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Sample records for asthmatic children clinicians

  1. Studies on periodontal conditions in asthmatic children.

    Science.gov (United States)

    Hyyppä, T M; Koivikko, A; Paunio, K U

    1979-01-01

    The effect of extrinsic asthma on periodontal conditions was studied in a group of 30 asthmatic children. Clinical examination revealed that asthmatic children had more gingivitis than their healthy controls. The asthmatic children who received an inhaled corticosteroid as treatment had more severe gingivitis compared with asthmatic children on disodium cromoglycate treatment. The amount of plaque was not altered. The peroxidase activity was assessed from whole saliva. The results revealed that this defense mechanism was not altered in asthma. An enzyme group which is involved in inflammation, the arginine aminopeptidases, was found to be slightly elevated in the gingival fluid of asthmatic children. The results indicate that gingival inflammation is increased in asthma.

  2. Clinical characteristics of black asthmatic children

    African Journals Online (AJOL)

    A prospective study of 455 black asthmatic children (277 boys) attending ... In black children in South Africa, in whom both pneumonia and tuberculosis remain significant problems,3,4 failure to recognise asthma may not only result in continued ..... Gie R, Klein M. Wesley A. Death from pneumonia in young children - time for.

  3. Is influenza vaccination in asthmatic children helpful?

    Science.gov (United States)

    Bueving, H J

    2006-01-01

    The rationale for influenza vaccination in asthmatic children theoretically lies in prevention of exacerbations and serious complications like pneumonia. Solid evidence from randomized clinical trials of its preventive effects on these clinical endpoints is, however, lacking. Nevertheless, most Western guidelines advise to vaccinate these children. In the real life situation this advice isn't very well followed: vaccine coverage for this indication is low. To assess the usefulness of influenza vaccination in children with asthma a set of fundamental questions regarding this activity is presented and answered. This leads to the conclusion that, given the evidence, influenza vaccination in children with mild to moderate disease should be reconsidered.

  4. Gender differences in objectively assessed physical activity in asthmatic and non-asthmatic children.

    Science.gov (United States)

    Yiallouros, Panayiotis K; Economou, Mary; Kolokotroni, Ourania; Savva, Savvas C; Gavatha, Marina; Ioannou, Phivos; Karpathios, Themistoclis; Middleton, Nicos

    2015-04-01

    To compare objectively assessed physical activity levels, between asthmatic children and non-asthmatic controls. From a random community sample of 794 children aged 8-9 years, in a case-control design, 104 children with ever doctor's diagnosis of asthma and 99 non-asthmatic controls were recruited and had assessment of physical activity with biaxial accelerometers for 7 days. Children with active (also reporting at least one episode of wheezing in the last 12 months) and inactive (no wheezing in past 12 months) asthma appeared to have similar physical activity and sedentary activity levels compared to non-asthmatic children. However, girls with active asthma had significantly lower moderate-to-vigorous physical activity (MVPA) levels than their peers with adjusted geometric mean ratio of 0.59 (95% CI: 0.369, 0.929, P-value = 0.024). No difference in physical and sedentary activity levels was observed between asthmatic and non-asthmatic boys. The difference between genders in the comparison of MVPA levels in asthmatics and controls was statistically significant (P-value of likelihood ratio test [LRT] for effect modification by gender = 0.034). Unlike boys, girls with active asthma appear to be less active than their healthy peers, and this gender difference might explain the inconsistent evidence from previous reports on physical activity levels in asthmatic children. Further studies are needed to confirm the gender interaction in the childhood asthma-physical activity relation and the implications on current guidelines for physical exercise prescriptions in asthmatic children. © 2014 Wiley Periodicals, Inc.

  5. Respiratory load perception in overweight and asthmatic children.

    Science.gov (United States)

    MacBean, Victoria; Wheatley, Lorna; Lunt, Alan C; Rafferty, Gerrard F

    2017-05-01

    Overweight asthmatic children report greater symptoms than normal weight asthmatics, despite comparable airflow obstruction. This has been widely assumed to be due to heightened perception of respiratory effort. Three groups of children (healthy weight controls, healthy weight asthmatics, overweight asthmatics) rated perceived respiratory effort throughout an inspiratory resistive loading protocol. Parasternal intercostal electromyogram was used as an objective marker of respiratory load; this was expressed relative to tidal volume and reported as a ratio of the baseline value (neuroventilatory activity ratio (NVEAR)). Significant increases in perception scores (pperception scores, with no influence of asthma or BMI-for-age percentile on the resistance-perception relationships. These data, indicating elevated overall respiratory effort in overweight asthmatic children but comparable responses to dynamic changes in load, suggest that the greater disease burden in overweight asthmatic children may be due to altered respiratory mechanics associated with increased body mass. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. The dental status of asthmatic British school children.

    Science.gov (United States)

    McDerra, E J; Pollard, M A; Curzon, M E

    1998-01-01

    This study was performed to determine the prevalence of dental disease in British school children with asthma. A convenience sample of 100 asthmatic children (aged 4-16 years) was examined for dental caries, periodontal condition, and tooth surface loss. School children, equated for age, sex, race, and socioeconomic status were chosen for comparison. Children were divided into two age ranges; 4-10 and 11-16 years. A significant difference was found in DMFT (0.96 vs. 0.31) and DMFS (1.37 vs. 0.37) between the 4-10-year-old asthmatic children compared with healthy control children. In the 11-16-year age range, the asthmatic children had a DMFT and DMFS of 2.48 and 3.39 compared with the control children who had a DMFT and DMFS of 1.11 and 1.97 respectively. Asthmatic children had significantly more plaque, gingivitis, and calculus compared with the control group. There was a significant difference in the severity and number of teeth affected by tooth surface loss affecting labial surfaces of the anterior teeth and occlusal surfaces of the posterior teeth of asthmatic children. It was concluded that asthmatic children have more decay affecting their permanent teeth, poorer periodontal status, and more tooth surface loss than healthy controls.

  7. The prevalence of atopic dermatitis history in asthmatic children

    OpenAIRE

    Rifda Suryati; Arwin AP Akib; I Boediman; Abdul Latief

    2016-01-01

    Background Atopic dermatitis (AD) is a risk factor of asthma. There is still limited information about its prevalence and characteristics in asthmatic children. Objective To find out the prevalence of AD history in asthmatic children. Methods This was a cross-sectional study conducted at the De- partment of Child Health, Cipto Mangunkusumo Hospital, Jakarta, from July until December 2004. Patients with asthma who were at or less than 5 years of age were included in the...

  8. [Oral health in asthmatic children: a dose-response study].

    Science.gov (United States)

    Eloot, A; Vanobbergen, J; Martens, L

    2004-01-01

    In literature there is a lack of consensus regarding the relationship between dental caries risk and asthma in a child population. Despite these divergent views, all studies conclude that asthmatic children are at risk and that special preventive programs are needed. The asthmatic through either its disease status or its pharmacotherapy carries several factors for an increased caries risk. PH values of most inhalant powders are less than 5.5. A decrease of the salivary and plaque pH has been detected in asthmatic children after use of these inhalers. This low pH value associated with a reduced salivary flow rate (caused by beta-adrenergic agonists and by anti-histaminic medication) makes asthmatics more susceptible to caries and erosion. There are only a few studies that take into account that asthma is a disease with a large diversity of severity and duration. This approach could help to clarify some variability in caries risk. The aim of the present study (a dose-response study) was to examine the oral health status of asthmatic children and to compare the oral health condition and oral health habits within different groups of asthmatic children.

  9. Learning preferences of caregivers of asthmatic children.

    Science.gov (United States)

    Dinakar, Chitra; Adams, Christina; Brimer, Alysa; Silva, Maria D

    2005-10-01

    People learn in different ways: visually, aurally, by reading/writing, and kinesthetically. In our clinic, we use color-coded Asthma Action Cards to educate our patients and their caregivers on asthma management. Our teaching is largely aural based, with the cards providing reading and visual stimulation and hands-on practice with devices offering kinesthetic stimulation. We sought to determine the learning styles of the caregivers of our asthmatic children. Caregivers in our Asthma/Allergy Clinic completed the Visual-Aural-Read/Write-Kinesthetic (VARK) questionnaire anonymously, and the responses were evaluated on the basis of previously validated scoring instructions. Analysis of 98 respondents showed that 42% had a single learning modality preference, and the remaining 58% were multimodal learners. Of those who reported a single mode of learning, 61% preferred kinesthetic, 27% preferred reading/writing, and less than 1% each preferred aural or visual stimuli. Of all 98 caregivers, 82% included kinesthetic as a learning preference, 59% included read/write, 50% included aural, and 41% included visual. The majority of caregivers preferred the kinesthetic learning method, whether as a single learning preference or in combination with other approaches. Incorporating kinesthetic methods of learning, such as role plays and problem-solving case scenarios, into standardized asthma education curricula may be beneficial to patients and families in terms of understanding and using their regimen.

  10. Dental health in asthmatic children: a South Italy study.

    Science.gov (United States)

    Ferrazzano, Gianmaria Fabrizio; Sangianantoni, Giancarla; Cantile, Tiziana; Amato, Ivana; Ingenito, Aniello; Noschese, Paolo

    2012-01-01

    The purpose of this study was to examine the oral health status of children with mild intermittent or mild persistent asthma compared to healthy children. A group of 124 asthmatic children was compared to 156 age-matched healthy children. Bitewing radiographs were taken and clinical examinations were carried out to record caries prevalence, caries experience in both dentitions, periodontal health and dental enamel defects. Caries prevalence for asthmatic patients was 39% in the permanent dentition and 32% in the primary dentition. Healthy subjects presented 36% caries prevalence in the permanent dentition and 26% in the primary dentition. There was no statistically significant difference between the 2 groups in caries experience. The differences between asthmatic subjects and healthy subjects for periodontal health and enamel defects were not statistically significant either. Children affected by mild intermittent or mild persistent asthma do not seem to be more susceptible to oral diseases than healthy children.

  11. Assessment of the oral health status of asthmatic children.

    Science.gov (United States)

    Arafa, Abla; Aldahlawi, Salwa; Fathi, Adel

    2017-01-01

    To assess the oral health status and salivary composition in a group of children suffering from bronchial asthma. The sample consisted of sixty asthmatic children, sixty healthy negative controls, and sixty healthy positive controls of both sexes with age ranging from 4 to 12 years old. The asthmatics were grouped according to disease severity into mild, moderate, or severe asthmatic. All the children were clinically examined to assess their dental caries experience (decayed, indicated for extraction, and filled primary tooth [def] and decayed-missing-filled permanent tooth [DMF]), dental erosion condition (tooth wear index), and gingival health condition (gingival index [GI]). Salivary samples were collected and assessed for salivary flow rate, salivary pH, and the level of calcium, sodium, and potassium. The results of this study revealed that asthmatic children presented significantly higher def, DMF score, and GI mean values compared to the control groups. Severe asthmatics significantly presented the highest def and GI score. Salivary analysis revealed reduced stimulated salivary flow rate and altered salivary pH. In addition, significantly elevated mean salivary calcium level found to be associated with higher GI mean score. Children suffering from bronchial asthma should receive special dental preventive attention as presented with greater risk for oral and dental diseases as compared to the healthy controls.

  12. Assessment of the oral health status of asthmatic children

    Science.gov (United States)

    Arafa, Abla; Aldahlawi, Salwa; Fathi, Adel

    2017-01-01

    Objectives: To assess the oral health status and salivary composition in a group of children suffering from bronchial asthma. Materials and Methods: The sample consisted of sixty asthmatic children, sixty healthy negative controls, and sixty healthy positive controls of both sexes with age ranging from 4 to 12 years old. The asthmatics were grouped according to disease severity into mild, moderate, or severe asthmatic. All the children were clinically examined to assess their dental caries experience (decayed, indicated for extraction, and filled primary tooth [def] and decayed-missing-filled permanent tooth [DMF]), dental erosion condition (tooth wear index), and gingival health condition (gingival index [GI]). Salivary samples were collected and assessed for salivary flow rate, salivary pH, and the level of calcium, sodium, and potassium. Results: The results of this study revealed that asthmatic children presented significantly higher def, DMF score, and GI mean values compared to the control groups. Severe asthmatics significantly presented the highest def and GI score. Salivary analysis revealed reduced stimulated salivary flow rate and altered salivary pH. In addition, significantly elevated mean salivary calcium level found to be associated with higher GI mean score. Conclusions: Children suffering from bronchial asthma should receive special dental preventive attention as presented with greater risk for oral and dental diseases as compared to the healthy controls. PMID:28932147

  13. The lipid profile in obese asthmatic children compared to non-obese asthmatic children.

    Science.gov (United States)

    Fang, L-J; Huang, C-S; Liu, Y-C; Su, Y-M; Wan, K-S

    2016-01-01

    A relationship between asthma and obesity has been documented in children and adolescents. An alternate day calorie restriction diet has been reported to improve asthma symptoms by decreasing levels of serum cholesterol and triglycerides, reducing markers of oxidative stress and increasing levels of the antioxidant uric acid. Therefore, to investigate the lipid profile in asthmatic children may be important in asthma control treatment. One hundred and sixty newly diagnosed persistent asthmatic children were selected to participate in the study. They were divided into four groups based on their body mass index (BMI): Group I normal weight (BMI=20-24.9kg/m(2), n=30); Group II under-weight (BMI30kg/m(2), n=25). Fasting blood sugar, fasting insulin, and HbA1c were measured to exclude the possibility of pre-diabetes. Lipid profile measurements included total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), apo-A1, apo-B and triglycerides. There were no significant differences in the levels of apo-A1, apo-B, triglycerides, cholesterol and LDL in all four groups. Only the level of HDL was higher in GIV>GIII>GII>GI (75.84±13.95, 68.56±15.28, 64.17±13.93, 63.17±14.34mg/dl, respectively). There were no cases of pre-diabetes in any of the four groups. Hypercholesterolaemia and hypertriglyceridaemia were not found in any of the persistent asthmatic children, and thus they are not high risk factors for asthma. Similarly, there were no differences in apo-A1 and apo-B between any of the BMI groups. No differences were found in LDL levels, however HDL levels were increased in all four groups, indicating that allergic sensitisation may have occurred. Controlling body weight and restricting calorie intake may be as important as appropriate pharmacological management in controlling asthma. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  14. 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.; de Jongh, Franciscus 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

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

    DEFF Research Database (Denmark)

    Bisgaard, H; Nielsen, K G

    2000-01-01

    We hypothesized that a leukotriene receptor antagonist (LTRA) could provide bronchoprotection against the cold, dry air-induced response in asthmatic preschool children. In a randomized, double-blind, placebo-controlled crossover study, we examined the effect of the specific LTRA montelukast at 5...

  16. 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.

  17. Increasing ventilation as an intervention in homes of asthmatic children

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    2016-01-01

    In children asthma is the most frequent chronic disease and house dust mite (HDM) allergy the most frequent cause of allergic asthma. Indoors most of the time, children are exposed to many indoor air pollutants that may act as asthma triggers. Reducing this exposure may improve asthma control...... in children. We conducted a double-blind, placebo-controlled intervention study with 46 asthmatic, house dust mite allergic children. The aim was to investigate the association between indoor air quality in homes and severity of asthma, in particular the effect of increased ventilation rate and expected lower...

  18. PIKO-6® vs. forced spirometry in asthmatic children.

    Science.gov (United States)

    Gochicoa-Rangel, Laura; Larios-Castañeda, Pablo José; Miguel-Reyes, José Luis; Briseño, David Martínez; Flores-Campos, Roberto; Sáenz-López, Juan Arturo; Torre-Bouscoulet, Luis

    2014-12-01

    The PIKO-6® is an electronic device that measures forced expiratory volume at seconds 1 (FEV1) and 6 (FEV6) of a forced vital capacity (FVC) maneuver. This device could aid in diagnosing obstructive respiratory diseases. To determine the concordance of FEV1, FEV6, and the FEV1/FEV6 quotient achieved with PIKO-6® versus spirometric values from asthmatic patients, and compare results with measures from healthy children. A cross-sectional study with asthmatic and healthy 6-to-14-year-old children, all of whom performed a forced spirometry as well as a PIKO-6® test. The study included 82 subjects (58 asthmatics, 24 healthy children). Except for the functional parameters, the basal characteristics of the two groups were similar. The concordance correlation coefficient (CCC) for FEV1 was 0.938 (P spirometry was lower in patients with partially controlled or uncontrolled asthma compared to controlled or healthy children. The broad limits of agreement show that the FEV1, FEV6, and FEV1/FEV6 obtained with the PIKO-6® are not interchangeable with spirometry results. Longitudinal evaluations of asthma patients are necessary to assess the utility of PIKO-6®. © 2014 Wiley Periodicals, Inc.

  19. Caries experience in asthmatic children: a review of literature.

    Science.gov (United States)

    Turkistani, Jihan Mohammed; Farsi, Najat; Almushayt, Abdullah; Alaki, Sumer

    2010-01-01

    This review explores the discriminating factors involved for increased caries experience in asthmatic children. Dental caries is the single most common chronic disease of childhood. Children with chronic medical conditions are considered high caries risk. Asthma is one of the most common chronic medical conditions in childhood. 27 studies examined the asthma-caries causative relationship. Most of them were cross sectional studies; only 5 longitudinal studies were reported. In the literature, there is a lack of consensus regarding the relationship between dental caries and asthma in a child population. Despite the fact that some relatively recent studies have provided little evidence for an asthma-caries causative relationship, the majority and the most recent reports have concluded that the individualistic nature of asthmatic condition, through either its disease status or its pharmacotherapy (diferent combinations of medicaments), or attempts to alleviate the condition's physiologic sequelea, carries several factors for an increased caries risk.

  20. Psychological problems in Turkish asthmatic children and their families.

    Science.gov (United States)

    Akçakaya, N; Aydogan, M; Hassanzadeh, A; Camcioglu, Y; Cokugraş, H

    2003-01-01

    Asthma is a chronic respiratory disorder characterized by recurrent episodes of impaired breathing. The disease causes psychological problems due to hospitalization, long-term medication use, and restricted social life. The aim of this study was to investigate the relationship between the severity and duration of asthma and psychological problems in asthmatic children, as well as the probability of maternal anxiety. Thirty-seven children with mild asthma, 55 with moderate asthma and eight with severe asthma were compared with 50 healthy children. The severity of asthma was evaluated using the Pearlman-Bierman classification. Psychological adjustment was measured using the Achenback child Behavior checklist and Spielberger's scale. Emotional factors and family dynamics were found to be triggering factors for disease attacks in 16% of children with mild asthma, 38% of those with moderate asthma and 63% of those with severe asthma (p anxiety score between the disease severity groups (p > 0.05). The mean depression score was significantly higher in children with moderate and severe asthma than in those with mild asthma (p anxiety. Both asthmatic children and their mothers are negatively affected by the disease.

  1. Cariogenic microorganisms and oral conditions in asthmatic children.

    Science.gov (United States)

    Botelho, M P J; Maciel, S M; Cerci Neto, A; Dezan, C C; Fernandes, K B P; de Andrade, F B

    2011-01-01

    This study evaluated the caries risk of asthmatic patients on the basis of mutans streptococci (MS) and lactobacilli levels in saliva samples as well as the index of oral hygiene and dental caries (DMFT index). The study population was composed of 80 asthmatic children, aged 3-15 years, who use specific medication, and 80 matched, healthy control children. The parents were interviewed about oral health-related factors. The World Health Organization criteria were used for dental examinations. The Köhler and Bratthal methodology was used to detect salivary MS levels and dilutions of saliva were done for lactobacilli counting. No differences between asthma and control groups were observed for caries prevalence in children aged 3-6 and 7-10 years, except in severe cases in the younger group. However, higher caries prevalence for permanent dentition was observed in 11- to 15-year-old asthmatic children. An increased dental biofilm was observed in the asthma group, as well as salivary levels of MS. No differences were observed in levels of lactobacilli. No statistical correlations were found between medication, frequency of treatment, method of consumption and caries experience, dental biofilm and salivary levels of MS or lactobacilli. However, there was a correlation between MS levels and treatment duration. The logistic regression revealed that MS level is an important risk factor for increased caries experience. Asthma should be evaluated as a risk factor for caries experience because it can increase the levels of MS and the dental biofilm. Copyright © 2011 S. Karger AG, Basel.

  2. Increasing ventilation as an intervention in homes of asthmatic children

    DEFF Research Database (Denmark)

    Hogaard, Nina Viskum; Rubak, Sune Leisgaard Mørck; Halken, Susanne

    2016-01-01

    In children asthma is the most frequent chronic disease and house dust mite (HDM) allergy the most frequent cause of allergic asthma. Indoors most of the time, children are exposed to many indoor air pollutants that may act as asthma triggers. Reducing this exposure may improve asthma control...... in children. We conducted a double-blind, placebo-controlled intervention study with 46 asthmatic, house dust mite allergic children. The aim was to investigate the association between indoor air quality in homes and severity of asthma, in particular the effect of increased ventilation rate and expected lower...... exposure to HDM on medication intake among these children. As a result of the intervention, the ventilation rate increased and the CO2 concentration fell significantly compared to baseline in the intervention group. The analyses of the effect of ventilation on health outcomes are being processed...

  3. Effect of disease severity and pharmacotherapy of asthma on oral health in asthmatic children.

    Science.gov (United States)

    Bjerkeborn, K; Dahllöf, G; Hedlin, G; Lindell, M; Modéer, T

    1987-04-01

    Oral health was studied in a group of asthmatic children (n = 61). The children were divided in two groups, 5-10 and 11-18 yr of age. The individuals with asthma were further subgrouped with respect to the disease severity. Severe asthma was defined as more than 10 asthmatic attacks per year. This patient group had daily medication compared to children with moderate asthma (less than 10 asthmatic attacks/yr) who medicated temporarily. 55 age matched children from the same area made up the control group. All children were examined clinically and two bitewing radiographs were taken. The results showed no statistically significant differences concerning caries prevalence and gingival condition in asthmatic children compared to a healthy control group. The study shows that neither the asthma per se nor the disease severity affected the caries prevalence and gingival condition in asthmatic children.

  4. [Asthmatic exacerbations: specific features in children].

    Science.gov (United States)

    Carsin, A; Pham-Thi, N

    2011-12-01

    Asthma concerns more than 10% of 10-year-old children. Despite the similarities between adult and childhood asthma, the pediatric population presents some specific characteristics, notably in relation to exacerbations. Asthma in the newborn infant is a specific entity, the definition of which has recently been officially recognized. In exacerbations, the most important trigger factors are respiratory virus infections, the strain having prognostic importance. The indoor and outdoor environments are risk factors, particularly high levels of atmospheric pollution. Nutrients seem to play a prognostic role through vitamin D or food allergy. Measurement of exhaled nitric oxide and examination of induced sputum may help in diagnosis and adjustment of treatment but these tools are not yet effective as predictive factors in asthma exacerbations. Prevention, early management and continued education of children and their families remain the best methods to improve asthma control. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  5. [Somatic development of asthmatic children and youth].

    Science.gov (United States)

    Szilágyi-Pagowska, I

    2000-01-01

    Systemic diseases especially the chronic ones, causing substance and oxygen insufficiency may lead to disturbances in growth, in the nutritional status and slowing of the maturation processes. Bronchial asthma is the most frequent inflammatory chronic disease of the respiratory system and it is estimated, that 5-10% of the population in the development period suffers from it. Somatic development retardation, disturbances in the nutritional status and maturation may be caused by respiratory insufficiency leading to anoxia, improper nutritional habits, recurrent or chronic infections, long-term physical and mental stress, limited physical activity and also pharmacological therapy. THE AIM of this work was to conduct, in children with bronchial asthma, the evaluation of: somatic development, body proportions, nutritional status, sexual maturation depending on the duration and degree of severity of the disease. The second aim was to assess whether the assumed standard for complex treatment depending on the severity of the diseases may lead to normal somatic development. In the research comprised 508 children (3 1 5 boys and 93 girls) between 7 and 1 5 years of age, treated for bronchial asthma in the Paediatric Department of the Institute of Tuberculosis and Lung Diseases in Rabka. Due to the multiplicity of factors influencing the course of development, the following were observed in the studied groups: birth weight and length, average height of parents (selected genetic factors); place of domicile and educational level of the parents (social-economic factors). The study concerned children born with normal birth weight and length. Evaluation of the impact of genetic factors, was based on the analysis of parent's height; it did not differ in the studied groups with regard to the women's or men's height in the average population. The majority of the studied children lived in towns, every third child lived in the country. Parents of the studied children suffering from

  6. 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.

    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,

  7. Clinical effects of air cleaners in homes of asthmatic children sensitized to pet allergens

    NARCIS (Netherlands)

    van der Heide, S.; van Aalderen, W. M.; Kauffman, H. F.; Dubois, A. E.; de Monchy, J. G.

    1999-01-01

    Exposure to cat and dog allergens is very common in the Western World and is a serious cause of asthma in sensitized subjects. We sought to study the clinical effects of air cleaners in living rooms and bedrooms of asthmatic children sensitized to cat or dog allergens. Twenty asthmatic children

  8. Inspiratory airflow limitation after exercise challenge in cold air in asthmatic children

    NARCIS (Netherlands)

    Driessen, J.M.; van der Palen, Jacobus Adrianus Maria; van Aalderen, W.M.; de Jongh, Franciscus H.C.; Thio, B.J.

    2012-01-01

    Methacholine and histamine can lead to inspiratory flow limitation in asthmatic children and adults. This has not been analyzed after indirect airway stimuli, such as exercise. The aim of the study was to analyze airflow limitation after exercise in cold, dry air. 72 asthmatic children with mild to

  9. Vitamin D and pulmonary function in obese asthmatic children.

    Science.gov (United States)

    Lautenbacher, Laura A; Jariwala, Sunit P; Markowitz, Morri E; Rastogi, Deepa

    2016-12-01

    Asthma-related morbidity is higher among children with vitamin D deficiency and obesity, morbidities that frequently co-exist among minority children. However, the effect of co-existent obesity and vitamin D deficiency on pulmonary function is poorly understood. We compared percent-predicted values of pulmonary function across vitamin D categories among 72 obese and 71 normal-weight Hispanic and African-American children with asthma recruited at an urban children's hospital. Serum cytokines associated with Th1 and Th2 inflammation and 25-hydroxyvitamin D (25-OHD) were quantified in fasting serum. 25-OHD levels ≥30 ng/ml were categorized as sufficient, children and did not differ by obese status. Forced Expiratory Volume in the first second (84.5 ± 9.4 vs. 94.8 ± 8.4, P Functional Residual Capacity (67.5 ± 20.1 vs. 79.3 ± 19, P = 0.01) were lower among vitamin D deficient obese asthmatics than their sufficient counterparts, and Total Lung Capacity was lower than their insufficient counterparts (86.9 ± 14.3 vs. 96.6 ± 10, P = 0.01); similar associations were not observed in normal-weight asthmatics and were not influenced by systemic inflammation. No association between Th1 and Th2 inflammatory measures, vitamin D deficiency, and pulmonary function tests was found. Vitamin D deficiency was associated with pulmonary function deficits among obese children, but not among normal-weight children with asthma, an association that was independent of Th1 and Th2 serum inflammatory measures. Vitamin D deficiency may be one potential mechanism underlying the obese-asthma phenotype. Pediatr Pulmonol. 2016;51:1276-1283. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Correlation between signs of temporomandibular (TMD) and cervical spine (CSD) disorders in asthmatic children.

    Science.gov (United States)

    Chaves, Thaís Cristina; Grossi, Débora Bevilaqua; de Oliveira, Anamaria Siriani; Bertolli, Fabiana; Holtz, Amanda; Costa, Dirceu

    2005-01-01

    Neck accessory respiratory muscles and mouth breathing suggest a direct relationship among asthma, Temporomandibular (TMD) and Cervical Spine (CSD) Disorders. This study was performed to evaluate and correlate TMD, CSD in asthmatic and non-asthmatic. Thirty asthmatic children (7.1 +/- 2.6 years old), 30 non-asthmatic predominantly mouth breathing children (Mouth Breathing Group - MBG) (8.80 +/- 1.61 years) and 30 non-asthmatic predominantly nasal breathing children (Nasal breathing Group - NBG) (9.00 +/- 1.64 years) participated in this study and they were submitted to clinical index to evaluate stomatognathic and cervical systems. Spearman correlation test and Chi-square were used. The level of significance was set at p temporomandibular joint (TMJ), TMJ sounds, pain during cervical extension and rotation, palpatory tenderness of sternocleidomastoids and paravertabrae muscles and a severe reduction in cervical range of motion were observed in AG. Both AG and MBG groups demonstrated palpatory tenderness of posterior TMJ, medial and lateral pterygoid, and trapezius muscles when compared to NBG. Results showed a positive correlation between the severity of TMD and CSD signs in asthmatic children (r = 0.48). No child was considered normal to CSD and cervical mobility. The possible shortening of neck accessory muscles of respiration and mouth breathing could explain the relationship observed between TMD, CSD signs in asthmatic children and emphasize the importance of the assessment of temporomandibular and cervical spine regions in asthmatic children.

  11. [Indoor air quality and parents of asthmatic children practices].

    Science.gov (United States)

    Larramendy Magnin, S; Desssome, B; Moret, L

    2017-09-01

    Indoor air pollution can worsen asthma in children. Better knowledge of factors determining parents' reception of recommendations to limit pollution of indoor air in the homes of asthmatic children would be helpful to improve implementation. A descriptive study evaluating practices known to have an impact on the quality of air in homes was conducted among parents of asthmatic children aged 3 to 16 years. From May to September 2013, parents answered anonymous self-administered questionnaires in waiting rooms of generalist practitioners, in the Nantes University pneumology pediatric outpatient clinic, and as part of therapeutic education sessions conducted by the Asthma-44 Network. There were 190 exploitable questionnaires: 88.2% of parents reported never smoking in the home; 48.4% used home fragrance in the living room at least once a week; 77.8% opened their children's bedroom windows more than 10minutes at least once a day; 32.6% used several cleaning products or bleach once or twice a week. Good practices concerning smoking in housing were applied less in homes where the child was monitored only by a general practitioner (OR=0.08; CI[0.02-0.34]). Good practices on the use of perfume were statistically linked to having an intermediate level occupation (OR=2.31; CI[1.01-5.32]) and being followed by the university hospital, by the asthma network or by a general practitioner if the child had already consulted a pneumo-pediatrician or an allergist (OR=0.24; CI[0.07-0.81]). Good ventilation practices forchildren's bedrooms were statistically linked to residing in a rural rather than urban setting (OR=4.72; CI[1.0-22.16]). Practices observed in parents of asthmatic children differ little from those of the general population. Recommendations on how to limit sources of chemical pollutants, with the exception of smoking, are still poorly applied. Specialist consultations and specific training for general practitioners should improve the penetration

  12. Underuse of controller medications in Egyptian asthmatic children

    African Journals Online (AJOL)

    EL-HAKIM

    children. Objectives: To assess the frequency of underuse of controller medications in Egyptian children and to clarify the causes and predictors for this underuse. Methods: This ... clinicians to develop the most effective strategies for addressing this ... whose parents had false beliefs about asthma were more susceptible to ...

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

    Science.gov (United States)

    Ehsani, Sara; Moin, Mostafa; Meighani, Ghasem; Pourhashemi, Seyed Jalal; Khayatpisheh, Hadi; Yarahmadi, Nazli

    2013-07-13

    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.

  14. 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

    to a standardized submaximal exercise test on the treadmill were measured in 111 school children with asthma. EIB could be excluded with a probability of 90% in asthmatic children with FeNO levels ... reducing the need for exercise testing. OBJECTIVE: The aim of this study was to estimate the value of FeNO as a predictor of EIB in asthmatic children. METHODS: Stable outpatient asthmatic school children performed standard exercise challenge tests and measurement of FeNO. RESULTS: FeNO and response...

  15. 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

  16. Knowledge and Practice of Asthmatic Children's Parents About Daily Air Quality

    OpenAIRE

    Yazdanparast, Taraneh; Seyedmehdi, Seyed Mohammad; Khalilzadeh, Soheila; Salehpour, Sousan; Boloursaz, Mohammad Reza; Baghaie, Nooshin; Hassanzad, Maryam; Velayati, Ali Akbar

    2013-01-01

    Background Knowledge and practice about air pollution are essential subjects in special groups such as cardio-pulmonary patients. For children with air pollution-related diseases, knowledge and attitude of parents play a determining role in this respect. Since providing a coherent curriculum needs evidence-based information, this survey was conducted to assess the knowledge and practice of asthmatic children's parents about daily air quality since asthmatic children are among the most vulnera...

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

    DEFF Research Database (Denmark)

    Bisgaard, H; Pedersen, S; Anhøj, J

    2007-01-01

    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...... and non-asthmatics, FEV(1)% pred was inversely related to having asthmatic siblings (-7.9%; p... of AHR was higher by having asthmatic siblings (OR 2.7; ptherapy, smoking, and positive allergy skin prick...

  18. Growth velocity and weight gain in prepubertal asthmatic children

    Directory of Open Access Journals (Sweden)

    Larissa Celiberto Renosto

    Full Text Available Summary Objective: To evaluate the stature growth rate (GR and the weight gain of prepubertal asthmatic children. Method: A retrospective cohort study evaluating medical records of 85 children diagnosed with asthma, aged less than 9 years, of both sexes, with at least one year of follow-up in the allergy outpatient clinic. The data on the disease, weights and heights were collected through a standardized questionnaire on two occasions, with an interval of one year. The curves proposed by Tanner were applied for the analysis of the GR, and the Z-score of the GR (ZGR was calculated. Results: Excess weight (risk for overweight, overweight and obesity was observed in 31.8% (27/85 of the patients, but there was no association with the severity of asthma. Low GR (ZGR < -2 was found in 13.9% (11/79 of patients, most frequently among children with moderate/severe persistent asthma compared to persistent mild and intermittent forms (7/11 - 63.6% vs. 21/68 - 30.2%, respectively, p=0.047. Use of steroids (dose, type and time of use was not associated with GR. Conclusion: GR was most affected in children with moderate/severe asthma.

  19. Oral health status and treatment needs of asthmatic children aged 6 – 12 Years in Lucknow

    Directory of Open Access Journals (Sweden)

    Pramod Kumar Yadav

    2017-01-01

    Full Text Available Introduction: Asthma is a growing public health problem affecting over 300 million people worldwide. Asthmatic children have an altered immune response and a high tendency to mouth breathing especially during an episode of rhinitis or an attack thus predisposing them to serious oral health problems. Aim: This study aims to assess oral health status of asthmatic children aged 6–12. Materials and Methods: A cross-sectional study was conducted among 450 asthmatic children aged 6–12 years in Lucknow, asthmatic children were chosen from pediatric department of major hospitals. Gingival index (GI, oral hygiene index-simplified (OHI-S, and dentition status and treatment need of World Health Organization oral health survey pro forma (1997 were used to assess oral health status. ANOVA, Chi-square test, and descriptive statistics were carried out. SPSS 16 was used for the data analysis. Results: Mean dynamical mean-field theory (DMFT was 2.98 ± 1.52 and 3.05 ± 1.60, mean GI score was 1.55 ± 0.52 and 1.53 ± 0.42 and mean OHI-S was 2.59 ± 0.68 and 2.48 ± 0.77 among the male and female asthmatic children. Conclusion: Female asthmatic children had higher mean DMFT score, but lower mean GI score and oral hygiene score than male children in comparison and also they had a compromised oral hygiene status.

  20. Sample size estimation in studies monitoring exercise-induced bronchoconstriction in asthmatic children

    OpenAIRE

    Hofstra, W. B.; Sont, J. K.; Sterk, P. J.; Neijens, H J; Kuethe, M. C.; Duiverman, E. J.

    1997-01-01

    BACKGROUND: The repeatability of the response to standardised treadmill exercise testing using dry air and monitoring of heart rate in asthmatic children suffering from exercise-induced bronchoconstriction (EIB) has not been well established. METHODS: Twenty seven asthmatic children with known EIB performed standardised exercise testing twice within a period of three weeks. The tests were performed on a treadmill while breathing dry air. During both tests heart rate had to reach 90% of ...

  1. Variability in anesthesiologists' approach to the preoperative management of asthmatic children.

    Science.gov (United States)

    Armoni Domany, Keren; Gut, Guy; Yakir, Bat-El; Sivan, Yakov

    2016-12-01

    No consensus guidelines exist for the preoperative treatment of asthmatic children referred for elective surgery. We investigated the attitude of pediatric anesthesiologists to this issue. A questionnaire survey was conducted. National survey. Certified Israeli pediatric anesthesiologists from all 24 general hospitals in Israel. Twenty-one questions regarding the approach to preoperative management of asthmatic children including 6 case scenarios with a variety of clinical situations and treatments of asthmatic children. The results were compared with the attitude of pediatric pulmonologists recently published using a similar methodology. Forty-four pediatric anesthesiologists from all 24 general hospitals in Israel responded. Twenty-five percent of pediatric anesthesiologists answered that, in addition to pediatric anesthesiologists, the primary pediatrician should be consulted, and 70% believed that a pediatric pulmonologists should also be consulted. Overall, results showed a wide variability between responders especially for preschool children and unstable school-aged asthmatic children for both disciplines. The variability referred to the use of any treatment, bronchodilators, inhaled corticosteroids and their combination, addition of systemic corticosteroids, and the length of preoperative treatment. Compared with pediatric pulmonologists, a better within-discipline agreement was observed by the pediatric anesthesiologists for stable school-aged asthmatic children with a lower inclination to augment preoperative treatment (P< .001). No difference was observed for the preschool children with asthma and for the unstable school-aged asthmatic child. A wide variability exists in pediatric anesthesiologists' approach to the preoperative management of asthmatic children for most common case scenarios. This is probably explained by the heterogeneity of asthma, the type of surgery, the lack of guidelines, and the paucity of data. Similarities as well as differences

  2. Relation of caries status on the salivary total antioxidant levels in asthmatic children

    Directory of Open Access Journals (Sweden)

    Amitha M Hegde

    2012-01-01

    Full Text Available Aim: To study the correlation between the caries status and the salivary antioxidant levels among asthmatic children. Settings and Design: One hundred children within the age group of 6 12 years were selected and equally subdivided into children having a history of asthma and their healthy siblings. Materials and Methods: Salivary antioxidant levels were assessed using spectrophotometric method, and the caries status was recorded using DMFT (Decayed, missing and Filled Teeth Index and dft (decayed, filled teeth index index. Result: The salivary antioxidant levels were reduced among the asthmatic children which was statistically highly significant, whereas the caries prevalence was reduced, but not statistically significant.

  3. Relation of caries status on the salivary total antioxidant levels in asthmatic children.

    Science.gov (United States)

    Hegde, Amitha M; Raj, Kiran; Shetty, Suchetha

    2012-10-01

    To study the correlation between the caries status and the salivary antioxidant levels among asthmatic children. One hundred children within the age group of 6 12 years were selected and equally subdivided into children having a history of asthma and their healthy siblings. Salivary antioxidant levels were assessed using spectrophotometric method, and the caries status was recorded using DMFT (Decayed, missing and Filled Teeth Index) and dft (decayed, filled teeth index) index. The salivary antioxidant levels were reduced among the asthmatic children which was statistically highly significant, whereas the caries prevalence was reduced, but not statistically significant.

  4. Influence of anti-asthmatic medications on dental caries in children in Slovenia.

    Science.gov (United States)

    Samec, Tomi; Amaechi, Bennett Tochukwu; Battelino, Tadej; Krivec, Uroš; Jan, Janja

    2013-05-01

    OBJECTIVE.  The study investigated the influence of exposure to anti-asthmatic medications and of various factors on the caries prevalence in children in Slovenia. METHODS.  The study population consisted of children aged 2 to 17 years (n = 220) under treatment for asthma, who had used anti-asthmatic medications for at least 1 year; 220 controls were matched for age. Caries status was determined by the number of decayed, missing, and filled surfaces through clinical examination by two calibrated dentists using the International Caries Detection and Assessment System-II scoring criteria. Questionnaires completed by parents and data from the patients' medical records provided information on various confounding factors. RESULTS.  Asthmatic children had significantly higher (P ≤ 0.01) prevalence of caries on primary and permanent teeth in all age groups, and the proportion of caries-free children was significantly smaller (P ≤ 0.05). In multivariate regression analysis, asthma diagnosis, child's age, daily use of inhaled glucocorticoids, length and frequency of medicine application, spacer use, mouth rinsing with water after medicine application, parents' education, frequent food and drink consumption, and frequency of toothbrushing were associated with caries experience of asthmatic children. CONCLUSION.  Children with asthma who had used anti-asthmatic medications had higher caries experience in primary and permanent teeth. © 2012 John Wiley & Sons Ltd, BSPD and IAPD.

  5. Study of the clinical and functional characteristics of asthmatic children with obstructive sleep apnea

    Directory of Open Access Journals (Sweden)

    Nguyen-Hoang Y

    2017-10-01

    Full Text Available Yen Nguyen-Hoang,1 Thuy Nguyen-Thi-Dieu,2 Sy Duong-Quy3–5 1Department of Pediatrics, Phu Tho General Hospital, Phu Tho Province, 2Department of Pediatrics, Hanoi Medical University, Hanoi, 3Biomedical Research Center, Lam Dong Medical College, Dalat, Vietnam; 4Department of Physiology and Lung Function Testing, Cochin Hospital, Paris Descartes University, Paris, France; 5Division of Asthma and Immuno-Allergology, Hershey Medical Center, Penn State Medical College, Hershey, PA, USA Background and objective: The obstructive sleep apnea (OSA is a common respiratory disorder in children, especially those at preschool and school ages. This study aimed to describe the characteristics of asthmatic children with OSA and the symptoms for a high risk of OSA. Subjects and methods: It was a prospective and descriptive study. The data of asthmatic children including medical history, clinical examination, blood tests, spirometry, exhaled nitric oxide (NO, and respiratory polygraphy were registered for analyses. Results: Eighty-five asthmatic children with a mean age of 9.5 ± 2.1 years were included. The prevalence of OSA was 65.9% (56/85 in study subjects. The prevalence of severe OSA in children with moderate asthma was significantly higher than intermittent and mild asthma. The percentage of asthmatic children with OSA who had snoring, sleep disturbance, and nocturnal sweats was significantly higher than that of asthmatic children without OSA (48.2% vs 17.2%, 71.4% vs 27.5%, and 55.1% vs 31.0%, respectively. The presence of allergic rhinitis and snoring was associated significantly with a high probability for the presence of OSA. Conclusion: Children with asthma have a risk of OSA. Asthmatic children with suggested symptoms such as snoring or waking up at night should be screened for OSA. Keywords: asthma, OSA, snoring, allergic rhinitis

  6. Effect of dental care programme and fluoridation in the prevention of dental caries in asthmatic children.

    Science.gov (United States)

    Kilinc, Gulser; Uzuner, Nevin; Karaman, Ozkan

    2016-11-01

    To investigate the effect of a regular dental care programme on the dental health of asthmatic children. This prospective, controlled study was conducted at Dokuz Eylul University, Izmir, Turkey, between 2012 and 2014, and comprised asthmatic and non-asthmatic children between 4 and 16 years of age who used inhaler corticosteroid treatment for at least 1 year. Patients were examined for dental caries, gingival index, salivary flow rate, and salivary pH values at baseline, 6 months, and at the end of the first year. Demographic features and tooth-brushing habits of the asthmatic and non-asthmatic children were also analysed. SPSS 20 was used for data analysis. Of the 102 patients, there were 51(50%) each in asthmatic and non-asthmatic groups. Besides, 38(70.6%) participants were boys and 15(29.4%) were girls in the first group compared to 30(58.8%) boys and 21(41.2%) girls in the second group. The mean age was 11.16±3.10 years and 10.33±2.62 years, respectively, in the two groups. The number of asthmatic patients was 45(88.2%) in visit 2 and 37(72.5%) in visit 3, whereas the number of participants for the control group was 41(80.4%) in visit 2 and 36(70.4%) in visit 3. During the first visit, mean values for salivary pH and flow rate were 7.135 0.15 and 3.878 0.71 mL/min among asthma patients, and 7.158 0.14 and 4.684 0.50 among controls. In the first visit, the rate of gingivitis was 31(60.8%) in asthmatic children and 12(23.5%) in the control group. During the third visit, the rate was 4(11.1%) and 5(13.5%) among the two groups, respectively. Decreased salivary flow rates associated with the drugs used by asthmatic patients caused an increase in the rate of dental caries and gingival disorders.

  7. Timing of first fillings in the primary dentition and permanent first molars of asthmatic children.

    Science.gov (United States)

    Kankaala, T M; Virtanen, J I; Larmas, M A

    1998-02-01

    The aim of this study was to analyze the timing of first fillings posteruptively in a cohort comprising 51 asthmatic children receiving inhaled corticosteroids and living in three communities in Ostrobothnia, Finland. They had all been born in the 1980s and had had asthma check-ups in the local asthma policlinic. A group of 102 healthy age- and sex-matched children served as controls. A longitudinal survival analysis of the timing of the first filling in the primary teeth and first permanent molars was conducted retrospectively using data from the annual dental health records. The timing of the first fillings in permanent first molars showed no statistically significant differences between asthmatic and healthy children, but the filling increments in the primary molars were consistently higher in the asthmatic group; the difference for the upper first primary molars was, for instance, statistically significant (risk ratio = 2.565; 95% confidence interval = 1.333-4.935). More extractions because of caries were also performed on primary molars in the asthmatic children. The findings support the hypothesis that factors related to the asthmatic condition might increase the risk of caries. A longer surveillance time would be needed to evaluate the effect of asthma on the permanent dentition.

  8. The effect of inhaled fluticasone propionate in the treatment of young asthmatic children

    DEFF Research Database (Denmark)

    Bisgaard, H; Gillies, J; Groenewald, M

    1999-01-01

    The response in asthmatic young children to inhaled steroids within the usual pediatric dose range is unknown. We therefore evaluated the dose-related response in young children with moderate asthma to inhaled fluticasone propionate (FP) (delivered via the Babyhaler spacer device) within the pedi...

  9. 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...

  10. J. . Sulphur dioxide sensitivity in South African asthmatic children

    African Journals Online (AJOL)

    preservatives in the food industry. They inhibit enzymatic browning in fresh fruit, vegetables and salads, and non-enzyrnatic browning in dried ..... choconstriction due to aspirin, azo dyes, non-azo dyes, and preser- vatives in a population of perennial asthmatics. ] Allergy Clin. Immll1w11979; 64: 32-36. 15. Bush RK, Taylor ...

  11. 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

    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

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

    Directory of Open Access Journals (Sweden)

    Geovanny F. Perez

    2013-01-01

    Full Text Available 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.

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

    DEFF Research Database (Denmark)

    Buchvald, F; Eiberg, H; Bisgaard, H

    2003-01-01

    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...... 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...

  14. Prevalence of secondhand smoke exposure in asthmatic children at home and in the car: A cross-sectional study

    Directory of Open Access Journals (Sweden)

    H. Antunes

    2016-07-01

    Full Text Available Objective: To compare secondhand smoke exposure (SHSe prevalence at home and inside the car between asthmatic and non-asthmatic Portuguese children. Materials and methods: This is a cross-sectional study that assessed children's SHSe in a representative sample of nine Portuguese cities. A validated self-reported questionnaire was administered to a random sample of 4th grade students during the school year of 2010/2011. The asthma prevalence was defined by the answers to three questions regarding asthma symptoms, medication and inhaler use. We performed chi-square tests and analysed frequencies, contingency tables, confidence intervals, and odd-ratios. Results: The self-reported questionnaire was administered to 3187 students. Asthma prevalence was 14.8% (472 students. Results showed that 32.3% of non-asthmatic children and 32.4% of asthmatic children were exposed to secondhand smoke as at least one of their household members smoked at home. The prevalence of parental smoking, smoking among fathers and smoking among mothers at home was also similar in both groups (asthmatic and non-asthmatic children. SHSe inside the car was 18.6% among non-asthmatic children and 17.9% among asthmatic children. Conclusions: Asthmatic and non-asthmatic children were equally exposed to secondhand smoke, because no significant differences were found between the two groups concerning the prevalence of SHSe at home and inside the car. These findings highlight the need to include SHSe brief advice in paediatric asthma management. Keywords: Secondhand smoke, Children, Asthma

  15. Effect of beta 2-adrenoceptor agonists on saliva proteins and dental caries in asthmatic children.

    Science.gov (United States)

    Ryberg, M; Möller, C; Ericson, T

    1987-08-01

    Twenty-four children, from 10 to 20 years old, with asthma treated with beta 2-adrenoceptor agonists were matched with healthy controls of the same age, sex, and social background. Stimulated whole and parotid saliva was collected, and decayed and filled tooth surfaces as well as oral hygiene habits were recorded. The dietary and sugar intake was carefully checked by a four-day dietary record. The asthmatic children had a 26% lower (p less than 0.05) value for secretion rate of whole saliva. Seventy percent of the children with Streptococcus mutans counts greater than 2 X 10(5) colony-forming units/mL of whole saliva belonged to the asthmatic group (p less than 0.05). The concentrations of total protein and amylase in parotid saliva were significantly lower for the asthmatic children. The concentrations of potassium, salivary peroxidase, bacteria-aggregating glycoproteins, and secretory IgA were not affected, but the secretion rate of parotid saliva was 36% lower in the asthma group (p less than 0.05). Oral hygiene and dietary habits did not differ between the groups. The asthmatic children had higher DFS scores, but these were not significantly different from those of the healthy controls (p = 0.07). We suggest that subjects with asthma treated with beta 2-receptor agonists should receive special prophylactic attention.

  16. High validity of mother-reported use of anti-asthmatics among children: a comparison with a population-based prescription database

    Science.gov (United States)

    Furu, Kari; Karlstad, Øystein; Skurtveit, Svetlana; Håberg, Siri E; Nafstad, Per; London, Stephanie J; Nystad, Wenche

    2011-01-01

    Objectives To examine the validity of: 1) maternal questionnaire report of children's use of anti-asthmatics using a prescription database as the reference standard, 2) dispensed anti-asthmatics as a measure of asthma using maternal report of children's asthma as the reference standard. Study Design and Setting 3394 children in the Norwegian Mother and Child Cohort Study (MoBa) aged seven were linked to the Norwegian Prescription Database (NorPD). Maternal report of both children's use of anti-asthmatics during the preceding year and of the presence of asthma was compared with data on dispensed anti-asthmatics. Results 2056 mothers responded and reported use of anti-asthmatics the previous year in 125 of 147 children who had been dispensed anti-asthmatics (sensitivity 85.0%). Of 1909 children with no dispensed anti-asthmatics, 1848 had no maternal report of anti-asthmatic use (specificity 96.8%). Mothers reported current asthma in 133 (6.5% of 2056) children, including 122 (5.9%) reported as verified by a doctor. Of these 122, 98 had been dispensed anti-asthmatics during the preceding year (sensitivity 80.3%). Only 1.2% of the children without reported asthma were dispensed anti-asthmatics. Conclusion Mother-reported use of anti-asthmatics during the previous year among 7 year old children is highly valid. Dispensed anti-asthmatics would be a useful proxy for the presence of current asthma when disease data are not available. PMID:21232920

  17. QUANTITATIVE PCR ANALYSIS OF MOLDS IN THE DUST FROM HOMES OF ASTHMATIC CHILDREN IN NORTH CAROLINA

    Science.gov (United States)

    The vacuum bag (VB) dust was analyzed by mold specific quantitative PCR. These results were compared to the analysis survey calculated for each of the homes. The mean and standard deviation (SD) of the ERMI values in the homes of the NC asthmatic children was 16.4 (6.77), compa...

  18. ِIncreased expression of T- cell- surface CXCR4 in asthmatic children.

    African Journals Online (AJOL)

    Ehab

    ِIncreased expression of T- cell- surface CXCR4 in asthmatic children. INTRODUCTION. Chemokines are a group of cytokines that ... cytokine responses 3. One of the typical aspects of airway inflammation is the infiltration of Th2 cells and ..... Mast cells can amplify airway reactivity and features of chronic inflammation in an ...

  19. Clinical effects of air cleaners in homes of asthmatic children sensitized to pet allergens

    NARCIS (Netherlands)

    van der Heide, S; van Aalderen, WMC; Kauffman, HF; Dubois, AEJ; de Monchy, JGR

    Background: Exposure to cat and dog allergens is very common in the Western World and is a serious cause of asthma in sensitized subjects. Objective: We sought to study the clinical effects of air cleaners in living rooms and bedrooms of asthmatic children sensitized to cat or dog allergens.

  20. Ambient air pollution, lung function, and airway responsiveness in asthmatic children

    NARCIS (Netherlands)

    Ierodiakonou, Despo; Zanobetti, Antonella; Coull, Brent A.; Melly, Steve; Postma, Dirkje S.; Boezen, H. Marike; Vonk, Judith M.; Williams, Paul V.; Shapiro, Gail G.; McKone, Edward F.; Hallstrand, Teal S.; Koenig, Jane Q.; Schildcrout, Jonathan S.; Lumley, Thomas; Fuhlbrigge, Anne N.; Koutrakis, Petros; Schwartz, Joel; Weiss, Scott T.; Gold, Diane R.

    BACKGROUND: Although ambient air pollution has been linked to reduced lung function in healthy children, longitudinal analyses of pollution effects in asthmatic patients are lacking. OBJECTIVE: We sought to investigate pollution effects in a longitudinal asthma study and effect modification by

  1. Trend in asthma severity in steroid naive asthmatic children in Benin ...

    African Journals Online (AJOL)

    2012-10-18

    Oct 18, 2012 ... Of all these, corticosteroids have been used worldwide for the treatment of both chronic asthma. Trend in asthma severity in steroid naive asthmatic children in Benin city, Nigeria. O Oviawe, WO Osarogiagbon. Department of Child Health, University of Benin Teaching Hospital, Benin City, Edo State, Nigeria.

  2. Hydrogen peroxide in exhaled air is increased in stable asthmatic children

    NARCIS (Netherlands)

    Q. Jobsis (Quirijn); R.H. Raatgeep (Rolien); P.W.M. Hermans (Peter); J.C. de Jongste (Johan)

    1997-01-01

    textabstractExhaled air condensate provides a noninvasive means of obtaining samples from the lower respiratory tract. Hydrogen peroxide (H2O2) in exhaled air has been proposed as a marker of airway inflammation. We hypothesized that in stable asthmatic children the

  3. 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

  4. 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.

  5. Trace metal exposure is associated with increased exhaled nitric oxide in asthmatic children.

    Science.gov (United States)

    Godri Pollitt, Krystal J; Maikawa, Caitlin L; Wheeler, Amanda J; Weichenthal, Scott; Dobbin, Nina A; Liu, Ling; Goldberg, Mark S

    2016-09-01

    Children with asthma experience increased susceptibility to airborne pollutants. Exposure to traffic and industrial activity have been positively associated with exacerbation of symptoms as well as emergency room visits and hospitalisations. The effect of trace metals contained in fine particulate matter (aerodynamic diameter 2.5 μm and lower, PM2.5) on acute health effects amongst asthmatic children has not been well investigated. The objective of this panel study in asthmatic children was to determine the association between personal daily exposure to ambient trace metals and airway inflammation, as measured by fractional exhaled nitric oxide (FeNO). Daily concentrations of trace metals contained on PM2.5 were determined from personal samples (n = 217) collected from 70 asthmatic school aged children in Montreal, Canada, over ten consecutive days. FeNO was measured daily using standard techniques. A positive association was found between FeNO and children's exposure to an indicator of vehicular non-tailpipe emissions (8.9 % increase for an increase in the interquartile range (IQR) in barium, 95 % confidence interval (CI): 2.8, 15.4) as well as exposure to an indicator of industrial emissions (7.6 % increase per IQR increase in vanadium, 95 % CI: 0.1, 15.8). Elevated FeNO was also suggested for other metals on the day after the exposure: 10.3 % increase per IQR increase in aluminium (95 % CI: 4.2, 16.6) and 7.5 % increase per IQR increase in iron (95 % CI: 1.5, 13.9) at a 1-day lag period. Exposures to ambient PM2.5 containing trace metals that are markers of traffic and industrial-derived emissions were associated in asthmatic children with an enhanced FeNO response.

  6. Exhaled nitric oxide in asthmatic and non-asthmatic children: influence of type of allergen sensitization and exposure to tobacco smoke.

