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Sample records for asthmatic children clinicians

  1. Quality of care of Egyptian asthmatic children: Clinicians adherence to asthma guidelines

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    Salama Ashraf A

    2010-04-01

    Full Text Available Abstract Background Despite the development and dissemination of guidelines for the diagnosis and management of asthma, a gap remains between current recommendations and actual practice. Objectives To assess the physicians attitude towards asthma guidelines and their adherence to its recommendations. Methods Three hundred and fifty two clinicians (101 General practitioners, 131 pediatric specialists, 35 pediatric consultants and 85 doctors did not report the qualification engaged in direct childhood asthma care in Cairo, Egypt were subjected to a self-administered questionnaire with 35 questions of which most were multiple choices, aiming at assessment of three important aspects about the involved physicians; physician's knowledge, practice and attitude. 165 of the clinicians were working in governmental hospitals, 68 clinicians work in private clinics and 119 clinicians work in both. Results Agreement with asthma guidelines was present in 76.2% of the studied physicians, however those who not in agreement with the guidelines claimed that this was mainly due to patient factors, firstly the poor socioeconomic standard of the patient (18.1% and secondly due to poor patient compliance (16%. Poor knowledge was found in 28.5%, poor practice was found in 43.6% and poor attitude was found in 14.4% of the studied physicians. There was positive highly significant correlation between qualification and knowledge, (p Conclusion The attitude of the studied physicians revealed agreement of their majority with the guidelines, while the disagreement was mainly explained by the poor socioeconomic standard of the patients. The degree of poor practice is more marked than that of poor knowledge or poor attitude reflecting resources limitations and applications obstacles in the physician's practice.

  2. Cotinine Levels in Asthmatic Children

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    A Delpisheh

    2005-10-01

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

  3. Plasma diamine oxidase activity in asthmatic children

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    Kyoichiro Toyoshima

    1996-01-01

    Full Text Available Histamine plays an important role in the development of asthmatic symptoms. Diamine oxidase (DAO histaminase, which inactivates histamine, is located in the intestine and kidney and is released into plasma. Plasma DAO activity in asthmatic children was measured by a recently developed high performance liquid chromatographic method using histamine as the DAO substrate. Diamine oxidase activity was higher in severely asthmatic children than in those with mild asthma. A time course study during the acute exacerbation phase revealed that DAO activity rose during acute asthmatic attacks and then decreased gradually over several days. Although the mechanisms of plasma DAO activity increase during acute asthmatic attacks could not be explained, data showed that plasma DAO activity is an important index of histamine metabolism in asthmatics and may relate to some mechanisms of acute exacerbation of airway inflammation. Consequently, fluctuations in plasma DAO can be used as one of various indices of instability in management of asthma.

  4. Change of bronchial hyperresponsiveness in asthmatic children

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    Stojković-Anđelković Anđelka

    2011-01-01

    Full Text Available Introduction. Bronchial hyperresponsiveness (BHR is a factor in predicting bronchial asthma independently of inflammation markers. Objective. The aims were to determine the frequency and important predictive facts of BHR and the effect of prophylaxis by Global Initiative for Asthma (GINA and National Asthma Education and Prevention Program (NAEPP on BHR in asthmatic children. Methods. BHR in 106 children was evaluated by the bronchoprovocation test with methacholine. Results. The prevalence rate of symptomatic BHR is 18% for crucial point of PC20=4.1±3.03 mg/ml and PD20=3.22±2.59 μmol methacholine. On average asthmatic children express moderate BHR, which persists even two years after administering prophylaxis. After two years bronchial reactivity is significantly smaller, the change of FEV1 is significantly smaller, the velocity of change of slope dose response curve (sDRC is faster and the provocative concentration of methacholine that causes wheezing is 2-3 times lower. A mild sDRC shows milder bronchoconstriction after two years. The fast change of bronchial reactivity in 41% of asthmatic children is contributed to aero-pollution with sulfur dioxide and/ or, possible insufficient and/or inadequate treatment during two years of administering prophylaxis. A simultaneous effect of allergens from home environment and grass and tree pollens and of excessive aero-pollution on children’s airways is important in the onset of symptomatic BHR. After two years of treatment by GINA and NAEPP children do not show asthma symptoms or show mild asthma symptoms, however bronchial sensitivity remains unchanged. Conclusion. Optimal duration of anti-inflammatory treatment in asthmatic children who show moderate bronchial hyperresponsiveness should be longer than two years.

  5. Short-term growth in asthmatic children using fluticasone propionate

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    Visser, MJ; van Aalderen, WMC; Elliott, BM; Odink, RJ; Brand, PLP

    1998-01-01

    Background: Inhaled corticosteroids may reduce short-term growth velocity in asthmatic children and knemometry is the most sensitive tool to detect this short-term growth suppression. Study objective: To compare lower leg growth velocity, as measured by knemometry, in asthmatic children during and a

  6. Linear growth in asthmatic children

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    Maria Ângela Reis de Góes Monteiro Antonio

    2003-01-01

    Full Text Available Asthma is the most frequent chronic inflammatory disease in childhood, and its prevalence has increased remarkably over the last decades. Therefore, the scientific community became interested in studying the growth of the affected children. The relationship between asthma and growth suffers the influence of the clinical picture, of therapeutics, but the different study methods make it difficult to distinguish the factors responsible for the growth retardation detected by some authors. This review has the purpose of providing an overall outlook on this matter.

  7. [Acute asthmatic crisis in children].

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    Dubus, J C; Bodiou, A C; Buttin, C; Jouglet, T; Stremler, N; Mély, L

    2000-03-01

    Acute asthma attack in children is an attack responsible for life-threatening acute respiratory distress with partial or no response to bronchodilator drugs. The severity of the episode needs to be quickly evaluated. This presupposes a perfect knowledge of the clinical signs of severity. Treatment is urgent and first based on the administration of high doses of inhaled short-acting beta 2-agonists. In the more obstructed children, anti-cholinergic drugs can be added to nebulized beta 2-agonists. Because of their delayed effect, systemic steroids require an early prescription. Symptomatic treatments are: urgent hospitalization, oxygen if needed, proper hydratation. Continuous nebulization or intravenous perfusion of beta 2-agonists are prescribed with cardiac monitoring when no objective improvement is noted. Admission into the pediatric intensive care unit when bronchial obstruction continues will permit the association of bronchodilator drugs and the proposal of mechanical ventilation if needed. When the episode is resolved, a prophylactic treatment using inhaled corticosteroids must be prescribed. Clinical and spirometric follow-up has to be organized, and the patient and his/her family have to be educated.

  8. Factors influencing mothers' compliance with a medication regimen for asthmatic children.

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    Radius, S M; Becker, M H; Rosenstock, I M; Drachman, R H; Schuberth, K C; Teets, K C

    1978-04-01

    This study lends support to the utility of a compliance-adapted health belief framework for exploring mothers' differential adherence to medication regiments prescribed for their asthmatic children. Most of the Model components behaved as hypothesized in predicting mothers' drug administration. The findings offer empirical evidence which can be applied to the purposes of identifying potential noncompliers and designating those specific, health-related orientations of the mother which are related to poor cooperation with therapy. Based on an educational diagnosis, the clinician may thus intervene to alter inappropriate health beliefs in order to enhance the likelihood of compliance for the asthmatic patient.

  9. Exercise-Induced Asthma in Asthmatic Children of Southern Iran

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    Fayezi, Abbas; Amin, Reza; Kashef, Sara; Yasin, Soheila Al; Bahadoram, Mohammad

    2014-01-01

    Background: Asthma is a common illness, especially among children. Exercise-induced asthma is an important consideration, both as a factor, limiting physical activity of patients, and also as an indicator of poor long term control. We investigated pre-Valence of exercise-induced asthma in a group of asthmatic children living in southern Iran. Methods: We conducted treadmill exercise challenge test in 40 young asthmatic patients aged 6 to 18. After 8 minutes exercise to achieve 80% of maximum ...

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

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

    2016-01-01

    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...

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

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    Magdy M Zedan

    2010-09-01

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

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

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

    2015-08-01

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

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

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

    2014-01-01

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

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

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    Roemer, W.

    1998-01-01

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

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

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    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

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    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. Determinants of lung function and airway hyperresponsiveness in asthmatic children

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

    2007-01-01

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

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

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    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

    The aim of this study was to assess the role of European ambulatory pediatricians in caring for asthmatic children, especially in terms of their therapeutic education. We developed a survey that was observational, declarative, retrospective and anonymous in nature. 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 from persistent asthma, who had been followed for at least 6 months. We considered the pediatricians' profile, and their role in the therapeutic education of children. 277 pediatricians (64%) responded: 81% were primary care pediatricians; 46% participated in networks; 4% had specific training in Therapeutic Patient Education; 69% followed more than 5 asthmatic children per month, and over long periods (7 ± 4 years). The profiles of 684 children were assessed. Answers diverged concerning the provision of a Personalized Action Plan (60-88%), training the child to measure and interpret his Peak Expiratory Flow (31-99%), and the prescription of pulmonary function tests during the follow-up programme of consultations (62-97%). Answers converged on pediatricians' perception of their role in teaching children about their condition and its treatment (99%), about inhalation techniques (96%), and in improving the children's ability to take preventive measures when faced with risk situations (97%). This study highlights the role of European pediatricians in caring for asthmatic children, and their lack of training in Therapeutic Patient Education. Programmes and tools are required in order to train ambulatory pediatricians in Therapeutic Patient Education, and such resources should be integrated into primary health care, and harmonized at the European level.

  19. Susceptibility of asthmatic children to respiratory infection

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    Pereira Júlio C. R.

    1997-01-01

    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.

  20. Adrenal function in asthmatic children treated with inhaled budesonide

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

    1991-01-01

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

  1. Lymphocytes sensitivity to Fas stimulation in healthy and asthmatic children.

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    Katarzyna Gomułka

    2010-05-01

    Full Text Available The T cell hypothesis of asthma is based on the concept that the disease is driven and maintained by the persistence of a specialized subset of chronically activated T memory cells sensitized against an array of allergenic, occupational or viral antigens. Overreaction of CD4+ T cells in the peripheral blood and airway tissues is an invariant feature of asthma; therefore a potent mechanism for augmenting the number of activated T cells in this disease would be the resistance to the normally programmed pathway for cell death. The aim of the study was to evaluate the presence of apoptotic markers on peripheral blood lymphocytes from healthy and asthmatic children before and after stimulation with antiCD95 antibodies. The blood was collected from 21 children with atopic asthma suffering from allergic rhinitis because of house dust mite and/or grass pollen allergens and 8 healthy children matched for their age and sex. Blood was mixed with purified monoclonal antibody antiCD95 (Beckman Coulter, incubated for 24 hours and than stained with Annexin V andPI (Becton Dickinson. Prepared suspensions were analyzed with Cytomics FC 500 (Beckman Coulter flow cytometer. Annexin V(+/PI(- cells were characterized as early apoptotic, Annexin V(+/PI(+ as late apoptotic and Annexin V(-/PI(+ as dead. In unstimulated sample from asthmatic children 21.09+/-11.20% cells were characterized as Annexin V positive/PI negative. After stimulation with antiCD95 Annexin V positive/PI negative cells constituted 18.72+/-9.42% of cells, p=0.1. In unstimulated sample from healthy children 11.69+/-6.70% cells were characterized as Annexin V positive/PI negative. In the sample stimulated with antiCD95 16.54+/-2.98% of cells were Annexin V positive/PI negative, p=0.02. There were no differences between results of late apoptotic and necrotic lymphocytes from healthy and asthmatic children. Performed research indicates that lymphocytes from asthmatic children are resistant to Fas

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

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    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.

  3. Liquid chromatography/mass spectrometry analysis of exhaled leukotriene B4 in asthmatic children

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    Barnes Peter J

    2005-10-01

    Full Text Available Abstract Background The role of leukotriene (LT B4, a potent inflammatory mediator, in atopic asthmatic and atopic nonasthmatic children is largely unknown. The lack of a gold standard technique for measuring LTB4 in exhaled breath condensate (EBC has hampered its quantitative assessment in this biological fluid. We sought to measure LTB4 in EBC in atopic asthmatic children and atopic nonasthmatic children. Exhaled nitric oxide (NO was measured as an independent marker of airway inflammation. Methods Fifteen healthy children, 20 atopic nonasthmatic children, 25 steroid-naïve atopic asthmatic children, and 22 atopic asthmatic children receiving inhaled corticosteroids were studied. The study design was of cross-sectional type. Exhaled LTB4 concentrations were measured using liquid chromatography/mass spectrometry-mass spectrometry (LC/MS/MS with a triple quadrupole mass spectrometer. Exhaled NO was measured by chemiluminescence with a single breath on-line method. LTB4 values were expressed as the total amount (in pg of eicosanoid expired in the 15-minute breath test. Kruskal-Wallis test was used to compare groups. Results Compared with healthy children [87.5 (82.5–102.5 pg, median and interquartile range], exhaled LTB4 was increased in steroid-naïve atopic asthmatic [255.1 (175.0–314.7 pg, p 4 than steroid-naïve asthmatics [125.0 (25.0–245.0 pg vs 255.1 (175.0–314.7 pg, p Conclusion In contrast to exhaled NO concentrations, exhaled LTB4 values are selectively elevated in steroid-naïve atopic asthmatic children, but not in atopic nonasthmatic children. Although placebo control studies are warranted, inhaled corticosteroids seem to reduce exhaled LTB4 in asthmatic children. LC/MS/MS analysis of exhaled LTB4 might provide a non-invasive, sensitive, and quantitative method for airway inflammation assessment in asthmatic children.

  4. Comparison of morning and afternoon exercise training for asthmatic children

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    C.S. Silva

    2006-01-01

    Full Text Available Fitness improvement was used to compare morning with afternoon exercise periods for asthmatic children. Children with persistent moderate asthma (according to GINA criteria, 8 to 11 years old, were divided into 3 groups: morning training group (N = 23, afternoon training group (N = 23, and non-training group (N = 23. The program was based on twice a week 90-min sessions for 4 months. We measured the 9-min running distance, resting heart rate and abdominal muscle strength (sit-up number before and after the training. All children took budesonide, 400 µg/day, and an on demand inhaled ß-agonist. The distance covered in 9 min increased (mean ± SEM from 1344 ± 30 m by 248 ± 30 m for the morning group, from 1327 ± 30 m by 162 ± 20 m for the afternoon group, and from 1310 ± 20 m by 2 ± 20 m for the control group (P 0.05 for morning with afternoon comparison. The reduction of resting heart rate from 83 ± 1, 85 ± 2 and 86 ± 1 bpm was 5.1 ± 0.8 bpm in the morning group, 4.4 ± 0.8 bpm in the afternoon group, and -0.2 ± 0.7 bpm in the control group (P > 0.05 for morning with afternoon comparison and P 0.05 for morning with afternoon comparison and P < 0.05 versus control. No statistically significant differences were detected between the morning and afternoon groups in terms of physical training of asthmatic children.

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

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

    2014-01-01

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

  6. Dysregulation of the stress response in asthmatic children.

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    Priftis, K N; Papadimitriou, A; Nicolaidou, P; Chrousos, G P

    2009-01-01

    The stress system co-ordinates the adaptive responses of the organism to stressors of any kind. Inappropriate responsiveness may account for increased susceptibility to a variety of disorders, including asthma. Accumulated evidence from animal models suggests that exogenously applied stress enhances airway reactivity and increases allergen-induced airway inflammation. This is in agreement with the clinical observation that stressful life events increase the risk of a new asthma attack. Activation of the hypothalamic-pituitary-adrenal (HPA) axis by specific cytokines increases the release of cortisol, which in turn feeds back and suppresses the immune reaction. Data from animal models suggest that inability to increase glucocorticoid production in response to stress is associated with increased airway inflammation with mechanical dysfunction of the lungs. Recently, a growing body of evidence shows that asthmatic subjects who are not treated with inhaled corticosteroids (ICS) are likely to have an attenuated activity and/or responsiveness of their HPA axis. In line with this concept, most asthmatic children demonstrate improved HPA axis responsiveness on conventional doses of ICS, as their airway inflammation subsides. Few patients may experience further deterioration of adrenal function, a phenomenon which may be genetically determined.

  7. HRCT findings of asthmatic children under maintenance therapy

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    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

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

    Science.gov (United States)

    McClafferty, Hilary

    2016-06-01

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

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

    DEFF Research Database (Denmark)

    Lochte, Lene; Angermann, Marie; Larsson, Benny

    2009-01-01

    INTRODUCTION: Predicted aerobic capacity (PAC) was estimated by submaximal exercise test and compared with monitored aerobic capacity (MAC) measured by laboratory conditions [maximal oxygen uptake (VO(2peak))] in 18 children and adolescents, 10 asthmatics and 8 matched controls. Objectives...

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

    Directory of Open Access Journals (Sweden)

    Sara Ehsani

    2013-09-01

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

  11. Evaluation of Right Ventricular Function by Tissue Doppler Echocardiography in Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Mehdi Ghaderian

    2016-11-01

    Full Text Available BackgroundAsthma is the most chronic inflammatory disorder of the airways in children and asthmatic patients can experience cardiac dysfunction, pulmonary hypertension and finally cor pulmonale later in life. We aimed to investigate Right Ventricular (RV functions in asthmatic children by conventional and tissue Doppler echocardiography (TDE.Materials and Methods Pulmonary function tests, conventional and TDE examinations were performed on 42 asthmatic and 42 age- and gender matched healthy controls subjects (n=42.Results Compared with healthy children the RV wall was statistically thicker among asthmatic patients (P= 0.01. Conventional echocardiography had not significant difference between cases and controls, but TDE had significant difference between these two groups. Peak E’ velocity, A’ velocity, E’/A’ ratio and S’ in lateral and medial sites of tricuspid annulus valve, were significantly differ from control group in our patients (P

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

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Arie Kurniasih

    2015-09-01

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

  14. Anti-asthmatic drugs dosage forms in children : a cross-sectional study

    NARCIS (Netherlands)

    Schirm, E; Tobi, H; Gebben, H; de Jong-van den Berg, LTW

    2002-01-01

    Objective: To describe the choice of drugs as well as the dosage forms of anti-asthmatic drugs in children with regard to different age groups. Methods: Cross-sectional study based on computerized pharmacy dispensing records of 1999 for children aged 0-16 years in the north of the Netherlands. All c

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

    DEFF Research Database (Denmark)

    Buchvald, F; Eiberg, H; Bisgaard, H

    2003-01-01

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

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

    Science.gov (United States)

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

    2013-01-01

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

  17. Clinical effectiveness of conventional influenza vaccination in asthmatic children

    NARCIS (Netherlands)

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

    2002-01-01

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

  18. Effects of Cupping Therapy on the Pulmonary Functions in Asthmatic Children

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    @@ Barely using the cupping therapy, we treated 75asthmatic children at the stage of attack in outpatient department of our hospital from February 2001 toOctober 2002 to observe the changes of theirpulmonary functions before and after treatment. Areport follows.

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

    NARCIS (Netherlands)

    Q. Jobsis (Quirijn); H.C. 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 H2O

  20. 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

    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-...

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

    NARCIS (Netherlands)

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

    2008-01-01

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

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

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

    OpenAIRE

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

    1991-01-01

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

  4. Homes of low-income minority families with asthmatic children have increased condition issues.

    Science.gov (United States)

    Pacheco, Christina M; Ciaccio, Christina E; Nazir, Niaman; Daley, Christine M; DiDonna, Anita; Choi, Won S; Barnes, Charles S; Rosenwasser, Lanny J

    2014-01-01

    The home is increasingly associated with asthma. It acts both as a reservoir of asthma triggers and as a refuge from seasonal outdoor allergen exposure. Racial/ethnic minority families with low incomes tend to reside in neighborhoods with low housing quality. These families also have higher rates of asthma. This study explores the hypothesis that black and Latino urban households with asthmatic children experienced more home mechanical, structural condition-related areas of concern than white households with asthmatic children. Participant families (n = 140) took part in the Kansas City Safe and Healthy Homes Program, had at least one asthmatic child, and met income qualifications of no more than 80% of local median income; many were below 50%. Families self-identified their race. Homes were assessed by environmental health professionals using a standard set of criteria and a specific set of on-site and laboratory sampling and analyses. Homes were given a score for areas of concern between 0 (best) and 53 (worst). The study population self-identified as black (46%), non-Latino white (26%), Latino (14.3%), and other (12.9%). Mean number of areas of concern were 18.7 in Latino homes, 17.8 in black homes, 13.3 in other homes, and 13.2 in white homes. Latino and black homes had significantly more areas of concern. White families were also more likely to be in the upper portion of the income. In this set of 140 low-income homes with an asthmatic child, households of minority individuals had more areas of condition concerns and generally lower income than other families.

  5. Flunisolide Decreases Exhaled Nitric Oxide and Nitrotyrosine Levels in Asthmatic Children

    Science.gov (United States)

    Bodini, A.; Peroni, D. G.; Zardini, F.; Corradi, M.; Alinovi, R.; Boner, A. L.; Piacentini, G. L.

    2006-01-01

    Background. Exhaled nitric oxide (FeNO) has been reported to be elevated in the oxidative stress involved in asthmatic patients, and the reaction of nitric oxide (NO) with superoxide anions results in the formation of nitrotyrosine. The purpose of this study was to investigate the effect of inhaled steroid treatment on nitrotyrosine levels collected by exhaled breath condensate (EBC) and on FeNO. Methods. This was a single-blind placebo-controlled study. The lung function, FeNO, and nitrotyrosine levels were evaluated in 10 asthmatic children. Results. The nitrotyrosine levels were stable during the placebo period (T0 = 1.16 ng/ml versus T1 = 1.05 ng/ml; NS.), whereas they decreased after the treatment with flunisolide (T2 = 1.14 ng/ml versus T3 = 0.88 ng/ml; P < .001). No significant reduction in FeNO levels was observed after placebo treatment (T0 = 38.4 ppb versus T1 = 34.7 ppb, NS.). In contrast, FeNO values decreased significantly being at T3 = 14.9 ppb (T1 versus T3; P = .024). Conclusions. This study shows that corticosteroid treatment reduces nitrotyrosine levels in EBC of asthmatic subjects. PMID:17047290

  6. Distinct Metabolic Profile of Inhaled Budesonide and Salbutamol in Asthmatic Children during Acute Exacerbation.

    Science.gov (United States)

    Quan-Jun, Yang; Jian-Ping, Zhang; Jian-Hua, Zhang; Yong-Long, Han; Bo, Xin; Jing-Xian, Zhang; Bona, Dai; Yuan, Zhang; Cheng, Guo

    2017-03-01

    Inhaled budesonide and salbutamol represent the most important and frequently used drugs in asthmatic children during acute exacerbation. However, there is still no consensus about their resulting metabolic derangements; thus, this study was conducted to determine the distinct metabolic profiles of these two drugs. A total of 69 children with asthma during acute exacerbation were included, and their serum and urine were investigated using high-resolution nuclear magnetic resonance (NMR). A metabolomics analysis was performed using a principal component analysis and orthogonal signal correction-partial least squares using SIMCA-P. The different metabolites were identified, and the distinct metabolic profiles were analysed using MetPA. A high-resolution NMR-based serum and urine metabolomics approach was established to study the overall metabolic changes after inhaled budesonide and salbutamol in asthmatic children during acute exacerbation. The perturbed metabolites included 22 different metabolites in the serum and 21 metabolites in the urine. Based on an integrated analysis, the changed metabolites included the following: increased 4-hydroxybutyrate, lactate, cis-aconitate, 5-hydroxyindoleacetate, taurine, trans-4-hydroxy-l-proline, tiglylglycine, 3-hydroxybutyrate, 3-methylhistidine, glucose, cis-aconitate, 2-deoxyinosine and 2-aminoadipate; and decreased alanine, glycerol, arginine, glycylproline, 2-hydroxy-3-methylvalerate, creatine, citrulline, glutamate, asparagine, 2-hydroxyvalerate, citrate, homoserine, histamine, sn-glycero-3-phosphocholine, sarcosine, ornithine, creatinine, glycine, isoleucine and trimethylamine N-oxide. The MetPA analysis revealed seven involved metabolic pathways: arginine and proline metabolism; taurine and hypotaurine metabolism; glycine, serine and threonine metabolism; glyoxylate and dicarboxylate metabolism; methane metabolism; citrate cycle; and pyruvate metabolism. The perturbed metabolic profiles suggest potential metabolic

  7. 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.

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

    Science.gov (United States)

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

    1996-01-01

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

  9. Nebulised cromoglycate, theophylline, and placebo in preschool asthmatic children.

    Science.gov (United States)

    Glass, J; Archer, L N; Adams, W; Simpson, H

    1981-01-01

    Sixteen children aged under 5 years with chronic asthma completed a double-blind crossover trial of treatment with oral choline theophyllinate (6.7 mg/kg four times daily) and nebulised sodium cromoglycate (20 mg four times daily). The trial comprised three 8-week treatment periods during which active sodium cromoglycate, active choline theophyllinate, and placebo were given in random order. Symptom scores for sleep disturbance, cough, wheeze, and daily activities were similar during the three treatment periods if results were analysed using Friedman's non-parametric analysis of variance. However the Mantel-Haenszel test showed that sodium cromoglycate was superior to placebo (P less than 0.05) in maintaining normal daily activities. Either regimen is safe and well tolerated by young children. PMID:6791596

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

    Directory of Open Access Journals (Sweden)

    Murat Tutanc

    2014-03-01

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

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

    Directory of Open Access Journals (Sweden)

    Rata Marinela

    2013-12-01

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

  12. Exhaled breath temperature and exercise-induced bronchoconstriction in asthmatic children.

    Science.gov (United States)

    Peroni, Diego G; Chinellato, Iolanda; Piazza, Michele; Zardini, Federica; Bodini, Alessandro; Olivieri, Francesca; Boner, Attilio L; Piacentini, Giorgio L

    2012-03-01

    It has been hypothesized that exhaled breath temperature (EBT) is related to the degree of airway inflammation/remodeling in asthma. The purpose of this study was to evaluate the relationship between the level of airway response to exercise and EBT in a group of controlled or partly controlled asthmatic children. Fifty asthmatic children underwent measurements of EBT before and after a standardized exercise test. EBT was 32.92 ± 1.13 and 33.35 ± 0.95°C before and after exercise, respectively (P < 0.001). The % decrease in FEV(1) was significantly correlated with the increase in EBT (r = 0.44, P = 0.0013), being r = 0.49 (P < 0.005) in the children who were not receiving regular inhaled corticosteroids (ICS) and 0.37 (n.s.) in those who were. This study further supports the hypothesis that EBT can be considered a potential composite tool for monitoring asthma.

  13. Poor asthma education and medication compliance are associated with increased emergency department visits by asthmatic children

    Directory of Open Access Journals (Sweden)

    Saleh Al-Muhsen

    2015-01-01

    Full Text Available BACKGROUND: Acute exacerbations of bronchial asthma remain a major cause of frequent Emergency Department (ED visits by pediatric patients. However, other factors including psychosocial, behavioural and educational, are also reportedly associated with repetitive ED visits. Therefore, it is necessary to determine whether such visits are justifiable. OBJECTIVE: The objective of this cross-sectional study was to identify risk factors associated with visits to ED by asthmatic children. METHODS: Asthmatic children (n = 297 between 1-17 years old were recruited and information collected at the time of visiting an ED facility at two major hospitals. RESULTS: Asthmatic patients visited the ED 3.9 ΁ 3.2 times-per-year, on average. Inadequately controlled asthma was perceived in 60.3% of patients. The majority of patients (56.4% reported not receiving education about asthma. Patients reflected misconceptions about the ED department, including the belief that more effective treatments are available (40.9%, or that the ED staff is better qualified (27.8%. About half of patients (48.2% visited the ED because of the convenience of being open 24 hours, or because they are received immediately (38.4%. Uncontrolled asthma was associated with poor education about asthma and/or medication use. Patients educated about asthma, were less likely to stop corticosteroid therapy when their symptoms get better (OR:0.55; 95% CI:0.3-0.9; P = 0.04. CONCLUSION: This study reports that most patients had poor knowledge about asthma and were using medications improperly, thus suggesting inefficient application of management action plan. Unnecessary and frequent visits to the ED for asthma care was associated with poor education about asthma and medication use. Potential deficiencies of the health system at directing patients to the proper medical facility were uncovered and underline the necessity to improve education about the disease and medication compliance of patients and

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

    Science.gov (United States)

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

    2002-01-01

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

  15. Clinical Predictors of Intensive Care Unit Admission for Asthmatic Children

    Directory of Open Access Journals (Sweden)

    Mohammad Hasan Kargar Maher

    2015-07-01

    Full Text Available IntroductionChildren with severe asthma attack are a challenging group of patients who could be difficult to treat and leading to significant morbidity and mortality. Asthma attack severity is qualitatively estimated as mild, moderate and severe attacks and respiratory failure based on conditions such as respiration status, feeling of dyspnea, and the degree of unconsciousness. part of which are subjective rather than objective. We investigated clinical findings as predictors of severe attack and probable requirement for Pediatric Intensive Care Unit (PICU admission.Materials and MethodsIn a cross sectional and analytical study 120 patients with asthma attack were enrolled from April 2010 to April 2014 (80 admitted in the ward and 40 in pediatric intensive care unit. Predictors of PICU admission were investigated regarding to initial heart rate(HR, respiratory rate (RR, Arterial Oxygen Saturation(SaO2 and PaCo2 and clinically evident cyanosis.ResultsInitial heart rate(p-value=0.02, respiratory rate (p-value=0.03, Arterial Oxygen Saturation(p-value=0.02 and PaCo2(p-value=0.03 and clinically evident cyanosis were significantly different in two groups(Ward admitted and PICU admittedConclusion There was a significant correlation between initial vital sign and blood gas analysis suggesting usefulness of these factors as predictors of severe asthma attack and subsequent clinical course.

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

    Directory of Open Access Journals (Sweden)

    R. Amin

    2003-03-01

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

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

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    Arie Kurniasih

    2016-11-01

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

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

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    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.

  19. Differences in candidate gene association between European ancestry and African American asthmatic children.

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    Tesfaye M Baye

    Full Text Available BACKGROUND: Candidate gene case-control studies have identified several single nucleotide polymorphisms (SNPs that are associated with asthma susceptibility. Most of these studies have been restricted to evaluations of specific SNPs within a single gene and within populations from European ancestry. Recently, there is increasing interest in understanding racial differences in genetic risk associated with childhood asthma. Our aim was to compare association patterns of asthma candidate genes between children of European and African ancestry. METHODOLOGY/PRINCIPAL FINDINGS: Using a custom-designed Illumina SNP array, we genotyped 1,485 children within the Greater Cincinnati Pediatric Clinic Repository and Cincinnati Genomic Control Cohort for 259 SNPs in 28 genes and evaluated their associations with asthma. We identified 14 SNPs located in 6 genes that were significantly associated (p-values <0.05 with childhood asthma in African Americans. Among Caucasians, 13 SNPs in 5 genes were associated with childhood asthma. Two SNPs in IL4 were associated with asthma in both races (p-values <0.05. Gene-gene interaction studies identified race specific sets of genes that best discriminate between asthmatic children and non-allergic controls. CONCLUSIONS/SIGNIFICANCE: We identified IL4 as having a role in asthma susceptibility in both African American and Caucasian children. However, while IL4 SNPs were associated with asthma in asthmatic children with European and African ancestry, the relative contributions of the most replicated asthma-associated SNPs varied by ancestry. These data provides valuable insights into the pathways that may predispose to asthma in individuals with European vs. African ancestry.

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  1. 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

    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......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.......14 fold (1.24, 3.69), or vs RinsedDelay 3.28 fold (2.13, 5.04). CONCLUSIONS: The relative lung dose of salbutamol from a plastic spacer may differ considerably depending on spacer handling suggesting that nonelectrostatic spacers may be the best way forward....

  2. Modeling exposures to traffic-related air pollutants for the NEXUS respiratory health study of asthmatic children in Detroit, MI

    Science.gov (United States)

    The Near-Road EXposures and Effects of Urban Air Pollutants Study (NEXUS) was designed to investigate associations between exposure to traffic-related air pollution and the respiratory health of asthmatic children living near major roadways in Detroit, MI. A combination of modeli...

  3. 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

    BACKGROUND: Inhaled, long-acting beta2-agonists or antileukotrienes are alternatives as add-on therapy for asthmatic children taking regular inhaled steroids. Any complementary effects would be relevant to the choice between these alternatives. Exhaled nitric oxide (FeNO) may reflect these effect...

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

    Science.gov (United States)

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

    2016-01-01

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

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

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    Reza Amin

    2010-06-01

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

  6. 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

    dose in 2 d during the run-in period. FP 50 micrograms twice daily (FP100) and 100 micrograms twice daily (FP200) was compared with placebo inhaled from a pressurized metered-dose inhaler (pMDI) and the Babyhaler spacer device. With FP200 there was a statistically significant improvement from baseline...... the pediatric dose range. A total of 237 children (mean age 28 mo, range 12 to 47) with moderate asthmatic symptoms were studied in this multicenter, randomized, double-blind, parallel group, placebo-controlled study of 12 wk treatment following a 4-wk run-in period. The median use of rescue medication was 1......, as compared with the placebo group, in 8 of 10 diary card parameters, including the three symptom domains of wheeze, cough, and breathlessness, and use of rescue medication. FP100 produced a significant reduction in 5 of these 10 parameters, whereas no significant differences were found between the FP200...

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

    DEFF Research Database (Denmark)

    Klug, B; Bisgaard, H

    1999-01-01

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

  8. Air pollution, PM2.5 composition, source factors, and respiratory symptoms in asthmatic and nonasthmatic children in Santiago, Chile.

    Science.gov (United States)

    Prieto-Parra, Laura; Yohannessen, Karla; Brea, Cecilia; Vidal, Daniella; Ubilla, Carlos A; Ruiz-Rudolph, Pablo

    2017-04-01

    The objective of this study was to determine the association of respiratory symptoms and medication use and exposure to various air pollutants, PM2.5 components, and source factors in a panel of asthmatic and nonasthmatic children in Santiago, Chile. To this end, 174 children (90 asthmatics and 84 nonasthmatics) were followed throughout the winter months of 2010 and 2011. During the study period, children filled out daily diaries to record respiratory symptoms and medication use. Air pollution data were obtained from government central site measurements and a PM2.5 characterization campaign. PM2.5 source factors were obtained using positive matrix factorization (PMF). Associations of symptoms and exposure to pollutants and source-factor daily scores were modeled separately for asthmatic and nonasthmatic children using mixed logistic regression models with random intercepts, controlling for weather, day of the week, year, and viral outbreaks. Overall, high concentrations of air pollutants and PM2.5 components were observed. Six source factors were identified by PMF (motor vehicles, marine aerosol, copper smelter, secondary sulfates, wood burning, and soil dust). Overall, single pollutant models showed significant and strong associations between 7-day exposures for several criteria pollutants (PM2.5, NO2, O3), PM2.5 components (OC, K, S, Se, V), and source factors (secondary sulfate) and coughing, wheezing and three other respiratory symptoms in both in asthmatic and nonasthmatic children. No associations were found for use of rescue inhalers in asthmatics. Two-pollutant models showed that several associations remained significant after including PM2.5, and other criteria pollutants, in the models, particularly components and source factors associated with industrial sources. In conclusion, exposure to air pollutants, especially PM2.5, NO2, and O3, were found to exacerbate respiratory symptoms in both asthmatic and nonasthmatic children. Some of the results suggest

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

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    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.

  10. Asthmatic symptoms and air pollution: a panel study on children living in the Italian Po Valley

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    Andrea Ranzi

    2015-11-01

    Full Text Available The Po Valley (Northern Italy has elevated levels of air-pollution due to various sources of pollution and adverse weather conditions. This study evaluates the short-term effects of exposure to particulate matter with a diameter of 10 microns or less (PM10 on asthma symptoms in school-aged children. An initial cross-sectional survey was conducted in the area to estimate asthma prevalence in children. Out of a total of 250 asthmatic children identified by the study, 69 agreed to participate in a panel study. The PM10 exposure assessment was based on a combination of geographic and environmental measurements leading to a focus on three different areas, each characterised by its own daily PM10 level. Participants were monitored daily for respiratory symptoms for eight weeks (January-March 2006. We assessed the relationship between daily PM10 exposure and occurrence of asthma symptoms with a generalised linear model based on a total of 3864 person-days of observation. Exposure to PM10 per m3 was found to be particularly associated with cough (OR=1.03, CI 95% 0.99; 1.08 and phlegm (OR=1.05, CI 95% 1.00; 1.10. In the most polluted area, exposure to PM10 was also associated with wheezing (OR=1.18, CI 95% 1.02; 1.37.

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

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    Rafael Alejandro Gómez Baute

    2005-11-01

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

  12. The first camps in Turkey for asthmatic children: six years' experience.

    Science.gov (United States)

    Oneş, Ulker; Sapan, Nihat; Yazicioğlu, Mehtap; Güler, Nermin; Tamay, Zeynep; Somer, Ayper; Canitez, Yakup

    2005-01-01

    The first asthma camp in Turkey was organized for one week in Iznik in September 1996. The camps were continued annually around the same time of the year in 1997, 1998, 2000, and in the consecutive years thereafter. The camp includes educational, sports and social activities. Children's knowledge about asthma and their attitudes towards physical and social activities were evaluated by a questionnaire. Pulmonary function tests were performed on the first and last day of the camp. There was no statistically significant difference between the mean spirometric values of the first and last day of the camp in spite of a vigorous physical and social program. Children enhanced their skills and knowledge about asthma and gained self-confidence in participating in sportive and social activities during the camp program. They did not experience any emergency room visit in the following year. In conclusion, a summer camping experience is very beneficial for asthmatic children in terms of both self-education and social and physical participation.

  13. 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

  14. 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.

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

    Science.gov (United States)

    Obata, T; Masaki, T; Iikura, Y

    1990-12-01

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

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

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    Nedeljković Miroslav

    2008-01-01

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

  17. Unique cytokine secretion profile in children with both type I diabetes and asthma distinct from that of solely diabetic or asthmatic children.

    Science.gov (United States)

    Kainonen, Essi; Rautava, Samuli; Korkeamäki, Mika; Isolauri, Erika

    2006-05-01

    Asthma and type I diabetes are major causes of chronic illness in childhood which, according to the current paradigm, have mutually antagonistic immunopathologies. Nonetheless, the disorders appear to preferably coexist both on population and individual levels. To assess whether children with asthma and type I diabetes might have a common immunoregulatory defect. The spontaneous and anti-CD3+ anti-CD28-stimulated cytokine production patterns by peripheral blood mononuclear cells of 13 children with both asthma and diabetes, nine children with diabetes, 11 children with asthma and nine healthy children were assessed using cytometric bead assay. The spontaneous production of IFN-gamma, TNF-alpha and IL-10 by mononuclear cells in children with both asthma and diabetes was elevated compared to the other study groups (p=0.02, p=0.001 and p=0.04, respectively). Stimulation in vitro increased IL-10 secretion in solely diabetic (p=0.008), asthmatic (p=0.008) and healthy children (p=0.01), but not in children with both diseases (p=0.22). Children suffering from both diabetes and asthma display a unique cytokine secretion pattern, distinct from those of solely diabetic, asthmatic and healthy children. In particular, these children appear to have a defect in regulation of IL-10 secretion.

