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Sample records for childhood asthma ureca

  1. The Urban Environment and Childhood Asthma (URECA birth cohort study: design, methods, and study population

    Directory of Open Access Journals (Sweden)

    Sandel Megan T

    2009-05-01

    Full Text Available Abstract Background The incidence and morbidity of wheezing illnesses and childhood asthma is especially high in poor urban areas. This paper describes the study design, methods, and population of the Urban Environment and Childhood Asthma (URECA study, which was established to investigate the immunologic causes of asthma among inner-city children. Methods and Results URECA is an observational prospective study that enrolled pregnant women in central urban areas of Baltimore, Boston, New York City, and St. Louis and is following their offspring from birth through age 7 years. The birth cohort consists of 560 inner-city children who have at least one parent with an allergic disease or asthma, and all families live in areas in which at least 20% of the population has incomes below the poverty line. In addition, 49 inner-city children with no parental history of allergies or asthma were enrolled. The primary hypothesis is that specific urban exposures in early life promote a unique pattern of immune development (impaired antiviral and increased Th2 responses that increases the risk of recurrent wheezing and allergic sensitization in early childhood, and of asthma by age 7 years. To track immune development, cytokine responses of blood mononuclear cells stimulated ex vivo are measured at birth and then annually. Environmental assessments include allergen and endotoxin levels in house dust, pre- and postnatal maternal stress, and indoor air nicotine and nitrogen dioxide. Nasal mucous samples are collected from the children during respiratory illnesses and analyzed for respiratory viruses. The complex interactions between environmental exposures and immune development will be assessed with respect to recurrent wheeze at age 3 years and asthma at age 7 years. Conclusion The overall goal of the URECA study is to develop a better understanding of how specific urban exposures affect immune development to promote wheezing illnesses and asthma.

  2. Childhood Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  3. Undiagnosed asthma in childhood

    NARCIS (Netherlands)

    van Gent, R.

    2008-01-01

    Asthma is the most prevalent chronic disease in childhood. To study the actual prevalence and impact of undiagnosed childhood asthma in daily life (i.e. quality of life, participation in physical and school activities) we performed a survey in schoolchildren (aged 7-10 years) in the southern part of

  4. Asthma in childhood.

    Science.gov (United States)

    de Benedictis, Fernando Maria; Attanasi, Marina

    2016-03-01

    Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events. Recent data suggest the possibility that exhaled volatile organic compounds may qualify as biomarkers in detecting early signs of asthma. Adding information of exhaled volatile organic compounds and expression of inflammation genes to a clinical tool significantly improves asthma prediction in preschool wheezy children. Personal communication with children and adolescents is likely more important than the tools actually used for monitoring asthma. Systemic corticosteroids do not affect the long-term prognosis in children with first viral-induced wheezing episode and should be used cautiously during acute episodes. Finally, stress and a polymorphism upstream of a specific gene are both associated with reduced bronchodilator response in children with asthma.

  5. Asthma in childhood

    Directory of Open Access Journals (Sweden)

    Fernando Maria de Benedictis

    2016-03-01

    Full Text Available Several topics on childhood asthma were addressed in the Paediatric Clinical Year in Review session at the 2015 European Respiratory Society International Congress. With regard to the relationship between lower respiratory tract infections and asthma, it emerges that is the number of respiratory episodes in the first years of life, but not the particular viral trigger, to be associated with later asthma development. Understanding which characteristics of individual patients are associated with an increased risk for asthma exacerbation is a critical step to implement strategies preventing these seasonal events. Recent data suggest the possibility that exhaled volatile organic compounds may qualify as biomarkers in detecting early signs of asthma. Adding information of exhaled volatile organic compounds and expression of inflammation genes to a clinical tool significantly improves asthma prediction in preschool wheezy children. Personal communication with children and adolescents is likely more important than the tools actually used for monitoring asthma. Systemic corticosteroids do not affect the long-term prognosis in children with first viral-induced wheezing episode and should be used cautiously during acute episodes. Finally, stress and a polymorphism upstream of a specific gene are both associated with reduced bronchodilator response in children with asthma.

  6. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents...

  7. Predicting adult asthma in childhood

    NARCIS (Netherlands)

    Vonk, JM; Boezen, HM

    2006-01-01

    PURPOSE OF REVIEW: There still is no cure for asthma. Early identification of patients at risk for disease progression may lead to better treatment opportunities and hopefully better disease outcomes in adulthood. Recent literature on childhood risk factors associated with the outcome of asthma in a

  8. Japanese Guideline for Childhood Asthma

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    Toshiyuki Nishimuta

    2011-01-01

    JAGL differs from the Global Initiative for Asthma Guideline (GINA in that the former emphasizes long-term management of childhood asthma based on asthma severity and early diagnosis and intervention at <2 years and 2–5 years of age. However, a management method, including step-up or step-down of long-term management agents based on the status of asthma symptoms, is easy to understand and thus JAGL is suitable for routine medical treatment. JAGL also introduced treatment and management using a control test for children, recommending treatment and management aimed at complete control through avoiding exacerbation factors and appropriate use of antiinflammatory agents.

  9. Childhood asthma and physical activity

    DEFF Research Database (Denmark)

    Lochte, Lene; Nielsen, Kim G; Petersen, Poul Erik;

    2016-01-01

    BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The obj......BACKGROUND: Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents...... and extracted data from original articles that met the inclusion criteria. Summary odds ratios (ORs) and confidence intervals (CIs) were used to express the results of the meta-analysis (forest plot). We explored heterogeneity using funnel plots and the Graphic Appraisal Tool for Epidemiology (GATE). RESULTS......: We retrieved 1,571 titles and selected 11 articles describing three cohort and eight cross-sectional studies for inclusion. A meta-analysis of the cohort studies revealed a risk of new-onset asthma in children with low PA (OR [95 % CI] 1.32 [0.95; 1.84] [random effects] and 1.35 [1.13; 1.62] [fixed...

  10. Examining the association between childhood asthma and parent and grandparent asthma status: Implications for Practice

    OpenAIRE

    Valerio, Melissa A.; Andreski, Patricia M.; Schoeni, Robert F.; McGonagle, Katherine A.

    2010-01-01

    Examination of intergenerational asthma beyond maternal asthma has been limited. The association between childhood asthma and intergenerational asthma status among a national cohort of children was examined.

  11. Managing Asthma in the Early Childhood Setting

    Science.gov (United States)

    Graville, Iris

    2011-01-01

    Asthma, one of the most common chronic disorders in childhood, affects more than seven million children in the United States, and is the third leading cause of hospitalization for children. Statistics like these make planning and preparing for asthma in the early childhood setting a high priority. With the high rates of asthma in the U.S. today,…

  12. Childhood Asthma: A Chance to HEAL

    Science.gov (United States)

    ... Home Current Issue Past Issues Special Section Childhood Asthma: A Chance to HEAL Past Issues / Fall 2007 ... a peak flow meter. Photo courtesy of MCAN Asthma, a reality of daily life for more than ...

  13. Progress in the management of childhood asthma

    OpenAIRE

    Vichyanond, Pakit; Pensrichon, Rattana; Kurasirikul, Suruthai

    2012-01-01

    Asthma has become the most common chronic disease in childhood. Significant advances in epidemiological research as well as in therapy of pediatric asthma have been made over the past 2 decades. In this review, we look at certain aspects therapy of childhood asthma, both in the past and present. Literature review on allergen avoidance (including mites, cockroach and cat), intensive therapy with β2-agonists in acute asthma (administering via continuous nebulization and intravenous routes), a r...

  14. Childhood asthma and risk factors

    Directory of Open Access Journals (Sweden)

    Ljuština-Pribić Radmila

    2010-01-01

    Full Text Available Introduction. This article summarizes the contribution of epidemiology to the understanding of childhood asthma. The first task in epidemiology is to determine prevalence and incidence of any disease. Prevalence. Epidemiological investigations are aimed at evaluating hypotheses about causes of disease by defining demographic characteristics of a certain population as well as by determining possible effects of environmental factors. In spite of some limitations, data obtained by epidemiological investigations have been valuable in confirming both the increasing incidence of asthma and the differences in prevalence in certain population groups. The observance of this phenomenon has led to much speculation and a lot of attempts to identify the reasons behind the rising prevalence. Risk factors. Epidemiological studies have identified risk factors for the development of childhood asthma and provided insight into natural history of disease and prognosis. Factors ranging from increased numbers of immunizations to increased air pollution have been suggested, but subsequent analysis has failed to provide the supporting evidence to implicate most of these possibilities. The concept known as the hygiene hypothesis has gained some support from epidemiological studies. Conclusion. The development of asthma as well as its severity are affected by numerous factors and their interactions can be explained by the heterogeneous nature of this disease.

  15. Asthma in childhood: a complex, heterogeneous disease

    Directory of Open Access Journals (Sweden)

    Hai Lee Chung

    2011-01-01

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

  16. Childhood Asthma Management and Environmental Triggers.

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    Hollenbach, Jessica P; Cloutier, Michelle M

    2015-10-01

    Asthma is the most common chronic disease among children. It cannot be prevented but can be controlled. Industrialized countries experience high lifetime asthma prevalence that has increased over recent decades. Asthma has a complex interplay of genetic and environmental triggers. Studies have revealed complex interactions of lung structure and function genes with environmental exposures such as environmental tobacco smoke and vitamin D. Home environmental strategies can reduce asthma morbidity in children but should be tailored to specific allergens. Coupled with education and severity-specific asthma therapy, tailored interventions may be the most effective strategy to manage childhood asthma.

  17. Asthma in childhood: a complex, heterogeneous disease

    OpenAIRE

    2011-01-01

    Asthma in childhood is a heterogeneous disease with different phenotypes and variable clinical manifestations, which depend on the age, gender, genetic background, and environmental influences of the patients. Several longitudinal studies have been conducted to classify the phenotypes of childhood asthma, on the basis of the symptoms, triggers of wheezing illness, or pathophysiological features of the disease. These studies have provided us with important information about the different wheez...

  18. Rhinovirus and childhood asthma: an update

    Science.gov (United States)

    2016-01-01

    Asthma is recognized as a complex disease resulting from interactions between multiple genetic and environmental factors. Accumulating evidence suggests that respiratory viral infections in early life constitute a major environmental risk factor for the development of childhood asthma. Respiratory viral infections have also been recognized as the most common cause of asthma exacerbation. The advent of molecular diagnostics to detect respiratory viruses has provided new insights into the role of human rhinovirus (HRV) infections in the pathogenesis of asthma. However, it is still unclear whether HRV infections cause asthma or if wheezing with HRV infection is simply a predictor of childhood asthma. Recent clinical and experimental studies have identified plausible pathways by which HRV infection could cause asthma, particularly in a susceptible host, and exacerbate disease. Airway epithelial cells, the primary site of infection and replication of HRV, play a key role in these processes. Details regarding the role of genetic factors, including ORMDL3, are beginning to emerge. This review discusses recent clinical and experimental evidence for the role of HRV infection in the development and exacerbation of childhood asthma and the potential underlying mechanisms that have been proposed. PMID:27895690

  19. Childhood asthma prediction models: a systematic review.

    Science.gov (United States)

    Smit, Henriette A; Pinart, Mariona; Antó, Josep M; Keil, Thomas; Bousquet, Jean; Carlsen, Kai H; Moons, Karel G M; Hooft, Lotty; Carlsen, Karin C Lødrup

    2015-12-01

    Early identification of children at risk of developing asthma at school age is crucial, but the usefulness of childhood asthma prediction models in clinical practice is still unclear. We systematically reviewed all existing prediction models to identify preschool children with asthma-like symptoms at risk of developing asthma at school age. Studies were included if they developed a new prediction model or updated an existing model in children aged 4 years or younger with asthma-like symptoms, with assessment of asthma done between 6 and 12 years of age. 12 prediction models were identified in four types of cohorts of preschool children: those with health-care visits, those with parent-reported symptoms, those at high risk of asthma, or children in the general population. Four basic models included non-invasive, easy-to-obtain predictors only, notably family history, allergic disease comorbidities or precursors of asthma, and severity of early symptoms. Eight extended models included additional clinical tests, mostly specific IgE determination. Some models could better predict asthma development and other models could better rule out asthma development, but the predictive performance of no single model stood out in both aspects simultaneously. This finding suggests that there is a large proportion of preschool children with wheeze for which prediction of asthma development is difficult.

  20. Environmental factors and childhood asthma.

    Science.gov (United States)

    Phipatanakul, Wanda

    2006-09-01

    Indoor allergens are potent triggers for acute and chronic pediatric asthma. Environmental control measures of these allergens should be considered first-line treatment measures. Allergen avoidance can produce changes in disease activity and symptoms that can be beneficial before any medical intervention is implemented. In addition to allergen avoidance, studies evaluating other exposures, such as endotoxin and diet, in the pathogenesis of asthma are in progress. Understanding the complex relationships between exposure and allergy/asthma development is vitally important to the development of potentially more effective primary and secondary prevention strategies.

  1. Salmeterol in the treatment of childhood asthma

    NARCIS (Netherlands)

    A.A.P.H. Vaessen-Verberne (Anja)

    1997-01-01

    textabstractAsthma is the most common chronic disease of childhood. Although mortality rates in the Netherlands and other Western European countries are low, astlmm causes a great deal of morbidity and school absence. Incidence rates in our country are about 10% and recent epidemiologic studies show

  2. Optimizing inhalation therapy in childhood asthma

    NARCIS (Netherlands)

    Visser, Reina

    2016-01-01

    Childhood asthma is a common chronic disease, featured by inflammation of the airways and episodic bronchoconstriction. Exercise is an important trigger for bronchoconstriction in asthmatic children. They experience this symptom, limiting participation in play and sports, as the most bothersome aspe

  3. Childhood Asthma: Diagnosis and Treatment

    Directory of Open Access Journals (Sweden)

    Wim M. van Aalderen

    2012-01-01

    Full Text Available Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  4. Childhood asthma: diagnosis and treatment.

    Science.gov (United States)

    van Aalderen, Wim M

    2012-01-01

    Many children suffer from recurrent coughing, wheezing and chest tightness. In preschool children one third of all children have these symptoms before the age of six, but only 40% of these wheezing preschoolers will continue to have asthma. In older school-aged children the majority of the children have asthma. Quality of life is affected by asthma control. Sleep disruption and exercised induced airflow limitation have a negative impact on participation in sports and social activities, and may influence family life. The goal of asthma therapy is to achieve asthma control, but only a limited number of patients are able to reach total control. This may be due to an incorrect diagnosis, co-morbidities or poor inhalation technique, but in the majority of cases non-adherence is the main reason for therapy failures. However, partnership with the parents and the child is important in order to set individually chosen goals of therapy and may be of help to improve control. Non-pharmacological measures aim at avoiding tobacco smoke, and when a child is sensitised, to avoid allergens. In pharmacological management international guidelines such as the GINA guideline and the British Guideline on the Management of Asthma are leading.

  5. Adherence with Preventive Medication in Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Scott Burgess

    2011-01-01

    Full Text Available Suboptimal adherence with preventive medication is common and often unrecognised as a cause of poor asthma control. A number of risk factors for nonadherence have emerged from well-conducted studies. Unfortunately, patient report a physician's estimation of adherence and knowledge of these risk factors may not assist in determining whether non-adherence is a significant factor. Electronic monitoring devices are likely to be more frequently used to remind patients to take medication, as a strategy to motivate patients to maintain adherence, and a tool to evaluate adherence in subjects with poor disease control. The aim of this paper is to review non-adherence with preventive medication in childhood asthma, its impact on asthma control, methods of evaluating non-adherence, risk factors for suboptimal adherence, and strategies to enhance adherence.

  6. Prevalence of childhood asthma in Istanbul, Turkey.

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    Oneş, U; Sapan, N; Somer, A; Dişçi, R; Salman, N; Güler, N; Yalçin, I

    1997-05-01

    In order to determine the asthma prevalence in 6-12-year-old schoolchildren in Istanbul, we issued 2350 questionnaires, according to ISAAC criteria, in six randomly selected city primary schools to be completed at home by parents. A total of 2232 of the questionnaires were completed, an overall response rate of 94.9%, and 2216 questionnaires were taken into consideration. The prevalence of asthma was found to be 9.8% and wheezing 15.1%. To investigate the effect of socioeconomic status on the prevalence of asthma, we evaluated the heating system at home, the place of residence, the educational levels of the mother and father, the number of people living in the house, the sharing of bedrooms, and the annual family income. In conclusion, the prevalence of childhood asthma was not affected by any of these factors. Atopic family history, food allergy, eczema, and frequent otitis media and sinusitis attacks were evaluated and found to be significant in asthma prevalence.

  7. Pre-eclampsia and childhood asthma.

    Science.gov (United States)

    Magnus, Maria C; Håberg, Siri E; Magnus, Per; Engeland, Anders; Nafstad, Per; Karlstad, Øystein; Nystad, Wenche

    2016-12-01

    Studies of pre-eclampsia and childhood asthma are conflicting, and none have performed a formal mediation analysis of preterm birth.We examined the association between pre-eclampsia and asthma at 7 years using national registries, including all births in Norway from 1999 to 2006 (n=406 907), and a subsample of children in the Norwegian Mother and Child Cohort Study (MoBa) (n=45 028) using log-linear regression. We performed a mediation analysis of preterm birth, and a sibling comparison to evaluate unobserved confounding.There was a positive association between pre-eclampsia and asthma in the registry study, with an adjusted relative risk of 1.31 (95% CI 1.22-1.41), but not in MoBa, which had an adjusted relative risk of 1.19 (95% CI 0.99-1.44). The odds ratios for the direct effect not mediated through preterm birth and the indirect effect in the registry linkage were 1.19 (95% CI 1.10-1.29) and 1.12 (95% CI 1.11-1.14), respectively. The sibling comparison indicated no association between pre-eclampsia and asthma (adjusted OR 1.07, 95% CI 0.87-1.33).In this large study, which used different datasets and analytic approaches, there was little evidence for an association between pre-eclampsia and childhood asthma. The association was weak and largely explained by pre-term birth and confounders shared by siblings.

  8. Japanese Guideline for Childhood Asthma 2014

    Directory of Open Access Journals (Sweden)

    Yuhei Hamasaki

    2014-01-01

    Full Text Available The Japanese Guideline for the Diagnosis and Treatment of Allergic Diseases 2013 (JAGL 2013 describes childhood asthma after the Japanese Pediatric Guideline for the Treatment and Management of Asthma 2012 (JPGL 2012 by the Japanese Society of Pediatric Allergy and Clinical Immunology. JAGL 2013 provides information on diagnosis by age group from infancy to puberty (0–15 years of age, treatment for acute exacerbations, long-term management by anti-inflammatory drugs, daily life guidance, and patient education to allow non-specialist physicians to refer to this guideline for routine medical treatment. JAGL differs from the Global Initiative for Asthma Guideline (GINA in that JAGL emphasizes early diagnosis and intervention at <2 years and 2–5 years of age. A management method, including step-up or step-down of long-term management drugs based on the status of asthma control levels, as in JAGL, is easy to understand, and thus the Guideline is suitable as a frame of reference for routine medical treatment. JAGL has also introduced treatment and management using a control test on children, recommending that the physician aim at complete control by avoiding exacerbation factors and by appropriate use of anti-inflammatory drugs.

  9. Perinatal Programming of Childhood Asthma: Early Fetal Size, Growth Trajectory during Infancy, and Childhood Asthma Outcomes

    Directory of Open Access Journals (Sweden)

    Steve Turner

    2012-01-01

    Full Text Available The “fetal origins hypothesis” or concept of “developmental programming” suggests that faltering fetal growth and subsequent catch-up growth are implicated in the aetiology of cardiovascular disease. Associations between reduced birth weight, rapid postnatal weight gain, and asthma suggest that there are fetal origins to respiratory disease. The present paper first summarises the literature relating birth weight and post natal growth trajectories to asthma outcomes. Second, issues regarding the interpretation of antenatal fetal ultrasound measurements are discussed. Finally, recent reports linking antenatal measurement and growth trajectory to early childhood asthma outcomes are discussed. Understanding the nature and timing of factors which influence antenatal growth may give important insight into the antecedents of early-onset asthma with implications for interventions.

  10. The PCDH1-gene and asthma in early childhood

    DEFF Research Database (Denmark)

    Mortensen, Li J; Kreiner-Møller, Eskil; Hakonarson, Hakon;

    2014-01-01

    Previous studies suggests that variants in the protocadherin-1 (PCDH1) gene, important for cell-cell adhesion, are associated with asthma, bronchial, hyperresponsiveness and atopic dermatitis in school-children.To associate common variants of the PCDH1-gene to longitudinally assessed asthma......-phenotypes and atopic dermatitis in early childhood.We analysed 8 SNPs in PCDH1 from 411 children born to asthmatic mothers from the Copenhagen Prospective Studies on Asthma in Childhood birth-cohort.Asthma and atopic dermatitis were diagnosed prospectively to age seven and asthma was categorized by temporal pattern...... dermatitis and rs11167761-A (OR=1.85, CI: 1.24-2.75, p=0.0026).Common variations in PCDH1 increase the risk of developing both transient early asthma and atopic dermatitis in early childhood....

  11. Examining the temporal relationships between childhood obesity and asthma.

    Science.gov (United States)

    Green, Tiffany L

    2014-07-01

    Childhood obesity has become an issue of increasing concern to health researchers and policymakers in the United States. One important chronic health condition linked to obesity is pediatric asthma. Although researchers have speculated that both conditions may have common origins, the majority of research in this area has focused on a unidirectional relationship between obesity and later asthma. However, much of the literature is limited by its reliance on cross-sectional data and its failure to examine the possibility that asthma may influence weight fluctuations through changes in physical and sedentary activity. Using data from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), I explore the bidirectional relationships between childhood obesity and asthma. The results in this paper suggest that past asthma levels are positively correlated with changes in BMI and the onset of obesity. However, only new onset asthma is positively correlated with subsequent changes in BMI. The potential mechanisms are unclear, as I find little evidence that asthma is structurally related to changes in physical or sedentary activity over time. When testing the prevailing hypothesis that obesity is related to subsequent asthma, I find that lagged weight status is strongly related to asthma prevalence levels but that the onset of overweight or obesity is not associated with the subsequent onset of asthma. These results suggest that the onset of asthma may be related to subsequent weight gain over time.

  12. Difficult childhood asthma: management and future.

    Science.gov (United States)

    Tillie-Leblond, Isabelle; Deschildre, Antoine; Gosset, Philippe; de Blic, Jacques

    2012-09-01

    Diagnosis and management of severe asthma implies the definition of different entities, that is, difficult asthma and refractory severe asthma, but also the different phenotypes included in the term refractory severe asthma. A complete evaluation by a physician expert in asthma is necessary, adapted for each child. Identification of mechanisms involved in different phenotypes in refractory severe asthma may improve the therapeutic approach. The quality of care and monitoring of children with severe asthma is as important as the prescription drug, and is also crucial for differentiating between severe asthma and difficult asthma, whereby expertise is required.

  13. Exhaled 8-isoprostane in childhood asthma

    Directory of Open Access Journals (Sweden)

    Bush Andrew

    2005-07-01

    Full Text Available Abstract Background Exhaled breath condensate (EBC is a non-invasive method to assess airway inflammation and oxidative stress and may be useful in the assessment of childhood asthma. Methods Exhaled 8-isoprostane, a stable marker of oxidative stress, was measured in EBC, in children (5–17 years with asthma (13 steroid-naïve and 12 inhaled steroid-treated and 11 healthy control. Results Mean exhaled 8-isoprostane concentration was significantly elevated in steroid-naïve asthmatic children compared to healthy children 9.3 (SEM 1.7 vs. 3.8 (0.6 pg/ml, p Conclusion We conclude that 8-isoprostane is elevated in asthmatic children, indicating increased oxidative stress, and that this does not appear to be normalized by inhaled steroid therapy. This suggests that 8-isoprostane is a useful non-invasive measurement of oxidative stress in children and that antioxidant therapy may be useful in the future.

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

    Data.gov (United States)

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

  15. Asthma Symptoms in Early Childhood: A public health perspective

    NARCIS (Netherlands)

    E.H.D. Hafkamp-De Groen (Esther)

    2014-01-01

    markdownabstract__Abstract__ This thesis focuses on asthma symptoms in early childhood. From a public health perspective, we aim to improve health and health-related quality of life through the prevention of asthma symptoms and by signaling, counselling or management of children who are at a high r

  16. Comorbidities of asthma during childhood : possibly important, yet poorly studied

    NARCIS (Netherlands)

    de Groot, E. P.; Duiverman, E. J.; Brand, P. L. P.

    2010-01-01

    Asthma in adults is associated with comorbidities such as obesity, gastro-oesophageal reflux, dysfunctional breathing and mental disorders. Herein, we provide an overview of the current state of evidence on these comorbidities in childhood asthma. The prevalence, known mechanisms and possible treatm

  17. Childhood Asthma May Encourage Obesity, Study Suggests

    Science.gov (United States)

    ... Human Services. More Health News on: Asthma in Children Obesity in Children Recent Health News Related MedlinePlus Health Topics Asthma in Children Obesity in Children About MedlinePlus Site Map FAQs Customer ...

  18. Patterns of Growth and Decline in Lung Function in Persistent Childhood Asthma

    NARCIS (Netherlands)

    McGeachie, Michael J; Yates, Katherine P; Zhou, Xiaobo; Guo, Feng; Sternberg, Alice L; Van Natta, Mark L; Wise, Robert A; Szefler, Stanley J; Sharma, Sunita; Kho, Alvin T; Cho, Michael H; Croteau-Chonka, Damien C; Castaldi, Peter J; Jain, Gaurav; Sanyal, Amartya; Zhan, Ye; Lajoie, Bryan R; Dekker, Job; Stamatoyannopoulos, John; Covar, Ronina A; Zeiger, Robert S; Adkinson, N Franklin; Williams, Paul V; Kelly, H William; Grasemann, Hartmut; Vonk, Judith M; Koppelman, Gerard H; Postma, Dirkje S; Raby, Benjamin A; Houston, Isaac; Lu, Quan; Fuhlbrigge, Anne L; Tantisira, Kelan G; Silverman, Edwin K; Tonascia, James; Weiss, Scott T; Strunk, Robert C

    2016-01-01

    BACKGROUND: Tracking longitudinal measurements of growth and decline in lung function in patients with persistent childhood asthma may reveal links between asthma and subsequent chronic airflow obstruction. METHODS: We classified children with asthma according to four characteristic patterns of lung

  19. Asthma: Not Just a Childhood Condition.

    Science.gov (United States)

    Strauss, Kandra

    2002-01-01

    Asthma has grown to epidemic proportions among school-age children, and nearly 10 million U.S. adults suffer from it. This paper describes asthma and its triggers and explains how to take measures to manage asthma symptoms within the school (e.g., dusting regularly and keeping medications available). A sidebar presents tips on controlling asthma…

  20. Preeclampsia Associates with Asthma, Allergy, and Eczema in Childhood

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Sevelsted, Astrid; Anderson, Ulrik D

    2017-01-01

    .55 to -0.06]; P = 0.0348), and allergic rhinitis (adjusted odds ratio, 4.83 [95% CI, 1.58-14.78]; P = 0.0057) in the 7-year-old children. Furthermore, the children had an increased risk of sensitization to both aeroallergens and food allergens, and increased amount of total IgE during childhood......RATIONALE: Preeclampsia reflects an unusual increase in systemic inflammation during pregnancy. OBJECTIVES: We studied associations between preeclampsia and asthma, allergy, and eczema in Copenhagen Prospective Studies on Asthma in Childhood2000 (COPSAC2000) and in national registries. METHODS....... In the registry-based cohort, 3.7% (n = 62,728) were born to mothers with preeclampsia. Preeclampsia was associated with increased risk of asthma, eczema, and aeroallergen and food allergy, especially pronounced after a duration of preeclampsia of 14 days or more. Maternal asthma increased the risk...

  1. Physical activity and aerobic fitness in childhood : associated with asthma?

    OpenAIRE

    Berntsen, Sveinung

    2009-01-01

    The prevalence of childhood asthma in the Western world has increased the last decades, whereas knowledge of asthma prevalence in districts where “Westernized lifestyle” is not adopted is inadequate. Even though there is a general lack of studies including objective physical activity measurements and direct measurements of maximal oxygen consumption, the overriding public perception of today’s children and adolescents is that they are less physical active and with lower leve...

  2. Prevalence of childhood asthma in Ulaanbaatar, Mongolia in 2009

    Directory of Open Access Journals (Sweden)

    Shigemi Yoshihara

    2016-01-01

    Conclusions: The asthma prevalence in Mongolian children was higher than that in the world and Asia–Pacific countries reported by ISAAC. The higher prevalence was probably attributable to households' (especially mothers smoking in draft-free houses designed for the cold area and severe air-pollution due to rapid industrialization and urbanization in Mongolia. Smoking prohibition in the mother (including family members and a reduction of exposure to air pollutants are urgently needed to prevent developing childhood asthma.

  3. Childhood asthma in low income countries

    DEFF Research Database (Denmark)

    Østergaard, Marianne Stubbe; Nantanda, Rebecca; Tumwine, James K

    2012-01-01

    Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts...... and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing...... in under-5s without fever, which suggests the diagnosis of asthma/wheezing rather than bacterial pneumonia. Ultimately, underlying asthma may have contributed to malnutrition and fatal bacterial pneumonia. In conclusion, preschool asthma in low-income countries may be significantly under...

  4. Association of Mycoplasma pneumoniae infection and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    YADAV Shakti Nrisingh; GAUTAM Mahesh Kumar; JIANG Li

    2015-01-01

    Mycoplasma pneumoniae is a frequent cause of acute respiratory infections in both children and adults.It can cause pharyngitis, otitis, tracheobronchitis, or community-acquired pneumonia, but may also remain totally asymptomatic.Mycoplasma pneumoniae is an organism that reportedly has a strong relationship to asthma.The role of atypical bacterial infection in the pathogenesis of asthma is a subject of continuing debate. There is an increasing body of literature concerning the association between Mycoplasma pneumoniae ( M. pneumoniae) and asthma pathogenesis.Moreover, many studies investigating such a link have been uncontrolled and have provided conflicting evidence, in part due to the difficulty in accurately diagnosing infection with these atypical pathogens. Large, general population-based prospective studies are necessary to investigate the development of asthma induced by M. pneumoniae infection in humans. This manuscript will review the relationship between M.pneumoniae infection and childhood asthma.

  5. Low level atmospheric sulfur dioxide pollution and childhood asthma

    Energy Technology Data Exchange (ETDEWEB)

    Tseng, R.Y.; Li, C.K. (Chinese Univ. of Hong Kong (Hong Kong))

    1990-11-01

    Quarterly analysis (1983-1987) of childhood asthma in Hong Kong from 13,620 hospitalization episodes in relation to levels of pollutants (SO{sub 2}, NO{sub 2}, NO, O{sub 3}, TSP, and RSP) revealed a seasonal pattern of attack rates that correlates inversely with exposure to sulfur dioxide (r = -.52, P less than .05). The same cannot be found with other pollutants. Many factors may contribute to the seasonal variation of asthma attacks. We speculate that prolonged exposure (in terms of months) to low level SO{sub 2} is one factor that might induce airway inflammation and bronchial hyperreactivity and predispose to episodes of asthma.

  6. Parental Perceptions and Practices toward Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Amani K. Abu-Shaheen

    2016-01-01

    Full Text Available Introduction. Parental perceptions and practices are important for improving the asthma outcomes in children; indeed, evidence shows that parents of asthmatic children harbor considerable misperceptions of the disease. Objective. To investigate the perceptions and practices of parents toward asthma and its management in Saudi children. Methods. Using a self-administered questionnaire, a two-stage cross-sectional survey of parents of children aged between 3 and 15 years, was conducted from schools located in Riyadh province in central Saudi Arabia. Results. During the study interval, 2000 parents were asked to participate in the study; 1450 parents responded, of whom 600 (41.4% reported that their children had asthma, dyspnea, or chest allergy (recurrent wheezing or coughing, while 478 (32.9% of the parents reported that their children were diagnosed earlier with asthma by a physician. Therefore, the final statistical analyses were performed with 600 participants. Furthermore, 321 (53.5% respondents believed that asthma is solely a hereditary disease. Interestingly, 361 (60.3% were concerned about side effects of inhaled corticosteroids and 192 (32% about the development of dependency on asthma medications. Almost 76% of parents had previously visited a pediatric emergency department during an asthma attack. Conclusions. Parents had misperceptions regarding asthma and exhibited ineffective practices in its management. Therefore, improving asthma care and compliance requires added parental education.

  7. Relationship between childhood asthma andHelicobacter pyloriinfection

    Institute of Scientific and Technical Information of China (English)

    Ying Wu

    2016-01-01

    Objective:To investigate the correlation between childhood asthma andHelicobacter pylori infection.Methods: A total of 80 children with asthma who were treated in our hospital from May 2012 to May 2015 were selected as the research subjects, and 40 cases of healthy children were selected as control group, theHelicobacter pylori infection of the two groups of patients were compared, the double antibody sandwich enzyme-linked immunosorbent assay was used to detect the serumHelicobacter pylori-IgG,Helicobacter pylori-CagAIgG, IL-4,Helicobacter pylori, IFN-γ and IL-1β,etc., and the correlation betweenHelicobacter pylori infection and asthma was analyzed.Results:The positive rates ofHelicobacter pylori infection in asthma group and children in attack stage were significantly higher than those in control group and children in remission stage (P<0.05). The positive rates of serumHelicobacter pylori-IgG and Helicobacter pylori-CagAIgG in asthma group and children in attack stage were significantly lower than those in control group and children in remission stage (P<0.05). The serum levels of IFN-γ in asthma group and children in attack stage were significantly lower than those in control group and children in remission stage, IL-4 and IL-1β levels in the former were significantly higher than those in the latter (P<0.05).Helicobacter pyloriinfection positive had significant positive correlation with IL-1β concentration (r=0.75,P<0.05).Conclusions:Helicobacter pylori infection in children has significant positive correlation with the incidence of asthma, suggesting thatHelicobacter pylori infection has a certain protective effect on childhood asthma, but persistentHelicobacter pyloriinfection in children with asthma can aggravate the immune disorder, which is the main reason for the difficulty of treatment of asthma.

  8. Exhaled nitric oxide and asthma in childhood

    NARCIS (Netherlands)

    R.J.P. van der Valk (Ralf)

    2013-01-01

    textabstractAsthma was first described in the medical literature of Greek antiquity. It is difficult to determine whether by referring to “asthma”, Hippocrates and his school (460-360 B.C.) meant an autonomous clinical entity or a symptom. The clinical presentation of asthma nowadays has probably ch

  9. Community violence and urban childhood asthma: a multilevel analysis.

    Science.gov (United States)

    Sternthal, M J; Jun, H-J; Earls, F; Wright, R J

    2010-12-01

    We examined the association between community violence exposure and childhood asthma risk in a multilevel, multimethod, longitudinal study controlling for individual- and neighbourhood-level confounders and pathway variables. Analyses included 2,071 children aged 0-9 yrs at enrolment from the Project on Human Development in Chicago Neighborhoods. Multilevel logistic regression models estimated the likelihood of asthma, controlling for individual-level (child's age, sex, race/ethnicity, maternal asthma, socioeconomic status and family violence in the home) and neighbourhood-level confounders (concentrated disadvantage, collective efficacy and social disorder), and pathway variables (maternal smoking, breastfeeding). In adjusted analyses, medium (OR 1.60, 95% CI 1.17-2.19) and high levels (OR 1.56, 95% CI 1.12-2.18) of community violence were associated with increased asthma risk, relative to low levels. The increased asthma risk remained for African Americans when models included community violence and all other individual-level covariates, but attenuated to borderline nonsignificance when further adjusting for collective efficacy. Community violence is associated with asthma risk when controlling for individual- and neighborhood-level confounders. Neither community violence, nor the other individual-level factors, fully accounted for the excess asthma burden among African Americans. These data suggest that public health interventions outside the biomedical model may be needed to reduce asthma in disadvantaged populations.

  10. Risk of psoriasis in patients with childhood asthma

    DEFF Research Database (Denmark)

    Egeberg, A; Khalid, U; Gislason, G H;

    2015-01-01

    BACKGROUND: Psoriasis and asthma are disorders driven by inflammation. Psoriasis may carry an increased risk of asthma, but the reverse relationship has not been investigated. OBJECTIVES: To investigate the risk of psoriasis in subjects with childhood asthma in a nationwide Danish cohort. METHODS......, concomitant medication and comorbidity were estimated by Poisson regression models. RESULTS: There were 21,725 cases of childhood asthma and 6586 incident cases of psoriasis. There were 5697 and 889 incident cases of mild and severe psoriasis, respectively. The incidence rates of overall, mild and severe...... psoriasis were 4.49, 3.88 and 0.61 for the reference population, and 5.95, 5.18 and 0.83 for subjects with childhood asthma, respectively. The IRRs for overall, mild and severe psoriasis were 3.94 [95% confidence interval (CI) 2.16-7.17], 5.03 (95% CI 2.48-10.21) and 2.27 (95% CI 0.61-8.42) for patients...

  11. Exercise-induced bronchoconstriction : clinical studies in childhood asthma

    NARCIS (Netherlands)

    W.B. Hofstra (Winfried)

    1997-01-01

    textabstractAt present, astluna is regarded as a chronic inflammatory disorder of the airways, In susceptible individuals, asthma causes symptoms, that are usually associated with variable, but often reversible airflow obstmction. Astlulla is the most conunon lung disease in childhood, with a sympto

  12. Parental stress and the onset and course of childhood asthma.

    Science.gov (United States)

    Yamamoto, Noriko; Nagano, Jun

    2015-01-01

    The influence of a caregiver's stress on the development of childhood asthma is an important aspect of the treatment and prevention of illness. Many cross-sectional studies have investigated the association between parenting attitude and/or caregiver's stress and childhood asthma morbidity, but prospective studies are more advantageous than cross-sectional studies in interpreting a causal relationship from the results. We here present an overview of prospective studies that have reported a relationship between parental stress and the morbidity or course of childhood asthma and discuss the role of parental mental health in its prevention and treatment. Almost all of the studies referred to in this paper show that caregiver (mostly mothers) stress contributed to the onset and to a poor prognosis, while only a few studies have examined the adverse effect of paternal stress on childhood asthma. Their results are inconsistent, and there is insufficient data examining specific stress-related properties that can be targeted in intervention studies. Not only maternal but also paternal influence should be considered in future studies, and it will be important to assess specific stress-related properties that can be the foundation of specific intervention methods.

  13. Maternal propensity for infections and risk of childhood asthma

    DEFF Research Database (Denmark)

    Stokholm, Jakob; Sevelsted, Astrid; Bønnelykke, Klaus;

    2014-01-01

    BACKGROUND: Maternal use of antibiotics during pregnancy has been associated with the development of asthmatic disorders in the offspring. The human microbiome has been suggested to act as an intermediary in this process. To provide clarification on this theory, we studied the temporal relation...... between maternal use of antibiotics and the risk of childhood asthma. METHODS: According to national registries, during the observation period (1997-2010), 910,301 children were born in Denmark and were included in the analysis. From these registries, data for cases of childhood asthma were obtained based...... on hospital admissions, outpatient attendance at a hospital, or use of inhaled corticosteroids. The effect of timing of maternal antibiotic use on the risk of asthma in the offspring was studied by analysis of maternal antibiotic use in the 80 weeks before pregnancy, during pregnancy, and the 80 weeks after...

  14. Personalizing the Approach to Childhood Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  15. Difficult-to-treat asthma in childhood.

    Science.gov (United States)

    Adams, Alexandra; Saglani, Sejal

    2013-06-01

    Asthma continues to be one of the greatest burdens to healthcare resources throughout the developed world. In most cases, good symptom control can be achieved with low-dose inhaled corticosteroids, and can be cared for in the primary and secondary healthcare systems. However, there is a group in whom control is not achieved despite high-dose inhaled corticosteroids and maximal add-on therapies; these are children with problematic severe asthma that should be referred to a specialist team for further investigation and management. In this review we aimed to provide an evidence-based guide for pediatricians providing care for children with asthma in secondary healthcare settings. The review focuses on a proposed investigation and management strategy for children aged between 6 and 16 years with problematic severe asthma, and is supported as far as possible by evidence from the literature. We first address recent advances in nomenclature and then discuss our proposed course of investigation and management of these children. Distinction of children with true, severe, therapy-resistant asthma from those with asthma that is difficult to treat because of unaddressed underlying modifiable factors is critical and is discussed in detail.

  16. Prematurity and prescription asthma medication from childhood to young adulthood

    DEFF Research Database (Denmark)

    Damgaard, Anne Louise; Hansen, Bo Moelholm; Mathiasen, Rene

    2015-01-01

    INTRODUCTION: Preterm birth is associated with increased risk of asthma-like symptoms and purchase of prescription asthma medication in childhood. We investigated whether this association persists into adulthood and whether it is affected by accounting for neonatal respiratory morbidity (acute...... respiratory disease and bronchopulmonary dysplasia). METHODS: A national cohort of all infants born in Denmark in the period 1980-2009 was included in this register study. Data on purchase of asthma medication (combination of inhaled β-2 agonists and other drugs for obstructive airway disease) in 2010......-2011 were obtained from the Danish National Prescription Registry. Associations between gestational age (GA), neonatal respiratory morbidity and a cross-sectional evaluation of asthma medication purchase were explored by multivariate logistic regressions. RESULTS: A full dataset was obtained on 1...

  17. Exacerbations of childhood asthma and ozone pollution in Atlanta

    Energy Technology Data Exchange (ETDEWEB)

    White, M.C.; Etzel, R.A.; Lloyd, C. (Centers for Disease Control and Prevention, Atlanta, GA (United States)); Wilcox, W.D. (Emory Univ. School of Medicine, Atlanta, GA (United States))

    1994-04-01

    Asthma prevalence and mortality due to asthma have been increasing during the last decade, and both the rates and the increases in rates have been higher for blacks than whites and higher for children than adults. Whether environmental factors such as air pollution contribute to these increases is unknown. The purpose of this study was to examine the relationship between emergency visits to a hospital for childhood asthma and exposure to ozone in an indigent, predominantly black population. Data were collected by abstracting clinical records for all children with asthma or reactive airway disease in one public hospital during the summer of 1990. From June 1, 1990, to August 31, 1990, 609 visits were made by children aged 1 to 16 years to an emergency clinic for treatment of asthma or reactive airway disease. Monitoring data indicated that maximum ozone levels equalled or exceeded 0.11 ppm on 6 days during the study period. The average number of visits for asthma or reactive airway disease was 37% higher on the days after those 6 days (from 6:00 PM to 6:00 PM the next day) than on other days (95% Cl, RR = 1.02-1.73). The results of the study suggest that among black children from low-income families, asthma may be exacerbated following periods of high ozone pollution. 45 refs., 1 fig., 4 tabs.

  18. Increased asthma risk and asthma-related health care complications associated with childhood obesity.

    Science.gov (United States)

    Black, Mary Helen; Zhou, Hui; Takayanagi, Miwa; Jacobsen, Steven J; Koebnick, Corinna

    2013-10-01

    Asthma is the most common chronic condition of childhood, yet the relationship between obesity and asthma risk and the impact of obesity on clinical asthma outcomes are not well understood. For this population-based, longitudinal study, demographic and clinical data were extracted from administrative and electronic health records of 623,358 patients aged 6-19 years who were enrolled in the Kaiser Permanente Southern California health plan in 2007-2011. Crude asthma incidence ranged from 16.9 per 1,000 person-years among normal-weight youth to 22.3 per 1,000 person-years among extremely obese youth. The adjusted risks of asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight youth were 1.16 (95% confidence interval: 1.13, 1.20), 1.23 (95% confidence interval: 1.19, 1.28), and 1.37 (95% confidence interval: 1.32, 1.42), respectively (Ptrend obesity and asthma risk was strongest in Asian/Pacific Islanders and in the youngest girls (aged 6-10 years), compared with other groups. Among youth who developed asthma, those who were moderately or extremely obese had more frequent asthma exacerbations requiring emergency department services and/or treatment with oral corticosteroids. In conclusion, obese youth are not only more likely to develop asthma, but they may be more likely to have severe asthma, resulting in a greater need for health care utilization and aggressive asthma treatment.

  19. Physical fitness and amount of asthma and asthma-like symptoms from childhood to adulthood

    DEFF Research Database (Denmark)

    Guldberg-Møller, Jørgen; Hancox, Bob; Mikkelsen, Dennis

    2015-01-01

    OBJECTIVE: The potential benefits of physical activity on the development of respiratory symptoms are not well known. The present study investigated the longitudinal association between physical fitness and the development of asthma-like symptoms from childhood to adulthood in a longitudinal...... reduced by 2% from early adolescence to young adulthood (ages 9-29 years) by increasing the maximal workload with 1 W/kg. CONCLUSION: This finding provide further evidence of a possible beneficial effect of physical activity in childhood on the development of respiratory symptoms in adulthood and supports...... the notion that the lower levels of physical activity in recent decades may have contributed to an increase in the prevalence of asthma and asthma-like symptoms....

  20. Periconceptional and Gestational Exposure to Antibiotics and Childhood Asthma.

    Directory of Open Access Journals (Sweden)

    Shuyuan Chu

    Full Text Available Previous studies suggest that maternal antibiotics exposure during pregnancy may increase the risk of childhood asthma, but the results were inconsistent. Furthermore, most studies did not examine periconception period as an exposure window. We aim to assess the associations between maternal exposure to specific antibiotics before and during pregnancy and the risk of asthma in early childhood.Data from the Collaborative Perinatal Project were used. Maternal exposure to antibiotics before and during pregnancy was recorded at each prenatal visit. A total of 39,907 singleton children were followed up to 7 years of age. Multilevel multiple logistic regression models were used to control for potential confounders and account for multiple pregnancies per woman.Maternal use of penicillin or chloramphenicol was associated with an increased risk of asthma in the offspring (adjusted odds ratio = 1.21, 95% confidence interval 1.08-1.36 for penicillin; 1.72 [1.14-2.59] for chloramphenicol. The risk was significantly increased if penicillin or chloramphenicol was used in the 1st trimester (1.09 [1.04-1.13] for penicillin and 1.23 [1.01-1.51] for chloramphenicol.Maternal exposure to certain antibiotics is associated with childhood asthma by 7 years of age. Early pregnancy may be a sensitive window.

  1. Is ketamine a lifesaving agent in childhood acute severe asthma?

    Directory of Open Access Journals (Sweden)

    Hendaus MA

    2016-02-01

    Full Text Available Mohamed A Hendaus,1,2 Fatima A Jomha,3 Ahmed H Alhammadi1,2 1Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, 2Department of Clinical Pediatrics, Weill Cornell Medical College in Qatar, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon Abstract: Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute severe asthma requiring intubation and invasive ventilation. The aim of this review is to detail evidence on the use of ketamine in childhood asthma exacerbations. A search of the MEDLINE, EMBASE, and Cochrane databases was performed, using different combinations of the following terms: ketamine, asthma, use, exacerbation, and childhood. In addition, we searched the references of the identified articles for additional articles. We then reviewed titles and included studies that were relevant to the topic of interest. Finally, the search was limited to studies published in English and Spanish from 1918 to June 2015. Due to the scarcity in the literature, we included all published articles. The literature reports conflicting results of ketamine use for acute severe asthma in children. Taking into consideration the relatively good safety profile of the drug, ketamine might be a reasonable option in the management of acute severe asthma in children who fail to respond to standard therapy. Furthermore, pediatricians and pediatric emergency clinicians administering ketamine should be knowledgeable about the unique actions of this drug and its potential side effects. Keywords: asthma, ketamine, children

  2. Anemia as a risk factor for childhood asthma

    Directory of Open Access Journals (Sweden)

    Ramakrishnan K

    2010-01-01

    Full Text Available Objective: This prospective-(cohort study was conducted to evaluate whether anemia is a risk factor for childhood asthma. Materials and Methods: Two hundred children in the age group of 2-18 years who attended the Outpatient Department with upper respiratory / lower respiratory tract infections were included in this study. One hundred children with anemia were taken as the study group and another 100, age - and sex-matched children without anemia were taken as the control.They were subjected to complete blood count (CBC C-reactive protein (CRP estimation, Mantoux test and chest X-ray. Pulmonary function tests (PFTs were performed on those above six years showing evidence of asthma. Peripheral smear, serum ferritin and serum iron-binding capacity were estimated for all anemic children. Results: Asthma was present in 74 (74% children in the study group and in 33 (33% children in the control group. Iron-deficiency anemia was present in 85 (85% anemia of chronic infection in 20 (20% and the other five (5% had hemolytic anemia. Anemia was found to be a risk factor for childhood asthma. Conclusion: Anemic children were 5.75 times more susceptible to asthmatic attacks when compared with nonanemic children.

