sharing-not least the technical and operational challenges that must be overcome to ensure that (i) the explicit biological meanings of the Physiome's quantitative methods to represent mechanisms are open to articulation, verification and study by clinicians, and that (ii) clinicians are given the tools and training to explicitly express disease manifestations in direct contribution to modelling. To this end, the Physiome and Clinical communities must co-develop a common computational toolkit, based on this blueprint, to bridge the representation of knowledge of pathophysiology mechanisms (a) that is implicitly depicted in electronic health records and the literature, with (b) that found in mathematical models explicitly describing mechanisms. In particular, this paper makes use of a step-wise description of a specific disease mechanism as a means to elicit the requirements of representing pathophysiological meaning explicitly. The computational blueprint developed from these requirements addresses the Clinical community goals to (i) organize and manage healthcare resources in terms of relevant disease-related knowledge of mechanisms and (ii) train the next generation of physicians in the application of quantitative methods relevant to their research and practice.

  13. Understanding Economic Evaluation: A Policy Perspective for Clinicians

    Directory of Open Access Journals (Sweden)

    M Giacomini

    1997-01-01

    Full Text Available The rhetoric of ‘efficiency’ frames much current debate about how limited health care resources should be used. Clinicians increasingly turn to economic evaluation literature to discern evidence-based claims of ‘efficiency’ or ‘cost effectiveness’ from empty ones. Economic evaluation research is designed to compare health services on the basis of their efficiency (eg, how well they produce health benefits relative to resource costs. Although economic studies appear throughout the respirology literature, relatively few are complete economic evaluations. Economic evaluation studies serve various purposes, including critical evaluation and persuasive marketing, which produce studies that vary in research agendas and scientific rigour. This paper is intended to serve clinicians and consumers of economic evaluation studies by: introducing economic evaluation research information as a policy making tool; describing the three basic elements and three basic types of economic evaluation (cost-benefit, cost-effectiveness, and cost-utility analyses; and reviewing some limitations of economic evaluation information for policy decision making. The usefulness of economic evaluation research for policy making depends not only on the scientific merit of the analysis but also crucially on whose specific concerns the research questions address.

  14. The Canadian clinician-scientist training program must be reinstated.

    Science.gov (United States)

    Twa, David D W; Squair, Jordan W; Skinnider, Michael A; Ji, Jennifer X

    2015-12-01

    Clinical investigators within the Canadian and international communities were shocked when the Canadian Institutes of Health Research (CIHR) announced that their funding for the MD/PhD program would be terminated after the 2015-2016 academic year. The program has trained Canadian clinician-scientists for more than two decades. The cancellation of the program is at odds with the CIHR's mandate, which stresses the translation of new knowledge into improved health for Canadians, as well as with a series of internal reports that have recommended expanding the program. Although substantial evidence supports the analogous Medical Scientist Training Program in the United States, no parallel analysis of the MD/PhD program has been performed in Canada. Here, we highlight the long-term consequences of the program's cancellation in the context of increased emphasis on translational research. We argue that alternative funding sources cannot ensure continuous support for students in clinician-scientist training programs and that platform funding of the MD/PhD program is necessary to ensure leadership in translational research. PMID:26529253

  15. Requirements for the formal representation of pathophysiology mechanisms by clinicians.

    Science.gov (United States)

    de Bono, B; Helvensteijn, M; Kokash, N; Martorelli, I; Sarwar, D; Islam, S; Grenon, P; Hunter, P

    2016-04-01

    Knowledge of multiscale mechanisms in pathophysiology is the bedrock of clinical practice. If quantitative methods, predicting patient-specific behaviour of these pathophysiology mechanisms, are to be brought to bear on clinical decision-making, the Human Physiome community and Clinical community must share a common computational blueprint for pathophysiology mechanisms. A number of obstacles stand in the way of this sharing-not least the technical and operational challenges that must be overcome to ensure that (i) the explicit biological meanings of the Physiome's quantitative methods to represent mechanisms are open to articulation, verification and study by clinicians, and that (ii) clinicians are given the tools and training to explicitly express disease manifestations in direct contribution to modelling. To this end, the Physiome and Clinical communities must co-develop a common computational toolkit, based on this blueprint, to bridge the representation of knowledge of pathophysiology mechanisms (a) that is implicitly depicted in electronic health records and the literature, with (b) that found in mathematical models explicitly describing mechanisms. In particular, this paper makes use of a step-wise description of a specific disease mechanism as a means to elicit the requirements of representing pathophysiological meaning explicitly. The computational blueprint developed from these requirements addresses the Clinical community goals to (i) organize and manage healthcare resources in terms of relevant disease-related knowledge of mechanisms and (ii) train the next generation of physicians in the application of quantitative methods relevant to their research and practice. PMID:27051514

  16. Eye dosimetry and protective eye wear for interventional clinicians

    International Nuclear Information System (INIS)

    Doses to the eyes of interventional clinicians can exceed 20 mSv. Various protective devices can afford protection to the eyes with the final barrier being protective eye wear. The protection provided by lead glasses is difficult to quantify, and the majority of dosimeters are not designed to be worn under lead glasses. This study has measured dose reduction factors (DRFs) equal to the ratio of the dose with no protection, divided by that when lead glasses are worn. Glasses have been tested in X-ray fields using anthropomorphic phantoms to simulate the patient and clinician. DRFs for X-rays incident from the front vary from 5.2 to 7.6, while values for orientations reminiscent of clinical practice are between 1.4 and 5.2. Results suggest that a DRF of two is a conservative factor that could be applied to personal dosimeter measurements to account for the dose reduction provided by most types of lead glasses. (authors)

  17. Prevalence and Treatment of Children's Asthma in Rural Areas Compared with Urban Areas in Beijing

    Institute of Scientific and Technical Information of China (English)

    Wen-Jing Zhu; Hai-Xia Ma; Hui-Ying Cui; Xu Lu; Ming-Jun Shao; Shuo Li; Yan-Qing Luo

    2015-01-01

    Background:The prevalence of childhood asthma has been increasing in China.This study aimed to compare the prevalence,diagnosis,and treatment of asthmatic children from urban and rural areas in Beijing,China.Methods:Schools,communities,and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing.Parents were surveyed by the same screening questionnaires.On-the-spot inquiries,physical examinations,medical records,and previous test results were used to diagnose asthmatic children.Information on previous diagnoses,treatments,and control of symptoms was obtained.Results:From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires,587 children were diagnosed as asthma.The prevalence of asthma in rural areas was lower than in urban areas (1.25% vs.3.68%,x2 =100.80,P < 0.001).The diagnosis of asthma in rural areas was lower than in urban areas (48.9% vs.73.9%,x2 =34.6,P < 0.001).Compared with urban asthmatic children (56.5%),only 35.6% of rural asthmatic children received inhaled corticosteroids (P < 0.05).The use ofbronchodilators was also lower in rural areas than in urban areas (56.5% vs.66.4%,x2 =14.2,P < 0.01).Conclusion:The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Beijing.A considerable number of children were not diagnosed and inadequately treated in rural areas.