    Science.gov (United States)

    Barreto, M; Villa, M P; Martella, S; Ronchetti, F; Darder, M T; Falasca, C; Pagani, J; Massa, F; Ronchetti, R

    2001-10-01

    Asthmatic bronchial inflammation is associated with increased nitric oxide concentrations in exhaled air (eNO). Recent data suggest that this effect arises from atopy. Our aim in this study was to find out whether atopy and sensitization to particular allergens influences eNO levels. A total of 213 subjects (41 asthmatics and 172 controls) (96 boys and 117 girls, 7.3-14 years of age) were studied. Parents completed a questionnaire that sought information on their children's respiratory symptoms and exposure to tobacco smoke. Subjects underwent skin-prick tests for the following common allergens: Dermatophagoides pteronyssinus (Dpt), cat fur, Aspergillus fumigatus, Alternaria tenuis, mixed grass, mixed tree pollen, Parietaria officinalis, egg, and cow's milk. eNO was collected in 1-l mylar bags (exhaled pressure 10 cmH2O, flow 58 ml/s) and analyzed by using chemiluminescence. Atopic and non-atopic children without a history of chronic respiratory symptoms had a similar geometric mean eNO (atopics, n = 28, 11.2 p.p.b.; non-atopics, n = 96, 10.0 p.p.b.; mean ratio 1.1, 95% confidence interval [CI]: 0.7-1.6). Conversely, atopic asthmatic subjects had significantly higher eNO values than non-atopic asthmatic subjects (atopics, n = 25, 24.8 p.p.b.; non-atopics, n = 16, 11.4 p.p.b.; mean ratio 2.2, 95% CI: 1.2-3.9, p= 0.000). In children with rhinitis alone (n = 15) and those with lower respiratory symptoms other than asthma (n = 33), eNO increased slightly, but not significantly, with atopy. eNO levels correlated significantly with Dpt wheal size (r = 0.51) as well with the wheal size for cat, mixed grass, and Parietaria officinalis (r = 0.30-0.29), and with the sum of all wheals (r = 0.47) (p= 0.000). Subjects sensitized only for Dpt (but not those subjects sensitized only for grass pollen or other allergens) showed significantly higher eNO levels than non-atopic subjects (16.4 p.p.b. vs. 10.2 p.p.b., mean ratio 1.6, 95% CI: 1.1-2.3, p= 0.002). In asthmatic subjects

  7. A cross-sectional survey of participation of asthmatic children in physical activity.

    Science.gov (United States)

    Cheng, Bo-Li; Huang, Ying; Shu, Chang; Lou, Xiao-Li; Fu, Zhou; Zhao, Jing

    2010-08-01

    Physical exercise has been proven to be beneficial to children with asthma, but the traditional view in China is that asthmatic children should not take part in sports. This study was undertaken to investigate the current status of children with asthma taking part in exercise in China. One hundred and twenty-three asthmatic children (7-14 years old) who had visited our asthma control center between February 2009 and June 2009 were enrolled in this cross-sectional study. Each child had a pulmonary function test and his/her health-related quality of life was assessed. The children also finished a questionnaire about their physical activity. As a control group, 109 nonasthmatic children from a primary school were surveyed about their level of activity. Asthmatic children took part in less exercise than their healthy peers, and 62.6% (77/123) of the children with asthma never reached the criteria of exercise prescription for patients with asthma advised by the American College of Sports Medicine. The asthmatic children were divided into two groups based on the level of activity; compared with the group with a higher physical activity level, more children in the group with lower activity believed that exercise could make asthma worse, more parents and teachers restricted the children's exercise, and fewer doctors approved them participating in exercise. All of the parameters of basic lung function were higher in the group with higher activity level. Moreover, the children with a higher exercise level had a higher score on all parts of the pediatric asthma quality-of-life questionnaire. About 78.5% (96/123) of children ever experienced coughing, chest distress, dyspnea, or gasping during exercise, but 49.6% (61/123) had these symptoms occasionally. Our study reveals that children with asthma do not have enough exercise in China. The concept that children, parents, teachers and doctors have about exercise for patients with asthma is urgent to be updated. We need to

  8. Evaluation of the left and right ventricular systolic and diastolic function in asthmatic children.

    Science.gov (United States)

    Akyüz Özkan, Esra; Khosroshahi, Hashem E

    2016-07-08

    Asthma is the most common cause of respiratory disorders among children. We aimed to investigate left (LV) and right (RV) ventricular function in asthmatic children as detected by conventional and tissue Doppler echocardiography. Fifty pediatric patients with asthma and forty healthy children were studied. Pulmonary function tests, electrocardiography and echocardiographic examinations were performed on all children. Rate-corrected velocity of circumferential fiber shortening (VCFc) (p = 0.044), the ratio between heights of early and late diastolic flow velocity peaks (E/A) (p = 0.019) and LV end-systolic wall stress (ESWSm) was lower (p = 0.003), RV stroke volume (SV) (p = 0.002), LV SV (p = 0.001), tricuspid annular plane systolic excursion (TAPSE) (p = 0.034), tricuspid annular peak velocity during systole (S') (p = 0.022), tricuspid and mitral early diastolic velocities (E') (p = 0.012, p = 0.003 respectively) were lower in asthmatic children than controls. The mitral valve ejection time (ET) was high in asthmatic group (p = 0.027). FEV1 was positively correlated with isovolumetric relaxation time (IVRT) (p = 0.018) (r = 0.382) and mitral ET (p = 0.018) (r = 0.381). PEF was negatively correlated with the RV work index (p = 0.032) (r = -0.348) and LV work index (p = 0.005) (r = -0.457). Although cardiac systolic function was found to be impaired in asthmatic patients, contrary to the literature, diastolic dysfunction was not observed in these patients, even by tissue Doppler imaging, and this finding may be attributed to using inhaled corticosteroid.

  9. [Cross-sectional study of school integration of asthmatic children in a general population sample].

    Science.gov (United States)

    Pin, I; Guerin-Develay, S; Cans, C; Vivier, S; Pequegnot, C; Lerendu, B; Pison, C; Paramelle, B

    2000-08-01

    Asthma is one of the most frequently encountered chronic illnesses in children. The aim of the present study was to investigate the problem of integration of asthmatic subjects at school by assessing the reactions of parents and teachers, and also by considering the medical aspects. A cross-sectional random study was carried out during autumn 1994 including 4,251 primary school children aged between five and 14 years, and including teachers from 188 classes and 26 schools in Grenoble and its inner suburbs. The first screening questionnaire was completed by the parents, and data on 3,799 children were obtained; from this, 191 currently asthmatic children were identified. One hundred and forty-six parents of the identified asthmatics subsequently answered a second questionnaire on the severity of the illness and its effects on school attendance and educational activities. The 186 teachers from the schools involved were interviewed about their knowledge of the disorder, and about what they knew of the treatment and management of asthmatic children in school. It was found that the cumulative prevalence of asthma amounted to 7.6%, and that the prevalence over the previous 12-month period was 4.3%. Sixteen percent of the asthmatic children reported an asthma-associated school absence of more than six days during the six preceding months. In 45.2% of cases, physical exercise was responsible for an asthmatic attack, but premedication was used in only 21% of cases. Nine percent of the children had obtained a medical certificate which exempted them from participating in sports activities and physical exercise. Seventy-three percent of the parents had informed the teachers of their child's illness, but the information communicated was incomplete. It was found that the teachers did not have a thorough knowledge of the disorder, but that many of them (92.7%) would appreciate further information on the subject and on its management. Eighty-three percent of the teaching staff

  10. Safety and efficacy of tiotropium in children aged 1-5 years with persistent asthmatic symptoms

    DEFF Research Database (Denmark)

    Vrijlandt, Elianne J L E; El Azzi, Georges; Vandewalker, Mark

    2018-01-01

    : This exploratory 12-week, randomised, double-blind, placebo-controlled, parallel-group, phase 2/3, regulatory multicentre trial was done at 32 hospitals, clinics, and clinical research units in 11 countries in Asia, Europe, and North America. Children aged 1-5 years with at least a 6-month history of persistent...... asthmatic symptoms and a need for inhaled corticosteroids were eligible. Patients were randomly allocated using an interactive voice or web-based response system to receive once-daily tiotropium 2·5 μg, tiotropium 5 μg, or placebo as an add-on to inhaled corticosteroids with or without additional controller....... INTERPRETATION: To our knowledge, our small study is the first to assess the safety and efficacy of tiotropium in children aged 1-5 years with persistent asthmatic symptoms. Tolerability of tiotropium was similar to that of placebo, which is consistent with previous findings in older populations. Although mean...

  11. Short-term heart rate variability in asthmatic obese children: effect of exhaustive exercise and different humidity conditions.

    Science.gov (United States)

    Rezvan, K; Dabidi Roshan, V; Mahmudi, S A

    2015-11-01

    Asthmatic obese children experience changes in functional capacity and autonomic control. Previous heart rate variability (HRV) studies were based on 24-hour recordings, little research has been conducted on the short-term HRV in asthmatic obese children, primarily during physical effort indifferent environmental humidity conditions. The aim of this study was to evaluate the effect of aerobic activity on short-term HRV in asthmatic obese children under two different environmental humidity conditions. Ten obese boys with mild asthma as experimental group and 15 obese healthy boys with the same conditions were involved as a control group. Protocol included progressive and exhaustive aerobic activities on a calibrated ergometer pedal bicycle in two various environmental humidity 35±5% and 65±5%. HRV was measured by PADSY MEDSET Holter monitoring device during three phases; pre-test, mid-test and post-test. Then, short-term HRV was assessed from calculation of the mean R-R interval measured on HRV at each phases. HRV significantly decreased at mid-test and post-test among asthmatic and health children. However, the aforesaid changes were significantly higher in the asthmatic than health children following. Moreover, decrease of short-term HRV was significantly greater in the 35±5% than 65±5% environmental humidity. Our findings suggest from the autonomic standpoint, asthmatic and non-asthmatic children respond differently to exhaustive exercise induced stress. Aerobic exercise at an environment with high humidity compared with the low humidity appears to have additional benefits on short-term HRV in that it enhances the parasympathetic and autonomic modulation of the heart in asthmatic obese children.

  12. [Association of FEV1 and PEF with small airway function in asthmatic children: cross-sectional analysis of 619 cases].

    Science.gov (United States)

    Wu, Xue-jun; Huang, Ying; Wang, Ying; Gong, Cai-hui

    2011-11-01

    To investigate the association of forced expiratory volume in 1 second (FEV1) and the maximum peak expiratory flow (PEF) with small airway function in asthmatic children of different ages and genders. This cross-sectional study was conducted among 619 asthmatic children with disease remission aged 3 to 13 years. The children were divided into 3 age groups, namely 3 to 5 years group (314 cases), 6 to 9 years group (207 cases) and 10 to 13 years group (98 cases), and their respiratory physiological parameters such as FEV1 and PEF were measured. Of the airway function parameters, PEF showed the highest abnormality rate (>85%) in these asthmatic children. In male and female asthmatic children aged 6 to 9 years, abnormalities in forced expiratory flow rate 25% (MEF25) showed the highest frequency (56% and 63%, respectively). In 3-5 years and 10-13 years groups, MEF25 abnormalities were the most frequent in male children (43% and 71%, respectively), whereas abnormalities in MEF50 were the most common in female children (33% and 69%, respectively). FEV1 and PEF were positively correlated to all the parameters of small airway functions in these asthmatic children (r>0.5, PPEF are positively correlated to the parameters of small airway function with only the exception of MEF25 in female children aged 3 to 5 years, suggesting the value of FEV1 in the diagnosis of asthma in children.

  13. Underuse of controller medications in Egyptian asthmatic children ...

    African Journals Online (AJOL)

    Background: International guidelines recommend daily use of controller medications for children with persistent asthma. Several studies from different regions of the world have reported low asthma control among children. Objectives: To assess the frequency of underuse of controller medications in Egyptian children and to ...

  14. Genetic variation in Ameloblastin is associated with caries in asthmatic children.

    Science.gov (United States)

    Ergöz, N; Seymen, F; Gencay, K; Tamay, Z; Deeley, K; Vinski, S; Vieira, A R

    2014-06-01

    Evidence suggests caries experience is higher in children with asthma. This study compared caries experience in asthmatic and non-asthmatic children and defined whether variation in the distribution of caries experience differed between the two groups and was dependent on the presence of genetic variation in enamel formation genes. Children with asthma were recruited at the Istanbul University, Faculty of Medicine, Department of Paediatrics, Division of Paediatric Allergy and Pulmonary Diseases, and non-affected children were recruited at the Istanbul University, Faculty of Dentistry, Department of Paedodontics. Cases (N = 100) were defined as children between the ages of 6 and 12 years with asthma and controls (N = 100) as children without asthma. Cases and controls were matched by sex and age. All study subjects received a complete dental exam, provided demographic and other caries and asthma risk factors data, and a saliva sample for DNA extraction. Caries experience was defined based on DMFT/dmft and DMFS/dmfs scores. Genotypes of 11 SNPs were selected in intronic regions of enamel development genes. PCR with TaqMan chemistry was used for genotyping all selected markers. Association between caries experience (caries-free versus caries affected) depending on asthma status and SNPs was tested with PLINK by logistic regression, adjusting by risk, and other preventive measures. p values below 0.0045 (0.05/11) were considered statistically significant. Logistic regression analysis showed an association between AMBN rs4694075 and caries experience (p = 2.525e-007). This study provides, for the first time, evidence that ameloblastin is associated with caries in asthmatic children.

  15. Quantitative PCR Analysis of Molds in the Dust from Homes of Asthmatic Children in North Carolina

    Energy Technology Data Exchange (ETDEWEB)

    Vesper, Stephen J.; McKinstry, Craig A.; Ashley, Peter; Haugland, Richard A.; Yeatts, Karin; Bradham, Karen; Svendsen, Eric

    2007-07-10

    The vacuum cleaner bag (VCB) dust from the homes of 19 asthmatic children in North Carolina (NC) was analyzed by mold specific quantitative PCR. These results were compared to the analysis of the VCB dust from 157 homes in the HUD “American Healthy Home Survey” of homes in the US. The American Relative Moldiness Index (ARMI) was calculated for each of the homes. The mean and standard deviation (SD) of the ARMI values in the homes of the NC asthmatic children was 11.0 (5.3), compared to the HUD survey VCB ARMI value mean and SD of 6.6 (4.4). The median ARMI value was significantly higher(p < 0.001) in the asthmatic childrens’s homes. The molds Chaetomium globosum and Eurotium amsterdameli were the primary species in the NC homes making the ARMI values higher. Vacuum cleaner bag dust samples may be a less expensive but still useful method of home mold analysis.

  16. Educating Asthmatic Children in European Ambulatory Pediatrics: Facts and Insights

    National Research Council Canada - National Science Library

    Robberecht, Marie Noëlle; Beghin, Laurent; Deschildre, Antoine; Hue, Valérie; Reali, Laura; Plevnik-Vodušek, Vesna; Moretto, Marilena; Agustsson, Sigurlaug; Tockert, Emile; Jäger-Roman, Elke; Deplanque, Dominique; Najaf-Zadeh, Abolfazl; Martinot, Alain

    2015-01-01

    .... 436 ambulatory pediatricians in Belgium, France, Germany, Italy, Luxembourg and Slovenia were asked to participate in the survey providing information on three children over 6 years old suffering...

  17. Prevalence of sinusitis in under 12 year old asthmatic children in Hamadan City, Western part of Iran

    OpenAIRE

    Mozdeh Safari; Nafiseh Mohebbi

    2010-01-01

    Introduction: Sinusitis is one of the differential diagnosis of asthma.  Association of sinusitit with asthma can result in severity of the disease and treatment failure. This study aimed to determine the prevalence of sinusitis in under 12 year old asthmatic children. Material and Methods:  In this prospective cross sectional study, the prevalence of sinusitis was determined in 60 under 12 years old asthmatic patients (47 boys, 13 girls) according to clinical signs (headache, productive coug...

  18. 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...

  19. Asthma exacerbations among asthmatic children receiving live attenuated versus inactivated influenza vaccines.

    Science.gov (United States)

    Ray, G Thomas; Lewis, Ned; Goddard, Kristin; Ross, Pat; Duffy, Jonathan; DeStefano, Frank; Baxter, Roger; Klein, Nicola P

    2017-05-09

    To investigate whether there is a difference in the risk of asthma exacerbations between children with pre-existing asthma who receive live attenuated influenza vaccine (LAIV) compared with inactivated influenza vaccine (IIV). We identified IIV and LAIV immunizations occurring between July 1, 2007 and March 31, 2014 among Kaiser Permanente Northern California members aged 2 to children receiving LAIV and those receiving IIV ("difference-in-differences"). Among 387,633 immunizations, 85% were IIV and 15% were LAIV. Children getting LAIV vs. IIV were less likely to have "current or recent, persistent" asthma (25% vs. 47%), and more likely to have "remote history" of asthma (47% vs. 25%). Among IIV-vaccinated asthmatic children, the OR of an inpatient/ED asthma exacerbation was 0.97 (95% CI: 0.82-1.15). Among LAIV-vaccinated asthmatic children the OR was 0.38 (95% CI: 0.17-0.90). In the difference-in-differences analysis, the odds of asthma exacerbation following LAIV were less than IIV (Ratio of ORs: 0.40, CI: 0.17-0.95, p value: 0.04). Among children ≥2years old with asthma, we found no increased risk of asthma exacerbation following LAIV or IIV, and a decreased risk following LAIV compared to IIV. Copyright © 2017 Elsevier Ltd. All rights reserved.

  20. The role of computer games in measuring spirometry in healthy and "asthmatic" preschool children.

    Science.gov (United States)

    Vilozni, Daphna; Barak, Asher; Efrati, Ori; Augarten, Arie; Springer, Chaim; Yahav, Yacov; Bentur, Lea

    2005-09-01

    To explore the role of respiratory interactive computer games in teaching spirometry to preschool children, and to examine whether the spirometry data achieved are compatible with acceptable criteria for adults and with published data for healthy preschool children, and whether spirometry at this age can assess airway obstruction. Feasibility study. Community kindergartens around Israel and a tertiary pediatric pulmonary clinic. Healthy and asthmatic preschool children (age range, 2.0 to 6.5 years). Multi-target interactive spirometry games including three targets: full inspiration before expiration, instant forced expiration, and long expiration to residual volume. One hundred nine healthy and 157 asthmatic children succeeded in performing adequate spirometry using a multi-target interactive spirometry game. American Thoracic Society (ATS)/European Respiratory Society spirometry criteria for adults for the start of the test, and repeatability were met. Expiration time increased with age (1.3 +/- 0.3 s at 3 years to 1.9 +/- 0.3 s at 6 years [+/- SD], p 1.5 SD for forced expiratory flow at 50% of vital capacity [FEF50] and forced expiratory flow at 75% of vital capacity [FEF75], p games can facilitate spirometry in very young children, yielding results that conform to most of the ATS criteria established for adults and published data for healthy preschool children. Spirometric indexes correlated with degree of asthma severity.

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

    Science.gov (United States)

    Nagano, Jun; Kakuta, Chikage; Motomura, Chikako; Odajima, Hiroshi; Sudo, Nobuyuki; Nishima, Sankei; Kubo, Chiharu

    2010-10-07

    To examine relationships between a mother's stress-related conditions and parenting attitudes and their children's asthmatic status. 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. 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 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.

  2. Serum Interleukin-5 Changes in Partly Controlled Atopic Asthmatic Children

    OpenAIRE

    Yamamah, Gamal A; Abdel Meguid, Iman E; Fatouh, Amany A; Shaaban, Hala H; Nagwa A Kantoush; Shereen F Beharrey

    2014-01-01

    BACKGROUND: Cytokines including Interleukin-5 play a key role in orchestrating the chronic inflammation of asthma. We aimed to determine the level of serum IL-5 in partly controlled atopic asthma in children and to assess the effect of different therapies on their levels. METHODS: The study included 40 children aged 6-12 years with partly controlled asthma. Cases were randomly divided into two groups; group ‘A’ receiving Leukotriene modifiers and group ‘B’ receiving inhaled corticosteroid...

  3. [Exploration and research of community management model for asthmatic children].

    Science.gov (United States)

    Li, Jingpeng; Wei, Hong; Li, Xuejun; Wang, Mengmeng; Wang, Genxiang; Zhao, Shunying

    2014-05-01

    To study the efficacy of community management model of bronchial asthma in children. Through community outreach and clinic, 120 cases of children with asthma were enrolled from the 11 000 children aged 0 to 14 in Zhanlanlu area, and a community management model of asthma was established according to the Global Initiative for Asthma requirements combined with the actual situation of the community, both physicians and patients participated in case identification, file creation, and long-term standardized management. Through repeated medical education, the telephone hotline and interactive network of asthma among physicians, children and parents, a physician-patient relationship was established. The data of standardized medication, scheduled re-visit to the hospital, frequency of asthma attacks, antibiotic use, medical expenses, the loss of parents work hours etc. before and after the implementation of community management model were analyzed and compared. After implementation of community management model, the use of systemic corticosteroids (19.4%), oral medication (31.6%) was significantly lower than those before implementation (68.3% and 90.0%) (χ(2) = 51.9, 41.1, P management level (10.0%), χ(2) = 106.0, P management, eventually the dropout rate was 9.2%. Enrollment of children with bronchial asthma into community management model made the children adhere to the management regularly and a standardized management was achieved.

  4. T-cell responses against rhinovirus species A and C in asthmatic and healthy children.

    Science.gov (United States)

    Gaido, Cibele M; Granland, Caitlyn; Laing, Ingrid A; Souëf, Peter N Le; Thomas, Wayne R; Currie, Andrew J; Hales, Belinda J

    2017-11-10

    Infections by rhinovirus (RV) species A and C are the most common causes of exacerbations of asthma and a major cause of exacerbations of other acute and chronic respiratory diseases. Infections by both species are prevalent in pre-school and school-aged children and, particularly for RV-C, can cause severe symptoms and a need for hospitalization. While associations between RV infection and asthma are well established, the adaptive immune-mechanisms by which RV infections influence asthma exacerbations are yet to be defined. The aim of this study was to characterize and compare T-cell responses between RV-A and RV-C and to test the hypothesis that T-cell responses would differ between asthmatic children and healthy controls. A multi-parameter flow cytometry assay was used to characterize the in vitro recall T-cell response against RV-A and RV-C in PBMCs from children with acute asthma (n = 22) and controls (n = 26). The responses were induced by pools of peptides containing species-specific VP1 epitopes of RV-A and RV-C. Regardless of children's clinical status, all children that responded to the in vitro stimulation (>90%) had a similar magnitude of CD4+ T-cell responses to RV-A and RV-C. However, asthmatic children had a significantly lower number of circulating regulatory T cells (Tregs), and healthy controls had significantly more Tregs induced by RV-A than RV-C. The comparable recall memory T-cell responses in asthmatic and control children to both RV-A and RV-C show that differences in the antibody and inflammatory responses previously described are likely to be due to regulation, with a demonstrated candidate being reduced regulatory T-cells. The reduced Treg numbers demonstrated here could explain the asthmatic's inability to appropriately control immunopathological responses to RV infections. © 2017 The Authors. Immunity, Inflammation and Disease Published by John Wiley & Sons Ltd.

  5. PARENTAL KNOWLEDGE OF THE ADVERSE EFFECTS OF HOUSEHOLD TOBACCO SMOKE EXPOSURE IN ASTHMATIC CHILDREN.

    Science.gov (United States)

    Poopat, Supanun; Sritippayawan, Suchada; Kamalaporn, Hanrutai; Phumethum, Sintra

    2015-11-01

    The aim of this study was to determine the prevalence of household tobacco smoke exposure in children presenting to asthma clinic at Prapokklao Hospital and to survey parental knowledge and perception to the dangers of household smoke exposure. Parents/guardians who brought their children to asthma clinic during June-September 2014 were interviewed to complete survey questionnaires. If there were smokers in the household, questionnaires with a postage paid self-addressed envelopes were given to the family to take back home for other household smokers to complete. There were 149 asthmatic children who attended the asthma clinic during the study period. Seventy-one pediatric patients (47.7%) lived with at least one household smoker. Thirty-one smokers completed the questionnaires. Only five (16.1%) accompanied the patients to asthma clinic. Almost all of the smokers had a desire to quit smoking, and 58.1% of the smokers and 63.2% of the non-smokers had received information regarding the dangers of household smoke exposure. The knowledge test scores were not different between the two groups. The prevalence of household smoke exposure in asthmatic children was high, despite most of the smokers knew about the adverse effects of household smoke exposure on their children' s health and desired to quit smoking.

  6. 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 8...

  7. 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

    -six asthmatic children 6 to 15 yr of age completed a double-blind crossover trial of 2 wk of treatment with 5 mg montelukast once daily versus placebo. FENO was measured during single-breath exhalation at a constant flow rate of 0.1 to 0.13 L/s against a resistance of 10 kPa/L/s. Eleven children were receiving......Nitric oxide in exhaled air (FENO) is increased in asthmatic children, probably reflecting aspects of airway inflammation. We have studied the effect of the leukotriene receptor antagonist (LTRA) montelukast on FENO with a view to elucidate potential anti-inflammatory properties of LTRAs. Twenty...... 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...

  8. Saliva and serum eosinophil cationic protein in asthmatic children and adolescents with and without allergic sensitization.

    Science.gov (United States)

    Koh, Gerald Choon-Huat; Shek, Lynette Pei-Chi; Kee, Janine; Wee, Andrew; Ng, Vivian; Koh, David

    2010-02-01

    Saliva eosinophil cationic protein (ECP) is higher in asthmatic adults than in healthy ones. However, its relationship with asthma severity, other atopic conditions and allergic sensitization have not been reported. Saliva collection is painless, readily acceptable to children and parents, and can be a potentially useful body fluid to measure asthma biomarkers. We recruited 102 physician-diagnosed young asthmatic subjects from outpatient clinics with change in FEV(1) > or = 12% with inhaled salbutamol and collected data on asthma severity, concurrent allergic rhinitis (AR) and atopic dermatitis (AD), and medication used (bronchodilator and corticosteroid). We measured whole saliva and serum ECP and performed skin prick tests (SPT) for three dust mites (Dermatophagoides pteronyssisinus, Dermatophagoides farinae and Blomia tropicalis) and two cockroaches (Periplaneta americana and Blatella germanica). Median salivary ECP was 84.6 microg/l (inter-quartile range [IQR]: 40.9-147.9) and median serum ECP was 14.7 microg/l (IQR: 6.4-32.1). Serum ECP was only higher in children whose sleep was disturbed by asthma in the past year than those who were not (geometric mean [GM]: 18.9 vs. 11.1 microg/l, relative mean difference [RMD]: 1.71 [95%CI: 1.09-2.69]). Serum ECP was increased among asthmatic children on inhaled corticosteroid than those not using them (GM: 15.6 vs. 8.1 microg/l, RMD: 1.93 [95%CI: 1.11-3.39]). Salivary ECP was not associated with asthma severity, concurrence of atopic conditions, medications used, or any SPT parameter. Saliva ECP did not correlate with serum ECP (r(s) = 0.032, p = 0.790). Salivary and serum ECP did not correlate with wheal size for any skin prick test.

  9. Are Clinicians' Assessments of Improvements in Children's Functioning "Global"?

    Science.gov (United States)

    De Los Reyes, Andres; Alfano, Candice A.; Beidel, Deborah C.

    2011-01-01

    In this study, the authors examined the relations among clinician ratings of treatment improvement and discrepancies between parent and blinded laboratory rater reports of child social functioning administered before and after treatment for social anxiety disorder. Participants included a clinic sample of 101 children (7-16 years old; M = 11.67,…

  10. Effect of inhaled fluticasone propionate on retinal nerve fiber layer thickness in asthmatic children.

    Science.gov (United States)

    Dereci, Selim; Pirgon, Ozgur; Akcam, Mustafa; Turkyilmaz, Kemal; Dundar, Bumin

    2015-01-01

    Corticosteroids are under suspicion of playing an important role in the development of retinopathy. We aimed to determine peripapillary retinal nerve fiber layer (RNFL) thinning by spectral-domain optical coherence tomography (OCT) in children being treated with inhaled fluticasone propionate due to asthma. Thirty-eight children diagnosed with allergic asthma (mean age 9.8 ± 2.8 years, age range 6-13 years) and 40 age-similar controls were enrolled in this study. All children with asthma were taking inhaled fluticasone propionate at a dosage of 250 µg or more per day for at least 1 year. The RNFL thickness measurements were performed using Cirrus HD spectral-domain OCT 400. Central subfield thickness, cube average thickness, and cube volume were also measured. Among the 38 children with asthma and 40 healthy subjects who completed follow-up, children with asthma had similar mean peripapillary RNFL thicknesses compared with control children. The mean central subfield thickness was significantly higher than that of controls (248.8 ± 23.4 vs 237.5 ± 23.5, p<0.037). There was a positive linear relationship between cube average thickness and eosinophil count with a Pearson correlation coefficient of 0.336 (p<0.039) and a negative correlation was found between central subfield thickness and disease duration (r = -0.385, p = 0.017) in children with asthma. Asthmatic children have similar peripapillary RNFL measurements compared to controls on spectral-domain OCT. Raised eosinophil counts in asthmatic children were found to be significantly associated with cube average thickness.

  11. Ozone exposure, vitamin C intake, and genetic susceptibility of asthmatic children in Mexico City: a cohort study

    Directory of Open Access Journals (Sweden)

    Moreno-Macías Hortensia

    2013-02-01

    Full Text Available Abstract Background We previously reported that asthmatic children with GSTM1 null genotype may be more susceptible to the acute effect of ozone on the small airways and might benefit from antioxidant supplementation. This study aims to assess the acute effect of ozone on lung function (FEF25-75 in asthmatic children according to dietary intake of vitamin C and the number of putative risk alleles in three antioxidant genes: GSTM1, GSTP1 (rs1695, and NQO1 (rs1800566. Methods 257 asthmatic children from two cohort studies conducted in Mexico City were included. Stratified linear mixed models with random intercepts and random slopes on ozone were used. Potential confounding by ethnicity was assessed. Analyses were conducted under single gene and genotype score approaches. Results The change in FEF25-75 per interquartile range (60 ppb of ozone in persistent asthmatic children with low vitamin C intake and GSTM1 null was −91.2 ml/s (p = 0.06. Persistent asthmatic children with 4 to 6 risk alleles and low vitamin C intake showed an average decrement in FEF25-75 of 97.2 ml/s per 60 ppb of ozone (p = 0.03. In contrast in children with 1 to 3 risk alleles, acute effects of ozone on FEF25-75 did not differ by vitamin C intake. Conclusions Our results provide further evidence that asthmatic children predicted to have compromised antioxidant defense by virtue of genetic susceptibility combined with deficient antioxidant intake may be at increased risk of adverse effects of ozone on pulmonary function.

  12. [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

    Social media has been used in support of patients with asthma. However, it remains unclear what are the expectations of parents or caregivers of asthmatic patients. To evaluate the expectations of parents or caregivers of asthmatic children treated at Children's Asthma Prevention Program (PIPA), Uruguaiana, RS, in relation to the use of social media. An observational, descriptive, cross-sectional survey of parents or caregivers of children seen at Children's Asthma Prevention Program through responses to a written questionnaire on the use of new technologies and different applications to enhance information about asthma. 210 parents or caregivers (median age: 25 years; age range: 18-42 years of patients were enrolled. The mean age of their children was 7.3 years (age range: 2 to 18 years), the mean duration of asthma was 4.7 years and 65% of parents/caregivers of these children had less than eight years of schooling. Most of them (72%) had no access to the Internet via cell/mobile phones and only 18% actively used to gathered information about asthma by internet. There was high interest (87%) in receiving information via social media. Parents or caregivers of children attending the PIPA program expressed high interest in using social media. However, few use it to control their children's disease. While providing a great benefit to use social media as a mean of communication in health, the content needs to be monitored for reliability and quality. The privacy of users (doctors and patients) must be preserved and it is very important to facilitate the access to Internet.

  13. Terbutaline nebulization and epinephrine injection in treating acute asthmatic children.

    Science.gov (United States)

    Lin, Y Z; Hsieh, K H; Chang, L F; Chu, C Y

    1996-05-01

    Ninety children with acute asthma, equally divided into two study groups, were studied to compare the efficacy and safety of nebulized terbutaline with injected epinephrine in the treatment of acute exacerbation. The terbutaline group received 2 ml (5,0 mg) terbutaline solution diluted with 2 ml 0.9% saline for inhalation over 10 minutes; the epinephrine group received 0.01 ml/kg of 1:1000 epinephrine (maximum 0,3 ml) through subcutaneous injection at deltoid area. Spirometry, pulse oximetry, and clinical severity scoring system were evaluated at baseline and again 15 minutes after treatment. The baseline data of the two groups were not significantly different. The clinical severity score and spirometry of both groups were significantly improved after treatment. Compared with the terbutaline group, the epinephrine group had better mean oxygen saturation (SaO2; p epinephrine treatment was more effective in the improvement of FEV1, FEF25-75%, and oxygen saturation (SaO2) (p = 0.011, 0.012, and 0.006, respectively). A Significantly higher rate of adverse effects occurred in patients given epinephrine (47% vs 11%, p = 0.0002); these included pallor, tremor, dizziness, headache, palpitation, soreness of legs, numbness of extremities, cold sweating, general weakness and nausea. Considering the general trend to noninvasive therapy in children and the more frequent adverse effects after epinephrine injection, such nebulized beta-2 agonists as terbutaline appear preferable for initial therapy of acute asthma if oxygen is supplemented to prevent possible hypoxemia. However, parenteral epinephrine still is worth trying, particularly in any severe, life-threatening attack.

  14. [Respiratory function in allergic asthmatic children and its relation to the environmental pollen concentration].

    Science.gov (United States)

    López Campos, Celsa; Rincón Castañeda, Cuauhtémoc B; Borja Aburto, Víctor; Gómez Muñoz, Aristides; Téllez Valdés, Oswaldo; Martínez Ordaz, Verónica; Cano Ríos, Pedro; Ramírez Arriaga, Elia; Martínez Hernández, Enrique; Martínez-Cairo Cueto, Salvador; Albores Medina, Arnulfo

    2003-01-01

    Bronchial asthma is the most common chronic disease in children, producing the highest absenteeism among children and adults. To determine the relation between respiratory function in asthmatic children and contaminant and climatic environmental factors. It was performed a study with 26 asthmatic patients, from the Immuno-Allergies Department of the Specialties Hospital no. 71 of the Centro Medico Nacional Torreon, with an 8-month-follow-up. By a home monitoring, subjects determined their peak expiratory flow (PEF) twice a day: PEF1: in the morning, at getting up without or before medication, and PEF2: at night, before sleeping without or before medication. From June to August 1995, as well as from September to November 1995, a relation between pulmonary function, measured by PEF1 and PEF2, and some of the palinologic families or species studied was not found. On the other hand, from December 1995 to February 1996 a significant relation between the concentration of pollen's particles of Chenopodiaceaes and Amaranthaceaes and the difference between PEF1 and PEF2 (Difpef), with a p value Comarca Lagunera.

  15. Assessment of sleep bruxism, orthodontic treatment need, orofacial dysfunctions and salivary biomarkers in asthmatic children.

    Science.gov (United States)

    Amato, Juliana Neide; Tuon, Rogério Antônio; Castelo, Paula Midori; Gavião, Maria Beatriz Duarte; Barbosa, Taís de Souza

    2015-05-01

    To evaluate the sleep bruxism, malocclusions, orofacial dysfunctions and salivary levels of cortisol and alpha-amylase in asthmatic children. 108 7-9-yr-old children were selected from Policlinic Santa Teresinha Doutor Antonio Haddad Dib (asthmatics, n=53) and from public schools (controls, n=55), Piracicaba, SP, Brazil. Sleep bruxism diagnosis was confirmed by parental report of grinding sounds and the presence of shiny and polish facets on incisors and/or first permanent molars. The index of orthodontic treatment need was used for occlusion evaluation. Orofacial dysfunctions were evaluated using the nordic orofacial test-screening (NOT-S). Salivary cortisol and alpha-amylase were expressed as "awakening response" (AR), calculated as the difference between levels immediately after awakening and 30 min after waking, and "diurnal decline" (DD), calculated as the difference between levels at 30 min after waking and at bedtime. Data were analyzed using Shapiro-Wilk/Kolmogorov-Smirnov, Chi-square, unpaired t test/Mann-Whitney and paired t/Wilcoxon tests. Sleep bruxism was more prevalent in children with asthma than controls (47.2% vs. 27.3%, pbruxism, negative perception of sensory, chewing and swallowing functions, and higher concentrations of salivary cortisol on weekend. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. 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...... 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...... asthmatic symptoms and no change in PEFR or spirometry. Daily measurements of FENO (NIOX MINO) might allow early detection of disease deterioration, and future studies could address such a measure for dynamic treatment strategies. CLINICAL IMPLICATIONS: This simple handheld device expands the potential use...

  17. Mite fauna and fungal flora in house dust from homes of asthmatic children.

    Science.gov (United States)

    Ishii, A; Takaoka, M; Ichinoe, M; Kabasawa, Y; Ouchi, T

    1979-12-01

    Mite fauna and fungal flora in the house dust from homes of asthmatic children with positive and negative skin test to house dust allergen and non-asthmatic controls were examined. There was no conspicuous difference in mite species distribution among the three groups. Pyroglyphid mites dominate the mite fauna in house dust more than half of which being Dermatophagoides: D. pteronyssinus and D. farinae. There was no statistically significant difference in numbers between the two species and either species could dominate depending on the conditions of the individual houses. The average number of acarina in 0.5 g of fine dust did not differ statistically among the three groups; however, mite number per square meter floor differed between patients with positive skin test and negative skin test. The results suggest that house-cleaning might influence the possible sensitization of children. The genetic distribution of mould fungi in house dust was largely similar to that of airborne fungi. The average number of fungal colonies detected in 0.5 g of dust did not differ statistically among the three groups. Wallemia with its minute spores may cause sensitization but has so far been insufficiently investigated.

  18. Sensitivity of Turbutester and Accuhaler tester in asthmatic children and adolescents.

    Science.gov (United States)

    Manuyakorn, Wiparat; Direkwattanachai, Chalerat; Benjaponpitak, Suwat; Kamchaisatian, Wasu; Sasisakulporn, Cherapat; Teawsomboonkit, Wanlapa

    2010-02-01

    Dry powder inhalers (DPI) are alternative devices for delivering medication for treatment of asthma. The amount of drug delivery to the lungs is directly influenced by peak inspiratory flow rate (PIFR). A minimum PIFR of -30 L/min is needed for the Turbuhaler and Accuhaler. In order to evaluate the sensitivity of the Turbutester and Accuhaler tester in detecting the minimum and optimum PIFR for the Turbuhaler and Accuhaler in asthmatic children, PIFR was measured using the In-Check Dial through the internal resistance of the Turbuhaler and Accuhaler and compared according to the child's ability to make a whistle sound via both testers. A total of 259 asthmatic children were studied: 20 pre-school children, aged 5-6 years; 174 school-age children, aged 7-12 years; and 65 adolescents, aged 13-18 years. The sensitivity of the Turbutester and Accuhaler tester to detect optimum PIFR were 98.40% and 97.2%, respectively. In the comparison among age groups, the sensitivity of the Accuhaler tester to detect optimum or minimum PIFR for the Accuhaler was 95%, 97.7% and 95.4%, respectively. The sensitivity of the Turbutester to detect optimum PIFR for the Turbuhaler was 94.4%, 98.8% and 98.5%, respectively. The sensitivity of the Turbutester to detect minimum PIFR for the Turbuhaler was 94.7%, 100% and 100%, respectively. There were no significant differences in percentage of having optimum or minimum PIFR among asthma severity and current device usage in all age groups. Most children aged at least 5 years could generate enough PIFR to use dry powder inhaler devices. Both the Turbutester and Accuhaler tester were found to have high sensitivity in detecting optimum and minimum required PIFR.

  19. 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.

  20. Exposure to tobacco smoke among asthmatic children: parents' smoking habits and level of education.

    Science.gov (United States)

    Radic, S D; Gvozdenovic, B S; Pesic, I M; Zivkovic, Z M; Skodric-Trifunovic, V

    2011-02-01

    Children's Hospital for Respiratory Diseases and Tuberculosis, Belgrade, Serbia. To compare parents' educational level and smoking habits with asthma in children exposed to environmental tobacco smoke (ETS) and in those not exposed. In this cross-sectional study, 231 asthmatic children (average age 10.6 years, 49% boys) from smoking and non-smoking families were compared by birth weight, birth length, first episode of wheezing, number of respiratory infections and exacerbations per year, severity of asthma, number of hospitalisations, total serum immunoglobulin E (IgE), skin prick tests and allergic manifestations. In our study, 77% of the children were from smoking families: 45.9% had active smoking mothers and 51% active smoking fathers. Smoking was more common among parents with lower education level. The mother being the only smoker in the family had a greater impact on respiratory infections and asthma exacerbations in the first years of life; however, after the third year, the effect of having both smoking parents was important. Children exposed to ETS had more allergic manifestations. The percentage of children with both non-smoking parents decreased and that of children with both smoking parents increased with increasing asthma severity (χ(2) = 17.73, P children with asthma.

  1. 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

    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 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...... 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...

  2. Vitamin D deficiency and its impact on asthma severity in asthmatic children.

    Science.gov (United States)

    Esfandiar, Nasrin; Alaei, Fariba; Fallah, Shahrzad; Babaie, Delara; Sedghi, Niloofar

    2016-12-17

    Despite obtaining evidences on association between vitamin D and development of lung in fetus, little is known about vitamin D level and its impact on severity of asthma in children. The present study aimed to assess the relationship between the asthma severity and vitamin D deficiency in asthmatic children. This case-control study was conducted on 106 individuals including asthmatic (n = 53) and healthy children (n = 53) who referred to Mofid hospital in Tehran in 2013. The level of serum vitamin D in both groups was measured by radioimmunoassay method at the reference lab and was categorized as sufficient (> 30 ng/ml), insufficient (20 to 30 ng/ml), or deficient (asthma in patients group was classified as controlled, partially controlled, and uncontrolled. In the groups with and without asthma, the prevalence of vitamin D deficiency was 73.6 and 49.1%, and the prevalence of vitamin D insufficiency was 18.9 and 18.9%, while normal vitamin D level was revealed in 7.5 and 32.1%, respectively with a significant difference (p = 0.005). Using the multivariate logistic regression analysis, the presence of asthma was associated with reduced level of vitamin D (OR = 1.068, 95% CI: 1.027-1.110, P = 0.001). In this context, the risk for asthma in the children with vitamin D deficiency was 6.3 times of those with normal vitamin D level. Although the presence of asthma was strongly associated with reduced level of vitamin D in serum, neither severity of asthma nor control status of asthma were associated with vitamin D deficiency. The presence of vitamin D deficiency effectively predict increased risk for childhood asthma; however the severity or control status of this event may not be predicted by confirming vitamin D deficiency.

  3. Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled and nasal corticosteroids--more common than expected?

    Science.gov (United States)

    Zöllner, Ekkehard Werner; Lombard, Carl; Galal, Ushma; Hough, Stephen; Irusen, Elvis; Weinberg, Eugene

    2011-01-01

    Hypothalamic pituitary adrenal axis suppression (HPAS) when treating asthmatic children with inhaled corticosteroids (ICS) is thought to be rare. To determine the prevalence of HPAS in asthmatic children treated with ICS and nasal steroids (NS). Twenty-six asthmatic children were recruited. Clinical features of HPAS, height, weight, height and weight velocity, steroid dose, adherence, symptom control and lung functions were documented. Metyrapone test was performed if the serum cortisol was > 83 nmol/L (> 3 microg/dL). No child had a serum cortisol < 83 nmol/L (< 3 microg/dL). Prevalence of HPAS was 35 (CI = 17%-56%). Daily NS dose/ m2 and cumulative NS dose/m2 were significantly (p = 0.03) inversely correlated with the post-metyrapone ACTH (r = -0.42 for both). Current ICS dose was not associated with the post-metyrapone ACTH (r = 0). There was a weak correlation with the daily ICS dose/m2 (r = -0.12) and cumulative ICS dose/m2 (r = -0.26). A third of asthmatic children on ICS and NS develop HPAS. Contributing factors are the use of NS, body size and cumulative dose of ICS.

  4. 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

    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 airwa...

  5. Effect of positive ionisation of inspired air on the response of asthmatic children to exercise.

    Science.gov (United States)

    Lipin, I; Gur, I; Amitai, Y; Amirav, I; Godfrey, S

    1984-01-01

    To evaluate the effect of positive ionisation of inspired air on bronchial reactivity, 12 asthmatic children were twice challenged by exercise in random order. During one test positively ionised air (5-10 X 10(5) ions/cm) was breathed. All challenges were matched in terms of basal lung function and exercise tests were matched in terms of ventilation and respiratory heat loss. Exercise induced asthma was significantly aggravated by exposure to positively ionised air, the postexercise fall in FEV1 (delta FEV1) being 24.7% (SEM and 5.3%) and 35.3% (5%) after the control and ionised air tests respectively (p less than 0.04). It is concluded that positive ionisation aggravates the bronchial response to exercise. PMID:6474386

  6. A cross-sectional study of medication-related factors and caries experience in asthmatic children.

    Science.gov (United States)

    Milano, Michael; Lee, Jessica Y; Donovan, Katherine; Chen, Jung-Wei

    2006-01-01

    The purpose of this study was to examine the relationship between the specific types of medication, length of use, frequency of use, and dosing time of day on the dental caries of children diagnosed with asthma. Using a patient list from a previous study, surveys were mailed to the parents of 179 asthmatic children. The survey itself consisted of a table that asked 4 questions: (1) What combination of asthma medications was used by the subject? (2) How long were the medications used? (3) How often were the medications used? (4) What time of day were the medications used? Of the 179 surveys that were mailed out, 156 were returned. Children who used their medication greater than twice daily were significantly more likely to experience dental disease in both the primary (odds ratio [OR]=2.56, 95% confidence interval [CI]=1.45-6.29) and mixed dentitions (OR=3.56, 95% CI 2.45-5.94). Increased frequency of asthma medication use was associated with increased likelihood of caries experience. The time of day asthma medication was used was associated with increased likelihood of caries experience in children in the primary dentition. Duration of asthma medication use was associated with a decreased likelihood of caries experience in children in the mixed dentition.

  7. Impulse oscillometry in acute and stable asthmatic children: a comparison with spirometry.

    Science.gov (United States)

    Batmaz, Sehra Birgul; Kuyucu, Semanur; Arıkoglu, Tugba; Tezol, Ozlem; Aydogdu, Ayse

    2016-01-01

    Lung function tests have attracted interest for the diagnosis and follow-up of childhood asthma in recent years. For patients who cannot perform forced expiratory maneuvers, impulse oscillometry (IOS), performed during spontaneous breathing, may be an alternative tool. Thirty-five acute, 107 stable asthmatic and 103 healthy children who presented to our clinic performed IOS followed by spirometry before and after salbutamol inhalation. The mean baseline and reversibility of IOS and spirometry parameters were compared between the groups. Correlation analyses were undertaken within the asthmatics, and the healthy controls separately. To distinguish the three groups, the sensitivity and specificity of baseline and reversibility values of IOS and spirometry were computed. When spirometry was taken as the gold standard, the discriminating performance of IOS to detect the airway obstruction and reversibility was investigated. The mean absolute values of Zrs, R5, R5-R20, X5, X10, X15, Fres, AX, and all spirometric parameters, and the mean reversibility values of R5, R10, Fres, AX and forced expiratory volume in one second were different between the groups and the highest area under curve values to discriminate the groups was obtained from area of reactance (AX) and ΔAX. Zrs, all resistance (including R5-R20) and reactance parameters, Fres and AX were correlated with at least one spirometric parameter. Spirometric reversibility was detected by ≤-22.34 and ≤-39.05 cut-off values of ΔR5 and ΔAX, respectively. IOS has shown a highly significant association with spirometric indices and reversibility testing. It may be a substitute for spirometry in children who fail to perform forced expiratory maneuvers.

  8. Lung function improvement and airways inflammation reduction in asthmatic children after a rehabilitation program at moderate altitude.

    Science.gov (United States)

    Bersuch, Eugen; Gräf, Florian; Renner, Ellen D; Jung, Andreas; Traidl-Hoffmann, Claudia; Lauener, Roger; Roduit, Caroline

    2017-12-01

    Rehabilitational programs at moderate altitude (1500-2500 m) showed improvement of lung function and reduction in airways inflammation in asthmatic adults. Allergen avoidance was postulated as the major cause of these improvements. Spirometries of 344 and fractional exhaled nitric oxide measurements (FeNO) of 124 asthmatic children and adolescents, staying in a rehabilitation hospital in Davos (1590 m) with at least 14 days between admission and discharge, were analyzed in association with atopic sensitization (skin-prick testing and/or specific IgE), level of asthma control, and inhalative corticosteroid (ICS) dose. Pulmonary conditions improved significantly on average during the sojourn. Uncontrolled asthmatics benefited most with an absolute increase in predicted FEV 1 , MEF 25 , and MEF 75 of 7.7%, 9.9%, and 12.7%, respectively (P pulmonary improvement was comparable between patients with and without house dust mites (HDM) sensitization. Pulmonary improvements of pollen-sensitized patients were not dependent on the season of the sojourn. For the group with constant ICS level, the absolute increase in FEV 1 was 4.9% (P pulmonary conditions in asthmatic children and adolescents independent of sensitization status to HDM or pollen. A positive effect was also observed in patients without change in medication. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.

  9. Bronchial challenges with aerosolized food in asthmatic, food-allergic children.

    Science.gov (United States)

    Roberts, G; Golder, N; Lack, G

    2002-08-01

    Allergic asthma is usually considered to be provoked by aeroallergens. However, we have recently recognized a group of children with food allergies who also develop asthma when exposed to the aerosolized form of the food. Between 1997 and 1999 we prospectively identified children with an immunoglobulin (Ig)E-mediated food allergy who develop asthma on inhalational exposure to the relevant food allergen while it is being cooked. Subjects were exposed for 20 min to the aerosolized form of the allergen and the symptoms and the lung function were monitored. Aerosolization was achieved by cooking the food in a small room. Where possible challenges were double-blinded. We identified 12 children with an IgE-mediated food allergy who developed asthma on inhalational exposure to food. The implicated foods were fish, chickpea, milk, egg or buckwheat. Nine out of the 12 children consented to undergo a bronchial food challenge. Five challenges were positive with objective clinical features of asthma. Additionally, two children developed late-phase symptoms with a decrease in lung function. Positive reactions were seen with fish, chickpea and buckwheat. There were no reactions to the seven placebo challenges. We have presented a prospective series of children with food allergy who developed symptoms of asthma with exposure to aerosolized food allergens. Our data demonstrates that, as in the case of other aeroallergens, inhaled food allergens can produce both early- and late-phase asthmatic responses. This highlights the importance of considering foods as aeroallergens in children with coexistent food allergy and allergic asthma. For these children, dietary avoidance alone may not be sufficient and further environmental measures may be required to limit exposure to aerosolized food.

  10. [Effect of obesity on pulmonary function in asthmatic children of different age groups].

    Science.gov (United States)

    Xu, Xiao-Wen; Huang, Ying; Wang, Jian; Zhang, Xue-Li; Liang, Fan-Mei; Luo, Rong

    2017-05-01

    To study the effect of obesity on pulmonary function in newly diagnosed asthmatic children of different age groups. Two hundred and ninety-four children with newly diagnosed asthma were classified into preschool-age (age (6 to 12.5 years) groups. They were then classified into obese, overweight, and normal-weight subgroups based on their body mass index (BMI). All the children underwent pulmonary function tests, including large airway function tests [forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%)] and small airway function tests [maximal expiratory flow at 25% of vital capacity (MEF25%), maximal expiratory flow at 50% of vital capacity (MEF50%), and maximal expiratory flow at 75% of vital capacity (MEF75%)]. The school-age group showed lower FEV1%, MEF25%, and MEF50% than the preschool-age group (Page group had lower FEV1%, MEF25%, and MEF50% compared with their counterparts in the preschool-age group (Page group showed lower FVC% and MEF50% than those in the preschool-age group. However, all the pulmonary function parameters showed no significant differences between the obese children in the preschool-age and school-age groups. In the preschool-age group, FVC%, FEV1%, and MEF75% of the obese children were lower than those of the normal-weight children. In the school-age group, only FVC% and FEV1% showed differences between the obese and normal-weight children (Page in children with asthma, and the effect is more obvious in those of preschool age.

  11. Nasal airway epithelial cell IL-6 and FKBP51 gene expression and steroid sensitivity in asthmatic children.

    Directory of Open Access Journals (Sweden)

    Michael Fayon

    Full Text Available Many asthmatic patients exhibit uncontrolled asthma despite high-dose inhaled corticosteroids (ICS. Airway epithelial cells (AEC have distinct activation profiles that can influence ICS response.A pilot study to identify gene expression markers of AEC dysfunction and markers of corticosteroid sensitivity in asthmatic and non-asthmatic control children, for comparison with published reports in adults.AEC were obtained by nasal brushings and primary submerged cultures, and incubated in control conditions or in the presence of 10 ng/ml TNFalpha, 10-8M dexamethasone, or both. RT-PCR-based expression of FKBP51 (a steroid hormone receptor signalling regulator, NF-kB, IL-6, LIF (an IL-6 family neurotrophic cytokine, serpinB2 (which inhibits plasminogen activation and promotes fibrin deposition and porin (a marker of mitochondrial mass were determined.6 patients without asthma (median age 11yr; min-max: 7-13, 8 with controlled asthma (11yr, 7-13; median daily fluticasone dose = 100 μg, and 4 with uncontrolled asthma (12yr, 7-14; 1000 μg fluticasone daily were included. Baseline expression of LIF mRNA was significantly increased in uncontrolled vs controlled asthmatic children. TNFalpha significantly increased LIF expression in uncontrolled asthma. A similar trend was observed regarding IL-6. Dexamethasone significantly upregulated FKBP51 expression in all groups but the response was blunted in asthmatic children. No significant upregulation was identified regarding NF-kB, serpinB2 and porin.LIF and FKBP51 expression in epithelial cells were the most interesting markers of AEC dysfunction/response to corticosteroid treatment.

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

    DEFF Research Database (Denmark)

    Chawes, Bl; Piccinno, A; Kreiner-Møller, Eskil

    2012-01-01

    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......-way crossover single dose study. Blood was collected pre-dose up to 8h post-dose for pharmacokinetic evaluation (AUC(0-t) , AUC(0-∞) , AUC(0-0.5h) , C(max) , t(max) , t(1/2) ). Pharmacodynamics included heart rate, plasma potassium, urinary glucose and cortisol excretion. Peak expiratory flow......-superior after administration of the two actives as fixed vs. the free combination in 5-11-year-old asthmatic children....

  13. [Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care].

    Science.gov (United States)

    Morishita, Rosinha Yoko Matsubayaci; Strufaldi, Maria Wany Louzada; Puccini, Rosana Fiorini

    2015-12-01

    To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care. A retrospective cohort study of 219 asthmatic patients (3 to 17 years old) enrolled in primary care services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level. 50.5% of patients started wheezing before the age of two years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0,409). After one year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids. The monitoring of asthmatic patients in PCSs showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  14. Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care

    Science.gov (United States)

    Morishita, Rosinha Yoko Matsubayaci; Strufaldi, Maria Wany Louzada; Puccini, Rosana Fiorini

    2015-01-01

    Objective: To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care. Methods: A retrospective cohort study of 219 asthmatic patients (3-17 years old) enrolled in Primary Care Services (PCSs) in Embu das Artes (SP), from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level. Results: 50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6%) and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0.409). After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids. Conclusions: The monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study. PMID:26316387

  15. Clinical evolution and nutritional status in asthmatic children and adolescents enrolled in Primary Health Care

    Directory of Open Access Journals (Sweden)

    Rosinha Yoko Matsubayaci Morishita

    2015-12-01

    Full Text Available Objective: To evaluate the clinical evolution and the association between nutritional status and severity of asthma in children and adolescents enrolled in Primary Health Care. Methods: A retrospective cohort study of 219 asthmatic patients (3-17 years old enrolled in Primary Care Services (PCSs in Embu das Artes (SP, from 2007 to 2011. Secondary data: gender, age, diagnosis of asthma severity, other atopic diseases, family history of atopy, and body mass index. To evaluate the clinical outcome of asthma, data were collected on number of asthma exacerbations, number of emergency room consultations and doses of inhaled corticosteroids at follow-up visits in the 6th and 12th months. The statistical analysis included chi-square and Kappa agreement index, with 5% set as the significance level. Results: 50.5% of patients started wheezing before the age of 2 years, 99.5% had allergic rhinitis and 65.2% had a positive family history of atopy. Regarding severity, intermittent asthma was more frequent (51.6% and, in relation to nutritional status, 65.8% of patients had normal weight. There was no association between nutritional status and asthma severity (p=0.409. After 1 year of follow-up, 25.2% of patients showed reduction in exacerbations and emergency room consultations, and 16.2% reduced the amount of inhaled corticosteroids. Conclusions: The monitoring of asthmatic patients in Primary Care Services showed improvement in clinical outcome, with a decreased number of exacerbations, emergency room consultations and doses of inhaled corticosteroids. No association between nutritional status and asthma severity was observed in this study.

  16. 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.