  3. The Influence of Setting on Care Coordination for Childhood Asthma.

    Science.gov (United States)

    Kelly, R Patrick; Stoll, Shelley C; Bryant-Stephens, Tyra; Janevic, Mary R; Lara, Marielena; Ohadike, Yvonne U; Persky, Victoria; Ramos-Valencia, Gilberto; Uyeda, Kimberly; Malveaux, Floyd J

    2015-11-01

    Asthma affects 7.1 million children in the United States, disproportionately burdening African American and Latino children. Barriers to asthma control include insufficient patient education and fragmented care. Care coordination represents a compelling approach to improve quality of care and address disparities in asthma. The sites of The Merck Childhood Asthma Network Care Coordination Programs implemented different models of care coordination to suit specific settings-school district, clinic or health care system, and community-and organizational structures. A variety of qualitative data sources were analyzed to determine the role setting played in the manifestation of care coordination at each site. There were inherent strengths and challenges of implementing care coordination in each of the settings, and each site used unique strategies to deliver their programs. The relationship between the lead implementing unit and entities that provided (1) access to the priority population and (2) clinical services to program participants played a critical role in the structure of the programs. The level of support and infrastructure provided by these entities to the lead implementing unit influenced how participants were identified and how asthma care coordinators were integrated into the clinical care team.

  4. Monitoring asthma in childhood: management-related issues

    Directory of Open Access Journals (Sweden)

    Bart L. Rottier

    2015-06-01

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

  5. Maternal smoking in pregnancy and its influence on childhood asthma

    Directory of Open Access Journals (Sweden)

    Angela Zacharasiewicz

    2016-07-01

    Full Text Available Maternal smoking in pregnancy (MSP is a large modifiable risk factor for pregnancy related mortality and morbidity and also the most important known modifiable risk factor for asthma. This review summarises the effects of MSP throughout infancy, childhood and adolescence with regards to asthma (development and severity. Firstly, the direct damage caused by nicotine on fetal lung development, fetal growth and neuronal differentiation is discussed, as well as the indirect effects of nicotine on placental functioning. Secondly, the effects of MSP on later immune functioning resulting in increased infection rate are summarised and details are given on the effects of MSP modulating airway hyperreactivity, reducing lung function and therefore increasing asthma morbidity. Furthermore, epigenetic effects are increasingly being recognised. These can also result in transgenerational detrimental effects induced by cigarette smoke. In summary, the causal relationship between MSP and asthma development is well documented and presents a major health problem for generations to come. The high prevalence of MSP is alarming and epigenetic effects of nicotine on immune functioning potentiate this danger. A considerable part of the increase in asthma prevalence worldwide is due to MSP.

  6. The Prevention of Early Asthma in Kids study: design, rationale and methods for the Childhood Asthma Research and Education network.

    Science.gov (United States)

    Guilbert, Theresa W; Morgan, Wayne J; Krawiec, Marzena; Lemanske, Robert F; Sorkness, Chris; Szefler, Stanley J; Larsen, Gary; Spahn, Joseph D; Zeiger, Robert S; Heldt, Gregory; Strunk, Robert C; Bacharier, Leonard B; Bloomberg, Gordon R; Chinchilli, Vernon M; Boehmer, Susan J; Mauger, Elizabeth A; Mauger, David T; Taussig, Lynn M; Martinez, Fernando D

    2004-06-01

    Pediatric asthma remains an important public health concern as its prevalence and cost to the health care system is rising. In order to promote innovative research in asthma therapies, the National Heart, Lung and Blood Institute created the Childhood Asthma Research and Education Network in 1999. As its first study, the steering committee of the Childhood Asthma Research and Education Network designed a randomized clinical trial to determine if persistent asthma could be prevented in children at a high risk to develop the disease. This communication presents the design of its first clinical trial, the Prevention of Asthma in Kids (PEAK) trial and the organization of the Childhood Asthma Research and Education Network that developed and implemented this trial. Studies of the natural history of asthma have shown that, in persistent asthma, the initial asthma-like symptoms and loss of lung function occur predominately during the first years of life. Therefore, in the Prevention of Asthma in Kids study, children 2 and 3 years old with a positive asthma predictive index were randomized to twice daily treatment with fluticasone 88 microg or placebo via metered-dose inhaler and Aerochamber for 2 years. The double blind treatment period was followed by a 1-year observational period. Lung function was measured by spirometry and oscillometry technique at 4-month intervals throughout the study. Bronchodilator reversibility and exhaled nitric oxide (ENO) studies were performed at the end of the treatment and observation periods. The primary outcome measure was the number of asthma-free days. Other secondary outcomes included number of exacerbations, use of asthma medications and lung function. These measures were chosen to reflect the progression of the disease from intermittent wheezing to persistent asthma and measurement of the extent of airflow limitation and airway reactivity.

  7. Biomarkers and childhood asthma: improving control today and tomorrow.

    Science.gov (United States)

    Liu, Andrew H

    2005-01-01

    Although we aim to normalize the lives of children with asthma by controlling their day and night symptoms and preventing exacerbations and morbidity, optimal childhood asthma management may result when the assessment and monitoring of asthma includes measured biomarkers--meaning objective, biological measures of lung dysfunction and inflammation. Precedence for such an approach to optimizing disease control and outcomes can be appreciated in comparing asthma with insulin-dependent diabetes mellitus (IDDM) management in children. Optimal management of these chronic conditions shares the fundamental goals to eliminate day and night symptoms and prevent exacerbations and morbidity. However, IDDM management focuses primarily on peripheral blood biomarkers of tight control (i.e., daily serum glucose levels) and predictors of long-term morbidity (i.e., hemoglobin A1C, or hemoglobin "remodeling" due to chronically poor control of glucose) for optimal assessment and monitoring and to best achieve these clinical objectives (Alemzadeh R, et al. Diabetes mellitus in children. In Nelson Textbook of Pediatrics, 17th ed. Behrman RE, Kliegman RM, and Jenson HB (Eds). Philadelphia: W.B. Saunders Co., 1947-1972, 2004). The improved outcomes in IDDM have resulted primarily from the progress to a biomarker-based assessment to achieve tight, optimal control and not, presently, as a dramatic change in therapy. The progress in IDDM management provides a compelling paradigm to consider for improving childhood asthma management. Indeed, the time is good to not only consider some newly available biomarkers, but also to reconsider some biomarkers of lung dysfunction, inflammation, and atopy that could be broadly used today. This article reconsiders the use of current and emerging measures of lung dysfunction, inflammation, and atopy in assessing tight control and long-term risk. Concluding emphasis will be placed on what can be implemented today.

  8. Outpatient management of childhood asthma by paediatrician or asthma nurse : randomised controlled study with one year follow up

    NARCIS (Netherlands)

    Kamps, AWA; Brand, PLP; Kimpen, JLL; Maille, AR; Overgoor-van de Groes, AW; van Helsdingen-Peek, LCJAM

    2003-01-01

    Background: Until now, care provided by asthma nurses has been additional to care provided by paediatricians. A study was undertaken to compare nurse led outpatient management of childhood asthma with follow up by a paediatrician. Methods: Seventy four children referred because of insufficient contr

  9. Asthma Symptoms in Early Childhood: A public health perspective [Astmasymptomen bij jonge kinderen: een volksgezondheids perspectief

    NARCIS (Netherlands)

    Hafkam-de Groen, E.

    2014-01-01

    This thesis focuses on asthma symptoms in early childhood. From a public health perspective, we aim to improve health and health-related quality of life through the prevention of asthma symptoms and by signaling, counselling or management of children who are at a high risk of developing asthma. The

  10. Rhinovirus Wheezing Illness and Genetic Risk of Childhood-Onset Asthma

    DEFF Research Database (Denmark)

    Calışkan, Minal; Bochkov, Yury A; Kreiner-Møller, Eskil

    2013-01-01

    Background Both genetic variation at the 17q21 locus and virus-induced respiratory wheezing illnesses are associated with the development of asthma. Our aim was to determine the effects of these two factors on the risk of asthma in the Childhood Origins of Asthma (COAST) and the Copenhagen...

  11. Childhood overweight and asthma symptoms, the role of pro-inflammatory proteins

    NARCIS (Netherlands)

    Bekkers, M. B. M.; Brunekreef, B.; de Jongste, J. C.; Kerkhof, M.; Smit, H. A.; Postma, D. S.; Gehring, U.; Wijga, A. H.

    2012-01-01

    Background Systemic inflammation is suggested as a mechanism by which overweight might induce asthma. However, few studies have linked childhood overweight, inflammation and asthma. Objective To study the association between body mass index (BMI), asthma symptoms and pro-inflammatory proteins. Metho

  12. Childhood overweight and asthma symptoms, the role of pro-inflammatory proteins

    NARCIS (Netherlands)

    Bekkers, M.B.M.; Brunekreef, B.; de Jongste, J.C.; Kerkhof, M.; Smit, H.A.; Postma, D.S.; Gehring, U.; Wijga, A.H.

    2012-01-01

    BACKGROUND Systemic inflammation is suggested as a mechanism by which overweight might induce asthma. However, few studies have linked childhood overweight, inflammation and asthma. OBJECTIVE To study the association between body mass index (BMI), asthma symptoms and pro-inflammatory proteins. METHO

  13. Use of Antibiotics during pregnancy increases the risk of Asthma in early childhood

    DEFF Research Database (Denmark)

    Stensballe, Lone Graff; Simonsen, Jacob; Jensen, Signe Marie;

    2013-01-01

    OBJECTIVES: To investigate the hypothesis that mother's use of antibiotics in pregnancy could influence asthma and eczema in early life. STUDY DESIGN: Subjects were included from the Copenhagen Prospective Study on Asthma in Childhood cohort of children born of mothers with asthma (N = 411). Seve...

  14. Parent misperception of control in childhood/adolescent asthma : the Room to Breathe survey

    NARCIS (Netherlands)

    Carroll, W. D.; Wildhaber, J.; Brand, P. L. P.

    2012-01-01

    The aim of our study was to determine how often asthma control is achieved in children and adolescents, and how asthma affects parents' and children's daily lives. Interviews, including the childhood asthma control test (C-ACT), were conducted with 1,284 parents of asthmatic children (aged 4-15 yrs)

  15. Forced Oscillation Technique and Childhood Asthma

    Directory of Open Access Journals (Sweden)

    Hiroyuki Mochizuki

    2012-01-01

    Full Text Available Most infants and preschool children are not able to voluntarily perform the physiological maneuvers required to complete the pulmonary function tests that are used in adults and older children. Recently, commercial devices using forced oscillation technique (FOT suitable for young children have become available. In devices with FOT, an oscillation pressure wave is generated by a loud speaker, is applied to the respiratory system, usually at the mouth, and the resulting pressure-flow relationship is analyzed in terms of impedance (Zrs. Zrs encompasses both resistance (Rrs and reactance (Xrs. Rrs is calculated from pressure and flow signals, and is a measure of central and peripheral airway caliber. Xrs is derived from the pressure in the phase with volume and is related to compliance (Crs and inertance (Irs. These parameters individually indicate the condition of the small and large airways in each patient and indirectly suggest the presence of airway inflammation. It is agreed that the clinical diagnostic capacity of FOT is comparable to that of spirometry. One of the advantages of FOT is that minimal cooperation of the patient is needed and no respiratory maneuvers are required. The use of FOT should be considered in patients in whom spirometry or other pulmonary function tests cannot be performed or in cases where the results of other tests appear to be unreliable. In addition, this approach is effective in assessing bronchial hyperresponsiveness. Considering these qualities, FOT is a useful method to study pulmonary function in preschool children with asthma.

  16. The Copenhagen Prospective Study on Asthma in Childhood (COPSAC)

    DEFF Research Database (Denmark)

    Bisgaard, Hans

    2004-01-01

    . Exposure assessments comprise respiratory, intestinal, and skin microbiology; the child's diet; indoor and outdoor air quality; allergens; and indicators of lifestyle. Genetic characteristics of probands and parents are evaluated. Quality assurance follows Good Clinical Practice guidelines. RESULTS: Four....... OBJECTIVE: To investigate the relationships among genetic, environmental, and lifestyle factors in the development of atopic diseases in high-risk children with the aim of developing evidence-based prevention strategies. METHODS: The Copenhagen Prospective Study on Asthma in Childhood is a single......-center, birth cohort study of children of asthmatic mothers. Objective assessments begin at birth, with scheduled visits every 6 months and when acute symptoms manifest. Clinical outcomes comprise preasthma, asthma, atopic dermatitis, allergic rhinitis, allergy, lung function, and bronchial responsiveness...

  17. Relationship between Vitamin D and Childhood Asthma: A Case–Control Study

    OpenAIRE

    Hatami, Gissou; Ghasemi, Khadijeh; Motamed, Niloofar; Firoozbakht, Saiideh; Movahed, Ali; Farrokhi, Shokrollah

    2014-01-01

    Objective: Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma. Methods: Data were obtained from 200 asthmatic children (age 3–12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium...

  18. Asthma trajectories in early childhood: identifying modifiable factors.

    Directory of Open Access Journals (Sweden)

    Lidia Panico

    Full Text Available BACKGROUND: There are conflicting views as to whether childhood wheezing represents several discreet entities or a single but variable disease. Classification has centered on phenotypes often derived using subjective criteria, small samples, and/or with little data for young children. This is particularly problematic as asthmatic features appear to be entrenched by age 6/7. In this paper we aim to: identify longitudinal trajectories of wheeze and other atopic symptoms in early childhood; characterize the resulting trajectories by the socio-economic background of children; and identify potentially modifiable processes in infancy correlated with these trajectories. DATA AND METHODS: The Millennium Cohort Study is a large, representative birth cohort of British children born in 2000-2002. Our analytical sample includes 11,632 children with data on key variables (wheeze in the last year; ever hay-fever and/or eczema reported by the main carers at age 3, 5 and 7 using a validated tool, the International Study of Asthma and Allergies in Childhood module. We employ longitudinal Latent Class Analysis, a clustering methodology which identifies classes underlying the observed population heterogeneity. RESULTS: Our model distinguished four latent trajectories: a trajectory with both low levels of wheeze and other atopic symptoms (54% of the sample; a trajectory with low levels of wheeze but high prevalence of other atopic symptoms (29%; a trajectory with high prevalence of both wheeze and other atopic symptoms (9%; and a trajectory with high levels of wheeze but low levels of other atopic symptoms (8%. These groups differed in terms of socio-economic markers and potential intervenable factors, including household damp and breastfeeding initiation. CONCLUSION: Using data-driven techniques, we derived four trajectories of asthmatic symptoms in early childhood in a large, population based sample. These groups differ in terms of their socio-economic profiles

  19. Gestational Medication Use, Birth Conditions, and Early Postnatal Exposures for Childhood Asthma

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    Yang-Ching Chen

    2012-01-01

    Full Text Available Our aim is to explore (1 whether gestational medication use, mode of delivery, and early postnatal exposure correlate with childhood asthma, (2 the dose responsiveness of such exposure, and (3 their links to early- and late-onset asthma. We conducted a matched case-control study based on the Taiwan Children Health Study, which was a nationwide survey that recruited 12-to-14-year-old school children in 14 communities. 579 mothers of the participants were interviewed by telephone. Exclusive breastfeeding protected children from asthma. Notably, childhood asthma was significantly associated with maternal medication use during pregnancy, vacuum use during vaginal delivery, recurrent respiratory tract infections, hospitalization, main caregiver cared for other children, and early daycare attendance. Exposure to these factors led to dose responsiveness in relationships to asthma. Most of the exposures revealed a greater impact on early-onset asthma, except for vacuum use and daycare attendance.

  20. Parent misperception of control in childhood/adolescent asthma: the Room to Breathe survey.

    Science.gov (United States)

    Carroll, W D; Wildhaber, J; Brand, P L P

    2012-01-01

    The aim of our study was to determine how often asthma control is achieved in children and adolescents, and how asthma affects parents' and children's daily lives. Interviews, including the childhood asthma control test (C-ACT), were conducted with 1,284 parents of asthmatic children (aged 4-15 yrs), as well as with the children themselves (aged 8-15 yrs; n=943), in Canada, Greece, Hungary, the Netherlands, South Africa and the UK. Parents reported mild asthma attacks at least weekly in 11% of children, and serious attacks (requiring oral corticosteroids or hospitalisation) at least annually in 35%. Although 73% of parents described their child's asthma as mild or intermittent, 40% of children/adolescents had C-ACT scores ≤ 19, indicating inadequate control, and only 14.7% achieved complete Global Initiative for Asthma (GINA)-defined control and just 9.2% achieved Scottish Intercollegiate Guidelines Network (SIGN)/British Thoracic Society (BTS)-defined control. Guideline-defined asthma control was significantly less common than well-controlled asthma using the C-ACT (pAsthma restricted the child's activities in 39% of families and caused lifestyle changes in 70%. Complete asthma control is uncommon in children worldwide. Guideline-defined control measures appear to be more stringent than those defined by C-ACT or families. Overall, parents underestimate their child's asthma severity and overestimate asthma control. This is a major potential barrier to successful asthma treatment in children.

  1. Self-efficacy and childhood asthma : an investigation of psychological factors

    OpenAIRE

    Slater, Joanne Tracy

    2001-01-01

    Childhood asthma is a chronic condition affecting up to one in every seven children. Self-management programs have been developed to help improve children's abilities to both manage and cope with their asthma. If these programs are to be fully effective, an understanding of the psychological factors that influence children's sense of competence to manage their condition is required. This study aimed to identify psychological variables that may influence children's asthma sel...

  2. Primary Care Pathway for Childhood Asthma: Protocol for a Randomized Cluster-Controlled Trial

    OpenAIRE

    2016-01-01

    Background Asthma is the most common chronic condition in children. For many, the disease is inadequately controlled, which can burden the lives of children and their families as well as the health care system. Improved use of the best available scientific evidence by primary care practitioners could reduce the need for hospital care and improve quality of life and asthma control, thereby reducing overall costs to society and families. Objective The Primary Care Pathway for Childhood Asthma a...

  3. Fetal and Infant Origins of Childhood Asthma: The Generation R Study

    NARCIS (Netherlands)

    A.M.M. van der Sonnenschein-Voort (Agnes)

    2014-01-01

    markdownabstract__Abstract__ Asthma is a chronic inflammatory disorder of the airways. Accumulating evidence suggest that childhood asthma has at least part of its origins in fetal life and infancy. The developmental plasticity hypothesis suggests that adverse exposures in early life lead to develo

  4. The Relationship between Maternal Atopy and Childhood Asthma in Pretoria, South Africa.

    Science.gov (United States)

    Abbott, Salome; Becker, Piet; Green, Robin J

    2013-01-01

    Introduction. Asthma is the commonest chronic condition of children. Diagnosis of this condition remains difficult. Many surrogate markers are used, such as documenting evidence of atopy. Method. A random sample of asthmatic children and their mothers attending the Children's Chest and Allergy Clinic at Steve Biko Academic Hospital were enrolled. Children were classified as having atopic or nonatopic asthma. Mothers completed a questionnaire to uncover atopic features. Results. Along with their mothers, 64 children with atopic asthma and 36 with nonatopic asthma were studied. The proportion of children with atopic asthma does not differ for mothers with and without a positive SPT (P = 0.836), a history of asthma (P = 0.045), symptoms suggestive of an allergic disease (P = 1.000), or who were considered to be allergic (P = 0.806). The odds ratio of a child having atopic asthma when having a mother with a doctor diagnosed history of asthma is 4.76, but the sensitivity is low (21.9%). Conclusion. The data demonstrates that all maternal allergic or asthmatic associations are poor predictors of childhood atopic asthma. Despite the increased risk of atopic asthma in a child to a mother that has a doctor diagnosis of asthma (OR 4.76 P = 0.045), this is a poor predictor of atopic asthma (sensitivity 21.9%).

  5. Childhood asthma and indoor allergens in Native Americans in New York

    Directory of Open Access Journals (Sweden)

    Tarbell Alice

    2006-07-01

    Full Text Available Abstract Background The objective of this study was to assess the correlation between childhood asthma and potential risk factors, especially exposure to indoor allergens, in a Native American population. Methods A case-control study of St. Regis Mohawk tribe children ages 2–14 years, 25 diagnosed with asthma and 25 controls was conducted. Exposure was assessed based on a personal interview and measurement of mite and cat allergens (Der p 1, Fel d 1 in indoor dust. Results A non-significant increased risk of childhood asthma was associated with self-reported family history of asthma, childhood environmental tobacco smoke exposure, and air pollution. There was a significant protective effect of breastfeeding against current asthma in children less than 14 years (5.2 fold lower risk. About 80% of dust mite and 15% of cat allergen samples were above the threshold values for sensitization of 2 and 1 μg/g, respectively. The association between current asthma and exposure to dust mite and cat allergens was positive but not statistically significant. Conclusion This research identified several potential indoor and outdoor risk factors for asthma in Mohawks homes, of which avoidance may reduce or delay the development of asthma in susceptible individuals.

  6. Effects of early intervention with inhaled sodium cromoglycate in childhood asthma.

    Science.gov (United States)

    Yoshihara, S; Kanno, N; Yamada, Y; Ono, M; Fukuda, N; Numata, M; Abe, T; Arisaka, O

    2006-01-01

    International and Japanese guidelines classify childhood asthma as mild, moderate, or severe, and recommend treatment with "as needed" bronchodilators, inhaled sodium cromoglycate, and inhaled corticosteroids, respectively. Alternatively, some investigators proposed inhaled corticosteroids as first-line therapy to prevent airway inflammatory obstruction. This article describes a clinical study assessing the effect of early intervention with inhaled sodium cromoglycate in childhood asthma. This was a retrospective study of 189 asthmatic children treated with inhaled sodium cromoglycate for five years and whose age of onset of asthma was six year of age or younger. An end-of-study questionnaire completed the examination. Children administered oral or inhaled corticosteroids simultaneously with sodium cromoglycate, were excluded. Asthma scores as defined by the Japanese Pediatric Allergic Committee, were reduced continuously during the five years after the start of sodium cromoglycate treatment. The frequency of emergency department visits and hospitalizations also decreased. Significant between-period intervention differences showed improvement of clinical outcomes for children with severe asthma during the five years of sodium cromoglycate inhalation. The early intervention regime of starting sodium cromoglycate inhalation within two years of the onset of asthma shows a large improvement in the long-term prognosis of childhood asthma, especially for children with severe asthma. It is possible that starting inhaled sodium cromoglycate earlier than the present recommendation of corticosteroids could further improve clinical outcomes, but a prospective study should be performed to verify our results.

  7. CORRELATION OF PEAK EXPIRATORY FLOW RATE WITH PULMONARY FUNCTION TEST IN CHILDHOOD ASTHMA

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    Antony Jenifer

    2014-08-01

    Full Text Available AIM: To ascertain whether the severity of childhood asthma as assessed by peak expiratory flow rate correlated with assessment by spirometry. MATERIALS AND METHODS: All patient between 6-18 years of age attending the asthma clinic during the non-exacerbation phase were included, those in whom PFT, PEFR could not be performed and those with diagnosis other than asthma were excluded. A total of 102 patients were enrolled in the study. CONCLUSION: The present study demonstrated that PEFR measurement alone had poor predictive value for abnormal spirometry. In the absence of PFTs, PEFR often overestimated how well a patient's asthma was controlled.

  8. Maternal bereavement and childhood asthma-analyses in two large samples of Swedish children.

    Directory of Open Access Journals (Sweden)

    Fang Fang

    Full Text Available BACKGROUND: Prenatal factors such as prenatal psychological stress might influence the development of childhood asthma. METHODOLOGY AND PRINCIPAL FINDINGS: We assessed the association between maternal bereavement shortly before and during pregnancy, as a proxy for prenatal stress, and the risk of childhood asthma in the offspring, based on two samples of children 1-4 (n = 426,334 and 7-12 (n = 493,813 years assembled from the Swedish Medical Birth Register. Exposure was maternal bereavement of a close relative from one year before pregnancy to child birth. Asthma event was defined by a hospital contact for asthma or at least two dispenses of inhaled corticosteroids or montelukast. In the younger sample we calculated hazards ratios (HRs of a first-ever asthma event using Cox models and in the older sample odds ratio (ORs of an asthma attack during 12 months using logistic regression. Compared to unexposed boys, exposed boys seemed to have a weakly higher risk of first-ever asthma event at 1-4 years (HR: 1.09; 95% confidence interval [CI]: 0.98, 1.22 as well as an asthma attack during 12 months at 7-12 years (OR: 1.10; 95% CI: 0.96, 1.24. No association was suggested for girls. Boys exposed during the second trimester had a significantly higher risk of asthma event at 1-4 years (HR: 1.55; 95% CI: 1.19, 2.02 and asthma attack at 7-12 years if the bereavement was an older child (OR: 1.58; 95% CI: 1.11, 2.25. The associations tended to be stronger if the bereavement was due to a traumatic death compared to natural death, but the difference was not statistically significant. CONCLUSIONS/SIGNIFICANCE: Our results showed some evidence for a positive association between prenatal stress and childhood asthma among boys but not girls.

  9. Functional variant in the autophagy-related 5 gene promotor is associated with childhood asthma.

    Directory of Open Access Journals (Sweden)

    Lisa J Martin

    Full Text Available RATIONALE AND OBJECTIVE: Autophagy is a cellular process directed at eliminating or recycling cellular proteins. Recently, the autophagy pathway has been implicated in immune dysfunction, the pathogenesis of inflammatory disorders, and response to viral infection. Associations between two genes in the autophagy pathway, ATG5 and ATG7, with childhood asthma were investigated. METHODS: Using genetic and experimental approaches, we examined the association of 13 HapMap-derived tagging SNPs in ATG5 and ATG7 with childhood asthma in 312 asthmatic and 246 non-allergic control children. We confirmed our findings by using independent cohorts and imputation analysis. Finally, we evaluated the functional relevance of a disease associated SNP. MEASUREMENTS AND MAIN RESULTS: We demonstrated that ATG5 single nucleotide polymorphisms rs12201458 and rs510432 were associated with asthma (p = 0.00085 and 0.0025, respectively. In three independent cohorts, additional variants in ATG5 in the same LD block were associated with asthma (p<0.05. We found that rs510432 was functionally relevant and conferred significantly increased promotor activity. Furthermore, Atg5 expression was increased in nasal epithelium of acute asthmatics compared to stable asthmatics and non-asthmatic controls. CONCLUSION: Genetic variants in ATG5, including a functional promotor variant, are associated with childhood asthma. These results provide novel evidence for a role for ATG5 in childhood asthma.

  10. The burden of severe asthma in childhood and adolescence

    DEFF Research Database (Denmark)

    Fleming, Louise; Murray, Clare; Bansal, Aruna T

    2015-01-01

    U-BIOPRED aims to characterise paediatric and adult severe asthma using conventional and innovative systems biology approaches. A total of 99 school-age children with severe asthma and 81 preschoolers with severe wheeze were compared with 49 school-age children with mild/moderate asthma and 53 pr...

  11. Effect of supplemental folic acid in pregnancy on childhood asthma: a prospective birth cohort study.

    Science.gov (United States)

    Whitrow, Melissa J; Moore, Vivienne M; Rumbold, Alice R; Davies, Michael J

    2009-12-15

    This study aimed to investigate the effect of the timing, dose, and source of folate during pregnancy on childhood asthma by using data from an Australian prospective birth cohort study (n = 557) from 1998 to 2005. At 3.5 years and 5.5 years, 490 and 423 mothers and children participated in the study, respectively. Maternal folate intake from diet and supplements was assessed by food frequency questionnaire in early (late (30-34 weeks) pregnancy. The primary outcome was physician-diagnosed asthma, obtained by maternal-completed questionnaire. Asthma was reported in 11.6% of children at 3.5 years (n = 57) and in 11.8% of children at 5.5 years (n = 50). Folic acid taken in supplement form in late pregnancy was associated with an increased risk of childhood asthma at 3.5 years (relative risk (RR) = 1.26, 95% confidence interval (CI): 1.08, 1.43) and with persistent asthma (RR = 1.32, 95% CI: 1.03, 1.69). The effect sizes did not change with adjustment for potential confounders. The association was similar at 5.5 years but did not reach statistical significance (RR = 1.17, 95% CI: 0.96, 1.42) in univariable models. These findings on childhood asthma support previous observations that supplementation with folate in pregnancy leads to an allergic asthma phenotype in mice via epigenetic mechanisms and is associated with poorer respiratory outcomes in young children.

  12. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola;

    2017-01-01

    INTRODUCTION: Caesarean section is thought to be a risk factor for childhood asthma, but this association may be caused by confounding from, for instance, familial factors. To address this problem, we used twin pairs to assess the risk of childhood asthma after emergency caesarean section. METHODS......: The study was a register-based nation-wide matched cohort study using twin pairs to minimise residual confounding. Included were twin pairs in which the first twin was delivered vaginally and the second by emergency caesarean section during the study period from January 1997 through December 2012. RESULTS......: In total, 464 twin pairs (928 twins) were included. In 30 pairs, the first twin (vaginal delivery) was diagnosed with asthma, but the second twin (emergency caesarean section) was not. In 20 pairs, the second twin (emergency caesarean section) was diagnosed with asthma, but the first twin (vaginal delivery...

  13. Childhood Overweight/Obesity and Pediatric Asthma: The Role of Parental Perception of Child Weight Status

    Directory of Open Access Journals (Sweden)

    the STRONG Kids Research Team

    2013-09-01

    Full Text Available Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child’s weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child’s overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.

  14. Childhood overweight/obesity and pediatric asthma: the role of parental perception of child weight status.

    Science.gov (United States)

    Musaad, Salma M A; Paige, Katie N; Teran-Garcia, Margarita; Donovan, Sharon M; Fiese, Barbara H; The Strong Kids Research Team

    2013-09-23

    Childhood obesity and asthma are on the rise in the U.S. Clinical and epidemiological data suggest a link between the two, in which overweight and obese children are at higher risk for asthma. Prevention of childhood obesity is preferred over treatment, however, in order to be receptive to messages, parents must perceive that their child is overweight. Many parents do not accurately assess their child's weight status. Herein, the relation between parental perceptions of child weight status, observed body mass index (BMI) percentiles, and a measure of child feeding practices were explored in the context of asthma, food allergy, or both. Out of the children with asthma or food allergy that were classified as overweight/obese by BMI percentiles, 93% were not perceived as overweight/obese by the parent. Mean scores for concern about child weight were higher in children with both asthma and food allergy than either condition alone, yet there were no significant differences among the groups in terms of pressure to eat and restrictive feeding practices. In summary, parents of children with asthma or food allergy were less likely to recognize their child's overweight/obese status and their feeding practices did not differ from those without asthma and food allergy.

  15. Early childhood wheezing: various natural courses and their relationship to later asthma

    Directory of Open Access Journals (Sweden)

    Dong In Suh

    2012-08-01

    Full Text Available Wheezing is one of the most frequent complaints that lead to the use of medical resources in younger children. Generally, wheezing is caused by bronchiolitis and resolves spontaneously without recurrence, but sometimes, wheezing can progress into asthma. Early data on the natural history of childhood wheezing was mostly obtained from retrospective reviews of medical records or from questionnaires, which made it difficult to exclude biases. Now that many cohort studies are available, reviewing the results of birth cohort studies makes it possible to understand the natural course of early childhood wheezing and the risk factors for asthma. In this study, we have reviewed the various phenotypes of early childhood wheezing and their natural courses to help select the most appropriate management modalities for the different types of early childhood wheezing.

  16. Body mass index trajectory classes and incident asthma in childhood

    DEFF Research Database (Denmark)

    Rzehak, Peter; Wijga, Alet H; Keil, Thomas;

    2013-01-01

    The causal link between body mass index (BMI) or obesity and asthma in children is still being debated. Analyses of large longitudinal studies with a sufficient number of incident cases and in which the time-dependent processes of both excess weight and asthma development can be validly analyzed ...

  17. Childhood obesity in relation to poor asthma control and exacerbations

    NARCIS (Netherlands)

    Ahmadizar, Fariba; Vijverberg, Susanne; Arets, Hubertus; De Boer, Anthonius; Lang, Jason; Kattan, Meyer; Palmer, Colin; Mukhopadhyay, Somnath; Turner, Steve; Van Der Zee, Anke-Hilse Maitland

    2016-01-01

    Background: The relationship between obesity and asthma severity in children is inconsistent across studies. Objectives: To estimate the association between obesity and poor asthma control/ risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are diff

  18. Recent perspectives on global epidemiology of asthma in childhood.

    Science.gov (United States)

    Asher, M I

    2010-01-01

    New research in asthma epidemiology in children includes the development of the ISAAC programme, which has shown large variations globally in the prevalence of asthma symptoms. Time trends in the prevalence of asthma symptoms have shown a mixed picture of increases in low prevalence centres, and a plateau or even a decrease in high prevalence centres. A range of environmental factors have been studied and some potentially protective associations have been found, as well as potentially aggravating factors. Atopy has less influence on the prevalence of symptoms of asthma in low and middle income countries. Breast feeding exerts a protective effect only on non-atopic asthma in non-affluent countries. Future research should explore these areas further.

  19. A longitudinal study on early hospitalized airway infections and subsequent childhood asthma.

    Directory of Open Access Journals (Sweden)

    Mei-Jy Jeng

    Full Text Available Acute airway infections, including bronchiolitis, are common causes of early childhood hospitalization. The development of later asthma may be related to early airway infections in young children. This study is to investigate the relationship between hospitalized airway infections (HAI in young children (< 3 years old and later childhood asthma.Hospitalized children (< 3 years old with bronchiolitis or other acute airway infections (other HAI group from 1997-2000 were retrieved from the National Health Insurance Research Database of Taiwan, and compared to age- and gender-matched subjects with regards to asthma until 10 years of age; and potential comorbidities and medical care conditions.In total, 3,264 children (1,981 with bronchiolitis; 1,283 with other HAIs were compared to 18,527 controls. The incidence of childhood asthma was higher in the study (16.2% than the control (11.7% group, and most cases were diagnosed between 3-5 years old. The hazard ratios were 1.583 (95% CI: 1.414-1.772 and 1.226 (95% CI: 1.053-1.428 for the bronchiolitis and other HAI subgroups, respectively, compared to the control group, and 1.228 (95% CI: 1.075-1.542 in the bronchiolitis subgroup compared to the other HAIs subgroup. A significantly higher odds ratio (1.973, 95% CI: 1.193-3.263 for the children with congenital heart disease (CHD in the bronchiolitis subgroup was found at an age of 3-5 years compared to the control group.Young children (< 3 years old hospitalized due to acute HAIs are at a higher risk of developing childhood asthma at age 3 to 10 years. The parents of children with HAIs at age 0 to 2 years should be informed for the higher risk of developing childhood asthma, especially in children with CHD and bronchiolitis.

  20. Revisiting the Hispanic health paradox: the relative contributions of nativity, country of origin, and race/ethnicity to childhood asthma.

    Science.gov (United States)

    Camacho-Rivera, Marlene; Kawachi, Ichiro; Bennett, Gary G; Subramanian, S V

    2015-06-01

    This study examined the relationship between race and Hispanic ethnicity, maternal and child nativity, country of origin and asthma among 2,558 non-Hispanic white and Hispanic children across 65 Los Angeles neighborhoods. A series of two-level multilevel models were estimated to examine the independent effects of race, ethnicity, and country of origin on childhood asthma. Lifetime asthma prevalence was reported among 9% of children, with no significant differences between Hispanics and non-Hispanic whites overall. However, in fully adjusted models, Hispanic children of non-Mexican origin reported higher odds of asthma compared to non-Hispanic white children. A protective nativity effect was also observed among children of foreign born mothers compared to US born mothers. Our study provides evidence in support of the heterogeneity of childhood asthma by Hispanic ethnicity and maternal nativity. These findings suggest moving beyond solely considering racial/ethnic classifications which could mask subgroups at increased risk of childhood asthma.

  1. Childhood Asthma and Allergies in Urban, Semiurban, and Rural Residential Sectors in Chile

    Directory of Open Access Journals (Sweden)

    Leonie Kausel

    2013-01-01

    Full Text Available While rural living protects from asthma and allergies in many countries, results are conflicting in Latin America. We studied the prevalence of asthma and asthma symptoms in children from urban, semiurban, and rural sectors in south Chile. A cross-sectional questionnaire study was conducted in semiurban and rural sectors in the province of Valdivia (n=559 using the ISAAC (International Study of Asthma and Allergies in Childhood questionnaire. Results were compared to prevalence in urban Valdivia (n=3105 by using data from ISAAC III study. Odds ratios (+95% confidence intervals were calculated. No statistical significant differences were found for asthma ever and eczema symptoms stratified by residential sector, but a gradient could be shown for current asthma and rhinoconjunctivitis symptoms with urban living having highest and rural living having lowest prevalence. Rural living was inversely associated in a statistical significant way with current asthma (OR: 0.4; 95% CI: 0.2–0.9 and rhinoconjunctivitis symptoms (OR: 0.3; 95% CI: 0.2–0.7 in logistic regression analyses. Rural living seems to protect from asthma and respiratory allergies also in Chile, a South American country facing epidemiological transition. These data would be improved by clinical studies of allergic symptoms observed in studied sectors.

  2. Smoke exposure as a risk factor for asthma in childhood: a review of current evidence.

    Science.gov (United States)

    Ferrante, Giuliana; Antona, Roberta; Malizia, Velia; Montalbano, Laura; Corsello, Giovanni; La Grutta, Stefania

    2014-01-01

    Asthma is a common chronic multifactorial disease that affects >300 million people worldwide. Outdoor and indoor pollution exposure has been associated with respiratory health effects in adults and children. Smoking still represents a huge public health problem and millions of children suffer the detrimental effects of passive smoke exposure. This study was designed to review the current evidences on exposure to passive smoke as a risk factor for asthma onset in childhood. A review of the most recent studies on this topic was undertaken to provide evidence about the magnitude of the effect of passive smoking on the risk of incidence of asthma in children. The effects of passive smoking are different depending on individual and environmental factors. Environmental tobacco smoke (ETS) is one of the most important indoor air pollutants and can interact with other air pollutants in eliciting respiratory outcomes during childhood. The increased risk of respiratory outcomes in children exposed to prenatal and early postnatal passive smoke might be caused by an adverse effect on both the immune system and the structural and functional development of the lung; this may explain the subsequent increased risk of incident asthma. The magnitude of the exposure is quite difficult to precisely quantify because it is significantly influenced by the child's daily activities. Because exposure to ETS is a likely cause for asthma onset in childhood, there is a strong need to prevent infants and children from breathing air contaminated with tobacco smoke.

  3. Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children: Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC).

    NARCIS (Netherlands)

    Anderson, H.R.; Ruggles, R.; Pandey, K.D.; Kapetanakis, V.; Brunekreef, B.; Lai, C.K.; Strachan, D.P.; Weiland, S.K.

    2010-01-01

    OBJECTIVES: To investigate the effect of ambient particulate matter on variation in childhood prevalence of asthma, rhinoconjunctivitis and eczema. METHODS: Prevalences of asthma, rhinoconjunctivitis and eczema obtained in Phase One of the International Study of Asthma and Allergies in Childhood (IS

  4. Ambient particulate pollution and the world-wide prevalence of asthma, rhinoconjunctivitis and eczema in children : Phase One of the International Study of Asthma and Allergies in Childhood (ISAAC)

    NARCIS (Netherlands)

    Anderson, H. Ross; Ruggles, Ruth; Pandey, Kiran D.; Kapetanakis, Venediktos; Brunekreef, Bert; Lai, Christopher K. W.; Strachan, David P.; Weiland, Stephan K.

    2010-01-01

    Objectives To investigate the effect of ambient particulate matter on variation in childhood prevalence of asthma, rhinoconjunctivitis and eczema. Methods Prevalences of asthma, rhinoconjunctivitis and eczema obtained in Phase One of the International Study of Asthma and Allergies in Childhood (ISAA

  5. Childhood obesity and risk of allergy or asthma.

    Science.gov (United States)

    Raj, Dinesh; Kabra, Sushil K; Lodha, Rakesh

    2014-11-01

    The simultaneous increment in the prevalence of obesity and allergic diseases suggests a possible link between them. This review focuses on the consequences of obesity on allergic diseases, especially asthma in children and adolescents, and evaluates the available evidence on the possible mechanisms. Obesity is related more strongly to nonatopic than atopic asthma, suggesting non-eosinophilic inflammation and Th1 polarization. Among other allergic diseases, the association is more consistent with eczema compared to allergic rhinitis/rhinoconjunctivitis. The mechanisms of asthma in obese individuals could involve mechanical effects of obesity on lung function, adipokines-mediated inflammation, shared factors (diet, genetics, sedentary lifestyle) and comorbidities.

  6. Prognostic characteristics of asthma diagnosis in early childhood in clinical practice

    NARCIS (Netherlands)

    Wever-Hess, J; Kouwenberg, JM; Duiverman, EJ; Hermans, J; Wever, AMJ

    1999-01-01

    A registration study from clinical practice was set up to assess the prognostic value of symptoms and laboratory data at first visit for doctor-diagnosed 'asthma' in early childhood. A total of 419 children aged 0-4 y, who were newly referred to the outpatient department of the Juliana Children's Ho

  7. Childhood Asthma Prevalence among Puerto Ricans and Mexican Americans: Implications for Behavioral Intervention Research.

    Science.gov (United States)

    Hurtado, A. Magdalena

    1995-01-01

    Data from the Hispanic Health and Nutrition Examination Survey, 1982-84, were used to examine lifetime prevalence (LTP) of childhood asthma among Mexican Americans and Puerto Ricans. LTP was related to Puerto Rican ethnicity, birth outside U.S. mainland, low weight for age, male gender, poverty, urban residence, and single parenthood. Implications…

  8. Maternal food consumption during pregnancy and the longitudinal development of childhood asthma

    NARCIS (Netherlands)

    Willers, Saskia M.; Wijga, Alet H.; Brunekreef, Bert; Kerkhof, Marjan; Gerritsen, Jorrit; Hoekstra, Maarten O.; de Jongste, Johan C.; Smit, Henriette A.

    2008-01-01

    Rationale Maternal diet during pregnancy has the potential to affect airway development and to promote T-helper-2-cell responses during fetal life. This might increase the risk of developing childhood asthma or allergy. Objectives: We investigated the influence of maternal food consumption during pr

  9. A multicentre study of air pollution exposure and childhood asthma prevalence: the ESCAPE project

    NARCIS (Netherlands)

    Mölter, Anna; Simpson, Angela; Berdel, Dietrich; Brunekreef, Bert; Custovic, Adnan; Cyrys, Josef; de Jongste, Johan; de Vocht, Frank; Fuertes, Elaine; Gehring, Ulrike; Gruzieva, Olena; Heinrich, Joachim; Hoek, Gerard; Hoffmann, Barbara; Klümper, Claudia; Korek, Michal; Kuhlbusch, Thomas A J; Lindley, Sarah; Postma, Dirkje; Tischer, Christina; Wijga, Alet; Pershagen, Göran; Agius, Raymond

    2015-01-01

    The aim of this study was to determine the effect of six traffic-related air pollution metrics (nitrogen dioxide, nitrogen oxides, particulate matter with an aerodynamic diameter <10 μm (PM10), PM2.5, coarse particulate matter and PM2.5 absorbance) on childhood asthma and wheeze prevalence in five E

  10. Childhood asthma after bacterial colonization of the airway in neonates

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Hermansen, Mette Northman; Buchvald, Frederik;

    2007-01-01

    Pathological features of the airway in young children with severe recurrent wheeze suggest an association between bacterial colonization and the initiating events of early asthma. We conducted a study to investigate a possible association between bacterial colonization of the hypopharynx in asymp......Pathological features of the airway in young children with severe recurrent wheeze suggest an association between bacterial colonization and the initiating events of early asthma. We conducted a study to investigate a possible association between bacterial colonization of the hypopharynx...

  11. Understanding childhood asthma in focus groups: perspectives from mothers of different ethnic backgrounds

    Directory of Open Access Journals (Sweden)

    McKenzie Sheila

    2001-09-01

    Full Text Available Abstract Background Diagnosing childhood asthma is dependent upon parental symptom reporting but there are problems in the use of words and terms. The purpose of this study was to describe and compare understandings of childhood 'asthma' by mothers from three different ethnic backgrounds who have no personal experience of diagnosing asthma. A better understanding of parents' perceptions of an illness by clinicians should improve communication and management of the illness. Method Sixty-six mothers living in east London describing their ethnic backgrounds as Bangladeshi, white English and black Caribbean were recruited to 9 focus groups. Discussion was semi-structured. Three sessions were conducted with each ethnic group. Mothers were shown a video clip of a boy with audible wheeze and cough and then addressed 6 questions. Sessions were recorded and transcribed verbatim. Responses were compared within and between ethnic groups. Results Each session, and ethnic group overall, developed a particular orientation to the discussion. Some mothers described the problem using single signs, while others imitated the sound or made comparisons to other illnesses. Hereditary factors were recognised by some, although all groups were concerned with environmental triggers. Responses about what to do included 'normal illness' strategies, use of health services and calls for complementary treatment. All groups were concerned about using medication every day. Expectations about the quality of life were varied, with recognition that restrictions may be based on parental beliefs about asthma, rather than asthma itself. Conclusion Information from these focus groups suggests mothers know a great deal about childhood asthma even though they have no personal experience of it. Knowledge of how mothers from these ethnic backgrounds perceive asthma may facilitate doctor – patient communication with parents of children experiencing breathing difficulties.

  12. Monitoring asthma in childhood: lung function, bronchial responsiveness and inflammation

    Directory of Open Access Journals (Sweden)

    Alexander Moeller

    2015-06-01

    Full Text Available This review focuses on the methods available for measuring reversible airways obstruction, bronchial hyperresponsiveness (BHR and inflammation as hallmarks of asthma, and their role in monitoring children with asthma. Persistent bronchial obstruction may occur in asymptomatic children and is considered a risk factor for severe asthma episodes and is associated with poor asthma outcome. Annual measurement of forced expiratory volume in 1 s using office based spirometry is considered useful. Other lung function measurements including the assessment of BHR may be reserved for children with possible exercise limitations, poor symptom perception and those not responding to their current treatment or with atypical asthma symptoms, and performed on a higher specialty level. To date, for most methods of measuring lung function there are no proper randomised controlled or large longitudinal studies available to establish their role in asthma management in children. Noninvasive biomarkers for monitoring inflammation in children are available, for example the measurement of exhaled nitric oxide fraction, and the assessment of induced sputum cytology or inflammatory mediators in the exhaled breath condensate. However, their role and usefulness in routine clinical practice to monitor and guide therapy remains unclear, and therefore, their use should be reserved for selected cases.

  13. Long-term studies of the natural history of asthma in childhood

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Bønnelykke, Klaus

    2010-01-01

    ). Prospective identification of endophenotypes allowing accurate prediction of the clinical course is currently not possible. The variability of the clinical course remains an enigma and difficult to predict. Three of 4 school-aged children with asthma have outgrown disease by midadulthood. The risk......Segmentation of children with asthma and other wheezy disorders remains the main research challenge today, as it was when described 2 centuries ago. Early childhood wheezy disorders follow different temporal trajectories, probably representing different underlying mechanisms (endophenotypes...... of persistence increases with severity, sensitization, smoking, and female sex. Genetic risk variants might help disentangle the heterogeneity of asthma and other wheezy disorders. At early school age, children with asthma have reduced lung function. It is an important and unresolved question whether the airflow...

