WorldWideScience

Sample records for asthmatic children clinicians

  1. Assessment of anxiety disorders in asthmatic children.

    Science.gov (United States)

    Vila, G; Nollet-Clémençon, C; de Blic, J; Falissard, B; Mouren-Simeoni, M C; Scheinmann, P

    1999-01-01

    The study's objective was to determine whether the State Trait Anxiety Inventory for Children, Trait version (STAIC), is suitable for the assessment of DSM-IV anxiety disorders in asthmatic children and adolescents. Ninety-two outpatients were given a semistructured diagnostic interview. They completed STAIC; another questionnaire about anxiety, the Echelle Comportementale d'Anxiété et de Peurs (ECAP); and the Child Depression Inventory. The parents filled in the Child Behavior Check-List (CBCL) and the Conners Parent Rating Scale (CPRS). A group of healthy children was assessed with STAIC. Thirty asthmatic children had anxiety disorders. They had significantly higher STAIC scores than the nonanxious asthmatic and the nonasthmatic children. STAIC scores were independent of age and sex and were correlated with ECAP, CPRS anxiety subscore, CBCL total score, internalizing score, and CBCL anxiety-depression subscore. Internal consistency was 0.75. With a threshold value of 34 for anxiety disorders, this method had a sensitivity of 73% and a specificity of 70%. STAIC was thus a useful method for anxiety disorder screening in a pediatric population. PMID:10479945

  2. Antioxidant status in acute asthmatic attack in children

    International Nuclear Information System (INIS)

    Objectives: To determine the oxidant - antioxidant imbalance in asthmatic children, by measuring the levels of malondialdehyde (MDA) as an oxidant marker of lipid peroxidation as well as antioxidant compounds like vitamin C, vitamin E and uric acid and to investigate whether their concentrations are associated with more severe asthma. Methods: This case controlled prospective study was conducted on 219 children aged 1-12 years, attending Basra Maternity and Children Hospital. Included were 98 asthmatic children during acute attack and 121 non asthmatic, apparently healthy children. Serum malondialdehyde (MDA) as an oxidant marker of lipid peroxidation, and vitamin C, vitamin E and uric acid (as antioxidants) were estimated in asthmatic children during acute attack and compared with non-asthmatic children. Results: Asthmatic children during exacerbation of their asthma have significant lower serum levels of antioxidant compounds like vitamin C, vitamin E and uric acid (p<0.001) and significantly high malondialdehyde as compared with the controls. MDA was significantly elevated (P< 0.001), while that of vitamin C, vitamin E and uric acid were significantly decreased with increasing severity of asthmatic attack (P<0.001). A significant negative correlation between MDA with vitamin C (P<0.05, r = - 0.44) was observed in severe asthmatic attacks. Conclusion: Asthmatic patients during acute attack suffer a high degree of reactive oxygen species formation causing considerable oxidative stress that is indicated by the high level of oxidants (MDA) and low level of antioxidants. (author)

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

    Science.gov (United States)

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

    2002-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Magdy M Zedan

    2010-09-01

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

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

    Science.gov (United States)

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

    2015-08-01

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

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

    Science.gov (United States)

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

    1989-01-01

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

  7. DRUG THERAPY IN ASTHMATIC CHILDREN: SURVEY IN MASHHAD

    Directory of Open Access Journals (Sweden)

    M.H Karimi

    2000-03-01

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

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

    Science.gov (United States)

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

    2006-01-01

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

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    2012-01-01

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

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

    DEFF Research Database (Denmark)

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

    2007-01-01

    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......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...

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

    DEFF Research Database (Denmark)

    Bisgaard, H; Nielsen, K G

    2000-01-01

    We hypothesized that a leukotriene receptor antagonist (LTRA) could provide bronchoprotection against the cold, dry air-induced response in asthmatic preschool children. In a randomized, double-blind, placebo-controlled crossover study, we examined the effect of the specific LTRA montelukast at 5...... repeatability of the bronchoprotection was examined by repeating the placebo-controlled study in six of the 13 children. sRaw increased by an average of 46% (95% confidence interval [CI]: 30 to 63%) after placebo treatment and 17% (95% CI: 3 to 31%) after montelukast (p < 0.01). Eight of the children were...... receiving regular treatment with budesonide delivered by an inhaler with a spacer in a mean daily dose of 350 microg, but the bronchoprotection provided by montelukast was independent of concurrent steroid treatment. There was no convincing evidence of failure to respond, and the protective effect of...

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

    Science.gov (United States)

    Zapletal, A; Zbojan, J; Pohanka, V

    1992-03-01

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

  16. 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. PMID:26846483

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2013-09-01

    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. PMID:23893809

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

    Directory of Open Access Journals (Sweden)

    Lene Lochte

    2012-01-01

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

  20. HRCT findings of asthmatic children under maintenance therapy

    Energy Technology Data Exchange (ETDEWEB)

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

    2000-05-01

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

  1. Study of some biochemical and genetic markers in asthmatic children

    International Nuclear Information System (INIS)

    Bronchial asthma is the most common chronic disease of childhood. Interleukin-4 (IL-4) and interleukin-13 (IL-13) are T-helper type 2 (Th2) cytokines with numerous activities that contribute to allergic inflammation and asthma. Both IL-4 and IL-13 use the IL-4 receptor alpha chain (IL-4 Ra) as a component of their respective systems. Allelic variants of IL-4 Ra have been reported and the R 576 IL-4 Ra allele was recently shown to be a risk factor for atopy. This study was designed to determine whether the R 576 allele was associated with the prevalence of asthma among children and also to evaluate the role of serum IL-4 and IL-13 in the development of asthma. Hence, we used a developed, rapid and reliable PCR-based assay to screen individuals for the R 576 IL-4 Ra allele. This assay has also used to genotype prospectively both recruited children with asthma (n = 22) and controls (n = 11). Serum IL-4 and IL-13 were determined by ELISA. The results of the PCR-based assay revealed a significant association of R 576 IL-4 Ra with the prevalence of all asthmatics, Chi-square (x2) 4.035; P 2 = 4.197, P 2 = 0.609, P > 0.05). Consequently, R 576 IL-4 Ra acts as an allergic asthma susceptibility gene. Also, asthmatic children displayed higher significant levels of IL-4 and IL-13 (P <0.()1). Allergic group exhibited significant higher levels of IL-4 (P < 0.001) and IL-13 (P < 0. 05). This gave clear evidence that both cytokines contributed to the development of asthma especially the allergic phenotype

  2. Tailored second line therapy in asthmatic children with the arginine-16 genotype

    OpenAIRE

    Lipworth, Brian J; Basu, Kaninika; Donald, Helen P; Tavendale, Roger; Macgregor, Donald F; Ogston, Simon A; Palmer, Colin N. A.; Mukhopadhyay, Somnath

    2012-01-01

    The arginine-16 beta-2 receptor genotype confers increased susceptibility to exacerbations in asthmatic children taking regular long acting beta-2 agonists. We therefore evaluated using montelukast as an alternative to salmeterol as tailored second line asthma controller therapy in children expressing this susceptible genotype. 62 persistent asthmatic children with the homozygous arginine-16 genotype were randomized to receive salmeterol 50ug bid or montelukast 5/10mg od as add on to inhaled ...

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

    OpenAIRE

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

    2013-01-01

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

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

    International Nuclear Information System (INIS)

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

  5. 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.

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

    OpenAIRE

    Lene Lochte

    2012-01-01

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

  7. Parameters of lung inflammation in asthmatic as compared to healthy children in a contaminated city

    OpenAIRE

    Linares Segovia, Benigno; Cortés Sandoval, Gabriela; Amador Licona, Norma; Guízar Mendoza, Juan Manuel; Núñez Lemus, Estela; Rocha Amador, Diana Olivia; Ramírez Gómez, Xóchitl Sofía; Monroy Torres, Rebeca

    2014-01-01

    Background The impact of air pollution on the respiratory system has been estimated on the basis of respiratory symptoms and lung function. However; few studies have compared lung inflammation in healthy and asthmatics children exposed to high levels of air pollution. The aim of the study was to elucidate the modulatory effect of air pollution on Cysteinyl-leukotrienes (Cys-LTs) levels in exhaled breath condensate (EBC) among healthy and asthmatic children. Methods We performed a cross-sectio...

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

    International Nuclear Information System (INIS)

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

  9. Allergen-induced cytokine secretion in atopic and non-atopic asthmatic children

    OpenAIRE

    Böttcher (Fagerås), Malin; Bjurström, Jenny; Mai, Xiaomei; Nilsson, Lennart; Jenmalm, Maria

    2003-01-01

    Atopic asthma is characterized by excessive T helper 2 (Th2)-like immunity to allergens in the bronchial mucosa. The Th2-cytokine interleukin (IL)-4 induces IgE production, while the Th2-cytokine IL-5 promotes eosinophilic inflammation in the airways of asthmatics. Most asthmatics are atopic, but a subgroup is non-atopic. We hypothesize that allergen-induced Th2, particularly IL-5, responses can be observed in peripheral blood in both atopic and non-atopic asthmatic children but not in health...

  10. 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...... asthma, well controlled on regular BUD 400 mcg daily: 20 children with normal FeNO and 20 with raised FeNO. FeNO, BHR and forced expiratory volume in 1 s improved significantly after BUD 1600 mcg (BUD1600). However, FeNO after ICS treatment exhibited a Gaussian distribution and FeNO was significantly...

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

    International Nuclear Information System (INIS)

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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    Hamzaoui A

    2011-11-01

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

  14. 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: To...... compare aerobic capacity between asthmatic children and controls, to estimate the agreement between PAC and MAC and observe for trend of PAC. MATERIALS AND METHODS: The design was prospective, 4 years (PAC) and cross-sectional (MAC and VO(2peak)). Non-parametric Wilcoxon rank sums were applied for......). Physical activity level and subjective health showed no differences between groups, or level and categories, respectively. CONCLUSION: The asthmatic participants presented with lower aerobic capacity than controls in both PAC and MAC; therefore, results confirmed the validity of the PAC method. Data...

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

    Science.gov (United States)

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

    1988-07-01

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

  16. Effect of Montelukast Treatment on Serum Paraoxonase Activity in Asthmatic Children

    OpenAIRE

    Can, Murat

    2007-01-01

    Montelukast, widely used in the treatment of asthma, is a selective and potent oral cysteinyl leukotriene-1 receptor antagonist. In this study, we investigated the effects of montelukast on oxidative stress and antioxidant defense in childhood asthma by measuring malondialdehyde and the paraoxonase activity. Twenty-five children with mild to moderate atopic asthma and 25 nonatopic children as controls were enrolled in the study. Asthmatic children were treated with montelukast, 5 mg tablets, ...

  17. 522 Association between Eosinophilic Airway Inflammation and Persistent Airflow Limitation in Asthmatic Children

    OpenAIRE

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

    2012-01-01

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

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

    NARCIS (Netherlands)

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

    1999-01-01

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

  19. 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

  20. Protective effect of theophylline on histamine-induced bronchoconstriction in asthmatic children.

    OpenAIRE

    Levene, S; McKenzie, S. A.

    1986-01-01

    The bronchial responsiveness of a group of asthmatic children was studied using histamine stimulation after a single dose of theophylline and after placebo. Theophylline, when levels were greater than 10 micrograms ml-1 significantly reduced responsiveness but only by just over one doubling concentration of histamine (P less than 0.001).

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

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

    1991-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

  4. Assessment of bronchodilatation after spontaneous recovery from a histamine challenge in asthmatic children.

    OpenAIRE

    Merkus, P J; Rooda, H M; van Essen-Zandvliet, E E; Duiverman, E. J.; Quanjer, P. H.; Kerrebijn, K F

    1992-01-01

    BACKGROUND: It would be convenient to be able to measure airway responsiveness to histamine and to bronchodilator drugs on the same day, but whether this can be done reliably is unknown. METHODS: The effect of a prior histamine challenge on the bronchodilator response to salbutamol after spontaneous recovery of FEV1 to 95% of the prechallenge level was studied in two groups of asthmatic children. Fourteen children inhaled 400 micrograms salbutamol after spontaneous recovery from a histamine c...

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

    DEFF Research Database (Denmark)

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

    1999-01-01

    -six asthmatic children 6 to 15 yr of age completed a double-blind crossover trial of 2 wk of treatment with 5 mg montelukast once daily versus placebo. FENO was measured during single-breath exhalation at a constant flow rate of 0.1 to 0.13 L/s against a resistance of 10 kPa/L/s. Eleven children were receiving...

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

    Science.gov (United States)

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

    2014-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Banovcin P

    2009-12-01

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

  8. Clinical evaluation of asthmatic children and adolescents: relevance of interdisciplinary attention

    Directory of Open Access Journals (Sweden)

    Karina Machado Siqueira

    2015-09-01

    Full Text Available Descriptive, retrospective study, aimed to evaluate clinical conditions of asthmatic children and adolescents at the beginning of treatment and after six months of accompaniment by a multi-professional team, focused on interdisciplinary attention. A research developed in a reference ambulatory for tertiary attention of infant asthma, in Goiânia, Goiás, Brazil. Data was collected from 101 medical records from January and March 2013. Children and adolescents were predominantly male (70,3%, aged between two and five years (31,7% and clinically classified as moderated persistent asthma (47,6%. After following them for six months, it was seen that most (64,4% obtained total or partial control of the disease, reduction of all symptoms identified in the first consultation and presented high adherence to the proposed pharmacological treatment (70,3%. Interdisciplinary attention can result in improved clinical control and contribute to advances in assistance quality to asthmatic children and adolescents.

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

    OpenAIRE

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

    2010-01-01

    Abstract Objective To examine relationships between a mother's stress-related conditions and parenting attitudes and their children's asthmatic status. Methods 274 mothers of an asthmatic child 2 to 12 years old completed a questionnaire including questions about their chronic stress/coping behaviors (the "Stress Inventory"), parenting attitudes (the "Ta-ken Diagnostic Test for Parent-Child Relationship, Parent Form"), and their children's disease status. One year later, a follow-up questionn...

  10. [Clinical effects of theophylline in the therapy of intractable asthmatic children. II. Theophylline therapy and behavior problems in children with asthma].

    Science.gov (United States)

    Segawa, H; Iikura, Y

    1990-10-01

    This study examined the relationship between long-term theophylline therapy and behavior problems in 14 asthmatic children that includes 5 intractable cases and 24 non-asthmatic children. Asthmatic children have received theophylline therapy and cromolyn inhalation for 3.6 +/- 3.8 years. Subjects were tested on neuropsychologic batteries; behavior problems and personality of children questionnaire, child behavior checklist, caffeine-like side effects questionnaire, manifest anxiety scale, visual attention test, Uchida-Kraepelin test and soft neurological signs. These tests were repeated with an interval of 1 to 12 weeks. Parents noted caffeine-like side effects, stomach ache and difficulty in sleeping, in their child during the theophylline therapy. The caffeine-like side effects decreased after stopping theophylline therapy. The rate of mistake in Uchida-Kraepelin test for the asthmatic group and for the intractable cases was significantly higher than that of the control group. Time of the sequential finger thumb opposition of the soft neurological signs was significantly prolonged in asthmatic group. There was no significant change in the other tests between asthmatic and non-asthmatic children and before and after stopping theophylline therapy. It seems that behavior problems and learning disability observed in the asthmatic children are due to the pathogenesis or symptoms of asthma rather than the effect of long-term theophylline therapy. PMID:2124479

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

    Directory of Open Access Journals (Sweden)

    Hamzaoui Agnès

    2010-02-01

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

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

    Science.gov (United States)

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

    2011-01-01

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

  13. Indoor environmental quality in homes of asthmatic children on the Elsipogtog Reserve (NB), Canada

    OpenAIRE

    Berghout, Joanne; Miller, J. David; Mazerolle, Roger; O’Neill, Len; Wakelin, Craig; Mackinnon, Barbara; Maybee, Kenneth; Augustine, Darlene; Levi, Carol Ann; Levi, Charlie; Levi, Terry; Milliea, Barbara

    2005-01-01

    Objective. To inspect houses and analyze settled dust from 26 homes with asthmatic children in the Elsipogtog Reserve, New Brunswick, for contaminants known to be associated with respiratory symptoms. This pilot observational study was conducted in order to enable larger research into housing and health in Aboriginal communities. Methods. Twenty-six homes were subject to an informed inspection and settled dust collection from the child’s bedroom. The fine dust (< 300 μm) was analyzed for e...

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Md Redzuan A

    2014-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Mahir Igde

    2009-09-01

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

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

    OpenAIRE

    2009-01-01

    Although current guidelines place single leukotriene receptor antagonists use as a therapeutic option in mild persistent asthma, there is still uncertainty about its place. In this study efficiency of montelukast monotherapy in children with moderate persistent asthma was evaluated. Children (age 6 to 16) with persistent moderate asthma were treated prospectively with budesonide combined with montelukast (n=20), or only montelukast (n=15) during six months. Asthma symptoms and exacerbations w...

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

    OpenAIRE

    2013-01-01

    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 ye...

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

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

    1996-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Farzad Ahmadabadi

    2015-01-01

    Conclusion: Results showed that vitamin D deficiency was more common in asthmatic than in non-asthmatic children and the level of vitamin D was directly associated with the response of the children to treatment. [Int J Res Med Sci 2015; 3(1.000: 239-243

  3. Attitudes of asthmatic and nonasthmatic children to physical exercise

    OpenAIRE

    Dimitrakaki V; Porpodis K; Bebetsos E; Zarogoulidis P; Papaiwannou A; Tsiouda T; Tsioulis H; Zarogoulidis K

    2013-01-01

    Vithleem Dimitrakaki,1 Konstantinos Porpodis,2 Evangelos Bebetsos,1 Paul Zarogoulidis,2 Antonis Papaiwannou,2 Theodora Tsiouda,2 Hlias Tsioulis,2 Konstantinos Zarogoulidis21Department of Physical Education and Sport Science, Democritus University of Thrace, Komotini, Greece; 2Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreecePurpose: The aim of this study was to examine the physical activity of children with and without asthma in ...

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

    OpenAIRE

    Hamzaoui Agnès; Ammar Jamel; Hamzaoui Kamel

    2010-01-01

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

  5. Domestic Exposure to Fungi and Total Serum IgE Levels in Asthmatic Children

    OpenAIRE

    Huey-Jen Jenny Su; Pei-Chih Wu; Huan-Yao Lei; Jiu-Yao Wang

    2005-01-01

    We measured the number of airborne, viable fungi and house dust mite (HDM) allergen levels in the homes of a group of asthmatic children. Blood samples were drawn and the amounts of total and specific serum IgE were determined. The association between the number of fungal colonies, dust mite allergen exposure, and specific and total IgE was evaluated. The number of viable airborne fungi was high (20 543 CFU/m3) in those investigated houses. Der p1 concentrations on child's mattress exceeding ...

  6. 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.

  7. Quantitative computed tomography detects peripheral airway disease in asthmatic children.

    Science.gov (United States)

    Jain, Neal; Covar, Ronina A; Gleason, Melanie C; Newell, John D; Gelfand, Erwin W; Spahn, Joseph D

    2005-09-01

    The aim of this study was to compare air-trapping as quantified by high-resolution computed tomography (HRCT) of the chest with measures of lung function and airway inflammation in children with mild to moderate asthma. Plethysmography indices, respiratory resistance, and reactance before and after bronchodilator with impulse oscillation (IOS), exhaled nitric oxide (eNO), total eosinophil count (TEC), and serum eosinophil cationic protein (ECP) levels were measured in 21 subjects. A single-cut HRCT image at end-expiration was obtained. Air-trapping was quantified and expressed in terms of the pixel index (PI) by determining the percentage of pixels in lung fields below -856 and -910 Hounsfeld units (HU). Pairwise linear correlations between PI and other parameters were evaluated. Subjects had only mild airflow limitation based on prebronchodilator forced expiratory volume in 1 sec (FEV(1)), but were hyperinflated and had air-trapping based on elevated total lung capacity (TLC) and residual volume (RV)/TLC ratio, respectively. The PI at -856 HU was positively correlated with % predicted TLC, total gas volume (TGV), and ECP level, and was inversely correlated with FEV(1)/forced vital capacity (FVC) and % predicted forced expiratory flow between 25-75% FVC (FEF(25-75)). The PI at -910 HU correlated similarly with these variables, and also correlated positively with IOS bronchodilator reversibility. This data suggest that quantitative HRCT may be a useful tool in the evaluation of peripheral airflow obstruction in children with asthma. PMID:16015663

  8. 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

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

    Science.gov (United States)

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

    2015-01-01

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

  10. 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.

  11. 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.

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

    Science.gov (United States)

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

    1994-01-01

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

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

    Science.gov (United States)

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

    2000-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Atqah Abdul Wahab

    2013-01-01

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

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

    Science.gov (United States)

    Rothe, T; Köhl, C; Mansfeld, H J

    1990-09-01

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

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

    DEFF Research Database (Denmark)

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

    2002-01-01

    AIMS: To study the effects of electrostatics in a plastic spacer on the lung deposition of salbutamol in asthmatic children. METHODS: Twenty-five children (5-12 years) with mild asthma were given salbutamol hydrofluoroalkane pressurized metered dose inhaler 400 micro g via a 750 ml plastic spacer...... repeated daily use (Used ), a spacer rinsed after repeated use (UsedRinsed ) and a spacer primed with benzalkonium chloride to avoid electrostatics (Primed1). In addition, spacers were evaluated using a 15 s inhalation delay following actuation with primed (PrimedDelay) and rinsed (RinsedDelay) spacers....... Data were log transformed and expressed as geometric mean fold difference for the average plasma salbutamol concentration (Cav) over 20 min. RESULTS: There were significant differences (P < 0.05) in Cav (as geometric mean fold difference and 95% CI) between Primed1 vs NewRinsed 1.92 fold (95% CI 1...

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

    DEFF Research Database (Denmark)

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

    2005-01-01

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

  18. Domestic exposure to fungi and total serum IgE levels in asthmatic children.

    Science.gov (United States)

    Su, Huey-Jen Jenny; Wu, Pei-Chih; Lei, Huan-Yao; Wang, Jiu-Yao

    2005-08-14

    We measured the number of airborne, viable fungi and house dust mite (HDM) allergen levels in the homes of a group of asthmatic children. Blood samples were drawn and the amounts of total and specific serum IgE were determined. The association between the number of fungal colonies, dust mite allergen exposure, and specific and total IgE was evaluated. The number of viable airborne fungi was high (20,543 CFU/m(3)) in those investigated houses. Der p1 concentrations on child's mattress exceeding 2 microg/g were found in 78.6% of the houses. A quantitative dose-response relationship was demonstrated between the exposure to viable, airborne molds and the amount of total IgE (r = 0.4399 and P = .0249) and the level was further increased in children with coexposure to viable fungi and HDM. PMID:16106103

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Reza Amin

    2010-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Mozhgan Moghtaderi

    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

  2. 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 effects....... OBJECTIVE: To compare the control of FeNO provided by salmeterol or montelukast add-on therapy in asthmatic children undergoing regular maintenance treatment with a daily dose of 400 microg of budesonide. METHODS: The study included children with increased FeNO despite regular treatment with budesonide, 400...... microg/d, and normal lung function. Montelukast, 5 mg/d, salmeterol, 50 microg twice daily, or placebo was compared as add-on therapy to budesonide, 400 microg, in a randomized, double-blind, double-dummy, crossover study. RESULTS: Twenty-two children completed the trial. The geometric mean FeNO level...

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

    Science.gov (United States)

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

    2010-03-01

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

  4. The investigation of inhalational allergen in 208 asthmatic infants and children

    International Nuclear Information System (INIS)

    The aim of the study was to investigate the inhalational allergen in 208 asthmatic infants and children with allergen steep puncturing skin. The positive cases were 169(81.25%). There were 18 inhalational allergens in allergen steep. The positive rate of the dust acarus was 78.85%, and the dust was 35.58%, the smoke was 32.69% among the allergens. There was not any positive reaction in other allergens. There were no sexual differences in the positive rate. There was nothing with hypersusceptibility of the individual and the family. The positive rate of the infant was less than the child. There was significant difference of the positive rate in the age group (P < 0.01). The result indicated that dust acarus, air pollution or passive smoke was the quite dangerous factor in the many factors of the asthma. It was very important to strengthen the study of the infant and child prevention and cure

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

    OpenAIRE

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

    2004-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Sudo Nobuyuki

    2010-10-01

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

  7. 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

    BACKGROUND: Exercise-induced bronchoconstriction (EIB) is of particular importance in children with asthma. It is an important measure of asthma control and should be monitored by exercise testing. However, exercise testing puts a large demand on health-care resources and is therefore not widely ...... inhaled corticosteroid treatment. CONCLUSION: Measurement of FeNO is a simple, and time- and resource-efficient tool that may be used to screen for EIB testing and therefore optimizes the resources for exercise testing in pediatric asthma monitoring.......BACKGROUND: Exercise-induced bronchoconstriction (EIB) is of particular importance in children with asthma. It is an important measure of asthma control and should be monitored by exercise testing. However, exercise testing puts a large demand on health-care resources and is therefore not widely...... 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...

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

    Directory of Open Access Journals (Sweden)

    Rafael Alejandro Gómez Baute

    2005-11-01

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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    OpenAIRE

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

    2011-01-01

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

  11. Classification of Impulse Oscillometric Patterns of Lung Function in Asthmatic Children using Artificial Neural Networks.

    Science.gov (United States)

    Barua, Miroslava; Nazeran, Homer; Nava, Patricia; Diong, Bill; Goldman, Michael

    2005-01-01

    Impulse Oscillometry (IOS) is an innovative patient-friendly pulmonary testing technique which measures the respiratory system impedance (Z) by using the spectral components of pressure to flow ratio which yields resistance and reactance values at different frequencies. The high dimensionality of IOS measurement data makes the analysis of this information difficult. Artificial Neural Networks (ANNs) are mathematical models composed of a large number of highly interconnected neurons that are able to learn and generalize from data. An ANN-based approach to the analysis of IOS data can potentially provide an efficient and automatic method to recognize and classify pulmonary diseases. This would help characterize major respiratory illnesses such as asthma based on IOS measurements. Asthma can be difficult to diagnose, because the symptoms are sometimes similar to other lung conditions. A data set composed of 361 impulse oscillometric patterns from asthmatic children was used in this study. The ANN was capable of distinguishing between relatively constricted and nonconstricted airway conditions in these patients. Using all of the 361 patterns during training as well as in the feed-forward stage, a classification accuracy of 95.01% was obtained for validation. When the ANN was presented with only 60% of the original 361 patterns in the data set during training and with the remaining 40% as unseen patterns, the generalization stage, a classification accuracy of 98.61% was achieved. PMID:17282180

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

    Directory of Open Access Journals (Sweden)

    Nedeljković Miroslav

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2000-01-01

    subjects. Thus sRaw had the highest sensitivity (68%). Specificity ranged from 93 to 100%. The correlation coefficient between sRaw responses to CACh repeated within 8 wk was 96%. In conclusion, CACh is feasible in young children age 2 to 5 yr. Whole body plethysmography (sRaw) was superior in separating......The aim of the study was to assess feasibility, sensitivity, specificity, predictive value, and repeatability of cold, dry air challenge (CACh) as a diagnostic test for asthma in young children 2 to 5 yr of age. Response to a 4-min single-step isocapnic CACh was measured in 38 asthmatics and 29...

  14. 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…

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

    OpenAIRE

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

    2015-01-01

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

  16. 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…

  17. 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.

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

    Directory of Open Access Journals (Sweden)

    Fariborz Zieh

    2006-06-01

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

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

    OpenAIRE

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Maalmi H

    2012-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Wei Liu

    2014-10-01

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

  3. 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.

  4. 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

    The primary aim of this study was to quantify and compare bronchodilator responsiveness in healthy and asthmatic children aged 2 to 5 yr. The secondary aim of the study was to compare discriminative capacity (i.e., sensitivity, specificity, and predictive values of the reversibility test for the...