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

  19. 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…

  20. 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…

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

    Institute of Scientific and Technical Information of China (English)

    牛轶; 程自立; 王高华; 姜毅

    2002-01-01

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

  2. Buccal health in asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Nora Sexto Delgado

    2003-04-01

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

  3. Aeração nasal em crianças asmáticas Nasal ventilation in asthmatics children

    Directory of Open Access Journals (Sweden)

    Daniele Andrade da Cunha

    2011-10-01

    Full Text Available OBJETIVO: identificar a presença de sinais de alterações na expiração de crianças asmáticas. MÉTODO: este estudo foi realizado com 30 crianças com idades entre 6 e 10 anos de ambos os sexos com diagnóstico clínico de asma confirmado pelo prontuário médico e 30 crianças não asmáticas também de ambos os sexos na mesma faixa etária. Foi avaliada a aeração nasal com o espelho milimetrado de Altmann, sendo mensurado o escape de ar nasal objetivando a verificação da saída uni ou bilateral do ar e a relação de simetria entre a narina direita e a esquerda. As imagens foram importadas para o computador por meio do scanner HP da série Scanjet 2400. A análise foi realizada no software Scion Image for Windows (Alpha 4.0.3.2. Para análise das variáveis quantitativas entre grupos foi aplicado o teste t-student e para a análise intragrupos foi aplicado o teste t-Student pareado.Todas as conclusões foram tomadas ao nível de significância de 5%, sendo usados o Excel 2000 e o SPSS v8.0, para as análises. RESULTADOS: não foram encontradas diferenças estatisticamente significantes entre as crianças asmáticas e não-ásmáticas, acerca das mensurações quanto à área total e quanto às áreas das narinas direita e esquerda. CONCLUSÃO: não foi identificada a presença de sinais de alterações na expiração de crianças asmáticas, desta forma, faz-se necessário um estudo mais específico das funções nasal e pulmonar.PURPOSE: to identify the symptoms of changes in the exhalation of asthmatic children. METHOD: this study was conducted with 30 children from 6 to 10 year-old, of both genders and with asthma clinical diagnosis confirmed by medical records and 30 non-asthmatic children from 6 to 10 year-old, of both genders, and with same age. We evaluated the nasal ventilation with Altmann millimeter nasal mirror measuring the nasal air escape in order to check their unilateral or bilateral air output and the relation of

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

    Science.gov (United States)

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

    2014-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2000-01-01

    We hypothesized that measurement of lung function (LF) and bronchial hyperresponsiveness (BHR) could serve as supplemental tools in evaluating the efficacy of treatment with inhaled corticosteroids in asthmatic children aged 2 to 5 yr. We studied 38 children (mean age: 53 mo; range: 35 to 71 mo......-acting beta(2)-agonist were monitored with diary cards. LF in awake children was measured as the specific airway resistance (sRaw), using whole-body plethysmography; as resistance by the interrupter technique (Rint); and as resistance and reactance at 5 Hz (Rrs5, Xrs5) by the impulse oscillation technique...... no improvement was found on MCh. In conclusion, inhaled BUD at a total dose of 800 microgram daily significantly improved SSc, asthma exacerbation rates, lung function, and BHR as assessed by CACh in asthmatic children aged 2 to 5 yr....

  8. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  10. 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

  11. 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.

  12. Distribution and seasonality of rhinovirus and other respiratory viruses in a cross-section of asthmatic children in Trinidad, West Indies

    Directory of Open Access Journals (Sweden)

    Roberg Kathy A

    2009-06-01

    Full Text Available Abstract Background Childhood asthma in the Caribbean is advancing in prevalence and morbidity. Though viral respiratory tract infections are reported triggers for exacerbations, information on these infections with asthma is sparse in Caribbean territories. We examined the distribution of respiratory viruses and their association with seasons in acute and stable asthmatic children in Trinidad. Methods In a cross-sectional study of 70 wheezing children attending the emergency department for nebulisation and 80 stable control subjects (2 to 16 yr of age in the asthma clinic, nasal specimens were collected during the dry (n = 38, January to May and rainy (n = 112, June to December seasons. A multitarget, sensitive, specific high-throughput Respiratory MultiCode assay tested for respiratory-virus sequences for eight distinct groups: human rhinovirus, respiratory syncytial virus, parainfluenza virus, influenza virus, metapneumovirus, adenovirus, coronavirus, and enterovirus. Results Wheezing children had a higher [χ2 = 5.561, p = 0.018] prevalence of respiratory viruses compared with stabilized asthmatics (34.3% (24 versus (vs. 17.5% (14. Acute asthmatics were thrice as likely to be infected with a respiratory virus (OR = 2.5, 95% CI = 1.2 – 5.3. The predominant pathogens detected in acute versus stable asthmatics were the rhinovirus (RV (n = 18, 25.7% vs. n = 7, 8.8%; p = 0.005, respiratory syncytial virus B (RSV B (n = 2, 2.9% vs. n = 4, 5.0%, and enterovirus (n = 1, 1.4% vs. n = 2, 2.5%. Strong odds for rhinoviral infection were observed among nebulised children compared with stable asthmatics (p = 0.005, OR = 3.6, 95% CI = 1.4 – 9.3,. RV was prevalent throughout the year (Dry, n = 6, 15.8%; Rainy, n = 19, 17.0% and without seasonal association [χ2 = 0.028, p = 0.867]. However it was the most frequently detected virus [Dry = 6/10, (60.0%; Rainy = 19/28, (67.9%] in both seasons. Conclusion Emergent wheezing illnesses during childhood can be

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

    Institute of Scientific and Technical Information of China (English)

    黎雅婷; 陈虹; 陈壮桂

    2013-01-01

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

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

    DEFF Research Database (Denmark)

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

    2006-01-01

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

  15. Antropometria e mastigação em crianças asmáticas Anthropometry and chewing in asthmatic children

    Directory of Open Access Journals (Sweden)

    Daniele Andrade da Cunha

    2009-01-01

    Full Text Available OBJETIVOS: caracterizar os padrões da antropometria facial em crianças asmáticas; identificar a presença de assimetrias faciais em crianças asmáticas e não asmáticas; e relacionar o lado de predomínio mastigatório com a presença de assimetria facial em crianças asmáticas e não asmáticas. MÉTODOS: participaram da pesquisa 60 crianças com idade entre 6 e 10 anos. Destas, 30 possuíam diagnóstico em prontuário de asma moderada ou grave e 30 crianças não apresentavam asma, fazendo parte do grupo controle. Foram realizadas avaliações antropométrica facial e da mastigação dessas crianças. RESULTADOS: em relação às mensurações antropométricas faciais nas crianças asmáticas e não-asmáticas não foram reveladas diferenças significativas entre os grupos. No que diz respeito à presença de assimetrias faciais, observou-se que estas ocorreram no grupo controle, assim como, no grupo asmático. O padrão mastigatório predominante em ambos os grupos foi o bilateral simultâneo e quando relacionados à assimetria facial e o predomínio mastigatório, não foram encontradas associações significantes. CONCLUSÃO: não foram encontradas diferenças significativas entre o grupo controle e o grupo asmático em relação às mensurações antropométricas. A assimetria facial foi observada nos dois grupos avaliados. Em ambos o padrão mastigatório bilateral simultâneo foi predominante, porém quando realizada a relação entre assimetria facial e o lado de predomínio mastigatório, não se observou relações significativas.PURPOSES: to characterize the facial anthropometry patterns in asthmatic children; to identify the presence of facial asymmetry and to relate the prevalence of masticatory side with the presence of facial asymmetry in asthmatic and non-asthmatic children. METHODS: 60 children aged 6 to 10 years were evaluated. Thirty among them had a diagnosis of moderate or severe asthma and 30 children with no

  16. 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.

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

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2001-01-01

    of 81% at the cutoff level of a 25% decrease in sRaw after bronchodilator administration. In conclusion, bronchodilator response measured by sRaw allows a separation of asthmatic from healthy young children. This may help define asthma in this clinically difficult-to-manage group of young wheezy...... for the diagnosis of asthma) for each of the lung function tests applied in the study. Specific airway resistance (sRaw) as measured by whole-body plethysmography, respiratory resistance as measured with the interrupter technique (Rint), and respiratory resistance and reactance at 5 Hz (Rrs5, Xrs5, respectively...

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

    Science.gov (United States)

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

    1996-08-01

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

  19. Characterization of indoor home vacuum dust allergens and serum based allergen specific IgE levels in asthmatic and non-asthmatic children

    Science.gov (United States)

    The Mechanistic Indicators of Childhood Asthma (MICA) study was conducted in the Detroit, Michigan area during fall to early winter 2006-2007. Children from 9-13 years of age were recruited into a cross-sectional study to examine biological markers of exposure, effects, and susce...

  20. 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.)

  1. Unmet needs in the treatment of asthmatic children and adolescents: 1.

    Science.gov (United States)

    Warner, J O

    2000-06-01

    The paediatric asthma guidelines have been successful in providing a uniform approach to the management of asthma for the medical profession as a whole. Unfortunately, the guidelines were generated without input from patients themselves and consequently do not consider issues that are important to patients such as a preference for oral treatment. Asthma is a heterogeneous group of conditions and the guidelines do not sufficiently define subgroups of patients and their particular needs. As a result, there has been a tendency to assume that all wheezing in infancy is asthma and this had led to gross overtreatment in certain patients. In contrast, severe asthma often remains underdiagnosed and undertreated. The most recent revision of the guidelines has classified asthma in terms of the patterns of disease; infrequent episodic, frequent episodic and chronic persistent. The treatment required for each of these groups is clearly defined and there is no need for stepwise therapy. Other changes to the guidelines will occur and are needed. None of the treatments available can modify the natural history of asthma; they control the symptoms not the disease process. Evidence from bronchial biopsies suggests that both inflammation and remodelling occur early, even before the first symptoms appear. We need to look for the factors in early life that predict which children will go on to develop asthma and intervene at that stage. Anti-histamines and leukotriene receptor antagonists may be interesting as interventions in that respect. Two important unresolved issues are to understand what drives remodelling and inflammation, and to look at early life origins of asthma. These approaches may provide effective therapeutic targets and, ultimately, a means of prevention.

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

    Directory of Open Access Journals (Sweden)

    ALBERTO VIDAL G

    2007-09-01

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

  3. The Nusing Strategy of Children With Asthmatic Bronchial Pneumonia%小儿喘息性支气管肺炎的护理对策探讨

    Institute of Scientific and Technical Information of China (English)

    钟彬彬

    2015-01-01

    Objective To investigate the nusing strategy of children with asthmatic bronchial pneumonia. Methods 80 children with asthmatic bronchial pneumonia were investigated. All children were offered the treatment and nursing care. The nursing care includes assessment and check, specific nursing and basic nursing. Evaluate the pulmonary function and therapeutic effect after two weeks. Results After two weeks, symptoms and signs has been improved in some extend. The average hospital stay is (12.9±3.6).The number of cured patients is 60 cases, effective is 19 cases, invalid is 1 case, the total effective rate was 98.75%.The FCV is (3.63±0.44)L, the PEF is (5.88±0.35) L/S, the FEV1 is (3.19±0.24)L (P<0.05). Conclusion The treatment and nursing care can improve pulmonary function, enhance therapeutic effect in children with asthmatic bronchial pneumonia.%目的:探讨小儿喘息性支气管肺炎的护理对策。方法选取80例喘息性支气管肺炎患儿为研究对象。对患儿进行治疗和护理,2周后评估患儿的治疗效果及肺功能情况。结果本组患儿的平均住院时间为(12.9±3.6)天,痊愈60例,有效19例,无效1例,总有效率为98.75%。干预两周后,患儿的肺活量为(3.63±0.44)L,最高呼气流速为(5.88±0.35)L/S,第一秒用力呼出的体积为(3.19±0.24)L,且干预前相比差异均有统计意义(P <0.05)。结论临床治疗和护理可以改善喘息性支气管肺炎患儿的肺功能和治疗效果。

  4. Función adrenal y metabolismo lipídico en niños asmáticos tratados con budesonida Adrenal function and lipid metabolism in asthmatic children with budesonide treatment

    Directory of Open Access Journals (Sweden)

    Mariela Paoli-de Valeri

    1999-03-01

    Full Text Available Objetivo. Evaluar el efecto de bajas dosis de budesonida inhalado sobre la función adrenal y el metabolismo lipídico en niños asmáticos. Material y métodos. Se estudiaron: 10 niños asmáticos (edad promedio, 8.6 años tratados con budesonida inhalado (200-300 µg/día por un lapso mayor a tres meses (grupo A; 15 niños asmáticos (edad promedio, 7.8 años sin tratamiento esteroideo (grupo B, y 10 niños no asmáticos (grupo C. Se determinaron los niveles de cortisol basal y postestímulo con ACTH, andrógenos adrenales, lípidos y cortisol urinario. Resultados. Entre los grupos A y B no hubo diferencias significativas en las variables estudiadas. En los niños asmáticos (grupo A-B el cortisol urinario fue significativamente mayor en relación con el grupo C. Los niveles de triglicéridos, colesterol total, colesterol de la lipoproteína de baja densidad e índices aterogénicos fueron mayores en el grupo de niños asmáticos, con y sin budesonida, comparados con el grupo C. Conclusiones. El tratamiento con dosis bajas de budesonida inhalado en niños asmáticos no modificó la función del eje adrenal ni el metabolismo lipídico. Los pacientes asmáticos presentaron un perfil lipídico aterogénico que podría incrementar el riesgo de enfermedad cardiovascular.Objective. To assess the effect of low doses of inhaled budesonide on the adrenal function and lipid metabolism of asthmatic children. Material and methods. The study included 10 asthmatic children (mean age, 8.8 years treated with inhaled budesonide (200-300 µg/day for a period longer than 3 months (group A; 15 asthmatic children (mean age, 7.8 years without steroid treatment (group B and 10 non-asthmatic children (group C. Basal cortisol levels, as well as postACTH, adrenal androgens, lipids and urinary cortisol were determined. Results. No significant differences were detected between groups A and B in the studied variables. In asthmatic children, urinary cortisol was

  5. LONG TERM EFFECTS OF PRENATAL AND POSTNATAL AIRBORNE PAH EXPOSURE ON VENTILATORY LUNG FUNCTION OF NON-ASTHMATIC PREADOLESCENT CHILDREN. PROSPECTIVE BIRTH COHORT STUDY IN KRAKOW

    Science.gov (United States)

    Jedrychowski, Wieslaw A.; Perera, Frederica P.; Maugeri, Umberto; Majewska, Renata; Mroz, Elzbieta; Flak, Elzbieta; Camman, David; Sowa, Agata; Jacek, Ryszard

    2014-01-01

    The main goal of the study was to test the hypothesis that prenatal and postnatal exposure to polycyclic aromatic hydrocarbons (PAH) is associated with depressed lung function in non-asthmatic children. The study sample comprises 195 non-asthmatic children of non-smoking mothers, among whom the prenatal PAH exposure was assessed by personal air monitoring in pregnancy. At the age of 3, residential air monitoring was carried out to evaluate the residential PAH exposure indoors and outdoors. At the age of 5 to 8, children were given allergic skin tests for indoor allergens; and between 5–9 years lung function testing (FVC, FEV05, FEV1 and FEF25–75) was performed. The effects of prenatal PAH exposure on lung function tests repeated over the follow-up were adjusted in the General Estimated Equation (GEE) model for the relevant covariates. No association between FVC with prenatal PAH exposure was found; however for the FEV1 deficit associated with higher prenatal PAH exposure (above 37ng/m3) amounted to 53 mL (p = 0.050) and the deficit of FEF25–75 reached 164 mL (p=0.013). The corresponding deficits related to postnatal residential indoor PAH level (above 42 ng/m3) were 59 mL of FEV1 (p=0.028) and 140 mL of FEF25–75 (p=0.031). At the higher residential outdoor PAH level (above 90 ng/m3) slightly greater deficit of FEV1 (71mL, p = 0.009) was observed. The results of the study suggest that transplacental exposure to PAH compromises the normal developmental process of respiratory airways and that this effect is compounded by postnatal PAH exposure. PMID:25300014

  6. Long term effects of prenatal and postnatal airborne PAH exposures on ventilatory lung function of non-asthmatic preadolescent children. Prospective birth cohort study in Krakow.

    Science.gov (United States)

    Jedrychowski, Wieslaw A; Perera, Frederica P; Maugeri, Umberto; Majewska, Renata; Mroz, Elzbieta; Flak, Elzbieta; Camann, David; Sowa, Agata; Jacek, Ryszard

    2015-01-01

    The main goal of the study was to test the hypothesis that prenatal and postnatal exposures to polycyclic aromatic hydrocarbons (PAH) are associated with depressed lung function in non-asthmatic children. The study sample comprises 195 non-asthmatic children of non-smoking mothers, among whom the prenatal PAH exposure was assessed by personal air monitoring in pregnancy. At the age of 3, residential air monitoring was carried out to evaluate the residential PAH exposure indoors and outdoors. At the age of 5 to 8, children were given allergic skin tests for indoor allergens; and between 5 and 9 years lung function testing (FVC, FEV05, FEV1 and FEF25-75) was performed. The effects of prenatal PAH exposure on lung function tests repeated over the follow-up were adjusted in the General Estimated Equation (GEE) model for the relevant covariates. No association between FVC with prenatal PAH exposure was found; however for the FEV1 deficit associated with higher prenatal PAH exposure (above 37 ng/m(3)) amounted to 53 mL (p=0.050) and the deficit of FEF25-75 reached 164 mL (p=0.013). The corresponding deficits related to postnatal residential indoor PAH level (above 42 ng/m(3)) were 59 mL of FEV1 (p=0.028) and 140 mL of FEF25-75 (p=0.031). At the higher residential outdoor PAH level (above 90 ng/m(3)) slightly greater deficit of FEV1 (71 mL, p=0.009) was observed. The results of the study suggest that transplacental exposure to PAH compromises the normal developmental process of respiratory airways and that this effect is compounded by postnatal PAH exposure.

  7. 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

    OpenAIRE

    Dóris Lieth Peçanha; Carl Lacharité

    2007-01-01

    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 dime...

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

    Institute of Scientific and Technical Information of China (English)

    王莉华; 郭庆辉; 李朝霞; 马宇; 王育龙

    2013-01-01

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

  9. The use of oscillometry as a measure of airway responsiveness in asthmatic children after histamine and methacholine bronchoprovocation with dosimeter-MedicAid and DeVilbiss nebulizers.

    Science.gov (United States)

    Kopriva, F; Szotkowská, J; Plocová, A; Závodská, J; Zápalka, M; Smatanová, D; Látalová, M; Slezáková, L; Radová, L

    2007-05-01

    To explore the use of oscillometry as a measure of airway responsiveness, 69 asthmatic children underwent histamine and methacholine bronchoprovocation using dosimeter-MedicAid (Jaeger Co.; Germany) and DeVilbiss nebulizers (DeVilbiss, Bornemouth; England). The mean increase in R5 resistance in challenge testing measured after methacholine with the dosimeter-MedicAid nebulizer was 77.14% compared with 65.05% using histamine. Using the dosimeter-DeVilbiss nebulizer, the mean increases in R5 resistance following methacholine and histamine testing were 57.50% and 59.36%, respectively. The resistance R5 over R20 significantly correlated with forced expiratory volume in 1 second (FEV1). The MedicAid produced a more aggressive challenge than the DeVilbliss nebulizer. Oscillometry can be used to monitor the level of airway hyperresponsiveness following bronchoprovocation tests.

  10. Increased ventilation rate as way to reduce the exposure to house dust mites and improve the health of asthmatic children - an intervention design

    DEFF Research Database (Denmark)

    Spilak, Michal; Kolarik, Barbara; Gunnarsen, Lars

    2012-01-01

    International field studies have documented that indoor air quality is unsatisfactory in many buildings. The overall hypothesis of this project is that improving the indoor environment in dwellings can improve health and reduce suffering from indoor related diseases such as allergy and asthma...... that have shown a marked increase in incidence all around the world during last decades. The purpose of this study is to investigate the effect of increased ventilation and expected lower exposure to house dust mites on symptoms and medication intake among asthmatic children. This will be done by installing...... balanced mechanical ventilation systems in 80 single-family houses. Half of the houses will be equipped with an effective ventilation system increasing air change rates from normal to approximately 3 h-1. A fake ventilation system will be installed in the other half of the houses. Primary subjects...

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

    Institute of Scientific and Technical Information of China (English)

    胡平; 张际; 黄英; 袁小平; 蒋永惠; 王倩

    2011-01-01

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

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

    Science.gov (United States)

    Schütze, G

    1976-07-01

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

  13. Disordered microbial communities in asthmatic airways.

    Directory of Open Access Journals (Sweden)

    Markus Hilty

    Full Text Available BACKGROUND: A rich microbial environment in infancy protects against asthma [1], [2] and infections precipitate asthma exacerbations [3]. We compared the airway microbiota at three levels in adult patients with asthma, the related condition of COPD, and controls. We also studied bronchial lavage from asthmatic children and controls. PRINCIPAL FINDINGS: We identified 5,054 16S rRNA bacterial sequences from 43 subjects, detecting >70% of species present. The bronchial tree was not sterile, and contained a mean of 2,000 bacterial genomes per cm(2 surface sampled. Pathogenic Proteobacteria, particularly Haemophilus spp., were much more frequent in bronchi of adult asthmatics or patients with COPD than controls. We found similar highly significant increases in Proteobacteria in asthmatic children. Conversely, Bacteroidetes, particularly Prevotella spp., were more frequent in controls than adult or child asthmatics or COPD patients. SIGNIFICANCE: The results show the bronchial tree to contain a characteristic microbiota, and suggest that this microbiota is disturbed in asthmatic airways.

  14. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  16. 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.

  17. [Physical activities and sports in asthmatic patients].

    Science.gov (United States)

    Todaro, A

    1983-05-31

    Asthma patients are too often advised to refrain from sport. Enforced sedentariness, especially in children, leads to muscle hypotonia, reduced mechanical efficiency, paramorphisms, and adverse psychological consequences. Not all asthmatics develop airway spasm as a result of exercise. On the other hand, there are subjects whose bronchial hyper-reactivity is stimulated solely by muscular effort. The pathogenesis of exercise-induced bronchospasm is not fully understood. In any event, numerous studies have demonstrated the beneficial and even therapeutic effect of physical exercise and sport in cases of asthma. Provided they are practised with judgment and in accordance with a suitable programme, swimming, activities of an alternating aerobic and anaerobic type, cross-country skiing, gymnastics, and fencing are primarily indicated. Some asthmatics have also won Olympic medals. In the light of the studies carried out so far, it is strongly suggested that asthmatics be encouraged to take up sport suitable to their psychophysical characteristics, and not kept wrapped up in cotton wool.

  18. Prevalence of common allergens among asthmatic children in Haikou%海口市儿童哮喘变应原流行病学调查研究

    Institute of Scientific and Technical Information of China (English)

    王灵; 陈实; 廖锋; 曾霞; 吴少皎; 谢跃琦; 林涛; 林霞; 陈冰

    2016-01-01

    Objective To investigate the prevalence of allergens in asthmatic children in Haikou. Methods A total of 10 241 children of 0~14 years old were involved and investigated by cluster sampling, in which 324 children were diagnosed as asthma. Allergic sensitization was studied with questionnaire, skin prick tests and specific IgE mea-surements. Results Among the 324 asthmatic children, 224 (69.1%) had allergy history, including 91 cases (28%) of ec-zema, 64 cases (19.8%) of food allergy, 28 cases (8.6%) of drug allergy, 18 cases (5.6%) of cigarette smoke allergy, 19 cases (5.9%) of decoration smell allergy, 13 cases (4.0%) of pet allergy, 11 cases (3.4%) of cooking oil smell allergy, and 9 cases (2.8%) of pollen allergy. A total of 269 asthmatic children (83.0%) showed SPT positive reaction, with 292 cases (90.1%) of Dermatophagoides pteronyssinus (Der p), 289 cases (89.2%) of Dermatophagoides farina (Der f), 277 cases (85.5%) of Blomia tropicalis (Blo t), 64 cases (19.6%) of cockroach, 11 cases (3.4%) of mould, 11 cases (3.4%) of pol-len, 38 cases (11.7%) of cat dander, and 82 cases (25.3%) of dog dander. The specific IgE-positive rate to inhaled aller-gens was 72.2%(235 cases), with 69.8%(226 cases) to mites, which was the highest. The specific IgE-positive rate to food allergens was 28.7%(93 cases), with 25.3%(82 cases) to milk, 9.9%(32 cases) to egg white, 22.8%(74 cases) to crab and shrimp, 9.0%(24 cases) to tropical fruit, and 8.3%(27 cases) to fish. Comparison of inhaled allergen specific IgE-positive rate between different age groups showed that, the positive rate to dust mites, cockroach was significantly higher in 3~7 years old group than 0~3 years old group old, and the positive rate to dust mites, cockroach, dog dander, cat dander was higher in 7~14 years old group than 0~3 years old group. Conclusion House dust mites and Blomia tropicalis are the major allergen sources among asthmatic children in Haikou. Dog dander, cat dander and cockroach are also

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

    DEFF Research Database (Denmark)

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

    1998-01-01

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

  20. Investigation of different approaches to reduce allergens in asthmatic children's homes--the Breath of Fresh Air Project, Cornwall, United Kingdom.

    Science.gov (United States)

    Eick, Susan Ann; Richardson, George

    2011-09-01

    During 2001 to 2004, a study was conducted to assess the indoor environmental and health impact of installing allergen-reducing interventions in the homes of asthmatic children. Based on the results of a pilot study, to determine an intervention that would provide improved symptom scores and a reduction in house dust mite allergen (Der p 1), mechanical ventilation and heat recovery (MVHR) systems were installed in 16 homes. Environmental and respiratory health assessments were conducted before and after the installation of the MVHR systems. The results indicated that the installation of MVHR systems reduced Der p 1 concentrations in living room carpets and mattresses. There were significant reductions in symptom scores for breathlessness during exercise, wheezing, and coughing during the day and night. Although, there was not a parallel control group for the main study, the lack of change in the pilot study control group (who did not receive an intervention), indicated that the changes in symptom scores were in part to do with the intervention. Larger scale trials are needed to determine the efficacy of MVHR systems in homes to improve indoor air quality and reduce asthma symptoms.

  1. 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…

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

    Institute of Scientific and Technical Information of China (English)

    袁方; 徐婉婷; 张建华; 李建军; 郭盛; 吴良霞; 盛锦云

    2013-01-01

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

  3. 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

  4. Indoor mite allergen levels, specific IgE prevalence and IgE cross-inhibition pattern among asthmatic children in Haikou,southern China

    Institute of Scientific and Technical Information of China (English)

    ZHENG Yi-wu; CHEN Shi; LAI Xu-xin; Birgitte Gjesing; ZHONG Nan-shan; Michael D Spangfort

    2012-01-01

    Background Haikou locates in tropical island with unique mite propagation.The aim of this stuy is to determine mite allergens levels in Haikou,and to investigate the prevalence of mite specific IgE-sensitization and IgE cross-reactivity between house dust mites.Methods Allergen and antigen concentrations against six mite species were tested by enzyme-linked immunosorbent assay (ELISA).Specific IgE concentrations and cross-inhibitions were measured with ADVIA Centaur(R).Results Allergen or antigen Dermatophagoides pteronyssinus (Der p 1 ),Blomia tropicalis (Blo t ) and Tyrophagus putrescentia (Tyr p) were detected in dust samples.Dermatophagoides farinae (Der f 1 ),Lepidoglyphus destructor (Lep d 2),and Acarus siro (Aca s ) were found in very few samples.Specific IgE tests showed high prevalence of sensitizations against all tested mites with high IgE levels to Der p,Der f,and Blo t.Storage mites,Blo t,Tyr p,Lep d,and Aca s,could inhibit Der p from 0 to 50%.Storage mites could inhibit Der f between 30% and 100%.Der p IgE could be inhibited by Der f with up to 90%,and vice versa.Der p could inhibit Blot from 40% to 80%.Blot was able to fully inhibit IgE binding to Lep d,Tyr p,and Aca s compared to partial inhibition by Der p.Conclusions Der p is the dominating mite and has the highest specific IgE prevalence among asthmatic children.Blo t represents an important source of storage mite sensitization and some patients may be independently sensitized to both Der p and Blo t.High prevalence of sensitization to Der f may be due to IgE-mediated cross-reactivity with Der p and Blo t.

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

    NARCIS (Netherlands)

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

    2010-01-01

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

  6. 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...

  7. Qualidade de vida na asma pediátrica: revisão da literatura Quality of life in asthmatic children: a literature review

    Directory of Open Access Journals (Sweden)

    Patricia Gomes de Souza

    2011-12-01

    Full Text Available OBJETIVO: Analisar as produções científicas que abordam a temática da qualidade de vida em crianças e adolescentes com asma, objetivando discutir o instrumento de pesquisa Pediatric Asthma Quality of Life Questionnaire (PAQLQ. FONTES DE DADOS: Revisão não sistemática da literatura incluindo artigos nos idiomas inglês, português e espanhol, a partir das bases de dados Medline, SciELO e Lilacs, no período de 1997 a 2009. Foram utilizados os termos "quality of life", "asthma pediatrics", "asthma quality of life" e "PAQLQ". SÍNTESE DOS DADOS: Os 26 artigos encontrados foram organizados em duas seções, a saber: estudos de validação do PAQLQ (n=12 e estudos de avaliação da qualidade de vida na asma pediátrica usando o questionário PAQLQ (n=14. CONCLUSÕES: A avaliação da qualidade de vida deve ser incorporada à avaliação clínica, uma vez que a doença crônica repercute nas diversas dimensões da vida dos pacientes. O PAQLQ é de fácil aplicação, reprodutível e constitui-se em instrumento para avaliar a qualidade de vida de crianças e adolescentes com asma.OBJECTIVE: To analyze scientific articles that discuss the quality of life related to the health of children and adolescents with asthma, focusing the Pediatric Asthma Quality of Life Questionnaire (PAQLQ evaluation tool. DATA SOURCES: Non-systematic review of the literature including articles in English, Portuguese and Spanish identified via Medline, SciELO and Lilacs, published between 1997 and 2009.The following descriptors were searched: "quality of life", "asthma pediatrics", "asthma quality of life" and "PAQLQ". DATA SYNTHESIS: The 26 articles were organized in two sections: studies on validity of PAQLQ (n=12 and the assessment of quality of life in asthmatic children using the PAQLQ (n=14. CONCLUSIONS: The assessment of quality of life should be incorporated in clinical evaluations considering that chronic illnesses may affect diverse dimensions of life. The

  8. 小儿喘息性支气管炎的雾化吸入治疗疗效观察及护理措施%Effect and Nursing Measures of Nebulization in the Treatment of Asthmatic Bronchitis in Children

    Institute of Scientific and Technical Information of China (English)

    李克芬

    2012-01-01

      目的:观察探讨雾化吸入治疗小儿喘息性支气管炎的效果及护理措施.方法:选取本院住院喘息性支气管炎患儿80例,随机分为治疗组和对照组,每组40例,根据患儿病情均给予抗感染、止咳、化痰等治疗.治疗组给予布地奈德和硫酸特布他林雾化吸入,对照组给予静脉地塞米松滴注.结果:治疗组总有效率95%,对照组77.5%,两组比较差异有统计学意义.结论:小儿喘息性支气管炎采取雾化吸入治疗,效果良好.%  Objective: To observe and discusses the effect and nursing measures of nebulization in the treatment of asthmatic bronchitis in children.Method:80 cases with asthmatic bronchitis in children were randomly divided into treatment group and compare group,40 cases in each group, according to the condition of children are given anti-infection,anti-tussive,phlegm,and so treatment.The treatment group was given budesonide and sulfuric acid terbutaline nebulization inhalation,and the compare group given dexamethasone intravenous injection.Result:Treatment group total effectiveness was 95%,the comparison group was 77.5%,two groups of comparisons difference was statistically significance.Conclusion:The curative effect of nebulization inhalation in the treatment of asthmatic bronchitis is affirmative,worthy of clinical application.

  9. 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

  10. 海南儿童哮喘常见吸入性变应原的调查%Survey of common inhaled allergens on asthmatic children in Hainan

    Institute of Scientific and Technical Information of China (English)

    陈实; 王灵; 陈冰; 林小珍; 陈晓玲

    2011-01-01

    Objective To investigate the prevalenve of common inhaled allergens in asthmatic children in Hainan for exploring an effective management of allergen avoidance and providing a basis in the promotion of specific immunotherapy. Methods The skin prick test (SPT) with a panel of 13 allergen extracts was undertaken in 2 361 children with asthma, and 450 cases of them futher received specific IgE test against 10 allergens. Results The results of the SPT showed that 86% of the patients were sensitized to at least one allergen extract, and consisting of 91.2% for Dermatophagoides pteronyssinus (Der p), 89.3% for Dermatophogoides farinae (Der f) and 86.3% for Blomia tropicalis (Blo t), respectively. The pereentage of strong SPT positive eases (> 3 class) against three kinds of mites was 65.7% for Der p, 65.4% for Der f and 58.2% for Blo t, respectively. Furthermore, the SPT positive rates for animal dander in children with asthma were 22.4% for dog dander, 14.4% for cat dander, 28.7% for German cockroach, and 21.9% for America cockroach, respectively. However, the positive levels to these alergens were generally low. The positive rate of the specific IgE test in 450 children with asthma was 72.4%, and consisting of 66.2% for Der p and 59.6% for Der f. Conclusions There is a very high prevalence of the sensitization against Der p, Der f, and Blo t,and the sensitization against animal dander including dog, cat and cockroach is also found in a certain proportion in Hainan, that will be significant to avoid allergens and to promote the specific immunotherapy in asthmatic children in Hainan.%目的 了解海南地区儿童哮喘常见吸入性变应原,探讨有效实施变应原避免的措施,为成功开展特异性免疫治疗提供依据.方法 对2 361例哮喘儿童进行13种常见过敏原皮肤点刺试验,对其中450例患儿进行10种过敏原体外特异性IgE检测.结果 2 361例哮喘患儿皮肤点刺阳性率为86.0%,其中,屋

  11. 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.

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

    Directory of Open Access Journals (Sweden)

    Ana Cristina C. F. Fonseca

    2006-12-01

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

  13. 阿奇霉素治疗小儿喘息性支气管炎的临床效果观察%Clinical Effect of Azithromycin in the Treatment of Children with Asthmatic Bronchitis

    Institute of Scientific and Technical Information of China (English)

    陈剑泓

    2014-01-01

    目的:探讨阿奇霉素治疗小儿喘息性支气管炎的临床效果。方法选取本院2O11年6月-2O13年6月收治的喘息性支气管炎患儿62例,随机分为对照组和观察组。两组均行常规治疗,观察组在此基础上给予阿奇霉素,比较两组临床效果。结果观察组总有效率(9O.32%)高于对照组(77.42%),差异有统计学意义( P children with asthmatic bronchitis. Methods 62 cases of children with asthmatic bronchitis in the hospital from June 2O11 to June 2O13,were random-ly divided into control group and observation group. Two groups were treated with conventional therapy,and observation group was given Azithromycin based on this,the clinical effects were compared between the two groups. Results The curative effect of observation group(9O. 32% )was higher than control group(77. 42% ),the difference was statistically significant(P children in the process of treatment had no obvious adverse reactions;The recurrence rate of observation group was lower than control group,the difference was statistically significant(P < O. O5). Conclusion The clinical effect of Azithromycin in the treatment of children with asthmatic bronchitis is remarkable,safe and reliable,has the value of clinical ap-plication.

  14. 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.

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

    Institute of Scientific and Technical Information of China (English)

    丁俊丽; 王亚亭; 周登余; 刘晓静; 魏丽华; 李鑫

    2015-01-01

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

  16. 孟鲁斯特治疗小儿喘息性支气管炎的临床观察%Clinical Observation of Montelukast in the Treatment of Children With Asthmatic Bronchitis

    Institute of Scientific and Technical Information of China (English)

    魏晓峰

    2016-01-01

    目的:探讨孟鲁斯特治疗小儿喘息性支气管炎的时效性。方法我院2013年5月~2015年4月确诊的小儿喘息性支气管炎患儿62例,均给予常规治疗。观察组睡前口服孟鲁司特,对照组睡前口服安慰剂。结果观察组喘息症状缓解时间(t=6.416,P=0.00)、肺部哮鸣音和啰音消失时间(t=4.190,P=0.00)、平均住院天数(t=4.111,P=0.00)短于对照组,疗效优于对照组(χ2=6.7721,P=0.0338)。结论孟鲁司特钠可加速喘息性支气管炎患儿的症状和体征的改善,提高临床效果。%Objective To investigate the effectiveness of montelukast in the treatment of children with asthmatic bronchitis. Methods 62 cases of children with asthmatic bronchitis in our hospital from May 2013 to April 2015 were treated with routine treatment. The observation group was oral before bedtime, and the control group received placebo before bedtime. Results In the observation group,the asthmatic symptoms remission time(t=6.416, P=0.00),pulmonary wheezing sound tone and rales disappearance time(t=4.190,P=0.00),the average hospitalization days(t=4.111,P=0.00) shorter than the control group,the curative effect was better than that of the control group(χ 2=6.772 1,P=0.033 8). Conclusion The effect of the improvement of the symptoms and signs of the patients with acute wheezing bronchitis can be improved by the conclusion of the conclusion.

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

    Institute of Scientific and Technical Information of China (English)

    王莉华; 郭庆辉; 李朝霞; 马宇; 张太娥; 乔艳红; 王育龙

    2014-01-01

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

  18. 呼出气一氧化氮监测评估儿童哮喘病情临床价值研究%Primary investigation of fractional concentration of exhaled nitric oxide in asthmatic children

    Institute of Scientific and Technical Information of China (English)

    沙莉; 曹玲; 马煜; 李硕; 娄小尚; 陈育智

    2011-01-01

    358 asthmatic children in our asthma clinic observed from October 2007 to August 2009 were divided into different groups as asthma attack group and non-attack group, and treatment group and non-treatment group. The therapy, attack symptoms and signs of them were recorded into clinical form. Tests of spiromety and FENO were performed at the same time. Results FENO in asthmatic children was 28.5( 15.5 ~ 55.0) × 10-9, there being no significant difference between male and female. FENO in asthmatic children older than 11 years was significantly higher than in normal children[36.0 (20.0 ~ 65.0) × 10-9,12.6(9.5 ~ 17.1 ) × 10-9, Z = -11.352, P < 0.001 ]. FEN O in asthmatic children was positively correlated with age (r = 0.206, P < 0.01 ), not related to asthma history course or FVC, but slightly negatively correlated with FEV1 and MMEF(r = -0.164,P < 0.0l,r = -0.176,P < 0.01). FENO in the group of asthma attack was significantly higher than the group of non-asthma attack [ 38.4 ( 16.7 ~ 59.1 ) × 10-9, 26.0 ( 15.0 ~ 51.0 ) × 10-9;Z = -2.327, 0.01 < P < 0.05] ;in the group of treatment it was significantly lower than in the non-treatment group [24.0( 13.0 ~ 48.5) × 10-9,31.0 (16.7 ~ 57.2) × 10-9, Z = -2.215,0.05 > P > 0.01]. By analysis with ROC in children older than 11 years, the cut-off point was 17.9 × 10-9, sensitivity was 0.802, specificity was 0.825. Seventy-seven out of the 96 asthmatic chil dren with normal lung function showed higher FENO and 15 out of them had asthma attack. Conclusion It is found that FENO in asthmatic children is significantly higher than in normal children. FENO is a useful method to identify non-specific inflammation in asthmatic children from the normal children. The patients who have asthma attack or non-treatment ones have a higher FENO. Higher FENO indicates bad control or even worse condition. Patients who have no symptoms but normal lung function still have abnormal FENO. The test of FENO can be used

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

    Institute of Scientific and Technical Information of China (English)

    王倩; 张际; 梅其霞; 黄英; 袁小平; 蒋永蕙; 胡平

    2011-01-01

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

  20. 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.

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

    Institute of Scientific and Technical Information of China (English)

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

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    胡琴; 连金媚; 陈晓玲

    2013-01-01

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

  3. Pregnancy Outcomes in Asthmatic Women

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    Mehran Karimi

    2008-06-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王峥; 刘长山; 阮小玲; 王雪艳; 张奕; 李霞; 杨静

    2010-01-01

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

  5. 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.