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

    Science.gov (United States)

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

    2016-01-01

    Objective : To present the Programa Infantil de Prevenção de Asma (PIPA, Program for the Prevention of Childhood Asthma) and the characteristics of the patients followed in this program. Methods : Implemented in the city of Uruguaiana, Brazil, PIPA has as its target population children and adolescents ( 3 years of age, respectively. Physician-diagnosed asthma was reported in 26.5% and 82.2%, respectively. In the sample as a whole, the prevalence of passive smoking was high (> 36%), occurring during pregnancy in > 15%; > 40% of the patients had been born by cesarean section; and 30% had a mother who had had < 8 years of schooling. Conclusions : A prevention program for children with asthma is an effective strategy for controlling the disease. Knowledge of local epidemiological and environmental characteristics is essential to reducing the prevalence of the severe forms of asthma, to improving the use of health resources, and to preventing pulmonary changes that could lead to COPD in adulthood. PMID:26982040

  15. Allergen-specific IL-5 responses in early childhood predict asthma at age eight.

    Directory of Open Access Journals (Sweden)

    Christina Weber-Chrysochoou

    Full Text Available BACKGROUND: The pattern of development of allergen-specific T cell cytokine responses in early childhood and their relation to later disease is poorly understood. Here we describe longitudinal changes in allergen-stimulated T cell cytokine responses and their relation to asthma and allergic disease during the first 8 years of life. METHODS: Subjects with a family history of asthma, who were enrolled antenatally in the Childhood Asthma Prevention Study (public trials registration number ACTRN12605000042640, had skin prick tests, clinical evaluation for asthma and eczema, and in vitro assessment of T cell cytokine responses to HDM extract performed at ages 18 months (n = 281, 3 years (n = 349, 5 years (n = 370 and 8 years (n = 275. We measured interleukin (IL- 13 at 3, 5 and 8 years, and IL-5, IL-10, and interferon-γ (IFN-γ, at 18 months, 3, 5 and 8 years by ELISA. A cohort analysis was undertaken. Independent effects of cytokine responses at each age on the risk of asthma and allergic outcomes at age 8 years were estimated by multivariable logistic regression. RESULTS: HDM-specific IL-5 responses increased with age. HDM-specific IL-13 and IL-10 responses peaked at age 5 years. HDM-specific IL-5 responses at 3 years, 5 years and 8 years were significantly associated with the presence of asthma and atopy at 8 years. IL-13 responses at 3 years, 5 years and 8 years were significantly associated with atopy at 8 years, but this association was not independent of the effect of IL-5. Other HDM-specific cytokine responses were not independently related to asthma or eczema at 8 years. CONCLUSION: HDM-specific IL-5 responses at age 3 years or later are the best measure of T cell function for predicting asthma at age 8 years.

  16. FeNO as a Marker of Airways Inflammation: The Possible Implications in Childhood Asthma Management

    Directory of Open Access Journals (Sweden)

    Marcello Verini

    2010-01-01

    Full Text Available The aim of this study was to verify FeNO usefulness, as a marker of bronchial inflammation, in the assessment of therapeutic management of childhood asthma. We performed a prospective 1-year randomized clinical trial evaluating two groups of 32 children with allergic asthma: “GINA group”, in which therapy was assessed only by GINA guidelines and “FeNO group”, who followed a therapeutic program assessed also on FeNO measurements. Asthma Severity score (ASs, Asthma Exacerbation Frequency (AEf, and Asthma Therapy score (ATs were evaluated at the start of the study (T1, 6 months (T2, and 1 year after (T3. ASs and AEf significantly decreased only in the FeNO group at times T2 and T3 (p[T1-T2] = 0.0001, and p[T1-T3] = 0.01; p[T1-T2] = 0.0001; and p[T1-T3] < 0.0001, resp.. After six months of follow-up, we found a significant increase of patients under inhaled corticosteroid and/or antileukotrienes in the GINA group compared to the FeNO group (=.02. Our data show that FeNO measurements, might be a very useful additional parameter for management of asthma, which is able to avoid unnecessary inhaled corticosteroid and antileukotrienes therapies, however, mantaining a treatment sufficient to obtain a meaningful improvement of asthma.

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

    Directory of Open Access Journals (Sweden)

    Pingsheng Wu

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

  18. Maternal depressive symptoms across early childhood and asthma in school children: findings from a Longitudinal Australian Population Based Study.

    Directory of Open Access Journals (Sweden)

    Rebecca Giallo

    Full Text Available There is a growing body of evidence attesting to links between early life exposure to stress and childhood asthma. However, available evidence is largely based on small, genetically high risk samples. The aim of this study was to explore the associations between the course of maternal depressive symptoms across early childhood and childhood asthma in a nationally representative longitudinal cohort study of Australian children. Participants were 4164 children and their biological mothers from the Longitudinal Study of Australian Children. Latent class analysis identified three trajectories of maternal depressive symptoms across four biennial waves from the first postnatal year to when children were 6-7 years: minimal symptoms (74.6%, sub-clinical symptoms (20.8%, and persistent and increasing high symptoms (4.6%. Logistic regression analyses revealed that childhood asthma at age 6-7 years was associated with persistent and increasing high depressive symptoms after accounting for known risk factors including smoking during pregnancy and maternal history of asthma (adjusted OR 2.36, 95% CI 1.61-3.45, p.001. Our findings from a nationally representative sample of Australian children provide empirical support for a relationship between maternal depressive symptoms across the early childhood period and childhood asthma. The burden of disease from childhood asthma may be reduced by strengthening efforts to promote maternal mental health in the early years of parenting.

  19. Maternal depressive symptoms across early childhood and asthma in school children: findings from a Longitudinal Australian Population Based Study.

    Science.gov (United States)

    Giallo, Rebecca; Bahreinian, Salma; Brown, Stephanie; Cooklin, Amanda; Kingston, Dawn; Kozyrskyj, Anita

    2015-01-01

    There is a growing body of evidence attesting to links between early life exposure to stress and childhood asthma. However, available evidence is largely based on small, genetically high risk samples. The aim of this study was to explore the associations between the course of maternal depressive symptoms across early childhood and childhood asthma in a nationally representative longitudinal cohort study of Australian children. Participants were 4164 children and their biological mothers from the Longitudinal Study of Australian Children. Latent class analysis identified three trajectories of maternal depressive symptoms across four biennial waves from the first postnatal year to when children were 6-7 years: minimal symptoms (74.6%), sub-clinical symptoms (20.8%), and persistent and increasing high symptoms (4.6%). Logistic regression analyses revealed that childhood asthma at age 6-7 years was associated with persistent and increasing high depressive symptoms after accounting for known risk factors including smoking during pregnancy and maternal history of asthma (adjusted OR 2.36, 95% CI 1.61-3.45), p.001). Our findings from a nationally representative sample of Australian children provide empirical support for a relationship between maternal depressive symptoms across the early childhood period and childhood asthma. The burden of disease from childhood asthma may be reduced by strengthening efforts to promote maternal mental health in the early years of parenting.

  20. Indoor air pollution on nurseries and primary schools: impact on childhood asthma – study protocol

    Directory of Open Access Journals (Sweden)

    Sousa Sofia I V

    2012-06-01

    Full Text Available Abstract Background Several studies have demonstrated an association between the exposure to indoor air pollution (IAP and childhood asthma. Evidence is suggesting that several air pollutants may contribute to both exacerbation and development of asthma, but some uncertainty remains concerning the specific causative role of IAP. This paper reports an epidemiologic study aiming to reduce the existing lacks on the association between long-term exposure to pollution mixtures and the development and exacerbation of childhood asthma. Methods/design Based on the implementation of the study in 8 nurseries and 8 primary schools, from which, 2 nurseries and 2 primary schools in sites influenced by traffic and other 2 nurseries and 2 primary schools in background sites at urban and rural areas, the study will analyse the exposure to both urban and rural pollution as well as to traffic emissions (some homes of the children will be included in the study. Furthermore, based on the answers to validated questionnaires (as those used in the International Study of Asthma and Allergies in Childhood - ISAAC filled in by the parents and on medical exams, the study will assess the prevalence, incidence and exacerbation of asthma, thus considering both short and long-term effects. The approximate number of children in the study will never be less than 600, guaranteeing 80% of study power (significant at a 5% level. Discussion This study intends to contribute for the understanding of the role of environmental factors, namely indoor air pollution, on asthma considering a risk group of different ages, and for the development of preventive measures, which are considered priority issues by the European Commission, according to the European Environmental Agency and the World Health Organization.

  1. Effects of BMI, fat mass, and lean mass on asthma in childhood: a Mendelian randomization study.

    Directory of Open Access Journals (Sweden)

    Raquel Granell

    2014-07-01

    Full Text Available Observational studies have reported associations between body mass index (BMI and asthma, but confounding and reverse causality remain plausible explanations. We aim to investigate evidence for a causal effect of BMI on asthma using a Mendelian randomization approach.We used Mendelian randomization to investigate causal effects of BMI, fat mass, and lean mass on current asthma at age 7½ y in the Avon Longitudinal Study of Parents and Children (ALSPAC. A weighted allele score based on 32 independent BMI-related single nucleotide polymorphisms (SNPs was derived from external data, and associations with BMI, fat mass, lean mass, and asthma were estimated. We derived instrumental variable (IV estimates of causal risk ratios (RRs. 4,835 children had available data on BMI-associated SNPs, asthma, and BMI. The weighted allele score was strongly associated with BMI, fat mass, and lean mass (all p-values<0.001 and with childhood asthma (RR 2.56, 95% CI 1.38-4.76 per unit score, p = 0.003. The estimated causal RR for the effect of BMI on asthma was 1.55 (95% CI 1.16-2.07 per kg/m2, p = 0.003. This effect appeared stronger for non-atopic (1.90, 95% CI 1.19-3.03 than for atopic asthma (1.37, 95% CI 0.89-2.11 though there was little evidence of heterogeneity (p = 0.31. The estimated causal RRs for the effects of fat mass and lean mass on asthma were 1.41 (95% CI 1.11-1.79 per 0.5 kg and 2.25 (95% CI 1.23-4.11 per kg, respectively. The possibility of genetic pleiotropy could not be discounted completely; however, additional IV analyses using FTO variant rs1558902 and the other BMI-related SNPs separately provided similar causal effects with wider confidence intervals. Loss of follow-up was unlikely to bias the estimated effects.Higher BMI increases the risk of asthma in mid-childhood. Higher BMI may have contributed to the increase in asthma risk toward the end of the 20th century. Please see later in the article for the Editors' Summary.

  2. Long-term studies of the natural history of asthma in childhood

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Bønnelykke, Klaus

    2010-01-01

    ). Prospective identification of endophenotypes allowing accurate prediction of the clinical course is currently not possible. The variability of the clinical course remains an enigma and difficult to predict. Three of 4 school-aged children with asthma have outgrown disease by midadulthood. The risk...... secondary prevention through the use of inhaled corticosteroids can effectively halt the long-term disease progression in childhood. In conclusion, the natural history of asthma and the associated airway changes is still poorly understood, and we have not managed to translate findings from long-term studies...

  3. The Effectiveness of Interventions to Address Childhood Asthma: A Scan of the Literature and Current Approaches. MDRC Working Paper

    Science.gov (United States)

    Lee, Helen; McCullough, Colleen

    2016-01-01

    Asthma is the leading chronic health condition among children in the United States and a major cause of childhood disability. It also disproportionately affects low-income and racial and ethnic minorities. Although a wide range of interventions have been implemented to improve asthma-related outcomes among socioeconomically disadvantaged and…

  4. Cross-site evaluation of a comprehensive pediatric asthma project: the Merck Childhood Asthma Network, Inc. (MCAN).

    Science.gov (United States)

    Viswanathan, Meera; Mansfield, Carol; Smith, Lucia Rojas; Woodell, Carol; Darcy, Niamh; Ohadike, Yvonne U; Lesch, Julie Kennedy; Malveaux, Floyd J

    2011-11-01

    The Merck Childhood Asthma Network, Inc. (MCAN) initiative selected five sites that had high asthma burden and established asthma programs but were ready for greater program integration across schools, health care systems, and communities. MCAN supported a community-based approach that was tailored to the needs of each program site. As a result, each site was unique in its combination of interventions, but all sites served common goals of integration of care, incorporation of evidence-based programs, and improvement in knowledge, self-management, health, and quality of life. This case study of the MCAN cross-site evaluation discusses the challenges associated with evaluating interventions involving multiple stakeholders that have been adjusted to fit the unique needs of specific communities. The evaluation triangulates data from site-specific monitoring and evaluation data; site documents, site visits, and cross-site meetings; qualitative assessments of families, organizational partners, and other stakeholders; and quantitative data from a common instrument on health indicators before and after the intervention. The evaluation employs the RE-AIM framework--reach, effectiveness, adoption, implementation, and maintenance--to assess the barriers and facilitators of translation from theory into practice. Our experience suggests trade-offs between rigor of evaluation and burden of assessment that have applicability for other community-based translational efforts.

  5. Low physical fitness in childhood is associated with the development of asthma in young adulthood

    DEFF Research Database (Denmark)

    Rasmussen, F; Lambrechtsen, J; Siersted, H C

    2000-01-01

    Intense physical activity in children may either improve fitness and protect against asthma, or may trigger symptoms. The aim of this study was to determine whether physical fitness in childhood has an impact on the development of asthma. In this prospective, community-based study, 757 (84......%) asymptomatic children with an average age at inclusion of 9.7 yrs were followed for 10.5 yrs. In both surveys a maximal progressive exercise test on a bicycle ergometer was used to measure physical fitness (maximal workload) and to induce airway narrowing. A methacholine provocation test was performed...... correlation was found between physical fitness in childhood and airway responsiveness to methacholine at follow-up when adjusted for body mass index, age and sex (r=0.11; p...

  6. Is ketamine a lifesaving agent in childhood acute severe asthma?

    OpenAIRE

    Hendaus MA; Jomha FA; Alhammadi AH

    2016-01-01

    Mohamed A Hendaus,1,2 Fatima A Jomha,3 Ahmed H Alhammadi1,2 1Department of Pediatrics, Section of Academic General Pediatrics, Hamad Medical Corporation, Doha, 2Department of Clinical Pediatrics, Weill Cornell Medical College in Qatar, Doha, Qatar; 3School of Pharmacy, Lebanese International University, Khiara, Lebanon Abstract: Children with acute severe asthma exacerbation are at risk of developing respiratory failure. Moreover, conventional aggressive management might be futile in acute ...

  7. Exhaled nitric oxide in childhood asthma: a review.

    Science.gov (United States)

    Pijnenburg, M W H; De Jongste, J C

    2008-02-01

    As an 'inflammometer', the fraction of nitric oxide in exhaled air (Fe(NO)) is increasingly used in the management of paediatric asthma. Fe(NO) provides us with valuable, additional information regarding the nature of underlying airway inflammation, and complements lung function testing and measurement of airway hyper-reactivity. This review focuses on clinical applications of Fe(NO) in paediatric asthma. First, Fe(NO) provides us with a practical tool to aid in the diagnosis of asthma and distinguish patients who will benefit from inhaled corticosteroids from those who will not. Second, Fe(NO) is helpful in predicting exacerbations, and predicting successful steroid reduction or withdrawal. In atopic asthmatic children Fe(NO) is beneficial in adjusting steroid doses, discerning those patients who require additional therapy from those whose medication dose could feasibly be reduced. In pre-school children Fe(NO) may be of help in the differential diagnosis of respiratory symptoms, and may potentially allow for better targeting and monitoring of anti-inflammatory treatment.

  8. A methodology to establish a database to study gene environment interactions for childhood asthma

    Directory of Open Access Journals (Sweden)

    McCormick Jonathan

    2010-12-01

    Full Text Available Abstract Background Gene-environment interactions are likely to explain some of the heterogeneity in childhood asthma. Here, we describe the methodology and experiences in establishing a database for childhood asthma designed to study gene-environment interactions (PAGES - Paediatric Asthma Gene Environment Study. Methods Children with asthma and under the care of a respiratory paediatrician are being recruited from 15 hospitals between 2008 and 2011. An asthma questionnaire is completed and returned by post. At a routine clinic visit saliva is collected for DNA extraction. Detailed phenotyping in a proportion of children includes spirometry, bronchodilator response (BDR, skin prick reactivity, exhaled nitric oxide and salivary cotinine. Dietary and quality of life questionnaires are completed. Data are entered onto a purpose-built database. Results To date 1045 children have been invited to participate and data collected in 501 (48%. The mean age (SD of participants is 8.6 (3.9 years, 57% male. DNA has been collected in 436 children. Spirometry has been obtained in 172 children, mean % predicted (SD FEV1 97% (15 and median (IQR BDR is 5% (2, 9. There were differences in age, socioeconomic status, severity and %FEV1 between the different centres (p≤0.024. Reasons for non-participation included parents not having time to take part, children not attending clinics and, in a small proportion, refusal to take part. Conclusions It is feasible to establish a national database to study gene-environment interactions within an asthmatic paediatric population; there are barriers to participation and some different characteristics in individuals recruited from different centres. Recruitment to our study continues and is anticipated to extend current understanding of asthma heterogeneity.

  9. Prenatal maternal psychological stress and childhood asthma and wheezing: a meta-analysis.

    Science.gov (United States)

    van de Loo, Kim F E; van Gelder, Marleen M H J; Roukema, Jolt; Roeleveld, Nel; Merkus, Peter J F M; Verhaak, Christianne M

    2016-01-01

    The aim of this study was to systematically review and meta-analyse observational studies on prenatal maternal psychological stress and the subsequent development of asthma and wheezing in early childhood.All available published literature from 1960 until November 2013 was systematically searched through electronic databases (PubMed, Embase, PsycInfo and Web of Science). All observational studies assessing associations between any form of prenatal maternal psychological stress and respiratory morbidity in the child were included. Data extraction, quality assessment and meta-analyses were performed.The overall meta-analysis included 10 studies and showed that the prevalence of wheezing, asthma and other respiratory symptoms is higher in children of mothers who were exposed to or experienced some form of psychological stress during pregnancy than in mothers who did not (pooled OR 1.56 (95% CI 1.36-1.80)). Comparable results were observed in subgroup analyses of stress exposure, perceived stress, asthma and wheezing.This study demonstrates that prenatal maternal psychological stress is associated with respiratory morbidity, including asthma and wheezing in the child. Future studies examining the early origins of asthma and wheezing need to account for the impact of prenatal maternal stress.

  10. 被动吸烟与儿童哮喘%Passive smoking and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    王天玥

    2011-01-01

    Passive smoking causes significant adverse effects on the origins and progress of childhood asthma. Passive smoking may lead to an increased risk for the development of new cases of asthma in child. For the children who have already established asthma, passive smoking has great impact on asthma control, including increasing asthma symptoms, inducing exacerbations, decreasing quality of life and responsiveness to therapy drugs. The related mechanisms by which passive smoking makes induction of asthma and worsening of established asthma are still in exploration. The presented mechanisms have been postulated are impaired immune responses,impaired lung development, bronchial hyperreactivity, and genetic predisposition.%被动吸烟对于儿童哮喘的发生及发展进程有着极大的负面影响.被动吸烟可导致发生儿童哮喘的风险上升.对于已经发展为哮喘的儿童,被动吸烟会影响哮喘控制,包括加重现有哮喘症状,诱发哮喘发作,降低生活质量,影响药物治疗.被动吸烟影响儿童哮喘发生及发展的机制还在进一步探索中,目前提出的相关机制主要有免疫功能异常、肺功能损害、气道高反应性及基因易患性.

  11. House dust mite barrier bedding for childhood asthma: randomised placebo controlled trial in primary care [ISRCTN63308372

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    Barnes Greta

    2002-06-01

    Full Text Available Abstract Background The house dust mite is the most important environmental allergen implicated in the aetiology of childhood asthma in the UK. Dust mite barrier bedding is relatively inexpensive, convenient to use, and of proven effectiveness in reducing mattress house dust mite load, but no studies have evaluated its clinical effectiveness in the control of childhood asthma when dispensed in primary care. We therefore aimed to evaluate the effectiveness of house dust mite barrier bedding in children with asthma treated in primary care. Methods Pragmatic, randomised, double-blind, placebo controlled trial conducted in eight family practices in England. Forty-seven children aged 5 to 14 years with confirmed house dust mite sensitive asthma were randomised to receive six months treatment with either house dust mite barrier or placebo bedding. Peak expiratory flow was the main outcome measure of interest; secondary outcome measures included asthma symptom scores and asthma medication usage. Results No difference was noted in mean monthly peak expiratory flow, asthma symptom score, medication usage or asthma consultations, between children who received active bedding and those who received placebo bedding. Conclusions Treating house dust mite sensitive asthmatic children in primary care with house dust mite barrier bedding for six months failed to improve peak expiratory flow. Results strongly suggest that the intervention made no impact upon other clinical features of asthma.

  12. The clinical significance of lung hypoexpansion in acute childhood asthma

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    Spottswood, Stephanie E. [Department of Radiology, Medical College of Virginia, Virginia Commonwealth University Health System, Box 980615, 23298-0615, Richmond, VA (United States); Department of Radiology, The Children' s Hospital of the King' s Daughters, 601 Children' s Lane, Norfolk, VA 23507 (United States); Allison, Kelley Z.; Narla, Lakshmana D.; Lowry, Patricia A. [Department of Radiology, Medical College of Virginia, Virginia Commonwealth University Health System, Box 980615, 23298-0615, Richmond, VA (United States); Lopatina, Olga A.; Sethi, Narinder N. [School of Medicine, Medical College of Virginia, Virginia Commonwealth University Health System, Richmond, VA (United States); Nettleman, Mary D. [Department of Internal Medicine, B-427 Clinical Center, Michigan State University, East Lansing, MI 48824 (United States)

    2004-04-01

    Many children experiencing acute asthmatic episodes have chest radiographs, which may show lung hyperinflation, hypoinflation, or normal inflation. Lung hypoinflation may be a sign of respiratory fatigue and poor prognosis. To compare the clinical course in children with asthma according to the degree of lung inflation on chest radiographs. We conducted a retrospective study during a 24-month period (from July 1999 to July 2001) of children aged 0-17 years, who presented to a pediatric emergency department or outpatient clinic with an asthma exacerbation. Chest radiographs obtained at presentation were reviewed independently by three pediatric radiologists who were blinded to the admission status of the patient. The correlation between hypoinflation and hospital admission was assessed in three age groups: 0-2 years, 3-5 years, and 6-17 years. Hypoinflation on chest radiographs was significantly correlated with hospital admission for children aged 6-17 years (odds ratio 16.00, 95% confidence interval 1.89-135.43). The inter-reader agreement for interpretation of these radiographs was strong, with a kappa score of 0.76. Hypoinflation was not correlated with admission in younger children. Lung hypoinflation is associated with a greater likelihood of hospital admission in children aged 6 years or older. Therefore, hypoinflation was a poor prognostic sign and may warrant more aggressive therapy. (orig.)

  13. Relationship between Vitamin D and Childhood Asthma: A Case–Control Study

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    Hatami, Gissou; Ghasemi, Khadijeh; Motamed, Niloofar; Firoozbakht, Saiideh; Movahed, Ali; Farrokhi, Shokrollah

    2014-01-01

    Objective: Studies determining the relationship between serum vitamin D status and childhood asthma have yielded controversial results. Findings indicated that vitamin D deficiency is associated with asthma and airway hyper responsiveness. The aim of this study was to assess the relationship between serum vitamin D status and childhood asthma. Methods: Data were obtained from 200 asthmatic children (age 3–12 years) and 200 healthy controls. Serum levels of 25(OH) vitamin D, total IgE, calcium, phosphorus, parathormone (PTH) and eosinophil count were measured in both asthmatic children and healthy controls. Also, the mean values of 25(OH) vitamin D were compared with asthma symptom severities. Findings: There was a significant decrease in the concentration of serum 25(OH) vitamin D in the asthmatic patients as compared with the controls (20.34±2.8 vs 25.39±4.1 ng/mL, 95%CI: 1.46–3.86, P=0.01). Out of total asthmatic subjects, 40 (20%) were vitamin D sufficient, 48 (24%) were insufficient, and 112 (56%) were deficient. Total IgE concentration was also significantly higher in asthmatic patients having vitamin D deficiency (132.4±20.1 IU/ml, 95%CI: 1.38–3.75, P=0.03). Comparing asthmatic patients with healthy controls, odds of having vitamin D level less than 20ng/mL was 2.47. Conclusion: Our findings suggest that vitamin D deficiency or insufficiency may be positively related to the prevalence of asthma in children. PMID:26019776

  14. Household mold and dust allergens: Exposure, sensitization and childhood asthma morbidity

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    Gent, Janneane F., E-mail: janneane.gent@yale.edu [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Kezik, Julie M., E-mail: julie.colburn@yale.edu [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Hill, Melissa E., E-mail: melissa.hill@yale.edu [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Tsai, Eling, E-mail: tsai.umiami@gmail.com [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States); Li, De-Wei, E-mail: DeWei.Li@ct.gov [Connecticut Agricultural Experiment Station, Valley Laboratory, 153 Cook Hill Road, Windsor, CT 06095 (United States); Leaderer, Brian P., E-mail: brian.leaderer@yale.edu [Yale Center for Perinatal, Pediatric and Environmental Epidemiology, Department of Epidemiology and Public Health, Yale University School of Medicine, One Church Street, 6th Floor, New Haven, CT 06510 (United States)

    2012-10-15

    Background: Few studies address concurrent exposures to common household allergens, specific allergen sensitization and childhood asthma morbidity. Objective: To identify levels of allergen exposures that trigger asthma exacerbations in sensitized individuals. Methods: We sampled homes for common indoor allergens (fungi, dust mites (Der p 1, Der f 1), cat (Fel d 1), dog (Can f 1) and cockroach (Bla g 1)) for levels associated with respiratory responses among school-aged children with asthma (N=1233) in a month-long study. Blood samples for allergy testing and samples of airborne fungi and settled dust were collected at enrollment. Symptoms and medication use were recorded on calendars. Combined effects of specific allergen sensitization and level of exposure on wheeze, persistent cough, rescue medication use and a 5-level asthma severity score were examined using ordered logistic regression. Results: Children sensitized and exposed to any Penicillium experienced increased risk of wheeze (odds ratio [OR] 2.12 95% confidence interval [CI] 1.12, 4.04), persistent cough (OR 2.01 95% CI 1.05, 3.85) and higher asthma severity score (OR 1.99 95% CI 1.06, 3.72) compared to those not sensitized or sensitized but unexposed. Children sensitized and exposed to pet allergen were at significantly increased risk of wheeze (by 39% and 53% for Fel d 1>0.12 {mu}g/g and Can f 1>1.2 {mu}g/g, respectively). Increased rescue medication use was significantly associated with sensitization and exposure to Der p 1>0.10 {mu}g/g (by 47%) and Fel d 1>0.12 {mu}g/g (by 32%). Conclusion: Asthmatic children sensitized and exposed to low levels of common household allergens Penicillium, Der p 1, Fel d 1 and Can f 1 are at significant risk for increased morbidity. - Highlights: Black-Right-Pointing-Pointer Few studies address concurrent allergen exposures, sensitization and asthma morbidity. Black-Right-Pointing-Pointer Children with asthma were tested for sensitivity to common indoor allergens

  15. Gene-gene and gene-environmental interactions of childhood asthma: a multifactor dimension reduction approach.

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    Ming-Wei Su

    Full Text Available BACKGROUND: The importance of gene-gene and gene-environment interactions on asthma is well documented in literature, but a systematic analysis on the interaction between various genetic and environmental factors is still lacking. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a population-based, case-control study comprised of seventh-grade children from 14 Taiwanese communities. A total of 235 asthmatic cases and 1,310 non-asthmatic controls were selected for DNA collection and genotyping. We examined the gene-gene and gene-environment interactions between 17 single-nucleotide polymorphisms in antioxidative, inflammatory and obesity-related genes, and childhood asthma. Environmental exposures and disease status were obtained from parental questionnaires. The model-free and non-parametrical multifactor dimensionality reduction (MDR method was used for the analysis. A three-way gene-gene interaction was elucidated between the gene coding glutathione S-transferase P (GSTP1, the gene coding interleukin-4 receptor alpha chain (IL4Ra and the gene coding insulin induced gene 2 (INSIG2 on the risk of lifetime asthma. The testing-balanced accuracy on asthma was 57.83% with a cross-validation consistency of 10 out of 10. The interaction of preterm birth and indoor dampness had the highest training-balanced accuracy at 59.09%. Indoor dampness also interacted with many genes, including IL13, beta-2 adrenergic receptor (ADRB2, signal transducer and activator of transcription 6 (STAT6. We also used likelihood ratio tests for interaction and chi-square tests to validate our results and all tests showed statistical significance. CONCLUSIONS/SIGNIFICANCE: The results of this study suggest that GSTP1, INSIG2 and IL4Ra may influence the lifetime asthma susceptibility through gene-gene interactions in schoolchildren. Home dampness combined with each one of the genes STAT6, IL13 and ADRB2 could raise the asthma risk.

  16. A multi-center survey of childhood asthma in Turke--I: the cost and its determinants.

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    Beyhun, Nazim E; Soyer, Ozge U; Kuyucu, Semanur; Sapan, Nihat; Altintaş, Derya U; Yüksel, Hasan; Anlar, Fehmi Y; Orhan, Fazil; Cevit, Omer; Cokuğras, Haluk; Boz, Ayşen B; Yazicioğlu, Mehtap; Tanaç, Remziye; Sekerel, Bülent E

    2009-02-01

    Successful management of childhood asthma requires a thorough idea of the economic impact of asthma and its determinants, as policy makers and physicians inevitably influence the outcome. The aim of this study was to define the cost of childhood asthma in Turkey and its determinants. In April 2006, a multi-center, national study was performed where data regarding cost and control levels were collected. Asthmatic children (6-18 yr) with at least a 1-yr follow-up seen during a 1-month period with scheduled or unscheduled visits were included. The survey included a questionnaire-guided interview and retrospective evaluation of files. Cost and its determinants during the last year were analyzed. A total of 618 children from 12 asthma centers were surveyed. The total annual cost of childhood asthma was US$1597.4 +/- 236.2 and there was a significant variation in costs between study centers (p < 0.05). Frequent physician visits [odds ratio (95% confidence intervals)] [2.3 (1.6-3.4)], hospitalization [1.9 (1.1-3.3)], asthma severity [1.6 (1.1-2.8)], and school absenteeism due to asthma [1.5 (1.1-2.1)] were major predictors of total annual costs (p < 0.05 for each). The comparable cost of asthma among Turkish children with that reported in developed countries suggests that interventions to decrease the economic burden of pediatric asthma should focus on the cost-effectiveness of anti-allergic household measures and on improving the control levels of asthma.

  17. O impacto da genética na asma infantil Impact of genetics in childhood asthma

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    Leonardo A. Pinto

    2008-08-01

    . SOURCES: Data were collected from MEDLINE. Genetic association studies were selected from the Genetic Association Database, which is an archive of human genetic association studies of complex diseases and disorders organized by the National Institutes of Health. SUMMARY OF THE FINDINGS: Considering the data from several important twin studies on asthma genetics, heritability, which measures the contribution of genetic factors to the variance of asthma, may be estimated in 0.48-0.79. A huge number of genetic association studies have been trying to identify asthma susceptibility genes. The most replicated results in the genetic association studies involve the following five regions of the human genome: 5q31-32, 6p21, 11q12-13, 16p11-12, and 20p13. Only recently a new asthma susceptibility gene (ORMDL3 has been identified by a whole genome association study, considered to be a major determinant for childhood asthma. CONCLUSIONS: Genetic contribution to asthma may be estimated ranging from 48 to 79%. Several different loci seem to influence asthma susceptibility. Genes located on chromosome 5q (ADRB2, IL13 and IL4 and the recently identified ORMDL3, on chromosome 17, seem to be determinants of childhood asthma. Diagnostics and pharmacogenetics may be the first clinical implication of extensive studies on asthma genetics.

  18. Childhood asthma, air quality, and social suffering among Mexican Americans in California's San Joaquin Valley: "Nobody talks to us here".

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    Schwartz, Norah Anita; Pepper, David

    2009-10-01

    Nearly one in five Mexican American children residing in California's San Joaquin Valley (the Valley) in 2007 had an asthma attack at some point in their life. Numerous epidemiological studies have suggested that compared with other ethnic groups and Latino subgroups residing in the United States, Mexican origin children have the lowest rates of pediatric asthma. Ethnographic research conducted in central California, however, suggests otherwise. Known for its agricultural produce, extreme poverty, and poor air quality, the Valley is a magnet for the Mexican immigrant farm worker population. We conducted an exploratory ethnographic study to examine health disparities, social suffering, and childhood asthma in the Valley. Many Valley residents believe that their children's health concerns are being ignored. Open-ended interviews uncovered a largely rural community suffering not only from the effects of childhood asthma but the inability to have their experiences taken seriously.

  19. Satellite-based Estimates of Ambient Air Pollution and Global Variations in Childhood Asthma Prevalence

    Science.gov (United States)

    Anderson, H. Ross; Butland, Barbara K.; Donkelaar, Aaron Matthew Van; Brauer, Michael; Strachan, David P.; Clayton, Tadd; van Dingenen, Rita; Amann, Marcus; Brunekreef, Bert; Cohen, Aaron; Dentener, Frank; Lai, Christopher; Lamsal, Lok N.; Martin, Randall V.

    2012-01-01

    Background: The effect of ambient air pollution on global variations and trends in asthma prevalence is unclear. Objectives: Our goal was to investigate community-level associations between asthma prevalence data from the International Study of Asthma and Allergies in Childhood (ISAAC) and satellite-based estimates of particulate matter with aerodynamic diameter prevalence of severe asthma as the outcome and multilevel models to adjust for gross national income (GNI) and center- and country-level sex, climate, and population density. We examined associations (adjusting for GNI) between air pollution and asthma prevalence over time in centers with data from ISAAC Phase One (mid-1900s) and Phase Three (2001-2003). Results: For the 13- to 14-year age group (128 centers in 28 countries), the estimated average within-country change in center-level asthma prevalence per 100 children per 10% increase in center-level PM2.5 and NO2 was -0.043 [95% confidence interval (CI): -0.139, 0.053] and 0.017 (95% CI: -0.030, 0.064) respectively. For ozone the estimated change in prevalence per parts per billion by volume was -0.116 (95% CI: -0.234, 0.001). Equivalent results for the 6- to 7-year age group (83 centers in 20 countries), though slightly different, were not significantly positive. For the 13- to 14-year age group, change in center-level asthma prevalence over time per 100 children per 10% increase in PM2.5 from Phase One to Phase Three was -0.139 (95% CI: -0.347, 0.068). The corresponding association with ozone (per ppbV) was -0.171 (95% CI: -0.275, -0.067). Conclusion: In contrast to reports from within-community studies of individuals exposed to traffic pollution, we did not find evidence of a positive association between ambient air pollution and asthma prevalence as measured at the community level.

  20. Validation of a web-based version of the asthma control test and childhood asthma control test

    NARCIS (Netherlands)

    Koolen, B.B.; Pijnenburg, M.W.; Brackel, H.J.; Landstra, A.M.; Berg, N.J. van den; Merkus, P.J.F.M.; Hop, W.C.J.; Vaessen-Verberne, A.A.

    2011-01-01

    RATIONALE: Recent guidelines focus on adjusting asthma treatment to the level of asthma control. The availability of a web-based asthma control questionnaire offers the possibility to assess asthma control without the need of outpatient clinic visits. The aim of this study was to evaluate the agreem

  1. The Immunomodulatory Effect of Acupoint Application for Childhood Asthma: A Systematic Review and Meta-Analysis

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    Xiao Cun Yang

    2015-01-01

    Full Text Available Objective. To evaluate the evidence on the immunomodulatory effect of acupoint application for childhood asthma. Methods. Five electronic databases through October 2014 were searched. The risk of bias in eligible studies was assessed using the Cochrane Collaboration tool. Standardised mean difference (SMD and 95% confidence intervals (CI of random-effects model were calculated. And heterogeneity was assessed using the Cochran Q statistic and quantified with the I2 index. Results. Six studies were included in our review. The aggregated results suggested that acupoint application showed the beneficial effect for childhood asthma in improving IgA (SMD, −0.83; 95% CI −1.14 to −0.52; P<0.00001, IgE (SMD, −0.52; 95% CI −0.76 to −0.29; P<0.001, IgG (SMD, −1.17; 95% CI −1.61 to −0.74; P<0.0001, IL-4 (SMD, −0.57; 95% CI −0.91 to −0.23; P=0.0009, and IFN-γ (SMD, −0.38; 95% CI −0.71 to −0.04; P=0.03 but not IgM (SMD, −0.40; 95% CI −0.98 to 0.18; P=0.18. And the effective dose of acupoint application may be 2–6 hours/time and a total of 3 times within 4 weeks. Conclusions. This review showed the positive evidence that acupoint application had the favorable immunomodulatory effect for childhood asthma. However, more studies with long follow-up are warrant to confirm the current findings.

  2. Recent advances on diagnosis and management of childhood asthma and food allergies.

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    Hakimeh, Dani; Tripodi, Salvatore

    2013-12-27

    The epidemic of childhood allergic disorders has been associated to the decline of infectious disease. However, exposure to many triggers (airborne viruses, tobacco smoke, pollution, indoor allergens, etc.) contribute to the disease. Breast feeding practices, nutrition, dietary and obesity also play a multifaceted role in shaping the observed worldwide trends of childhood allergies. Guidelines for treatment are available, but their implementation is suboptimal. Then developed countries are slowing learning integrating the development of suitable guidelines with implementation plans. Awareness, psychosocial and family factors strongly influence asthma and food allergy control. Moreover, monitoring tools are necessary to facilitate self-management. By taking into consideration these and many other pragmatic aspects, national public health programs to control the allergic epidemic have been successful in reducing its impact and trace the need for future research in the area.

  3. What has the ECRHS told us about the childhood risks of asthma, allergy and lung function?

    Science.gov (United States)

    Svanes, C

    2008-10-01

    Few studies investigate how environmental factors in childhood may influence adult respiratory health. The European Community Respiratory Health Survey (ECRHS) is a longitudinal multi-centre study of Western world adults, including retrospective assessment of early life factors. Analyses of the ECRHS showed both beneficial and harmful long-term effects of childhood factors on adult asthma, allergy and lung function. Childhood pets were associated with less adult atopy and hay fever; beneficial effects were also indicated for growing up on a farm and for early exposure to other children. The findings have contributed to further development of the hygiene hypothesis and further understanding of the mechanisms relating microbial stimulation to allergy; however, the public health consequences may be limited. Harmful effects of early life factors on adult asthma and lung function were indicated for severe respiratory infections early in life, parental smoking and long-term dog keeping. Intervention with regard to parental smoking and vaccination against common lower airways infections may improve respiratory health in the population. Thus, early life environment had permanent beneficial and adverse effects on adult respiratory health. The multi-centre structure of the ECRHS, the large sample size, the extensive information about each participant and follow-up until the age of 56 years, have given the basis for convincing conclusions, and made possible publication of unsuspected findings in spite of the problems related to adult recall of childhood events. The ECRHS have contributed substantially to increased knowledge about the early life origins of allergy and obstructive pulmonary disease, providing a basis for prevention.

  4. Asthma

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    Kim Harold

    2011-11-01

    Full Text Available Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA inhalers are preferred for most adults who fail to achieve control with ICS therapy. Allergen-specific immunotherapy represents a potentially disease-modifying therapy for many patients with asthma, but should only be prescribed by physicians with appropriate training in allergy. Regular monitoring of asthma control, adherence to therapy and inhaler technique are also essential components of asthma management. This article provides a review of current literature and guidelines for the appropriate diagnosis and management of asthma.

  5. Environmental Public Health Tracking of Childhood Asthma Using California Health Interview Survey, Traffic, and Outdoor Air Pollution Data

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    Wilhelm, Michelle; Meng, Ying-Ying; Rull, Rudolph P.; English, Paul; Balmes, John; Ritz, Beate

    2008-01-01

    Background Despite extensive evidence that air pollution affects childhood asthma, state-level and national-level tracking of asthma outcomes in relation to air pollution is limited. Objectives Our goals were to evaluate the feasibility of linking the 2001 California Health Interview Survey (CHIS), air monitoring, and traffic data; estimate associations between traffic density (TD) or outdoor air pollutant concentrations and childhood asthma morbidity; and evaluate the usefulness of such databases, linkages, and analyses to Environmental Public Health Tracking (EPHT). Methods We estimated TD within 500 feet of residential cross-streets of respondents and annual average pollutant concentrations based on monitoring station measurements. We used logistic regression to examine associations with reported asthma symptoms and emergency department (ED) visits/hospitalizations. Results Assignment of TD and air pollution exposures for cross-streets was successful for 82% of children with asthma in Los Angeles and San Diego, California, Counties. Children with asthma living in high ozone areas and areas with high concentrations of particulate matter < 10 μm in aerodynamic diameter experienced symptoms more frequently, and those living close to heavy traffic reported more ED visits/hospitalizations. The advantages of the CHIS for asthma EPHT include a large and representative sample, biennial data collection, and ascertainment of important socio-demographic and residential address information. Disadvantages are its cross-sectional design, reliance on parental reports of diagnoses and symptoms, and lack of information on some potential confounders. Conclusions Despite limitations, the CHIS provides a useful framework for examining air pollution and childhood asthma morbidity in support of EPHT, especially because later surveys address some noted gaps. We plan to employ CHIS 2003 and 2005 data and novel exposure assessment methods to re-examine the questions raised here. PMID

  6. Exposure to Indoor Pollutants and Wheeze and Asthma Development during Early Childhood

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    Evridiki Patelarou

    2015-04-01

    Full Text Available Background: This review aimed to summarize existing epidemiological evidence of the association between quantitative estimates of indoor air pollution with early childhood respiratory disease. Methods: We carried out a systematic literature search of peer-reviewed epidemiological studies undertaken in “westernized” countries that have assessed exposure to indoor pollutants and asthma and wheeze from infancy up to the age of 5. Results: The search, between January 2004 and February 2014 yielded 1840 studies for consideration. Following application of eligibility criteria to titles and abstracts 22 independent studies were deemed relevant for further review. Two additional studies were next identified through examination of the references’ lists of these studies. Of these 24 selected studies, 16 adopted a prospective cohort design and 8 were case-control studies. Fourteen studies assessed exposure to bio-aerosols, 8 studies assessed exposure to specific air chemicals and two studies assessed exposure to bio-aerosols and air chemicals. Furthermore, 11 studies examined the association of exposure with asthma and 16 with wheeze. Findings indicate that existing studies have reported contradictory effects of indoor pollutants levels and occurrence of asthma/wheeze. Conclusion: Additional research to establish causality and evaluate interventions to prevent disease onset is needed.

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

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    Kentaro Matsuda

    1999-01-01

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

  8. Effects of endotoxin exposure on childhood asthma risk are modified by a genetic polymorphism in ACAA1

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    Sordillo Joanne E

    2011-12-01

    Full Text Available Abstract Background Polymorphisms in the endotoxin-mediated TLR4 pathway genes have been associated with asthma and atopy. We aimed to examine how genetic polymorphisms in innate immunity pathways interact with endotoxin to influence asthma risk in children. Methods In a previous analysis of 372 children from the Boston Home Allergens and the Connecticut Childhood Asthma studies, 7 SNPs in 6 genes (CARD15, TGFB1, LY96, ACAA1, DEFB1 and IFNG involved in innate immune pathways were associated with asthma, and 5 SNPs in 3 genes (CD80, STAT4, IRAK2 were associated with eczema. We tested these SNPs for interaction with early life endotoxin exposure (n = 291, in models for asthma and eczema by age 6. Results We found a significant interaction between endotoxin and a SNP (rs156265 in ACAA1 (p = 0.0013 for interaction. Increased endotoxin exposure (by quartile showed protective effects for asthma in individuals with at least one copy of the minor allele (OR = 0.39 per quartile increase in endotoxin, 95% CI 0.15 to 1.01. Endotoxin exposure did not reduce the risk of asthma in children homozygous for the major allele. Conclusion Our findings suggest that protective effects of endotoxin exposure on asthma may vary depending upon the presence or absence of a polymorphism in ACAA1.

  9. An ADAM33 polymorphism associates with progression of preschool wheeze into childhood asthma: a prospective case-control study with replication in a birth cohort study.

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    Ester M M Klaassen

    Full Text Available The influence of asthma candidate genes on the development from wheeze to asthma in young children still needs to be defined.To link genetic variants in asthma candidate genes to progression of wheeze to persistent wheeze into childhood asthma.In a prospective study, children with recurrent wheeze from the ADEM (Asthma DEtection and Monitoring study were followed until the age of six. At that age a classification (transient wheeze or asthma was based on symptoms, lung function and medication use. In 198 children the relationship between this classification and 30 polymorphisms in 16 asthma candidate genes was assessed by logistic regression. In case of an association based on a p<0.10, replication analysis was performed in an independent birth cohort study (KOALA study, n = 248 included for the present analysis.In the ADEM study, the minor alleles of ADAM33 rs511898 and rs528557 and the ORMDL3/GSDMB rs7216389 polymorphisms were negatively associated, whereas the minor alleles of IL4 rs2243250 and rs2070874 polymorphisms were positively associated with childhood asthma. When replicated in the KOALA study, ADAM33 rs528557 showed a negative association of the CG/GG-genotype with progression of recurrent wheeze into childhood asthma (0.50 (0.26-0.97 p = 0.04 and no association with preschool wheeze.Polymorphisms in ADAM33, ORMDL3/GSDMB and IL4 were associated with childhood asthma in a group of children with recurrent wheeze. The replication of the negative association of the CG/GG-genotype of rs528557 ADAM33 with childhood asthma in an independent birth cohort study confirms that a compromised ADAM33 gene may be implicated in the progression of wheeze into childhood asthma.

  10. Early eczema and the risk of childhood asthma: a prospective, population-based study

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    Saunes Marit

    2012-10-01

    Full Text Available Abstract Background Severe eczema in young children is associated with an increased risk of developing asthma and rhino-conjunctivitis. In the general population, however, most cases of eczema are mild to moderate. In an unselected cohort, we studied the risk of current asthma and the co-existence of allergy-related diseases at 6 years of age among children with and without eczema at 2 years of age. Methods Questionnaires assessing various environmental exposures and health variables were administered at 2 years of age. An identical health questionnaire was completed at 6 years of age. The clinical investigation of a random subsample ascertained eczema diagnoses, and missing data were handled by multiple imputation analyses. Results The estimate for the association between eczema at 2 years and current asthma at 6 years was OR=1.80 (95% CI 1.10-2.96. Four of ten children with eczema at 6 years had the onset of eczema after the age of 2 years, but the co-existence of different allergy-related diseases at 6 years was higher among those with the onset of eczema before 2 years of age. Conclusions Although most cases of eczema in the general population were mild to moderate, early eczema was associated with an increased risk of developing childhood asthma. These findings support the hypothesis of an atopic march in the general population. Trial registration The Prevention of Allergy among Children in Trondheim study has been identified as ISRCTN28090297 in the international Current Controlled Trials database

  11. Outdoor particulate matter and childhood asthma admissions in Athens, Greece: a time-series study

    Directory of Open Access Journals (Sweden)

    Roma Eleftheria S

    2010-07-01

    Full Text Available Abstract Background Particulate matter with diameter less than 10 micrometers (PM10 that originates from anthropogenic activities and natural sources may settle in the bronchi and cause adverse effects possibly via oxidative stress in susceptible individuals, such as asthmatic children. This study aimed to investigate the effect of outdoor PM10 concentrations on childhood asthma admissions (CAA in Athens, Greece. Methods Daily counts of CAA from the three Children's Hospitals within the greater Athens' area were obtained from the hospital records during a four-year period (2001-2004, n = 3602 children. Mean daily PM10 concentrations recorded by the air pollution-monitoring network of the greater Athens area were also collected. The relationship between CAA and PM10 concentrations was investigated using the Generalized Linear Models with Poisson distribution and logistic analysis. Results There was a statistically significant (95% CL relationship between CAA and mean daily PM10 concentrations on the day of exposure (+3.8% for 10 μg/m3 increase in PM10 concentrations, while a 1-day lag (+3.4% for 10 μg/m3 increase in PM10 concentrations and a 4-day lag (+4.3% for 10 μg/m3 increase in PM10 concentrations were observed for older asthmatic children (5-14 year-old. High mean daily PM10 concentration (the highest 10%; >65.69 μg/m3 doubled the risk of asthma exacerbations even in younger asthmatic children (0-4 year-old. Conclusions Our results provide evidence of the adverse effect of PM10 on the rates of paediatric asthma exacerbations and hospital admissions. A four-day lag effect between PM10 peak exposure and asthma admissions was also observed in the older age group.