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

    OpenAIRE

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

    2003-01-01

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

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

    Science.gov (United States)

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

  7. Indoor exposures to air pollutants and allergens in the homes of asthmatic children in inner-city Baltimore.

    Science.gov (United States)

    Breysse, Patrick N; Buckley, Timothy J; Williams, D'Ann; Beck, Christopher M; Jo, Seong-Joon; Merriman, Barry; Kanchanaraksa, Sukon; Swartz, Lee J; Callahan, Karen A; Butz, Arlene M; Rand, Cynthia S; Diette, Gregory B; Krishnan, Jerry A; Moseley, Adrian M; Curtin-Brosnan, Jean; Durkin, Nowella B; Eggleston, Peyton A

    2005-06-01

    This paper presents indoor air pollutant concentrations and allergen levels collected from the homes of 100 Baltimore city asthmatic children participating in an asthma intervention trial. Particulate matter (PM), NO2, and O3 samples were collected over 72 h in the child's sleeping room. Time-resolved PM was also assessed using a portable direct-reading nephelometer. Dust allergen samples were collected from the child's bedroom, the family room, and the kitchen. The mean PM10 concentration, 56.5+/-40.7 microg/m3, is 25% higher than the PM2.5 concentration (N=90), 45.1+/-37.5 microg/m3. PM concentrations measured using a nephelometer are consistent and highly correlated with gravimetric estimates. Smoking households' average PM2.5 and PM10 concentrations are 33-54 microg/m3 greater than those of nonsmoking houses, with each cigarette smoked adding 1.0 microm/m3 to indoor PM2.5 and PM10 concentrations. Large percentages of NO2 and O3 samples, 25% and 75%, respectively, were below the limit of detection. The mean NO2 indoor concentration is 31.6+/-40.2 ppb, while the mean indoor O3 concentration in the ozone season was 3.3+/-7.7 ppb. The levels of allergens are similar to those found in other inner cities. Results presented in this paper indicate that asthmatic children in Baltimore are exposed to elevated allergens and indoor air pollutants. Understanding this combined insult may help to explain the differential asthma burden between inner-city and non-inner-city children. PMID:15820722

  8. Is the Childhood Asthma Questionnaire a Good Measure of Health-Related Quality of Life of Asthmatic Children in Asia?: Validation Among Paediatric Patients with Asthma in Singapore

    OpenAIRE

    Lee-Yee Chong; Oh-Moh Chay; Li Shu-Chuen

    2006-01-01

    Background: Health-related quality of life (HR-QOL) is an important outcome in the treatment of chronic childhood diseases such as asthma. However, this measure is rarely used in young children in Asia because of the difficulty of obtaining valid, reliable instruments that are developmentally and culturally suitable. Objectives: To select, culturally adapt and validate a disease-specific HR-QOL questionnaire (Childhood Asthma Questionnaire [CAQ]-B) for asthmatic children aged 7-11 years in Si...

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

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2001-01-01

    We evaluated the bronchodilatory and the bronchoprotective effect of the long-acting beta(2)-agonist formoterol administered as dry powder from a mechanically actuated dry-powder inhaler (DPI) using spacer in 12 asthmatic children 2 to 5 yr of age. Lung function was measured as the specific airway...... resistance (sRaw) in a whole body plethysmograph. Hyperventilation of cold, dry air was used as bronchial challenge, and the responsiveness was estimated as change in sRaw. The bronchoprotective effect of formoterol Turbohaler 9 microg was compared with salbutamol 200 microg and placebo at 15 min, 4 and 8 h...... postdose in a randomized, double-blind, placebo-controlled, crossover study. All treatments were administered from DPI (Turbohaler) actuated mechanically into a spacer. Formoterol and salbutamol caused similar and significant bronchodilation at the first measurement 3 min postdose. Formoterol offered a...

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

    Science.gov (United States)

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

    2016-05-01

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

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

    Science.gov (United States)

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

    1998-06-01

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

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

    Directory of Open Access Journals (Sweden)

    M. Rohrbach

    1998-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈蒙; 田曼; 陆悦倩; 赵德育

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  15. 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.

  16. Decreased expression of acetaminophen-metabolizing enzymes and glutathione in asthmatic children after acetaminophen exposure

    OpenAIRE

    Stephenson, Susan T.; Hadley, Graham; Brown, Lou Ann; Fitzpatrick, Anne M.

    2011-01-01

    Children with moderate-to-severe asthma have decreased expression of acetaminophen metabolizing genes and glutathione that may account for the previously-reported risk of acetaminophen in this vulnerable population.

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

    NARCIS (Netherlands)

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

    1996-01-01

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

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

    DEFF Research Database (Denmark)

    Klug, B; Bisgaard, H

    1999-01-01

    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...

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

    International Nuclear Information System (INIS)

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

  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. 194 Influence of Montelukast on the State of Eosinophil Activation in Asthmatic Children

    OpenAIRE

    Botan, Valéria; Miranda, Marthina; Couto, Shirley; Rocha, Erica; Muniz-Junqueira, Maria Imaculada

    2012-01-01

    Background Eosinophils play an important role in inflammation asthma. In asthma, the leukotrienes are implicated in pathophysiological mechanisms. The antileukotriene montelukast inhibits proinflammatory cytokines and decreases half-life of eosinophils. However, the influence of montelukast on the activation of eosinophils is not clear yet. Therefore, the objective of this work was to evaluate the effect of montelukast on the state of activation of eosinophils in children with persistent asth...

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Hanne Krage Carlsen

    2016-06-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

    Nielsen, K G; Bisgaard, H

    2000-01-01

    ) with moderately severe asthma in a single-center, randomized, double-blind, parallel-group, placebo-controlled study involving 8 wk of treatment. Budesonide (BUD) 400 microgram twice daily was administered via a pressurized metered-dose inhaler and metal spacer device. Symptom scores (SSc) and use of......, whereas 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....

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

    Institute of Scientific and Technical Information of China (English)

    陈泓伶; 谢庆玲; 贺海兰; 黎重清; 温志红

    2014-01-01

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

  7. 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

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

    Science.gov (United States)

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

    2015-12-01

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

  9. 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

  10. 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

  11. 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

  12. Can asthmatic subjects dive?

    Science.gov (United States)

    Adir, Yochai; Bove, Alfred A

    2016-06-01

    Recreational diving with self-contained underwater breathing apparatus (scuba) has grown in popularity. Asthma is a common disease with a similar prevalence in divers as in the general population. Due to theoretical concern about an increased risk for pulmonary barotrauma and decompression sickness in asthmatic divers, in the past the approach to asthmatic diver candidates was very conservative, with scuba disallowed. However, experience in the field and data in the current literature do not support this dogmatic approach. In this review the theoretical risk factors of diving with asthma, the epidemiological data and the recommended approach to the asthmatic diver candidate will be described. PMID:27246598

  13. Can asthmatic subjects dive?

    Directory of Open Access Journals (Sweden)

    Yochai Adir

    2016-06-01

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

  14. 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.

  15. Can asthmatic subjects dive?

    OpenAIRE

    Yochai Adir; Alfred A. Bove

    2016-01-01

    Recreational diving with self-contained underwater breathing apparatus (scuba) has grown in popularity. Asthma is a common disease with a similar prevalence in divers as in the general population. Due to theoretical concern about an increased risk for pulmonary barotrauma and decompression sickness in asthmatic divers, in the past the approach to asthmatic diver candidates was very conservative, with scuba disallowed. However, experience in the field and data in the current literature do not ...

  16. Effect of long-term inhalation of glucocorticoids on the level of leptin, IL-13 and IL-2 in bronchial asthmatic children

    International Nuclear Information System (INIS)

    Objective: To determine the effect of long-term inhalation of glucocorticoids on the level of leptin, IL-13, and IL-2 in bronchial asthmatic patient. Methods: Enzyme-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 post-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 decreased gradually after inhaling glucocorticoids for 3 months (P<0.05). The treatment of inhaled glucocorticoids 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 glucocorticoid is an important means for asthma, and the effects are related to the decrease of level of leptin, IL-13, and IL-2. (authors)

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    A. Bercedo Sanz

    2009-01-01

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

  19. 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

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

    Directory of Open Access Journals (Sweden)

    Kyoung Hee Cho

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

  1. 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...

  2. 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

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

    DEFF Research Database (Denmark)

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

    1998-01-01

    In vitro studies with the Diskus inhaler at low and high flow rates show consistent doses of drug as fine particles <4.7 microm. The present study was designed to ascertain whether this in vitro flow independency translates into flow-independent clinical effect when the device is used by patients...... at low (30 L x min[-1]) and high (90 L x min[-1]) flow rates. A pilot study in 129 children aged 3-10 yrs demonstrated that 99% of children of 3 yrs and above can generate a flow > or = 30 L x min(-1) through the device, while 26% performed > or = 90 L x min(-1). Eighteen children aged 8-15 yrs with...... after salmeterol at either flow rates as compared to placebo. There was no significant difference in the protection from salmeterol on the day of low-flow inhalation versus the day of high-flow inhalation. Consistent in vitro fine particle dosing from the Diskus inhaler translates into a consistent...

  4. 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.

  5. Primary care clinician antibiotic prescribing decisions in consultations for children with RTIs:a qualitative interview study

    OpenAIRE

    Horwood, Jeremy; Cabral, Christie; Hay, Alastair D; Ingram, Jenny

    2016-01-01

    Background Respiratory tract infections (RTIs) are a major primary care challenge in children because they are common and costly, there is uncertainty regarding their diagnosis, prognosis, and management, and the overuse of antibiotics leads to illness medicalisation and bacterial resistance.Aim To investigate healthcare professional (HCP) diagnostic and antibiotic prescribing decisions for children with RTIs.Design and setting Semi-structured interviews conducted with 22 GPs and six nurses. ...

  6. 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

  7. 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%),

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

    Institute of Scientific and Technical Information of China (English)

    张国卿; 赵京; 申昆玲; 向莉; 夏光明; 杨雪秋; 鲍慧玲

    2009-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Aguocha Chinyere M

    2009-09-01

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

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

    Science.gov (United States)

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

    2016-08-01

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

  11. 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

  12. 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.

  13. Steroid Response in Refractory Asthmatics

    OpenAIRE

    Jang, An-Soo

    2012-01-01

    Inhaled glucocorticosteroids are currently the most effective anti-inflammatory controller medications for treating persistent asthma. The efficacies of glucocorticoids include reducing asthma symptoms, reducing exacerbation frequency, improving quality of life, improving lung function, decreasing airway hyperresponsiveness, controlling airway inflammation, and reducing mortality. However, the treatment response to glucocorticosteroids in asthmatics varies, and certain subtypes of asthma, suc...

  14. Chlamydia pneumoniae enhances the Th2 profile of stimulated peripheral blood mononuclear cells from asthmatic patients.

    Science.gov (United States)

    Smith-Norowitz, Tamar A; Chotikanatis, Kobkul; Erstein, David P; Perlman, Jason; Norowitz, Yitzchok M; Joks, Rauno; Durkin, Helen G; Hammerschlag, Margaret R; Kohlhoff, Stephan

    2016-05-01

    Chlamydia pneumoniae is a cause of respiratory infection in adults and children. There is evidence for an association between atypical bacterial respiratory pathogens and the pathogenesis of asthma. We compared T helper (Th) responses in C. pneumoniae - infected peripheral blood mononuclear cells (PBMC) in patients with or without asthma. PBMC (1×10(6)/mL) from asthmatic patients (N=11) and non-asthmatic controls (N=12) were infected or mock-infected for 1h +/- C. pneumoniae TW-183 at a multiplicity of infection (MOI)=1 and MOI=0.1, or cultured for 24h +/- Lactobacillus rhamnosus GG (LGG). Interleukin (IL)-4, IL-10, IL-12, Interferon (IFN)-gamma and total IgE levels were measured in supernatants (ELISA). C. pneumoniae infection led to an increase (>50%) of IgE levels in PBMC from asthmatics, compared with mock-infected on day 10; IgE wasn't detected in non-asthmatics. C. pneumoniae - infected PBMC from asthmatics increased levels of IL-4 and IFN-gamma after 24h, compared with PBMC alone; levels of IL-10 and IL-12 were low. When uninfected-PBMC from asthmatics were LGG-stimulated, after 24h, IL-4 was undetectable, but IL-10, IL-12, and IFN-gamma increased, compared with PBMC alone. Thus, C. pneumoniae infection has the ability to induce allergic responses in PBMC of asthmatics, as evidenced by production of Th2 responses and IgE. PMID:26924667

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

    Directory of Open Access Journals (Sweden)

    Elisete E. Arend

    2006-06-01

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

  16. 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

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

    International Nuclear Information System (INIS)

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

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

    Institute of Scientific and Technical Information of China (English)

    张玲; 江忠; 徐静

    2012-01-01

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

  19. 25例小儿支气管哮喘并肺部感染的治疗体会%Treating bronchial asthmatic children by combining Montelukast Sodium Chewable Tablets and Budesonide Suspension for Inhalation plus Terbutaline Sulphate Solution for Nebulisation

    Institute of Scientific and Technical Information of China (English)

    朱至明; 陈建华; 吴思雨

    2010-01-01

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

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

    OpenAIRE

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

    2010-01-01

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

  1. Supporting clinicians in infrastructuring

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten; Karasti, Helena

    2015-01-01

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

  2. Supporting Clinicians in Infrastructuring

    DEFF Research Database (Denmark)

    Simonsen, Jesper; Hertzum, Morten; Karasti, Helena

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

  3. 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…

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

    DEFF Research Database (Denmark)

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

    2010-01-01

    "maternal effect.'' Methodology/Principal Findings: We screened the medical literature from 1966 to 2009 and performed a meta-analysis to compare the effect of maternal asthma vs. paternal asthma on offspring asthma susceptibility. Aggregating data from 33 studies, the odds ratio for asthma in children of......Background: Many human epidemiologic studies demonstrate that maternal asthma confers greater risk of asthma to offspring than does paternal disease. However, a handful have shown the opposite. Given this disparity, a meta-analysis is necessary to determine the veracity and magnitude of the...... asthmatic mothers compared with non-asthmatic mothers was significantly increased at 3.04 (95% confidence interval: 2.59-3.56). The corresponding odds ratio for asthma in children of asthmatic fathers was increased at 2.44 (2.14-2.79). When comparing the odds ratios, maternal asthma conferred greater risk...

  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) PMID:24488830

  6. 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

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

    DEFF Research Database (Denmark)

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

    2004-01-01

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

  8. 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)

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    The purpose of the present study was to investigate pharmacokinetics of procaterol in asthmatics and non-asthmatics after nebulized and oral administration in relation to doping. Ten asthmatic and ten non-asthmatic subjects underwent two pharmacokinetic trials. At first trial, 4 μg procaterol was...

  10. Mime in language therapy and clinician training.

    Science.gov (United States)

    Balick, S; Spiegel, D; Greene, G

    1976-01-01

    A speech pathologist developed a program with language goals which included spontaneous communication, focus, attention span, auditory memory, receptive and expressive vocabulary, and concepts such as body image, spatial relationships, and same and different polarities. The services of a professional mime were used to translate these goals into mimetic activities and to perform the activities in group sessions with the children. In addition, the mime taught the speech clinicians some simple mimetic activities. The subjects were five children with mental retardation, language delay, lack of spontaneity, short attention span and very poor visual and auditory memory. The results suggested increase in spontaneity and attention span in all the children and a facility to remember the illusions depicted for them by the mime. The experience with the mime training for clinicians was also positive. PMID:1247375

  11. 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

  12. Radiosensitivity and the clinician

    International Nuclear Information System (INIS)

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

  13. Radiosensitivity and the clinician

    Energy Technology Data Exchange (ETDEWEB)

    1985-07-06

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

  14. Perception of Wheezing in the Elderly Asthmatics

    OpenAIRE

    Joo, Jae Hak; Lim, Gun Il; Seo, Moon Jeong; Park, Sang Joon; Lee, Jun Hyek; Uh, Soo Taek; Kim, Yong Hoon; Park, Choon Sik

    2001-01-01

    Background In elderly asthmatics, underdiagnosis is one of the important features. The main reason for underdiagnosis is thought to be a low frequency in complaining of symptoms due to the reduction of intellectual recognition and physical activity. Among the various symptoms, wheezing is the principal due in diagnosing bronchial asthma, and decreased complaints for wheezing are also noted in elderly asthmatics. The objective of this study is to determine if less complaints of wheezing in eld...

  15. Patient-clinician conflict: causes and compromises.

    Science.gov (United States)

    Lask, Bryan

    2003-03-01

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

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

    Science.gov (United States)

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

    1998-04-01

    Although most clinicians believe that social support has beneficial effects on health, the mechanisms mediating this relationship have not been clearly established. We examined the direct effect of social support on several immune measures and its role in moderating the response to academic exams in healthy and asthmatic adolescents. Three types of students--healthy, mild asthma, and severe asthma--completed social support and stress questionnaires and gave blood samples during the midsemester and final exam periods. Social support and natural killer cell (NK) function showed a significant reduction during exams in both healthy and asthmatic adolescents. Social support, however, did not have a direct effect on immune responses. Nevertheless, high social support appeared to attenuate the magnitude of exam-induced reduction in NK activity, suggesting a role for social support in protecting against immune decrements during times of stress. PMID:9535404

  17. 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.

  18. Fasciculation anxiety syndrome in clinicians.

    Science.gov (United States)

    Simon, Neil G; Kiernan, Matthew C

    2013-07-01

    The goal of this study is to define the clinical features, pathogenesis and key investigation findings of fasciculation anxiety syndrome in clinicians (FASICS). Twenty consecutive clinicians presenting with fasciculations were prospectively assessed with serial clinical and neurophysiological evaluations. Clinicians with fasciculations formed three groups: 70 % of clinicians experienced symptomatic fasciculations and anxiety about the possibility of amyotrophic lateral sclerosis (ALS), termed FASICS; a further 15 % of clinicians experienced fasciculations associated with cramps and consistent with cramp-fasciculation syndrome (CFS). The final 15 % of clinicians presented with fasciculations associated with sensory symptoms or muscle weakness and were diagnosed with neuropathy (10 %) and ALS (5 %). In FASICS, fasciculations most often involved the lower limbs, without evidence of muscle weakness on clinical examination. Exercise, stress, fatigue and caffeine consumption were identified as common exacerbating factors. Neurophysiological studies confirmed normal nerve conduction studies and the presence of simple fasciculations, without acute denervation or neurogenic motor unit changes. Antibodies to voltage-gated potassium channels were assayed in each clinician and were not detected, and systemic autoantibodies were detected only in clinicians with features of CFS. FASICS is a disorder common among physicians presenting for evaluation of fasciculations. The present study delineates the diagnostic features of FASICS and contrasts the clinical presentation with other causes of fasciculations in clinicians. PMID:23400500

  19. Epidemiology of Depression for Clinicians.

    Science.gov (United States)

    Bromberger, Joyce T.; Costello, Elizabeth Jane

    1992-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Michal Sarna

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    MARCELA LINARES P.

    2002-04-01

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

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

    OpenAIRE

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

    1989-01-01

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

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

    OpenAIRE

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

    2013-01-01

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

  7. Asthmatic cough and airway oxidative stress.

    Science.gov (United States)

    Koskela, Heikki O; Purokivi, Minna K; Nieminen, Riina M; Moilanen, Eeva

    2012-05-31

    The mechanisms of cough in asthma are unclear. Asthma is associated with an oxidative stress. Many reactive oxygen species sensitize or activate sensory C-fibers which are capable to induce cough. It was hypothesized that oxidative stress in the airways might contribute to the cough severity in asthma. Exhaled breath condensate samples were collected in ten healthy and 26 asthmatic subjects. The concentration of 8-isoprostane was measured. In addition, the subjects filled in Leicester Cough Questionnaire and underwent cough provocation tests with dry air hyperpnoea and hypertonic saline, among other measurements. Among the asthmatic subjects, high 8-isoprostane was associated with severe cough response to hyperpnoea (p=0.001), low Leicester Cough Questionnaire values (indicating severe subjective cough, p=0.02), and usage of combination asthma drugs (p=0.03-0.04). However, the 8-isoprostane concentrations did not differ significantly between the healthy and the asthmatic subjects. Airway oxidative stress may be associated with experienced cough severity and measured cough sensitivity in asthma. PMID:22546340

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

    Directory of Open Access Journals (Sweden)

    Kajaria Divya

    2013-02-01

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

  9. 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

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

    Institute of Scientific and Technical Information of China (English)

    马秋莉; 彭韶; 梁鹏; 李会娟; 张曼

    2011-01-01

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

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

    Science.gov (United States)

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

    2001-02-01

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

  12. 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....

  13. β2-Adrenoreceptor Polymorphisms in Asthmatic Patients

    OpenAIRE

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

    2003-01-01

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

  14. Help wanted: developing clinician leaders

    OpenAIRE

    Stoller, James K

    2014-01-01

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

  15. Diffusion imaging concepts for clinicians.

    Science.gov (United States)

    Neil, Jeffrey J

    2008-01-01

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

  16. Childhood agricultural injuries: an update for clinicians.

    Science.gov (United States)

    Wright, Suzanne; Marlenga, Barbara; Lee, Barbara C

    2013-02-01

    Every three days a child dies in an agriculture-related incident, and every day 45 children are injured in the United States. These tragedies should not be regarded as "accidents," as they often follow predictable and preventable patterns. Prevention is not only possible, but vital, since many of these injuries are almost immediately fatal. Major sources of fatal injuries are machinery, motor vehicles, and drowning. Tractor injuries alone account for one-third of all deaths. The leading sources of nonfatal injuries are structures and surfaces, animals (primarily horses), and vehicles (primarily all-terrain vehicles [ATVs]). Children living on farms are at a higher risk than hired workers, and are unprotected by child labor laws. Preschool children and older male youth are at the highest risk for fatal injury, while nonfatal injury was most common among boys aged 10-15 years. Multiple prevention strategies have been developed, yet economic and cultural barriers often impede their implementation. Educational campaigns alone are often ineffective, and must be coupled with re-engineering of machines and safety devices to reduce fatalities. Legislation has the potential to improve child safety, yet political and economic pressures often prohibit changes in child labor laws and mandated safety requirements. Clinicians play a pivotal role in injury prevention, and should actively address common rural risk-taking behaviors as part of the routine office visit in order to help prevent these tragedies. PMID:23395394

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

    Directory of Open Access Journals (Sweden)

    Linjie Zhang

    2005-12-01

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

  18. 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

  19. 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

  20. 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.

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Joel González Beriao

    2003-05-01

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

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

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

    Institute of Scientific and Technical Information of China (English)

    陆小霞

    2011-01-01

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

  4. Psychological effects on the family having children with asthma.

    OpenAIRE

    Pantha Aryal, Barsha

    2015-01-01

    Asthma is the most common chronic childhood disease which is defined as the chronic inflammatory disorder of the airways. The study deals with the problems of families having asthmatic children as well as about self-esteem in asthmatic children. The aim of the study is to find out the problems of families with asthmatic children and the measures to maintain positive self-esteem in those children. The research questions of this study include-(1) what are the problems of family having children ...

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

    Institute of Scientific and Technical Information of China (English)

    黄雪琼; 檀卫平; 吴葆菁; 蓝丹; 吴海飞; 麦贤弟

    2014-01-01

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

  6. Traffic Pollution Tied to Preterm Birth Risk for Asthmatic Women

    Science.gov (United States)

    ... nih.gov/medlineplus/news/fullstory_157539.html Traffic Pollution Tied to Preterm Birth Risk for Asthmatic Women ... suggests. Both short- and long-term exposure to pollution from vehicles was linked to a higher risk ...

  7. 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

  8. Airway responses to NO2 and allergen in asthmatics

    OpenAIRE

    Barck, Charlotte

    2005-01-01

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

  9. Lung epithelial permeability and inhaled furosemide. Added dimensions in asthmatics

    International Nuclear Information System (INIS)

    Lung clearance rates of inhaled 99mTc-diethylene-triamine-pentaacetic acid (DTPA) aerosols constitute a sensitive index to evaluate the permeability changes characteristic of airway epithelial damage. It was thought that edema of the airway wall which is reported in asthma could be relieved with a diuretic like furosemide, helping to relieve the symptoms. We intended to study the effect of inhaled furosemide on lung epithelial permeability in asthmatics and smokers with the help of 99mTc-DTPA lung clearance test (LCT). The study included three groups (n=15), viz. normal healthy controls, asymptomatic chronic smokers, and chronic persistent asthmatics. Each subject underwent the LCT twice, baseline and post-furosemide (Lasix) study, within a week's interval. The post-furosemide study was carried out 15 min after inhalation of 10 mg of lasix. Lung epithelial permeability was determined in terms of clearance half-life (T1/2). The baseline mean T1/2 values for controls, smokers, and asthmatics were 50.95±16.58, 20.81±5.47, 24.06±6.19 min, respectively. Post-lasix T1/2 values were 50.83±15.84, 20.70±5.65, 41.27±15.07 min, respectively. There was a significant difference (P<0.001) in baseline and post-lasix clearance values in asthmatics only. Baseline lung epithelial permeability was altered in smokers and asthmatics compared to the controls. Furosemide was effective only in asthmatics in reverting the permeability almost back to the normal range. Inhaled furosemide was effective even in moderate and severe asthmatics. Furosemide has multiple mechanisms of action. It possibly acts at bronchial level in view of the pathology in asthmatics lying in the airways. (author)

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

    Science.gov (United States)

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

    2002-11-01

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

  11. Haematological and lipid profile assays in Nigerian asthmatics

    Institute of Scientific and Technical Information of China (English)

    Caroline E Omotil; Egbagbe Eruke Elizabeth

    2009-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Weiling Xu

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

  14. Soft Stethoscope for Detecting Asthma Wheeze in Young Children

    OpenAIRE

    Chun Yu; Tzu-Hsiu Tsai; Shi-Ing Huang; Chii-Wann Lin

    2013-01-01

    Asthma is a chronic disease that is commonly suffered by children. Asthmatic children have a lower quality of life than other children. Physicians and pediatricians recommend that parents record the frequency of attacks and their symptoms to help manage their children’s asthma. However, the lack of a convenient device for monitoring the asthmatic condition leads to the difficulties in managing it, especially when it is suffered by young children. This work develops a wheeze detection system f...

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

    Directory of Open Access Journals (Sweden)

    Celso Taques Saldanha

    2005-12-01

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

  16. 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. 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

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

    Science.gov (United States)

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

    2016-04-01

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

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

    Directory of Open Access Journals (Sweden)

    Huang Mao

    2010-04-01

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

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

    Institute of Scientific and Technical Information of China (English)

    魏向阳; 滕永华

    2012-01-01

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

  1. 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.

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

    Directory of Open Access Journals (Sweden)

    Lisa G. Wood

    2013-09-01

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

  3. Noninvasive positive pressure ventilation in acute asthmatic attack

    Directory of Open Access Journals (Sweden)

    A. Soroksky

    2010-03-01

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

  4. T-cell apoptosis in asthmatics before and after immunotherapy

    International Nuclear Information System (INIS)

    This study aimed to observe some of the mechanisms of allergen specific immunotherapy and to see if the idea of delayed Th2 lymphocytes apoptosis is a contributing factor in asthma pathogenesis that could be corrected by immunotherapy. The study was conducted on 40 persons 30 asthmatic patients, 10 healthy control groups. After taking full history and clinical examination all subjects was submitted to the following assays: 1- Measuring of the CD95 on T lymphocytes in fresh blood samples using flow cytometric analysis. 2- Measuring level of lgE (nephlometer).3-Measuring level of IL-4 (ELISA).4-Measuring level of IFN-gamma (ELISA). CD95 was significantly increased in asthmatic patients denoting up regulation of the receptor on T-lymphocytes in asthmatics . The percent of CD95 was decreased in treated asthmatic subjects with no statistical significant difference. Total lgE and serum IL-4 were significantly increased in asthmatics denoting allergic nature, these levels were decreased after the immunotherapy confirming a relation ship between the application course duration of the immunotherapy and the relief of the inflammatory symptoms and remolding.

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

    DEFF Research Database (Denmark)

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

    2013-01-01

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

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

    Science.gov (United States)

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

    2015-11-15

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

  7. Dyphylline aerosol can induce bronchospasm in human asthmatics.

    Science.gov (United States)

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

    1982-01-01

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

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

    OpenAIRE

    Mostafa M. Shaaban*, Manal Hashem

    2012-01-01

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

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

    OpenAIRE

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

    2009-01-01

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

  10. How the October 2007 San Diego fires affected asthmatics

    OpenAIRE

    Vora, Chirag Harshad

    2008-01-01

    This study investigates how the October, 2007 wildfires in San Diego produced poor air quality. It then investigates how this poor air quality affects the respiratory health of eight asthmatic subjects in real time. It was found that the wildfires caused a statistical significant increase in both morning and evening Particulate Matter (PM2.5) values (p

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

    Directory of Open Access Journals (Sweden)

    Seno Pradopo

    2008-03-01

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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  14. 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.

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

    Science.gov (United States)

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

    2015-11-01

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

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

    DEFF Research Database (Denmark)

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

    2009-01-01

    . The intervention group completed a 5-day communication course, whereas the control group had no intervention. The intervention was evaluated using questionnaires measuring parents' perception of the communication and their satisfaction. The questionnaires were filled out by parents to children consulting....... There were no significant differences between the satisfaction of parents visiting clinicians from the intervention group and those visiting clinicians from the control group; however, the proportion of parents who had a positive perception of the communication was up to 9.8% higher in the intervention group...... compared with the control group. For example: 'the clinician told my child what he/she could do in order to feel better'. Discussion: Although no statistically significant differences were found, the study indicates that parents who had visited a clinician from the intervention group have experienced...

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

    OpenAIRE

    Huang Mao; Sun Yun; Bai Jianling; Yu Rongbin; Yao Xin; Zhang Jingying; Adcock Ian M; Barnes Peter J

    2010-01-01

    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 ar...