  17. Allergen-specific immunotherapy in asthmatic children: from the basis to clinical applications.

    Science.gov (United States)

    Aryan, Zahra; Compalati, Enrico; Comapalati, Enrico; Canonica, Giorgio Walter; Rezaei, Nima

    2013-06-01

    Atopic asthma in childhood with the tendency to persist into adult life is an important issue in pediatrics. Allergen-specific immunotherapy (SIT) is the only curative treatment option for these children, being directed to the causes of the disease. The Th2 phenotype is a predominant immunological pattern in atopic asthma and SIT leads to apoptosis/anergy of T cells and induces immune-regulatory responses and immune deviation towards Th1. Many factors can affect the safety and efficacy of SIT, such as pattern of sensitization, allergy vaccine (allergen extracts, adjuvants and conjugated molecules), route of administration (subcutaneous or sublingual) and different treatment schedules. Overall, asthma symptoms and medication scores usually decrease following a SIT course and the most common observed side effects are restricted to local swelling, erythema and pruritus. Compared with conventional pharmacotherapy, SIT may be more cost effective, providing a benefit after discontinuation and a steroid-sparing effect. In addition, it can prevent new sensitizations in monosensitized asthmatic children. Microbial supplements such as probiotics, immunomodulatory substances like anti-IgE/leukotrienes, antibodies and newer allergen preparations such as recombinant forms have been tested to improve the efficacy and safety of SIT with inconclusive results. In conclusion, SIT provides an appropriate solution for childhood asthma that should be employed more often in clinical practice. Further studies are awaited to improve current knowledge regarding the mechanisms behind SIT and determine the most appropriate materials and schedule of immunotherapy for children with asthma.

  18. 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 am...

  19. Effects of inhaled fluticasone on intraocular pressure and central corneal thickness in asthmatic children without a family history of glaucoma.

    Science.gov (United States)

    Alsaadi, Muslim M; Osuagwu, Uchechukwu L; Almubrad, Turki M

    2012-01-01

    The aim of this study is to report the effects of fluticasone-inhaled corticosteroid on intraocular pressure (IOP) and central corneal thickness (CCT) of asthmatic children without a family history of glaucoma. In this prospective study, 93 children were divided into two groups: 69 asthmatic children with no family history of glaucoma who were taking inhaled fluticasone propionate 250 μg daily for at least 6 months (Group 1) and 24 age-matched control subjects without asthma (Group 2). Three measurements each, of IOP and CCT, were performed with a hand-held noncontact tonometer and a noncontact specular microscope, respectively, over a 12-week period. The order of IOP and CCT measured were randomized at each visit. Between-group comparison and the relationship between CCT and IOP measurements were investigated. P IOP was 14 ± 3.3 mmHg (range, 10-24 mmHg) and 14 ± 2.9 mmHg (range, 11-22 mmHg) for Groups 1 and 2, respectively (P = 0.3626). The mean CCT was 531 ± 30.1 μm (range, 467-601 μm) and 519 ± 47.0 μm (range, 415589 μm) for Groups 1 and 2, respectively (P = 0.1625). There was a weak but statistically significant correlation between IOP and CCT in Group 1 (Pearson's R = 0.3580, P = 0.0025). Inhaled fluticasone at the regular dose used in this study over a short period (6-24 months) was not associated with a significant effect on CCT and IOP measured with noncontact devices in asthmatic children between 5 and 15 years, without a family history of glaucoma. A weak correlation between IOP and CCT values in asthmatic children did exist.

  20. Air pollution and acute respiratory response in a panel of asthmatic children along the U.S.-Mexico border.

    Science.gov (United States)

    Sarnat, Stefanie Ebelt; Raysoni, Amit U; Li, Wen-Whai; Holguin, Fernando; Johnson, Brent A; Flores Luevano, Silvia; Garcia, Jose Humberto; Sarnat, Jeremy A

    2012-03-01

    Concerns regarding the health impact of urban air pollution on asthmatic children are pronounced along the U.S.-Mexico border because of rapid population growth near busy border highways and roads. We conducted the first binational study of the impacts of air pollution on asthmatic children in Ciudad Juarez, Mexico, and El Paso, Texas, USA, and compared different exposure metrics to assess acute respiratory response. We recruited 58 asthmatic children from two schools in Ciudad Juarez and two schools in El Paso. A marker of airway inflammation [exhaled nitric oxide (eNO)], respiratory symptom surveys, and pollutant measurements (indoor and outdoor 48-hr size-fractionated particulate matter, 48-hr black carbon, and 96-hr nitrogen dioxide) were collected at each school for 16 weeks. We examined associations between the pollutants and respiratory response using generalized linear mixed models. We observed small but consistent associations between eNO and numerous pollutant metrics, with estimated increases in eNO ranging from 1% to 3% per interquartile range increase in pollutant concentrations. Effect estimates from models using school-based concentrations were generally stronger than corresponding estimates based on concentrations from ambient air monitors. Both traffic-related and non-traffic-related particles were typically more robust predictors of eNO than was nitrogen dioxide, for which associations were highly sensitive to model specification. Associations differed significantly across the four school-based cohorts, consistent with heterogeneity in pollutant concentrations and cohort characteristics. Models examining respiratory symptoms were consistent with the null. The results indicate adverse effects of air pollution on the subclinical respiratory health of asthmatic children in this region and provide preliminary support for the use of air pollution monitors close to schools to track exposure and potential health risk in this population.

  1. Air Pollution and Acute Respiratory Response in a Panel of Asthmatic Children along the U.S.–Mexico Border

    Science.gov (United States)

    Raysoni, Amit U.; Li, Wen-Whai; Holguin, Fernando; Johnson, Brent A.; Luevano, Silvia Flores; Garcia, Jose Humberto

    2011-01-01

    Background: Concerns regarding the health impact of urban air pollution on asthmatic children are pronounced along the U.S.–Mexico border because of rapid population growth near busy border highways and roads. Objectives: We conducted the first binational study of the impacts of air pollution on asthmatic children in Ciudad Juarez, Mexico, and El Paso, Texas, USA, and compared different exposure metrics to assess acute respiratory response. Methods: We recruited 58 asthmatic children from two schools in Ciudad Juarez and two schools in El Paso. A marker of airway inflammation [exhaled nitric oxide (eNO)], respiratory symptom surveys, and pollutant measurements (indoor and outdoor 48-hr size-fractionated particulate matter, 48-hr black carbon, and 96-hr nitrogen dioxide) were collected at each school for 16 weeks. We examined associations between the pollutants and respiratory response using generalized linear mixed models. Results: We observed small but consistent associations between eNO and numerous pollutant metrics, with estimated increases in eNO ranging from 1% to 3% per interquartile range increase in pollutant concentrations. Effect estimates from models using school-based concentrations were generally stronger than corresponding estimates based on concentrations from ambient air monitors. Both traffic-related and non–traffic-related particles were typically more robust predictors of eNO than was nitrogen dioxide, for which associations were highly sensitive to model specification. Associations differed significantly across the four school-based cohorts, consistent with heterogeneity in pollutant concentrations and cohort characteristics. Models examining respiratory symptoms were consistent with the null. Conclusions: The results indicate adverse effects of air pollution on the subclinical respiratory health of asthmatic children in this region and provide preliminary support for the use of air pollution monitors close to schools to track exposure and

  2. Baseline and post-bronchodilator interrupter resistance and spirometry in asthmatic children.

    Science.gov (United States)

    Beydon, Nicole; Mahut, Bruno; Maingot, L; Guillo, H; La Rocca, M C; Medjahdi, N; Koskas, M; Boulé, M; Delclaux, Christophe

    2012-10-01

    In children unable to perform reliable spirometry, the interrupter resistance (R(int) ) technique for assessing respiratory resistance is easy to perform. However, few data are available on the possibility to use R(int) as a surrogate for spirometry. We aimed at comparing R(int) and spirometry at baseline and after bronchodilator administration in a large population of asthmatic children. We collected retrospectively R(int) and spirometry results measured in 695 children [median age 7.8 (range 4.8-13.9) years] referred to our lab for routine assessment of asthma disease. Correlations between R(int) and spirometry were studied using data expressed as z-scores. Receiver operator characteristic curves for the baseline R(int) value (z-score) and the bronchodilator effect (percentage predicted value and z-score) were generated to assess diagnostic performance. At baseline, the relationship between raw values of R(int) and FEV(1) was not linear. Despite a highly significant inverse correlation between R(int) and all of the spirometry indices (FEV(1) , FVC, FEV(1) /FVC, FEF(25-75%) ; P 12% baseline increase) with 70% sensitivity and 69% specificity (AUC = 0.79). R(int) measurements fitted a one-compartment model that explained the relationship between flows and airway resistance. We found that R(int) had poor sensitivity to detect baseline obstruction, but fairly good sensitivity and specificity to detect reversibility. However, in order to implement asthma guidelines for children unable to produce reliable spirometry, bronchodilator response measured by R(int) should be systematically studied and further assessed in conjunction with clinical outcomes. Copyright © 2012 Wiley Periodicals, Inc.

  3. The effect of serum levels of vitamin C on asthmatic children: a systematic review

    Directory of Open Access Journals (Sweden)

    Farhad Heydarian

    2016-07-01

    Full Text Available Introduction: Asthma is a chronic inflammatory airway disorder that is distinguished by coughing, wheezing, and dyspnea. It is the most common chronic disease among children. Epidemiological trials have suggested that there may be a correlation between vitamin C intake and the incidence of asthma. Specifically, according to these studies, a rapid increase in the occurrence of asthma may be caused by a decreased intake of dietary antioxidants and various vitamins such as vitamin C. A systematic review was performed to determine the role that vitamin C, in terms of both dietary intake and serum levels, had on asthma in children. Methods: PubMed and Scopus databases were searched for studies that provide information on the effects of vitamin C on asthma in children aged between 1 and 17 years. The inclusion criteria specified that the studies involved needed to be cohort and case series involving at least ten patients. Exclusion criteria were non-English articles, case reports, and articles involving children who were aged below or above the age 1 and 17 respectively.Result: A total of 13 studies involving 6503 patients met the inclusion criteria. Dietary vitamin C intake was lower in people with asthma than in those without asthma. Lower quantity dietary intakes and serum levels of vitamin C were also associated with increased incidents of asthma.Conclusion: According to the extracted data, a relatively low dietary intake of vitamin C is associated with an increased risk of asthma and wheezing. Moreover, asthmatic patients who consumed vitamin C exhibited an improvement in their diseases.

  4. Body mass index, adipokines and insulin resistance in asthmatic children and adolescents.

    Science.gov (United States)

    Morishita, Rosinha; Franco, Maria do Carmo; Suano-Souza, Fabíola Isabel; Solé, Dirceu; Puccini, Rosana Fiorini; Strufaldi, Maria Wany Louzada

    2016-06-01

    This study aimed to describe the body mass index, insulin resistance, levels of adipokines and inflammatory markers in Brazilian asthmatic children and adolescents and to investigate their possible association with the severity and control of asthma. Cross-sectional study (n = 92; age: 3-18 years). Assessed data: Body weight and height, used to calculate the body mass index (BMIZ) and height-for-age (HAZ). Laboratory measurements: Lipid profile; glycemia and insulin for homeostasis model assessment (HOMA); adipokines; tumor necrosis factor alpha (TNF-α), C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1); total immunoglobulin E (IgE) and specific IgE against aeroallergens. The median age was 9.6 years (3.0-16.6); most participants were male (n = 52, 56.5%), pre-pubertal (n = 54, 58.6%) and had atopic asthma (n = 85, 92.4%). Overweight/obesity (38%) showed an inverse correlation with age (adjusted odds ratio [OR] = 0.781; 95% confidence interval [CI] 0.66-0.92) and a direct correlation with the leptin concentration (adjusted OR = 1.13; 95% CI 1.04-1.22). Insulin concentration was independently associated with moderated persistent asthma (adjusted OR = 1.31; 95% CI 1.09-1.52). HOMA showed a direct correlation with the leptin (β = 0.475; 95% CI 0.117-0.268) and total IgE (β = 0.197; 95% CI 0.002-0.096) levels and an inverse correlation with the TNF-α levels (β = -0.255; 95% CI;-0.366-0.055). Asthma was associated with insulin resistance and a systemic inflammatory response possibly mediated by adipokines, with leptin levels standing out among the participants with excess weight.

  5. Tai-Chi-Chuan Exercise Improves Pulmonary Function and Decreases Exhaled Nitric Oxide Level in Both Asthmatic and Nonasthmatic Children and Improves Quality of Life in Children with Asthma

    Directory of Open Access Journals (Sweden)

    Hsin-Chia Lin

    2017-01-01

    Full Text Available Tai-Chi-Chuan (TCC is an exercise of low-to-moderate intensity which is suitable for asthmatic patients. The aim of our study is to investigate improvements of the lung function, airway inflammation, and quality of life of asthmatic children after TCC. Participants included sixty-one elementary school students and they were divided into asthmatic (n=29 and nonasthmatic (n=32 groups by the International Study of Asthma and Allergies in Childhood (ISAAC questionnaire. Among them, 20 asthmatic and 18 nonasthmatic children volunteered to participate in a 60-minute TCC exercise weekly for 12 weeks. Baseline and postintervention assessments included forced expiratory volume in one second (FEV1, forced vital capacity (FVC, peak expiratory flow rate (PEFR, fractional exhaled nitric oxide (FeNO level, and Standardised Pediatric Asthma Quality of Life Questionnaire (PAQLQ(S. After intervention, the level of FeNO decreased significantly; PEFR and the FEV1/FVC also improved significantly in both asthmatic group and nonasthmatic group after TCC. The asthmatic children also had improved quality of life after TCC. The results indicated that TCC could improve the pulmonary function and decrease airway inflammation in both children with mild asthma and those without asthma. It also improves quality of life in mild asthmatic children. Nevertheless, further studies are required to determine the effect of TCC on children with moderate-to-severe asthma.

  6. Social and family-related correlates of medical care utilization by asthmatic children in Upper Silesia, Poland.

    Science.gov (United States)

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

    2012-01-01

    Studies on childhood asthma demonstrate socioeconomic disparities in medical care utilization. A lack of information for Poland prompted our investigation into this question. Its goal was to discover if the utilization of medical services by asthmatic children depends on social and family factors. Subjects were 186 children with physician-diagnosed asthma, identified through a questionnaire survey of 4,535 school children in Katowice District, Poland. Utilization of medical care was assessed by such past year events as medical visits (44.0%), any diagnostic test (35.4%) and spirometry (30.6%). Association of those events with socioeconomic variables was explored by means of logistic regression, according to the criterion prelated to younger age (p=0.009), family history of respiratory diseases (p=0.08) and rural residence (p=0.09), any diagnostic tests to younger age (p=0.08), smaller number of siblings (p=0.01) and rural residence (p=0.004); spirometry to smaller number of siblings (p=0.09) and rural residence (p=0.006). Clinical status and age are important determinants of utilization of medical services by asthmatic children. The effects of rural residence and family size may reflect a more attentive response to the needs of a sick child.

  7. Association of hypothalamic-pituitary-adrenal axis-related polymorphisms with stress in asthmatic children on inhaled corticosteroids.

    Science.gov (United States)

    Tsartsali, Lemonia; Papadopoulos, Marios; Lagona, Evagelia; Papadimitriou, Anastasios; Kanaka-Gantenbein, Christina; Louizou, Eirini; Kastania, Anastasia; Priftis, Kostas N; Chrousos, George

    2012-01-01

    Long-term treatment of asthmatic children with low and moderate doses of inhaled corticosteroids (ICS) may result in mild adrenal suppression. Various associations have been shown between adrenal reactivity and single nucleotide polymorphisms (SNPs) related to the hypothalamic-pituitary-adrenal (HPA) axis. We aimed to investigate the genetic contribution of four HPA axis-related SNPs to the individual stress response when on ICS. The low dose Synacthen test was performed in 62 asthmatic children (43 males, median age 7.9 years) before and after 3 months of treatment with inhaled fluticasone (200 μg/day) or budesonide (400 μg/day). The SNPs determined were: rs1876828 and rs242941 in the corticotropin-releasing hormone receptor 1 (CRHR1) gene, T(-2C) in the promoter region of the melanocortin receptor 2 (MC2R) gene and BclI restriction fragment length polymorphsism in the glucocorticoid receptor (GR) gene. Homozygotes for the variant rs242941 (TT) demonstrated a delayed cortisol response after treatment with ICS compared to heterozygotes (GT) (p = 0.033) and those with the wild-type (GG) genotype (p = 0.018). Homozygotes for the variant rs1876828 (AA) manifested lower baseline cortisol levels before treatment (p = 0.009) compared to the GG genotype and delayed cortisol response after treatment compared to the GA genotype (p = 0.05). BclI heterozygotes for the G allele (GC) demonstrated higher basal cortisol levels before and after treatment with ICS compared to homozygotes (CC) (p = 0.024, p = 0.018). Three SNP interactions were associated with serum cortisol levels. There is evidence of a contribution of HPA axis-related genetic variation to the stress response of asthmatic children on ICS. The clinical importance of this finding needs further elucidation. Copyright © 2012 S. Karger AG, Basel.

  8. Epigenome-wide analysis links SMAD3 methylation at birth to asthma in children of asthmatic mothers.

    Science.gov (United States)

    DeVries, Avery; Wlasiuk, Gabriela; Miller, Susan J; Bosco, Anthony; Stern, Debra A; Lohman, I Carla; Rothers, Janet; Jones, Anya C; Nicodemus-Johnson, Jessie; Vasquez, Monica M; Curtin, John A; Simpson, Angela; Custovic, Adnan; Jackson, Daniel J; Gern, James E; Lemanske, Robert F; Guerra, Stefano; Wright, Anne L; Ober, Carole; Halonen, Marilyn; Vercelli, Donata

    2017-08-01

    The timing and mechanisms of asthma inception remain imprecisely defined. Although epigenetic mechanisms likely contribute to asthma pathogenesis, little is known about their role in asthma inception. We sought to assess whether the trajectory to asthma begins already at birth and whether epigenetic mechanisms, specifically DNA methylation, contribute to asthma inception. We used the Methylated CpG Island Recovery Assay chip to survey DNA methylation in cord blood mononuclear cells from 36 children (18 nonasthmatic and 18 asthmatic subjects by age 9 years) from the Infant Immune Study (IIS), an unselected birth cohort closely monitored for asthma for a decade. SMAD3 methylation in IIS (n = 60) and in 2 replication cohorts (the Manchester Asthma and Allergy Study [n = 30] and the Childhood Origins of Asthma Study [n = 28]) was analyzed by using bisulfite sequencing or Illumina 450K arrays. Cord blood mononuclear cell-derived IL-1β levels were measured by means of ELISA. Neonatal immune cells harbored 589 differentially methylated regions that distinguished IIS children who did and did not have asthma by age 9 years. In all 3 cohorts methylation in SMAD3, the most connected node within the network of asthma-associated, differentially methylated regions, was selectively increased in asthmatic children of asthmatic mothers and was associated with childhood asthma risk. Moreover, SMAD3 methylation in IIS neonates with maternal asthma was strongly and positively associated with neonatal production of IL-1β, an innate inflammatory mediator. The trajectory to childhood asthma begins at birth and involves epigenetic modifications in immunoregulatory and proinflammatory pathways. Maternal asthma influences epigenetic mechanisms that contribute to the inception of this trajectory. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Does treatment of asthmatic children with inhaled corticosteroids affect their adult height?

    Science.gov (United States)

    Van Bever, H P; Desager, K N; Lijssens, N; Weyler, J J; Du Caju, M V

    1999-06-01

    In this retrospective study, adult height was assessed in young adult asthmatics who were treated with inhaled corticosteroids (ICs) during childhood (n = 42; 26 boys) and compared to those obtained in asthmatic patients who were never treated with ICs during childhood (n = 43; 23 boys). Standing height of all subjects and their parents was measured. Height data were analyzed using actual length and target height in centimeters, standard deviation scores (SDS), and difference between adult height of the patients and their target height (adult height minus target height). Mean adult height was the same in subjects who took ICs during childhood as compared to those who had never received ICs (boys: 179.3cm+/-6.8 vs. 180.4 cm+/-5.6; girls: 165.8 cm+/-7.5 vs. 167.7 cm+/-7.2). SDS of adult height was also not different between the two groups: in subjects who did not take ICs it was 0.89+/-1.00, while in those who took ICs it was 0.66+/-1.10 (P = 0.31). SDS of target height was also not different between the two groups: in subjects not taking ICs it was 0.95+/-0.86, while in those who took ICs it was 0.28+/-0.76 (P = 0.30). However, subjects who took ICs during childhood showed a statistically significant lower value of adult height minus target height than those who never took ICs (whole group: -0.003+/-5.9 vs. 2.54 +/-4.8, P = 0.03 ; boys: 0.004+/-5.8 vs. 3.09+/-4.5, P = 0.04 ; girls: -0.075+/-6.3 vs. 1.91+/-5.2, P = 0.31). Patients on ICs during childhood who had ever been hospitalized for asthma showed a lower value for adult height minus target height than those who took ICs but were never hospitalized (-3.08+/-7.8 vs. 1.06+/-4.8, P = 0.046). A logistic regression analysis predicting growth impairment showed that the best-fitting model was one that used only ICs as a dependent variable (crude odds ratio, 3.3; 95% CI, 1.3-8.4). Patients who were treated with ICs in combination with intranasal corticosteroids (treatment for rhinitis) tended to have a lower value of

  10. Increased expression of T- cell- surface CXCR4 in asthmatic children

    African Journals Online (AJOL)

    Background: Signals delivered through the chemokine receptor CXCR4 upon interaction with its ligand, SDF-1 α/β result in the most efficacious chemoattraction of T lymphocytes to the asthmatic airways with the resultant lung inflammation and airway hyperresponsiveness. Objective: The extensive pharmacological and ...

  11. 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

  12. Effects of ultrafine and fine particles in urban air on peak expiratory flow among children with asthmatic symptoms.

    Science.gov (United States)

    Pekkanen, J; Timonen, K L; Ruuskanen, J; Reponen, A; Mirme, A

    1997-01-01

    It has been suggested that ultrafine particles in urban air may cause the health effects associated with thoracic particles (PM10). We therefore compared the effects of daily variations in particles of different sizes on peak expiratory flow (PEF) during a 57-day follow-up of 39 asthmatic children aged 7-12 years. The main source of particulate air pollution in the area was traffic. In addition to the measurements of PM10 and black smoke (BS) concentrations, an electric aerosol spectrometer was used to measure particle number concentrations in six size classes ranging from 0.01 to 10.0 microns. Daily variations in BS and particle number concentrations in size ranges between 0.032 and 0.32 micron and between 1.0 and 10.0 microns were highly intercorrelated (correlation coefficients about 0.9). Correlations with PM10 were somewhat lower (below 0.7). All these pollutants tended also to be associated with declines in morning PEF. However, the only statistically significant associations were observed with PM10 and BS. Different time lags of PM10 were also most consistently associated with declines in PEF. Therefore, in the present study on asthmatic children, the concentration of ultrafine particles was no more strongly associated with variations in PEF than PM10 or BS, as has earlier been suggested.

  13. Assessing the quality of life of asthmatic children using the PedQL™

    Directory of Open Access Journals (Sweden)

    Yulia Wigoeno

    2011-10-01

    Conclusions We observed a relatively high (26.8-35% impaired QoL in asthmatic patients. Parental assessment of their child’s QoL was generally lower than the child’s self-assessment. Male gender is a protective factor against impaired QoL, but having partly controlled/uncontrolled asthma is a risk factor for lower QoL. [Paediatr Indones. 2011;51:245-51].

  14. Evaluation of a capacity building clinical educational model for oral health clinicians treating very young children.

    Science.gov (United States)

    Martin, J M; O'Halloran, K A; Butcher, J A; Hopcraft, M S; Arnold-Smith, T S; Calache, H

    2014-09-01

    There are significant levels of dental caries in Australian school-aged children, with children aged five years having a mean dmft of 1.3. It has also been identified that, in general, oral health clinicians lack confidence to treat very young children and this study aimed to increase capacity of public sector oral health clinicians to treat preschool children. An educational program was developed, implemented and evaluated for its capability to increase the confidence and knowledge of oral health clinicians and dental assistants in providing oral care for children aged 12 months to 5 years. In 2011 and 2012, the course was delivered to 36 clinicians (22 dentists, 12 dental therapists, and two oral health therapists) and showed increases in their confidence and knowledge for participants when providing dental procedures to preschool children. The educational program that was developed and implemented has met its objective of increasing the knowledge and confidence of practicing oral health clinicians and dental assistants in the management of preschool children. Strategies to further enhance the outcomes of this educational program have been proposed.

  15. Traffic-related air pollution and respiratory symptoms among asthmatic children, resident in Mexico City: the EVA cohort study

    Directory of Open Access Journals (Sweden)

    Cortez-Lugo Marlene

    2008-11-01

    Full Text Available Abstract Background Taffic-related air pollution has been related to adverse respiratory outcomes; however, there is still uncertainty concerning the type of vehicle emission causing most deleterious effects. Methods A panel study was conducted among 147 asthmatic and 50 healthy children, who were followed up for an average of 22 weeks. Incidence density of coughing, wheezing and breathing difficulty was assessed by referring to daily records of symptoms and child's medication. The association between exposure to pollutants and occurrence of symptoms was evaluated using mixed-effect models with binary response and poisson regression. Results Wheezing was found to relate significantly to air pollutants: an increase of 17.4 μg/m3 (IQR of PM2.5 (24-h average was associated with an 8.8% increase (95% CI: 2.4% to 15.5%; an increase of 34 ppb (IQR of NO2 (1-h maximum was associated with an 9.1% increase (95% CI: 2.3% to16.4% and an increase of 48 ppb (IQR in O3 levels (1 hr maximum to an increase of 10% (95% CI: 3.2% to 17.3%. Diesel-fueled motor vehicles were significantly associated with wheezing and bronchodilator use (IRR = 1.29; 95% CI: 1.03 to 1.62, and IRR = 1.32; 95% CI: 0.99 to 1.77, respectively, for an increase of 130 vehicles hourly, above the 24-hour average. Conclusion Respiratory symptoms in asthmatic children were significantly associated with exposure to traffic exhaust, especially from natural gas and diesel-fueled vehicles.

  16. Traffic-related air pollution and respiratory symptoms among asthmatic children, resident in Mexico City: the EVA cohort study.

    Science.gov (United States)

    Escamilla-Nuñez, Maria-Consuelo; Barraza-Villarreal, Albino; Hernandez-Cadena, Leticia; Moreno-Macias, Hortensia; Ramirez-Aguilar, Matiana; Sienra-Monge, Juan-Jose; Cortez-Lugo, Marlene; Texcalac, Jose-Luis; del Rio-Navarro, Blanca; Romieu, Isabelle

    2008-11-16

    Taffic-related air pollution has been related to adverse respiratory outcomes; however, there is still uncertainty concerning the type of vehicle emission causing most deleterious effects. A panel study was conducted among 147 asthmatic and 50 healthy children, who were followed up for an average of 22 weeks. Incidence density of coughing, wheezing and breathing difficulty was assessed by referring to daily records of symptoms and child's medication. The association between exposure to pollutants and occurrence of symptoms was evaluated using mixed-effect models with binary response and poisson regression. Wheezing was found to relate significantly to air pollutants: an increase of 17.4 microg/m3 (IQR) of PM2.5 (24-h average) was associated with an 8.8% increase (95% CI: 2.4% to 15.5%); an increase of 34 ppb (IQR) of NO2 (1-h maximum) was associated with an 9.1% increase (95% CI: 2.3% to 16.4%) and an increase of 48 ppb (IQR) in O3 levels (1 hr maximum) to an increase of 10% (95% CI: 3.2% to 17.3%). Diesel-fueled motor vehicles were significantly associated with wheezing and bronchodilator use (IRR = 1.29; 95% CI: 1.03 to 1.62, and IRR = 1.32; 95% CI: 0.99 to 1.77, respectively, for an increase of 130 vehicles hourly, above the 24-hour average). Respiratory symptoms in asthmatic children were significantly associated with exposure to traffic exhaust, especially from natural gas and diesel-fueled vehicles.

  17. Relationship between the level of physical activity and sedentary, overweight and health-related quality of life in scholar-age asthmatic children: an explanatory study in Seville

    Directory of Open Access Journals (Sweden)

    Alfonso Rosa, Rosa María

    2012-07-01

    Full Text Available The aim of this study was: 1 To determine the differences between normal-weight asthmatic children and overweight asthmatic children in terms of HRQoL and amount of physical activity and sedentary and 2 To determine the relationship between amount of physical activity, sedentary and BMI and their influence on the HRQoL of this population in Seville. Method. We used a cohort design study that included 69 school-age children with controlled persistent asthma. The measures included in the study were: the questionnaire PAQL (S, to assess the HRQoL of children and the IPAQ-A questionnaire to assess the amount of physical activity and sedentary lifestyle of children. BMI was also calculated and determined if the participant was of normal-weight or overweight. Results. Overweight children scored worse on HRQoL and IPAQ-A values than their peers with normal-weight. Positive correlations were also observed between BMI and the amount of sedentary lifestyle. Negative correlations were observed between BMI and the amount of physical activity and also negative correlations were observed between BMI and HRQoL. Conclusion. BMI negatively affect HRQoL in school- age asthmatic children

  18. The metabolic syndrome in children and adolescents: a clinician's guide.

    Science.gov (United States)

    Biltoft, Christel A; Muir, Andrew

    2009-04-01

    This article reviews the components of the metabolic syndrome, the theory behind the combined negative effects of insulin resistance and obesity and discusses the clinical utility of this concept in pediatrics. The latest diagnostic criteria for obesity, dyslipidemia and hypertension in children and adolescents as well as management and prevention strategies are also discussed.

  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. Periodontal diseases in children and adolescents: a clinician's perspective part.

    Science.gov (United States)

    Masamatti, Sujata Surendra; Kumar, Ashish; Virdi, Mandeep Singh

    2012-10-01

    Contrasting forms of periodontal disease can affect children and adolescents with varying prevalence, severity and extent, leading to a diverse prognosis in these age groups. For an early diagnosis and treatment of periodontal conditions in young patients, it is essential for the dental practitioner to be able to identify and classify the disease correctly at the earliest opportunity, applying basic principles along with understanding of aetiology and risk factors. The first part of this article discusses the classification, plaque-induced and non-plaque-induced gingival diseases, localized and generalized forms of chronic, as well as aggressive, periodontitis. Knowledge of different forms of periodontal diseases affecting children and adolescents may help to distinguish between different forms of diseases and have value in screening and early diagnosis of the disease.

  1. 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...

  2. The effectiveness of psychosocial interventions designed to improve health-related quality of life (HRQOL) amongst asthmatic children and their families: a systematic review.

    Science.gov (United States)

    Clarke, Sally-Ann; Calam, Rachel

    2012-06-01

    Asthmatic children are at risk of compromised health-related quality of life (HRQOL) compared with their healthy peers. This systematic review reports the range and effectiveness of psychosocial interventions designed to improve HRQOL amongst asthmatic children, adolescents, and their families. Data sources included The Cochrane Airways Group Trials Register of trials, PubMed database, and reference lists from review articles. Eighteen studies of psychosocial interventions were identified. Interventions were designed to improve HRQOL amongst a range of psychosocial, health care, school-related and clinical outcomes, and were delivered in numerous settings and formats. Four studies reported that interventions were effective for significant improvements in child overall HRQOL scores. These include asthma education (n = 2), asthma education plus problem solving (n = 1), and art therapy (n = 1). Most interventions focussed on the delivery of asthma education to children, with the purpose of improving knowledge about asthma and disease management. There is limited evidence to suggest that interventions currently available are effective for significantly improving HRQOL amongst asthmatic children, adolescents, and their families. Most interventions lacked a theoretical basis and did not focus on family functioning variables. Multi-component interventions that incorporate asthma education along with strategies to assist families with implementing behaviour change towards improved asthma management are required. Future interventions should also attempt to address the wider context of family functioning likely to contribute to the family's ability to engage in successful asthma management in order to improve HRQOL.

  3. Effect of negative ionisation of inspired air on the response of asthmatic children to exercise and inhaled histamine.

    Science.gov (United States)

    Ben-Dov, I; Amirav, I; Shochina, M; Amitai, I; Bar-Yishay, E; Godfrey, S

    1983-01-01

    To evaluate the effect of negative ionisation of inspired air on bronchial reactivity, 11 asthmatic children were challenged twice by exercise and 10 were challenged twice by histamine inhalation. The children breathed negatively ionised air (4 X 10(5) - 10 X 10(5) ions/cm3) or control room air in random order in a double-blind fashion. All challenges were matched in terms of basal lung function and the exercise tests were matched in terms of ventilation and respiratory heat loss. Exercise-induced asthma was significantly attenuated by exposure to negatively ionised air, the mean postexercise fall in one-second forced expiratory volume (FEV1) being 29% (SE 5%) of the initial value after the control and 21% (3%) after the ionised air test (p less than 0.02). Ten of the 11 subjects developed less exercise-induced asthma while breathing ionised air. Although the median dose of histamine (cumulative breath units) which caused a constant fall in FEV1 for each individual was higher with the ionised air challenge than with the control challenge the difference was not significant. Five of the 10 subjects were less sensitive to histamine and the other five more sensitive when breathing ionised air. It is concluded that negative ionisation of inspired air can modulate the bronchial response to exercise but the effect on the response to histamine is much more variable. PMID:6351332

  4. 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.

  5. [Influence of changing from chlorofluorocarbon (CFC)-beclomethasone dipropionate (BDP) to hydrofluoroalkane (HFA)-BDP on pulmonary function in asthmatic children].

    Science.gov (United States)

    Yoshida, Yukinori; Inoue, Toshishige; Nishikido, Tomoki; Kameda, Makoto; Takamatu, Isamu; Doi, Satoru

    2007-12-01

    The discontinuation of chlorofluorocarbon- beclomethasone dipropionate (CFC-BDP) products has made it necessary to switch to hydrofluoroalkane (HFA)-BDP. We studied the influence of the changing from CFC-BDP to HFA-BDP on pulmonary function in asthmatic children. In twenty asthmatic children (mean: 10.5 years of age) who were clinically well-controlled with CFC-BDP for longer than 6 months, CFC-BDP was switched to HFA-BDP, at half the dose of CFC-BDP. We examined the changes in spirometric parameters at 3-6 months after the switch. FEV1.0% ([FEV1.0/FVC]x100) and %V50 ([V50 measured/V50 predicted]x100) were significantly improved (FEV1.0%: pre 81.7+/-4.7-->post 84.1+/-4.1 [ppost74.4+/-11.3 [pCFC-BDP (former 2.8+/-0.9 years, latter 5.2+/-2.4 years [pCFC-BDP. The changing from CFC-BDP to HFA-BDP showed the improvement of lung function in a part of asthmatic children. We should keep in mind that there are some differences of efficacy among the inhaled corticosteroid products. The long-term anti-inflammatory medication should be adjusted to normalize the pulmonary function on the basis of the degree of airway inflammation.

  6. 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…

  7. Clinician-parent discussions about influenza vaccination of children and their association with vaccine acceptance.

    Science.gov (United States)

    Hofstetter, Annika M; Robinson, Jeffrey D; Lepere, Katherine; Cunningham, Morgan; Etsekson, Nicole; Opel, Douglas J

    2017-05-09

    To examine how clinicians communicate with parents about influenza vaccination and the effect of these communication behaviors on parental vaccine decision-making. We performed a secondary analysis of data obtained from a cross-sectional observational study in which health supervision visits between pediatric clinicians and English-speaking parents of young children were videotaped. Eligible visits occurred during the 2011-2012 and 2013-2014 influenza seasons, included children ≥6months, and contained an influenza vaccine discussion. A coding scheme of 10 communication behaviors was developed and applied to each visit. Associations between clinician communication behaviors and parental verbal vaccine acceptance and parental visit experience were examined using bivariate analysis and generalized linear mixed models. Fifty visits involving 17 clinicians from 8 practices were included in analysis. The proportion of parents who accepted influenza vaccine was higher when clinicians initiated influenza vaccine recommendations using presumptive rather than participatory formats (94% vs. 28%, pinfluenza vaccine concurrent with (vs. separate from) recommendations for other vaccines due at the visit (83% vs. 33%, pinfluenza vaccine recommendations, pursuit in the face of resistance, and concurrent vaccine recommendations appear to increase parental acceptance of influenza vaccine without negatively affecting visit experience. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Serum transforming growth factor-beta1 in asthmatic children | El ...

    African Journals Online (AJOL)

    Objective: To outline the changes in serum TGF-beta1 in children with bronchial asthma in relation to severity of asthma and different treatment modalities. Methods: Twenty-three children with bronchial asthma recruited from the Pediatric Allergy and Immunology Clinic of Ain Shams University Children's Hospital were ...

  9. Fractional exhaled nitric oxide and multiple breath nitrogen washout in preschool healthy and asthmatic children

    DEFF Research Database (Denmark)

    Vilmann, Lea; Buchvald, Frederik; Green, Kent

    2017-01-01

    Introduction Objectively assessing pulmonary disease is challenging in preschool children with asthma. We evaluated the feasibility of measuring fractional exhaled nitrogen oxide (FeNO) and multiple breath nitrogen washout (N2MBW) in children. We compared their capacities for discriminating between...... children with asthma and healthy controls. Methods We measured FeNO and N2MBW-derived indices of lung clearance (LCI2.5) and conductive and acinar ventilation heterogeneity (Scond and Sacin) in 65 preschool children; 35 with physician-diagnosed asthma and 30 healthy. FeNO was measured with a portable.......023), but similar FeNO, LCI2.5 and Sacinvalues. Conclusion The feasibility of measuring FeNO was highly age-dependent and not applicable in children under age 4. N2MBW was feasible in the majority of preschool children. Scond, but not FeNO, could discriminate between children with asthma and healthy controls....

  10. Exhaled nitric oxide and other exhaled biomarkers in bronchial challenge with exercise in asthmatic children: current knowledge.

    Science.gov (United States)

    Barreto, Mario; Zambardi, Rosanna; Villa, Maria Pia

    2015-01-01

    The fractional concentration of exhaled nitric oxide (FENO), a known marker of atopic-eosinophilic inflammation, may be used as a surrogate to assess exercise-induced bronchoconstriction (EIB) in asthmatic children. The predictive value of baseline FENO for EIB appears to be influenced by several factors, including age, atopy, current therapy with corticosteroids and measurement technique. Nonetheless, FENO cut-off values appear to be able to rule out EIB. FENO levels decrease during EIB, apparently through neural mechanisms rather than by decreased airway-epithelial surface. Partition of FENO into proximal and peripheral contributions of the respiratory tract may improve our understanding on NO exchange during exercise and help to screen subjects prone to EIB. Other biomarkers of inflammation and oxidative stress contained in exhaled gases and exhaled breath condensate (EBC) may shed light on the pathophysiology of EIB. Exhaled breath temperature is a promising real-time measurement whose routine use for assessing EIB warrants further investigation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. 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…

  12. Evaluation of sleep quality and anxiety–depression parameters in asthmatic children and their mothers

    National Research Council Canada - National Science Library

    Yuksel, Hasan; Sogut, Ayhan; Yilmaz, Ozge; Demet, Murat; Ergin, Dilek; Kirmaz, Cengiz

    2007-01-01

    ... and lead to psychological problems such as anxiety and depression in mothers of children with asthma. Decreased sleep quality may also be associated with psychological problems. Depression has been reported to be common among mothers of children with asthma. 5,6 Sleep quality disorders may also play a role in increasing anxiety–depression sensitivity in these mo...

  13. A randomized open-label comparative study of montelukast versus theophylline added to inhaled corticosteroid in asthmatic children.

    Science.gov (United States)

    Kondo, Naomi; Katsunuma, Toshio; Odajima, Yasuhei; Morikawa, Akihiro

    2006-09-01

    Inhaled corticosteroids (ICSs) are widely used in combination with other classes of drugs for treatment of childhood asthma. The efficacy and the safety of montelukast added to low-dose ICS therapy were compared with those of sustained-release theophylline added to low-dose ICS therapy in asthmatic children in the present study. Following the 2-week run-in period, 6-to 14-year old patients receiving treatment with ICSs were randomized to treatment for 4 weeks with either montelukast 5 mg once daily or sustained release theophylline 5-8 mg/kg (dry syrup) or 100-200 mg (tablet) twice daily. Patients also received a fixed dose of ICS throughout the run-in and treatment periods. The primary efficacy endpoint was the change from baseline in peak expiratory flow (PEF) at Week 2. A significant increase in morning PEF was observed in the add-on montelukast group as compared with the add-on theophylline group at Week 2 (change from baseline of 22.8 L/minvs. 8.7 L/min; p = 0.041 for between-group difference) and at Week 4 (31.0 L/minvs. 9.8 L/min; p = 0.012). A significant increase in evening PEF was observed in the add-on montelukast group as compared with the add-on theophylline group at Week 4 (24.7 L/minvs. 8.7 L/min; p = 0.027). There were no significant differences between the treatment groups in incidences of clinical and laboratory adverse experiences. The results indicate that montelukast added to low-dose ICS is an effective and safe option for the treatment of asthma in children.

  14. Helicobacter pylori in children with asthmatic conditions at school age, and their mothers.

    Science.gov (United States)

    den Hollander, W J; Sonnenschein-van der Voort, A M M; Holster, I L; de Jongste, J C; Jaddoe, V W; Hofman, A; Perez-Perez, G I; Moll, H A; Blaser, M J; Duijts, L; Kuipers, E J

    2016-04-01

    Helicobacter pylori prevalence in Western countries has been declining simultaneously with increases in childhood asthma and allergic diseases; prior studies have linked these phenomena. To examine the association between H. pylori colonisation in children and risk of asthma and related conditions at school age. We secondly examined additional effects of maternal H. pylori status by pairing with children's status. This study was embedded in a multi-ethnic population-based cohort in Rotterdam, The Netherlands. We measured anti-H. pylori and anti-CagA antibodies in serum of children obtained at age 6 years, and of their mothers obtained during midpregnancy. Asthma or related conditions were reported for children at age 6 years. We used multivariate logistic regression analyses among 3797 subjects. In children, the H. pylori positivity rate was 8.7%, and 29.2% of these were CagA-positive. A child's colonisation with a CagA-negative-H. pylori strain was associated with an increased risk of asthma (Odds ratio 2.11; 95% CI 1.23-3.60), but this differed for European (3.64; 1.97-6.73) and non-European (0.52; 0.14-1.89) children. When taking into account maternal H. pylori status, only H. pylori-positive children with an H. pylori-negative mother had increased risk of asthma (2.42; 1.11-5.27), accounting for 3.4% of the asthma risk. Colonisation of a European child with a CagA-negative-H. pylori strain at age 6 was associated with an increased prevalence of asthma, but there was no association for non-European children. The underlying mechanisms for the observed risk differences require further research. © 2016 John Wiley & Sons Ltd.

  15. Agreement between parents and clinicians on the communication function levels and relationship of classification systems of children with cerebral palsy.

    Science.gov (United States)

    Mutlu, Akmer; Kara, Özgün Kaya; Livanelioğlu, Ayşe; Karahan, Sevilay; Alkan, Halil; Yardımcı, Bilge Nur; Hidecker, Mary Jo Cooley

    2017-11-14

    Functional classification systems have generally been used by clinicians and recently by parents to classify various functions of children with cerebral palsy (CP). This study evaluated the agreement between clinicians and parents when classifying the communication function of children with CP using the Communication Function Classification System (CFCS). In addition, the relationships between the Gross Motor Function Classification System - Expanded and Revised (GMFCS-E&R), the Manual Ability Classification System (MACS), and CFCS were investigated. This study was a cross-sectional study and included 102 children aged 4-18 years with CP and their parents. The parents and clinician classified the communication of children by using the Turkish language version of CFCS. Furthermore GMFCS-E&R and MACS were used for classification only by the clinician. The weighted Kappa agreement between CFCS results of the parents and clinicians was 0.95 (95% CI 0.95-0.96, p communication was classified as indicating higher functioning by the parents compared with the clinicians. The excellent agreement between parents and clinicians with the Turkish language version of CFCS for children with CP indicated that parents and clinicians could use the same language while classifying the communication function of children. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled and nasal corticosteroids: is the early-morning serum adrenocorticotropic hormone (ACTH) a useful screening test?

    Science.gov (United States)

    Zöllner, Ekkehard W; Lombard, Carl; Galal, Ushma; Hough, Stephen; Irusen, Elvis; Weinberg, Eugene

    2011-09-01

    Hypothalamic-pituitary-adrenal axis suppression (HPAS) in asthmatic children treated with inhaled corticosteroids (ICS), with or without nasal steroids (NS), may be more common than previously thought. Only dynamic testing will identify children at risk of adrenal crisis. It is impractical to test all asthmatic children for HPAS with a gold standard adrenal function test, i.e. the metyrapone or insulin tolerance test. To determine which clinical or biochemical parameter is the most useful screening test for HPAS in asthmatic children. Twenty-six asthmatic children, 5-18 yr old, on ICS ± NS, not treated with oral or topical steroids in the preceding year were recruited. Height, weight, height velocity, weight velocity and a change in systolic blood pressure from the recumbent to the standing position (ΔSBP) were recorded. Early-morning urine for urinary free cortisol (UFC) and urinary cortisol metabolites (UCM) was collected. UFC was analysed by both a chemiluminescent assay and gas chromatography/mass spectrometry (GC-MS). Morning serum cortisol and adrenocorticotropic hormone (ACTH) levels were measured. The overnight metyrapone test was performed if the fasting morning serum cortisol was >83 nmol/l. HPAS was diagnosed if the ACTH failed to rise >100 pg/ml after metyrapone. Spearman correlation coefficients (r) were calculated between the post-metyrapone ACTH and each variable. A receiver-operating characteristics (ROC) curve was drawn for the most promising test, and the diagnostic performance was calculated. All clinical and biochemical parameters investigated were weakly and non-significantly correlated with the post-metyrapone ACTH, except for the morning serum ACTH (r = 0.68; p <0.001). The best discrimination between those who have and those who do not have HPAS is a morning serum ACTH level of 11.7 pg/ml. This corresponds to a sensitivity of 0.89 (0.57-0.98), a specificity of 0.77 (0.53-0.90), a positive predictive value of 0.67 (0.39-0.87), a negative

  17. Ethics of fertility preservation for prepubertal children: should clinicians offer procedures where efficacy is largely unproven?

    Science.gov (United States)

    McDougall, Rosalind J; Gillam, Lynn; Delany, Clare; Jayasinghe, Yasmin

    2018-01-01

    Young children with cancer are treated with interventions that can have a high risk of compromising their reproductive potential. 'Fertility preservation' for children who have not yet reached puberty involves surgically removing and cryopreserving reproductive tissue prior to treatment in the expectation that strategies for the use of this tissue will be developed in the future. Fertility preservation for prepubertal children is ethically complex because the techniques largely lack proven efficacy for this age group. There is professional difference of opinion about whether it is ethical to offer such 'experimental' procedures. The question addressed in this paper is: when, if ever, is it ethically justifiable to offer fertility preservation surgery to prepubertal children? We present the ethical concerns about prepubertal fertility preservation, drawing both on existing literature and our experience discussing this issue with clinicians in clinical ethics case consultations. We argue that offering the procedure is ethically justifiable in certain circumstances. For many children, the balance of benefits and burdens is such that the procedure is ethically permissible but not ethically required; when the procedure is medically safe, it is the parents' decision to make, with appropriate information and guidance from the treating clinicians. We suggest that clinical ethics support processes are necessary to assist clinicians to engage with the ethical complexity of prepubertal fertility preservation and describe the framework that has been integrated into the pathway of care for patients and families attending the Royal Children's Hospital in Melbourne, Australia. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. Using public policy to improve outcomes for asthmatic children in schools.

    Science.gov (United States)

    Lynn, Jewlya; Oppenheimer, Sophie; Zimmer, Lorena

    2014-12-01

    School-based services to improve asthma management need to be accompanied by public policies that can help sustain services, scale effective interventions, create greater equity across schools, and improve outcomes for children. Several national organizations, including the Centers for Disease Control and Prevention, have recommended specific public policies the adoption of which in school settings can improve asthma outcomes for children. Although many states and school districts have adopted some of these policies, adoption is not universal, and implementation is not always successful, leaving inequities in children's access to asthma services and supports. These issues can be addressed by changing public policy. Policy change is a complex process, but it is one that will benefit from greater involvement by asthma experts, including the researchers who generate the knowledge base on what services, supports, and policies have the best outcomes for children. Asthma experts can participate in the policy process by helping to build awareness of the need for school-based asthma policy, estimating the costs associated with policy options and with inaction, advocating for the selection of specific policies, assisting in implementation (including providing feedback), conducting the research that can evaluate the effectiveness of implementation, and ultimately providing information back into the policy process to allow for improvements to the policies. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  19. Helicobacter pylori in children with asthmatic conditions at school age, and their mothers

    NARCIS (Netherlands)

    W.J. den Hollander (Wouter); A.M.M. van der Sonnenschein-Voort (Agnes); I.L. Holster (Ingrid); J.C. de Jongste (Johan); V.W.V. Jaddoe (Vincent); A. Hofman (Albert); G.I. Perez; H.A. Moll (Henriëtte); M.J. Blaser (Martin J.); L. Duijts (Liesbeth); E.J. Kuipers (Ernst)

    2016-01-01

    textabstractBackground Helicobacter pylori prevalence in Western countries has been declining simultaneously with increases in childhood asthma and allergic diseases; prior studies have linked these phenomena. Aims To examine the association between H. pylori colonisation in children and risk of

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

    DEFF Research Database (Denmark)

    Klug, B; Bisgaard, H

    1999-01-01

    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...

  1. Trend in asthma severity in steroid naive asthmatic children in Benin ...

    African Journals Online (AJOL)

    Objective: To determine the trend in severity of asthma in steroid naive children, in an era when steroid use in the treatment of asthma was uncommon. Materials and Methods: Case notes of patients managed for asthma from 1985 to 1995 and age 5 - 16 years were retrieved and reviewed (these case notes are usually ...

  2. REPEATED PROVOCATION TESTS IN ASTHMATIC-CHILDREN FOR TESTING TACHYPHYLAXIS TO HISTAMINE

    NARCIS (Netherlands)

    ROORDA, RJ; GERRITSEN, J; VANAALDEREN, WMC; SCHOUTEN, JP; KNOL, K

    1991-01-01

    Tachyphylaxis to histamine was investigated in 16 children, aged 7-15 years, with mild asthma. Three consecutive histamine challenges were performed at intervals of 24 hours and 1 hour, respectively. No significant differences in IVC, FEV1, and PC20-histamine values between the three measurements

  3. Variability of aerosol delivery via spacer devices in young asthmatic children in daily life

    NARCIS (Netherlands)

    H.M. Janssens (Hettie); S.G. Devadason; W.C.J. Hop (Wim); P.N. LeSouef; J.C. de Jongste (Johan); H.A.W.M. Tiddens (Harm)

    1999-01-01

    textabstractPressurized metered dose inhalers (pMDI) are widely used together with spacers for the treatment of asthma in children. However, the variability of daily medication dose for pMDI/spacer combinations is not known. Electrostatic charge is a potential source

  4. Exogenous stimuli and circadian peak expiratory flow variation in allergic asthmatic children

    NARCIS (Netherlands)

    Postma, DS; VanderHeide, S; DeReus, DM; Koeter, GH; VanAalderen, WMC; Meijer, G.

    The influence of exogenous factors in the home on the circadian variation of airway obstruction has not been fully assessed in children with asthma. The aim of the present study was to investigate the contribution of exogenous stimuli to the degree of peak expiratory flow (PEF) variability during 24

  5. General practice clinicians' perspectives on involving and supporting children and adult perpetrators in families experiencing domestic violence and abuse.

    Science.gov (United States)

    Larkins, Cath; Drinkwater, Jessica; Hester, Marianne; Stanley, Nicky; Szilassy, Eszter; Feder, Gene

    2015-12-01

    Government and professional guidance encourages general practice clinicians to identify and refer children who experience domestic violence and abuse (DVA) but there is scant understanding of how general practice clinicians currently work with DVA in families. The study explored general practice clinicians' practice with children and their parents experiencing DVA and reflected on the findings in the light of current research and policy guidelines. Semi-structured interviews with 54 clinicians (42 GPs and 12 practice nurses/nurse practitioners) were conducted across six sites in England. Data were analysed using current literature and emerging themes. Data presented here concern clinicians' perspectives on engaging with family members when a parent discloses that she is experiencing DVA. When a parent disclosed DVA, clinicians were more likely to consider talking to abusive fathers than talking to children about the abuse. Perspectives varied according to whether consultation opportunities arose, risks, consent and confidentiality. Perceptions of 'patienthood', relationships and competence shaped clinicians' engagement. Perpetrators were seen as competent informers and active service users, with potential for accepting advice and support. Clinicians were more hesitant in talking with children. Where this was considered, children tended to be seen as passive informants, only two GPs described direct and ongoing consultations with children and providing them with access to support. Clinicians appear more inclined to engage directly with abusive fathers than children experiencing DVA. Clinician skills and confidence to talk directly with children experiencing DVA, in child sensitive ways, should be developed through appropriate training. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Dental caries status and salivary properties of asthmatic children and adolescents.

    Science.gov (United States)

    Paganini, Mônica; Dezan, Cássia Cilene; Bichaco, Thiago Rodrigo; de Andrade, Flaviana Bombarda; Neto, Alcindo Cerci; Fernandes, Karen Barros Parron

    2011-05-01

    This study aimed to investigate the dental caries status and salivary properties in 3- to 15-year-old children/adolescents. The sample was split in two groups: asthma group (AG), composed of 65 patients who attended Public Health Service; asthma-free group (AFG), composed of 65 nonasthmatic children/adolescents recruited in two public schools. Stimulated salivary samples were collected for 3 min. Buffering capacity and pH were ascertained in each salivary sample. A single trained and calibrated examiner (kappa = 0.98) performed the dental caries examination according to WHO criteria. The AFG showed salivary flow rate (1.10 ± 0.63 mL/min) higher (P = 0.002) than AG (0.80 ± 0.50 mL/min). An inverse relationship was observed between asthma severity and salivary flow rate (Phi coefficient, rφ: 0.79, P = 0.0001). Children with moderate or severe asthma showed an increased risk for reduced salivary flow rate (OR: 17.15, P  0.05) and drug type (P > 0.05) with salivary flow rate. Buffering capacity was similar in both groups. No significant differences were encountered in dental caries experience between AFG and AG groups. Although asthma can cause reduction in flow rate, the illness did not seem to influence dental caries experience in children with access to proper dental care. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.

  7. Effect of Air Pollution in Frequency of Hospitalizations in Asthmatic Children.

    Science.gov (United States)

    Alizadeh, Medhi; Ghasemi Hashtroodi, Leila; Chavoshzadeh, Zahra; Rezaei, Nima

    2016-08-01

    Asthma is one of the most common diseases in childhood, which has been increased during last decade because of epidemiological pattern changes with climate and industrialization of the communities. There are some controversies on the relationship between air pollution and asthma. Tehran, as the capital of Iran, is one of the densest populations and is one of the most polluted cities in the world. This study was performed to search effects of various air pollutants using GIS-based modeling on the rate of hospitalizations due to asthma in children in Tehran. Information of patients who were admitted with a diagnosis of asthma in a referral pediatric hospital was checked and the total number of admissions in the same age range (2 to 14 years) during a 2-year period (March 2009-March 2011) were calculated. Information about air pollutants including carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide, obtained from the air quality control center. Days of the year divided into GOOD and NONGOOD days according to the guideline for reporting of the daily air quality index (AQI). Two thousand two hundred nineteen cases enrolled in the study and asthma admission to total admission ratio compared with air pollutants data in admission day (725 days), using nonlinear regression method. Analysis of the data revealed that there is a significant relationship between NONGOOD nitrogen dioxide (P=0.01), ozone (P=0.01), and sulfur dioxide (P=0.04), levels and admission due to asthma in children, but There was no significant relationship between carbon monoxide levels and asthma admission in children. A significant relationship between nitrogen dioxide, ozone and sulfur dioxide concentration in air and admission due to asthma at levels other than GOOD, reveals air pollutants levels can be significantly harmful to children before AQI reaches to hazardous levels.

  8. Effect of Air Pollution in Frequency of Hospitalizations in Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Medhi Alizadeh

    2016-09-01

    Full Text Available Asthma is one of the most common diseases in childhood, which has been increased during last decade because of epidemiological pattern changes with climate and industrialization of the communities. There are some controversies on the relationship between air pollution and asthma. Tehran, as the capital of Iran, is one of the densest populations and is one of the most polluted cities in the world. This study was performed to search effects of various air pollutants using GIS-based modeling on the rate of hospitalizations due to asthma in children in Tehran. Information of patients who were admitted with a diagnosis of asthma in a referral pediatric hospital was checked and the total number of admissions in the same age range (2 to 14 years during a 2-year period (March 2009-March 2011 were calculated. Information about air pollutants including carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide, obtained from the air quality control center. Days of the year divided into GOOD and NONGOOD days according to the guideline for reporting of the daily air quality index (AQI. Two thousand two hundred nineteen cases enrolled in the study and asthma admission to total admission ratio compared with air pollutants data in admission day (725 days, using nonlinear regression method. Analysis of the data revealed that there is a significant relationship between NONGOOD nitrogen dioxide (P=0.01, ozone (P=0.01, and sulfur dioxide (P=0.04, levels and admission due to asthma in children, but There was no significant relationship between carbon monoxide levels and asthma admission in children. A significant relationship between nitrogen dioxide, ozone and sulfur dioxide concentration in air and admission due to asthma at levels other than GOOD, reveals air pollutants levels can be significantly harmful to children before AQI reaches to hazardous levels.