  12. In utero exposure to 25(OH) D and risk of childhood asthma, wheeze and respiratory tract infections

    DEFF Research Database (Denmark)

    Feng, Haixia; Xun, Pengcheng; Pike, Katharine;

    2016-01-01

    BACKGROUND: Studies of the associations between in utero 25-hydroxyvitamin D [25(OH) D] exposure and childhood asthma risk, wheeze and respiratory tract infections are inconsistent and inconclusive. OBJECTIVES: To assess the associations between 25(OH) D levels in cord blood or maternal venous bl...

  13. Asthma

    Science.gov (United States)

    ... 1.25 million of those individuals have severe asthma, a condition that can be difficult to control and treat. Learn more about his research by visiting the NHLBI Laboratory of Asthma and Lung Inflammation website: http://www.nhlbi.nih. ...

  14. Asthma

    OpenAIRE

    Kim, Harold; Mazza, Jorge

    2011-01-01

    Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA) inhalers are pr...

  15. Asthma

    OpenAIRE

    Kim Harold; Mazza Jorge

    2011-01-01

    Abstract Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICSs) represent the standard of care for the majority of patients. Combination ICS/long-acting beta2-agonists (LABA) inhale...

  16. Typical halogenated persistent organic pollutants in indoor dust and the associations with childhood asthma in Shanghai, China.

    Science.gov (United States)

    Meng, Ge; Nie, Zhiqing; Feng, Yan; Wu, Xiaomeng; Yin, Yong; Wang, Yan

    2016-04-01

    Halogenated persistent organic pollutants (Hal-POPs) are significant contaminants in the indoor environment that are related to many human diseases. Ingestion of indoor dust is considered the major pathway of Hal-POP exposures, especially for children aged 3-6 years. Alongside a retrospective study on the associations between typical Hal-POP exposure and childhood asthma in Shanghai, indoor dust samples from asthmatic and non-asthmatic children's homes (n = 60, each) were collected. Polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCPs) were measured by GC-MS. BDE-209, PCB-8 and p,p'-DDE were the predominant components in each chemical category. The concentrations of most Hal-POPs were significantly higher in the asthmatic families. The associations between Hal-POP exposure and asthma occurrence were examined by calculating the odds ratios (ORs) using a logistic regression model. A positive association was found between p,p'-DDE in indoor dust and childhood asthma (OR = 1.825, 95%CI: 1.004, 3.317; p = 0.048). The average daily doses of Hal-POP intake were calculated using the method provided by the USEPA. Non-carcinogenic health risks were preliminarily assessed. Our study indicated that exposure to p,p'-DDE via indoor dust may contribute to childhood asthma occurrence. Non-carcinogenic health risks were not found with the intake of Hal-POPs via the ingestion of indoor dust.

  17. The application of theory in childhood asthma self-help programs.

    Science.gov (United States)

    Bruhn, J G

    1983-11-01

    Theories from research in health education and compliance (adherence) behavior are reviewed and examined for their applicability to studies of self-management of childhood asthma. Specific theories discussed include: (1) the health belief model, (2) models of health, illness, and sick-role behavior, (3) social learning theory, (4) models of physician-patient relationships, (5) self-regulation model, (6) communication theory, (7) attribution, control, and decision-making theory, (8) grounded theory, (9) ecologic theory, and (10) family and social systems theories. A scheme to guide development and testing of theories in children's health and illness behavior is presented. The key common elements in the examined theories on adherence behavior are integrated and organized into a paradigm for the family determinants of the self-management of chronic illness.

  18. Feeding Bottles Usage and the Prevalence of Childhood Allergy and Asthma

    DEFF Research Database (Denmark)

    Hsu, Nai-Yun; Wu, Pei-Chih; Bornehag, Carl-Gustaf

    2012-01-01

    infant formula or complementary foods, family history, parental educational levels, and smoking status, as well as the problem of indoor water damage. This study was the first to reveal the potential risk of using plastic consumer products such as feeding bottles on the reported health status......This study aimed to examine the association between the length of use of feeding bottles or pacifiers during childhood and the prevalence of respiratory and allergic morbidities. A large-scale questionnaire survey was performed in day care centers and kindergartens (with children's ages ranging...... from 2 to 7 years) in southern Taiwan, and a total of 14,862 questionnaires completed by parents were finally recruited for data analysis. Effects of using feeding bottles on children's wheezing/asthma (adjusted OR: 1.05, 95% CI 1.00-1.09), allergic rhinitis (adjusted OR: 1.04, 95% CI 1...

  19. Childhood asthma in Beijing, China: A population-based case-control study

    Energy Technology Data Exchange (ETDEWEB)

    Zheng, T.Z.; Niu, S.R.; Lu, B.Y.; Fan, X.E.; Sun, F.Y.; Wang, J.P.; Zhang, Y.W.; Zhang, B.; Owens, P.; Hao, L.Y.; Li, Y.D.; Leaderer, B. [Yale School of Medicine, New Haven, CT (United States). Dept. of Epidemiology & Public Health

    2002-11-15

    A population-based case-control study was conducted in Shunyi County, People's Republic of China, in January 1999 and March 2001 to investigate the risk factors for childhood asthma. An increased risk of childhood asthma was associated with smoking by relatives in front of the mother while she was pregnant with the child (odds ratio (OR) = 1.3, 95% confidence interval (CI): 1.0, 1.6) and with smoking by relatives in front of the child (OR = 1.4, 95% CI: 1.1, 1.9). The risk increased with the increasing number of smokers and the total minutes of smoking by relatives in front of both the child and the mother while she was pregnant with the child. An increased risk was observed for use of coal for heating (OR = 1.5, 95% CI: 1.1, 1.9). Those who reported using coal for cooking without ventilation also had an increased risk (OR = 2.3, 95% CI: 1.5, 3.5). An increased risk was observed for those who reported having molds or fungi on the ceilings of their houses (OR = 1.8, 95% CI: 1.1, 2.9) or inside the child's room (OR 1.8, 95% CI: 1.0, 3.2). An increased risk was also found for those having both a dog and a cat as pets (OR 1.5, 95% CI: 1.0, 2.3) or for finding both cockroaches and rats inside their houses (OR = 1.8, 95% CI: 1.2, 2.8).

  20. Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Thorsen, Poul; Jensen, Jørgen Skov;

    2002-01-01

    BACKGROUND: Infants with wheezing and allergic diseases have a microflora that differs from that of healthy infants. The fetus acquires microorganisms during birth when exposed to the maternal vaginal microflora. It is therefore conceivable that the maternal vaginal microflora might influence...... the establishment of the infant flora and, as a consequence, the development of wheezing and allergic diseases. OBJECTIVE: We sought to study the associations between the composition of the maternal vaginal microflora and the development of wheezing and asthma in childhood. METHODS: We performed a population....... Maternal colonization with staphylococci (OR, 2.2; 95% CI, 1.4-3.4) and use of antibiotics in pregnancy (OR, 1.7; 95% CI, 1.1-2.6) were associated with asthma during the fifth year of life. CONCLUSION: The composition of the maternal vaginal micro-flora might be associated with wheezing and asthma...

  1. Evaluation of the Correlation Between Childhood Asthma and Helicobacter pylori in Kashan

    OpenAIRE

    Khamechian, Tahere; Movahedian, Amir Hossein; Ebrahimi Eskandari, Ghasem; Heidarzadeh Arani, Marzieh; Mohammadi, Abouzar

    2015-01-01

    Background: Asthma is a chronic inflammatory air-way disease with increasing prevalence rate during the recent years. There are studies about the relationship between asthma and infectious diseases, including the association between asthma and Helicobacter pylori. According to the latest studies, there is an epidemiological correlation between asthma prevalence and prevalence of H. pylori. Objectives: The aim of this research was to study the correlation between H. pylori and asthma by biopsy...

  2. The interaction of glutathione S-transferase M1-null variants with tobacco smoke exposure and the development of childhood asthma

    DEFF Research Database (Denmark)

    Rogers, A J; Brasch-Andersen, C; Ionita-Laza, I;

    2009-01-01

    : To explore the joint interactive effects of GSTM1 copy number and tobacco smoke exposure on the development of asthma and asthma-related phenotypes in a family-based cohort of childhood asthmatics. METHODS: We performed quantitative PCR-based genotyping for GSTM1 copy number in children of self......BACKGROUND: The glutathione S-transferase M1 (GSTM1)-null variant is a common copy number variant associated with adverse pulmonary outcomes, including asthma and airflow obstruction, with evidence of important gene-by-environment interactions with exposures to oxidative stress. OBJECTIVE......-reported white ancestry with mild to moderate asthma in the Childhood Asthma Management Program. Questionnaire data regarding intrauterine (IUS) and post-natal, longitudinal smoke exposure were available. We performed both family-based and population-based tests of association for the interaction between GSTM1...

  3. Translating evidence-based interventions into practice: the design and development of the Merck Childhood Asthma Network, Inc. (MCAN).

    Science.gov (United States)

    Viswanathan, Meera; Lux, Linda; Lohr, Kathleen N; Evans, Tammeka Swinson; Smith, Lucia Rojas; Woodell, Carol; Mansfield, Carol; Darcy, Niamh; Ohadike, Yvonne U; Lesch, Julie Kennedy; Malveaux, Floyd J

    2011-11-01

    Pediatric asthma is a multifactorial disease, requiring complex, interrelated interventions addressing children, families, schools, and communities. The Merck Childhood Asthma Network, Inc. (MCAN) is a nonprofit organization that provides support to translate evidence-based interventions from research to practice. MCAN developed the rationale and vision for the program through a phased approach, including an extensive literature review, stakeholder engagement, and evaluation of funding gaps. The analysis pointed to the need to identify pediatric asthma interventions implemented in urban U.S. settings that have demonstrated efficacy and materials for replication and to translate the interventions into wider practice. In addition to this overall MCAN objective, specific goals included service and system integration through linkages among health care providers, schools, community-based organizations, patients, parents, and other caregivers. MCAN selected sites based on demonstrated ability to implement effective interventions and to address multiple contexts of pediatric asthma prevention and management. Selected MCAN program sites were mature institutions or organizations with significant infrastructure, existing funding, and the ability to provide services without requiring a lengthy planning period. Program sites were located in communities with high asthma morbidity and intended to integrate new elements into existing programs to create comprehensive care approaches.

  4. Childhood Exposure to Ambient Air Pollutants and the Onset of Asthma: An Administrative Cohort Study in Québec

    Science.gov (United States)

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

    2016-01-01

    Background: Although it is well established that air pollutants can exacerbate asthma, the link with new asthma onset in children is less clear. Objective: We assessed the association between the onset of childhood asthma with both time of birth and time-varying exposures to outdoor air pollutants. Method: An open cohort of children born in the province of Québec, Canada, was created using linked medical–administrative databases. New cases of asthma were defined as one hospital discharge with a diagnosis of asthma or two physician claims for asthma within a 2 year period. Annual ozone (O3) levels were estimated at the child’s residence for all births 1999–2010, and nitrogen dioxide (NO2) levels during 1996–2006 were estimated for births on the Montreal Island. Satellite based concentrations of fine particles (PM2.5) were estimated at a 10 km × 10 km resolution and assigned to residential postal codes throughout the province (1996–2011). Hazard ratios (HRs) were assessed with Cox models for the exposure at the birth address and for the time-dependent exposure. We performed an indirect adjustment for secondhand smoke (SHS). Results: We followed 1,183,865 children (7,752,083 person-years), of whom 162,752 became asthmatic. After controlling for sex and material and social deprivation, HRs for an interquartile range increase in exposure at the birth address to NO2 (5.45 ppb), O3 (3.22 ppb), and PM2.5 (6.50 μg/m3) were 1.04 (95% CI: 1.02, 1.05), 1.11 (95% CI: 1.10, 1.12), and 1.31 (95% CI: 1.28, 1.33), respectively. Effects of O3 and PM2.5 estimated with time-varying Cox models were similar to those estimated using exposure at birth, whereas the effect of NO2 was slightly stronger (HR = 1.07; 95% CI: 1.05, 1.09). Conclusions: Asthma onset in children appears to be associated with residential exposure to PM2.5, O3 and NO2. Citation: Tétreault LF, Doucet M, Gamache P, Fournier M, Brand A, Kosatsky T, Smargiassi A. 2016. Childhood exposure to ambient air

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

    Directory of Open Access Journals (Sweden)

    Patrick A Hessel

    2001-01-01

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

  6. Atomic structure of a rhinovirus C, a virus species linked to severe childhood asthma.

    Science.gov (United States)

    Liu, Yue; Hill, Marchel G; Klose, Thomas; Chen, Zhenguo; Watters, Kelly; Bochkov, Yury A; Jiang, Wen; Palmenberg, Ann C; Rossmann, Michael G

    2016-08-09

    Isolates of rhinovirus C (RV-C), a recently identified Enterovirus (EV) species, are the causative agents of severe respiratory infections among children and are linked to childhood asthma exacerbations. The RV-C have been refractory to structure determination because they are difficult to propagate in vitro. Here, we report the cryo-EM atomic structures of the full virion and native empty particle (NEP) of RV-C15a. The virus has 60 "fingers" on the virus outer surface that probably function as dominant immunogens. Because the NEPs also display these fingers, they may have utility as vaccine candidates. A sequence-conserved surface depression adjacent to each finger forms a likely binding site for the sialic acid on its receptor. The RV-C, unlike other EVs, are resistant to capsid-binding antiviral compounds because the hydrophobic pocket in VP1 is filled with multiple bulky residues. These results define potential molecular determinants for designing antiviral therapeutics and vaccines.

  7. Feeding bottles usage and the prevalence of childhood allergy and asthma.

    Science.gov (United States)

    Hsu, Nai-Yun; Wu, Pei-Chih; Bornehag, Carl-Gustaf; Sundell, Jan; Su, Huey-Jen

    2012-01-01

    This study aimed to examine the association between the length of use of feeding bottles or pacifiers during childhood and the prevalence of respiratory and allergic morbidities. A large-scale questionnaire survey was performed in day care centers and kindergartens (with children's ages ranging from 2 to 7 years) in southern Taiwan, and a total of 14,862 questionnaires completed by parents were finally recruited for data analysis. Effects of using feeding bottles on children's wheezing/asthma (adjusted OR: 1.05, 95% CI 1.00-1.09), allergic rhinitis (adjusted OR: 1.04, 95% CI 1.00-1.08), and eczema (adjusted OR: 1.07, 95% CI 1.01-1.2) were found. Moreover, significant dose-dependent relationships were further established after an adjustment for confounders was performed that included children's ages, gender, gestational age, birth weight, length of breastfeeding, the age when first given infant formula or complementary foods, family history, parental educational levels, and smoking status, as well as the problem of indoor water damage. This study was the first to reveal the potential risk of using plastic consumer products such as feeding bottles on the reported health status of preschool children in Asian countries.

  8. Childhood diet and asthma and atopy at 8 years of age : the PIAMA birth cohort study

    NARCIS (Netherlands)

    Willers, S. M.; Wijga, A. H.; Brunekreef, B.; Scholtens, S.; Postma, D. S.; Kerkhof, M.; de Jongste, J. C.; Smit, H. A.

    2011-01-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA)

  9. Declines with Age in Childhood Asthma Symptoms and Health Care Use: An Adjustment for Evaluations

    Science.gov (United States)

    Ko, Yi-An; Song, Peter X. K.; Clark, Noreen M.

    2014-01-01

    Rationale: Asthma is a variable condition with an apparent tendency for a natural decline in asthma symptoms and health care use occurring as children age. As a result, asthma interventions using a pre-post design may overestimate the intervention effect when no proper control group is available. Objectives: Investigate patterns of natural decline…

  10. [Frequency of childhood asthma in various Italian regions. Results from ISAAC. Collaborating group of ISRDCE (Italian Studies of Respiration Disorders in Childhood and the Environment)].

    Science.gov (United States)

    1997-01-01

    In the framework of ISAAC-International Studies on Asthma and Allergies in Childhood--the SIDRIA collaborative project--Studi Italiani sui Disturbi Respiratori nell'Infanzia e l'Ambiente--was established in order to estimate the prevalence of asthma, rinithis and eczema in ten geographic areas in Italy. Data collection spanned from October 1994 to March 1995. Overall 18,737 children 6-7 years old in the primary schools and 21,846 adolescents 13-14 years old in the secondary schools entered the study. The parents of pupils in both age groups filled in standardised questionnaires at home; furthermore both a traditional and a video questionnaire was administered at school to the adolescents. The overall response rate was 96.3%. Based on the interviews to the parents a prevalence of asthma of 9.0% in both age groups was estimated, with the lowest values in Cremona (4.6% children; 6.2% adolescents) and the highest in Roma (11.1% children; 10.4% adolescents). Parents also reported a higher prevalence of wheezing (7.7%) and dyspnea (5.3%) in the last year among children than among adolescents (4.7% and 3.4% respectively). Through the direct interview of the adolescents higher prevalence of asthma (10.4%), wheezing (10.3%) and dyspnea (7.8%) were estimated. Within a narrow range of variability, the reported prevalence of asthma and asthmatic symptoms in Trento and Cremona were the lowest and those in Roma, Empoli and Siena the highest. Nor an urban-rural neither a north-south gradient was detected. A higher prevalence of the same disorders was observed among females than males in the youngest age group, but this difference was no more evident among the adolescents.

  11. The role of polymorphisms in ADAM33, a disintegrin and metalloprotease 33, in childhood asthma and lung function in two German populations

    Directory of Open Access Journals (Sweden)

    Klopp Norman

    2006-06-01

    Full Text Available Abstract Background ADAM33, the first asthma candidate gene identified by positional cloning, may be associated with childhood asthma, lung function decline and bronchial hyperresponsiveness. However, replication results have been inconclusive in smaller previous study populations probably due to inconsistencies in asthma phenotypes or yet unknown environmental influences. Thus, we tried to further elucidate the role of ADAM33 polymorphisms (SNPs in a genetic analysis of German case control and longitudinal populations. Methods Using MALDI-TOF, ten ADAM33 SNPs were genotyped in 1,872 children from the International Study of Asthma and Allergy in Childhood (ISAAC II in a case control setting and further 824 children from the longitudinal cohort Multicentre Study of Allergy (MAS. In both populations the effects of single SNPs and haplotypes were studied and a gene environment analysis with passive smoke exposure was performed using SAS/Genetics. Results No single SNP showed a significant association with doctor's diagnosis of asthma. A trend for somewhat more profound effects of ADAM33 SNPs was observed in individuals with asthma and BHR. Haplotype analyses suggested a minor effect of the ADAM33 haplotype H4 on asthma (p = 0.033 but not on BHR. Associations with non atopic asthma and baseline lung function were identified but no interaction with passive smoke exposure could be detected. Conclusion The originally reported association between ADAM33 polymorphisms and asthma and BHR could not be confirmed. However, our data may suggest a complex role of ADAM33 polymorphisms in asthma ethiology, especially in non atopic asthma.

  12. Comparable risk of childhood asthma after vaginal delivery and emergency caesarean section

    DEFF Research Database (Denmark)

    Brix, Nis; Stokholm, Lonny; Jonsdottir, Fjola

    2017-01-01

    ) was not. In 11 pairs, both twins developed asthma. In the unadjusted analysis, emergency caesarean section did not affect the risk of asthma (odds ratio = 0.67 (95% confidence interval: 0.38-1.17); p = 0.16). After adjusting for birth weight, gender, umbilical cord pH, Apgar score at 5 min. and neonatal...

  13. Maternal fish consumption during pregnancy and risk of early childhood asthma.

    Science.gov (United States)

    Salam, Muhammad T; Li, Yu-Fen; Langholz, Bryan; Gilliland, Frank D

    2005-01-01

    Maternal fish consumption during pregnancy may affect children's asthma risk by modulating early-life immune development. Type of fish intake may be important because of differences in fatty acid content. To test this hypothesis, we conducted a nested case-control study, selecting subjects from the Children's Health Study, a population-based study of school-aged children in southern California. Cases had physician-diagnosed asthma and controls were asthma-free by age 5 years. Mothers or guardians provided information on fish consumption during pregnancy in telephone interviews. We computed odds ratio (OR) and 95% confidence interval (CI) by using conditional logistic regression models that accounted for the sampling. In children born to mothers with a history of asthma, the OR of asthma was 0.20 (95% CI = 0.06-0.65) when mothers ate oily fish at least monthly during pregnancy compared with no consumption (p(trend) = 0.006). Maternal oily fish consumption during pregnancy did not benefit children of non-asthmatic mothers. In contrast, fish stick (a source of trans-fats) consumption during pregnancy increased asthma risk in children (OR = 2.04; 95% CI = 1.18-3.51). Our results suggest that maternal oily fish intake during pregnancy may protect offspring from asthma; however, eating fish sticks during pregnancy may increase asthma risk in children.

  14. Cadherin-related family member 3, a childhood asthma susceptibility gene product, mediates rhinovirus C binding and replication.

    Science.gov (United States)

    Bochkov, Yury A; Watters, Kelly; Ashraf, Shamaila; Griggs, Theodor F; Devries, Mark K; Jackson, Daniel J; Palmenberg, Ann C; Gern, James E

    2015-04-28

    Members of rhinovirus C (RV-C) species are more likely to cause wheezing illnesses and asthma exacerbations compared with other rhinoviruses. The cellular receptor for these viruses was heretofore unknown. We report here that expression of human cadherin-related family member 3 (CDHR3) enables the cells normally unsusceptible to RV-C infection to support both virus binding and replication. A coding single nucleotide polymorphism (rs6967330, C529Y) was previously linked to greater cell-surface expression of CDHR3 protein, and an increased risk of wheezing illnesses and hospitalizations for childhood asthma. Compared with wild-type CDHR3, cells transfected with the CDHR3-Y529 variant had about 10-fold increases in RV-C binding and progeny yields. We developed a transduced HeLa cell line (HeLa-E8) stably expressing CDHR3-Y529 that supports RV-C propagation in vitro. Modeling of CDHR3 structure identified potential binding sites that could impact the virus surface in regions that are highly conserved among all RV-C types. Our findings identify that the asthma susceptibility gene product CDHR3 mediates RV-C entry into host cells, and suggest that rs6967330 mutation could be a risk factor for RV-C wheezing illnesses.

  15. Eczema in early childhood is strongly associated with the development of asthma and rhinitis in a prospective cohort

    Directory of Open Access Journals (Sweden)

    von Kobyletzki Laura B

    2012-07-01

    Full Text Available Abstract Background This study aimed to estimate the association between eczema in early childhood and the onset of asthma and rhinitis later in life in children. Methods A total of 3,124 children aged 1–2 years were included in the Dampness in Building and Health (DBH study in the year 2000, and followed up 5 years later by a parental questionnaire based on an International Study of Asthma and Allergies in Childhood protocol. The association between eczema in early childhood and the incidence of asthma and rhinitis later in life was estimated by univariable and multivariable logistic regression modelling. Results The prevalence of eczema in children aged 1–2 years was 17.6% at baseline. Children with eczema had a 3-fold increased odds of developing asthma (adjusted odds ratio [aOR], 3.07; 95% confidence interval (CI 1.79–5.27, and a nearly 3-fold increased odds of developing rhinitis (aOR, 2.63; 1.85–3.73 at follow-up compared with children without eczema, adjusted for age, sex, parental allergic disease, parental smoking, length of breastfeeding, site of living, polyvinylchloride flooring material, and concomitant allergic disease. When eczema was divided into subgroups, moderate to severe eczema (aOR, 3.56; 1.62–7.83 and aOR, 3.87; 2.37–6.33, respectively, early onset of eczema (aOR, 3.44; 1.94–6.09 and aOR, 4.05; 2.82–5.81; respectively, and persistence of eczema (aOR, 5.16; 2.62–10.18 and aOR, 4.00; 2.53–6.22, respectively further increased the odds of developing asthma and rhinitis. Further independent risk factors increasing the odds of developing asthma were a parental history of allergic disease (aOR, 1.83; 1.29–2.60 and a period of breast feeding shorter than 6 months (aOR, 1.57; 1.03–2.39. The incidence of rhinitis was increased for parental history of allergic disease (aOR, 2.00; 1.59–2.51 and polyvinylchloride flooring (aOR, 1.60; 1.02–2.51. Conclusion Eczema in infancy is associated with

  16. The expression of a novel anti-inflammatory cytokine IL-35 and its possible significance in childhood asthma.

    Science.gov (United States)

    Ma, Yanyan; Liu, Xingli; Wei, Zengtao; Wang, Xiaoyan; Xu, Dong; Dai, Shen; Li, Yan; Gao, Meng; Ji, Changqin; Guo, Chun; Zhang, Lining; Wang, Xiaoyan

    2014-11-01

    Interleukin-35 (IL-35) is a novel anti-inflammatory cytokine and has been shown to play an important role in maintaining immune homeostasis. However, the effect of IL-35 on human asthma remains unclear. The present study is to investigate the expression and significance of IL-35 in childhood asthma. Forty-one asthmatic children and forty-two healthy controls were recruited in Qilu Children's Hospital of Shandong University. Serum total immunoglobulin E level was measured by radioimmunosorbent test. Peripheral blood eosinophils were counted using BC-5800 Automatic Blood Cell Analyzer. IL-35 mRNA in peripheral blood mononuclear cells was detected by quantitative real-time polymerase chain reaction. Serum IL-35, IL-4 and interferon-γ levels were measured using enzyme-linked immunosorbent assay. The correlations among the above indexes were also analyzed using Pearson's method. Our results showed that serum total IgE, eosinophil count and serum IL-4 were significantly increased in asthmatic children compared with control children, and serum IFN-γ level in asthmatic patients was obviously lower than that in healthy controls. We also found that there was an obviously positive correlation between serum IgE and IL-4 levels in asthmatic patients. In addition, significantly negative correlation was found between serum total IgE and IFN-γ levels. More importantly, we found that the expression of IL-35 mRNA and protein was both down-regulated in asthmatic children, and serum IL-35 level was inversely related to serum IL-4 level. Moreover, significantly positive correlation was also found between serum IL-35 and IFN-γ levels. The results suggest that the decreased expression of IL-35 could be involved in the pathogenesis of childhood asthma.

  17. Childhood diet and asthma and atopy at 8 years of age: the PIAMA birth cohort study.

    Science.gov (United States)

    Willers, S M; Wijga, A H; Brunekreef, B; Scholtens, S; Postma, D S; Kerkhof, M; de Jongste, J C; Smit, H A

    2011-05-01

    Diet may affect the development of asthma. We investigated whether asthma or atopy outcomes at 8 yrs of age were associated with long-term dietary exposure, and whether associations were different for consumption at early or later age. The Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort enrolled 4,146 participants at baseline, who were followed up to 8 yrs of age. Dietary intakes of interest were fruit, vegetables, brown/wholemeal bread, fish, milk, butter and margarine. Associations between food intake at early (2-3 yrs) and later (7-8 yrs) age, and long-term intake, asthma and atopy at 8 yrs of age were calculated by logistic regression. Complete longitudinal dietary data for at least one of the food groups were available for 2,870 children. Fruit consumption at early age was associated with reduced asthma symptoms (OR per 1 consumption day per week increase 0.93, 95% CI 0.85-1.00). Long-term fruit intake was inversely associated with asthma symptoms (OR 0.90, 95% CI 0.82-0.99) and sensitisation to inhaled allergens (OR 0.90, 95% CI 0.82-0.99). We found no consistent associations between diet and outcomes for other foods. This study indicates no consistent effects of increased early or late consumption, or long-term intake of certain foods on asthma and atopy in 8-yr-olds, with a possible exception for fruit.

  18. Early infancy microbial and metabolic alterations affect risk of childhood asthma.

    Science.gov (United States)

    Arrieta, Marie-Claire; Stiemsma, Leah T; Dimitriu, Pedro A; Thorson, Lisa; Russell, Shannon; Yurist-Doutsch, Sophie; Kuzeljevic, Boris; Gold, Matthew J; Britton, Heidi M; Lefebvre, Diana L; Subbarao, Padmaja; Mandhane, Piush; Becker, Allan; McNagny, Kelly M; Sears, Malcolm R; Kollmann, Tobias; Mohn, William W; Turvey, Stuart E; Finlay, B Brett

    2015-09-30

    Asthma is the most prevalent pediatric chronic disease and affects more than 300 million people worldwide. Recent evidence in mice has identified a "critical window" early in life where gut microbial changes (dysbiosis) are most influential in experimental asthma. However, current research has yet to establish whether these changes precede or are involved in human asthma. We compared the gut microbiota of 319 subjects enrolled in the Canadian Healthy Infant Longitudinal Development (CHILD) Study, and show that infants at risk of asthma exhibited transient gut microbial dysbiosis during the first 100 days of life. The relative abundance of the bacterial genera Lachnospira, Veillonella, Faecalibacterium, and Rothia was significantly decreased in children at risk of asthma. This reduction in bacterial taxa was accompanied by reduced levels of fecal acetate and dysregulation of enterohepatic metabolites. Inoculation of germ-free mice with these four bacterial taxa ameliorated airway inflammation in their adult progeny, demonstrating a causal role of these bacterial taxa in averting asthma development. These results enhance the potential for future microbe-based diagnostics and therapies, potentially in the form of probiotics, to prevent the development of asthma and other related allergic diseases in children.

  19. Evaluation of genetic susceptibility to childhood allergy and asthma in an African American urban population

    Directory of Open Access Journals (Sweden)

    Hudgens Edward E

    2011-02-01

    Full Text Available Abstract Background Asthma and allergy represent complex phenotypes, which disproportionately burden ethnic minorities in the United States. Strong evidence for genomic factors predisposing subjects to asthma/allergy is available. However, methods to utilize this information to identify high risk groups are variable and replication of genetic associations in African Americans is warranted. Methods We evaluated 41 single nucleotide polymorphisms (SNP and a deletion corresponding to 11 genes demonstrating association with asthma in the literature, for association with asthma, atopy, testing positive for food allergens, eosinophilia, and total serum IgE among 141 African American children living in Detroit, Michigan. Independent SNP and haplotype associations were investigated for association with each trait, and subsequently assessed in concert using a genetic risk score (GRS. Results Statistically significant associations with asthma were observed for SNPs in GSTM1, MS4A2, and GSTP1 genes, after correction for multiple testing. Chromosome 11 haplotype CTACGAGGCC (corresponding to MS4A2 rs574700, rs1441586, rs556917, rs502581, rs502419 and GSTP1 rs6591256, rs17593068, rs1695, rs1871042, rs947895 was associated with a nearly five-fold increase in the odds of asthma (Odds Ratio (OR = 4.8, p = 0.007. The GRS was significantly associated with a higher odds of asthma (OR = 1.61, 95% Confidence Interval = 1.21, 2.13; p = 0.001. Conclusions Variation in genes associated with asthma in predominantly non-African ethnic groups contributed to increased odds of asthma in this African American study population. Evaluating all significant variants in concert helped to identify the highest risk subset of this group.

  20. Evaluation of clinical data in childhood asthma. Application of a computer file system

    Energy Technology Data Exchange (ETDEWEB)

    Fife, D.; Twarog, F.J.; Geha, R.S.

    1983-10-01

    A computer file system was used in our pediatric allergy clinic to assess the value of chest roentgenograms and hemoglobin determinations used in the examination of patients and to correlate exposure to pets and forced hot air with the severity of asthma. Among 889 children with asthma, 20.7% had abnormal chest roentgenographic findings, excluding hyperinflation and peribronchial thickening, and 0.7% had abnormal hemoglobin values. Environmental exposure to pets or forced hot air was not associated with increased severity of asthma, as assessed by five measures of outcome: number of medications administered, requirement for corticosteroids, frequency of clinic visits, frequency of emergency room visits, and frequency of hospitalizations.

  1. Long-acting beta(2)-agonists in management of childhood asthma

    DEFF Research Database (Denmark)

    Bisgaard, H

    2000-01-01

    This review assesses the evidence regarding the use of long-acting beta(2)-agonists in the management of pediatric asthma. Thirty double-blind, randomized, controlled trials on the effects of formoterol and salmeterol on lung function in asthmatic children were identified. Single doses of inhaled......, long-acting beta(2)-agonists provide effective bronchodilatation and bronchoprotection when used as intermittent, single-dose treatment of asthma in children, but not when used as regular treatment. Future studies should examine the positioning of long-acting beta(2)-agonists as an "as needed" rescue...... medication instead of short-acting beta(2)-agonists for pediatric asthma management....

  2. Indoor Dust Allergen Levels in the Homes of Patients with Childhood Asthma: An Experience From Southwestern Iran

    Directory of Open Access Journals (Sweden)

    Mozhgan Moghtaderi

    2016-04-01

    Full Text Available Exposure to indoor allergens plays an important role in the etiology of asthma. This study was designed to quantify indoor allergens from homes of families that had at least one case of childhood asthma at home in a southwestern city of Iran. The relationship between the indoor allergen levels and home characteristics was also investigated. Dust samples were collected from the bedrooms and the kitchens of 35 homes where children with persistent asthma were living. The levels of indoor allergens were measured by enzyme linked immunosorbent assay (ELISA. Detectable amounts of mite, mouse and cockroach allergens were found in all evaluated places. None of our patients were exposed to a threshold concentration of indoor allergen for sensitizing at home. Regarding of mite allergens, the levels of Der f1 were significantly higher than Der p1 and a direct correlation was observed between living in an apartment and Der f1 levels. Moreover, Fel d1 (cat and Bla g1 (cockroach allergens were found in the children’s bedrooms more frequently than those in the kitchens. In this study, direct associations were obtained between Bla g1 allergen and the duration of occupancy and between Fel d1 and average home size. A total of 34.2% of the patients showed positive skin reactions to at least one of the tested allergens as 17.1% of them showed reactivity to D. pteronyssinus. Proper controlling of cockroaches and mice by public health officials would be a practical approach to avoid inducing asthma or worsening the symptoms.

  3. Genetic variants in the PSMA6, PSMC6 and PSMA3 genes associated with childhood asthma in Latvian and Taiwanese populations

    Directory of Open Access Journals (Sweden)

    Paramonova N.

    2014-09-01

    Full Text Available Proteasomes mediate functional realization of signaling proteins implicated in asthma pathogenesis. Aim. To evaluate main and sex-specific association between the PSMA6, PSMC6 and PSMA3 proteasomal genes variations and childhood asthma in Latvians and Taiwanese. Methods. SNPs rs2277460, rs1048990, rs2295826, rs2295827 and rs2348071 were genotyped in 102 Latvian and 159 Taiwanese cases for comparison with genetic diversity in populations (191 and 1097 subjects respectively. Results. Haplotype CGACG showed strong (P < 0.0001 association with asthma risk in both populations. All loci heterozygous genotypes and haplotype CCGTA were identified as asthma risk factors in Latvians; rs1048990 and rs2348071 GG homozygotes and rs2295826 and rs2295827 heterozygotes showed asthma risk and protective effect in Taiwanese females respectively. The multi locus genotypes homozygous for alleles being common in Latvian population were identified as protective in Latvians and disease susceptible in Taiwanese. Conclusions. Our results suggest an association of the 14q13-23 proteasomal genes polymorphisms with the childhood asthma in Latvians and Taiwanese and high-light risk and/or protective factors being the same or different between the populations.

  4. Blood lipid levels associate with childhood asthma, airway obstruction, bronchial hyperresponsiveness, and aeroallergen sensitization

    DEFF Research Database (Denmark)

    Vinding, Rebecca K; Stokholm, Jakob; Chawes, Bo Lund Krogsgaard

    2016-01-01

    BACKGROUND: Studies of children's blood lipid profiles in relation to asthma are few, and the results are ambiguous. OBJECTIVE: We sought to examine whether the lipid profile is associated with concurrent asthma, altered lung function, and allergic sensitization in children. METHODS: High...... with assessments of lung function, bronchial responsiveness, fraction of exhaled nitric oxide (Feno), and allergic sensitization. Associations between lipid levels and clinical outcomes were adjusted for sex, passive smoking, and body mass index. RESULTS: High levels of low-density lipoprotein cholesterol were...... of increased Feno levels (aβ coefficient, 0.14 log-ppb; 95% CI, -0.02 to 0.30 log-ppb; P = .08). CONCLUSION: The blood lipid profile is associated with asthma, airway obstruction, bronchial responsiveness, and aeroallergen sensitization in 7-year-old children. These findings suggest that asthma and allergy...

  5. Association of prenatal exposure to acetaminophen and coffee with childhood asthma

    DEFF Research Database (Denmark)

    Liu, Xiaoqin; Liew, Zeyan; Olsen, Jørn

    2016-01-01

    PurposeSome studies have suggested that maternal acetaminophen use during pregnancy is associated with asthma in the offspring, and coffee consumption may modify the toxicity of acetaminophen. We aim to examine whether pregnancy maternal acetaminophen use increases the risk for offspring asthma......, and whether such a potential association could be modified by maternal coffee consumption. MethodsWe included 63 652 live-born singletons enrolled in the Danish National Birth Cohort. Maternal acetaminophen use and coffee consumption during pregnancy were assessed prospectively via the enrolment questionnaire...... and three computer-assisted telephone interviews. Asthma cases were identified by using the Danish National Patient Register and the Danish National Prescription Registry. We estimated the hazard ratios (HRs) for asthma according to prenatal acetaminophen and coffee exposure using Cox proportional hazards...

  6. Distribuição da gravidade da asma na infância Distribution of severity of asthma in childhood

    Directory of Open Access Journals (Sweden)

    Silvia de Magalhães Simões

    2010-10-01

    Full Text Available OBJETIVO: Estimar a distribuição dos padrões de gravidade da asma em uma amostra populacional de crianças em Salvador (BA. MÉTODOS: Questionário epidemiológico (International Study of Asthma and Allergies in Childhood - ISAAC foi aplicado juntamente com questionário elaborado com base em critérios de gravidade adotados na prática clínica (Global Initiative for Asthma - GINA em 417 crianças de 5 a 12 anos com sintomas de asma nos últimos 12 meses. Com base nas questões do ISAAC, as crianças foram classificadas em asma grave e não grave. De acordo com os critérios clínicos da GINA, quatro categorias de gravidade foram criadas: intermitente, persistente leve, persistente moderada e grave. RESULTADOS: Noventa crianças (22,3% apresentaram indicadores de gravidade segundo o ISAAC. Com base nos critérios da GINA, havia 143 crianças com asma intermitente, 160 com asma leve persistente, 51 com asma moderada e 43 com asma grave. A concordância entre os dois questionários foi de 81,3%, com índice kappa de 0,5. CONCLUSÕES: A maioria das crianças asmáticas em Salvador possui asma persistente. Há bom nível de concordância na identificação da asma grave, entre a classificação epidemiológica e a clínica.OBJECTIVE: To estimate the distribution of asthma severity in a population-based sample of children from Salvador, Brazil. METHODS: An epidemiologically oriented questionnaire (International Study of Asthma and Allergies in Childhood, ISAAC and a questionnaire based on criteria used in clinical practice (The Global Initiative for Asthma, GINA were administered simultaneously to 417 children aged 5 to 12 years who reported symptoms of asthma in the past 12 months. According to the ISAAC instrument, children were classified into severe and non-severe asthma, whereas GINA clinical criteria produced four categories of severity: intermittent, mild persistent, moderate persistent and severe asthma. RESULTS: Ninety children reported

  7. Frequency of emergency room visits for childhood asthma in Ottawa, Canada: the role of weather

    Science.gov (United States)

    Villeneuve, Paul J.; Leech, Judy; Bourque, Denis

    2005-09-01

    The aim of this study was to evaluate associations between meteorological conditions and the number of emergency department visits for asthma in a children's hospital in Ottawa, Canada. A case-crossover study design was used. Hospital emergency department visits for asthma between 1992 and 2000 were identified based on patients' presenting complaints. We obtained hourly measures for the following meteorological variables: wind speed, temperature, atmospheric pressure, relative humidity, and visibility. Particular emphasis was placed on exploring the association between asthma visits and fog, thunderstorms, snow, and liquid and freezing forms of precipitation. In total, there were 18,970 asthma visits among children between 2 and 15 years of age. The number of visits and weather characteristics were grouped into 6 h case and control intervals. The occurrence of fog or liquid precipitation was associated with an increased number of asthma visits, while snow was associated with a reduced number (Pasthma visits and visibility, change in relative humidity and change in temperature. In contrast, summertime thunderstorm activity was associated with an odds ratio of 1.35 (95% CI=1.02-1.77) relative to summer periods with no activity. Models that incorporate calendar and meteorological data may help emergency departments to more efficiently allocate resources needed to treat children presenting with respiratory distress.

  8. Prenatal Maternal Stress Predicts Childhood Asthma in Girls: Project Ice Storm

    Directory of Open Access Journals (Sweden)

    Anne-Marie Turcotte-Tremblay

    2014-01-01

    Full Text Available Little is known about how prenatal maternal stress (PNMS influences risks of asthma in humans. In this small study, we sought to determine whether disaster-related PNMS would predict asthma risk in children. In June 1998, we assessed severity of objective hardship and subjective distress in women pregnant during the January 1998 Quebec Ice Storm. Lifetime asthma symptoms, diagnoses, and corticosteroid utilization were assessed when the children were 12 years old (N=68. No effects of objective hardship or timing of the exposure were found. However, we found that, in girls only, higher levels of prenatal maternal subjective distress predicted greater lifetime risk of wheezing (OR=1.11; 90% CI = 1.01–1.23, doctor-diagnosed asthma (OR=1.09; 90% CI = 1.00–1.19, and lifetime utilization of corticosteroids (OR=1.12; 90% CI = 1.01–1.25. Other perinatal and current maternal life events were also associated with asthma outcomes. Findings suggest that stress during pregnancy opens a window for fetal programming of immune functioning. A sex-based approach may be useful to examine how prenatal and postnatal environments combine to program the immune system. This small study needs to be replicated with a larger, more representative sample.

  9. Prenatal maternal stress predicts childhood asthma in girls: project ice storm.

    Science.gov (United States)

    Turcotte-Tremblay, Anne-Marie; Lim, Robert; Laplante, David P; Kobzik, Lester; Brunet, Alain; King, Suzanne

    2014-01-01

    Little is known about how prenatal maternal stress (PNMS) influences risks of asthma in humans. In this small study, we sought to determine whether disaster-related PNMS would predict asthma risk in children. In June 1998, we assessed severity of objective hardship and subjective distress in women pregnant during the January 1998 Quebec Ice Storm. Lifetime asthma symptoms, diagnoses, and corticosteroid utilization were assessed when the children were 12 years old (N = 68). No effects of objective hardship or timing of the exposure were found. However, we found that, in girls only, higher levels of prenatal maternal subjective distress predicted greater lifetime risk of wheezing (OR = 1.11; 90% CI = 1.01-1.23), doctor-diagnosed asthma (OR = 1.09; 90% CI = 1.00-1.19), and lifetime utilization of corticosteroids (OR = 1.12; 90% CI = 1.01-1.25). Other perinatal and current maternal life events were also associated with asthma outcomes. Findings suggest that stress during pregnancy opens a window for fetal programming of immune functioning. A sex-based approach may be useful to examine how prenatal and postnatal environments combine to program the immune system. This small study needs to be replicated with a larger, more representative sample.

  10. Analysis of risk factors of childhood bronchial asthma%儿童支气管哮喘发病的危险因素分析

    Institute of Scientific and Technical Information of China (English)

    彭桂英

    2014-01-01

    Objective To investigate and analyze the risk factors of childhood bronchial asthma. Methods 176 children with bronchial asthma treated in our hospital were selected as the asthma group and 176 normal children in the corresponding period were selected as the normal group in the same time. First, SPSS17.0 was used to conduct univariate analysis on 17 pathogenic factors of childhood bronchial asthma and the screened out single factors with P < 0.05 served as the independent variables of Logistic regression model for multivariate analysis. Then the high risk factors of childhood bronchial asthma were obtained. Results Univariate analysis showed that there were 10 single factors influencing childhood bronchial asthma, with statistically significant differences to the normal group (P<0.05). Logistic multivariate regression analysis showed that the high risk factors of childhood bronchial asthma were respiratory tract infection, family history of asthma,non-supplement of cod liver oil and family smoking and the protective factor of asthma was breastfeeding. Conclusion Preventing high risk factors of childhood bronchial asthma actively and increasing protective awareness are of important significance to the prevention and control of childhood bronchial asthma.%目的:探讨儿童支气管哮喘发病的危险因素。方法选取就诊于我院的儿童支气管患儿176例纳入哮喘组,同时选取同期正常儿童176例纳入正常组。首先采用SPSS17.0作单因素分析可能引起儿童支气管哮喘的发病因素17项,筛选出P<0.05的单因素作Logistic回归模型的自变量,作多因素分析,得出影响儿童支气管哮喘的高危因素。结果经单因素分析结果显示,影响儿童支气管哮喘的单因素共有10项,且P<0.05,与正常组对比具有统计学意义。Logistic多因素回归分析结果显示,影响儿童支气管哮喘的高危因素为呼吸道感染、家族哮喘史、未补充鱼肝油、家人

  11. Guidelines for maintenance treatment of childhood asthma: development of a score card system by multivariate cluster analysis.

    Science.gov (United States)

    Donnelly, W J; Donnelly, J E; Thong, Y H

    1987-01-01

    Multivariate cluster analysis of data on 128 asthmatic children resulted in the identification of 8 major discriminating variables. Stepwise divisions by this computer programme resulted in the formation of 6 grades of severity. There was significant correlation between higher grades of severity and early onset of the disease (P less than 0.02). There was also significant correlation between higher grades of severity and greater use of interval medications (P less than 0.002). However, 27.3% were receiving inadequate interval medications in respect of their grade of severity. Assignation of a 5-point scale to each of the 8 major discriminating variables resulted in the generation of computer-designated scores commensurate with each grade of severity. This was coupled to current recommendations for stepwise maintenance medications appropriate for each grade. This Score Card system for maintenance management of childhood asthma may prove useful in busy clinical settings.

  12. Cord blood 25(OH)-vitamin D deficiency and childhood asthma, allergy and eczema

    DEFF Research Database (Denmark)

    Chawes, Bo L; Bønnelykke, Klaus; Jensen, Pia F

    2014-01-01

    with respiratory infections or asthma. We saw no association between cord blood 25(OH)-Vitamin D level and lung function, sensitization, rhinitis or eczema. The effects were unaffected from adjusting for multiple lifestyle factors. CONCLUSION: Cord blood 25(OH)-Vitamin D deficiency associated with increased risk......BACKGROUND: Epidemiological studies have suggested an association between maternal vitamin D dietary intake during pregnancy and risk of asthma and allergy in the offspring. However, prospective clinical studies on vitamin D measured in cord blood and development of clinical end-points are sparse....... OBJECTIVE: To investigate the interdependence of cord blood 25-hydroxyvitamin D (25(OH)-Vitamin D) level and investigator-diagnosed asthma- and allergy-related conditions during preschool-age. METHODS: Cord blood 25(OH)-Vitamin D level was measured in 257 children from the Copenhagen Prospective Studies...

  13. Geographic variations of childhood asthma hospitalization and outpatient visits and proximity to ambient pollution sources at a U.S.-Canada border crossing

    Directory of Open Access Journals (Sweden)

    Rivers Patrick A

    2005-06-01

    Full Text Available Abstract Background Childhood asthma is a significant public health problem in the United States and evidence is accumulating regarding the contribution from traffic and ambient air pollution. This study is a companion piece of a related Buffalo asthma study in adults recently published in the July 2004 issue of American Journal of Public Health. This study focuses on children under 18 years of age diagnosed with asthma during a three-year period (2000–2002. In order to determine the effects of particulate air pollution on public health, we conducted an ecologic study of childhood asthma and point-source respirable particulate air pollution in patients diagnosed with asthma (n = 6,425. Patients diagnosed with gastroenteritis (n = 5,132 were used as controls. Results Although the results of this study show spatial patterns similar to the ones observed in the adult study, a multiple-comparison test shows that EPA-designated focus sites located in Buffalo's east side are statistically (p Conclusion Findings of this study can be useful in geographic targeting and in the design of optimal and preventive measures.