  18. Effects of exercise rehab on male asthmatic patients: Aerobic verses rebound training

    OpenAIRE

    Vahid Zolaktaf; Ghasemi, Gholam A; Morteza Sadeghi

    2013-01-01

    Background: There are some auspicious records on applying aerobic exercise for asthmatic patients. Recently, it is suggested that rebound exercise might even increase the gains. This study was designed to compare the effects of rebound therapy to aerobic training in male asthmatic patients. Methods: Sample included 37 male asthmatic patients (20-40 years) from the same respiratory clinic. After signing the informed consent, subjects volunteered to take part in control, rebound, or aerobic ...

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

    OpenAIRE

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

    2011-01-01

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

  20. Effects of Exercise Rehab on Male Asthmatic Patients: Aerobic Verses Rebound Training

    OpenAIRE

    Zolaktaf, Vahid; Ghasemi, Gholam A; Sadeghi, Morteza

    2013-01-01

    Background: There are some auspicious records on applying aerobic exercise for asthmatic patients. Recently, it is suggested that rebound exercise might even increase the gains. This study was designed to compare the effects of rebound therapy to aerobic training in male asthmatic patients. Methods: Sample included 37 male asthmatic patients (20-40 years) from the same respiratory clinic. After signing the informed consent, subjects volunteered to take part in control, rebound, or aerobic gro...

  1. 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. PMID:25004832

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

    OpenAIRE

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

    2015-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stefania La Grutta

    2012-01-01

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

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

    Science.gov (United States)

    Way, Ineke; VanDeusen, Karen; Cottrell, Tom

    2007-01-01

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

  5. 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

  6. The clinician's guide to diagnostic imaging

    International Nuclear Information System (INIS)

    ''Contains accurate and essential information on the imaging work-up of many clinical problems. It is best suited for medical students, house staff, and general practitioners who need a quick and easy basic reference when choosing among the various imaging modalities.'' -Radiology ''A practical manual designed for clinicians at any level....Provides a clear working framework.'' -Lancet ''The clarity of the text...is refreshing...It should be read by both referring physicians and imaging specialists.'' This pocket manual provides clinicians, house officers, and medical students with the first practical guide to the most appropriate, cost-effective use of computed tomography, ultrasound, nuclear medicine, and radiography. For each of 42 medical, surgical, and pediatric problems whose workup depends upon imaging, the text presents a logical, step-by-step imaging sequence, outlining the most direct, least invasive route to a diagnosis

  7. Clinical Photography: A Guide for the Clinician

    Directory of Open Access Journals (Sweden)

    Nayler J

    2003-01-01

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

  8. Intuitive information technology: enhancing clinician efficiency.

    Science.gov (United States)

    Procuniar, Molly; Murphy, Sue

    2008-01-01

    Although medical technology is making great strides in improved diagnosis and treatment, the technologies used to document, communicate, and manage those activities are limiting its progress by converting clinicians into computer operators. In an environment of nurse and doctor shortages, reducing their efficiency is counter productive. Technology in healthcare that does not serve patients by improving cost, quality, or care delivery is technology that serves no purpose. Requiring clinicians to chart away from the bedside using technologies that do not feel intuitive, such as keyboarding and mouse use reduces efficiency of workflow, impedes direct care, and increases the cost of training. Intuitive forms of technology such as surface technology, voice activated charting, or digital pens, if embraced, could cause significant changes in healthcare workflows. Clinicians could be more focused on direct care and less utilized in clerical activity. The time it takes to access information could be decreased exponentially--and the opportunities to interact with that information would present a nearly endless horizon. This impact would be especially crucial in high acuity areas and emergency patient care situations. In short, technology should embrace familiar, natural movements and develop intuitive interfaces to improve effectiveness in the healthcare market of the future. PMID:18999045

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

    Science.gov (United States)

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

    2011-09-01

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

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

    Science.gov (United States)

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

    2015-01-01

    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…

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

    Directory of Open Access Journals (Sweden)

    Vetter Thomas R

    2012-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Yoko Murakami

    2014-01-01

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

  13. 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...

  14. 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.

  15. Sexuality in the child, teen, and young adult: concepts for the clinician.

    Science.gov (United States)

    Fonseca, Helena; Greydanus, Donald E

    2007-06-01

    This article discusses basic concepts of sexuality in children, adolescents, and young adults based on development stages. Sexual behavior of adolescents is a common phenomenon, leading to sexually transmitted diseases (STDs) and unwanted pregnancy. Clinicians should provide anticipatory guidance to help with healthy sexuality development while reducing negative aspects of human sexuality. Comprehensive sexuality education should be provided, with emphasis on avoiding unwanted sexual advances (including Internet dangers), bullying, pregnancy, and STDs. Clinicians can teach sexually active patients to use effective contraception and condoms for STD protection. Ensuring full immunization with the hepatitis B vaccine and the human papillomavirus vaccine also is important. PMID:17666227

  16. Geriatric neuropsychology: implications for front line clinicians.

    Science.gov (United States)

    Jamora, Christina Weyer; Ruff, Ronald M; Connor, Bonnie B

    2008-01-01

    Consistent with the aging population, neuropsychologists are being asked with increased frequency to evaluate older adults. These assessments are often complicated by medical and psychiatric co-morbidities, polypharmacy, and complex psychosocial and legal issues that are frequently encountered in this population. The aim of this review article is to address the challenges neuropsychologists and other frontline clinicians often confront when evaluating older individuals. Specifically, we review psychiatric and medical co-morbidities, testing accommodations, diagnostic versus descriptive testing approaches, normative issues, polypharmacy, and reimbursement rates. Finally, future implications are discussed for advancing the neuropsychologist's role in evaluating and treating older individuals. PMID:18957725

  17. Why clinicians should embrace individual budgets.

    Science.gov (United States)

    Duffy, Simon John

    2012-06-01

    The use of individual budgets in healthcare marks the beginning of a new set of opportunities for clinicians to collaborate with their patients and use approaches that are not limited to traditional medical treatments. Individual budgets will be particularly valuable in areas of healthcare where increased patient control, responsiveness, creativity or personalisation are useful. Individual budgets are likely to be particularly useful for people with chronic health conditions or mental health needs and for those people who are at the end of life. PMID:24654045

  18. [Asthma and scuba diving: can asthmatic patients dive?].

    Science.gov (United States)

    Sade, Kobi; Wiesel, Ory; Kivity, Shmuel; Levo, Yoram

    2007-04-01

    Self-contained underwater breathing apparatus (scuba) diving has grown in popularity, with millions of divers enjoying the sport worldwide. This activity presents unique physical and physiological challenges to the respiratory system, raising numerous concerns about individuals with asthma who choose to dive. Asthma had traditionally been a contraindication to recreational diving, although this caveat has been ignored by large numbers of such patients. Herein we review the currently available literature to provide evidence-based evaluation of the risks associated with diving that are posed to asthmatics. Although there is some indication that asthmatics may be at an increased risk of pulmonary barotrauma, the risk seems to be small. Thus, under the right circumstances, patients with asthma can safely participate in recreational diving without any apparent increased risk of an asthma-related event. Decisions on whether or not diving is hazardous must be made on an individual basis and be founded upon an informed decision shared by both patient and physician. PMID:17476937

  19. Clinician preferences and the estimation of causal treatment differences

    OpenAIRE

    Korn, Edward L.; Baumrind, Sheldon

    1998-01-01

    Clinician treatment preferences affect the ability to perform randomized clinical trials and the ability to analyze observational data for treatment effects. In clinical trials, clinician preferences that are based on a subjective analysis of the patient can make it difficult to define eligibility criteria for which clinicians would agree to randomize all patients who satisfy the criteria. In addition, since each clinician typically has some preference for the choice of treatment for a given ...

  20. 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."

  1. Peer Support for Clinicians: A Programmatic Approach.

    Science.gov (United States)

    Shapiro, Jo; Galowitz, Pamela

    2016-09-01

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

  2. 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

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

    Directory of Open Access Journals (Sweden)

    Thomas Trian

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

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

    International Nuclear Information System (INIS)

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

  5. 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.

  6. A clinician-driven home care delivery system.

    Science.gov (United States)

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

    1993-12-01

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

  7. A Clinician's perspective on clinical exome sequencing.

    Science.gov (United States)

    O'Donnell-Luria, Anne H; Miller, David T

    2016-06-01

    Clinical exome sequencing has clearly improved our ability as clinicians to identify the cause of a wide variety of disorders. Prior to exome sequencing, a majority of patients with apparent syndromes never received a specific molecular genetic diagnosis despite extensive diagnostic odysseys. Even for those receiving an answer to the question of what caused their disorder, the diagnostic odyssey often spanned years to decades. Determining the particular genetic cause in an individual patient can be challenging due to inherent phenotypic and genetic heterogeneity of disease, technical limitations of testing or both. Blended phenotypes, due to multiple monogenic disorders in the same patient, are true dilemmas for traditional genetic evaluations, but are increasingly being diagnosed through clinical exome sequencing. New sequencing technologies have increased the proportion of patients receiving molecular diagnoses, while significantly shortening the time scale, providing multiple benefits for the health-care team, patient and family. PMID:27126233

  8. 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.

  9. Renal dysplasia and MRI: a clinician's perspective

    International Nuclear Information System (INIS)

    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.)

  10. Acute quadriparesis in an asthmatic treated with atracurium.

    Science.gov (United States)

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

    1995-03-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

  12. 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...

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

    Directory of Open Access Journals (Sweden)

    Anupsinh H

    2014-10-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

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

    2016-01-01

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

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

    OpenAIRE

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

    1998-01-01

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

  17. 24 hour and fractionated profiles of adrenocortical activity in asthmatic patients receiving inhaled and intranasal corticosteroids

    OpenAIRE

    Wilson, A.; LIPWORTH, B.

    1999-01-01

    BACKGROUND—As both rhinitis and asthma are allergic conditions, they frequently occur together. The objective of this study was to assess the diurnal adrenocortical activity in asthmatics receiving inhaled (inh) and intranasal (n) formulations of two different corticosteroids, fluticasone propionate (FP) and triamcinolone acetonide (TAA), both given at clinically recommended doses.
METHODS—Twelve stable moderately severe asthmatic subjects of mean age 23.9 years and mean ...

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

    OpenAIRE

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

    2009-01-01

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

  19. Media literacy for clinicians and parents.

    Science.gov (United States)

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

    2005-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Nguyen Khoa D

    2010-03-01

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

  1. Analysis of Clinicians' Perceptual Cough Evaluation.

    Science.gov (United States)

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

    2016-08-01

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

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

    Directory of Open Access Journals (Sweden)

    M. Malagola

    2011-01-01

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

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

    OpenAIRE

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

    2014-01-01

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

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

    OpenAIRE

    McKneally, Martin F.; Peter A Singer

    2001-01-01

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

  5. Adolescent autonomy revisited: clinicians need clearer guidance.

    Science.gov (United States)

    Brierley, Joe; Larcher, Victor

    2016-08-01

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

  6. 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.

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

    Science.gov (United States)

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

    2016-01-01

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

  8. 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

  9. Asthma Control in Asthmatic Patients Treated for Lung Cancer

    Directory of Open Access Journals (Sweden)

    Chung-Hsing Hsieh

    2011-02-01

    Full Text Available Background: The balance of the Th1 and Th2 immune response plays an important role inthe regulation of the immune system and in general health. Tumor bearinghosts are supposed to have a balance shifting to the Th2 pathway, while afavorable Th1 anti-tumor pathway is induced in tumor-resected hosts. Theclinical impacts of a tumor-related Th2 environment have not been clearlystudied. The present study was conducted to test the hypothesis that nonsmallcell lung cancer (NSCLC has an impact on control of asthma, a wellknownTh2-predominant inflammatory disease.Method: Thirty-eight patients with the diagnoses of both asthma and lung cancer wereretrospectively enrolled. Patients were divided into two groups according totheir response to lung cancer treatment, the responder group (completeregression, partial regression and stable disease and non-responder group(progression of disease. Asthma control test (ACT scores were analyzedone year before diagnosis, at the time of diagnosis of lung cancer, and at thetime of re-staging after cancer treatment.Results: All the asthmatics with lung cancer had worsening of their symptomsaccording to their ACT scores at the time of diagnosis of lung cancer comparedto scores in the preceding year (21.6

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

    Science.gov (United States)

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

    1993-10-01

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

  11. 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.

  12. 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....

  13. Childhood discipline: challenges for clinicians and parents.

    Science.gov (United States)

    Banks, J Burton

    2002-10-15

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

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

    Science.gov (United States)

    Cassel, Stacy Gallese; Hadley Edd, Amy J

    2016-01-01

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

  15. Asthmatic inflammatory reaction in the lung tissues of juvenile rats following exposure to cyolane pesticide

    International Nuclear Information System (INIS)

    The present study was carried out to evaluate the effect of the organophosphorus pesticide cyolane on the tissues of the respiratory system and the pro-inflammatory markers in the serum.The study was carried out on thirty juvenile Sprague Dawley rats. Animals were divided into three groups, one used as control and the other two groups, (Gr.I and Gr.Il) received daily diet contained cyolane equivalent to 1.0 mg/kg b.wt. for 2 and 4 weeks, respectively.Nitric oxide (No), immunoglobulins E(IgE) and G (IgG) were measured in the serum of control and treated rats as an important pro-inflammatory markers.The results revealed that nitric oxide was highly significantly increased in Gr.II (P< 0.001) and significantly increased in Gr.I (P< 0.01).As regards to serum immunoglobulins, the data obtained revealed significant increase in serum total IgE in both treated groups. The IgG, as an anaphylactic antibody, showed significant increase in both groups.Histopathological examination of lung tissue revealed increased inflammatory cells infiltration and congested blood vessels in Gr.I while Gr.II showed massive inflammatory cells infiltration and congestion of blood vessels which became more pronounced. In addition, the hypertrophied muscle fibers were increased in the sub-bronchial epithelium.We concluded that young adolescents and children must advised to avoid exposure to organophosphorus pesticides, even for short time, to prevent asthmatic inflammatory reaction, which by time destroy their lung tissues. Also, the study recommended importance of measuring No, IgE and IgG serum levels as inflammatory markers for early diagnosis and management of asthma

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

    Science.gov (United States)

    Arocha-Sandoval, Francisco; Parra-Quevedo, Katynna

    2002-09-01

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

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

    Science.gov (United States)

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

    2012-09-01

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

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

    DEFF Research Database (Denmark)

    Davidsen, Jesper Rømhild; Søndergaard, Jens; Hallas, Jesper; Siersted, Hans Christian; Knudsen, Thomas Bøllingtoft; Lykkegaard, Jesper; Andersen, Morten

    2011-01-01

    OBJECTIVE: The aim of this population-based longitudinal study was to examine the associations between socioeconomic status (SES) and anti-asthmatic treatment with inhaled corticosteroids (ICS) among young Danish adult asthmatics, and to investigate whether these associations were consistent over...... ICS use in young adult asthmatics. To encourage ICS use, special attention should be paid to asthmatics with low educational level and low income. Further studies are needed to elucidate underlying mechanisms for this socioeconomic inequality....... time. METHODS: We extracted data on prescription drug use, education, and income in 97 665 users of anti-asthmatic drugs, aged 18-44 years, identified in Statistics Denmark during 1997-2005. Individual information on education and income was used as measures of SES. Education was categorised into basic...... school/high school, vocational training, and higher education, and income was categorised into low, middle, and high income. Associations between ICS use and SES were estimated by logistic regression models. RESULTS: High levels of education and income were independently associated with ICS use...

  19. 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

  20. Inter-clinician and intra-clinician reliability of force application during joint mobilization: a systematic review.

    Science.gov (United States)

    Gorgos, Kara S; Wasylyk, Nicole T; Van Lunen, Bonnie L; Hoch, Matthew C

    2014-04-01

    Joint mobilizations are commonly used by clinicians to decrease pain and restore joint arthrokinematics following musculoskeletal injury. The force applied during a joint mobilization treatment is subjective to the individual clinician but may have an effect on patient outcomes. The purpose of this systematic review was to critically appraise and synthesize the studies which examined the reliability of clinicians' force application during joint mobilization. A systematic search of PubMed and EBSCO Host databases from inception to March 1, 2013 was conducted to identify studies assessing the reliability of force application during joint mobilizations. Two reviewers utilized the Quality Appraisal of Reliability Studies (QAREL) assessment tool to determine the quality of included studies. The relative reliability of the included studies was examined through intraclass correlation coefficients (ICC) to synthesize study findings. All results were collated qualitatively with a level of evidence approach. A total of seven studies met the eligibility and were included. Five studies were included that assessed inter-clinician reliability, and six studies were included that assessed intra-clinician reliability. The overall level of evidence for inter-clinician reliability was strong for poor-to-moderate reliability (ICC = -0.04 to 0.70). The overall level of evidence for intra-clinician reliability was strong for good reliability (ICC = 0.75-0.99). This systematic review indicates there is variability in force application between clinicians but individual clinicians apply forces consistently. The results of this systematic review suggest innovative instructional methods are needed to improve consistency and validate the forces applied during of joint mobilization treatments. This is particularly evident for improving the consistency of force application across clinicians. PMID:24405786

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

    Science.gov (United States)

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

    2011-10-01

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

  2. Supporting novice clinicians cognitive strategies: System design perspective

    Science.gov (United States)

    Islam, Roosan; Mayer, Jeanmarie; Clutter, Justin

    2016-01-01

    Infections occur among all clinical domains. The changing nature of microbes, viruses and infections poses a great threat to the overall well-being in medicine. Clinicians in the infectious disease (ID) domain deal with diagnostic as well as treatment uncertainty in their everyday practice. Our current health information technology (HIT) systems do not consider the level of clinician expertise into the system design process. Thus, information is presented to both novice and expert ID clinicians in identical ways. The purpose of this study was to identify the cognitive strategies novice ID clinicians use in managing complex cases to make better recommendations for system design. In the process, we interviewed 14 ID experts and asked them to give us a detailed description of how novice clinicians would have dealt with complex cases. From the interview transcripts, we identified four major themes that expert clinicians suggested about novices’ cognitive strategies including: A) dealing with uncertainty, B) lack of higher macrocognition, C) oversimplification of problems through heuristics and D) dealing with peer pressure. Current and future innovative decision support tools embedded in the electronic health record that can match these cognitive strategies may hold the key to cognitively supporting novice clinicians. The results of this study may open up avenues for future research and suggest design directions for better healthcare systems.

  3. 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. PMID:1670796

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

    Directory of Open Access Journals (Sweden)

    Leme A.S.

    2002-01-01

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

  5. Use of complementary and alternative medicine among asthmatic patients in primary care clinics in Malaysia

    Directory of Open Access Journals (Sweden)

    Alshagga Mustafa

    2011-01-01

    Full Text Available Objectives: This study aimed to determine the knowledge about asthma and the prevalence, disclosure and evaluation of the use of complementary and alternative medicine (CAM among asthmatic patients. Methods: This cross-sectional study was conducted on 95 patients diagnosed with asthma in a primary healthcare centre in Kuala Lumpur, Malaysia using a self-administered questionnaire. Results: Ninety-five patients with a mean age of 47.06 years (±12.8 participated, the majority were female (66.7%, Malay (72.6%. The prevalence of ever-CAM use was 61.1%. The non-ever-CAM users′ mean age was 51±13.9 years while the ever-CAM users′ mean age was 44.5 ±11.5 years ( P = 0.021. Sixty-three females (66.8% used CAM compared to 14 males (43.8% ( P = 0.014. Thirty-six (62.1% CAM users had not discussed use of CAM with their doctors. The main reason of non-disclosure was "the doctor never asked" (55.6%, and the main sources of information about CAM were family and relatives (46.6%. There was no significant difference between use of CAM and knowledge about asthma. The majority of asthmatic patients used rubs (39%, foods (16.9% and herbs (16.9%. About 76% of asthmatic patients perceived CAM as good for their disease management. On linear multiple regression, Malay race ( P = 0.026 and female gender ( P = 0.006 were significant predictors of CAM use. Conclusion: Use of CAM among asthmatic patients is relatively high, particularly among females. The majority of asthmatic patients valued the use of CAM. Non-disclosure was high in this study. Health education of asthmatic patients about CAM is highly recommended.

  6. 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

    2016-01-01

    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 of clinical consultation with specific clinician and supervisor elements. This model has been used by the New York State Office of Mental Health for the past 3 years to train 1,210 clinicians and supervisors statewide. This article describes the early adoption and initial implementation of a statewide training program in cognitive-behavioral therapy for youth. The training and consultation model and descriptive findings are presented; lessons learned are described. Future plans include a focus on sustainability and measurement feedback of youth outcomes to enhance the continuity of this program and the quality of the clinical services.

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

    OpenAIRE

    Findley, Thomas W.

    2011-01-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    OpenAIRE

    Restifo, Linda L; Phelan, Gerald R.

    2011-01-01

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

  10. Cardiovascular magnetic resonance physics for clinicians: part I

    OpenAIRE

    Ridgway John P

    2010-01-01

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

  11. Oral health in children with asthma

    OpenAIRE

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

    2015-01-01

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

  12. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    Energy Technology Data Exchange (ETDEWEB)

    McQueen, A.S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)], E-mail: andrewmcqueen7@hotmail.com; Worthy, S. [Department of Radiology, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom); Keir, M.J. [Department of Medical Physics, Royal Victoria Infirmary, Newcastle upon Tyne (United Kingdom)

    2008-06-15

    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

  13. Investigating suspected acute pulmonary embolism - what are hospital clinicians thinking?

    International Nuclear Information System (INIS)

    Aims: To assess local clinical knowledge of the appropriate investigation of suspected acute pulmonary embolism (PE) and this compare with the 2003 British Thoracic Society (BTS) guidelines as a national reference standard. Methods: A clinical questionnaire was produced based on the BTS guidelines. One hundred and eight-six participants completed the questionnaires at educational sessions for clinicians of all grades, within a single NHS Trust. The level of experience amongst participants ranged from final year medical students to consultant physicians. Results: The clinicians were divided into four groups based on seniority: Pre-registration, Junior, Middle, and Senior. Forty-six point eight percent of all the clinicians correctly identified three major risk factors for PE and 25.8% recognized the definition of the recommended clinical probability score from two alternatives. Statements regarding the sensitivity of isotope lung imaging and computed tomography pulmonary angiography (CTPA) received correct responses from 41.4 and 43% of participants, respectively, whilst 81.2% recognized that an indeterminate ventilation-perfusion scintigraphy (V/Q) study requires further imaging. The majority of clinicians correctly answered three clinical scenario questions regarding use of D-dimers and imaging (78, 85, and 57.5%). There was no statistically significant difference between the four groups for any of the eight questions. Conclusions: The recommended clinical probability score was unfamiliar to all four groups of clinicians in the present study, and the majority of doctors did not agree that a negative CTPA or isotope lung scintigraphy reliably excluded PE. However, questions based on clinical scenarios received considerably higher rates of correct responses. The results indicate that various aspects of the national guidelines on suspected acute pulmonary embolism are unfamiliar to many UK hospital clinicians. Further research is needed to identify methods to improve

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

    Directory of Open Access Journals (Sweden)

    Abdolreza Norouzy

    2013-07-01

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

  15. Effects of exercise rehab on male asthmatic patients: Aerobic verses rebound training

    Directory of Open Access Journals (Sweden)

    Vahid Zolaktaf

    2013-01-01

    Conclusions: Regular exercise strengthens the respiratory muscles and improves the cellular respiration. At the same time, it improves the muscular, respiratory, and cardio-vascular systems. Effects of rebound exercise seem to be promising. Findings suggest that rebound exercise is a useful complementary means for asthmatic male patients.

  16. 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…

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

    Institute of Scientific and Technical Information of China (English)

    姜洪娟

    2014-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1980-01-01

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

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

    Science.gov (United States)

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

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

    International Nuclear Information System (INIS)

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

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

    OpenAIRE

    Sarinho E.; Schor D.; Veloso M.A.; Rizzo J.A.

    2004-01-01

    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...

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

    Directory of Open Access Journals (Sweden)

    Jaikrit Bhutani

    2012-01-01

    Full Text Available Background: Compassion fatigue is a broad term comprising of two components - burnout and secondary traumatic stress. The current study is aimed at identifying ′burnout′ and ′compassion fatigue′ among clinicians involved in care of individuals suffering from medical illness. Materials and Methods: A total of 60 clinicians were included in the study. A semi-structured questionnaire was administered to gather information related to personal, professional, anthropometric, and metabolic profile of the study participants. Professional Quality of Life Scale (ProQoL Version V was used to assess burnout, compassion satisfaction and secondary traumatic stress. Analysis was carried out using the SPSS version 19.0. Results: The mean age of clinicians was 46.68±11.06 (range 26-67 years. Burnout score was significantly higher in those involved in diabetology practice. Similarly, compassion satisfaction score was greater among those with greater years of practice as well as among those in private practice. Clinicians who reported a poor working condition, as opposed to good, had more burnout and less compassion satisfaction. Conclusion: The current study suggests that it is important to find out ways of decreasing burnout and compassion fatigue among clinicians.

  3. From leader to leadership: clinician managers and where to next?

    Science.gov (United States)

    Fulop, Liz; Day, Gary E

    2010-08-01

    Individual clinician leadership is at the forefront of health reforms in Australia as well as overseas with many programs run by health departments (and hospitals) generally focus on the development of individual leaders. This paper argues, along with others, that leadership in the clinician management context cannot be understood from an individualistic approach alone. Clinician managers, especially in the ranks of doctors, are usually described as 'hybrid-professional managers' as well as reluctant leaders for whom most leadership theories do not easily apply. Their experiences of leadership development programs run by health departments both in Australia and internationally are likely to be based on an individual leader-focussed approach that is driving health care reforms. These approaches work from three key assumptions: (1) study and fix the person; (2) give them a position or title; and (3) make them responsible for results. Some would argue that the combination of these three approaches equates to heroic and transformational leadership. Several alternative approaches to leadership development are presented to illustrate how reforms in healthcare, and notably in hospitals, must incorporate alternative approaches, such as those based on collective and relational forms of leadership. This does not mean eschewing individual approaches to leadership but rather, thinking of them differently and making them more relevant to the daily experiences of clinician managers. We conclude by highlighting several significant challenges facing leadership development for clinician managers that arise from these considerations. PMID:20797368

  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. 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.

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

    Science.gov (United States)

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

    2016-08-01

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

  7. 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; Uljarević, Mirko; Butter, Eric; Mulick, James A

    2016-07-01

    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 judgement accuracy was compared against final diagnosis for high and low confidence levels (with confidence assessed on a 0-100 % scale). We identified a significant CA relationship with predictive accuracy highest at confidence levels of 90-100 %. Parent report of unusual behaviors was the only significant independent predictor of confidence. Clinicians' confidence may be important when evaluating decisions to refer, or not to refer, children for further diagnostic assessment. PMID:26975451

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

    Directory of Open Access Journals (Sweden)

    Sarinho E.

    2004-01-01

    Full Text Available Although asthma has been commonly associated with sensitivity to cockroaches, a clear causal relationship between asthma, allergy to cockroaches and exposure levels has not been extensively investigated. The objective of the present study was to determine whether asthma occurs more frequently in children living in homes with high cockroach infestation. The intensity of household infestation was assessed by the number of dead insects after professional pesticide application. Children living in these houses in the metropolitan area of Recife, PE, were diagnosed as having asthma by means of a questionnaire based on the ISAAC study. All children had physician-diagnosed asthma and at least one acute exacerbation in the past year. Children of both sexes aged 4 to 12 years who had been living in the households for more than 2 years participated in this transverse study and had a good socioeconomic status. In the 172 houses studied, 79 children were considered to have been exposed to cockroaches and 93 not to have been exposed. Children living in residences with more than 5 dead cockroaches after pesticide application were considered to be at high infestation exposure. Asthma was diagnosed by the questionnaire in 31.6% (25/79 of the exposed group and in 11.8% (11/93 of the non-exposed group (P = 0.001, with a prevalence ratio of 3.45 (95%CI, 1.48-8.20. The present results indicate that exposure to cockroaches was significantly associated with asthma among the children studied and can be considered a risk factor for the disease. Blattella germanica and Periplaneta americana were the species found in 96% of the infested houses.

  9. 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.