  9. Factors associated with degree of atopy in Latino children in a nationwide pediatric sample: the Genes-environments and Admixture in Latino Asthmatics (GALA II) study.

    Science.gov (United States)

    Kumar, Rajesh; Nguyen, Elizabeth A; Roth, Lindsey A; Oh, Sam S; Gignoux, Christopher R; Huntsman, Scott; Eng, Celeste; Moreno-Estrada, Andres; Sandoval, Karla; Peñaloza-Espinosa, Rosenda I; López-López, Marisol; Avila, Pedro C; Farber, Harold J; Tcheurekdjian, Haig; Rodriguez-Cintron, William; Rodriguez-Santana, Jose R; Serebrisky, Denise; Thyne, Shannon M; Williams, L Keoki; Winkler, Cheryl; Bustamante, Carlos D; Pérez-Stable, Eliseo J; Borrell, Luisa N; Burchard, Esteban G

    2013-10-01

    Atopy varies by ethnicity, even within Latino groups. This variation might be due to environmental, sociocultural, or genetic factors. We sought to examine risk factors for atopy within a nationwide study of US Latino children with and without asthma. Aeroallergen skin test responses were analyzed in 1830 US Latino subjects. Key determinants of atopy included country/region of origin, generation in the United States, acculturation, genetic ancestry, and site to which subjects migrated. Serial multivariate zero-inflated negative binomial regressions stratified by asthma status examined the association of each key determinant variable with the number of positive skin test responses. In addition, the independent effect of each key variable was determined by including all key variables in the final models. In baseline analyses African ancestry was associated with 3 times (95% CI, 1.62-5.57) as many positive skin test responses in asthmatic participants and 3.26 times (95% CI, 1.02-10.39) as many positive skin test responses in control participants. Generation and recruitment site were also associated with atopy in crude models. In final models adjusted for key variables, asthmatic patients of Puerto Rican (exp[β] [95% CI], 1.31 [1.02-1.69]) and mixed (exp[β] [95% CI], 1.27 [1.03-1.56]) ethnicity had a greater probability of positive skin test responses compared with Mexican asthmatic patients. Ancestry associations were abrogated by recruitment site but not region of origin. Puerto Rican ethnicity and mixed origin were associated with degree of atopy within US Latino children with asthma. African ancestry was not associated with degree of atopy after adjusting for recruitment site. Local environment variation, represented by site, was associated with degree of sensitization. Copyright © 2013 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  10. Pediatrician self-efficacy for counseling parents of asthmatic children to quit smoking.

    Science.gov (United States)

    Cabana, Michael D; Rand, Cynthia; Slish, Kathryn; Nan, Bin; Davis, Matthew M; Clark, Noreen

    2004-01-01

    Although environmental tobacco smoke is a common trigger for asthma exacerbations in children, pediatricians infrequently counsel parents who smoke to quit. High physician self-efficacy, or self-confidence, in the ability to counsel parents about smoking cessation is associated with increased physician screening and counseling on this topic. However, it is not clear which factors are associated with high physician self-efficacy for counseling, such as previous training in smoking-cessation counseling or number of years in pediatric practice. To identify factors associated with high levels of physician self-efficacy for 4 skills associated with smoking-cessation counseling. Cross-sectional survey. A national random sample of 829 primary care pediatricians. The response rate was 55% (457 of 829). The percentage of physicians with high levels of self-efficacy for screening parents and screening patients to identify smokers was 87% and 84%, respectively. The percentage of physicians with high levels of self-efficacy for counseling parents and patients was 59% for both groups. The presence of previous training in smoking-cessation counseling was associated with high levels of self-efficacy for all 4 skills including inquiring about an asthma patient's smoking status (odds ratio [OR]: 3.91; 95% confidence interval [CI]: 1.63, 9.37); inquiring about a parent's smoking status (OR: 2.51; 95% CI: 1.09, 5.75); counseling a patient to quit smoking (OR: 5.30; 95% CI: 3.02, 9.31); and counseling a parent to quit (OR: 4.96; 95% CI: 2.85, 8.61). Years since completion of residency were not associated with high self-efficacy. These findings suggest that formal training in smoking cessation has a significant impact on physician self-efficacy related to smoking cessation throughout a physician's career.

  11. Oral magnesium supplementation in asthmatic children: a double-blind randomized placebo-controlled trial.

    Science.gov (United States)

    Gontijo-Amaral, C; Ribeiro, M A G O; Gontijo, L S C; Condino-Neto, A; Ribeiro, J D

    2007-01-01

    To investigate the long-term effect of oral magnesium supplementation on clinical symptoms, bronchial reactivity, lung function and allergen-induced skin responses in children and adolescents with moderate persistent asthma. A double-blind randomized parallel placebo-controlled study. The patients were recruited from the Pediatric Outpatient Clinic, Division of Pulmonology, Allergy and Immunology, and followed at the Center for Investigation in Pediatrics at State University of Campinas Hospital, Brazil. Thirty-seven out of 72 patients met the study criteria. There were no dropouts. The 37 patients (aged 7-19 years, 19 males) were randomized in two groups: magnesium (n=18, 300 mg/day) and placebo (n=19), during 2 months. Both patient groups received inhaled fluticasone (250 microg twice a day) and salbutamol as needed. The primary outcome was bronchial reactivity evaluated with methacholine challenge test (PC20). After a follow-up of 2 months, the methacholine PC20 for testing bronchial reactivity has augmented significantly in the magnesium group only. The skin responses to recognized antigens have also decreased in patients treated with magnesium. The forced vital capacity (FVC), the forced expiratory volume at first second (FEV1), the forced expiratory flow at 25-75 and the FEV1/FVC ratio were similar in both groups. The magnesium group presented fewer asthma exacerbations and used less salbutamol compared to the placebo group. Oral magnesium supplementation helped to reduce bronchial reactivity to methacholine, to diminish their allergen-induced skin responses and to provide better symptom control in pediatric patients with moderate persistent asthma treated with inhaled fluticasone.

  12. A disease model for wheezing disorders in preschool children based on clinicians' perceptions.

    Directory of Open Access Journals (Sweden)

    Ben D Spycher

    Full Text Available BACKGROUND: Wheezing disorders in childhood vary widely in clinical presentation and disease course. During the last years, several ways to classify wheezing children into different disease phenotypes have been proposed and are increasingly used for clinical guidance, but validation of these hypothetical entities is difficult. METHODOLOGY/PRINCIPAL FINDINGS: The aim of this study was to develop a testable disease model which reflects the full spectrum of wheezing illness in preschool children. We performed a qualitative study among a panel of 7 experienced clinicians from 4 European countries working in primary, secondary and tertiary paediatric care. In a series of questionnaire surveys and structured discussions, we found a general consensus that preschool wheezing disorders consist of several phenotypes, with a great heterogeneity of specific disease concepts between clinicians. Initially, 24 disease entities were described among the 7 physicians. In structured discussions, these could be narrowed down to three entities which were linked to proposed mechanisms: a allergic wheeze, b non-allergic wheeze due to structural airway narrowing and c non-allergic wheeze due to increased immune response to viral infections. This disease model will serve to create an artificial dataset that allows the validation of data-driven multidimensional methods, such as cluster analysis, which have been proposed for identification of wheezing phenotypes in children. CONCLUSIONS/SIGNIFICANCE: While there appears to be wide agreement among clinicians that wheezing disorders consist of several diseases, there is less agreement regarding their number and nature. A great diversity of disease concepts exist but a unified phenotype classification reflecting underlying disease mechanisms is lacking. We propose a disease model which may help guide future research so that proposed mechanisms are measured at the right time and their role in disease heterogeneity can be

  13. The IVAIRE project--a randomized controlled study of the impact of ventilation on indoor air quality and the respiratory symptoms of asthmatic children in single family homes.

    Science.gov (United States)

    Lajoie, P; Aubin, D; Gingras, V; Daigneault, P; Ducharme, F; Gauvin, D; Fugler, D; Leclerc, J-M; Won, D; Courteau, M; Gingras, S; Héroux, M-È; Yang, W; Schleibinger, H

    2015-12-01

    A randomized controlled trial was carried out to measure the impact of an intervention on ventilation, indoor air contaminants, and asthma symptoms of children. Eighty-three asthmatic children living in low-ventilated homes were followed over 2 years. Several environmental parameters were measured during the summer, fall, and winter. The children were randomized after Year 1 (43 Intervention; 40 Control). The intervention included the installation of either a Heat Recovery Ventilator (HRV) or Energy Recovery Ventilator (ERV). During the fall and winter seasons, there was a significant increase in the mean ventilation rate in the homes of the intervention group. A statistically significant reduction in mean formaldehyde, airborne mold spores, toluene, styrene, limonene, and α-pinene concentrations was observed in the intervention group. There was no significant group difference in change in the number of days with symptoms per 14 days. However, there was a significant decrease in the proportion of children who experienced any wheezing (≥1 episode) and those with ≥4 episodes in the 12-month period in the intervention group. This study indicates that improved ventilation reduces air contaminants and may prevent wheezing. Due to lack of power, a bigger study is needed. Positive findings from this study include the fact that, upon recruitment, most of the single family homes with asthmatic children were already equipped with a mechanical ventilation system and had relatively good indoor air quality. However, the 8-h indoor guideline for formaldehyde (50 μg/m3) was frequently exceeded and the ventilation rates were low in most of the homes, even those with a ventilation system. Both ERVs and HRVs were equally effective at increasing air exchange rates above 0.30 ACH and at preventing formaldehyde concentrations from exceeding the 50 μg/m3 guideline during the fall and winter seasons. Furthermore, the ERVs were effective at preventing excessively low relative

  14. Immune modulator pidotimod decreases the in vitro expression of CD30 in peripheral blood mononuclear cells of atopic asthmatic and normal children.

    Science.gov (United States)

    Gourgiotis, Dimitrios; Papadopoulos, Nikolaos G; Bossios, Apostolos; Zamanis, Petros; Saxoni-Papageorgiou, Photini

    2004-01-01

    Recurrent viral infections are frequently observed in children with atopic asthma. In this study we investigated the ability of the synthetic immunomodulator pidotimod to affect in vitro the phenotype and/or cytokine profile of blood cells in relation to atopic asthma. Peripheral blood mononuclear cells were isolated from 13 atopic asthmatic and 9 normal children and stimulated in culture with mitogen either in the presence or not of the drug. Expression of surface markers was evaluated by flow cytometry, and production of interleukin-4 and interferon-gamma was measured in supernatants. Pidotimod was able to down-regulate the expression of CD30 on cells from both atopic and normal subjects. Because CD30 has been associated with Th-2 cells, this observation supports the possibility of pidotimod being able to affect the Th-1/Th-2 balance in atopic asthma.

  15. The first 2-year home environment in relation to the new onset and remission of asthmatic and allergic symptoms in 4246 preschool children.

    Science.gov (United States)

    Lin, Zhijin; Norback, Dan; Wang, Tingting; Zhang, Xin; Shi, Jingjin; Kan, Haidong; Zhao, Zhuohui

    2016-05-15

    The home environment can influence childhood allergies and respiratory health but there is little information on associations between early life exposure at home and new onset and remission of the asthmatic or allergic symptoms in preschool children. A questionnaire survey was performed in a random cluster sample of 4246 preschool children in Urumqi, China. Information on the home environment (perceptions of odors and indicators of pollution sources) and children's health (wheeze, rhinitis and eczema) was collected for the first 2 years of life and the last year (before answering the questionnaire) from one of the parents or another guardian of the child. Associations between the home environment the first 2 years of life and new onset and remission of childhood symptoms were analyzed by multiple logistic regression. Home environment factors reported for the first 2 years of life were consistently positively associated with new onset of symptoms and negatively associated with remission of symptoms. Visible mold (OR 1.46, 95% CI 1.12-1.90), moldy odor (OR 2.15, 95% CI 1.45-3.18), air dryness (OR 1.31, 95% CI 1.08-1.59), stuffy odor (OR 1.25, 95% CI 1.01-1.54) and parental smoking (OR 1.36, 95% CI 1.13-1.65) were associated with new onset of symptoms. These factors were negatively associated with the remission of symptoms. In conclusion, mold contamination at home (moldy odor/visible mold), poor indoor air quality (stuffy odor, air dryness) and exposure to environmental tobacco smoke (ETS) in the first 2 years of life can increase the incidence of asthmatic and allergic symptoms and decrease the remission from these symptoms in preschool children. Copyright © 2016. Published by Elsevier B.V.

  16. Quality of life in children with psychiatric disorders: Self-, parent- and clinician report [IF: 3.8

    NARCIS (Netherlands)

    Bastiaansen, A.; Koot, H.M.; Ferdinand, R.F.; Verhulst, F.C.

    2004-01-01

    Objective: To study the relationship between child psychiatric disorders and quality of life (QoL). Method: In a sample of 310 children (ages 6-18 years) referred for psychiatric problems, children, parents, and clinicians reported on psychopathology and subjective and objective QoL indicators.

  17. A Practical Procedure for Instituting a Chore and Allowance Program for Grade School Children: Specific Guidelines for Clinicians.

    Science.gov (United States)

    Neul, Shari K. T.; Drabman, Ronald S.

    2001-01-01

    This article provides a use plan for instituting and maintaining a successful chore and allowance program for children. Specific guidelines are outlined regarding how to teach children basic money management skills. Explicit examples are offered for teaching these skills that can be easily adopted by parents and clinicians who specialize in…

  18. Juggling confidentiality and safety: a qualitative study of how general practice clinicians document domestic violence in families with children.

    Science.gov (United States)

    Drinkwater, Jessica; Stanley, Nicky; Szilassy, Eszter; Larkins, Cath; Hester, Marianne; Feder, Gene

    2017-06-01

    Domestic violence and abuse (DVA) and child safeguarding are interlinked problems, impacting on all family members. Documenting in electronic patient records (EPRs) is an important part of managing these families. Current evidence and guidance, however, treats DVA and child safeguarding separately. This does not reflect the complexity clinicians face when documenting both issues in one family. To explore how and why general practice clinicians document DVA in families with children. A qualitative interview study using vignettes with GPs and practice nurses (PNs) in England. Semi-structured telephone interviews with 54 clinicians (42 GPs and 12 PNs) were conducted across six sites in England. Data were analysed thematically using a coding frame incorporating concepts from the literature and emerging themes. Most clinicians recognised DVA and its impact on child safeguarding, but struggled to work out the best way to document it. They described tensions among the different roles of the EPR: a legal document; providing continuity of care; information sharing to improve safety; and a patient-owned record. This led to strategies to hide information, so that it was only available to other clinicians. Managing DVA in families with children is complex and challenging for general practice clinicians. National integrated guidance is urgently needed regarding how clinicians should manage the competing roles of the EPR, while maintaining safety of the whole family, especially in the context of online EPRs and patient access. © British Journal of General Practice 2017.

  19. 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. Copyright © 2016 Mosby, Inc. All rights reserved.

  20. 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.

  1. Quality of life of asthmatic children and adolescents: Portuguese translation, adaptation, and validation of the questionnaire "Pediatric Quality of Life (PedsQL) Asthma Module".

    Science.gov (United States)

    Monteiro, Fernanda Pereira; Solé, Dirceu; Wandalsen, Gustavo

    2017-11-01

    The objectives of the study were to translate, validate, and verify the psychometric properties of the Portuguese version of the instrument "Pediatric Quality of Life Asthma Module" (PedsQL Asthma) culturally adapted for the Brazilian culture. After being translated to Portuguese and being culturally adapted, the questionnaire was answered by 200 asthmatic children and adolescents (aged 2-18) as well as the adults responsible for them. Validation required the use of the following instruments: PedsQL Asthma Children (applied to children and adolescents), PedsQL Asthma Parents (applied to adults responsible for children and adolescents), Pediatric Asthma Quality of Life (PAQLQ), Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT), as well as socioeconomic and personal information questionnaires. A group of 45 clinically stable children repeated the questionnaires 15-60 days after answering the first questionnaire. Correlations between the scores of PedsQL Children and PedsQL Parents (r  =  0.67), PedsQL Children and PAQLQ (r  =  0.66), and PedsQL Parents and PAQLQ (r  =  0.64) were moderate and significant. Correlations were higher for men (r  =  0.72) when analyzing the children's and parents' answers to PedsQL according to gender. The 5- to 7-year-old age group had the strongest correlations with PAQLQ (r  =  0.79). Cronbach's alpha coefficient for PedsQL Children and Parents had values of 0.85 and 0.87, respectively. A high concordance was observed in both tests at different times, with kappa values of 0.89 and 0.87 for PedsQL Children and Parents, respectively. The instrument used in this study was considered valid, consistent, and reproducible and has acceptable psychometric properties for the Brazilian population.

  2. Clinicians' management of young children with co-occurring stuttering and speech sound disorder.

    Science.gov (United States)

    Unicomb, Rachael; Hewat, Sally; Spencer, Elizabeth; Harrison, Elisabeth

    2013-08-01

    Speech sound disorders reportedly co-occur in young children who stutter at a substantial rate. Despite this, there is a paucity of scientific research available to support a treatment approach when these disorders co-exist. Similarly, little is known about how clinicians are currently working with this caseload given that best practice for the treatment of both disorders in isolation has evolved in recent years. This study used a qualitative approach to explore current clinical management and rationales when working with children who have co-occurring stuttering and speech sound disorder. Thirteen participant SLPs engaged in semi-structured telephone interviews. Interview data were analysed based on principles derived from grounded theory. Several themes were identified including multi-faceted assessment, workplace challenges, weighing-up the evidence, and direct intervention. The core theme, clinical reasoning, highlighted the participants' main concern, that not enough is known about this caseload on which to base decisions about intervention. There was consensus that little is available in the research literature to guide decisions relating to service delivery. These findings highlight the need for further research to provide evidence-based guidelines for clinical practice with this caseload.

  3. 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

  4. Clinicians' Implicit and Explicit Attitudes about Weight and Race and Treatment Approaches to Overweight for American Indian Children.

    Science.gov (United States)

    Sabin, Janice A; Moore, Kelly; Noonan, Carolyn; Lallemand, Odile; Buchwald, Dedra

    2015-08-01

    Obesity is one of the most serious health problems among American Indian/Alaska Native (AI/AN) children. We investigated Indian Health Service (IHS) primary care providers' implicit and explicit attitudes about weight and race and their association with treatment approaches to overweight in children. We conducted an online survey of long-term primary care clinicians in two western regions of the IHS. We used the existing Weight Attitude Implicit Association Test (IAT) and developed a new Native American Attitude IAT to measure implicit attitudes. Explicit attitudes about weight and race were assessed through self-report. We assessed self-rated treatment approaches to childhood overweight. We used linear regression models to evaluate the association of attitudes about weight and race with treatment approaches. Our sample included 75 clinicians (56% response rate) who, on average, saw 74 patients per week. Fifty-five percent of clinicians reported that 30-60% of their child and adolescent patients were overweight or obese, and 25% of clinicians reported that 60-100% of their patients were overweight or obese. We found strong implicit bias favoring thin people (Cohen's d=1.44) and weak implicit bias favoring whites (Cohen's d=0.35). We found no association between implicit or explicit bias scores and self-reported treatment of childhood overweight. Continuing education on obesity was associated with self-rated success and competence in weight management. Weight and race bias exists among long-term IHS clinicians, but may not influence treatment approaches for overweight AI/AN children. Further research should assess the effect of clinicians' attitudes on real-world weight management.

  5. 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.

  6. Virtual community centre for power wheelchair training: Experience of children and clinicians.

    Science.gov (United States)

    Torkia, Caryne; Ryan, Stephen E; Reid, Denise; Boissy, Patrick; Lemay, Martin; Routhier, François; Contardo, Resi; Woodhouse, Janet; Archambault, Phillipe S

    2017-11-02

    To: 1) characterize the overall experience in using the McGill immersive wheelchair - community centre (miWe-CC) simulator; and 2) investigate the experience of presence (i.e., sense of being in the virtual rather than in the real, physical environment) while driving a PW in the miWe-CC. A qualitative research design with structured interviews was used. Fifteen clinicians and 11 children were interviewed after driving a power wheelchair (PW) in the miWe-CC simulator. Data were analyzed using the conventional and directed content analysis approaches. Overall, participants enjoyed using the simulator and experienced a sense of presence in the virtual space. They felt a sense of being in the virtual environment, involved and focused on driving the virtual PW rather than on the surroundings of the actual room where they were. Participants reported several similarities between the virtual community centre layout and activities of the miWe-CC and the day-to-day reality of paediatric PW users. The simulator replicated participants' expectations of real-life PW use and promises to have an effect on improving the driving skills of new PW users. Implications for rehabilitation Among young users, the McGill immersive wheelchair (miWe) simulator provides an experience of presence within the virtual environment. This experience of presence is generated by a sense of being in the virtual scene, a sense of being involved, engaged, and focused on interacting within the virtual environment, and by the perception that the virtual environment is consistent with the real world. The miWe is a relevant and accessible approach, complementary to real world power wheelchair training for young users.

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

    Energy Technology Data Exchange (ETDEWEB)

    Dramowski, Angela; Morsheimer, Megan M.; Schaaf, H.S.; Rabie, Helena; Sorour, Gillian; Cotton, Mark F. [Tygerberg Children' s Hospital, Department of Paediatrics and Child Health, P.O. Box 19063, Tygerberg (South Africa); Frigati, Lisa [Red Cross Children' s Hospital and University of Cape Town, Department of Paediatrics and Child Health, Cape Town (South Africa)

    2009-06-15

    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.)

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

    Science.gov (United States)

    Cho, Kyoung Hee; Park, Eun-Cheol; Nam, Young Soon; Lee, Seon-Heui; Nam, Chung Mo; Lee, Sang Gyu

    2016-01-01

    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 Market competition appears to reduce COC; decreased COC was associated with a higher OR for hospital admissions.

  9. Reduced medication use and improved pulmonary function with supplements containing vegetable and fruit concentrate, fish oil and probiotics in asthmatic school children: a randomised controlled trial.

    Science.gov (United States)

    Lee, Shu-Chen; Yang, Yao-Hsu; Chuang, Shao-Yuan; Huang, Shih-Yi; Pan, Wen-Harn

    2013-07-14

    Dietary pattern changes may be one of the key factors associated with increasing asthma prevalence. Observational studies have found negative associations between fruit, vegetable and fish consumption and risk of asthma. Experimental studies have also shown that probiotics can modulate the immune system. However, each dietary component exhibits a modest effect. The objective of the present study was to investigate the joint effect of multiple beneficial dietary components on asthma. We designed a 16-week school-based double-blind placebo-controlled randomised trial. The supplement group received fruit plus vegetable concentrate, fish oil and probiotics (FVFP supplement), while the control group received placebos. A total of 192 asthmatic children aged 10-12 years were recruited from elementary schools in metropolitan Taipei. Pulmonary function, medication usage, Paediatric Asthma Quality of Life Questionnaire (PAQLQ) score and the Childhood Asthma Control Test score were evaluated at baseline, and at weeks 8 and 16. Compared with the placebo group, the supplement group showed significant improvement in pulmonary function parameters (91 v. 178 ml for forced vital capacity (FVC), 40 v. 107 ml for forced expiratory volume in 1 s (FEV1) and 1·6 v. 4·8 % for FEV1:FVC ratio; all P values vegetable, fish and probiotic foods.

  10. Helping military children cope with parental deployment: role of attachment theory and recommendations for mental health clinicians and counselors.

    Science.gov (United States)

    Miller, Laurence; Miller, Halle B; Bjorklund, David

    2010-01-01

    Military deployment of a parent carries with it a number of stresses for children, all centering around uncertainty, instability and unpredictability. This article conceptualizes military deployment and relocation stress in the context of attachment theory, and describes the types of adverse outcomes that can occur as the result of impaired attachment. It then presents a set of practical recommendations for mental health clinicians and counselors for helping children and families cope productively and negotiate the developmental hurdles associated with maintaining healthy attachment and family stability in the face of military deployment.

  11. A Study of the Effects of Physical Activity on Asthmatic Symptoms and Obesity Risk in Elementary School-Aged Children

    Science.gov (United States)

    Haines, Michael S.; Kim, Danny H.

    2013-01-01

    Background: Children with moderate persistent asthma are often reluctant to engage in physical activity and as a result are more prone to obesity and increased incidence of asthma attacks. Purpose: This study developed an asthma program that included physical activity and asthma management education for elementary school children with moderate…

  12. Call-Center Based Disease Management of Pediatric Asthmatics

    Science.gov (United States)

    2006-04-01

    Cagnani CE. Allergic rhinitis and asthma in children: disease management and outcomes. Current Allergy & Asthma Reports. 1(6):515-22, 2001. 58. Chan...of Pediatric Asthmatics PRINCIPAL INVESTIGATOR: James M. Quinn, M.D. CONTRACTING ORGANIZATION: The Geneva Foundation...CONTRACT NUMBER Call-Center Based Disease Management of Pediatric Asthmatics 5b. GRANT NUMBER DAMD17-02-1-0182 5c. PROGRAM ELEMENT NUMBER 6

  13. 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

    In vitro studies with the Diskus inhaler at low and high flow rates show consistent doses of drug as fine particles flow independency translates into flow-independent clinical effect when the device is used by patients...... 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...... after salmeterol at either flow rates as compared to placebo. There was no significant difference in the protection from salmeterol on the day of low-flow inhalation versus the day of high-flow inhalation. Consistent in vitro fine particle dosing from the Diskus inhaler translates into a consistent...

  14. 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...

  15. 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...

  16. Placebo-controlled study of montelukast and budesonide on short-term growth in prepubertal asthmatic children

    DEFF Research Database (Denmark)

    Pedersen, Søren; Agertoft, Lone; Williams-Herman, Debora

    2007-01-01

    Inhaled corticosteroids and anti-leukotriene agents are widely used in the treatment of pediatric asthma. Although data on the effect of corticosteroids on growth are available, there are few such data on anti-leukotriene agents. The aim of this study was to assess the influence of montelukast on...... on short-term lower leg growth rate (LLGR) in prepubertal children with asthma....

  17. 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

  18. 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

    control subjects. Specific airway resistance (sRaw) by whole body plethysmography was the primary outcome. In addition, lung function was measured as respiratory resistance by the interrupter technique (Rint) and respiratory resistance and reactance at 5 Hz (Rrs5, Xrs5) by the impulse oscillation...... subjects. Thus sRaw had the highest sensitivity (68%). Specificity ranged from 93 to 100%. The correlation coefficient between sRaw responses to CACh repeated within 8 wk was 96%. In conclusion, CACh is feasible in young children age 2 to 5 yr. Whole body plethysmography (sRaw) was superior in separating...

  19. 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

  20. Factors influencing speech and language outcomes of children with early identified severe/profound hearing loss: Clinician-identified facilitators and barriers.

    Science.gov (United States)

    Fulcher, Anne Nivelles; Purcell, Alison; Baker, Elise; Munro, Natalie

    2015-06-01

    Early identification of severe/profound childhood hearing loss (HL) gives these children access to hearing devices and early intervention to facilitate improved speech and language outcomes. Predicting which infants will go on to achieve such outcomes remains difficult. This study describes clinician identified malleable and non-malleable factors that may influence speech and language outcomes for children with severe/profound HL. Semi-structured interviews were conducted with six experienced auditory verbal clinicians. A collective case study design was implemented. The interviews were transcribed and coded into themes using constant comparative analysis. Clinicians identified that, for children with severe/profound HL, early identification, early amplification and commencing auditory-verbal intervention under 6 months of age may facilitate child progress. Possible barriers were living in rural/remote areas, the clinicians' lack of experience and confidence in providing intervention for infants under age 6-months and belonging to a family with a culturally and linguistically diverse (CALD) background. The results indicate that multiple factors need to be considered by clinicians working with children with HL and their families to determine how each child functions within their own environment and personal contexts, consistent with the International Classification of Functioning, Disability and Health (ICF) framework. Such an approach is likely to empower clinicians to carefully balance potential barriers to, and facilitators of, optimal speech and language outcomes for all children with HL.

  1. Asthma control and need for future asthma controller therapy among inner-city Hispanic asthmatic children engaged in a pediatric asthma disease management program (the Breathmobile program, Mobile Asthma Care for Kids Network).

    Science.gov (United States)

    Scott, Lyne; Li, Marilyn; Thobani, Salima; Nichols, Breck; Morphew, Tricia; Kwong, Kenny Yat-Choi

    2016-08-01

    To determine whether significant numbers of asthmatic children with initially rated intermittent asthma later suffer poor asthma control and require the addition of controller medications. Inner-city Hispanic children were followed prospectively in an asthma-specific disease management system (Breathmobile) for a period of 2 years. Clinical asthma symptoms, morbidity treatment, and demographic data were collected at each visit. Treatment was based upon National Heart, Lung, and Blood Institute (NHLBI) Expert Panel Report 3 asthma guidelines. Primary outcome was percentage of patients with intermittent asthma who had not well or poorly controlled asthma during subsequent visits and required controller agents. Secondary outcomes were factors associated with the maintenance of asthma control. About 30.9% of the patients with initial rating of intermittent asthma had not well controlled and poorly controlled asthma during subsequent visits and required the addition of controller agents. Factors associated with good asthma control were compliance, no previous emergency room visits and previous visit during spring season. Asthmatic children with intermittent asthma often lose asthma control and require controller therapy. This justifies asthma guideline recommendations to assess asthma control at follow-up visits and adjust therapy accordingly.

  2. The frequency of vitamin D deficiency among asthmatic Egyptian ...

    African Journals Online (AJOL)

    EL-HAKIM

    The frequency of vitamin D deficiency among asthmatic Egyptian children. INTRODUCTION. Asthma is defined as a common chronic inflammatory disease of the airways characterized by variable and recurrent symptoms, reversible airflow obstruction, and bronchospasm. Children have smaller airways than adults, which ...

  3. Effects of a pulmonary rehabilitation program on physical capacity, peripheral muscle function and inflammatory markers in asthmatic children and adolescents: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Reimberg, Mariana Mazzuca; Castro, Rejane Agnelo Silva; Selman, Jessyca Pachi Rodrigues; Meneses, Aline Santos; Politti, Fabiano; Mallozi, Márcia Carvalho; Wandalsen, Gustavo Falbo; Solé, Dirceu; De Angelis, Kátia; Dal Corso, Simone; Lanza, Fernanda Cordoba

    2015-08-13

    Individuals with chronic lung disease are more susceptible to present reduction in exercise tolerance and muscles strength not only due to pulmonary limitations but also due systemic repercussions of the pulmonary disease. The aim of this study is to assess the physical capacity, peripheral muscle function, physical activity in daily life, and the inflammatory markers in children and adolescents with asthma after pulmonary rehabilitation program. This is a study protocol of randomized controlled trial in asthmatic patients between 6 to 18 years old. The assessments will be conducted in three different days and will be performed at the beginning and at the end of the protocol. First visit: quality of life questionnaire, asthma control questionnaire, pre- and post-bronchodilator spirometry (400 μcg salbutamol), inflammatory assessment (blood collection), and cardiopulmonary exercise test on a cycle ergometer to determine aerobic capacity. Second visit: assessment of strength and endurance of the quadriceps femoris and biceps brachii muscles with concomitant electromyography to assess peripheral muscle strength. Third visit: incremental shuttle walk test (ISWT) and accelerometer to evaluate functional capacity and physical activity in daily life during 7 days. Then, the volunteers will be randomized to receive pulmonary rehabilitation program (intervention group) or chest physiotherapy + stretching exercises (control group). Both groups will have a supervised session, twice a week, each session will have 60 minutes duration, with minimum interval of 24 hours, for a period of 8 weeks. Intervention group: aerobic training (35 minutes) intensity between 60 to 80 % of the maximum workload of cardiopulmonary exercise testing or of ISWT; strength muscle training will be applied to the quadriceps femoris, biceps brachii and deltoid muscles (intensity: 40 to 70 % of maximal repetition, 3 x 8 repetition); finally the oral high-frequency oscillation device (Flutter®) will be

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

    Directory of Open Access Journals (Sweden)

    Fei Di

    Full Text Available 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

  5. A Disease Model for Wheezing Disorders in Preschool Children Based on Clinicians' Perceptions

    NARCIS (Netherlands)

    Spycher, B.D.; Silverman, M.; Barben, J.; Eber, E.; Guinand, S.; Levy, M.L.; Pao, C.; van Aalderen, W.M.; van Schayck, O.C.P.; Kuehni, C.E.

    2009-01-01

    Background: Wheezing disorders in childhood vary widely in clinical presentation and disease course. During the last years, several ways to classify wheezing children into different disease phenotypes have been proposed and are increasingly used for clinical guidance, but validation of these

  6. The clinical impact of the radiology report in wheezing and nonwheezing febrile children: a survey of clinicians

    Energy Technology Data Exchange (ETDEWEB)

    Spottswood, Stephanie E.; Hernanz-Schulman, Marta; Hilmes, Melissa A.; Kan, J.H. [Vanderbilt University, Department of Radiology and Radiological Sciences, Monroe Carell Jr. Children' s Hospital, Nashville, TN (United States); Liaw, Kevin [Vanderbilt University School of Medicine, Nashville, TN (United States); Moore, Paul E. [Vanderbilt University, Department of Pediatric Pulmonary, Allergy and Immunology, Monroe Carell Jr. Children' s Hospital, Nashville, TN (United States); Patterson, Barron [Vanderbilt University, Department of Pediatrics, Monroe Carell Jr. Children' s Hospital, Nashville, TN (United States); Chen, Heidi [Vanderbilt University Medical Center, Department of Biostatistics, Nashville, TN (United States)

    2009-04-15

    The chest radiograph is commonly used in the diagnosis and management of patients presenting with respiratory illness. The language used to describe the findings is important to ensure appropriate communication with the referring clinician and thereby optimize patient management. In this study we attempted to determine how clinicians interpret specific terms commonly used in a chest radiograph report, and to assess how these terms impact the management of children with respiratory symptoms. An online survey was distributed to 562 pediatric practitioners asking their interpretation of the terms ''peripheral airway disease (PAD),'' ''focal airspace consolidation,'' and ''focal infiltrate'' in a febrile child with or without wheezing. There were 112 respondents. Most practitioners defined the term ''PAD'' as viral pneumonia (61.5%) or asthma (56.9%), ''consolidation'' as atelectasis (83%) followed by pneumonia (69.6%), and ''infiltrate'' as pneumonia (100%), followed by atelectasis (22.3%). Practitioners were more likely to treat a nonwheezing child with antibiotics if the report stated ''focal airspace consolidation'' (80%) or ''focal infiltrate'' (100%; P=0.001). Some radiologic descriptors may lead to diverse and sometimes unintended diagnostic conclusions. Our findings support continued effort to structure and standardize the radiology report and our descriptive terminology. (orig.)

  7. What gives rise to clinician gut feeling, its influence on management decisions and its prognostic value for children with RTI in primary care: a prospective cohort study.

    Science.gov (United States)

    Turnbull, Sophie; Lucas, Patricia J; Redmond, Niamh M; Christensen, Hannah; Thornton, Hannah; Cabral, Christie; Blair, Peter S; Delaney, Brendan C; Thompson, Matthew; Little, Paul; Peters, Tim J; Hay, Alastair D

    2018-02-05

    The objectives were to identify 1) the clinician and child characteristics associated with; 2) clinical management decisions following from, and; 3) the prognostic value of; a clinician's 'gut feeling something is wrong' for children presenting to primary care with acute cough and respiratory tract infection (RTI). Multicentre prospective cohort study where 518 primary care clinicians across 244 general practices in England assessed 8394 children aged ≥3 months and feeling'; clinician management decisions (antibiotic prescribing, referral for acute admission); and child's prognosis (reconsultation with evidence of illness deterioration, hospital admission in the 30 days following recruitment). Clinician years since qualification, parent reported symptoms (illness severity score ≥ 7/10, severe fever feeling that something was wrong'. 'Gut feeling' was independently associated with increased antibiotic prescribing and referral for secondary care assessment. After adjustment for other associated factors, gut feeling was not associated with reconsultations or hospital admissions. Clinicians were more likely to report a gut feeling something is wrong, when they were more experienced or when children were more unwell. Gut feeling is independently and strongly associated with antibiotic prescribing and referral to secondary care, but not with two indicators of poor child health.

  8. Periodontal diseases in children and adolescents: a clinician's perspective part 2.

    Science.gov (United States)

    Kumar, Ashish; Masamatti, Sujata Surendra; Virdi, Mandeep Singh

    2012-11-01

    The general dental practitioner and paediatric dentist are in a unique position to identify and distinguish between a seemingly innocuous condition that may be a normal physiological aberration or an early sign of severe destructive periodontal disease. Although severe destructive periodontal conditions are uncommon in children, it is essential that children receive a periodontal screening as part of their regular dental examination. Early diagnosis ensures a high likelihood of a successful therapeutic outcome, primarily by reduction of aetiologic factors, remedial therapy and development of an effective maintenance protocol. This prevents the recurrence and progression of disease and reduces the incidence of tooth loss. In the first article, we discussed the classification, plaque-induced and non plaque-induced gingival diseases, localized and generalized forms of chronic as well as aggressive periodontitis. In this second article, we discuss periodontitis as a manifestation of systemic disease, necrotizing periodontal diseases, periodontal screening and basic periodontal examination, and treatment of periodontal diseases in children and adolescents. Incorporation of periodontal screening in regular dental examination by dentists can help in early diagnosis and treatment of periodontal diseases. This could prevent further progression of disease and reduce the frequency of tooth loss.

  9. Diagnosis and management of primary autoimmune neutropenia in children: insights for clinicians

    Science.gov (United States)

    Dufour, Carlo

    2015-01-01

    Autoimmune neutropenia of infancy (AIN), also called primary autoimmune neutropenia, is a disease in which antibodies recognize membrane antigens of neutrophils, mostly located on immunoglobulin G (IgG) Fc receptor type 3b (FcγIIIb receptor), causing their peripheral destruction. It is the most frequent type of neutropenia in children under 3–4 years of age and in most cases shows a benign, self-limited course. The diagnosis is based on evidence of indirect antineutrophil antibodies, whose detection frequently remains difficult. In this review we have analyzed the literature regarding AIN and present our personal experience in diagnosis and management. PMID:25642312

  10. Função respiratória em filhos de mães asmáticas Respiratory function in children of asthmatic mothers

    Directory of Open Access Journals (Sweden)

    Marco A. Valadares

    2013-04-01

    nested in a cohort of 4,757 pregnant women. A total of 86 six-year-old children were evaluated, born to mothers with a medical diagnosis of asthma before pregnancy. Information was collected regarding clinical symptoms of atopy and respiratory diseases, as well as socioeconomic and exposure variables; the children were submitted to spirometry. RESULTS: Spirometric alterations were observed in 30.3% of cases, with a prevalence of asthma in those who had an obstructive pattern. 9.3% of the children had a previous medical diagnosis of asthma; however, the established diagnosis based on the presence and frequency of asthma symptoms was 18.6%. Of the 86 participating children, 37.2% had a score of five or more points in the International Study of Asthma and Allergies in Childhood (ISAAC questionnaire, which was associated with spirometry alterations (p = 0.002. After multiple logistic regression analysis, higher paternal education, higher number of bedrooms in the family's home, and mother who did not have "wheezing" episodes during pregnancy were statistically significant as protective factors for the presence of respiratory disorder detected by spirometry. CONCLUSIONS: The frequency of spirometry alterations in children of asthmatic mothers was high; the restrictive pattern was more often observed that the obstructive. There was a higher incidence of obstructive test results in those who presented clinical symptoms of asthma, with a higher frequency of clinical diagnosis of asthma than that found in the literature.

  11. original article clinical effects of yoga on asthmatic patients

    African Journals Online (AJOL)

    user

    CONCLUSION: Yoga exercise among asthmatic patients resulted in a decreased number of day and ... children in USA and Australia have the disorder. (4). ... emotional wellbeing and positive out look in general and to result in a feeling of freedom and relaxation. Twenty four patients diagnosed to have asthma and.

  12. Dengue 2 virus enhancement in asthmatic and non asthmatic individual

    Directory of Open Access Journals (Sweden)

    Maria G. Guzman

    1992-12-01

    Full Text Available During the 1981 dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS Cuban epidemic, bronchial asthma (BA was frequently found as a personal or family antecedent in dengue hemorragic fever patients. Considering that antibody dependent enhancement (ADE plays an important role in the etiopathogenic mechanism of DHF/DSS, we decide to study the Dengue 2 virus (D2V capability of replication in peripheral blood leukocytes (PBL from asthmatic patients and healthy persons. In 90% of asthmatic patients and 53.8% of control group it was obtained PBL with a significant D2V enhancing activity (X² p < 0.01. Power enhancement was higher in asthmatic group. This is the first in vitro study relating BA and the dengue 2 virus immuno enhancement. The results obtained support the role of BA as a risk factor for DHF/DSS as already described on epidemiological data.

  13. Oral manifestations of asthmatic patients.

    Science.gov (United States)

    Ghapanchi, Janan; Rezazadeh, Fahimeh; Kamali, Fereshte; Rezaee, Mostafa; Ghodrati, Maryam; Amanpour, Sara

    2015-11-01

    The effect of asthma on oral health is the subject of debate among dental practitioners. The current study was planned to investigate the oral manifestations of asthmatics compared to healthy subjects. The study group composed of 100 asthmatics and 100 age-matched healthy controls. The caries status based on Decayed/Missing/Filled Teeth (DMFT) criteria and oral lesion were evaluated in all subjects. The mean age of the asthmatics group was 47.5±3.5 years and in the control group it was 43.5±3.0 years. Asthmatics included 45(45%) males and 55(55%) females. There was no statistical difference between caries prevalence in both groups. The most prevalent oral lesions in asthmatics group were geographic tongue 10(10%), fissured tongue 13(13%), chronic atrophic candidiasis13(13%), and in the control group were fissured tongue(11%) and lichenoid reaction(2%). The dental professional must be familiar with all signs and symptoms of this disease in order to offer effective and safe treatment.

  14. Clinician and Parent Perspectives on Parent and Family Contextual Factors that Impact Community Mental Health Services for Children with Behavior Problems

    Science.gov (United States)

    Baker-Ericzen, Mary J.; Jenkins, Melissa M.; Brookman-Frazee, Lauren

    2010-01-01

    The present study employed qualitative methods to examine multiple stakeholder perspectives regarding the role of parent and family contextual factors on community child mental health treatment for children with behavior problems. Findings suggest agreement between clinicians and parents on the number, types and importance of parent and family…

  15. 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.

  16. Evaluation of factors that allow the clinician to taper inhaled corticosteroids in childhood asthma

    Directory of Open Access Journals (Sweden)

    Kentaro Matsuda

    1999-01-01

    Full Text Available Inhaled corticosteroids are potent and effective treatment agents for controlling symptoms of childhood asthma. However, there are no predictive factors that help to determine which patients with asthma are likely to be tapered off inhaled corticosteroids successfully. We examined whether any factor or combination of factors could help the clinician safely discontinue inhaled steroid therapy. Thirty-six asthmatic children whose symptoms were stable on low-dose beclomethasone dipropionate (BDP were divided by parental choice into two groups: maintenance BDP (n = 11 and no BDP (n = 25. Methacholine inhalation tests were performed at the beginning of the study and after 1 month. Twelve children (48% who had BDP discontinued developed exacerbations after 2–3 months, whereas there were no problems in the maintenance group. The no BDP group was retrospectively divided into two subgroups: exacerbation (+ and (−. The threshold to methacholine in the exacerbation (+ subgroup decreased significantly in advance of clinical symptoms. The two subgroups were analyzed statistically by two-group discriminant function analysis. The change in threshold to methacholine, the dose and potency of drugs, duration of asthma and gender (female correlated with exacerbation. These results suggest that discontinuation of inhaled steroids should be done carefully, even in stable asthmatic children. The methacholine inhalation test, gender, drugs and history may be used as references for discontinuing inhaled steroids.

  17. Hipersensibilidade a fungos em crianças asmáticas de uma comunidade do Recife, Pernambuco Hypersensitivity to molds in asthmatic children from a community of Recife, Pernambuco

    Directory of Open Access Journals (Sweden)

    Ana Carla de Albuquerque Osório

    2006-06-01

    Full Text Available OBJETIVOS: identificar a sensibilização a testes cutâneos de hipersensibilidade imediata para fungos em crianças asmáticas, residentes em comunidade urbana de baixa renda. MÉTODOS: no período de março de 1997 a junho de 1998 foram avaliadas 13 crianças com mais de três episódios de dispnéia nos últimos 12 meses, selecionadas a partir de um estudo transversal, em que todos os 123 escolares de 6 a 10 anos residentes na comunidade responderam ao questionário International Study of Asthma and Allergies in Childhood. Nas 13 crianças com asma em atividade, foram aplicados testes cutâneos de hipersensibilidade imediata para avaliar resposta a seis extratos fúngicos padronizados: Aspergillus mix, Penicillium mix, Hormodendrum cladosporidiodes, Alternaria tenius, Helminthosporium interseninatum e Mold mix. RESULTADOS: dentre as 13 crianças analisadas, 12 apresentaram sensibilididade a pelo menos um dos fungos testados (12/13, cujos extratos com maior frequência de positividade foram: Aspergillus mix (7/13, Penicillium mix (6/13 e Hormodendrum cladosporidiodes (5/13. CONCLUSÕES: a freqüência elevada de hipersensibilidade aos extratos de fungos nas crianças avaliadas sugere a necessidade de estudos analíticos observacionais para esclarecer uma possível associação causal entre fungos e asma.OBJECTIVES: to identify prick test hypersensitivity to molds in asthmatic school children in a low-income urban community. METHODS: thirteen children who had more than three asthma attacks in the last 12 months from March'1997 to June'1998 were evaluated. These children were selected from a previous cross-sectional survey studying 123 children from 6 to 10 years old residing at the low-income urban community of Campo do Banco-Várzea, Recife, Pernambuco. The 123 children were tested by the International Study of Asthma and Allergies in Childhood survey to determine asthma. The 13 asthmatic children selected were evaluated with the prick test

  18. 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.

  19. Effects of Clinician-Guided Emergent Literacy Intervention Using Interactive Tablet Technology for Preschool Children with Cochlear Implants

    Science.gov (United States)

    Brouwer, Kyle; Downing, Hannah; Westhoff, Sara; Wait, Ryann; Entwisle, Lavin K.; Messersmith, Jessica J.; Hanson, Elizabeth K.

    2017-01-01

    The purpose of this study was to investigate if intervention based on a mobile application would improve the print knowledge and vocabulary of preschool children with and without hearing loss. This was a multiple baseline study that included four preschool children. Two of the children had hearing loss and utilized cochlear implants, while the…

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

    Energy Technology Data Exchange (ETDEWEB)

    Tsai, Shiu-Lin; Crain, Ellen F. [Division of Emergency Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY (United States); Department of Pediatrics, Jacobi Medical Center, Albert EinsteinCollege of Medicine, Bronx, NY (United States); Silver, Ellen J. [Department of Pediatrics, Jacobi Medical Center, Albert EinsteinCollege of Medicine, Bronx, NY (United States); Goldman, Harold S. [Department of Pediatrics, Jacobi Medical Center, Albert EinsteinCollege of Medicine, Bronx, NY (United States); Department of Radiology, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY (United States)

    2002-07-01

    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.)

  1. Rhinovirus infection results in stronger and more persistent genomic dysregulation: Evidence for altered innate immune response in asthmatics at baseline, early in infection, and during convalescence.

    Directory of Open Access Journals (Sweden)

    Peter W Heymann

    Full Text Available Rhinovirus (HRV is associated with the large majority of virus-induced asthma exacerbations in children and young adults, but the mechanisms remain poorly defined.Asthmatics and non-asthmatic controls were inoculated with HRV-A16, and nasal epithelial samples were obtained 7 days before, 36 hours after, and 7 days after viral inoculation. RNA was extracted and subjected to RNA-seq analysis.At baseline, 57 genes were differentially expressed between asthmatics and controls, and the asthmatics had decreased expression of viral replication inhibitors and increased expression of genes involved in inflammation. At 36 hours (before the emergence of peak symptoms, 1329 genes were significantly altered from baseline in the asthmatics compared to 62 genes in the controls. At this time point, asthmatics lacked an increase in IL-10 signaling observed in the controls. At 7 days following HRV inoculation, 222 genes were significantly dysregulated in the asthmatics, whereas only 4 genes were dysregulated among controls. At this time point, the controls but not asthmatics demonstrated upregulation of SPINK5.As judged by the magnitude and persistence of dysregulated genes, asthmatics have a substantially different host response to HRV-A16 infection compared with non-asthmatic controls. Gene expression differences illuminate biologically plausible mechanisms that contribute to a better understanding of the pathogenesis of HRV-induced asthma exacerbations.

  2. 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

  3. 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

  4. IL-13 R130Q single nucleotide polymorphism in asthmatic Egyptian ...

    African Journals Online (AJOL)

    IL-13 R130Q single nucleotide polymorphism in asthmatic Egyptian children. ... Egyptian Journal of Pediatric Allergy and Immunology (The) ... Objective: We sought to study the association of IL-13 genetic variant R130Q with bronchial asthma in Egyptian children and its relation to various clinical and laboratory phenotypes ...

  5. Structured Trauma-Focused CBT and Unstructured Play/Experiential Techniques in the Treatment of Sexually Abused Children: A Field Study With Practicing Clinicians.

    Science.gov (United States)

    Allen, Brian; Hoskowitz, Natalie Armstrong

    2017-05-01

    Structured, trauma-focused cognitive-behavioral therapy (CBT) techniques are widely considered an effective intervention for children who experienced sexual abuse. However, unstructured (i.e., nondirective) play/experiential techniques have a longer history of widespread promotion and are preferred by many practicing clinicians. No evidence is available, however, to determine how the integration of these techniques impacts treatment outcome. In this study, community-based clinicians who received training in a structured, trauma-focused cognitive-behavioral intervention administered pretreatment and posttreatment evaluations to 260 sexually abused children presenting with elevated posttraumatic stress. In addition, they completed a questionnaire describing the treatment techniques implemented with each child. Overall, significant improvement was observed for each of the six clinical outcomes. Regression analyses indicated that technique selection was a significant factor in posttreatment outcome for posttraumatic stress, dissociation, anxiety, and anger/aggression. In general, a greater utilization of the structured CBT techniques was related to lower posttreatment scores, whereas a higher frequency of play/experiential techniques was associated with higher posttreatment scores. However, no interaction effects were observed. The implication of these findings for clinical practice and future research are examined.

  6. [Evaluation of a program for asthmatic children treated in primary care outpatient units in Embu, São Paulo, 1988-1993

    Science.gov (United States)

    Ventura; Naspitz; Puccini; Silva

    1998-04-30

    The main objective of this study was to evaluate the effectiveness of the Program Targeting Children with 'Chest Wheezing' carried in the city of Embu, São Paulo. The study analyzed a total of 434 children aged zero to 14 years, admitted to the program from May 1988 to July 1993. Over 90% had never been treated for this medical problem in outpatient clinics. Only 6.2% had to be referred to other health care services during follow-up in this program. The program successfully performed clinical diagnosis of asthma in children over 2 years of age. The moderate and severe cases followed up for over a year showed the best clinical evolution, with the positive factor being better compliance with medication. The number of exacerbations decreased among the severe patients after a year of regular follow-up, although patients used bronchodilators during the 12 months of our analysis. Of the children enrolled, 53.2% gave up treatment principally in the first six months, most of them from the moderate group. We concluded that children with steadier compliance with the program benefited in spite of both the simplicity and the lack of some currently existing medications.

  7. Effect of anti-asthmatic drugs on dental health: A comparative study.

    Science.gov (United States)

    Chellaih, P; Sivadas, G; Chintu, S; Vaishnavi Vedam, V K; Arunachalam, Rajeev; Sarsu, M

    2016-10-01

    Bronchial asthma constitutes important problem worldwide. This chronic lung disease has detrimental effect in the oral cavity like reduction of salivary secretion, change in salivary composition and pH. This study was conducted to compare the prevalence of dental caries in asthmatic children and healthy children, and also to evaluate the correlation between the Streptococcus mutans, Lactobacillus and dental caries in both the groups. In this study, the mean decayed, missing, filled teeth score of children in the study group was (4.53 ± 3.38) higher than the control group (1.51 ± 1.58) (P dental caries than the control group with odds ratio = 6.26 and 95% confidence interval. The dental caries prevalence increases with the usage of β2 agonist and corticosteroid inhalers for the treatment of asthma. Thus in asthmatic children, increase in caries prevalence might be due to the drug treatment and not due to the disease by itself. It can be concluded that asthmatic children have a higher prevalence of dental caries than healthy children. Hence, special oral health care is needed for asthmatic children.

  8. 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

    indicated that F4.5 microg had the same systemic activity as the clinically less effective dose of 250 microg terbutaline. The duration of systemic effects differed marginally between treatments. Spontaneously reported adverse events (most frequently tremor) were fewer with formoterol (78% of the children...

  9. Basophil histamine release in the diagnosis of house dust mite and dander allergy of asthmatic children. Comparison between prick test, RAST, basophil histamine release and bronchial provocation.

    Science.gov (United States)

    Ostergaard, P A; Ebbesen, F; Nolte, H; Skov, P S

    1990-04-01

    The aim of the study is to compare the glass fibre-based basophil histamine release test with skin test (Phazet), RAST (Phadebas) and bronchial provocation test in children with allergic asthma. The study comprised 68 selected children with a case history of extrinsic allergic asthma to danders (cat and dog) and house-dust mite. Skin prick test, RAST, and histamine release were performed in all children and the bronchial provocation test was used as a reference of "true allergic asthma". A total of 81 allergen bronchial challenges were performed and 44 children experienced 49 positive provocations. In 2.9% (2/68) of the children histamine release could not be performed due to technical difficulties (low histamine release with anti-IgE). Concordances in the range 76-87% were observed with no significant difference between the tests. The highest concordance (87%) was found between histamine release and bronchial provocation test followed by skin prick test vs bronchial provocation (84%) and RAST vs bronchial provocation (80%). The sensitivity and specificity were calculated for each test. All tests showed sensitivities in the range 90-94% and no significant difference between them was observed. The specificity of histamine release, skin prick test, and RAST was 0.78, 0.69, and 0.63, respectively. The specificity of histamine release was better than RAST demonstrated by 95% confidence intervals. In conclusion, it was found that the histamine release test is a convenient diagnostic method and the study indicates a diagnostic value comparable to the common diagnostic methods in clinical allergy.

  10. Effectiveness of school-based family asthma educational programs in quality of life and asthma exacerbations in asthmatic children aged five to 18: a systematic review.

    Science.gov (United States)

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

    2016-11-01

    Asthma is a common, chronic, non-communicable respiratory disease that affects millions of children worldwide. Asthma exacerbations can range from mild to severe and can have an unfavorable impact on the quality of life of children and their caregivers. Asthma exacerbations often result in absenteeism from school or work, activity intolerance and emergency hospital visits. One strategy to address this health issue in an attempt to improve health outcomes is school-based asthma educational programs. A review of the literature revealed that previous systematic reviews have examined similar topics on the effectiveness of school-based asthma educational programs that have included collaborative efforts between parents and schools. No systematic reviews were found that examined the effectiveness of school-based asthma educational programs that exclusively included children and their caregivers. Research has not been systematically reviewed to determine the effectiveness of a school-based asthma educational program within a familial context. To identify the best available evidence on the effectiveness of school-based family asthma educational programs that exclusively included both children and caregivers on the quality of life and number of asthma exacerbations of children aged five to 18 years with a clinical diagnosis of asthma. Children aged five to 18 years of any gender, race or ethnicity with a clinical diagnosis of asthma and their caregivers. School-based family asthma educational programs. Randomized controlled trials. Quality of life and the number of asthma exacerbations measured by either missed days from school or work, and/or physical activity intolerance, and/or emergency hospital visits. The search strategy aimed to find both published and unpublished studies from inception of the database to August 21, 2015. Quantitative papers selected for retrieval were assessed by two independent reviewers for methodological validity before inclusion in the review

  11. Risk for Asthma in Offspring of Asthmatic Mothers versus Fathers: A Meta-Analysis

    DEFF Research Database (Denmark)

    Lim, R.H.; Kobzik, L.; Dahl, Morten

    2010-01-01

    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...

  12. Current updates on HIV-related pulmonary disease in children: What do radiologists and clinicians need to know?

    Directory of Open Access Journals (Sweden)

    Tracy Kilborn

    2015-10-01

    Full Text Available Despite substantial advances in diagnosis and treatment, pulmonary human immunodeficiency virus (HIV infection continues to be a major cause of morbidity and mortality in infants and children particularly those who live in developing countries. This article provides an up-to-date review on underlying etiology, often characteristic imaging findings and current management of pulmonary HIV infection in infants and children. Increased understanding of clinical and unique imaging findings of pulmonary HIV infection has a great potential for early and accurate diagnosis which, in turn, can eventually improve pediatric patient care.