  18. Different Profile of Interleukin-10 Production in Circulating T Cells from Atopic Asthmatics Compared with Healthy Subjects

    Directory of Open Access Journals (Sweden)

    K Matsumoto

    2004-01-01

    Full Text Available BACKGROUND: Interleukin (IL-10 is a pleiotropic cytokine released from various cells, including T cells. Although IL-10 is suggested to inhibit allergic responses, its role in asthma remains uncertain. The purpose of the present study was to compare the profile of IL-10 in circulating T cells from stable atopic asthmatics, atopic nonasthmatics and healthy controls.

  19. Effect of Smoking Abstinence and Reduction in Asthmatic Smokers Switching to Electronic Cigarettes: Evidence for Harm Reversal

    Directory of Open Access Journals (Sweden)

    Riccardo Polosa

    2014-05-01

    Full Text Available Electronic cigarettes (e-cigs are marketed as safer alternatives to tobacco cigarettes and have shown to reduce their consumption. Here we report for the first time the effects of e-cigs on subjective and objective asthma parameters as well as tolerability in asthmatic smokers who quit or reduced their tobacco consumption by switching to these products. We retrospectively reviewed changes in spirometry data, airway hyper-responsiveness (AHR, asthma exacerbations and subjective asthma control in smoking asthmatics who switched to regular e-cig use. Measurements were taken prior to switching (baseline and at two consecutive visits (Follow-up/1 at 6 (±1 and Follow-up/2 at 12 (±2 months. Eighteen smoking asthmatics (10 single users, eight dual users were identified. Overall there were significant improvements in spirometry data, asthma control and AHR. These positive outcomes were noted in single and dual users. Reduction in exacerbation rates was reported, but was not significant. No severe adverse events were noted. This small retrospective study indicates that regular use of e-cigs to substitute smoking is associated with objective and subjective improvements in asthma outcomes. Considering that e-cig use is reportedly less harmful than conventional smoking and can lead to reduced cigarette consumption with subsequent improvements in asthma outcomes, this study shows that e-cigs can be a valid option for asthmatic patients who cannot quit smoking by other methods.

  20. Airway protease/antiprotease imbalance in atopic asthmatics contributes to increased influenza A virus cleavage and replication

    Science.gov (United States)

    Asthmatics are more susceptible to influenza infections, yet mechanisms mediating this enhanced susceptibility are unknown. Influenza virus hemagglutinin (HA) protein binds to sialic add residues on the host cells. HA requires cleavage to allow fusion of the viral HA with host ce...

  1. Clinician styles of care: transforming patient care at the intersection of leadership and medicine.

    Science.gov (United States)

    Huynh, Ho P; Sweeny, Kate

    2014-11-01

    A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician-patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians' effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care.

  2. Clinician styles of care: transforming patient care at the intersection of leadership and medicine.

    Science.gov (United States)

    Huynh, Ho P; Sweeny, Kate

    2014-11-01

    A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician-patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians' effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care. PMID:23864074

  3. Airway responsiveness to leukotriene C4 (LTC4), leukotriene E4 (LTE4) and histamine in aspirin-sensitive asthmatic subjects.

    Science.gov (United States)

    Christie, P E; Schmitz-Schumann, M; Spur, B W; Lee, T H

    1993-11-01

    We wanted to determine whether the airway response to inhaled leukotriene C4 (LTC4) is similar to inhaled leukotriene E4 (LTE4) in aspirin-sensitive asthma and, therefore, determined airway responsiveness to histamine, LTC4 and LTE4 in seven aspirin-sensitive subjects and 13 control asthmatic subjects, who were tolerant of aspirin. The concentration of inhaled lysine-aspirin which produced a 15% fall in forced expiratory volume in one second (FEV1) (PC15) was determined in aspirin-sensitive asthmatic subjects. The dose of histamine, LTC4 and LTE4 which produced a 35% fall in specific airways conductance (PD35sGaw) was determined by linear interpolation from the log dose response curve. There was no correlation between the PC15 for lysine-aspirin and the airway reactivity to inhaled LTC4 or LTE4. There was no difference in airway response to histamine and LTC4 between any of the groups of asthmatic subjects. There was a rank order of potency LTC4 > LTE4 > histamine in both groups, with LTC4 approximately 1,000 fold more potent than histamine in both groups. Aspirin-sensitive asthmatic subjects were significantly more responsive to LTE4 (p = 0.02) than aspirin-tolerant asthmatic subjects. The relative responsiveness of LTE4 to histamine (PD35 histamine/PD35 LTE4) was significantly greater in aspirin-sensitive asthmatic subjects compared to aspirin-tolerant asthmatic subjects (p = 0.05). There was no difference in relative responsiveness of LTC4 to histamine between aspirin-sensitive or aspirin-tolerant asthmatic subjects. We conclude that the airways of aspirin-sensitive asthmatic subjects demonstrate a selective hyperresponsiveness to LTE4, which is not observed for LTC4. PMID:8112440

  4. Distribution of radioactive aerosol in the airways of children and adolescents with bronchial hyper-responsiveness

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the relationship between the pulmonary distribution of inhaled radioaerosol, bronchial responsiveness, and lung function in children and adolescents. The participating subjects were divided into three groups: (1) 14 asthmatics with bronchial hyper-responsiveness (BHR), (2) five non-asthmatic subjects with BHR, and (3) 20 controls without BHR. Pulmonary distribution of [99Tcm] albumin radioaerosol, maximal expiratory flow when 25% of forced vital capacity remain to be exhaled (MEF25), and bronchial responsiveness to inhaled histamine were measured. Twenty subjects (52%) has irregular central distribution and 19 subjects (48%) had regular distribution of radioaerosol in their lungs. No difference in distribution of radioaerosol was found between the three groups of children. The median MEF25 among non-asthmatic subjects (80% predicted) was lower than that found in controls (92% predicted) but higher than that found in asthmatic subjects (55% predicted). A relationship was found between reduced flow at the peripheral airways, as indicated by MEF25 and the degree of central distribution of radioaerosol. Furthermore, subjects with irregular central distribution of radioaerosol had an increase degree of bronchial responsiveness. In conclusion, children and adolescents who have flow rates in the peripheral airways or increased degree of bronchial responsiveness tend to have abnormal distribution of radioaerosols. (author)