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

    Institute of Scientific and Technical Information of China (English)

    魏然; 叶依娜; 龚享锋; 石就家; 谭丹

    2016-01-01

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

  7. 病毒感染与儿童哮喘急性发作相关性分析%The Correlation Analysis between Virus Infection and Acute Asthmatic Attack in Children

    Institute of Scientific and Technical Information of China (English)

    范如艳; 范楚平; 潘俊秀; 陈礼娟; 肖志兵; 刘婵

    2015-01-01

    Objective :To explore the correlation analysis between virus infection and acute asthmatic attack in chil‐dren .Methods :Totally seven‐hundred seventy children with asthma were recruited ,and divided into experimental group (n= 367)with acute asthmatic attack and control group(n= 403) with asthma in remission stage .Seven virus infections were identified by immunofluorescence testing of nasopharyngeal swabs was collected during respiratory episodes .Re‐sults :There are at least one virus was detected in experimental group (239/367 ,65 .1% ) and control group(60/403 , 14.9% ) .Respiratory syncytial virus (RSV) was the most (154/367 ,42 .0% in experimental group and 39/403 ,9 .7%in control group) ,and the others were parainfluenza Ⅲ (31/367 ,8 .4% and 11/403 ,2 .7% ,respectively) ,adenovirus (25/367 ,6 .8% and 5/403 ,1 .2% ,respectively) ,influenza A virus (11/367 ,3 .0% and 3/403 ,0 .7% ,respectively) ,in‐fluenza B virus(9/367 ,2 .5% and 1/403 ,0 .2% ,respectively) ,parainfluenza Ⅰ (5/367 ,1 .4% and 1/403 ,0 .2% ,respec‐tively) ,parainfluenza Ⅱ (4/367 ,1 .1% and 0/403 ,0% ,respectively) .It is significantly difference between experimen‐tal group and control group(P< 0 .01). The detection rates of virus was highest in children aged < 6 month(67 .5% ) . RSV infection has obvious seasonal character ,most illness occurs in yearly outbreak in the winter and early spring months ,e .g .October to April .Conclusion :There is a close relationship between virus infection and acute asthmatic at‐tack in children .RSV is the major causes of acute asthmatic attack in infant ,and the peak of onset was in winter and spring .%目的:了解病毒感染与儿童哮喘急性发作之间的相关性。方法:应用直接免疫荧光法(DIF),对实验组(367例哮喘急性发作患儿)和对照组(403例哮喘缓解期患儿)鼻咽分泌物进行7种病毒抗原检测。结果:实验组239例检出至少1种病毒,总检出率65.1%。呼吸

  8. HT. A clinician demurs.

    Science.gov (United States)

    Speroff, Leon

    2003-10-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王文英

    2014-01-01

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

  10. 吸入糖皮质激素治疗哮喘儿童5年后回顾性研究%5-year retrospective study on inhaled corticosteroid therapy in asthmatic children

    Institute of Scientific and Technical Information of China (English)

    汤正珍; 郑跃杰

    2013-01-01

    目的 了解哮喘儿童吸入糖皮质激素(Inhaled corticosteroids ICS)治疗5年后的病情控制情况,探讨影响儿童哮喘病情控制水平的相关因素.方法 对2003年至2004年在哮喘门诊登记、当时均给予ICS治疗的186例儿童进行现场回顾性调查.现场调查包括填写调查表,进行肺功能检测和皮肤过敏原点刺试验(Skin-prick testing SPT).结果 186例完成了现场调查,完全控制率为42%,其中完成ICS治疗的145例的完全控制率为47.6%,明显高于未完成治疗组(22%).完全控制和部分/未控制两组的性别、年龄、家族过敏史和哮喘家族史差异无统计学意义(P>0.05),而部分/未控制组的本人过敏明显高于完全控制组(P<0.05).ICS起始治疗的年龄和病程对哮喘完全控制率无明显影响;部分/未控制组中ICS疗程>2年和目前持续ICS治疗的比例明显高于完全控制组(P<0.05).结论 儿童哮喘患者5年后,仅有42%达到并且维持完全控制,哮喘儿童的长期控制情况并不理想.ICS治疗能够明显提高哮喘儿童的完全控制率,其效果可能与起始治疗的年龄和病程无关,要达到并维持完全控制,可能需要长期、持续的ICS治疗.%Objective To assess the prognosis of asthmatic children received inhaled corticosteroid (ICS) therapy for 5 years,and explore the relevant factors associated with persistent childhood asthma.Methods The retrospective study was carried out in 186 asthmatic children received treatment of ICS from 2003 to 2004 in Shenzhen Children' s Hospital.The patients were assessed by questionnaire,lung function examination and skin prick tests (SPT).Results All 186 patients finished the investigation.The rate of patients whose disease were fully controlled in 145 cases who received ICS therapy for more than 3 months was 47.6%,which was significantly higher than that (22%) of the patients who received no ICS therapy or for less than 3 months.There was no

  11. 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

  12. 厦门市学龄期哮喘儿童的疾病知识与自我处理行为的探讨%Knowledge of asthma and coping behavior among asthmatic school children in Xiamen

    Institute of Scientific and Technical Information of China (English)

    马洁; 许丽旋; 林淑芬; 李秀珍

    2012-01-01

    [Objective] To investigate the characteristics of school-age children with asthma, the degree of disease knowledge and self-management behavior,and to explore the awareness of children with asthma symptoms and self-management behavior. [Method] A cross-sectional descriptive study design targeted at 100 7~12 years old asthmatic children from three top three hospital pediatric asthma clinic of Xiamen city,the asthma knowledge scale "and" asthma self-management behavior scale were filled out. [Results] 1) disease knowledge and treatment behavior-related factors as age,disease severity,showed a positive correlation. 2) the disease was significantly and positively related to knowledge and self-management behavior. [Conclusion] It should be to strengthen the knowledge of school-age children with asthma awareness and self-processing capacity.%[目的]了解学龄期哮喘儿童的疾病知识程度和自我处理行为的特性,并探讨哮喘儿童对症状的认知与自我处理行为的相关性. [方法]采用横断式描述性相关性研究设计,对象为厦门市三所三甲医院儿科哮喘门诊100位7~12岁的哮喘儿童,填写了哮喘知识量表和哮喘自我处理行为量表. [结果] 1)与疾病知识和处理行为重要的相关因素为年龄、疾病的严重程度,呈正相关;2)疾病知识与自我处理行为呈中度的正相关. [结论]应加强学龄期哮喘儿童的知识认知及自我处理的能力.

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

    Institute of Scientific and Technical Information of China (English)

    林菊清; 黄春香; 张立岗

    2011-01-01

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

  14. 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

  15. 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...

  16. 儿童哮喘急性发作支气管肺泡灌洗液病毒病原学分析%The Bronchoalveolar Lavage Fluid Viral Pathogens Analysis of Acute Asthmatic Attack in Children

    Institute of Scientific and Technical Information of China (English)

    潘俊秀; 范楚平; 范如艳; 陈礼娟; 肖志兵; 刘婵

    2015-01-01

    目的:了解病毒感染与儿童哮喘急性发作相关性。方法:应用直接免疫荧光法(DIF),对实验组(67例哮喘急性发作患儿)和对照组(73例哮喘缓解期患儿)支气管肺泡灌洗液进行7种病毒抗原检测。结果:实验组51例检出至少1种病毒,总检出率76.1%。呼吸道合胞病毒(RSV)检出最多,为32例,检出率47.8%,其余,依次为副流感病毒Ⅲ(PIV Ⅲ)7例(10.4% ),腺病毒(ADV)5例(7.5% ),流感病毒 A(IFA) 3例(4.5% ),流感病毒 B(IFB)2例(3.0% ),副流感病毒Ⅰ(PIV Ⅰ)1例(1.5% ),副流感病毒Ⅱ(PIV Ⅱ) 1例(1.5%)。对照组12例检出至少 1种病毒,总检出率16.4%。 呼吸道合胞病毒(RSV)检出最多,为9例,检出率12.3%,其余,依次为副流感病毒Ⅲ (PIV Ⅲ) 2例(2.7% ),腺病毒(ADV)1例(1.4% ),流感病毒 A(IFA)、流感病毒 B(IFB)、副流感病毒Ⅰ(PIV Ⅰ)、副流感病毒Ⅱ(PIV Ⅱ)均未检测到。两组比较差异有显著性意义(P< 0.01)。结论:病毒感染与儿童哮喘急性发作有密切相关性,RSV 是引起儿童哮喘急性发作的主要病毒。%Objective :To explore the correlation analysis between virus infection and acute asthmatic attack in chil‐dren .Methods :Totally one‐hundred forty children with asthma were recruited ,and divided into experimental group(n=67) with acute asthmatic attack and control group(n= 73) with asthma in remission stage .Seven virus infections were identified by immunofluorescence testing of bronchoalveolar lavage fluid(BALF) .Results :There are at least one virus was detected in experimental group ,(51/67 ,76 .1% ) and control group(12/73 ,16 .4% ) .Respiratory syncytial virus (RSV) was the most (32/67 ,47 .8% in experimental group and 9/73 ,12 .3% in control group) ,and the others were parainfluenza Ⅲ (7

  17. The effects of polysaccharide nucleic acid fractiion of bacillus calmette guerin and specific immunotherapy on pulmonary function and serum IgE in asthmatic children%卡介菌多糖核酸和特异性免疫治疗对哮喘儿童肺功能和血清IgE的影响

    Institute of Scientific and Technical Information of China (English)

    黄李平; 刘战军; 汪清

    2011-01-01

    目的 研究卡介菌多糖核酸(BCG-PNA)和特异性免疫治疗(SIT)对哮喘儿童肺功能和血清IgE的影响.方法 用BCG-PNA和SIT治疗42例哮喘儿童,治疗前后检测肺功能,用酶联免疫吸附试验检测血清IgE水平.结果 BCG-PNA、SIT能明显改善哮喘儿童肺功能FVC、FEV1、V25等指标,BCG-PNA还能降低血清IgE水平.两者联合治疗比SIT治疗降低血清IgE更明显.结论 BCG-PNA和SIT能改善哮喘儿童肺功能,两者联合治疗对降低血清IgE有协同作用.%Objective This research aimed to explore the effects of polysaccharide nucleic acid fraction of Bacillus calmette Guerin (BCG-PNA) and specific immunotherapy (SIT) on pulmonary function and serum IgE in asthmatic children. Methods Before and after treatments with BCG-PNA and SIT, pulmonary function of 40 asthmatic children was analyzed. The serum IgE was detected by ELISA. Results BCG-PNA and SIT could improve FVC, FEV1 and V25 of pulmonary function indexes. BCG-PNA decreased serum IgE. Combination of these two treatments reduced serum IgE compared with SIT. Conclusion Both BCG-PNA and SIT can improve pulmonary function of asthmatic children. Combination of them has stronger effect in reducing serum IgE.

  18. Fatores de risco para consultas em pronto-socorro por crianças asmáticas no Sul do Brasil Asthmatic children's risk factors for emergency room visits, Brazil

    Directory of Open Access Journals (Sweden)

    Moema Chatkin

    2000-10-01

    Full Text Available OBJETIVOS: Traçar um perfil das crianças asmáticas do município de Pelotas, RS, conhecer o manejo da doença e os fatores de risco associados a consultas em pronto-socorro, motivadas por asma. MÉTODOS: Estudo transversal aninhado a um estudo de coorte, realizado na área urbana de Pelotas, cidade de médio porte do Sul do Brasil. Participaram 981 crianças de 4-5 anos, pertencentes à coorte de 1993. RESULTADOS: A prevalência de asma encontrada na amostra estudada foi de 25,4%. A morbidade por asma foi elevada: 31% das crianças asmáticas haviam procurado o pronto-socorro no último ano, 57% tinham consultado médico e 26%, de 1 a 4 anos, foram internadas por asma. Na análise geral, escolaridade e renda familiar baixas associaram-se com consultas em pronto-socorro (RO=4,1 para 0 a 4 anos de escolaridade e RO=6,5 para menos de 1 salário-mínimo. Dormir em quartos com 3 ou mais pessoas também mostrou-se associado (RO=2,2, bem como severidade das crises (RO=2,7, uso de medicamentos para asma no último ano (RO=1,9 e internações por asma (RO=3,0. CONCLUSÕES: A prevalência de asma entre crianças pré-escolares em Pelotas é alta, levando a grande morbidade. Encontraram-se como fatores preditores de consultas em pronto-socorro por asma, após análise multivariada, a baixa escolaridade das mães, severidade das crises e internação por asma.OBJECTIVES: To study a sample of asthmatic children to get to know how the disease is managed by caretakers and to identify predictive factors associated with attendance in emergency room for asthma. METHODS: A cross-sectional study nested in a cohort was undertaken in the urban area of Pelotas, Southern Brazil. 981 children aged 4-5 years, who belong to the cohort of 1993, participated in this study. RESULTS: The asthma prevalence in the children sample was 25.4%. Morbidity for asthma was quite high: 31% of the children were seen in emergency rooms in the last year, 57% attended medical clinics and

  19. Lactation resources for clinicians.

    Science.gov (United States)

    Turner-Maffei, Cynthia

    2007-01-01

    Breastfeeding is widely acknowledged as the optimal infant feeding choice. However, many clinicians working in maternal and child health do not receive adequate university preparation to support breastfeeding. Knowledge and skill are most often gained through on-the-job and personal experience. Myriad resources exist to support clinicians in delivering the best quality care to breastfeeding clients. Among the available resources are policies and protocols of professional organizations, governmental, and health advocacy groups. Breastfeeding-focused academic and continuing education programs are identified. Electronic and other resources for breastfeeding information are available for both professional and consumer audiences.

  20. Exploration and research of community management model for asthmatic children%儿童支气管哮喘社区管理模式的探索

    Institute of Scientific and Technical Information of China (English)

    李京鹏; 魏红; 李学军; 王蒙蒙; 王根香; 赵顺英

    2014-01-01

    Objective To study the efficacy of community management model of bronchial asthma in children.Method 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.Result 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%) (x2 =51.9,41.1,P <0.01),use of inhaled corticosteroids (76.5%) and oral leukotriene receptor antagonist (79.6%) was significantly higher compared with control and before management level (10.0%),x2 =106.0,P < 0.01.The days of attacks of asthma (4.6 ± 2.3),the use of antibiotics (16.2 ± 6.1),(5.7 ± 2.9) and the cost of treatment significantly decreased.In 16 cases (13.3%) two-way referral was applied.In this study,the dropout rate was 18.3%,by telephone and network supervision of lost cases,re-education,made some children return to management,eventually the dropout rate was 9.2%.Conclusion Enrollment of children with bronchial asthma into community management model made the children adhere to the management regularly and a standardized management was achieved.%目的 探讨儿童支气管哮

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2010-02-15

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

  2. 社区卫生管理儿童哮喘的效果分析%Exploration of Community Medical Management Model for Asthmatic Children

    Institute of Scientific and Technical Information of China (English)

    吕广秀; 周娟; 曹勇

    2015-01-01

    目的:讨论社区卫生管理儿童哮喘的成效。方法依据《全球哮喘防治指南》的要求,对昆山地区发现的患哮喘儿童230例,建立和健全社区卫生医院管理儿童哮喘的方案,即建立患儿病案,通过专线、微信及网络等医患互动信息,对患儿与家长举办哮喘知识培训学校,督导规范用药,定期门诊随访。并对实施社区卫生管理前和管理1年后的哮喘患儿在规范用药,病情变化,抗生素等药物使用,家长认同等方面进行对比分析。结果管理1年后,用局部吸入糖皮质激素(75.8%)及口服白三烯受体拮抗剂-孟鲁司特(75.2%)与管理前使用(6.8%、6.5%)比较有显著增加(P<0.01)。哮喘年发作次数(0.8±0.3),抗生素及β2受体激动剂使用天数(3.9±1.8),最大呼气流量值提高50%的百分比(32.3±7.6)较管理前(4.8±2.6)、(17.4±5.9)、(70.3±10.8)比较,均有统计学意义(P均<0.01)。其管理后全身用激素(18.5%)与管理前(70.4%)比较明显减少(χ2=53.2,P<0.01);家长对治疗满意率为(97.2%)比管理前的(62.7%)明显提升(χ2=52.9,P<0.01)。有28例(12.2%)初始失诊,对其跟踪、教育,最后失诊为18例(7.8%)。结论把患哮喘儿童纳入社区卫生管理是防治儿童哮喘的有效模式。%Objective To discuss the efficacy of community medical management model of bronchial asthma in children.Method Through community medical center and clinic, 230 cases of children with asthma were enrolled from the kunshan area, aged 0 to 12 year, to build a community medical management model of asthma according to the Global Initiative for Asthma requirements combined with the actul situation of the community,both pediatics and patients with parents participated in case identification, file creation, and long-term standardized management, with repeated medical asthma education, the

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  4. 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…

  5. 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)

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

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    MARIA ÂNGELA G. MONTEIRO-ANTONIO

    2002-06-01

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

  7. Expired nitric oxide levels in adult asthmatics

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    Chiharu Okada

    1996-01-01

    Full Text Available The expired nitric oxide (NO concentration is known to be higher in asthmatic subjects than in normal subjects. To elucidate the role of NO in asthma, we examined the expired NO concentrations in relation to the type (atopic, mixed, non- atopic, and severity (mild, moderate, severe of asthmatics, as well as the influence of steroid treatment. Twenty-seven normal subjects, 48 asthmatics, 8 subjects with allergic rhinitis, and 13 subjects with pulmonary emphysema participated in the study. The expired NO concentration was significantly higher in asthmatics and patients with allergic rhinitis than in normal subjects (P<0.01. No significant difference was observed between the expired NO concentration in patients with pulmonary emphysema and that of normal subjects. The expired NO concentrations were significantly lower in non- atopic asthma than in atopic asthma. Nitric oxide levels were significantly lower in severe asthma than in mild asthma. High doses of steroid treatment are often used in severe asthma. The dose of inhaled beclomethasone and expired NO concentrations showed a negative correlation (r= −0.51587, P<0.004. Drip infusion of hydrocortisone tended to increase the exhaled NO concentration just after drip infusion, however, it decreased after 24 h. These results suggest that steroid treatment decreases the expired NO concentrations in asthmatics, although it cannot be concluded that NO increases the severity of asthma. The measurement of expired NO concentrations is an easy, non-invasive test, which may be a useful tool for monitoring the condition of asthmatics.

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

    Directory of Open Access Journals (Sweden)

    Roberto Travieso Peña

    Full Text Available

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

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

  9. Clinical efficacy of a standardized specific immunotherapy against house dust mite in 85 asthmatic children%尘螨标准化免疫治疗85例哮喘儿童疗效相关指标分析

    Institute of Scientific and Technical Information of China (English)

    张璇; 李孟荣; 王超; 王晓宁; 张海邻; 林剑; 金可; 李迎春

    2010-01-01

    , total IgE, specific IgE, peak expiratory flow rate (PEF), etc. during a standardized SIT against house dust mite in allergic asthmatic children. Method Children (5-13 years old) with mild to moderate allergic asthma seen from February 2005 to June 2008 were enrolled into this study. A non- randomized retrospective study was performed. All children were diagnosed sensitive to dust mites, the treatment group accepted standardized dust mite allergen specific immunotherapy. Each fourth injections were defined as observation points, the study took 3.4 years. The investigators recorded the treatment, the cumulative allergen extract, changes of daffy doses of inhaled corticosteroid, peak expiratory flow (PEF), total IgE (TIgE), specific IgE (SIgE). The control group only received inhaled corticosteroids. The daily doses of inhaled corticosteroid and the number of asthma attacks,and the control rate were compared between the 2 groups. Result Totally 85 children were treated with SIT [(7.6 ± 1.4) years], 45 males and 40 females; 50 children received only drug treatment [(7.7 ± 1.5)years], 28 males and 22 females. The cumulative dose of allergen was up to (69.7 ± 4.8) μg after the 20 times injection, the dose of inhaled corticosteroids was significantly less than that in the control group ( t =2. 359, P < 0.05). PEF was significantly higher than that of pre-treatment level ( F = 7.874, P < 0.05 ).TIgE and SIgE had no significant change (t = 0.313, P > 0.05, tDerp = 0.517, tDerf = 0.717,P > 0.05 ). After the treatment, the control rate of the SIT group was 85.5%, that of the control group was 62.0% (X2 =10.150, P <0.01). Conclusion The standardized SIT against house dust mite could reduce steroid use in mild to moderate allergic asthmatic children. After ( 38.7± 2.3 ) weeks, the cumulative dose of allergen was up to (69.7 + 4.8) μg, inhaled corticosteroid was significantly reduced. At the end of SIT, 85% of patients obtained complete control of asthma. Total Ig

  10. 广州市支气管哮喘患儿家长知信行问卷调查分析%Knowledge-Attitude-Practice Survey on Asthmatic Children's Parents in Guangzhou

    Institute of Scientific and Technical Information of China (English)

    黄顺开; 陈爱欢; 孙丽红; 王金华; 黄穗; 陈虹; 陈奋华

    2011-01-01

    Objective To investigate the recognition of asthma by parents of children with asthma in Guangzhou and current prevalence of pediatric asthma.Methods Multicenter survey was carried out on parents who were permanent Guangzhou residents, whose children had the diagnosis of asthma made for over 6 months,or resorted to asthma or pediatric specialists in 2 hospitals in Guangzhou.Results A total of 148 parents were enrolled,among whom 69.86% were aware that asthma was chronic airway inflammatory disease,61.49% realized that long - term inhaled cortieosteroids affected children's growth and development,and 82.43% knew that asthma was mainly induced by cold.There were 76.22% percent of children never used peak flow meter,and 95.17% of children never applied Children - Asthma Control Tests ( C -ACT).In the past 12 months,56.8% of children had wheezing with an average annual frequency of (3.37 ± 0.28 ) episodes.There were 37.5% of children required emergency treatments,with an average of ( 1 320.34 ± 223.97) yuan for emergency treatment and (6 111.84 ±1 828.41 ) yuan for direct economic costs.The average absence from class was ( 28.13 ± 6.67 ) days, and the average loss of working time was (18.88 ± 8.73 ) days per family per year.Conclusions Parents of asthmatic children in Guangzhou have certain recognition of asthma.However,knowledge of controlling medication,inducing factors,family and self-management need to be improved.%目的 了解广州市支气管哮喘(简称哮喘)患儿家长对哮喘认知及患儿哮喘的现状.方法 采用多中心调查方法,对广州市常住居民诊断为哮喘6个月以上,在广州市2家医院哮喘专科或儿科门诊就诊患儿的家长进行调查.结果 共调查148例患儿家长,69.86%的家长意识到哮喘是一种呼吸道慢性炎症性疾病;61.49%的家长认为长期吸入激素对于孩子的生长发育有影响;82.43%的家长认为哮喘主要由感冒诱发.76.22%的患儿未使用过峰流

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

    Institute of Scientific and Technical Information of China (English)

    郝创利; 陶慧; 沈美菊; 侯政

    2008-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Gustavo Nino

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

  13. Transthoracic Ultrasonography for Clinicians

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    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

  14. Nitrites in induced sputum as a simple and cheap non-invasive marker of airway inflammation for asthmatic schoolchildren.

    Science.gov (United States)

    Recabarren, Arturo; Apaza, Carlos; Castro-Rodríguez, José A

    2008-08-01

    To determine if there are differences in the nitric oxide metabolites (nitrites) in sputum of patients with persistent asthma and healthy schoolchildren, we performed a case-control study in a tertiary care hospital in Arequipa, Perú. Nitrites in induced sputum samples were measured using the Griess assay in 30 persistent asthmatics (mean age of 10.1 yr) and 30 controls (mean age of 11.9 yr). The mean +/- s.d. of nitrites among asthmatics was significantly higher than the controls (16.30 +/- 8.6 vs. 10.25 +/- 4.68 nmol/ml, respectively, p = 0.001). Moreover, the nitrite level in the sputum in children with severe persistent asthma was higher than in the level found in the moderate and mild asthmatics (32.83 +/- 9.48 vs. 18.10 +/- 1.96 vs. 11.84 +/- 4.73 nmol/ml, respectively, p < 0.01 for linear trend). This study showed for the first time in children that asthmatics have significantly higher levels of nitrites in induced sputum than healthy controls and that the level of nitrite correlates with the severity of the asthma. Nitrite levels in sputum, a simple and cheap, non-invasive method, may be a good alternative to measure the severity of inflammation in asthmatic children.

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

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    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.

  16. 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.

    2016-01-01

    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 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 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. PMID:27829752

  17. 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...... 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....

  18. 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.

  19. 不同亚型中重度支气管哮喘患儿白细胞介素-5、免疫球蛋白E水平变化及意义%Changes of Interleukin-5 and Immunoglobulin E Levels in Moderate to Severe Asthmatic Children with Di-fferent Asthma Subtypes and Their Clinical Significance

    Institute of Scientific and Technical Information of China (English)

    陈环; 檀卫平; 李静; 麦贤弟; 蓝丹

    2011-01-01

    目的 研究IL-5、IgE水平在不同亚型中重度患儿哮喘发病中的变化及意义.方法 选取2009年9月-2010年3月于本院儿科哮喘专科门诊就诊的中重度哮喘患儿65例(哮喘组),将哮喘组中急性发作期患儿按诱导痰的细胞分类分为嗜酸性粒细胞(EOS)型哮喘(EA)组及非EOS型哮喘(NEA)组.选取20例健康儿童为健康对照组.采用ELISA法检测不同亚型哮喘患儿血清IgE水平.将哮喘组及健康对照组儿童外周血单个核细胞(PBMC)与CD3单克隆抗体及CD28单克隆抗体共培养,ELISA法检测PBMC在抗体刺激下分泌的IL-5水平.并对IL-5表达水平与IgE水平进行相关性分析,了解IL-5、IgE在不同亚型中重度哮喘患儿中的作用.结果 EA组诱导痰EOS百分比明显高于NEA组(P=0.000).哮喘组患儿PBMC表达的IL-5水平显著高于健康对照组,急性发作组明显高于临床缓解组,急性发作重度持续组显著高于中度持续组,EA组显著高于健康对照组及NEA组.EA组血清IgE水平显著高于NEA组(P=0.010).哮喘患儿外周血及EOS诱导痰EOS比例与IL-5、IgE水平呈显著正相关(Pa=0.000);哮喘患儿IL-5水平与IgE水平也呈显著正相关(r=0.482,P=0.001).结论 IL-5、IgE参与哮喘的发病,IL-5、IgE在EA中的作用较NEA更为突出.IL-5水平与哮喘病情分度密切相关.%Objective To investigate the changes and significances of interleukin - 5 ( IL - 5 ) and immunoglobulin E ( IgE ) levels in children with different subtypes asthma, ranging from moderate to severe cases. Methods Sixty - five moderate to severe asthmatic children (asthma group) and 20 healthy children (healthy control group) were selected from Sep. 2008 to Mar. 2009 in Department of Pediatrics, Sun Yat - Sen Memorial Hospital of Sun Yat - Sen University in the research. The asthmatic children in the acute stage were divided into 2 groups according to the cell type in induced sputum, one group was labeled as eosinophilic (EOS) asthma (EA

  20. Bronchial hyperresponsiveness and anti-asthmatic therapy

    NARCIS (Netherlands)

    Kraan, Jan

    1990-01-01

    Many asthmatic patients experience shortness of breath or wheezing, when exposed to cold air, or irritants like baking fumes, exhaust gases or cigarette smoke. This clinical phenomenon has been called bronchial hypemsponsiveness (BHR), which is defined as an exaggerated broncho-obstructive response

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

    NARCIS (Netherlands)

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

    2011-01-01

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

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

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    Michal Sarna

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    倪玉婷; 孙素涛; 张晶洁; 冯海音; 唐君; 徐荣谦

    2014-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Gómez Baute

    2003-04-01

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

  6. 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

  7. [Determination of serum immunoglobulins in asthmatic patients].

    Science.gov (United States)

    Cabrera Jiménez, M; Valdés Sánchez, A F; Argüelles Sobrino, D; Gómez Echevarría, A H; Lastra Alfonso, G

    1989-01-01

    One hundred eighty one asthmatic patients were evaluated at the Allergy Consultation in Hermanos Ameijeiras Clinical Surgical Hospital. A case history was made for each of the patients, where the family background and personal history of allergy was collected; possible precipitating factors (such as inhalable, food, infectious, irritant, as well as climate factors) and physical and respiratory examinations. Serum immunoglobulin tests (by means of the ultramicroanalitic system (SUMA) and the rest of Igs: IgA, IgG, IgM by means of Mancini's simple radial immunodifusion method were made. Total eosinophil count was made to all of the patients in the study as well as serial studies of the faces. An increase in the IgE and IgM figures was found in asthmatic patients related to individual controls, and in relation to the normal figures for the adult population in our country. IgA and IgG determinations were normal both in the asthmatic and control groups, related to the standard figures.

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

    Institute of Scientific and Technical Information of China (English)

    郭玉兰; 郦银芳; 张莉

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Kajaria Divya

    2013-02-01

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

  10. Air pollution and respiratory health of children: the PEACE panel study in Katowice, Poland.

    NARCIS (Netherlands)

    Niepsuj, G.; Niepsuj, K.; Nieroda-Muller, A.; Rauer, R.; Krzywiecki, Z.; Borowska, M.; Hlawiczka, Z.; Brunekreef, B.

    1998-01-01

    This study was carried out within the framework of the multicentre Pollution Effects on Asthmatic Children in Europe (PEACE) project. Two panels of mildly asthmatic children were studied. Seventy two children living in the Upper Silesia (the largest Polish industrial agglomeration) and 73 children i

  11. Urban air pollution and children's asthma: what do parents and health professionals think?

    Science.gov (United States)

    Stevens, Emma; Cullinan, Paul; Colvile, Roy

    2004-06-01

    Our objective was to explore and compare, in the context of other exposures, lay and professional perceptions of the links between urban air pollution and children's asthma. We used a triangulated survey approach, using quantitative questionnaire surveys enriched by qualitative interviews. Derivation of indicators of actual local air quality used modelled air pollution and a geographical information system. Our setting involved families and community health professionals in the London borough of Ealing, and pediatric respiratory specialists across the United Kingdom. Participants included 863 parents of children aged 3-11 years, 151 reporting currently asthmatic children, of whom 20 were extensively interviewed; 98 local general practitioners and 50 practice nurses; and 75 paediatric respiratory consultants and 55 specialist nurses. Main outcome measures involved views about the links between urban air pollution and children's asthma, relative to other triggers. Comparison of assessments of local air quality, with actual pollution levels, was made by parents with and without asthmatic children. Many parents were unsure as to what factors initiate asthma, but the most frequently cited was traffic pollution; it was also considered important in the exacerbation of asthma. Health professionals' assessments were inconsistent: specialists conformed to the dominant literature dismissing strong links between air pollution and asthma, while local clinicians reflected the views of parents in their community. Surrounding parents' views were difficulties defining exposures to urban air pollution, underlying concerns about risks to general health, perceived lack of control, unclear expert opinion, and widely accepted informal "messages" which assumed strong links. Parents with experience of asthma were found to have significantly less accurate (negatively biased) perceptions of local air quality. In conclusion, reactions to uncertainty surrounding associations between asthma

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

    Directory of Open Access Journals (Sweden)

    Meguro,Tadamichi

    1982-08-01

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

  13. 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.......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....

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

    Directory of Open Access Journals (Sweden)

    Lokendra

    2014-06-01

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

  15. Acute Chlamydia pneumoniae infections in asthmatic and non-asthmatic military conscripts during a non-epidemic period.

    Science.gov (United States)

    Juvonen, R; Bloigu, A; Paldanius, M; Peitso, A; Silvennoinen-Kassinen, S; Harju, T; Leinonen, M; Saikku, P

    2008-03-01

    Chlamydia pneumoniae respiratory tract infections were studied in 512 male military conscripts (123 asthmatic and 389 non-asthmatic) taking part in 180-day service between July 2004 and July 2005 in Kajaani, Finland. Respiratory tract infections requiring a medical consultation were analysed prospectively. At baseline, at end of service, and during each episode of respiratory infection, blood samples were obtained for measurement of C. pneumoniae antibodies. Data concerning the clinical features of each infection episode were collected. Serological evidence of acute C. pneumoniae infection was found in 34 of the 512 conscripts with antibody data available, including 9.8% of the asthmatic subjects and 5.7% of the non-asthmatic subjects (p 0.111). A serological diagnosis could be made for 25 clinical episodes in 24 conscripts. The spectrum of respiratory tract infections included 13 episodes of mild upper respiratory tract infection and seven episodes of sinusitis, with five episodes involving asthma exacerbation. Two of three pneumonias were primary infections. Primary infections were diagnosed in five subjects, and re-infection/reactivation in 19 subjects, with the latter comprising 12 non-asthmatic subjects and seven asthmatic subjects (p 0.180). Prolonged infections were present in six asthmatic subjects and one non-asthmatic subject (p 0.001). A wide variety of respiratory tract infections, ranging from common cold to pneumonia, were associated with serologically confirmed C. pneumoniae infections. Infections were often mild, with common cold and sinusitis being the most common manifestations. Acute, rapidly resolved C. pneumoniae infections were equally common among asthmatic subjects and non-asthmatic subjects, whereas prolonged infections were more common among subjects with asthma.

  16. Tobacco control for clinicians who treat adolescents.

    Science.gov (United States)

    Sargent, James D; DiFranza, Joseph R

    2003-01-01

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

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

    Science.gov (United States)

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

    2013-12-01

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

  18. STUDY OF AIRBORNE INSECT ALLERGEN IN ASTHMATIC PATIENTS

    Institute of Scientific and Technical Information of China (English)

    孙秀珍; 刘云; 周玎

    2004-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Cínthia Maria X. Costa

    2012-09-01

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

  1. Fathers with mental illness: implications for clinicians and health services.

    Science.gov (United States)

    Fletcher, Richard J; Maharaj, O'Neil N; Fletcher Watson, Chloe H; May, Chris; Skeates, Nigel; Gruenert, Stefan

    2013-08-05

    A significant proportion of fathers living with their natural, adopted, step or foster children experience mental illness. Psychiatric illness among fathers can have a devastating impact on children's wellbeing, and even milder forms of paternal mental illness can have serious developmental effects on children. While several pathways linking paternal mental illness with poor child outcomes have been identified, fathers' impaired parenting is an important, potentially malleable factor. Clinicians can assist fathers with mental illness and their families by proactively inquiring about children and by exploring fathering-focused psychological support.

  2. 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

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

    NARCIS (Netherlands)

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

    2004-01-01

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

  4. [Influence of the inhaler device on bronchodilatation in the asthmatic child].

    Science.gov (United States)

    Dubus, J C; Stremler, N; Mely, L; Bruguerolle, B

    1997-06-01

    The use of spacer devices is recommended in asthmatic children for inhaled therapeutics. Therefore, in vitro studies prove the dependent-device delivery of the drug. The aim of this study was to compare, in vivo, the effect of 200 micrograms of albuterol, delivered via one of the five spacer devices currently marketed in France (Aerochamber, Aeroscopic, Babyhaler with a face mask, Nebuhaler or Volumatic) and assessed by the induced peak expiratory flow (PEF) change. One hundred asthmatic children were recruited and randomized in 5 groups. The mean age was 8.9 +/- 3.3 years. Each group was comparable regardless of gender, height, weight, characteristics of asthma and baseline PEF. The maximal change in PEF was obtained with Babyhaler (14.9 +/- 12.8%; p = 0.009). The increase in PEF elicited with Aeroscopic was 9.7 +/- 10.2%. The others spacer devices did not offer a change greater than the variation of PEF in the studied population. Further studies, concerned with a measurement of drug deposition or with an assessment of its use in obstructive episodes of asthma, are required, but Babyhaler with a face mask, usually reserved to infants, deserves to be advised to older children for salbutamol intake.

  5. Haematological and lipid profile assays in Nigerian asthmatics

    Institute of Scientific and Technical Information of China (English)

    Caroline E Omotil; Egbagbe Eruke Elizabeth

    2009-01-01

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

  6. 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.

  7. 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 a

  8. Clinician-performed thyroid ultrasound.

    Science.gov (United States)

    Coltrera, Marc D

    2014-08-01

    This article is intended to demystify the process for those with a potential interest in acquiring ultrasound skills. It is not intended to be a comprehensive review of head and neck ultrasound but, rather, is focused on the bare minimum requirements and considerations involved in clinician-performed ultrasound. The article covers the initial diagnosis and the unparalleled usefulness of ultrasound for surgical planning just before incision. Further readings are listed at the end of the article to direct the reader to some excellent texts to help build confidence and experience.

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

    Institute of Scientific and Technical Information of China (English)

    王艳军

    2015-01-01

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

  10. 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.

  11. 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.

  12. Contemporary topics in pediatric pulmonology for the primary care clinician.

    Science.gov (United States)

    Mueller, Gary A; Wolf, Stephen; Bacon, Elizabeth; Forbis, Shalini; Langdon, Leora; Lemming, Charlotte

    2013-07-01

    Disorders of the respiratory system are commonly encountered in the primary care setting. The presentations are myriad and this review will discuss some of the more intriguing or vexing disorders that the clinician must evaluate and treat. Among these are dyspnea, chronic cough, chest pain, wheezing, and asthma. Dyspnea and chest pain have a spectrum ranging from benign to serious, and the ability to effectively form a differential diagnosis is critical for reassurance and treatment, along with decisions on when to refer for specialist evaluation. Chronic cough is one of the more common reasons for primary care office visits, and once again, a proper differential diagnosis is necessary to assist the clinician in formulating an appropriate treatment plan. Infant wheezing creates much anxiety for parents and accounts for a large number of office visits and hospital admissions. Common diagnoses and evaluation strategies of early childhood wheezing are reviewed. Asthma is one of the most common chronic diseases of children and adults. The epidemiology, diagnosis, evaluation, treatment, and the patient/parent education process will be reviewed. A relatively new topic for primary care clinicians is cystic fibrosis newborn screening. The rationale, methods, outcomes, and implications will be reviewed. This screening program may present some challenges for clinicians caring for newborns, and an understanding of the screening process will help the clinician communicate effectively with parents of the patient.

  13. 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.

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

    Institute of Scientific and Technical Information of China (English)

    谭永强; 曹兰芳; 沈瑾; 陈柳; 叶桂云; 徐决平

    2011-01-01

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

  15. 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...... 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....... 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...

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

    Directory of Open Access Journals (Sweden)

    Matiana Ramírez-Aguilar

    2008-02-01

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

  17. 85例小儿喘息性支气管肺炎的护理体会%The clinical nrusing of asthmatic bronchial pneumonia in 85 cases

    Institute of Scientific and Technical Information of China (English)

    徐帅丽; 白文娟; 彭秋菊

    2012-01-01

    目的 讨论喘息性支气管肺炎的护理方法.方法 回顾分析85例喘息性支气管肺炎患儿的临床护理资料.结果 经过加强护理和优化护理流程,提高了喘息性支气管肺炎的治愈率与好转率,缩短了平均住院天数.结论 通过加强对喘息性支气管肺炎患儿的护理,促进患儿康复;通过护理指导使患儿家长掌握了喘息性支气管肺炎的相关知识,促进合理养育,降低复发概率,减少病情转向哮喘.%Objective To discuss the clinical nursing methods of asthmatic bronchial pneumonia. Method we retrospectively analysed the clinical nursing materials of 85 children with asthmatic bronchial pneumonia from January to April in 2012. Result Emphasized on the care of children with asthmatic bronchial pneumonia,we can promote the rehabilitation of children; shorten the period of hospitalization. Conclusion Through nursing instruction,parents of children master the knowledge of the asthmatic bronchial pneumonia,can promote the rational parenting and reduce the relapse chance of asthmatic bronchial pneumonia,or evove into asthma.

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

    Directory of Open Access Journals (Sweden)

    Ana Maria Siga Stephan

    2009-06-01

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

  19. 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.

  20. Gene expression in asthmatic airway smooth muscle: a mixed bag.

    Science.gov (United States)

    Pascoe, Christopher D; Swyngedouw, Nicholas E; Seow, Chun Y; Paré, Peter D

    2015-02-01

    It has long been known that airway smooth muscle (ASM) contraction contributes significantly to the reversible airflow obstruction that defines asthma. It has also been postulated that phenotypic changes in ASM contribute to the airway hyper-responsiveness (AHR) that is a characteristic feature of asthma. Although there is agreement that the mass of ASM surrounding the airways is significantly increased in asthmatic compared with non-asthmatic airways, it is still uncertain whether there are quantitative or qualitative changes in the level of expression of the genes and proteins involved in the canonical contractile pathway in ASM that could account for AHR. This review will summarize past attempts at quantifying gene expression changes in the ASM of asthmatic lungs as well as non-asthmatic ASM cells stimulated with various inflammatory cytokines. The lack of consistent findings in asthmatic samples coupled with the relative concordance of results from stimulated ASM cells suggests that changes to the contractility of ASM tissues in asthma may be dependent on the presence of an inflammatory environment surrounding the ASM layer. Removal of the ASM from this environment could explain why hypercontractility is rarely seen ex vivo.

  1. Airways obstruction in asthmatics induced by body cooling.

    Science.gov (United States)

    Chen, W Y; Horton, D J

    1978-02-01

    Pulmonary and thermoregulatory reactions to body cooling were studied in eight asthmatic and five normal subjects. The cooling was achieved by a cold shower at water temperature (T) of 15 degrees C for 1 min, followed by exposing the wet body to a high wind generated by a fan for another minute. The skin T, oral T and pulmonary functions were measured before and after cooling. After the cooling, skin T fell a mean of 7 degrees in all subjects and the oral T fell 0.5 degrees in the normals and 0.7 degrees in the asthmatics. In asthmatics, the post-cooling forced expiratory volume in 1 s (FEV1) and maximal mid-expiratory flow (MMEF) fell significantly (P less than .05) to a mean of 79% and 72%of baseline, respectively, and thoracic gas volume (TGV) and airway resistance (Raw) increased significantly to 133% and 198% of baseline, respectively. In normal subjects a small but significant increase in Raw was found. No obstruction developed in the asthmatics after a warm shower at 37 degrees or after breathing the cold shower mist. It is suggested that it is body cooling which leads first to vasoconstriction and then cooling of respiratory mucosa that initiates bronchoconstriction in asthmatics.