  13. Relationship Between Different Types and Forms of Anti-Asthmatic Medications and Dental Caries in Three to 12 Year Olds

    OpenAIRE

    Alireza Heidari; Bahman Seraj; Mehdi Shahrabi; Hamideh Maghsoodi; Mohammad Javad Kharazi Fard; Tara Zarabian

    2016-01-01

    Objectives: Asthma is a common chronic disease. Asthma and anti-asthmatic medications have been suggested as risk factors for increased susceptibility to caries. This study was conducted to evaluate the effects of different types and forms of antihistaminic medications and the duration of drug consumption on the severity of dental caries in asthmatic children.Materials and Methods: This cross-sectional study was conducted in Asthma and Allergy Department of Children’s Medical Center in Tehran...

  14. Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5.

    Science.gov (United States)

    Grzadzinski, Rebecca; Dick, Catherine; Lord, Catherine; Bishop, Somer

    2016-01-01

    Children with attention deficit/hyperactivity disorder (ADHD) often present with social difficulties, though the extent to which these clearly overlap with symptoms of autism spectrum disorder (ASD) is not well understood. We explored parent-reported and directly-observed ASD symptoms on the Autism Diagnostic Interview-Revised (ADI-R) and the Autism Diagnostic Observation Schedule (ADOS) in children referred to ASD-specialty clinics who received diagnoses of either ADHD (n = 48) or ASD (n = 164). Of the ADHD sample, 21 % met ASD cut-offs on the ADOS and 30 % met ASD cut-offs on all domains of the ADI-R. Four social communication ADOS items (Quality of Social Overtures, Unusual Eye Contact, Facial Expressions Directed to Examiner, and Amount of Reciprocal Social Communication) adequately differentiated the groups while none of the items on the ADI-R met the criteria for adequate discrimination. Results of this work highlight the challenges that clinicians and researchers face when distinguishing ASD from other disorders in verbally fluent, school-age children.

  15. Rural Clinician Evaluation of Children's Health Care Quality Measures: An Oregon Rural Practice-based Research Network (ORPRN) Study.

    Science.gov (United States)

    Fagnan, Lyle J; Michaels, LeAnn; Ramsey, Katrina; Shearer, Stefan; Droppers, Oliver; Gallia, Charles

    2015-01-01

    Responding to quality metrics is an accepted and expected component of the current health care environment. Little is known about which measures physicians identify as a priority when reporting the quality of care to their patients, especially the care of children in rural settings. The objective of this study is for physicians caring for children in rural communities to identify which of the initial core sets of 24 child health quality measures are useful and are a priority for reporting and improving care. A survey was sent to rural Oregon physicians who provide care to children. Of 955 eligible physicians, 172 (18%) completed the survey. The majority of respondents were family physicians (84%), and most respondents (58%) were in private practice. The child health measures stratified into 3 priority tiers: high, medium, and low priority. The top-tier priority measures included childhood immunization status, well-child visits, adolescent immunization status, body mass index assessment, and developmental screening. Dental treatment services, adequate prenatal care, and lower-birth-weight infants were among the lower-tier measures. The priority measures identified by rural family physicians reflect the relevance of the selected measures to their daily practice responsibilities, with missed opportunities to improve community health. © Copyright 2015 by the American Board of Family Medicine.

  16. Oral and dental manifestations of young asthmatics related to medication, severity and duration of condition.

    Science.gov (United States)

    Ersin, Nazan Kocataş; Gülen, Figen; Eronat, Nesrin; Cogulu, Dilsah; Demir, Esen; Tanaç, Remziye; Aydemir, Söhret

    2006-12-01

    The aim of this study was to investigate the caries risk of asthmatics in relation to dental plaque indices, salivary flow rate, pH and buffer capacity, saliva composition and salivary levels of Streptococcus mutans compared with healthy subjects and also to evaluate these parameters within different groups of asthmatics according to their medication, duration and severity of the disease. The study group composed of 106 asthmatics and 100 healthy controls with the same age and social background aged between 6 and 19-years-old. For dental examinations, World Health Organization criteria and for plaque indices the Silness and Löe plaque index was used. All data were analyzed using t-test, chi2-test, Spearman rank correlation, Kruskal- Wallis, Mann-Whitney U-tests and Logistic Regression Analysis with Forward Stepwise Likelihood ratio method. A statistically significant decrease in the salivary flow rate and pH were found in the asthmatic group. The children in the asthmatic group aged between 6 and 10 years had significantly higher caries prevalence compared with the control group at the same age. There was a negative correlation between the duration of medication and the salivary pH and a positive correlation between duration of illness and the salivary levels of S. mutans in the asthmatics. It was found that asthma, through its disease status and its pharmacotherapy, carries some risk factors including decreased salivary flow rate and pH for caries development. It was also demonstrated that the duration of medication and illness had significant influences on the risk of caries in asthmatics.

  17. Anaphylactic deaths in asthmatic patients.

    Science.gov (United States)

    Settipane, G A

    1989-01-01

    We reviewed seven documented deaths to peanuts and two near deaths. We excluded hearsay undocumented deaths to peanuts. Peanut allergy is one of the most common food allergies and probably the most common cause of death by food anaphylaxis in the United States. About one-third of peanut-sensitive patients have severe reactions to peanuts. Asthmatics with peanut sensitivity appear more likely to develop fatal reactions probably because of the exquisite sensitivity that asthamatics have to chemical mediators of anaphylaxis. Severe reactions occur within a few minutes of ingestion and these patients must carry preloaded epinephrine syringes, antihistamines, and medic-alert bracelets. Treatment should include repeated doses of epinephrine, antihistamines and corticosteroids as well as availability of oxygen, mechanical methods to open airways, vasopressors, and intravenous fluids. Hidden sources of peanuts such as chili, egg rolls, cookies, candy, and pastry should be recognized and identified. Scratch/prick test to peanuts are highly diagnostic. Peanut is one of the most sensitive food allergens known requiring only a few milligrams to cause a reaction. In some individuals, even contact of peanut with unbroken skin can cause an immediate local reaction. Unfortunately, peanut reaction is not outgrown and remains a life-long threat.

  18. THE ROLE OF THE VIRUS RESPIRATORY INFECTIONS IN THE PATHOGENESIS OF THE ASTHMATIC EXARCEBATIONS

    Directory of Open Access Journals (Sweden)

    Boris Djindjic

    2000-01-01

    Full Text Available The virus infections of the respiratory pathways represent an important cause of the emergence of the symptoms of the puffing (wheezing in the lungs of the patients of all age groups. In the patients suffering from asthma the virus respiratory infections are the main causes of asthmatic exarcebations. In 80 to 85 % of the school children and in 50 % of the adult asthmatics, the exarcebations are caused by the respiratory virus infection while the most frequent cause is the rhinovirus. It is believed that in the pathogenesis of the virus-induced asthmatic exarcebations the following mechanisms are involved: the damage of the epithelium, the inflammation increase in the respiratory pathways, the disturbance of the small respiratory pathways' geometry, the disturbance of the nerve controlling mechanisms and the disturbance of the IgE synthesis regulation.

  19. A deep breath bronchoconstricts obese asthmatics.

    Science.gov (United States)

    Holguin, Fernando; Cribbs, Sushma; Fitzpatrick, Anne M; Ingram, Roland H; Jackson, Andrew C

    2010-02-01

    Asthma is characterized by the loss of a deep breath (DB)-induced bronchodilation and bronchoprotection. Obesity causes lung restriction and increases airway resistance, which may further worsen the capacity of a DB to induce bronchodilation; however, whether increasing BMI impairs the bronchodilatory response to a DB in asthmatics is unknown. The population consisted of 99 subjects, 87 with moderate to severe persistent asthma and 12 obese control subjects. Using transfer impedance we derived airway resistance (Raw). Participants breathed for 1 minute and took a slow DB followed by passive exhalation to functional residual capacity (FRC) and tidal breathing for another minute. After a DB, obese asthmatics had the largest percent increase in Raw (median 9.8% interquartile range [IQR] 3.1-15.1), compared with overweight (6.5% IQR -1.3, 12.1) and lean (0.7% IQR -3, 7.9) asthmatics and obese controls (2.5% IQR -.6, 11) (p for trend = 0.008). The association between the percent increase in Raw after a DB and BMI as a continuous variable was significant (p = 0.02). In obese, moderate to severe and poorly controlled asthmatics, a DB results in increased Raw. This phenomenon was not observed in leaner asthmatics of similar severity or in obese control subjects.

  20. Depression, anxiety, distress and somatization in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Hala Mohamed Shalaby Samaha

    2015-04-01

    Conclusions: Asthmatic patients are at high risk of psychiatric problems, particularly depression, anxiety and somatization. Asthmatic patients need psychotherapy besides their medication of asthma to obtain better asthma out come and management.

  1. Perception of wheezing in the elderly asthmatics.

    Science.gov (United States)

    Joo, J H; Lim, G I; Seo, M J; Park, S J; Lee, J H; Uh, S T; Kim, Y H; Park, C S

    2001-12-01

    In elderly asthmatics, underdiagnosis is one of the important features. The main reason for underdiagnosis is thought to be a low frequency in complaining of symptoms due to the reduction of intellectual recognition and physical activity. Among the various symptoms, wheezing is the principal clue in diagnosing bronchial asthma, and decreased complaints for wheezing are also noted in elderly asthmatics. The objective of this study is to determine if less complaints of wheezing in elderly asthmatic is due to decrease in the development of wheezing. 61 young (20-39 years old), 68 middle-aged (40-59 years old) and 65 elderly (older than 60 years old) stable asthmatic subjects were studied (each group shall be called, hereafter, Young Group, Middle-aged Group and Old Group, respectively). During the methacholine induced airway narrowing, lung auscultation and questionnaire survey about presence and perception of wheezing were conducted in 194 asthmatics. One hundred and sixty-nine patients (87%) developed wheezing during the methacholine induced airway obstruction. The frequency of wheezing during the methacholine challenge was found to be comparable among the groups. The methacholine concentration, % fall in FEV1, and FEV1 levels of the initial detection of wheezing were not different among the groups. Among the patients who developed wheezing, 47 patients (77%), 42 patients (61.8%) and 26 patients (40%) complained of wheezing in Young, Middle and Old Group, respectively. In conclusion, the decreased perception of wheezing is a main factor for the low frequency of complaints of wheezing in elderly asthmatics.

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

    Science.gov (United States)

    Nino, Gustavo; Huseni, Shehlanoor; Perez, Geovanny F; Pancham, Krishna; Mubeen, Humaira; Abbasi, Aleeza; Wang, Justin; Eng, Stephen; Colberg-Poley, Anamaris M; Pillai, Dinesh K; Rose, Mary C

    2014-01-01

    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. 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. 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. 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.

  3. 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 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.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.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.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.

  4. Pediatric pulmonologists approach to the pre-operative management of the asthmatic child.

    Science.gov (United States)

    Armoni-Domany, Keren; Gut, Guy; Soferman, Ruth; Sivan, Yakov

    2015-05-01

    No consensus guidelines exist for the respiratory treatment of asthmatic children referred for elective surgery. The aim of this study was to evaluate the attitude of pediatric pulmonologists regarding the pre-operative management of these children. A survey of pre-operative management of asthmatic children was conducted. All 48 certified pediatric pulmonologists in Israel completed a questionnaire that comprised 20 questions regarding their approach to pre-operative management including six case scenarios with a variety of clinical situations and treatments of children with asthma. Response rate was 100%. All believed that pre-operative treatment should be considered in all asthmatic children. Almost 50% suggested that a pediatric pulmonologist should be consulted in all pre-operative assessments. 50% recommended consultation only in individual cases. Overall, results showed a very wide variability between responders especially in pre-school and poorly controlled school children. The variability referred to the use of bronchodilators, inhaled corticosteroids and their combination during the pre-operative days, the addition of systemic CS and the length of pre-operative treatment. Almost all participants suggested either the initiation or augmentation of pre-operative treatment in high risk situations. This data demonstrate an important variability among pediatric pulmonologists in Israel regarding the practice of pre-operative treatment of infants and children with asthma especially for the less controlled and high risk children. This is most probably explained by the paucity of evidence-based data and the lack of established guidelines. Consensus guidelines for the pre-operative management of asthmatic children are needed.

  5. Increased cytokine/chemokines in serum from asthmatic and non‐asthmatic patients with viral respiratory infection

    National Research Council Canada - National Science Library

    Giuffrida, María J; Valero, Nereida; Mosquera, Jesús; Alvarez de Mon, Melchor; Chacín, Betulio; Espina, Luz Marina; Gotera, Jennifer; Bermudez, John; Mavarez, Alibeth

    2014-01-01

    ...: regulated on activation normal T cell expressed and secreted) in patients with an asthmatic versus a non-asthmatic background with respiratory syncytial virus, parainfluenza virus or adenovirus respiratory infection...

  6. Relationship of social support to stress responses and immune function in healthy and asthmatic adolescents.

    Science.gov (United States)

    Kang, D H; Coe, C L; Karaszewski, J; McCarthy, D O

    1998-04-01

    Although most clinicians believe that social support has beneficial effects on health, the mechanisms mediating this relationship have not been clearly established. We examined the direct effect of social support on several immune measures and its role in moderating the response to academic exams in healthy and asthmatic adolescents. Three types of students--healthy, mild asthma, and severe asthma--completed social support and stress questionnaires and gave blood samples during the midsemester and final exam periods. Social support and natural killer cell (NK) function showed a significant reduction during exams in both healthy and asthmatic adolescents. Social support, however, did not have a direct effect on immune responses. Nevertheless, high social support appeared to attenuate the magnitude of exam-induced reduction in NK activity, suggesting a role for social support in protecting against immune decrements during times of stress.

  7. 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....

  8. Effect of anti-asthmatic drugs on dental health: A comparative study

    Directory of Open Access Journals (Sweden)

    P Chellaih

    2016-01-01

    Full Text Available Aims: Bronchial asthma constitutes important problem worldwide. This chronic lung disease has detrimental effect in the oral cavity like reduction of salivary secretion, change in salivary composition and pH. Materials and Methods: This study was conducted to compare the prevalence of dental caries in asthmatic children and healthy children, and also to evaluate the correlation between the Streptococcus mutans , Lactobacillus and dental caries in both the groups. Results: In this study, the mean decayed, missing, filled teeth score of children in the study group was (4.53 ± 3.38 higher than the control group (1.51 ± 1.58 (P < 0.01. The S. mutans count of the study group was (59574.47 ± 28510.67 higher than the control group (19777.78 ± 17899.83 P < 0.01. The Lactobacillus count in study group was (43553.19 ± 58776.96 higher than the control group (8843.84 ± 7982.72 P < 0.01. Subjects using inhaled corticosteroids were more prone to develop dental caries than the control group with odds ratio = 6.26 and 95% confidence interval. Conclusions: The dental caries prevalence increases with the usage of β2agonist and corticosteroid inhalers for the treatment of asthma. Thus in asthmatic children, increase in caries prevalence might be due to the drug treatment and not due to the disease by itself. It can be concluded that asthmatic children have a higher prevalence of dental caries than healthy children. Hence, special oral health care is needed for asthmatic children.

  9. Fatores de risco para hospitalização de crianças e adolescentes asmáticos Risk factors for hospital admissions among asthmatic children and adolescents

    Directory of Open Access Journals (Sweden)

    Laura Lasmar

    2002-08-01

    prestar adequada assistência a crianças e adolescentes asmáticos, especialmente para os menores de dois anos de idade.OBJECTIVE: To assess the prevalence rate and risk factors for hospital admissions among asthma children and to evaluate care delivered to these patients. METHODS: Three-hundred and twenty-five asthmatic children attending a public outpatient reference clinic were studied. Of them, 202 were hospitalized. Care was evaluated using a questionnaire covering general aspects of hospital stay and biological, demographics, socioeconomic and asthma-related factors. Univariate and multivariate analyses were performed to measure the association between hospital admissions and selected independent variables. RESULTS: Of the total, 62.2% had already been hospitalized due to asthma, 64.9% developed asthma episodes, and 60.9% were hospitalized in their first year of life. Most (76.0% had moderate to severe asthma. Despite that, 94.2% were not on anti-inflammatory drugs and were treated only during isolated acute episodes. None of these were regularly seen in primary health care centers for a periodic control of their steroid inhalants. Most parents (97.8% referred not to know how to take care of asthma children. Symptoms onset is normally seen before the age of 12 months (OR=3.20; 95%CI 1.55-6,61 or between 12 and 24 months (OR=3.89; 95%CI 1.62-9.36. Mothers have attended school for less than 7 years (OR=3.06; 95%CI 1.62-5.76. Disease severity (OR=2.32; 95%CI 1.24-3.88, 2 or more monthly visits to emergency wards (OR=2.19; 95%CI 1.24-3.88, and referred recurrent pneumonia (OR=2.00; 95%IC 1.06-3.80 were the main risk factors for hospital admissions. CONCLUSIONS: Organizing health care services is crucial to reduce hospital admissions and provide adequate care for asthma children and adolescents, especially those less than 2 years old.

  10. Idiopathic bronchocentric granulomatosis in an asthmatic adolescent

    Directory of Open Access Journals (Sweden)

    Hiroki Umezawa

    2015-01-01

    Full Text Available Bronchocentric granulomatosis in asthmatic patients has been generally considered to be associated with allergic bronchopulmonary aspergillosis and represent a histopathologic manifestation of fungal hypersensitivity. Here we report a case of an idiopathic bronchocentric granulomatosis in a 17-year-old man with a history of asthma. He was admitted to the hospital with a fever and cough, and a chest CT scan showed peribronchial consolidation in the pulmonary parenchyma, which was unresponsive to antibiotic therapy. The pathological findings obtained by video-assisted thoracoscopic lung biopsy revealed necrotizing granulomatous inflammation centered on bronchi and bronchioles and there was no evidence of fungal colonization, resulting in a diagnosis of idiopathic bronchocentric granulomatosis. Systemic corticosteroid therapy led to clinical and radiological recovery. Physicians should take into account the possibility of the idiopathic process in bronchocentric granulomatosis of asthmatic patients.

  11. Association of both consistency and strength of self-reported clinician recommendation for HPV vaccination and HPV vaccine uptake among 11- to 12-year-old children.

    Science.gov (United States)

    Finney Rutten, Lila J; St Sauver, Jennifer L; Beebe, Timothy J; Wilson, Patrick M; Jacobson, Debra J; Fan, Chun; Breitkopf, Carmen Radecki; Vadaparampil, Susan T; MacLaughlin, Kathy L; Jacobson, Robert M

    2017-10-27

    We tested the hypotheses that consistency and strength of clinician recommendation of the human papillomavirus (HPV) vaccination would be associated with vaccine delivery rates. From October 2015 through January 2016, we conducted a survey of primary care clinicians (n=227) in Southeastern Minnesota to evaluate clinician behaviors regarding HPV vaccination. The survey response rate was 41.0% (51 clinical sites). We used the Rochester Epidemiology Project, a clinical data linkage infrastructure, to ascertain clinical site-level HPV vaccination rates. We examined associations of clinician self-reports of both the consistency and strength of their recommendations for HPV vaccination for patients aged 11-12years (n=14,406) with site-level vaccination rates. The majority of clinicians reported consistently (always or usually) recommending the HPV vaccine to females (79.0%) and to males (62.2%); 71.9% of clinicians reported strongly recommending the vaccine to females while 58.6% reported strongly recommending to males. Consistency and strength of recommending the HPV vaccine was significantly higher among those practicing in pediatrics and board certified in pediatrics compared to family medicine. Higher rates of initiation (1 dose) [Incidence Rate Ratio (IRR)=1.05; 95% CI (1.01-1.09)] and completion (3 doses) [IRR=1.08; 95% CI (1.02-1.13)] were observed among clinical sites where, on average, clinicians more frequently reported always or usually recommending the vaccine for females compared to sites where, on average, clinicians reported recommending the vaccine less frequently. Similarly, higher rates of initiation [IRR=1.03; 95% CI (1.00-1.06)] and completion [IRR=1.04; CI (1.00, 1.08)] were observed among sites where clinicians reported strongly recommending the vaccine to females more frequently compared to sites where, on average, clinicians reported strongly recommending the HPV vaccine less frequently; similar associations were observed for male initiation [IRR

  12. Dental Erosion and Dentin Hypersensitivity among Adult Asthmatics and Non-asthmatics Hospital-based: A Preliminary Study.

    Science.gov (United States)

    Farag, Zahra Hassan Abdelaziz; Awooda, Elhadi Mohieldin

    2016-01-01

    Asthma is a chronic inflammatory condition affecting the airways leading to spasm and swelling of the airways. The medications taken for the treatment of asthma can result in dental erosion and dentin hypersensitivity. The aims of this study were to investigate the severity of dental erosion amongst adult asthmatics according to: gender, type and duration of medication taken and to compare dental erosion and dentin hypersensitivity between asthmatics and non-asthmatics. Comparative, cross-sectional hospital based study among 40 asthmatics (M=15 & F=25) and 40 non-asthmatics (M=18 & F=22) in the age range of 18-60 year selected purposefully from Al-Shaab Teaching Hospital in Khartoum city. The Basic Erosive Wear Index was used for dental erosion assessment. Dentine hypersensitivity was determined by giving ice cold water and rated using the Visual Analogue Scale. Chi-square and Student's t-test were used for statistical analysis with P value ≤.05. There was an association between severity of dental erosion and presence of asthma (P=0.03), where asthmatics had a higher degree of erosion (moderate and severe) and non-asthmatics a lower degree. No significant association was found between dental erosion and gender, type and duration of medication among asthmatics group. A statistically significant difference was revealed in the degree of dentin hypersensitivity (P=0.00) among asthmatics (35.13%) and non-asthmatics (14.13%). Asthmatic patients had a higher degree of dental erosion and dentin hypersensitivity compared to non-asthmatics. Among asthmatic patients there was no association between severity of dental erosion and gender, type and duration medication was taken for.

  13. Improving Clinician Self-Efficacy Does Not Increase Asthma Guideline Use by Primary Care Clinicians

    Science.gov (United States)

    Cloutier, Michelle M.; Tennen, Howard; Wakefield, Dorothy B.; Brazil, Kevin; Hall, Charles B.

    2012-01-01

    Objectives The association between changes in clinician self-efficacy and readiness to change and implementation of an asthma management program (Easy Breathing©) was examined. Methods A 36 month randomized, controlled trial was conducted involving 24 pediatric practices (88 clinicians). Randomized clinicians received interventions designed to enhance clinician self-efficacy and readiness to change which were measured at baseline and 3 years. Interventions consisted of an educational toolbox, seminars, teleconferences, mini-fellowships, opinion leader visits, clinician-specific feedback, and pay for performance. The primary outcome was program utilization (number of children enrolled in Easy Breathing/year); secondary outcomes included development of a written treatment plan and severity-appropriate therapy. Results At baseline, clinicians enrolled 149 ± 147 (mean ± SD) children/clinician/year; 84% of children had a written treatment plan and 77% of plans used severity-appropriate therapy. At baseline, higher self-efficacy scores were associated with greater program utilization (Relative Rate (RR) 1.34 (95% Confidence Interval 1.04, 1.72), p=0.04) but not treatment plan development (RR 0.63 (0.29, 1.35), p=.23) or anti-inflammatory use (RR 1.76 (0.92, 3.35), p=.09). Intervention clinicians participated in 17 interventions over 36 months. At study end, self-efficacy scores increased in intervention clinicians compared to control clinicians (p=0.01) and more clinicians were in an action stage of change (p=0.001) but these changes were not associated with changes in primary or secondary outcomes. Conclusions Self-efficacy scores correlated with program use at baseline and increased in the intervention arm but these increases were not associated with greater program-related activities. Self-efficacy may be necessary but not sufficient for behavior change. PMID:22634077

  14. Supporting clinicians in infrastructuring

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten; Karasti, Helena

    2015-01-01

    the notion of infrastructuring, we carry out an infrastructural analysis of eWBs and approach our joint efforts as unfolding and continuing the con-figuration of participatory design activities. We identify a need for local support and novel competences among the clinicians in order for them to engage...

  15. 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…

  16. 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

  17. 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)

  18. Data mining by clinicians.

    OpenAIRE

    Nigrin, D. J.; Kohane, I. S.

    1998-01-01

    Clinical databases are becoming commonplace in healthcare environments. However, clinicians have been unable to readily explore these information sources, because currently available data retrieval tools require substantial technical skill, as well as knowledge of the underlying database structures. To address this, we have defined a group of "atomic" queries, including both population-based and temporal predicates, to enable the extraction of clinically meaningful information form these data...

  19. Exploratory study comparing dysautonomia between asthmatic and non-asthmatic elite swimmers

    Directory of Open Access Journals (Sweden)

    M. Couto

    2015-01-01

    Full Text Available Background: Dysautonomia has been independently associated with training and exercise-induced bronchoconstriction. In addition, neurogenic airway inflammation was recently associated with swimmers-asthma. We aimed to assess the relation between autonomic nervous system and airway responsiveness of asthmatic elite swimmers. Methods: Twenty-seven elite swimmers, 11 of whom had asthma, were enrolled in this exploratory cross-sectional study. All performed spirometry with bronchodilation, skin prick tests and methacholine challenge according to the guidelines. Pupillometry was performed using PLR-200™ Pupillometer. One pupil light response curve for each eye was recorded and the mean values of pupil's maximal and minimal diameters, percentage of constriction, average and maximum constriction velocities (parasympathetic parameters, dilation velocity, and total time to recover 75% of the initial size (sympathetic parameters were used for analysis. Asthma was defined using IOC-MC criteria; subjects were divided into airway hyperesponsiveness (AHR severity according to methacholine PD20 in: no AHR, borderline, mild, moderate and severe AHR. Differences for pupillary parameters between groups and after categorization by AHR severity were assessed using SPSS 20.0 (p ≤ 0.05. In individuals with clinically relevant AHR, correlation between PD20 and pupillary parameters was investigated with Spearman's correlation test. Results: No statistically significant differences were observed between asthmatic and non-asthmatic swimmers regarding parasympathetic parameters. When stratified by AHR, maximal and minimal diameters and percentage of constriction were significantly lower among those with severe AHR. Among swimmers with clinically relevant AHR (n = 18, PD20 correlated with parasympathetic activity: maximal (r = 0.67, p = 0.002 and minimal diameters (r = 0.75, p < 0.001, percentage of constriction (r

  20. Parent-reported and clinician-observed autism spectrum disorder (ASD) symptoms in children with attention deficit/hyperactivity disorder (ADHD): implications for practice under DSM-5

    National Research Council Canada - National Science Library

    Grzadzinski, Rebecca; Dick, Catherine; Lord, Catherine; Bishop, Somer

    2016-01-01

    Children with attention deficit/hyperactivity disorder (ADHD) often present with social difficulties, though the extent to which these clearly overlap with symptoms of autism spectrum disorder (ASD...

  1. Transthoracic Ultrasonography for Clinicians

    Directory of Open Access Journals (Sweden)

    Morné Johan Vorster

    2015-04-01

    Full Text Available Transthoracic ultrasonography (US has become an essential tool for respiratory, emergency, and critical care physicians. It can be performed with basic equipment and by personnel with minimum training as a modality for the evaluation of a wide range of thoracic pathologies. Its advantages include immediate application at the point of care, low cost, and lack of radiation. The main indications for transthoracic US are the qualitative and quantitative assessment of pleural effusions, pleural thickening, diaphragmatic pathology, as well as chest wall and pleural tumors. Transthoracic US is also useful in visualizing pulmonary pathologies that abut the pleura, such as pneumonic consolidation and interstitial syndromes, including pulmonary edema. Transthoracic US is more sensitive than the traditional chest radiograph in the detection of pneumothoraces, and it is useful in diagnosing skeletal abnormalities such as rib fractures. It is the ideal tool to guide transthoracic procedures, including thoracocentesis and pleural biopsy. Moreover, transthoracic US-guided procedures can be performed by a single clinician with no sedation and minimal monitoring. Transthoracic US-guided fine needle aspiration and/or cutting needle biopsy of extrathoracic lymph nodes and lesions arising from the chest wall, pleura, peripheral lung, and mediastinum are safe to perform and have a high yield in the of hands of experienced clinicians. Transthoracic US can also potentially guide the aspiration and biopsy of diffuse pulmonary infiltrates, consolidations, and lung abscesses. Moreover, transthoracic US may be used in the detection of pulmonary embolism

  2. Relationship Between Different Types and Forms of Anti-Asthmatic Medications and Dental Caries in Three to 12 Year Olds.

    Science.gov (United States)

    Heidari, Alireza; Seraj, Bahman; Shahrabi, Mahdi; Maghsoodi, Hamideh; Kharazifard, Mohammad Javad; Zarabian, Tara

    2016-08-01

    Asthma is a common chronic disease. Asthma and anti-asthmatic medications have been suggested as risk factors for increased susceptibility to caries. This study was conducted to evaluate the effects of different types and forms of antihistaminic medications and the duration of drug consumption on the severity of dental caries in asthmatic children. This cross-sectional study was conducted in Asthma and Allergy Department of Children's Medical Center in Tehran, Iran. Eighty-five children between three to 12 years who had been diagnosed with asthma, by means of taking medical history, clinical examination and spirometry were chosen by non-simple random sampling. The participants and their parents were interviewed. Oral examination was performed by a qualified dentist. The data were collected by use of questionnaires and analyzed by the stepwise multivariate linear regression analysis, using SPSS version 16. Pdental caries even in presence of confounders (sex, age, duration of disease, tooth brushing, sugar consumption, fluoride therapy, mouth dryness).

  3. When should clinicians suspect group A streptococcus empyema in children? A multicentre case-control study in French tertiary care centres.

    Science.gov (United States)

    Bellulo, Sophia; Sommet, Julie; Lévy, Corinne; Gillet, Yves; Hees, Laure; Lorrot, Mathie; Gras-Le-Guen, Christèle; Craiu, Irina; Dubos, François; Minodier, Philippe; Biscardi, Sandra; Dommergues, Marie-Aliette; Béchet, Stéphane; Bidet, Philippe; Alberti, Corinne; Cohen, Robert; Faye, Albert

    2016-08-01

    The incidence of invasive group A streptococcus (GAS) infections is increasing worldwide, whereas there has been a dramatic decrease in pneumococcal invasive diseases. Few data describing GAS pleural empyema in children are available. To describe the clinical and microbiological features, management and outcome of GAS pleural empyema in children and compare them with those of pneumococcal empyema. Fifty children admitted for GAS pleural empyema between January 2006 and May 2013 to 8 hospitals participating in a national pneumonia survey were included in a descriptive study and matched by age and centre with 50 children with pneumococcal empyema. The median age of the children with GAS pleural empyema was 2 (range 0.1-7.6) years. Eighteen children (36%) had at least one risk factor for invasive GAS infection (corticosteroid use and/or current varicella). On admission, 37 patients (74%) had signs of circulatory failure, and 31 (62%) had a rash. GAS was isolated from 49/50 pleural fluid samples and from one blood culture. The commonest GAS genotype was emm1 (n=17/22). Two children died (4%). Children with GAS empyema presented more frequently with a rash (punit admissions (p<0.01), drainage procedures (p=0.04) and short-term complications (p=0.01) were also more frequent in patients with GAS empyema. Pleural empyema following varicella or presenting with rash, signs of circulatory failure and leucopenia may be due to GAS. These features should prompt the addition to treatment of an antitoxin drug, such as clindamycin. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  4. Blood and urinary concentrations of salbutamol in asthmatic subjects

    DEFF Research Database (Denmark)

    Elers, Jimmi; Pedersen, Lars; Henninge, John

    2010-01-01

    Data on blood and urinary concentrations of salbutamol after inhalation and oral administration in healthy subjects are scarce. Accordingly, we examined the pharmacokinetics of inhaled and oral salbutamol in asthmatic subjects....

  5. Physiological Changes at Altitude in Nonasthmatic and Asthmatic Subjects

    Directory of Open Access Journals (Sweden)

    Dianna Louie

    2004-01-01

    Full Text Available Exercised-induced asthma is not due to exercise itself per se, but rather is due to cooling and/or drying of the airway because of the increased ventilation that accompanies exercise. Travel to high altitudes is accompanied by increased ventilation of cool, often dry, air, irrespective of the level of exertion, and by itself, this could represent an 'exercise' challenge for asthmatic subjects. Exercise-induced bronchoconstriction was measured at sea level and at various altitudes during a two-week trek through the Himalayas in a group of nonasthmatic and asthmatic subjects. The results of this study showed that in mild asthmatics, there was a significant reduction in peak expiratory flow at very high altitudes. Contrary to the authors' hypothesis, there was not a significant additional decrease in peak expiratory flow after exercise in the asthmatic subjects at high altitude. However, there was a significant fall in arterial oxygen saturation postexercise in the asthmatic subjects, a change that was not seen in the nonasthmatic subjects. These data suggest that asthmatic subjects develop bronchoconstriction when they go to very high altitudes, possibly via the same mechanism that causes exercise-induced asthma.

  6. 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.

  7. 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

  8. 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

  9. The ECM deposited by basal asthmatic and non-asthmatic ASM cells is different in composition but not biological function

    NARCIS (Netherlands)

    Harkness, L.; Ashton, A.; Burgess, J.

    2015-01-01

    Aim: The remodelled asthmatic airway has increased airway smooth muscle cell (ASMC) growth, expanded vasculature, and altered extracellular matrix (ECM). The ECM is the external cellular microenvironment which regulates cell behaviour. Under proliferative, inflammatory, or fibrotic conditions, the

  10. Conhecimentos de pais de crianças asmáticas sobre a doença no momento da admissão a um serviço especializado Asthma related knowledge among parents of asthmatic children at the moment of admission to a specialized service

    Directory of Open Access Journals (Sweden)

    Linjie Zhang

    2005-12-01

    Full Text Available OBJETIVO: Avaliar conhecimentos de pais de crianças asmáticas sobre a doença no momento da admissão a um serviço especializado. MÉTODOS: O presente trabalho foi um estudo descritivo. Foram entrevistados os pais de 93 crianças asmáticas com idade entre 29 dias e 18 anos, no momento da admissão ao ambulatório de Pneumologia Pediátrica de um hospital universitário, por meio de um questionário para avaliar os conhecimentos deles sobre asma. As avaliações concentraram-se no entendimento da natureza, do prognóstico e do tratamento da asma. Foram analisados somente os dados obtidos em pais de 87 crianças com idade entre 29 dias e 10 anos. RESULTADOS: Na auto-avaliação, 93,1% dos pais consideraram seus conhecimentos sobre asma insuficientes; e 88,5% demonstraram interesse em adquirir mais informações. Na avaliação específica de conhecimentos sobre natureza, prognóstico e tratamento da asma, 96,6% dos pais não sabiam o papel da inflamação das vias aéreas na síntese dos sintomas da doença; e 51,7% acreditavam na cura desta doença; entre os pais cujos filhos usavam nebulizador domiciliar, 80,6% costumavam cometer erros na sua aplicação; e todos os pais cujos filhos usavam inalador pressurizado sem espaçador não conheciam a técnica inalatória correta; 65,5% dos pais não tinham consciência da importância sobre o controle do ambiente domiciliar; e a presença de fonte dos alérgenos e de fumantes foi encontrada respectivamente em 77% e 68,9% dos domicílios. CONCLUSÕES: O presente trabalho mostra a insuficiência de conhecimento sobre asma por parte dos pais de crianças asmáticas no momento da admissão a um serviço especializado, caracterizando-se pelo desconhecimento sobre natureza e prognóstico da doença, técnica inadequada no uso dos fármacos inalatórios e descuido no controle do ambiente domiciliar.OBJECTIVE: To assess asthma related knowledge among parents of asthmatic children at the moment of admission

  11. Identification of a Core Set of Exercise Tests for Children and Adolescents with Cerebral Palsy: A Delphi Survey of Researchers and Clinicians

    Science.gov (United States)

    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 identify a core set of exercise tests for children…

  12. A Response to Papatola and Lustig's Paper on Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis in the Treatment of Children on the Autism Spectrum.

    Science.gov (United States)

    Kornack, Julie; Herscovitch, Brandon; Williams, Ashley L

    2017-12-01

    In their 2016 article, "Navigating a Managed Care Peer Review: Guidance for Clinicians Using Applied Behavior Analysis [ABA] in the Treatment of Children on the Autism Spectrum," Papatola and Lustig provide an overview of the managed care process, discuss the medical necessity of ABA, and offer guidance to clinicians on how to navigate the managed care peer review process. Given that the authors are employed by a large international health insurance carrier and conduct peer reviews on behalf of that organization, this response seeks to provide guidance from both the clinical and public policy perspectives that reflect best practices in the field of autism treatment. This response is not written with the intention of providing or replacing legal advice; rather, this paper offers health care providers of ABA an essential understanding of some of the laws that govern and support their efforts to secure medically necessary treatment and the mechanisms in place with which to challenge decisions by managed care organizations, health plans, and health insurance issuers that may be contrary to best practices. Finally, suggestions are offered on how to navigate a peer review to ensure optimal outcomes and, when necessary, to lay the groundwork to overturn a funding source decision that does not reflect best practices or the standard of care in ABA-based autism treatment.

  13. What Do Clinicians Caring for Children Need to Know about Pediatric Medical Traumatic Stress and the Ethics of Trauma-Informed Approaches?

    Science.gov (United States)

    Kassam-Adams, Nancy; Butler, Lucas

    2017-08-01

    Medical experiences can be frightening and traumatic for children. Ill and injured children can experience pediatric medical traumatic stress-psychological and physiological distress responses related to their medical event and subsequent medical treatment experiences-which can lead to symptoms of posttraumatic stress disorder (PTSD) and suboptimal health outcomes. Trauma-informed care provides a framework for acknowledging, addressing, and mitigating the risks of psychological trauma associated with medical treatment experiences and is congruent with the ethical principles of respect for autonomy, beneficence, nonmaleficence, and justice. Health care systems and professionals are encouraged to apply the principles of trauma-informed care to address the effects of pediatric medical traumatic stress. © 2017 American Medical Association. All Rights Reserved.

  14. [Paediatric prescribing of anti-asthmatics in primary care in Castilla-León. Geographical variability].

    Science.gov (United States)

    Casares Alonso, I; Cano Garcinuño, A; Blanco Quirós, A; Pérez García, I

    2015-09-01

    Asthma is one of the most prevalent chronic diseases with effective treatment in paediatrics. The aim of this study is to describe the paediatric prescribing of anti-asthmatics in Castilla-León, analyzing its geographic variability and temporal evolution. An analysis was made of prescriptions dispensed in pharmacies of R03 therapeutic subgroup (anti-asthmatic agents), and the active ingredients mepyramine and ketotifen, prescribed in children less than 14 years of age in the Castilla-León health service from 2005 to 2010 in Primary Care. Data is presented in prescribed daily doses per thousand inhabitants per day (PDHD) for each active ingredient being calculated raw rates and age-adjusted to the variables health area, type of health zone and year of study. A total of 462,354 prescriptions of anti-asthmatic agents were dispensed to a population of 1,580,229 persons/year. There was wide variation between areas in the type and intensity of anti-asthmatic agents used, partly explained by differences in the prevalence of asthma. Montelukast predominated as controller drug in most of them (PDHD 3.1 to 7.7), being similar the consumption intensity in the three types of health zones (PDHD 4.7 to 4.8). The annual variability was low. The study describes the paediatric prescribing pattern of anti-asthmatic agents in Castilla-León between 2005-2010. It shows wide geographical variation, as well as inadequacies regarding current recommendations of asthma treatment. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  15. É possível prever o número de nebulizações e o uso de corticosteróide intravenoso em crianças com crise asmática na unidade de emergência? Is it possible to predict the number of nebulizations and the use of intravenous corticosteroid in children with asthmatic attack at the emergency room?

    Directory of Open Access Journals (Sweden)

    Maria L. Z. Paro

    2001-06-01

    Full Text Available OBJETIVO: identificar o número de nebulizações necessárias e a demanda de corticosteróide intravenoso em crianças em crise asmática, a partir de características clínicas e funcionais observadas no momento da admissão na unidade de emergência. MÉTODOS: Foram avaliadas prospectivamente 130 crianças em crise asmática, na faixa etária de 1 a 13 anos. No momento da admissão, as crianças foram avaliadas por meio de escore clínico e medidas de saturação arterial de oxigênio (por oximetria de pulso e de pico de fluxo expiratório. Em seguida, receberam um tratamento padronizado e foram acompanhadas em relação à necessidade de nebulizações consecutivas com b2 agonista e costicosteróide intravenoso. Através de análise de regressão buscou-se uma correlação dos parâmetros avaliados com o número de nebulizações realizadas e o uso de corticosteróide. RESULTADOS: Oitenta e oito crianças (67,7% receberam de uma até três nebulizações, e 42 crianças (32,3% receberam seis nebulizações. Sessenta e oito crianças (52,3% receberam corticosteróide. Os valores iniciais de escore clínico, saturação arterial de oxigênio e pico de fluxo expiratório mostraram uma correlação significativa com o número de nebulizações realizadas e com a necessidade do uso de corticosteróide. CONCLUSÃO: Com base em nossos resultados, é possível predizer e antecipar, no momento da admissão das crianças em crise asmática na Unidade de Emergência, a necessidade do uso de corticosteróide e de um maior número de nebulizações, o que pode alterar o prognóstico e o tempo de evolução da crise.OBJECTIVE: to identify the number of nebulizations needed and the demand for intravenous corticosteroids in children with asthmatic attack, considering clinical and functional characteristics presented at the moment children were admitted to the emergency room. METHODS: we prospectively evaluated 130 children with asthmatic attack and from 1

  16. 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

  17. Leukocytes in expressed breast milk of asthmatic mothers.

    Science.gov (United States)

    Dixon, D-L; Forsyth, K D

    Infants are born immunologically immature. However, breastfeeding mothers retain an immunological link to their infants. While it is generally accepted that infants are at an immunological advantage when compared with formula-fed infants, the benefit of long-term exclusive breastfeeding by atopic mothers remains controversial. Inconsistency in the conferral of benefit may be due to differences in the immunological constituents passed to the recipient infant. The aim of this investigation was to examine the profile of human milk cells and cytokines from asthmatic compared to non-asthmatic mothers. Twenty-five exclusively breastfeeding mothers with a clinical diagnosis of asthma were postpartum age matched in a double-control 2:1 design with 50 non-asthmatic controls. Each mother provided a single milk sample which was assayed for cell differential by flow cytometry, for ex vivo cytokine production in culture and for aqueous phase cytokines. Milks from asthmatic mothers differed from non-asthmatics in that they contained a higher proportion of polymorphonuclear (PMN) cells and lower proportion of lymphocytes, predominantly CD3(+)/CD4(+) T helper cells, reflected by a decrease in the chemokine CCL5 in the milk aqueous phase. More PMN and lymphocytes from asthmatic mothers expressed the adhesion molecule CD11b and lymphocytes the IgE receptor CD23, than those from non-asthmatic mothers. Changes to human milk leucocyte prevalence, activation state and cytokines due to maternal asthma may result in changes to immunological priming in the infant. Consequently, the protective effect of long-term breastfeeding may be altered in these mother-infant pairs. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  18. Epidemiological profile of smoking and nicotine addiction among asthmatic adolescents.

    Science.gov (United States)

    Vázquez-Nava, F; Vázquez-Rodríguez, E M; Vázquez-Rodríguez, C F; Castillo Ruiz, O; Peinado Herreros, J

    2017-08-01

    Despite the harmful effects of cigarette smoking, this habit in asthmatic adolescents continues to be a health problem worldwide. Our objectives were to determine the epidemiological profile of smoking and the degree of nicotine dependence among asthmatic adolescents. Through a cross-sectional investigation, 3383 adolescents (13-19 years of age) were studied. Information was collected using a previously validated questionnaire. Two study groups of adolescent smokers were formed: one composed of asthmatic adolescents and the other of healthy youths. Asthmatic adolescents were found to be more likely to smoke (21.6% vs 11.8%) and to have some degree of nicotine dependence compared with healthy adolescents (51.6% vs 48.8%). The most important characteristic of smoking in asthmatic adolescents was found to be an onset before 11 years of age due to curiosity about cigarettes. Asthmatic youths continue smoking because this habit decreases their anxiety and stress. Adolescents know that smoking is addictive and often smoke on waking up in the morning or when they are sick. Yet, these adolescents do not consider smoking to be a problem. In this study, curiosity about cigarettes was the primary reason why asthmatic adolescents smoked for the first time and developed a greater dependence to nicotine compared with healthy adolescents. Moreover, the findings show that many of the factors that favour the development of smoking are preventable, given that they are present in the family and social environment. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  19. 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.

  20. Dip patterns in asthmatic and non-asthmatic children in Benin-city ...

    African Journals Online (AJOL)

    Objective: Although the calibre of the airway is kept patent by multifactorial control system, there is evidence that the calibre of the bronchi varies with time of the day in normal subjects. Asthma is now known to be a chronic inflammatory disease and this chronic inflammation causes hyperreactivity and lability in the airway.

  1. Prevalence of sinusitis and efficacy of intranasal corticosteroid treatment on asthmatic symptoms in asthmatic patients with rhinosinusitis: a pilot study.

    Science.gov (United States)

    Yatera, Kazuhiro; Yamasaki, Kei; Noguchi, Shingo; Nishida, Chinatsu; Oda, Keishi; Akata, Kentarou; Kido, Takashi; Ishimoto, Hiroshi; Mukae, Hiroshi

    2016-04-01

    Prevalence of sinusitis on sinus computed tomography (CT) in asthmatic patients and efficacy of intranasal corticosteroid treatment on asthmatic symptoms in asthmatic patients with rhinosinusitis on sinus CT is unclear. Sinus CT of asthmatic patients were evaluated using the Lund-Mackay system (LMS). Intranasal corticosteroid treatment (mometasone furoate) was newly added to symptomatic asthmatic patients with rhinosinusitis treated without intranasal corticosteroids, and the findings of the Asthma Control Test (ACT), Asthma Control Questionnaire in 5 items (ACQ5), spirometry, and sinus CT were evaluated before and 3 months after additional intranasal corticosteroid treatment. In a total of 160 asthmatic patients, rhinosinusitis and maxillary, ethmoidal, sphenoidal, and frontal sinusitis were observed in 75.0%, 70.0%, 53.1%, 33.1%, and 28.8%, respectively. Nasal symptoms and rhinophonia were observed in 81.9% and 72.5%, respectively, and patients with nasal symptoms and those with rhinophonia both showed significantly higher LMS scores in each sinus. Chronic rhinosinusitis (CRS) was observed in 66.9%, and these patients had significantly more severe asthma than the patients without CRS. In patients with CRS, patients with rhinophonia showed significantly higher LMS scores than those without rhinophonia. ACT, ACQ5, and the value of the forced expiratory volume in 1 second (FEV1) all significantly improved 3 months after the additive intranasal corticosteroid treatment in 24 patients, despite the fact that their LMS scores remained unchanged. Additive intranasal corticosteroid treatment may be an effective treatment option for symptomatic asthmatic patients with rhinosinusitis. © 2015 ARS-AAOA, LLC.

  2. Use of Anti-Asthmatic Medications in Elderly Taiwanese Patients

    Directory of Open Access Journals (Sweden)

    Chi-Yu Chen

    2003-06-01

    Full Text Available The aim of this study was to assess the use of anti-asthmatic medications in Taiwanese geriatric asthmatic patients. We used computerized prescription databases from the National Health Insurance Program, Taiwan, and classified drugs according to the Anatomical Therapeutic Chemical Classification System to analyze the patterns and extent of medication use in people aged over 65 years, and the influence of physician specialty on the prescription of anti-asthmatics. A total of 708,624 prescriptions for 226,018 patients were analyzed. Oral medications were most often prescribed. Only 3.94% and 7.79% of patients were treated with inhaled corticosteroids and inhaled short-acting b-agonists, respectively. Pulmonologists prescribed significantly more inhaled anti-asthmatics, except for cromolyn, than other types of physicians. More males than females were prescribed each category of anti-asthmatic medications, except for ketotifen. In conclusion, physicians in Taiwan do not prescribe as many inhaled anti-inflammatory agents for the treatment of asthma in the elderly as suggested in international treatment guidelines.

  3. 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.

  4. Clinical practice variation and need for pediatric-specific treatment guidelines among rheumatologists caring for children with ANCA-associated vasculitis: an international clinician survey.

    Science.gov (United States)

    Westwell-Roper, Clara; Lubieniecka, Joanna M; Brown, Kelly L; Morishita, Kimberly A; Mammen, Cherry; Wagner-Weiner, Linda; Yen, Eric; Li, Suzanne C; O'Neil, Kathleen M; Lapidus, Sivia K; Brogan, Paul; Cimaz, Rolando; Cabral, David A

    2017-08-07

    Because pediatric antineutrophil cytoplasmic antibody-associated vasculitis is rare, management generally relies on adult data. We assessed treatment practices, uptake of existing clinical assessment tools, and interest in pediatric treatment protocols among rheumatologists caring for children with granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA). A needs-assessment survey developed by an international working group of pediatric rheumatologists and two nephrologists was circulated internationally. Data were summarized with descriptive statistics. Pearson's chi-square tests were used in inferential univariate analyses. The 209 respondents from 36 countries had collectively seen ~1600 children with GPA/MPA; 144 had seen more than two in the preceding 5 years. Standardized and validated clinical assessment tools to score disease severity, activity, and damage were used by 59, 63, and 36%, respectively; barriers to use included lack of knowledge and limited perceived utility. Therapy varied significantly: use of rituximab rather than cyclophosphamide was more common among respondents from the USA (OR = 2.7 [1.3-5.5], p = 0.0190, n = 139), those with >5 years of independent practice experience (OR = 3.8 [1.3-12.5], p = 0.0279, n = 137), and those who had seen >10 children with GPA/MPA in their careers (OR = 4.39 [2.1-9.1], p = 0.0011, n = 133). Respondents who had treated >10 patients were also more likely to continue maintenance therapy for at least 24 months (OR = 3.0 [1.4-6.4], p = 0.0161, n = 127). Ninety six percent of respondents believed in a need for pediatric-specific treatment guidelines; 46% supported adaptation of adult guidelines while 69% favoured guidelines providing a limited range of treatment options to allow comparison of effectiveness through a registry. These data provide a rationale for developing pediatric-specific consensus treatment guidelines for GPA/MPA. While pediatric rheumatologist uptake

  5. 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

  6. Gender and international clinician educators.

    Science.gov (United States)

    Stadler, Dora J; Archuleta, Sophia; Ibrahim, Halah; Shah, Nina G; Al-Mohammed, Ahmed Ali; Cofrancesco, Joseph

    2017-03-31

    To describe gender differences of international clinician educators (CEs) and leaders, and CEs' perceptions by gender of preparation, roles, rewards and factors affecting job satisfaction and retention in emerging international competency-based residency programmes. Cross-sectional surveys of CEs and leadership were conductedJune 2013-June 2014 at institutions that had adopted competency-based graduate medical education and were accredited by the Accreditation Council for Graduate Medical Education-International. 274 (76.3%) of 359 eligible participants responded; 69 (25.2%) were female. Two (18%) of 11 chief executive officers and 1 (9%) of 11 chief medical officers were women. Female CEs were younger, more likely to be single and childless. They were less likely to hold academic appointments, despite no gender differences in length of time at current institution or in current position. A greater proportion of female CEs felt they were 'never' rewarded by academic promotion. Satisfaction rates were similar between the genders. Single female CEs were five times as likely to report being 'extremely likely' to stay in the country. Female CEs with children international academic medicine programmes studied, there were fewer female CEs in the pipeline and they perceived a gender gap in appointment and advancement. Stakeholders at international programmes need to develop contextualised strategies to expand entry and decrease attrition of women into CE tracks, and promote gender equity. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. An autopsy case of asthmatic death: Usefulness of biochemical examination

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    Kinoshita Hiroshi

    2008-01-01

    Full Text Available Background. Asthma is the one of the major causes of sudden death in Japan. Postmortem diagnosis of asthma has been based on morphological findings in lungs, but it histological evidence, was also reported that the biochemical markers such as total and specific immunoglobulin E (IgE are useful. Case report. We present here a case of fatal asthmatic death. A Japanese male in his thirties, complaining of dyspnea, collapsed suddenly. He was taken by ambulance to hospital, but cardiopulmonary resuscitation was ineffective. From autopsy findings, we concluded that the cause of death was asphyxia due to asthma attack. Biochemical findings indicated that the deceased had a severe asthmatic condition. Conclusion. In the presented case, the biochemical examination of the serum obtained at autopsy gave helpful information for the diagnosis that asthmatic attack was a cause of death.

  8. 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...

  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. 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

    2015-03-01

    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. This study included 9755 asthmatic and 38,487 non-asthmatic middle and high school students. Secondary data analysis incorporated the complex sample design; and univariate, bivariate, and logistic regression statistics. Asthmatic students had greater odds of smoking than non-asthmatic students. Asthmatic female students were more likely than asthmatic male students to have been exposed to secondhand smoke in rooms or cars and to smoking actors, but less likely to associate smoking with intent to wear tobacco-marketing products, or with looking cool/fitting in. Asthmatic male and female students, who have smoking friends, were exposed to secondhand smoke in rooms (only girls) or cars, intended to smoke if best friends offered cigarettes, or received/bought tobacco marketing products had greater odds of smoking than other asthmatic students. The observed associations suggest the need for general interventions to reduce middle and high school students' cigarette smoking as well as targeted interventions for asthmatic adolescent students. © 2015, American School Health Association.

  11. 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 included 9755 asthmatic and 38,487 non-asthmatic middle and high school students. Secondary data analysis incorporated the complex sample design; and univariate, bivariate, and logistic regression statistics. RESULTS Asthmatic students had greater odds of smoking than non-asthmatic students. Asthmatic female students were more likely than asthmatic male students to have been exposed to secondhand smoke in rooms or cars and to smoking actors, but less likely to associate smoking with intent to wear tobacco-marketing products, or with looking cool/fitting in. Asthmatic male and female students, who have smoking friends, were exposed to secondhand smoke in rooms (only girls) or cars, intended to smoke if best friends offered cigarettes, or received/bought tobacco marketing products had greater odds of smoking than other asthmatic students. CONCLUSIONS The observed associations suggest the need for general interventions to reduce middle and high school students’ cigarette smoking as well as targeted interventions for asthmatic adolescent students. PMID:25611937

  12. 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

  13. 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.

  14. Effects of asthma and inhalation corticosteroids on the dental arch morphology in children.

    Science.gov (United States)

    Kumar, S S; Nandlal, B

    2012-01-01

    Hereditary, environmental and developmental factors play an important role in dentofacial development, as well as the initiation of malocclusion disorder. Allergic phenomenon such as asthma that induces an alternative mode of breathing in patients is a contributing factor in development of the dental arch. Our aim in this study was to evaluate the dentoalveolar morphology in asthmatic children and to analyze the effects of asthmatic medications on the dental arch. This study is centered on 44 asthmatic children aged between 6-12 years from J.S.S Hospital, Mysore. Selected variables from model analysis of the casts of the asthmatic group were subjected to comparison with those of the non-asthmatic group, which comprised of 44 non-asthmatic children. Selected parameters were arch width, arch length and palatal depth. Impressions of upper and lower arches were made with rubber based impression material. A sliding digital caliper was used to measure the casts for arch width and arch length. A palatal depth gauge was used to measure the palatal depth. Differences in arch widths, arch lengths and palatal depths between asthmatics and non-asthmatics groups were evaluated by independent sample t-tests. Chi-square test was applied to assess the frequency of occurrence of malocclusion in the asthmatic children. The results obtained revealed that the arch length and palatal depth of asthmatic group had higher values compared to that of non-asthmatic groups for both age groups (6 to 8-year-old males and females, 10 to 12-year-old males and females). Inter molar width showed a significant lower value in asthmatics in the maxillary arches of 10 to 12-year-old females. Fifty percent of the asthmatic children aged 10 to 12-years had open-bite. Children under regular medication showed significant deviation in the dentoalveolar morphology as compared to those under irregular medication. The present study proves a strong relation between asthma and dentoalveolar morphology.

  15. Variações climáticas e uso de serviços de saúde em crianças asmáticas menores de cinco anos de idade: um estudo ecológico Climate variations and health services use for the treatment of asthmatic children under five years of age: an ecological study

    Directory of Open Access Journals (Sweden)

    Celso Taques Saldanha

    2005-12-01

    were most often affected. The overall asthma hospitalization rate was 1.3% (336/25,802, rising to 10.7% (336/3140 among the asthmatic children treated in the emergency room. In the rainy season, the percentage of outpatients seeking treatment for asthma was higher than in the dry season: 39.1% (1228/3140 versus 60.9% (1912/3140. However, during the dry season, a greater proportion of such patients were hospitalized: 52.3% (176/336 versus 47.7% (160/336. These differences were statistically significant (p < 0.05. CONCLUSIONS: The dry season, which was correlated with higher asthma hospitalization rates, seems to be related to more severe cases of asthma in children under five years of age.