  5. Retrostyloid parapharyngeal space tumors: A clinician and imaging perspective

    International Nuclear Information System (INIS)

    Although tumors of the parapharyngeal space are rare, they represent a formidable diagnostic and treatment challenge. The differentiation of a retrostyloid lesion from a prestyloid lesion is critical for guiding the differential diagnosis. The majority of lesions involving the retrostyloid parapharyngeal space are either peripheral nerve sheath tumors, head and neck paragangliomas or metastatic lymph node metastases. This article provides insights into the many currently available radiological and radionuclide imaging procedures and guides clinicians toward their appropriate use. In the near future, many patients might also benefit from new diagnostic approaches such as high resolution integrated PET/MRI and new tracers that enable “in vivo” assessment of these tumors at molecular level

  6. Oral Syphilis: A Reemerging Infection Prompting Clinicians' Alertness.

    Science.gov (United States)

    Dybeck Udd, Sebastian; Lund, Bodil

    2016-01-01

    Syphilis is a rare but increasing disease. Due to changing sexual habits, presentation of oral manifestations may rise. Since syphilis may mimic other oral manifestations, diagnoses can be difficult. Clinicians need to be aware that ambiguous oral manifestations may in fact be caused by oral syphilis. Here, we present a case of extended diagnostic delay highlighting the importance of consulting an expert in infectious diseases in case of obscure oral lesions not responding to standard treatment. Despite seven visits to six different medical doctors, a patient who presented with oral syphilis was continuously misdiagnosed. After 6 months of increasing complaints and deteriorating severity of disease, the patient was referred to an oral and maxillofacial surgeon where the correct diagnosis was determined and proper treatment initiated. PMID:27293914

  7. Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis

    Directory of Open Access Journals (Sweden)

    Fry Margaret

    2011-09-01

    Full Text Available Abstract Background Venous Thromboembolism (VTE is a cause of hospital mortality and managing its morbidity is associated with significant expenditure. Uptake of evidenced based guideline recommendations intended to prevent VTE in hospital settings is sub-optimal. This study was conducted to explore clinicians' attitudes and the clinical environment in which they work to understand their reluctance to adopt VTE prophylaxis guidelines. Methods Between February and November 2009, 40 hospital employed doctors from 2 Australian metropolitan hospitals were interviewed in depth. Qualitative data were analysed according to thematic methodology. Results Analysis of interviews revealed that barriers to evidence based practice include i the fragmented system of care delivery where multiple members of teams and multiple teams are responsible for each patient's care, and in the case of VTE, where everyone shares responsibility and no-one in particular is responsible; ii the culture of practice where team practice is tailored to that of the team head, and where medicine is considered an 'art' in which guidelines should be adapted to each patient rather than applied universally. Interviewees recommend clear allocation of responsibility and reminders to counteract VTE risk assessment being overlooked. Conclusions Senior clinicians are the key enablers for practice change. They will need to be convinced that guideline compliance adds value to their patient care. Then with the support of systems in the organisation designed to minimize the effects of care fragmentation, they will drive practice changes in their teams. We believe that evidence based practice is only possible with a coordinated program that addresses individual, cultural and organisational constraints.

  8. Symptoms, but Not a Biomarker Response to Inhaled Corticosteroids, Predict Asthma in Preschool Children with Recurrent Wheeze

    Directory of Open Access Journals (Sweden)

    E. M. M. Klaassen

    2012-01-01

    Full Text Available Background. A reliable asthma diagnosis is challenging in preschool wheezing children. As inhaled corticosteroids (ICS are more effective in asthmatics than in children with transient wheeze, an ICS response might be helpful in early asthma diagnosis. Methods. 175 children (aged two–four years with recurrent wheeze received 200 μg Beclomethasone extra-fine daily for eight weeks. Changes in Exhaled Breath Condensate (EBC biomarkers (pH, interleukin (IL-1α, IL-2, IL-4, IL-5, IL-10, IFN-γ, sICAM, and CCL-11, Fractional exhaled Nitric Oxide (FeNO, airway resistance, and symptoms were assessed. At six years of age a child was diagnosed as transient wheezer or asthmatic. Adjusted logistic regression analysis was performed with multiple testing correction. Results. 106 transient wheezers and 64 asthmatics were analysed at six years of age. Neither changes in EBC biomarkers, nor FeNO, airway resistance, or symptoms during ICS trial at preschool age were related to asthma diagnosis at six years of age. However, asthmatics had more airway symptoms before the start of the ICS trial than transient wheezers (P<0.01. Discussion. Although symptom score in preschool wheezing children at baseline was associated with asthma at six years of age, EBC biomarkers, airway resistance, or symptom response to ICS at preschool age could not predict asthma diagnosis at six years of age.

  9. Is asthma in 2-12 year-old children associated with physician-attended recurrent upper respiratory tract infections?

    NARCIS (Netherlands)

    Hak, Eelko; Rovers, Maroeska M; Sachs, Alfred P E; Stalman, Wim A B; Verheij, Theo J M

    2003-01-01

    In a prevalence study, we evaluated whether recurrent physician-attended URTI episodes are more common in asthmatic children as compared to age- and gender-matched controls. URTI proneness, defined as > or = 5 episodes of rhinitis/pharyngitis, sinusitis, laryngitis/tracheitis or otitis media in a 24

  10. Children and chiropractic care

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Hestbaek, Lise

    2009-01-01

    care profession has convincingly assumed the responsibility of spinal and musculoskeletal health for children. Considering the magnitude of the challenges ahead for both researchers and clinicians, this may be a good opportunity for doctors of chiropractic to take responsibility and engage...