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

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    Nurhan Sarioglu

    2015-02-01

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

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

    Institute of Scientific and Technical Information of China (English)

    崔艳梅

    2015-01-01

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

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

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    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

  5. 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

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

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    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.

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

    Directory of Open Access Journals (Sweden)

    Juan David Fernández Villada

    2009-07-01

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

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

    Institute of Scientific and Technical Information of China (English)

    顾希茜; 段红梅; 侯小妮; 向莉

    2014-01-01

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

  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. Suicide Survivors' Perceptions of the Treating Clinician.

    Science.gov (United States)

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

    2002-01-01

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

  11. 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

  12. Functional phenotype of airway myocytes from asthmatic airways

    NARCIS (Netherlands)

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

    2013-01-01

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

  13. Exercise-induced asthma and the asthmatic athlete.

    Science.gov (United States)

    Enright, T

    1996-06-01

    Almost all asthmatics involved in moderate to heavy exercise will experience exercise-induced asthma (EIA). Up to 14% of athletes exhibit EIA, symptoms of which include dyspnea, coughing, chest tightness and wheezing. Education, warm-up exercises and pre-treatment with the appropriate medications can enable an athlete to excel and even win a gold medal in the 1996 Olympic games.

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

    Directory of Open Access Journals (Sweden)

    Anisia Torquilho Praxedes

    2012-01-01

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

  15. Viral bronchiolitis for the clinician.

    Science.gov (United States)

    Fitzgerald, Dominic A

    2011-04-01

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

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

    Science.gov (United States)

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

    2016-03-01

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

  17. 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.

  18. Inhaled corticosteroids and growth of airway function in asthmatic children

    NARCIS (Netherlands)

    Merkus, PJFM; van Pelt, W; van Houwelingen, JC; van Essen-Zandvliet, LEM; Duiverman, EJ; Kerrebijn, KF; Quanjer, PH

    2004-01-01

    Airway inflammation and remodelling play an important role in the pathophysiology of asthma. Remodelling may affect childhood lung function, and this process may be reversed by anti-inflammatory treatment. The current study assessed longitudinaily whether asthma affects growth of airway function rel

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

    Directory of Open Access Journals (Sweden)

    King Nicholas JC

    2006-05-01

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

  20. Primary Care Clinician Expectations Regarding Aging

    OpenAIRE

    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 Survey (ERA-12) was used to assess (a) age expectations in a sample of primary care clinicians practicing in the United States and (b) clinician chara...

  1. 布地奈德联合沙丁胺醇雾化对喘息性支气管炎儿童肺功能的影响%Effect of Budesonide Combined with Salbutamol on Lung Function of Chil-dren with Asthmatic Bronchitis

    Institute of Scientific and Technical Information of China (English)

    姚毅; 王德兰; 邓春晖; 吴正文

    2015-01-01

    OBJECTIVE To study the effect of budesonide combined with salbutamol on lung function of chil-drenwithasthmaticbronchitis.METHODS 100casesofchildrenwithasthmaticbronchitiswerecollectedinDe-cember 2013 to December 2014 for treatment,they were divided into treatment group and control group with 50 cases in each group according to the random number table methods, the control group received salbutamol for treatment while the observation group were given budesonide atomization treatment on basis of salbutamol,the changes of pul-monary function of the two group before and after treatment were compared.RESULTS The clinical effective rate of the treatment group after treatment was 94%,higher than 74%in the control group,there was significant difference between two groups (χ2 =7.15,P<0.05).The clinical symptoms,signs disappeared time and hospitalization time of the treatment group after treatment was better than the control group, with significant differences between the two groups(t=5.15,6.03,7.31,5.80,5.68,P <0.05).The pulmonary function index in the treatment group after treatment was significantly better than the control group, there was significant difference between two groups ( t =12.10,9.60,8.49,11.03,13.43,P<0.05).CONCLUSION Budesonide combined with salbutamol may improve the curative effect,symptoms and signs and lung function in treatment of children with asthmatic bronchitis,which is worthy of clinical application.%目的 探讨布地奈德联合沙丁胺醇雾化对喘息性支气管炎儿童肺功能的影响. 方法 收集2013年12 月~2014 年12 月接受治疗的喘息性支气管炎患儿100例,按照随机数字表格法分为治疗组与对照组,各50 例,其中对照组给予沙丁胺醇雾化治疗;观察组在沙丁胺醇治疗基础上给予布地奈德雾化治疗,比较两组患儿治疗前后肺功能的变化. 结果 治疗组患儿治疗后临床有效率为94.00%,高于对照组患儿74.00%(χ2 =7.15,P<0.05). 治疗组患儿的临床相关

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

    Institute of Scientific and Technical Information of China (English)

    潘炯伟

    2011-01-01

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

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

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    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.

  4. 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......: Mean patient age was 67 years (confidence interval: 63-71) with a mean FEV1 of 78 % predicted (confidence interval: 70-85%). AHR correlated with sputum eosinophils (r = 0.68, P = 0.005) and eNO (r = 0.71, P ... or eNO. CONCLUSIONS: In older patients with asthma, airway inflammatory cells are linked to abnormal airway physiology. Eosinophilic airway inflammation is associated with AHR while neutrophilic inflammation may be an important determinant of airflow limitation at rest and airway closure during...

  5. Unsweetened natural cocoa has anti-asthmatic potential.

    Science.gov (United States)

    Awortwe, C; Asiedu-Gyekye, I J; Nkansah, E; Adjei, S

    2014-01-01

    Unsweetened natural cocoa powder is enriched with nutraceutical abundance of anti-asthmatic compounds theobromine and theophylline. Cocoa powder, which is prepared after removal of the cocoa butter, contains about 1.9% theobromine and 0.21% caffeine. Anecdotal reports indicate that regular consumption of unsweetened natural cocoa powder (UNCP), a common practice in Ghana, West Africa, has the potential to reduce the tendency of asthmatic episodes. In the present paper we studied the effect of regular ingestion of aqueous extract of UNCP on hematological and histopathological changes that occur in ovalbumin (OVA)-sensitized guinea pigs. OVA-sensitized guinea pigs were challenged with aerosolized OVA 1 hour after ingestion of 300 mg/kg (low dose) or 600 mg/kg (high dose) of UNCP for 35 consecutive days. Histopathological and haematological changes in the OVA-sensitized guinea pigs were evaluated. Both negative and positive controls with distilled water and prednisolone, respectively, were used. OVA-sensitized guinea pigs demonstrated concentration-independent reduction in immune response to aerosolized OVA. There were no histo-architectural changes in the bronchiolar smooth muscles of the treated groups. Unsweetened natural cocoa powder has potential anti-asthmatic properties when administered orally at the doses tested.

  6. High prevalence of gastroesophageal reflux disease with minimal mucosal change in asthmatic patients.

    Science.gov (United States)

    Shimizu, Yasuo; Dobashi, Kunio; Kobayashi, Setsuo; Ohki, Ichiro; Tokushima, Masahiko; Kusano, Motoyasu; Kawamura, Osamu; Shimoyama, Yasuyuki; Utsugi, Mitsuyoshi; Mori, Masatomo

    2006-08-01

    It is known that the prevalence of gastroesophageal reflux disease (GERD) in asthmatic patients is high. Although an endoscopic diagnosis of GERD based on the established Los Angeles (LA) classification requires the detection of erosive mucosal breaks, there are patients with GERD who have prominent erythema of the esophageal membrane without erosive mucosal breaks. Non-erosive mucosal change denotes the minimal change of the discoloring type of reflux esophagitis. This study was undertaken to determine the prevalence of GERD in asthmatic patients using the LA classification with the inclusion of minimal change, compared to the prevalence determined using the established LA classification without minimal change. The presence of GERD in asthmatic patients (n = 78), non-asthmatic disease control patients (n = 56), and healthy subjects (n = 150) was evaluated by endoscopic examination. The frequency of GERD in asthmatic patients based on the LA classification with minimal change was higher (54/78, 69.2%) than in asthmatic patients based on the LA classification without minimal change (37/78, 47.4%) (p disease control patients (17/56, 30.4%) and healthy subjects (27/150, 18.0%) based on the LA classification with minimum change. These data indicate that asthmatic patients have a high frequency of GERD. In addition, without the inclusion of minimum change to the diagnosis of GERD, the prevalence of GERD appears to be underestimated in asthmatic patients. Therefore, physicians should carefully observe asthmatic patients with minimal change on endoscopy.

  7. Clinician Percent Syllables Stuttered, Clinician Severity Ratings and Speaker Severity Ratings: Are They Interchangeable?

    Science.gov (United States)

    Karimi, Hamid; Jones, Mark; O'Brian, Sue; Onslow, Mark

    2014-01-01

    Background: At present, percent syllables stuttered (%SS) is the gold standard outcome measure for behavioural stuttering treatment research. However, ordinal severity rating (SR) procedures have some inherent advantages over that method. Aims: To establish the relationship between Clinician %SS, Clinician SR and self-reported Speaker SR. To…

  8. Training improves physical fitness and decreases CRP also in asthmatic conscripts.

    Science.gov (United States)

    Juvonen, Raija; Bloigu, Aini; Peitso, Ari; Silvennoinen-Kassinen, Sylvi; Saikku, Pekka; Leinonen, Maija; Hassi, Juhani; Harju, Terttu

    2008-04-01

    To study the respiratory and physical health of young men, 224 asthmatic and 668 non-asthmatic military conscripts were recruited from the intake groups of July 2004 and January 2005 in Kajaani, Finland. Factors affecting respiratory health were elicited by a questionnaire at the beginning of the service, and results of high sensitive C-reactive protein (hsCRP) determination, peak expiratory flow (PEF), and 12-minute running test were collected at the beginning and the end of the service. Respiratory infections were diagnosed by a study physician. Upon entering military service, asthmatics had frequent exercise- and cold-related asthma symptoms (69.6% and 76.3%), and 48% of them had no medication for asthma. At the beginning, 25.8% of asthmatics and 19.1% of non-asthmatics had a poor result of less than 2,200 m (p = 0.05) in the 12-minute running test, and after 180 to 362 days of service, the corresponding percentages were 11.7% and 9.7% (p = 0.434). The levels of hsCRP, a marker of low-grade systemic inflammation, decreased significantly among both asthmatics, 1.5 (p = 0.001), and non-asthmatics, 1.6 mg/L (p < 0.001). Asthmatic men had 0.2 and non-asthmatics 0.1 respiratory infections per month (p < 0.001). In summary, asthmatic conscripts can enhance their physical fitness by training similarly to non-asthmatic ones. Their levels of hsCRP also decrease.

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

    Science.gov (United States)

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

    2012-04-01

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

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

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    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.

  11. Zika virus: A primer for clinicians.

    Science.gov (United States)

    Flores, Michelle S; Burgess, Timothy H; Rajnik, Michael

    2016-04-01

    The ongoing outbreak of Zika virus infection that began in South America and Central America in 2014 is worrisome because of associations with fetal microcephaly and with Guillain-Barré syndrome. Here we summarize what has happened and what is known so far. As the outbreak continues to evolve, we urge clinicians to watch for updates at cdc.gov.

  12. Dialogue on Separation: Clinicians as Educators.

    Science.gov (United States)

    Boss, Pauline Grossenbacher; Whitaker, Carl

    1979-01-01

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

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

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    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.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-01-01

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

  16. Diabetes mellitus and insulin in an aspirin sensitive asthmatic.

    Science.gov (United States)

    Caplin, I

    1976-03-01

    The infrequency of diabetes mellitus and asthma in the same individual is re-examined. The antagonism between epinephrine and insulin, as suggested by Konig in 1935, is indeed accurate. The assays done by the Eli Lilly Research Department revealed no in vitro effect of insulin on the CAMP and GMP level of mast cells as occurs in liver cells. It is felt that this effect is probably an in vivo effect produced via the vagus nerve and alpha-adrenergic receptor system stimulation. This would explain the mechanism of aggravation of asthma by excess insulin. Dr. Petersen's studies, the negative intradermal skin tests to insulin and the absence of change on either beef or pork insulin usage by our patient all point to a nonatopic factor in the aggravation of the asthma of this patient. In the uncommon occurrence of asthma and diabetes in the same patient, insulin dosage should be considered as a factor in all such asthmatics who do not respond well to conventional therapy. Two additional asthmatics who also have diabetes did improve with cessation of nocturnal asthma by a reduction of their evening dose of insulin. A high fat, low carbohydrate diet, as suggested by Abrahamson to avoid dietary hyperinsulinism, is certainly worth considering in patients with nocturnal asthma. If patients cannot be made to follow a diet requiring frequent feedings high in protein and fats and low in carbohydrates, another approach suggests itself. Abrahamson was able to relieve the patients who developed nocturnal asthma with hypoglycemia by having them drink a glass of milk. Assuming other causes have been eliminated and a patient awakens each day at 3:00 a.m., an alarm clock could be set at 2:00 a.m. Milk or a milk substitute in milk sensitive patients could be taken at 2:00 a.m. to raise the blood sugar and hopefully prevent the asthma associated with hypoglycemia. Also to be noted is the ubiquitous use of tartrazine in so many drugs, including those used to relieve asthmatic symptoms

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

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    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.

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

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    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

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

    Science.gov (United States)

    Tyack, Dorothy; Gottsleben, Robert

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

  20. The effect of stimuli on basophil-mediated atopic responses during asthmatic lying-in women and in newborns.

    Science.gov (United States)

    Yang, Ling; Guo, Yin-Shi; Jiang, Jin-Qi; Guo, Xue-Jun; Xu, Yi-Ping; Tian, Ye; Xiong, Ying; Han, Li

    2012-08-01

    Morbidity from allergic diseases is increasing. Basophils play a critical role in systemic anaphylaxis and chronic allergic inflammation. The prenatal environment must be regarded as a possible early risk factor for allergic diseases in children. Our objective was to determine if basophils harvested from neonates genetically predisposed to atopic disease had different levels of CD63 expression and IL-4 release properties in response to various stimuli (peptidoglycan, Dermatophagoides farinae, hyperosmotic mannitol). Blood samples were collected from 16 asthmatic and 18 healthy women and their newborns. Peripheral blood basophil histamine was measured using the human basophil degranulation test (HBDT), whereas activation was assessed by flow cytometric measurement of CD63 expression on the cord blood basophil surface. IL-4 levels were quantified by ELISA following allergen stimulation. The basophil degranulation index (DI) in granulocytes harvested from the peripheral blood of asthmatic women was assessed following stimulation with peptidoglycan (PGN), Dermatophagoides farinae (Df ) extract, or hyperosmotic mannitol. The DI was significantly higher in atopic women than in healthy controls. Upregulation of CD63 on the cord blood basophil surface was also detected in response to these stimuli. Basophils purified from the cord blood of neonates born to atopic mothers produced more IL-4 compared to basophils purified from the controls. These data suggested that various stimuli play a role in augmenting allergic reactions via modulation of activated basophil cytokine secretion. It may require new methods to stabilize the basophils in allergic diseases.

  1. 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

  2. Clinical Photography: A Guide for the Clinician

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    Nayler J

    2003-01-01

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

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

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    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.

  5. Mechanism of hypothalamic paraventricular nucleus in regulating asthmatic attack

    Institute of Scientific and Technical Information of China (English)

    Jia Liu; Rong Dong; Jian Xiao; Nina Liu

    2006-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2007-01-01

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

  7. Molecular mechanism of icariin on rat asthmatic model

    Institute of Scientific and Technical Information of China (English)

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

    2011-01-01

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

  8. 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.

  9. Kounis syndrome secondary to amoxicillin use in an asthmatic patient.

    Science.gov (United States)

    Viana-Tejedor, Ana; Espinosa, M Ángeles; Cuesta, J; Núñez, A; Bueno, H; Fernández-Avilés, F

    2011-08-04

    A sixty-four year old man with a past history of hypercholesterolemia, asthma, food allergy, epilepsy and myocardial infarction was admitted to the emergency department because of a generalized erythema, nausea, vomiting, and chest pain after taking an oral dose of amoxicillin. Electrocardiography showed ST segment elevation in anterior leads. After coronary angiography, type 2 variant of Kounis syndrome was diagnosed. We present the first case of oral amoxicillin induced Kounis syndrome in an asthmatic patient with severe anaphylactic shock. The present report also shows that atopic people expressing an amplified mast cell degranulation may have more serious hemodynamic decompensation during hypersensitivity reactions. Case selective mast cell surface membrane stabilization should be considered a potential therapeutic strategy for people with food induced allergy, for atopic patients and for patients who have already experienced a first Kounis syndrome.

  10. 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.

  11. Bronchodilatory effect of Portulaca oleracea in airways of asthmatic patients.

    Science.gov (United States)

    Malek, F; Boskabady, M H; Borushaki, M T; Tohidi, M

    2004-07-01

    Therapeutic effects of Portulaca oleracea for respiratory diseases are indicated in ancient Iranian medical books. The relaxant effect of this plant have also been observed on smooth muscle tissue in previous studies. Therefore, in the present study, the bronchodilatory effect of the boiled extract of Portulaca oleracea in the airway of asthmatic patients was examined. The relaxant effect of the orally administered 0.25 ml/kg of 5% boiled extract in comparison with 3 mg/kg oral theophylline and 200 microg inhaled salbutamol was studied by measuring forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal mid-expiratory flow (MEF(25-75)), and specific airway conductance (sGaw). The FEV1, PEF, MEF(25-75), and sGaw were measured before, administration and repeated 15, 30, 60, 90, and 120 min after administration of the oral extract and theopylline. For inhaled salbutamol measurements were performed 5, 15, 30, and 60 min post-inhalation. Results showed that the boiled extract of Portulaca oleracea caused significant increases in all measured pulmonary function tests (PFTs), (P < 0.05 to P < 0.01). There was no significant difference between the maximum increase in measured PFTs due to the boiled extract and theophylline. However, maximum increase in PEF and MEF(25-75) due to the boiled extract were significantly lower than those of salbutamol (P < 0.05 for both cases). The onset of brochodilatory effect of extract was similar to that of theophylline beginning 60 min, but the effect of extract decline after 120 min after administration. In conclusion, the results of the present study showed that Portulaca oleracea has a relatively potent but transient bronchodilatory effect on asthmatic airways.

  12. 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 Ben

  13. 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

  14. 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

  15. Peer Support for Clinicians: A Programmatic Approach.

    Science.gov (United States)

    Shapiro, Jo; Galowitz, Pamela

    2016-09-01

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

  16. Cyberbullying Education for Parents: A Guide for Clinicians

    Directory of Open Access Journals (Sweden)

    Margaret Hannah

    2010-01-01

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

  17. Cyclin D1 in ASM Cells from Asthmatics Is Insensitive to Corticosteroid Inhibition.

    Science.gov (United States)

    Allen, Jodi C; Seidel, Petra; Schlosser, Tobias; Ramsay, Emma E; Ge, Qi; Ammit, Alaina J

    2012-01-01

    Hyperplasia of airway smooth muscle (ASM) is a feature of the remodelled airway in asthmatics. We examined the antiproliferative effectiveness of the corticosteroid dexamethasone on expression of the key regulator of G(1) cell cycle progression-cyclin D1-in ASM cells from nonasthmatics and asthmatics stimulated with the mitogen platelet-derived growth factor BB. While cyclin D1 mRNA and protein expression were repressed in cells from nonasthmatics in contrast, cyclin D1 expression in asthmatics was resistant to inhibition by dexamethasone. This was independent of a repressive effect on glucocorticoid receptor translocation. Our results corroborate evidence demonstrating that corticosteroids inhibit mitogen-induced proliferation only in ASM cells from subjects without asthma and suggest that there are corticosteroid-insensitive proliferative pathways in asthmatics.

  18. 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...

  19. 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.

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

    Science.gov (United States)

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

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

    OpenAIRE

    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...

  2. 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.

  3. Intratracheal dosing with disodium cromoglycate inhibits late asthmatic response by attenuating eicosanoid production in guinea pigs.

    Science.gov (United States)

    Nabe, Takeshi; Yamamoto, Maki; Suga, Mikiko; Kohno, Shigekatsu

    2004-08-16

    Disodium cromoglycate is an anti-asthmatic drug that has mast cell-stabilizing effects and other anti-inflammatory effects. However, the mechanisms of its anti-inflammatory effects are unclear. In this study, we evaluated effects of disodium cromoglycate on eosinophilia, early and late asthmatic responses, and production of arachidonic acid metabolites in guinea pig lungs. Guinea pigs were alternately sensitized and challenged by exposure to mists of ovalbumin+Al(OH)(3) and ovalbumin, respectively. Disodium cromoglycate (0.5-2 mg/0.1 ml/animal) administered intratracheally before the fifth challenge dose-dependently inhibited asthmatic response, but early asthmatic response was not affected. Disodium cromoglycate at 2 mg/animal potently suppressed increases in cysteinyl leukotrienes (CysLTs) and thromboxane A(2) in the lung during late asthmatic response. Eosinophilia was slightly reduced by disodium cromoglycate. The inhibitory effect of disodium cromoglycate on late asthmatic response is apparently due to inhibition of the release of arachidonic acid metabolites, some of which may be derived from eosinophils that infiltrate the lung.

  4. 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.

  5. Bayes’ Rule for Clinicians: An Introduction

    Directory of Open Access Journals (Sweden)

    Chris F Westbury

    2010-11-01

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

  6. Do clinicians use more question marks?

    Science.gov (United States)

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

    2015-01-01

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

  7. A clinician-driven home care delivery system.

    Science.gov (United States)

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

    1993-12-01

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

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

    Directory of Open Access Journals (Sweden)

    Serap Balci

    2010-02-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  10. Analysis of body posture in children with mild to moderate asthma.

    Science.gov (United States)

    Belli, Juliana Fernanda Canhadas; Chaves, Thaís Cristina; de Oliveira, Anamaria Siriani; Grossi, Débora Bevilaqua

    2009-10-01

    The mechanical alterations related to the excessive use of accessory respiratory muscles and the mouth breathing observed in children with asthma may lead to the development of alterations in head posture, shoulders, thoracic region and, consequently, in alterations of body posture. The purpose of this study was to assess body posture changes of children with asthma compared to a non-asthmatic control group matched for gender, age, weight, and height. Thirty children with asthma and 30 non-asthmatic children aged 7 to 12 years were enrolled in this study. Digital photographic records were obtained for analysis of the body posture of the children by computed photogrammetry. The intraclass correlation coefficient and Student's t test (p postural alterations compared to non-asthmatic controls since the only angle for which there was a significant difference between groups showed weak reproducibility. The findings of this study do not support the notion that children with asthma present alterations in body posture.

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

    Directory of Open Access Journals (Sweden)

    Marina S Leino

    Full Text Available 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.

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

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    M. Malagola

    2011-01-01

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

  13. A clinician's guide to systematic reviews.

    Science.gov (United States)

    Crowther, David M

    2013-08-01

    The purpose of this article is to discuss systematic reviews, how they are performed, and their associated strengths and limitations. A systematic review is an assessment of evidence involving exact methods to systematically identify, select, and critically evaluate all available literature on a particular topic. Unlike most narrative reviews, systematic reviews have defined methods established a priori for searching, evaluating, extracting, synthesizing, and reporting available evidence. Key characteristics differentiating systematic reviews from most narrative reviews include: clearly stated objectives, pre-defined inclusion/exclusion criteria, an explicit reproducible methodology, systematic exhaustive searches to identify all sources of evidence, an assessment of the validity for each included study, and a systematic presentation of the study characteristics/results. Though there are significant advantages to systematic reviews, there are also clear limitations such as: the quality of included evidence; heterogeneity and homogeneity of included studies; and publication bias. Even with these limitations, systematic reviews are beneficial to front line clinicians when the quantity of evidence is so substantial that reviewing and synthesizing it is not feasible, available evidence is conflicting, or when the robustness of available evidence is unknown.

  14. Clinicians' perceptions of minor cervical instability.

    Science.gov (United States)

    Niere, Kenneth Robert; Torney, Sarah Kathryn

    2004-08-01

    Appropriate musculoskeletal physiotherapy management of spinal conditions requires recognition of clinical patterns in order to make a provisional diagnosis. This study aimed to assist the recognition of minor cervical instability (MCI) by surveying clinicians experienced in the management of neck conditions. A total of 153 Australian physiotherapists with postgraduate qualifications in manipulative physiotherapy and experience in the management of neck conditions completed a questionnaire that required them to indicate the importance of 15 clinical findings in the diagnosis of MCI. The responses were examined descriptively then subjected to factor analysis to identify possible groupings of findings. Clinical findings considered by greater than 50% of respondents to be either very important or vitally important in the diagnosis of MCI were: a history of major trauma; reports of the neck catching or locking or giving way; poor muscular control; signs of hypermobility on X-ray; excessively free end-feel on passive motion testing and unpredictability of symptoms. The factor analysis resulted in four distinct factors, each clinically interpretable. Therapists treating patients with neck conditions should at least consider the possibility of MCI when presented with any of the six findings reported above or with any of the groupings of findings identified by the factor analysis.

  15. Evaluation of the medical assistance to asthmatic patients.

    Directory of Open Access Journals (Sweden)

    Margarita Roméu Escobar

    2005-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Le Annie V

    2006-09-01

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

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

    Institute of Scientific and Technical Information of China (English)

    颜世军; 潘秋莎; 周炳文; 孙雨

    2016-01-01

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

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

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    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

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

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    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

  20. 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....

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

    Science.gov (United States)

    Arocha-Sandoval, Francisco; Parra-Quevedo, Katynna

    2002-09-01

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

  2. Asthmatic persons are prone to the persistence of Chlamydia pneumoniae antibodies.

    Science.gov (United States)

    Paldanius, Mika; Juvonen, Raija; Leinonen, Maija; Bloigu, Aini; Silvennoinen-Kassinen, Sylvi; Saikku, Pekka

    2007-10-01

    Acute Chlamydia pneumoniae infection may initiate asthma or worsen asthmatic symptoms. In crowded conditions, such as military service, young men are susceptible to respiratory infections, including C. pneumoniae. We recruited 127 asthmatic and 391 nonasthmatic military conscripts, followed up their respiratory tract infections and the kinetics of serum C. pneumoniae antibodies, and assessed the association between C. pneumoniae and asthma during 6 months of military service in 2 intake groups. During the 6-month period, in the July intake group, IgG antibody prevalence decreased from 60.3% to 43.8% in asthmatic and from 55.6% to 22.6% in nonasthmatic conscripts. In the January intake group, IgG antibody prevalence increased from 38.3% to 48.4% in asthmatic and from 37.2% to 43% in nonasthmatic recruits. IgG and IgA antibodies persisted more often in the asthmatic groups. In conclusion, the prevalence of IgG antibodies showed seasonal variation. Military recruits seem to be most vulnerable to C. pneumoniae infections during the period from January to June. The antibody titer changes were more rapid than previously thought.

  3. Adolescent autonomy revisited: clinicians need clearer guidance.

    Science.gov (United States)

    Brierley, Joe; Larcher, Victor

    2016-08-01

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

  4. Asthma in children : origins and outcomes

    NARCIS (Netherlands)

    Zomer - Kooijker, K.

    2014-01-01

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

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

    Science.gov (United States)

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

    2000-10-01

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

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

    Science.gov (United States)

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

    2007-06-01

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

  7. Bronchiolitis: what the clinician should know

    Directory of Open Access Journals (Sweden)

    Roberto Antonucci

    2015-10-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  9. Statewide CBT Training for Clinicians and Supervisors Treating Youth: The New York State Evidence Based Treatment Dissemination Center

    Science.gov (United States)

    Gleacher, Alissa A.; Nadeem, Erum; Moy, Amanda J.; Whited, Andria L.; Albano, Anne Marie; Radigan, Marleen; Wang, Rui; Chassman, Janet; Myrhol-Clarke, Britt; Hoagwood, Kimberly Eaton

    2011-01-01

    In recent years, several states have undertaken efforts to disseminate evidence-based treatments to agencies and clinicians in their children's service system. In New York, the Evidence Based Treatment Dissemination Center adopted a unique translation-based training and consultation model in which an initial 3-day training was combined with a year…

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

    Science.gov (United States)

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

    2010-04-01

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

  11. The experience of clinician-researchers in occupational therapy.

    Science.gov (United States)

    Cusick, A

    2001-01-01

    This study examined the experience of occupational therapy clinicians who do research to illuminate factors that influenced their research, the processes involved, and the outcomes. The qualitative approach of grounded theory was used. Purposive sampling of all research-productive clinicians in acute care hospitals in one Australian city occurred. Fifteen clinicians participated in in-depth interviews that explored their experiences of research. Results were analyzed with the constant comparative method, and six conceptual categories were developed. These categories were further analyzed in terms of their relationships, and a core category that explained and synthesized the data was identified--becoming a clinician-researcher. This category encompassed a process of role change during which the person changed from clinician to clinician-researcher. Conditions for this change were identified, and three key concepts were derived to elaborate the core category. In becoming a clinician-researcher, the person was active in (a) identifying research as significant, (b) constructing actions in relation to research, and (c) evaluating the experience. The findings further the understanding of clinician-researchers through the description of their experience and the empirically based theoretical formulation that explains it.

  12. The Parent Interview; Guidelines for Student and Practicing Speech Clinicians.

    Science.gov (United States)

    Emerick, Lon

    The importance and nature of the speech clinician's diagnostic interview with his client's parents are discussed; also discussed are factors preventing establishment of effective communication, including the clinician's fears and attitudes toward parents. An approach to interviewing is presented in terms of the goals of obtaining and giving…

  13. Why MIC matters? Microbiologists vs. clinicians

    Directory of Open Access Journals (Sweden)

    Corrado Girmenia

    2013-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Stacy Gallese Cassel

    2016-07-01

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

  15. 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

    Introduction: In paediatric care, it is a great challenge to make sure that all parties feel involved and heard, they all have had the opportunity to take part in the decisions and all the participants experienced that their expectations to the consultation are fulfilled. Previous research....... 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...

  16. Being empathetic: benefits and challenges for the clinician and client.

    Science.gov (United States)

    Abbott Moore, Lisa

    2010-01-01

    This article explores the meaning of empathy and how it influences clinicians in their personal and professional lives. Empathy may benefit client and clinician by improving patient satisfaction and pain management, reducing medical errors, and helping to keep clinicians grounded in the priorities of patient care. The cultural and developmental origins and neural basis of empathy are reviewed to provide insight into how a clinician's and client's emotions can interact and influence each other. Methods for cultivating and communicating empathetic responses in the clinical setting are provided, including ways of identifying and dealing with difficult clients. Concepts such as attunement, emotional labor, and parallel emotions are explained. The limitations to empathy and potential challenges or difficulties for the clinician are also explored, along with possible solutions. Narratives from the author's personal and professional life are included to illustrate how a clinician's emotions can play a significant part in interactions with clients. This discussion shows that clinicians must combine both evidenced-based practice and empathy in their interactions with clients to achieve the professional goal of high-quality care.

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

    NARCIS (Netherlands)

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

    1998-01-01

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

  18. Randomised clinical trials with clinician-preferred treatment.

    Science.gov (United States)

    Korn, E L; Baumrind, S

    1991-01-19

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

  19. Myasthenia gravis: an update for the clinician.

    Science.gov (United States)

    Sieb, J P

    2014-03-01

    This paper provides a thorough overview of the current advances in diagnosis and therapy of myasthenia gravis (MG). Nowadays the term 'myasthenia gravis' includes heterogeneous autoimmune diseases, with a postsynaptic defect of neuromuscular transmission as the common feature. Myasthenia gravis should be classified according to the antibody specificity [acetylcholine, muscle-specific receptor tyrosine kinase (MuSK), low-density lipoprotein receptor-related protein 4 (LRP4), seronegative], thymus histology (thymitis, thymoma, atrophy), age at onset (in children; aged less than or more than 50 years) and type of course (ocular or generalized). With optimal treatment, the prognosis is good in terms of daily functions, quality of life and survival. Symptomatic treatment with acetylcholine esterase inhibition is usually combined with immunosuppression. Azathioprine still remains the first choice for long-term immunosuppressive therapy. Alternative immunosuppressive options to azathioprine include cyclosporin, cyclophosphamide, methotrexate, mycophenolate mofetil and tacrolimus. Rituximab is a promising new drug for severe generalized MG. Emerging therapy options include belimumab, eculizumab and the granulocyte- macrophage colony-stimulating factor. One pilot study on etanercept has given disappointing results. For decades, thymectomy has been performed in younger adults to improve non-paraneoplastic MG. However, controlled prospective studies on the suspected benefit of this surgical procedure are still lacking. In acute exacerbations, including myasthenic crisis, intravenous immunoglobulin, plasmapheresis and immunoadsorption are similarly effective.

  20. 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.

  1. The actin regulator zyxin reinforces airway smooth muscle and accumulates in airways of fatal asthmatics

    Science.gov (United States)

    Blankman, Elizabeth; Jensen, Christopher C.; Krishnan, Ramaswamy; James, Alan L.; Elliot, John G.; Green, Francis H.; Liu, Jeffrey C.; Seow, Chun Y.; Park, Jin-Ah; Beckerle, Mary C.; Paré, Peter D.; Fredberg, Jeffrey J.; Smith, Mark A.

    2017-01-01

    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. PMID:28278518

  2. 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.

  3. 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.

  4. 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…

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

    NARCIS (Netherlands)

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

    2014-01-01

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

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  7. Protective effect of sodium cromoglycate on lipopolysaccharide-induced bronchial obstruction in asthmatics.

    Science.gov (United States)

    Michel, O; Ginanni, R; Sergysels, R

    1995-11-01

    Lipopolysaccharides (LPS, the major part of endotoxins) are bacterial proinflammatory substances which can induce in asthmatic patients after inhalation a bronchial obstruction with an increase in both histamine bronchial hyperresponsiveness and blood inflammatory markers. The aim of the present study was to evaluate whether an acute inhalation of sodium cromoglycate, an anti-inflammatory and membrane-stabilizating agent, can block the LPS-induced lung function response. Using a double-blind placebo-controlled crossover method, 7 asthmatic subjects were submitted, at 4 days' interval, to a bronchial challenge test with either solvent solution or LPS (20 micrograms) preceded by inhalation of sodium cromoglycate (10 mg) or placebo. Compared to the solvent reaction, LPS induced a significant bronchial obstruction [measured by both the forced expiratory volume in 1 s (FEV1) and the airway resistances] beginning at the 60th minute and lasting more than 300 min (p sodium cromoglycate significantly inhibited the LPS-induced bronchial obstruction. The total lung capacity did not change significantly after LPS inhalation. Thus, this study showed that in asthmatics the LPS-induced FEV1 response is blocked by acute treatment with sodium cromoglycate. Sodium cromoglycate could be an active treatment in asthmatics exposed to house dust containing endotoxin.

  8. AMBIENT COARSE PARTICLE MATTER ASSOCIATED WITH HRV, BLOOD COAGULATION, AND BLOOD LIPIDS IN ADULT ASTHMATICS

    Science.gov (United States)

    Introduction: We investigated whether systemic inflammation markers in asthmatics change in response to fluctuations in ambient PM. Methods: Twelve atopic adults with mild to moderate persistent asthma living within a 30 mile radius of the US EPA clinic were followed for twelve w...

  9. BRONCHIAL LAVAGE AND BRONCHOALVEOLAR LAVAGE IN ALLERGEN-INDUCED SINGLE EARLY AND DUAL ASTHMATIC RESPONDERS

    NARCIS (Netherlands)

    AALBERS, R; KAUFFMAN, HF; VRUGT, B; SMITH, M; KOETER, GH; TIMENS, W; DEMONCHY, JGR

    1993-01-01

    The phenotypic cellular profile of bronchial lavage (BL) and bronchoalveolar lavage (BAL) was studied in 7 single early (SR) and 10 dual asthmatic responders (DR). Lavage was performed, after previously having determined bronchial hyperresponsiveness to histamine and the response to house dust mite

  10. EVALUATION OF ACUTE TOXICITY STUDY AND ANTI-ASTHMATIC ACTIVITY OF ZEAL HERBAL GRANULES

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    Bhatt Swati

    2013-06-01

    Full Text Available Objective: To evaluate the Acute toxicity study and Anti-asthmatic activity of Zeal Herbal Granules. Materials & Methods: In the present study, acute toxicity study was carried out as per OECD guideline 423. Anti-asthmatic activity of Zeal Herbal Granules was investigated against compound 48/80-induced mast cell degranulation. Percentage mast cell degranulation was calculated at different concentration level i.e.1, 10, 100 and 1000μg/mL. Results: Zeal Herbal Granules showed significant protection of rat mesenteric mast cells from disruption caused by compound 48/80. Significant dose dependent effect was observed in percentage mast cell degranulation at different dose level of Zeal Herbal Granules in comparison to negative control. 26.83% mast cell degranulation was observed at 100μg/mL dose level of Zeal Herbal Granules. Conclusion: The present study revealed that Zeal Herbal Granules has significant anti-asthmatic activity against compound 48/80-induced mast cell degranulation comparable to that produced by Ketotifen fumarate. There was no lethal and toxic reactions found among the tested animals. Zeal Herbal Granules can be a safe and effective drug for patient with asthmatic complaints.

  11. Relationship between Deficiency of Vitamin D and the Incidence of Asthmatic Bronchitis%维生素D 缺乏与喘息性支气管炎发病的关系

    Institute of Scientific and Technical Information of China (English)

    何玉珍; 林冬云; 蓝永乐

    2013-01-01

    Objective :By measuring children with asthmatic bronchitis serum 25-hydroxy vitamin D levels ,and to ex-plore the relationship between serum vitamin D levels and incidence of asthmatic bronchitis ,and provide a new theoreti-cal and clinical basis for the treatment of asthmatic disease .Methods :80 cases of pediatric outpatient children with asth-matic bronchitis ,were randomly divided into the VitD treatment group and the non-VitD treatment group .Healthy chil-dren during the same period 30 cases (control group) as a control .By liquid chromatography-tandem mass spectrome-try to detect serum 25-hydroxyvitamin D levels ;simultaneously record the duration of remission of clinical symptoms ,as well as six months ,the number of respite recurrence .Results:VitD tveatmert group compared with the control group serum 25-hydroxy D levels were statistically significant difference (P< 0 .01) .VitD treatment group compared with non-rapid remission of clinical symptoms of VitD treatment group ,six months respite recurrence less frequently ,two group differences were statistically significant (P<0 .05) .Conclusion:The VitD lack is closely related to the pathogen-esis of asthmatic bronchitis , may be the underlying cause of asthmatic bronchitis .Asthmatic bronchitis treatment process ,the supplement VitD alleviate clinical symptoms ,reduce respite recurrence rate .%目的:通过喘息性支气管炎患儿血清25-羟基维生素D水平的测定,探讨血清维生素D水平与喘息性支气管炎发病的关系,为小儿喘息性疾病的治疗提供新的理论和临床依据。方法:选择儿科门诊喘息性支气管炎患儿80例,随机分为VitD治疗组和非VitD治疗组,以同期健康体检儿30例作为对照组。采用液相色谱串联质谱技术检测血清25-羟基维生素D水平;同时记录喘息性支气管炎患儿临床症状的缓解时间以及半年喘息再发次数。结果:(1)治疗前VitD治疗组较对照组血清25-

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

    Institute of Scientific and Technical Information of China (English)

    周林福; 殷凯生; 周智敏

    2003-01-01

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

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

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    Susanna L Lundström

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

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

    Science.gov (United States)

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

    2014-01-01

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

  15. The Effect of Positions on Spirometric Values in Obese Asthmatic Patients

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    Ebrahim Razi Gholam Abbass Moosavi

    2007-09-01

    Full Text Available Obesity as a common health risk is increasing all over the world. The aim of this study was evaluation of standing and sitting positions on spirometric values in obese asthmatic patients, in comparison with normal obese subjects.The study included 49 obese asthmatic patients with mean age of 42.63 years and body mass index of 36.06 kg/m2, and 51 control obese normal subjects with mean age of 39.86 years and body mass index of 36.69 kg/m2. Subjects with body mass index of (BMI ≥30 kg/m2  were enrolled in the study. Spirometric values were measured according to American Thoracic Society (ATS recommendation. In both groups forced vital capacity (FVC and forced expiratory volume in 1 second (FEV1 were measured in sitting and standing positions, and the results were compared.The mean±SD of FVC in sitting and standing positions in obese asthmatic patients were: 3.04±0.93 lit and 3.03±0.96lit, p=0.37; and in control group: 3.68±1.12 lit and 3.72± 1.11 lit, p=0.39, respectively. The mean±SD of FEV1 in the sitting position and standing positions in obese asthmatic patients were: 2.38± 0.75 lit and 2.40± 0.81 lit, p=0.20; and in control subjects: 3.17± 0.92 lit and 3.21± 0.93 lit, p=0.07.This study showed that spirometric values in obese asthmatic patients with BMI≥30 are not affected by the standing and sitting positions.