  14. Validating childhood asthma in an epidemiological study using linked electronic patient records

    NARCIS (Netherlands)

    Cornish, Rosaleen P; Henderson, John; Boyd, Andrew W; Granell, Raquel; Van Staa, Tjeerd; Macleod, John

    2014-01-01

    OBJECTIVE: To investigate the performance of parent-reported data in identifying physician-confirmed asthma. DESIGN AND SETTING: Validation study using linkage between the Avon Longitudinal Study of Parents and Children (ALSPAC) and electronic patient records held within the General Practice Researc

  15. Prenatal and childhood nutrition and the development of asthma and allergy in children

    NARCIS (Netherlands)

    Willers, S.M.

    2008-01-01

    Since the 1960’s of the last century the prevalence of asthma and allergic disease has increased considerably, especially in the Western world. Prosperity related changes in diet have possibly contributed to this increase. However, the evidence from epidemiological studies for a relation between nut

  16. Modeling of Regional Climate Change Effects on Ground-Level Ozone and Childhood Asthma

    Science.gov (United States)

    Sheffield, Perry E.; Knowlton, Kim; Carr, Jessie L.; Kinney, Patrick L.

    2011-01-01

    Background The adverse respiratory effects of ground-level ozone are well-established. Ozone is the air pollutant most consistently projected to increase under future climate change. Purpose To project future pediatric asthma emergency department visits associated with ground-level ozone changes, comparing 1990s to 2020s. Methods This study assessed future numbers of asthma emergency department visits for children aged 0–17 years using (1) baseline New York City metropolitan area emergency department rates, (2) a dose–response relationship between ozone levels and pediatric asthma emergency department visits, and (3) projected daily 8-hour maximum ozone concentrations for the 2020s as simulated by a global-to-regional climate change and atmospheric chemistry model. Sensitivity analyses included population projections and ozone precursor changes. This analysis occurred in 2010. Results In this model, climate change could cause an increase in regional summer ozone-related asthma emergency department visits for children aged 0–17 years of 7.3% across the New York City metropolitan region by the 2020s. This effect diminished with inclusion of ozone precursor changes. When population growth is included, the projections of morbidity related to ozone are even larger. Conclusions The results of this analysis demonstrate that the use of regional climate and atmospheric chemistry models make possible the projection of local climate change health effects for specific age groups and specific disease outcomes – such as emergency department visits for asthma. Efforts should be made to improve on this type of modeling to inform local and wider-scale climate change mitigation and adaptation policy. PMID:21855738

  17. Analysis of epidemiological investigation and prevention of childhood asthma%儿童哮喘流行病学及防治现状探析

    Institute of Scientific and Technical Information of China (English)

    孔涛

    2014-01-01

    Objective: To investigate the epidemiology, distribution feature and influencing factors of asthma in order to provide epidemiology evidence for asthma management. Methods 5600 children aged 0~14 years old with bronchial asthma in Laiwu City were investigated in order to explore the risk factors of childhood asthma. Results: The incidence rate of asthma was 4.4%. The incidence rate in male was obviously higher than that of female.The first age of onset of asthma before 3 yeas old was 61.8%.With multivariate Logistic regression analysis showed that 11 risk factors for children asthma included premature birth, cesarean section,a family history of allergy, et al. Breastfeeding is the protective factor. Conclusion: The morbidity rate of asthma in Laiwu City is relatively high. We must control and correct the risk factors of children asthma,which has great significance to prevent and control childhood asthma.%目的:对儿童哮喘的患病情况及其相关影响因素进行流行病学调查,为儿童哮喘的防治策略提供依据。方法:对莱芜市5600名0~14岁的儿童进行儿童哮喘的流行病学调查,分析疾病发生的危险因素。结果:儿童哮喘的患病率为4.4%;其中男孩患病率高于女孩;在哮喘患儿中,首次发病以3岁以内为最多(61.8%);经多因素 Logistic 回归分析,儿童哮喘发病的危险因素有剖宫产,早产,家族过敏史等11个因素,而母乳喂养为哮喘的保护因素。结论:莱芜市儿童哮喘的发病率较高,积极控制发生儿童哮喘的相关危险因素,对儿童哮喘防治有重要意义。

  18. Prevention and control of childhood asthma and allergy in the EU from the public health point of view: Polish Presidency of the European Union.

    Science.gov (United States)

    Samoliński, B; Fronczak, A; Kuna, P; Akdis, C A; Anto, J M; Bialoszewski, A Z; Burney, P G; Bush, A; Czupryniak, A; Dahl, R; Flood, B; Galea, G; Jutel, M; Kowalski, M L; Palkonen, S; Papadopoulos, N; Raciborski, F; Sienkiewicz, D; Tomaszewska, A; Von Mutius, E; Willman, D; Włodarczyk, A; Yusuf, O; Zuberbier, T; Bousquet, J

    2012-06-01

    The leading priority for the Polish Presidency of the Council of the European Union was to reduce health inequalities across European societies, and, within its framework, prevention and control of respiratory diseases in children. This very important paper contain proposal of international cooperation on the prevention, early detection and monitoring of asthma and allergic diseases in childhood which will be undertaken by the EU member countries as a result of EU conclusion developed during the Polish Presidency of the Council of the European Union. This will result in collaboration in the field of chronic diseases, particularly respiratory diseases, together with the activity of the network of national institutions and NGOs in this area. Paper also contains extensive analysis of the socio-economic, political, epidemiological, technological and medical factors affecting the prevention and control of childhood asthma and allergy presented during Experts presidential conference organized in Warsaw-Ossa 21-22 September 2011.

  19. Juvenile rheumatoid arthritis and asthma, but not childhood-onset systemic lupus erythematosus are associated with FCRL3 polymorphisms in Mexicans.

    Science.gov (United States)

    Ramírez-Bello, J; Jiménez-Morales, S; Espinosa-Rosales, F; Gómez-Vera, J; Gutiérrez, A; Velázquez Cruz, R; Baca, V; Orozco, L

    2013-04-01

    A regulatory single nucleotide polymorphism located in the 5' region (-169T/C) of the Fc receptor-like 3 (FCRL3_3) gene has been associated with both susceptibility and protection in immune diseases. This case-control study aimed to evaluate the association between FCRL3 polymorphisms and juvenile rheumatoid arthritis (JRA), asthma, and childhood-onset systemic lupus erythematosus (SLE) in a Mexican population. We performed PCR-based genotyping to identify four FCRL3 single nucleotide polymorphisms (FCRL3_3 to FCRL3_6) in patients with JRA (n=202), asthma (n=239), or childhood-onset SLE (n=377), and healthy controls (n=400). The case-control analysis showed a male-gender dependent association between the FCRL3_3C, FCRL3_5C, and FCRL3_6A alleles and either JRA (OR=0.57, p=0.003; OR=0.55, p=0.002; OR=0.53, p=0.0007, respectively) or asthma (OR=0.72, p=0.04; OR=0.74, p=0.05; OR=0.70, p=0.02, respectively). As expected, minor alleles of these SNPs with the CGCA haplotype were also significantly associated with JRA (OR=0.35, p=0.00005) and asthma (OR=0.61, p=0.007). We found no association between FCRL3 SNPs or haplotypes and childhood-onset SLE. These results supported the notion that FCRL3 is involved in the etiology of several immune diseases. Our results also suggested that SNPs located in the FCRL3 gene were protective against JRA and asthma in male Mexican patients.

  20. Childhood asthma management in the era of internet%儿童哮喘管理的互联网时代

    Institute of Scientific and Technical Information of China (English)

    孙文思

    2016-01-01

    The advent of internet era takes the "big data" as future development tendency instead of merely simple "great amount of data accumulation".The current situation and prospect is introduced in this paper combined with medical science growth,particularly with management aimed to childhood asthma.Accompanied with childhood asthma management platform,as much data as possible can be comprehended for asthma,this kind of disease,by the researchers in the aspect of groups,after that the management of asthma is improved through detecting problems.%在互联网时代下,大数据不是简单的“很多数据的累积”,而是未来的发展趋势.该文介绍大数据分析的现状与前景,并与医学发展相结合,尤其是针对儿童哮喘的管理.随着儿童哮喘管理平台的建立,尽可能多的数据可供研究人员从群体角度了解哮喘这一疾病,并通过发现问题来完善哮喘的管理.

  1. Determinação de escore e nota de corte do módulo de asma do International Study of Asthma and Allergies in Childhood para discriminação de adultos asmáticos em estudos epidemiológicos Determining the score and cut-off point that would identify asthmatic adults in epidemiological studies using the asthma module of the International Study of Asthma and Allergies in Childhood questionnaire

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    Elayne de Fátima Maçãira

    2005-12-01

    Full Text Available OBJETIVO: Validar o questionário padronizado escrito do International Study of Asthma and Allergies in Childhood, módulo sobre asma, para pesquisa de prevalência de asma, estabelecendo seu escore e a nota de corte para discriminação de adultos asmáticos. MÉTODOS: Entrevistamos pacientes ambulatoriais adultos, 40 asmáticos e 38 controles, pareados por sexo e idade, utilizando o módulo de asma do International Study of Asthma and Allergies in Childhood, composto por oito aspectos dicotômicos de asma. Determinamos o escore e a nota de corte para discriminação de asmáticos, definindo sua sensibilidade, especificidade e índice de Youden. Validamos o método em contraposição ao diagnóstico clínico e funcional. A reprodutibilidade das questões individuais foi testada por meio de reentrevistas de metade dos pacientes após algumas semanas. RESULTADOS: O escore variou de 0 a 14 pontos. Um escore = 5 pontos permitiu discriminar pacientes asmáticos (sensibilidade = 93%, especificidade = 100% e índice de Youden = 0,93. A maioria das questões apresentou boa reprodutibilidade, observada em reentrevista após 48,2 ± 11,1 dias (Kappa e Kappa ponderado variando de 0,43 a 1,00 para as questões individuais. CONCLUSÃO: A validação de uma nota de corte permite uma interpretação alternativa às informações fornecidas pelo módulo de asma do International Study of Asthma and Allergies in Childhood, levando em conta o conjunto das informações e não somente as respostas individuais de cada questão em estudos de prevalência de asma em adultos.OBJECTIVE: To validate, for use in asthma prevalence studies, the asthma module of the standardized written questionnaire developed for use in the International Study of Asthma and Allergies in Childhood, establishing the score and cut-off point that would identify asthmatic adults. METHODS: We interviewed 78 adult outpatients (40 adult asthmatics and 38 age-matched and gender-matched controls

  2. Sodium cromoglycate as a replacement for inhaled corticosteroids in mild-to-moderate childhood asthma.

    Science.gov (United States)

    Petersen, W; Karup-Pedersen, F; Friis, B; Howitz, P; Nielsen, F; Strömquist, L H

    1996-12-01

    We investigated whether sodium cromoglycate 10 mg three times daily, delivered as an aerosol via Nebuhaler (in addition to terbutaline 0.5 mg three times daily), could replace inhaled steroid in children with mild-to-moderate asthma. Children (mean age 10.3 years) were randomly allocated to 12-week treatment with sodium cromoglycate 10 mg plus terbutaline 0.5 mg (group A; n = 30) or placebo plus terbutaline 0.5 mg (group B; n = 32), both taken three times a day. The daily steroid dose was reduced by 50 microg/week for 4 weeks from a starting dose of 200 microg. Fewer patients withdrew owing to worsening asthma from group A (n = 1) than group B (n = 11). Symptom scores, morning and evening peak flows, and additional beta2-agonist usage, recorded on diary cards, were better in group A than group B. Lung function measured at clinic visits was unchanged in either group. Overall opinions of efficacy favoured Group A. Adverse events were similar in the groups. Sodium cromoglycate plus terbutaline substituted effectively for inhaled steroid therapy.

  3. 母乳喂养与儿童哮喘的关系%Correlation between breast-feeding and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    田玉双; 金哲英; 王玉凤; 马印慧; 汪俊红

    2011-01-01

    目的 研究母乳喂养对儿童哮喘的影响.方法 对6个月到4岁的164例哮喘儿童和1763名非哮喘儿童进行问卷调查,收集母乳喂养情况,并分析母乳喂养与儿童哮喘的关系.结果 1927名儿童中母乳喂养<4月组的儿童有818例(42.4%),母乳喂养≥4月组的儿童有1109例(57.6%).母乳喂养≥4月组的儿童哮喘发生率显著低于母乳喂养<4月组(x2=6.456,P=0.011),同时母乳喂养可以降低儿童发生哮喘的危险(OR=1.512;95%CI:1.097-2.083).进一步分析发现:年龄<3岁组、女性儿童组、孕周≥37周组、体重<2500 g组、出生时母亲年龄≥30岁组以及父母亲没有过敏史组的儿童母乳喂养≥4月组的哮喘发生率均明显低于母乳喂养<4月组(P<0.05),其他各组的儿童哮喘发生率差异均没有显著性差异(P>0.05).结论 母乳喂养可能减少感染和特应性变态反应,因此可以明显降低儿童的哮喘发生率.%Objective To investigate the effects of breast-fecding on childhood asthma. Methods 164 children with asthma and 1763 children without asthma in 6 months to 4 years of age were investigated by questionnaire. The data of breast-feeding was collected,and analyzed the correlation between breast-feeding and childhood asthma. Results There were 818(42. 4% ) children in breast-feeding <4 months group and 1109 (57.6%) children in breast-feeding≥ 4 months group among 1927 children. The incidence of childhood asthina in breast-feeding ≥4 months group was lower than that in breast-feeding <4 months group (x2 =6.4.56, P=0.011), and breast-feeding could reduce the risk of childhood asthma ( 0R = 1.512; 95% CI: 1. 097~2. 083 ). Further analysis showed that children in age <3 years, female children, gestational age≥37 weeks, weight <2500 g, mother's age≥30 years or parents without allergic history group had lower incidence of asthma by breast-feeding ≥4months than that by breast-feeding < 4 months ( P

  4. Identification of KIF3A as a novel candidate gene for childhood asthma using RNA expression and population allelic frequencies differences.

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    Melinda Butsch Kovacic

    Full Text Available BACKGROUND: Asthma is a chronic inflammatory disease with a strong genetic predisposition. A major challenge for candidate gene association studies in asthma is the selection of biologically relevant genes. METHODOLOGY/PRINCIPAL FINDINGS: Using epithelial RNA expression arrays, HapMap allele frequency variation, and the literature, we identified six possible candidate susceptibility genes for childhood asthma including ADCY2, DNAH5, KIF3A, PDE4B, PLAU, SPRR2B. To evaluate these genes, we compared the genotypes of 194 predominantly tagging SNPs in 790 asthmatic, allergic and non-allergic children. We found that SNPs in all six genes were nominally associated with asthma (p<0.05 in our discovery cohort and in three independent cohorts at either the SNP or gene level (p<0.05. Further, we determined that our selection approach was superior to random selection of genes either differentially expressed in asthmatics compared to controls (p = 0.0049 or selected based on the literature alone (p = 0.0049, substantiating the validity of our gene selection approach. Importantly, we observed that 7 of 9 SNPs in the KIF3A gene more than doubled the odds of asthma (OR = 2.3, p<0.0001 and increased the odds of allergic disease (OR = 1.8, p<0.008. Our data indicate that KIF3A rs7737031 (T-allele has an asthma population attributable risk of 18.5%. The association between KIF3A rs7737031 and asthma was validated in 3 independent populations, further substantiating the validity of our gene selection approach. CONCLUSIONS/SIGNIFICANCE: Our study demonstrates that KIF3A, a member of the kinesin superfamily of microtubule associated motors that are important in the transport of protein complexes within cilia, is a novel candidate gene for childhood asthma. Polymorphisms in KIF3A may in part be responsible for poor mucus and/or allergen clearance from the airways. Furthermore, our study provides a promising framework for the identification and

  5. 探讨儿童肥胖与哮喘的相关性%Explore the correlation between childhood obesity and asthma

    Institute of Scientific and Technical Information of China (English)

    赵金华; 洪菲; 韩英

    2014-01-01

    Objective To investigate the relationship between childhood obesity,asthma and lung function.Method Based on body weight and whether with asthma the 45 children were divided into normal control group,asthma group,obesity and asthma group,15 cases each.Each child was measured leptin levels and pulmonary function was measured with a spirometer.Each asthmatic children was surveyed by Asthma Control Test (C-ACT) questions.Results Asthmatic children have varying degrees harm of lung function.Obesity and asthma group compared with asthma group of children is more decreased in lung function.Children with asthma compared with normal control group of children is more higher in serum leptin concentration.Obesity and asthma children is highest in serum leptin concentrations.Asthmatic children C-ACT average score than obesity and asthma score,the difference was statistically significant (P < 0.01).Conclusion Lung function and leptin abnormalities are exist in children with asthma.Also in the case of asthma,the abnormal levels of lung function and leptin in obese children compared with normal-weight children are more apparent,C-ACT score are more lower,and asthma is more severe.Weight control in obese children with asthma is favorable measures to control asthma attacks.%目的 探讨儿童肥胖与哮喘的相关性.方法 根据体重和是否有哮喘将45名儿童分为对照组、哮喘组、肥胖+哮喘组.测定每组儿童瘦素及肺功能水平.哮喘儿童用哮喘控制测试(C-ACT)题进行调查.结果 哮喘儿童均有肺功能损害.肥胖+哮喘组儿童的肺功能较哮喘组降低.哮喘儿童较正常对照组儿童的血清瘦素浓度升高,肥胖+哮喘组儿童血清瘦素浓度更高.哮喘儿童C-ACT平均得分较肥胖+哮喘组得分高,差异有统计学意义(P<0.01).结论 哮喘儿童存在肺功能及瘦素水平异常.同样在患哮喘的情况下,肥胖儿童的肺功能及瘦素水平异常较正常体重儿更加明显,C-ACT得分

  6. Pediatric obesity and asthma quality of life.

    Science.gov (United States)

    Velsor-Friedrich, Barbara; Militello, Lisa K; Kouba, Joanne; Harrison, Patrick R; Manion, Amy; Doumit, Rita

    2013-06-01

    Widely researched as separate entities, our understanding of the comorbid effects of childhood obesity and asthma on quality of life is limited. This article discusses the effects of childhood obesity and asthma on self-reported quality of life in low-income African American teens with asthma. When controlling for the influence of symptom frequency, asthma classification, asthma self-efficacy, and asthma self-care levels, body mass index remains a most important factor in determining self-reported quality of life among teens with asthma. Although overweight and obesity did not change the effectiveness of the asthma intervention program, obesity did affect participants quality of life scores.

  7. IL13 gene polymorphisms modify the effect of exposure to tobacco smoke on persistent wheeze and asthma in childhood, a longitudinal study

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    Kurukulaaratchy Ramesh

    2008-01-01

    Full Text Available Abstract Background Tobacco smoke and genetic susceptibility are risk factors for asthma and wheezing. The aim of this study was to investigate whether there is a combined effect of interleukin-13 gene (IL13 polymorphisms and tobacco smoke on persistent childhood wheezing and asthma. Methods In the Isle of Wight birth cohort (UK, 1989–1999, five IL13 single nucleotide polymorphisms (SNPs: rs1800925 (-1112C/T, rs2066960, rs1295686, rs20541 (R130Q and rs1295685 were genotyped. Parents were asked whether their children had wheezed in the last 12 months at ages 1, 2, 4 and 10 years. Children who reported wheeze in the first 4 years of life and also had wheezing at age 10 were classified as early-onset persistent wheeze phenotype; non-wheezers never wheezed up to age 10. Persistent asthma was defined as having a diagnosis of asthma both during the first four years of life and at age 10. Logistic regression methods were used to analyze data on 791 children with complete information. Potential confounders were gender, birth weight, duration of breast feeding, and household cat or dog present during pregnancy. Results Maternal smoking during pregnancy was associated with early-onset persistent wheeze (OR 2.93, p IL13 were not (OR 1.15, p = 0.60 for the common haplotype pair. However, the effect of maternal smoking during pregnancy was stronger in children with the common IL13 haplotype pair compared to those without it (OR 5.58 and OR 1.29, respectively; p for interaction = 0.014. Single SNP analysis revealed a similar statistical significance for rs20541 (p for interaction = 0.02. Comparable results were observed for persistent childhood asthma (p for interaction = 0.03. Conclusion This is the first report that shows a combined effect of in utero exposure to smoking and IL13 on asthma phenotypes in childhood. The results emphasize that genetic studies need to take environmental exposures into account, since they may explain contradictory findings.

  8. Evaluation of systematic assessment of asthma-like symptoms and tobacco smoke exposure in early childhood by well-child professionals: a randomised trial.

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    Esther Hafkamp-de Groen

    Full Text Available This study aimed to evaluate the effectiveness of systematic assessment of asthma-like symptoms and environmental tobacco smoke (ETS exposure during regular preventive well-child visits between age 1 and 4 years by well-child professionals.Sixteen well-child centres in Rotterdam, the Netherlands, were randomised into 8 centres where the brief assessment form regarding asthma-like symptoms and ETS exposure was used and 8 centres that applied usual care. 3596 and 4179 children (born between April 2002 and January 2006 and their parents visited the intervention and control centres, respectively. At child's age 6 years, physician-diagnosed asthma ever, wheezing, fractional exhaled nitric oxide (FeNO, airway resistance (Rint, health-related quality of life (HRQOL and ETS exposure at home ever were measured. Linear mixed models were applied.No differences in asthma, wheezing, FeNO, Rint or HRQOL measurements between intervention and control group were found using multilevel regression in an intention-to-treat analysis (p>0.05. Children of whom the parents were interviewed by using the brief assessment form at the intervention well-child centres had a decreased risk on ETS exposure at home ever, compared to children who visited the control well-child centres, in an explorative per-protocol analysis (aOR = 0.71, 95% CI:0.59-0.87.Systematic assessment and counselling of asthma-like symptoms and ETS exposure in early childhood by well-child care professionals using a brief assessment form was not effective in reducing the prevalence of physician-diagnosed asthma ever and wheezing, and did not improve FeNO, Rint or HRQOL at age 6 years. Our results hold some promise for interviewing parents and using information leaflets at well-child centres to reduce ETS exposure at home in preschool children.Controlled-Trials.com ISRCTN15790308.

  9. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma curriculum…

  10. 儿童哮喘与肠道菌群%Childhood asthma and intestinal flora

    Institute of Scientific and Technical Information of China (English)

    孙夏烨

    2014-01-01

    儿童过敏性疾病发病的上升趋势越来越引起人们的重视,尤其是儿童支气管哮喘,严重影响婴幼儿的生活质量.“卫生假说”的提出,提示了早期的微生物接触和刺激可影响机体的免疫系统发育,早期微生物刺激的缺乏可导致以后对无害抗原的异常免疫应答.过敏患儿体内肠道菌群分布与健康儿童的差异也提示了肠道菌群与过敏性疾病发生的相关性.调节性T细胞数量或功能的异常是过敏性疾病发生的重要因素之一,但其确切的免疫机制尚在进一步研究中.同时,益生菌在防治哮喘等过敏性疾病中也显示出积极作用.关于过敏性疾病与肠道菌群的研究将对其防治提供新的途径.%The increasing trend of incidence rate in children with allergic diseases has drawn increasingly attention,especially in children with bronchial asthma,which may affect children's life quality.The" hygiene hypothesis" indicates that early microbial contact and stimulation can affect the development of body immune system,lack of early microbial stimulation results in aberrant immune responses to innocuous antigens later in life.The distribution of intestinal flora in the body between children with allergic diseases and healthy children are different,indicating that the occurrence of allergic diseases is associated with intestinal flora.The abnormal number or function of regulatory T cell may be the key mechanism of allergic diseases.Although the exact mechanism is not yet fully understood,more and more researches are underway.Meanwhile,the positive effect of probiotics has been showed in the prevention and treatment of asthma and other allergic diseases cannot be ignored.Studies on allergic diseases and intestinal flora may provide a new way for their prevention and control.

  11. 益生菌在儿童哮喘防治中的作用%The role of probiotics in the prevention and treatment of childhood asthma

    Institute of Scientific and Technical Information of China (English)

    相云

    2012-01-01

    “卫生学假说”可能是导致近年来儿童哮喘发病率增加的原因,大量的临床试验表明在消化系统疾病方面起着积极作用的益生菌制剂能够预防和治疗儿童特应性皮炎、食物过敏,但对预防、治疗哮喘的结论不一,越来越多的动物实验显示了益生菌在哮喘的预防或治疗方面的积极作用,其机制仍在探索中,以乳酸杆菌为代表的益生菌制剂在未来可能为儿童哮喘的临床防治提供新的思路.%“Hygiene hypothesis” may be the reason for the increased incidence of childhood asthma in recent years.A large number of clinical studies indicate that,probiotics,which play a positive role in the digestive system diseases,can prevent and treat children atopic dermatitis as well as food allergies,but the conclusions of prevention and treatment of asthma have been inconsistent.More and more of the animal experiments show that probiotics have benefical effects in the prevention or therapy of asthma,its mechanism is still in the exploration,probiotics such as lactobacillus will provide a new clinical thought for the prevention and treatment of childhood asthma in the future.

  12. Use of digital media for the education of health professionals in the treatment of childhood asthma

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    Helena F. Velasco

    2015-04-01

    Full Text Available OBJECTIVES: Inhalation therapy is the main treatment for asthma and its adequate use has been a factor responsible for disease control; therefore, the aim of the study was to determine whether a digital media tool, which features portability on mobile phones, modifies the assimilation of the inhalation technique. METHODS: A total of 66 professionals working in the health care area with the pediatric population were selected. They were submitted to a pre-test on their knowledge of inhalation therapy. The professionals were randomized into two groups (A and B. Group A received a media application on their mobile phones showing the steps of inhalation therapy, while group B received the same information in written form only. A post-test was applied after 15 days. The results (pre- and post- were analyzed by two pediatric pulmonologists. RESULTS: Of the 66 professionals, 87.9% were females. Of a total possible score of ten, the mean score obtained in the pre-test was 5.3 ± 3, and in the second test, 7.5 ± 2 (p < 0.000. There were no significant differences when comparing the two groups (p = 0.726. The nurses had the lowest mean scores in the initial test (2.3 ± 2; however, they were the group that learned the most with the intervention, showing similar means to those of other groups in the second test (6.1 ± 3. CONCLUSION: There was significant improvement in knowledge about inhalation therapy in all professional categories using both methods, demonstrating that education, when available to professionals, positively modifies medical practice.

  13. Prevalence of symptoms of asthma, rhinitis and eczema in 13- to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III.

    Science.gov (United States)

    Ait-Khaled, N; Odhiambo, J; Pearce, N; Adjoh, K S; Maesano, I A; Benhabyles, B; Bouhayad, Z; Bahati, E; Camara, L; Catteau, C; El Sony, A; Esamai, F O; Hypolite, I E; Melaku, K; Musa, O A; Ng'ang'a, L; Onadeko, B O; Saad, O; Jerray, M; Kayembe, J M; Koffi, N B; Khaldi, F; Kuaban, C; Voyi, K; M'Boussa, J; Sow, O; Tidjani, O; Zar, H J

    2007-03-01

    Phase I of the International Study of Asthma and Allergies in Childhood has provided valuable information regarding international prevalence patterns and potential risk factors in the development of asthma, allergic rhinoconjunctivitis and eczema. However, in Phase I, only six African countries were involved (Algeria, Tunisia, Morocco, Kenya, South Africa and Ethiopia). Phase III, conducted 5-6 years later, enrolled 22 centres in 16 countries including the majority of the centres involved in Phase I and new centres in Morocco, Tunisia, Democratic Republic of Congo, Togo, Sudan, Cameroon, Gabon, Reunion Island and South Africa. There were considerable variations between the various centres of Africa in the prevalence of the main symptoms of the three conditions: wheeze (4.0-21.5%), allergic rhinoconjunctivitis (7.2-27.3%) and eczema (4.7-23.0%). There was a large variation both between countries and between centres in the same country. Several centres, including Cape Town (20.3%), Polokwane (18.0%), Reunion Island (21.5%), Brazzaville (19.9%), Nairobi (18.0%), Urban Ivory Coast (19.3%) and Conakry (18.6%) showed relatively high asthma symptom prevalences, similar to those in western Europe. There were also a number of centres showing high symptom prevalences for allergic rhinoconjunctivitis (Cape Town, Reunion Island, Brazzaville, Eldoret, Urban Ivory Coast, Conakry, Casablanca, Wilays of Algiers, Sousse and Eldoret) and eczema (Brazzaville, Eldoret, Addis Ababa, Urban Ivory Coast, Conakry, Marrakech and Casablanca).

  14. 儿童哮喘危险因素的病例对照研究%Case-control Study on Risk Factors of Childhood Asthma

    Institute of Scientific and Technical Information of China (English)

    杨霞

    2015-01-01

    目的:探讨导致儿童哮喘患病的原因及其危险因素。方法选择2004年5月~2014年5月我院诊治的哮喘患儿进入病例组,按照1:1配比的病例对照研究方法,另择同期于我院就诊的未患哮喘的儿童进入对照组,分析两组患儿的临床资料,通过条件的Logistic回归分析,筛选患儿哮喘患病的危险因素。结果共有102例哮喘患儿进入病例组,匹配了102例未患哮喘的患儿进入对照组,两组患儿在年龄、性别等一般资料上差异无统计学意义(P>0.05)。Logistic回归分析结果显示,家族哮喘史、过敏史、容易感冒、家人吸烟、出生前后家庭装修史、居室有霉斑、家中使用地毯是儿童哮喘的危险因素,<6个月龄纯母乳喂养是儿童哮喘的保护因素,差异有统计学意义(P<0.05)。结论重视家长及大龄儿童的健康教育,提高医务人员识别儿童哮喘高危人群的专业能力可有效改善哮喘患儿的病情,减少并发症的发生。%Objective To explore the reason and risk factors of childhood asthma.Methods Patients with childhood asthma of our hospital from May 2004 to May 2014 were taken into case group, and patients without childhood asthma during the same period were taken into control group, clinic materials of two groups were analyzed, Logistic regression analysis were used to choose the risk factors of childhood asthma.Results 102 patients were taken into the case group and 102 into the control group, there were no statistical signiifcant differences of age, gender between two groups (P>0.05). The result of Logistic regression analysis showed, family asthma history, allergic history, prone to common cold, family smoking, decoration before or after the birth, mould spot in living room, usage of carpet were risk factors of childhood asthma, pure breast feeding in 0-6 month age was the protective factors (P<0.05).Conclusion Pay attention to health education

  15. Epidemiological survey of childhood asthma in Hefei City, China%合肥市儿童哮喘流行病学调查

    Institute of Scientific and Technical Information of China (English)

    熊梅; 倪陈; 潘家华; 王强; 郑礼林

    2013-01-01

    目的 调查合肥市儿童哮喘累计患病率、分布特征、好发季节、诱发因素及治疗现状.方法 采用随机分层整群抽样的方法,集中访问与分散家访相结合的方式,填写初筛调查表,对初筛阳性的儿童依据哮喘的诊断标准进行诊断与排除诊断.统计分析哮喘累计患病率、治疗现状、诱发因素及不同性别、不同年龄段儿童哮喘分布特征.结果 儿童哮喘累计患病率为5.92%,男童累计患病率为6.33%,女童累计患病率为5.42%,男女差异无统计学意义(P>0.05).3~6岁儿童患病率为8.25%,是儿童哮喘发病的高峰年龄.哮喘急性发作在换季时较多,占42.0%.午夜时易发作,占34.4%.确诊的552名哮喘儿童中,533例诱因为呼吸道感染(96.6%),312例诱因为天气变化(56.5%).使用抗生素治疗的患儿比例最高,为92.9% (513/552),其次为使用全身激素治疗,占89.1%(492/552).结论 合肥市儿童哮喘累计患病率为5.92%,3~6岁为发病高峰.哮喘急性发作多在换季时、午夜时.呼吸道感染及天气变化是儿童哮喘的主要发病诱因.哮喘目前的治疗现状仍广泛使用抗生素和全身激素.%Objective To investigate the cumulative prevalence rate, distribution characteristics, epidemic seasons, predisposing factors and current treatment situation of childhood asthma in Hefei City, China. Methods In the investigation, stratified cluster random sampling as well as centralized access and separate home visits were applied, and primary screening forms were filled out. Further confirmation was sought in the primary positive cases, according to the diagnostic criteria for asthma. Statistical analysis was performed to determine the cumulative prevalence rate, current treatment situation and predisposing factors for childhood asthma as well as the distribution characteristics of asthma in children of different ages and sexes. Results The cumulative prevalence rate of

  16. Barriers to Asthma Management for School Nurses: An Integrative Review

    Science.gov (United States)

    Hanley Nadeau, Ellen; Toronto, Coleen E.

    2016-01-01

    Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in…

  17. GSTP1 and TNF Gene Variants and Associations between Air Pollution and Incident Childhood Asthma : The Traffic, Asthma and Genetics (TAG) Study

    NARCIS (Netherlands)

    MacIntyre, Elaina A.; Brauer, Michael; Melen, Erik; Bauer, Carl Peter; Bauer, Mario; Berdel, Dietrich; Bergstroem, Anna; Brunekreef, Bert; Chan-Yeung, Moira; Kluemper, Claudia; Fuertes, Elaine; Gehring, Ulrike; Gref, Anna; Heinrich, Joachim; Herbarth, Olf; Kerkhof, Marjan; Koppelman, Gerard H.; Kozyrskyj, Anita L.; Pershagen, Goran; Postma, Dirkje S.; Thiering, Elisabeth; Tiesler, Carla M. T.; Carlsten, Christopher

    2014-01-01

    Background: Genetics may partially explain observed heterogeneity in associations between traffic-related air pollution and incident asthma. Objective: Our aim was to investigate the impact of gene variants associated with oxidative stress and inflammation on associations between air pollution and i

  18. Severe asthma in children.

    Science.gov (United States)

    Guilbert, Theresa W; Bacharier, Leonard B; Fitzpatrick, Anne M

    2014-01-01

    Severe asthma in children is characterized by sustained symptoms despite treatment with high doses of inhaled corticosteroids or oral corticosteroids. Children with severe asthma may fall into 2 categories, difficult-to-treat asthma or severe therapy-resistant asthma. Difficult-to-treat asthma is defined as poor control due to an incorrect diagnosis or comorbidities, or poor adherence due to adverse psychological or environmental factors. In contrast, treatment resistant is defined as difficult asthma despite management of these factors. It is increasingly recognized that severe asthma is a highly heterogeneous disorder associated with a number of clinical and inflammatory phenotypes that have been described in children with severe asthma. Guideline-based drug therapy of severe childhood asthma is based primarily on extrapolated data from adult studies. The recommendation is that children with severe asthma be treated with higher-dose inhaled or oral corticosteroids combined with long-acting β-agonists and other add-on therapies, such as antileukotrienes and methylxanthines. It is important to identify and address the influences that make asthma difficult to control, including reviewing the diagnosis and removing causal or aggravating factors. Better definition of the phenotypes and better targeting of therapy based upon individual patient phenotypes is likely to improve asthma treatment in the future.

  19. Quality of life in childhood asthma: use of the Paediatric Asthma Quality of Life Questionnaire in a Swedish sample of children 7 to 9 years old.

    Science.gov (United States)

    Reichenberg, K; Broberg, A G

    2000-08-01

    To validate a Swedish translation of the Paediatric Asthma Quality of Life Questionnaire (PAQLQ) and to study determinants of asthmatic children's quality of life, seventy-one 7-9-y-old children and their families were approached. Sixty-one children (86%) participated, 36 boys and 25 girls: 11 children with mild, 40 with moderate and 10 with severe asthma. The mean age was 8.7 y. Most commonly restricted activities during the week preceding the investigation were running (74%), gymnastics (30%), walking uphill (26%), playing football (20%) and shouting (13%). Parental rating of symptoms (Spearman's rho = -0.40, p = 0.001), percentage of expected peak flow rate (PEFR) (rho = 0.30, p = 0.009) and physicians' grading (mild, moderate and severe asthma, p = 0.047) all correlated significantly with PAQLQ scores. Younger children reported more impairment of QoL, as did children of parents not sharing household. Sex or presence of eczema or rhinoconjunctivitis did not significantly affect the scores. Children suffering from food allergy scored less impairment of QoL. The instrument was easy to administer, was well accepted by the children and had acceptable internal consistency.

  20. Small-particle Inhaled Corticosteroid as First-line or Step-up Controller Therapy in Childhood Asthma

    NARCIS (Netherlands)

    van Aalderen, Willem M. C.; Grigg, Jonathan; Guilbert, Theresa W.; Roche, Nicolas; Israel, Elliot; Martin, Richard J.; Colice, Gene; Postma, Dirkje S.; Hillyer, Elizabeth V.; Burden, Anne; Thomas, Victoria; von Ziegenweidt, Julie; Price, David

    2015-01-01

    BACKGROUND: Because randomized controlled trials of established pediatric asthma therapies are expensive and difficult to perform, observational studies may fill gaps in the evidence base. OBJECTIVES: To compare the effectiveness of representative small-particle inhaled corticosteroid (ICS) with tha

  1. Prenatal Exposure to Nicotine and Childhood Asthma: Role of Nicotine Acetylcholine Receptors, Neuropeptides and Fibronectin Expression in Lung

    Science.gov (United States)

    2008-12-01

    original articles and 1 review article . 15. SUBJECT TERMS asthma, lung development, matrix, receptors 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF...and Roman J. Exp Lung Research, 34:481-499, 2008). A review article describing this and other work related to tobacco-related lung disease and how...and Roman J. Tobacco smoke exposure, nicotine, and the embryologic origins of asthma. Current Respiratory Reviews, 2009, in press.

  2. "Kickin' Asthma": School-Based Asthma Education in an Urban Community

    Science.gov (United States)

    Magzamen, Sheryl; Patel, Bina; Davis, Adam; Edelstein, Joan; Tager, Ira B.

    2008-01-01

    Background: In urban communities with high prevalence of childhood asthma, school-based educational programs may be the most appropriate approach to deliver interventions to improve asthma morbidity and asthma-related outcomes. The purpose of this study was to evaluate the implementation of "Kickin' Asthma", a school-based asthma…

  3. Relationship between pet keeping and childhood asthma in Shenyang city%家养皮毛宠物与儿童哮喘关系

    Institute of Scientific and Technical Information of China (English)

    刘苗苗; 王达; 任万辉; 高峰; 何钦成; 董光辉

    2012-01-01

    Objective To assess the association of pet keeping at home with childhood asthma. Methods Totally 6 278 children in 10 kindergartens and 5 primary schools in Shenyang city were recruited for a cross-sectional study. Information on respiratory health was obtained by a standard questionnaire from the American Thoracic Society (ATS). Results The prevalence of persistent cough, persistent phlegm, asthma, current asthma, current wheeze, and rhinitis were 9. 53% ,4. 49% ,6. 23% ,2. 42% ,5. 61% ,and 5. 27% Respectively. And the prevalence of asthma, current wheeze, and rhinitis in the boys were higher than those in the girls (P < 0. 05). Pet keeping in home was not associated with asthma and asthma related symptoms of the children,however,sleeping with pet significantly increased the prevalence of asthma (P<0. 05). Compared with the subjects without both family atopy history and pet exposure, the effect of family atopy history alone was significant in subjects without pet exposure,with an adjusted odds ratio(OR) of 3. 29(95% confidence interval [C/] ; 2. 55 -4.25). In the case of the presence of these two factors (both pet exposure and family atopy history) ,the adjusted OR of the asthma decreased to 2. 01(95% Cl-.1. 17 -3.43) ,and there was no significantly interactive effect of pet keeping and family atopy history of asthma and asthma related symptoms among the children. Conclusion Family atopy and pet exposure are the risk factors of asthma and asthma-related diseases in children. Asthma and asthma-related symptoms are positively associated with the level of pet exposure,however, there is no interactive effect between pet keeping in home and family atopy history of asthma among children.%目的 了解家养皮毛宠物与儿童哮喘的关系.方法 采用整群抽样方法,在沈阳市5个行政区内随机选取10所幼儿园和5所小学,采用国际统一标准问卷ATS调查表对所有学生进行呼吸系统疾病及症状调查.结果 沈阳市儿童持续咳

  4. Asthma Basics

    Science.gov (United States)

    ... Old Feeding Your 1- to 2-Year-Old Asthma Basics KidsHealth > For Parents > Asthma Basics A A ... Asthma Categories en español Asma: aspectos fundamentales About Asthma Asthma is a common lung condition in kids ...

  5. Early childhood infections and immunisation and the development of allergic disease in particular asthma in a high-risk cohort: A prospective study of allergy-prone children from birth to six years.

    Science.gov (United States)

    Thomson, Jennifer A; Widjaja, Constance; Darmaputra, Abbi A P; Lowe, Adrian; Matheson, Melanie C; Bennett, Catherine M; Allen, Katrina; Abramson, Michael J; Hosking, Cliff; Hill, David; Dharmage, Shyamali C

    2010-11-01

    The role of early childhood infections and immunisation in the development of allergic diseases remains controversial. To examine these associations, six hundred and twenty infants with first-degree relatives with allergic diseases were recruited into the Melbourne Atopy Cohort Study. Information on risk factors and outcomes was collected by interviewer administered questionnaire and was based on parental report and/or a physician's diagnosis. Risk factors examined included early childhood infections (including gastroenteritis, otitis media and lower respiratory tract infections) and immunisations in the first 2 yr of life. Outcomes were current asthma, allergic rhinitis and eczema at 6 yr of age. Univariate and multivariate regression analysis were used to estimate relative risk (RR) and assess confounding. By 6 yr, 79% of the original cohort remained in the study. Those with at least three episodes of gastroenteritis showed an increased risk (crude RR 2.36, 95%CI 1.41 3.95; adjusted RR 2.03 95%CI 1.50 2.75) for the later development of asthma at age 6. Of the scheduled immunisations, Sabin immunisation in the second year had a reduced risk of asthma at 6 yr (crude RR 0.60, 95%CI 0.37 0.98; adjusted RR 0.63 95%CI 0.39 1.02). Combined diphtheria and tetanus (CDT) immunisation in the first year had an increased risk of asthma at 6 yr (RR 1.76, 95%CI 1.11 2.78; adjusted RR 1.88 95%CI 1.28 2.77). Recurrent gastroenteritis in early childhood is associated with a later risk of asthma. This may reflect a cause and effect relationship, or exposure to common risk factors. In contrast, Sabin immunisation in the second year is associated with a decreased risk of asthma in later childhood. CDT immunisation in the first year may be a risk factor for asthma, but the need for CDT immunisation may also be a marker of increased risk of asthma in later childhood.

  6. Interleukin-12 and Peripheral Blood Invariant Natural Killer T Cells as an Axis in Childhood Asthma Pathogenesis

    Directory of Open Access Journals (Sweden)

    Magdy M Zedan

    2010-03-01

    Full Text Available Interleukin-12 (IL-12 is a key cytokine involved in regulating the balance between TH1 and TH2 cells by promoting TH1 response. A reduced capacity to produce this cytokine could lead to aberrant TH2 development. On the same aspect significant impact of IL-12 on invariant natural killer T (iNKT cells was reported. Therefore, we examined the serum levels of IL-12 and the absolute number of peripheral blood iNKT cells from 37 children with controlled asthma and 11 normal controls (age-matched and correlating these two parameters with clinical asthma severity and Pulmonary function tests (PFTs.A significant decrease of serum levels of IL-12 and peripheral iNKT cells was found in total asthmatic cases compared with normal controls. This significant decrease of IL-12 levels was observed in severe asthmatic patients compared with mild and moderate cases. Serum levels of IL-12 and the numbers of peripheral iNKT cells were positively correlated with PFTs in both total asthmatic groups and in children with severe persistent asthma. Inverse correlation was found between serum level of IL-12 and different degrees of asthma. Whereas the numbers of peripheral blood iNKT cells showed no significant difference between clinical asthma severities.Impaired IL-12 production in asthmatic children beside decreasing the number of peripheral blood iNKT cells could be considered as a key component in asthma pathogenesis and hence their therapeutic manipulation may be of help in asthma management.

  7. Risk factors of childhood asthma in Wuhan city%武汉市儿童支气管哮喘的危险因素

    Institute of Scientific and Technical Information of China (English)

    黄洋; 杨磊; 龙珍

    2014-01-01

    Objective To conform the risk factors of childhood asthma and to provide accordance for the healthy management of children with asthma.Methods A cross-section investigation was carried out by multi-stage random sampling in Wuhan city.The investigation included questionnaire and clinic examination.The study population was the infant and children whose age were 0 to 14 years old,and the sample size was 4 132.One hundren and seventyfour children were diagnosed as asthma,and 173 non-asthma children with similar age in the same region were selected as controls.Chi-square test and multiple Logistic regression analysis were used to screen the risk factors of childhood asthma in Wuhan city.Results Family allergy history,allergic rhinitis,eczema,food allergy and drug allergy were the risk factors of childhood asthma.Furthermore,dust mites,mould,anther dust,mugwort,cat/dog hair were main allergize source.In addition,premature delivery,abdominal delivery,mildew stain in ceiling or floor,raise pets especially cat,chemical fiber pillow and blanket bedclothes will increase the incidence,while spontaneous delivery and breast feeding were with protection effect.The results of multiple Logistic regression analysis showed that children who were with allergic rhinitis,familiar allergic history,dust mites positive test,drug allergy and blanker bedclothes were the high risk group of childhood asthma.Conclusions Childhood asthma is high relative with atopy,and these children who are with allergic rhinitis,familiar allergic history and dust mites positive test should be strictly health management.Chemical fiber pillow,blanket bedclothes,raising pet cats and mould in ceiling and floor in atopy children family should be avoided.%目的 探讨儿童支气管哮喘(哮喘)的危险因素,为哮喘儿童的健康管理提供依据.方法 对武汉地区儿童哮喘的发病现状进行多阶段随机整群抽样调查,开展问卷调查及临床体检.研究对象为武汉地区0 ~14

  8. The role of Childhood Asthma Control Test and pulmonary function testing in asthma management%儿童哮喘控制测试与肺功能检测在哮喘管理中的应用

    Institute of Scientific and Technical Information of China (English)

    王斌; 王成秀; 唐晓燕

    2013-01-01

    目的 探讨儿童哮喘控制测试(C-ACT)与肺功能检测在中国儿童哮喘管理中的应用价值.方法 对急性发作期83例哮喘患儿于治疗前、治疗后1个月、3个月时进行肺功能检测,测定PEF、FEV1,并同时进行C-ACT评分.观察入选时和治疗1个月、3个月结束时的C-ACT评分和肺功能的变化.结果 在治疗后1个月及3个月时,C-ACT评分及PEF、FEV1较治疗前均有明显提高,差异有统计学意义(均P<0.01).治疗后1个月时哮喘患儿完全控制43例(51.8%);治疗后3个月时,哮喘患儿完全控制72例(86.7%).C-ACT评分与肺功能检查指标PEF、FEV1具有良好的相关性.结论 C-ACT简便易行,可作为哮喘专科门诊筛查哮喘是否控制的可行方法,肺功能检测是指导儿童哮喘正确用药的主要依据.%Objective To study the value of clinical application of Childhood-Asthma Control Test (C-ACT) and pulmonary function test(PFT) in children patients with asthma.Metholds Totally 83 asthmatic children at the acute episode were given C-ACT score and PET including maximal expiratory flow (PEF) FEV1 after treatment.Results The symptoms were controlled in 56 after 1 month and in 84 after 3 months.C-ACT scores,PEF and FEV1 at post-treatment foor 1 month and 3 months were significantly improved compared with pre-treatment.The differences were statistically significant(P<0.01).C-ACT values were correlated with Pulmonary function test results.Conclusion C-ACT sores as a simple,safe and effective way can be promoted to pediatric asthma control.Pulmonary Function testing is mainly based on the guidance of management of asthma.