  11. Structural and functional rejuvenation of the aged brain by an approved anti-asthmatic drug.

    Science.gov (United States)

    Marschallinger, Julia; Schäffner, Iris; Klein, Barbara; Gelfert, Renate; Rivera, Francisco J; Illes, Sebastian; Grassner, Lukas; Janssen, Maximilian; Rotheneichner, Peter; Schmuckermair, Claudia; Coras, Roland; Boccazzi, Marta; Chishty, Mansoor; Lagler, Florian B; Renic, Marija; Bauer, Hans-Christian; Singewald, Nicolas; Blümcke, Ingmar; Bogdahn, Ulrich; Couillard-Despres, Sebastien; Lie, D Chichung; Abbracchio, Maria P; Aigner, Ludwig

    2015-10-27

    As human life expectancy has improved rapidly in industrialized societies, age-related cognitive impairment presents an increasing challenge. Targeting histopathological processes that correlate with age-related cognitive declines, such as neuroinflammation, low levels of neurogenesis, disrupted blood-brain barrier and altered neuronal activity, might lead to structural and functional rejuvenation of the aged brain. Here we show that a 6-week treatment of young (4 months) and old (20 months) rats with montelukast, a marketed anti-asthmatic drug antagonizing leukotriene receptors, reduces neuroinflammation, elevates hippocampal neurogenesis and improves learning and memory in old animals. By using gene knockdown and knockout approaches, we demonstrate that the effect is mediated through inhibition of the GPR17 receptor. This work illustrates that inhibition of leukotriene receptor signalling might represent a safe and druggable target to restore cognitive functions in old individuals and paves the way for future clinical translation of leukotriene receptor inhibition for the treatment of dementias.

  12. The impact of vitamin D on asthmatic human airway smooth muscle.

    Science.gov (United States)

    Hall, Sannette C; Fischer, Kimberly D; Agrawal, Devendra K

    2016-02-01

    Asthma is a chronic heterogeneous disorder, which involves airway inflammation, airway hyperresponsiveness (AHR) and airway remodeling. The airway smooth muscle (ASM) bundle regulates the broncho-motor tone and plays a critical role in AHR as well as orchestrating inflammation. Vitamin D deficiency has been linked to increased severity and exacerbations of symptoms in asthmatic patients. It has been shown to modulate both immune and structural cells, including ASM cells, in inflammatory diseases. Given that current asthma therapies have not been successful in reversing airway remodeling, vitamin D supplementation as a potential therapeutic option has gained a great deal of attention. Here, we highlight the potential immunomodulatory properties of vitamin D in regulating ASM function and airway inflammation in bronchial asthma. PMID:26634624

  13. Effect of All-trans Retinoic Acid on Airway Inflammation in Asthmatic Rats and Its Mechanism

    Institute of Scientific and Technical Information of China (English)

    方红; 金红芳; 王宏伟

    2004-01-01

    Summary: The inhibitive effects of all-trans retinoic acid (ARTA) on airway inflammation in asthmatic rats and its mechanism on the basis of the regulation of nuclear factor kappaB (NF-κB) were explored. Thirty-two SD rats were randomly divided into 4 groups: control group, asthma group,dexamethasone treatment group and retinotic acid treatment group. The total and differential cell counts in the collected bronchoalveolar lavage fluid (BALF) were measured. The pathological changes in lung tissues were estimated by scoring. The expression of NF-κB inhibitor (IκBa), NF-κB,intercellular adhering molecule-1 (ICAM-1) in lung tissue was detected by immunohistochemical method. The results showed that in the two treatment groups, the total cell counts and proportion of inflammatory cells in BALF were significantly reduced, but there was no significant difference in differential cell counts in BALF between, them. The pathological changes in lung tissues in the treatment groups were significantly attenuated as compared with asthma group. Except the epithelial injury in retinotic acid treatment group was milder than in dexamethasone treatment group, the remaining lesions showed no significant difference between them. In the two treatment groups, the expression of IκBa was increased, while the expression of NF-κB and ICAM-1 decreased with the difference between the two groups being not significant. It was concluded that the similar anti-inflammatory effects and mechanism of ATRA on airway in asthmatic rats to those of dexamethasone were contributed to the increase of cytoplasmic IκBa content and suppression of NF-cB activation and expression.

  14. Do self- reported intentions predict clinicians' behaviour: a systematic review

    Directory of Open Access Journals (Sweden)

    Dickinson Heather O

    2006-11-01

    Full Text Available Abstract Background Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted behaviours, and study settings make generalisation difficult. Therefore, it is necessary to identify the 'active ingredients' in professional behaviour change strategies. Theories of human behaviour that feature an individual's "intention" to do something as the most immediate predictor of their behaviour have proved to be useful in non-clinical populations. As clinical practice is a form of human behaviour such theories may offer a basis for developing a scientific rationale for the choice of intervention to use in the implementation of new practice. The aim of this review was to explore the relationship between intention and behaviour in clinicians and how this compares to the intention-behaviour relationship in studies of non-clinicians. Methods We searched: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Science/Social science citation index, Current contents (social & behavioural med/clinical med, ISI conference proceedings, and Index to Theses. The reference lists of all included papers were checked manually. Studies were eligible for inclusion if they had: examined a clinical behaviour within a clinical context, included measures of both intention and behaviour, measured behaviour after intention, and explored this relationship quantitatively. All titles and abstracts retrieved by electronic searching were screened independently by two reviewers, with disagreements resolved by discussion. Discussion Ten studies were found that examined the relationship between intention and clinical behaviours in 1623 health professionals. The proportion of variance in behaviour explained by

  15. Cardiovascular magnetic resonance physics for clinicians: part I

    Directory of Open Access Journals (Sweden)

    Ridgway John P

    2010-11-01

    Full Text Available Abstract There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinicians using CMR in their daily practice. This is the first of two reviews that are intended to cover the essential aspects of CMR physics in a way that is understandable and relevant to this group. It begins by explaining the basic physical principles of MR, including a description of the main components of an MR imaging system and the three types of magnetic field that they generate. The origin and method of production of the MR signal in biological systems are explained, focusing in particular on the two tissue magnetisation relaxation properties (T1 and T2 that give rise to signal differences from tissues, showing how they can be exploited to generate image contrast for tissue characterisation. The method most commonly used to localise and encode MR signal echoes to form a cross sectional image is described, introducing the concept of k-space and showing how the MR signal data stored within it relates to properties within the reconstructed image. Before describing the CMR acquisition methods in detail, the basic spin echo and gradient pulse sequences are introduced, identifying the key parameters that influence image contrast, including appearances in the presence of flowing blood, resolution and image acquisition time. The main derivatives of these two pulse sequences used for cardiac imaging are then described in more detail. Two of the key requirements for CMR are the need for data acquisition first to be to be synchronised with the subject's ECG and to be

  16. Cardiovascular magnetic resonance physics for clinicians: part I.

    Science.gov (United States)