  16. Cigarette smoke causes caspase-independent apoptosis of bronchial epithelial cells from asthmatic donors.

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    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.

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

    Science.gov (United States)

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

    2015-12-01

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

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

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    Kesic Matthew J

    2012-09-01

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

  19. The patient perspective: arthritis care provided by Advanced Clinician Practitioner in Arthritis Care program-trained clinicians

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    Warmington K

    2015-08-01

    Full Text Available Kelly Warmington,1 Carol A Kennedy,2 Katie Lundon,3 Leslie J Soever,4 Sydney C Brooks,5 Laura A Passalent,6 Rachel Shupak,7 Rayfel Schneider,8 1Learning Institute, Hospital for Sick Children, 2Musculoskeletal Health and Outcomes Research, St Michael’s Hospital, 3Continuing Professional Development, Faculty of Medicine, University of Toronto, 4University Health Network, 5Ontario Division, Arthritis Society, 6Toronto Western Hospital, 7Division of Rheumatology, St Michael's Hospital, 8Division of Rheumatology, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada Objective: To assess patient satisfaction with the arthritis care services provided by graduates of the Advanced Clinician Practitioner in Arthritis Care (ACPAC program. Materials and methods: This was a cross-sectional evaluation using a self-report questionnaire for data collection. Participants completed the Patient–Doctor Interaction Scale, modified to capture patient–practitioner interactions. Participants completed selected items from the Group Health Association of America's Consumer Satisfaction Survey, and items capturing quality of care, appropriateness of wait times, and a comparison of extended-role practitioner (ERP services with previously received arthritis care. Results: A total of 325 patients seen by 27 ERPs from 15 institutions completed the questionnaire. Respondents were primarily adults (85%, female (72%, and living in urban areas (79%. The mean age of participants was 54 years (range 3–92 years, and 51% were not working. Patients with inflammatory (51% and noninflammatory conditions (31% were represented. Mean (standard deviation Patient–Practitioner Interaction Scale subscale scores ranged from 4.50 (0.60 to 4.63 (0.48 (1 to 5 [greater satisfaction]. Overall satisfaction with the quality of care was high (4.39 [0.77], as was satisfaction with wait times (referral to appointment, 4.27 [0.86]; in clinic, 4.24 [0.91]. Ninety-eight percent of

  20. There are more asthmatics in homes with high cockroach infestation

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    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.

  1. Air pollution and respiratory health of children: the PEACE study in Oslo, Norway.

    NARCIS (Netherlands)

    Clench-Aas, J.; Bartonova, A.; Skjonsberg, O.H.; Leegaard, J.; Hagen, L.O.; Giaever, P.; Moseng, J.; Roemer, W.

    1998-01-01

    As a part of the Pollution Effects on Asthmatic Children in Europe (PEACE) investigation, a 10 week panel study was conducted in Oslo, Norway, from December 1, 1993 to February 14, 1994. Of the 180 children recruited, 125 satisfactorily filled out a daily diary for the entire period, in addition to

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

    NARCIS (Netherlands)

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

    2002-01-01

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

  3. Air pollution and respiratory health of children: the PEACE panel study in Krakow., Poland.

    NARCIS (Netherlands)

    Haluszka, J.; Pisiewics, K.; Miczynski, J.; Roemer, W.; Tomalak, W.

    1998-01-01

    The Krakow panel study was performed as part of the Pollution Effects on Asthmatic Children in Europe (PEACE) project. The aim of the study was to examine the acute effects of short-term changes in air pollution on symptomatic children. Krakow served as the urban area and Rabka, a small health resor

  4. Beta 2-adrenergic receptor gene association with overweight and asthma in children and adolescents and its relationship with physical fitness

    Directory of Open Access Journals (Sweden)

    Neiva Leite

    2015-12-01

    Full Text Available Objective: To investigate the association of Arg16Gly and Gln27Glu polymorphisms of β2-adrenergic receptor gene (ADRB2 with the occurrence of asthma and overweight and the gene's influence on anthropometric, clinic, biochemical and physical fitness variables in children and adolescents. Methods: Subjects were evaluated for allelic frequencies of the β2-adrenergic receptor gene, height, weight, body mass index (BMI, BMI Z-score, waist circumference (WC, pubertal stage, resting heart rate (HRres, blood pressure (BP, total cholesterol (TC, glucose, insulin, high density lipoprotein (HDL-C, low density lipoprotein (LDL-C, triglyceride (TG, Homeostasis Metabolic Assessment (HOMA2-IR, Quantitative Insulin Sensitivity Check Index (QUICKI and maximal oxygen uptake (VO2max. The participants were divided in four groups: overweight asthmatic (n=39, overweight non-asthmatic (n=115, normal weight asthmatic (n=12, and normal weight non-asthmatic (n=40. Results: Regarding the Gln27Glu polymorphism, higher total cholesterol was observed in usual genotype individuals than in genetic variant carriers (p=0.04. No evidence was found that the evaluated polymorphisms are influencing the physical fitness. The Arg16 allele was found more frequently among the normal weight asthmatic group when compared to the normal weight non-asthmatic group (p=0.02, and the Glu27 allele was more frequently found in the overweight asthmatics group when compared to the normal weight non-asthmatic group (p=0.03. Conclusions: The association of Arg16 allele with the occurrence of asthma and of the Glu27 allele with overweight asthmatic adolescents evidenced the contribution of the β2-adrenergic receptor gene to the development of obesity and asthma.

  5. Impaired P2X1 Receptor-Mediated Adhesion in Eosinophils from Asthmatic Patients.

    Science.gov (United States)

    Wright, Adam; Mahaut-Smith, Martyn; Symon, Fiona; Sylvius, Nicolas; Ran, Shaun; Bafadhel, Mona; Muessel, Michelle; Bradding, Peter; Wardlaw, Andrew; Vial, Catherine

    2016-06-15

    Eosinophils play an important role in the pathogenesis of asthma and can be activated by extracellular nucleotides released following cell damage or inflammation. For example, increased ATP concentrations were reported in bronchoalveolar lavage fluids of asthmatic patients. Although eosinophils are known to express several subtypes of P2 receptors for extracellular nucleotides, their function and contribution to asthma remain unclear. In this article, we show that transcripts for P2X1, P2X4, and P2X5 receptors were expressed in healthy and asthmatic eosinophils. The P2X receptor agonist α,β-methylene ATP (α,β-meATP; 10 μM) evoked rapidly activating and desensitizing inward currents (peak 18 ± 3 pA/pF at -60 mV) in healthy eosinophils, typical of P2X1 homomeric receptors, which were abolished by the selective P2X1 antagonist NF449 (1 μM) (3 ± 2 pA/pF). α,β-meATP-evoked currents were smaller in eosinophils from asthmatic patients (8 ± 2 versus 27 ± 5 pA/pF for healthy) but were enhanced following treatment with a high concentration of the nucleotidase apyrase (17 ± 5 pA/pF for 10 IU/ml and 11 ± 3 pA/pF for 0.32 IU/ml), indicating that the channels are partially desensitized by extracellular nucleotides. α,β-meATP (10 μM) increased the expression of CD11b activated form in eosinophils from healthy, but not asthmatic, donors (143 ± 21% and 108 ± 11% of control response, respectively). Furthermore, α,β-meATP increased healthy (18 ± 2% compared with control 10 ± 1%) but not asthmatic (13 ± 1% versus 10 ± 0% for control) eosinophil adhesion. Healthy human eosinophils express functional P2X1 receptors whose activation leads to eosinophil αMβ2 integrin-dependent adhesion. P2X1 responses are constitutively reduced in asthmatic compared with healthy eosinophils, probably as the result of an increase in extracellular nucleotide concentration.

  6. Evaluation of Asthmatic Patients Referred to Jahrom Hospital and Clinic

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    Soheila Alyasin

    2004-09-01

    Full Text Available Asthma is the most common chronic respiratory disease of children in the world. Serial studies in the world have showed an increased prevalence of bronchial asthma. In this study, the children younger than 12 years old referred to Jahrom hospital and clinic due to asthma were selected. We issued 100 questionnaires, according to International Study of Asthma and Allergies in Childhood (ISAAC criteria and were completed by the physicians. The ratio of male to female was 1 to 9. The patients who were under the age of 4, 3 and 1 year were 82%, 60% and 15% respectively. Passive smoking was present in 56% of the patients, and 22% had pets at home like cat, dog or bird. Home dampness was present in 33%. Ninety percent of patients had used breast feeding during the first year of life. Seventy percent of patients had family history of asthma. Food allergy was present and could trigger asthma in 15%. The result of ISSAC questionnaire showed that during the last year wheezing was present in 10%, 6% had 1-3 attacks and 4% had 4-12 attacks. Sleep disturbance by wheezing had occurred in 5% but cough in 16%. Thirteen percent of patients had wheezing after exercise. In Jahrom town the climate is warm and dry. In this town asthma in children is more common among the children who are younger than 4 years old. The risk factor like smoking at home, pets and home dampness should be eliminated from their environment.

  7. 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

  8. HIV/AIDS Clinician Training Needs in China: A Review

    Institute of Scientific and Technical Information of China (English)

    Joseph D. Tucker

    2002-01-01

    @@ THE URGENCY OF the HIV epidemic in China hascreated substantial interest in the prevention, treatment,care, and advocacy of HIV and AIDS.1 China hasinvested large portions of its public health structure tocurb the spread of the HIV epidemic within its borders.However, training and education of physicians has beentraditionally less emphasized, stalled at the intersectionbetween health education, clinical science, and publichealth.2 The emerging HIV/AIDS clinician trainingneeds must be revisited in light of the historical andbiological context of HIV in China. This brief review ofthe clinician training needs in China will examine thehistory of STDs in China, the biological corollariesimportant to training, and the endpoints of recent studiesassessing Chinese HIV and sexually transmitted diseases(STI) clinician training.

  9. Rehabilitating time: multiple temporalities among military clinicians and patients.

    Science.gov (United States)

    Messinger, Seth D

    2010-04-01

    In this article I explore the different orientations to time experienced by clinicians and patients in the US Armed Forces Amputee Patient Care Program at Walter Reed Army Medical Center in Washington DC. In structuring, describing, and working with patients, clinicians rely on a rehabilitative program that is embedded in a narrative notion of time. This approach seeks to embed the grievous wounds patients have sustained along a trajectory of injured to well. Patients are often eager to adopt this approach to their injury but in many cases find that the linear flow of time, upon which this clinical approach relies, is not matched by their experience. Instead the past, the present, and the future can flow together so that patients are simultaneously experiencing these three time orientations. This can create the potential for misunderstanding and conflict between clinicians over adherence and the meaning of a good rehabilitative outcome.

  10. Multiple bronchoceles in a non-asthmatic patient with allergic bronchopulmonary aspergillosis.

    Science.gov (United States)

    Amin, Muhammad Umar; Mahmood, Rabia

    2008-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction due to a fungus, Aspergillus fumigatus. It is typically seen in patients with long-standing asthma. Our patient was a non-asthmatic 18 years old male who presented with chronic cough for 2 years. Peripheral blood eosinophilia and elevated scrum IgE were observed. His x-ray chest revealed v-shaped opacity in the left upper lobe close to the hilum. High resolution computed tomographic scan of the chest revealed multiple dilated bronchi filled with mucous (bronchoceles) and central bronchiectasis (CB) involving main segmental bronchi. Central bronchiectasis (CB) was typical of ABPA but bronchocele formation was a rare manifestation of the disease. The patient was managed with oral prednisolone and was relieved of his symptoms. Occurrence of ABPA in non-asthmatics is very rare and deserves reporting.

  11. Digitizing the Facebow: A Clinician/Technician Communication Tool.

    Science.gov (United States)

    Kalman, Les; Chrapka, Julia; Joseph, Yasmin

    2016-01-01

    Communication between the clinician and the technician has been an ongoing problem in dentistry. To improve the issue, a dental software application has been developed--the Virtual Facebow App. It is an alternative to the traditional analog facebow, used to orient the maxillary cast in mounting. Comparison data of the two methods indicated that the digitized virtual facebow provided increased efficiency in mounting, increased accuracy in occlusion, and lower cost. Occlusal accuracy, lab time, and total time were statistically significant (P<.05). The virtual facebow provides a novel alternative for cast mounting and another tool for clinician-technician communication.

  12. Clinicians' ratings and self-reports of basic symptoms.

    Science.gov (United States)

    Rubino, I Alex; Romeo, Domenico; Scarpellino, Angelo; Siracusano, Alberto

    2002-10-01

    A sample of 34 paranoid or undifferentiated schizophrenic outpatients were given the Rome Basic Disorders Scale, a self-rating questionnaire aimed to the assessment of basic symptoms, as defined by the Bonn Scale. These patients were then interviewed on the same 54 basic symptoms explored with the scale, by two independent clinicians blind to the outpatients' data. Self-ratings compared with clinicians' ratings by Student t for dependent samples yielded only one significant difference (p< .01) for the item measuring hypersensitivity to light. Present findings suggest that the Rome Basic Disorders Scale may be safely self-rated even by collaborative schizophrenic patients.

  13. An organizational assessment of disruptive clinician behavior: findings and implications.

    Science.gov (United States)

    Walrath, Jo M; Dang, Deborah; Nyberg, Dorothy

    2013-01-01

    This study investigated registered nurses' (RNs) and physicians' (MD) experiences with disruptive behavior, triggers, responses, and impacts on clinicians, patients, and the organization. Using the Disruptive Clinician Behavior Survey for Hospital Settings, it was found that RNs experienced a significantly higher frequency of disruptive behaviors and triggers than MDs; MDs (45% of 295) and RNs (37% of 689) reported that their peer's disruptive behavior affected them most negatively. The most frequently occurring trigger was pressure from high census, volume, and patient flow; 189 incidences of harm to patients as a result of disruptive behavior were reported. Findings provide organizational leaders with evidence to customize interventions to strengthen the culture of safety.

  14. Spontaneous epidural emphysema and pneumomediastinum during an asthmatic attack in a child

    Energy Technology Data Exchange (ETDEWEB)

    Caramella, D.; Bulleri, A.; Battolla, L.; Bartolozzi, C. [Department of Radiology, University of Pisa, Via Roma 67, I-56 100 Pisa (Italy); Pifferi, M.; Baldini, G. [Department of Pediatrics, University of Pisa, Pisa (Italy)

    1997-12-01

    CT revealed the presence of epidural emphysema as an incidental finding in a 13-year-old boy in whom mild infrequent coughing during an asthmatic attack resulted in a pneumomediastinum and subcutaneous emphysema. Epidural emphysema was not associated with neurological symptoms. The CT images demonstrated the pathway of air leakage from the posterior mediastinum through the intervertebral foramina into the epidural space. Repeat CT showed spontaneous resolution of the epidural emphysema. (orig.) With 2 figs., 9 refs.

  15. Stereoselective total synthesis of the potent anti-asthmatic compound CMI-977 (LDP-977)

    Energy Technology Data Exchange (ETDEWEB)

    Dias, Luiz Carlos; Farina, Lui Strambi; Ferreira, Marco Antonio Barbosa, E-mail: ldias@iqm.unicamp.br [Universidade de Campinas (UNICAMP), SP (Brazil). Instituto de Quimica

    2013-02-15

    A short and efficient stereoselective total synthesis of CMI-977 (LDP-977), a potent and orally active anti-asthmatic compound, was developed. The key steps involve a highly diastereoselective Mukaiyama oxidative cyclization, which provides the trans-THF (tetrahydrofuran) unit and a Seyferth-Gilbert homologation to construct the triple bond in the target molecule. The synthesis of the key chiral building block was performed using Jacobsen hydrolytic kinetic resolution. (author)

  16. Eicosanoid Mediators in the Airway Inflammation of Asthmatic Patients: What is New?

    Science.gov (United States)

    Sanak, Marek

    2016-11-01

    Lipid mediators contribute to inflammation providing both pro-inflammatory signals and terminating the inflammatory process by activation of macrophages. Among the most significant biologically lipid mediators, these are produced by free-radical or enzymatic oxygenation of arachidonic acid named "eicosanoids". There were some novel eicosanoids identified within the last decade, and many of them are measurable in clinical samples by affordable chromatography-mass spectrometry equipment or sensitive immunoassays. In this review, we present some recent advances in understanding of the signaling by eicosanoid mediators during asthmatic airway inflammation. Eicosanoid profiling in the exhaled breath condensate, induced sputum, or their metabolites measurements in urine is complementary to the cellular phenotyping of asthmatic inflammation. Special attention is paid to aspirin-exacerbated respiratory disease, a phenotype of asthma manifested by the most profound changes in the profile of eicosanoids produced. A hallmark of this type of asthma with hypersensitivity to non-steroid anti-inflammatory drugs (NSAIDs) is to increase biosynthesis of cysteinyl leukotrienes on the systemic level. It depends on transcellular biosynthesis of leukotriene C₄ by platelets that adhere to granulocytes releasing leukotriene A₄. However, other abnormalities are also reported in this type of asthma as a resistance to anti-inflammatory activity of prostaglandin E₂ or a robust eosinophil interferon-γ response resulting in cysteinyl leukotrienes production. A novel mechanism is also discussed in which an isoprostane structurally related to prostaglandin E₂ is released into exhaled breath condensate during a provoked asthmatic attack. However, it is concluded that any single eicosanoid or even their complex profile can hardly provide a thorough explanation for the mechanism of asthmatic inflammation.

  17. 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

  18. A proton pump inhibitor, lansoprazole, ameliorates asthma symptoms in asthmatic patients with gastroesophageal reflux disease.

    Science.gov (United States)

    Shimizu, Yasuo; Dobashi, Kunio; Kobayashi, Setsuo; Ohki, Ichiro; Tokushima, Masahiko; Kusano, Motoyasu; Kawamura, Osamu; Shimoyama, Yasuyuki; Utsugi, Mitsuyoshi; Sunaga, Noriaki; Ishizuka, Tamotsu; Mori, Masatomo

    2006-07-01

    Aspiration of acid to the airway causes airway inflammation, and acid stress to the airway caused by gastroesophageal reflux disease (GERD) has been known as a potential mechanism of deteriorated asthma symptoms. However, the efficacy of the acid suppressive drugs, H(2)-receptor blockers (H(2) blocker) and proton pump inhibitors, on asthma symptoms and pulmonary functions remains controversial. We therefore designed the randomized prospective study to determine the efficacy of an H(2) blocker (roxatidine, 150 mg/day) and a proton pump inhibitor (lansoprazole, 30 mg/day) on asthma symptoms of 30 asthmatic patients with GERD. These patients were divided in the two groups (15 patients for each group) and treated with either roxatidine or lansoprazole. The diagnosis of GERD was established by the method of Los Angeles classification including mucosal minimum change of Grade M and questionnaire for the diagnosis of reflux disease (QUEST) score. The efficacy of acid suppressive drugs was evaluated by peak expiratory flow (PEF), asthma control questionnaire (ACQ) that evaluates the improvement of asthma symptoms, and forced expiratory volume in 1 second (FEV(1.0)). Lansoprazole, but not roxatidine, significantly improved PEF and ACQ scores (p < 0.05) with the improved QUEST scores. However, these acid suppressive drugs did not change the pulmonary function of FEV(1.0) in asthmatic patients. In conclusion, treatment with a proton pump inhibitor, lansoprazole, appears to be useful in improvement of asthma symptoms in asthmatic patients with GERD.

  19. Disease impact and patient insight--a study on a local population of asthmatics.

    Science.gov (United States)

    Ahmad, N S; Chan, M Y; Hiew, F L; Sharif, S A; Vijayasingham, P; Thayaparan, T; Loh, L C

    2003-10-01

    The cornerstone of asthma management is achieving adequate symptom control and patient education. We studied in our local population of asthmatic patients how well their symptoms were controlled with currently prescribed treatment and their insight into the disease and its management. Over a 6-month period, 93 asthmatics recruited from two local government health clinics and a state hospital were interviewed using a standard questionnaire. Patients were classified into 4 groups based on the treatment they were on according to Global Initiative for Asthma (GINA) treatment guidelines. The number of patients in Step 1 (rescue medication alone), Step 2 (1 controller medication), Step 3 (2 controller medications) and Step 4 (at least 3 controller medications) were 8, 39, 34 and 12, respectively. Except for day symptoms in Step 1 group, fewer than 50% achieved minimum day or night symptoms and no restriction of daily activities. Questions on patient insight were only available for 50 patients. Weather change (74%), air pollution (66%) and physical stress (46%) were the three highest ranked common asthma triggers. More than half correctly recognized the important symptoms of a serious asthma attack but fewer than 15% were familiar with the peak flow meter and its use or with the asthma self-management plan. Most patients perceived that their treatment had helped reduce disease severity and exacerbations. We conclude that symptom control and some aspect of patient education are still lacking in our local asthmatics.

  20. Effects of systemic glucocorticosteroids on peripheral neutrophil functions in asthmatic subjects: an ex vivo study

    Directory of Open Access Journals (Sweden)

    P. L. Paggiaro

    1995-01-01

    Full Text Available In 21 asthmatic subjects, several functions of isolated peripheral neutrophils (chemokinesis and chemotaxis toward 10% E. coli; superoxide anion generation after PMA; leukotriene B4 (LTB4 release from whole blood and isolated neutrophtls, before and after different stimuli were evaluated during an acute exacerbation of asthma, and after 14 – 54 days of treatment with systemic glucocorticosteroids (GCS. During acute exacerbation, superoxide anion generation was higher in asthmatics than in eleven normal subjects (39.2 ± 14.1 vs. 25.2 ± 7.3 nmol, p 20% after GCS treatment (from 131 ± 18 to 117 ± 21 μm, p = 0.005. Chemokinesis sicantly decreased in all subjects, and the changes significantly correlated with an arbitrary score of the total administered dose of GCS (r = 0.57, p < 0.05. These data suggest that neutrophil activation plays a minor role in asthma, and that treatment with GCS is not able to modify most functions of peripheral neutrophils in asthmatic subjects; chemotaxis seems to be related only to the severity of the asthma and it could reflect the improvement of the disease.

  1. Effects of Ramadan fasting on spirometric values and clinical symptoms in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-03-01

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

  2. Airway responses to sulfate and sulfuric acid aerosols in asthmatics. An exposure-response relationship.

    Science.gov (United States)

    Utell, M J; Morrow, P E; Speers, D M; Darling, J; Hyde, R W

    1983-09-01

    Epidemiologic studies support an association between elevated levels of sulfates and increased symptoms in asthmatics. To determine if these pollutants produce airway responses, 17 asthmatics inhaled the following sulfates: sodium bisulfate, ammonium sulfate, ammonium bisulfate (NH4HSO4), or sulfuric acid (H2SO4) aerosols with an aerodynamic diameter of 0.80 micron at concentrations of 100 micrograms/m3, 450 micrograms/m3, and 1,000 micrograms/m3. A sodium chloride (NaCl) aerosol of similar characteristics, administered by double-blind randomization, served as a control. Subjects breathed these aerosols for a 16-minute period via a mouthpiece. Deposition studies showed 54 to 65% retention of the inhaled aerosols. At the 1,000 micrograms/m3 concentration, the Threshold Limit Value for occupational exposure, H2SO4 and NH4HSO4 inhalation produced significant reductions in specific airway conductance (SGaw) (p less than 0.05) and forced expiratory volume in one second (p less than 0.01) compared with NaCl or pre-exposure values. At the 450 micrograms/m3 concentration, only H2SO4 inhalation produced a significant reduction in SGaw (p less than 0.01). At 100 micrograms/m3, a level 3 to 5 times greater than peak urban levels, no significant change in airway function occurred after any sulfate exposure. These data indicate that asthmatics demonstrate bronchoconstriction after brief exposure to common acidic sulfate pollutants.

  3. Interpretation of spirometric tests in asthmatic patients with reduced forced vital capacity.

    Science.gov (United States)

    Almirall, J J; Páez, I

    1994-01-01

    We have studied 175 consecutive asthmatic patients presenting with: 1) a reversible airflow obstruction, demonstrated by an increase in the forced expiratory volume in 1 second (FEV1) or in the forced vital capacity (FVC) by at least 12% along with an absolute increase of 200 ml versus prebronchodilator values after inhalation of salbutamol; 2) FVC below the lower normal limit before administration of the bronchodilator; and 3) normal FVC or slow vital capacity after bronchodilator. Two different criteria for the lower normal limit of the FEV1/FVC ratio were used to determine whether prebronchodilator spirometric patterns could be considered obstructive or not. The use of the predicted FEV1/FVC ratio as the lower normal limit allowed correct identification of obstruction in 94.9% of the patients, whereas taking the estimated fifth percentile as the lower normal limit of the FEV1/FVC correctly identified obstruction in only 78.9% of the asthmatics. Our results suggest that the predicted FEV1/FVC ratio is an adequate estimate of the lower normal limit in asthmatic patients with reduced FVC in order to distinguish obstructive from nonobstructive patterns.

  4. Relationship of reinforcement by student clinicians and peers to accuracy of imitated grammatical constructions during language training.

    Science.gov (United States)

    Friedman, P; Alster, K P; Reaves, J Y

    1980-12-01

    Percentages of correctly imitated grammatical constructions were examined within a framework of reinforcement theory. Four small treatment groups, each of 4 language-delayed children, were repeatedly observed interacting with different student-clinicians. The Therapy Reinforcement Schedule was used to obtain frequency counts of verbal and non-verbal reinforcements so that within each language group the students could be objectively divided into those who frequently and infrequently were reinforcing, and the children into those for whom peer-reinforcement was high or low. The resulting 4 groups were compared for proportions of accurately imitated constructions with a repeated-measures analysis of variance design (student-clinicians' reinforcement x peers' reinforcement x trials). Correctly scored imitations increased significantly over trials. In addition, children interacting with frequently reinforcing students received higher imitation scores than those with infrequently rewarding ones. Significant main effects of reinforcement by the peer group were not observed, although a reliable interaction of student-clinicians' reinforcement x peers' reinforcement was present. Regression analyses indicated the importance of certain types of reinforcements in predicting accuracy of imitation.

  5. Association of IL-4RA single nucleotide polymorphisms, HLA-DR and HLA-DQ in children with Alternaria-sensitive moderate-severe asthma

    Directory of Open Access Journals (Sweden)

    Santiago Luis A

    2010-03-01

    Full Text Available Abstract Background Asthma afflicts 6% to 8% of the United States population, and severe asthma represents approximately 10% of asthmatic patients. Several epidemiologic studies in the United States and Europe have linked Alternaria sensitivity to both persistence and severity of asthma. In order to begin to understand genetic risk factors underlying Alternaria sensitivity and asthma, in these studies we examined T cell responses to Alternaria antigens, HLA Class II restriction and HLA-DQ protection in children with severe asthma. Methods Sixty children with Alternaria-sensitive moderate-severe asthma were compared to 49 children with Alternaria-sensitive mild asthma. We examined HLA-DR and HLA-DQ frequencies in Alternaria-sensitive asthmatic by HLA typing. To determine ratios of Th1/Th2 Alternaria-specific T-cells, cultures were stimulated in media alone, Alternaria alternata extract and Alt a1. Sensitivity to IL-4 stimulation was measured by up-regulation of CD23 on B cells. Results Children with Alternaria-sensitive moderate-severe asthma trended to have increased sensitivities to Cladosporium (46% versus 35%, to Aspergillus (43% versus 28%, and significantly increased sensitivities to trees (78% versus 57% and to weeds (68% versus 48%. The IL-4RA ile75val polymorphism was significantly increased in Alternaria-sensitive moderate-severe asthmatics, 83% (0.627 allele frequency compared to Alternaria-sensitive mild asthmatics, 57% (0.388 allele frequency. This was associated with increased sensitivity to IL-4 stimulation measured by significantly increased IL-4 stimulated CD23 expression on CD19+ and CD86+CD19+ B cells of Alternaria-sensitive moderate-severe asthmatics. IL-5 and IL-13 synthesis was significantly increased in Alternaria-sensitive moderate-severe asthmatics compared to mild asthmatics to Alternaria extract and Alt a1 stimulation. The frequency of HLA-DQB1*03 allele was significantly decreased in Alternaria-sensitive moderate

  6. Long-term adherence to daily controller medication in children with asthma : The role of outpatient clinic visits

    NARCIS (Netherlands)

    Keemink, Yvette S.; Klok, Ted; Brand, Paul L. P.

    2015-01-01

    ObjectiveTo investigate changes in inhaled corticosteroids adherence, both before and after a scheduled follow-up visit, in young children in a comprehensive asthma management program. Study designOne-year prospective follow-up study in 104 asthmatic children (mean age 4.8 years). Adherence to inhal

  7. Investigating the Effects of Asthma Medication on the Cognitive and Psychosocial Functioning of Primary School Children with Asthma

    Science.gov (United States)

    Naude, H.; Pretorius, E.

    2003-01-01

    The effects of asthma medication on the cognitive and psychosocial functioning of primary school children with asthma are investigated. A questionnaire survey was conducted in a primary school in Stellenbosch (South Africa) with a population of six hundred and thirty-five students. Among these students, fifty-nine asthmatic children were…

  8. Smartphone and mobile phone security for the clinician.

    Science.gov (United States)

    Barber, Harry

    2016-08-02

    Smartphones are near ubiquitous and widely used by doctors in discussing patients. In all communication doctors should take steps to protect confidentiality, yet there is a paucity of available information on how clinicians can bolster cyber security and minimize risk when using their mobile phone.

  9. Donation after cardiac death : are Australian emergency clinicians supportive?

    NARCIS (Netherlands)

    Marck, C. H.; Neate, S. L.; Weiland, T. J.; Hickey, B. B.; Jelinek, G. A.

    2013-01-01

    To improve organ donation processes and outcomes, many Australian hospitals have introduced donation after cardiac death (DCD) following the 2010 publication of the National Protocol for DCD. As emergency clinicians play a significant role in identifying potential DCD donors, it is critical to asses

  10. Research on recurrent pregnancy complications: a clinician's perspective.

    Science.gov (United States)

    Smulian, John C

    2007-07-01

    Research on recurrent pregnancy complications is essential to help clinicians provide appropriate counselling and guide the management of patients with a history of adverse pregnancy outcomes. However, recurrence research is complex, in both its execution and interpretation. The paucity of appropriate data sets accessible for study of recurrent pregnancy outcomes presents significant challenges in performing recurrence research. This is further compounded by the different perspectives on recurrence between epidemiologists and clinicians. The interpretation of risk, whether it is absolute risk, relative risk or population-attributable fraction, underlies the often opposing perspectives of researchers and clinicians. Because clinicians acutely feel the need to provide appropriate counselling and management strategies when there has been a previous pregnancy complication, it is necessary that all those involved in research and care for these women work together to address gaps in our knowledge for recurrent pregnancy outcomes. In this way, we can develop a better understanding of disease processes, counsel patients better, design management plans and, ultimately, achieve better outcomes for our patients.

  11. Colonic Diverticula and Diverticular Disease: 10 Facts Clinicians Should Know.

    Science.gov (United States)

    Peery, Anne F

    2016-01-01

    Diverticular disease accounts for substantial health care utilization and costs. Despite this public health burden, clinical practice has been largely based on poor-quality evidence. Fortunately, there is growing interest in this neglected disease. Based on recent work, clinicians should be familiar with the following 10 facts about diverticula and diverticular disease.

  12. Using clinicians' search query data to monitor influenza epidemics.

    Science.gov (United States)

    Santillana, Mauricio; Nsoesie, Elaine O; Mekaru, Sumiko R; Scales, David; Brownstein, John S

    2014-11-15

    Search query information from a clinician's database, UpToDate, is shown to predict influenza epidemics in the United States in a timely manner. Our results show that digital disease surveillance tools based on experts' databases may be able to provide an alternative, reliable, and stable signal for accurate predictions of influenza outbreaks.

  13. Clinicians' information sources for new substance abuse treatment.

    Science.gov (United States)

    Arfken, Cynthia L; Agius, Elizabeth; Dickson, Marcus W

    2005-09-01

    Little is known about clinicians' information sources for new treatments or ways to improve dissemination of that information. We analyzed 163 clinicians' responses to a checklist of where and how frequently they obtain information on new treatment approaches. They reported at least yearly use of a median of four cosmopolite categories (e.g., journals or books, Internet) and a median of three local categories (e.g., co-workers, personal experience) with interpersonal contact with co-workers (89%) and seminars/conferences (86%) being the most frequently endorsed responses for at least yearly use. In response to the hypothetical scenario of receiving monthly e-mail summaries of journal articles, 59% of the clinicians rated the strategy as "very helpful". If continuing education credits were offered, more clinicians (from 50-80%) would read the relevant articles. Information dissemination may improve with expanded Internet access at programs and short e-mailed summaries carrying links to full articles coupled with the incentive of earning continuing education credits.

  14. A nurse clinician's approach to knife crime prevention.

    Science.gov (United States)

    England, Rachel; Jackson, Rob

    This article outlines a new and creative contribution to knife crime prevention by an emergency nurse clinician and an initial evaluation of its effectiveness. The 'knife crime prevention programme' is delivered to young people aged 11-16 years by one of the authors, Rob Jackson, an emergency nurse clinician at Liverpool University Hospital; the aim is to educate young people about the medical consequences of knife injury. A group of 140 students and 17 teachers responded to a questionnaire evaluating the effectiveness of the session delivered to four schools in Liverpool. Students and teachers positively rated the session, with the combination of the nurse clinician's knowledge and expertise and photographs and depictions of knife crime as a unique and impacting approach to knife crime prevention. It is suggested that the nurse clinician and other experienced health professionals have an important contribution to make in preventive approaches to knife crime. Further evaluation of the knife crime prevention programme will be conducted by the authors.

  15. [Why should clinicians be engaged in research and publication?].

    Science.gov (United States)

    Hoka, Sumio

    2015-01-01

    Why should clinicians be engaged in research and publication? The reason is that they have to deliver comprehensive medical care for patients. Clinicians endeavor to improve their clinical skills by learning updated medical knowledge and new techniques in order to save lives. By taking part in research and publications, clinicians are able to contribute actively to the progress in medicine contrary to passive involvement in it without research and publications. Mission of Japanese Society of Anesthesiologists (JSA), clearly mention that JSA aims to advance high quality research and developing new methods in medicine. JSA also necessitates, as a minimum requirement for Board Certified Anesthesiologists, presentations in annual meeting of JSA or related society meetings and also publications in Journal of Anesthesia, an official journal of JSA, or other related anesthesia journals. By experiencing research and publications, clinicians can obtain knowledge, skills as well as attitudes, which are also useful in everyday clinical work, such as logical way of thinking, how to write papers to be understood, tolerance to peer review and objective evaluation, and maintaining spirit of enterprise in their career.

  16. Dietary intake, lung function and airway inflammation in Mexico City school children exposed to air pollutants

    Directory of Open Access Journals (Sweden)

    Díaz-Sánchez David

    2009-12-01

    Full Text Available Abstract Introduction Air pollutant exposure has been associated with an increase in inflammatory markers and a decline in lung function in asthmatic children. Several studies suggest that dietary intake of fruits and vegetables might modify the adverse effect of air pollutants. Methods A total of 158 asthmatic children recruited at the Children's Hospital of Mexico and 50 non-asthmatic children were followed for 22 weeks. Pulmonary function was measured and nasal lavage collected and analyzed every 2 weeks. Dietary intake was evaluated using a 108-item food frequency questionnaire and a fruit and vegetable index (FVI and a Mediterranean diet index (MDI were constructed. The impact of these indices on lung function and interleukin-8 (IL-8 and their interaction with air pollutants were determined using mixed regression models with random intercept and random slope. Results FVI was inversely related to IL-8 levels in nasal lavage (p 1 (test for trend p 1 and FVC as was with MDI and ozone for FVC. No effect of diet was observed among healthy children. Conclusion Our results suggest that fruit and vegetable intake and close adherence to the Mediterranean diet have a beneficial effect on inflammatory response and lung function in asthmatic children living in Mexico City.

  17. Effect of Nuclear Factor-κB on Airway Remodeling in Asthmatic Rats

    Institute of Scientific and Technical Information of China (English)

    许淑云; 徐永健; 张珍祥; 倪望; 陈士新

    2004-01-01

    Summary: In order to investigate the effect of nuclear factor-κB (NF-κB) on airway remodeling in asthmatic rats, 18 Wistar rats were divided into three groups: asthmatic group; pyrrolidine dithiocarbamate (PDTC) group, in which rats were injected intraperitoneally with NF-κB specific inhibitor PDTC (100 mg/kg) before ovalbumin (OVA) challenge; control group. The NF-κB activity and the expression of inhibitory protein κBa (I-κBα) in airway were detected by electrophoretic mobility shift assay (EMSA), Western blot and immunohistochemistry respectively. The infiltration of inflammatory cells, the number of Goblet cells, the area of collagen and smooth muscle in airway were measured by means of image analysis system. The results showed that with the up-regulation of airway NF-κB activity in asthmatic group, the number of goblet cells (3.08 ±0.86/100μm basement membrane (BM)), the area of collagen (24.71 ± 4. 24 μm2/μm BM) and smooth muscle (13.81 ± 2.11 μm2/μm BM) in airway were significantly increased (P<0.05) as compared with control group (0.14±0. 05/100μm BM, 14.31 ±3.16 μm2/μm BM and 7.67±2.35 μm2/μm BM respectively) and PDTC group (0. 33±0. 14/100 μm BM, 18. 16±2.85 μm2/μm BM and 8.95±2.16 μm2/μm BM respectively). However, there was no significant difference between PDTC group and control group (P>0.05). It was concluded that the activity of NF-κB is increased in airway of asthmatic rats. Inhibition of NF-κB activation can attenuate constructional changes in asthma airway, suggesting NF-κB may contribute to asthmatic airway remodeling.

  18. Does industry take the susceptible subpopulation of asthmatic individuals into consideration when setting derived no-effect levels?

    Science.gov (United States)

    Johansson, Mia K V; Johanson, Gunnar; Öberg, Mattias; Schenk, Linda

    2016-11-01

    Asthma, a chronic respiratory disease, can be aggravated by exposure to certain chemical irritants. The objectives were first to investigate the extent to which experimental observations on asthmatic subjects are taken into consideration in connection with the registration process under the EU REACH regulation, and second, to determine whether asthmatics are provided adequate protection by the derived no-effect levels (DNELs) for acute inhalation exposure. We identified substances for which experimental data on the pulmonary functions of asthmatics exposed to chemicals under controlled conditions are available. The effect concentrations were then compared with DNELs and other guideline and limit values. As of April 2015, only 2.6% of 269 classified irritants had available experimental data on asthmatics. Fourteen of the 22 identified substances with available data were fully registered under REACH and we retrieved 114 reliable studies related to these. Sixty-three of these studies, involving nine of the 14 substances, were cited by the REACH registrants. However, only 17 of the 114 studies, involving four substances, were regarded as key studies. Furthermore, many of the DNELs for acute inhalation were higher than estimated effect levels for asthmatics, i.e., lowest observed adverse effect concentrations or no-observed adverse effect concentrations, indicating low or no safety margin. We conclude that REACH registrants tend to disregard findings on asthmatics when deriving these DNELs. In addition, we found examples of DNELs, particularly among those derived for workers, which likely do not provide adequate protection for asthmatics. Copyright © 2016 The Authors Journal of Applied Toxicology Published by John Wiley & Sons Ltd.

  19. What motivates senior clinicians to teach medical students?

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    Owen Cathy

    2005-07-01

    Full Text Available Abstract Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia. Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24% were female and 57 (76% were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%, 41–55 years = 46 participants (61.3% and >55 years = 13 participants (17.3%. Most participants (n = 48, 64% were staff specialists and 27 (36% were visiting medical officers. Half of the participants were internists (n = 39, 52%, 12 (16% were surgeons, and 24 (32% were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce.