  10. Ensuring the survival of the clinician-scientist.

    Science.gov (United States)

    Schrier, R W

    1997-07-01

    Many forces threaten the survival of the clinician-scientist as an academic species, among them: (1) the changing health environment; (2) the complexity of and rapid advances in biomedical science, which necessitate that MD-PhD graduates "retool" after completing their clinical training; (3) the length and rigor of the research training required to train clinician-scientists adequately; (4) the scarcity of funding for subspecialty training positions; (5) the perception that the successful clinician-scientists in academic medicine are those who focus on basic, rather than clinical, research; (6) the indebtedness of young physicians when they complete medical schools; (7) the fierce competition for research funding; and (8) pessimism among senior faculty about the clinician-scientist's potential for survival. There are solutions to these issues that must be vigorously pursued to ensure the survival of the clinician-scientist: (1) Rigorous six- to seven-year programs (e.g., two in internal medicine, four to five in a subspecialty) for physicians must be established. They should include a minimum of three years of research and should lead to board certification in internal medicine, pediatrics, psychiatry, etc., board certification in a subspecialty, and a PhD in clinical science. (2) These programs must have a choice of three tracks, (a) disease-oriented basic research, (b) clinical investigation in patients, and (c) health services research. Such a program--the PhD in Clinical Science program--has recently been approved and begun at the University of Colorado. (3) Funding organizations such as the National Institutes of Health should designate their training resources primarily for programs with a minimum of three years of formal and rigorous research training. (4) These rigorous research training programs must be integrated with young-faculty awards for clinician-scientists to ensure continuity in their investigative careers. (5) Loan-repayment programs must be

  11. Clinicians' management strategies for patients with dyspepsia: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Ohlsson Bodil

    2005-05-01

    Full Text Available Abstract Background Symptoms from the upper gastrointestinal tract are frequently encountered in clinical practice and may be of either organic or functional origin. For some of these conditions, according to the literature, certain management strategies can be recommended. For other conditions, the evidence is more ambiguous. The hypothesis that guided our study design was twofold: Management strategies and treatments suggested by different clinicians vary considerably, even when optimal treatment is clear-cut, as documented by evidence in the literature. Clinicians believe that the management strategies of their colleagues are similar to their own. Methods Simulated case histories of four patients with symptoms from the upper gastrointestinal tract were presented to 27 Swedish clinicians who were specialists in medical gastroenterology, surgery, and general practice and worked at three hospitals in the southern part of Sweden. The patients' histories contained information on the patient's sex and age and the localisation of the symptoms, but descriptions of subjective symptoms and findings from examinations differed from history to history. Interviews containing open-ended questions were conducted. Results For the same patient, the management strategies and treatments suggested by the clinicians varied widely, as did the strategies suggested by clinicians in the same speciality. Variation was more pronounced if the case history noted symptoms but no organic findings than if the case history noted unambiguous findings and symptoms. However, even in cases with a consensus in the scientific literature on treatment, the variations in clinicians' opinion on management were pronounced. Conclusion Despite these variations, the clinicians believed that the decisions made by their colleagues would be similar to their own. The overall results of this study indicate that we as researchers must make scientific evidence comprehensible and communicate

  12. Change of Regulatory Treg Cells Levels in Asthmatic Children Allergic to House Dust Mite and Its Clinical Significance%屋尘螨过敏的支气管哮喘患儿调节性T淋巴细胞水平变化及其临床意义

    Institute of Scientific and Technical Information of China (English)

    王炜; 李芳; 段国威; 吴晓玲; 宋青

    2012-01-01

    Objective To investigate the changes of frequency and function of CD4 + CD25 + Foxp3 +Treg cells and their roles in the evaluation of severity in children with asthma allergic to house dust mite( HDM). Methods Sixty children sensitive to HDM with asthma were divided into mild asthma group,moderate asthma group and severe asthma group according to their clinical features,and 20 healthy children were enrolled as the healthy control group. Peripheral Mood monouctear cells ( PBMC) were isolated from the subjects. After 48 hours of in vitro stimulation with HDM extracts, CD4 + CD25+ Foxp3 + regulatory T cells and CD4+ CD25 + Foxp3 + IL - 10+ regulatory T cells were measured by using flow cytometry. Results The frequency of CD4 + CD25+ Foxp3 + Treg cells had no statistical significance between the mild asthma group and moderate asthma group(P, >0.05) .but significantly decreased in the severe asthma group compared with the healthy control group(P <0.001). The frequency of IL - 10 - secreting - CD4 + CD25+ Foxp3 + Treg cells was also decreased significantly in the asthma group compared with that in the healthy control group( P <0.001). The frequency of IL - 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells was significantly lower in the moderate asthma group compared with that in the mild asthma group(P<0.05) ,and the IL- 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells in the severe asthma group were hardly found. The. frequency of IL - 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells was significantly lower in the severe asthma group compared with that in the moderate asthma group( P<0.01). There was a remarkably negative correlation between IL - 10 - secreting - CD4 + CD25 + Foxp3 + Treg cells level and the asthma severity(r= -0. 637,P<0.05). Conclusions In the mild asthma children and moderate asthma children, there are quantitative but functional insufficiency of regulatory T cells. And in severe asthma group there are both quantitative and functional

  13. 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

  14. Breast-feeding and human immunodeficiency virus infection: assessment of knowledge among clinicians in Kenya.

    Science.gov (United States)

    Murila, Florence; Obimbo, Moses M; Musoke, Rachel; Tsikhutsu, Isaac; Migiro, Santau; Ogeng'o, Julius

    2015-02-01

    In Kenya, human immunodeficiency virus (HIV) prevalence ranks among the highest in the world. Approximately 60 000 infections yearly are attributed to vertical transmission including the process of labour and breast-feeding. The vast of the population affected is in the developing world. Clinical officers and nurses play an important role in provision of primary health care to antenatal and postnatal mothers. There are a few studies that have explored the clinicians' knowledge on breast-feeding in the face of HIV and in relation to vertical transmission this being a vital component in prevention of maternal-to-child transmission. The aim of this study was to evaluate clinicians' knowledge on HIV in relation to breast-feeding in Kenya. A cross-sectional survey was conducted to assess knowledge of 161 clinical officers and nurses serving in the maternity and children' wards in various hospitals in Kenya. The participants were derived from all district and provincial referral facilities in Kenya. A preformatted questionnaire containing a series of questions on HIV and breast-feeding was administered to clinicians who were then scored and analyzed. All the 161 participants responded. Majority of clinicians (92%) were knowledgeable regarding prevention of mother-to-child transmission. Regarding HIV and breast-feeding, 49.7% thought expressed breast milk from HIV-positive mothers should be heated before being given. Majority (78.3%) thought breast milk should be given regardless of availability of alternatives. According to 74.5% of the participants, exclusive breast-feeding increased chances of HIV transmission. Two-thirds (66.5%) would recommend breast-feeding for mothers who do not know their HIV status (66.5%). This study observes that a majority of the clinicians have inadequate knowledge on breast-feeding in the face of HIV. There is need to promote training programmes on breast-feeding and transmission of HIV from mother to child. This can be done as in

  15. 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...

  16. The preventive effect of Brassica napus L. oil on pathophysiological changes of respiratory system in experimental asthmatic rat

    Directory of Open Access Journals (Sweden)

    Mehdi Kabiri rad

    2012-12-01

    Results: Eosinophil numbers in the submucosal layer, as well as smooth muscle layer thicknesses were significantly lower in the rat group treated with 0.75 mg/kg B. napus oil as compared with asthmatic group (p

  17. Smartphone and mobile phone security for the clinician.

    Science.gov (United States)

    Barber, Harry

    2016-08-01

    Smartphones are near ubiquitous and widely used by doctors in discussing patients. In all communication doctors should take steps to protect confidentiality, yet there is a paucity of available information on how clinicians can bolster cyber security and minimize risk when using their mobile phone. PMID:27487057

  18. Attitudes of clinicians following large-scale pharmacogenomics implementation.

    Science.gov (United States)

    Peterson, J F; Field, J R; Shi, Y; Schildcrout, J S; Denny, J C; McGregor, T L; Van Driest, S L; Pulley, J M; Lubin, I M; Laposata, M; Roden, D M; Clayton, E W

    2016-08-01

    Clinician attitudes toward multiplexed genomic testing may be vital to the success of translational programs. We surveyed clinicians at an academic medical center about their views on a large pharmacogenomics implementation, the PREDICT (Pharmacogenomic Resource for Enhanced Decisions in Care and Treatment) program. Participants were asked about test ordering, major factors influencing use of results, expectations of efficacy and responsibility for applying results to patient care. Virtually all respondents (99%) agreed that pharmacogenomics variants influence patients' response to drug therapy. The majority (92%) favored immediate, active notification when a clinically significant drug-genome interaction was present. However, clinicians were divided on which providers were responsible for acting on a result when a prescription change was indicated and whether patients should be directly notified of a significant result. We concluded genotype results were valued for tailoring prescriptions, but clinicians do not agree on how to appropriately assign clinical responsibility for actionable results from a multiplexed panel.The Pharmacogenomics Journal advance online publication, 11 August 2015; doi:10.1038/tpj.2015.57. PMID:26261062

  19. Posttraumatic Stress Disorder: Examination of What Clinicians Know

    Science.gov (United States)

    McKenzie, Kylie J.; Smith, David I.

    2006-01-01

    Undetected posttraumatic stress disorder (PTSD) has serious adverse consequences. General practitioners (GPs), psychologists, and psychiatrists all have an important part to play in recognising, assessing, and treating individuals with PTSD. The knowledge level of these clinicians was investigated using a purpose-designed PTSD Knowledge…

  20. Perception of adults' smile esthetics among orthodontists, clinicians and laypeople

    Directory of Open Access Journals (Sweden)

    Enio Ribeiro Cotrim

    2015-02-01

    Full Text Available OBJECTIVE: Smile esthetics has become a major concern among patients and orthodontists. Therefore, the aim of this study was: (1 To highlight differences in perception of smile esthetics by clinicians, orthodontists and laypeople; (2 To assess factors such as lip thickness, smile height, color gradation, tooth size and crowding, and which are associated with smile unpleasantness. METHODS: To this end, edited photographs emphasizing the lower third of the face of 41 subjects were assessed by three groups (orthodontists, laypeople and clinicians who graded the smiles from 1 to 9, highlighting the markers that evince smile unpleasantness. Kruskall-Wallis test supplemented by Bonferroni test was used to assess differences among groups. Additionally, the prevailing factors in smile unpleasantness were also described. RESULTS: There was no significant difference (P = 0.67 among groups rates. However, the groups highlighted different characteristics associated with smile unpleasantness. Orthodontists emphasized little gingival display, whereas laypeople emphasized disproportionate teeth and clinicians emphasized yellow teeth. CONCLUSION: Orthodontists, laypeople and clinicians similarly assess smile esthetics; however, noticing different characteristics. Thus, the orthodontist must be careful not to impose his own perception of smile esthetics.

  1. Clinician Perceptions of Childhood Risk Factors for Future Antisocial Behavior

    Science.gov (United States)

    Koegl, Christopher J.; Farrington, David P.; Augimeri, Leena K.

    2009-01-01

    We asked 176 mental health clinicians to list factors that place a child at risk for engaging in future antisocial behavior. Participants were randomly assigned to do this in relationship to boys and girls. Listed factors were then coded into broad item categories using the Early Assessment Risk Lists (EARL). Of the 1,695 factors listed, 1,476…

  2. Perceived Food Hypersensitivity Relates to Poor Asthma Control and Quality of Life in Young Non-Atopic Asthmatics

    OpenAIRE

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

    2015-01-01

    Background The relationship between perceived food hypersensitivity in asthmatics, food allergen sensitization, asthma control and asthma-related quality of life has not been studied. Objective Our aim was to study the prevalence of perceived food hypersensitivity in a cohort of young asthmatics, its relation to food allergen sensitization, and any correlation to asthma control and asthma-related quality of life. Methods Perceived food hypersensitivity, as well as IgE sensitization to common ...

  3. BCG-Induced Dendritic Cell Responses and Suppression of Interleukin-5 Production from T Cells in Atopic Asthmatics

    OpenAIRE

    Choi, Inseon S.; Lin, Xiang-Hua; Koh, Young-Ah; Cui, Yong

    2008-01-01

    Bacille Calmette-Guérin (BCG) induces potent Th1 responses with the help of interleukin (IL)-10 and IL-12 released from dendritic cells (DCs), and suppresses Th2-associated allergic reactions. However, there are still some controversies on therapeutic effects of BCG in asthmatics. This study investigated whether BCG administration to DCs suppresses IL-5 production from T cells in atopic asthmatics. DCs derived from peripheral blood of subjects were cultured with or without BCG and Dermatophag...

  4. Comparison of circadian variations using FEV1 and peak expiratory flow rates among normal and asthmatic subjects.

    OpenAIRE

    Troyanov, S; Ghezzo, H; Cartier, A; Malo, J.L.

    1994-01-01

    BACKGROUND--Most studies that describe circadian variations in asthma have used maximum rate of peak expiratory flow (PEF) rather than forced expiratory volume in one second (FEV1) to assess airway calibre. This study was designed to assess circadian variations in PEF and FEV1 measured simultaneously and to compare variations in these measurements in normal and asthmatic subjects in a stable clinical state. METHODS--Twenty nine subjects (nine asthmatic subjects on bronchodilators, 10 on inhal...

  5. Impact of different combinations of inhaled corticosteroids and long-acting sympathicomimetics on dental health of asthmatics.

    OpenAIRE

    George Christoff; Emilia Karova

    2012-01-01

    The aim of the investigation is to study the effect of inhaled corticosteroids and long-acting sympathicomimetics on dental health in asthmatics. Thirty patients, from 20 to 55 years old, participate in the study. D-, M-, F- and DMFT indexes are determined in a 6 months period. All participants fill in a questionnaire. Asthmatics complain most frequently from oral dryness, take frequently sugar and soft drinks and visit irregularly dental practitioners. A significant increase in M-index is fo...

  6. What motivates senior clinicians to teach medical students?

    Science.gov (United States)

    Dahlstrom, Jane; Dorai-Raj, Anna; McGill, Darryl; Owen, Cathy; Tymms, Kathleen; Watson, D Ashley R

    2005-01-01

    Background This study was designed to assess the motivations of senior medical clinicians to teach medical students. This understanding could improve the recruitment and retention of important clinical teachers. Methods The study group was 101 senior medical clinicians registered on a teaching list for a medical school teaching hospital (The Canberra Hospital, ACT, Australia). Their motivations to teach medical students were assessed applying Q methodology. Results Of the 75 participants, 18 (24%) were female and 57 (76%) were male. The age distribution was as follows: 30–40 years = 16 participants (21.3%), 41–55 years = 46 participants (61.3%) and >55 years = 13 participants (17.3%). Most participants (n = 48, 64%) were staff specialists and 27 (36%) were visiting medical officers. Half of the participants were internists (n = 39, 52%), 12 (16%) were surgeons, and 24 (32%) were other sub-specialists. Of the 26 senior clinicians that did not participate, two were women; 15 were visiting medical officers and 11 were staff specialists; 16 were internists, 9 were surgeons and there was one other sub-specialist. The majority of these non-participating clinicians fell in the 41–55 year age group. The participating clinicians were moderately homogenous in their responses. Factor analysis produced 4 factors: one summarising positive motivations for teaching and three capturing impediments for teaching. The main factors influencing motivation to teach medical students were intrinsic issues such as altruism, intellectual satisfaction, personal skills and truth seeking. The reasons for not teaching included no strong involvement in course design, a heavy clinical load or feeling it was a waste of time. Conclusion This study provides some insights into factors that may be utilised in the design of teaching programs that meet teacher motivations and ultimately enhance the effectiveness of the medical teaching workforce. PMID:16022738

  7. What motivates senior clinicians to teach medical students?

    Directory of Open Access Journals (Sweden)

    Owen Cathy

    2005-07-01

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

  8. The clinician's dilemma: two dimensions of ethical care.

    Science.gov (United States)

    Gillett, Grant; Chamberlain, Joshua

    2013-01-01

    There is a continuing intense medico-ethico-legal debate around legalized euthanasia and physician assisted suicide such that ethically informed clinicians often agree with the arguments but feel hesitant about the conclusion, especially when it may bring about a change in law. We argue that this confusion results from the convergence of two continua that underpin the conduct of a clinician and are especially prominent in psychiatry. The two continua concern the duty of care and the importance of patient autonomy and they do not quite map into traditional divides in debates about sanctity of life, paternalism, and autonomy. As ethical dimensions, they come into sharp focus in the psychological complexities of end-of-life care and they form two key factors in most ethical and legal or disciplinary deliberations about a clinician's actions. Whereas both dimensions are important when a clinician reflects on what s/he has done or should do, they need careful balancing in a request for euthanasia or physician assisted suicide where the patient wants to take a decisive role in his or her own end-of-life care. However, end-of-life is also a situation where clinicians often encounter 'cries for help' so that both continua are importantly in play. Balancing these two continua without using blunt legal instruments is often required in psychiatric care in such a way as to problematize the idea that patient decisions should dominate the care options available. A simplistic approach to that issue arguably plays into what has been called an 'impoverished construction of life and death' and, some would say, devalues the basic commitments fundamental to medical care. PMID:23830641

  9. 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

  10. Efeito do índice de massa corpórea na gravidade da asma e na reatividade brônquica induzida pelo exercício em crianças asmáticas com sobrepeso e obesas Effect of body mass index on asthma severity and exercise-induced bronchial reactivity in overweight and obese asthmatic children

    Directory of Open Access Journals (Sweden)

    Joaquim Carlos Rodrigues

    2007-09-01

    Full Text Available OBJETIVO: Analisar a relação entre o grau de obesidade ou sobrepeso medido pelo índice de massa corpórea (IMC de crianças e adolescentes asmáticos com a gravidade clínica e funcional da doença e com a intensidade do broncoespasmo induzido pelo exercício (BIE. MÉTODOS: 20 pacientes com idade entre seis e 18 anos, asma persistente e sobrepeso ou obesidade foram submetidos ao teste padronizado com exercício em bicicleta ergométrica e avaliação seriada dos parâmetros espirométricos, realizada aos 3, 6, 10, 15, 20 e 30 minutos após o exercício. BIE foi definido como a queda do volume expiratório forçado no primeiro segundo (VEF1 >10% e/ou do fluxo médio expiratório forçado medido entre 25 e 75% da capacidade vital forçada (FEF25-75% >26% em relação aos valores pré-teste. Foram avaliadas as freqüências de positividade do teste e as maiores quedas de VEF1 e FEF25-75% após o término do exercício. RESULTADOS: A gravidade clínica da asma foi considerada leve, moderada e grave em dez, cinco e cinco pacientes, respectivamente. Houve BIE em 50% dos pacientes testados. Não houve correlação significativa entre os seguintes parâmetros confrontados: valores de IMC e valores basais do VEF1 e FEF25-75% percentuais em relação ao previsto; valores do IMC e as maiores quedas do VEF1 e do FEF25-75% em relação aos valores basais; valores do IMC e gravidade da asma. A melhor correlação ocorreu entre o IMC e as maiores quedas do FEF25-75% em relação ao basal. CONCLUSÕES: O IMC não teve influência no grau de hiperresponsividade brônquica induzida pelo exercício em crianças asmáticas com sobrepeso e obesas e na gravidade da obstrução basal medida pelo VEF1 e FEF25-75%.OBJECTIVE: To analyze the association between the degree of obesity or overweight measured by the body mass index (BMI in children and adolescents with asthma and the clinical and functional severity of the disease and the intensity of exercise

  11. 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.

  12. Analysis of the dynamic states of pulmonary ventilation and perfusion in bronchial asthmatics using 133Xe gas ventilation scintigraphy and 99mTc-MAA lung perfusion scintigraphy

    International Nuclear Information System (INIS)

    To clarify the organic changes and pathophysiology of the lungs in intractable asthmatics, the dynamic states of pulmonary ventilation and perfusion were analyzed in 15 bronchial asthmatics in the stable state using 133Xe gas ventilation scintigraphy and 99mTc-MAA lung perfusion scintigraphy, respectively. Dysfunction of pulmonary ventilation and impairment of pulmonary perfusion were significantly severer in intractable asthmatics than in non-intractable asthmatics (p<0.01, p<0.05, respectively) and those of asthma caused by aging. Late onset asthmatics with a long duration of disease tended to show severe impairment of pulmonary perfusion. Above all, the longer the duration of the disease, the severer became the impairment of pulmonary perfusion in late onset intractable asthmatics (LOIA). These findings suggest that the progression of irreversible organic changes of lungs in LOIA is involved in the severity of bronchial asthma. (author)

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

    Science.gov (United States)

    Amin, Muhammad Umar; Mahmood, Rabia

    2008-09-01

    Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity reaction due to a fungus, Aspergillus fumigatus. It is typically seen in patients with long-standing asthma. Our patient was a non-asthmatic 18 years old male who presented with chronic cough for 2 years. Peripheral blood eosinophilia and elevated scrum IgE were observed. His x-ray chest revealed v-shaped opacity in the left upper lobe close to the hilum. High resolution computed tomographic scan of the chest revealed multiple dilated bronchi filled with mucous (bronchoceles) and central bronchiectasis (CB) involving main segmental bronchi. Central bronchiectasis (CB) was typical of ABPA but bronchocele formation was a rare manifestation of the disease. The patient was managed with oral prednisolone and was relieved of his symptoms. Occurrence of ABPA in non-asthmatics is very rare and deserves reporting. PMID:18846804

  14. "Effect of Aerobic Exercise Training on Pulmonary Function and Tolerance of Activity in Asthmatic Patients "

    Directory of Open Access Journals (Sweden)

    "Reza Farid

    2005-09-01

    There were significant changes in FEV1, FVC, PEF, FEF25-75%, MVV, RF and 6MWT between asthmatic patients of the two groups (P≤0.05, but FEV1/FVC showed no significant change. Mean of changes in FEV1, FVC, PEF, FEF25-75%, MVV, RF and 6MWT were –25.56, -17.19, 32.09, -27.93, -22.18, 5.63 and –307.5 in case group respectively while they were 6.2, 4.67, 1.96, 6.65, 15.56,-2.87 and 18.78 in the control group. This study shows that aerobic exercises in asthmatic patients lead to an improvement in pulmonary functions. Aerobic exercise rehabilitation can be a complement to medical treatment of asthma.

  15. Inhaled corticosteroid effects both eosinophilic and non-eosinophilic inflammation in asthmatic patients.

    OpenAIRE

    2004-01-01

    AIM: To determine induced sputum cell counts and interleukin-8 (IL-8), tumor necrosis factor alpha (TNF-alpha) and leukotriene B4 (LTB4) levels as markers of neutrophilic inflammation in moderate persistent asthma, and to evaluate the response to inhaled steroid therapy. METHODS: Forty-five moderate asthmatic patients and 10 non-smoker controls were included in this study. All patients received inhaled corticosteroid (800 microg of budesonide) for 12 weeks. Before and after treatment pulmonar...

  16. Prostaglandin I2 enhances cough reflex sensitivity to capsaicin in the asthmatic airway

    OpenAIRE

    Ishiura, Yoshihisa; Fujimura, Masaki; Nobata, Kouichi; Oribe, Yoshitaka; Abo, Miki; Myou, Shigeharu

    2007-01-01

    Inflammatory mediators are involved in the pathogenesis of airway inflammation, but the role of prostaglandin I2 (PGI2) remains obscure. This study was designed to investigate the role of PGI2 in cough reflex sensitivity of the asthmatic airway, which is characterized by chronic eosinophilic airway inflammation. The effect of beraprost, a chemically and biologically stable analogue of PGI2, on cough response to inhaled capsaicin was examined in 21 patients with stable asthma in a randomized, ...

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

    Science.gov (United States)

    Sanak, Marek

    2016-11-01

    Lipid mediators contribute to inflammation providing both pro-inflammatory signals and terminating the inflammatory process by activation of macrophages. Among the most significant biologically lipid mediators, these are produced by free-radical or enzymatic oxygenation of arachidonic acid named "eicosanoids". There were some novel eicosanoids identified within the last decade, and many of them are measurable in clinical samples by affordable chromatography-mass spectrometry equipment or sensitive immunoassays. In this review, we present some recent advances in understanding of the signaling by eicosanoid mediators during asthmatic airway inflammation. Eicosanoid profiling in the exhaled breath condensate, induced sputum, or their metabolites measurements in urine is complementary to the cellular phenotyping of asthmatic inflammation. Special attention is paid to aspirin-exacerbated respiratory disease, a phenotype of asthma manifested by the most profound changes in the profile of eicosanoids produced. A hallmark of this type of asthma with hypersensitivity to non-steroid anti-inflammatory drugs (NSAIDs) is to increase biosynthesis of cysteinyl leukotrienes on the systemic level. It depends on transcellular biosynthesis of leukotriene C₄ by platelets that adhere to granulocytes releasing leukotriene A₄. However, other abnormalities are also reported in this type of asthma as a resistance to anti-inflammatory activity of prostaglandin E₂ or a robust eosinophil interferon-γ response resulting in cysteinyl leukotrienes production. A novel mechanism is also discussed in which an isoprostane structurally related to prostaglandin E₂ is released into exhaled breath condensate during a provoked asthmatic attack. However, it is concluded that any single eicosanoid or even their complex profile can hardly provide a thorough explanation for the mechanism of asthmatic inflammation. PMID:27582398

  18. Montelukast as a Successful Treatment for Eosinophilic Cystitis in an Asthmatic Woman Patient

    OpenAIRE

    Yu, Shicheng; ZHANG, ZHIGEN; Li, Gonghui

    2013-01-01

    Eosinophilic cystitis (EC) is a rare inflammatory disorder. We herein report a case of EC in an asthmatic female patient who had a recent exacerbation with none known allergen. She was administered montelukast sodium orally for four weeks and received complete remission. This medication was successfully discontinued after a three-month follow up period. This case report about successful treatment of an adult EC patient using montelukast sodium may provide a new option for EC patients with all...

  19. Formulation and evaluation of anti-asthmatic drug montelukast in mucoadhesive buccal patches

    OpenAIRE

    Magdy Ibrahim Mohamed; , Enas Abd El-Moneim Mohamed Radwan Afify; Mary Kamal Gad Mekhael

    2014-01-01

    Objective: To formulate and evaluate anti-asthmatic drug montelukast in mucoadhesive buccal patches. Methods: Buccal patches were formulated by using different hydrophilic polymers by solvent casting technique. Buccal patches were evaluated by seven physical appearances, in addition to in vitro drug release study. Results: All patches were uniform and translucent, and had smooth surface. In vitro release studies were conducted for montelukast buccal patches proved that...

  20. Inhibition of methoxamine-induced bronchoconstriction by ipratropium bromide and disodium cromoglycate in asthmatic subjects.

    OpenAIRE

    Black, J.; Vincenc, K; Salome, C.

    1985-01-01

    We compared the effects of pretreatment with saline, ipratropium bromide, and disodium cromoglycate (DSCG) on bronchoconstriction induced by methoxamine--an alpha-adrenoceptor agonist, in asthmatic subjects. All 12 patients bronchoconstricted in response to methoxamine after saline. The PD20 (the dose of methoxamine causing a 20% fall in forced expiratory volume in 1 s [FEV1]) ranged from 0.3-18 mumol. Ipratropium bromide (200 micrograms administered by aerosol) significantly inhibited (P les...

  1. Effects of the inhaled treatment of liriope radix on an asthmatic mouse model.

    Science.gov (United States)

    Kim, Ki-Suk; Cho, Dong-Hyuk; Yang, Hea Jung; Choi, Eun-Kyeong; Shin, Min Hee; Kim, Kang-Hoon; Ahn, Kwang Seok; Ha, In Jin; Na, Yun-Cheol; Um, Jae Young; Chung, Won Seok; Jung, Hee-Jae; Jung, Sung-Ki; Jang, Hyeung-Jin

    2015-01-01

    As a treatment for allergic asthma, inhaled treatments such as bronchodilators that contain β2-agonists have an immediate effect, which attenuates airway obstructions and decreases airway hypersensitivity. However, bronchodilators only perform on a one off basis, but not consistently. Asthma is defined as a chronic inflammatory disease of the airways accompanying the overproduction of mucus, airway wall remodeling, bronchial hyperreactivity and airway obstruction. Liriope platyphylla radix extract (LPP), a traditional Korean medicine, has been thoroughly studied and found to be an effective anti-inflammatory medicine. Here, we demonstrate that an inhaled treatment of LPP can attenuate airway hyperresponsiveness (AHR) in an ovalbumin-induced asthmatic mouse model, compared to the saline-treated group (p < 0.01). Moreover, LPP decreases inflammatory cytokine levels, such as eotaxin (p < 0.05), IL-5 (p < 0.05), IL-13 (p < 0.001), RANTES (p < 0.01), and TNF-α (p < 0.05) in the bronchoalveolar lavage (BAL) fluid of asthmatic mice. A histopathological study was carried out to determine the effects of LPP inhalation on mice lung tissue. We performed UPLC/ESI-QTOF-MS, LC/MS, and GC/MS analyses to analyze the chemical constituents of LPP, finding that these are ophiopogonin D, spicatoside A, spicatoside B, benzyl alcohol, and 5-hydroxymethylfurfural. This study demonstrates the effect of an inhaled LPP treatment both on airway AHR and on the inflammatory response in an asthmatic mouse model. Hence, LPP holds significant promise as a nasal inhalant for the treatment of asthmatic airway disease. PMID:25967662

  2. Superoxide Dismutase Inactivation in Pathophysiology of Asthmatic Airway Remodeling and Reactivity

    OpenAIRE

    Comhair, Suzy A.A.; Xu, Weiling; Ghosh, Sudakshina; Thunnissen, Frederik B. J. M.; Almasan, Alexandru; Calhoun, William J.; Janocha, Allison J.; Zheng, Lemin; Hazen, Stanley L.; Erzurum, Serpil C.