    Ridgway, John P

    2010-01-01

    There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR) techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR) techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinicians using CMR in their daily practice. This is the first of two reviews that are intended to cover the essential aspects of CMR physics in a way that is understandable and relevant to this group. It begins by explaining the basic physical principles of MR, including a description of the main components of an MR imaging system and the three types of magnetic field that they generate. The origin and method of production of the MR signal in biological systems are explained, focusing in particular on the two tissue magnetisation relaxation properties (T1 and T2) that give rise to signal differences from tissues, showing how they can be exploited to generate image contrast for tissue characterisation. The method most commonly used to localise and encode MR signal echoes to form a cross sectional image is described, introducing the concept of k-space and showing how the MR signal data stored within it relates to properties within the reconstructed image. Before describing the CMR acquisition methods in detail, the basic spin echo and gradient pulse sequences are introduced, identifying the key parameters that influence image contrast, including appearances in the presence of flowing blood, resolution and image acquisition time. The main derivatives of these two pulse sequences used for cardiac imaging are then described in more detail. Two of the key requirements for CMR are the need for data acquisition first to be to be synchronised with the subject's ECG and to be fast enough for the subject

  17. Effects of interleukin-18 on asthmatic airway inflammation and nuclear factor kappa-B in murine models

    Institute of Scientific and Technical Information of China (English)

    张惠兰; 张珍祥; 徐永健

    2003-01-01

    Objective To investigate the effects of Interleukin-18 (IL-18) on asthmatic airway inflammation and nuclear factor kappa-B (NF-κB) in a murine asthmatic model. Methods BALB/C mice were randomly divided into three groups: group A(control group,n=10); group B (asthmatic model group, n=10); group C (IL-18 injection group, n=10). The asthmatic model was established in group B and C by respiratory syncytial virus (RSV) killed by ultraviolet light. Saline solution (0.1 ml) and IL-18 (0.1 ml, 1 μg) was injected in groups B and C at seven time points (1, 2, 7, 8, 9, 21, 22 d). The symptoms and the numbers of eosinophils and plasmacytes in the airways were observed and the expression of NF-κB activation in the lung was analyzed by Immohistochemistry (IHC) and Western blot. Results The symtoms of group C were more severe than in groups A and B. Group A did not have EOS and plasmacytes in the airway submucosal while the numbers of eosinophils [15±3 (average cell counts per microscopic visual field, the same below)] and plasmacytes (10±2) in group B were found to have increased significantly. But the numbers of eosinophils and plasmacytes in group C were decreased significantly when compared with group B (6±2 and 2±1, respectively, both P<0.05). ISH showed that the expression of NF-κB activation in group B was stronger than that in groups A and C. The amount of NF-κB inhibitor (IκB) in group A and group C were 3.5 times and 2.5 times more than that of group B respectively via Western blot. Conclusion IL-18 can inhibit asthmatic airway inflammation in mice and its mechamism may be due to the fact that IL-18 can inhibit the activation of NF-κB in the murine asthmatic model.

  18. Effects of glucocorticoid and cysteinyl leukotriene 1 receptor antagonist on CD34 + hematopoietic cells in bone marrow of asthmatic mice

    Institute of Scientific and Technical Information of China (English)

    毛辉; 殷凯生; 王曾礼; 李富宇; 张希龙; 刘春涛; 雷松

    2004-01-01

    Background Corticosteroids remain the most effective therapy available for asthma. They have widespread effects on asthmatic airway inflammation. However, little is known about the effects of corticosteroids on the production of bone marrow inflammatory cells in asthma. This study observed the effects of glucocorticoid and cysteinyl leukotriene 1 receptor antagonist on CD34 + hematopoietic cells, so as to explore the possible effectiveness of a bone marrow-targeted anti-inflammatory strategy.Methods Balb/c mice were sensitized and challenged with ovalbumin (OVA) to establish an asthmatic model. For two consecutive weeks, asthmatic mice were challenged with OVA while being given either prednisone, montelukast, prednisone plus montelukast, or sterile saline solution. The mice were killed 24 hours after the last challenge with OVA, and bronchoalveolar lavage fluid (BALF),peripheral blood, and bone marrow were collected. Eosinophils in peripheral blood and BALF, and nucleated cells in BALF, peripheral blood, and bone marrow were counted. The percentages of CD34+cells, CD4 + T lymphocytes and CD8 + T lymphocytes among nucleated cells in peripheral blood and bone marrow were counted by flow cytometry. Immunocytochemistry and in situ hybridization were employed to detect expression of CD34 and interleukin (IL)-5Rαx mRNA (CD34 + IL-5Rα mRNA+ cells)among bone marrow hematopoietic cells.Results Compared with the sterile saline solution group, the number of eosinophils in BALF and peripheral blood, CD34 + cells in peripheral blood and bone marrow, and CD34 + IL-5Rc mRNA+ cells in bone marrow of mice from the prednisone and prednisone plus montelukast groups were significantly lower (P<0.01). The number of eosinophils in BALF from the montelukast group was also significantly lower (P<0.05).Conclusions The results suggest that, in this asthmatic mouse model, prednisone probably inhibits proliferation, differentiation, and migration of CD34 + cells in bone marrow, blocks

  19. Zika Virus in the Americas: A Review for Clinicians.

    Science.gov (United States)

    Sampathkumar, Priya; Sanchez, Joyce L

    2016-04-01

    Zika virus has recently emerged as a new public health threat. An arthropod-borne virus named after the Zika forest in Uganda, it was first discovered in 1947. The virus caused only sporadic cases of Zika infection in Africa and Southeast Asia until 2007, when the first large outbreak occurred in the Yap State in the Federated States of Micronesia. Another outbreak in French Polynesia in 2013 was notable for being associated temporally with an increase in cases of Guillain-Barré syndrome. In 2015, the virus was first reported in Brazil and since then has spread explosively through several additional countries in South and Central America and the Caribbean. Simultaneously, several of these countries have seen a dramatic increase in the incidence of infants born with microcephaly. The rapid spread of Zika virus through the Americas, together with the association of infection with microcephaly and Guillain-Barré syndrome, has resulted in the World Health Organization declaring a public health emergency. Zika virus has the potential to spread to new areas where the Aedes mosquito vector is present and therefore presents a risk to the United States. This concise review describes the clinical features of Zika virus infection and provides advice for clinicians on counseling travelers and others about the disease. PMID:27046524

  20. Interprofessional clinical education: clinicians' views on the importance of leadership.

    Science.gov (United States)

    Missen, Karen; Jacob, Elisabeth R; Barnett, Tony; Walker, Lorraine; Cross, Merylin

    2012-01-01

    The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students' clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants (n = 57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians' views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates' readiness for collaborative and cross-disciplinary practice.