  9. Spatial analysis of air pollution and childhood asthma in Hamilton, Canada: comparing exposure methods in sensitive subgroups

    Directory of Open Access Journals (Sweden)

    Arain Altaf

    2009-04-01

    Full Text Available Abstract Background Variations in air pollution exposure within a community may be associated with asthma prevalence. However, studies conducted to date have produced inconsistent results, possibly due to errors in measurement of the exposures. Methods A standardized asthma survey was administered to children in grades one and eight in Hamilton, Canada, in 1994–95 (N ~1467. Exposure to air pollution was estimated in four ways: (1 distance from roadways; (2 interpolated surfaces for ozone, sulfur dioxide, particulate matter and nitrous oxides from seven to nine governmental monitoring stations; (3 a kriged nitrogen dioxide (NO2 surface based on a network of 100 passive NO2 monitors; and (4 a land use regression (LUR model derived from the same monitoring network. Logistic regressions were used to test associations between asthma and air pollution, controlling for variables including neighbourhood income, dwelling value, state of housing, a deprivation index and smoking. Results There were no significant associations between any of the exposure estimates and asthma in the whole population, but large effects were detected the subgroup of children without hayfever (predominately in girls. The most robust effects were observed for the association of asthma without hayfever and NO2LUR OR = 1.86 (95%CI, 1.59–2.16 in all girls and OR = 2.98 (95%CI, 0.98–9.06 for older girls, over an interquartile range increase and controlling for confounders. Conclusion Our findings indicate that traffic-related pollutants, such as NO2, are associated with asthma without overt evidence of other atopic disorders among female children living in a medium-sized Canadian city. The effects were sensitive to the method of exposure estimation. More refined exposure models produced the most robust associations.

  10. 舒利迭治疗儿童哮喘的临床疗效%Clinical Efficacy of Seretide for Treatment of Childhood Asthma

    Institute of Scientific and Technical Information of China (English)

    唐彬

    2015-01-01

    目的:探讨舒利迭治疗儿童哮喘的临床疗效。方法对2012年1月~2015年1月我院收治的53例儿童哮喘采用舒利迭治疗后,对患儿肺功能和咳嗽症状进行评价。结果治疗后,患者的肺功能具有显著改善(P<0.05),具有统计学差异。有2例患儿治疗无效,有17例患儿临床疗效显著,所占比例为32.1%,治疗总有效率为96.2%。结论舒利迭治疗儿童哮喘的临床疗效显著,值得临床进一步推广和使用。%Objective:To investigate the clinical efficacy of Seretide in treatment of asthma of children.Methods:53 patients diagnosed with childhood asthma in our hospital from Jan 2012 - Jan 2015 were treated with seretide,then we evaluated lung function and cough symptom.Results:After treatment,the patient's lung function has improved significantly(P <0.05).There are two cases of children without clinical efficacy.17 cases of children had significant clinical efficacy with the proportion of 32.1%,and the total effective rate was 96.2%.Conclusion:The clinical efficacy of Seretide in the treatment of asthma in children was significant,and it was worthy of further promotion and usage.

  11. Family-based association analysis of beta(2)-adrenergic receptor polymorphisms in the Childhood Asthma Management Program

    NARCIS (Netherlands)

    Silverman, EK; Kwiatkowski, DJ; Sylvia, JS; Lazarus, R; Drazen, JM; Lange, C; Laird, NM; Weiss, ST

    2003-01-01

    Background: beta(2)-Adrenergic receptor (B2AR) polymorphisms have been associated with a variety of asthma-related phenotypes, but association results have been inconsistent across different studies. Objective: We sought to apply family-based association methods to individual single nucleotide polym

  12. Maternal waterpipe smoke exposure and the risk of asthma and allergic diseases in childhood: A post hoc analysis

    Directory of Open Access Journals (Sweden)

    Mirna Waked

    2015-02-01

    Full Text Available Introduction This analysis was conducted with the objective of evaluating association between waterpipe passive smoking exposure and asthma, and allergies among Lebanese children. Material and methods Data were taken from a crosssectional study on children from public and private schools. A sample of 22 schools participated in the study, where standardized written core questionnaires were distributed. From 5 to 12-year-old students filled in the questionnaires at home, while 13–14-year-old students filled it in in the class. In total, 5522 children were evaluated for the prevalence of asthma, allergic rhinitis and atopic eczema, and their associated factors, including waterpipe exposure due to parents’ smoking. Results The descriptive results of parental smoking were, as follows: among mothers: 1609 (29% mothers smoked cigarettes, 385 (7% smoked waterpipe and 98 (1.8% smoked both; among fathers: 2449 (44.2% smoked cigarettes, 573 (10.3% smoked waterpipe and 197 (3.5% smoked both. Maternal waterpipe smoking was significantly and moderately associated with allergic diseases (p < 0.001; ORa = 1.71, including probable asthma, rhinitis and dermatitis (p < 0.001 for all. Quite on the opposite, father’s waterpipe smoking was not associated with any of the diseases. Parental cigarette smoking demonstrated some positive effects: father’s cigarette smoking did not show association with dermatitis or asthma diagnosed by a physician, while mother’s cigarette smoking showed a positive association only with probable asthma. Moreover, no interactions between cigarette and waterpipe smoking were observed. Conclusions Maternal waterpipe smoking should be regarded as a high risk behavior; however, additional studies are necessary to confirm this finding.

  13. Predicted risk of childhood allergy, asthma, and reported symptoms using measured phthalate exposure in dust and urine

    DEFF Research Database (Denmark)

    Hsu, N.-Y.; Lee, C.-C.; Wang, J.-Y.;

    2012-01-01

    The associated risk of phthalate exposure, both parent compounds in the home and their metabolites in urine, to childhood allergic and respiratory morbidity, after adjusting for exposures of indoor pollutants, especially bioaerosols, was comprehensively assessed. Levels of five phthalates...

  14. Understanding Children with Asthma: Trouble and Triggers

    Science.gov (United States)

    Lim, JungHa; Wood, Beatrice L.; Cheah, PoAnn

    2009-01-01

    Asthma is one of the most common illnesses of childhood; in the United States, nearly 9% of children have the condition (Federal Interagency Forum on Child and Family Statistics, 2006). Among children with chronic illnesses, asthma is the most common cause for school absence and hospitalization (Akinbami, 2006). Asthma is a chronic disorder of the…

  15. Asthma phenotypes modify the impact of environmetnal factors on lung function

    Science.gov (United States)

    Previous studies have examined the role of childhood asthma phenotypes based on clinical history on asthma severity and symptom aggravation by environmental risk factors. The current study focuses on the associations between lung function in childhood and environmental factors an...

  16. Pediatric Asthma

    Science.gov (United States)

    ... Plan Asthma Epidemic Eating with Asthma Helping Your Child Cope With a Medical Condition Nasal Wash Guide Cleaning Dirty Items Impact on Families Asthma & Pets Peak Flow Meter Athletes & Asthma Helpful Tools for ...

  17. Atopic endotype in childhood

    DEFF Research Database (Denmark)

    Schoos, Ann-Marie Malby; Chawes, Bo Lund Krogsgaard; Rasmussen, Morten Arendt

    2016-01-01

    against 28 inhalant and food allergens was assessed at ½, 1½, 4, 6, and 13 years of age in 399 children from the Copenhagen Prospective Study on Asthma in Childhood2000 birth cohort by using both skin prick test responses and specific IgE levels. Asthma and eczema were diagnosed longitudinally by strictly...... with asthma through early childhood (0-6 years) when analyzed as any sensitization (odds ratio [OR] range, 0.78-1.29; P ≥ .48). However, at 13 years of age, any sensitization was associated with asthma (OR range, 4.02-5.94; all P ...%), eczema (26%), asthma (14%), or healthy status (24%). Conclusion: We found very little interdependency between asthma, eczema, and allergic sensitization through childhood. The associations between those entities were strongly dependent on age, type of allergens, and method of testing for sensitization...

  18. Difficult Asthma

    Directory of Open Access Journals (Sweden)

    Ahmet Uslu

    2003-03-01

    Full Text Available Difficult asthma is a distinct entity of asthma, comprising approximately %5 of asthmatic patients. There is no agreed definition of difficult asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant and severe asthma. In this study difficult asthma; clinical features, risk factors, pathophysiology and novel therapies are summarized by literatures.

  19. Difficult asthma

    OpenAIRE

    Ahmet Uslu; Tülay Özdemir

    1989-01-01

    Difficult asthma is a distinct entity of asthma, comprising approximately %5 of asthmatic patients. There is no agreed definition of difficult asthma. It will include asthma uncontrolled by new standard therapy, steroid dependent, steroid resistant and severe asthma. In this study difficult asthma; clinical features, risk factors, pathophysiology and novel therapies are summarized by literatures.

  20. 儿童哮喘流行病学现状及其危险因素研究进展%Current Prevalence of Childhood Asthma and Progress in the Risk Factors Research

    Institute of Scientific and Technical Information of China (English)

    文辉; 周金艳

    2013-01-01

    儿童哮喘是常见的儿童慢性呼吸系统疾病之一,近年来全球报道其患病率总体呈上升趋势,且有较大的地区分布差异和性别分布差异.儿童哮喘的危险因素主要包括宿主因素和环境因素两大方面,其中遗传、特应质和孕期母体不良情况是主要的宿主危险因素,户外空气污染和室内通风不良、接触变应原等是主要的环境危险因素.%Childhood asthma is a common chronic respiratory disease in children. The global reports a-bout the prevalence of childhood asthma show an increasing trend, and great regional differences and gender differences. The risk factors of childhood asthma include both host factors and environmental factors, among which, heredity, atopy and bad maternal condition during pregnancy are the main host risk factors, outdoor air pollution, bad indoor ventilation,allergens exposure,etc. Are the environmental risk factors.

  1. Efficacy of the I Can Control Asthma and Nutrition Now (ICAN) Pilot Program on Health Outcomes in High School Students with Asthma

    Science.gov (United States)

    Kouba, Joanne; Velsor-Friedrich, Barbarba; Militello, Lisa; Harrison, Patrick R.; Becklenberg, Amy; White, Barb; Surya, Shruti; Ahmed, Avais

    2013-01-01

    Asthma is the most prevalent chronic illness in childhood affecting 7 million youth. Many youth with asthma face another risk factor in obesity. Obesity, in turn, increases disorders such as asthma. Studies have recommended that asthma programs also address weight management in youth. Taking this into consideration, the I Can Control Asthma and…

  2. Children with Asthma and Sports

    Directory of Open Access Journals (Sweden)

    Selda Yuzer

    2014-06-01

    Full Text Available Asthma is one of the chronic diseases which have are widely seen among the children. The disease has recently been in the increase all over the world and affects many children. In a study conducted with International Study of Asthma and Allergies in Childhood (ISAAC method, it was found out that prevalence of childhood asthma was 17.1%. Participation in sportive activities by the children with asthma, which is today considered as a part of asthma treatment program, makes contributions to their physical, mental and psychological development and increases their quality of life. The most recommended sports for the children with asthma are swimming and water sports. Sports like tennis and volleyball are too advised. Choice of sports depends on severity of asthma, child and #8217;s choice and whether or not asthma is kept under control. Nursing approaches for the children with asthma include correction of symptoms, training of children and their families, assistance with disease adaptation, continuing asthma care at home and interventions to make children lead healthy activities of daily life of children. With protective measures to be taken by families and children; children should be encourage for sportive activities. [TAF Prev Med Bull 2014; 13(3.000: 241-244

  3. 宣桂琪主任辨治小儿哮喘与提高疗效的思路%Doctor Xuan Guiqi's Experience in the Diagnosis and Treatment of Childhood Asthma and the Thinking of Improving Efficacy

    Institute of Scientific and Technical Information of China (English)

    宣晓波; 宣桂琪

    2013-01-01

    [Objective]To summarize Doctor Xuan Guiqi's experience in the treatment of childhood asthma and the idea of improving the curative efficacy. [Methods]By learning from Doctor Xuan and clearing up medical cases, the author finishes the summary on doctor Xuan's clinical experience on child-hood asthma based on the syndrome differentiation and clinical medication.[Results]The childhood asthma is divided into acute and chronic, the former is divided into cold asthma, heat asthma and wind-phlegm types. At the same time, we strengthen pertinence treatment of clearing heat and removing toxi-city, Qi spasmolytics, dispel ing wind and desensitization, activating blood and eliminating stasis, promoting Qi and regulating middle-jiao and relieving dyspepsia.[Conclusions] Doctor Xuan Guiqi's experience in the diagnosis and treatment of childhood asthma can significantly improve the clinical efficacy , and it is meaningful to clinic.%  [目的]总结宣桂琪主任对于小儿哮喘的临床治疗经验及提高疗效的思路。[方法]笔者通过跟师学习、整理医案,从辨证分型和临床用药等方面分析和总结宣主任治疗小儿哮喘的临床经验。[结果]宣主任将小儿哮喘分为急性哮喘与慢性哮喘进行辨治,其中前者又分寒哮、热哮、风痰哮三型,同时加强清热解毒、理气解痉、祛风脱敏、活血祛瘀、理气调中、消导积滞等针对性治疗,显著提高了哮喘的疗效。[结论]宣桂琪主任对小儿哮喘分型辨治及根据不同病因病机的针对性治疗显著提高了临床疗效,具有临床启示意义。

  4. Helicobacter Pylori Infection and Pediatric Asthma

    OpenAIRE

    Abdullah Karimi; Koroush Fakhimi Derakhshan; Farid Imanzadeh; Mohamad Rezaei; Zahra Cavoshzadeh; Saeid Maham

    2013-01-01

    Objective Childhood infectious diseases are one of the most known environmental pathogenic causes of childhood asthma. The high prevalence of both Helicobacter pylori infection and asthma in our country prompted us to assess anyprobable association between them in childhood. Methods This cross-sectional study recruited 196 children aged 6 to 12 years old comprising 98 asthmatic (case group) and 98 healthy (control group) individuals. Urea breath test was performed for all of the children and ...

  5. The revision points for Chinese guideline of childhood asthma%中国儿童支气管哮喘防治指南修订要点的探讨

    Institute of Scientific and Technical Information of China (English)

    洪建国

    2014-01-01

    发表于2008年的《儿童支气管哮喘诊断与防治指南》为我国儿童哮喘管理水平的提高起到了积极的促进作用。近年来随着对疾病认识的深入,儿童哮喘的诊治技术又有了新的进展,有必要对现有指南进行适当修订,以更好地指导临床实践。文章对儿童哮喘指南修订的要点提出一些探索性的看法,内容主要涉及疾病的诊断、监测、评估和治疗。%The current guideline for the diagnosis and optimal management of asthma in children, published in 2008, has played a positive role in promoting the clinical practice level on the management of childhood asthma in China. With the deepening of understanding of the disease, there have been some new technologies on the management of child-hood asthma in recent years. It is necessary to revise the existing guidelines accordingly for better use in clinical practice. This paper puts forward some exploratory points of view on the revision of childhood asthma guideline. The main con-tents are involved in disease diagnosis, monitoring and evaluation, and treatment.

  6. Persistent Airflow Obstruction in Young Adult Asthma Patients

    Directory of Open Access Journals (Sweden)

    Kiyoshi Sekiya

    2012-01-01

    Conclusions: In this study, patients not undergoing treatment for asthma were examined. History of childhood asthma and smoking history may be the risk factors for persistent airway obstruction in the asthma patients with mild subjective symptoms. Tests on the bronchodilator change in FEV1 should be performed in patients with history of childhood asthma and smoking history, even if they have only mild subjective symptoms.

  7. 诱发儿童哮喘的家庭环境危险因素分析%Analysis on the risk factors of family environment inducing childhood asthma

    Institute of Scientific and Technical Information of China (English)

    李上淼; 李绍锦; 胡伟国; 丛丽

    2012-01-01

    Objective: To analyze the risk factors of family environment inducing childhood asthma. Methods: Four hundred children with asthma who were diagnosed in outpatient department and inpatient department of the hospital from January 2009 to January 2011 were selected as study objects, the ill children without respiratory tract diseases during the same period were selected as control group. Questionnaire investigation was performed to survey the related factors of childhood asthma. Results: Univariate analysis showed that family history of asthma, family history of allergy, allergic constitution, raising animals, passive smoking, using air - conditioning, exposure to pollen, educational levels of parents, the proportion of often being depressed in asthma group were significantly higher than those in control group (P<0.01) . Non - conditional multivariate regression analysis showed that family history of asthma, family history of allergy, educational levels of parents, passive smoking, and raising animals had great significances (P<0.05) . Conclusion; Family history of asthma, family history of allergy, educational levels of parents, passive smoking, and raising animals were risk factors of childhood asthma, which indicate that controlling and correcting the related risk factors of asthma and onset of asthma timely have important actual significances for preventing and controlling asthma.%目的:分析儿童哮喘发病家庭环境的危险因素.方法:选择2009年1月~2011年1月在医院门诊及住院诊断为哮喘患儿400例,以同时期来医院治疗的非呼吸道疾病患儿403例为对照,采用问卷调查法调查与儿童哮喘有关的因素.结果:单因素分析显示,家族哮喘史、家族过敏史、过敏性体质、饲养动物、被动吸烟、使用空调、接触花粉、父母的受教育程度、经常情绪低落的比例哮喘组明显高于对照组,差异有统计学意义(P<0.01).多因素非条件Logisitc回归分析显示家族

  8. A double-blind, placebo-controlled comparison of sodium cromoglycate and ketotifen in the treatment of childhood asthma.

    Science.gov (United States)

    Croce, J; Negreiros, E B; Mazzei, J A; Isturiz, G

    1995-06-01

    We compared three treatments: sodium cromoglycate 5 mg aerosol and placebo syrup (39 patients), placebo aerosol and ketotifen syrup (39 patients), and placebo aerosol and syrup (36 patients). The patients (mean age 11.7 years) had mostly allergic, moderately severe asthma. Treatments were added to current therapy (mostly bronchodilators only) for 3 months. Aerosols were taken four times daily and syrups twice daily. The following results were significant at a level of 5%. At the final clinic visit, the changes from baseline in lung function favored sodium cromoglycate over the other treatments. During month 3, sodium cromoglycate was superior to ketotifen for night symptoms, morning tightness, daytime symptoms, and cough. Bronchodilator use decreased more with sodium cromoglycate than ketotifen. Patients' and clinicians' overall opinions of treatment effectiveness favored sodium cromoglycate over ketotifen and placebo. In these patients, sodium cromoglycate was both effective and superior to ketotifen.

  9. Asthma in adolescent athletes.

    Science.gov (United States)

    Carlsen, Kai-Håkon; Hem, Erlend; Stensrud, Trine

    2011-12-01

    Athletes active in endurance sports are at an increased risk of acquiring asthma through their sports activities, especially so for cross-country skiers, biathlon skiers, swimmers and athletes of other endurance sports. Asthma may be present from early childhood or develop while in active sports. This article focuses on the physical activity and sports activities in children and adolescents. Exercise-induced asthma (EIA) is found in 8-10% of a normal child population of school age and in about 35% of children with current asthma. EIA is caused by the markedly increased ventilation during exercise, with increased heat and water loss through respiration, leading to bronchial constriction. The risk of developing asthma in the young athlete is related to the repeated daily training activity with increased epithelial damage of the airways, delayed repair due to the daily repetition of the training and increased airway mucosal inflammation. The increased environmental exposure through the sports activity to environmental agents, such as cold, dry air in skiers and chlorine compounds in swimmers, increases symptoms and signs of asthma and bronchial hyper-responsiveness, either worsening an existing asthma or leading to a novel disease in a previously healthy athlete. Several specific aspects of daily training life, environmental exposure, diagnostic procedures and aspects of treatment related to the regulations of medication use in sports need particular attention when addressing the adolescent athlete with respiratory symptoms.

  10. Epidemiology of adult asthma in Asia: toward a better understanding

    OpenAIRE

    Song, Woo-Jung; Kang, Min-Gyu; Chang, Yoon-Seok; Cho, Sang-Heon

    2014-01-01

    Asia is the world's most dynamic area. Asthma is a major chronic disease in Asia, like other continents. However, unlike childhood asthma, the epidemiological burden of asthma in Asian adults has been unclear. Here we reviewed the currently available literatures on the epidemiology of adult asthma in the Asian community populations. Adult asthma prevalence was generally lower in Asian than in Europe, but the increasing trends suggested the disease burden to rise in the near future. However, f...

  11. Metabolic asthma: is there a link between obesity, diabetes, and asthma?

    Science.gov (United States)

    Perez, Miriam K; Piedimonte, Giovanni

    2014-11-01

    Childhood asthma and obesity have reached epidemic proportions worldwide, and the latter is also contributing to increasing rates of related metabolic disorders, such as diabetes. However, the relationship between asthma, obesity, and abnormal metabolism is not well understood nor has it been adequately explored in children. This article discusses the concept of metabolic asthma and the recent hypothesis that early derangement in lipid and glucose metabolism is independently associated with increased risk for asthma.

  12. Occupational asthma

    Science.gov (United States)

    ... Names Asthma - occupational exposure; Irritant-induced reactive airways disease Images Spirometry Respiratory system References Lemiere C, Vandenplas O. Occupational allergy and asthma. In: Adkinson NF Jr., Bochner ...

  13. Study on family history of allergic diseases and childhood asthma%过敏性疾病家族史与儿童哮喘发病的相关研究

    Institute of Scientific and Technical Information of China (English)

    马红茹; 倪莎莎; 吕菊红; 安昱; 李文君

    2013-01-01

    Objective To explore the relationship between family history of allergic diseases and childhood asthma .Methods Two-stage stratified cluster random sampling survey method was used to select 1 029 children under 14 years from Baoji City for investigation on risk factors of childhood asthma .The relationship between family history of allergic diseases and childhood asthma was analyzed with chi -square test.Results Stratified according to sex , childhood asthma for boys was associated with the asthma history of the first degree relatives (OR=17.83, 95%CI:2.36-134.77) and their history of other allergic diseases (OR=1.92, 95%CI:1.06-3.49), asthma history of the second degree relatives(OR=4.18, 95%CI:1.55-11.29) and their history of other allergic diseases (OR=3.87, 95%CI:1.27-11.79). For girls, childhood asthma was correlated with the asthma history of the first degree relatives (OR=4.58, 95%CI:4.58-16.02) and of the second degree relatives(OR=3.87, 95%CI:1.41-10.66).According to merged ORM-H, childhood asthma was also associated with the first degree relatives'history of asthma(ORM-H =7.94, 95%CI:2.77-22.73), the first degree relatives'history of other allergies(ORM-H =1.80, 95%CI:1.14-2.84), the second degree relatives'history of asthma(ORM-H =4.03, 95%CI:1.98-8.19), and the second degree relatives'history of other allergies(ORM-H =2.36, 95%CI:1.11-5.00).Conclusion Family history of allergic diseases is a risk factor for children asthma .Children with family history of allergic diseases should avoid other risk factors for asthma so as to reduce the occurrence probability of asthmatic attack .%目的探讨过敏性疾病家族史与儿童哮喘发病的关系。方法采取两阶段分层整群随机抽样调查方法,抽取宝鸡市区1029名0~14岁儿童进行哮喘危险因素调查,利用χ2检验分析过敏性家族史与儿童哮喘的关系。结果按照性别分层,男童中一级亲属哮喘史(OR=17.83,95%CI:2.36~134.77)、一

  14. Correlation of serum leptin, simple obesity and childhood asthma%瘦素小儿单纯性肥胖与儿童哮喘的相关性研究

    Institute of Scientific and Technical Information of China (English)

    张慧平; 庞随军; 李元霞; 冯娜; 王春芬

    2012-01-01

    Objective To investigate the serum levels of leptin and simple obesity for effect of nosogenesis and the relationship between each other in childhood asthma. Methods Eighty four children under 10 years old who visited pediatric outpatient or inpatient department during asthma attack period in the Affiliated Hospital of Medical College, Yanan University from January 2010 to May 2011 were divided into overweight group( n =32) and normal weight group( n =52 ) according to Kaup index. Control group:32 children with simple obesity and 43 healthy children were selected. Serum leptin was measured by radioimmunity. Results In both overweight group and normal weight group with childhood asthma, the levels of serum leptin during the childrens attack period were significantly higher than that in control group, and the difference had statistical significance ( P<0.05 );there was significant difference between attack period and remission period ( P <0. 05 ); there was significant difference between children with simple obesity and normal weight children ( P < 0.05 ). During the asthmatic children s attack period and remission period, the levels of serum leptin in simple obesity group with childhood asthma were significantly higher than those in normal weight group with childhood asthma, and the difference had statistical significance ( P <0. 05 ). Conclusion Leptin maybe participates in nosogenesis of asthma. Simple obesity may be a single risk factor for childhood asthma.%目的 探讨Leptin、小儿单纯性肥胖在儿童哮喘发病中的作用及其相互关系.方法 选择52例正常体质量的哮喘患儿,32例合并小儿单纯性肥胖的哮喘患儿,32例单纯性肥胖儿童及43例健康同龄儿童为研究对象,采用放射免疫分析法测外周血清瘦素水平.结果 正常体质量的哮喘患儿以及合并单纯性肥胖的哮喘患儿,急性期血清Leptin水平均高于临床缓解期、单纯性肥胖组及对照组(P均<0.05),临床缓解期Leptin

  15. 教育和管理在儿童哮喘防治中的作用%Effect of education and management on the prevention and treatment of childhood asthma

    Institute of Scientific and Technical Information of China (English)

    高苗苗

    2011-01-01

    通过对目前全世界范围内哮喘发病率持续增高和防治工作中所面临的各种困难以及有效教育管理机制缺陷的分析,评价规范化标准化哮喘教育管理内容及其在儿童哮喘防治中所产生的正向推动作用,分析当前国内外现有的哮喘管理模式,了解各种模式的出发点、优势以及能够带来的效果,以正视国内哮喘管理中存在的问题和挑战,并通过对国内现存管理策略的剖析和新型模式的展望,力求寻找适合我国国情和现状的有效对策,达到对哮喘患儿进行早期干预、早期诊断与治疗.%To analyze the continuing increase of asthma incidence, the difficulties in the prevention and management of asthma, and the deficiency of management system in the efficient asthma education all over the world; To evaluate the positive effects of standard and systemic management education in the prevention of childhood asthma; To analyze the extant models of asthma management at home and abroad, and to understand the starting point, the advantage, and the effect of different models; To face up to the problems and challenges of asthma management in our country, to seek an effective strategy suited to our country based on the analysis of the current asthma management in our country and the prospection of the new models, and to accomplish the purpose of early prevention, diagnosis and therapy for asthma.

  16. The research progress on family management and psychotherapy of childhood asthma%儿童哮喘家庭管理和心理治疗研究进展

    Institute of Scientific and Technical Information of China (English)

    顾希茜(综述); 向莉(审校)

    2014-01-01

    哮喘的高患病率及其反复发作、慢性持续、难以治愈的特点对哮喘儿童生理、心理及其家庭都会产生重要影响。该文一方面通过简述儿童哮喘家庭管理的研究现状及其影响因素,深入了解哮喘家庭管理的必要性;另一方面综述行为疗法、认知疗法、认知行为疗法、放松疗法、家庭心理疗法等目前国内外现有的心理治疗措施,以及上述各种心理疗法的实施效果,以期为制定儿童哮喘综合防治体系及实施研究提供思路。%The childhood asthma is characterized as high morbidity,recurrent attack,chronic persistence and refractoriness. So asthma with these features mentioned above can have important effect on children′s emo-tional and physical development as well as their families. This review sketches the studies of children asthma family management present situation and its influencing factors,and stresses the necessity of asthma family man-agement. Methods of psychotherapy used in our country and abroad and its implementation effect are reviewed, including behavior therapy,cognitive therapy,cognitive behavioral therapy,relaxation therapy,family therapy and other existing psychological treatment,in order that these measures can be conductive to the development of pre-vention methods of pediatric asthma and further researches.

  17. 东营市儿童支气管哮喘的相关因素分析%Related factors of childhood bronchial asthma in Dongying

    Institute of Scientific and Technical Information of China (English)

    赵雪莲; 耿玉青

    2015-01-01

    目的:采用横断面研究对山东省东营市0~12岁儿童支气管哮喘的相关危险因素进行探究。方法随机抽取2013年6月至2014年6月东营市0~12岁儿童9500例,最后获得完整资料的例数有9120例,通过调查问卷初筛、专科医护人员病史采集和专科检查进行确诊,并对影响哮喘病患儿的危险因素进行分析。结果确诊为儿童哮喘的人数有301人(3.30%)。男性患儿患病率高于女性患儿(χ2=7.844,P<0.05)。0~3岁患儿患病率最高,7~12岁患儿次之,4~6岁患儿患病率最低(χ2=14.364,P<0.001)。单因素分析发现,过敏性鼻炎、荨麻疹、湿疹、药物过敏史、肥胖症、早期使用抗生素的0~12岁儿童哮喘患病率较高,均有统计学意义(OR值分别为7.901、3.281、2.677、2.586、7.348、1.434和3.193,均P<0.05)。多因素分析发现,过敏性鼻炎、荨麻疹、湿疹、药物过敏史、肥胖症、早期使用抗生素均是0~12岁儿童哮喘发作的危险因素[OR(95%CI)值分别为4.623(1.336~9.645)、4.031(1.712~8.493)、3.728(1.327~10.474)、2.186(1.231~3.882)、1.355(1.063~1.728)和2.787(1.429~5.438),均P<0.05]。结论哮喘病在儿童中的发病率较高,过敏性鼻炎、荨麻疹、湿疹、药物过敏史、肥胖症、早期使用抗生素是0~12岁儿童哮喘发作的危险因素。%Objective To explore the related factors of bronchial asthma of children aged 0 -12 years old by cross-sectional study in Dongying of Shandong Province. Methods From June 2013 to June 2014 9 500 children aged 0-12 years old were randomly sampled in Dongying of Shandong Province, and complete data of 9 120 children were received finally. They were diagnosed by preliminary screening with questionnaire, history collecting by medical personnel and specialized examination, and related factors of childhood asthma were analyzed. Results There were 301 children (3. 30%) diagnosed with asthma. The incidence rate of male patients was higher than that of female

  18. 母孕期及新生儿期危险因素与儿童支气管哮喘的关系%A study on the relationship between pregnant, neonatal risk factors and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    贾春梅; 王俊卿; 陈小琴; 王冬梅; 姜采荣; 姜黎

    2014-01-01

    目的:分析儿童支气管哮喘与母孕期及新生儿期各因素的相关性,为疾病预防提供依据。方法对已确诊为支气管哮喘的162例患儿以及213名正常儿童进行回顾性调查,包括一般情况,母亲围孕期情况(产次、孕早期发热、妊娠高血压综合征、妊娠糖尿病、孕早期服药史),新生儿情况(出生时体表缺陷、窒息、胎盘粗糙、出生体质量、胎数、胎龄、剖宫产)。结果支气管哮喘儿童与对照儿童,母亲孕早期发热、妊娠高血压综合征、孕早期服药、胎盘粗糙、窒息、出生体质量、早产、剖宫产的差异均有统计学意义(P<0.05);多因素Logistic回归分析发现,母亲孕早期发热(OR=9.43,95%CI:3.08~28.82)、胎盘粗糙(OR=2.15,95%CI:1.29~3.59)、早产(OR=5.16,95%CI:1.53~17.39)、剖宫产(OR=4.05,95%CI:2.40~6.86)均为儿童哮喘的独立危险因素。结论母亲孕早期发热、胎盘粗糙、早产、剖宫产可能与儿童支气管哮喘发生相关。%Objective To explore the relationship between childhood asthma and pregnant and neonatal risk factors, thus provide evidence for early prevention of childhood asthma. Methods 162 children diagnosed asthma and 213 healthy children in pediatric outpatient and the inpatient services of our hospital who was born and living in Baotou city were retrospectively analyzed. The pregnancy related factors (parity, fever during pregnancy, pregnancy-induced hypertension syndrome, gestational diabetes mellitus, history of overdose in early-pregnancy) and the neonatal period related factors (surface defects, asphyxia, rough placenta, birth weight, number of fetus during this pregnancy, gestational age, premature birth, cesarean section) were investigated. The sex and age showed no signiifcance between childhood asthma and control group. Results Eight pregnant and neonatal factors (fever during pregnancy, pregnancy-induced hypertension syndrome, history of

  19. Temporal and Spatial Trends in Childhood Asthma-Related Hospitalizations in Belo Horizonte, Minas Gerais, Brazil and Their Association with Social Vulnerability

    Directory of Open Access Journals (Sweden)

    Cláudia Silva Dias

    2016-07-01

    Full Text Available Introduction: Asthma is a multifactorial disease and a serious public health problem. Environmental factors and poverty are the main determinants of this disease. Objective: To describe the spatial and temporal distribution of asthma-related hospitalizations and identify the areas with the highest prevalence of and vulnerability to severe asthma in a major Brazilian city. Methods: An ecological study of hospitalizations for asthma from 2002 to 2012, in children and adolescents under 15 years of age, living in Belo Horizonte, Southeast Brazil. All events were geocoded by residence address using Hospital Information System data. The socioeconomic vulnerability of residence address was ranked using the Health Vulnerability Index. Raster surfaces were generated and time-series plots were constructed to determine spatial and time trends in the frequency of asthma-related hospitalizations, respectively. Results: Asthma-related hospitalization rates were highest in children aged 0–4 years and in boys. There was a decreasing trend in the number of asthma-related hospitalizations across the study period. Approximately 48% of all hospitalizations were children living in health vulnerable areas. Seasonal trends showed a hospitalization peak in March, April, and May, coinciding with the post-rainy period. Conclusion: Our findings suggest that social and environmental factors may be determinants of disparities in severe asthma.

  20. Infectious triggers of pediatric asthma.

    Science.gov (United States)

    Gern, James E; Lemanske, Robert F

    2003-06-01

    Respiratory infections can cause wheezing illnesses in children of all ages and also can influence the causation and disease activity of asthma. For years it has been recognized that respiratory syncytial virus infections often produce the first episode of wheezing in children who go on to develop chronic asthma. More recently, it has been proposed that repeated infections with other common childhood viral pathogens might help the immune system develop in such a way as to prevent the onset of allergic diseases and possibly asthma. In addition to the effects of viral infections, infections with certain intracellular pathogens, such as chlamydia and mycoplasma, may cause acute and chronic wheezing in some individuals, whereas common cold and acute sinus infections can trigger acute symptoms of asthma. In this article, the epidemiologic, mechanistic, and treatment implications of the association between respiratory infections and asthma are discussed.

  1. An Evaluation of Asthma Interventions for Preteen Students

    Science.gov (United States)

    Clark, Noreen M.; Shah, Smita; Dodge, Julia A.; Thomas, Lara J.; Andridge, Rebecca R.; Little, Roderick J. A.

    2010-01-01

    Background: Asthma is a serious problem for low-income preteens living in disadvantaged communities. Among the chronic diseases of childhood and adolescence, asthma has the highest prevalence and related health care use. School-based asthma interventions have proven successful for older and younger students, but results have not been demonstrated…

  2. Asthma and Chronic Obstructive Pulmonary Disease : Similarities and Differences

    NARCIS (Netherlands)

    Postma, Dirkje S.; Reddel, Helen K.; ten Hacken, Nicolaas; van den Berge, Maarten

    2014-01-01

    Asthma and CORD are both heterogeneous lung diseases including many different phenotypes. The classical asthma and CORD phenotypes are easy to discern because they reflect extremes of a phenotypical spectrum. Thus asthma in childhood and CORD in smokers have their own phenotypic expression with unde

  3. Predicting Children's Asthma Hospitalizations: Rural and Urban Differences in Texas

    Science.gov (United States)

    Grineski, Sara E.

    2009-01-01

    Asthma is the number one chronic health condition facing children today; however, little is known about rural-urban inequalities in asthma. This "area effects on health" study examines rural-urban differences in childhood asthma hospitalizations within the state of Texas using negative binomial regression models. Effects associated with…

  4. Co-risk factors in early life for childhood asthma and obesity%儿童肥胖与哮喘在生命早期的共同危险因素

    Institute of Scientific and Technical Information of China (English)

    陆娇

    2010-01-01

    Childhood asthma and obesity are significant public health problems all over the world.In the past decades,the prevalence of both diseases has increased considerably.Because both asthma and obesity appear to have their beginnings in early childhood,common exposures that predispose individuals to both conditions may explain how they are associated.These exposures include common genetic predictors,prenatal exposure to specific nutrients and overall maternal nutrition, colonization patterns of the neonatal and infant gut,birth weight and infant weight gain,and sedentary behaviors in early life.%儿童哮喘与肥胖是当今世界的两项重大健康问题.在过去的几十年里,两者的发病率均有明显的升高.尽管已有大量的临床和基础研究发现两者的相关性及可能的发病机制,但两者是如何相关联的仍不甚清楚.肥胖与哮喘均有着生命早期的起源,这些起源的共同部分包括共同的基因片段、产前营养、肠道菌群的定植、出生体质量的情况以及生活方式等.

  5. Metabolic Abnormalities in Children with Asthma

    OpenAIRE

    2010-01-01

    Rationale: Childhood asthma and obesity have reached epidemic proportions worldwide, and the latter is also contributing to increasing rates of related metabolic disorders, such as diabetes. Yet, the relationship between asthma, obesity, and abnormal lipid and glucose metabolism is not well understood, nor has it been adequately explored in children.

  6. Cough in asthma triggered by reflux episodes.

    Science.gov (United States)

    Mehta, Devendra; He, Zhaoping; Padman, Raj

    2014-05-01

    With combined pH and impedance monitoring, non-acid, as well as acid reflux episodes, are more commonly detected immediately prior to cough in asthma in children. Gastroesophageal reflux should be evaluated as a trigger for cough in difficult childhood asthma.

  7. Distribution Characteristics of Induced Etiology of Childhood Asthma Episodes Infection%感染诱发儿童哮喘急性发作的病原学分布特点

    Institute of Scientific and Technical Information of China (English)

    庄浩林; 郭幼平

    2014-01-01

    Objective: To investigate the distribution characteristics of induced etiology of childhood asthma episodes infection. Methods: The etiology of deep sputum were cultured and analyzed in 344 children with acute asthma attacks induced by infection from Jan 2009 to Dec 2014. Results: 304 cases of microorganisms were identified,included 78 cases of virus detection (22.7%),63 cases of Streptococcus pneumoniae (18.3%) and 49 cases of Haemophilus influenzae (14.2%). Conclusion: Childhood asthma episodes is closely related to virus detection,Streptococcus pneumoniae and Haemophilus influenza.%目的:了解感染诱发儿童哮喘性发作的病原学分布特点。方法:对2009年1月至2013年12月收治的感染诱发哮喘急性发作的344例儿童进行深部痰培养,分析其病原学分布特点。结果:鉴定出病原微生物304例,其中病毒78例(22.7%),肺炎链球菌63例(18.3%)及流感嗜血菌49例(14.2%)。结论:病毒、肺炎链球菌和流感嗜血菌与儿童哮喘急性发作密切相关。

  8. 生命早期抗生素使用与儿童哮喘:因果关系还是混杂效应?%Antibiotic use in early life and childhood asthma:causation or confounding?

    Institute of Scientific and Technical Information of China (English)

    胡润芳

    2015-01-01

    儿童哮喘的发病率逐年上升.基于卫生假说,抗生素使用可能减少了微生物暴露,从而增加了过敏性疾病发生的风险.近十年来,就早期抗生素暴露与儿童哮喘的关系进行的大量的流行病学调查的结果并不一致.大多数回顾性研究发现正相关联系,但前瞻性研究未发现联系或联系强度较弱.逆向因果和指示混淆可部分解释两者的关系,但也难以否定因果关系的存在.%The prevalence of childhood asthma has been increased yearly.Based on the hygiene hypothesis,the antibiotic use may increase the risk of the allergic disease by reducing microbial exposure.In the last decade,a number of epidemiological studies have been conducted on the association between early exposure of antibiotic and childhood asthma,and the results are not consistent.The majority retrospective studies have found a positive association but the prospective studies have showed a null or weak association.Reverse causation and confounding-by-indication may partly explain the relation.But it is difficult to deny a causal link between antibiotic use and asthma.

  9. Developing asthma in childhood from exposure to secondhand tobacco smoke: insights from a meta-regression Asma na infância por exposição ao tabagismo passivo: compreensão a partir de uma meta-regressão

    Directory of Open Access Journals (Sweden)

    Kathleen Vork

    2008-08-01

    Full Text Available Studies have shown links between household secondhand tobacco smoke (SHS exposure and induction of childhood asthma. But the true nature of this link remains unclear in many studies. We conducted a meta-analysis of studies published from 1970 to 2005 to uncover consistent patterns of relative risk estimates (RRs, and found substantial heterogeneity within initial summary RRs of 1.48 [95% confidence interval (CI, 1.32-1.65], 1.25 (1.21-1.30, and 1.21 (1.08-1.36, for ever, current, and incident asthma, respectively. Lack of control for type of atopy history (familial or child and child's own smoking status within studies and age category altered summary RRs in separate metaregressions. After adjustments, consistent patterns of association emerged between SHS exposure and childhood asthma induction. Our summary RR of 1.33 (95% CI, 1.14-1.56 from studies of incident asthma among older children (618 years old is 1.27 times the estimate from studies of younger children and higher than estimates from earlier meta-analyses. This showns that exposure duration may be a more important factor than previously understood, and suggests that SHS could be a more fundamental cause of childhood asthma than some previous meta-analyses have indicated.

  10. 生命早期室内环境暴露与儿童哮喘的关系%Relationship between early life exposure to indoor environment and childhood asthma

    Institute of Scientific and Technical Information of China (English)

    朱慧瑶; 李猛; 潘睿; 张宸罡; 罗飞; 徐艳丽; 张璐璐; 黄丽素; 张军

    2015-01-01

    哮喘是最常见的慢性疾病之一, 其病因复杂并具有多基因遗传倾向, 是由多种细胞和细胞组分参与的气道慢性炎症性疾病. 研究表明, 生命早期的某些室内环境暴露与儿童期甚至成人期哮喘的发病存在一定的相关性, 如室内油烟、 湿度、 尘螨等暴露. 该综述就生命早期室内环境暴露对儿童哮喘的影响进行讨论, 并提出相应的干预措施, 旨在为哮喘预防和控制措施的制定提供参考.%Asthma, caused by complicated pathogens, is one of the most common chronic diseases, and is polygenic inheritance. It is a kind of airway chronic inflammatory disease, and a variety of cells and cellular components are involved. It has been suggested that exposure of early life to certain indoor environments, such as indoor oil, humidity, and house mites is correlated with asthma in childhood and even in adulthood. The review analyzes and discusses the impact of early life exposure to indoor environment on children asthma. Besides, the corresponding intervention measures are put forward to provide some references for the prevention and control of asthma.

  11. Research and analysis of the treatment effect of atomization inhalation drug in childhood bronchial asthma%儿童支气管哮喘雾化吸入药物治疗效果研究分析

    Institute of Scientific and Technical Information of China (English)

    瞿萍萍

    2014-01-01

    目的:分析雾化吸入普米克令舒和硫酸沙丁胺醇在儿童支气管哮喘中的应用。方法:选择支气管哮喘儿童64例,分析其初步情况,将患儿随机分成观察组和对照组,对照组给予常规哮喘治疗,而观察组加用普米克令舒和硫酸沙丁胺醇雾化吸入。两组进行疗效对比。结果:治疗后,治疗组无论在治疗时间还是在疗效上更优于对照组。结论:哮喘儿童应用普米克令舒和硫酸沙丁胺醇雾化吸入起效快,疗效好,可有效改善症状体征和肺功能。%Objective:To analyze the application of atomization inhalation pulmicort respulas and salbutamol sulfate in childhood bronchial asthma.Methods:64 children with bronchial asthma were selected.The initial condition was analyzed.They were randomly divided into the observation group and the control group.The control group were given the conventional treatment of asthma.The observation group were treated with pulmicort respulas and salbutamol sulfate atomization inhalation.The curative effects of two groups were compared.Results:After treatment,the treatment time and the urative effect of the treatment group were better than those of the control group.Conclusion:Application of pulmicort respulas and salbutamol sulfate atomization inhalation in children with asthma has quick and good curative effect.It can effectively improve the symptoms,signs and pulmonary function.

  12. Challenges in treating pediatric asthma in developing countries.

    Science.gov (United States)

    Zar, Heather J; Levin, Michael E

    2012-12-01

    Asthma is the most common chronic disease in children in many low- and middle-income countries. In these settings, the burden of childhood asthma is increasing and is associated with severe disease. There are a number of challenges to providing optimal management of childhood asthma in such settings. These include under-diagnosis of childhood asthma, access to care, ability of healthcare workers to manage asthma, availability and affordability of inhaled therapy, environmental control of potential triggers, education of healthcare providers and of the public, and cultural or language issues. International and national guidelines for childhood asthma have been produced, but implementation remains a real challenge. Access to and affordability of essential inhaled asthma drugs, especially low-dose inhaled corticosteroids and short-acting bronchodilators, are major challenges to effective asthma control in many countries. A low-cost spacer made from a plastic bottle is effective for use with a metered-dose inhaler, but use must be included in asthma educational initiatives. Educational programs for healthcare personnel and for the public that are culturally and language appropriate are needed for effective implementation of asthma guidelines. Socioeconomic and structural barriers to care within health services remain obstacles to achieving optimal treatment of asthma for many children.

  13. Prenatal Stress, Prematurity, and Asthma.

    Science.gov (United States)

    Medsker, Brock; Forno, Erick; Simhan, Hyagriv; Celedón, Juan C

    2015-12-01

    Asthma is the most common chronic disease of childhood, affecting millions of children in the United States and worldwide. Prematurity is a risk factor for asthma, and certain ethnic or racial minorities such as Puerto Ricans and non-Hispanic blacks are disproportionately affected by both prematurity and asthma. In this review, we examine current evidence to support maternal psychosocial stress as a putative link between prematurity and asthma, while also focusing on disruption of the hypothalamic-pituitary-adrenal (HPA) axis and immune responses as potential underlying mechanisms for stress-induced "premature asthma." Prenatal stress may cause not only abnormalities in the HPA axis but also epigenetic changes in the fetal glucocorticoid receptor gene (NR3C1), leading to impaired glucocorticoid metabolism. Moreover, maternal stress can alter fetal cytokine balance, favoring TH2 (allergic) immune responses characteristic of atopic asthma: interleukin 6 (IL-6), which has been associated with premature labor, can promote TH2 responses by stimulating production of IL-4 and IL-13. Given a link among stress, prematurity, and asthma, future research should include birth cohorts aimed at confirming and better characterizing "premature asthma." If confirmed, clinical trials of prenatal maternal stress reduction would be warranted to reduce the burden of these common comorbidities. While awaiting the results of such studies, sound policies to prevent domestic and community violence (eg, from firearms) are justified, not only by public safety but also by growing evidence of detrimental effects of violence-induced stress on psychiatric and somatic health.

  14. Viral infections and atopy in asthma pathogenesis: new rationales for asthma prevention and treatment.

    Science.gov (United States)

    Holt, Patrick G; Sly, Peter D

    2012-05-04

    Prospective birth cohort studies tracking asthma initiation and consolidation in community cohorts have identified viral infections occurring against a background of allergic sensitization to aeroallergens as a uniquely potent risk factor for the expression of acute severe asthma-like symptoms and for the ensuing development of asthma that can persist through childhood and into adulthood. A combination of recent experimental and human studies have suggested that underlying this bipartite process are a series of interactions between antiviral and atopic inflammatory pathways that are mediated by local activation of myeloid cell populations in the airway mucosa and the parallel programming and recruitment of their replacements from bone marrow. Targeting key components of these pathways at the appropriate stages of asthma provides new opportunities for the treatment of established asthma but, more crucially, for primary and secondary prevention of asthma during childhood.