    2005-01-01

    Airway hyperresponsiveness and remodeling are defining features of asthma. We hypothesized that impaired superoxide dismutase (SOD) antioxidant defense is a primary event in the pathophysiology of hyperresponsiveness and remodeling that induces apoptosis and shedding of airway epithelial cells. Mechanisms leading to apoptosis were studied in vivo and in vitro. Asthmatic lungs had increased apoptotic epithelial cells compared to controls as determined by terminal dUTP nick-end labeling-positiv...

  3. Reported Respiratory Symptom Intensity in Asthmatics During Exposure to Aerosolized Florida Red Tide Toxins

    OpenAIRE

    Milian, Alexyz; Nierenberg, Kate; Fleming, Lora E.; Bean, Judy A.; Wanner, Adam; Reich, Andrew; Backer, Lorraine C.; Jayroe, David; Kirkpatrick, Barbara

    2007-01-01

    Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation. Symptoms of brevetoxin inhalation include: eye, nose, and throat irritation, coughing, wheezing, chest tightness, and shortness of breath. Asthmatics appear t...

  4. Effect of Different Positions on FVC and FEV1 Measurements of Asthmatic Patients

    OpenAIRE

    Melam, Ganeswara Rao; Buragadda, Syamala; Alhusaini, Adel; Alghamdi, Mohammed Abdulrahman; Alghamdi, Mansour Saleh; Kaushal, Parmveer

    2014-01-01

    [Purpose] The purpose of our study was to investigate the effect of different positions on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) of asthmatic patients .[Subjects and Methods] Thirty subjects with severe asthma aged between 20–39 years were enrolled after they had signed a written consent. Subjects were selected using the inclusion criteria, and PFT were randomly administered. Spirometer measurements (FVC, FEV...

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

    Directory of Open Access Journals (Sweden)

    Juliana Veiga

    2009-01-01

    Full Text Available INTRODUCTION: The within-breath analysis of respiratory mechanics by the monofrequency Forced Oscillation Technique (mFOT is of great interest in both physiopathology studies and the diagnosis of respiratory diseases. However, there are limited data on the use of this technique in the analysis of asthma. This study evaluates within-breath mechanics of asthmatic individuals and the contribution of the mFOT in the asthma diagnosis. METHODS: Twenty-two healthy and twenty-two asthmatic subjects, including patients with mild (n=8, moderate (n=8, and severe (n=6 obstruction, were studied. Forced Oscillation Technique data were interpreted using the mean respiratory impedance (Zt, the impedance during inspiration (Zi, expiration (Ze, at the beginning of inspiration (Zii, and at expiration (Zie. The peakto-peak impedance (Zpp was also calculated by the subtraction of Zii from Zie. Receiver operating characteristic curves were used to determine the sensitivity (Se and specificity (Sp of m Forced Oscillation Technique parameters in identifying asthma. RESULTS: Respiratory impedance values were significantly higher in asthmatics: Zt (p<0.001, Zi (p<0.001, Ze (p<0.001, Zii (p<0.001, Zie (p<0.001, and Zpp (p<0.003. The best parameters for detecting asthma were Zi, Zii, and Zie (Se=90.9%, Sp=90.9%, followed by Zt and Ze. These results are in close agreement with recently published theories and pathophysiological fundamentals. CONCLUSIONS: mFOT permits a non-invasive and detailed analysis in different phases of the respiratory cycle, providing parameters that are adequate for the diagnosis of asthma with high accuracy. These results confirm the high clinical and scientific potential of this methodology in the evaluation of asthmatic patients.

  6. Use of complementary and alternative medicine among asthmatic patients in primary care clinics in Malaysia

    OpenAIRE

    Alshagga Mustafa; Al-Dubai Sami; Muhamad Faiq Siti; Yusuf Ahmad

    2011-01-01

    Objectives: This study aimed to determine the knowledge about asthma and the prevalence, disclosure and evaluation of the use of complementary and alternative medicine (CAM) among asthmatic patients. Methods: This cross-sectional study was conducted on 95 patients diagnosed with asthma in a primary healthcare centre in Kuala Lumpur, Malaysia using a self-administered questionnaire. Results: Ninety-five patients with a mean age of 47.06 years (±12.8) participated, the majority were fem...

  7. 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)

  8. Soft Stethoscope for Detecting Asthma Wheeze in Young Children

    Directory of Open Access Journals (Sweden)

    Chun Yu

    2013-06-01

    Full Text Available Asthma is a chronic disease that is commonly suffered by children. Asthmatic children have a lower quality of life than other children. Physicians and pediatricians recommend that parents record the frequency of attacks and their symptoms to help manage their children’s asthma. However, the lack of a convenient device for monitoring the asthmatic condition leads to the difficulties in managing it, especially when it is suffered by young children. This work develops a wheeze detection system for use at home. A small and soft stethoscope was used to collect the respiratory sound. The wheeze detection algorithm was the Adaptive Respiratory Spectrum Correlation Coefficient (RSACC algorithm, which has the advantages of high sensitivity/specificity and a low computational requirement. Fifty-nine sound files from eight young children (one to seven years old were collected in the emergency room and analyzed. The results revealed that the system provided 88% sensitivity and 94% specificity in wheeze detection. In conclusion, this small soft stethoscope can be easily used on young children. A noisy environment does not affect the effectiveness of the system in detecting wheeze. Hence, the system can be used at home by parents who wish to evaluate and manage the asthmatic condition of their children.

  9. 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

  10. Reported respiratory symptom intensity in asthmatics during exposure to aerosolized Florida red tide toxins.

    Science.gov (United States)

    Milian, Alexyz; Nierenberg, Kate; Fleming, Lora E; Bean, Judy A; Wanner, Adam; Reich, Andrew; Backer, Lorraine C; Jayroe, David; Kirkpatrick, Barbara

    2007-09-01

    Florida red tides are naturally occurring blooms of the marine dinoflagellate, Karenia brevis. K. brevis produces natural toxins called brevetoxins. Brevetoxins become part of the marine aerosol as the fragile, unarmored cells are broken up by wave action. Inhalation of the aerosolized toxin results in upper and lower airway irritation. Symptoms of brevetoxin inhalation include: eye, nose, and throat irritation, coughing, wheezing, chest tightness, and shortness of breath. Asthmatics appear to be more sensitive to the effects of inhaled brevetoxin. This study examined data from 97 asthmatics exposed at the beach for 1 hour during K. brevis blooms, and on separate occasions when no bloom was present. In conjunction with extensive environmental monitoring, participants were evaluated utilizing questionnaires and pulmonary function testing before and after a 1-hour beach walk. A modified Likert scale was incorporated into the questionnaire to create respiratory symptom intensity scores for each individual pre- and post-beach walk. Exposure to Florida red tide significantly increased the reported intensity of respiratory symptoms; no significant changes were seen during an unexposed period. This is the first study to examine the intensity of reported respiratory symptoms in asthmatics after a 1-hour exposure to Florida red tide. PMID:17885863

  11. Dynamics of eosinophil infiltration in the bronchial mucosa before and after the late asthmatic reaction.

    Science.gov (United States)

    Aalbers, R; de Monchy, J G; Kauffman, H F; Smith, M; Hoekstra, Y; Vrugt, B; Timens, W

    1993-06-01

    We wanted to determine whether changes in bronchial hyperresponsiveness (BHR) following allergen challenge show a time relationship with inflammatory events in the airways of allergic asthmatic subjects. Lavage was performed and endobronchial biopsies were taken via the fiberoptic bronchoscope, before, and 3 and 24 h after, allergen challenge, on separate occasions, in nine dual asthmatic responders. The numbers of activated eosinophils, identified by immunohistochemistry, using the monoclonal anti-eosinophil cationic protein antibody, EG2, were significantly increased both at 3 h and at 24 h in the submucosa and bronchial lavage. A significant negative correlation was found between the number of EG2+ cells in the submucosa and in the bronchial lavage 24 h after the allergen challenge (r = -0.70). At 24 h, the amount of eosinophil cationic protein (ECP) was increased in the bronchial lavage. A significant correlation was observed between the amount of ECP at 3 h and the log provocative dose of house dust mite producing a 20% fall in forced expiratory volume in one second (PD20 HDM) (r = -0.63). The results suggest a recruitment of activated eosinophils to the submucosa and, further, to the epithelial lining, followed by degranulation. This process has already started 3 h after allergen challenge, and lasts for at least 24 h, which may result in mucosal damage and subsequent allergen-induced increase in BHR, before and after the late asthmatic reaction. PMID:8339804

  12. Fetal Alcohol Spectrum Disorders and Challenges Faced by Caregivers: Clinicians' Perspectives.

    Science.gov (United States)

    Baskin, Jonathan; Delja, Jolie R; Mogil, Catherine; Gorospe, Clarissa M; Paley, Blair

    2016-01-01

    BackgroundThere is a notable absence of evidence based early interventions for young children with FASD.  ObjectiveThis study examines clinicians' perspectives regarding the needs of caregivers of children with FASD and how such perspectives informed the development of a family-centered early intervention for young children with prenatal alcohol exposure.  Method19 professionals who work with children with prenatal alcohol exposure and / or in out-of-home care were recruited to participate in focus groups. The facilitator used a semi-structured topic guide to elicit feedback from participants. These data were transcribed, coded, and categorized to reflect themes in a manner informed by a grounded theory approach. A second investigator repeated the process. Codes were chosen and assigned to data by consensus.   ResultsThe coded data yielded five distinct perceived challenges faced by caregivers: (1) seeking and possibly receiving a diagnosis; (2) processing emotions and coming to terms with the child's difficulties; (3) seeking support and belonging within a knowledgeable community; (4) developing a new understanding of the child's behavior; and (5) becoming an educator, advocate, and expert on the child and FASD.   ConclusionProfessionals believe specific capacities are essential insofar as the human service systems that caregivers engage are perceived to be under-equipped to respond to the distinct set of challenges faced by children with FASD and their families. Findings are discussed in terms of how the proposed intervention was designed to address such challenges and to cultivate those key capacities in order for families to meet their children's needs. PMID:27462878

  13. A qualitative analysis of EHR clinical document synthesis by clinicians.

    Science.gov (United States)

    Farri, Oladimeji; Pieckiewicz, David S; Rahman, Ahmed S; Adam, Terrence J; Pakhomov, Serguei V; Melton, Genevieve B

    2012-01-01

    Clinicians utilize electronic health record (EHR) systems during time-constrained patient encounters where large amounts of clinical text must be synthesized at the point of care. Qualitative methods may be an effective approach for uncovering cognitive processes associated with the synthesis of clinical documents within EHR systems. We utilized a think-aloud protocol and content analysis with the goal of understanding cognitive processes and barriers involved as medical interns synthesized patient clinical documents in an EHR system to accomplish routine clinical tasks. Overall, interns established correlations of significance and meaning between problem, symptom and treatment concepts to inform hypotheses generation and clinical decision-making. Barriers identified with synthesizing EHR documents include difficulty searching for patient data, poor readability, redundancy, and unfamiliar specialized terms. Our study can inform recommendations for future designs of EHR clinical document user interfaces to aid clinicians in providing improved patient care. PMID:23304398

  14. Conflict of Interest in Research--The Clinician Scientist's Perspective.

    Science.gov (United States)

    Kong, Nicole H Y; Chow, Pierce K H

    2013-11-01

    Conflict of interest (COI) in research represents situations that pose risks of undue influence on scientific objectivity and judgment because of secondary interests. This is complex but is inherent to biomedical research. The role of a clinician scientist can be conflicted when scientific objectivity is perceived to compete with scientific success (publications, grants), partiality to patients (clinical trials), obligations to colleagues (allowing poor scholarship to pass), research sponsors (industry), and financial gains (patents, royalties). While there are many ways which COIs can occur in research, COI mitigations remain reliable. Collaborations between investigators and industry are valuable to the development of novel therapies and undue discouragement of these relationships may inadvertently harm the advancement of healthcare. As a result, proper management of COI is fundamental and crucial to the maintenance of long-term, mutually beneficial relationships between industry and academia. The nature of COI in research and methods of mitigation are discussed from the perspective of a clinician scientist. PMID:24356664

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

    Directory of Open Access Journals (Sweden)

    Linda L. Restifo

    2011-07-01

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

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

    Science.gov (United States)

    Restifo, Linda L; Phelan, Gerald R

    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. PMID:21708897

  17. Middle East respiratory syndrome coronavirus: update for clinicians.

    Science.gov (United States)

    Rasmussen, Sonja A; Gerber, Susan I; Swerdlow, David L

    2015-06-01

    Although much recent focus has been on the recognition of Ebola virus disease among travelers from West Africa, cases of Middle East respiratory syndrome coronavirus (MERS-CoV), including travel-associated cases, continue to be reported. US clinicians need to be familiar with recommendations regarding when to suspect MERS-CoV, how to make a diagnosis, and what infection control measures need to be instituted when a case is suspected. Infection control is especially critical, given that most cases have been healthcare-associated. Two cases of MERS-CoV were identified in the United States in May 2014; because these cases were detected promptly and appropriate control measures were put in place quickly, no secondary cases occurred. This paper summarizes information that US clinicians need to know to prevent secondary cases of MERS-CoV from occurring in the United States. PMID:25701855

  18. Bioethics for clinicians: 5. Substitute decision-making.

    OpenAIRE

    Lazar, N M; Greiner, G G; Robertson, G; Singer, P A

    1996-01-01

    Substitute decision-making is a means of making health care decisions on behalf of people who are incapable of making these decisions for themselves. It is based on the ethical principle of respect for autonomy. Substitute decision-making poses two main questions: Who-should make the decision for the incapable person, and, How should the decision be made? Because the applicable statutory and common law varies across Canada, clinicians should become familiar with the legal requirements of thei...

  19. Clinician experiences assessing work disability related to mental disorders

    OpenAIRE

    Dewa, Carolyn S; Hiske Hees; Lucy Trojanowski; Schene, Aart H

    2015-01-01

    OBJECTIVE: Medical certification is one of the basic administrative mechanisms used by social policies aimed at income protection. The assessment of work disability is central to the income protection application. Yet, there is evidence suggesting that determining work disability related to mental disorders is challenging. Although essential to the disability application process, few studies have looked at physician and other clinician experiences with the process. However, this type of infor...

  20. Cardiovascular magnetic resonance physics for clinicians: part II

    OpenAIRE

    Biglands John D; Radjenovic Aleksandra; Ridgway John P

    2012-01-01

    Abstract This is the second of two reviews that is intended to cover the essential aspects of cardiovascular magnetic resonance (CMR) physics in a way that is understandable and relevant to clinicians using CMR in their daily practice. Starting with the basic pulse sequences and contrast mechanisms described in part I, it briefly discusses further approaches to accelerate image acquisition. It then continues by showing in detail how the contrast behaviour of black blood fast spin echo and bri...

  1. Clinician-Educators as Dual Professionals: A Contemporary Reappraisal.

    Science.gov (United States)

    Stoddard, Hugh A; Brownfield, Erica D

    2016-07-01

    Physicians who teach face unique responsibilities and expectations because they must educate learners while simultaneously caring for patients. Recently this has become even more difficult as the environment for clinician-educators has been undermined by public antipathy toward both the education profession and the medicine profession.Erosion of public confidence in both professions is evidenced by three trends. First, the democratizing nature of the Internet and the availability of technical knowledge to laypeople have encroached on the domain of professional knowledge. Second, the responsibility of a professional to make decisions has been undercut by legal interpretations regarding how physicians are paid for patient care and how teachers are evaluated on performance. And finally, altruistic motivations in both professions have been called into question by external forces promoting "accountability" rather than trusting professionals to act for the best interest of their patients or students.In this climate of increasing accountability and decreasing trust for professionals, clinician-educators can best serve patients and learners through transdisciplinary collaboration with professional educators. Clinician-educators should rely on professional educators for judgment and specialized knowledge in the field of education rather than embodying both professions by themselves. Health care practice has become more team oriented; health care education should do likewise to counteract the social and political trends eroding public confidence in medicine and education. Relying on collaboration with education professionals constitutes a substantial change to how clinician-educators define themselves, but it holds the best promise for medical training in the current social milieu. PMID:27119327

  2. Self-neglect in Older Adults: a Primer for Clinicians

    OpenAIRE

    Pavlou, Maria P.; Lachs, Mark S.

    2008-01-01

    Self-neglect in older adults is an increasingly prevalent, poorly understood problem, crossing both the medical and social arenas, with public health implications. Although lacking a standardized definition, self-neglect is characterized by profound inattention to health and hygiene. In light of the aging demographic, physicians of all specialties will increasingly encounter self-neglectors. We outline here practical strategies for the clinician, and suggestions for the researcher. Clinical e...

  3. Emergency contraception review: evidence-based recommendations for clinicians

    OpenAIRE

    Cleland, Kelly; Raymond, Elizabeth G.; Westley, Elizabeth; Trussell, James

    2014-01-01

    Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile and availability. The most effective emergency contraceptive is the copper IUD, followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, while ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Althoug...

  4. Biosimilar insulins: guidance for data interpretation by clinicians and users

    OpenAIRE

    Heinemann, L.; Home, P D; Hompesch, M.

    2015-01-01

    Biosimilar insulins are approved copies of insulins outside patent protection. Advantages may include greater market competition and potential cost reduction, but clinicians and users lack a clear perspective on ‘biosimilarity’ for insulins. The manufacturing processes for biosimilar insulins are manufacturer‐specific and, although these are reviewed by regulators there are few public data available to allow independent assessment or review of issues such as intrinsic quality or batch‐to‐batc...

  5. Oral health in children with asthma

    Directory of Open Access Journals (Sweden)

    Marković Dejan

    2015-01-01

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

  6. Clinician's Attitudes to the Introduction of Routine Weighing in Pregnancy

    Science.gov (United States)

    Beckmann, Michael M.; Wilkinson, Shelley A.

    2016-01-01

    Background. Excessive gestational weight gain poses significant short- and long-term health risks to both mother and baby. Professional bodies and health services increasingly recommend greater attention be paid to weight gain in pregnancy. A large Australian tertiary maternity hospital plans to facilitate the (re)introduction of routine weighing of all women at every antenatal visit. Objective. To identify clinicians' perspectives of barriers and enablers to routinely weighing pregnant women and variations in current practice, knowledge, and attitudes between different staff groups. Method. Forty-four maternity staff from three professional groups were interviewed in four focus groups. Staff included midwives; medical staff; and dietitians. Transcripts underwent qualitative content analysis to identify and examine barriers and enablers to the routine weighing of women throughout pregnancy. Results. While most staff supported routine weighing, various concerns were raised. Issues included access to resources and staff; the ability to provide appropriate counselling and evidence-based interventions; and the impact of weighing on patients and the therapeutic relationship. Conclusion. Many clinicians supported the practice of routine weighing in pregnancy, but barriers were also identified. Implementation strategies will be tailored to the discrete professional groups and will address identified gaps in knowledge, resources, and clinician skills and confidence. PMID:27446614

  7. iAIDS: HIV-related internet resources for the practicing clinician.

    Science.gov (United States)

    Krakower, Douglas; Kwan, Candice K; Yassa, David S; Colvin, Richard A

    2010-10-01

    In this review, we collate 25 clinically useful human immunodeficiency virus (HIV)-related Web sites to facilitate efficient access to online resources according to themes of clinical inquiry: (1) comprehensive clinical information, (2) opportunistic infections, (3) antiretroviral drug interactions, (4) care of HIV-infected women and children, and (5) continuing medical education. We evaluated these Web sites for clinical content and quality using criteria including the currency of information, inclusion of references, sponsors, whether the site is useful in resource-limited settings, ease of navigation, and content specific for each theme. Using the specified criteria, we provided overall ratings for each Web site. We conclude that the Web sites listed in this review can help extend knowledge about best practices and provide real-time patient care support to clinicians. PMID:20738185

  8. Special considerations for adolescent athletic and asthmatic patients

    Directory of Open Access Journals (Sweden)

    Wuestenfeld JC

    2013-01-01

    Full Text Available Jan C Wuestenfeld,1,2 Bernd Wolfarth1,21Department of Preventive and Rehabilitative Sports Medicine, Technical University Munich (TUM, Munich, Germany; 2Institute for Applied Training Science (IAT, Leipzig, GermanyAbstract: Asthma is defined as a chronic inflammatory disorder of the airways with bronchial hyperresponsiveness and variable bronchoconstriction, and is one of the most common diseases in childhood and adolescence. Exercise-induced asthma-like symptoms and asthma are also frequently seen in highly trained athletes. Exercise-induced asthma (EIA and exercise-induced bronchoconstriction (EIB are found in 8%–10% of healthy school-aged children and in 35% of children with asthma. Highly increased ventilation, inhalation of cold, dry air and air pollutants (eg, chlorine are thought to be important triggers for EIA and EIB. EIA is often experienced concurrently with vocal cord dysfunction, which needs to be considered during the differential diagnosis. The pharmacological treatment of EIA is similar to the treatment of asthma in nonexercising adolescents. The therapy is based on anti-inflammatory drugs (eg, inhaled glucocorticosteroids and bronchodilators (eg, β2-agonists. The treatment of EIB is comparable to the treatment of EIA and leukotriene modifiers offer a new and promising treatment option, particularly in EIB. Generally, athletes may not use β2-agonists according to the prohibited list of the World Anti-Doping Agency (WADA. However, the WADA list contains specific β2-agonistic substances that are permitted to be used by inhalation.Keywords: exercise-induced asthma, exercise-induced bronchospasm, adolescents, asthma, athletes

  9. Determine Efficacy of a Short Course of Montelukast in Children with Intermittent Asthma and Viral Infection

    OpenAIRE

    Hamid Ahanchian; Fatemeh Behmanesh; Hamid Reza Kianifar; Nasrin Sadat Motevalli; Seyed Ali Jafari

    2013-01-01

    Introduction Mild intermittent asthma is common in children and viral infections are responsible for the majority of exacerbations. As leukotrienes are potent inflammatory mediators, some studies have shown that Montelukast, a leukotriene receptor antagonist, may be effective on reduction of asthma symptom. To determine whether a short course of Montelukast in asthmatic children with common cold would modify the severity of an asthma episode.     Materials and Methods Children, aged 6-12 year...

  10. Oral health in pre-school children with asthma - followed from 3 to 6 years

    OpenAIRE

    Stensson, Malin; Wendt, Lill-Kari; Koch, Göran; Oldaeus, Göran; Nilsson, Mats; Birkhed, Dowen

    2010-01-01

    OBJECTIVE: The aim of this study was to investigate caries and its determinants in preschool children with and without asthma, followed from 3 to 6 years. METHODS AND SUBJECTS: Caries, plaque, and gingivitis were examined at 3 and 6 years of age in 64 asthmatic children and 50 matched, healthy control children. Furthermore, at 6 years radiographic examination and saliva sampling were conducted. The parents were interviewed about various oral health-related factors. RESULTS: Initial caries inc...

  11. The Translation Evidence Mechanism. The Compact between Researcher and Clinician.

    Science.gov (United States)

    Bauer, Janet G; Chiappelli, Francesco

    2010-01-01

    Currently, best evidence is a concentrated effort by researchers. Researchers produce information and expect that clinicians will implement their advances in improving patient care. However, difficulties exist in maximizing cooperation and coordination between the producers, facilitators, and users (patients) of best evidence outcomes. The Translational Evidence Mechanism is introduced to overcome these difficulties by forming a compact between researcher, clinician and patient. With this compact, best evidence may become an integral part of private practice when uncertainties arise in patient health status, treatments, and therapies. The mechanism is composed of an organization, central database, and decision algorithm. Communication between the translational evidence organization, clinicians and patients is through the electronic chart. Through the chart, clinical inquiries are made, patient data from provider assessments and practice cost schedules are collected and encrypted (HIPAA standards), then inputted into the central database. Outputs are made within a timeframe suitable to private practice and patient flow. The output consists of a clinical practice guideline that responds to the clinical inquiry with decision, utility and cost data (based on the "average patient") for shared decision-making within informed consent. This shared decision-making allows for patients to "game" treatment scenarios using personal choice inputs. Accompanying the clinical practice guideline is a decision analysis that explains the optimized clinical decision. The resultant clinical decision is returned to the central database using the clinical practice guideline. The result is subsequently used to update current best evidence, indicate the need for new evidence, and analyze the changes made in best evidence implementation. When updates in knowledge occur, these are transmitted to the provider as alerts or flags through patient charts and other communication modalities. PMID

  12. 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...

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

    OpenAIRE

    Hamzaoui A; Maalmi H; Berraïes A; Abid H; Ammar J; Hamzaoui K

    2011-01-01

    Agnes Hamzaoui1,2,*, Haïfa Maalmi1,*, Anissa Berraïes1,2, Hanadi Abid1,2, Jamel Ammar1,2, Kamel Hamzaoui11Department of Pediatrics and Respiratory Disease, Homeostasis and Cell Dysfunction Unit Research, Abderrahman Mami Hospital, Ariana, Tunisia; 2Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia *These authors contributed to this work equallyBackground: Asthma is a chronic inflammatory disorder, hypothetically caused by autoreactive Th2 cells, whereas...

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

    OpenAIRE

    Reza Amin; Soheila Aleyasin; Mozhgan Moghtaderi; Sara Kashef

    2010-01-01

    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 mold...

  15. 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

    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 the...

  16. Factors affecting the frequency of micronuclei in asthmatic and healthy children from Ostrava

    Czech Academy of Sciences Publication Activity Database

    Rössnerová, Andrea; Špátová, Milada; Rössner ml., Pavel; Nováková, Zuzana; Solanský, I.; Šrám, Radim

    2011-01-01

    Roč. 708, č. 12 (2011), s. 44-49. ISSN 0027-5107 R&D Projects: GA MŽP(CZ) SP/1B3/8/08 Institutional research plan: CEZ:AV0Z50390512 Keywords : air pollution * asthma * automated image analysis Subject RIV: DN - Health Impact of the Environment Quality Impact factor: 2.850, year: 2011

  17. 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.

  18. End points in dermatologic clinical trials: A review for clinicians.

    Science.gov (United States)

    Wei, Erin X; Kirsner, Robert S; Eaglstein, William H

    2016-07-01

    Clinical trials are critical for the development of new therapies in dermatology, and their results help determine US Food and Drug Administration (FDA) approval and guide care. Of special relevance is the clinical trial efficacy end point, the metric from which statistically significant outcome is derived. Clinicians' understanding of a clinical trial's end point is necessary for critical analysis of the trial results and for applying those results to daily practice. This review provides practical knowledge and critical evaluation of end points used in treatment approvals by the FDA. The end points for actinic keratosis, acne vulgaris, atopic dermatitis, onychomycosis, and cutaneous ulcer serve as examples. PMID:26936300

  19. 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.

  20. Casemix perspectives for clinicians in the private sector.

    Science.gov (United States)

    Maxwell, C N

    1998-10-19

    All private hospitals and clinics must now supply deidentified data, using AN-DRG classification, on all admitted patients to the Private Hospitals Data Bureau. Contracts between health funds and hospitals must also be described on the basis of AN-DRGs, which will enable funds to undertake hospital variance analysis. These data provide the foundation for nationally developed clinical pathways and utilisation reviews which could modify clinical practice, improve standards and reduce health costs. Clinicians must understand and participate in these changes, and adequate safeguards are needed to protect them against loss of their clinical integrity, and against inappropriate discretionary control by private hospitals, healthcare corporations and health insurers. PMID:9830414

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

    Directory of Open Access Journals (Sweden)

    Wegienka Ganesa

    2012-07-01

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

  2. Attention deficit hyperactivity disorder (ADHD): review for primary care clinicians

    OpenAIRE

    Ougrin, Dennis; Chatterton, Sandie; Banarsee, Ricky

    2010-01-01

    Attention deficit hyperactivity disorder (ADHD) is characterised by impulsivity, hyperactivity and inattention. Up to 5% of primary school age children have ADHD. Both genes and environment play a role in the aetiology of ADHD. If left untreated, children with ADHD demonstrate a range of poor long-term psychosocial outcomes. The Strengths and Difficulties Questionnaire (SDQ) may be used to screen children for a range of psychiatric disorders, including ADHD.1

  3. Morning-evening changes in airway responsiveness to methacholine in normal and asthmatic subjects: analysis using partial flow-volume curves.

    OpenAIRE

    Heaton, R W; Gillett, M K; Snashall, P. D.

    1988-01-01

    In eight normal and eight asthmatic subjects airway responsiveness to methacholine was measured by means of partial flow-volume loops at 0800 and 1800 hours on the same day. Airway responsiveness was lower in the evening in both normal and asthmatic subjects.