  20. Lifestyle Risk Factors for Weight Gain in Children with and without Asthma

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    Megan E. Jensen

    2017-02-01

    Full Text Available A higher proportion of children with asthma are overweight and obese compared to children without asthma; however, it is unknown whether asthmatic children are at increased risk of weight gain due to modifiable lifestyle factors. Thus, the aim of this cross-sectional study was to compare weight-gain risk factors (sleep, appetite, diet, activity in an opportunistic sample of children with and without asthma. Non-obese children with (n = 17; age 10.7 (2.4 years and without asthma (n = 17; age 10.8 (2.3 years, referred for overnight polysomnography, underwent measurement of lung function, plasma appetite hormones, dietary intake and food cravings, activity, and daytime sleepiness. Sleep latency (56.6 (25.5 vs. 40.9 (16.9 min, p = 0.042 and plasma triglycerides (1.0 (0.8, 1.2 vs. 0.7 (0.7, 0.8 mmol/L, p = 0.013 were significantly greater in asthmatic versus non-asthmatic children. No group difference was observed in appetite hormones, dietary intake, or activity levels (p > 0.05. Sleep duration paralleled overall diet quality (r = 0.36, p = 0.04, whilst daytime sleepiness paralleled plasma lipids (r = 0.61, p =0.001 and sedentary time (r = 0.39, p = 0.02. Disturbances in sleep quality and plasma triglycerides were evident in non-obese asthmatic children referred for polysomnography, versus non-asthmatic children. Observed associations between diet quality, sedentary behavior, and metabolic and sleep-related outcomes warrant further investigation, particularly the long-term health implications.

  1. Clinician acceptance is the key factor for sustainable telehealth services.

    Science.gov (United States)

    Wade, Victoria A; Eliott, Jaklin A; Hiller, Janet E

    2014-05-01

    Telehealth, the delivery of health care services at a distance using information and communications technology, has been slow to be adopted and difficult to sustain. Researchers developing theories concerning the introduction of complex change into health care usually take a multifactorial approach; we intentionally sought a single point of intervention that would have maximum impact on implementation. We conducted a qualitative interview study of 36 Australian telehealth services, sampled for maximum variation, and used grounded theory methods to develop a model from which we chose the most important factor affecting the success of telehealth. We propose that clinician acceptance explains much of the variation in the uptake, expansion, and sustainability of Australian telehealth services, and that clinician acceptance could, in most circumstances, overcome low demand, technology problems, workforce pressure, and lack of resourcing. We conclude that our model offers practical advice to those seeking to implement change with limited resources.

  2. Clinician feedback on using episode groupers with Medicare claims data.

    Science.gov (United States)

    Thomas, Fred; Caplan, Craig; Levy, Jesse M; Cohen, Marty; Leonard, James; Caldis, Todd; Mueller, Curt

    2010-01-01

    CMS is investigating techniques that might help identify costly physician practice patterns. One method presently under evaluation is to compare resource use for certain episodes of care using commercially available episode grouping software. Although this software has been used by the private sector to classify insured individuals' medical claims into episodes of care, it has never been used with fee-for-service Medicare claims except in the studies by the Medicare Payment Advisory Commission (MedPAC) and CMS. This study reviews and reports on clinician feedback on the most obvious and important decisions that must be faced by Medicare to use grouped claims data as the foundation for a physician performance measurement system. The panel reactions show the importance of bringing persons with clinical knowledge into the development process. The clinician feedback confirms that additional research is needed.

  3. How is health economics relevant to transplant clinicians?

    Science.gov (United States)

    Wong, Germaine; Howard, Kirsten; Webster, Angela C; Morton, Rachael L; Chapman, Jeremy R; Craig, Jonathan C

    2014-07-27

    Decision making is complex and difficult in clinical practice. Clinicians are often faced with a large range of possible alternative decision options, each with their own consequences and trade-offs. Health economics methods enable informed decision making on how best to allocate limited resources that could lead to most health gains. Economic evaluation in particular is highly relevant in transplantation medicine. Transplantation is an expensive intervention, but it improves the quality of life and survival of people with chronic diseases. The balance between health care resource use and the optimal health gains is useful not only to decision-makers, but also to consumers, clinicians, and researchers. This article is an overview of the concepts of economic evaluation in the setting of transplantation and highlights the applicability of these concepts in clinical transplantation.

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

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    Linda L. Restifo

    2011-07-01

    Despite remarkable advances in basic biomedical science that have led to improved patient care, there is a wide and persistent gap in the abilities of researchers and clinicians to understand and appreciate each other. In this Editorial, the authors, a scientist and a clinician, discuss the rift between practitioners of laboratory research and clinical medicine. Using their first-hand experience and numerous interviews throughout the United States, they explore the causes of this ‘cultural divide’. Members of both professions use advanced problem-solving skills and typically embark on their career paths with a deeply felt sense of purpose. Nonetheless, differences in classroom education, professional training environments, reward mechanisms and sources of drive contribute to obstacles that inhibit communication, mutual respect and productive collaboration. More than a sociological curiosity, the cultural divide is a significant barrier to the bench-to-bedside goals of translational medicine. Understanding its roots is the first step towards bridging the gap.

  5. [The clinician-scientist: proposal for a new paradigm].

    Science.gov (United States)

    Leibovici, Leonard; Paul, Mical

    2010-10-01

    The decline in the attraction and prestige of the clinician-scientist paradigm is due to the dissonance between clinical work and conducting research in basic science. Medicine entails alleviating distress and prolonging life. Thus, medical research deals directly with the questions: what ails our patients and what shortens their lives? How can it be prevented? How can we alleviate suffering and prolong life? Research designs that fit these questions are: researcher (or patient) initiated randomized controlled trials; systematic reviews and meta-analysis; high-quality observational studies that address risk factors, natural history of disease, side-effects, and efficiency of treatment; research in ethics; and qualitative research. The clinician-scientist should perform medical research. Investing in this paradigm wilt encourage young doctors to conduct research directly oriented to benefit their patients.

  6. Surveying clinicians by web: current issues in design and administration.

    Science.gov (United States)

    Dykema, Jennifer; Jones, Nathan R; Piché, Tara; Stevenson, John

    2013-09-01

    The versatility, speed, and reduced costs with which web surveys can be conducted with clinicians are often offset by low response rates. Drawing on best practices and general recommendations in the literature, we provide an evidence-based overview of methods for conducting online surveys with providers. We highlight important advantages and disadvantages of conducting provider surveys online and include a review of differences in response rates between web and mail surveys of clinicians. When administered online, design-based features affect rates of survey participation and data quality. We examine features likely to have an impact including sample frames, incentives, contacts (type, timing, and content), mixed-mode approaches, and questionnaire length. We make several recommendations regarding optimal web-based designs, but more empirical research is needed, particularly with regard to identifying which combinations of incentive and contact approaches yield the highest response rates and are the most cost-effective.

  7. Oral health in children with asthma

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    Marković Dejan

    2015-01-01

    Full Text Available Introduction. It has been suggested that asthmatic patients may have a higher risk for oral diseases, both as a result of the medical condition and effects of medications. Objective. The aim of the study was to determine the oral health status of children with asthma and to evaluate the oral health parameters according to the medications and severity of the disease. Methods. The study group consisted of 158 children with asthma and 100 healthy control subjects aged 2-18 years. The diagnosis of dental caries was performed using the Decayed, Missing, and Filled Teeth (DMFT/dmft criteria. The oral hygiene, periodontal status and gingival health were assessed with the Simplified Oral Hygiene Index (Greene-Vermillion, Community Periodontal Index of Treatment Needs and Gingival Index (Löe-Silness, respectively. Results. Thirty (19% patients with asthma and 43 (43% healthy children were caries-free (p<0.001. There were no significant differences between asthmatic and control children in caries experience (for children with asthma mean DMFT=2.1±1.8, mean dmft=4.2±3.3; for healthy children mean DMFT=2.5±0.9, mean dmft=5.2±1.3. Level of asthma control did not have influence on dental health, while dose of inhaled corticosteroid had impact on primary dentition. Periodontal status and gingival health did not differ between asthmatic and control children. However, children with asthma had poorer oral hygiene (p<0.001. Conclusion. Results of the study do not show a relationship between asthma and oral diseases. However, further improvement could be made in educating children and parents on the importance of good oral hygiene and prevention of oral diseases.

  8. Crew resource management training--clinicians' reactions and attitudes.

    Science.gov (United States)

    France, Daniel J; Stiles, Renee; Gaffney, E Andrew; Seddon, Margaret R; Grogan, Eric L; Nixon, William R; Speroff, Theodore

    2005-08-01

    Many health care organizations are adopting crew resource management (CRM) training from the aviation industry as a patient safety practice. Although CRM has high face validity, its effects have not been thoroughly evaluated in aviation or health care. Its potential to improve team communication, coordination, and patient safety, however, makes efforts to study CRM necessary and worthwhile. This article evaluates clinicians' attitudes about and reactions to CRM after they participated in an eight-hour, commercially developed training program.

  9. Studying forced expiratory volume at 1 second over menstrual segments in asthmatic and non-asthmatic women: assessing protocol feasibility

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    Wegienka Ganesa

    2012-07-01

    Full Text Available Abstract Background Sex hormones may play an important role in observed gender differences in asthma incidence and severity, as well as in the observed changes in asthma symptoms during times of hormonal fluctuation (i.e.; premenstrual, pregnancy, etc.. This pilot study sought to demonstrate the feasibility of data collection methods to investigate the effects of sex hormones on lung function in women. Findings A cohort of 13 women (6 with and 7 without prior asthma diagnoses who were having menstrual periods and were not taking hormones collected urine samples daily for measurement of estrogen (estrone E1C and progesterone (Pregnanediol-glucuronide PDG metabolites over the course of a menstrual segment (bleeding episode plus the following bleeding-free interval. Hormones were used to estimate menstrual segment phase (follicular versus luteal based on a published algorithm. Daily bleeding and FEV1 measurements were recorded and percent predicted FEV1 was calculated. Percent predicted FEV1 decreased over the course of the follicular but not the luteal phase. More specifically, among women without a prior asthma diagnosis, the E1C/PDG ratio and E1C and PDG were individually associated with FEV1 in the follicular phase. No associations were found between hormones and percent predicted FEV1 in the luteal phase or among asthmatic women. E1C was associated with FEV1 in the five days before bleeding onset only among non-asthmatic women. Discussion A study of contiguous daily hormones and symptoms over menstrual segments from a large group of women with and without asthma is needed to better determine within-woman cyclicity of the observed patterns.

  10. The many faces of moral distress among clinicians.

    Science.gov (United States)

    Rushton, Cynda Hylton; Boss, Renee; Hallett, Kristina; Hensel, Jaime; Humphrey, G Bennett; Les, Jessica; Mack, Cheryl; McCammon, Susan; Murray, John S; Nathanson, Esther; Pniewski, Janet; Shuham, A M t; Volpe, Rebecca L

    2013-01-01

    This narrative symposium illuminates the problem of clinician moral distress. NIB editorial staff and narrative symposium editors, Cynda Rushton, PhD, RN, FAAN and Renee Boss, MD, MHS, developed a call for stories, which was sent to several list serves and posted on Narrative Inquiry in Bioethics' website. The request for personal stories from inter-professional healthcare providers asked them to: identify specific clinical situations that give rise to moral distress; discuss the sources of this distress; reflect on how they experienced moral distress-physically, psychologically, socially, or spiritually; assess how they managed their situations; and offer suggestions for avoiding future problems of a similar nature. Twelve stories are found in the print version of the journal and an additional eight supplemental stories are published online only through Project MUSE. The clinicians describe a wide range of experiences with patients, other clinicians, and their own professional and personal identities. Embedded in each of the narratives are deeply felt emotions that accompany their experiences of moral distress. Katherine Brown-Saltzman (a nurse), Alisa Carse (a philosopher), Zhanna Bagdasarov and Shane Connelly (industrial-organizational psychologists), and Nancy Berlinger (a bioethicist) provided commentaries.

  11. Prevalence of Asthma in Children of Chemical Warfare Victims

    Science.gov (United States)

    Mirsadraee, Majid; Mozaffari, Abolfazl; Attaran, Davood

    2011-01-01

    Objective Exposure of DNA to sulfur mustard gas may increase the inheritance of asthma in chemical warfare victims' (CWV) offspring. The objective of this study was to determine the prevalence of asthma in children of CWV and compare it to asthmatic children in the general population. Methods Four hundred and nine children from 130 CWV fathers and 440 children from 145 asthmatic parents from two cities in Iran participated in this study. The prevalence of asthma was determined by standard questionnaire released for epidemiological survey of asthma in children and compared between two groups. Findings The prevalence of asthma in the CWV group was 15%; this was not significantly different from the control group (12.5%). The children of the CWV group reported a significantly greater incidence of wheezing (1.2±3.1 attacks) per year, but the control group reported more severe attacks leading to speech difficulties (3%) and coughing (7%). Regression analysis showed that with increasing family size in the control group, the number of subjects suffering from asthmatic symptoms decreases significantly (r=0.86, P=0.001). Conclusion Chemical agents may increase the prevalence of asthma in the offspring of CWV. PMID:23056804

  12. Alteration of airway responsiveness mediated by receptors in ovalbumin-induced asthmatic E3 rats

    Institute of Scientific and Technical Information of China (English)

    Jing-wen LONG; Xu-dong YANG; Lei CAO; She-min LU; Yong-xiao CAO

    2009-01-01

    Aim:Airway hyperresponsiveness is a constant feature of asthma.The aim of the present study was to investigate airway hyperreactivity mediated by contractile and dilative receptors in an ovalbumin (OVA)-induced model of rat asthma.Methods:Asthmatic E3 rats were prepared by intraperitoneal injection with OVA/aluminum hydroxide and then challenged with intranasal instillation of OVA-PBS two weeks later.The myograph method was used to measure the responses of constriction and dilatation in the trachea,main bronchi and lobar bronchi.Results:In asthmatic E3 rata,β2 adrenoceptor-mediated relaxation of airway smooth muscle pre-contracted with 5-HT was inhibited,and there were no obvious difference in relaxation compared with normal E3 rats.Contraction of lobar bronchi mediated by 5-HT and sarafotoxin 6c was more potent than in the trachea or main bronchi.Airway contractions mediated by the endothelin (ET)A receptor,ETB receptor and M3 muscarinic receptor were augmented,and the augmented contraction was most obvious in lobar bronchi.The order of efficacy of contraction for lobar bronchi induced by agonists was ET-1,sarafotoxin 6c>ACh>5-HT.OX8 (an antibody against CD8+ T cells) strongly shifted and 0X35 (an antibody against CD4+ T cells) modestly shifted isoprenaline-induced concentration-relaxation curves in a nonparallel fashion to the left with an increased Rmax in asthmatic rats and sarafotoxin 6c-induced concentration-contractile curves to the right with a decreased Emax.Conclusion:The inhibition of airway relaxation and the augmentation of contraction mediated by receptors contribute to airway hyperresponsiveness and involve CD8+ and CD4+ T cells.

  13. Can an ozone system generator reduce indoor triggers in asthmatic patient?

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    Alessandro Zanasi

    2015-09-01

    Full Text Available Objective: During the last decades, an increase in the prevalence of asthma and other allergic diseases has been recorded, together with modifications in the living environment and consequent changes in the quality of indoor air. Indoor environment is favorable to the proliferation of allergens such as: house dust mites, fungal spores and cockroaches. The primary action to be undertaken for an effective eradication of infectious agents constitutes in modifying the house environmental conditions, which make it favorable to infestations. Ozone can play a sanitize role, but at the same time it can cause inflammation, especially in the lung. The aim of this study was to verify the role and safety of ozone in the sanitation of the bedroom of a subject suffering from asthma. Methods: A daily ozone treatment was carried during a 14-day time period in the bedroom of an asthmatic patient. Aerobiological sampling in indoor air, microbiological sampling and detection of ATP bioluminescence on the surface were performed before and after treatment at the first day, as well as after treatment at the 7th and 14th day of the study. An aerobiological measurement was also performed outdoor of the patient and #8217;s bedroom only for the first day. Results: Our analysis confirms that low ozone levels induced a marked reduction of indoor air microbiological pollution without adverse effects on lung functionality of the asthmatic patient we considered. Conclusion: Our observations warrant further investigation on the role that ozone-based sterilization might have in controlling asthmatic symptoms. [J Exp Integr Med 2015; 5(3.000: 128-136

  14. Effect of omeprazole and domperidone on adult asthmatics with gastroesophageal reflux

    Institute of Scientific and Technical Information of China (English)

    Bhavneesh Sharma; Manisha Sharma; Mradul Kumar Daga; Gopal Krishan Sachdev; Elliott Bondi

    2007-01-01

    AIM: To study the effect of combined omeprazole(Ome) and domperidone(Dom) therapy on asthma symptoms and pulmonary function in asthmatics with gastroesoph ageal reflux.METHODS: We selected 198 asthmatics with gastro esophageal reflux diagnosed by 24-h esophageal pH moni toring to receive Ome 20 mg twice daily and Dom 10 mg three times daily or placebo for 16 wk (1:1 double-blind randomization). Spirometry was done at baseline and af ter 16 wk of treatment. The primary outcome measures were: mean daily daytime and nighttime asthma symp tom scores. Mean daily reflux symptom scores, albuterol use as rescue medication (number of puffs), daytime and nighttime peak expiratory flow rate (PEFR), postbroncho dilator forced expiratory volume in 1 second (FEV1) and postbronchodilator forced vital capacity (FVC) were sec ondary outcome measures.RESULTS: Comparison of mean change from baseline between antireflux therapy and placebo groups revealed significant reduction in daytime asthma symptom score (17.4% vs 8.9 %), nighttime asthma symptom score (19.6% vs 5.4%), reflux symptom score (8.7% vs 1.6%) and rescue medication use (23.2% vs 3.1%) after antire flux therapy compared to mean change in placebo group (P < 0.001). There was significant improvement in morn ing PEFR (7.9% vs 0.2%), evening PEFR (9.8% vs 0.5%), FEV1 (11.1% vs 3.78%) and FVC (9.3% vs 1.52%) in the antireflux therapy group compared to placebo on comparing the mean change from baseline after 16 wk (P < 0.01).CONCLUSION: Combined therapy with Ome and Dom in adult asthmatics with gastroesophageal reflux may be beneficial by reducing asthma symptoms, rescuing medi cation use, and improving pulmonary function.

  15. Phytochemistry, anti-asthmatic and antioxidant activities of Anchomanes difformis(Blume) Engl. leaf extract

    Institute of Scientific and Technical Information of China (English)

    Ovuakporie-Uvo Oghale; Mac Donald Idu

    2016-01-01

    Objective: To study the phytochemistry, anti-asthmatic and antioxidant activities of the aqueous leaf extract of Anchomanes difformis(Blume) Engl.(A. difformis) and to verify claims of use in folk medicine.Methods: For anti-asthmatic activity, male and female guinea pigs with average body weight of(451.4 ± 118.1) g were divided into six groups of six animals each. Group 1served as control(distilled water); Group 2 was administered with salbutamol(reference drug) only; Group 3 served as ovalbumin sensitized group, Group 4, 5 and 6 were treated with A. difformis extract at doses of 100, 200 and 400 mg/kg, respectively. Described methods were used to test fluid viscosity, fluid volume and quantitative phytochemistry analysis. Absorbance was read using a UV–Vis spectrophotometer and results computed in percentage. Total antioxidant assays [2, 2-diphenyl-1-picrylhydrazyl(DPPH) and lipid peroxidation assay], were carried out using reported procedures.Results: The anti-asthmatic evaluation showed that protection from asthma of the animals in Group 6(400 mg/kg, 32.7%) were similar to that in Group 2(salbutamol, 33.0%).Excised trachea was free of mucus secretion in Group 5(200 mg/kg) as was observed in the control group. Fluid volume increase in Groups 3 and 6 indicated mucus secretion.DPPH radical scavenging activity of extract was effective as ascorbic acid which served as standard at 20 mg/m L. But, the extract elicited low lipid peroxidation activity compared with the reference(tocopherol) at concentrations tested.Conclusions: A. difformis aqueous leaf extract is safe and possesses positive antiasthmatic and antioxidant activities as claimed by traditional herbal practitioners in Delta State.

  16. Gastroesophageal reflux episodes in asthmatic patients and their temporal relation with sleep architecture

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    L. Mello-Fujita

    2008-02-01

    Full Text Available Gastroesophageal reflux (GER is common in asthma patients and can contribute to sleep disruption. The aim of the present study was to determine the time-related distribution of GER events together with their impact on sleep in asthmatic subjects with GER disease symptoms. The inclusion criteria were: 18-65 years, controlled moderate to severe asthma and GER-compatible clinical evidence. The exclusion criteria were: chronic obstructive lung disease, smoking, infections of the upper airways, use of oral corticosteroids, other co-morbidities, pregnancy, sleep-related disorders, night-time shift work, and the use of substances with impact on sleep. Asthmatic patients with nocturnal symptoms were excluded. All-night polysomnography and esophageal pH monitoring were recorded simultaneously. Of the 147 subjects selected, 31 patients and 31 controls were included. Seventeen patients were classified as DeMeester positive and 14 as DeMeester negative. Both groups displayed similar outcomes when general variables were considered. Sleep stage modification one minute prior to GER was observed in the DeMeester-positive group. Awakening was the most frequent occurrence at GER onset and during the 1-min period preceding 38% of the nocturnal GER. Sleep stage 2 was also prevalent and preceded 36% of GER events. In the DeMeester-negative group, awakening was the most frequent response before and during GER. Modifications in sleep stages, arousals or awakenings were associated with 75% of the total GER events analyzed during the period of one minute before and after the fall of esophageal pH below 4 in the DeMeester-positive group. These data provide evidence that sleep modifications precede the GER events in asthmatic patients.

  17. FoxO1 regulates allergic asthmatic inflammation through regulating polarization of the macrophage inflammatory phenotype.

    Science.gov (United States)

    Chung, Sangwoon; Lee, Tae Jin; Reader, Brenda F; Kim, Ji Young; Lee, Yong Gyu; Park, Gye Young; Karpurapu, Manjula; Ballinger, Megan N; Qian, Feng; Rusu, Luiza; Chung, Hae Young; Unterman, Terry G; Croce, Carlo M; Christman, John W

    2016-04-05

    Inflammatory monocyte and tissue macrophages influence the initiation, progression, and resolution of type 2 immune responses, and alveolar macrophages are the most prevalent immune-effector cells in the lung. While we were characterizing the M1- or M2-like macrophages in type 2 allergic inflammation, we discovered that FoxO1 is highly expressed in alternatively activated macrophages. Although several studies have been focused on the fundamental role of FoxOs in hematopoietic and immune cells, the exact role that FoxO1 plays in allergic asthmatic inflammation in activated macrophages has not been investigated. Growing evidences indicate that FoxO1 acts as an upstream regulator of IRF4 and could have a role in a specific inflammatory phenotype of macrophages. Therefore, we hypothesized that IRF4 expression regulated by FoxO1 in alveolar macrophages is required for established type 2 immune mediates allergic lung inflammation. Our data indicate that targeted deletion of FoxO1 using FoxO1-selective inhibitor AS1842856 and genetic ablation of FoxO1 in macrophages significantly decreases IRF4 and various M2 macrophage-associated genes, suggesting a mechanism that involves FoxO1-IRF4 signaling in alveolar macrophages that works to polarize macrophages toward established type 2 immune responses. In response to the challenge of DRA (dust mite, ragweed, and Aspergillus) allergens, macrophage specific FoxO1 overexpression is associated with an accentuation of asthmatic lung inflammation, whereas pharmacologic inhibition of FoxO1 by AS1842856 attenuates the development of asthmatic lung inflammation. Thus, our study identifies a role for FoxO1-IRF4 signaling in the development of alternatively activated alveolar macrophages that contribute to type 2 allergic airway inflammation.

  18. Phloretin Attenuates Allergic Airway Inflammation and Oxidative Stress in Asthmatic Mice

    Science.gov (United States)

    Huang, Wen-Chung; Fang, Li-Wen; Liou, Chian-Jiun

    2017-01-01

    Phloretin (PT), isolated from the apple tree, was previously demonstrated to have antioxidative and anti-inflammatory effects in macrophages and anti-adiposity effects in adipocytes. Inflammatory immune cells generate high levels of reactive oxygen species (ROS) for stimulated severe airway hyperresponsiveness (AHR) and airway inflammation. In this study, we investigated whether PT could reduce oxidative stress, airway inflammation, and eosinophil infiltration in asthmatic mice, and ameliorate oxidative and inflammatory responses in tracheal epithelial cells. BALB/c mice were sensitized with ovalbumin (OVA) to induce asthma symptoms. Mice were randomly assigned to the five experimental groups: normal controls; OVA-induced asthmatic mice; and OVA-induced mice injected intraperitoneally with one of the three PT doses (5, 10, or 20 mg/kg). In addition, we treated inflammatory human tracheal epithelial cells (BEAS-2B cells) with PT to assess oxidative responses and the levels of proinflammatory cytokines and chemokines. We found that PT significantly reduced goblet cell hyperplasia and eosinophil infiltration, which decreased AHR, inflammation, and oxidative responses in the lungs of OVA-sensitized mice. PT also decreased malondialdehyde levels in the lung and reduced Th2 cytokine production in bronchoalveolar lavage fluids. Furthermore, PT reduced ROS, proinflammatory cytokines, and eotaxin production in BEAS-2B cells. PT also suppressed monocyte cell adherence to inflammatory BEAS-2B cells. These findings suggested that PT alleviated pathological changes, inflammation, and oxidative stress by inhibiting Th2 cytokine production in asthmatic mice. PT showed therapeutic potential for ameliorating asthma symptoms in the future. PMID:28243240

  19. [Social media monitoring of asthmatic children treated in a specialized program: Parents and caregivers expectations].

    Science.gov (United States)

    Urrutia-Pereira, Marilyn; Ávila, Jennifer Bg; Cherrez-Ojeda, Ivan; Ivancevich, Juan Carlos; Solé, Dirceu

    2015-01-01

    Antecedentes: las redes sociales se utilizan para el apoyo de los pacientes con asma; sin embargo, no se conocen las expectativas de los padres y los cuidadores de los pacientes con respecto al uso de estas redes. Objetivo: evaluar las expectativas de los padres y los cuidadores de niños asmáticos atendidos en el Programa de Prevención del Asma Infantil (PIPA, Uruguaiana, RS) con respecto al uso de las redes sociales. Material y método: estudio observacional, descriptivo, de corte transversal, en el que padres y cuidadores de niños tratados en el Programa de Prevención del Asma Infantil respondieron a un cuestionario escrito acerca del uso de las nuevas tecnologías y las diversas aplicaciones para mejorar la información acerca del asma. Resultados: participaron 210 padres o cuidadores (mediana de edad: 25 años; intervalo de edad: 18-42 años) de pacientes con edad promedio de 7.3 años (intervalo de edad: 2 a 18 años) y duración del asma de 4.7 años; 65% de los padres o cuidadores tuvo menos de ocho años de grado de escolaridad. La mayoría de ellos (72%) no tenía acceso a Internet a través de sus teléfonos y sólo 18% obtenía información activamente acerca del asma por Internet; 87% refirió su interés por recibir información a través de las redes sociales. Conclusión: los padres o cuidadores de niños atendidos en el Programa de Prevención del Asma Infantil expresaron gran interés en el uso de redes sociales, pero pocos las usan para controlar la enfermedad de los niños. Aunque las redes sociales proporcionan un gran beneficio para la salud, esta información debe ser vigilarse en relación con su fiabilidad y calidad. La privacidad de los usuarios (médicos y pacientes) debe ser preservada y debe facilitarse su acceso a Internet.

  20. Reversibility after inhaling salbutamol in different body postures in asthmatic children: a pilot study

    NARCIS (Netherlands)

    Visser, R.; Palen, van der J.; Jongh, de F.H.C.; Thio, B.J.

    2015-01-01

    Rationale Pulmonary medication is mostly delivered in the form of medical aerosols to minimize systemic side effects. A major drawback of inhaled medication is that the majority of inhaled particles impacts in the oropharynx at the sharp bend of the airway. Stretching the airway by a forward leaning

  1. Side-effects of fluticasone in asthmatic children : no effects after dose reduction

    NARCIS (Netherlands)

    Visser, MJ; van der Veer, E; Postma, DS; Arends, LR; de Vries, TW; Brand, PLP; Duiverman, EJ

    2004-01-01

    To assess long-term effects and side-effects of fluticasone propionate (FP), a 2-yr study was performed, comparing a step-down dose approach (1,000 mug.day(-1), with reductions every 2 months to 500, 200 and 100 mug.day(-1) for the remainder of the study) versus a constant dose (200 mug.day(-1)). In

  2. AIR POLLUTION AND RESPIRATORY HEALTH AMONG CHILDREN WITH ASTHMATIC OR COUGH SYMPTOMS. (R825265)

    Science.gov (United States)

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  3. Reversibility of pulmonary function after inhaling salbutamol in different doses and body postures in asthmatic children

    NARCIS (Netherlands)

    Visser, R.; Kelderman, S.; Jongh, de F.H.C.; Palen, van der J.; Thio, B.J.

    2015-01-01

    Rationale Pulmonary medication is often delivered in the form of medical aerosols designed for inhalation. Recently, breath actuated inhalers (BAI's) gained popularity as they can be used without spacers. A major drawback of BAI's is the impaction in the upper airway. Stretching the upper airway by

  4. The clinical utility of reticular basement membrane thickness measurements in asthmatic children

    NARCIS (Netherlands)

    van Mastrigt, Esther; Vanlaeken, Leonie; Heida, Fardou; Caudri, Daan; de Jongste, Johan C.; Timens, Wim; Rottier, Bart L.; de Krijger, Ronald R.; Pijnenburg, Marielle W.

    2015-01-01

    Objective: Reticular basement membrane (RBM) thickness is one of the pathological features of asthma and can be measured in endobronchial biopsies. We assessed the feasibility of endobronchial biopsies in a routine clinical setting and investigated the clinical value of RBM thickness measurements fo

  5. Airflow limitation in asthmatic children assessed with a non-invasive EMG technique

    NARCIS (Netherlands)

    Maarsingh, EJW; van Eykern, LA; de Haan, RJ; Griffioen, RW; Hoekstra, MO; van Aalderen, WMC

    2002-01-01

    The aim of the study was to investigate the association between electromyography (EMG) of the diaphragm and intercostal muscles and the forced expiratory volume in 1 s (FEV1) at different levels of histamine-induced airflow limitation, and the response to salbutamol. Moreover, we assessed the reprod

  6. Different breathing patterns in healthy and asthmatic children : Responses to an arithmetic task

    NARCIS (Netherlands)

    Fokkema, DS; Maarsingh, EJW; van Eykern, LA; van Aalderen, WMC

    2006-01-01

    Asthma patients have been reported to be sensitive to breathlessness, independent of the degree of airway obstruction. Paying attention and task performance may induce changes in breathing pattern and these in turn may mediate such a feeling. The present experiment investigates whether strained brea

  7. The impact of discussing exercise test results of young asthmatic children on adherence to maintenance medication

    NARCIS (Netherlands)

    Visser, R.; Brusse-Keizer, M.; Palen, van der J.; Klok, T.; Thio, B.J.

    2015-01-01

    Objective: Parents’ awareness of their child’s asthma may improve by discussing an exercise challenge test (ECT) result with them. We investigated the influence of discussing an ECT result with parents on adherence to inhaled maintenance medication, parental illness perceptions and medication belief

  8. Assessment of asthmatic inflammation using hybrid fluorescence molecular tomography-x-ray computed tomography

    Science.gov (United States)

    Ma, Xiaopeng; Prakash, Jaya; Ruscitti, Francesca; Glasl, Sarah; Stellari, Fabio Franco; Villetti, Gino; Ntziachristos, Vasilis

    2016-01-01

    Nuclear imaging plays a critical role in asthma research but is limited in its readings of biology due to the short-lived signals of radio-isotopes. We employed hybrid fluorescence molecular tomography (FMT) and x-ray computed tomography (XCT) for the assessment of asthmatic inflammation based on resolving cathepsin activity and matrix metalloproteinase activity in dust mite, ragweed, and Aspergillus species-challenged mice. The reconstructed multimodal fluorescence distribution showed good correspondence with ex vivo cryosection images and histological images, confirming FMT-XCT as an interesting alternative for asthma research.

  9. Role of extracellular signal-regulated kinase in regulating expression of interleukin 13 in lymphocytes from an asthmatic rat model

    Institute of Scientific and Technical Information of China (English)

    LI Yuan-yuan; LIU Xian-sheng; LIU Chang; XU Yong-jian; XIONG Wei-xing

    2010-01-01

    Background The extracellular signal-regulated kinase (ERK) is widely expressed in mammal cells and involved in airway proliferation and remodeling in asthma. In this study, we intend to explore the role of ERK in the expression of the Th2 cytokine, interleukin 13 (IL-13) in lymphocytes in asthma.Methods Forty Sprague-Dawley rats were randomly divided into two groups: normal control and asthmatic groups. Peripheral blood lymphocytes were isolated and purified from the blood of each rat and divided into five groups: control, asthmatic lymphocytes, asthmatic cells stimulated with ERK activator epidermal growth factor (EGF), or with ERK inhibitor PD98059, or with EGF and PD98059 together. The expression of phosphorylated-ERK (p-ERK) was observed by immunocvtochemical staining, the expression of ERK mRNA was determined by reverse transcriptase-PCR, IL-13 protein in supernatants was measured by ELISA.Results (1) The ERK mRNA level and the percentage of cells with p-ERK in lymphocytes from asthmatic rats were significantly higher than those in normal controls, and were significantly increased by EGF administration. This effect of EGF was significantly inhibited by PD98059 pretreatment. (2) IL-13 protein in supematants of asthmatic lymphocytes was higher than that produced by normal control lymphocytes, and was significantly increased by EGF treatment. This EGF effect was partly blocked by PD98059 pretreatment. (3) There was a significant positive correlation between the percentage of cells with p-ERK in peripheral blood lymphocytes and IL-13 protein in supematants of lymphocytes from asthmatic rats.Conclusions In asthma the ERK expression and activation levels were increased, as was the protein level of IL-13. The ERK signaling pathway may be involved in the increased expression of the Th2 cytokine IL-13 in asthma.

  10. Antibiotic consumption in children prior to diagnosis of asthma

    Directory of Open Access Journals (Sweden)

    FitzGerald Mark J

    2011-05-01

    Full Text Available ABSTRACT Background Asthma is difficult to diagnose in children and at times misdiagnosis of an infection can occur. However, little is known about the magnitude and patterns of antibiotic consumption in children with asthma relative to those without asthma. Methods Using population-based data, 128,872 children were identified with at least 6 years of follow-up. The adjusted rate-ratio (RR of antibiotics dispensed to asthmatic as compared to non-asthmatic children was determined. Results At age six, the RR of antibiotic consumption for asthmatics compared to non-asthmatics varied between, 1.66 to 2.32, depending on the year of asthma diagnosis. Of the 18,864 children with asthma at ages 2-8, 52% (n = 9,841 had antibiotics dispensed in the 6 months prior to their index date of asthma diagnosis. The RR of antibiotic consumption in the 1 month prior to asthma diagnosis compared to 5 months prior was 1.66 (95% CI 1.60-1.71. The RR was lower in males compared to females (1.58 vs 1.77, and lower in those who received antibiotics in the first year of life relative to those that did not (1.60 vs. 1.76. Conclusions There is higher antibiotic consumption in children with asthma compared to those without asthma. The pattern of antibiotic use suggests that diagnosis guidelines are difficult to follow in young children leading to misdiagnosis and over treatment with antibiotics.

  11. [Pulmonary metabolism of beta-endorphin in asthmatic patients in asymptomatic periods and after bronchospasm induced by methacholine].

    Science.gov (United States)

    Bottino, G; Antognozzi, G; Degrandi, R; Augeri, C; Bogliolo, G; Zoccali, P

    1995-01-01

    Blood concentration of endogenous beta-endorphines can change during the clinical evolution of chronic bronchopneumopathies. The authors assessed the beta-endorphine concentrations in the pulmonary arterial and systemic arterial blood in 8 asthmatic patients during a symptom-free period and after methacholine-induced bronchospasm. The beta-endorphine analysis was performed in duplicate dor each sample, by means of a RIA assay. There is not difference in the systemic arterial blood concentration of beta-endorphines between asthmatic patients and normal subjects. Furthermore, there is no change in the beta-endorphine blood concentration during the passage through the pulmonary tissue after methacoline-induced bronchospasm.

  12. What Clinicians Need to Know about Bilingual Development.

    Science.gov (United States)

    Hoff, Erika; Core, Cynthia

    2015-05-01

    Basic research on bilingual development suggests several conclusions that can inform clinical practice with children from bilingual environments. They include the following: (1) Dual language input does not confuse children. (2) It is not necessary for the two languages to be kept separate in children's experience to avoid confusion. (3) Learning two languages takes longer than learning one; on average, bilingual children lag behind monolingual children in single language comparisons. (4) A dominant language is not equivalent to an only language. (5) A measure of total vocabulary provides the best indicator of young bilingual children's language learning capacity. (6) Bilingual children can have different strengths in each language. (7) The quantity and quality of bilingual children's input in each language influence their rates of development in each language. (8) Immigrant parents should not be discouraged from speaking their native language to their children. (9) Bilingual environments vary enormously in the support they provide for each language, with the result that bilingual children vary enormously in their dual language skills. Empirical findings in support of each conclusion are presented.

  13. Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey

    Science.gov (United States)

    Ozkaya, Emin; Sogut, Ayhan; Küçükkoç, Mehmet; Eres, Mustafa; Acemoglu, Hamit; Yuksel, Hasan; Murat, Naci

    2015-11-01

    Variability in children's allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6-15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [ p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67-6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [ p = 0.00, OR 2.6 (CI 1.79-3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma.

  14. Sensitization pattern of inhalant allergens in children with asthma who are living different altitudes in Turkey.

    Science.gov (United States)

    Ozkaya, Emin; Sogut, Ayhan; Küçükkoç, Mehmet; Eres, Mustafa; Acemoglu, Hamit; Yuksel, Hasan; Murat, Naci

    2015-11-01

    Variability in children's allergic sensitization has been detected not only among different countries but also among cities within the same nation but yet different climatic areas. The aim of this study was to investigate the sensitization pattern of asthmatic children who lived in different altitude areas: the two largest Turkish cities, Istanbul (sea level) and Erzurum (high altitude). Five hundred and twelve asthmatic children (6-15 years old) from Istanbul (western Turkey, at sea level) and 609 from Erzurum (eastern Turkey, at an altitude of 1800 m) were included in the study. All participants underwent skin testing with common inhalant allergens, spirometry, total IgE level, and clinical examination. The positive sensitization ratio to aeroallergens in children with asthma living at sea level was statistically higher than that in children living in the high altitude group [p = 0.001, OR (odds ratio) 4.9 (confidence interval (CI) 3.67-6.459)]. However, pollen sensitization in asthmatic children living in high altitudes was significantly higher than that in children living at sea level [p = 0.00, OR 2.6 (CI 1.79-3.87)]. Children with asthma who live at high altitudes are characterized by higher pollen but lower mite sensitization rates than those living at sea level in Turkey. Different climatic conditions and altitudes may affect aeroallergen sensitization in children with asthma.

  15. Inhaled corticosteroid treatment modulates ZNF432 gene variant's effect on bronchodilator response in asthmatics

    Science.gov (United States)

    Wu, Ann C.; Himes, Blanca E.; Lasky-Su, Jessica; Litonjua, Augusto; Peters, Stephen P.; Lima, John; Kubo, Michiaki; Tamari, Mayumi; Nakamura, Yusuke; Qiu, Weiliang; Weiss, Scott T.; Tantisira, Kelan

    2013-01-01

    Background Single nucleotide polymorphisms (SNPs) influence a patient's response to inhaled corticosteroids and β2-agonists, and the effect of treatment with inhaled corticosteroids is synergistic with the effect of β2-agonists. We hypothesized that use of inhaled corticosteroids could influence the effect of SNPs associated with bronchodilator response. Objective To assess whether, among asthma subjects, the association of SNPs with bronchodilator response is different between those treated with inhaled corticosteroids vs. those on placebo. Methods A genome-wide association analysis was conducted using 581 white subjects from the Childhood Asthma Management Program (CAMP). Using data for 449,540 SNPs, we conducted a gene by environment analysis in PLINK with inhaled corticosteroid treatment as the environmental exposure and bronchodilator response as the outcome measure. We attempted to replicate the top 12 SNPs in the Leukotriene Modifier Or Corticosteroid or Corticosteroid-Salmeterol (LOCCS) Trial. Results The combined P-value for the CAMP and LOCCS populations was 4.81E-08 for rs3752120, which is located in the zinc finger protein gene ZNF432, and has unknown function. Conclusions Inhaled corticosteroids appear to modulate the association of bronchodilator response with variant(s) in the ZNF432 gene among adults and children with asthma. Clinical Implications Clinicians who treat asthma patients with inhaled corticosteroids should be aware that the patient's genetic makeup likely influences response as measured in lung function. Capsule Summary Our study suggests that inhaled corticosteroids could influence the effect of multiple SNPs associated with bronchodilator response across the genome. PMID:24280104

  16. Long-term asthma treatment guided by airway hyperresponsiveness in children : a randomised controlled trial

    NARCIS (Netherlands)

    Nuijsink, M.; Hop, W. C. J.; Sterk, P. J.; Duiverman, E. J.; de Jorgste, J. C.