  1. In utero fuel homeostasis: Lessons for a clinician

    Directory of Open Access Journals (Sweden)

    P. N Suman Rao

    2013-01-01

    Full Text Available Fetus exists in a complex, dynamic, and yet intriguing symbiosis with its mother as far as fuel metabolism is concerned. Though the dependence on maternal fuel is nearly complete to cater for its high requirement, the fetus is capable of some metabolism of its own. The first half of gestation is a period of maternal anabolism and storage whereas the second half results in exponential fetal growth where maternal stores are mobilized. Glucose is the primary substrate for energy production in the fetus though capable of utilizing alternate sources like lactate, ketoacids, amino acids, fatty acids, and glycogen as fuel under special circumstances. Key transporters like glucose transporters (GLUT are responsible for preferential transfers, which are in turn regulated by complex interaction of maternal and fetal hormones. Amino acids are preferentially utilized for growth and essential fatty acids for development of brain and retina. Insulin, insulin like growth factors, glucagon, catecholamines, and letpin are the hormones implicated in this fascinating process. Hormonal regulation of metabolic substrate utilization and anabolism in the fetus is secondary to the supply of nutrient substrates. The knowledge of fuel homeostasis is crucial for a clinician caring for pregnant women and neonates to manage disorders of metabolism (diabetes, growth (intrauterine growth restriction, and transitional adaptation (hypoglycemia.

  2. PubMed searches: overview and strategies for clinicians.

    Science.gov (United States)

    Lindsey, Wesley T; Olin, Bernie R

    2013-04-01

    PubMed is a biomedical and life sciences database maintained by a division of the National Library of Medicine known as the National Center for Biotechnology Information (NCBI). It is a large resource with more than 5600 journals indexed and greater than 22 million total citations. Searches conducted in PubMed provide references that are more specific for the intended topic compared with other popular search engines. Effective PubMed searches allow the clinician to remain current on the latest clinical trials, systematic reviews, and practice guidelines. PubMed continues to evolve by allowing users to create a customized experience through the My NCBI portal, new arrangements and options in search filters, and supporting scholarly projects through exportation of citations to reference managing software. Prepackaged search options available in the Clinical Queries feature also allow users to efficiently search for clinical literature. PubMed also provides information regarding the source journals themselves through the Journals in NCBI Databases link. This article provides an overview of the PubMed database's structure and features as well as strategies for conducting an effective search. PMID:23442731

  3. Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians.

    Science.gov (United States)

    Asnis, Gregory M; Thomas, Manju; Henderson, Margaret A

    2016-01-01

    Insomnia is a prevalent disorder with deleterious effects such as decreased quality of life, and a predisposition to a number of psychiatric disorders. Fortunately, numerous approved hypnotic treatments are available. This report reviews the state of the art of pharmacotherapy with a reference to cognitive behavioral therapy for insomnia (CBT-I) as well. It provides the clinician with a guide to all the Food and Drug Administration (FDA) approved hypnotics (benzodiazepines, nonbenzodiazepines, ramelteon, low dose sinequan, and suvorexant) including potential side effects. Frequently, chronic insomnia lasts longer than 2 years. Cognizant of this and as a result of longer-term studies, the FDA has approved all hypnotics since 2005 without restricting the duration of use. Our manuscript also reviews off-label hypnotics (sedating antidepressants, atypical antipsychotics, anticonvulsants and antihistamines) which in reality, are more often prescribed than approved hypnotics. The choice of which hypnotic to choose is discussed partially being based on which segment of sleep is disturbed and whether co-morbid illnesses exist. Lastly, we discuss recent label changes required by the FDA inserting a warning about "sleep-related complex behaviors", e.g., sleep-driving for all hypnotics. In addition, we discuss FDA mandated dose reductions for most zolpidem preparations in women due to high zolpidem levels in the morning hours potentially causing daytime carry-over effects. PMID:26729104

  4. Zika Virus in the Americas: A Review for Clinicians.

    Science.gov (United States)

    Sampathkumar, Priya; Sanchez, Joyce L

    2016-04-01

    Zika virus has recently emerged as a new public health threat. An arthropod-borne virus named after the Zika forest in Uganda, it was first discovered in 1947. The virus caused only sporadic cases of Zika infection in Africa and Southeast Asia until 2007, when the first large outbreak occurred in the Yap State in the Federated States of Micronesia. Another outbreak in French Polynesia in 2013 was notable for being associated temporally with an increase in cases of Guillain-Barré syndrome. In 2015, the virus was first reported in Brazil and since then has spread explosively through several additional countries in South and Central America and the Caribbean. Simultaneously, several of these countries have seen a dramatic increase in the incidence of infants born with microcephaly. The rapid spread of Zika virus through the Americas, together with the association of infection with microcephaly and Guillain-Barré syndrome, has resulted in the World Health Organization declaring a public health emergency. Zika virus has the potential to spread to new areas where the Aedes mosquito vector is present and therefore presents a risk to the United States. This concise review describes the clinical features of Zika virus infection and provides advice for clinicians on counseling travelers and others about the disease.

  5. Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians

    Directory of Open Access Journals (Sweden)

    Gregory M. Asnis

    2015-12-01

    Full Text Available Insomnia is a prevalent disorder with deleterious effects such as decreased quality of life, and a predisposition to a number of psychiatric disorders. Fortunately, numerous approved hypnotic treatments are available. This report reviews the state of the art of pharmacotherapy with a reference to cognitive behavioral therapy for insomnia (CBT-I as well. It provides the clinician with a guide to all the Food and Drug Administration (FDA approved hypnotics (benzodiazepines, nonbenzodiazepines, ramelteon, low dose sinequan, and suvorexant including potential side effects. Frequently, chronic insomnia lasts longer than 2 years. Cognizant of this and as a result of longer-term studies, the FDA has approved all hypnotics since 2005 without restricting the duration of use. Our manuscript also reviews off-label hypnotics (sedating antidepressants, atypical antipsychotics, anticonvulsants and antihistamines which in reality, are more often prescribed than approved hypnotics. The choice of which hypnotic to choose is discussed partially being based on which segment of sleep is disturbed and whether co-morbid illnesses exist. Lastly, we discuss recent label changes required by the FDA inserting a warning about “sleep-related complex behaviors”, e.g., sleep-driving for all hypnotics. In addition, we discuss FDA mandated dose reductions for most zolpidem preparations in women due to high zolpidem levels in the morning hours potentially causing daytime carry-over effects.