  15. 第三次中国城市儿童哮喘流行病学调查%Third nationwide survey of childhood asthma in urban areas of China

    Institute of Scientific and Technical Information of China (English)

    全国儿科哮喘协作组; 中国疾病预防控制中心环境与健康相关产品安全所

    2013-01-01

    Objective Asthma is the most common chronic respiratory disease among children.In recent years,the prevalence of childhood asthma was rising in most countries around the world.This nationwide study was conducted to investigate the prevalence of childhood asthma in urban areas of large cities in China,and to find the characteristics of attacks,the diagnosis and treatment status,and provide scientific data for improving the prevention and management of asthma in children.Method This nationalwide,cross-sectional survey was organized by the National Cooperative Group on Childhood Asthma,and conducted in 43 cities all over the country,including 27 capital cities of provinces or autonomous regions,4 municipalities,from September 2009 to August 2010.Children born from July 1 st 1995 to June 30th 2010 were enrolled in the survey,consisting of children who had been living in the surveyed cities and those born outside the city but had lived in the cities for over 6 months.Schools,kindergartens and communities in each city were selected by phased stratified random cluster sampling.Standardized preliminary questionnaire was used for screening out possible patients in the survey.Diagnosis of asthma was confirmed by enquiry of history,together with review of previous record and tests,physical examination in suspected asthmatic children.Asthmatic children were further asked for past diagnosis,treatment and concomitant allergic diseases.Double entry and validation was adopted for all data using Epi-Info software,and analysis was carried out by SPSS V19.0.Result Totally 463 982 children were investigated for the survey.Asthma was diagnosed in 13 992 children,12 634 children with classical asthma (90.3 %) and 1358 children with cough variant asthma (9.7%) ; 4387 cases (31.4%) were newly diagnosed in all asthmatic children.The total asthma incidence rate was 3.02% (95% CI:2.97%-3.06%),with classical asthma at 2.72% (95% CI:2.68%-2.77%) and cough variant asthma

  16. Pediatric asthma controller therapy.

    Science.gov (United States)

    Anselmo, Mark

    2011-02-01

    The treatment of children with asthma has historically relied upon expert opinion using data extrapolated from adult studies. Over the past few years, landmark studies have been completed providing healthcare professionals with evidence on which a reasonable approach can be made for children suffering from this common and serious disease. Asthmatic phenotype in children, unlike adults, tends to differ according to age, which must be taken into account as well as triggers, severity, and level of control. The care of the child with asthma is complex, but accumulating data have demonstrated that we are on the right path for optimizing control while reducing the burden of side effects. The newest Global Initiative for Asthma (GINA) guidelines, as well as recent updates from the landmark CAMP (Childhood Asthma Management Program) study and information from the PACT (Pediatric Asthma Control Trial) and budesonide/formoterol controller and reliever studies, along with recent comparisons of higher dose inhaled corticosteroids (ICS), and ICS/long-acting β(2)-adrenoceptor agonist (LABA) combination and leukotriene receptor antagonist (LTRA) therapies in children have clarified a few of the big questions in pediatric asthma. For children with asthma aged 5 years and older, the CAMP trial demonstrated that regular use of ICS reduces the frequency of symptoms; however, height was adversely affected and there is no evidence for altering the natural history of asthma. In patients aged 6 years and over whose asthma is uncontrolled on ICS alone, combination therapy with ICS and a LABA has been recently compared with the use of higher dose ICS and the addition of an LTRA in pediatric patients. The addition of a LABA statistically will be of most benefit; however, some children will have optimal control with doubling the baseline dose of ICS or addition of an LTRA. Use of budesonide/formoterol as a controller and reliever therapy extends the time to first exacerbation versus

  17. Eastern Carolina Asthma Prevention Program (ECAPP): An Environmental Intervention Study Among Rural and Underserved Children with Asthma in Eastern North Carolina

    OpenAIRE

    2014-01-01

    OBJECTIVE Asthma is the most common chronic childhood condition affecting 6.3 million (US) children aged less than 18 years. Home-based, multi-component, environmental intervention studies among children with asthma have demonstrated to be effective in reducing asthma symptoms. In this study, a local hospital and university developed an environmental intervention research pilot project, Eastern Carolina Asthma Prevention Program (ECAPP), to evaluate self-reported asthma symptoms, breathing me...

  18. Pediatric asthma: an integrative approach to care.

    Science.gov (United States)

    Mark, John David

    2009-01-01

    Asthma in children and young adults is a complex disease with many different phenotypic expressions. Diagnosis is often made based on history and lung function including measuring airway reversibility. However, in children younger than 6 years of age, the diagnosis is more difficult because many children wheeze in the first 4-6 years of life, especially with viral infections. For those children, asthma treatment is often started empirically. Those who go on to develop chronic asthma most likely have a genetic predisposition and exposure to various environmental factors resulting in chronic inflammation of the lower respiratory tract. There are established national guidelines for diagnosing and treating asthma in children and adults. For persistent asthma, it is recommended that medications be taken on a regular basis after identifying and avoiding environmental triggers. Because many factors play a role in developing asthma in children, many nonmedical approaches to asthma and asthma-like conditions have been promoted even when the diagnosis is at times uncertain. The nonmedical approaches and therapies are often referred to as complementary and alternative medicine (CAM). This review will discuss the conventional therapies recommended for children with asthma in addition to CAM therapies, some of which have supporting scientific evidence. Integrating conventional and CAM therapies can prove to be an effective way to treat pediatric asthma, a common and chronic childhood lung disorder. A case is provided to illustrate how such an integrative approach was used in the successful treatment of a child with moderate persistent asthma.

  19. Maternal infection in pregnancy and risk of asthma in offspring.

    Science.gov (United States)

    Collier, Charlene H; Risnes, Kari; Norwitz, Errol R; Bracken, Michael B; Illuzzi, Jessica L

    2013-12-01

    This study estimates the effect of maternal infections during pregnancy on childhood asthma. One-thousand four-hundred and twenty-eight pregnant women were prospectively followed using structured interviews and chart review until their child's 6th year of life. Infections were identified from outpatient and hospital visits. Childhood asthma was defined as physician diagnosis with symptoms at age six. Adjusted odds ratios were calculated from multivariable logistic regression models. Six-hundred and thirty-five women experienced an infection during pregnancy. Among antepartum infections, maternal urinary tract infections were significantly associated with childhood asthma (aOR 1.60, 95 % CI 1.12-2.29). Chorioamnionitis and maternal group beta streptococcus colonization were not significantly associated with an increased risk in childhood asthma. This study found an increased risk of asthma in children of women diagnosed with urinary tract infections during pregnancy, while other maternal infections did not increase the risk.

  20. Use of acid-suppressive drugs in pregnancy and the risk of childhood asthma : Bidirectional case-crossover study using the general practice research database

    NARCIS (Netherlands)

    Hak, Eelko; Mulder, Bianca; Schuiling-Veninga, Nynke C. M.; De Vries, Tjalling W.; Jick, Susan S.

    2013-01-01

    Background: Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. Objectives: To assess the association between the use of acid-suppre

  1. Use of Acid-Suppressive Drugs in Pregnancy and the Risk of Childhood Asthma : Bidirectional Crossover Study using the General Practice Research Database

    NARCIS (Netherlands)

    Hak, Eelko; Mulder, Bianca; Schuiling-Veninga, Catharina C. M.; de Vries, Tjalling W.; Jick, Susan S.

    2013-01-01

    Background Recent studies have reported an association between maternal use of gastric acid-suppressive drugs during pregnancy and asthma in the offspring, but the association could have been confounded by unmeasured risk factors. Objective We assessed the association between the use of acid-suppres

  2. Epidemiological investigation and risk factor analysis of childhood asthma in Dongguan area%东莞地区儿童支气管哮喘流行病学调查及危险因素分析

    Institute of Scientific and Technical Information of China (English)

    范雪金; 彭琪; 陆小梅; 赖茂; 陈秀英; 黎四平; 李文瑞; 马可泽; 何晓光

    2014-01-01

    目的 调查东莞地区儿童支气管哮喘(哮喘)的流行现状,分析与哮喘发病相关的危险因素,为本地区儿童哮喘防治工作提供流行病学依据.方法 采用整群随机抽样的方法,抽取东莞地区0 ~ 14岁儿童8 680人,进行初筛问卷调查,对可疑对象进行确诊,统计分析儿童哮喘的患病现状;采用病例-对照研究方法对哮喘发病危险因素进行研究,进行单因素分析和Logistic回归分析.结果 东莞市0~14岁儿童哮喘患病率为3.27%,男、女患病率比为1.43∶1.00;哮喘患儿中,0~3岁和6~11岁年龄段儿童患病率最高,分别为4.57%和3.96%;首次发病以3岁内居多[141例(49.6%)],好发季节为换季时[110例(38.86%)],易发时间无规律者居多[109例(38.45%)],发作诱因最常见的为呼吸道感染[264例(92.96%)].通过对284例哮喘患儿及284例非哮喘儿童的病例-对照研究并对多种因素进行Logistic回归分析,结果显示,以下因素为儿童哮喘发生的独立危险因素:家族过敏史(OR =0.586,95%CI:0.353 ~0.927)、食物过敏史(OR=0.508,95%CI:0.306~0.843)、湿疹(OR=0.302,95% CI:0.163~0.561)、荨麻疹(OR=0.292,95%CI:0.141~0.607)、婴幼儿期使用抗生素(OR =0.377,95% CI:0.169 ~0.841),差异均有统计学意义(P均<0.001).结论 东莞地区0~ 14岁儿童哮喘患病率为3.27%,高于全国水平.增加儿童抵抗力,积极预防呼吸道感染是本地区防治儿童哮喘发病的重要途径.%Objective To investigate the prevalence rate of asthma and explore the risk factors of asthma in children of Dongguan,and to provide epidemiological evidence for prevention and treatment of childhood asthma.Methods A cluster random sampling survey of 8 680 children aged 0 to 14 years from Dongguan was conducted to finish the standardized screening questionnaire for diagnosis of suspicious objects.Asthmatic patients and suspect cases were screened out for further examination

  3. Therapeutic effect of Montelukast combined with Glucocorticoid on childhood cough variant asthma%孟鲁司特联合糖皮质激素治疗儿童咳嗽变异型哮喘疗效研究

    Institute of Scientific and Technical Information of China (English)

    刘卫周

    2011-01-01

    目的:评估应用孟鲁司特联合糖皮质激素对咳嗽变异性哮喘患儿的疗效.方法:将我院2006年1月~2010年6月咳嗽变异性哮喘86例患儿随机分为对照组和观察组,各43例,对照组患儿吸入丙酸氟地卡松125μg/次,每天早晚各1次,观察组除予糖皮质激素吸人治疗外,同时睡前予口服孟鲁司特4 mg 1次,连续治疗8周,观察治疗前和治疗后咳嗽症状和咳嗽对患儿睡眠、日常行为的影响.结果:孟鲁司特联合糖皮质激素总有效率为95.35%.与对照组有效率(74.42%)比较差异有统计学意义(x2=42.742,P<0.05),治疗前对照组和观察组症状评分比较差异无统计学意义(t=0.716,P>0.05),治疗后对照组和观察组症状评分比较差异有统计学意义(t=5.321,P<0.05),且未增加药物的副作用.结论:孟鲁司特联合糖皮质激素在咳嗽变异性哮喘患儿治疗中能有效提高治疗的有效率.明显改善患儿的临床症状,值得推广应用.%Objective: To evaluate the therapeutic effect of the combined treatment by the oral Montelukast and inhaled Glucocorticoid on the childhood cough variant asthma.Methods: 86 cases children with cough variant asthma were selected in our hospital from January 2006 to June 2010 and divided into observation group and control group evenly.The control group only inhaled 125 μg Fluticasone propionate per time, twice a day with one in the morning and the other in the night.In the regular treatment with the inhaled Glucocorticoid, observation group was added with Montelukast orally taken 4 mg once daily before bedtime.After eight weeks with the continuous therapy, the clinical efficacy before and after treatment were compared in order to find out the influence of asthma symptom and asthma itself on the sleeping quality and daily behavior of sick children.Results: Total efficiency rate of Montelukast combined with Glucocorticoid was 95.35%, compared with the efficiency rate of control group (74.42

  4. The impact of food allergy on asthma

    Directory of Open Access Journals (Sweden)

    Anupama Kewalramani

    2010-07-01

    Full Text Available Anupama Kewalramani, Mary E BollingerDepartment of Pediatrics, Division of Pediatric Allergy/Pulmonology, University of Maryland School of Medicine, Baltimore, MD, USAAbstract: Food allergy is a potentially severe immune response to a food or food additive. Although a majority of children will outgrow their food allergies, some may have lifelong issues. Food allergies and other atopic conditions, such as asthma, are increasing in prevalence in Western countries. As such, it is not uncommon to note the co-existence of food allergy and asthma in the same patient. As part of the atopic march, many food allergic patients may develop asthma later in life. Each can adversely affect the other. Food allergic patients with asthma have a higher risk of developing life-threatening food-induced reactions. Although food allergy is not typically an etiology of asthma, an asthmatic patient with food allergy may have higher rates of morbidity and mortality associated with the asthma. Asthma is rarely a manifestation of food allergy alone, but the symptoms can be seen with allergic reactions to foods. There may be evidence to suggest that early childhood environmental factors, such as the mother’s and child’s diets, factor in the development of asthma; however, the evidence continues to be conflicting. All food allergic patients and their families should be counseled on the management of food allergy and the risk of developing co-morbid asthma.Keywords: food allergy, diagnosis, treatment, asthma

  5. 儿童支气管哮喘发作相关影响因素分析%Analysis of risk factors of childhood asthma

    Institute of Scientific and Technical Information of China (English)

    黄亮

    2016-01-01

    Objective To investigate the related factors of children with asthma, in order to induct the valid treatment in clinic. Methods 137 children with asthma were selected as the observation group, and 113 children without asthma as the control group. Questionnaires, examinations and asthma history analysis were used to determine the correlative factors for asthma children. Results The survey found that there was a significant difference in history of allergic diseases, acute respiratory infection, breast feeding, passive smoking, harmful gases history and pet own-ership between the two groups(P <0. 05). According to logistic regression analysis, it found that heredofamilial asthma(OR=2. 353, P=0. 001), acute respiratory infection(OR=1. 262, P=0. 004), and history of allergic diseases(OR=5. 527, P=0. 003)were the related factors causing incision infection, and breast feeding(OR=0. 429, P=0. 017)was the protective factor. Conclusion Children with asthma attack causes by many factors. Ac-cording to the relevant factors, we should control and correct the risk factors of children asthma, advocate breast feed-ing. There is a great significance to prevent and control of asthma in children.%目的 对照分析儿童哮喘急性发作的危险因素,为临床诊治提供依据.方法 选择支气管哮喘患儿137例作为观察组与同期门诊113例健康体检患儿作为对照组,对两组资料进行对比分析,寻找发作的危险因素.结果 对比两组患儿发现哮喘家族史、被动吸烟史、呼吸道感染史、有害气体接触史、母乳喂养、过敏性疾病史方面比较,差异有显著统计学意义(P<0.05);Logistic多因素回归分析发现哮喘家族史(OR=2.353,P=0.001)、呼吸道感染史(OR=1.262,P=0.004)、过敏性疾病史(OR=5.527,P=0.003)是小儿支气管哮喘发作的危险因素,而母乳喂养(OR=0.429,P=0.017)是保护性因素.结论 小儿哮喘发作是多因素综合作用的结果,应当根据相关因素采取有针对

  6. Phenotypes and endotypes of severe asthma in children

    Directory of Open Access Journals (Sweden)

    Young Yoo

    2013-05-01

    Full Text Available Severe childhood asthma is a complicated and heterogeneous disorder with distinct phenotypes. Children with severe asthma have more persistent symptoms despite receiving treatment, more atopy, greater airway obstruction, and more air trapping than those with mild-to-moderate asthma. They also have higher morbidity and substantial airflow limitations that persist throughout adulthood. Identification of the phenotype clusters and endotypes of severe asthma can allow further modulation of the natural history of severe asthma and may provide the pathophysiologic rationale for appropriate management strategies.

  7. A Case of Severe Bronchial Asthma Controlled with Tacrolimus

    Directory of Open Access Journals (Sweden)

    Hirokazu Taniguchi

    2011-01-01

    Full Text Available Background. The control of severe bronchial asthma, such as corticosteroid-resistant asthma, is difficult. It is also possible that immunosuppressive agents would be effective for bronchial asthma. Case Summary. A 55-year-old Japanese female presented with severe bronchial asthma controlled with tacrolimus. She had been diagnosed with bronchial asthma during childhood. Her asthma worsened, and a chest radiograph showed atelectasis of the left lung. Bronchoscopy revealed the left main bronchus to be obstructed with viscous sputum consisting of 82% neutrophils and no eosinophils. The atelectasis did not improve with corticosteroid treatment, but was ameliorated by administration of tacrolimus. Discussion. This patient had severe asthma due to neutrophilic inflammation of the airways. Tacrolimus is effective for treating severe asthma, for example, in corticosteroid-resistant cases.

  8. Asthma and endocrine disorders: shared mechanisms and genetic pleiotropy.

    Science.gov (United States)

    Tesse, Riccardina; Schieck, Maximilian; Kabesch, Michael

    2011-02-20

    Asthma is a common inflammatory disease for which the cause is not yet known. Studies of the epidemiology and natural history of childhood asthma into adulthood demonstrate a change in gender prevalence with age. Hormones and inflammation may interact in asthma pathogenesis and determine its course. The same may be true for some endocrine disorders, including diabetes and obesity. Obesity plays a major role in the development of the metabolic syndrome and has been identified as an important risk factor for chronic diseases such as type 2 diabetes mellitus. The prevalence of asthma has paralleled the rise in obesity, suggesting that shared environmental factors could affect both conditions. In addition, endocrine diseases and asthma may share common genetic determinants. In the first part of this review we assess endocrine influences on asthma and overlaps between endocrine disorders and asthma while in the second part we explore the potential benefit of comparative genetic analyses between asthma and endocrine diseases.

  9. 2003 Canadian Asthma Consensus Guidelines Executive Summary

    Directory of Open Access Journals (Sweden)

    Becker Allan

    2006-03-01

    Full Text Available Abstract Background Guidelines for the diagnosis and management of asthma have been published over the last 15 years; however, there has been little focus on issues relating to asthma in childhood. Since the last revision of the 1999 Canadian Asthma Consensus Report, important new studies, particularly in children, have highlighted the need to incorporate new information into the asthma guidelines. The objectives of this article are to review the literature on asthma published between January 2000 and June 2003 and to evaluate the influence of new evidence on the recommendations made in the 1999 Canadian Asthma Consensus Report and its 2001 update, with a major focus on pediatric issues. Methods The diagnosis of asthma in young children and prevention strategies, pharmacotherapy, inhalation devices, immunotherapy, and asthma education were selected for review by small expert resource groups. The reviews were discussed in June 2003 at a meeting under the auspices of the Canadian Network For Asthma Care and the Canadian Thoracic Society. Data published through December 2004 were subsequently reviewed by the individual expert resource groups. Results This report evaluates early-life prevention strategies and focuses on treatment of asthma in children, emphasizing the importance of early diagnosis and preventive therapy, the benefits of additional therapy, and the essential role of asthma education. Conclusion We generally support previous recommendations and focus on new issues, particularly those relevant to children and their families. This document is a guide for asthma management based on the best available published data and the opinion of health care professionals, including asthma experts and educators.

  10. School variation in asthma: compositional or contextual?

    Directory of Open Access Journals (Sweden)

    Tracy K Richmond

    Full Text Available BACKGROUND: Childhood asthma prevalence and morbidity have been shown to vary by neighborhood. Less is known about between-school variation in asthma prevalence and whether it exists beyond what one might expect due to students at higher risk of asthma clustering within different schools. Our objective was to determine whether between-school variation in asthma prevalence exists and if so, if it is related to the differential distribution of individual risk factors for and correlates of asthma or to contextual influences of schools. METHODS: Cross-sectional analysis of 16,640 teens in grades 7-12 in Wave 1 (data collected in 1994-5 of the National Longitudinal Study of Adolescent Health. Outcome was current diagnosis of asthma as reported by respondents' parents. Two-level random effects models were used to assess the contribution of schools to the variance in asthma prevalence before and after controlling for individual attributes. RESULTS: The highest quartile schools had mean asthma prevalence of 21.9% compared to the lowest quartile schools with mean asthma prevalence of 7.1%. In our null model, the school contributed significantly to the variance in asthma (sigma(u0(2 = 0.27, CI: 0.20, 0.35. Controlling for individual, school and neighborhood attributes reduced the between-school variance modestly (sigma(u0(2 = 0.19 CI: 0.13-0.29. CONCLUSION: Significant between-school variation in current asthma prevalence exists even after controlling for the individual, school and neighborhood factors. This provides evidence for school level contextual influences on asthma. Further research is needed to determine potential mechanisms through which schools may influence asthma outcomes.

  11. Maternal smoking in pregnancy and asthma in preschool children

    DEFF Research Database (Denmark)

    Neuman, Åsa; Hohmann, Cynthia; Orsini, Nicola;

    2012-01-01

    Although epidemiological studies suggest that exposure to maternal smoking during fetal and early life increases the risk of childhood wheezing and asthma, previous studies were not able to differentiate the effects of prenatal from postnatal exposure....

  12. Asthma pharmacotherapy.

    Science.gov (United States)

    Schofield, Minka L

    2014-02-01

    Asthma is a chronic inflammatory disease of the airway that leads to airway obstruction via bronchoconstriction, edema, and mucus hypersecretion. The National Asthma Education and Prevention Program has outlined evidence-based guidelines to standardize asthma therapy and improve outcomes. The initial recommendation of choice for persistent asthmatic patients is an inhaled corticosteroid (ICS). Long-acting beta-2 agonists in combination with ICS, oral corticosteroids, leukotriene modifiers, and anti-IgE therapeutic options can be considered for patients with persistent or worsening symptoms. Many novel therapies are being developed, with an emphasis on anti-inflammatory mechanisms, gene expression, and cytokine modification.

  13. Overdiagnosis of asthma in children in primary care : A retrospective analysis

    NARCIS (Netherlands)

    Looijmans-Van Den Akker, I.; Van Luijn, K. R S; Verheij, T. J M

    2016-01-01

    Background Asthma is one of the most common chronic diseases in childhood. According to guidelines, a diagnosis of asthma should be confirmed using lung function testing in children aged >6 years. Previous studies indicate that asthma in children is probably overdiagnosed. However, the extent has no

  14. Factors associated with asthma among under-fives in Mulago hospital, Kampala Uganda

    DEFF Research Database (Denmark)

    Nantanda, Rebecca; Ostergaard, Marianne S; Ndeezi, Grace;

    2013-01-01

    Asthma is the most common chronic childhood illness, with rapidly increasing prevalence in low-income countries. Among young children, asthma is often under-diagnosed.We investigated the factors associated with asthma among under-fives presenting with acute respiratory symptoms at Mulago hospital...

  15. Recognition and management of asthma in children and young people.

    Science.gov (United States)

    Pinfield, Jenny; Gaskin, Kerry; Bentley, Jackie; Rouse, Jo

    2015-09-16

    Asthma is a common childhood disorder that has global significance. Developing an understanding of the aetiology, effects, diagnosis and management of the disorder enables healthcare practitioners to reduce the physical, psychological and social effects of asthma on children, families and healthcare systems. This article refers to the Scottish Intercollegiate Guidelines Network and British Thoracic Society guideline on the management of asthma, and enables the reader to incorporate this guidance into their practice.

  16. Child-parent shared decision making about asthma management.

    OpenAIRE

    Garnett, V; Smith, J; Ormandy, P

    2016-01-01

    Aim To explore and describe child-parent shared decision making for the management of childhood asthma. Methods A qualitative, descriptive, interview-based study was undertaken. Eight children and nine parents participated. The framework approach underpinned data analysis. Findings A dynamic model of the way children and parents transfer, shift and share asthma management decisions was uncovered. Asthma management decisions between children and parents were non-linear, with responsibility tra...

  17. Exercise and Asthma

    Science.gov (United States)

    ... Español Text Size Email Print Share Exercise and Asthma Page Content Article Body Almost every child (and ... of Pediatrics about asthma and exercise. What is asthma Asthma is the most common chronic medical problem ...

  18. Asthma and Hispanic Americans

    Science.gov (United States)

    ... and Data > Minority Population Profiles > Hispanic/Latino > Asthma Asthma and Hispanic Americans In 2014, 2.1 million Hispanics reported that they currently have asthma. Puerto Rican Americans have almost twice the asthma ...

  19. Antibiotic use during pregnancy and asthma in preschool children : the influence of confounding

    NARCIS (Netherlands)

    Mulder, B; Pouwels, K B; Schuiling-Veninga, C C M; Bos, Jens; De Vries, T. W.; Jick, S S; Hak, E

    2016-01-01

    BACKGROUND: A recent study suggested that early-life intestinal microbiota may play an important role in the development of childhood asthma,indicating that antibiotics taken during early life or in late pregnancy may be associated with childhood asthma. OBJECTIVE: This study aims to assess the asso

  20. 中重度持续性哮喘儿童吸入ICS减量停药的随访研究%The follow-up study of stepping down inhaled corticosteroids in childhood asthma

    Institute of Scientific and Technical Information of China (English)

    孙丽红; 陈爱欢; 张艺; 肖雪葵; 余颖华

    2009-01-01

    Objective To explore the course of inhaled corticosteroids (ICS) in moderate to severe childhood asthma, assess the possibility of successful withdrawal of ICS following a good control. Methods There 84 children (5~12 years old) with moderate to severe asthma were allocated to receive budesenide dry power 400μg/d or 600μg/d, depending on the age,once achieved asthma control for a period,ICS reduced 50% to a maintenance level,later the dosage was reduced by 50~100μg at intervals of 3 months,then followed by 24 months. Results The initial period on a high dose was 5.7 months (4~10 months) ,the mean total duration of treatment was 26.4 months (20~39 months). of the 62 children who successfully withdrawaled, 51 (82.3%) remained well, 9(14.5%) had mild episodes of wheezing, 2 (3.2%) had troublesome recurrences. Numbers (%) of patients with asthma exacerations and related events as visit to emergency department ,absece from school, admission to hospital are all lower than pretherapy (x2=58.899,73.255,94.891,4.2799; P<0.001 or P<0.05). Conclusion Children with asthma who require moderate to high dosage ICS once achieving good control for more than 3 months,ICS can be reduced by 50%. It is possible to withdraw ICS in a significant proportion asthmatic children who has been on a maintence dose for a considerable period.%目的 观察中重度持续性哮喘儿童吸入糖皮质激素(ICS)的疗程,哮喘达到良好控制后ICS成功减停的可行性.方法 将76例年龄(8.8±2.6)岁的中重度哮喘患儿,依年龄吸入布地奈德干粉刺起始剂量为400μg/d或600μg/d,达到哮喘控制3个月以上,ICS减少50%剂量维持治疗后,每3个月减少50~100μg,停药后进行24个月的随访.结果 初始高剂量时间平均为5.7月(4~10月),总的疗程平均为26.4月(20~39月).成功减停激素的患儿有62例(90%),其中51例(82.3%)控制良好,9例(14.5%)有轻度喘息发作用,2例(3.2%)病人反复发作.治疗后发生哮喘恶化事

  1. A NATIONAL POLICY ON ASTHMA MANAGEMENT FOR SCHOOLS

    NARCIS (Netherlands)

    MELLIS, CM; BOWES, G; HENRY, RL; MITCHELL, CA; PHELAN, PD; SHAH, S; SHAROTA, L; STAUGAS, R; SLY, PD; YOUNG, L

    1994-01-01

    Since asthma is the most common chronic illness in childhood, many of the problems associated with this condition will impact on the child's education. Because of widespread concerns regarding the management of asthma in schools, a subcommittee of the Thoracic Society of Australia and New Zealand, A

  2. Occupational Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  3. Asthma Quiz

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  4. 东莞地区儿童哮喘社区干预模式的建立与效果评价%Establishment and effect evaluation of childhood asthma community intervention model in Dongguan area

    Institute of Scientific and Technical Information of China (English)

    范雪金; 彭琪; 陆小梅; 赖茂; 陈秀英; 黎四平; 李文瑞; 马可泽; 何晓光

    2014-01-01

    Objective To establish a set of childhood asthma community intervention model suitable for Dongguan area which can improve the cognitive level and prevention ability of the children and their parents,reduce the incidence rate of childhood asthma in community.Methods Through the establishment of community residents dynamic files,68 cases of bronchial asthma children were collected in our study.Systematic community intervention were implemented into the children and their parents,including the establishment of personal health records,supervising children with asthma reasonable and standardized medication,establishing asthmatic children daily record card,establishing community asthma control panel to give health education,regular follow-up and evaluating effect of intervention.Results After one-year systematic community intervention,the cognitive level to asthma knowledge of parents had been significantly improved,the standardized treatment rate reached to 86.3% from 68.2%,annual average times of emergency treatment per capita reduced to 1.5 ± 0.2 from 3.2 ± 0.4,annual average incidence per capita reduced to 2.0 ± 0.4 from 4.5 ± 0.8,annual average hospital stays per capita reduced to (5.0 ± 1.6) days from (8.0 ± 2.8) days,and the average hospitalization expenses reduced to (1 554 ± 30.9) yuan from (2 698 ± 20.2) yuan.There were significant differences of all these indexes between before and after community intervention (P < 0.05).Conclusion The implementation of community intervention on children with asthma and long-term monitoring,management and education can effectively control the disease of acute attack,which also can improve the treatment efficiency,alleviate the condition and reduce the medical cost.%目的 建立一套适合东莞地区的儿童哮喘社区干预模式以提高哮喘患儿及家长的认知水平和防治能力,降低社区儿童的哮喘发病率.方法 通过建立社区居民动态档案,经调查访问收集68例支气管哮

  5. Recognizing asthma mimics and asthma complications.

    Science.gov (United States)

    Amundson, Dennis; Seda, Gilbert; Daheshia, Massoud

    2011-10-01

    Asthma is a chronic inflammatory disorder of the airways characterized by airflow obstruction, bronchial hyperreactivity, and underlying inflammation. Two common reasons asthmatics fail standard therapy are incorrect diagnosis and failure to recognize underlying contributing factors. A correct diagnosis of asthma is of great importance to military practitioners since misdiagnosis or uncontrolled asthma affects an individual's operational readiness or determines whether one can receive a medical waiver to enlist in military service. This article presents four cases of patients with dyspnea that have conditions which mimic asthma or complicate asthma management: vocal cord dysfunction misdiagnosed as asthma, respiratory bronchiolitis interstitial lung disease mistaken as asthma, difficult-to-control asthma because of bronchiectasis and allergic bronchopulmonary aspergillosis, and difficult and fatal asthma. Asthma is contrasted to other respiratory disorders, and an outlined approach to asthma diagnosis and management is presented using the Global Initiative for Asthma guidelines.

  6. Arginase 1 and arginase 2 variations associate with asthma, asthma severity and beta(2) agonist and steroid response

    NARCIS (Netherlands)

    Vonk, Judith M.; Postma, Dirkje S.; Maarsingh, Harm; Bruinenberg, Marcel; Koppelman, Gerard H.; Meurs, Herman

    2010-01-01

    Rationale Arginase probably plays an important role in asthma development, severity and progression. Polymorphisms in arginase 1 and arginase 2 genes have been associated with childhood asthma and FEV1 reversibility to beta(2) agonists. Objectives We investigated the association between arginase 1 a

  7. Observation on the Effect of Freeing Lung and Relieving Asthma and Ex_pelling Wind and Removing Toxicity Regimen on Childhood Asthma with Eczema During Chronic Persistent Period%宣肺平喘、祛风解毒法治疗小儿哮喘慢性持续期伴湿疹的疗效观察

    Institute of Scientific and Technical Information of China (English)

    李明忠

    2014-01-01

    目的:对宣肺平喘、祛风解毒法治疗小儿哮喘慢性持续期伴湿疹的疗效进行分析°方法资料随机选自2011年1月—2012年12月该院收治的哮喘合并湿疹患儿68例,采用数字分析法,将其平均分为两组,研究组和对照组,每组34例°给予对照组患儿吸入治疗+抗组胺药+外用激素治疗,给予研究组患儿吸入治疗+中药治疗,并对两组临床资料进行回顾性分析°结果对照组采用吸入治疗+抗组胺药+外用激素治疗,研究组采用吸入治疗+中药治疗;经治疗,研究组总有效率为94.12%,对照组总有效率为79.41%,研究组总有效率明显优于对照组总有效率,组间比较差异显著,差异有统计学意义(P<0.05﹚°结论给予哮喘合并湿疹患儿吸入治疗+中药治疗的效果较为显著,不仅能够有效的抑制患儿并发症的发生,而且还能够缓解患儿由于西医治疗而带来的疼痛,进而提高患儿的生活质量以及治疗的有效率,值得在临床中推广和应用°%Objective To analyze the effect of freeing lung and relieving asthma and expelling wind and removing toxicity regimen on childhood asthma with eczema during chronic persistent period. Methods The data of 68 children with asthma and eczema ad_mitted to our hospital from January 2011 to December 2012 were randomly selected. And the children were equally divided into two groups, the study group and the control group, with 34 children in each according to the digital analysis method. Children in the control group were treated by inhalation therapy, antihistamine drug and hormone for external use, and the children in the study group were treated by inhalation therapy and traditional Chinese medicine. And the clinical data of the two groups were ana_lyzed retrospectively. Results The control group were treated by inhalation therapy, antihistamine drug and hormone for external use, and the study group were treated by

  8. Single nucleotide polymorphisms in ORMDL3 gene impact on childhood asthma%支气管哮喘患儿ORMDL3基因单核苷酸多态性对其发病的影响

    Institute of Scientific and Technical Information of China (English)

    王桂兰; 王冰洁; 陈德晖; 王文祥; 黄娟; 容嘉妍; 刘翔腾; 姚苗苗; 杨赛

    2015-01-01

    Objective To examine the single nucleotide polymorphisms in ORMDL3 gene impact on childhood asthma in Guangdong Chinese population.Methods A multicenter,large sample,prospective case-control study was conducted.A total of 598 cases of Guangdong cadastral children (300 cases in asthmatic group and 298 cases in control group) were selected.Using univariate Logistic regression analysis was adopted to analyze the association between ORMDL3 gene SNP rs12603332 CC and the risk factors related to age,gender,family history,atopic history of physique,respiratory virus infection,suction sensitization,and food sensitization.Multifactor Logistic regression analysis was selected to analyze the interactive effect between ORMDL3 gene and the risk factors for childhood asthma.Results ORMDL3 gene SNP rs12603332 CC genotype was significantly associated with family history(P =0.007,OR =1.845,95 % CI 1.178-2.889) and respiratory virus infection (P =0.007,OR =1.976,95 % CI 1.206-3.235).ORMDL3 gene SNP rs12603332 CC genotype,CT genotype and TT genotype had interactive effect with family history [OR =22.644 (95 % CI 9.390-54.606),OR =33.500 (95 % CI 7.839-143.157),and OR =11.167 (95 % CI 1.319-94.559)].ORMDL3 gene SNP rs12603332 CC genotype,CT genotype and TT genotype had interactive effect with respiratory virus infection [OR =32.476 (95 % CI 9.875-106.805),OR =12.667 (95 % CI 3.699-43.375),and OR =7.917(95% CI0.909-68.945)].Conclusions ORMDL3 gene SNP rs12603332 CC genotype indicates a high frequency in asthmatic children.The children who have ORMDL3 gene SNP rs12603332 CC genotype are easily attacked by respiratory virus.Compared with other asthma risk factors,SNP rs12603332 and family history of asthma or SNP rs12603332 and respiratory virus infection are more likely to have childhood asthma in Guangdong population.%目的 探讨广东地区支气管哮喘患儿ORMDL3基因单核苷酸多态性(SNP)对其发病的影响.方法 采用多中心、大样本、前瞻性

  9. Asthma consultations with specialists: what do the pediatricians seek?

    Science.gov (United States)

    Poowuttikul, Pavadee; Kamat, Deepak; Thomas, Ronald; Pansare, Milind

    2011-01-01

    "Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma" includes guidelines for referral to an asthma specialist. Because most cases of asthma are managed by primary care physicians, we intended to explore the referral practices of pediatricians managing childhood asthma. This study was designed to identify important considerations by pediatricians while referring a child to an asthma specialist. An electronic survey was sent to 1200 graduated pediatricians enlisted in the Michigan Chapter, American Academy of Pediatrics directory. The questions explored asthma disease characteristics, physician preferences when referring children with asthma, and reasons and barriers for asthma consultations. All responses were collected anonymously. We received 240/1200 (20%) questionnaires. The majority of pediatricians considered referral to a specialist if a child had severe persistent asthma (201/236 [85.2%]) or had a single life-threatening asthma event (188/229 [82.1%]). The top two likely reasons of referral included poor asthma control (200/224 [89.3%]) and unclear diagnosis (139/224 [62.1%]). We found 74/219 (33.8%) preferred consultation to a pediatric pulmonologist when compared with 93/219 (42.5%) allergists. We found the minority of pediatricians "always" recommended referral to a specialist for the following reasons: allergy skin testing (30/222 [13.5%]), possible allergen immunotherapy (54/223 [24.2%]), and spirometry (26/221 [11.8%]). The major barrier for childhood asthma specialist consultations was issues with medical insurance coverage (137/205 [66.8%]). Allergists have to educate primary care providers about the importance of allergen control, role of allergen immunotherapy, and updating current asthma treatment guidelines when treating a child with allergic asthma.

  10. Clinical value of exhaled nitric oxide in childhood asthma%呼出气一氧化氮在儿童哮喘中的临床价值

    Institute of Scientific and Technical Information of China (English)

    干欣欣

    2012-01-01

    Allergic asthma is a chronic obstructive disease of the airways characterized by airway hyperresponsiveness,inflammation and remodeling.Exhaled nitric oxide (eNO) level is highly correlated with eosinophilic airway inflammation.Since the advantage of noninvasion,convenience,and specificity of eNO measurement,it has been widely used as a biomarker.In this article eNO metabolism and its effects on airway physiology and pathophysiology are described.The usefulness of eNO in asthma diagnosis and management is discussed in detail.%哮喘是一种气道慢性炎症性疾病,已成为儿童中最常见的慢性疾病之一.临床上对哮喘的诊断及治疗主要依据临床表现及肺功能,但两者并不能反映气道炎症.呼出气一氧化氮(exhaled nitric oxide,eNO)作为气道炎症的标志物,与气道炎症有显著相关性.eNO检测方法具有无创、简单、方便、特异性好等优点,在临床应用方面具有明显优势.该文介绍了NO在气道中的代谢及其作用,并从哮喘的诊断及鉴别诊断、哮喘管理方面阐述eNO检测在儿童哮喘临床应用中的研究进展.

  11. 334 Asthma in the Elderly: A Mexican Point of View

    OpenAIRE

    2012-01-01

    Background Asthma has been considered as mainly a childhood disease, however, 4 to 8% of the aged population suffer from it. In the National Institute of Respiratory Diseases (Instituto Nacional de Enfermedades Respiratorias, INER) Asthma's Clinic, in the year 2010, 1056 medical attention appointments were attended for patients of this group of age, representing 12.7% of total medical consults for asthma. In this study we describing the characteristics of elderly patients with asthma of INER'...

  12. METABOLIC ASTHMA: IS THERE A LINK BETWEEN OBESITY, DIABETES AND ASTHMA?

    OpenAIRE

    2014-01-01

    Childhood asthma and obesity have reached epidemic proportions worldwide, and the latter is also contributing to increasing rates of related metabolic disorders like diabetes. Yet, the relationship between asthma, obesity, and abnormal metabolism is not well understood, nor has it been adequately explored in children. This article discusses the concept of “metabolic asthma” and the recent hypothesis that early derangement in lipid and glucose metabolism is independently associated to increase...

  13. Helicobacter Pylori Infection and Pediatric Asthma

    Directory of Open Access Journals (Sweden)

    Abdullah Karimi

    2013-06-01

    Full Text Available Objective: Childhood infectious diseases are one of the most known environmental pathogenic causesof childhood asthma. The high prevalence of both Helicobacter pylori infection and asthma in our country prompted us to assess anyprobable association between them in childhood.Methods: This cross-sectionalstudy recruited 196 children aged 6 to 12 years old comprising 98 asthmatic (case group and 98 healthy (control group individuals. Urea breath test was performed for all of the children and H. pyloriinfection was compared between the two groups according to the urea breath test results.Results:Urea breath test was positive in 18 asthmatic (18.36 and 23 (23.36 healthy subjects but was not significantly different between the case and controls(p=0.380.Furtheranalysis in the asthmatic group revealed association ofH. pyloriinfection withage (p<0.001 and duration of asthma (p=0.010. However, no significant correlation was found between sex, severity of asthma, controledasthma or abnormal pulmonary function testswith H. pyloriinfection (p= 0.804, 0.512 ,0.854 and 0.292, respectively.Conclusion:Given the results of the study, H. pylori infection was not significantly differentbetween asthmatic and healthy children.In asthmatic patients, there wasnosignificant association between H.pyloriinfection andsex,severity of disease, control status of disease andnormal or abnormal pulmonary function tests.H. Pylori infection had a significant association withincreasing age and duration of asthma.

  14. Bronchial asthma

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    2008049 Activation ralated genes of memory CD+4 T cells in asthma patients. PI Weifeng(皮卫峰),et al. Dept Respir Med, Xinhua Hosp, Sch Med, Shanghai Jiaotong Univ, Shanghai 200092. Chin J Tuberc Respir Dis 2007;30(12):932-935. Objective To screen and identify the genes of activated memory CD+4 T cells in asthma. Methods Differential display polymerase chain reaction(DDPCR) was utilized to identify genes of memory CD+4 T cells after activation from asthmatic patients and normal individuals,

  15. President Calvin Coolidge's asthma and modern management of asthma patients in the dental setting.

    Science.gov (United States)

    Maloney, William James; Maloney, Maura P

    2012-03-01

    Asthma affects millions of individuals worldwide. President Calvin Coolidge was one of these individuals. Coolidge suffered from asthma since childhood. It affected his outlook toward aggressive physical activity and was a strong factor in shaping his personality and, eventually, his politics. He was devoted to the status quo in American business enterprises and was known for his reserved personality and conservative political beliefs. One can speculate as to what role his passive personality, developed as a direct and conscious result of his desire for physical self-preservation in light of his asthma, played in leading the United States to the brink of the Great Depression. Dentists encounter individuals with asthma in their private practices daily. It is imperative that all dentists be aware of the symptoms of asthma, its many orofacial manifestations and possible modifications to dental treatment.

  16. Comparison of clinically diagnosed asthma with parental assessment of children's asthma in a questionnaire

    DEFF Research Database (Denmark)

    Hederos, C.A.; Hasselgren, M.; Hedlin, G.;

    2007-01-01

    Epidemiological evaluations of the prevalence of asthma are usually based on written questionnaires (WQs) in combination with validation by clinical investigation. In the present investigation, we compared parental assessment of asthma among their preschool children in response to a WQ...... with the corresponding medical records in the same region. An International Study of Asthma and Allergies in Childhood (ISAAC)-based WQ was answered by 75% of the parents of 6295 children aged 1-6 yr. Clinically diagnosed asthma, recorded in connection with admissions to the hospital or a visit to any of the outpatient...... clinics in the same region, were analysed in parallel. Finally, a complementary WQ was sent to the parents of children identified as asthmatic by either or both of this approaches. In response to the WQ 5.9% were claimed to suffer from asthma diagnosed by a doctor. According to the medical records...

  17. Does using an asthma prompting form improve asthma care in a pediatric office?

    Science.gov (United States)

    Pile, Debra

    2013-01-01

    An asthma exacerbation can be a life-threatening experience. This project tested the effectiveness of using a prompting form to improve childhood asthma care. Thirty randomly selected charts without a prompt form in a pediatric practice were compared for differences with thirty randomly selected charts with a completed prompting form. The number of medications reviewed (p=.001) and the frequency of refills written (p=.024) were significantly higher in the prompt group. Education was higher (p=.000) and triggers were more frequently discussed in the prompt group. The use of a prompting form facilitates discussion and improves preventive asthma care.

  18. Occupational Medicine Model and Asthma Military Recruitment.

    Science.gov (United States)

    Brooks, Stuart M

    2015-11-01

    Medical evidence hints that asymptomatic recruits with a history of childhood asthma, quiescent since their 13th birthday, are still at risk for adverse changes in their clinical status following unfavorable environmental exposures during military deployment or combat. Asthmatic persons, claiming none or few symptoms, may still manifest airflow obstruction and display biomarkers of airway inflammation even when they are relatively asymptomatic and experience few if any respiratory complaints. The occupational medicine model offers a credible foundation for acknowledging the importance of personal susceptibility in the pathogenesis of military-associated asthma. It is appropriate to re-explore the current military standard for recruits with asymptomatic childhood asthma (≥12 months) not prescribed antiasthma medications. Raising the acceptance age for these recruits may be a consideration. Unfortunately, there is no effectual screening test that recognizes such susceptible soldiers at risk for future asthma attacks. Nevertheless, there is general support for evidence-based, scientifically valid medical screening that judges fitness for military service. Screening tests comprising asthma biomarkers and genetic indices may better verify vulnerable soldiers destined to suffer future asthma reactivation.

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

    Directory of Open Access Journals (Sweden)

    Serap Balci

    2010-02-01

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

  20. Inhaled sodium cromoglycate for asthma in children

    NARCIS (Netherlands)

    van der Wouden, Johannes C.; Uijen, Johannes H. J. M.; Bernsen, Roos M. D.; Tasche, Marjolein J. A.; de Jongste, Johan C.; Ducharme, Francine

    2008-01-01

    Background Sodium cromoglycate has been recommended as maintenance treatment for childhood asthma for many years. Its use has decreased since 1990, when inhaled corticosteroids became popular, but it is still used in many countries. Objectives To determine the efficacy of sodium cromoglycate compare

  1. 《儿童哮喘管理和预防指南》介绍%The introduce of Pocket Guide for Asthma Management and Prevention in childhood

    Institute of Scientific and Technical Information of China (English)

    陈育智

    2003-01-01

    @@ 1994年在美国国立卫生研究院心、肺、血液研究所与世界卫生组织共同努力下,共有17个国家50多名专家组成专家组制定哮喘管理和预防的全球策略,并出版(即 Global Intinative for Asthma,简称GINA)的系列丛书,包括及,并于2002年再次修订.尽管儿童哮喘与成人哮喘有共同的病理生理基础,但由于儿童处于生长发育阶段,哮喘对其产生的影响及治疗中的效果和副作用与成人有所不同,故于2002年出版.以上系列丛书均已有中文译本,为临床医生提供哮喘管理方案,并可根据各地不同情况因地制宜的使用.

  2. 呼出气一氧化氮在儿童哮喘和肺炎中的水平及意义%The Levels and Significance of FeNO in Childhood Asthma and Pneumonia

    Institute of Scientific and Technical Information of China (English)

    张倩; 孙中厚; 郑晓静; 曾彩霞; 唐晓迪; 武帆

    2014-01-01

    Objective To investigate the levels of Fractional Exhaled Nitric Oxide ( FeNO) in childhood asthma and pneumonia and the relationship with peripheral blood eosinophils ( EOS) and the forced expiratory volume in one second/predicted value ratio ( FEVl%) . Methods Sixty-two children with asthma ( 33 exacerbation patients and 29 remittent patients ) and 21 children with bronchial pneumonia were collected from July to December in 2013 in the Affiliated Hospital of Weifang Medical University ,21 healthy children as control group . FeNO,EOS and FEV1 levels were measured in these three groups and statistically analysed .Results ①The levels of FeNO and EOS in ex-acerbation group were higher than those in remittent group and control group ,FEV1 levels were less than those in remittent group and control group(P0.05).③The levels of FeNO,EOS and FEV1 between the control group and the pneumonia group had no statistical significance (P>0.05).④In asthma group,the FeNO level was positively correlated with the EOS(r=0.68,P0.05,the EOS level and FEV1 had no obvious correlation(r=-0.04,P>0.05).⑤In children with asthma,the positive rates of FeNO,EOS and FEV1 were 82.26%,62.90%and 41.94%(χ2 =21.49,P<0.05).Conclusion FeNO has a good correlation with the EOS in patients with asthma ,and the FeNO level can reflect the eosinophil inflammation in airway of asthma patients ,but its sensitivity is higher than EOS .FeNO and EOS can be used to help identify allergic inflammation and common infections in clinical practice .%目的:探讨儿童哮喘及肺炎呼出气一氧化氮( FeNO)水平及其与外周血嗜酸性粒细胞( EOS)和第1秒用力呼出气量占预计值百分比( FEV1%)的相关性。方法选择2013年7月~2013年12月收治的哮喘患儿共62例。其中,急性发作期患儿33例,缓解期患儿29例。同时收集肺炎患儿21例,健康对照组21例;哮喘组、肺炎组及对照组分别测定FeNO,EOS及FEV1水平并进行统计学

  3. [Severe asthma].