  4. Exhaled nitric oxide predicts airway hyper-responsiveness to hypertonic saline in children that wheeze

    NARCIS (Netherlands)

    de Meer, G; van Amsterdam, JGC; Janssen, NAH; Meijer, E; Brunekreef, B; STEERENBERG, PA

    2005-01-01

    Background: Exhaled nitric oxide (eNO) has shown good validity for the assessment of airway inflammation in asthmatic children. In large-scale epidemiological studies, this method would be preferred above airway challenge tests, because it is a quick and easy applicable tool. Objective: In this stud

  5. YKL-40 and genetic status of CHI3L1 in a large group of asthmatics

    DEFF Research Database (Denmark)

    Hansen, Jakob W; Thomsen, Simon F; Porsbjerg, Celeste;

    2015-01-01

    SNP (-131 C/G, rs4950928). METHODS: In this study, 1,137 patients with asthma, 415 with rhinitis only, and 275 non-asthmatic controls were included. Assessment included a clinical interview concerning the diagnosis of asthma, severity of asthma, and asthma treatment as well as clinical tests to assess...... asthma and rhinitis. Serum YKL-40 was measured, and genotyping for the SNP (-131 C/G) was conducted. RESULTS: No significant difference in the serum concentration of YKL-40 was found between patients with asthma, patients with rhinitis, and non-asthmatic controls; however, YKL-40 was increased in.......0001). CONCLUSION: There was no association between polymorphisms of SNP (-131 C/G) and asthma. The highest serum YKL-40 concentrations were seen in severe asthmatics. Individuals with less severe asthma showed a smaller difference against controls, limiting its clinical usefulness. More research is needed to...

  6. Deposition of inhaled particles in the mouth and throat of asthmatic subjects

    International Nuclear Information System (INIS)

    We previously studied the deposition of inhaled particles in the mouth and throat of asthmatic patients, and found large, reproducible differences among subjects. In the present study, we examined whether anatomical and/or functional differences in the pharynx and larynx could underlie this interindividual variation. Deposition in the mouth and throat, and in the lung was estimated in 16 asthmatic subjects after inhalation of 3.6 μm (aerodynamic diameter) monodisperse Teflon particles labelled with 111In. The particles were inhaled at a flow rate of 0.5 l.s- with maximally deep breaths. Radioactivity was measured by external scanning over head and neck, lungs and stomach, immediately after the inhalation. Radioactivity in the lungs was also measured 24 h later. A measure of the total amount of particles deposited in the mouth and throat was obtained from the added activities in mouthwash, head and neck, and stomach, immediately after the inhalation of the test particles. Pharynx and larynx function was examined by fibreoptic laryngoscopy performed during a corresponding inhalation procedure. Deposition in the mouth and throat varied widely among the subjects, ranging 9-76% (median 12%). We found two subpopulations, 13 subjects in the range 9-34%, and 3 subjects with >70% deposition. Deviations in pharyngeal configuration during inhalation were significantly related to high mouth and throat deposition, whereas functional difference in the larynx were not. Our study shows that mouth and throat deposition may be extremely high in some asthmatics, and that pharyngeal configuration affects deposition of particles in the mouth and throat. (au) (11 refs.)

  7. 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.

  8. The Canadian clinician-scientist training program must be reinstated.

    Science.gov (United States)

    Twa, David D W; Squair, Jordan W; Skinnider, Michael A; Ji, Jennifer X

    2015-12-01

    Clinical investigators within the Canadian and international communities were shocked when the Canadian Institutes of Health Research (CIHR) announced that their funding for the MD/PhD program would be terminated after the 2015-2016 academic year. The program has trained Canadian clinician-scientists for more than two decades. The cancellation of the program is at odds with the CIHR's mandate, which stresses the translation of new knowledge into improved health for Canadians, as well as with a series of internal reports that have recommended expanding the program. Although substantial evidence supports the analogous Medical Scientist Training Program in the United States, no parallel analysis of the MD/PhD program has been performed in Canada. Here, we highlight the long-term consequences of the program's cancellation in the context of increased emphasis on translational research. We argue that alternative funding sources cannot ensure continuous support for students in clinician-scientist training programs and that platform funding of the MD/PhD program is necessary to ensure leadership in translational research. PMID:26529253

  9. Understanding Economic Evaluation: A Policy Perspective for Clinicians

    Directory of Open Access Journals (Sweden)

    M Giacomini

    1997-01-01

    Full Text Available The rhetoric of ‘efficiency’ frames much current debate about how limited health care resources should be used. Clinicians increasingly turn to economic evaluation literature to discern evidence-based claims of ‘efficiency’ or ‘cost effectiveness’ from empty ones. Economic evaluation research is designed to compare health services on the basis of their efficiency (eg, how well they produce health benefits relative to resource costs. Although economic studies appear throughout the respirology literature, relatively few are complete economic evaluations. Economic evaluation studies serve various purposes, including critical evaluation and persuasive marketing, which produce studies that vary in research agendas and scientific rigour. This paper is intended to serve clinicians and consumers of economic evaluation studies by: introducing economic evaluation research information as a policy making tool; describing the three basic elements and three basic types of economic evaluation (cost-benefit, cost-effectiveness, and cost-utility analyses; and reviewing some limitations of economic evaluation information for policy decision making. The usefulness of economic evaluation research for policy making depends not only on the scientific merit of the analysis but also crucially on whose specific concerns the research questions address.

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

    Science.gov (United States)

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

    2016-04-01

    Knowledge of multiscale mechanisms in pathophysiology is the bedrock of clinical practice. If quantitative methods, predicting patient-specific behaviour of these pathophysiology mechanisms, are to be brought to bear on clinical decision-making, the Human Physiome community and Clinical community must share a common computational blueprint for pathophysiology mechanisms. A number of obstacles stand in the way of this sharing-not least the technical and operational challenges that must be overcome to ensure that (i) the explicit biological meanings of the Physiome's quantitative methods to represent mechanisms are open to articulation, verification and study by clinicians, and that (ii) clinicians are given the tools and training to explicitly express disease manifestations in direct contribution to modelling. To this end, the Physiome and Clinical communities must co-develop a common computational toolkit, based on this blueprint, to bridge the representation of knowledge of pathophysiology mechanisms (a) that is implicitly depicted in electronic health records and the literature, with (b) that found in mathematical models explicitly describing mechanisms. In particular, this paper makes use of a step-wise description of a specific disease mechanism as a means to elicit the requirements of representing pathophysiological meaning explicitly. The computational blueprint developed from these requirements addresses the Clinical community goals to (i) organize and manage healthcare resources in terms of relevant disease-related knowledge of mechanisms and (ii) train the next generation of physicians in the application of quantitative methods relevant to their research and practice. PMID:27051514

  11. Eye dosimetry and protective eyewear for interventional clinicians.

    Science.gov (United States)

    Martin, C J; Magee, J S; Sandblom, V; Almén, A; Lundh, C

    2015-07-01

    Doses to the eyes of interventional clinicians can exceed 20 mSv. Various protective devices can afford protection to the eyes with the final barrier being protective eyewear. The protection provided by lead glasses is difficult to quantify, and the majority of dosimeters are not designed to be worn under lead glasses. This study has measured dose reduction factors (DRFs) equal to the ratio of the dose with no protection, divided by that when lead glasses are worn. Glasses have been tested in X-ray fields using anthropomorphic phantoms to simulate the patient and clinician. DRFs for X-rays incident from the front vary from 5.2 to 7.6, while values for orientations reminiscent of clinical practice are between 1.4 and 5.2. Results suggest that a DRF of two is a conservative factor that could be applied to personal dosimeter measurements to account for the dose reduction provided by most types of lead glasses. PMID:25848118

  12. Eye dosimetry and protective eye wear for interventional clinicians

    International Nuclear Information System (INIS)

    Doses to the eyes of interventional clinicians can exceed 20 mSv. Various protective devices can afford protection to the eyes with the final barrier being protective eye wear. The protection provided by lead glasses is difficult to quantify, and the majority of dosimeters are not designed to be worn under lead glasses. This study has measured dose reduction factors (DRFs) equal to the ratio of the dose with no protection, divided by that when lead glasses are worn. Glasses have been tested in X-ray fields using anthropomorphic phantoms to simulate the patient and clinician. DRFs for X-rays incident from the front vary from 5.2 to 7.6, while values for orientations reminiscent of clinical practice are between 1.4 and 5.2. Results suggest that a DRF of two is a conservative factor that could be applied to personal dosimeter measurements to account for the dose reduction provided by most types of lead glasses. (authors)

  13. Emotional exhaustion and workload predict clinician-rated and objective patient safety

    OpenAIRE

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

    2015-01-01

    Aims: To investigate the role of clinician burnout, demographic, and organizational characteristics in predicting subjective and objective indicators of patient safety. Background: Maintaining clinician health and ensuring safe patient care are important goals for hospitals. While these goals are not independent from each other, the interplay between clinician psychological health, demographic and organizational variables, and objective patient safety indicators is poorly understood. The p...

  14. Prison Clinicians' Perceptions of Antisocial Personality Disorder as a Formal Diagnosis.

    Science.gov (United States)

    Stevens, Gail Flint

    1994-01-01

    Surveyed and interviewed 53 clinicians who work with prison inmates. Results indicated that clinicians used diagnosis of antisocial personality disorder liberally among inmates and felt majority of inmates could be so diagnosed. Large minority of clinicians went beyond Diagnostic and Statistical Manual of Mental Disorders criteria and reported…

  15. 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.

  16. IL-17-producing peripheral blood CD177+ neutrophils increase in allergic asthmatic subjects

    OpenAIRE

    Ramirez-Velazquez, Carlos; Castillo, Elena Cristina; Guido-Bayardo, Leopoldo; Ortiz-Navarrete, Vianney

    2013-01-01

    Background A T helper cell (TH) 17-biased response has been observed in patients with allergic asthma, particularly in those with neutrophil accumulation in the lung. Therefore, we sought to test the hypothesis that neutrophils might be an important source of interleukin (IL)-17 in allergic asthma. Methods Whole peripheral blood cells from non-asthmatic control subjects (n = 17) and patients with mild asthma (n = 7), moderate but persistent asthma (n = 4), or acute asthma (n = 6) were analyze...

  17. Histone modifications of Notch1 promoter affect lung CD4+ T cell differentiation in asthmatic rats.

    Science.gov (United States)

    Cui, Z-L; Gu, W; Ding, T; Peng, X-H; Chen, X; Luan, C-Y; Han, R-C; Xu, W-G; Guo, X-J

    2013-01-01

    Asthma is an inflammatory disease of the airways, and the current treatment in managing asthma is the control of inflammation. Notch signaling pathway has been linked to T-cell imbalance. The present study aimed to explore the histone modifications of Notch1 promoter in normal and asthmatic lung CD4+ T cells. Chromatin immunoprecipitation analysis showed that the acetylation levels of total H3, H4, site-specific H3K9, H3K14, H3K27, H3K18, H4K16, and the trimethylation levels of H3K4, H3K79 of Notch1 gene promoter were increased significantly in asthmatic lung CD4+ T cells compared to the control group, which correlated with increased P300, PCAF activity and decreased HDAC1, HDAC2 activity. After intervention of garcinol, a potent inhibitor of histone acetyltransferases, in asthmatic lung CD4+ T cells, HAT activity decreased significantly and the increased Notch1 and hes-1 expression was reversed. The total H3ac, H4ac, site-specific H3K9ac, H3K14ac, H3K27ac, H3K18ac, H4K16ac and H3K79me3 levels of Notch1 gene promoter decreased significantly, and the H3K4me3, H3K9me3, H4K20me3 levels had no significant difference. We further investigated the suppressive effects of GAR on asthmatic parameters. Results showed that the levels of IL-4, IL-5 and IL-13 were significantly reduced and a small reverse trend was found in the level of IFN-g after GAR treatment. Furthermore, the expression of NF-κB and AP-1 reduced significantly. These results suggest that asthma is associated with changes in the epigenetic status of Notch1 promoter, including abnormal histone acetylation and methylation, and GAR may have applications in the treatment of asthma. PMID:23755752

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

    Science.gov (United States)

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

    2014-01-01

    Background: Nitrogen dioxide (NO2), a ubiquitous atmospheric pollutant, may enhance the asthmatic response to allergens through eosinophilic activation in the airways. However, the effect of NO2 on inflammation without allergen exposure is poorly studied. Objectives: We investigated whether repeated peaks of NO2, at various realistic concentrations, induce changes in airway inflammation in asthmatics. Methods: Nineteen nonsmokers with asthma were exposed at rest in a double-blind, crossover study, in randomized order, to 200 ppb NO2, 600 ppb NO2, or clean air once for 30 min on day 1 and twice for 30 min on day 2. The three series of exposures were separated by 2 weeks. The inflammatory response in sputum was measured 6 hr (day 1), 32 hr (day 2), and 48 hr (day 3) after the first exposure, and compared with baseline values measured twice 10–30 days before the first exposure. Results: Compared with baseline measurements, the percentage of eosinophils in sputum increased by 57% after exposure to 600 ppb NO2 (p = 0.003) but did not change significantly after exposure to 200 ppb. The slope of the association between the percentage of eosinophils and NO2 exposure level was significant (p = 0.04). Eosinophil cationic protein in sputum was highly correlated with eosinophil count and increased significantly after exposure to 600 ppb NO2 (p = 0.001). Lung function, which was assessed daily, was not affected by NO2 exposure. Conclusions: We observed that repeated peak exposures of NO2 performed without allergen exposure were associated with airway eosinophilic inflammation in asthmatics in a dose-related manner. Citation: Ezratty V, Guillossou G, Neukirch C, Dehoux M, Koscielny S, Bonay M, Cabanes PA, Samet JM, Mure P, Ropert L, Tokarek S, Lambrozo J, Aubier M. 2014. Repeated nitrogen dioxide exposures and eosinophilic airway inflammation in asthmatics: a randomized crossover study. Environ Health Perspect 122:850–855; http://dx.doi.org/10.1289/ehp.1307240 PMID

  19. Expression of Interleukin-17 in Lung and Peripheral Blood of Asthmatic Rats and the Influence of Dexamethasone

    Institute of Scientific and Technical Information of China (English)

    XIONG Weining; ZENG Daxiong; XU Yongjian; FANG Huijuan; CAO Yong; SONG Qingfeng; CAO Chao

    2007-01-01

    The expression of interleukin-17 (IL-17) in lung and peripheral blood of asthmatic rats and the influence of dexamethasone, and the role of IL-17 in the pathogenesis of asthma were inves-tigated. Thirty Sprague-Dawley (SD) adult rats were randomly divided into three groups (n=10 in each group): normal group, asthmatic group, and dexamethasone-interfered group. Rat asthmatic model was established by intraperitoneal (I.p.) injection of 10% ovalbumin (OVA) and challenge with 1% OVA via inhalation. Rats in dexamethasone-interfered group were pretreated with dexa-methasone (2 mg/kg, I.p.) 30 rain before each challenge. The expression of IL-17 protein in serum and bronchoalveolar lavage fluid (BALF) was detected by ELISA. The expression of IL-17 mRNA in peripheral blood mononuclear cells (PBMC) and BALF cells was semi-quantitatively detected by RT-PCR. The expression of IL-17 protein in serum and BALF of asthmatic rats was significantly elevated as compared with normal rats and dexamethsone-interfered rats (P<0.01), and there was sig- nificant difference between normal rats and dexamethsone-interfered rats (P<0.05). The expression of IL-17 mRNA in PBMC and BALF cells of asthmatic rats was markedly increased as compared with normal rats and dexamethsone-interfered rats (P<0.01), and significant difference was found between normal rats and dexamethsone-interfered rats (P<0.05). It was concluded that the expression of IL-17 was increased significantly in asthmatic rats and could be inhibited partly by dexamethasone, sug-gesting that IL-17 might play an important role in the pathogenesis of asthma as an inflammation regulation factor.

  20. Distributions of sup(81m)Kr and pulmonary responses after exercise tolerance test in the adult asthmatics

    International Nuclear Information System (INIS)

    In order to assess the presence and severity of EIA in adult asthmatics, sup(81m)Kr inhalation study by bolus method and pulmonary function test were performed on 34 adult asthmatics and 6 normal subjects before and after exercise. Ventilatory abnormalities were detected in 30 out of 34 asthmatics by sup(81m)Kr inhalation study and in 19 out of 32 patients by the pulmonary function test. Patterns of defects on sup(81m)Kr inhalation study were classified into two types, A and B. A type defect: The defect was larger in maximum forced inhalation (MFI) than in static inhalation (SI). B type defect: The defect was larger on the SI than that on the MFI and disappeared when sup(81m)Kr gasses were inhaled at high lung levels. A type defect involves central airway obstruction. In B type defect, there is peripheral airway obstruction and early airway closure is, for the most part, considerable. On the exercise test, sixteen asthmatics showed A type dominant, 8 asthmatics showed B type dominant and the 6 asthmatics showed AB type. Exercise-induced changes in FVC after 5 minutes were -3.71 +- 7.77% in the type A dominant group, -17.44 +- 19.92% in the type B dominant group and -15.05 +- 22.06% in the type AB group; and changes in FEVsub(1.0) were -11.38 +- 11.33%, -20.88 +- 20.55% and -27.66 +- 26.78%, respectively. Percentage changes in FVC and FEVsub(1.0) were significantly lower in the type B dominant and type AB groups, compared to those in the type A dominant group. (author)

  1. 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.

  2. 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.

  3. Acquired Aplastic Anemia in Children

    OpenAIRE

    Hartung, Helge D.; Olson, Timothy S.; Bessler, Monica

    2013-01-01

    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.

  4. Clinician styles of care: transforming patient care at the intersection of leadership and medicine.

    Science.gov (United States)

    Huynh, Ho P; Sweeny, Kate

    2014-11-01

    A key role of clinicians is to motivate their patients to initiate and maintain beneficial health behaviors. This article integrates research on transformational leadership, clinician-patient communication, and health behavior to introduce a novel approach to understanding and improving clinicians' effectiveness as motivators. We describe three dominant clinician styles or patterned approaches to patient care that derive from leadership theory (in order of least to most effective): laissez-faire, transactional, and transformational. Additionally, we suggest potential mediators and effects of the transformational style of care. Finally, we discuss future research directions for the study of clinician styles of care. PMID:23864074

  5. Prediction of mandibular rotation: an empirical test of clinician performance.

    Science.gov (United States)

    Baumrind, S; Korn, E L; West, E E

    1984-11-01

    An experiment was conducted in an attempt to determine empirically how effective a number of expert clinicians were at differentiating "backward rotators" from "forward rotators" on the basis of head-film information which might reasonably have been available to them prior to instituting treatment for the correction of Class II malocclusion. As a result of a previously reported ongoing study, pre- and posttreatment head films were available for 188 patients treated in the mixed dentition for the correction of Class II malocclusion and for 50 untreated Class II subjects. These subjects were divided into 14 groups (average size of group, 17; range, 6 to 23) solely on the basis of type of treatment and the clinician from whose clinic the records had originated. From within each group, we selected the two or three subjects who had exhibited the most extreme backward rotation and the two or three subjects who had exhibited the most extreme forward rotation of the mandible during the interval between films. The sole criterion for classification was magnitude of change in the mandibular plane angle of Downs between the pre- and posttreatment films of each patient. The resulting sample contained 32 backward-rotator subjects and 32 forward-rotator subjects. Five expert judges (mean clinical experience, 28 years) were asked to identify the backward-rotator subjects by examination of the pretreatment films. The findings may be summarized as follows: (1) No judge performed significantly better than chance. (2) There was strong evidence that the judges used a shared, though relatively ineffective, set of rules in making their discriminations between forward and backward rotators. (3) Statistical analysis of the predictive power of a set of standard cephalometric measurements which had previously been made for this set of subjects indicated that the numerical data also failed to identify potential backward rotators at a rate significantly better than chance. We infer from these

  6. 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.

  7. STAT6 expression in T cells, alveolar macrophages and bronchial biopsies of normal and asthmatic subjects

    Directory of Open Access Journals (Sweden)

    Tomita Katsuyuki

    2012-03-01

    Full Text Available Abstract Background Asthma is characterised by increased numbers of Th2-like cells in the airways and IgE secretion. Generation of Th2 cells requires interleukin (IL-4 and IL-13 acting through their specific receptors and activating the transcription factor, signal transducer and activator of transcription 6 (STAT6. STAT6 knockout mice fail to produce IgE, airway hyperresponsiveness and bronchoalveolar lavage eosinophilia after allergen sensitisation, suggesting a critical role for STAT6 in allergic responses. Methods We have investigated the expression of STAT6 in peripheral blood T-lymphocytes, alveolar macrophages and bronchial biopsies from 17 normal subjects and 18 mild-moderate steroid-naïve stable asthmatic patients. Results STAT6 expression was variable and was detected in T-lymphocytes, macrophages and bronchial epithelial cells from all subjects with no difference between normal and stable asthmatic subjects. Conclusions STAT6 expression in different cells suggests that it may be important in regulating the expression of not only Th2-like cytokines in T cells of man, but may also regulate STAT-inducible genes in alveolar macrophages and airway epithelial cells.

  8. A MYLK variant regulates asthmatic inflammation via alterations in mRNA secondary structure.

    Science.gov (United States)

    Wang, Ting; Zhou, Tong; Saadat, Laleh; Garcia, Joe G N

    2015-06-01

    Myosin light-chain kinase (MYLK) is a gene known to be significantly associated with severe asthma in African Americans. Here we further examine the molecular function of a single-nucleotide polymorphism (SNP), located in the non-muscle myosin light-chain kinase isoform (nmMLCK), in asthma susceptibility and pathobiology. We identified nmMLCK variant (reference SNP: rs9840993, NM_053025: 721C>T, c.439C>T) with a distinct mRNA secondary structure from the other variants. The nmMLCK variant (721C) secondary structure exhibits increased stability with an elongated half-life in the human endothelial cell, and greater efficiency in protein translation initiation owing to an increased accessibility to translation start site. Finally, nmMLCK expression of 721C- and 721T-containing MYLK transgenes were compared in nmMLCK(-/-) mice and confirmed deleterious effects of nmMLCK expression on asthmatic indices and implicated the augmented influence of MYLK 721C>T (c.439C>T) SNP on asthma severity. The confirmation of the novel mechanism of the regulation of asthmatic inflammation by a MYLK advances knowledge of the genetic basis for asthma disparities, and further suggests the potential of nmMLCK as a therapeutic target. Our study suggests that in addition to altering protein structure and function, non-synonymous SNPs may also lead to phenotypic disparity by altering protein expression. PMID:25271083

  9. Metabolism in vitro of leukotriene B4 in blood of normal subjects and asthmatic patients

    International Nuclear Information System (INIS)

    The metabolism of exogenous leukotriene B4 (LTB4) was investigated in venous blood obtained from normal and asthmatic subjects. Using specific radioimmunoassay (RIA) and reverse-phase high performance liquid chromatography (RP-HPLC) techniques we have demonstrated that LTB4 is relatively stable during a 2 hr incubation period at 37 degrees C in our system in vitro. Nevertheless, chromatographic analysis revealed the presence of two products which had retention times identical to 20-hydroxy LTB4 (20-0H LTB4) and 20-carboxy LTB4 (20-C00H LTB4) in which the dicarboxylic derivative was the main metabolite present after 15 min incubation. The amount of LTB4 and its w-oxidation products observed after a 2 hr incubation period was 73% and 24% respectively. There was no basal release of LTB4 from blood. The appearance of these oxidative products was totally suppressed at 4 degrees C and with incubations performed with either venous plasma or Hartmann's control. No significant difference was observed in substrate metabolism between normal and asthmatic subjects. Our results demonstrate that LTB4 is slowly degraded in human whole blood through a cellular dependent process of w-oxidation which may be an important pathway for regulating the availability of this potent biologically active substance

  10. The biotransformation in vitro of cysteinyl leukotrienes in blood of normal and asthmatic subjects

    Energy Technology Data Exchange (ETDEWEB)

    Zakrzewski, J.T.; Sampson, A.P.; Evans, J.M.; Barnes, N.C.; Piper, P.J.; Costello, J.F. (King' s College School of Medicine and Dentistry, Denmark Hill, London (England))

    1989-04-01

    The metabolism of exogenous leukotriene C4 (LTC4), LTD4 and LTE4 (10(-8) M) was studied in vitro in blood of normal and asthmatic subjects for up to 2 hr by reverse-phase high performance liquid chromatography. In whole blood, incubation of LTC4 (T1/2 = 11.5 min) resulted in the formation of LTD4 and LTE4 whose biosynthesis was inhibited by serine borate (30 mM). Similar experiments performed with LTD4 (T1/2 = 5 min) produced a single metabolite (LTE4) which was inhibited by L-cysteine (10 mM). On the other hand, LTE4 represented a highly stable product in our in vitro system. The bioconversion of LTC4 or LTD4 was slower in plasma but this effect appeared more pronounced for the cysteinylglycinyl derivative. The bioconversion of LTD4 in whole blood or plasma was almost twice as rapid as LTC4. Experiments performed with asthmatic blood showed no significant difference in the survival of LTC4. These results suggest that blood may play a role in regulating the bioavailability of cysteinyl-containing LTs which could be of relevance to their excretion in man.

  11. Retrostyloid parapharyngeal space tumors: A clinician and imaging perspective

    International Nuclear Information System (INIS)

    Although tumors of the parapharyngeal space are rare, they represent a formidable diagnostic and treatment challenge. The differentiation of a retrostyloid lesion from a prestyloid lesion is critical for guiding the differential diagnosis. The majority of lesions involving the retrostyloid parapharyngeal space are either peripheral nerve sheath tumors, head and neck paragangliomas or metastatic lymph node metastases. This article provides insights into the many currently available radiological and radionuclide imaging procedures and guides clinicians toward their appropriate use. In the near future, many patients might also benefit from new diagnostic approaches such as high resolution integrated PET/MRI and new tracers that enable “in vivo” assessment of these tumors at molecular level

  12. Combat with emerging infectious diseases: clinicians should do better.

    Science.gov (United States)

    Lu, Hongzhou

    2013-10-01

    In the spring of 2013, an emerging infectious disease emerged in China, 132 cases of human were infected with the H7N9 avian influenza virus, 39 cases were resulted in death within 3 month, which sparked a global concern about public health. Many reports have been published about this disease, including clinical characteristics and genomic information. However, more emerging infectious disease may infect human in the future. Confronted with the escalating scale of compounding probabilities, physicians or clinicians as the first line that meet patients who suffering from emerging infectious disease, we should do better by using our intellect and strong will to carry out public health measures, biomedical research, and technological advances. PMID:24241178

  13. Oral Syphilis: A Reemerging Infection Prompting Clinicians' Alertness

    Science.gov (United States)

    Dybeck Udd, Sebastian; Lund, Bodil

    2016-01-01

    Syphilis is a rare but increasing disease. Due to changing sexual habits, presentation of oral manifestations may rise. Since syphilis may mimic other oral manifestations, diagnoses can be difficult. Clinicians need to be aware that ambiguous oral manifestations may in fact be caused by oral syphilis. Here, we present a case of extended diagnostic delay highlighting the importance of consulting an expert in infectious diseases in case of obscure oral lesions not responding to standard treatment. Despite seven visits to six different medical doctors, a patient who presented with oral syphilis was continuously misdiagnosed. After 6 months of increasing complaints and deteriorating severity of disease, the patient was referred to an oral and maxillofacial surgeon where the correct diagnosis was determined and proper treatment initiated. PMID:27293914

  14. 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. PMID:26253024

  15. Oral Syphilis: A Reemerging Infection Prompting Clinicians' Alertness.

    Science.gov (United States)

    Dybeck Udd, Sebastian; Lund, Bodil

    2016-01-01

    Syphilis is a rare but increasing disease. Due to changing sexual habits, presentation of oral manifestations may rise. Since syphilis may mimic other oral manifestations, diagnoses can be difficult. Clinicians need to be aware that ambiguous oral manifestations may in fact be caused by oral syphilis. Here, we present a case of extended diagnostic delay highlighting the importance of consulting an expert in infectious diseases in case of obscure oral lesions not responding to standard treatment. Despite seven visits to six different medical doctors, a patient who presented with oral syphilis was continuously misdiagnosed. After 6 months of increasing complaints and deteriorating severity of disease, the patient was referred to an oral and maxillofacial surgeon where the correct diagnosis was determined and proper treatment initiated. PMID:27293914

  16. Online Continuing Education for Expanding Clinicians' Roles in Breastfeeding Support.

    Science.gov (United States)

    Edwards, Roger A; Colchamiro, Rachel; Tolan, Ellen; Browne, Susan; Foley, Mary; Jenkins, Lucia; Mainello, Kristen; Vallu, Rohith; Hanley, Lauren E; Boisvert, Mary Ellen; Forgit, Julie; Ghiringhelli, Kara; Nordstrom, Christina

    2015-11-01

    Lack of health professional support is an important variable affecting mothers' achievement of breastfeeding goals. Online continuing education is a recognized pathway for disseminating content for improving clinicians' knowledge and supporting efforts to change practices. At the time we developed our project, free, accredited continuing education for physicians related to breastfeeding management that could be easily accessed using portable devices (via tablets/smartphones) was not available. Such resources were in demand, especially for facilities pursuing designation through the Baby-Friendly Hospital Initiative. We assembled a government, academic, health care provider, and professional society partnership to create such a tutorial that would address the diverse content needed for supporting breastfeeding mothers postdischarge in the United States. Our 1.5-hour-long continuing medical and nursing education was completed by 1606 clinicians (1172 nurses [73%] and 434 physicians [27%]) within 1 year. More than 90% of nurses and over 98% of physicians said the tutorial achieved its 7 learning objectives related to breastfeeding physiology, broader factors in infant feeding decisions and practices, the American Academy of Pediatrics' policy statement, and breastfeeding management/troubleshooting. Feedback received from the tutorial led to the creation of a second tutorial consisting of another 1.5 hours of continuing medical and nursing education related to breast examination and assessment prior to delivery, provision of anticipatory guidance to pregnant women interested in breastfeeding, maternity care practices that influence breastfeeding outcomes, breastfeeding preterm infants, breastfeeding's role in helping address disparities, and dispelling common myths. The tutorials contribute to achievement of 8 Healthy People 2020 Maternal, Infant and Child Health objectives. PMID:26013061

  17. 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.