  6. Biosimilar insulins: guidance for data interpretation by clinicians and users.

    Science.gov (United States)

    Heinemann, L; Home, P D; Hompesch, M

    2015-10-01

    Biosimilar insulins are approved copies of insulins outside patent protection. Advantages may include greater market competition and potential cost reduction, but clinicians and users lack a clear perspective on 'biosimilarity' for insulins. The manufacturing processes for biosimilar insulins are manufacturer-specific and, although these are reviewed by regulators there are few public data available to allow independent assessment or review of issues such as intrinsic quality or batch-to-batch variation. Preclinical measures used to assess biosimilarity, such as tissue and cellular studies of metabolic activity, physico-chemical stability and animal studies of pharmacodynamics, pharmacokinetics and immunogenicity may be insufficiently sensitive to differences, and are often not formally published. Pharmacokinetic and pharmacodynamic studies (glucose clamps) with humans, although core assessments, have problems of precision which are relevant for accurate insulin dosing. Studies that assess clinical efficacy and safety and device compatibility are limited by current outcome measures, such as glycated haemoblobin levels and hypoglycaemia, which are insensitive to differences between insulins. To address these issues, we suggest that all comparative data are put in the public domain, and that systematic clinical studies are performed to address batch-to-batch variability, delivery devices, interchangeability in practice and long-term efficacy and safety. Despite these challenges biosimilar insulins are a welcome addition to diabetes therapy and, with a transparent approach, should provide useful benefit to insulin users. PMID:25974131

  7. Defiant Teens: A Clinician's Manual for Assessment and Family Intervention.

    Science.gov (United States)

    Barkley, Russell A.; Edwards, Gwenyth H.; Robin, Arthur L.

    This manual presents an 18-step program designed both to teach parents the skills they need to manage difficult adolescent behavior and to improve family relationships overall. Steps 1 through 9 modify the approach presented in Russell Barkley's earlier edition, "Defiant Children," to focus on developmental concerns of adolescence. Clear…

  8. [Dexamethasone increases the expression of reversion-inducing cysteine-rich protein with Kazal motifs (RECK) in lung tissues of bronchial asthmatic mice].

    Science.gov (United States)

    Li, Zhenxing; He, Sheng; Wei, Liping; Lin, Lin; Xiong, Hanzhen; Li, Junhong; Chen, Peifen; Lai, Wenyan

    2016-05-01

    Objective To investigate the expression of reversion-inducing cysteine-rich protein with Kazal motifs (RECK) in the lung tissues of bronchial asthmatic mice and the effect of dexamethasone treatment on its expression. Methods Thirty BALB/c mice were randomly divided into three equal groups: a control group, an asthmatic group and a dexamethasone-treated group. The asthmatic mouse models were established by intraperitoneal injection and inhalation with ovalbumin (OVA). The number of eosinophils (EOS) and lymphocytes (Lym) in bronchoalveolar lavage fluid (BALF) were counted. HE staining was used to observe airway inflammation and remodeling. The mRNA and protein expression of RECK were determined by real-time PCR and immunohistochemistry, respectively. Results Compared with the control group and the dexamethasone-treated group, the total cell number and EOS number in the BALF of the asthma group significantly increased. The expression of RECK mRNA in the asthmatic group was significantly lower than that in the control group and the dexamethasone-treated group. Immunohistochemistry showed that RECK was mainly expressed in the airway epithelial cells and inflammatory cells. RECK protein expression was highest in the control group and lowest in the asthmatic group. Conclusion Dexamethasone can increase the expression of RECK in the lung tissues of asthmatic mice. PMID:27126937

  9. Using reflexivity to enhance in-depth interviewing skills for the clinician researcher

    OpenAIRE

    Hegarty Kelsey; Taft Angela; McNair Ruth

    2008-01-01

    Abstract Background Primary health care clinicians are being encouraged to undertake qualitative research, however the in-depth interviewing skills required are not as straightforward as might be first supposed. While there are benefits and certain skills that clinicians can bring to interview-based research, there are important new skills to develop. To date there has been neither discussion about these new skills, nor any preparatory guidelines for clinicians entering into interview-based r...

  10. Clinician Recommendations and Perceptions of Factors Associated With Ankle Brace Use

    OpenAIRE

    Denton, Jason M.; Waldhelm, Andrew; Hacke, Jonathon D.; Gross, Michael T.

    2015-01-01

    Background: Little information is available regarding the ankle braces orthopaedic sports medicine clinicians recommend or clinicians’ concerns that may influence their decisions to recommend use of an ankle brace. Hypotheses: (1) Clinicians most frequently recommend lace-up braces with straps. (2) Clinicians who are concerned about potential adverse side effects from ankle brace use are less likely to recommend an ankle brace to prevent ankle sprain injuries. Study Design: Descriptive survey...

  11. The role of clinician emotion in clinical reasoning: balancing the analytical process

    OpenAIRE

    Langridge, Neil; Roberts, Lisa; Pope, Catherine

    2015-01-01

    Introduction This review paper identifies and describes the role of clinicians' memory, emotions and physical responses in clinical reasoning processes. Clinical reasoning is complex and multi-factorial and key models of clinical reasoning within musculoskeletal physiotherapy are discussed, highlighting the omission of emotion and subsequent physical responses and how these can impact upon a clinician when making a decision. Discussion It is proposed that clinicians should conside...

  12. Guided by priority: how clinicians manage access to opioid replacement therapy.

    Science.gov (United States)

    Harlow, Warren; Happell, Brenda; Browne Rn, Graeme

    2014-06-01

    Access to opioid replacement therapy is a problem in some parts of Australia and it is not known how clinicians respond to this situation. The aim of this study is to develop a conceptual understanding of how clinicians apply clinical judgements in managing access to treatment. Grounded theory methodology was used to guide this study. Thirty-five clinicians were interviewed. The substantive theory presented to explain the process is Guided by Priority. By presenting this understanding of practice, clinicians can reflect on their actions related to the task and determine if they are beneficial or detrimental to consumers, which may influence their future practice.

  13. Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America.

    Science.gov (United States)

    Giugliani, Roberto; Villarreal, Martha Luz Solano; Valdez, C Araceli Arellano; Hawilou, Antonieta Mahfoud; Guelbert, Norberto; Garzón, Luz Norela Correa; Martins, Ana Maria; Acosta, Angelina; Cabello, Juan Francisco; Lemes, Aída; Santos, Mara Lucia Schmitz Ferreira; Amartino, Hernán

    2014-06-01

    This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S), an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S) (Elaprase(®), Shire) enzyme replacement therapy (ERT), designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses. PMID:25071396

  14. Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America

    Directory of Open Access Journals (Sweden)

    Roberto Giugliani

    2014-06-01

    Full Text Available This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S, an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S (Elaprase®, Shire enzyme replacement therapy (ERT, designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses.