  16. Avaliação de um programa de treinamento físico por quatro meses para crianças asmáticas Evaluation of a four-month program of physical training designed for asthmatic children

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    Cristiane Soncino Silva

    2005-08-01

    Full Text Available OBJETIVO: Avaliar condicionamento físico e força muscular de crianças asmáticas antes e depois de quatro meses de participação num programa de exercícios físicos. MÉTODOS: Dois grupos de crianças com asma moderada e idade entre oito e onze anos foram formados. Ambos realizaram testes pré e pós-treinamento físico, duas vezes por semana, por quatro meses, em sessões de 90 minutos, com exercícios em solo e em água. Orientações sobre asma, seu controle e tratamento foram fornecidos a ambos os grupos. RESULTADOS: Na avaliação final, observou-se aumento das variáveis antropométricas em ambos os grupos. O grupo exercício apresentou melhora significativa na distância percorrida em nove minutos (inicial 1,333 + 0,03 km e final 1,440 + 0,03 km; p OBJECTIVE: The aim of this study was to evaluate physical conditioning and muscle strength before and after a four-month program of physical training. METHODS: Two groups of children, ages 8 to 11 years, with moderate asthma were studied. All subjects were tested before and after a program of physical training, which was conducted in 90-min sessions, twice weekly, for four months and also included exercises performed in the water. Children in both groups received general information about asthma, as well as information about the management and treatment of asthma. RESULTS: In the final evaluation, anthropometric parameters (height and weight were found to have increased. Children in the exercise group presented significant gains in the distance run in nine minutes (initial 1.333 + 0.03 km vs. final 1.440 + 0.03 km; p < 0.05, number of abdominal crunches (initial 24.3 + 1.4 abdominais vs. final 33.2 + 1.1; p < 0.05, maximal inspiratory pressure (initial 73 + 5 cmH2O vs. final 103 + 5 cmH2O; p < 0.05, maximal expiratory pressure (initial 75 + 4 cmH2O vs. final 102 + 4 cmH2O; p < 0.05 and heart rate at rest (initial 84.3 + 1.6 bpm vs. final 77.1 + 2.7 bpm; p < 0.05. The control group

  17. Assessment Practices of Child Clinicians.

    Science.gov (United States)

    Cook, Jonathan R; Hausman, Estee M; Jensen-Doss, Amanda; Hawley, Kristin M

    2017-03-01

    Assessment is an integral component of treatment. However, prior surveys indicate clinicians may not use standardized assessment strategies. We surveyed 1,510 clinicians and used multivariate analysis of variance to explore group differences in specific measure use. Clinicians used unstandardized measures more frequently than standardized measures, although psychologists used standardized measures more frequently than nonpsychologists. We also used latent profile analysis to classify clinicians based on their overall approach to assessment and examined associations between clinician-level variables and assessment class or profile membership. A four-profile model best fit the data. The largest profile consisted of clinicians who primarily used unstandardized assessments (76.7%), followed by broad-spectrum assessors who regularly use both standardized and unstandardized assessment (11.9%), and two smaller profiles of minimal (6.0%) and selective assessors (5.5%). Compared with broad-spectrum assessors, unstandardized and minimal assessors were less likely to report having adequate standardized measures training. Implications for clinical practice and training are discussed.

  18. Evaluación clínica y funcional en niños asmáticos tratados con montelukast Clinical and functional evaluation in asthmatic children treated with montelukast

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    Concepción Sánchez Infante

    2011-09-01

    . Conclusiones: con montelukast mejoraron significativamente los síntomas nocturnos, la limitación en las actividades físicas, los días perdidos de escuela, la necesidad de ingreso hospitalario y la función respiratoria. Se logró el control del asma en 57 % de los pacientes.Introduction: bronchial asthma is a disease that may to be controlled, although is not curable, but its clinical manifestations affecting the patient may to disappear or to decrease until to achieve a normal or almost-normal life for patient and for its family with a series of drug and non-drug measures. Objective: to assess the effectiveness of montelukast in treatment pf children with persistent asthma. Methods: in 65 children presenting with persistent asthma seen in the "William Soler" University Children Hospital authors conducted a study. The symptoms, respiratory functional tests, days absent to school and disease control were initially assessed and one year after introduction of the montelukast. There was a possibility of secondary effects. Results: fifty five patients (84,6 % had daily nocturnal cough before treatment. One year after above mentioned cough was observed only in 9 (13,9 %; 43 (66,1 % had sibilismus when laugh; 41 (63,0 % had initially affection of physical activity, whereas at one year 51 of them (78,4 % hadn't any limitation. The 100 % had school absences. During the year of treatment 34 (57,0 % not showed such absences; 42 (64,6 % had daily crises, however, in re-evaluation, 38 (58,5 % hadn't crises. Twenty three were admitted in the hospital (35,4 % but later only 5 needed to be admitted. Before treatment, 49 (75,0 % need rescue treatment, on the other hand, during that year decreased to 27 (41,0 %. A total of 19 children (38,0 % initially had a forced expiratory volume (FEV1 less than 80 % and only 8 (16,0 % had it later. Before treatment the 100 % of patients has non-controlled or partly controlled asthma, whereas after one year the 57 % had a controlled asthma. There were

  19. Cockroach hypersensitivity in asthmatics in Lagos, Nigeria | Adanijo ...

    African Journals Online (AJOL)

    both sexes was not significant. Other highlights of the study included the fact that cockroach sensitivity was related to age, duration of asthma, nocturnal asthmatic attacks, frequency of attacks, and the levels of infestation. There was an insignificant relationship between cockroach sensitivity and the location of residences as ...

  20. daily, sustained-release theophylline on sleep in nocturnal asthmatics

    African Journals Online (AJOL)

    To examine the effects of once-daily, sustained- release theophylline on sleep patterns in nocturnal asthmatics. Design. Double-blind, randomised, cross-over, placebo- controlled trial ... 22-day trial, 3 patients having withdrawn due to adverse events. During the initial 7 days of the stUdy, serum was obtained at 07hOO and ...

  1. Clinical Effects of Yoga on Asthmatic Patients: A Preliminary Clinical ...

    African Journals Online (AJOL)

    BACKGROUND: Asthma is one of the commonest respiratory diseases in Jimma area as well as a significant disease burden worldwide costing billions of dollars. Anti-asthmatic drugs that are available in the market are expensive and have adverse effects. Thus, it is wise to look for an adjunct therapy to alleviate these ...

  2. An assessment of asthmatic patients at four Western Cape ...

    African Journals Online (AJOL)

    Objectives. To identify the profile of asthmatic patients visiting community pharmacies and to assess the appropriateness of their current asthma therapy. Design. Patients were identified as either chronic, newly diagnosed or undiagnosed. Asthma status was assessed from their current symptom and medication profiles and ...

  3. plasma magnesium in adult asthmatics at the lagos university

    African Journals Online (AJOL)

    hi-tech

    2003-09-09

    Sep 9, 2003 ... Objective: To determine the plasma magnesium levels in adult asthmatics. Design: Case control study. Setting: Lagos ... using spectrophotometric end point methods. Results: Mean (SD) plasma magnesium ... and it is known to have a direct effect on calcium uptake resulting in smooth muscle relaxation (3).

  4. 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

    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

  5. Atopic asthmatic subjects but not atopic subjects without ...

    Science.gov (United States)

    BACKGROUND: Asthma is a known risk factor for acute ozone-associated respiratory disease. Ozone causes an immediate decrease in lung function and increased airway inflammation. The role of atopy and asthma in modulation of ozone-induced inflammation has not been determined. OBJECTIVE: We sought to determine whether atopic status modulates ozone response phenotypes in human subjects. METHODS: Fifty volunteers (25 healthy volunteers, 14 atopic nonasthmatic subjects, and 11 atopic asthmatic subjects not requiring maintenance therapy) underwent a 0.4-ppm ozone exposure protocol. Ozone response was determined based on changes in lung function and induced sputum composition, including airway inflammatory cell concentration, cell-surface markers, and cytokine and hyaluronic acid concentrations. RESULTS: All cohorts experienced similar decreases in lung function after ozone. Atopic and atopic asthmatic subjects had increased sputum neutrophil numbers and IL-8 levels after ozone exposure; values did not significantly change in healthy volunteers. After ozone exposure, atopic asthmatic subjects had significantly increased sputum IL-6 and IL-1beta levels and airway macrophage Toll-like receptor 4, Fc(epsilon)RI, and CD23 expression; values in healthy volunteers and atopic nonasthmatic subjects showed no significant change. Atopic asthmatic subjects had significantly decreased IL-10 levels at baseline compared with healthy volunteers; IL-10 levels did not significa

  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.

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    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. HLA-G Haplotypes Are Differentially Associated with Asthmatic Features

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    Camille Ribeyre

    2018-02-01

    Full Text Available Human leukocyte antigen (HLA-G, a HLA class Ib molecule, interacts with receptors on lymphocytes such as T cells, B cells, and natural killer cells to influence immune responses. Unlike classical HLA molecules, HLA-G expression is not found on all somatic cells, but restricted to tissue sites, including human bronchial epithelium cells (HBEC. Individual variation in HLA-G expression is linked to its genetic polymorphism and has been associated with many pathological situations such as asthma, which is characterized by epithelium abnormalities and inflammatory cell activation. Studies reported both higher and equivalent soluble HLA-G (sHLA-G expression in different cohorts of asthmatic patients. In particular, we recently described impaired local expression of HLA-G and abnormal profiles for alternatively spliced isoforms in HBEC from asthmatic patients. sHLA-G dosage is challenging because of its many levels of polymorphism (dimerization, association with β2-microglobulin, and alternative splicing, thus many clinical studies focused on HLA-G single-nucleotide polymorphisms as predictive biomarkers, but few analyzed HLA-G haplotypes. Here, we aimed to characterize HLA-G haplotypes and describe their association with asthmatic clinical features and sHLA-G peripheral expression and to describe variations in transcription factor (TF binding sites and alternative splicing sites. HLA-G haplotypes were differentially distributed in 330 healthy and 580 asthmatic individuals. Furthermore, HLA-G haplotypes were associated with asthmatic clinical features showed. However, we did not confirm an association between sHLA-G and genetic, biological, or clinical parameters. HLA-G haplotypes were phylogenetically split into distinct groups, with each group displaying particular variations in TF binding or RNA splicing sites that could reflect differential HLA-G qualitative or quantitative expression, with tissue-dependent specificities. Our results, based on a

  8. 10 lessons for new clinicians

    OpenAIRE

    Macfarlane, Angela; McKeown, Paul

    2008-01-01

    The paper will focus on the experiences and expectations of two new clinicians in their first year in legal clinic. They will draw on their own training experiences compared to the training the students receive in clinic.\\ud The paper will take the format of 10 (or maybe more!) lessons for new clinicians. A sneak preview of some of the lessons includes “How to deal with a hopeless student – its not private practice so you cannot sack them so what can you do?” and “Patience!– don’t forget that...

  9. Home telemonitoring of severe chronic respiratory insufficient and asthmatic patients

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    Manuela Zamith

    2009-05-01

    Full Text Available For 9 months we evaluated a portable device to transfer patient-clinician data by Internet: oximetry, ECG, clinical questionnaires and messages from the doctor. Fifty-one patients with severe chronic respiratory insufficiency (CRI were followed at the hospital Pulido Valente and Espirito Santo and 21 asthmatics (A were followed at the latter hospital. The use and acceptance of this device was evaluated through questionnaires soliciting patients’ and health professionals’ opinions. Patients with CRI followed in Lisbon were also asked about hospital admissions and quality of life compared with a nine month period before the monitoring programme.CRI patients found learning to use the system more difficult; the majority (80% reported problems with the equipment, qualified as rare/occasional in 62% of the cases. For 31 CRI patients followed in Lisbon, the use of the system was classified as correct in 12 patients, incorrect in 7 and reasonable in 12 patients. The first group had a reducded number and duration of hospital admissions and also improved quality of life. With this remote monitoring system 80% of CRI patients reported they were more/much more supported and 33 patients (75% would use this system in the future. 81% of asthmatic patients would also like to maintain this type of monitoring. The service was considered useful by the researchers. We concluded that home telemonitoring was a positive contribution to the management of chronic patients and raised awareness of it should be considered in the future. Resumo: Durante nove meses avaliámos umdispositivo portátil para transferência de dados pelaInternet entre doentes e profissionais de saúde: oximetria,ECG, respostas a questionários e mensagens. Foramincluídos 51 insuficientes respiratórioscrónicos (IRC graves acompanhados no Hospital de PulidoValente (Lisboa e no Hospital do Espírito Santo(Évora e 21 asmáticos deste último hospital. Autiliza

  10. Veterinary dentistry: a clinician's viewpoint.

    Science.gov (United States)

    Baxter, Colin

    2013-06-01

    This is a clinician's view of the current state of veterinary dentistry at the level of the general practitioner across the different species. An indication of the work done and the hazards commonly encountered are covered. To increase awareness within the dental profession of the current state of veterinary dentistry.

  11. TREATMENT OF STEROID DEPENDENT ASTHMATICS WITH LOW DOSES OF CYCLOSPORINE

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    Stanislav Šuškovič

    2004-01-01

    Full Text Available Background. Asthmatics with glucocorticoid dependent asthma should be treated with systemic steroids. Cyclosporine is in many ways a potent anti-inflammatory drug. Cyclosporine is sometimes very effective in treating asthmatics and could allow us to lower the dose of oral steroid. In some randomized, double blind studies steroid dependent asthmatics were treated 12–36 weeks with cyclosporine in dose 5 mg/kg/day. We tried cyclosporine in steroid dependent asthmatics in shorter course and in lower dose.Methods. 13 steroid dependent asthmatics were in the first four weeks of the study treated by their own drugs (phase 1. Then they were for the next four weeks (phase 2 randomly and in double blind fashion treated with either cyclosporine (mean 1.7 mg/kg/day, SD 0.5, 6 patients – group 1 or by identical placebo (7 patients – group 2. To the patients in the group 2 serum concentration of cyclosporine was measured on the eight day of the study.Results. Morning peak expiratory flow (PEF raised significantly in group 1 (200 L/sec to 247 L/sec or for 23%. Patients in group1 had significantly less episodes of nocturnal asthma (2.2 episodes/night to 1.5 episodes/night or for 32%. In group 2 were not found any changes between first phase and second phase of the study. Steroid consumption did not change in any group. Mean serum concentration of cyclosporine in patients of group1 was 35.7 µg/L. We did not find any adverse effects of cyclosporine or placebo.Conclusions. Cyclosporine could have dangerous side effects, which are dependent on its serum concentration. So it should be administered in the lowest possible dose and for the most possible short period. In our study it was found that it is possible to successfully treat steroid dependent asthmatics with lower daily dose and for shorter time, than was found in other similar studies.

  12. Comparison of six-minute walk test in children with moderate/severe asthma with reference values for healthy children

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    Lívia Barboza de Andrade

    2014-05-01

    Conclusions: asthmatic children's performance in the 6MWT evaluated through distance walked is significantly lower than the predicted values for healthy children of the same age, and is directly influenced by sedentary life style.

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

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    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.

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

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    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

  15. 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.

  16. Phenotype and Functional Features of Human Telomerase Reverse Transcriptase Immortalized Human Airway Smooth Muscle Cells from Asthmatic and Non-Asthmatic Donors

    NARCIS (Netherlands)

    Burgess, J. K.; Ketheson, A.; Faiz, A.; Rempel, K. A. Limbert; Oliver, B. G.; Ward, J. P. T.; Halayko, A. J.

    2018-01-01

    Asthma is an obstructive respiratory disease characterised by chronic inflammation with airway hyperresponsiveness. In asthmatic airways, there is an increase in airway smooth muscle (ASM) cell bulk, which differs from non-asthmatic ASM in characteristics. This study aimed to assess the usefulness

  17. Brain-derived neurotrophic factor in asthmatic children | Salama ...

    African Journals Online (AJOL)

    Background: Brain-derived neurotrophic factor (BDNF) regulates the cross-talk between the immune and nervous systems which may play an important role in asthma pathophysiology. Objective: This study was aimed to investigate the relation between BDNF and asthma exacerbation and severity, and to study its possible ...

  18. Socio-demographic and clinical characteristics of asthmatic children ...

    African Journals Online (AJOL)

    Introduction: Asthma is a chronic inflammatory disorder associated with variable air flow obstruction and bronchial hyperresponsiveness. It is characterised clinically by recurrent episodes of cough, difficulty in breathing and wheezing which resolves spontaneously or with treatment. The socio-demographic and clinical ...

  19. Brain-derived neurotrophic factor in asthmatic children.

    African Journals Online (AJOL)

    Ehab

    Neurotrophins represent candidate molecules regulating and controlling this cross-talk between the immune and nervous system3. Neurotrophins are a family of peptides that promote survival, growth and differentiation of neurons. They include; nerve growth factor (NGF), brain- derived neurotrophic factor (BDNF), and.

  20. Brain-derived neurotrophic factor in asthmatic children.

    African Journals Online (AJOL)

    Ehab

    INTRODUCTION. The development and maintenance of asthma is thought to involve the nervous system and the immune system1. The regulatory network between the immunological events and the neuronal control of airway smooth muscle contractility remains to be defined2. Neurotrophins represent candidate molecules ...

  1. Serum Interleukin-5 Changes in Partly Controlled Atopic Asthmatic Children

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    Gamal A Yamamah

    2014-06-01

    CONCLUSION: Serum IL-5 seems to have a role in asthma pathogenesis. Efficiency of the two therapies (ICs & LTA was similar in this group of patients. Both treatments led to significant decline in serum IL-5, IgE levels and eosinophilic count.

  2. Avaliação funcional pulmonar em crianças e adolescentes asmáticos: comparação entre a micro espirometria e a espirometria convencional Pulmonary function tests in asthmatic children and adolescents: Comparison between a microspirometer and a conventional spirometer

    Directory of Open Access Journals (Sweden)

    Lúcia Bartmann Wild

    2005-04-01

    spirometer, although there is little evidence of its accuracy. OBJECTIVE: Tocompare the microspirometer to a regular spirometer for use in asthmatic children and adolescents. METHODS: The instruments used were a Micro Spirometer, manufactured by Micro Medical, and a conventional Cosmed Pony Graphic 3.5 spirometer, both with turbinometers (flow sensors. The study sample consisted of 62 children and adolescents, of both genders, clinically diagnosed with asthma and under treatment at a pulmonology clinic. Ages ranged from 5 and 16 years. All spirometric tests were carried out according to the guidelines established by the American Thoracic Society and by the Associacão Brasileira de Normas Técnicas (Brazilian Technical Standards Association. For each patient, microspirometry was performed first, followed by conventional spirometry. The parameters analyzed in both devices were forced vital capacity, forced expiratory volume in one second and peak expiratory flow. Data were analyzed using the Student's t-test and Pearson's correlation test. RESULTS: Strong correlations were found between the two devices in the parameters analyzed: forced expiratory volume in one second: r = 0.97; forced vital capacity: r = 0.97; and peak expiratory flow: r = 0.91. CONCLUSION: These results demonstrate that the microspirometer is a useful diagnostic tool that can be used when a conventional spirometer is unavailable.

  3. Body Mass Index and Comorbidities in Adult Severe Asthmatics

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    Andreina Bruno

    2014-01-01

    Full Text Available Both severe asthma and obesity are growing health problems. Severe asthma leads to a poor quality of life. The relationship among BMI, comorbidities, and severe asthma control in adults is still unclear. The aim of the study is to better understand the effect of the comorbidities as atopy, type II diabetes, OSAS, gastroesophageal reflux, hypertension, cardiovascular diseases, osteoporosis, infections, and psychological factors with BMI on asthma control in a cohort of adult severe asthmatics. One hundred and two patients were enrolled in a cross-sectional study assessing asthma control, treatments, pulmonary function, inflammatory markers, and comorbidities. Patients were divided into 3 classes according to BMI: normal weight, overweight, and obese. We found that the optimal state of asthma control is lower. whereas the score of Asthma Control Questionnaire, the number of asthma exacerbations during last year, the oral corticosteroids requirement during the previous year, and the LABA treatments are higher in obese than in overweight and normal weight severe asthmatics. The number of subjects with type II diabetes and OSAS are higher among obese and overweight patients than in normal weight asthmatics. In conclusion, BMI represents per se a factor for the deterioration in disease control in severe asthma.

  4. 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...

  5. A comparison of clinician and caregiver assessment of functioning in ...

    African Journals Online (AJOL)

    To compare clinician and caregiver assessments of functioning and impairment among children attending a specialist mental ... Methods. Caregivers of patients attending the Harvey Road Child and Adolescent Centre (N=155) were consecutively recruited over ..... that raters on the CGAS were not blind to patient diagnosis.

  6. Sulforaphane improves the bronchoprotective response in asthmatics through Nrf2-mediated gene pathways

    OpenAIRE

    Brown, Robert H.; Reynolds, Curt; Brooker, Allison; Talalay, Paul; Fahey, Jed W.

    2015-01-01

    Background It is widely recognized that deep inspiration (DI), either before methacholine (MCh) challenge (Bronchoprotection, BP) or after MCh challenge (Bronchodilation, BD) protects against this challenge in healthy individuals, but not in asthmatics. Sulforaphane, a dietary antioxidant and antiinflammatory phytochemical derived from broccoli, may affect the pulmonary bronchoconstrictor responses to MCh and the responses to DI in asthmatic patients. Methods Forty-five moderate asthmatics we...

  7. Relationship Between Different Types and Forms of Anti-Asthmatic Medications and Dental Caries in Three to 12 Year Olds

    Directory of Open Access Journals (Sweden)

    Alireza Heidari

    2016-11-01

    Full Text Available Objectives: Asthma is a common chronic disease. Asthma and anti-asthmatic medications have been suggested as risk factors for increased susceptibility to caries. This study was conducted to evaluate the effects of different types and forms of antihistaminic medications and the duration of drug consumption on the severity of dental caries in asthmatic children.Materials and Methods: This cross-sectional study was conducted in Asthma and Allergy Department of Children’s Medical Center in Tehran, Iran. Eighty-five children between three to 12 years who had been diagnosed with asthma, by means of taking medical history, clinical examination and spirometry were chosen by non-simple random sampling. The participants and their parents were interviewed. Oral examination was performed by a qualified dentist. The data were collected by use of questionnaires and analyzed by the stepwise multivariate linear regression analysis, using SPSS version 16. P<0.05 was considered statistically significant.Results: There was a significant correlation between the number of cetirizine and ketotifen tablets taken and decayed/missing/filled (dmf/DMF teeth score (P=0.006. There were no correlations between the number of consumed sprays and dmf/DMF score (P=0.923, the duration of drug therapy (P=0.907 or the type of medication taken including ß2 agonists, antihistamines, steroids or a combination of them (P=0.907.Conclusions: The present study showed that the tablet form of medications significantly increased the severity of dental caries even in presence of confounders (sex, age, duration of disease, tooth brushing, sugar consumption, fluoride therapy, mouth dryness.Keywords: Asthma; Anti-Asthmatic Agents; Dental Caries

  8. 'Learning Organizations': a clinician's primer.

    Science.gov (United States)

    O'Connor, Nick; Kotze, Beth

    2008-06-01

    Most clinicians are poorly informed in relation to the key concepts of organizational learning. Yet the paradigm may offer clinicians a powerful method for using their knowledge and skills to respond to the demands of a changing environment through experimentation and learning. The concept is critically examined. Organizational learning principles are presented, including a conceptual framework for assessing health services as Learning Organizations. Barriers to organizational learning and strategies to overcome these are discussed. The seminal works of Argyris and Senge are reviewed and a framework for assessing organizational learning in health services is proposed. Current area health service actions are evaluated against the 'diagnostic' framework for a Learning Organization. Although critical examination reveals a poor empirical basis for the concept, the metaphor of the Learning Organization provides a useful conceptual framework and tools for individuals and organizations to apply in developing knowledge and effecting change. The Clinical Practice Improvement and Root Cause Analysis programs being conducted across NSW area health services meet the criteria for effective organizational learning. Key concepts from organizational learning theory provide a diagnostic framework for evaluating area health services as Learning Organizations and support two current strategies for overcoming barriers to organizational learning.

  9. Effect of Inhaled Budesonide on Interleukin-4 and Interleukin-6 in Exhaled Breath Condensate of Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Chun-Hua Chi

    2016-01-01

    Conclusions: The concentration of IL-4 in the EBC of asthmatic patients decreased gradually with ICS treatment. Measurement of IL-4 in EBC could be useful to monitor airway inflammation in asthmatics.

  10. 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.

  11. 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

  12. Molecular Mechanism of the Additive Effects of Leukotriene Modifier in Asthmatic Patients Receiving Steroid Therapy

    Directory of Open Access Journals (Sweden)

    Kazuto Matsunaga

    2009-01-01

    Conclusions: LM caused a greater improvement in pulmonary function and airway inflammation in asthmatics with AR. The RANTES-mediated pathway may be involved in the improvement of the airflow limitation and airway lability by LM additive therapy in asthmatics receiving steroid therapy.

  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.

  14. Volumes and Breathing Patterns during Speech in Healthy and Asthmatic Subjects.

    Science.gov (United States)

    Loudon, Robert G.; And Others

    1988-01-01

    Lung volumes and ventilatory patterns used by 10 healthy and 14 asthmatic subjects during conversation, monologue, and counting at two loudness levels were studied. Asthmatics were found to favor respiratory over communications needs. They used a greater percentage of their reduced vital capacity, with slower inspiratory and faster expiratory flow…

  15. Rejuvenating clinician-scientist training.

    Science.gov (United States)

    Ambati, Balamurali K; Cahoon, Judd

    2014-03-28

    Clinician-scientists are becoming increasingly rare in medicine as a whole, but especially in ophthalmology. There is a structural gap between MD-PhD training and K-series awards where interested candidates go through residency and fellowship without any structured research exposure or involvement. Furthermore, the success rate of the MD-PhD and K awards leaves much to be desired. The authors propose a redeployment of training resources to reconfigure residency and fellowship training programs for interested candidates with sufficient additional time for a credible research project, augmented salary, and sound mentoring. Opportunities for research training in nontraditional pathways to diversify skill sets and build interdisciplinary teams also would be a prime objective of this novel "Learn-and-Earn" approach.

  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....... Thirty-four (33%) participants did not carry out US after the course; 19 did not have access to US apparatus, 7 claimed that they lacked the time, 6 lacked supervision and 1 participant cited insufficiency of the course. Clinical approach was changed by 48 (47%), acute workout by 45 (44%) and pattern...... on clinical behaviour was sent to 162 participants. RESULTS: The response rate was 64% (103). Forty-eight (47%) participants changed their clinical approach, 45 (44%) their workout programme and 25 (24%) the pattern of referral. Eleven (10%) sent in the required pathological findings for final authorization...

  17. Bioethics for clinicians: 4. Voluntariness.

    Science.gov (United States)

    Etchells, E; Sharpe, G; Dykeman, M J; Meslin, E M; Singer, P A

    1996-10-15

    In the context of consent, "voluntariness" refers to a patient's right to make health care choices free of any undue influence. However, a patient's freedom to make choices can be compromised by internal factors such as pain and by external factors such as force, coercion and manipulation. In exceptional circumstances--for example, involuntary admission to hospital--patients may be denied their freedom of choice; in such circumstances the least restrictive means possible of managing the patient should always be preferred. Clinicians can minimize the impact of controlling factors on patients' decisions by promoting awareness of available choices, inviting questions and ensuring that decisions are based on an adequate, unbiased disclosure of the relevant information.

  18. Bioethics for clinicians: 4. Voluntariness.

    Science.gov (United States)

    Etchells, E; Sharpe, G; Dykeman, M J; Meslin, E M; Singer, P A

    1996-01-01

    In the context of consent, "voluntariness" refers to a patient's right to make health care choices free of any undue influence. However, a patient's freedom to make choices can be compromised by internal factors such as pain and by external factors such as force, coercion and manipulation. In exceptional circumstances--for example, involuntary admission to hospital--patients may be denied their freedom of choice; in such circumstances the least restrictive means possible of managing the patient should always be preferred. Clinicians can minimize the impact of controlling factors on patients' decisions by promoting awareness of available choices, inviting questions and ensuring that decisions are based on an adequate, unbiased disclosure of the relevant information. PMID:8873637

  19. 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…

  20. Vitamin D deficiency as a strong predictor of asthma in children.

    Science.gov (United States)

    Bener, Abdulbari; Ehlayel, Mohammad S; Tulic, Meri K; Hamid, Qutayba

    2012-01-01

    Epidemiological studies suggest a link between vitamin D deficiency in early life and development of asthma in later life. The aim of this study was to measure serum vitamin D levels in asthmatic children and to compare these to healthy non-asthmatic controls. Asthmatic (n = 483) and healthy control (n = 483) children were recruited from the Pediatric Allergy-Immunology Clinics of Hamad General Hospital and the Primary Health Care Clinics in Qatar from October 2009 to July 2010. All children were below 16 years of age and asthma was diagnosed by a physician. Parents of all children completed extensive questionnaires documenting demographics, child's feeding practice and vitamin D intake. Serum vitamin D (25-hydroxyvitamin D), calcium, phosphorus, alkaline phosphatase, magnesium, creatinine and parathyroid hormone assays were performed. Subjects with serum containing less than 20 ng/ml vitamin D were deemed deficient. Asthmatic children had significantly reduced serum vitamin D levels compared to non-asthmatic children (p , p = 0.005) and asthma (36.4%, p = 0.009) were significantly higher in asthmatic children. Along with vitamin D deficiency, asthmatics also had reduced phosphorus (p , p = 0.006) and less physical activity (71.3%, p asthma in this population (OR 4.82; 95% CI 2.41-8.63, p asthma in Qatari children. Copyright © 2011 S. Karger AG, Basel.

  1. Air pollution and increased levels of fractional exhaled nitric oxide in children with no history of airway damage.

    Science.gov (United States)

    Flamant-Hulin, Marion; Caillaud, Denis; Sacco, Paolo; Penard-Morand, Celine; Annesi-Maesano, Isabella

    2010-01-01

    Air pollution is associated with a wide range of adverse respiratory events. In order to study the mechanism associated with these effects, the relationships between fractional exhaled nitric oxide (FeNO), a potential marker of airway inflammation, and exposure to air pollution were examined in schoolchildren. FeNO was measured in 104 children (34 asthmatics and 70 non-asthmatics) drawn from the general population simultaneously with air pollution assessments (fine particles with an aerodiameter under 2.5 microm, nitrogen dioxide, acetaldehyde, and formaldehyde, with pumps and passive samplers) in schoolyards and classrooms. Asthmatics exhaled more FeNO than non-asthmatics. FeNO levels were significantly elevated in both asthmatic and non-asthmatic children exposed to high concentrations of formaldehyde, acetaldehyde, and PM(2.5). Differences between high versus low exposure in non-asthmatics resulted in an FeNO increase ranging from 45% for indoor acetaldehyde to 62% for indoor PM(2.5). Stronger associations were found in non-asthmatic children who were atopic, suggesting that atopic children may be more sensitive to air pollution than non-atopic children. Exposure to air pollution may lead to airway inflammation, as measured by FeNO, in schoolchildren. These associations occur even in children with no history of airway damage and seem to be enhanced in atopic subjects.

  2. [The asthmatic patient and his/her family dynamics].

    Science.gov (United States)

    Vázquez Nava, Francisco; Santos Díaz, Aidee del Pilar; Martínez Burnes, Julio; Caballero Rico, Frida; Morales González, Francisco; Prado Lobato, Simón Carlos

    2003-01-01

    Asthma is a chronic disorder of the airways that modify behavior response of persons and affect family function. To determine if there is a disorder of the familial dynamics in asthmatic patients of Tamaulipas. An observational, comparative, open and cross-sectional study was performed to determine: family categorization, family function and evaluation of conjugal subsystem. We included 300 persons who were 30 to 50 years old, male and female: 100 subjects with asthma diagnosis, 100 with diabetes type 2 and 100 healthy people. The asthmatic subjects' age average was of 45.67 years, complete nuclear family was documented in 15% of sick persons, women were the family head in 50% of the cases, we appreciated great family dysfunction in relation to: adaptability function (50%), participation (63%), family grow-up (61%) and feeling manifestations (64%). In 53% of the conjugal couple cases of the patients, do not carry out her family functions like: communication 59%, share out functions 59%, sexual satisfaction 60%, and making decision 59%. It is only feasible to treat these patients when there is an active participation of the family members.

  3. Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians.

    Science.gov (United States)

    Haik, Josef; Brown, Stav; Liran, Alon; Visentin, Denis; Sokolov, Amit; Zilinsky, Isaac; Kornhaber, Rachel

    2017-01-01

    Acute health care environments can be stressful settings with clinicians experiencing deleterious effects of burnout and compassion fatigue affecting their mental health. Subsequently, the quality of patient care and outcomes may be threatened if clinicians experience burnout or compassion fatigue. Therefore, the aim of this descriptive, cross-sectional study was to evaluate the prevalence of burnout and compassion fatigue among burn clinicians in Israel. Fifty-five clinicians from Burns, Plastics and Reconstruction Surgery and Intensive Care completed four validated surveys to assess burnout (Maslach Burnout Inventory), depression (PRIME-MD), health-related quality of life (SF-8), and compassion fatigue (Professional Quality of Life version 5). Burn clinicians were compared with Plastics and Reconstruction Surgery and Intensive Care clinicians. This study identified a high prevalence of burnout (38.2%) among Intensive Care, Plastics and Reconstruction and Burns clinicians, with Burns clinicians having a greatly increased prevalence of burnout compared to Intensive Care clinicians (OR =24.3, P=0.017). Additional factors contributing to compassion fatigue were those without children (P=0.016), divorced (P=0.035), of a younger age (P=0.019), and a registered nurse (P=0.05). Burnout increased clinicians' risk of adverse professional and personal outcomes and correlated with less free time (PBurnout was also associated with higher physical (mean difference =3.8, Pburnout, compassion fatigue, and vicarious trauma. Identifying strategies to abate these issues is essential to ensure improved clinicial environments and patient outcomes.

  4. Clinician-scientist trainee: a German perspective.

    Science.gov (United States)

    Bossé, Dominick; Milger, Katrin; Morty, Rory E

    2011-12-01

    Clinician-scientists are particularly well positioned to bring basic science findings to the patient's bedside; the ultimate objective of basic research in the health sciences. Concerns have recently been raised about the decreasing workforce of clinician-scientists in both the United States of America and in Canada; however, little is known about clinician-scientists elsewhere around the globe. The purpose of this article is two-fold: 1) to feature clinician-scientist training in Germany; and 2) to provide a comparison with the Canadian system. In a question/answer interview, Rory E. Morty, director of a leading clinician-scientist training program in Germany, and Katrin Milger, a physician and graduate from that program, draw a picture of clinician-scientist training and career opportunities in Germany, outlining the place of clinician-scientists in the German medical system, the advantages and drawbacks of this training, and government initiatives to promote training and career development of clinician-scientists. The interview is followed by a discussion comparing the German and Canadian clinician-scientist development programs, focusing on barriers to trainee recruitment and career progress, and efforts to eliminate the barriers encountered along this very demanding but also very rewarding career path.

  5. Inhaled beclomethasone in pregnant asthmatic women--a systematic review.

    Science.gov (United States)

    de Aguiar, M M; da Silva, H J; Rizzo, J Â; Leite, D F B; Silva Lima, M E P L; Sarinho, E S C

    2014-01-01

    The aim of this study was to systematically review the safety and efficacy of inhaled beclomethasone for asthma treatment in pregnant women. We performed a systematic review in Medline, LILACS and SciELO electronic databases in December 2012. A total of 3433 articles were found by using the keywords asthma, pregnancy and beclomethasone. Among these, 1666 were from Medline, via PubMed, and 1767 were from LILACS and SciELO. Nine of these articles were selected. Only one paper suggested an increased foetal risk for congenital malformations, and one other for offspring endocrine and metabolic disturbances. Data are mostly reassuring, supporting the use of glucocorticoid inhalants during pregnancy, and we found no evidence of inferiority in relation to efficacy and safety of beclomethasone compared to other drugs used in pregnant asthmatic women. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

  6. Asthma and leukotrienes: antileukotrienes as novel anti-asthmatic drugs.

    Science.gov (United States)

    Claesson, H E; Dahlén, S E

    1999-03-01

    Antileukotriene drugs inhibit the formation or action of leukotrienes, which are potent lipid mediators generated from arachidonic acid in lung tissue and inflammatory cells. The leukotrienes were discovered in basic studies of arachidonic acid metabolism in leucocytes 20 years ago and were found to display a number of biological activities which may contribute to airway obstruction. Clinical studies with antileukotriene drugs have indeed demonstrated that leukotrienes are significant mediators of airway obstruction evoked by many common trigger factors in asthma. Moreover, treatment trials have established that this new class of drugs has beneficial anti-asthmatic properties, and several antileukotrienes have recently been introduced as new therapy of asthma. This communication presents an overview of the biosynthesis of leukotrienes, their biological effects and clinical effects of antileukotrienes in the treatment of asthama.

  7. Qualidade de vida na asma brônquica: a concordância das percepções das crianças, adolescentes e seus pais Calidad de vida en el asma brónquico: la concordancia de las percepciones de los niños, adolescentes y sus padres Quality of life in asthmatics: concordance among children, adolescents, and their parents

    Directory of Open Access Journals (Sweden)

    Laura Janne L. Aragão

    2012-01-01

    Life Questionnaire Adaptado (PAQLQ-A. MÉTODOS: Estudio transversal realizado en dos ambulatorios universitarios de referencia para seguimiento de niños y adolescentes pediátricos asmáticos en Recife (PE, Brasil. Después del cumplimiento de las exigencias éticas, los datos sobre la calidad de vida fueron obtenidos mediante la aplicación del PAQLQ, en su versión traducida adaptada y validada para la lengua portuguesa. El cuestionario fue contestado por 126 pacientes (70 niños y 56 adolescentes y sus respectivos padres. Una base de datos creada en el programa SPSS, versión 13.0, fue analizada estadísticamente con la prueba de concordancia de Kappa. RESULTADOS: La concordancia de las respuestas entre niños y padres varió de mala a aceptable, observándose las peores concordancias en el dominio síntomas para el ítem «sibilancias en el pecho» y en el dominio emociones para el ítem «se sintió irritado». Las respuestas de los adolescentes y sus padres tuvieron la concordancia evaluada entre mala y regular; siendo la peor concordancia observada en el dominio actividades, en el ítem «incomodado por no poder estar con otros» y la menor concordancia notada en el dominio emociones, en el ítem «incómodo». CONCLUSIONES: El PAQLQ-A no fue bien comprendido por la población estudiada y no hubo concordancia en la percepción sobre calidad de vida de los niños y adolescentes asmáticos y sus padres. Se recomienda la elaboración de instrumentos adecuados a las especificidades regionales o, además, mediante la revalidación de instrumentos internacionales, de modo a que atiendan a la diversidad regional.OBJECTIVE: To evaluate the perception of the quality of life of asthmatic children and adolescents and their parents, investigating the agreement rates in each domain using the Pediatric Asthma Quality of Life Questionnaire - Adapted (PAQLQ-A. METHODS: Cross-sectional study conducted at two outpatient clinics of a university reference center for asthmatic

  8. Exhaled nitric oxide dynamics in asthmatic reactions induced by diisocyanates.

    Science.gov (United States)

    Mason, P; Scarpa, M C; Guarnieri, G; Giordano, G; Baraldi, E; Maestrelli, P

    2016-12-01

    Isocyanate-induced asthmatic reactions are associated with delayed increase in fractional exhaled nitric oxide measured at expiratory flow of 50 mL/s (FeNO50), a biomarker of airway inflammation. The time course of FeNO increase is compatible with the activation of NO synthase, but the origin of NO production in the lung is undetermined. The aim of this study was to define the dynamics of airway and alveolar NO during specific inhalation challenge (SIC) with isocyanates and the role of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of NO synthase. Spirometry, exhaled NO parameters (FeNO50, bronchial wall NO concentration, NO airway diffusing capacity, NO flux to luminal space, alveolar NO) and ADMA levels in exhaled breath condensate were measured before and at intervals up to 24 h after exposure to isocyanates. The results were compared between 17 SIC-positive and eight SIC-negative subjects. A significant FeNO50 increase in SIC-positive subjects was detected 24 h after exposure and was associated with the augmented NO flux from airway wall to the lumen, whereas airway NO diffusion and alveolar NO were not affected. The changes in NO dynamics were specific for the subjects who developed an asthmatic reaction, but were independent from the pattern and magnitude of bronchoconstriction. There was no evidence that exhaled NO is modulated by the changes in ADMA concentration. Because isocyanate-induced increase in FeNO50 was almost exclusively determined by the increase in NO flux, the use of FeNO50 appears adequate to monitor the exhaled NO dynamics during SIC. FeNO50 measurement may provide additional information to spirometry, because bronchoconstriction and airway inflammatory responses are dissociated. © 2016 John Wiley & Sons Ltd.

  9. Primary Care Clinician Expectations Regarding Aging

    Science.gov (United States)

    Davis, Melinda M.; Bond, Lynne A.; Howard, Alan; Sarkisian, Catherine A.

    2011-01-01

    Purpose: Expectations regarding aging (ERA) in community-dwelling older adults are associated with personal health behaviors and health resource usage. Clinicians' age expectations likely influence patients' expectations and care delivery patterns; yet, limited research has explored clinicians' age expectations. The Expectations Regarding Aging…

  10. DYNAMICS OF EOSINOPHIL INFILTRATION IN THE BRONCHIAL-MUCOSA BEFORE AND AFTER THE LATE ASTHMATIC REACTION

    NARCIS (Netherlands)

    AALBERS, R; DEMONCHY, JGR; KAUFFMAN, HF; SMITH, M; HOEKSTRA, Y; VRUGT, B; TIMENS, W

    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 fibreoptic bronchoscope,

  11. CYP1A2 polymorphism and theophylline clearance in Korean non-smoking asthmatics

    National Research Council Canada - National Science Library

    Yim, Eun-Young; Kang, Hye-Ryun; Jung, Jae-Woo; Sohn, Seong-Wook; Cho, Sang-Heon

    2013-01-01

    .... However, the underlying mechanism remains unknown in humans. We investigated the relationship between differences in theophylline clearance and genetic polymorphisms in the CYP1A2 and CYP2E1 gene in 89 Korean asthmatic patients...

  12. Amelioration of asthmatic inflammation by an aqueous extract of Spinacia oleracea Linn.

    Science.gov (United States)

    Heo, Jin-Chul; Park, Chul-Hong; Lee, Hyun-Jin; Kim, Si-Oh; Kim, Tae-Ho; Lee, Sang-Han

    2010-03-01

    Inflammation of the respiratory tract is a crucial process in immune diseases, including asthma, and atopic rhinitis. To establish whether an aqueous extract of Spinacia oleracea Linn (SoL) has a beneficial influence in terms of anti-asthmatic activity, we examined its effects on an ovalbumin-induced asthmatic model. Mice sensitized to ovalbumin were orally administered the SoL extract, and their lungs examined by hematoxylin and eosin staining to determine IL-4/13 cytokine expression. The SoL extract exerted strong anti-asthmatic effects by inducing a decrease in the CD4+ cell number, IL-4/13, and other molecular markers in the lung. Our results collectively indicate that the aqueous SoL extract ameliorates asthmatic symptoms effectively in a mouse ovalbumin-challenge model.

  13. 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...

  14. Do dental procedures affect lung function and arterial oxygen saturation in asthmatic patients?

    Directory of Open Access Journals (Sweden)

    Magdy Mahmoud Emara

    2013-04-01

    Conclusion: Asthmatic patients may be at a higher risk of developing oxygen desaturation after dental procedures regardless of their type with and without local anesthesia and a decrease in PEF after dental procedures with local anesthesia.

  15. Analysis of anti-asthmatic drug patents published in China between 2004 and 2013.

    Science.gov (United States)

    Xie, Hua; Zhang, Huiyun; Cao, Ke; He, Ping; Dai, Hongliang; He, Shaoheng

    2016-01-01

    We previously reported that 789 anti-allergic patents were granted in China between 1988 and 2008, but the number of patents seems to have grown much faster in China in recent years. Therefore, it is necessary to analyse the patents for anti-asthmatic products between 2004 and 2013 to give pharmaceutical companies and individuals a better understanding of potential candidates for anti-asthmatic drug development from patents published in China. The current report analyses the scientific progress that supports anti-asthmatic drug patent applications and reviews the published patent literature in China from 2004 to 2013. The rapid increase in the number of anti-asthmatic patents in China indicates that more specific discoveries have been made and that more people are aware of the importance of intellectual property protection in China. Holding patents may guarantee protection for an innovative new product.

  16. Gingival immunologic defense index: a new indicator for evaluating dental plaque infection risk in allergic children

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2008-03-01

    Full Text Available There is a possible relationship between dental plaque and children allergic diseases. According to literatures, gingivitis suffered mostly by allergic children than control. Case reports also revealed that dental plaque control therapy was able to reduce, even eliminate rhinosinusitis and asthmatic symptoms without additional medications. However, the exact method for confirming the gingivitis-related allergy is still uncertain. Allergic diseases have multifactorial etiologies and dental plaque had been proposed as a new trigger of allergic symptoms. Nevertheless, since not every child with gingivitis suffered from allergy or vice versa, this uncertain phenomenon may lead to patients or other clinician disbelief. The objective of the present study was to propose a new method, which involving the Gingival immunologic defense index (GIDI to evaluate the susceptibility to allergic diseases. GIDI is an index that had been developed earlier for evaluating gingival immunologic defense with respect to immunoglobulin A (IgA levels. This index based on the simple count of the inflamed gingival surfaces of a child plus the measurement of salivary IgA content. It provides clinicians with important information about the immunologic defense potential of each subject. Interestingly, most allergic children also had inherited IgA deficiency, thus this concept is likely. Based on literatures, GIDI could be a potential index for evaluating the risk of allergic diseases through gingival health assessment. However, prior investigation to the value of Indonesian GIDI index which related to allergy should be conducted.

  17. Effect of inhaled medication and inhalation technique on dental caries in asthmatic patients.

    Science.gov (United States)

    Boskabady, Marzie; Nematollahi, Hossein; Boskabady, Mohammad Hossein

    2012-12-01

    The purpose of this study was to examine the relationship between the type of inhaled medication, length of use, dosing, the inhaler use technique and the severity and duration of disease on the dental caries of asthmatic patients. In the present study, the frequency of dental caries in the asthmatic patients and control group was examined. In addition the possible association of dental caries with disease duration, disease severity, asthma symptoms, chest wheeze, PFT values, and dose of medication and inhalation use technique was evaluated. 40 asthmatic patients of both sex (20-30 years old) and 40 age and sex matched controls were studied. In asthmatic patients, the type, dose, duration of medications, the technique of inhaler use and severity and duration of the disease were recorded. The dental health status including DT, MT, FT and DMFT (decay, missing, filling teeth) were examined. In addition, pulmonary function tests (PFTs) were performed for both groups. All PFT variables in asthmatic patients were significantly lower than those of control group except for FVC (P dental caries in asthmatic group were higher than those of controls which was statistically significant for MT and DMFT (P asthma duration were significantly more than those of 6-10 years (P dental caries and disease duration, PFT values; doses of medication or the technique of inhaler use; although the technique of inhaler use was relatively acceptable in all asthmatic patients. These results showed that dental caries among asthmatic patients was more common than control group which can be due to using inhaler drugs or the technique of inhaler use.

  18. Dietary supplementation with soybean lecithin increases pulmonary PAF bioactivity in asthmatic rats.

    Science.gov (United States)

    Muehlmann, Luis A; Zanatta, Ana L; Farias, Carolina L A; Bieberbach, Eloyse W; Mazzonetto, Ana C; Michellotto, Pedro V; Fernandes, Luiz C; Nishiyama, Anita

    2010-06-01

    The prevalence of asthma has risen over the last few decades, and some studies correlate this with the greater consumption of polyunsaturated fatty acids (PUFAs). Dietary PUFAs are known to increase the susceptibility of biological structures to lipid peroxidation, a process by which platelet-activating factor (PAF)-like lipids can be generated. These lipids functionally mimic the bioactivity of PAF, a potent proinflammatory mediator that exerts several deleterious effects on asthma. Thus, this work aimed to investigate if dietary supplementation with soybean lecithin (SL), a source of PUFAs, increases lipid peroxidation and PAF bioactivity in lungs of asthmatic Wistar rats. Animals were separated into groups: control, supplemented, asthmatic, asthmatic supplemented with SL (2 g/kg body weight), asthmatic supplemented with SL (2 g/kg body weight) and DL-alpha-tocopheryl acetate (100 mg/kg body weight). Asthmatic inflammation increased pulmonary lipid peroxidation, PAF bioactivity, alveolar-capillary barrier permeability and production of nitric oxide. In asthmatics, dietary supplementation with SL promoted an increase in pulmonary lipid peroxidation and PAF bioactivity, and an increase in the permeability of the alveolar-capillary barrier. Moreover, the treatment of asthmatic rats with DL-alpha-tocopheryl acetate inhibited the lipid peroxidation and decreased the PAF bioactivity. Therefore, the increase in pulmonary PAF bioactivity in asthmatic individuals elicited by the dietary supplementation with SL probably involves the generation of PAF-like lipids. This finding suggests that PAF-like lipids may account for the deleterious effects of dietary PUFAs on asthma. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  19. House-plant placement for indoor air purification and health benefits on asthmatics

    OpenAIRE

    Ho-Hyun Kim; Ji-Yeon Yang; Jae-Young Lee; Jung-Won Park; Kwang-Jin Kim; Byung-Seo Lim; Geon-Woo Lee; Si-Eun Lee; Dong-Chun Shin; Young-Wook Lim

    2014-01-01

    Objectives Some plants were placed in indoor locations frequented by asthmatics in order to evaluate the quality of indoor air and examine the health benefits to asthmatics. Methods The present study classified the participants into two groups: households of continuation and households of withdrawal by a quasi-experimental design. The households of continuation spent the two observation terms with indoor plants, whereas the households of withdrawal passed the former observation terms with ind...

  20. Asthmatic exacerbations and environmental pollen concentration in La Comarca Lagunera (Mexico).

    Science.gov (United States)

    Ordaz, V A; Castaneda, C B; Campos, C L; Rodríguez, V M; Saenz, J G; Ríos, P C

    1998-01-01

    In order to determine the correlation between the concentration of environmental pollen and the frequency of asthmatic exacerbations in La Comarca Lagunera (México), a study in a cohort of a 104 diagnosed patients suffering allergic asthma was carried out monitoring monthly from July '93 to July '95 in order to register the existence of asthmatic exacerbations. Environmental samples were taken weekly during the same period of time through a PST high volume collector (Andersen Samplers Inc). The above mentioned samples were processed under acetolysis technics and the pollen grain count under light microscopy. Linear correlation measures were made between the rates of asthmatic exacerbations and the concentration of pollen grain in m3 of air by means of a statistical computer program SAS. There was a 1469 persons/month follow up ('X 15.5) and the correlation between the rates of asthmatic exacerbations and the concentration of environmental pollen was relevant (r = 0.63, r2 = 0.39, p < 0.01). The correlation increased (r = 0.70, r2 = 0.49 and p < 0.01) when the asthmatic exacerbations associated to infectious disease in the upper respiratory system were restricted. The conclusion reached is that the concentration of environment pollen has influence in the development of asthmatic exacerbations in patients with allergic asthma.

  1. Firearms, mental illness, dementia and the clinician.

    Science.gov (United States)

    Wand, Anne P F; Peisah, Carmelle; Strukovski, Julie-Anne; Brodaty, Henry

    2014-12-11

    Clinicians have an obligation to report to state or territory police any concerns about risk of harm from patients with access to firearms. Dementia is an under-recognised medical problem which may increase the risk of firearm injury or violence in those with such access. There are no guidelines for clinicians regarding mandatory screening for access to firearms, and currently the onus is on the firearm licence holder to declare any relevant medical conditions. We propose that clinicians should screen patients for firearm possession and use a combined capacity and risk assessment approach to evaluating fitness for firearm licences.

  2. Oscillometric blood pressure: a review for clinicians.

    Science.gov (United States)

    Alpert, Bruce S; Quinn, David; Gallick, David

    2014-12-01

    Oscillometric devices for the non-invasive estimation of blood pressure (BP) have become the "clinical standard" because of training requirements for determination of BP by auscultation, cost, and the phasing-out/banning of mercury in many states and countries. Analysis of recent publications reveals a lack of understanding of the "meaning" of oscillometric blood pressure (OBP) measurements by authors, journal editors, and clinicians. We were invited to submit a review of OBP methodology written for clinicians. We hope that the material contained herein will clarify how clinicians should interpret OBP values for their patients. Copyright © 2014 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.

  3. 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 < 0.08) when viewed 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.

  4. Effects of Asthma and Inhalation corticosteroids on the dental arch morphology in children

    Directory of Open Access Journals (Sweden)

    S S Kumar

    2012-01-01

    Full Text Available Background: Hereditary, environmental and developmental factors play an important role in dentofacial development, as well as the initiation of malocclusion disorder. Allergic phenomenon such as asthma that induces an alternative mode of breathing in patients is a contributing factor in development of the dental arch. Aim: Our aim in this study was to evaluate the dentoalveolar morphology in asthmatic children and to analyze the effects of asthmatic medications on the dental arch. Setting and Design : This study is centered on 44 asthmatic children aged between 6-12 years from J.S.S Hospital, Mysore. Selected variables from model analysis of the casts of the asthmatic group were subjected to comparison with those of the non-asthmatic group, which comprised of 44 non-asthmatic children. Selected parameters were arch width, arch length and palatal depth. Materials and Methods : Impressions of upper and lower arches were made with rubber based impression material. A sliding digital caliper was used to measure the casts for arch width and arch length. A palatal depth gauge was used to measure the palatal depth. Statistical Analysis : Differences in arch widths, arch lengths and palatal depths between asthmatics and non-asthmatics groups were evaluated by independent sample t-tests. Chi-square test was applied to assess the frequency of occurrence of malocclusion in the asthmatic children. Result: The results obtained revealed that the arch length and palatal depth of asthmatic group had higher values compared to that of non-asthmatic groups for both age groups (6 to 8-year-old males and females, 10 to 12-year-old males and females. Inter molar width showed a significant lower value in asthmatics in the maxillary arches of 10 to 12-year-old females. Fifty percent of the asthmatic children aged 10 to 12-years had open-bite. Children under regular medication showed significant deviation in the dentoalveolar morphology as compared to those under

  5. Do clinicians use online evidence to support patient care? A study of 55,000 clinicians.

    Science.gov (United States)

    Westbrook, Johanna I; Gosling, A Sophie; Coiera, Enrico

    2004-01-01

    To determine clinicians' (doctors', nurses', and allied health professionals') "actual" and "reported" use of a point-of-care online information retrieval system; and to make an assessment of the extent to which use is related to direct patient care by testing two hypotheses: hypothesis 1: clinicians use online evidence primarily to support clinical decisions relating to direct patient care; and hypothesis 2: clinicians use online evidence predominantly for research and continuing education. Web-log analysis of the Clinical Information Access Program (CIAP), an online, 24-hour, point-of-care information retrieval system available to 55,000 clinicians in public hospitals in New South Wales, Australia. A statewide mail survey of 5,511 clinicians. Rates of online evidence searching per 100 clinicians for the state and for the 81 individual hospitals studied; reported use of CIAP by clinicians through a self-administered questionnaire; and correlations between evidence searches and patient admissions. Monthly rates of 48.5 "search sessions" per 100 clinicians and 231.6 text hits to single-source databases per 100 clinicians (n = 619,545); 63% of clinicians reported that they were aware of CIAP and 75% of those had used it. Eighty-eight percent of users reported CIAP had the potential to improve patient care and 41% reported direct experience of this. Clinicians' use of CIAP on each day of the week was highly positively correlated with patient admissions (r = 0.99, p true for all ten randomly selected hospitals. Clinicians' online evidence use increases with patient admissions, supporting the hypothesis that clinicians' use of evidence is related to direct patient care. Patterns of evidence use and clinicians' self-reports also support this hypothesis.

  6. The use of technology for urgent clinician to clinician communications: a systematic review of the literature.

    Science.gov (United States)

    Nguyen, Cristina; McElroy, Lisa M; Abecassis, Michael M; Holl, Jane L; Ladner, Daniela P

    2015-02-01

    Urgent clinician-clinician communications require routes of contact that are fast and dependable, and allow for the exchange of complex information. Despite the increasing focus on improving healthcare delivery systems over the past decade, few studies have examined the role of technology in clinician-clinician communication. The aim of this study was to review the literature examining the role of devices and technology in facilitating urgent clinician-clinician communication to identify critical areas for future research. A search of Pub Med was performed using the terms (((("Critical Care"[Mesh] OR "urgent")))) AND (((hospital communication systems[MeSH Terms]) OR health communication[MeSH Terms]) OR interdisciplinary communication[MeSH Terms]). Commentaries and editorials were excluded. The initial search returned 272 articles, which were reviewed to identify articles describing: (1) the role of technological support or devices in clinician-clinician communication, (2) technology-based interventions that improved clinician-to-clinician communication in hospitals or acute care facilities related to critically ill patients, or (3) critical information exchange. A total of 16 articles were included in the final review. These were grouped into three categories: alphanumeric pagers, cellular and smart telephones, and novel uses of technology. Breakdowns in clinician-clinician communication are complex and cannot be solved through the implementation of devices or technologically advanced systems alone. It is essential to understand the correlation between emerging technologies, a demanding workload, and clinician-clinician interaction. Enhanced communication of clinical ideas, opportunities for team discussion, and a sense of partnership and support require not just increased information, but enhanced delivery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  7. Lead poisoning and asthma among low-income and African American children in Saginaw, Michigan.