  18. Treatment of adult ADHD: Is current knowledge useful to clinicians?

    Directory of Open Access Journals (Sweden)

    Terje Torgersen

    2008-03-01

    Full Text Available Terje Torgersen1,2, Bjørn Gjervan1,3, Kirsten Rasmussen31Department of Psychiatry, Sykehuset Levanger, Helse Nord-Troendelag HF, Levanger, Norway; 2Faculty of Medicine and 3Department of Psychology, Norwegian University of Science and Technology, Trondheim, NorwayAbstract: Psychostimulant drugs have for decades been considered the cornerstone of ADHD treatment. Non-stimulant drugs have also been reported successful. However, many controlled studies exclude patients with comorbidities typical for patients seen in clinical setting. Many patients are also considered non-responders to medication. Current knowledge might not be directly useful to clinicians. The present article reviews the literature on pharmacological and psychotherapeutic treatment in adult ADHD emphasizing comorbidity and other clinically important factors, as well as ADHD specific outcomes. Thirty-three relevant studies of pharmacotherapy and three studies of psychotherapy were included. Most subjects had little current comorbidity, but some studies included subjects with substance use disorder. Significant effect of treatment on ADHD symptoms was found in most studies using pharmacotherapy and all studies of psychotherapy. Both positive and negative effects on comorbid anxiety and depression measures were reported. Pharmacotherapy did not seem to have effect on substance use disorder. Few pharmacotherapy studies conducted any long-term follow-up; two studies that did, found that most subjects had discontinued medication. A clear-cut dose-respons relationship was not substanciated. In conclusion, clinicians have good support for both pharmacological and psychotherapeutic treatment of ADHD in adults, but should take additional measures to deal with comorbidities as well as treatment adherence.Keywords: ADHD, adults, treatment, stimulants, psychotherapy, comorbidity

  19. 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.)

  20. Distribution of radioactive aerosol in the airways of children and adolescents with bronchial hyper-responsiveness

    International Nuclear Information System (INIS)

    The purpose of this study was to examine the relationship between the pulmonary distribution of inhaled radioaerosol, bronchial responsiveness, and lung function in children and adolescents. The participating subjects were divided into three groups: (1) 14 asthmatics with bronchial hyper-responsiveness (BHR), (2) five non-asthmatic subjects with BHR, and (3) 20 controls without BHR. Pulmonary distribution of [99Tcm] albumin radioaerosol, maximal expiratory flow when 25% of forced vital capacity remain to be exhaled (MEF25), and bronchial responsiveness to inhaled histamine were measured. Twenty subjects (52%) has irregular central distribution and 19 subjects (48%) had regular distribution of radioaerosol in their lungs. No difference in distribution of radioaerosol was found between the three groups of children. The median MEF25 among non-asthmatic subjects (80% predicted) was lower than that found in controls (92% predicted) but higher than that found in asthmatic subjects (55% predicted). A relationship was found between reduced flow at the peripheral airways, as indicated by MEF25 and the degree of central distribution of radioaerosol. Furthermore, subjects with irregular central distribution of radioaerosol had an increase degree of bronchial responsiveness. In conclusion, children and adolescents who have flow rates in the peripheral airways or increased degree of bronchial responsiveness tend to have abnormal distribution of radioaerosols. (author)

  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. 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.

  3. 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...

  4. 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.

  5. 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...

  6. The effect of an angiotensin converting enzyme inhibitor, ramipril, on bronchial responses to inhaled histamine and bradykinin in asthmatic subjects.

    OpenAIRE

    Dixon, C M; Fuller, R W; Barnes, P J

    1987-01-01

    The effect of a potent inhibitor of angiotensin-converting enzyme, ramipril, was studied on both inhaled histamine and bradykinin-induced bronchoconstriction in six male, normotensive, mild asthmatic subjects. Oral administration of 10 mg ramipril caused no change in lung function or airway reactivity to inhaled histamine or bradykinin despite achieving adequate reduction in angiotensin-converting enzyme activity.

  7. Airway responsiveness to leukotriene C4 (LTC4), leukotriene E4 (LTE4) and histamine in aspirin-sensitive asthmatic subjects.

    Science.gov (United States)

    Christie, P E; Schmitz-Schumann, M; Spur, B W; Lee, T H

    1993-11-01

    We wanted to determine whether the airway response to inhaled leukotriene C4 (LTC4) is similar to inhaled leukotriene E4 (LTE4) in aspirin-sensitive asthma and, therefore, determined airway responsiveness to histamine, LTC4 and LTE4 in seven aspirin-sensitive subjects and 13 control asthmatic subjects, who were tolerant of aspirin. The concentration of inhaled lysine-aspirin which produced a 15% fall in forced expiratory volume in one second (FEV1) (PC15) was determined in aspirin-sensitive asthmatic subjects. The dose of histamine, LTC4 and LTE4 which produced a 35% fall in specific airways conductance (PD35sGaw) was determined by linear interpolation from the log dose response curve. There was no correlation between the PC15 for lysine-aspirin and the airway reactivity to inhaled LTC4 or LTE4. There was no difference in airway response to histamine and LTC4 between any of the groups of asthmatic subjects. There was a rank order of potency LTC4 > LTE4 > histamine in both groups, with LTC4 approximately 1,000 fold more potent than histamine in both groups. Aspirin-sensitive asthmatic subjects were significantly more responsive to LTE4 (p = 0.02) than aspirin-tolerant asthmatic subjects. The relative responsiveness of LTE4 to histamine (PD35 histamine/PD35 LTE4) was significantly greater in aspirin-sensitive asthmatic subjects compared to aspirin-tolerant asthmatic subjects (p = 0.05). There was no difference in relative responsiveness of LTC4 to histamine between aspirin-sensitive or aspirin-tolerant asthmatic subjects. We conclude that the airways of aspirin-sensitive asthmatic subjects demonstrate a selective hyperresponsiveness to LTE4, which is not observed for LTC4. PMID:8112440

  8. 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

  9. Asthma-related knowledge, attitudes, practices (KAP of parents of children with bronchial asthma: A hospital-based study

    Directory of Open Access Journals (Sweden)

    Kaushik Sudha Bhagavatheeswaran

    2016-01-01

    Full Text Available Background: Prevention of asthma exacerbations is one of the major challenges of public health. Parents are crucial for exacerbation prevention and management at home. This study was conducted with the objective of assessing asthma knowledge in the parents of asthmatic children and to understand parents′ attitude and practices in dealing with the exacerbation of their children′s asthma. Materials and Methods: A convenient sample of 100 parents of asthmatic children was enrolled. Any parents (mother or/and father with a child aged 8 years and above, diagnosed with bronchial asthma, and attending the Outpatient Department of Paediatrics, Saveetha Medical College and Hospital with his/her child in the study period could be included. Results: In this study, 62% children were male and 38% female, the average age was 12.53 years [standard deviation (SD 2.95], and the average time duration for living with an asthmatic condition was 6 years (SD 3. Of the parents, 80% responded that they did not know what inhaled corticosteroids were and most (86% of them did not know how they worked, while 41% were aware of aerosol therapy. Of the respondents, 87% had never used a Children′s Asthma Control Test questionnaire and 78% said that they did not have any written action plan in case of their child suffering an asthma attack. Conclusion: There is an urgent need for the preparation of parental guidelines for preventing asthma exacerbations among asthmatic children living in India.

  10. Clinicians' caseload management behaviours as explanatory factors in patients' length of time on caseloads: a predictive multilevel study in paediatric community occupational therapy

    OpenAIRE

    Kolehmainen Niina; MacLennan Graeme; Francis Jillian J; Duncan Edward AS

    2010-01-01

    Abstract Background Long waiting times and large caseloads are a challenge to children's therapy services internationally. Research in hospital-based healthcare indicates that waiting times are a function of throughput, and that length of care episode is related to clinicians' caseload management behaviour (i.e. actions at assessment, treatment, post-treatment, and discharge). There have been few attempts to study this in community health services. The present study investigated whether commu...

  11. Cardiovascular magnetic resonance physics for clinicians: part I

    Directory of Open Access Journals (Sweden)

    Ridgway John P

    2010-11-01

    Full Text Available Abstract There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinicians using CMR in their daily practice. This is the first of two reviews that are intended to cover the essential aspects of CMR physics in a way that is understandable and relevant to this group. It begins by explaining the basic physical principles of MR, including a description of the main components of an MR imaging system and the three types of magnetic field that they generate. The origin and method of production of the MR signal in biological systems are explained, focusing in particular on the two tissue magnetisation relaxation properties (T1 and T2 that give rise to signal differences from tissues, showing how they can be exploited to generate image contrast for tissue characterisation. The method most commonly used to localise and encode MR signal echoes to form a cross sectional image is described, introducing the concept of k-space and showing how the MR signal data stored within it relates to properties within the reconstructed image. Before describing the CMR acquisition methods in detail, the basic spin echo and gradient pulse sequences are introduced, identifying the key parameters that influence image contrast, including appearances in the presence of flowing blood, resolution and image acquisition time. The main derivatives of these two pulse sequences used for cardiac imaging are then described in more detail. Two of the key requirements for CMR are the need for data acquisition first to be to be synchronised with the subject's ECG and to be

  12. Cardiovascular magnetic resonance physics for clinicians: part I.

    Science.gov (United States)

    Ridgway, John P

    2010-01-01

    There are many excellent specialised texts and articles that describe the physical principles of cardiovascular magnetic resonance (CMR) techniques. There are also many texts written with the clinician in mind that provide an understandable, more general introduction to the basic physical principles of magnetic resonance (MR) techniques and applications. There are however very few texts or articles that attempt to provide a basic MR physics introduction that is tailored for clinicians using CMR in their daily practice. This is the first of two reviews that are intended to cover the essential aspects of CMR physics in a way that is understandable and relevant to this group. It begins by explaining the basic physical principles of MR, including a description of the main components of an MR imaging system and the three types of magnetic field that they generate. The origin and method of production of the MR signal in biological systems are explained, focusing in particular on the two tissue magnetisation relaxation properties (T1 and T2) that give rise to signal differences from tissues, showing how they can be exploited to generate image contrast for tissue characterisation. The method most commonly used to localise and encode MR signal echoes to form a cross sectional image is described, introducing the concept of k-space and showing how the MR signal data stored within it relates to properties within the reconstructed image. Before describing the CMR acquisition methods in detail, the basic spin echo and gradient pulse sequences are introduced, identifying the key parameters that influence image contrast, including appearances in the presence of flowing blood, resolution and image acquisition time. The main derivatives of these two pulse sequences used for cardiac imaging are then described in more detail. Two of the key requirements for CMR are the need for data acquisition first to be to be synchronised with the subject's ECG and to be fast enough for the subject

  13. 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

  14. PubMed searches: overview and strategies for clinicians.

    Science.gov (United States)

    Lindsey, Wesley T; Olin, Bernie R

    2013-04-01

    PubMed is a biomedical and life sciences database maintained by a division of the National Library of Medicine known as the National Center for Biotechnology Information (NCBI). It is a large resource with more than 5600 journals indexed and greater than 22 million total citations. Searches conducted in PubMed provide references that are more specific for the intended topic compared with other popular search engines. Effective PubMed searches allow the clinician to remain current on the latest clinical trials, systematic reviews, and practice guidelines. PubMed continues to evolve by allowing users to create a customized experience through the My NCBI portal, new arrangements and options in search filters, and supporting scholarly projects through exportation of citations to reference managing software. Prepackaged search options available in the Clinical Queries feature also allow users to efficiently search for clinical literature. PubMed also provides information regarding the source journals themselves through the Journals in NCBI Databases link. This article provides an overview of the PubMed database's structure and features as well as strategies for conducting an effective search. PMID:23442731

  15. 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.

  16. Pharmacotherapy Treatment Options for Insomnia: A Primer for Clinicians.

    Science.gov (United States)

    Asnis, Gregory M; Thomas, Manju; Henderson, Margaret A

    2016-01-01

    Insomnia is a prevalent disorder with deleterious effects such as decreased quality of life, and a predisposition to a number of psychiatric disorders. Fortunately, numerous approved hypnotic treatments are available. This report reviews the state of the art of pharmacotherapy with a reference to cognitive behavioral therapy for insomnia (CBT-I) as well. It provides the clinician with a guide to all the Food and Drug Administration (FDA) approved hypnotics (benzodiazepines, nonbenzodiazepines, ramelteon, low dose sinequan, and suvorexant) including potential side effects. Frequently, chronic insomnia lasts longer than 2 years. Cognizant of this and as a result of longer-term studies, the FDA has approved all hypnotics since 2005 without restricting the duration of use. Our manuscript also reviews off-label hypnotics (sedating antidepressants, atypical antipsychotics, anticonvulsants and antihistamines) which in reality, are more often prescribed than approved hypnotics. The choice of which hypnotic to choose is discussed partially being based on which segment of sleep is disturbed and whether co-morbid illnesses exist. Lastly, we discuss recent label changes required by the FDA inserting a warning about "sleep-related complex behaviors", e.g., sleep-driving for all hypnotics. In addition, we discuss FDA mandated dose reductions for most zolpidem preparations in women due to high zolpidem levels in the morning hours potentially causing daytime carry-over effects. PMID:26729104

  17. A clinician's approach to acute low back pain.

    Science.gov (United States)

    Borenstein, D G

    1997-01-27

    Two important goals in treating acute low back pain are to return the patient to regular activity as quickly as possible and to do so in a manner that is cost-effective. By following a logical treatment protocol, the clinician is often able to provide the treatment necessary to provide the patient with relief. Referral to an orthopedist or neurosurgeon may be appropriate in only a minority of cases. Thus, after the initial history and physical examination, ruling out (or in) conditions that require urgent or emergent care is essential. These conditions include cauda equina syndrome, circulatory collapse due to expanding abdominal aortic aneurysm, and tumor, infection, and other underlying disorders as a cause of low back pain. Patients without these conditions can be started on conservative therapy-without radiographic or laboratory tests-regardless of the specific diagnosis. Conservative therapy consists of passage of time, controlled physical activity, physical modalities (e.g., cryotherapy or thermotherapy), local injections, nonsteroidal anti-inflammatory drugs, and muscle relaxants. Because low back pain is so common, even the small proportion of patients who do not improve after 6 weeks of conservative therapy represents a sizable number. The location and radiation of pain are used as initial guides to classifying these patients into four groups: those with localized pain, sciatica, anterior thigh pain, or posterior thigh pain. Each follows a different diagnostic path, which will be described herein. PMID:9217555

  18. 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. PMID:23362604

  19. Can clinicians accurately assess esophageal dilation without fluoroscopy?

    Science.gov (United States)

    Bailey, A D; Goldner, F

    1990-01-01

    This study questioned whether clinicians could determine the success of esophageal dilation accurately without the aid of fluoroscopy. Twenty patients were enrolled with the diagnosis of distal esophageal stenosis, including benign peptic stricture (17), Schatski's ring (2), and squamous cell carcinoma of the esophagus (1). Dilation attempts using only Maloney dilators were monitored fluoroscopically by the principle investigator, the physician and patient being unaware of the findings. Physicians then predicted whether or not their dilations were successful, and they examined various features to determine their usefulness in predicting successful dilation. They were able to predict successful dilation accurately in 97% of the cases studied; however, their predictions of unsuccessful dilation were correct only 60% of the time. Features helpful in predicting passage included easy passage of the dilator (98%) and the patient feeling the dilator in the stomach (95%). Excessive resistance suggesting unsuccessful passage was an unreliable feature and was often due to the dilator curling in the stomach. When Maloney dilators are used to dilate simple distal strictures, if the physician predicts successful passage, he is reliably accurate without the use of fluoroscopy; however, if unsuccessful passage is suspected, fluoroscopy must be used for confirmation. PMID:2210278

  20. Biosimilar insulins: guidance for data interpretation by clinicians and users.

    Science.gov (United States)

    Heinemann, L; Home, P D; Hompesch, M

    2015-10-01

    Biosimilar insulins are approved copies of insulins outside patent protection. Advantages may include greater market competition and potential cost reduction, but clinicians and users lack a clear perspective on 'biosimilarity' for insulins. The manufacturing processes for biosimilar insulins are manufacturer-specific and, although these are reviewed by regulators there are few public data available to allow independent assessment or review of issues such as intrinsic quality or batch-to-batch variation. Preclinical measures used to assess biosimilarity, such as tissue and cellular studies of metabolic activity, physico-chemical stability and animal studies of pharmacodynamics, pharmacokinetics and immunogenicity may be insufficiently sensitive to differences, and are often not formally published. Pharmacokinetic and pharmacodynamic studies (glucose clamps) with humans, although core assessments, have problems of precision which are relevant for accurate insulin dosing. Studies that assess clinical efficacy and safety and device compatibility are limited by current outcome measures, such as glycated haemoblobin levels and hypoglycaemia, which are insensitive to differences between insulins. To address these issues, we suggest that all comparative data are put in the public domain, and that systematic clinical studies are performed to address batch-to-batch variability, delivery devices, interchangeability in practice and long-term efficacy and safety. Despite these challenges biosimilar insulins are a welcome addition to diabetes therapy and, with a transparent approach, should provide useful benefit to insulin users. PMID:25974131

  1. Defiant Teens: A Clinician's Manual for Assessment and Family Intervention.

    Science.gov (United States)

    Barkley, Russell A.; Edwards, Gwenyth H.; Robin, Arthur L.

    This manual presents an 18-step program designed both to teach parents the skills they need to manage difficult adolescent behavior and to improve family relationships overall. Steps 1 through 9 modify the approach presented in Russell Barkley's earlier edition, "Defiant Children," to focus on developmental concerns of adolescence. Clear…

  2. Using reflexivity to enhance in-depth interviewing skills for the clinician researcher

    OpenAIRE

    Hegarty Kelsey; Taft Angela; McNair Ruth

    2008-01-01

    Abstract Background Primary health care clinicians are being encouraged to undertake qualitative research, however the in-depth interviewing skills required are not as straightforward as might be first supposed. While there are benefits and certain skills that clinicians can bring to interview-based research, there are important new skills to develop. To date there has been neither discussion about these new skills, nor any preparatory guidelines for clinicians entering into interview-based r...

  3. The role of clinician emotion in clinical reasoning: balancing the analytical process

    OpenAIRE

    Langridge, Neil; Roberts, Lisa; Pope, Catherine

    2015-01-01

    Introduction This review paper identifies and describes the role of clinicians' memory, emotions and physical responses in clinical reasoning processes. Clinical reasoning is complex and multi-factorial and key models of clinical reasoning within musculoskeletal physiotherapy are discussed, highlighting the omission of emotion and subsequent physical responses and how these can impact upon a clinician when making a decision. Discussion It is proposed that clinicians should conside...

  4. Clinician-Targeted Intervention and Patient-Reported Counseling on Physical Activity

    OpenAIRE

    Carroll, Jennifer K.; Winters, Paul C.; Sanders, Mechelle R; Decker, Francesca; Ngo, Thanh ,; Sciamanna, Christopher N.

    2014-01-01

    Introduction Limited time and lack of knowledge are barriers to physical activity counseling in primary care. The objective of this study was to examine the effectiveness of a clinician-targeted intervention that used the 5As (Ask, Advise, Agree, Assist, Arrange) approach to physical activity counseling in a medically underserved patient population. Methods Family medicine clinicians at 2 community health centers were randomized to Group 1 or Group 2 intervention. Both clinician groups partic...

  5. Paying clinicians to join clinical trials: a review of guidelines and interview study of trialists

    OpenAIRE

    Hawker Sheila; Kerr Christine; Raftery James; Powell John

    2009-01-01

    Abstract Background The motivations of clinicians to participate in clinical trials have been little studied. This project explored the potential role of payment for participation in publicly funded clinical trials in the UK. The aims were to review relevant guidelines and to collate and analyse views of clinical trialists on the role of payments and other factors that motivated clinicians to join clinical trials. Methods Review of guidelines governing payments to clinicians for recruitment t...

  6. Clinician Recommendations and Perceptions of Factors Associated With Ankle Brace Use

    OpenAIRE

    Denton, Jason M.; Waldhelm, Andrew; Hacke, Jonathon D.; Gross, Michael T.

    2015-01-01

    Background: Little information is available regarding the ankle braces orthopaedic sports medicine clinicians recommend or clinicians’ concerns that may influence their decisions to recommend use of an ankle brace. Hypotheses: (1) Clinicians most frequently recommend lace-up braces with straps. (2) Clinicians who are concerned about potential adverse side effects from ankle brace use are less likely to recommend an ankle brace to prevent ankle sprain injuries. Study Design: Descriptive survey...

  7. 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.

  8. The impact of vitamin D on asthmatic human airway smooth muscle.

    Science.gov (United States)

    Hall, Sannette C; Fischer, Kimberly D; Agrawal, Devendra K

    2016-02-01

    Asthma is a chronic heterogeneous disorder, which involves airway inflammation, airway hyperresponsiveness (AHR) and airway remodeling. The airway smooth muscle (ASM) bundle regulates the broncho-motor tone and plays a critical role in AHR as well as orchestrating inflammation. Vitamin D deficiency has been linked to increased severity and exacerbations of symptoms in asthmatic patients. It has been shown to modulate both immune and structural cells, including ASM cells, in inflammatory diseases. Given that current asthma therapies have not been successful in reversing airway remodeling, vitamin D supplementation as a potential therapeutic option has gained a great deal of attention. Here, we highlight the potential immunomodulatory properties of vitamin D in regulating ASM function and airway inflammation in bronchial asthma. PMID:26634624

  9. 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.

  10. 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.

  11. Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America

    Directory of Open Access Journals (Sweden)

    Roberto Giugliani

    2014-06-01

    Full Text Available This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S, an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S (Elaprase®, Shire enzyme replacement therapy (ERT, designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses.

  12. Guidelines for diagnosis and treatment of Hunter Syndrome for clinicians in Latin America.

    Science.gov (United States)

    Giugliani, Roberto; Villarreal, Martha Luz Solano; Valdez, C Araceli Arellano; Hawilou, Antonieta Mahfoud; Guelbert, Norberto; Garzón, Luz Norela Correa; Martins, Ana Maria; Acosta, Angelina; Cabello, Juan Francisco; Lemes, Aída; Santos, Mara Lucia Schmitz Ferreira; Amartino, Hernán

    2014-06-01

    This review aims to provide clinicians in Latin America with the most current information on the clinical aspects, diagnosis, and management of Hunter syndrome, a serious and progressive disease for which specific treatment is available. Hunter syndrome is a genetic disorder where iduronate-2-sulfatase (I2S), an enzyme that degrades glycosaminoglycans, is absent or deficient. Clinical manifestations vary widely in severity and involve multiple organs and tissues. An attenuated and a severe phenotype are recognized depending on the degree of cognitive impairment. Early diagnosis is vital for disease management. Clinical signs common to children with Hunter syndrome include inguinal hernia, frequent ear and respiratory infections, facial dysmorphisms, macrocephaly, bone dysplasia, short stature, sleep apnea, and behavior problems. Diagnosis is based on screening urinary glycosaminoglycans and confirmation by measuring I2S activity and analyzing I2S gene mutations. Idursulfase (recombinant I2S) (Elaprase(®), Shire) enzyme replacement therapy (ERT), designed to address the underlying enzyme deficiency, is approved treatment and improves walking capacity and respiratory function, and reduces spleen and liver size and urinary glycosaminoglycan levels. Additional measures, responding to the multi-organ manifestations, such as abdominal/inguinal hernia repair, carpal tunnel surgery, and cardiac valve replacement, should also be considered. Investigational treatment options such as intrathecal ERT are active areas of research, and bone marrow transplantation is in clinical practice. Communication among care providers, social workers, patients and families is essential to inform and guide their decisions, establish realistic expectations, and assess patients' responses. PMID:25071396

  13. The Representation of Suicide on the Internet: Implications for Clinicians

    Science.gov (United States)

    Hadlaczky, Gergo; Wasserman, Danuta

    2012-01-01

    Background Suicide is one of the major causes of death in the world, leading to approximately 1 million deaths per year. While much of what is said about suicide and its causes is still taboo in most contemporary societies and cultures, internet websites and discussion forums have become an important and controversial source of information on the subject. A great deal of ambivalence is discernible as to whether online communication about suicide primarily should be seen as an opportunity or a serious threat. Objective To investigate how the subject of suicide is represented on the Internet, based on hits generated by the search engine Google. Methods In an exploratory design, Google search results on the target word “suicide”, for the years 2005, 2009, and 2012 respectively, were systematically analyzed and compared. Results The study shows that web pages of institutional origin on the subject predominate, that the content provided by these institutions concerns primarily research and prevention, and that the form of communication used by these senders is almost exclusively monological. However, besides these institutional pages there are a substantial number of private senders and pages, often anti-medical and against treatment of depression and other mental problems, characterized by dialogue, confessions and narratives, and to a higher degree, an alternative pro-suicide stance. Conclusions To counteract the influence of anti-medical and pro-suicide information, the role of the Internet should be discussed with the patient in clinical practice. Dialogical and confessional communications provide an opportunity for the clinician to gain a deeper perspective into perceptions of patients, regarding both their afflictions and the role of medical treatment in their lives. PMID:23010086

  14. 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

  15. [Dexamethasone increases the expression of reversion-inducing cysteine-rich protein with Kazal motifs (RECK) in lung tissues of bronchial asthmatic mice].

    Science.gov (United States)

    Li, Zhenxing; He, Sheng; Wei, Liping; Lin, Lin; Xiong, Hanzhen; Li, Junhong; Chen, Peifen; Lai, Wenyan

    2016-05-01

    Objective To investigate the expression of reversion-inducing cysteine-rich protein with Kazal motifs (RECK) in the lung tissues of bronchial asthmatic mice and the effect of dexamethasone treatment on its expression. Methods Thirty BALB/c mice were randomly divided into three equal groups: a control group, an asthmatic group and a dexamethasone-treated group. The asthmatic mouse models were established by intraperitoneal injection and inhalation with ovalbumin (OVA). The number of eosinophils (EOS) and lymphocytes (Lym) in bronchoalveolar lavage fluid (BALF) were counted. HE staining was used to observe airway inflammation and remodeling. The mRNA and protein expression of RECK were determined by real-time PCR and immunohistochemistry, respectively. Results Compared with the control group and the dexamethasone-treated group, the total cell number and EOS number in the BALF of the asthma group significantly increased. The expression of RECK mRNA in the asthmatic group was significantly lower than that in the control group and the dexamethasone-treated group. Immunohistochemistry showed that RECK was mainly expressed in the airway epithelial cells and inflammatory cells. RECK protein expression was highest in the control group and lowest in the asthmatic group. Conclusion Dexamethasone can increase the expression of RECK in the lung tissues of asthmatic mice. PMID:27126937

  16. A Clinician's Quick Guide of Evidence-Based Approaches Number 2: Depression

    Science.gov (United States)

    Moulds, Michelle L.; Werner-Seidler, Aliza; Dalgleish, Tim

    2013-01-01

    This quick guide presents resources for clinicians on evidence-based approaches for assessing and treating depression. It also briefly describes the mood disorder module of the clinician administered Structured Clinical Interview for DSM-IV Axis I Disorders, treatment approaches, and new and emerging developments demonstrating the effectiveness of…

  17. Lyme Disease in West Virginia: An Assessment of Distribution and Clinicians' Knowledge of Disease and Surveillance.

    Science.gov (United States)

    Singh, Sarah; Parker, David; Mark-Carew, Miguella; White, Robert; Fisher, Melanie

    2016-01-01

    Lyme disease case misclassification, a top public health concern, may be attributed to the current disconnect between clinical diagnosis and surveillance. This study examines Lyme disease distribution in West Virginia (WV) and determines clinicians' knowledge of both disease and surveillance. Lyme disease surveillance data for 2013 were obtained from the WV Bureau for Public Health. A validated survey, distributed to clinicians at an academic medical center, assessed clinicians' knowledge of disease diagnosis and surveillance. There were 297 adult Lyme disease cases of which 83 were confirmed. Clinician survey responses resulted in a correct response rate of 70% for Lyme disease knowledge questions. Fewer than half of all clinicians were aware of the surveillance criteria for confirming Lyme disease cases. Neither medical specialty nor previous treatment of patients with Lyme disease were significantly associated with clinicians' knowledge of the disease. Clinicians in WV are familiar with symptoms and clinical management of Lyme disease. However, they are less knowledgeable about diagnosis and public health surveillance comprising reporting and confirming cases of the disease. Clinicians and public health authorities should collaborate more closely to promote education and awareness as a key step to successfully reducing the burden of Lymne disease. PMID:27491103

  18. Does Using Nonnumerical Terms to Describe Risk Aid Violence Risk Communication? Clinician Agreement and Decision Making

    Science.gov (United States)

    Hilton, N. Zoe; Carter, Angela M.; Harris, Grant T.; Sharpe, Amilynn J. B.