  15. Analysis of the dynamic states of pulmonary ventilation and perfusion in bronchial asthmatics using [sup 133]Xe gas ventilation scintigraphy and [sup 99m]Tc-MAA lung perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ishihama, Hidenobu (Okayama Univ. (Japan). School of Medicine)

    1994-04-01

    To clarify the organic changes and pathophysiology of the lungs in intractable asthmatics, the dynamic states of pulmonary ventilation and perfusion were analyzed in 15 bronchial asthmatics in the stable state using [sup 133]Xe gas ventilation scintigraphy and [sup 99m]Tc-MAA lung perfusion scintigraphy, respectively. Dysfunction of pulmonary ventilation and impairment of pulmonary perfusion were significantly severer in intractable asthmatics than in non-intractable asthmatics (p<0.01, p<0.05, respectively) and those of asthma caused by aging. Late onset asthmatics with a long duration of disease tended to show severe impairment of pulmonary perfusion. Above all, the longer the duration of the disease, the severer became the impairment of pulmonary perfusion in late onset intractable asthmatics (LOIA). These findings suggest that the progression of irreversible organic changes of lungs in LOIA is involved in the severity of bronchial asthma. (author).

  16. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in non-atopic asthmatic patients

    DEFF Research Database (Denmark)

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

    2015-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women ...... endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.......Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women...... (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower...

  17. Histophatologic changes of lung in asthmatic male rats treated with hydro-alcoholic extract of Plantago major and theophylline

    Directory of Open Access Journals (Sweden)

    Farah Farokhi

    2013-03-01

    Full Text Available Objective: Plantago major (P. major is one of the medicinal crops in the world which has therapeutic properties for treatment of respiratory and gastrointestinal diseases. Theophylline is commonly used for the treatment of respiratory diseases. In this study, we investigated the protective effects of hydro-alcoholic extract of P. major on lung in asthmatic male rats. Materials and Methods: 32 male adult rats were randomly divided into 4 groups: The control group (C received normal saline; Asthma (A group received a normal diet; Asthma group treated with Theophylline (200 mg/kg b.w. (T; Asthma group which received p.major (100 mg/kg b.w. (P. Asthma was induced by citric acid, 0.1 mg in form of spraying. The injection of P.major extract and theophylline was administered intraperitoneally for four weeks. At the end of the treatment, all of the rats were sacrificed and lungs were taken out, fixed, and stained with H&E, toluidine blue, and PAS, then histological studies were followed with light microscope. Results: Results showed that, in asthmatic group, the mean number of mast cells was significantly increased (p<0.05. Thickness of alveolar epithelium and accumulation of glycoprotein in airways was increased. Moreover, in some of alveolar sac hemorrhaging was observed. Administration of p.major extract in asthmatic rats restored these changes towards normal group.Conclusion: The present study revealed that P. major compared with theophylline, has a protective effect on lung in asthmatic rats.

  18. Histophatologic changes of lung in asthmatic male rats treated with hydro-alcoholic extract of Plantago major and theophylline

    OpenAIRE

    Farah Farokhi; Fereshteh Khaneshi

    2013-01-01

    Objective: Plantago major (P. major) is one of the medicinal crops in the world which has therapeutic properties for treatment of respiratory and gastrointestinal diseases. Theophylline is commonly used for the treatment of respiratory diseases. In this study, we investigated the protective effects of hydro-alcoholic extract of P. major on lung in asthmatic male rats. Materials and Methods: 32 male adult rats were randomly divided into 4 groups: The control group (C) received normal saline; A...

  19. Perception of bronchial obstruction in asthmatic patients. Relationship with bronchial eosinophilic inflammation and epithelial damage and effect of corticosteroid treatment.

    OpenAIRE

    Roisman, G L; Peiffer, C; Lacronique, J. G.; Le Cae, A; Dusser, D J

    1995-01-01

    We studied the perception of bronchoconstriction in asthmatic subjects who were randomly treated with inhaled beta 2 agonist given either alone (n = 9) or associated with inhaled corticosteroids (n = 9). Methacholine and bradykinin challenges, bronchoalveolar lavage, and bronchial biopsies were performed in all subjects. After each dose of agonist, breathlessness was assessed using a visual analog scale (VAS) and the forced expiratory volume in 1 s (FEV1) was measured. The relationship betwee...

  20. No effect of elevated operating lung volumes on airway function during variable workrate exercise in asthmatic humans.

    Science.gov (United States)

    Klansky, Andrew; Irvin, Charlie; Morrison-Taylor, Adriane; Ahlstrand, Sarah; Labrie, Danielle; Haverkamp, Hans Christian

    2016-07-01

    In asthmatic adults, airway caliber fluctuates during variable intensity exercise such that bronchodilation (BD) occurs with increased workrate whereas bronchoconstriction (BC) occurs with decreased workrate. We hypothesized that increased lung mechanical stretch would prevent BC during such variable workrate exercise. Ten asthmatic and ten nonasthmatic subjects completed two exercise trials on a cycle ergometer. Both trials included a 28-min exercise bout consisting of alternating four min periods at workloads equal to 40 % (Low) and 70% (High) peak power output. During one trial, subjects breathed spontaneously throughout exercise (SVT), such that tidal volume (VT) and end-inspiratory lung volume (EILV) were increased by 0.5 and 0.6 liters during the high compared with the low workload in nonasthmatic and asthmatic subjects, respectively. During the second trial (MVT), VT and EILV were maintained constant when transitioning from the high to the low workload. Forced exhalations from total lung capacity were performed during each exercise workload. In asthmatic subjects, forced expiratory volume 1.0 s (FEV1.0) increased and decreased with the increases and decreases in workrate during both SVT (Low, 3.3 ± 0.3 liters; High, 3.6 ± 0.2 liters; P < 0.05) and MVT (Low, 3.3 ± 0.3 liters; High, 3.5 ± 0.2 liters; P < 0.05). Thus increased lung stretch during MVT did not prevent decreases in airway caliber when workload was reduced. We conclude that neural factors controlling airway smooth muscle (ASM) contractile activity during whole body exercise are more robust determinants of airway caliber than the ability of lung stretch to alter ASM actin-myosin binding and contraction. PMID:27150833