    2007-01-01

    Management plans for childhood asthma show limited success in optimising asthma control. The aim of the present study was to assess whether a treatment strategy guided by airway hyperresponsiveness (AHR) increased the number of symptom-free days and improved lung function in asthmatic children, comp

  17. How do clinicians become teachers? A communities of practice perspective.

    Science.gov (United States)

    Cantillon, P; D'Eath, M; De Grave, W; Dornan, T

    2016-12-01

    There is widespread acceptance that clinical educators should be trained to teach, but faculty development for clinicians is undermined by poor attendance and inadequate learning transfer. As a result there has been growing interest in situating teacher development initiatives in clinical workplaces. The relationship between becoming a teacher and clinical workplace contexts is under theorised. In response, this qualitative research set out to explore how clinicians become teachers in relation to clinical communities and institutions. Using communities of practice (CoP) as a conceptual framework this research employed the sensitising concepts of regimes of competence and vertical (managerial) and horizontal (professional) planes of accountability to elucidate structural influences on teacher development. Fourteen hospital physicians completed developmental timelines and underwent semi-structured interviews, exploring their development as teachers. Despite having very different developmental pathways, participants' descriptions of their teacher identities and practice that were remarkably congruent. Two types of CoP occupied the horizontal plane of accountability i.e. clinical teams (Firms) and communities of junior doctors (Fraternities). Participants reproduced teacher identities and practice that were congruent with CoPs' regimes of competence in order to gain recognition and legitimacy. Participants also constructed their teacher identities in relation to institutions in the vertical plane of accountability (i.e. hospitals and medical schools). Institutions that valued teaching supported the development of teacher identities along institutionally defined lines. Where teaching was less valued, clinicians adapted their teacher identities and practices to suit institutional norms. Becoming a clinical educator entails continually negotiating one's identity and practice between two potentially conflicting planes of accountability. Clinical CoPs are largely

  18. Diagnosis of gastrointestinal bleeding: A practical guide for clinicians

    Institute of Scientific and Technical Information of China (English)

    Bong; Sik; Matthew; Kim; Bob; T; Li; Alexander; Engel; Jaswinder; S; Samra; Stephen; Clarke; Ian; D; Norton; Angela; E; Li

    2014-01-01

    Gastrointestinal bleeding is a common problem encountered in the emergency department and in the primary care setting. Acute or overt gastrointestinal bleeding is visible in the form of hematemesis, melena or hematochezia. Chronic or occult gastrointestinal bleeding is notapparent to the patient and usually presents as positive fecal occult blood or iron deficiency anemia. Obscure gastrointestinal bleeding is recurrent bleeding when the source remains unidentified after upper endoscopy and colonoscopic evaluation and is usually from the small intestine. Accurate clinical diagnosis is crucial and guides definitive investigations and interventions. This review summarizes the overall diagnostic approach to gastrointestinal bleeding and provides a practical guide for clinicians.

  19. Leucocyte kinesis in blood, bronchoalveoli and nasal cavities during late asthmatic responses in guinea-pigs.

    Science.gov (United States)

    Nabe, T; Shinoda, N; Yamashita, K; Yamamura, H; Kohno, S

    1998-03-01

    Recently, we reported a reproducible model of asthma in guinea-pigs in vivo, which developed a late asthmatic response (LAR) as well as an early response. In this study, time-related changes in the occurrence of the LAR and leucocyte kinesis were assessed. Furthermore, the state of the activation of eosinophils that migrated into the lower airways was characterized in vitro. Guinea-pigs were alternately sensitized/challenged by inhalation with aerosolized ovalbumin adsorbed on aluminium hydroxide and ovalbumin alone, once every 2 weeks. At defined times before and after the fifth challenge, airway resistance was measured, blood was drawn and bronchoalveolar lavage (BAL) and nasal cavity lavage (NCL) were performed. Superoxide anion (.O2-) production of eosinophils was measured with cytochrome c. Occurrence of LAR and considerable increases in circulating eosinophils coincided with each other 5-7 h after the challenge. After 7 h, eosinophil infiltrations into bronchoalveolar spaces were observed. The capacity of eosinophils from the sensitized animals to produce .O2- was higher than those from the non-sensitized ones, when eosinophils were stimulated by platelet-activating factor. Although an increased number of eosinophils in the NCL fluid was observed, it was much less than that in the BAL fluid. Thus, it has been concluded that eosinophilia in the blood and the lung may participate in the occurrence of the late asthmatic response, which is thought to be preferentially evoked in the lower airways in guinea-pigs in vivo.

  20. Accumulating evidence for increased velocity of airway smooth muscle shortening in asthmatic airway hyperresponsiveness.

    Science.gov (United States)

    Ijpma, Gijs; Matusovsky, Oleg; Lauzon, Anne-Marie

    2012-01-01

    It remains unclear whether airway smooth muscle (ASM) mechanics is altered in asthma. While efforts have originally focussed on contractile force, some evidence points to an increased velocity of shortening. A greater rate of airway renarrowing after a deep inspiration has been reported in asthmatics compared to controls, which could result from a shortening velocity increase. In addition, we have recently shown in rats that increased shortening velocity correlates with increased muscle shortening, without increasing muscle force. Nonetheless, establishing whether or not asthmatic ASM shortens faster than that of normal subjects remains problematic. Endobronchial biopsies provide excellent tissue samples because the patients are well characterized, but the size of the samples allows only cell level experiments. Whole human lungs from transplant programs suffer primarily from poor patient characterization, leading to high variability. ASM from several animal models of asthma has shown increased shortening velocity, but it is unclear whether this is representative of human asthma. Several candidates have been suggested as responsible for increased shortening velocity in asthma, such as alterations in contractile protein expression or changes in the contractile apparatus structure. There is no doubt that more remains to be learned about the role of shortening velocity in asthma.

  1. Is Health-Related Quality of Life Associated with Upper and Lower Airway Inflammation in Asthmatics?

    Directory of Open Access Journals (Sweden)

    Nicola Scichilone

    2013-01-01

    Full Text Available Background. Allergic diseases impair health-related quality of life (HR-QoL. However, the relationship between airway inflammation and HR-QoL in patients with asthma and rhinitis has not been fully investigated. We explored whether the inflammation of upper and lower airways is associated with HR-QoL. Methods. Twenty-two mild allergic asthmatics with concomitant rhinitis (10 males, 38 ± 17 years were recruited. The Rhinasthma was used to identify HR-QoL, and the Asthma Control Test (ACT was used to assess asthma control. Subjects underwent lung function and exhaled nitric oxide (eNO test, collection of exhaled breath condensate (EBC, and nasal wash. Results. The Rhinasthma Global Summary score (GS was 25 ± 11. No relationships were found between GS and markers of nasal allergic inflammation (% eosinophils: , ; ECP: , or bronchial inflammation (pH of the EBC: , ; bronchial NO: , ; alveolar NO: , . The mean ACT score was 18. When subjects were divided into controlled (ACT ≥ 20 and uncontrolled (ACT < 20, the alveolar NO significantly correlated with GS in uncontrolled asthmatics (, . Conclusions. Upper and lower airways inflammation appears unrelated to HR-QoL associated with respiratory symptoms. These preliminary findings suggest that, in uncontrolled asthma, peripheral airway inflammation could be responsible for impaired HR-QoL.

  2. Transformation of adrenal medullary chromaffin cells increases asthmatic susceptibility in pups from allergen-sensitized rats

    Directory of Open Access Journals (Sweden)

    Feng Jun-Tao

    2012-11-01

    Full Text Available Abstract Background Studies have shown that epinephrine release is impaired in patients with asthma. The pregnancy of female rats (dams with asthma promotes in their pups the differentiation of adrenal medulla chromaffin cells (AMCCs into sympathetic neurons, mediated by nerve growth factor, which leads to a reduction in epinephrine secretion. However, the relatedness between the alteration of AMCCs and increased asthma susceptibility in such offspring has not been established. Methods In this study, we observed the effects of allergization via ovalbumin on rat pups born of asthmatic dams. Results Compared to the offspring of untreated controls, bronchial hyperreactivity and airway inflammation were more severe in the pups from sensitized (asthmatic dams. In pups exposed to nerve growth factor (NGF in utero these effects were aggravated further, but the effects were blocked in pups whose dams had been treated with anti-NGF. Furthermore, alterations in AMCC phenotype corresponded to the degree of bronchial hyperreactivity and lung lesions of the different treatment groups. Such AMCC alterations included degranulation of chromaffin granules, reduction of epinephrine and phenylethanolamine-n-methyl transferase, and elevation of NGF and peripherin levels. Conclusions Our results present evidence that asthma during the pregnancy of rat dams promotes asthma susceptibility in their offspring, and that the transformation of AMCCs to neurons induced by NGF plays an important role in this process.

  3. Correlation among regional ventilation, airway resistance and particle deposition in normal and severe asthmatic lungs

    Science.gov (United States)

    Choi, Sanghun; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

    2012-11-01

    Computational fluid dynamic simulations are performed to investigate flow characteristics and quantify particle deposition with normal and severe asthmatic lungs. Continuity and Navier-Stokes equations are solved with unstructured meshes and finite element method; a large eddy simulation model is adopted to capture turbulent and/or transitional flows created in the glottis. The human airway models are reconstructed from CT volumetric images, and the subject-specific boundary condition is imposed to the 3D ending branches with the aid of an image registration technique. As a result, several constricted airways are captured in CT images of severe asthmatic subjects, causing significant pressure drop with high air speed because the constriction of airways creates high flow resistance. The simulated instantaneous velocity fields obtained are then employed to track transport and deposition of 2.5 μm particles. It is found that high flow resistance regions are correlated with high particle-deposition regions. In other words, the constricted airways can induce high airway resistance and subsequently increase particle deposition in the regions. This result may be applied to understand the characteristics of deposition of pharmaceutical aerosols or bacteria. This work was supported in part by NIH grants R01-HL094315 and S10-RR022421.

  4. Relationship between airway narrowing, patchy ventilation and lung mechanics in asthmatics.

    Science.gov (United States)

    Tgavalekos, N T; Musch, G; Harris, R S; Vidal Melo, M F; Winkler, T; Schroeder, T; Callahan, R; Lutchen, K R; Venegas, J G

    2007-06-01

    Bronchoconstriction in asthma results in patchy ventilation forming ventilation defects (VDefs). Patchy ventilation is clinically important because it affects obstructive symptoms and impairs both gas exchange and the distribution of inhaled medications. The current study combined functional imaging, oscillatory mechanics and theoretical modelling to test whether the degrees of constriction of airways feeding those units outside VDefs were related to the extent of VDefs in bronchoconstricted asthmatic subjects. Positron emission tomography was used to quantify the regional distribution of ventilation and oscillatory mechanics were measured in asthmatic subjects before and after bronchoconstriction. For each subject, ventilation data was mapped into an anatomically based lung model that was used to evaluate whether airway constriction patterns, consistent with the imaging data, were capable of matching the measured changes in airflow obstruction. The degree and heterogeneity of constriction of the airways feeding alveolar units outside VDefs was similar among the subjects studied despite large inter-subject variability in airflow obstruction and the extent of the ventilation defects. Analysis of the data amongst the subjects showed an inverse relationship between the reduction in mean airway conductance, measured in the breathing frequency range during bronchoconstriction, and the fraction of lung involved in ventilation defects. The current data supports the concept that patchy ventilation is an expression of the integrated system and not just the sum of independent responses of individual airways.

  5. Montelukast modulates lung CysLT1 receptor expression and eosinophilic inflammation in asthmatic mice

    Institute of Scientific and Technical Information of China (English)

    Yan-jun ZHANG; Lei ZHANG; Shao-bin WANG; Hua-hao SHEN; Er-qing WEI

    2004-01-01

    AIM: To determine the expressions of cysteinyl leukotriene receptors, CysLT1 and CysLT2, in airway eosinophilic inflammation of OVA-induced asthmatic mice and the modulation by montelukast, a CysLT1 receptor antagonist.METHODS: Asthma model was induced by chronic exposure to ovalbumin (OVA) in C57BL/6 mice. The eosinophils in bronchoalveolar lavage (BAL) fluid and lung tissues were counted, IL-5 level in BAL fluid was measured,and CysLT1 and CysLT2 receptor mRNA expressions were detected by semi-quantitative RT-PCR. RESULTS:Montelukast (6 mg/kg, once per day for 20 d) significantly suppressed the increased eosinophils in BAL fluid and lung tissue, and increased IL-5 level in BAL fluid in OVA challenged mice. OVA challenge increased CysLT1 but decreased CysLT2 receptor mRNA expression. Montelukast inhibited the increased CysLT1 but not the reduced CysLT2 expression after OVA challenge. CONCLUSION: CysLT receptors are modulated immunologically, and montelukast inhibits up-regulation of CysLT1 receptor and airway eosinophilic inflammation in asthmatic mice.

  6. Regulation of airway inflammation and remodeling in asthmatic mice by TLR3/TRIF signal pathway.

    Science.gov (United States)

    Yang, Mei; Wang, Hao-Ying; Chen, Jian-Chang; Zhao, Jing

    2017-03-23

    This paper aims to investigate the effect of Toll-like receptors 3 (TLR3)/TIR-domain-containing adapter-inducing interferon-β (TRIF) signal pathway on the airway inflammation and remodeling in asthmatic mice. C57BL/6 and TLR3(-/-) mice were randomly divided into three groups (10 mice per group), including Control group (mice inhaled phosphate buffer saline (PBS)), Asthma group (mice inhaled ovalbumin (OVA)) and polyriboinosinic-ribocytidylic acid (poly (I: C)) group (asthmatic mice were injected intraperitoneally with TLR3 agonist poly (I: C)). Hematoxylin-eosin (HE) staining, Wright-Giemsa staining, Enzyme-linked immunosorbent assay (ELISA), Immunohistochemistry, Hydroxyproline assay, quantitative real time polymerase chain reaction (qRT-PCR) and Western blot were used to assess for the indices of airway inflammation and remodeling. In terms of WT mice, all asthma groups with or without the addition of poly (I: C) showed exaggerated inflammation and remodeling in the airways as compared to Control group, which were more seriously in poly (I: C) group than Asthma group. Furthermore, we observed the significant inhibition of airway inflammation and remodeling in the TLR3(-/-) mice in both Asthma no matter with or without addition of poly (I: C) than the WT mice. TLR3 knockout could obviously relieve the airway inflammation and remodeling in asthma through inhibiting TLR3/TRIF signaling pathway.

  7. Requirements for the formal representation of pathophysiology mechanisms by clinicians.

    Science.gov (United States)

    de Bono, B; Helvensteijn, M; Kokash, N; Martorelli, I; Sarwar, D; Islam, S; Grenon, P; Hunter, P

    2016-04-01

    Knowledge of multiscale mechanisms in pathophysiology is the bedrock of clinical practice. If quantitative methods, predicting patient-specific behaviour of these pathophysiology mechanisms, are to be brought to bear on clinical decision-making, the Human Physiome community and Clinical community must share a common computational blueprint for pathophysiology mechanisms. A number of obstacles stand in the way of this sharing-not least the technical and operational challenges that must be overcome to ensure that (i) the explicit biological meanings of the Physiome's quantitative methods to represent mechanisms are open to articulation, verification and study by clinicians, and that (ii) clinicians are given the tools and training to explicitly express disease manifestations in direct contribution to modelling. To this end, the Physiome and Clinical communities must co-develop a common computational toolkit, based on this blueprint, to bridge the representation of knowledge of pathophysiology mechanisms (a) that is implicitly depicted in electronic health records and the literature, with (b) that found in mathematical models explicitly describing mechanisms. In particular, this paper makes use of a step-wise description of a specific disease mechanism as a means to elicit the requirements of representing pathophysiological meaning explicitly. The computational blueprint developed from these requirements addresses the Clinical community goals to (i) organize and manage healthcare resources in terms of relevant disease-related knowledge of mechanisms and (ii) train the next generation of physicians in the application of quantitative methods relevant to their research and practice.

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

    NARCIS (Netherlands)

    Trian, Thomas; Burgess, Janette K; Niimi, Kyoko; Moir, Lyn M; Ge, Qi; Berger, Patrick; Liggett, Stephen B; Black, Judith L; Oliver, Brian G

    2011-01-01

    BACKGROUND AND OBJECTIVE: Asthma is associated with airway narrowing in response to bronchoconstricting stimuli and increased airway smooth muscle (ASM) mass. In addition, some studies have suggested impaired β-agonist induced ASM relaxation in asthmatics, but the mechanism is not known. OBJECTIVE:

  9. Different Profile of Interleukin-10 Production in Circulating T Cells from Atopic Asthmatics Compared with Healthy Subjects

    Directory of Open Access Journals (Sweden)

    K Matsumoto

    2004-01-01

    Full Text Available BACKGROUND: Interleukin (IL-10 is a pleiotropic cytokine released from various cells, including T cells. Although IL-10 is suggested to inhibit allergic responses, its role in asthma remains uncertain. The purpose of the present study was to compare the profile of IL-10 in circulating T cells from stable atopic asthmatics, atopic nonasthmatics and healthy controls.

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  11. EFFECT OF INHALED ENDOTOXIN ON AIRWAY AND CIRCULATING INFLAMMATORY CELL PHAGOCYTOSIS AND CD11B EXPRESSION IN ATOPIC ASTHMATIC SUBJECTS

    Science.gov (United States)

    Effect of inhaled endotoxin on airway and circulating inflammatory cell phagocytosis and CD11b expression in atopic asthmatic subjects Neil E. Alexis, PhD, Marlowe W. Eldridge, MD, David B. Peden, MD, MS Chapel Hill and Research Triangle Park, NCBackgrou...

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

    Science.gov (United States)

    Asthmatics are more susceptible to influenza infections, yet mechanisms mediating this enhanced susceptibility are unknown. Influenza virus hemagglutinin (HA) protein binds to sialic add residues on the host cells. HA requires cleavage to allow fusion of the viral HA with host ce...

  13. T-cell repertoire in the blood and lungs of atopic asthmatics before and after ragweed challenge

    NARCIS (Netherlands)

    Yurovsky, VV; Weersink, EJM; Meltzer, SS; Moore, WC; Postma, DS; Bleecker, ER; White, B

    1998-01-01

    T cells play a pivotal role in initiating and orchestrating allergic responses in asthma. The goal of this work was to learn whether ragweed challenge in the lungs alters the T-cell repertoire expressed in the blood and lungs of atopic asthmatics. Analyses of cell numbers, differentials, and T-cell

  14. Effect of Smoking Abstinence and Reduction in Asthmatic Smokers Switching to Electronic Cigarettes: Evidence for Harm Reversal

    Directory of Open Access Journals (Sweden)

    Riccardo Polosa

    2014-05-01

    Full Text Available Electronic cigarettes (e-cigs are marketed as safer alternatives to tobacco cigarettes and have shown to reduce their consumption. Here we report for the first time the effects of e-cigs on subjective and objective asthma parameters as well as tolerability in asthmatic smokers who quit or reduced their tobacco consumption by switching to these products. We retrospectively reviewed changes in spirometry data, airway hyper-responsiveness (AHR, asthma exacerbations and subjective asthma control in smoking asthmatics who switched to regular e-cig use. Measurements were taken prior to switching (baseline and at two consecutive visits (Follow-up/1 at 6 (±1 and Follow-up/2 at 12 (±2 months. Eighteen smoking asthmatics (10 single users, eight dual users were identified. Overall there were significant improvements in spirometry data, asthma control and AHR. These positive outcomes were noted in single and dual users. Reduction in exacerbation rates was reported, but was not significant. No severe adverse events were noted. This small retrospective study indicates that regular use of e-cigs to substitute smoking is associated with objective and subjective improvements in asthma outcomes. Considering that e-cig use is reportedly less harmful than conventional smoking and can lead to reduced cigarette consumption with subsequent improvements in asthma outcomes, this study shows that e-cigs can be a valid option for asthmatic patients who cannot quit smoking by other methods.

  15. IL-4 increases type 2, but not type 1, cytokine production in CD8+ T cells from mild atopic asthmatics

    Directory of Open Access Journals (Sweden)

    Coyle Anthony J

    2005-07-01

    Full Text Available Abstract Background Virus infections are the major cause of asthma exacerbations. CD8+ T cells have an important role in antiviral immune responses and animal studies suggest a role for CD8+ T cells in the pathogenesis of virus-induced asthma exacerbations. We have previously shown that the presence of IL-4 during stimulation increases the frequency of IL-5-positive cells and CD30 surface staining in CD8+ T cells from healthy, normal subjects. In this study, we investigated whether excess IL-4 during repeated TCR/CD3 stimulation of CD8+ T cells from atopic asthmatic subjects alters the balance of type 1/type 2 cytokine production in favour of the latter. Methods Peripheral blood CD8+ T cells from mild atopic asthmatic subjects were stimulated in vitro with anti-CD3 and IL-2 ± excess IL-4 and the expression of activation and adhesion molecules and type 1 and type 2 cytokine production were assessed. Results Surface expression of very late antigen-4 [VLA-4] and LFA-1 was decreased and the production of the type 2 cytokines IL-5 and IL-13 was augmented by the presence of IL-4 during stimulation of CD8+ T cells from mild atopic asthmatics. Conclusion These data suggest that during a respiratory virus infection activated CD8+ T cells from asthmatic subjects may produce excess type 2 cytokines and may contribute to asthma exacerbation by augmenting allergic inflammation.

  16. Prevalence and Treatment of Children's Asthma in Rural Areas Compared with Urban Areas in Beijing

    Institute of Scientific and Technical Information of China (English)

    Wen-Jing Zhu; Hai-Xia Ma; Hui-Ying Cui; Xu Lu; Ming-Jun Shao; Shuo Li; Yan-Qing Luo

    2015-01-01

    Background:The prevalence of childhood asthma has been increasing in China.This study aimed to compare the prevalence,diagnosis,and treatment of asthmatic children from urban and rural areas in Beijing,China.Methods:Schools,communities,and kindergartens were randomly selected by cluster random sampling from urban and rural areas in Beijing.Parents were surveyed by the same screening questionnaires.On-the-spot inquiries,physical examinations,medical records,and previous test results were used to diagnose asthmatic children.Information on previous diagnoses,treatments,and control of symptoms was obtained.Results:From 7209 children in rural areas and 13,513 children in urban areas who completed screening questionnaires,587 children were diagnosed as asthma.The prevalence of asthma in rural areas was lower than in urban areas (1.25% vs.3.68%,x2 =100.80,P < 0.001).The diagnosis of asthma in rural areas was lower than in urban areas (48.9% vs.73.9%,x2 =34.6,P < 0.001).Compared with urban asthmatic children (56.5%),only 35.6% of rural asthmatic children received inhaled corticosteroids (P < 0.05).The use ofbronchodilators was also lower in rural areas than in urban areas (56.5% vs.66.4%,x2 =14.2,P < 0.01).Conclusion:The prevalence of asthma in children was lower in rural areas compared with children in the urban area of Beijing.A considerable number of children were not diagnosed and inadequately treated in rural areas.

  17. Finding and Fixing Mistakes: Do Checklists Work for Clinicians with Different Levels of Experience?

    Science.gov (United States)

    Sibbald, Matthew; De Bruin, Anique B. H.; van Merrienboer, Jeroen J. G.

    2014-01-01

    Checklists that focus attention on key variables might allow clinicians to find and fix their mistakes. However, whether this approach can be applied to clinicians of varying degrees of expertise is unclear. Novice and expert clinicians vary in their predominant reasoning processes and in the types of errors they commit. We studied 44 clinicians…

  18. Allergic asthmatics show divergent lipid mediator profiles from healthy controls both at baseline and following birch pollen provocation.

    Directory of Open Access Journals (Sweden)

    Susanna L Lundström

    Full Text Available BACKGROUND: Asthma is a respiratory tract disorder characterized by airway hyper-reactivity and chronic inflammation. Allergic asthma is associated with the production of allergen-specific IgE and expansion of allergen-specific T-cell populations. Progression of allergic inflammation is driven by T-helper type 2 (Th2 mediators and is associated with alterations in the levels of lipid mediators. OBJECTIVES: Responses of the respiratory system to birch allergen provocation in allergic asthmatics were investigated. Eicosanoids and other oxylipins were quantified in the bronchoalveolar lumen to provide a measure of shifts in lipid mediators associated with allergen challenge in allergic asthmatics. METHODS: Eighty-seven lipid mediators representing the cyclooxygenase (COX, lipoxygenase (LOX and cytochrome P450 (CYP metabolic pathways were screened via LC-MS/MS following off-line extraction of bronchoalveolar lavage fluid (BALF. Multivariate statistics using OPLS were employed to interrogate acquired oxylipin data in combination with immunological markers. RESULTS: Thirty-two oxylipins were quantified, with baseline asthmatics possessing a different oxylipin profile relative to healthy individuals that became more distinct following allergen provocation. The most prominent differences included 15-LOX-derived ω-3 and ω-6 oxylipins. Shared-and-Unique-Structures (SUS-plot modeling showed a correlation (R(2 = 0.7 between OPLS models for baseline asthmatics (R(2Y[cum] = 0.87, Q(2[cum] = 0.51 and allergen-provoked asthmatics (R(2Y[cum] = 0.95, Q(2[cum] = 0.73, with the majority of quantified lipid mediators and cytokines contributing equally to both groups. Unique structures for allergen provocation included leukotrienes (LTB(4 and 6-trans-LTB(4, CYP-derivatives of linoleic acid (epoxides/diols, and IL-10. CONCLUSIONS: Differences in asthmatic relative to healthy profiles suggest a role for 15-LOX products of both ω-6 and ω-3 origin in allergic

  19. Clinician styles of care: transforming patient care at the intersection of leadership and medicine.

    Science.gov (United States)

    Huynh, Ho P; Sweeny, Kate

    2014-11-01

    A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician-patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians' effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care.

  20. Patient- and clinician- reported outcome in eating disorders

    DEFF Research Database (Denmark)

    Winkler, Laura Vad; Frølich, Jacob Stampe; Gudex, Claire

    2017-01-01

    -sectional study compared data assessed by the clinician to patient-reported measures in patients with a history of EDs. We included data from a cohort of patients with EDs (n=544) referred to a specialized ED unit in Denmark. Patient-reported measures included the Eating Disorder Inventory-2 (EDI-2) and the Short...... Form 36 (SF-36), and clinical data included remission status and body mass index (BMI). We found a positive association between BMI and EDI-2 scores for anorexia nervosa (AN) and eating disorder not otherwise specified (EDNOS), reflecting increasing ED symptomatology with increasing BMI......Patient-reported outcome is increasingly applied in health sciences. Patients with eating disorders (EDs) characteristically have a different opinion of their needs to that of the health professionals, which can lead to ambivalence towards treatment and immense compliance difficulties. This cross...

  1. A clinician's perspective on evidence-based dentistry.

    Science.gov (United States)

    Feinberg, Edward M

    2010-01-01

    Evidence-based dentistry seems to be more popular with researchers and those in policy positions than with clinicians. A private practitioner looks at the difference between the promise of evidence-based dentistry, which urges a blend of science, clinical judgment, and patient preferences, and the actuality of the rhetoric of rigorous and formulaic clinical trials. The same dichotomy exists in medicine, where the concept originated. Without subscribing to the formality of evidence-based dentistry, practitioners can place a valid scientific foundation under their practices by avoiding unproven assumptions, carefully monitoring outcomes, using measures that are clinically relevant, relating both positive and negative outcomes to possible explanations, and cautiously introducing new techniques. The standards for publishing clinical research seem to favor adherence to methodological rules over useful of outcomes.

  2. One clinician's journey - a retreat from 'the front line'.

    Science.gov (United States)

    Murchie, B

    2017-01-27

    Whether the clinician has recently qualified or graduation day is a distant memory, it is important for him/her to be aware of the alternative options available outside of the general practice setting as these are not always fully explained. It is essential that one enjoys their career choice when even a brief consideration is given to the length of time that one will spend at work and thinking about work, including the additional hours spent in the workplace for countless other reasons. The author worked as a general dental practitioner for several years at different practices. However, dissatisfaction with the daily routine eventually led to a crossroads and a new chapter of his professional career blossomed at a later stage in life. This article is aimed at undergraduates and postgraduates alike, so that others can learn from the author's unconventional career pathway.

  3. Developing the HIV Workforce: The MATEC Clinician Scholars Program.

    Science.gov (United States)

    Boehler, Malinda; Schechtman, Barbara; Rivero, Ricardo; Jacob, Beth-Anne; Sherer, Renslow; Wagner, Cornelia; Alabduljabbar, Salma A; Linsk, Nathan L

    2016-01-01

    Engaging new clinical providers in the HIV workforce is a critical need due to rapidly evolving treatment paradigms, aging out of existing providers, and special population needs. The 1-year competency-based Clinician Scholar Program for minority-serving providers with limited HIV care experience was individually tailored for each provider (n = 74), mostly nurse practitioners, physicians, and clinical pharmacists. Baseline and endpoint self-assessments of clinical knowledge and skills showed significant improvements in all 11 targeted competencies, particularly in managing antiretroviral medications, screening and testing methods, incorporating prevention into HIV care, understanding risk reduction methods, and describing current care standards. Faculty mentor assessments also showed significant improvement in most competencies. Additional benefits included ongoing access to mentorship and training, plus sustained engagement in local and statewide HIV care networks. Our intensive mentoring program model is replicable in other AIDS Education and Training Centers and in other structured training programs.

  4. Network meta-analysis: an introduction for clinicians.

    Science.gov (United States)

    Rouse, Benjamin; Chaimani, Anna; Li, Tianjing

    2017-02-01

    Network meta-analysis is a technique for comparing multiple treatments simultaneously in a single analysis by combining direct and indirect evidence within a network of randomized controlled trials. Network meta-analysis may assist assessing the comparative effectiveness of different treatments regularly used in clinical practice and, therefore, has become attractive among clinicians. However, if proper caution is not taken in conducting and interpreting network meta-analysis, inferences might be biased. The aim of this paper is to illustrate the process of network meta-analysis with the aid of a working example on first-line medical treatment for primary open-angle glaucoma. We discuss the key assumption of network meta-analysis, as well as the unique considerations for developing appropriate research questions, conducting the literature search, abstracting data, performing qualitative and quantitative synthesis, presenting results, drawing conclusions, and reporting the findings in a network meta-analysis.

  5. Renal dysplasia and MRI: a clinician's perspective

    Energy Technology Data Exchange (ETDEWEB)

    Greenbaum, Larry A. [Emory University, Division of Pediatric Nephrology, Children' s Healthcare of Atlanta, Atlanta, GA (United States)

    2008-01-15

    Renal dysplasia is a common abnormality in children. The role of MRI in evaluating children with renal dysplasia is evolving. More information is clearly necessary before MRI replaces conventional imaging modalities. In order to appropriately use MRI, the radiologist must have an understanding of the clinical questions that are important in the management of children with renal dysplasia. This review provides background information on renal dysplasia for the pediatric radiologist. The focus is on unilateral disease, especially multicystic dysplastic kidneys, and bilateral dysplasia, which is the most common cause of kidney failure in children. The emphasis is on the important clinical issues, and the potential of MRI as a methodology for providing clinically useful information not otherwise available from other imaging modalities. (orig.)

  6. Clinicians adopting evidence based guidelines: a case study with thromboprophylaxis

    Directory of Open Access Journals (Sweden)

    Fry Margaret

    2011-09-01

    Full Text Available Abstract Background Venous Thromboembolism (VTE is a cause of hospital mortality and managing its morbidity is associated with significant expenditure. Uptake of evidenced based guideline recommendations intended to prevent VTE in hospital settings is sub-optimal. This study was conducted to explore clinicians' attitudes and the clinical environment in which they work to understand their reluctance to adopt VTE prophylaxis guidelines. Methods Between February and November 2009, 40 hospital employed doctors from 2 Australian metropolitan hospitals were interviewed in depth. Qualitative data were analysed according to thematic methodology. Results Analysis of interviews revealed that barriers to evidence based practice include i the fragmented system of care delivery where multiple members of teams and multiple teams are responsible for each patient's care, and in the case of VTE, where everyone shares responsibility and no-one in particular is responsible; ii the culture of practice where team practice is tailored to that of the team head, and where medicine is considered an 'art' in which guidelines should be adapted to each patient rather than applied universally. Interviewees recommend clear allocation of responsibility and reminders to counteract VTE risk assessment being overlooked. Conclusions Senior clinicians are the key enablers for practice change. They will need to be convinced that guideline compliance adds value to their patient care. Then with the support of systems in the organisation designed to minimize the effects of care fragmentation, they will drive practice changes in their teams. We believe that evidence based practice is only possible with a coordinated program that addresses individual, cultural and organisational constraints.

  7. Telementoring Primary Care Clinicians to Improve Geriatric Mental Health Care.

    Science.gov (United States)

    Fisher, Elisa; Hasselberg, Michael; Conwell, Yeates; Weiss, Linda; Padrón, Norma A; Tiernan, Erin; Karuza, Jurgis; Donath, Jeremy; Pagán, José A

    2017-01-20

    Health care delivery and payment systems are moving rapidly toward value-based care. To be successful in this new environment, providers must consistently deliver high-quality, evidence-based, and coordinated care to patients. This study assesses whether Project ECHO(®) (Extension for Community Healthcare Outcomes) GEMH (geriatric mental health)-a remote learning and mentoring program-is an effective strategy to address geriatric mental health challenges in rural and underserved communities. Thirty-three teleECHO clinic sessions connecting a team of specialists to 54 primary care and case management spoke sites (approximately 154 participants) were conducted in 10 New York counties from late 2014 to early 2016. The curriculum consisted of case presentations and didactic lessons on best practices related to geriatric mental health care. Twenty-six interviews with program participants were conducted to explore changes in geriatric mental health care knowledge and treatment practices. Health insurance claims data were analyzed to assess changes in health care utilization and costs before and after program implementation. Findings from interviews suggest that the program led to improvements in clinician geriatric mental health care knowledge and treatment practices. Claims data analysis suggests that emergency room costs decreased for patients with mental health diagnoses. Patients without a mental health diagnosis had more outpatient visits and higher prescription and outpatient costs. Telementoring programs such as Project ECHO GEMH may effectively build the capacity of frontline clinicians to deliver high-quality, evidence-based care to older adults with mental health conditions and may contribute to the transformation of health care delivery systems from volume to value.

  8. Increased use of inhaled corticosteroids among young Danish adult asthmatics: An observational study

    DEFF Research Database (Denmark)

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

    2010-01-01

    OBJECTIVE: This population-based longitudinal study aimed to investigate trends in use of inhaled corticosteroids (ICS) and determinants of ICS use in young Danish adults with asthma. METHODS: 106 757 users, aged 18-44 years, of anti-asthmatic drugs were identified in the Danish Register of Medical...... Product Statistics during 1997-2006. One year prevalences of ICS use were calculated in categories of gender, age, and annual consumption of inhaled beta-2-agonists (IBA) in defined daily doses (DDD) per year. Determinants of ICS use were estimated by logistic regression models. RESULTS: The one year...... prevalence of ICS use was constant, approximately 64%, during 1997-2000. An annual increase was observed from 67% in 2001 to 77% in 2006. This trend also existed when stratifying on gender, age and IBA use. Using 1997 as baseline, the adjusted odds ratios (ORs) of ICS use in 2000 was 0.98 (95% CI 0...

  9. Effects of omeprazole and cisapride treatment in Japanese asthmatics with reflux esophagitis

    Directory of Open Access Journals (Sweden)

    Katsuya Fujimori

    1997-01-01

    Full Text Available In the United States and Europe, gastroesophageal reflux (GER is receiving attention as a potential cause of bronchial asthma. Few Japanese case reports have described this relationship. Therefore, we investigated the effect of omeprazole and cisapride on pulmonary function tests, blood gases and home peak expiratory flow rates (PEFR in six Japanese outpatients with asthma and proven GER. After 8 weeks of treatment, reflux esophagitis had improved in all patients. However, the parameters of pulmonary function showed no change other than a significant post- treatment increase in home PEFR (4.4-27.7% in three patients. These results suggest that anti-reflux (omeprazole and cisapride treatment will produce small improvements in the PEFR in some Japanese asthmatics with GER.

  10. Acute Adrenal Crisis in an Asthmatic Child Treated with Inhaled Fluticasone Proprionate

    Directory of Open Access Journals (Sweden)

    Ratzan Susan

    2010-07-01

    Full Text Available Adrenal suppression secondary to prolonged inhaled corticosteroid use is usually limited to biochemical abnormalities, with no obvious clinical effects. Acute adrenal crisis is much rarer event but has been reported with increasing frequency. We report a case of a 7-year-old asthmatic child who presented with an acute history of lethargy after a respiratory infection. He was maintained on 220 g/day of fluticasone propionate for several years. Initial evaluation revealed severe adrenal suppression, with undetectable cortisol levels and minimal response after stimulation with ACTH. After fluticasone was discontinued, a gradual recovery of the adrenal axis was seen. This case shows that acute adrenal crisis may be a consequence even at the usual prescribed doses, stressing the importance of using the lowest dose of inhaled steroids needed to control symptoms and having an increased awareness of this complication.

  11. Acute Adrenal Crisis in an Asthmatic Child Treated with Inhaled Fluticasone Proprionate

    Directory of Open Access Journals (Sweden)

    Angela H. Santiago

    2010-01-01

    Full Text Available Adrenal suppression secondary to prolonged inhaled corticosteroid use is usually limited to biochemical abnormalities, with no obvious clinical effects. Acute adrenal crisis is much rarer event but has been reported with increasing frequency. We report a case of a 7-year-old asthmatic child who presented with an acute history of lethargy after a respiratory infection. He was maintained on 220 μg/day of fluticasone propionate for several years. Initial evaluation revealed severe adrenal suppression, with undetectable cortisol levels and minimal response after stimulation with ACTH. After fluticasone was discontinued, a gradual recovery of the adrenal axis was seen. This case shows that acute adrenal crisis may be a consequence even at the usual prescribed doses, stressing the importance of using the lowest dose of inhaled steroids needed to control symptoms and having an increased awareness of this complication.

  12. Skin prick test results of atopic asthmatic subjects in a chest disease clinic in Sanliurfa

    Directory of Open Access Journals (Sweden)

    İbrahim Koç

    2015-06-01

    Full Text Available Objective: Skin prick test (SPT is used widely to determine the allergens in atopic patients. In this study, we aimed to determine the spectrum of aeroallergen sensitivity of atopic asthmatic subjects in Şanlıurfa district. Methods: We evaluated clinical, demographic findings and SPT results of 95 male and 162 female in a total 257 patients who had asthma and allergic symptoms. Results: Most common allergens causing a sensitivity reaction detected in our clinic were as follows; cockroach (56.8%, wheat pollen (53.3%, corn pollen (47.4%, grass pollen (36.5%, poplar tree pollen (26%, house dust mite (19.4%, pepper (16.7% and cat dander (15.1%. Conclusion: High levels of sensitivity to wheat and corn pollens and relatively low sensitivity levels of cat dander results meet our expectations in the area of agricultural land and where pet ownership is not common.

  13. Structural and functional rejuvenation of the aged brain by an approved anti-asthmatic drug.

    Science.gov (United States)

    Marschallinger, Julia; Schäffner, Iris; Klein, Barbara; Gelfert, Renate; Rivera, Francisco J; Illes, Sebastian; Grassner, Lukas; Janssen, Maximilian; Rotheneichner, Peter; Schmuckermair, Claudia; Coras, Roland; Boccazzi, Marta; Chishty, Mansoor; Lagler, Florian B; Renic, Marija; Bauer, Hans-Christian; Singewald, Nicolas; Blümcke, Ingmar; Bogdahn, Ulrich; Couillard-Despres, Sebastien; Lie, D Chichung; Abbracchio, Maria P; Aigner, Ludwig

    2015-10-27

    As human life expectancy has improved rapidly in industrialized societies, age-related cognitive impairment presents an increasing challenge. Targeting histopathological processes that correlate with age-related cognitive declines, such as neuroinflammation, low levels of neurogenesis, disrupted blood-brain barrier and altered neuronal activity, might lead to structural and functional rejuvenation of the aged brain. Here we show that a 6-week treatment of young (4 months) and old (20 months) rats with montelukast, a marketed anti-asthmatic drug antagonizing leukotriene receptors, reduces neuroinflammation, elevates hippocampal neurogenesis and improves learning and memory in old animals. By using gene knockdown and knockout approaches, we demonstrate that the effect is mediated through inhibition of the GPR17 receptor. This work illustrates that inhibition of leukotriene receptor signalling might represent a safe and druggable target to restore cognitive functions in old individuals and paves the way for future clinical translation of leukotriene receptor inhibition for the treatment of dementias.