    Science.gov (United States)

    Pugh Smith, Pamela; Nriagu, Jerome O

    2011-01-01

    We sought to ascertain whether asthmatic children are more likely to have elevated blood lead levels (EBLLs), BLLs ≥ 10 μg/dL, than non-asthmatic children. Household risk factors associated with both lead and asthma were examined. We undertook a cross-sectional study involving children residing in mainly low-income and minority households in Michigan which were identified by the Statewide Systemic Tracking of Elevated Lead Levels and Remediation database (STELLAR) (n=356 children). Of the 356 index children, 19% had EBLLs and 15% were doctor-diagnosed asthmatic. After adjusting for confounders known to be related to lead poisoning and/or asthma, association remained between asthmatic children and EBLL children (AOR: 5.17; 95% CI (1.25-21.37)). The results of our study show that asthmatic children are over 5 times more likely to have EBLLs than non-asthmatics (AOR: 5.17; 95% CI (1.25-21.37)). Intervention strategies designed to address lead poisoning prevention may be effective in reducing incidence of asthma. Further study is required. Copyright © 2010 Elsevier Inc. All rights reserved.

  8. Clinician advice to quit smoking among seniors

    National Research Council Canada - National Science Library

    Shadel, William G; Elliott, Marc N; Haas, Ann C; Haviland, Amelia M; Orr, Nate; Farmer, Melissa M; Ma, Sai; Weech-Maldonado, Robert; Farley, Donna O; Cleary, Paul D

    2015-01-01

    Little smoking research in the past 20years includes persons 50 and older; herein we describe patterns of clinician cessation advice to US seniors, including variation by Medicare beneficiary characteristics...

  9. Accuracy of Clinician Suspicion of Lyme Disease in the Emergency Department.

    Science.gov (United States)

    Nigrovic, Lise E; Bennett, Jonathan E; Balamuth, Fran; Levas, Michael N; Chenard, Rachel L; Maulden, Alexandra B; Garro, Aris C

    2017-12-01

    To make initial management decisions, clinicians must estimate the probability of Lyme disease before diagnostic test results are available. Our objective was to examine the accuracy of clinician suspicion for Lyme disease in children undergoing evaluation for Lyme disease. We assembled a prospective cohort of children aged 1 to 21 years who were evaluated for Lyme disease at 1 of the 5 participating emergency departments. Treating physicians were asked to estimate the probability of Lyme disease (on a 10-point scale). We defined a Lyme disease case as a patient with an erythema migrans lesion or positive 2-tiered serology results in a patient with compatible symptoms. We calculated the area under the curve for the receiver operating curve as a measure of the ability of clinician suspicion to diagnose Lyme disease. We enrolled 1021 children with a median age of 9 years (interquartile range, 5-13 years). Of these, 238 (23%) had Lyme disease. Clinician suspicion had a minimal ability to discriminate between children with and without Lyme disease: area under the curve, 0.75 (95% confidence interval, 0.71-0.79). Of the 554 children who the treating clinicians thought were unlikely to have Lyme disease (score 1-3), 65 (12%) had Lyme disease, and of the 127 children who the treating clinicians thought were very likely to have Lyme disease (score 8-10), 39 (31%) did not have Lyme disease. Because clinician suspicion had only minimal accuracy for the diagnosis of Lyme disease, laboratory confirmation is required to avoid both under- and overdiagnosis. Copyright © 2017 by the American Academy of Pediatrics.

  10. [The problem of obstructive sleep apnea syndrome in asthmatic patients].

    Science.gov (United States)

    Sheludko, E G; Naumov, D E; Perelman, Yu M; Kolosov, V P

    2017-01-01

    Asthma and obstructive sleep apnea syndrome (OSAS) are one of the most common chronic respiratory diseases. These have common risk factors that include obesity, gastroesophageal reflux disease (GERD) and impaired nasal breathing (allergic rhinitis, sinusitis). At the same time, experimental evidence demonstrates common pathophysiological mechanisms of these diseases, such as involvement in the process of the respiratory tract, a systemic inflammatory response, and implementation of neuromechanical reflexes. Thus, there is an obvious synergism between these conditions, which affects symptoms, response to therapy, and prognosis. The available data allow discussion on whether there is a need to identify and treat OSAS in asthmatic patients. By keeping in mind the high incidence of OSAS in patients with severe asthma, it may be suggested that treatment for OSAS can reduce the number of exacerbations, improve the quality of life, and decline the number of obstinate asthma cases. It is very important for general practitioners to assess risk factors, such as body weight, nasal stuffiness, and GERD, and to utilize screening tools for more efficient use of healthcare resources. Considering the known positive effects of CPAP therapy in short-term studies, future investigations should focus on the impact of CPAP therapy on asthma symptoms in the long-term, as well as on the effects of asthma drugs on the course of OSAS.

  11. Management of oral focal infection in patients with asthmatic symptoms

    Directory of Open Access Journals (Sweden)

    Haryono Utomo

    2006-09-01

    Full Text Available Asthma is commonly related to allergic diseases, nevertheless only 40% of asthma patients are related to allergy or atopy. There are some unknown etiologies of asthma that are still in researches. One of the possible causes of asthma is the multiple chemical sensitivity syndrome (MCS which related to the “neurogenic switching hypothesis”. Since rhinitis, sinusitis and asthma are closely related, treatments which are successfully reduce or eliminate the rhinitis and sinusitis symptoms should also be advantageous to asthma management. There were a lot of sinusitis treatments which reduced asthma symptoms such as nasal corticosteroid, diathermy and surgery. It was also been reported that oral focal infection might cause sinusitis. However, the involvement of oral focal infection in the etiopathogenesis of asthma was seldom discussed. The objective of this study is to propose a mechanism of the relationship between oral focal infection and asthma which is explained by the “neurogenic switching hypothesis”. Two asthmatic patients who also had periodontal disease, pulpal and periapical infection were treated with conventional and/or surgical dental treatments. After the dental and periodontal treatments were completed, the usual triggers of severe asthma attacks such as cold and house dust did not elicit the asthma symptoms. It concluded that regarding to the disappearing of asthma symptoms, the elimination of oral focal infection had a beneficial effect in reducing asthma symptoms.

  12. Sulforaphane improves the bronchoprotective response in asthmatics through Nrf2-mediated gene pathways.

    Science.gov (United States)

    Brown, Robert H; Reynolds, Curt; Brooker, Allison; Talalay, Paul; Fahey, Jed W

    2015-09-15

    It is widely recognized that deep inspiration (DI), either before methacholine (MCh) challenge (Bronchoprotection, BP) or after MCh challenge (Bronchodilation, BD) protects against this challenge in healthy individuals, but not in asthmatics. Sulforaphane, a dietary antioxidant and antiinflammatory phytochemical derived from broccoli, may affect the pulmonary bronchoconstrictor responses to MCh and the responses to DI in asthmatic patients. Forty-five moderate asthmatics were administered sulforaphane (100 μmol daily for 14 days), BP, BD, lung volumes by body-plethsmography, and airway morphology by computed tomography (CT) were measured pre- and post sulforaphane consumption. Sulforaphane ameliorated the bronchoconstrictor effects of MCh on FEV1 significantly (on average by 21 %; p = 0.01) in 60 % of these asthmatics. Interestingly, in 20 % of the asthmatics, sulforaphane aggravated the bronchoconstrictor effects of MCh and in a similar number was without effect, documenting the great heterogeneity of the responsiveness of these individuals to sulforaphane. Moreover, in individuals in whom the FEV1 response to MCh challenge decreased after sulforaphane administration, i.e., sulforaphane was protective, the activities of Nrf2-regulated antioxidant and anti-inflammatory genes decreased. In contrast, individuals in whom sulforaphane treatment enhanced the FEV1 response to MCh, had increased expression of the activities of these genes. High resolution CT scans disclosed that in asthmatics sulforaphane treatment resulted in a significant reduction in specific airway resistance and also increased small airway luminal area and airway trapping modestly but significantly. These findings suggest the potential value of blocking the bronchoconstrictor hyperresponsiveness in some types of asthmatics by phytochemicals such as sulforaphane.

  13. Barrier disrupting effects of alternaria alternata extract on bronchial epithelium from asthmatic donors.

    Science.gov (United States)

    Leino, Marina S; Loxham, Matthew; Blume, Cornelia; Swindle, Emily J; Jayasekera, Nivenka P; Dennison, Patrick W; Shamji, Betty W H; Edwards, Matthew J; Holgate, Stephen T; Howarth, Peter H; Davies, Donna E

    2013-01-01

    Sensitization and exposure to the allergenic fungus Alternaria alternata has been associated with increased risk of asthma and asthma exacerbations. The first cells to encounter inhaled allergens are epithelial cells at the airway mucosal surface. Epithelial barrier function has previously been reported to be defective in asthma. This study investigated the contribution of proteases from Alternaria alternata on epithelial barrier function and inflammatory responses and compared responses of in vitro cultures of differentiated bronchial epithelial cells derived from severely asthmatic donors with those from non-asthmatic controls. Polarised 16HBE cells or air-liquid interface (ALI) bronchial epithelial cultures from non-asthmatic or severe asthmatic donors were challenged apically with extracts of Alternaria and changes in inflammatory cytokine release and transepithelial electrical resistance (TER) were measured. Protease activity in Alternaria extracts was characterised and the effect of selectively inhibiting protease activity on epithelial responses was examined using protease inhibitors and heat-treatment. In 16HBE cells, Alternaria extracts stimulated release of IL-8 and TNFα, with concomitant reduction in TER; these effects were prevented by heat-treatment of the extracts. Examination of the effects of protease inhibitors suggested that serine proteases were the predominant class of proteases mediating these effects. ALI cultures from asthmatic donors exhibited a reduced IL-8 response to Alternaria relative to those from healthy controls, while neither responded with increased thymic stromal lymphopoietin (TSLP) release. Only cultures from asthmatic donors were susceptible to the barrier-weakening effects of Alternaria. Therefore, the bronchial epithelium of severely asthmatic individuals may be more susceptible to the deleterious effects of Alternaria.

  14. 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.

  15. High incidence of oral corticosteroids prescriptions in children with asthma in early childhood

    NARCIS (Netherlands)

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

    2016-01-01

    Objective: Severe asthma exacerbations are often treated with short courses of oral corticosteroids (OCS). This study assessed the incidence of OCS being prescribed in asthmatic children of various age groups and calculated their chances of receiving subsequent OCS prescriptions. Methods:

  16. High incidence of oral corticosteroids prescriptions in children with asthma in early childhood

    NARCIS (Netherlands)

    Arabkhazaeli, A.; Vijverberg, S.J.H.; Van Der Ent, C. Kors; Raaijmakers, J.A.M.; van der Zee, A.H.

    2016-01-01

    OBJECTIVE: Severe asthma exacerbations are often treated with short courses of oral corticosteroids (OCS). This study assessed the incidence of OCS being prescribed in asthmatic children of various age groups and calculated their chances of receiving subsequent OCS prescriptions. METHODS:

  17. Relation between asthma and body mass index in 6-15 years old children.

    Directory of Open Access Journals (Sweden)

    Akefeh Ahmadiafshar

    2013-09-01

    Full Text Available Childhood asthma and obesity are significant public health problems. Most prospective studies suggest that obesity increases the risk of asthma. But, some authors did not found this association. In this study the association between asthma and body mass index (BMI was investigated. This case-control study was conducted on 200 asthmatic children aged 6-15 years and 200 children without asthma. The criteria for asthma diagnosis and its classification were on the basis of National Asthma Education and Prevention Program (NAEPP. BMI of patients and controls were also measured and BMI grater than 85% and 95% were defined as overweight and obese respectively. The data was analyzed by SPSS software. The BMI among the asthmatic children (17.9 kg/m2 was higher than the BMI among the non-asthmatics (16.5 kg/m2, P=0.0001. This relationship was significant in both males and females. 18% of asthmatic children were classified as overweight and 13.5% of them were obese versus 7.5% and 6% respectively in non asthmatics (P=0.0001. However, there was no significant relationship between severity, duration of asthma, kind of medication and BMI in children with asthma (P>0.05. Result of this study showed that there is an association between asthma symptoms and obesity in children. Therefore, any attempts for weight control in asthmatic children might be beneficial.

  18. Characteristics Associated with Utilization of Asthma-Related Traditional Chinese Medicine Services among Asthma Children in Taiwan: A Nationwide Cohort Study

    Directory of Open Access Journals (Sweden)

    Shiou-Ian Lin

    2015-01-01

    Full Text Available Introduction. Previous studies have demonstrated the advantages of TCM use among asthmatic children. However, there is a paucity of epidemiologic reports on features of TCM users among asthmatic children. This cohort study aimed to investigate child’s, parent’s, and provider’s characteristics associated with the use of asthma-related TCM services among newly diagnosed asthmatic children. Materials and Methods. A nationally representative cohort of one million National Health Insurance beneficiaries was used. The newly diagnosed asthma children who received asthma medication from western medicine providers from 2005 to 2010 were selected as our sample for analysis. Generalized estimating equation was applied to identify the child’s, parents’, and provider’s characteristics associated with the use of asthma-related TCM among the newly diagnosed asthmatic children. Results. Of 20,080 children who were enrolled and followed up for one year, 4,034 children used TCM for asthma-related treatment. Children with prior experience of TCM, pre-school and school aged children, boys, those with more severe asthma or poorer health, with higher income parents were more likely to use asthma-related TCM. Herbal medicine was the most common modality among asthmatic children. Conclusions. There were only 20% newly diagnosed asthmatic children using TCM. The findings may shed light on possible integration of TCM with western medicine services.

  19. 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

  20. 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

  1. Assessing caries, dental plaque and salivary flow in asthmatic adolescents using inhaled corticosteroids.

    Science.gov (United States)

    Santos, N C; Jamelli, S; Costa, L; Baracho Filho, C; Medeiros, D; Rizzo, J A; Sarinho, E

    2012-01-01

    A number of studies have reported that inhaled corticosteroids may cause a greater incidence of caries, reduced salivary flow, changes in saliva composition and an increased frequency of dental plaque, probably through alterations in the oral microbiota. The objective was to compare the frequency of caries, dental plaque and non-stimulated salivary flow rate among asthmatic adolescents using inhaled corticosteroids and non-asthmatic adolescents, as well as the salivary biochemical parameters (pH and leucocytes) in both groups. This research has a descriptive cross-sectional design to compare dental health of 40 asthmatics on inhaled corticosteroids and 40 non-asthmatic adolescents (median age 13 years). The findings were a higher number of tooth surfaces affected by dental caries (median 4 versus 1.5), and more dental plaques (median 70.5 versus 60.7) among asthmatic adolescents. They also had a significantly higher frequency of salivary leucocytes. The non-stimulated salivary flow was similar in both groups. The results suggest an association between the use of inhaled corticosteroids and an increased risk of dental caries and bacterial plaque, which calls for special attention of these patients by doctors and dental health professionals. Copyright © 2010 SEICAP. Published by Elsevier Espana. All rights reserved.

  2. DENTAL HEALTH IN ASTHMATICS TREATED WITH INHALED CORTICOSTEROIDS AND LONG-ACTING SYMPATHICOMIMETICS.

    Directory of Open Access Journals (Sweden)

    Emilia Karova

    2012-06-01

    Full Text Available There is no enough evidence in literature for the effect of inhaled corticosteroids and long-acting sympathicomimetics on dental health in asthmatics. The aim of the study is to follow up the changes in dental plaque pH and dental health in asthmatics with mild persistent asthma, treated with different combinations of inhaled corticosteroids and long-acting sympathicomimetics. Seventy patients of both sexes, from 20 to 55 years old participated in the study. Changes in plaque pH and dental status are evaluated in two visits, in six months interval.There are no significant differences between asthmatics and controls when plaque pH values are compared. Substantially lower pH values are determined for maxillary teeth in both groups.DMFT index is significantly higher in asthmatics than in the controls. It increases substantially at their second visit. Significantly higher mean levels of DMFT index for each jaw are found out in asthmatic group.

  3. Anti-inflammatory effects of embelin in A549 cells and human asthmatic airway epithelial tissues.

    Science.gov (United States)

    Lee, In-Seung; Cho, Dong-Hyuk; Kim, Ki-Suk; Kim, Kang-Hoon; Park, Jiyoung; Kim, Yumi; Jung, Ji Hoon; Kim, Kwanil; Jung, Hee-Jae; Jang, Hyeung-Jin

    2018-02-01

    Allergic asthma is the most common type in asthma, which is defined as a chronic inflammatory disease of the lung. In this study, we investigated whether embelin (Emb), the major component of Ardisia japonica BL. (AJB), exhibits anti-inflammatory effects on allergic asthma via inhibition of NF-κB activity using A549 cells and asthmatic airway epithelial tissues. Inflammation was induced in A549 cells, a human airway epithelial cell line, by IL-1β (10 ng/ml) treatment for 4 h. The effects of Emb on NF-κB activity and COX-2 protein expression in inflamed airway epithelial cells and human asthmatic airway epithelial tissues were analyzed via western blot. The secretion levels of NF-κB-mediated cytokines/chemokines, including IL-4, 6, 9, 13, TNF-α and eotaxin, were measured by a multiplex assay. Emb significantly blocked NF-κB activity in IL-1β-treated A549 cells and human asthmatic airway epithelial tissues. COX-2 expression was also reduced in both IL-1β-treated A549 cells and asthmatic tissues Emb application. Emb significantly reduced the secretion of IL-4, IL-6 and eotaxin in human asthmatic airway epithelial tissues by inhibiting activity of NF-κB. The results of this study suggest that Emb may be used as an anti-inflammatory agent via inhibition of NF-κB and related cytokines.

  4. 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.

  5. 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.......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....

  6. The clinician's role in assessing workplace violence.

    Science.gov (United States)

    Lion, J R

    1999-03-01

    Workplace violence can be an area of consultation for psychiatrists. However, the clinician must understand not only the limits of violence prediction, but also the corporate culture in which he or she will become involved. Evaluation of threats may involve review of written notes or taped recordings; the employee may or may not be seen. Corporate consultations sometime involve a split allegiance on the part of the clinician who must both advise the company and render a decision about the employee. The dynamics of violence within the workplace are discussed.

  7. Prader-Willi syndrome: A primer for clinicians

    Science.gov (United States)

    2011-01-01

    The advent of sensitive genetic testing modalities for the diagnosis of Prader-Willi syndrome has helped to define not only the phenotypic features of the syndrome associated with the various genotypes but also to anticipate clinical and psychological problems that occur at each stage during the life span. With advances in hormone replacement therapy, particularly growth hormone children born in circumstances where therapy is available are expected to have an improved quality of life as compared to those born prior to growth hormone. This manuscript was prepared as a primer for clinicians-to serve as a resource for those of you who care for children and adults with Prader-Willi syndrome on a daily basis in your practices. Appropriate and anticipatory interventions can make a difference. PMID:22008714

  8. Prader-Willi syndrome: A primer for clinicians

    Directory of Open Access Journals (Sweden)

    Hertz Gila

    2011-10-01

    Full Text Available Abstract The advent of sensitive genetic testing modalities for the diagnosis of Prader-Willi syndrome has helped to define not only the phenotypic features of the syndrome associated with the various genotypes but also to anticipate clinical and psychological problems that occur at each stage during the life span. With advances in hormone replacement therapy, particularly growth hormone children born in circumstances where therapy is available are expected to have an improved quality of life as compared to those born prior to growth hormone. This manuscript was prepared as a primer for clinicians-to serve as a resource for those of you who care for children and adults with Prader-Willi syndrome on a daily basis in your practices. Appropriate and anticipatory interventions can make a difference.

  9. Genetic polymorphisms of the beta-2 adrenergic receptor in Israelis with severe asthma compared to non-asthmatic Israelis.

    Science.gov (United States)

    Shachor, Joshua; Chana, Ziv; Varsano, Shabtai; Erlich, Tamar; Goldman, Elizabeth; Dror, Yigal; Yakovy, Ilana; Navon, Ruth

    2003-11-01

    It has been argued that arginine replacement in locus 16 (Arg16) of beta 2 adrenergic receptor with glycin (Gly16) increases asthma severity, while glutamin replacement in locus 27 (Gln27) with glutamic acid (Glu27) decreases it. In addition, ethnic dependency of these polymorphisms has been described, but few studies investigated its relation to asthma severity in a non-anglosaxic population. To investigate non-anglosaxic ethnic influences on beta 2AR polymorphisms and its correlations to asthma severity. Sixty-six Israeli Jewish and Arab asthmatics who had near-fatal asthma and/or severe nocturnal asthma and/or steroid-dependency were investigated for genetic polymorphisms of beta 2AR and compared to matched controls. The Jewish patients included both Ashkenazi (of European origin) and non-Ashkenazi (originating from the Middle East or North Africa). The results were compared with those of ethnically matched 113 non-asthmatic Israelis and non-asthmatic Anglo-Saxons described in the literature. We found no significant genetic differences between the asthmatics and their controls or between the various ethnic groups of our population. However, the prevalence of Glu27 was significantly lower in non-asthmatic Israelis compared to non-asthmatic Anglo-Saxons. The genetic distribution of beta 2AR polymorphisms in severe Israeli asthmatics is not different from that of non-asthmatic Israelis and therefore its clinical impact on asthma is probably minimal.

  10. Effect of an inhaled adenosine A(2A) agonist on the allergen-induced late asthmatic response

    NARCIS (Netherlands)

    Luijk, B.; van den Berge, M.; Kerstjens, H. A. M.; Postma, D. S.; Cass, L.; Sabin, A.; Lammers, J. -W. J.

    Background: Adenosine receptor activation is suggested to play a role in asthmatic airway inflammation. Inhibition of adenosine receptors may have an effect on the late asthmatic response (LAR) after allergen inhalation and this mechanism could offer a potential new treatment in asthma. Methods: We

  11. Prevalence of CCR5-delta32 mutation in asthmatic and non-asthmatic subjects from department of medicine, JUCM, Cracow.

    Science.gov (United States)

    Gomulska, Martyna; Rusin, Gabriela; Gwiazdak, Piotr

    2014-01-01

    C-C chemokine receptor type 5 (CCR5) is chemokine receptor encoded by CCR5 gene located on the short arm of chromosome 3. Asthma is a chronic bronchial inflammatory disease of either allergic or idiopathic etiology. CCR5 Δ32 mutation is a common deletion of 32 nucleotides resulting in a frameshift and non-functional receptor. Its prevalence in European population ranges between 4 and 16% (frequency of homozygotes is 1%). The current study was aimed to assess frequency of this mutation in asthmatics and its possible impact on asthma. The study was conducted on 254 subjects (125 diagnosed with asthma and 129 in control group). Isolated DNA was analysed by PCR. Primers were designed to flank the deletion region, thus PCR products could be genotyped by mere agarose gel electrophoresis. The variant alleles were represented as bands of 270 and 238 pb lengths. The shorter amplification product was diagnostic for the presence of CCR5-delta32 deletion. Visualisation of agarose gel revealed non-mutated, mutated homozygotes as well as heterozygotes. In the control group there were 37 women and 92 men, whereas the study group comprised 87 women and 38 men. In the control group genotypes distribution was: 105 non-mutated homozygotes, 21 hetezygotes and 3 mutated homozygotes, whereas in the study group 103, 21 and 1 respectively. No statistically significant differences between these groups were detected. Prevalence of homozygotes was 1,6%. Current study revealed no association between CCR5 Δ32 mutation and incidence of asthma. It may be assumed that CCR5 Δ32 deletion is neutral as a risk factor of asthma.

  12. Regulation of bronchial epithelial barrier integrity by type 2 cytokines and histone deacetylases in asthmatic patients.

    Science.gov (United States)

    Wawrzyniak, Paulina; Wawrzyniak, Marcin; Wanke, Kerstin; Sokolowska, Milena; Bendelja, Kreso; Rückert, Beate; Globinska, Anna; Jakiela, Bogdan; Kast, Jeannette I; Idzko, Marco; Akdis, Mübeccel; Sanak, Marek; Akdis, Cezmi A

    2017-01-01

    Tight junctions (TJs) form a barrier on the apical side of neighboring epithelial cells in the bronchial mucosa. Changes in their integrity might play a role in asthma pathogenesis by enabling the paracellular influx of allergens, toxins, and microbes to the submucosal tissue. The regulation of bronchial epithelial TJs by TH2 cells and their cytokines and their involvement in epigenetic regulation of barrier function were investigated. The expression, regulation, and function of TJs were determined in air-liquid interface (ALI) cultures of control and asthmatic primary human bronchial epithelial cells (HBECs) by means of analysis of transepithelial electrical resistance, paracellular flux, mRNA expression, Western blotting, and immunofluorescence staining. HBECs from asthmatic patients showed a significantly low TJ integrity in ALI cultures compared with HBECs from healthy subjects. TH2 cell numbers and levels of their cytokines, IL-4 and IL-13, decreased barrier integrity in ALI cultures of HBECs from control subjects but not in HBECs from asthmatic patients. They induced a physical separation of the TJs of adjacent cells in immunofluorescence staining of the TJ molecules occludin and zonula occludens-1. We observed that expression of histone deacetylases (HDACs) 1 and 9, and Silent information regulator genes (sirtuins [SIRTs]) 6 and 7 were significantly high in HBECs from asthmatic patients. IL-4 and IL-13 significantly increased the expression of HDACs and SIRTs. The role of HDAC activation on epithelial barrier leakiness was confirmed by HDAC inhibition, which improved barrier integrity through increased synthesis of TJ molecules in epithelium from asthmatic patients to the level seen in HBECs from control subjects. Our data demonstrate that barrier leakiness in asthmatic patients is induced by TH2 cells, IL-4, and IL-13 and HDAC activity. The inhibition of endogenous HDAC activity reconstitutes defective barrier by increasing TJ expression. Copyright © 2016

  13. Regulatory T and B Cells in Asthmatic Women: Variations From Pregnancy to Postpartum.

    Science.gov (United States)

    Martins, C; Lima, J; Nunes, G; Borrego, L M

    Allergic asthma and rhinitis are common in pregnancy. The immune mechanisms underlying the effects of asthma on pregnancy and vice versa are not completely understood. The aim of this study was to investigate changes in regulatory T and B cells in asthmatic women from late pregnancy to postpartum. Four groups of women were enrolled for this study: asthmatic (n=23) and healthy (n=43) third trimester-pregnant women and asthmatic (n=33) and healthy (n=35) nonpregnant women. Pregnant women were also evaluated postpartum (>6 weeks after delivery). Blood samples were taken from each woman and flow cytometry was used to characterize circulating regulatory T cells (Tregs) and regulatory B cells (Bregs). Foxp3 expression was assessed in CD4DimCD25Hi Tregs. Tregs did not vary significantly from pregnancy to postpartum in asthmatic or healthy women, but CD24HiCD38Hi Bregs decreased in pregnancy and increased significantly postpartum. Foxp3 expression in Tregs was also impaired during pregnancy in both asthmatic and healthy women, but recovered postpartum. Asthmatic pregnant women had higher Foxp3 expression levels than healthy pregnant women (P=.007), probably due to the use of control medication. Women with controlled asthma showed variations in regulatory cell subsets during pregnancy and postpartum. A similar pattern was observed for Foxp3 expression and CD24HiCD38Hi Bregs during this period, corroborating the interaction between Tregs and Bregs in immune responses. Considering the immunomodulatory potential of these immune mediators, more studies are needed to evaluate their relationship with asthma and rhinitis complications in pregnancy.

  14. 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.

  15. The interplay between teamwork, clinicians' emotional exhaustion, and clinician-rated patient safety: a longitudinal study.

    Science.gov (United States)

    Welp, Annalena; Meier, Laurenz L; Manser, Tanja

    2016-04-19

    Effectively managing patient safety and clinicians' emotional exhaustion are important goals of healthcare organizations. Previous cross-sectional studies showed that teamwork is associated with both. However, causal relationships between all three constructs have not yet been investigated. Moreover, the role of different dimensions of teamwork in relation to emotional exhaustion and patient safety is unclear. The current study focused on the long-term development of teamwork, emotional exhaustion, and patient safety in interprofessional intensive care teams by exploring causal relationships between these constructs. A secondary objective was to disentangle the effects of interpersonal and cognitive-behavioral teamwork. We employed a longitudinal study design. Participants were 2100 nurses and physicians working in 55 intensive care units. They answered an online questionnaire on interpersonal and cognitive-behavioral aspects of teamwork, emotional exhaustion, and patient safety at three time points with a 3-month lag. Data were analyzed with cross-lagged structural equation modeling. We controlled for professional role. Analyses showed that emotional exhaustion had a lagged effect on interpersonal teamwork. Furthermore, interpersonal and cognitive-behavioral teamwork mutually influenced each other. Finally, cognitive-behavioral teamwork predicted clinician-rated patient safety. The current study shows that the interrelations between teamwork, clinician burnout, and clinician-rated patient safety unfold over time. Interpersonal and cognitive-behavioral teamwork play specific roles in a process leading from clinician emotional exhaustion to decreased clinician-rated patient safety. Emotionally exhausted clinicians are less able to engage in positive interpersonal teamwork, which might set in motion a vicious cycle: negative interpersonal team interactions negatively affect cognitive-behavioral teamwork and vice versa. Ultimately, ineffective cognitive

  16. DENTAL HEALTH IN ASTHMATICS TREATED WITH INHALED CORTICOSTEROIDS AND LONG-ACTING SYMPATHICOMIMETICS.

    OpenAIRE

    Emilia Karova; George Christoff

    2012-01-01

    There is no enough evidence in literature for the effect of inhaled corticosteroids and long-acting sympathicomimetics on dental health in asthmatics. The aim of the study is to follow up the changes in dental plaque pH and dental health in asthmatics with mild persistent asthma, treated with different combinations of inhaled corticosteroids and long-acting sympathicomimetics. Seventy patients of both sexes, from 20 to 55 years old participated in the study. Changes in plaque pH and dental st...

  17. [The agony of rubbish to clinicians].

    Science.gov (United States)

    Xhauflaire-Uhoda, E; Quatresooz, P; Piérard-Franchimont, C; Piérard, G E

    2008-11-01

    The clinician is at the crossroad between scientific information and some rubbish presentations of low level communication. In this background, searching for objectivity is mandatory in clinical trials. We summarize the main aspects of assessment on nominal scale, ordinal scale, interval scale as well as on structured and non structured scales.

  18. Evaluating clinicians' representations of schizoaffective disorder.

    Science.gov (United States)

    Webb, Christopher A; Keeley, Jared W

    2017-04-01

    Schizoaffective disorder (SAD) has routinely exhibited poor diagnostic accuracy and reliability. In addition to phenomenological problems with the definition of SAD, the way in which clinicians represent the symptoms of the disorder could contribute to its poor diagnostic outcomes. The present study sought to examine clinicians' representations of SAD compared to schizophrenia (SCZ), bipolar disorder with psychotic features (BiPD-PSY), and major depressive disorder with psychotic features (MDD-PSY). Participants (N=113) were clinicians recruited via email as part of a larger study. They were randomly assigned to either select symptoms from a predetermined criteria list or freely list features of the disorders based on their own mental representations. Participants' conceptualizations of SAD were not entirely congruent with DSM-5 criteria; they conceptualized it as less psychotic than SCZ and less affective than the two mood disorder tasks. SAD was conceptualized as significantly more depressive than manic. This study's findings support the notion that clinicians' conceptualizations of SAD are not entirely congruent with its DSM-5 criteria, which could contribute to diagnostic difficulties. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Clinicians' Knowledge and Perception of Telemedicine Technology.

    Science.gov (United States)

    Ayatollahi, Haleh; Sarabi, Fatemeh Zahra Pourfard; Langarizadeh, Mostafa

    2015-01-01

    Telemedicine is an application of information and communication technology in the healthcare environment. This study aimed to compare knowledge and perceptions of telemedicine technology among different groups of clinicians. This survey study was conducted in 2013. The potential participants included 532 clinicians who worked in two hospitals and three clinics in a northern province of Iran. Data were collected using a five-point Likert-scale questionnaire. The content validity of the questionnaire was checked, and the reliability was calculated using Cronbach's alpha coefficient (α = 0.73). The results showed that most of the clinicians (96.1 percent) had little knowledge about telemedicine. They perceived the advantages of telemedicine at a moderate level and its disadvantages at a low level. The knowledge of dentists about this technology was less than that of other groups, and as a result they were less positive about the advantages of telemedicine compared to nurses, general physicians, and specialists. The limited knowledge of clinicians about telemedicine seems to have influenced their perceptions of the technology. Therefore, providing healthcare professionals with more information about new technologies in healthcare, such as telemedicine, can help to gain a more realistic picture of their perceptions.

  20. Effects of a communication course for clinicians on parents' perception of care

    DEFF Research Database (Denmark)

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

    2009-01-01

    . 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...... compared with the control group. For example: 'the clinician told my child what he/she could do in order to feel better'. Discussion: Although no statistically significant differences were found, the study indicates that parents who had visited a clinician from the intervention group have experienced...

  1. Sputum RNA signature in allergic asthmatics following allergen bronchoprovocation test

    Directory of Open Access Journals (Sweden)

    Rob G.J.A. Zuiker

    2016-07-01

    correlated significantly with lung function and sputum eosinophil counts. Conclusion: Our RNA extraction and profiling protocols allowed reproducible assessments of inflammatory signatures in sputum including quantification of drug effects on this response in allergic asthmatics. This approach offers novel possibilities for the development of pharmacodynamic (PD biomarkers in asthma.

  2. School-Based Educational Interventions Can Significantly Improve Health Outcomes in Children with Asthma.

    Science.gov (United States)

    Suwannakeeree, Pussayaban; Deerojanawong, Jitladda; Prapphal, Nuanchan

    2016-02-01

    Lack of asthma knowledge among the pediatric patients and their caregivers contribute to poor asthma control in children. There is no data from Thailand on the health outcomes of school-based educational interventions for asthmatic children. To assess the effectiveness of school-based asthma educational interventions on health outcomes, asthma control, and management in asthmatic children. Forty-seven asthmatic students (6-15 years old), 14 caregivers, and five teachers from the Homkred School participated in the study. Asthma knowledge, workshops on pMDI (pressurized metered dose inhaler) techniques, use of asthma diaries, and self-management plans were provided Pre- and post-tests were administered to assess the asthma knowledge of the asthmatic students, their caregivers, and teachers. Pulmonary function tests (PFT) were used to assess the health outcomes. The controls of asthma and self-management behaviors were assessed at three and six months post-intervention. There were significant improvements of asthma knowledge in all groups (p management behaviors in the asthmatic children improved. The teachers' management of asthmatic attacks during the classes also improved. As a result of this, there were fewer emergency room (ER) visits. School-based educational interventions can significantly improve asthma outcomes in children with asthma. Therefore, the authors highly recommend the use of this intervention.

  3. Predicting the long-term prognosis of children with symptoms suggestive of asthma at preschool age.

    Science.gov (United States)

    Caudri, Daan; Wijga, Alet; A Schipper, C Maarten; Hoekstra, Maarten; Postma, Dirkje S; Koppelman, Gerard H; Brunekreef, Bert; Smit, Henriette A; de Jongste, Johan C

    2009-11-01

    Clinicians have difficulty in diagnosing asthma in preschool children with suggestive symptoms. We sought to develop a clinical asthma prediction score for preschool children who have asthma-like symptoms for the first time. The Prevalence and Incidence of Asthma and Mite Allergy birth cohort followed 3,963 children for 8 years. Between 0 and 4 years of age, 2,171 (55%) children reported "wheezing," "coughing at night without a cold," or both. In these children possible predictor variables for asthma were assessed at the age respiratory symptoms were first reported. Asthma was defined as wheezing, inhaled steroid prescription, or a doctor's diagnosis of asthma at both age 7 and 8 years of age. Eleven percent of children with symptoms at 0 to 4 years of age had asthma at 7 to 8 years of age. Eight clinical parameters independently predicted asthma at 7 to 8 years of age: male sex, postterm delivery, parental education and inhaled medication, wheezing frequency, wheeze/dyspnea apart from colds, respiratory infections, and eczema. In 72% of the cases, the model accurately discriminated between asthmatic and nonasthmatic children. A clinical risk score was developed (range, 0-55 points). Symptomatic children with a score of less than 10 points had a 3% risk, whereas children with a score of 30 points or greater had a 42% risk of asthma. A risk score based on 8 readily available clinical parameters at the time preschool children first reported asthma-like symptoms predicted the risk of asthma at 7 to 8 years of age.

  4. 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

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

    NARCIS (Netherlands)

    Vondra, V.; Branis, M.; Reisova, M.; Maly, M.; Hoek, G.

    1998-01-01

    A multicentre study (Pollution Effects on Asthmatic Children in Europe (PEACE)) project investigated the relationship between the air pollution and daily variation of respiratory health in children with chronic respiratory symptoms. Data were collected on 66 children in Prague and 68 children in

  6. 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

  7. Burnout and compassion fatigue: prevalence and associations among Israeli burn clinicians

    Science.gov (United States)

    Haik, Josef; Brown, Stav; Liran, Alon; Visentin, Denis; Sokolov, Amit; Zilinsky, Isaac; Kornhaber, Rachel

    2017-01-01

    Acute health care environments can be stressful settings with clinicians experiencing deleterious effects of burnout and compassion fatigue affecting their mental health. Subsequently, the quality of patient care and outcomes may be threatened if clinicians experience burnout or compassion fatigue. Therefore, the aim of this descriptive, cross-sectional study was to evaluate the prevalence of burnout and compassion fatigue among burn clinicians in Israel. Fifty-five clinicians from Burns, Plastics and Reconstruction Surgery and Intensive Care completed four validated surveys to assess burnout (Maslach Burnout Inventory), depression (PRIME-MD), health-related quality of life (SF-8), and compassion fatigue (Professional Quality of Life version 5). Burn clinicians were compared with Plastics and Reconstruction Surgery and Intensive Care clinicians. This study identified a high prevalence of burnout (38.2%) among Intensive Care, Plastics and Reconstruction and Burns clinicians, with Burns clinicians having a greatly increased prevalence of burnout compared to Intensive Care clinicians (OR =24.3, P=0.017). Additional factors contributing to compassion fatigue were those without children (P=0.016), divorced (P=0.035), of a younger age (P=0.019), and a registered nurse (P=0.05). Burnout increased clinicians’ risk of adverse professional and personal outcomes and correlated with less free time (Pdepression (P=0.001) and decreased career satisfaction (P=0.01). Burnout was also associated with higher physical (mean difference =3.8, Pburnout, compassion fatigue, and vicarious trauma. Identifying strategies to abate these issues is essential to ensure improved clinicial environments and patient outcomes. PMID:28670122

  8. Reviewing social media use by clinicians.

    Science.gov (United States)

    von Muhlen, Marcio; Ohno-Machado, Lucila

    2012-01-01

    Adoption studies of social media use by clinicians were systematically reviewed, up to July 26th, 2011, to determine the extent of adoption and highlight trends in institutional responses. This search led to 370 articles, of which 50 were selected for review, including 15 adoption surveys. The definition of social media is evolving rapidly; the authors define it broadly to include social networks and group-curated reference sites such as Wikipedia. Facebook accounts are very common among health science students (64-96%) and less so for professional clinicians (13-47%). Adoption rates have increased sharply in the past 4 years. Wikipedia is widely used as a reference tool. Attempts at incorporating social media into clinical training have met with mixed success. Posting of unprofessional content and breaches of patient confidentiality, especially by students, are not uncommon and have prompted calls for social media guidelines.

  9. 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.

  10. Effect of 1,25-dihydroxyvitamin D3 on mast cells tryptase in asthmatic guinea pigs.

    Science.gov (United States)

    Zheng, Xiao-He; Zhang, Gui-Dong; Zhang, Guo-Hong; Mai, Rui-Qin; Shen, Ling

    2015-06-01

    To explore the effect of 1,25-dihydroxyvitamin D3 on the mast cell tryptase (MCT) in asthmatic guinea pigs. A total of 60 male or female healthy guinea pigs were randomly divided into control group (group A), asthmatic group (group B), and 1,25-dihydroxyvitamin D3 group (group C), with 20 cases in each group. To establish asthmatic guinea pig models, 1 mL peanut oil was filled into stomach in the morning in group A and group B, and 1 mL peanut oil with 1,25-dihydroxyvitamin D3 was filled into stomach in group C. Airway resistance (Re) of asthmatic guinea pigs was detected, and the bronchoalveolar lavage fluid (BALF) cells were counted. Lung tissue with HE and MCT immunohistochemical staining were used to observe the pathological changes in lung tissue and the distribution of MCT. After injection of different concentration of acetylcholine chloride, the Re in group B and group C were increased significantly compared with group A (P guinea pigs are treated with 1,25-dihydroxyvitamin D3, their BALF, Re, infiltration degree of inflammatory cells in the trachea and lung tissue and airway inflammatory reaction are reduced significantly. 1,25-dihydroxyvitamin D3 has a certain inhibiting effect on the activation of mast cells and the release of MCT granules. Copyright © 2015 Hainan Medical College. Production and hosting by Elsevier B.V. All rights reserved.

  11. 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

    time. METHODS: We extracted data on prescription drug use, education, and income in 97 665 users of anti-asthmatic drugs, aged 18-44 years, identified in Statistics Denmark during 1997-2005. Individual information on education and income was used as measures of SES. Education was categorised into basic...

  12. The actin regulator zyxin reinforces airway smooth muscle and accumulates in airways of fatal asthmatics.

    Directory of Open Access Journals (Sweden)

    Sonia R Rosner

    Full Text Available Bronchospasm induced in non-asthmatic human subjects can be easily reversed by a deep inspiration (DI whereas bronchospasm that occurs spontaneously in asthmatic subjects cannot. This physiological effect of a DI has been attributed to the manner in which a DI causes airway smooth muscle (ASM cells to stretch, but underlying molecular mechanisms-and their failure in asthma-remain obscure. Using cells and tissues from wild type and zyxin-/- mice we report responses to a transient stretch of physiologic magnitude and duration. At the level of the cytoskeleton, zyxin facilitated repair at sites of stress fiber fragmentation. At the level of the isolated ASM cell, zyxin facilitated recovery of contractile force. Finally, at the level of the small airway embedded with a precision cut lung slice, zyxin slowed airway dilation. Thus, at each level zyxin stabilized ASM structure and contractile properties at current muscle length. Furthermore, when we examined tissue samples from humans who died as the result of an asthma attack, we found increased accumulation of zyxin compared with non-asthmatics and asthmatics who died of other causes. Together, these data suggest a biophysical role for zyxin in fatal asthma.

  13. 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.

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

    NARCIS (Netherlands)

    Koster, Ellen S.|info:eu-repo/dai/nl/308480643; Philbert, Daphne; Van Dijk, Liset L.; De Vries, Tjalling W.; Bouvy, Marcel L.|info:eu-repo/dai/nl/153182210

    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

  15. Assessment of Bone Status in Inhaled Corticosteroid User Asthmatic Patients with an Ultrasound Measurement Method

    Directory of Open Access Journals (Sweden)

    Mayumi Sasagawa

    2011-01-01

    Conclusions: The 6 month manegement of asthma in the actual clinical setting, including regular ICS use, might have a harmful influence on the bone status of female asthmatic patients. It may be necessary to manage and treat female patients for potent corticosteroid-induced osteoporosis, although further analyses of bone status in asthma patient ICS users will be required.

  16. Clinical Characteristics of Exacerbation-Prone Adult Asthmatics Identified by Cluster Analysis.

    Science.gov (United States)

    Kim, Mi Ae; Shin, Seung Woo; Park, Jong Sook; Uh, Soo Taek; Chang, Hun Soo; Bae, Da Jeong; Cho, You Sook; Park, Hae Sim; Yoon, Ho Joo; Choi, Byoung Whui; Kim, Yong Hoon; Park, Choon Sik

    2017-11-01

    Asthma is a heterogeneous disease characterized by various types of airway inflammation and obstruction. Therefore, it is classified into several subphenotypes, such as early-onset atopic, obese non-eosinophilic, benign, and eosinophilic asthma, using cluster analysis. A number of asthmatics frequently experience exacerbation over a long-term follow-up period, but the exacerbation-prone subphenotype has rarely been evaluated by cluster analysis. This prompted us to identify clusters reflecting asthma exacerbation. A uniform cluster analysis method was applied to 259 adult asthmatics who were regularly followed-up for over 1 year using 12 variables, selected on the basis of their contribution to asthma phenotypes. After clustering, clinical profiles and exacerbation rates during follow-up were compared among the clusters. Four subphenotypes were identified: cluster 1 was comprised of patients with early-onset atopic asthma with preserved lung function, cluster 2 late-onset non-atopic asthma with impaired lung function, cluster 3 early-onset atopic asthma with severely impaired lung function, and cluster 4 late-onset non-atopic asthma with well-preserved lung function. The patients in clusters 2 and 3 were identified as exacerbation-prone asthmatics, showing a higher risk of asthma exacerbation. Two different phenotypes of exacerbation-prone asthma were identified among Korean asthmatics using cluster analysis; both were characterized by impaired lung function, but the age at asthma onset and atopic status were different between the two.

  17. 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.

  18. Bronchial Asthma in Sokoto: A Study of 128 Adult Asthmatic Patients ...

    African Journals Online (AJOL)

    128 adult asthmatics, made up of 62 males and 66 females were seen at Usmanu Danfodiyo University Teaching Hospital, Sokoto between the 1st of January 1993 and 31 st of December 1998. The mean age of presentation for the males was 34.8 years while for the females it was 28.2 years. Those between the age of 20 ...

  19. High density lipoproteins and type 2 inflammatory biomarkers are negatively correlated in atopic asthmatics.

    Science.gov (United States)

    Barochia, Amisha V; Gordon, Elizabeth M; Kaler, Maryann; Cuento, Rosemarie A; Theard, Patricia; Figueroa, Debbie M; Yao, Xianglan; Weir, Nargues A; Sampson, Maureen L; Stylianou, Mario; Choy, David F; Holweg, Cecile T J; Remaley, Alan T; Levine, Stewart J

    2017-08-01

    Blood eosinophil counts and serum periostin levels are biomarkers of type 2 inflammation. Although serum levels of HDL and apoA-I have been associated with less severe airflow obstruction in asthma, it is not known whether serum lipids or lipoprotein particles are correlated with type 2 inflammation in asthmatics. Here, we assessed whether serum lipids and lipoproteins correlated with blood eosinophil counts or serum periostin levels in 165 atopic asthmatics and 163 nonasthmatic subjects with and without atopy. Serum lipids and lipoproteins were quantified using standard laboratory assays and NMR spectroscopy. Absolute blood eosinophils were quantified by complete blood counts. Periostin levels were measured using the Elecsys® periostin assay. In atopic asthmatics, blood eosinophils negatively correlated with serum HDL cholesterol and total HDL particles measured by NMR spectroscopy (HDLNMR). Serum periostin levels negatively correlated with total HDLNMR In contrast, blood eosinophil counts positively correlated with serum triglyceride levels. This study demonstrates for the first time that HDL particles were negatively correlated, whereas serum triglycerides were positively correlated, with blood eosinophils in atopic asthmatics. This supports the concept that serum levels of HDL and triglycerides may be linked to systemic type 2 inflammation in atopic asthma. Copyright © 2017 by the American Society for Biochemistry and Molecular Biology, Inc.

  20. 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…

  1. Uncoordinated production of Laminin-5 chains in airways epithelium of allergic asthmatics

    Directory of Open Access Journals (Sweden)

    Virtanen Ismo

    2005-09-01

    Full Text Available Abstract Background Laminins are a group of proteins largely responsible for the anchorage of cells to basement membranes. We hypothesized that altered Laminin chain production in the bronchial mucosa might explain the phenomenon of epithelial cell shedding in asthma. The aim was to characterize the presence of Laminin chains in the SEBM and epithelium in allergic and non-allergic asthmatics. Patients and methods Biopsies were taken from the bronchi of 11 patients with allergic and 9 patients with non-allergic asthma and from 7 controls and stained with antibodies against the Laminin (ln chains alpha1-alpha5, beta1-beta2 and gamma1-gamma2. Results Lns-2,-5 and -10 were the main Laminins of SEBM. The layer of ln-10 was thicker in the two asthmatic groups while an increased thickness of lns-2 and -5 was only seen in allergic asthmatics. The ln gamma2-chain, which is only found in ln 5, was exclusively expressed in epithelial cells in association with epithelial injury and in the columnar epithelium of allergic asthmatics. Conclusion The uncoordinated production of chains of ln-5 in allergic asthma could have a bearing on the poor epithelial cell anchorage in these patients.

  2. Designing and Implementing a Clinician Workstation

    Science.gov (United States)

    Tape, Thomas G.; Campbell, James R.

    1993-01-01

    We describe a simple approach to designing and quickly implementing a clinician workstation that helps practitioners access a variety of information resources. Using easy-to-use graphical tools, we installed a pilot workstation in our clinics. We were able to accommodate most of our users' needs and have a functional workstation installed in two months. This is the first step of an evolutionary process moving from separate tasks to full application integration.

  3. 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

  4. Intuitive information technology: enhancing clinician efficiency.

    Science.gov (United States)

    Procuniar, Molly; Murphy, Sue

    2008-11-06

    Although medical technology is making great strides in improved diagnosis and treatment, the technologies used to document, communicate, and manage those activities are limiting its progress by converting clinicians into computer operators. In an environment of nurse and doctor shortages, reducing their efficiency is counter productive. Technology in healthcare that does not serve patients by improving cost, quality, or care delivery is technology that serves no purpose. Requiring clinicians to chart away from the bedside using technologies that do not feel intuitive, such as keyboarding and mouse use reduces efficiency of workflow, impedes direct care, and increases the cost of training. Intuitive forms of technology such as surface technology, voice activated charting, or digital pens, if embraced, could cause significant changes in healthcare workflows. Clinicians could be more focused on direct care and less utilized in clerical activity. The time it takes to access information could be decreased exponentially--and the opportunities to interact with that information would present a nearly endless horizon. This impact would be especially crucial in high acuity areas and emergency patient care situations. In short, technology should embrace familiar, natural movements and develop intuitive interfaces to improve effectiveness in the healthcare market of the future.

  5. Senior Clinician | Center for Cancer Research

    Science.gov (United States)

    The Center for Cancer Research (CCR), NCI, NIH, HHS is seeking to fill several Senior Clinician positions with outstanding oncologists with research experience and expertise in one of the following areas:  1) genitourinary malignancies, 2) thoracic malignancies; 3) gastrointestinal malignancies; 4) lymphomas; 5) pediatric cancers; or 6) genetic tumor predisposition syndromes. These positions are located at the NIH campus in Bethesda, Maryland. The NIH Clinical Center is the world’s largest research hospital which offers state-of-the-art facilities, collaborative opportunities, and core facilities for advanced technologies.  The Senior Clinician will have available resources including funding for clinical trials, nurse practitioners, research nurses, and patient care coordinators.  In addition, the senior clinician will have access to a robust clinical trials infrastructure including data management, training, protocol support office, regulatory support, information systems and technology, and data safety monitoring.  The CCR’s collaborative culture also offers research staff access to a wide array of intellectual and technological assets, including high-quality technology cores dedicated to pharmacokinetics/pharmacodynamics, protein chemistry, natural products chemistry, biophysics, mass spectrometry, imaging, microscopy, proteomics and genomics, bioinformatics/biostatistics, and flow cytometry.  For an overview of CCR, please visit http://ccr.cancer.gov/.  For more information contact Lori Holliday at hollidal@mail.nih.gov.

  6. Oxygen and pulse oximetry in childhood pneumonia: surveys of clinicians and student clinicians in Cambodia.

    Science.gov (United States)

    Ginsburg, Amy Sarah; Gerth-Guyette, Emily; Mollis, Brenda; Gardner, Michelle; Chham, Samnang

    2014-05-01

    To better understand the availability of oxygen and pulse oximetry, barriers to use, clinician perceptions and practices regarding their role in the management of childhood pneumonia, and the formal education and training regarding these technologies received by student clinicians in Cambodia. In the clinician survey, we surveyed 81 clinicians practising at all national paediatric, provincial and district referral hospitals throughout Cambodia. Respondents were primarily physicians whose scope of practice included paediatrics, and most reported the presence of oxygen (93% (95% confidence interval (CI) [87, 98])) but less availability of pulse oximetry (51% (95% CI [39, 61])). Common barriers to use included a lack of policies and guidelines, as well as a lack of training. In the student clinician survey, 332 graduating medical and nursing students were surveyed, and most reported learning about oxygen (96% (95% CI [94, 98])) and pulse oximetry (72% (95% CI [67, 77])) during their training. Data from both surveys indicate that despite their utility, oxygen and pulse oximetry may be underused in Cambodia. The reported barriers and perceptions of the tools indicate a clear role for improved training for clinicians and students on the use of oxygen and pulse oximetry, the value of oxygen and pulse oximetry for managing childhood pneumonia, and the need for improved policies and guidelines governing their use. © 2014 John Wiley & Sons Ltd.

  7. 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

  8. Moving Triadic Gaze Intervention into Practice: Measuring Clinician Attitude and Implementation Fidelity

    Science.gov (United States)

    Feuerstein, Julie; Olswang, Lesley B.; Greenslade, Kathryn; Pinder, Gay Lloyd; Dowden, Patricia; Madden, Jodi

    2017-01-01

    Purpose: This research investigated a first step in implementing the dynamic assessment (DA) component of Triadic Gaze Intervention (Olswang, Feuerstein, Pinder, & Dowden, 2013; Olswang et al., 2014), an evidence-based protocol for teaching early signals of communication to young children with physical disabilities. Clinician attitudes about…

  9. Vicarious Trauma: A Comparison of Clinicians Who Treat Survivors of Sexual Abuse and Sexual Offenders

    Science.gov (United States)

    Way, Ineke; VanDeusen, Karen M.; Martin, Gail; Applegate, Brooks; Jandle, Deborah

    2004-01-01

    This study compared vicarious trauma in a random sample of male and female clinicians who treat survivors (n=95) and those who treat offenders (n=252). A national survey was conducted with members of the Association for the Treatment of Sexual Abusers (ATSA) and the American Professional Society on the Abuse of Children (APSAC). These data were…

  10. Cigarette smoke causes caspase-independent apoptosis of bronchial epithelial cells from asthmatic donors.

    Directory of Open Access Journals (Sweden)

    Fabio Bucchieri

    Full Text Available Epidemiologic studies have demonstrated important links between air pollution and asthma. Amongst these pollutants, environmental cigarette smoke is a risk factor both for asthma pathogenesis and exacerbation. As the barrier to the inhaled environment, the bronchial epithelium is a key structure that is exposed to cigarette smoke.Since primary bronchial epithelial cells (PBECs from asthmatic donors are more susceptible to oxidant-induced apoptosis, we hypothesized that they would be susceptible to cigarette smoke-induced cell death.PBECs from normal and asthmatic donors were exposed to cigarette smoke extract (CSE; cell survival and apoptosis were assessed by fluorescence-activated cell sorting, and protective effects of antioxidants evaluated. The mechanism of cell death was evaluated using caspase inhibitors and immunofluorescent staining for apoptosis-inducing factor (AIF.Exposure of PBEC cultures to CSE resulted in a dose-dependent increase in cell death. At 20% CSE, PBECs from asthmatic donors exhibited significantly more apoptosis than cells from non-asthmatic controls. Reduced glutathione (GSH, but not ascorbic acid (AA, protected against CSE-induced apoptosis. To investigate mechanisms of CSE-induced apoptosis, caspase-3 or -9 inhibitors were tested, but these failed to prevent apoptosis; in contrast, CSE promoted nuclear translocation of AIF from the mitochondria. GSH reduced the number of nuclear-AIF positive cells whereas AA was ineffective.Our results show that PBECs from asthmatic donors are more susceptible to CSE-induced apoptosis. This response involves AIF, which has been implicated in DNA damage and ROS-mediated cell-death. Epithelial susceptibility to CSE may contribute to the impact of environmental tobacco smoke in asthma.

  11. 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 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.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.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.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.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.