    2008-01-01

    Actuarial risk assessments yield valid numerical information about violence risk, but research suggests that forensic clinicians prefer to communicate risk using nonnumerical information (i.e., verbal terms such as high risk). In an experimental questionnaire study, 60 forensic clinicians disagreed on the interpretation of nonnumerical terms, and…

  19. Symptom Severity in Bilingual Hispanics as a Function of Clinician Ethnicity and Language of Interview.

    Science.gov (United States)

    Malgady, Robert G.; Costantino, Giuseppe

    1998-01-01

    In this study, 148 Hispanic Americans with schizophrenia, depression, and anxiety disorders were interviewed in English, Spanish, or both. Hispanic clinicians rated symptoms more severely than did Anglo clinicians, and severity was rated highest in bilingual interviews, followed by Spanish, and lowest in English. Implications for diagnosis and…

  20. Analysis of the dynamic states of pulmonary ventilation and perfusion in bronchial asthmatics using [sup 133]Xe gas ventilation scintigraphy and [sup 99m]Tc-MAA lung perfusion scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ishihama, Hidenobu (Okayama Univ. (Japan). School of Medicine)

    1994-04-01

    To clarify the organic changes and pathophysiology of the lungs in intractable asthmatics, the dynamic states of pulmonary ventilation and perfusion were analyzed in 15 bronchial asthmatics in the stable state using [sup 133]Xe gas ventilation scintigraphy and [sup 99m]Tc-MAA lung perfusion scintigraphy, respectively. Dysfunction of pulmonary ventilation and impairment of pulmonary perfusion were significantly severer in intractable asthmatics than in non-intractable asthmatics (p<0.01, p<0.05, respectively) and those of asthma caused by aging. Late onset asthmatics with a long duration of disease tended to show severe impairment of pulmonary perfusion. Above all, the longer the duration of the disease, the severer became the impairment of pulmonary perfusion in late onset intractable asthmatics (LOIA). These findings suggest that the progression of irreversible organic changes of lungs in LOIA is involved in the severity of bronchial asthma. (author).

  1. A mixed methods approach for measuring the impact of delivery-centric interventions on clinician workflow.

    Science.gov (United States)

    Cady, Rhonda G; Finkelstein, Stanley M

    2012-01-01

    Health interventions vary widely. Pharmaceuticals, medical devices and wellness promotion are defined as 'outcome-centric.' They are implemented by clinicians for the use and benefit of consumers, and intervention effectiveness is measured by a change in health outcome. Electronic health records, computerized physician order entry systems and telehealth technologies are defined as 'delivery-centric.' They are implemented by organizations for use by clinicians to manage and facilitate consumer health, and the impact of these interventions on clinician workflow has become increasingly important. The methodological framework introduced in this paper uses a two-phase sequential mixed methods design that qualitatively explores clinician workflow before and after implementation of a delivery-centric intervention, and uses this information to quantitatively measure changes to workflow activities. The mixed methods protocol provides a standardized approach for understanding and determining the impact of delivery-centric interventions on clinician workflow. PMID:23304393

  2. Histophatologic changes of lung in asthmatic male rats treated with hydro-alcoholic extract of Plantago major and theophylline

    Directory of Open Access Journals (Sweden)

    Farah Farokhi

    2013-03-01

    Full Text Available Objective: Plantago major (P. major is one of the medicinal crops in the world which has therapeutic properties for treatment of respiratory and gastrointestinal diseases. Theophylline is commonly used for the treatment of respiratory diseases. In this study, we investigated the protective effects of hydro-alcoholic extract of P. major on lung in asthmatic male rats. Materials and Methods: 32 male adult rats were randomly divided into 4 groups: The control group (C received normal saline; Asthma (A group received a normal diet; Asthma group treated with Theophylline (200 mg/kg b.w. (T; Asthma group which received p.major (100 mg/kg b.w. (P. Asthma was induced by citric acid, 0.1 mg in form of spraying. The injection of P.major extract and theophylline was administered intraperitoneally for four weeks. At the end of the treatment, all of the rats were sacrificed and lungs were taken out, fixed, and stained with H&E, toluidine blue, and PAS, then histological studies were followed with light microscope. Results: Results showed that, in asthmatic group, the mean number of mast cells was significantly increased (p<0.05. Thickness of alveolar epithelium and accumulation of glycoprotein in airways was increased. Moreover, in some of alveolar sac hemorrhaging was observed. Administration of p.major extract in asthmatic rats restored these changes towards normal group.Conclusion: The present study revealed that P. major compared with theophylline, has a protective effect on lung in asthmatic rats.

  3. Anti-IL-5 treatment reduces deposition of ECM proteins in the bronchial subepithelial basement membrane of mild atopic asthmatics

    OpenAIRE

    Flood-Page, Patrick; Menzies-Gow, Andrew; Phipps, Simon; Ying, Sun; Wangoo, Arun; Ludwig, Mara S.; Barnes, Neil; Robinson, Douglas; Kay, A. Barry

    2003-01-01

    Eosinophil-derived TGF-β has been implicated in remodeling events in asthma. We hypothesized that reduction of bronchial mucosal eosinophils with anti–IL-5 would reduce markers of airway remodeling. Bronchial biopsies were obtained before and after three infusions of a humanized, anti–IL-5 monoclonal antibody (mepolizumab) in 24 atopic asthmatics in a randomized, double-blind, placebo-controlled study. The thickness and density of tenascin, lumican, and procollagen III in the reticular baseme...

  4. The effects of aerobic and strength exercises on pulmonary function tests and quality of life in asthmatic patients

    Directory of Open Access Journals (Sweden)

    Fesharaki M

    2010-09-01

    Full Text Available "nBackground: Asthma is a major health condition in Iran. This randomized clinical trial was aimed for the comparison of the effects of two exercise protocols (aerobic and aerobic-strength on the pulmonary indices and quality of life of asthmatic patients."n "nMethods: The study was conducted in pulmonary ward of Dr Shariati Hospital in Tehran, and Research Center of Exercise Medicine of Tehran in 2009. Fifty six asthmatic patients were selected and after two weeks of education, their spirometric parameters were recorded and the St George's respiratory questionnaire was completed. Then patients were randomly assigned to two groups of A and B. For ten weeks group A did the aerobic-strength exercises and group B did only the aerobic ones at home. At the end, again their spirometric parameters were recorded and the questionnaire was completed. Finally 42 patients completed the study. "n "nResults: After the intervention, FEV1 and FVC but not FEV1/FVC increased in group A. There were no changes in these parameters in group B. In addition, post-intervention FEV1 and FVC were significantly higher in group A than group B. All scores of St George's respiratory questionnaire were significantly improved in both groups but they were not different between them."n "nConclusions: Our findings showed that regular aerobic exercises, individually or concomitant with strength exercises, could improve vital signs and quality of life of mild to moderate asthmatic patients. However, only aerobic exercises with strength ones improve spirometric parameters. Therefore, a combination of both aerobic and strength exercises could be considered in treatment protocols of asthmatic patients.

  5. The early asthmatic response is associated with glycolysis, calcium binding and mitochondria activity as revealed by proteomic analysis in rats

    Directory of Open Access Journals (Sweden)

    Xu Yu-Dong

    2010-08-01

    Full Text Available Abstract Background The inhalation of allergens by allergic asthmatics results in the early asthmatic response (EAR, which is characterized by acute airway obstruction beginning within a few minutes. The EAR is the earliest indicator of the pathological progression of allergic asthma. Because the molecular mechanism underlying the EAR is not fully defined, this study will contribute to a better understanding of asthma. Methods In order to gain insight into the molecular basis of the EAR, we examined changes in protein expression patterns in the lung tissue of asthmatic rats during the EAR using 2-DE/MS-based proteomic techniques. Bioinformatic analysis of the proteomic data was then performed using PPI Spider and KEGG Spider to investigate the underlying molecular mechanism. Results In total, 44 differentially expressed protein spots were detected in the 2-DE gels. Of these 44 protein spots, 42 corresponded to 36 unique proteins successfully identified using mass spectrometry. During subsequent bioinformatic analysis, the gene ontology classification, the protein-protein interaction networking and the biological pathway exploration demonstrated that the identified proteins were mainly involved in glycolysis, calcium binding and mitochondrial activity. Using western blot and semi-quantitative RT-PCR, we confirmed the changes in expression of five selected proteins, which further supports our proteomic and bioinformatic analyses. Conclusions Our results reveal that the allergen-induced EAR in asthmatic rats is associated with glycolysis, calcium binding and mitochondrial activity, which could establish a functional network in which calcium binding may play a central role in promoting the progression of asthma.

  6. Small airway dysfunction by impulse oscillometry in asthmatic patients with normal forced expiratory volume in the 1st second values.

    Science.gov (United States)

    Pisi, Roberta; Tzani, Panagiota; Aiello, Marina; Martinelli, Enrico; Marangio, Emilio; Nicolini, Gabriele; Olivieri, Dario; Chetta, Alfredo

    2013-01-01

    Small airways are relevant to the pathophysiology of asthma. We investigated whether in asthmatic patients with normal forced expiratory volume in the 1st second (FEV(1)) values, impulse oscillometry system (IOS), as a measure of small airway function, contributed additional information to spirometry either at baseline or after bronchodilator, and whether it was related to the disease control. The fall in resistance from 5 to 20 Hz (R5-R20) and reactance at 5 Hz (X5) by IOS and spirometry measures of small airway function (forced expiratory flow at 25-75% [FEF(25-75)] and forced vital capacity/slow inspiratory vital capacity [FVC/SVC]) at baseline and after 400 micrograms of salbutamol were prospectively measured in 33 asthmatic patients (18 women; age range, 18-66 years). Disease control was assessed by the Asthma Control Test (ACT). R5-R20 but not X5 values were significantly related to FEF(25-75) and FVC/SVC values (p < 0.05 for both correlations). When the bronchodilator response was assessed, no correlation was found among IOS and spirometry changes. ACT scores were related to R5-R20, FEF(25-75), and FVC/SVC values (p < 0.01 for all correlations). In asthmatic patients with normal FEV(1) values, R5-R20 values were related to spirometry measures of small airway function. However, when the bronchodilator response was assessed, IOS and spirometry provided quite different results. Moreover, small airway dysfunction, as assessed by IOS and spirometry, was associated with poor disease control and history of asthma exacerbations. The results of this study confirm the value of IOS, as an investigative tool, and suggest that in asthmatic patients with normal FEV(1) values and poor disease control, small airway function should be investigated. PMID:23406931

  7. Registration-based assessment of regional lung function via volumetric CT images of normal subjects vs. severe asthmatics

    OpenAIRE

    Choi, Sanghun; Eric A Hoffman; Sally E. Wenzel; Tawhai, Merryn H.; Yin, Youbing; Castro, Mario; Lin, Ching-Long

    2013-01-01

    The purpose of this work was to explore the use of image registration-derived variables associated with computed tomographic (CT) imaging of the lung acquired at multiple volumes. As an evaluation of the utility of such an imaging approach, we explored two groups at the extremes of population ranging from normal subjects to severe asthmatics. A mass-preserving image registration technique was employed to match CT images at total lung capacity (TLC) and functional residual capacity (FRC) for a...

  8. Blockade of Airway Inflammation by Kaempferol via Disturbing Tyk-STAT Signaling in Airway Epithelial Cells and in Asthmatic Mice

    Directory of Open Access Journals (Sweden)

    Ju-Hyun Gong

    2013-01-01

    Full Text Available 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 μM suppressed the LPS-induced IL-8 production through the TLR4 activation, inhibiting eotaxin-1 induction. The in vivo study explored the demoting effects of kaempferol on asthmatic inflammation in BALB/c mice sensitized with ovalbumin (OVA. Mouse macrophage inflammatory protein-2 production and CXCR2 expression were upregulated in OVA-challenged mice, which was attenuated by oral administration of ≥10 mg/kg kaempferol. Kaempferol allayed the airway tissue levels of eotaxin-1 and eotaxin receptor CCR3 enhanced by OVA challenge. This study further explored the blockade of Tyk-STAT signaling by kaempferol in both LPS-stimulated BEAS-2B cells and OVA-challenged mice. LPS activated Tyk2 responsible for eotaxin-1 induction, while kaempferol dose-dependently inhibited LPS- or IL-8-inflamed Tyk2 activation. Similar inhibition of Tyk2 activation by kaempferol was observed in OVA-induced mice. Additionally, LPS stimulated the activation of STAT1/3 signaling concomitant with downregulated expression of Tyk-inhibiting SOCS3. In contrast, kaempferol encumbered STAT1/3 signaling with restoration of SOCS3 expression. Consistently, oral administration of kaempferol blocked STAT3 transactivation elevated by OVA challenge. These results demonstrate that kaempferol alleviated airway inflammation through modulating Tyk2-STAT1/3 signaling responsive to IL-8 in endotoxin-exposed airway epithelium and in asthmatic mice. Therefore, kaempferol may be a therapeutic agent targeting asthmatic diseases.

  9. Th17/Treg ratio derived using DNA methylation analysis is associated with the late phase asthmatic response

    OpenAIRE

    Singh, Amrit; Yamamoto, Masatsugu; Ruan, Jian; Choi, Jung Young; Gail M. Gauvreau; Olek, Sven; Hoffmueller, Ulrich; Carlsten, Christopher; FitzGerald, J Mark; Boulet, Louis-Philippe; O'Byrne, Paul M; Scott J Tebbutt

    2014-01-01

    Background The imbalance between Th17 and Treg cells has been studied in various diseases including allergic asthma but their roles have not been fully understood in the development of the late phase asthmatic response. Objectives To determine changes in Th17 and Treg cell numbers between isolated early responders (ERs) and dual responders (DRs) undergoing allergen inhalation challenge. To identify gene expression profiles associated with Th17 and Treg cells. Methods 14 participants (8 ERs an...

  10. Multiple in vitro and in vivo regulatory effects of budesonide in CD4+ T lymphocyte subpopulations of allergic asthmatics.

    Directory of Open Access Journals (Sweden)

    Elisabetta Pace

    Full Text Available BACKGROUND: Increased activation and increased survival of T lymphocytes characterise bronchial asthma. OBJECTIVES: In this study the effect of budesonide on T cell survival, on inducible co-stimulator T cells (ICOS, on Foxp3 and on IL-10 molecules in T lymphocyte sub-populations was assessed. METHODS: Cell survival (by annexin V binding and ICOS in total lymphocytes, in CD4+/CD25+ and in CD4+/CD25- and Foxp3 and IL-10 in CD4+/CD25+ and in CD4+/CD25-cells was evaluated, by cytofluorimetric analysis, in mild intermittent asthmatics (n = 19 and in controls (n = 15. Allergen induced T lymphocyte proliferation and the in vivo effects of budesonide in mild persistent asthmatics (n = 6 were also explored. RESULTS: Foxp3 was reduced in CD4+/CD25- and in CD4+/CD25+ cells and ICOS was reduced in CD4+/CD25+ cells but it was increased in CD4+CD25-in asthmatics when compared to controls. In asthmatics, in vitro, budesonide was able to: 1 increase annexin V binding and to reduce ICOS in total lymphocytes; 2 increase annexin V binding and Foxp3 and to reduce ICOS in CD4+/CD25- cells; 3 reduce annexin V binding and to increase IL-10 and ICOS in CD4+/CD25+ cells; 4 reduce cell allergen induced proliferation. In vivo, budesonide increased ICOS in CD4+/CD25+ while it increased Foxp3 and IL-10 in CD4+/CD25+ and in CD4+/CD25- cells. CONCLUSIONS: Budesonide modulates T cell survival, ICOS, Foxp3 and IL-10 molecules differently in T lymphocyte sub-populations. The findings provided shed light on new mechanisms by which corticosteroids, drugs widely used for the clinical management of bronchial asthma, control T lymphocyte activation.

  11. Perception of bronchial obstruction in asthmatic patients. Relationship with bronchial eosinophilic inflammation and epithelial damage and effect of corticosteroid treatment.

    OpenAIRE

    Roisman, G L; Peiffer, C; Lacronique, J. G.; Le Cae, A; Dusser, D J

    1995-01-01

    We studied the perception of bronchoconstriction in asthmatic subjects who were randomly treated with inhaled beta 2 agonist given either alone (n = 9) or associated with inhaled corticosteroids (n = 9). Methacholine and bradykinin challenges, bronchoalveolar lavage, and bronchial biopsies were performed in all subjects. After each dose of agonist, breathlessness was assessed using a visual analog scale (VAS) and the forced expiratory volume in 1 s (FEV1) was measured. The relationship betwee...

  12. No effect of elevated operating lung volumes on airway function during variable workrate exercise in asthmatic humans.

    Science.gov (United States)

    Klansky, Andrew; Irvin, Charlie; Morrison-Taylor, Adriane; Ahlstrand, Sarah; Labrie, Danielle; Haverkamp, Hans Christian

    2016-07-01

    In asthmatic adults, airway caliber fluctuates during variable intensity exercise such that bronchodilation (BD) occurs with increased workrate whereas bronchoconstriction (BC) occurs with decreased workrate. We hypothesized that increased lung mechanical stretch would prevent BC during such variable workrate exercise. Ten asthmatic and ten nonasthmatic subjects completed two exercise trials on a cycle ergometer. Both trials included a 28-min exercise bout consisting of alternating four min periods at workloads equal to 40 % (Low) and 70% (High) peak power output. During one trial, subjects breathed spontaneously throughout exercise (SVT), such that tidal volume (VT) and end-inspiratory lung volume (EILV) were increased by 0.5 and 0.6 liters during the high compared with the low workload in nonasthmatic and asthmatic subjects, respectively. During the second trial (MVT), VT and EILV were maintained constant when transitioning from the high to the low workload. Forced exhalations from total lung capacity were performed during each exercise workload. In asthmatic subjects, forced expiratory volume 1.0 s (FEV1.0) increased and decreased with the increases and decreases in workrate during both SVT (Low, 3.3 ± 0.3 liters; High, 3.6 ± 0.2 liters; P < 0.05) and MVT (Low, 3.3 ± 0.3 liters; High, 3.5 ± 0.2 liters; P < 0.05). Thus increased lung stretch during MVT did not prevent decreases in airway caliber when workload was reduced. We conclude that neural factors controlling airway smooth muscle (ASM) contractile activity during whole body exercise are more robust determinants of airway caliber than the ability of lung stretch to alter ASM actin-myosin binding and contraction. PMID:27150833

  13. 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.Results:Both asthma scores and lung function parameters were significantly improved by ICS treatment.The mean IL-4 concentration in the EBC was decreased gradually,from 1.92 ± 0.56 pmol/L before treatment to 1.60 ± 0.36 pmol/L after 8 weeks of treatment (P < 0.05) and 1.54 ± 0.81 pmol/L after 12 weeks of treatment (P < 0.01).However,the IL-6 concentration was not significantly decreased.The change in the IL-4 concentration was correlated with improvements in mean FEV1,PEF and FEF50 values (correlation coefficients-0.468,-0.478,and-0.426,respectively).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.

  14. Pentraxin 3 (PTX3 expression in allergic asthmatic airways: role in airway smooth muscle migration and chemokine production.

    Directory of Open Access Journals (Sweden)

    Jingbo Zhang

    Full Text Available BACKGROUND: Pentraxin 3 (PTX3 is a soluble pattern recognition receptor with non-redundant functions in inflammation and innate immunity. PTX3 is produced by immune and structural cells. However, very little is known about the expression of PTX3 and its role in allergic asthma. OBJECTIVES AND METHODS: We sought to determine the PTX3 expression in asthmatic airways and its function in human airway smooth muscle cells (HASMC. In vivo PTX3 expression in bronchial biopsies of mild, moderate and severe asthmatics was analyzed by immunohistochemistry. PTX3 mRNA and protein were measured by real-time RT-PCR and ELISA, respectively. Proliferation and migration were examined using (3H-thymidine incorporation, cell count and Boyden chamber assays. RESULTS: PTX3 immunoreactivity was increased in bronchial tissues of allergic asthmatics compared to healthy controls, and mainly localized in the smooth muscle bundle. PTX3 protein was expressed constitutively by HASMC and was significantly up-regulated by TNF, and IL-1β but not by Th2 (IL-4, IL-9, IL-13, Th1 (IFN-γ, or Th-17 (IL-17 cytokines. In vitro, HASMC released significantly higher levels of PTX3 at the baseline and upon TNF stimulation compared to airway epithelial cells (EC. Moreover, PTX3 induced CCL11/eotaxin-1 release whilst inhibited the fibroblast growth factor-2 (FGF-2-driven HASMC chemotactic activity. CONCLUSIONS: Our data provide the first evidence that PTX3 expression is increased in asthmatic airways. HASMC can both produce and respond to PTX3. PTX3 is a potent inhibitor of HASMC migration induced by FGF-2 and can upregulate CCL11/eotaxin-1 release. These results raise the possibility that PTX3 may play a dual role in allergic asthma.

  15. ASSESSMENT OF COMPLIANCE TO TREATMENT AMONG AMBULATORY ASTHMATIC PATIENTS IN A SECONDARY HEALTH CARE FACILITY IN NIGERIA

    OpenAIRE

    S. J. Showande et al.

    2012-01-01

    This study assessed the level of compliance using three different methods: pill count, self report and peak expiratory flow rate, in asthmatic patients attending a secondary health care facility. Self report (using a pre-tested structured questionnaire), peak expiratory flow rate and pill count were used to assess patient’s compliance and identify the factors which may be responsible for non compliance. Measurement of peak expiratory flow rate and the pill count were done at two different occ...

  16. Human metapneumovirus and respiratory syncytial virus in hospitalized danish children with acute respiratory tract infection

    DEFF Research Database (Denmark)

    von Linstow, Marie-Louise; Larsen, Hans Henrik; Eugen-Olsen, Jesper;

    2004-01-01

    The newly discovered human metapneumovirus (hMPV) has been shown to be associated with respiratory illness. We determined the frequencies and clinical features of hMPV and respiratory syncytial virus (RSV) infections in 374 Danish children with 383 episodes of acute respiratory tract infection...... children 1-6 months of age. Asthmatic bronchitis was diagnosed in 66.7% of hMPV and 10.6% of RSV-infected children (p < 0.001). Overall symptoms and clinical findings were similar among hMPV and RSV positive episodes, but more RSV-infected children required respiratory support. hMPV is present in young...

  17. GINA 联合阿法骨化醇对支气管哮喘患儿血清25-(OH)D3、IL-4、IL-12、IgE 的影响%The effects of GINA regimen combined alfacalcidol on serum 25-(OH)D3,IL-4,IL-12,IgE in asthmatic children

    Institute of Scientific and Technical Information of China (English)

    黄仁勇; 刘运广; 林娜

    2015-01-01

    Objective To investigate the effects GINA regimen combined alfacalcidol on serum 25-(OH) D3 ,IL-4,IL-12,IgE and its efficacy in treatment of children with asthma. Methods Patients in accord-ance with bronchial asthma diagnostic criteria visited pediatric outpatient department of our hospital from March 2012 to December 2013 were divided into a GINA treatment + vitamin D group (GINA + D group)and a GINA regimen group (GINA group)with using a random number table method,and the other healthy chil-dren selected for the same period were enrolled in the control group.The first two groups were given standard-ized treatment with GINA regimen,GINA + D group were added with oral alfacalcidol capsule.All children with asthma were traced,observed and followed up for one year.The treatment efficacy was evaluated and the serum 25-(OH)D3 ,IgE,IL-4,IL-12 levels were detected among three groups in different periods. Re-sults ①The difference was statistically significant (P <0.01)in asthma attack total control rate between GI-NA + D group and GINA group.②The serum IgE,IL-4 levels in GINA group and GINA + D group were significantly higher than the control group (all P <0.001),the serum IL-12 level in treatment group was sig-nificantly lower than the control group (P <0.001).③Three months after 25-(OH)D3 treatment,GINA +D group had lower serum IgE,IL-4 level,comparison of post-treatment IgE and IL-4 to pre-treatment in GINA + D group and those of post-treatment in GINA group yielded statistically significant differences (all P<0.001)and the 25-(OH)D3 ,IL-12 level was significantly increased at the same period (all P <0.001). Conclusion Low serum level occurred in children with asthma,25 -(OH)D3 played an important role as an immunomodulation,in immune response in asthma,airway hyper- responsiveness.and in treatment of chil-dren with asthma by GINA standardization regimen,while giving 25 - (OH)D3 adjuvant therapy will help greatly improve the condition of children and reduce

  18. Lithium Attenuates TGF-β1-Induced Fibroblasts to Myofibroblasts Transition in Bronchial Fibroblasts Derived from Asthmatic Patients

    Directory of Open Access Journals (Sweden)

    Marta Michalik

    2012-01-01

    Full Text Available Bronchial asthma is a chronic disorder accompanied by phenotypic transitions of bronchial epithelial cells, smooth muscle cells, and fibroblasts. Human bronchial fibroblasts (HBFs derived from patients with diagnosed asthma display predestination towards TGF-β-induced phenotypic switches. Since the interference between TGF-β and GSK-3β signaling contributes to pathophysiology of chronic lung diseases, we investigated the effect of lithium, a nonspecific GSK-3β inhibitor, on TGF-β1-induced fibroblast to myofibroblast transition (FMT in HBF and found that the inhibition of GSK-3β attenuates TGF-β1-induced FMT in HBF populations derived from asthmatic but not healthy donors. Cytoplasmically sequestrated β-catenin, abundant in TGF-β1/LiCl-stimulated asthmatic HBFs, most likely interacts with and inhibits the nuclear accumulation and signal transduction of Smad proteins. These data indicate that the specific cellular context determines FMT-related responses of HBFs to factors interfering with the TGF-β signaling pathway. They may also provide a mechanistic explanation for epidemiological data revealing coincidental remission of asthmatic syndromes and their recurrence upon the discontinuation of lithium therapy in certain psychiatric diseases.

  19. Gene-metabolite expression in blood can discriminate allergen-induced isolated early from dual asthmatic responses.

    Directory of Open Access Journals (Sweden)

    Amrit Singh

    Full Text Available Some asthmatic individuals undergoing allergen inhalation challenge develop an isolated early response whereas others develop a dual response (early plus late response. In the present study we have used transcriptomics (microarrays and metabolomics (mass spectrometry of peripheral blood to identify molecular patterns that can discriminate allergen-induced isolated early from dual asthmatic responses. Peripheral blood was obtained prior to (pre- and 2 hours post allergen inhalation challenge from 33 study participants. In an initial cohort of 14 participants, complete blood counts indicated significant differences in neutrophil and lymphocyte counts at pre-challenge between early and dual responders. At post-challenge, significant genes (ALOX15, FADS2 and LPCAT2 and metabolites (lysolipids were enriched in lipid metabolism pathways. Enzymes encoding for these genes are involved in membrane biogenesis and metabolism of fatty acids into pro-inflammatory and anti-inflammatory mediators. Correlation analysis indicated a strong negative correlation between ALOX15, FADS2, and IL5RA expression with 2-arachidonoylglycerophosphocholine levels in dual responders. However, measuring arachidonic acid and docosahexaenoic acid levels in a validation cohort of 19 participants indicated that the free form of DHA (nmoles/µg of protein was significantly (p = 0.03 different between early and dual responders after allergen challenge. Collectively these results may suggest an imbalance in lipid metabolism which dictates pro- (anti- inflammatory and pro-resolving mechanisms. Future studies with larger sample sizes may reveal novel mechanisms and therapeutic targets of the late phase asthmatic response.

  20. Effect of Arsenic Trioxide with Various Concentrations on Dendritic Cells in the Conducting Airways of Asthmatic Mice

    Institute of Scientific and Technical Information of China (English)

    YINKai-sheng; ZHOULin-fu; JIXiao-hui; LENGJing; YANGYu

    2004-01-01

    To investigate the effect of arsenic trioxide (As2O3 )with three different concentration groups on the distribution and recruitment of dendritic cells(DCs) in the conducting airways of asthmatic mice. Methods: Fifty BALB/c mice were divided into 5 groups at random: control group, asthmatic group, therapeutic groups with low dose(1 mg/kg), moderate dose( 5 mg/lqg) and high dose( 10 mg/kg) of As2O3. The immunohistochomistry, scanning electron microscope and computerized image analysis were applied to detect airway DCs, respectively. Results: We demonstrated from the control mice that all intraepithelial NLDC-145 DCs throughout the respiratory tree cotdd be accounted for a network of cells with dendritic cell morphology, and the density of DCs varied from(500±50) cells/ram2 epithelial surface in the large airways, to(60±10)cells/mm2 epithelial surface in the small airways(P0.05).Conchsion : Our findings suggest that it might be an important therapeutic mechanism of As2 03 to downregulate not the distribution but the density of DCs in the conducting airways of asthmatic mice,and low dose of As203 has potential value in treating asthma.