  14. L-Carnitine Improves the Asthma Control in Children with Moderate Persistent Asthma

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Biltagi

    2012-01-01

    Full Text Available The objective. was to investigate L-Carnitine level and the effects of its supplementation in children with moderate persistent Asthma. Methods. Free and total serum carnitine levels were measured in 50 children having moderate persistent asthma and 50 healthy control children. The patients group was randomly divided into two subgroups. Subgroup A was supplemented with L-carnitine for 6 months while subgroup B was used as a placebo controls. Both subgroups were assessed by pulmonary function tests (PFT and childhood-asthma control test (C-ACT before and 6 months after carnitine supplementation. Results. Total and free carnitine levels were significantly lower in patient group than in control group. PFT and C-ACT showed significant improvements in asthmatic children supplemented with L-carnitine than in those who were not supplemented. Conclusion. L-carnitine levels were initially lower in moderate persistent asthmatic children as compared to healthy control children. Asthmatic children who received L-carnitine supplementation showed statistically significant improvement of C-ACT and PFT.

  15. Symptoms, but Not a Biomarker Response to Inhaled Corticosteroids, Predict Asthma in Preschool Children with Recurrent Wheeze

    Directory of Open Access Journals (Sweden)

    E. M. M. Klaassen

    2012-01-01

    Full Text Available Background. A reliable asthma diagnosis is challenging in preschool wheezing children. As inhaled corticosteroids (ICS are more effective in asthmatics than in children with transient wheeze, an ICS response might be helpful in early asthma diagnosis. Methods. 175 children (aged two–four years with recurrent wheeze received 200 μg Beclomethasone extra-fine daily for eight weeks. Changes in Exhaled Breath Condensate (EBC biomarkers (pH, interleukin (IL-1α, IL-2, IL-4, IL-5, IL-10, IFN-γ, sICAM, and CCL-11, Fractional exhaled Nitric Oxide (FeNO, airway resistance, and symptoms were assessed. At six years of age a child was diagnosed as transient wheezer or asthmatic. Adjusted logistic regression analysis was performed with multiple testing correction. Results. 106 transient wheezers and 64 asthmatics were analysed at six years of age. Neither changes in EBC biomarkers, nor FeNO, airway resistance, or symptoms during ICS trial at preschool age were related to asthma diagnosis at six years of age. However, asthmatics had more airway symptoms before the start of the ICS trial than transient wheezers (P<0.01. Discussion. Although symptom score in preschool wheezing children at baseline was associated with asthma at six years of age, EBC biomarkers, airway resistance, or symptom response to ICS at preschool age could not predict asthma diagnosis at six years of age.

  16. Is asthma in 2-12 year-old children associated with physician-attended recurrent upper respiratory tract infections?

    NARCIS (Netherlands)

    Hak, Eelko; Rovers, Maroeska M; Sachs, Alfred P E; Stalman, Wim A B; Verheij, Theo J M

    2003-01-01

    In a prevalence study, we evaluated whether recurrent physician-attended URTI episodes are more common in asthmatic children as compared to age- and gender-matched controls. URTI proneness, defined as > or = 5 episodes of rhinitis/pharyngitis, sinusitis, laryngitis/tracheitis or otitis media in a 24

  17. Effect of All-trans Retinoic Acid on Airway Inflammation in Asthmatic Rats and Its Mechanism

    Institute of Scientific and Technical Information of China (English)

    方红; 金红芳; 王宏伟

    2004-01-01

    Summary: The inhibitive effects of all-trans retinoic acid (ARTA) on airway inflammation in asthmatic rats and its mechanism on the basis of the regulation of nuclear factor kappaB (NF-κB) were explored. Thirty-two SD rats were randomly divided into 4 groups: control group, asthma group,dexamethasone treatment group and retinotic acid treatment group. The total and differential cell counts in the collected bronchoalveolar lavage fluid (BALF) were measured. The pathological changes in lung tissues were estimated by scoring. The expression of NF-κB inhibitor (IκBa), NF-κB,intercellular adhering molecule-1 (ICAM-1) in lung tissue was detected by immunohistochemical method. The results showed that in the two treatment groups, the total cell counts and proportion of inflammatory cells in BALF were significantly reduced, but there was no significant difference in differential cell counts in BALF between, them. The pathological changes in lung tissues in the treatment groups were significantly attenuated as compared with asthma group. Except the epithelial injury in retinotic acid treatment group was milder than in dexamethasone treatment group, the remaining lesions showed no significant difference between them. In the two treatment groups, the expression of IκBa was increased, while the expression of NF-κB and ICAM-1 decreased with the difference between the two groups being not significant. It was concluded that the similar anti-inflammatory effects and mechanism of ATRA on airway in asthmatic rats to those of dexamethasone were contributed to the increase of cytoplasmic IκBa content and suppression of NF-cB activation and expression.

  18. Phenotypic responses of differentiated asthmatic human airway epithelial cultures to rhinovirus.

    Directory of Open Access Journals (Sweden)

    Jianwu Bai

    Full Text Available Human airway epithelial cells are the principal target of human rhinovirus (HRV, a common cold pathogen that triggers the majority of asthma exacerbations. The objectives of this study were 1 to evaluate an in vitro air liquid interface cultured human airway epithelial cell model for HRV infection, and 2 to identify gene expression patterns associated with asthma intrinsically and/or after HRV infection using this model.Air-liquid interface (ALI human airway epithelial cell cultures were prepared from 6 asthmatic and 6 non-asthmatic donors. The effects of rhinovirus RV-A16 on ALI cultures were compared. Genome-wide gene expression changes in ALI cultures following HRV infection at 24 hours post exposure were further analyzed using RNA-seq technology. Cellular gene expression and cytokine/chemokine secretion were further evaluated by qPCR and a Luminex-based protein assay, respectively.ALI cultures were readily infected by HRV. RNA-seq analysis of HRV infected ALI cultures identified sets of genes associated with asthma specific viral responses. These genes are related to inflammatory pathways, epithelial structure and remodeling and cilium assembly and function, including those described previously (e.g. CCL5, CXCL10 and CX3CL1, MUC5AC, CDHR3, and novel ones that were identified for the first time in this study (e.g. CCRL1.ALI-cultured human airway epithelial cells challenged with HRV are a useful translational model for the study of HRV-induced responses in airway epithelial cells, given that gene expression profile using this model largely recapitulates some important patterns of gene responses in patients during clinical HRV infection. Furthermore, our data emphasize that both abnormal airway epithelial structure and inflammatory signaling are two important asthma signatures, which can be further exacerbated by HRV infection.

  19. Inhibition of methoxamine-induced bronchoconstriction by ipratropium bromide and disodium cromoglycate in asthmatic subjects.

    Science.gov (United States)

    Black, J; Vincenc, K; Salome, C

    1985-01-01

    We compared the effects of pretreatment with saline, ipratropium bromide, and disodium cromoglycate (DSCG) on bronchoconstriction induced by methoxamine--an alpha-adrenoceptor agonist, in asthmatic subjects. All 12 patients bronchoconstricted in response to methoxamine after saline. The PD20 (the dose of methoxamine causing a 20% fall in forced expiratory volume in 1 s [FEV1]) ranged from 0.3-18 mumol. Ipratropium bromide (200 micrograms administered by aerosol) significantly inhibited (P less than 0.05) the response to methoxamine in all patients without producing significant changes in the mean baseline lung function. The mean PD20 for methoxamine after saline was 6.8 mumol and 95% confidence limits (CL) were 3.6, 12.7 mumol. The mean PD20 for methoxamine after ipratropium bromide was 35.4 (95% CL 28.8, 43.6) mumol. DSCG also produced significant (P less than 0.05) shifts to the right in the methoxamine dose response curves, but did not affect resting airway calibre as measured by the FEV1. The mean PD20 for methoxamine increased from 3.3 mumol (95% CL 1.1, 10.0 mumol) after saline to 25.1 mumol (95% CL 14.1, 44.6) after DSCG pretreatment. These findings suggest that alpha-adrenoceptors in the airways of asthmatic subjects may be located at sites other than smooth muscle--possibly on mast cells but more likely on nerve endings and/or parasympathetic ganglia. PMID:2992563

  20. The possible prophylactic effect of Nigella sativa seed extract in asthmatic patients.

    Science.gov (United States)

    Boskabady, Mohammad Hossein; Javan, H; Sajady, M; Rakhshandeh, H

    2007-10-01

    In previous studies, the relaxant, anticholinergic (functional antagonism) antihistaminic, effects of Nigella sativa have been demonstrated on guinea-pig tracheal chains. In the present study, the prophylactic effect of boiled extract of N. sativa on asthmatic disease was examined. Twenty-nine asthmatic adults were randomly divided into control group (14 patients) and study group (15 patients), and they were studied for 3 months. In the study group 15 mL/kg of 0.1 g% boiled extract and in the control group a placebo solution was administrated daily throughout the study. Asthma symptom score, asthma severity, frequency of symptoms/week and wheezing were recorded in the beginning (first visit), 45 days after treatment (second visit), and at the end of the study (third visit). Pulmonary function tests (PFTs) were also measured, and the drug regimen of the patients was evaluated at three different visits. All asthma symptoms, frequency of asthma symptoms/week, chest wheezing, and PFT values in the study group significantly improved in the second and third visits compared with the first visit (P < 0.05 to P < 0.001). In addition, further improvement of chest wheezing and severity of disease on the third visit were observed compared with the second visit in this group (P < 0.05 for both cases). In the third visit all symptoms in the study group were significantly different from those of the control group (P < 0.01 to P < 0.001). However, in the control group, there were only small improvements in some parameters in just the second visit. The usage of inhaler and oral beta-agonists, oral corticosteroid, oral theophylline and even inhaler corticosteroid in the study group decreased at the end of the study while there were no obvious changes in usage of the drugs in control subjects. The results of phase I study generally suggest a prophylactic effect of N. sativa on asthma disease and warrant further research regarding this effect.

  1. Effects of Sodium Cromoglycate on Iranian Asthmatic Subjects Without Exposure to any Bronchoconstrictor agent.

    Science.gov (United States)

    Mombeini, Tajmah; Zahedpoure-Anaraki, Mohammad Reza; Dehpour, Ahmad Reza

    2012-01-01

    Cromolyn sodium, a mast cell stabilizing agent, provides an immediate protective effect against the exercise-induced bronchoconstriction while being used before the exercise. However, cromolyn is ineffective in reversing asthmatic bronchospasm; it is used as a maintenance therapy and has a prophylactic role in chronic asthma. The purpose of this study was to determine the extent of change in baseline lung function tests following a single dose of cromolyn sodium in adult asthmatics. Forty volunteers (33 women and 7 men) with moderate to severe persistent asthma were randomly assigned to receive 20 mg cromolyn, 40 mg cromolyn or cromolyn-placebo. The percent of improvement in lung function parameters was compared among the groups, during 1 h of inhalation. Low dose of cromolyn induced more improvement in most lung function parameters such as forced expiratory flow volume in one second, forced vital capacity and peak expiratory flow compared with other groups. After 15 min, the improvement percentage of baseline forced expiratory flow volume in one second was 3.35 ± 1.5, for sodium cromoglycate-20 mg group compared with 0.98 ± 1.43 and - 0.68 ± 1.2 for sodium cromoglycate-placebo and sodium cromoglycate-40 mg, groups respectively. However, the differences between means were not significant. Furthermore, based on the definition of American Thoracic Society (ATS) for a "significant post-bronchodilator response" developed in a few patients 15 min after the inhalation of 20 mg cromolyn sodium. It is suggested that probably the inhalation of 20 mg of cromolyn sodium could immediately improve the lung function in few adults with asthma.

  2. Mangiferin Attenuates Th1/Th2 Cytokine Imbalance in an Ovalbumin-Induced Asthmatic Mouse Model

    Science.gov (United States)

    Hou, Guang-Han; Du, Jun; Huang, Xin; Lu, Yi; Keller, Evan T.; Zhang, Jian; Deng, Jia-Gang

    2014-01-01

    Mangiferin is a major bioactive ingredient in Mangifera indica Linn. (Anacardiaceae) leaves. Aqueous extract of such leaves have been used as an indigenous remedy for respiratory diseases like asthma and coughing in traditional Chinese medicine. However, underlying molecular mechanisms of mangiferin on anti-asthma remain unclear. In our present study, we investigated the anti-asthmatic effect of mangiferin on Th1/Th2 cytokine profiles and explored its underlying immunoregulatory mechanism in mouse model of allergic asthma. Mangiferin significantly reduced the total inflammatory cell counts and eosinophil infiltration, decreased the production of ovalbumin-specific IgE in serum and PGD2 in BALF. The antibody array analysis showed that mangiferin down-regulated the levels of one group of cytokines/chemokines including Th2-related IL-4, IL-5, IL-13, and others IL-3, IL-9, IL-17, RANTES, TNF-α, but simultaneously up-regulated Th1-related IFN-γ, IL-2 and IL-10 and IL-12 expression in serum. Thus it attenuates the imbalance of Th1/Th2 cells ratio by diminishing the abnormal mRNA levels of Th1 cytokines (IFN-γ and IL-12) and Th2 cytokines (IL-4, IL-5 and IL-13). Finally, mangiferin substantially inhibited the activation and expression of STAT-6 and GATA-3 in excised lung tissues. Our results suggest that mangiferin can exert anti-asthmatic effect. The underlying mechanism may attribute to the modulation of Th1/Th2 cytokine imbalance via inhibiting the STAT6 signaling pathway. PMID:24955743

  3. Mangiferin attenuates TH1/TH2 cytokine imbalance in an ovalbumin-induced asthmatic mouse model.

    Directory of Open Access Journals (Sweden)

    Hong-Wei Guo

    Full Text Available Mangiferin is a major bioactive ingredient in Mangifera indica Linn. (Anacardiaceae leaves. Aqueous extract of such leaves have been used as an indigenous remedy for respiratory diseases like asthma and coughing in traditional Chinese medicine. However, underlying molecular mechanisms of mangiferin on anti-asthma remain unclear. In our present study, we investigated the anti-asthmatic effect of mangiferin on Th1/Th2 cytokine profiles and explored its underlying immunoregulatory mechanism in mouse model of allergic asthma. Mangiferin significantly reduced the total inflammatory cell counts and eosinophil infiltration, decreased the production of ovalbumin-specific IgE in serum and PGD2 in BALF. The antibody array analysis showed that mangiferin down-regulated the levels of one group of cytokines/chemokines including Th2-related IL-4, IL-5, IL-13, and others IL-3, IL-9, IL-17, RANTES, TNF-α, but simultaneously up-regulated Th1-related IFN-γ, IL-2 and IL-10 and IL-12 expression in serum. Thus it attenuates the imbalance of Th1/Th2 cells ratio by diminishing the abnormal mRNA levels of Th1 cytokines (IFN-γ and IL-12 and Th2 cytokines (IL-4, IL-5 and IL-13. Finally, mangiferin substantially inhibited the activation and expression of STAT-6 and GATA-3 in excised lung tissues. Our results suggest that mangiferin can exert anti-asthmatic effect. The underlying mechanism may attribute to the modulation of Th1/Th2 cytokine imbalance via inhibiting the STAT6 signaling pathway.

  4. Small airway impairment in moderate to severe asthmatics without significant proximal airway obstruction.

    Science.gov (United States)

    Perez, Thierry; Chanez, Pascal; Dusser, Daniel; Devillier, Philippe

    2013-11-01

    Asthma is a disease characterized by inflammation which affects both proximal and distal airways. We evaluated the prevalence of small airway obstruction (SAO) in a group of clinically stable asthmatics with both normal forced expiratory volume in the first second (FEV1) and normal FEV1/forced vital capacity (FVC) and treated with an association of inhaled corticosteroids (ICSs) and long acting β2-agonists (LABAs). Clinical evaluation included the measurement of dyspnea, asthma control test and drug compliance. The prevalence of SAO was estimated by spirometry and plethysmography and defined by the presence of one or more of the following criteria: functional residual capacity (FRC) > 120% predicted (pred), residual volume (RV) > pred + 1.64 residual standard deviation (RSD), RV/total lung capacity (TLC) > pred + 1.64 RSD, forced expiratory flow (FEF)25-75% slow vital capacity (SVC) - FVC > 10%. Among the 441 patients who were included, 222 had normal FEV1 and FEV1/FVC. At least one criteria of SAO was found in 115 (52%) mainly lung hyperinflation (39% based on high FRC, RV or RV/TLC) and more rarely distal airflow limitation (15% based on FEF25-75% or FEF50%) or expiratory trapping (10% based on increased SVC - FVC). In the patients with only SAO (no PAO), there was no relationship between SAO, asthma history and the scores of dyspnea, asthma control or drug compliance. These results suggest that in asthmatics with normal FEV1 and FEV1/FVC, treated with ICSs and LABAs, SAO is found in more than half of the patients indicating that the routinely used lung function tests can underestimate dysfunctions occurring in the small airways.

  5. The Clinical Research of Montelukast Sodium for the Treatment of Pediatric Asthmatic Bronchitis%应用孟鲁司特钠治疗小儿喘息性支气管炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    刘金联

    2015-01-01

    ObjectiveTo investigate the clinical effect of application of montelukast sodium in treatment of children with asthmatic bronchitis. MethodsTo our hospital for 76 children with asthmatic bronchitis patients treated cases selected in accordance with the different treatment methods for the observation group and the control group, patients in the control group using conventional methods of treatment, patients in the observation group based on the treatment in control group were treated with montelukast sodium.Results After treatment, the patients in observation group were signiifcantly better than the treatment effect of patients in the control group, P<0.05.Conclusion The addition of montelukast sodium in the process of traditional therapy in treatment can signiifcantly improve the treatment effect.%目的探讨应用孟鲁司特钠治疗小儿喘息性支气管炎的临床治疗效果。方法选取来我院进行治疗的小儿喘息性支气管炎患者76例,按照治疗方式的不同分为对照组和观察组,对照组患者使用常规方式进行治疗,观察组患者在对照组治疗的基础上加用孟鲁司特钠进行治疗。结果经过治疗后,观察组患者的治疗效果明显优于对照组患者, P<0.05。结论在传统治疗的过程中加入孟鲁司特钠进行治疗能够明显提高治疗的效果。

  6. Acquired aplastic anemia in children.

    Science.gov (United States)

    Hartung, Helge D; Olson, Timothy S; Bessler, Monica

    2013-12-01

    This article provides a practice-based and concise review of the etiology, diagnosis, and management of acquired aplastic anemia in children. Bone marrow transplantation, immunosuppressive therapy, and supportive care are discussed in detail. The aim is to provide the clinician with a better understanding of the disease and to offer guidelines for the management of children with this uncommon yet serious disorder.

  7. The effectiveness of fish oil supplementation in asthmatic rats is limited by an inefficient action on ASM function.

    Science.gov (United States)

    Miranda, D T S Z; Zanatta, A L; Dias, B C L; Fogaça, R T H; Maurer, J B B; Donatti, L; Calder, P C; Nishiyama, A

    2013-09-01

    Episodes of acute exacerbation are the major clinical feature of asthma and therefore represent an important focus for developing novel therapies for this disease. There are many reports that the n-3 fatty acids found in fish oil exert anti-inflammatory effects, but there are few studies of the action of fish oil on airway smooth muscle (ASM) function. In the present investigation, we evaluated the effect of fish oil supplementation on smooth muscle force of contraction in ovalbumin-induced asthmatic Wistar rats, and its consequences on static lung compliance, mucus production, leukocyte chemotaxis and production of proinflammatory cytokines. Fish oil supplementation suppressed the infiltration of inflammatory cells into the lung in asthmatic animals (2.04 ± 0.19 × 10(6) cells vs. 3.33 ± 0.43 × 10(6) cells in the control asthmatic group; P < 0.05). Static lung compliance increased with fish oil supplementation in asthmatic rats (0.640 ± 0.053 mL/cm H2O vs. 0.399 ± 0.043 mL/cm H2O; P < 0.05). However, fish oil did not prevent asthma-associated lung eosinophilia and did not affect the concentrations of tumor necrosis factor-α and interleukin-1β in lung tissue or the proportion of the airways obliterated with mucus. Fish oil had no effect on the force of contraction in asthmatic rats in response to acetylcholine (3.026 ± 0.274 mN vs. 2.813 ± 0.364 mN in the control asthmatic group). In conclusion, although fish oil exerts some benefits in this model of asthma, its effectiveness appears to be limited by an inefficient action on airway smooth muscle function.

  8. Leukotriene B4, administered via intracerebroventricular injection, attenuates the antigen-induced asthmatic response in sensitized guinea pigs

    Directory of Open Access Journals (Sweden)

    Jiang Jun-Xia

    2010-02-01

    Full Text Available Abstract Background Despite intensive studies focused on the pathophysiology of asthmatic inflammation, little is known about how cross-talk between neuroendocrine and immune systems regulates the inflammatory response during an asthmatic attack. We recently showed corresponding changes of cytokines and leukotriene B4 (LTB4 in brain and lung tissues of antigen-challenged asthmatic rats. Here, we investigated how LTB4 interacts with the neuroendocrine-immune system in regulating antigen-induced asthmatic responses in sensitized guinea pigs. Methods Ovalbumin-sensitized guinea pigs were challenged by inhalation of antigen. Vehicle, LTB4 or U75302 (a selective LTB4 BLT1 receptor inhibitor was given via intracerebroventricular injection (i.c.v. 30 min before challenge. Airway contraction response was evaluated using Penh values before and after antigen challenge. The inflammatory response in lung tissue was evaluated 24 h after challenge. The LTB4 content of lung and brain homogenate preparations was detected by reversed phase high-performance liquid chromatography (RP-HPLC. Plasma levels of adrenocorticotropic hormone (ACTH and corticosterone (CORT were measured using ELISA kits. Results Antigen challenge impaired pulmonary function and increased inflammatory cell infiltration in lung tissue. These responses could be significantly suppressed by LTB4, 30 ng i.c.v., in ovalbumin-sensitized guinea pigs. LTB4 content of lung and brain homogenates from antigen-challenged guinea pigs was significantly increased. In addition, administration of LTB4 via i.c.v. markedly increased CORT and ACTH level in plasma before antigen challenge, and there were further increases in CORT and ACTH levels in plasma after antigen challenge. U75302, 100 ng i.c.v., completely blocked the effects of LTB4. In addition, U75302, 100 ng via i.c.v. injection, markedly decreased LTB4 content in lung homogenates, but not in brain homogenates. Conclusions Increased LTB4 levels in

  9. Effects of glucocorticoid and cysteinyl leukotriene 1 receptor antagonist on CD34 + hematopoietic cells in bone marrow of asthmatic mice

    Institute of Scientific and Technical Information of China (English)

    毛辉; 殷凯生; 王曾礼; 李富宇; 张希龙; 刘春涛; 雷松

    2004-01-01

    Background Corticosteroids remain the most effective therapy available for asthma. They have widespread effects on asthmatic airway inflammation. However, little is known about the effects of corticosteroids on the production of bone marrow inflammatory cells in asthma. This study observed the effects of glucocorticoid and cysteinyl leukotriene 1 receptor antagonist on CD34 + hematopoietic cells, so as to explore the possible effectiveness of a bone marrow-targeted anti-inflammatory strategy.Methods Balb/c mice were sensitized and challenged with ovalbumin (OVA) to establish an asthmatic model. For two consecutive weeks, asthmatic mice were challenged with OVA while being given either prednisone, montelukast, prednisone plus montelukast, or sterile saline solution. The mice were killed 24 hours after the last challenge with OVA, and bronchoalveolar lavage fluid (BALF),peripheral blood, and bone marrow were collected. Eosinophils in peripheral blood and BALF, and nucleated cells in BALF, peripheral blood, and bone marrow were counted. The percentages of CD34+cells, CD4 + T lymphocytes and CD8 + T lymphocytes among nucleated cells in peripheral blood and bone marrow were counted by flow cytometry. Immunocytochemistry and in situ hybridization were employed to detect expression of CD34 and interleukin (IL)-5Rαx mRNA (CD34 + IL-5Rα mRNA+ cells)among bone marrow hematopoietic cells.Results Compared with the sterile saline solution group, the number of eosinophils in BALF and peripheral blood, CD34 + cells in peripheral blood and bone marrow, and CD34 + IL-5Rc mRNA+ cells in bone marrow of mice from the prednisone and prednisone plus montelukast groups were significantly lower (P<0.01). The number of eosinophils in BALF from the montelukast group was also significantly lower (P<0.05).Conclusions The results suggest that, in this asthmatic mouse model, prednisone probably inhibits proliferation, differentiation, and migration of CD34 + cells in bone marrow, blocks

  10. The clinician's role in the diagnosis of breast disease.

    Science.gov (United States)

    Poma, S; Longo, A

    2011-06-01

    Until 20 or 30 years ago, the diagnosis and treatment of breast disease was managed exclusively by the surgeon. This situation has changed to some extent as a result of recent technological advances, and clinicians' contributions to the diagnostic work-up and/or treatment of these cases can begin at any time. If they are the first physician to see the patient after the examination and formulation of a diagnostic hypothesis, they will almost always have to order a panel of imaging/instrumental examinations that is appropriate for the type of lesion suspected, the patient's age, and other factors; if they intervene at the end of the diagnostic work-up, it will be their job to arrive at a conclusion based on all of the data collected. The clinical examination includes various steps - history taking and inspection and palpation of the breasts - each of which is essential and requires the use of appropriate methods and techniques. The diagnostic capacity of the examination will depend largely on the consistency of the breasts, but it is influenced even more strongly by the doctor-patient relationship. Physicians must know their patient well, listen to and understand what she is saying, explain their own findings and verify that the explanations have been understood, and they must be convincing. Clinicians must also be able to assess the results of imaging studies (rather than relying solely on the radiologist's report), and this requires interaction with other specialists. The days are over when a clinician or radiologist or sonographer worked alone, certain that his/her examination method was sufficient in itself: today, teamwork is essential. But this also means that each member of the team must be extremely competent in his/her own sector and be aware of the other team members' limitations and expectations. The clinical examination remains central to the process since it is the basis for selecting appropriate treatment. SOMMARIO: Da quando si conosce la patologia

  11. Studies on platelet function in bronchial asthma Part 2. Production of 12-hydroxyeicosatetraenoic acid from platelets and the platelet-lymphocyte interaction in bronchial asthmatics

    OpenAIRE

    角南, 宏二

    1992-01-01

    To clarify the role of platelets in the pathogenesis of bronchial asthma, the production of 12-hydroxyeicosatetraenoic acid(12HETE) from platelets of asthmatics was examined by high performance liquid chromatography(HPLC). The effect of platelets on lymphocyte function was also studied by lymphocyte blastogenesis. The results were as follows : 1) The production of 12HETE from platelets of asthmatics were significantly higher than that of normal subjects(p

  12. Do self- reported intentions predict clinicians' behaviour: a systematic review

    Directory of Open Access Journals (Sweden)

    Dickinson Heather O

    2006-11-01

    Full Text Available Abstract Background Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice. Several interventions have been shown to be effective in changing health care professionals' behaviour, but heterogeneity within interventions, targeted behaviours, and study settings make generalisation difficult. Therefore, it is necessary to identify the 'active ingredients' in professional behaviour change strategies. Theories of human behaviour that feature an individual's "intention" to do something as the most immediate predictor of their behaviour have proved to be useful in non-clinical populations. As clinical practice is a form of human behaviour such theories may offer a basis for developing a scientific rationale for the choice of intervention to use in the implementation of new practice. The aim of this review was to explore the relationship between intention and behaviour in clinicians and how this compares to the intention-behaviour relationship in studies of non-clinicians. Methods We searched: PsycINFO, MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Science/Social science citation index, Current contents (social & behavioural med/clinical med, ISI conference proceedings, and Index to Theses. The reference lists of all included papers were checked manually. Studies were eligible for inclusion if they had: examined a clinical behaviour within a clinical context, included measures of both intention and behaviour, measured behaviour after intention, and explored this relationship quantitatively. All titles and abstracts retrieved by electronic searching were screened independently by two reviewers, with disagreements resolved by discussion. Discussion Ten studies were found that examined the relationship between intention and clinical behaviours in 1623 health professionals. The proportion of variance in behaviour explained by

  13. Assesment of Quality of Life in Children with Asthma

    OpenAIRE

    Serhat Gümüş; Selvi Kelekçi; İlyas Yolbaş; Mehmet Gürkan

    2012-01-01

    Aim: Bronchial asthma is among the most common chronic pediatric diseases that can result in variable restriction in the physical, emotional and social aspects of the patient%u2019s life. The aim of this study was to assess impairment on quality of life (QOL) in asthmatic children. Material and Method: Ninety seven patients aged between 7 and 15 years which followed up at Pediatric Pulmonology Department of Dicle University Hospital were included into the study, during October 2009 %u2013 Jan...

  14. 对1例急性喘息性支气管炎患者进行全程化药学监护的体会%The experience of full pharmaceutical care in one patient with acute asthmatic bronchitis

    Institute of Scientific and Technical Information of China (English)

    石俊峰; 徐利; 韩旭亮; 龙丽辉

    2012-01-01

    In this article, one case of individualized pharmaceutical care for one hospitalized patient with acute asthmatic bronchitis was reported to explore the role of clinical pharmacists in patient treatment. In the course of treatment, the treatment protocol optimization was carried out by a team composed of clinical pharmacists, clinicians and nurse. To protect the patient's medication safety and effectiveness, they worked together to accomplish proper operation of drug infusion, medication education to patients and adverse reaction monitoring.%本文通过对我院1例急性喘息性支气管炎患者的个体化药学监护,探讨临床药师在患者治疗过程中的作用.在治疗过程中,临床药师与临床医师、护师组成治疗团队,共同完成治疗方案的优化、输注药物的正确操作、对患者的用药教育以及不良反应监测,保障了患者的用药安全、有效.

  15. In utero fuel homeostasis: Lessons for a clinician

    Directory of Open Access Journals (Sweden)

    P. N Suman Rao

    2013-01-01

    Full Text Available Fetus exists in a complex, dynamic, and yet intriguing symbiosis with its mother as far as fuel metabolism is concerned. Though the dependence on maternal fuel is nearly complete to cater for its high requirement, the fetus is capable of some metabolism of its own. The first half of gestation is a period of maternal anabolism and storage whereas the second half results in exponential fetal growth where maternal stores are mobilized. Glucose is the primary substrate for energy production in the fetus though capable of utilizing alternate sources like lactate, ketoacids, amino acids, fatty acids, and glycogen as fuel under special circumstances. Key transporters like glucose transporters (GLUT are responsible for preferential transfers, which are in turn regulated by complex interaction of maternal and fetal hormones. Amino acids are preferentially utilized for growth and essential fatty acids for development of brain and retina. Insulin, insulin like growth factors, glucagon, catecholamines, and letpin are the hormones implicated in this fascinating process. Hormonal regulation of metabolic substrate utilization and anabolism in the fetus is secondary to the supply of nutrient substrates. The knowledge of fuel homeostasis is crucial for a clinician caring for pregnant women and neonates to manage disorders of metabolism (diabetes, growth (intrauterine growth restriction, and transitional adaptation (hypoglycemia.

  16. Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians

    Directory of Open Access Journals (Sweden)

    Gregory M. Asnis

    2015-12-01

    Full Text Available Insomnia is a prevalent disorder with deleterious effects such as decreased quality of life, and a predisposition to a number of psychiatric disorders. Fortunately, numerous approved hypnotic treatments are available. This report reviews the state of the art of pharmacotherapy with a reference to cognitive behavioral therapy for insomnia (CBT-I as well. It provides the clinician with a guide to all the Food and Drug Administration (FDA approved hypnotics (benzodiazepines, nonbenzodiazepines, ramelteon, low dose sinequan, and suvorexant including potential side effects. Frequently, chronic insomnia lasts longer than 2 years. Cognizant of this and as a result of longer-term studies, the FDA has approved all hypnotics since 2005 without restricting the duration of use. Our manuscript also reviews off-label hypnotics (sedating antidepressants, atypical antipsychotics, anticonvulsants and antihistamines which in reality, are more often prescribed than approved hypnotics. The choice of which hypnotic to choose is discussed partially being based on which segment of sleep is disturbed and whether co-morbid illnesses exist. Lastly, we discuss recent label changes required by the FDA inserting a warning about “sleep-related complex behaviors”, e.g., sleep-driving for all hypnotics. In addition, we discuss FDA mandated dose reductions for most zolpidem preparations in women due to high zolpidem levels in the morning hours potentially causing daytime carry-over effects.

  17. Interprofessional clinical education: clinicians' views on the importance of leadership.

    Science.gov (United States)

    Missen, Karen; Jacob, Elisabeth R; Barnett, Tony; Walker, Lorraine; Cross, Merylin

    2012-01-01

    The current shortage of health professionals necessitates new approaches to clinical education that can expand the number of undergraduate students undertaking clinical placements without increasing the burden on clinical staff or placing patients at risk. Interprofessional education has the potential to help increase clinical capacity whilst enriching students' clinical experience. This paper reports on a project which investigated the potential for interprofessional education to increase undergraduate clinical placement capacity in clinical settings. The project utilised an exploratory descriptive methodology to obtain the views of health care professionals about the use of interprofessional education in clinical education at three rural health facilities in Victoria, Australia. Participants (n = 57) had a key role with each health care facility in coordinating and facilitating undergraduate clinical placements. This paper examines the clinicians' views about the central role that leadership plays in actioning interprofessional education in the clinical setting. Whilst interprofessional education was regarded favourably by the majority of participants, data indicated that leadership from education providers, health services, and regulatory authorities was crucial to enable interprofessional education to be implemented and sustained within the clinical learning environment. Without leadership from each of these three spheres of influence, interprofessional education will continue to be difficult to implement for undergraduate students and compromise their exposure to an important aspect of the working life of health care professionals. Such a failure will limit graduates' readiness for collaborative and cross-disciplinary practice.

  18. PubMed searches: overview and strategies for clinicians.

    Science.gov (United States)

    Lindsey, Wesley T; Olin, Bernie R

    2013-04-01

    PubMed is a biomedical and life sciences database maintained by a division of the National Library of Medicine known as the National Center for Biotechnology Information (NCBI). It is a large resource with more than 5600 journals indexed and greater than 22 million total citations. Searches conducted in PubMed provide references that are more specific for the intended topic compared with other popular search engines. Effective PubMed searches allow the clinician to remain current on the latest clinical trials, systematic reviews, and practice guidelines. PubMed continues to evolve by allowing users to create a customized experience through the My NCBI portal, new arrangements and options in search filters, and supporting scholarly projects through exportation of citations to reference managing software. Prepackaged search options available in the Clinical Queries feature also allow users to efficiently search for clinical literature. PubMed also provides information regarding the source journals themselves through the Journals in NCBI Databases link. This article provides an overview of the PubMed database's structure and features as well as strategies for conducting an effective search.

  19. Zika Virus in the Americas: A Review for Clinicians.

    Science.gov (United States)

    Sampathkumar, Priya; Sanchez, Joyce L

    2016-04-01

    Zika virus has recently emerged as a new public health threat. An arthropod-borne virus named after the Zika forest in Uganda, it was first discovered in 1947. The virus caused only sporadic cases of Zika infection in Africa and Southeast Asia until 2007, when the first large outbreak occurred in the Yap State in the Federated States of Micronesia. Another outbreak in French Polynesia in 2013 was notable for being associated temporally with an increase in cases of Guillain-Barré syndrome. In 2015, the virus was first reported in Brazil and since then has spread explosively through several additional countries in South and Central America and the Caribbean. Simultaneously, several of these countries have seen a dramatic increase in the incidence of infants born with microcephaly. The rapid spread of Zika virus through the Americas, together with the association of infection with microcephaly and Guillain-Barré syndrome, has resulted in the World Health Organization declaring a public health emergency. Zika virus has the potential to spread to new areas where the Aedes mosquito vector is present and therefore presents a risk to the United States. This concise review describes the clinical features of Zika virus infection and provides advice for clinicians on counseling travelers and others about the disease.

  20. Genitourinary sarcoidosis: An essential review for the practicing clinician

    Science.gov (United States)

    Block, Norman L.; Kava, Bruce R.

    2017-01-01

    Introduction: Sarcoidosis is a multisystem disease that commonly involves the lungs, but may also present with extrapulmonary manifestations. Genitourinary (GU) tract involvement has been traditionally thought to be rare, but that view may underestimate the true prevalence of the disease due to the often, silent presentation thereof. Methods: The literature pertaining to sarcoidosis from the general systemic point of view, etiology and therapy and with regard to specific organs was reviewed by identifying key words in a PubMed search. That material with special relevance to the Indian experience was emphasized. Results: There are a number of isolated case reports in the literature describing symptomatic and asymptomatic GU tract sarcoidosis. The world literature associated with the generalized syndrome was reviewed and summarized. Specific aspects of GU involvement are presented for each organ of the GU tract. Conclusions: It is critical for the practicing clinician to have a working knowledge of the clinical manifestations of this disease as it involves the GU tract, as well as to be able to distinguish it from tuberculosis and the various malignancies that affect this organ system. PMID:28197023

  1. Children and chiropractic care

    DEFF Research Database (Denmark)

    Hartvigsen, Jan; Hestbaek, Lise

    2009-01-01

    care profession has convincingly assumed the responsibility of spinal and musculoskeletal health for children. Considering the magnitude of the challenges ahead for both researchers and clinicians, this may be a good opportunity for doctors of chiropractic to take responsibility and engage...

  2. Lower values of VEGF in endometrial secretion are a possible cause of subfertility in non-atopic asthmatic patients

    DEFF Research Database (Denmark)

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

    2015-01-01

    Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women ...... endometrial secretions, which might affect the receptiveness of the endometrium and thereby increase time to pregnancy. The effect appears to be associated with non-atopic asthma with general increased systemic inflammation.......Abstract Objective: Using endometrial secretion analysis, we assessed whether altered inflammatory cytokine levels can be detected in the uterine environment in asthma patients, thereby providing a possible cause of reduced fertility in asthmatics. Methods: Forty-four unexplained infertile women...... (aged 28-44) underwent asthma and allergy testing, questionnaires, endometrial secretion and blood samples in the mid-secretory phase of the menstrual cycle (day 19-23) during assisted reproduction. Differences in cytokines and growth factors were analyzed. Results: Mean log-VEGF in uteri was lower...

  3. Blockade of Airway Inflammation by Kaempferol via Disturbing Tyk-STAT Signaling in Airway Epithelial Cells and in Asthmatic Mice

    OpenAIRE

    Ju-Hyun Gong; Daekeun Shin; Seon-Young Han; Sin-Hye Park; Min-Kyung Kang; Jung-Lye Kim; Young-Hee Kang

    2013-01-01

    Asthma is characterized by bronchial inflammation causing increased airway hyperresponsiveness and eosinophilia. The interaction between airway epithelium and inflammatory mediators plays a key role in the asthmatic pathogenesis. The in vitro study elucidated inhibitory effects of kaempferol, a flavonoid found in apples and many berries, on inflammation in human airway epithelial BEAS-2B cells. Nontoxic kaempferol at ≤20  μ M suppressed the LPS-induced IL-8 production through the TLR4 activat...

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

    Institute of Scientific and Technical Information of China (English)

    Chun-Hua Chi; Ji-Ping Liao; Yan-Ni Zhao; Xue-Ying Li; Guang-Fa Wang

    2016-01-01

    Background:Studies ofinterleukin (IL)-4 and IL-6 in the exhaled breath condensate (EBC) of asthmatic patients are limited.This study was to determine the effect of inhaled corticosteroid (ICS) treatment on IL-4 and IL-6 in the EBC of asthmatic patients.Methods:In a prospective,open-label study,budesonide 200 μg twice daily by dry powder inhaler was administered to 23 adult patients with uncontrolled asthma (mean age 42.7 years) for 12 weeks.Changes in asthma scores,lung function parameters (forced expiratory volume in 1 s [FEV1],peak expiratory flow [PEF],forced expiratory flow at 50% of forced vital capacity [FEF50],forced expiratory flow at 75% of forced vital capacity,maximum mid-expiratory flow rate) and the concentrations of IL-4 and IL-6 in EBC were measured.Re