  12. Infection with human rhinovirus 16 promotes enhanced IgE responsiveness in basophils of atopic asthmatics.

    Science.gov (United States)

    Agrawal, R; Wisniewski, J; Yu, M D; Kennedy, J L; Platts-Mills, T; Heymann, P W; Woodfolk, J A

    2014-10-01

    Rhinovirus and IgE act in concert to promote asthma exacerbations. While basophils are the principal cell type in the blood that is activated by IgE, their role in virus-induced asthma episodes remains elusive. To monitor IgE responsiveness in circulating basophils of rhinovirus-infected atopic asthmatics during acute infection and convalescence. The capacity for basophils to respond to IgE was assessed by testing the effects of allergen, or cross-linking anti-FcεRI and anti-IgE antibodies, on surface TSLP receptor in 24-hour PBMC cultures. Activation profiles of basophils from atopic asthmatics challenged intranasally with human rhinovirus 16 were monitored directly ex vivo or else in 24-hour cultures, at baseline (day 0), and then at days 4 and 21 post-challenge. Basophils in atopic asthmatics, but not in non-atopic controls, upregulated TSLP receptor upon IgE receptor ligation. The magnitude of this response was correlated with the proportion of serum total IgE that was allergen-specific (r = 0.615, P rhinovirus infection, all subjects developed nasal symptoms that peaked 3-5 days after viral challenge. Basophils displayed maximal IgE responsiveness 3 weeks post-challenge as judged by TSLP receptor levels in 24-hour cultures. No significant change in total IgE or specific IgE antibodies was detected during rhinovirus infection. By contrast, levels of IgE receptor-associated spleen tyrosine kinase, Syk, were increased on day 4 (P rhinovirus infection in atopic asthmatics. This observation, coupled with increased expression of Syk, implicates basophils in promoting, or else prolonging, rhinovirus-induced inflammation in atopic asthmatics. © 2014 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Davidsen, Jesper Rømhild; Søndergaard, Jens; Hallas, Jesper; Siersted, Hans Christian; Knudsen, Thomas Bøllingtoft; Lykkegaard, Jesper; Andersen, Morten

    2011-05-01

    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 time. We extracted data on prescription drug use, education, and income in 97 665 users of anti-asthmatic drugs, aged 18-44 years, identified in Statistics Denmark during 1997-2005. Individual information on education and income was used as measures of SES. Education was categorised into basic school/high school, vocational training, and higher education, and income was categorised into low, middle, and high income. Associations between ICS use and SES were estimated by logistic regression models. High levels of education and income were independently associated with ICS use, education demonstrating the strongest association. Using basic school/high school and low income as baselines, the adjusted odds ratios (ORs) of ICS use for higher education were 1.46 (95% CI 1.40-1.51) and 1.10 (95% CI 1.06-1.14) for high income. Higher education was a nearly constant factor associated with ICS use throughout the observation period, but high income did not demonstrate any association before 2001 with increasing ORs observed each year hereafter. All associations became more pronounced when restricting to 35-44 year-olds. High levels of SES were positively associated with ICS 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. Copyright © 2010 Elsevier Ltd. All rights reserved.

  14. The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects.

    Science.gov (United States)

    Goldstein, Nira A; Aronin, Charlotte; Kantrowitz, Beth; Hershcopf, Ronald; Fishkin, Sherry; Lee, Haesoon; Weaver, Diana E; Yip, Candice; Liaw, Christine; Saadia, Tehila A; Abramowitz, Jason; Weedon, Jeremy

    2015-11-01

    To determine the prevalence of sleep-disordered breathing (SDB) in children with asthma compared to non-asthmatic children and to determine if behavior problems are associated with asthma and SDB. Cross-Sectional. Parents of 263 children with asthma and 266 controls ages 2 to 15 years attending routine pediatric office visits completed the Pediatric Sleep Questionnaire (PSQ) and the Child Behavior Checklist. Asthma severity was classified based on NIH guidelines. The prevalence of snoring was significantly higher in asthmatic children (35.5%) than controls (15.7%) and the prevalence of a positive PSQ was significantly higher in asthmatic children (25.9%) than controls (10.6%) (P < 0.001 for both). The effect of asthma was "dose-dependent" as children with more severe asthma had increased odds ratios for snoring and a positive PSQ. On multivariate analysis, there were significant interactions of gender with asthma and age with gender. A positive modified PSQ along with measures of socioeconomic status and age were the only independent predictors of abnormal Child Behavior Checklist scores and score classifications. There was a higher prevalence of SDB in asthmatic children compared to non-asthmatic children and the prevalence of SDB increased with increasing asthma severity. In multivariate analysis the role of asthma was much less clear as it predicted a positive PSQ in girls but not boys. SDB, but not asthma, was an independent predictor of behavioral problems. © 2014 Wiley Periodicals, Inc.

  15. Effect of montelukast on excessive airway narrowing response to methacholine in adult asthmatic patients not on controller therapy

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Diamant, Zuzana

    2009-01-01

    -response plateau to Mtc in adult asthmatic patients not on controller therapy, and, hence, protects against excessive airway narrowing. Thirty-one asthmatic patients (13 male patients, 18-50 years old; forced expiratory volume in 1 second [FEV(1)], >70% predicted; PD(20), ... of treatment with Mont neither induced a plateau response nor affected maximum FEV(1) response or PD(20). Our findings, therefore, suggest that monotherapy with a LTRA does not protect against excessive airway narrowing in adult asthmatic patients not on inhaled corticosteroids....

  16. There are more asthmatics in homes with high cockroach infestation

    Directory of Open Access Journals (Sweden)

    Sarinho E.

    2004-01-01

    Full Text Available Although asthma has been commonly associated with sensitivity to cockroaches, a clear causal relationship between asthma, allergy to cockroaches and exposure levels has not been extensively investigated. The objective of the present study was to determine whether asthma occurs more frequently in children living in homes with high cockroach infestation. The intensity of household infestation was assessed by the number of dead insects after professional pesticide application. Children living in these houses in the metropolitan area of Recife, PE, were diagnosed as having asthma by means of a questionnaire based on the ISAAC study. All children had physician-diagnosed asthma and at least one acute exacerbation in the past year. Children of both sexes aged 4 to 12 years who had been living in the households for more than 2 years participated in this transverse study and had a good socioeconomic status. In the 172 houses studied, 79 children were considered to have been exposed to cockroaches and 93 not to have been exposed. Children living in residences with more than 5 dead cockroaches after pesticide application were considered to be at high infestation exposure. Asthma was diagnosed by the questionnaire in 31.6% (25/79 of the exposed group and in 11.8% (11/93 of the non-exposed group (P = 0.001, with a prevalence ratio of 3.45 (95%CI, 1.48-8.20. The present results indicate that exposure to cockroaches was significantly associated with asthma among the children studied and can be considered a risk factor for the disease. Blattella germanica and Periplaneta americana were the species found in 96% of the infested houses.

  17. Cost-effectiveness of a nurse-led telemonitoring intervention based on peak expiratory flow measurements in asthmatics: results of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Wouters Emiel FM

    2007-07-01

    Full Text Available Abstract Background Asthma is a chronic lung disease in which recurrent asthma symptoms create a substantial burden to individuals and their families. At the same time the economic burden associated with asthma is considerable. Methods The cost-effectiveness study was part of a single centre prospective randomised controlled trial comparing a nurse-led telemonitoring programme to usual care in a population of asthmatic outpatients. The study included 109 asthmatic outpatients (56 children; 53 adults. The duration of follow-up was 12 months, and measurements were performed at baseline, 4, 8, and 12 months. Patients were asked to transfer their monitor data at least twice daily and by judging the received data and following a stepwise intervention protocol a nurse was able to act as the main caregiver in the intervention group. In both groups the EQ-5D and the SF-6D were used to obtain estimates of health state utilities. One year health care costs, patient and family costs, and productivity losses were calculated. The mean incremental costs were weighted against the mean incremental effect in terms of QALY. Results The study population generally represented mild to moderate asthmatics. No significant differences were found between the groups with regard to the generic quality of life. Overall, the mean health care costs per patient were higher in the intervention group than in the control group. The intervention costs mainly caused the cost difference between the groups. The intervention costs the society € 31,035/QALY gained with regard to adults and with regard to children € 59,071/QALY gained. Conclusion If the outcome is measured by generic quality of life the nurse-led telemonitoring programme is of limited cost-effectiveness in the study population. From the societal perspective the probability of the programme being cost-effective compared to regular care was 85% at a ceiling ratio of € 80,000/QALY gained among the adults and 68

  18. Dental caries in 3-12-year-old Sudanese children with bronchial asthma

    OpenAIRE

    Sara Mohamed Hamid; Fatima Elkhadir Elhassan; Awatif Hassan

    2015-01-01

    Background: There is a lack of consensus regarding the relationship between the risk of dental caries and asthma in the child population. Most studies concluded that asthmatic children are at risk of dental caries from the disease status or its pharmacotherapy. The objectives of this study werer to assess the dental caries status of asthmatic patients in the age group of 3-14 years and to examine the possible association of these conditions to various aspects of bronchial asthma and its manag...

  19. Accuracy of rapid disposition by emergency clinicians.

    Science.gov (United States)

    Backay, Andrew; Bystrzycki, Adam; Smit, De Villiers; Keogh, Martin; O'Reilly, Gerard; Mitra, Biswadev

    2017-05-01

    Objectives Rapid disposition protocols are increasingly being considered for implementation in emergency departments (EDs). Among patients presenting to an adult tertiary referral hospital, this study aimed to compare prediction accuracy of a rapid disposition decision at the conclusion of history and examination, compared with disposition following standard assessment. Methods Prospective observational data were collected for 1 month between October and November 2012. Emergency clinicians (including physicians, registrars, hospital medical officers, interns and nurse practitioners) filled out a questionnaire within 5min of obtaining a history and clinical examination for eligible patients. Predicted patient disposition (representing 'rapid disposition') was compared with final disposition (determined by 'standard assessment'). Results There were 301 patient episodes included in the study. Predicted disposition was correct in 249 (82.7%, 95% confidence interval (CI) 78.0-86.8) cases. Accuracy of predicting discharge to home appeared highest among emergency physicians at 95.8% (95% CI 78.9-99.9). Overall accuracy at predicting admission was 79.7% (95% CI 67.2-89.0). The remaining 20.3% (95% CI 11.0-32.8) were not admitted following standard assessment. Conclusion Rapid disposition by ED clinicians can predict patient destination accurately but was associated with a potential increase in admission rates. Any model of care using rapid disposition decision making should involve establishment of inpatient systems for further assessment, and a culture of timely inpatient team transfer of patients to the most appropriate treating team for ongoing patient management. What is known about the topic? In response to the National Emergency Access Targets, there has been widespread adoption of rapid-disposition-themed care models across Australia. Although there is emerging data that clinicians can predict disposition accurately, this data is currently limited. What does this

  20. CHEST: Home of the Clinician-Educator.

    Science.gov (United States)

    Kelly, William F; Niven, Alexander S

    2017-11-28

    Many hands can build a house; it takes trust to make that house a home. Trust has two main components: credibility (worthiness based on preparation and past performance) and empathy (the ability to understand and share another person's values). CHEST has maintained its credibility and empathy as the global leader in clinical pulmonary, critical care, and sleep medical education. It follows that the leader in chest clinical education would also be the home of the clinician-educator. You are that educator. Published by Elsevier Inc.

  1. Prevalence and pattern of asthma exacerbation in children seen at ...

    African Journals Online (AJOL)

    Background: Acute exacerbation is a major cause of morbidity in asthmatic children. It can occur even in well controlled asthma. Aim: To determine the prevalence and pattern of acute exacerbation of asthma in children seen at the emergency room of the University of Nigeria Teaching Hospital (UNTH), Enugu. Materials ...

  2. Academic examinations significantly impact immune responses, but not lung function, in healthy and well-managed asthmatic adolescents.

    Science.gov (United States)

    Kang, D H; Coe, C L; McCarthy, D O

    1996-06-01

    The influence of academic examinations on immunity and lung function was investigated in 64 adolescents to determine if stress-related changes would differ between healthy and asthmatic students. Blood samples were collected on three occasions: 1 month prior, during, and 2-3 weeks after exams. Leukocyte subsets were enumerated, and in vitro assays were conducted to assess lymphocyte proliferative and cytolytic responses and neutrophil production of superoxides. Examinations elicited significant changes in several lymphocyte subsets and marked alterations in the three functional measures in all students. However, the magnitude and pattern of change did not differ between healthy and asthmatic students. Similarly, neither mild nor more severe asthmatics showed an exam-related decrement in lung function, as reflected by peak expiratory flow rate. This research validated that examinations are a salient cause of altered immune responses, but indicates that there is not a concomitant aggravation of inflammatory disease in well-managed asthmatics.

  3. Bradykinin-induced asthmatic fibroblast/myofibroblast activities via bradykinin B2 receptor and different MAPK pathways

    NARCIS (Netherlands)

    Sabatini, Federica; Luppi, Fabrizio; Petecchia, Loredana; Stefano, Antonino Di; Longo, Anna M.; Eva, Alessandra; Vanni, Cristina; Hiemstra, Pieter S.; Sterk, Peter J.; Sorbello, Valentina; Fabbri, Leonardo M.; Rossi, Giovanni A.; Ricciardolo, Fabio L. M.

    2013-01-01

    Bradykinin drives normal lung fibroblasts into myofibroblasts, induces fibroblast proliferation and activates mitogen activated protein kinase pathways (MAPK) but its effects on bronchial fibroblasts from asthmatics (HBAFb) have not been yet studied. We studied bradykinin-induced fibroblast

  4. 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 ...

  5. Do clinicians use more question marks?

    Science.gov (United States)

    Zijlmans, Maeike; Otte, Willem M; Van't Klooster, Maryse A; van Diessen, Eric; Leijten, Frans Ss; Sander, Josemir W

    2015-05-01

    To quantify the use of question marks in titles of published studies. Literature review. 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. Total number of question marks in titles. 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 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.

  6. Do clinical guidelines reduce clinician dependent costs?

    Science.gov (United States)

    Kosimbei, George; Hanson, Kara; English, Mike

    2011-06-16

    Clinician dependent costs are the costs of care that are under the discretion of the healthcare provider. These costs include the costs of drugs, tests and investigations, and discretionary outpatient visits and impatient stays. The purpose of this review was to summarize recent evidence, relevant to both developed and developing countries on whether evidence based clinical guidelines can change hospitals variable costs which are clinician dependent, and the degree of financial savings achieved at hospital level. Potential studies for inclusion were identified using structured searches of Econlit, J-Stor, and Pubmed databases. Two reviewers independently evaluated retrieved studies for inclusion. The methodological quality of the selected articles was assessed using the Oxford Centre for Evidence- Based Medicine (CEBM) levels of evidence. The results suggest that 10 of the 11 interventions were successful reducing financial costs. Most of the interventions, either in modeling studies or real interventions generate significant financial saving, although the former reported higher savings because the studies assumed 100 percent compliance.

  7. Clinicians' perceptions of pharmacogenomics use in psychiatry.

    Science.gov (United States)

    Chan, Christopher Yi Wen; Chua, Boon Yiang; Subramaniam, Mythily; Suen, Emily Liew Kai; Lee, Jimmy

    2017-04-01

    This study aims to assess the attitudes and opinions of clinicians practicing in psychiatry toward pharmacogenomic testing, and in so doing elicits possible barriers and risks to employ this technology in patient care. Doctors and pharmacists presently practicing in psychiatry were invited to participate in an anonymous web-based survey. Besides information on participant characteristics and experience in psychiatry, specific themes on pharmacogenomics including self-assessed competency, perceived usefulness in clinical situations, perceived risks and preferred mode of education were evaluated. A total of 81% of respondents believed that pharmacogenomic testing would be useful for identifying suitable treatments and 71% believed that pharmacogenomic testing would be useful for medication intolerance. However, only 46.4% felt competent to order these tests. There were significant differences in responses for gender, doctors versus pharmacists and seniority in position. A total of 94.3% of respondents were concerned about costs and 84.5% were concerned about the lack of clear guidelines on its use. A total of 98.5% of respondents were keen on learning more about the applicability of pharmacogenomics, and the most preferred format of education was a lecture (44.5%). Most clinicians acknowledge the potential of pharmacogenomic testing in clinical practice. However, concerns with regard to its cost-effectiveness and the lack of clear guidelines are possible barriers to its clinical implementation.

  8. Examining agreement between clinicians when assessing sick children.

    Directory of Open Access Journals (Sweden)

    John Wagai

    Full Text Available BACKGROUND: Case management guidelines use a limited set of clinical features to guide assessment and treatment for common childhood diseases in poor countries. Using video records of clinical signs we assessed agreement among experts and assessed whether Kenyan health workers could identify signs defined by expert consensus. METHODOLOGY: 104 videos representing 11 clinical sign categories were presented to experts using a web questionnaire. Proportionate agreement and agreement beyond chance were calculated using kappa and the AC1 statistic. 31 videos were selected and presented to local health workers, 20 for which experts had demonstrated clear agreement and 11 for which experts could not demonstrate agreement. PRINCIPAL FINDINGS: Experts reached very high level of chance adjusted agreement for some videos while for a few videos no agreement beyond chance was found. Where experts agreed Kenyan hospital staff of all cadres recognised signs with high mean sensitivity and specificity (sensitivity: 0.897-0.975, specificity: 0.813-0.894; years of experience, gender and hospital had no influence on mean sensitivity or specificity. Local health workers did not agree on videos where experts had low or no agreement. Results of different agreement statistics for multiple observers, the AC1 and Fleiss' kappa, differ across the range of proportionate agreement. CONCLUSION: Videos provide a useful means to test agreement amongst geographically diverse groups of health workers. Kenyan health workers are in agreement with experts where clinical signs are clear-cut supporting the potential value of assessment and management guidelines. However, clinical signs are not always clear-cut. Video recordings offer one means to help standardise interpretation of clinical signs.

  9. Impact of different combinations of inhaled corticosteroids and long-acting sympathicomimetics on dental health of asthmatics.

    OpenAIRE

    George Christoff; Emilia Karova

    2012-01-01

    The aim of the investigation is to study the effect of inhaled corticosteroids and long-acting sympathicomimetics on dental health in asthmatics. Thirty patients, from 20 to 55 years old, participate in the study. D-, M-, F- and DMFT indexes are determined in a 6 months period. All participants fill in a questionnaire. Asthmatics complain most frequently from oral dryness, take frequently sugar and soft drinks and visit irregularly dental practitioners. A significant increase in M-index is fo...

  10. Expression of activated Fc gamma RII discriminates between multiple granulocyte-priming phenotypes in peripheral blood of allergic asthmatic subjects.

    Science.gov (United States)

    Kanters, Deon; ten Hove, Willem; Luijk, Bart; van Aalst, Corneli; Schweizer, René C; Lammers, Jan-Willem J; Leufkens, Hubert G M; Raaijmakers, Jan A M; Bracke, Madelon; Koenderman, Leo

    2007-11-01

    Allergic asthma is associated with chronic airway and systemic immune responses. Systemic responses include priming of peripheral blood eosinophils, which is enhanced after allergen challenge. In a subpopulation of asthmatic subjects, neutrophils are associated with bronchial inflammation. We sought to monitor systemic granulocyte priming in allergic asthmatic subjects as a consequence of chronic and acute inflammatory signals initiated by allergen challenge. Blood was taken at baseline and 6 to 24 hours after allergen challenge in asthmatic subjects with and without late asthmatic responses. Systemic granulocyte priming was studied by using expression of cellular markers, such as alpha-chain of Mac-1 (alpha m)/CD11b, L-selectin/CD62L, and an activation epitope present on Fc gamma RII/CD32 recognized by monoclonal phage antibody A17. Eosinophils of asthmatic subjects have a primed phenotype identified by cell-surface markers. Neutrophils of these patients were subtly primed, which was only identified after activation with N-formyl-methionyl-leucyl-phenylalanine. After allergen challenge, an acute increase in eosinophil priming characterized by enhanced expression of activated Fc gamma RII was found in patients experiencing a late asthmatic response and not in patients with a single early asthmatic response. In contrast, expression of alpha m/CD11b and L-selectin on granulocytes was not different between control and asthmatic subjects and was not affected by allergen challenge. Interestingly, expression of both adhesion molecules was positively correlated, and alpha m expression on eosinophils and neutrophils correlated positively with bronchial hyperresponsiveness. Different phases, phenotypes, or both of allergic asthma are associated with distinct priming profiles of inflammatory cells in peripheral blood. Insight in differences of systemic innate responses will lead to better definition of asthma subtypes and to better designs of new therapeutic options.

  11. Alterations in vasodilator-stimulated phosphoprotein (VASP phosphorylation: associations with asthmatic phenotype, airway inflammation and β2-agonist use

    Directory of Open Access Journals (Sweden)

    Cirelli Rosemary

    2006-02-01

    Full Text Available Abstract Background Vasodilator-stimulated phosphoprotein (VASP mediates focal adhesion, actin filament binding and polymerization in a variety of cells, thereby inhibiting cell movement. Phosphorylation of VASP via cAMP and cGMP dependent protein kinases releases this "brake" on cell motility. Thus, phosphorylation of VASP may be necessary for epithelial cell repair of damage from allergen-induced inflammation. Two hypotheses were examined: (1 injury from segmental allergen challenge increases VASP phosphorylation in airway epithelium in asthmatic but not nonasthmatic normal subjects, (2 regular in vivo β2-agonist use increases VASP phosphorylation in asthmatic epithelium, altering cell adhesion. Methods Bronchial epithelium was obtained from asthmatic and non-asthmatic normal subjects before and after segmental allergen challenge, and after regularly inhaled albuterol, in three separate protocols. VASP phosphorylation was examined in Western blots of epithelial samples. DNA was obtained for β2-adrenergic receptor haplotype determination. Results Although VASP phosphorylation increased, it was not significantly greater after allergen challenge in asthmatics or normals. However, VASP phosphorylation in epithelium of nonasthmatic normal subjects was double that observed in asthmatic subjects, both at baseline and after challenge. Regularly inhaled albuterol significantly increased VASP phosphorylation in asthmatic subjects in both unchallenged and antigen challenged lung segment epithelium. There was also a significant increase in epithelial cells in the bronchoalveolar lavage of the unchallenged lung segment after regular inhalation of albuterol but not of placebo. The haplotypes of the β2-adrenergic receptor did not appear to associate with increased or decreased phosphorylation of VASP. Conclusion Decreased VASP phosphorylation was observed in epithelial cells of asthmatics compared to nonasthmatic normals, despite response to

  12. Do Clinician Disruptive Behaviors Make an Unsafe Environment for Patients?

    Science.gov (United States)

    Dang, Deborah; Bae, Sung-Heui; Karlowicz, Karen A; Kim, Miyong T

    2016-01-01

    The magnitude of negative consequences of clinician disruptive behaviors on patients and clinicians was examined using data collected from 1559 clinicians working at an urban academic medical center in the United States. For the impact of disruptive behavior on patient safety, psychological aggression as caused by disruptive behavior or incivility increased the likelihood of patient harm as well as job dissatisfaction and physical symptoms.

  13. 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

  14. Mechanisms of Change in the ARC Organizational Strategy: Increasing Mental Health Clinicians' EBP Adoption Through Improved Organizational Culture and Capacity.

    Science.gov (United States)

    Williams, Nathaniel J; Glisson, Charles; Hemmelgarn, Anthony; Green, Philip

    2017-03-01

    The development of efficient and scalable implementation strategies in mental health is restricted by poor understanding of the change mechanisms that increase clinicians' evidence-based practice (EBP) adoption. This study tests the cross-level change mechanisms that link an empirically-supported organizational strategy for supporting implementation (labeled ARC for Availability, Responsiveness, and Continuity) to mental health clinicians' EBP adoption and use. Four hundred seventy-five mental health clinicians in 14 children's mental health agencies were randomly assigned to the ARC intervention or a control condition. Measures of organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers were collected before, during, and upon completion of the three-year ARC intervention. EBP adoption and use were assessed at 12-month follow-up. Multilevel mediation analyses tested changes in organizational culture, clinicians' intentions to adopt EBPs, and job-related EBP barriers as linking mechanisms explaining the effects of ARC on clinicians' EBP adoption and use. ARC increased clinicians' EBP adoption (OR = 3.19, p = .003) and use (81 vs. 56 %, d = .79, p = .003) at 12-month follow-up. These effects were mediated by improvement in organizational proficiency culture leading to increased clinician intentions to adopt EBPs and by reduced job-related EBP barriers. A combined mediation analysis indicated the organizational culture-EBP intentions mechanism was the primary carrier of ARC's effects on clinicians' EBP adoption and use. ARC increases clinicians' EBP adoption and use by creating proficient organizational cultures that increase clinicians' intentions to adopt EBPs.

  15. IgG and IgE antibodies to Chironomidae in asthmatic patients.

    Science.gov (United States)

    Yamashita, N; Ito, K; Nakagawa, T; Haida, M; Okudaira, H; Nakada, S; Miyamoto, T; Shibuya, T; Kamei, K; Sasa, M

    1987-01-01

    IgG antibodies to Chironomidae and its correlations to radioallergosorbent and skin reactions were examined with the aim of clarifying the relationship between asthma and Chironomidae. The level of specific IgG antibody in asthmatic patients (0.698 +/- 0.034, n = 104) was significantly greater than that in normal subjects (0.367 +/- 0.032, n = 52) (P less than 0.01). The specific IgG level was not correlated to skin reaction, nor to IgE RAST scores. Specific IgG1 and IgG4 levels in asthmatic patients were significantly greater than in control subjects (n = 14) (P less than 0.01). Images Fig. 5 PMID:3652516

  16. 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.

  17. Differing response of asthmatics to sulfur dioxide exposure with continuous and intermittent exercise

    Energy Technology Data Exchange (ETDEWEB)

    Kehrl, H.R.; Roger, L.J.; Hazucha, M.J.; Horstman, D.H.

    1986-08-29

    Ten mild asthmatics were initially exposed in an environmental chamber (26 C, 70% RH) to clean air and 1.0 ppm sulfur dioxide while performing three sets of 10 minutes treadmill exercise (ventilation = 41 1/min) and 15 minutes rest. To evaluate the effects of the pattern and duration of exercise on the response to sulfur dioxide exposure, the subjects were then exposed to the same environmental conditions, while exercising continuously for 30 minutes. Specific airways resistance (SRaw) was measured by body plethysmography prior to exposures and after each exercise. All SRaw responses with sulfur dioxide exposure were significantly different than the clean air responses. It appears that asthmatics show an attenuated response to repetitive exercise in a 1.00 ppm sulfur dioxide atmosphere and that the response to sulfur dioxide exposure develops rapidly and is maintained during 30 minutes continuous exercise.

  18. Eosinophilic airway inflammation in asthmatic patients is associated with an altered airway microbiome

    DEFF Research Database (Denmark)

    Sverrild, Asger; Kiilerich, Pia; Brejnrod, Asker Daniel

    2017-01-01

    BACKGROUND: Asthmatic patients have higher microbiome diversity and an altered composition, with more Proteobacteria and less Bacteroidetes compared with healthy control subjects. Studies comparing airway inflammation and the airway microbiome are sparse, especially in subjects not receiving anti......-inflammatory treatment. OBJECTIVE: We sought to describe the relationship between the airway microbiome and patterns of airway inflammation in steroid-free patients with asthma and healthy control subjects. METHODS: Bronchoalveolar lavage fluid was collected from 23 steroid-free nonsmoking patients with asthma and 10...... of eosinophilic airway inflammation correlates with variations in the microbiome across asthmatic patients, whereas neutrophilic airway inflammation does not. This warrants further investigation on molecular pathways involved in both patients with eosinophilic and those with noneosinophilic asthma....

  19. Oral health and habits in children with asthma related to severity and duration of condition.

    Science.gov (United States)

    Eloot, A K; Vanobbergen, J N; De Baets, F; Martens, L C

    2004-12-01

    This study was designed to examine the oral health status of asthmatic children and to compare the oral health condition and habits of different groups of asthmatic children. 140 asthmatic children were involved in the present study. Of those, 30 were younger than 7 years of age, 73 were between 7 and 12, 37 were older than 12. Dental caries was scored according to the guidelines of the BASCD. No radiographs were taken. The gingival health and the amount of plaque were assessed using the bleeding index described by Mühleman and Son [1971] and the plaque index of Silness and Löe [1964] respectively. To differentiate between the asthmatic children three explanatory variables were used: the time the asthmatic symptoms had lasted, the exposure time to the medication and the severity of the asthmatic condition. Finally the parents and children were asked to fill in a questionnaire referring to oral health habits. The mean dmft was 1.99 (SD+/-2.74) and the mean DMFT was 1.10 (SD+/-1.98). Non-parametric correlation and multiple logistic regression analyses showed no significant difference between the caries (dmft/s, DMFT/S), the gingival health (bleeding index) and plaque indices and the three explanatory variables. The impact of possible compensatory factors as oral hygiene and dietary habits was of no significant importance. This analysis revealed that neither the period (of the disease and the medication) nor the severity of the asthma had a significant influence on the risk of caries and gingivitis in asthmatic children. No reported oral health and dietary habits could explain this lack of correlation.

  20. [Agreement in asthmatics' perception of dyspnea during acute and chronic obstruction].

    Science.gov (United States)

    Martínez-Moragón, E; Perpiñá, M; Belloch, A; de Diego, A; Martínez-Francés, M E

    2005-07-01

    Three types of asthmatic patients can be identified during periods of clinical stability: "poor perceivers," "normal perceivers," and "over perceivers." When asthmatics undergo bronchial challenge in the laboratory, the same distinctions in type of perception can be observed. The aim of the present study was to determine the level of agreement between the 2 situations. A total of 93 patients with persistent moderate asthma (36 men and 57 women; mean age 40 years) were studied. We asked them to assess their dyspnea on a modified Borg scale when stable and after each histamine dose in a bronchial provocation test. When a patient's Borg scale assessment in stable situation was below the 25th percentile, that patient was classified as a poor perceiver. Patients were considered over perceivers if their score in stable situation was in the 75th percentile. Others were labeled normal perceivers. Type of perception during acute bronchoconstriction was defined in function of the change in Borg assessment once forced expiratory volume in the first second had decreased 20%: poor perceivers were those whose change in Borg assessment was in the 25th percentile, over perceivers were in the 75th percentile, and normal perceivers in the middle percentiles. In stable situation, 23 patients were poor perceivers, 58 were normal perceivers, and 12 were over perceivers. During bronchoconstriction, there were 23 poor perceivers, 47 normal perceivers, and 23 over perceivers. Agreement was estimated by a kappa index of 0.0574 for poor perception, 0.1521 for over perception, and 0.3980 for normal perception. Asthmatics' perception of dyspnea during periods of stability and during acute bronchoconstriction are independent phenomena. It is therefore not possible to infer how a patient will perceive an asthmatic attack by evaluating only how he or she perceives breathlessness during stable periods.

  1. Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America

    Science.gov (United States)

    Cherrez, Annia; Ramón, Germán Darío; Lopez Jove, Orlando; Baptist, Alan; Matos, Edgar; Morfín Maciel, Blanca; Calero, Erick; Sanchez-Borges, Mario; Cherrez, Sofia; Simancas-Racines, Daniel

    2017-01-01

    Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%). The most used ICT was the short message service (SMS) (69.9%). SMS and E-mail are useful tools for communicating (i.e. receiving and seeking information) with all asthma patients, irrespective of their age. WhatsApp (61.5%) and Facebook (32.0%) were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient. PMID:28717641

  2. 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...

  3. Stereoselective total synthesis of the potent anti-asthmatic compound CMI-977 (LDP-977)

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    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)

  4. Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America.

    Science.gov (United States)

    Calderón, Juan; Cherrez, Annia; Ramón, Germán Darío; Lopez Jove, Orlando; Baptist, Alan; Matos, Edgar; Morfín Maciel, Blanca; Calero, Erick; Sanchez-Borges, Mario; Cherrez, Sofia; Simancas-Racines, Daniel; Cherrez Ojeda, Ivan

    2017-07-01

    Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs) make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%). The most used ICT was the short message service (SMS) (69.9%). SMS and E-mail are useful tools for communicating ( i.e. receiving and seeking information) with all asthma patients, irrespective of their age. WhatsApp (61.5%) and Facebook (32.0%) were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient.

  5. Effects of Immunoglobulin Replacement on Asthma Exacerbation in Adult Asthmatics with IgG Subclass Deficiency.

    Science.gov (United States)

    Kim, Joo Hee; Ye, Young Min; Ban, Ga Young; Shin, Yoo Seob; Lee, Hyun Young; Nam, Young Hee; Lee, Soo Keol; Cho, You Sook; Jang, Seung Hun; Jung, Ki Suck; Park, Hae Sim

    2017-11-01

    Recurrent respiratory tract infection is a common manifestation of primary immunodeficiency disease, and respiratory viruses or bacteria are important triggers of asthma exacerbations. Asthma often coexists with humoral immunodeficiency in adults, and some asthmatics with immunoglobulin (Ig) G subclass deficiency (IgGSCD) suffer from recurrent exacerbations. Although some studies suggest a benefit from Ig replacement, others have failed to support its use. This study aimed to assess the effect of Ig replacement on asthma exacerbation caused by respiratory infection as well as the asthma control status of adult asthmatics with IgGSCD. This is a multi-center, open-label study of adult asthmatics with IgGSCD. All patients received monthly intravenous immunoglobulin (IVIG) for 6 months and were evaluated regarding asthma exacerbation related to infection, asthma control status, quality of life, and lung function before and after IVIG infusion. A total of 30 patients were enrolled, and 24 completed the study. Most of the patients had a moderate degree of asthma severity with partly (52%) or uncontrolled (41%) status at baseline. IVIG significantly reduced the proportion of patients with asthma exacerbations, lowered the number of respiratory infections, and improved asthma control status, compared to the baseline values (P<0.001). The mean asthma-specific quality of life and asthma control test scores were improved significantly (P=0.009 and P=0.053, respectively); however, there were no significant changes in lung function. IVIG reduced the frequency of asthma exacerbations and improved asthma control status in adult asthmatics with IgGSCD, suggesting that IVIG could be an effective treatment option in this population.

  6. Network analysis of quantitative proteomics on asthmatic bronchi: effects of inhaled glucocorticoid treatment

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    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

  7. Cardiorespiratory and sensory responses to exercise in well-controlled asthmatics.

    Science.gov (United States)

    Cortés-Télles, Arturo; Torre-Bouscoulet, Luis; Mejía-Alfaro, Roberto; Silva-Cerón, Monica; Wilkie, Sabrina S; Guenette, Jordan A

    2015-01-01

    The purpose of this study was to evaluate detailed ventilatory, cardiovascular and sensory responses to cycle exercise in sedentary patients with well-controlled asthma and healthy controls. Subjects included sedentary patients meeting criteria for well-controlled asthma (n = 14), and healthy age- and activity-matched controls (n = 14). Visit 1 included screening for eligibility, medical history, anthropometrics, physical activity assessment, and pre- and post-bronchodilator spirometry. Visit 2 included spirometry and a symptom limited incremental cycle exercise test. Detailed ventilatory, cardiovascular and sensory responses were measured at rest and throughout exercise. Asthmatics and controls were well matched for age, body mass index and physical activity levels. Baseline forced expiratory volume in 1 second (FEV(1)) was similar between asthmatics and controls (98 ± 10 versus 95 ± 9% predicted, respectively, p > 0.05). No significant differences were observed between asthmatics and controls for maximal oxygen uptake (31.8 ± 5.6 versus 30.6 ± 5.9 ml/kg/min, respectively, p > 0.05) and power output (134 ± 35 versus 144 ± 32 W, respectively, p > 0.05). Minute ventilation (V(E)) relative to maximum voluntary ventilation (V(E)/MVV) was similar between groups at maximal exercise with no subjects showing evidence of ventilatory limitation. Asthmatics and controls achieved similar age-predicted maximum heart rates (92 ± 7 versus 93 ± 8% predicted, respectively, p > 0.05). Ratings of perceived breathing discomfort and leg fatigue were not different between groups throughout exercise. The results of this study indicate that sedentary patients with well-controlled asthma have preserved sensory and cardiorespiratory responses to exercise with no evidence of exercise impairment or ventilatory limitation.

  8. Information and communication technology use in asthmatic patients: a cross-sectional study in Latin America

    Directory of Open Access Journals (Sweden)

    Juan Calderón

    2017-07-01

    Full Text Available Rapid diffusion, low cost and broad availability of information and communication technologies (ICTs make them an attractive platform for managing care, communication and interventions in asthma. There is little information in Latin America about usage frequency of ICTs in asthmatic patients. The analysis undertaken consisted of an observational, cross-sectional study that aimed to identify the frequency and type of ICTs most often used by asthmatics. The Spanish version of the Michigan questionnaire was employed in five Latin American countries. Age and educational level was categorised. Logistic regression was performed among these groups concerning the frequency of ICT usage and the level of interest shown in seeking and receiving information about asthma. In total, 673 asthma patients were surveyed. The mean age was 43.44 years. Over two-thirds of the participants were female (68.4%. The most used ICT was the short message service (SMS (69.9%. SMS and E-mail are useful tools for communicating (i.e. receiving and seeking information with all asthma patients, irrespective of their age. WhatsApp (61.5% and Facebook (32.0% were rated as being the most interesting channels of communication for receiving information. Regression analysis showed that younger asthmatics and asthmatics with higher educational levels were most likely to use almost all forms of ICTs. ICTs are generally an attractive platform for managing care, communication and interventions to improve asthma care. SMS and E-mail were found to be the preferred ICT forms among users. However, social media forms such as WhatsApp and Facebook may also be appropriate for certain types of patient.

  9. 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.

  10. Ethical issues in sexual misconduct by clinicians.

    Science.gov (United States)

    Gutheil, T G

    1994-01-01

    Sexual misconduct by clinicians in the form of sexual relations with patients has long been recognized as an ethics violation and an activity suitable for assessment by the ethics committees of institutions and local and national professional organizations. The issue can be examined from the vantage point of several types of duties which bear ethical implications; these ethical duties proceed from the following four notions in this area: Sexual misconduct represents a violation of professional ethics as a fiduciary breach, abuse of a power asymmetry, exploitation of vulnerability and use of undue influence. While objections to these criteria may be raised in terms of freedom of association and consent, the violation of ethical principles by sexual misconduct remains clear.

  11. The making of expert clinicians: reflective practice.

    Science.gov (United States)

    Maestre, J M; Szyld, D; Del Moral, I; Ortiz, G; Rudolph, J W

    2014-05-01

    Debriefing is a rigorous reflection process which helps trainees recognize and resolve clinical and behavioral dilemmas raised by a clinical case. This approach emphasizes eliciting trainees'assumptions about the situation and their reasons for performing as they did (mental models). It analyses their impact on actions, to understand if it is necessary to maintain them or construct new ones that may lead to better performance in the future. It blends evidence and theory from education research, the social and cognitive sciences, and experience drawn from conducting and teaching debriefing to clinicians worldwide, on how to improve professional effectiveness through "reflective practice". Copyright © 2013 Elsevier España, S.L. All rights reserved.

  12. Artificial intelligence: the clinician of the future.

    Science.gov (United States)

    Gallagher, S M

    2001-09-01

    Human beings have long been fascinated with the idea of artificial intelligence. This fascination is fueled by popular films such as Stanley Kubrick's 2001: A Space Odyssey and Stephen Spielberg's recent film, AI. However intriguing artificial intelligence may be, Hubert and Spencer Dreyfus contend that qualities exist that are uniquely human--the qualities thought to be inaccessible to the computer "mind." Patricia Benner further investigated the qualities that guide clinicians in making decisions and assessments that are not entirely evidence-based or grounded in scientific data. Perhaps it is the intuitive nature of the human being that separates us from the machine. The state of artificial intelligence is described herein, along with a discussion of computerized clinical decision-making and the role of the human being in these decisions.

  13. [Leadership and management courses for clinicians].

    Science.gov (United States)

    Wichelhaus, Daniel; Fischer, Peter

    2017-08-01

    The aim of the present study was to evaluate the benefit of Leadership and Management Courses for clinicians, specifically which leadership and management contents are beneficial to their daily clinical work and whether these contents support their individual career. E-mail invitations to participate in the study were sent to all 543 medical doctors of the University Hospital Hanover, Germany, who had taken part in one of the leadership and management courses offered between June 2005 and June 2015. The enquiry was carried out between June 1 and June 30, 2015. 84 e-mail addresses were no longer active; and so, N=459 clinicians actually received the invitation. Of these, 104 participated (22.7%). The study included 59 items. Six were free text items, twelve items were closed questions which could be answered by choosing from a drop down menu, and 41 were answered on a Likert scale from 0 (not fitting at all) to 10 (perfect fit). Based on the items answered on a Likert scale, the following scales and mean values were deduced: Job Satisfaction (M=7.44); Leadership (M=7.77); Trust (M=7.22); Striving for Power (M=7,45); negative Affect (M=4,91); Target Achievement Motivation (M=8.19); Communication (M=8.30) and Management (M=6.48). Regression analysis showed that Job- and Team Satisfaction can predict to what extent the participants regard themselves as good leaders. The study participants defined the following topics as very important: leadership and management style, managerial functions, team management, human resources development and project management. Further topics included rhetoric skills, presentation techniques, as well as basic economics such as understanding balance sheets, profit & loss statements and contribution margin calculation. 55% of the course contents were described as being directly applicable to their daily working environment. In the clinicians' view, the ideal leader acts as a role model (passing on values like respect, appreciation, honesty

  14. Bayes’ Rule for Clinicians: An Introduction

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    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.

  15. Oral health in preschool children with asthma.

    Science.gov (United States)

    Stensson, Malin; Wendt, Lill-Kari; Koch, Göran; Oldaeus, Göran; Birkhed, Dowen

    2008-07-01

    The aim of this study was to investigate oral health and its determinants in 3-year-old and 6-year-old children with asthma. Caries and gingivitis were examined in 127 asthmatic (all children with asthma in a selected area and born during a specific time period) and 117 matched, healthy control children. The parents were interviewed regarding various oral-health-related factors. The mean dfs (+/- standard deviation) in the 3-year-old with asthma was 1.4 +/- 3.2 compared with 0.5 +/- 1.2 in the controls (P gingival bleeding than the healthy controls (P gingivitis in the 6-year-old children. Asthmatic children reported higher consumption of sugar-containing drinks and were more frequently mouthbreathers than healthy children (P asthma and immigrant background, the mean dfs was higher compared with immigrant children in the control group (P asthma have higher caries prevalence than healthy children. The factors discriminating for caries in asthmatic children are higher intake of sugary drinks, mouth breathing, and immigrant background.

  16. Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

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    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

  17. 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.

  18. The asthmatic athlete: inhaled Beta-2 agonists, sport performance, and doping.

    Science.gov (United States)

    McKenzie, Donald C; Fitch, Kenneth D

    2011-01-01

    The asthmatic athlete has a long history in competitive sport in terms of success in performance and issues related to doping. Well documented are detailed objective tests used to evaluate the athlete with symptoms of asthma or airway hyperresponsiveness and the medical management. Initiated at the 2002 Salt Lake City Games, the International Olympic Committee's Independent Asthma Panel required testing to justify the use of inhaled beta-2 agonists (IBAs) in Olympic athletes and has provided valuable guidelines to the practicing physician. This program was educational and documented the variability in prevalence of asthma and/or airway hyperresponsiveness and IBA use between different sports and different countries. It provided a standard of care for the athlete with respiratory symptoms and led to the discovery that asthmatic Olympic athletes outperformed their peers at both Summer and Winter Olympic Games from 2002 to 2010. Changes to the World Anti-Doping Agency's Prohibited List in 2010 permitted the use of 2 IBA produced by the same pharmaceutical company. All others remain prohibited. However, there is no pharmacological difference between the permitted and prohibited IBAs. As a result of these changes, asthmatic athletes are being managed differently based on a World Anti-Doping Agency directive that has no foundation in pharmacological science or in clinical practice.

  19. TO STUDY THE EFFECTIVENESS OF BUTEYKO BREATHING TECHNIQUE VERSUS DIAPHRAGMATIC BREATHING IN ASTHMATICS

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    Gauri Mayank Afle

    2014-08-01

    Full Text Available Background:Asthma is one of the most common chronic diseases in the world. It is estimated that around 300 million people in the world currently have asthma In Asthmatics dysfunctional breathing pattern is common. Breathing pattern is the basis of abnormal patterns in asthma. The purpose of this study was to find out the effectiveness of Buteyko breathing technique versus diaphragmatic breathing in asthmatics. Methods: 46 patients with asthma aged 20-65 years were taken. The duration of the study was 2 weeks & data was collected on day zero and at the end of 2nd week. The subjects were divided into two groups A & B 23 patients of asthma in each group were distributed by convenient sampling. Each subject was assessed according to FEV1, FEV1/FVC and PEFR Statistics were applied by using SPSS 11. Results: Results were calculated by using 0.05 level of significance. On the basis of above statistical analysis the p value for group A is less than 0.05. So the intervention on group A is effective than intervention on group B. Conclusion: So Buteyko breathing technique proves to be more effective than diaphragmatic breathing technique in asthmatics.

  20. Atividade mioelétrica dos músculos respiratórios em crianças asmáticas durante manobra inspiratória máxima Myoelectrical activity of the respiratory muscles in asthmatic children during the maximum inspiratory maneuver

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    Maria do Socorro Brasileiro-Santos

    2012-09-01

    Full Text Available OBJETIVOS: avaliar a atividade dos músculos escalenos e esternocleidomastóideo (ETMD no período basal e durante manobra de pressão inspiratória máxima (PImax em crianças asmáticas. MÉTODOS: foram estudadas 15 crianças, divididas em grupo asma (n=8 e grupo controle (n=7. Foi realizada a análise da função pulmonar e da PImax através da espirometria e da manovacuometria, respectivamente. A atividade mioelétrica dos músculos escaleno e ETMD foram realizadas pela eletromiografia de superfície durante período basal e manobra de PImax. RESULTADOS: a eletromiografia de superfície (EMGs basal do músculo escaleno é maior no grupo asma quando comparado ao grupo controle. Diferentemente, a EMGs basal do músculo ETMD não apresentou diferença significativa nos grupos estudados. O percentual da EMGs dos músculos escaleno e ETMD durante manobra de PImax foi maior no grupo asma quando comparado ao grupo controle. CONCLUSÕES: EMGs do escaleno durante o período basal está aumentada em crianças asmáticas. A atividade eletromiográfica do músculo ETMD no período basal é similar em ambos os grupos estudados. A EMGs dos músculos ETMD e escaleno na geração de pressão intratorácica, durante a manobra de PImax, está aumentada em crianças asmáticas.OBJECTIVES: to evaluate the activity of the scalene and sternocleidomastoid muscles at the baseline and during the maximum inspiratory pressure maneuver (PImax in children with asthma. METHODS: fifteen children were divided into an asthma (n=8 and a control group (n=7. Lung functioning was investigated and the PImax using spirometry and manovacometry respectively. The myoelectrical activity of the scalene and sternocleidomastoid muscles was measured using surface electromyography at the baseline and during the PImax maneuver. RESULTS: the baseline surface electromyography for the scalene muscle was greater in the asthma group than in the control. However, the base surface

  1. Roles of Clinician, Patient, and Community Characteristics in the Management of Pediatric Upper Respiratory Tract Infections.

    Science.gov (United States)

    Yaeger, Jeffrey P; Temte, Jonathan L; Hanrahan, Lawrence P; Martinez-Donate, P

    2015-11-01

    Prior studies have evaluated factors predictive of inappropriate antibiotic prescription for upper respiratory tract infections (URIs). Community factors, however, have not been examined. The aim of this study was to evaluate the roles of patient, clinician, and community factors in predicting appropriate management of URIs in children. We used a novel database exchange, linking electronic health record data with community statistics, to identify all patients aged 3 months to 18 years in whom URI was diagnosed in the period from 2007 to 2012. We followed the Healthcare Effectiveness Data and Information Set (HEDIS) quality measurement titled "Appropriate treatment for children with upper respiratory infection" to determine the rate of appropriate management of URIs. We then stratified data across individual and community characteristics and used multiple logistic regression modeling to identify variables that independently predicted antibiotic prescription. Of 20,581 patients, the overall rate for appropriate management for URI was 93.5%. Family medicine clinicians (AOR = 1.5; 95% CI 1.31, 1.71; reference = pediatric clinicians), urgent care clinicians (AOR = 2.23; 95% CI 1.93, 2.57; reference = pediatric clinicians), patients aged 12 to 18 years (AOR = 1.44; 95% CI 1.25, 1.67; reference = age 3 months to 4 years), and patients of white race/ ethnicity (AOR = 1.83; 95% CI 1.41, 2.37; reference = black non-Hispanic) were independently predictive of antibiotic prescription. No community factors were independently predictive of antibiotic prescription. Results correlate with prior studies in which non-pediatric clinicians and white race/ethnicity were predictive of antibiotic prescription, while association with older patient age has not been previously reported. Findings illustrate the promise of linking electronic health records with community data to evaluate health care disparities. © 2015 Annals of Family Medicine, Inc.

  2. 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.

  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. Evaluation of correlation between airway and serum inflammatory markers in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Abolhasan Halvani

    2012-01-01

    Full Text Available Context: Asthma is one of the most common chronic diseases all over the world, resulting from a state of persistent sub-acute inflammation of the airways. Beside local inflammation, systemic inflammation is also present, which can be shown by increased levels of C-reactive protein (CRP. One of the most important cells in this disease is eosinophil, and sputum eosinophilia is used for its diagnosis. Aims: The purpose of the present study was to compare and evaluate the correlation between CRP level and sputum eosinophilia in asthmatic and control subjects. Materials and Methods: A total of 61 patients suffering from mild-to-moderate asthma participated in this study. They were divided into two groups based on whether they used inhaled steroid or not. Sputum was induced by ultrasonic nebulizer, and then samples of peripheral venous blood were collected to measure peripheral cell count and CRP by Enzyme-linked immunosorbent assay (ELISA. Thirty-seven healthy subjects were selected and their blood samples were taken. Thirty-seven healthy subjects were selected and their blood samples were taken. Results: Thirty asthmatic patients in user group (14 females/16 males with the mean age of 39.4±9.37 years, 31 asthmatic patients in non-user group (13 females/18 males with the mean age of 35.5±8.87 years, and 37 healthy controls (17 females/20 males were included in our study. The mean serum concentration of CRP was 2.6 μg/mL, 3.32 μg/mL, and 1.16 μg/mL in user, non-user, and control groups, respectively. Compared to healthy controls, serum concentrations of high sensitivity-CRP (hs-CRP significantly increased in the non-user group (P=0.0001, and user group as well. (P=0.016. The number of sputum eosinophils and peripheral blood eosinophils significantly increased in the non-users compared to the healthy controls (P=0.0001, P=0.003, respectively. In the non-user group, serum hs-CRP levels correlated negatively with FEV 1 and positively with numbers of

  5. Academic Performance of Primary School Children with Asthma

    OpenAIRE

    Nduagubam OC; Oguonu TA; Ojinnaka N; Ibekwe RC

    2017-01-01

    The academic performance of children with asthma may differ from that of their non-asthmatic colleagues. Reports on the academic performance of children with asthma are limited and the findings are inconsistent. The academic performance of children with asthma in Enugu, Nigeria is determined in this study. Children with asthma aged 5 and ndash;11 years were recruited consecutively at the weekly asthma clinic of the University of Nigeria Teaching Hospital (UNTH) Enugu, Nigeria. Their age-, sex...

  6. 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.

  7. Corticosteroid therapy and airflow obstruction influence the bronchial microbiome, which is distinct from that of bronchoalveolar lavage in asthmatic airways

    Energy Technology Data Exchange (ETDEWEB)

    Denner, Darcy R.; Sangwan, Naseer; Becker, Julia B.; Hogarth, D. Kyle; Oldham, Justin; Castillo, Jamee; Sperling, Anne I.; Solway, Julian; Naureckas, Edward T.; Gilbert, Jack A.; White, Steven R.

    2016-05-01

    The lung has a diverse microbiome that is modest in biomass. This microbiome differs in asthmatic patients compared with control subjects, but the effects of clinical characteristics on the microbial community composition and structure are not clear. OBJECTIVES: We examined whether the composition and structure of the lower airway microbiome correlated with clinical characteristics of chronic persistent asthma, including airflow obstruction, use of corticosteroid medications, and presence of airway eosinophilia. METHODS: DNA was extracted from endobronchial brushings and bronchoalveolar lavage fluid collected from 39 asthmatic patients and 19 control subjects, along with negative control samples. 16S rRNA V4 amplicon sequencing was used to compare the relative abundance of bacterial genera with clinical characteristics. RESULTS: Differential feature selection analysis revealed significant differences in microbial diversity between brush and lavage samples from asthmatic patients and control subjects. Lactobacillus, Pseudomonas, and Rickettsia species were significantly enriched in samples from asthmatic patients, whereas Prevotella, Streptococcus, and Veillonella species were enriched in brush samples from control subjects. Generalized linear models on brush samples demonstrated oral corticosteroid use as an important factor affecting the relative abundance of the taxa that were significantly enriched in asthmatic patients. In addition, bacterial α-diversity in brush samples from asthmatic patients was correlated with FEV1 and the proportion of lavage eosinophils. CONCLUSION: The diversity and composition of the bronchial airway microbiome of asthmatic patients is distinct from that of nonasthmatic control subjects and influenced by worsening airflow obstruction and corticosteroid use. Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  8. Rhinovirus-induced alterations on peripheral blood mononuclear cell phenotype and costimulatory molecule expression in normal and atopic asthmatic subjects.

    Science.gov (United States)

    Papadopoulos, N G; Stanciu, L A; Papi, A; Holgate, S T; Johnston, S L

    2002-04-01

    Rhinovirus (RV) infection is the commonest trigger of acute asthma exacerbations; however, the immune response to these viruses and any potential implications in the mechanisms leading to asthma exacerbations are not well understood. To assess the effects of in vitro RV infection on the phenotype and expression of costimulatory molecules on peripheral blood mononuclear cells (PBMC) from normal and atopic asthmatic subjects, as a model for RV antigen presentation. PBMC from seven normal and seven asthmatic subjects were exposed to one infectious unit/cell of RV16 for 48 h. Surface expression of CD25, CD28, CD40, CD54, CD80, CD86 and CTLA-4 was evaluated on CD3, CD4, CD8, CD14 and CD19 PBMC subpopulations by three-colour flow cytometry. No changes in the percentage of CD3, CD4, CD8 or CD19 were observed. CD14 was significantly reduced by the infection and this was more pronounced in normal subjects. On Th cells CTLA-4 was increased after RV infection only in the asthmatic group. Levels of CD80 and CD86 in the control cultures were lower in the asthmatic group. RV infection induced a significant increase of CD80 on monocytes and of CD86 on B cells, which occurred in both groups but were less marked in atopic asthmatic subjects. Exposure of PBMC to RV is able to activate the antigen presentation machinery. Differences between normal and atopic asthmatic individuals are compatible with the hypothesis that an aberrant immune response to RV may be involved in the development of acute exacerbations in atopic asthmatic subjects.

  9. Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants

    Science.gov (United States)

    2009-01-01

    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 Mexico City. PMID:20003306

  10. 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

  11. 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

  12. Lipid profiles in children with and without asthma: interaction of asthma and obesity on hyperlipidemia.

    Science.gov (United States)

    Chen, Yang Ching; Tung, Kuan Yen; Tsai, Ching Hui; Su, Ming Wei; Wang, Pei Chuan; Chen, Chien Han; Lee, Yungling Leo

    2013-01-01

    The joint effect of obesity and asthma on hyperlipidemia has never been explored. We aim to examine (1) the association of dyslipidemia and asthma, (2) the interaction effect of asthma and obesity on hyperlipidemia, and (3) whether a gender difference existed in the above relationships. Between 2009 and 2010, 10- to 15-year-old children were recruited from 7 schools and 2 hospitals in Northern Taiwan. The population consisted of 237 asthmatic children and 225 non-asthmatic controls, and was further divided into four groups: non-obese controls, obese controls, non-obese asthmatics, and obese asthmatics. Measurements included anthropometric measures and blood samples for analysis of metabolic factors. The Cook's criteria were used to define childhood metabolic syndrome. General linear models were used to analyze how lipid profiles were associated with obesity and asthma. Total cholesterol and low density lipoprotein cholesterol levels increased progressively in the group order obese asthmatics>non-obese asthmatics>obese controls>non-obese controls. In boys, low density lipoprotein cholesterol levels were significantly higher in obese asthmatics compared to obese non-asthmatics, with a mean difference of 6.2 mmol/L in the general linear model. We also discovered a significant interactive effect of obesity and asthma on hyperlipidemia in boys (p for interaction=0.03). Asthma was associated with higher low density lipoprotein cholesterol levels and this association was amplified in overweight and obese subjects. A gender difference was observed in the joint effect of obesity and asthma on hyperlipidemia. Copyright © 2013 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  13. Asthma and obesity in children: current evidence and potential systems biology approaches.

    Science.gov (United States)

    Frey, U; Latzin, P; Usemann, J; Maccora, J; Zumsteg, U; Kriemler, S

    2015-01-01

    Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Bioethics for clinicians: 27. Catholic bioethics

    Science.gov (United States)

    Markwell, Hazel J.; Brown, Barry F.

    2001-01-01

    THERE IS A LONG TRADITION OF BIOETHICAL REASONING within the Roman Catholic faith, a tradition expressed in scripture, the writings of the Doctors of the Church, papal encyclical documents and reflections by contemporary Catholic theologians. Catholic bioethics is concerned with a broad range of issues, including social justice and the right to health care, the duty to preserve life and the limits of that duty, the ethics of human reproduction and end-of-life decisions. Fundamental to Catholic bioethics is a belief in the sanctity of life and a metaphysical conception of the person as a composite of body and soul. Although there is considerable consensus among Catholic thinkers, differences in philosophical approach have given rise to some diversity of opinion with respect to specific issues. Given the influential history of Catholic reflection on ethical matters,