    Science.gov (United States)

    González, Claudio D

    2016-01-01

    The objectives of this work were to investigate the frequency of severe asthma (SA) according to WHO definition and to compare SA patients' characteristics with those of non-severe asthma (NSA); secondly, to investigate the level of control reached throughout a period of regular treatment. Between 1-1-2005 and 12-31-2014, 471 medical records from patients with bronchial asthma assisted in Buenos Aires City were analyzed. SA frequency was 40.1% (189/471), being significantly higher among patients from the public health system (47.7%, 108/226 vs. 33%, 81/245, p = 0.001). SA patients were older than NSA ones (51.3 ± 17.4 vs. 42.6 ± 17.1 years, p = 0.000), presented longer time since onset of the disease (median 30 vs. 20 years, p = 0.000), lower educational levels (secondary level or higher 41.7% vs. 58.1%, p = 0.000), lower frequency of rhinitis (47% vs. 60.6%, p = 0.004), more severe levels of airway obstruction (FEV% 50.2 ± 13.7 vs. 77.7 ± 12.4, p = 0.000), more frequent antecedents of Near Fatal Asthma (11.1% vs. 2.8%, p = 0.000), higher levels of serum IgE (median of 410 vs. 279 UI/l, p = 0.01) and higher demand of systemic steroids requirements and hospitalizations (68.7% vs. 50.7%, p = 0.000 and 37.5% vs. 15.9%, p = 0.000, respectively). A 30.6% of SA patients (58/189) reached a follow-up period of 12 months, 13 (22.5%) of whom reached the controlled asthma level. The frequency of SA found seems to be considerable. Multicenter studies to investigate the levels of control reached by SA patients with access to proper treatment are recommended.

  4. Social Inequalities in Young Children’s Lifestyle Behaviors and Childhood Overweight : The Generation R Study

    NARCIS (Netherlands)

    A.I. Wijtzes (Anne)

    2015-01-01

    markdownabstract__Abstract__ Childhood overweight and obesity is a major public health concern. Adverse health and psychosocial outcomes associated with childhood overweight include elevated blood pressure and hypertension, type 2 diabetes, asthma, sleeping disorders, low self-esteem, and decreased

  5. Asthma Hospitalization Rates among Children, and School Building Conditions, by New York State School Districts, 1991-2001

    Science.gov (United States)

    Belanger, Erin; Kielb, Christine; Lin, Shao

    2006-01-01

    School-age children spend a significant portion of their day at school where they can be exposed to asthma triggers, but little information exists regarding potential relationships between childhood asthma and school environmental factors. This study examined patterns of asthma hospitalization and possible factors contributing to asthma…

  6. Children developing asthma by school-age display aberrant immune responses to pathogenic airway bacteria as infants

    DEFF Research Database (Denmark)

    Larsen, Jeppe Madura; Pedersen, Susanne Brix; Thysen, Anna Hammerich;

    2014-01-01

    Asthma is a highly prevalent chronic lung disease that commonly originates in early childhood. Colonisation of neonatal airways with the pathogenic bacterial strains H. influenzae, M. catarrhalis and S. pneumoniae is associated with increased risk of later childhood asthma. We hypothesized...

  7. Allergies, asthma, and dust

    Science.gov (United States)

    Reactive airway disease - dust; Bronchial asthma - dust; Triggers - dust ... Things that make allergies or asthma worse are called triggers. Dust is a common trigger. When your asthma or allergies become worse due to dust, you are ...

  8. Allergies, asthma, and molds

    Science.gov (United States)

    Reactive airway - mold; Bronchial asthma - mold; Triggers - mold; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. Mold is a common trigger. When your asthma or allergies become worse due to mold, you are ...

  9. Asthma: Basic Information

    Science.gov (United States)

    ... Air Pollution & Respiratory Health Learn How to Control Asthma Language: English Español (Spanish) Recommend on Facebook Tweet ... Treated? Select a Language Español (Spanish) What Is Asthma? Asthma is a disease that affects your lungs. ...

  10. Asthma in Children

    Science.gov (United States)

    ... have asthma. Nearly 9 million of them are children. Children have smaller airways than adults, which makes asthma especially serious for them. Children with asthma may experience wheezing, coughing, chest tightness, ...

  11. Asthma triggers (image)

    Science.gov (United States)

    ... things make your asthma worse. These are called asthma "triggers". Avoiding them is your first step toward feeling better. The most common asthma triggers are mold, pets, dust, grasses, pollen, cockroaches, odors ...

  12. Prevalência de sintomas de asma, rinite e eczema atópico entre crianças e adolescentes brasileiros identificados pelo International Study of Asthma and Allergies (ISAAC: fase 3 Prevalence of symptoms of asthma, rhinitis, and atopic eczema among Brazilian children and adolescents identified by the International Study of Asthma and Allergies in Childhood (ISAAC: phase 3

    Directory of Open Access Journals (Sweden)

    Dirceu Solé

    2006-10-01

    Full Text Available OBJETIVO: Determinar a prevalência de sintomas relacionados à asma, rinite e eczema atópico em escolares (EC entre 6 e 7 anos e adolescentes (AD entre 13 e 14 anos, residentes em 20 cidades brasileiras, empregando o questionário escrito padronizado do ISAAC, e avaliar a sua associação com a latitude, altitude e temperatura média anual dos centros de residência. MÉTODOS: Participaram do estudo EC e AD das cinco regiões do Brasil, totalizando 23.422 questionários ISAAC respondidos pelos pais de EC e 58.144 pelos próprios AD. Os índices de latitude, altitude e temperatura média anual foram obtidos do Instituto Brasileiro de Geografia e Estatística. RESULTADOS: As prevalências médias para os EC e AD, respectivamente, foram: asma ativa, 24,3 e 19,0%; rinoconjuntivite, 12,6 e 14,6%; e eczema flexural, 8,2 e 5,0%. Associação significante e negativa foi observada entre latitude e prevalência de asma diagnosticada por médico para os EC, asma grave, asma diagnosticada por médico, eczema e eczema flexural para os AD. Não houve associação com a altitude dos centros. CONCLUSÃO: A prevalência de asma, rinite e eczema atópico no Brasil foi variável. Valores mais altos, sobretudo de asma e eczema, foram observados nos centros localizados mais próximos ao Equador.OBJECTIVE: To determine the prevalence of symptoms of asthma, rhinitis, and atopic eczema among schoolchildren aged 6 to 7 years and adolescents aged 13 to 14 years in 20 Brazilian cities by using the standardized ISAAC written questionnaire, and to assess the association of this prevalence with latitude, altitude and average annual temperature of collaborating centers. METHODS: Schoolchildren and adolescents from five Brazilian regions participated in the study, totaling 23,422 ISAAC questionnaires answered by schoolchildren's parents and 58,144 questionnaires answered by adolescents. The values for latitude, altitude and average annual temperature were obtained from the

  13. Asthma essentials

    Directory of Open Access Journals (Sweden)

    Timothy Greene

    2013-12-01

    Full Text Available Asthma is a chronic, reversible obstructive disease that when in exacerbation can present to the emergency department in a spectrum of severity. Prompt recognition of the potentially severely ill asthmatic requires a careful history and physical exam while considering alternative diagnoses for the presenting symptoms. Early administration of salbutamol and corticosteroids is indicated in almost all patients with other medications such as ipratropium and magnesium and supportive modalities like BiPAP reserved for sicker patients. The global impact of asthma is increasing, especially amongst children. While the benign clinical presentation is most common and mortality has decreased in recent decades due to improved recognition and care, the ubiquity of the condition and frequent lack of regular outpatient management contribute to the disease claiming 250,000 lives worldwide annually. The emergency physician must be prepared to assess and appropriately manage both the young child with a mild wheeze and the adult in respiratory failure.

  14. Advances in pediatric asthma in 2011: moving forward.

    Science.gov (United States)

    Szefler, Stanley J

    2012-01-01

    Last year's "Advances in pediatric asthma" concluded with the following statement: "Perhaps new directions in personalized medicine and improved health care access and communication will help maintain steady progress in alleviating the burden of this disease in children, especially young children." This year's summary will focus on recent advances in pediatric asthma that show significant accomplishments in reducing asthma morbidity and mortality over the last 10 years and discuss some pathways to further reduce asthma burden, as indicated in Journal of Allergy and Clinical Immunology publications in 2011. Some of the recent reports continue to shed light on methods to improve asthma management through steps to reduce asthma exacerbations, identify features of the disease in early childhood, alter asthma progression, intervene with nutrition, and more effectively implement the asthma guidelines. As new information evolves, it is also time to consider a revision of the asthma guidelines based on key studies that affect our management of the disease since the last revision in 2007. Now is also the time to use information recorded in electronic medical records to develop innovative disease management plans that will track asthma over time and enable timely decisions on interventions to maintain control that can lead to disease remission and prevention.

  15. Understanding the origin of asthma and its relationship to breastfeeding.

    Science.gov (United States)

    Wills-Karp, Marsha; Brandt, Dominique; Morrow, Ardythe L

    2004-01-01

    Asthma is a chronic disease of the lung that has been increasing at an alarming rate in industrialized countries around the world over the last few decades. Although considerable progress has been made in our understanding of the underlying pathogenesis of the disease, the exact causes of the increasing prevalence are unknown. Studies suggest that most asthma develops in early childhood and that environmental factors present early in life may be crucial in the development of disease. One potential explanation for the recent epidemic referred to as the "hygiene hypothesis" postulates that factors that have resulted in a reduction in exposure to microbial products and/or infections in the western world may be contributing to this rise in disease prevalence. As early life influences are known to play an important role in establishment of asthma, studies have focused on the interface between mother and child that occurs during gestation and through breastfeeding. In this regard, the body of evidence regarding the relationship between breastfeeding and asthma indicates benefit but with the potential for risk. While providing population-level protection from infections and atopy in infancy and early childhood, breastfeeding might also pose an increased risk of atopic asthma among children with asthmatic mothers. In order to put this controversy in context, we discuss our current understanding of asthma pathogenesis, current theories on the factors driving the rising prevalence of asthma, and then discuss the potential influence of breastfeeding on asthma pathogenesis.

  16. Temporal asthma patterns using repeated questionnaires over 13 years in a large French cohort of women.

    Directory of Open Access Journals (Sweden)

    Margaux Sanchez

    Full Text Available Variable expression is one aspect of the heterogeneity of asthma. We aimed to define a variable pattern, which is relevant in general health epidemiological cohorts. Our objectives were to assess whether: 1 asthma patterns defined using simple asthma questions through repeated measurements could reflect disease variability 2 these patterns may further be classified according to asthma severity/control. Among 70,428 French women, we used seven questionnaires (1992-2005 and a comprehensive reimbursement database (2004-2009 to define three reliable asthma patterns based on repeated positive answers to the ever asthma attack question: "never asthma" (n = 64,061; "inconsistent" ("yes" followed by "no", n = 3,514; "consistent" (fully consistent positive answers, n = 2,853. The "Inconsistent" pattern was related to both long-term (childhood-onset asthma with remission in adulthood and short-term (reported asthma attack in the last 12 months, associated with asthma medication asthma variability, showing that repeated questions are relevant markers of the variable expression of asthma. Furthermore, in this pattern, the number of positive responses (1992-2005 predicted asthma drug consumption in subsequent years, a marker of disease severity. The "Inconsistent" pattern is a phenotype that may capture the variable expression of asthma. Repeated answers, even to a simple question, are too often neglected.

  17. Responsiveness, longitudinal- and cross-sectional construct validity of the Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in Dutch children with asthma

    NARCIS (Netherlands)

    Raat, H; Bueving, H; de Jongste, J; Grol, MH; Juniper, EF; van der Wouden, JC

    2005-01-01

    Objective: Health-related quality of life is an important measure in evaluations of the management of childhood asthma. In this study, we assessed psychometric properties, responsiveness, and longitudinal and cross-sectional construct validity of the Dutch version of the 23-item Pediatric Asthma Qua

  18. Asthma and obesity

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ali, Zarqa; Nilas, Lisbeth

    2012-01-01

    Obesity is a major health problem, and obesity is associated with a high incidence of asthma and poor asthma control. The aim of the present paper is to systematically review the current knowledge of the effect on overall asthma control of weight reduction in overweight and obese adults with asthma....

  19. TRPV1基因多态性和室内空气污染与儿童哮喘关系的病例对照研究%Relationship between Indoor Air Pollution,TRPV1 Gene 3'-UTR Polymorphism and Childhood Asthma in Beijing,China

    Institute of Scientific and Technical Information of China (English)

    王强; 王桂芳; 白雪涛; 徐东群; 李红; 董小艳; 徐春雨; 王秦; 方建龙; 常君瑞

    2009-01-01

    Objective To study whether TRPV1 polymorphism and indoor air pollutants were interactive risk factors for childhood asthma. Methods Three hundred and twenty-eight subjects aged under 14 years were recruited in the case-control study from Beijing Children's Hospital and Capital Institute of Pediatrics during Sep.2007-Aug. 2008. Sixty-eight subjects with atopic asthma, 109 subjects with nonatopic asthma, and 151 controls were confirmed by International Study of Asthma and Allergies in Childhood questionnaire results. Atopy status was determined by elevated levels of serum total IgE and specific IgE of common aeroallergens. PCR-based assay were performed to test TRPV1 genotypes. Indoor air pollutants, VOCs, PM2.5, formaldehyde and NO_2 in bedrooms and living rooms in 44 families were monitored according to GB/T18883-2002 Indoor Air Quality Standard. T-test, chi-square, and Logistic stepwise analysis were used to test roles of interactions between TRPV1 gene polymorphism and indoor air pollutants on susceptibility of childhood asthma. Multiple Logistic regression was used to adjust for potential confounding factors. Statistical significance was set at 0.05 based on a two-sided calculation. Statistic analysis was performed with SAS 9.1 software. Results Genotypes of SNP rs4790522 and rs4790521 were associated with both atopic and nonatopic childhood asthma (P的检验方法对44户家庭室内空气中PM2.5、甲醛、VOCs及NO2浓度进行监测.采用X~2检验和Logistic逐步回归对室内空气污染物与TRPV1基因多态性的交互作用对儿童哮喘易感性影响进行分析.结果 哮喘儿童及对照儿童SNP rs4790522及rs4790521基因型存在统计学差异(p<0.05);哮喘儿童家庭室内空气中TVOC、苯、甲苯、二甲苯、苯乙烯、十一烷浓度显著高于对照组(P<0.05,P<0.01);室内TVOC浓度与TRPV1基因SNPrs4790522杂合子M/C基因型及ra4790521显性纯合子TT基因型对儿童哮喘影响具有相乘交互作用(P<0

  20. The prevalence survey of 0 ~ 14-year childhood asthma in 2010 in Fuzhou, Fujian%2010年福建省福州地区0~14岁儿童哮喘患病情况调查

    Institute of Scientific and Technical Information of China (English)

    唐素萍; 陈育智; 刘传合; 华云汉; 刘艳琳; 王世彪; 陈燊; 张敏军; 董李; 郭依华; 林东如; 王强

    2012-01-01

    Objective To understand the prevalence, law of incidence and influencing factors of childhood asthma in Fuzhou, Fujian. Methods Totally 12 235 cases of children were chosen to participate in the survey with method of Cluster sampling in Tai jian and Gu lou District in Fuzhou. The survey was conducted by the National Children's Asthma Collaborative Group, who developed a unified program, trained unified investigators and issued a uniform screening questionnaire. The children who were diagnosed on-site as asthma, cough variant asthma and suspected asthma by hospital expert from suspicious patients were asked to fill in the questionnaire. All survey data were input with epi-info software. All survey data through the logic checkment and double audition were analysed by the SAS 9.1 statistical software. Results The total asthma detection rate was 5.52%(including asthma,cough variant asthma and suspected asthma)in the 11 738 cases ,with a response rate of 95.9% in this survey. The asthma prevalence rate was 4.13%,cough variant asthma prevalence rate was 0.73% , and the rate of suspicious asthma prevalence was 0.66%. Two years' prevalence rate was 4.02%.The cases of male asthmatic children were 317(65.0%)and female asthmatic children were 168(35.0%) , with the ratio of male to female being 1.86:1.Conclusion The prevalence of asthma in 0 - 14-year children now is significantly higher than in 1990 and 2000 in Fuzhou, Fujian. The history of allergy gender and family asthma are important risk factors for childhood asthma.%目的 了解福建省福州地区儿童哮喘的患病率、发病规律及影响因素.方法 采取整群抽样的调查方法,在福州市台江区和鼓楼区抽取12235名儿童,由全国儿童哮喘防治协作组统一制定调查方案,统一培训调查人员,发放统一的初筛调查表,筛选出的可疑患者经我院哮喘专家现场确诊的哮喘、咳嗽变异型哮喘及可疑哮喘的患儿填写哮喘调查表.调查数据使用epi

  1. Asthma exacerbation in children: a practical review.

    Science.gov (United States)

    Fu, Lin-Shien; Tsai, Ming-Chin

    2014-04-01

    Asthma is the most common chronic lower respiratory tract disease in childhood throughout the world. Despite advances in asthma management, acute exacerbations continue to be a major problem in patients and they result in a considerable burden on direct/indirect health care providers. A severe exacerbation occurring within 1 year is an independent risk factor. Respiratory tract viruses have emerged as the most frequent triggers of exacerbations in children. It is becoming increasingly clear that interactions may exist between viruses and other triggers, increasing the likelihood of an exacerbation. In this study, we provide an overview of current knowledge about asthma exacerbations, including its definition, impact on health care providers, and associated factors. Prevention management in intermittent asthma as well as intermittent wheeze in pre-school children and those with persistent asthma are discussed. Our review findings support the importance of controlling persistent asthma, as indicated in current guidelines. In addition, we found that early episodic intervention appeared to be crucial in preventing severe attacks and future exacerbations. Besides the use of medication, timely education after an exacerbation along with a comprehensive plan in follow up is also vitally important.

  2. Is Chronic Asthma Associated with Shorter Leukocyte Telomere Length at Midlife?

    Science.gov (United States)

    Shalev, Idan; Sears, Malcolm R.; Hancox, Robert J.; Lee Harrington, Hona; Houts, Renate; Moffitt, Terrie E.; Sugden, Karen; Williams, Benjamin; Poulton, Richie; Caspi, Avshalom

    2014-01-01

    Rationale: Asthma is prospectively associated with age-related chronic diseases and mortality, suggesting the hypothesis that asthma may relate to a general, multisystem phenotype of accelerated aging. Objectives: To test whether chronic asthma is associated with a proposed biomarker of accelerated aging, leukocyte telomere length. Methods: Asthma was ascertained prospectively in the Dunedin Multidisciplinary Health and Development Study cohort (n = 1,037) at nine in-person assessments spanning ages 9–38 years. Leukocyte telomere length was measured at ages 26 and 38 years. Asthma was classified as life-course-persistent, childhood-onset not meeting criteria for persistence, and adolescent/adult-onset. We tested associations between asthma and leukocyte telomere length using regression models. We tested for confounding of asthma-leukocyte telomere length associations using covariate adjustment. We tested serum C-reactive protein and white blood cell counts as potential mediators of asthma-leukocyte telomere length associations. Measurements and Main Results: Study members with life-course-persistent asthma had shorter leukocyte telomere length as compared with sex- and age-matched peers with no reported asthma. In contrast, leukocyte telomere length in study members with childhood-onset and adolescent/adult-onset asthma was not different from leukocyte telomere length in peers with no reported asthma. Adjustment for life histories of obesity and smoking did not change results. Study members with life-course-persistent asthma had elevated blood eosinophil counts. Blood eosinophil count mediated 29% of the life-course-persistent asthma-leukocyte telomere length association. Conclusions: Life-course-persistent asthma is related to a proposed biomarker of accelerated aging, possibly via systemic eosinophilic inflammation. Life histories of asthma can inform studies of aging. PMID:24956257

  3. Occupational asthma in Japan

    OpenAIRE

    Dobashi, Kunio

    2012-01-01

    Research into occupational asthma (OA) in Japan has been led by the Japanese Society of Occupational and Environmental Allergy. The first report about allergic OA identified konjac asthma. After that, many kinds of OA have been reported. Cases of some types of OA, such as konjac asthma and sea squirt asthma, have been dramatically reduced by the efforts of medical personnel. Recently, with the development of new technologies, chemical antigen-induced asthma has increased in Japan. Due to adva...

  4. 47 Year Old Patient with Pseudo-Asthma

    Directory of Open Access Journals (Sweden)

    Bulent Altinsoy

    2011-01-01

    Full Text Available 47- year- old female patient presented in out-patient department in Afyon Chest Disease Hospital with dyspnea, cough and purulent sputum. She has been receiving regular inhaler β-agonist and corticosteroids with the diagnosis of asthma bronchial since childhood. However, the patient had a history of very often upper and lower respiratory tract infections. The patient did not smoke, drink alcohol, or use illicit drugs intravenously. She was currently on asthma medications.

  5. Asthma in Urban Children: Epidemiology, Environmental Risk Factors, and the Public Health Domain.

    Science.gov (United States)

    Milligan, Ki Lee; Matsui, Elizabeth; Sharma, Hemant

    2016-04-01

    Asthma is the most commonly reported chronic condition of childhood in developed countries, with 6.5 million children affected in the USA. A disparate burden of childhood asthma is seen among socioeconomically disadvantaged youth, often concentrated in urban areas with high poverty rates. Host factors that predispose a child to asthma include atopy, male gender, parental history of asthma, and also race, ethnicity, and genetic and epigenetic susceptibilities. Environmental factors, such as improved hygiene, ambient air pollution, and early life exposures to microbes and aeroallergens, also influence the development of asthma. With greater than 90% of time spent indoors, home exposures (such as cockroach, rodent, and indoor air pollution) are highly relevant for urban asthma. Morbidity reduction may require focused public health initiatives for environmental intervention in high priority risk groups and the addition of immune modulatory agents in children with poorly controlled disease.

  6. Data-driven asthma endotypes defined from blood biomarker and gene expression data

    Science.gov (United States)

    The diagnosis and treatment of childhood asthma is complicated by its mechanistically distinct subtypes (endotypes) driven by genetic susceptibility and modulating environmental factors. Clinical biomarkers and blood gene expression were collected from a stratified, cross-section...

  7. Obesity and asthma in children: current and future therapeutic options.

    Science.gov (United States)

    Lang, Jason E

    2014-06-01

    With the childhood prevalence of obesity and asthma increasing, it is important for pediatric professionals to appreciate that obesity modifies the diagnosis and management of asthma. These disease modifications present challenges to clinical management, including decreased responsiveness to controller therapy and decreased quality of life compared with normal-weight asthmatic children. While consensus guidelines do not currently suggest specific changes in asthma management for obese patients, management of some patients may be improved with consideration of the latest evidence. This article briefly summarizes what is known regarding the complex relationship between obesity and asthma in children, and discusses practical issues associated with the diagnosis and effective clinical management of asthma in obese children. On average, obese patients with asthma do not respond as well to inhaled corticosteroid therapy. Management approaches including weight loss and routine exercise are safe, and may improve important asthma outcomes. Asthma providers should learn to facilitate weight loss for their obese patients. In addition, pharmacologic interventions for weight loss in obese asthma, though not currently recommended, may soon be considered.

  8. Evaluation of a web-based asthma self-management system: a randomised controlled pilot trial

    OpenAIRE

    2015-01-01

    Background Asthma is the most common chronic condition of childhood and disproportionately affects inner-city minority children. Low rates of asthma preventer medication adherence is a major contributor to poor asthma control in these patients. Web-based methods have potential to improve patient knowledge and medication adherence by providing interactive patient education, monitoring of symptoms and medication use, and by facilitation of communication and teamwork among patients and health ca...

  9. What's an Asthma Action Plan?

    Science.gov (United States)

    ... to 2-Year-Old What's an Asthma Action Plan? KidsHealth > For Parents > What's an Asthma Action Plan? ... normal everyday activities without having asthma symptoms. Action Plans Are Unique Each person's experience with asthma is ...

  10. Stay away from asthma triggers

    Science.gov (United States)

    Asthma triggers - stay away from; Asthma triggers - avoiding; Reactive airway disease - triggers; Bronchial asthma - triggers ... to them. Have someone who does not have asthma cut the grass, or wear a facemask if ...

  11. Obesity and Asthma

    DEFF Research Database (Denmark)

    Juel, Caroline Trunk-Black; Ulrik, Charlotte Suppli

    2013-01-01

    Asthma is more prevalent in obese compared with normal weight subjects. Our aim has been to review current knowledge of the impact of obesity on asthma severity, asthma control, and response to therapy.Several studies have shown that overweight and obesity is associated with more severe asthma...... and impaired quality of life compared with normal weight individuals. Furthermore, obesity is associated with poorer asthma control, as assessed by asthma control questionnaires, limitations in daily activities, breathlessness and wheezing, use of rescue medication, unscheduled doctor visits, emergency...... department visits, and hospitalizations for acute asthma. Studies of the impact of a high body mass index (BMI) on response to asthma therapy have, however, revealed conflicting results. Most studies show that overweight and obesity is associated with less favorable response to asthma therapy with regard...

  12. Asthma at 8 years of age in children born by caesarean section

    NARCIS (Netherlands)

    Roduit, C.; Scholtens, S.; de Jongste, J.C.; Wijga, A.H.; Gerritsen, J.; Postma, D.S.; Brunekreef, B.; Hoekstra, M.O.; Aalberse, R.; Smit, H.A.

    2009-01-01

    Background: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sens

  13. Asthma at 8 years of age in children born by caesarean section.

    NARCIS (Netherlands)

    Roduit, C.; Scholtens, S.; de Jongste, J.C.; Wijga, A.H.; Gerritsen, J.; Postma, D.S.; Brunekreef, B.; Hoekstra, M.O.; Aalberse, R.C.; Smit, H.A.

    2009-01-01

    BACKGROUND: Caesarean section might be a risk factor for asthma because of delayed microbial colonisation, but the association remains controversial. A study was undertaken to investigate prospectively whether children born by caesarean section are more at risk of having asthma in childhood and sens

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

    NARCIS (Netherlands)

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

    2007-01-01

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

  15. Combination therapy versus monotherapy for gastroesophageal reflux in children with difficult-to-treat bronchial asthma

    Directory of Open Access Journals (Sweden)

    Adel Salah Bediwy

    2014-01-01

    Conclusions: Combination of domperidone and esomeprazole was more effective in improving the endoscopic reflux score, childhood-asthma control test (C-ACT and FEV1 (% of predicted and significantly reduced the sputum SP than the use of esomeprazole only in children with difficult-to-treat asthma.

  16. Native and foreign born as predictors of pediatric asthma in an Asian immigrant population: a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Woodin Mark

    2007-05-01

    Full Text Available Abstract Background Asthma prevalence is lower in less developed countries and among some recent immigrant populations in the US, but the reasons for this are not clear. One possibility is that early childhood infections are protective against asthma. Methods We surveyed Asian immigrant children (n = 204; age 4–18 to assess the relationship between asthma and native or foreign place of birth. We included questions about environmental exposures, demographic variables and family history of asthma to test whether they might explain effects of place of birth on asthma. Results The native and foreign born groups were similar in most respects. Analysis of association with diagnosed asthma for all ages together resulted in two logistic regression models. Both retained born in the US (ORs were 3.2 and 4.3; p Conclusion Our findings are consistent with early childhood infections that are prevalent outside the US protecting against asthma.

  17. Risk of Asthma from Cesarean Delivery Depends on Membrane Rupture

    DEFF Research Database (Denmark)

    Sevelsted, Astrid; Stokholm, Jakob; Bisgaard, Hans

    2016-01-01

    OBJECTIVE: To assess our prospective mother-child cohort and the national registry data to analyze the risk of asthma by delivery mode and whether cesarean delivery before or after membrane rupture affects this risk differently. STUDY DESIGN: The Copenhagen Prospective Studies on Asthma in Childh......OBJECTIVE: To assess our prospective mother-child cohort and the national registry data to analyze the risk of asthma by delivery mode and whether cesarean delivery before or after membrane rupture affects this risk differently. STUDY DESIGN: The Copenhagen Prospective Studies on Asthma...... in Childhood2000 is a high-risk birth cohort of 411 Danish children. Asthma was diagnosed prospectively by physicians at the research site, and associations with cesarean delivery were investigated using Cox proportional hazard models. From the Danish national prospective registry we included data from 1997......-2010. Childhood asthma was defined from recurrent use of inhaled corticosteroids filled at pharmacies. Cesarean delivery was classified as either before or after rupture of membranes, and the risk of asthma was compared with vaginal delivery. Results were adjusted stepwise for age and calendar year, sex, birth...

  18. Association between obesity and asthma in preschool Mexican children.

    Science.gov (United States)

    Vàzquez-Nava, Francisco; Morales Romero, Jaime; Crodova Fernandez, José A; Saldívar-González, Atenogenes H; Vázquez-Rodriguez, Carlos F; Barrientos Gomez, Maria del C; Lin-Ochoa, Dolorez; Vázquez Rodríguez, Eliza M

    2010-07-07

    The elevated prevalence of obesity as well as of asthma in preschool children has prompted investigators to speculate that obesity in childhood might be a causal factor in the development of asthma. The results obtained to date are debatable. We investigated the association between obesity and asthma in 1,160 preschool Mexican children. Diagnosis of asthma was performed using the International Study of Asthma and Allergy in Childhood (ISAAC) questionnaire. The body mass index (BMI) in units of kg/m2 was determined, and children were categorized according to age- and gender-specific criteria, such as normal weight (5th-85th percentile), overweight (> or =85th and obesity (> or =95th percentile). Power test for logistic regression model was calculated. We found no association between overweight (adjusted OR = 1.02; 95% CI = 0.66-1.58), obesity (adjusted OR = 0.94; 95% CI = 0.68-1.30), and wheezing during the last year as determined by logistic regression model adjusted. We did not find an association between overweight, obesity, and asthma-associated hospitalizations. Further longitudinal studies are required to provide a better understanding of the relationship between obesity and asthma in preschool children.

  19. Association between Obesity and Asthma in Preschool Mexican Children

    Directory of Open Access Journals (Sweden)

    Francisco Vázquez-Nava

    2010-01-01

    Full Text Available The elevated prevalence of obesity as well as of asthma in preschool children has prompted investigators to speculate that obesity in childhood might be a causal factor in the development of asthma. The results obtained to date are debatable. We investigated the association between obesity and asthma in 1,160 preschool Mexican children. Diagnosis of asthma was performed using the International Study of Asthma and Allergy in Childhood (ISAAC questionnaire. The body mass index (BMI in units of kg/m2 was determined, and children were categorized according to age- and gender-specific criteria, such as normal weight (5th-85th percentile, overweight (ࣙ85th and <95th percentile, and obesity (ࣙ95th percentile. Power test for logistic regression model was calculated. We found no association between overweight (adjusted OR = 1.02; 95% CI = 0.66–1.58, obesity (adjusted OR = 0.94; 95% CI = 0.68–1.30, and wheezing during the last year as determined by logistic regression model adjusted. We did not find an association between overweight, obesity, and asthma-associated hospitalizations. Further longitudinal studies are required to provide a better understanding of the relationship between obesity and asthma in preschool children.

  20. Asthma and obesity.

    Science.gov (United States)

    Boulet, L-P

    2013-01-01

    The prevalence and incidence of asthma have increased among obese children and adults, particularly among women. Obesity seems to be a predisposing factor for the development of asthma, but the underlying mechanisms of its influence are still uncertain. Various hypotheses have been proposed to explain the link between obesity and asthma such as a common genetic predisposition, developmental changes, altered lung mechanics, the presence of a systemic inflammatory process, and an increased prevalence of associated comorbid conditions. Over-diagnosis of asthma does not seem to be more frequent in obese compared to non-obese subjects, but the added effects of obesity on respiratory symptoms can affect asthma control assessment. Obesity can make asthma more difficult to control and is associated with a reduced beneficial effect of asthma medications. This could be due to a change in asthma phenotype, particularly evidenced as a less eosinophilic type of airway inflammation combined to the added effects of changes in lung mechanics. Weight loss is associated with a universal improvement of asthma and should be part of asthma management in the obese patient. Additional research should be conducted to better determine how obesity influences the development and clinical expression of asthma, establish the optimal management of asthma in this population and determine how obesity affects long-term asthma outcomes in these patients.

  1. Exercise-Induced Asthma

    Science.gov (United States)

    ... management of exercise-induced bronchoconstriction: A practice parameter. Annals of Allergy, Asthma & Immunology. 2010;105:S1. Krafczyk ... up exercise on exercise-induced bronchoconstriction. Medicine and Science in Sports and Exercise. 2012;44:383. Asthma ...

  2. Psychopathology in difficult asthma

    NARCIS (Netherlands)

    Prins, L.C.; van Son, M.J.M.; Keimpema, A.R.; van Ranst, D; Pommer, A; Meijer, J.W.; Pop, V.J.M.

    2015-01-01

    OBJECTIVE: Within the asthma population, difficult asthma (DA) is a severe condition in which patients present with frequent exacerbations, hospitalizations and emergency room visits. The identification and treatment of psychopathology is included in the management of DA. Psychopathology is supposed

  3. Test Your Asthma Knowledge

    Science.gov (United States)

    ... narrowing of the bronchi. This can make breathing difficult, particularly expiration (exhaling) and can cause a feeling of tightness in the chest. Answer: D. All of these can make asthma worse. But some things that make asthma worse ...

  4. Allergies, asthma, and pollen

    Science.gov (United States)

    Reactive airway - pollen; Bronchial asthma - pollen; Triggers - pollen; Allergic rhinitis - pollen ... Things that make allergies or asthma worse are called triggers. It is important to know your triggers because avoiding them is your first step toward feeling better. ...

  5. Asthma - child - discharge

    Science.gov (United States)

    Pediatric asthma - discharge; Wheezing - discharge; Reactive airway disease - discharge ... Your child has asthma , which causes the airways of the lungs to swell and narrow. In the hospital, the doctors and nurses helped ...

  6. Exercise-induced asthma

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000036.htm Exercise-induced asthma To use the sharing features on this page, ... such as running, basketball, or soccer. Use Your Asthma Medicine Before you Exercise Take your short-acting, ...

  7. Smoking and asthma

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000504.htm Smoking and asthma To use the sharing features on ... your allergies or asthma worse are called triggers. Smoking is a trigger for many people who have ...

  8. Obesity and asthma

    DEFF Research Database (Denmark)

    Ali, Zarqa; Ulrik, Charlotte Suppli

    2013-01-01

    Epidemiological data has established increasing adiposity as a risk factor for incident asthma. However, the mechanisms underlying the association between obesity and asthma are incompletely understood. In the present paper, we review current knowledge of possible mechanisms mediating the observed...

  9. International Consensus On (ICON) Pediatric Asthma

    Science.gov (United States)

    Papadopoulos, N. G.; Arakawa, H.; Carlsen, K.-H.; Custovic, A.; Gern, J.; Lemanske, R.; Le Souef, P.; Makela, M.; Roberts, G.; Wong, G.; Zar, H.; Akdis, C. A.; Bacharier, L. B.; Baraldi, E.; van Bever, H. P.; de Blic, J.; Boner, A.; Burks, W.; Casale, T. B.; Castro-Rodriguez, J. A.; Chen, Y. Z.; El-Gamal, Y. M.; Everard, M. L.; Frischer, T.; Geller, M.; Gereda, J.; Goh, D. Y.; Guilbert, T. W.; Hedlin, G.; Heymann, P. W.; Hong, S. J.; Hossny, E. M.; Huang, J. L.; Jackson, D. J.; de Jongste, J. C.; Kalayci, O.; Khaled, N.; Kling, S.; Kuna, P.; Lau, S.; Ledford, D. K.; Lee, S. I.; Liu, A. H.; Lockey, R. F.; Lodrup-Carlsen, K.; Lotvall, J.; Morikawa, A.; Nieto, A.; Paramesh, H.; Pawankar, R.; Pohunek, P.; Pongracic, J.; Price, D.; Robertson, C.; Rosario, N.; Rossenwasser, L. J.; Sly, P. D.; Stein, R.; Stick, S.; Szefler, S.; Taussig, L. M.; Valovirta, E.; Vichyanond, P.; Wallace, D.; Weinberg, E.; Wennergren, G.; Wildhaber, J.; Zeiger, R. S.

    2015-01-01

    Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences, thus providing a concise reference. The principles of pediatric asthma management are generally accepted. Overall, the treatment goal is disease control. In order to achieve this, patients and their parents should be educated to optimally manage the disease, in collaboration with health care professionals. Identification and avoidance of triggers is also of significant importance. Assessment and monitoring should be performed regularly to re-evaluate and fine-tune treatment. Pharmacotherapy is the cornerstone of treatment. The optimal use of medication can, in most cases, help patients control symptoms and reduce the risk for future morbidity. The management of exacerbations is a major consideration, independent from chronic treatment. There is a trend towards considering phenotype specific treatment choices; however this goal has not yet been achieved. PMID:22702533

  10. International consensus on (ICON) pediatric asthma.

    Science.gov (United States)

    Papadopoulos, N G; Arakawa, H; Carlsen, K-H; Custovic, A; Gern, J; Lemanske, R; Le Souef, P; Mäkelä, M; Roberts, G; Wong, G; Zar, H; Akdis, C A; Bacharier, L B; Baraldi, E; van Bever, H P; de Blic, J; Boner, A; Burks, W; Casale, T B; Castro-Rodriguez, J A; Chen, Y Z; El-Gamal, Y M; Everard, M L; Frischer, T; Geller, M; Gereda, J; Goh, D Y; Guilbert, T W; Hedlin, G; Heymann, P W; Hong, S J; Hossny, E M; Huang, J L; Jackson, D J; de Jongste, J C; Kalayci, O; Aït-Khaled, N; Kling, S; Kuna, P; Lau, S; Ledford, D K; Lee, S I; Liu, A H; Lockey, R F; Lødrup-Carlsen, K; Lötvall, J; Morikawa, A; Nieto, A; Paramesh, H; Pawankar, R; Pohunek, P; Pongracic, J; Price, D; Robertson, C; Rosario, N; Rossenwasser, L J; Sly, P D; Stein, R; Stick, S; Szefler, S; Taussig, L M; Valovirta, E; Vichyanond, P; Wallace, D; Weinberg, E; Wennergren, G; Wildhaber, J; Zeiger, R S

    2012-08-01

    Asthma is the most common chronic lower respiratory disease in childhood throughout the world. Several guidelines and/or consensus documents are available to support medical decisions on pediatric asthma. Although there is no doubt that the use of common systematic approaches for management can considerably improve outcomes, dissemination and implementation of these are still major challenges. Consequently, the International Collaboration in Asthma, Allergy and Immunology (iCAALL), recently formed by the EAACI, AAAAI, ACAAI, and WAO, has decided to propose an International Consensus on (ICON) Pediatric Asthma. The purpose of this document is to highlight the key messages that are common to many of the existing guidelines, while critically reviewing and commenting on any differences, thus providing a concise reference. The principles of pediatric asthma management are generally accepted. Overall, the treatment goal is disease control. To achieve this, patients and their parents should be educated to optimally manage the disease, in collaboration with healthcare professionals. Identification and avoidance of triggers is also of significant importance. Assessment and monitoring should be performed regularly to re-evaluate and fine-tune treatment. Pharmacotherapy is the cornerstone of treatment. The optimal use of medication can, in most cases, help patients control symptoms and reduce the risk for future morbidity. The management of exacerbations is a major consideration, independent of chronic treatment. There is a trend toward considering phenotype-specific treatment choices; however, this goal has not yet been achieved.

  11. Genetics of asthma

    DEFF Research Database (Denmark)

    Thomsen, Simon F

    2015-01-01

    Asthma runs in families, and children of asthmatic parents are at increased risk of asthma. Prediction of disease risk is pivotal for the clinician when counselling atopic families. However, this is not always an easy task bearing in mind the vast and ever-increasing knowledge about asthma genetics...... of methods and advances in asthma genetics in an attempt to help the clinician keep track of the most important knowledge in the field....

  12. Fatal asthma or anaphylaxis?

    OpenAIRE

    Rainbow, J; Browne, G

    2002-01-01

    The incidence of anaphylaxis is under-reported. Children with asthma are frequently atopic and prone to allergic reactions. Parents and clinicians may attribute wheeze of rapid onset to acute severe asthma, rather than recognising an anaphylactic event. Two cases of fatal anaphylaxis are reported who were initially diagnosed as acute severe asthma, and responded poorly to bronchodilator treatment. Survivors of "acute asphyxic asthma" should be screened for reactions to common allergens that p...

  13. Identifying asthma triggers.

    Science.gov (United States)

    McCarty, Justin C; Ferguson, Berrylin J

    2014-02-01

    Asthma has many triggers including rhinosinusitis; allergy; irritants; medications (aspirin in aspirin-exacerbated respiratory disease); and obesity. Paradoxic vocal fold dysfunction mimics asthma and may be present along with asthma. This article reviews each of these triggers, outlining methods of recognizing the trigger and then its management. In many patients more than one trigger may be present. Full appreciation of the complexity of these relationships and targeted therapy to the trigger is needed to best care for the patient with asthma.

  14. The asthma epidemic and our artificial habitats

    Directory of Open Access Journals (Sweden)

    Maziak Wasim

    2005-03-01

    Full Text Available Abstract Background The recent increase in childhood asthma has been a puzzling one. Recent views focus on the role of infection in the education of the immune system of young children. However, this so called hygiene hypothesis fails to answer some important questions about the current trends in asthma or to account for environmental influences that bear little relation to infection. Discussion The multi-factorial nature of asthma, reflecting the different ways we tend to interact with our environment, mandates that we look at the asthma epidemic from a broader perspective. Seemingly modern affluent lifestyles are placing us increasingly in static, artificial, microenvironments very different from the conditions prevailed for most part of our evolution and shaped our organisms. Changes that occurred during the second half of the 20th century in industrialized nations with the spread of central heating/conditioning, building insulation, hygiene, TV/PC/games, manufactured food, indoor entertainment, cars, medical care, and sedentary lifestyles all seem to be depriving our children from the essential inputs needed to develop normal airway function (resistance. Asthma according to this view is a manifestation of our respiratory maladaptation to modern lifestyles, or in other words to our increasingly artificial habitats. The basis of the artificial habitat notion may lie in reduced exposure of innate immunity to a variety of environmental stimuli, infectious and non-infectious, leading to reduced formulation of regulatory cells/cytokines as well as inscribed regulatory pathways. This could contribute to a faulty checking mechanism of non-functional Th2 (and likely Th1 responses, resulting in asthma and other immuno-dysregulation disorders. Summary In this piece I discuss the artificial habitat concept, its correspondence with epidemiological data of asthma and allergy, and provide possible immunological underpinning for it from an evolutionary

  15. Asthma and Pregnancy

    Science.gov (United States)

    ... in the airways of the lungs. When an asthma attack occurs, it is difficult for air to pass through the lungs which ... others have not. In these studies, it is difficult to determine whether the problems noted were due to the mother’s asthma, the medicines needed to control the asthma, or ...

  16. School and Asthma

    Science.gov (United States)

    ... What Happens in the Operating Room? School and Asthma KidsHealth > For Kids > School and Asthma A A A What's in this article? Have ... La escuela y el asma If you have asthma , you probably have a routine at home for ...

  17. Exercise-Induced Asthma

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Exercise-Induced Asthma KidsHealth > For Parents > Exercise-Induced Asthma A A ... previous continue Tips for Kids With Exercise-Induced Asthma For the most part, kids with exercise-induced ...

  18. Traveling and Asthma

    Science.gov (United States)

    ... What Happens in the Operating Room? Traveling and Asthma KidsHealth > For Kids > Traveling and Asthma A A A What's in this article? Pack ... Or how about sleepover camp? If you have asthma , you'll be packing more than your clothes ...

  19. Do Allergies Cause Asthma?

    Science.gov (United States)

    ... Happens in the Operating Room? Do Allergies Cause Asthma? KidsHealth > For Kids > Do Allergies Cause Asthma? A A A en español ¿Las alergias provocan ... kinds of allergies are more likely to have asthma. Do you have allergies that affect your nose ...

  20. Antifungals in severe asthma

    NARCIS (Netherlands)

    Parulekar, Amit D.; Diamant, Zuzana; Hanania, Nicola A.

    2015-01-01

    Purpose of review Despite guideline-based treatment, many patients with severe asthma continue to have uncontrolled disease. Fungal allergy is being increasingly recognized in the pathogenesis of severe asthma. Limited data exist on the approach to treatment of fungal asthma. This review summarizes

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

    Science.gov (United States)

    Jassal, Mandeep S

    2015-01-01

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

  2. A systematic review of CD14 and toll-like receptors in relation to asthma in Caucasian children.

    Science.gov (United States)

    Klaassen, Ester Mm; Thönissen, Brenda Ejt; van Eys, Guillaume; Dompeling, Edward; Jöbsis, Quirijn

    2013-03-15

    The aetiology of childhood asthma is complex. An early dysfunction in the immunological development of the innate immune system in combination with environmental factors possibly triggers asthma. CD14 and toll-like receptors are important components of the innate immune system. The aim of this systematic review was to obtain a better insight into the relation between CD14 and toll-like receptors and childhood asthma in Caucasians. We searched PubMed and EMBASE for relevant articles. In total, 44 articles were included. The quality of the selected studies was independently assessed by the first two authors using the Newcastle-Ottawa quality assessment scale. Toll-like receptor 2, toll-like receptor 6, toll-like receptor 9, and toll-like receptor 10 appear to have some association with childhood asthma in Caucasians. The evidence for a relation of CD14 with childhood asthma is limited. In conclusion, there is no convincing evidence yet for a role of CD14 and toll-like receptors in relation to childhood asthma. Future studies should include haplotype analysis and take environmental factors into account to further clarify the role of CD14 and toll-like receptors on childhood asthma.

  3. Pranlukast hydrate in the treatment of pediatric bronchial asthma

    Directory of Open Access Journals (Sweden)

    Yoshihara S

    2013-07-01

    Full Text Available Shigemi Yoshihara Department of Pediatrics, Dokkyo Medical University, Tochigi, Japan Abstract: Pranlukast hydrate is a potent, selective, orally active, cysteinyl leukotriene antagonist that binds at the type 1 receptor. It is used as a 10% dry syrup to treat asthma and allergic rhinitis in pediatric patients. In a 4-week, dose-finding study, a dose-dependent improvement in lung function was observed in pediatric patients with asthma at an optimal dose of 5.1–10 mg/kg/day. In a comparative, randomized, double-blind, 4-week multicenter trial, pranlukast dry syrup 7 mg/kg/day achieved significantly better final overall improvement (71.4% versus oxatomide 1 mg/kg/day (37.2% in pediatric patients older than one year with asthma. In two 12-week, open-label trials and in a long-term open-label trial of treatment for up to 24 months, pranlukast dry syrup improved asthma control over baseline values. In a prospective post-marketing surveillance study and a long-term follow-up study, the safety and efficacy of pranlukast dry syrup was confirmed in infants younger than one year with bronchial asthma. In a 4-week, open-label trial, pranlukast dry syrup improved overall health-related quality of life and physical and emotional domain scores over baseline in pediatric patients with asthma. In a randomized, multicenter, double-blind, placebo-controlled, two-period crossover trial, pranlukast dry syrup significantly inhibited exercise-induced bronchospasm in children with asthma compared with placebo. In a modified Childhood Asthma Control Test, pranlukast dry syrup was significantly more effective in controlling asthma in patients younger than 4 years with the common cold. These findings show that pranlukast is useful and beneficial for treating pediatric patients with bronchial asthma. Keywords: pranlukast, leukotriene receptor antagonist, pediatric asthma

  4. The potential role of vitamin D in the link between obesity and asthma severity/control in children.

    Science.gov (United States)

    Vo, Phuong; Bair-Merritt, Megan; Camargo, Carlos A

    2015-06-01

    Childhood obesity and asthma are major public health problems. Obesity is not only associated with increased risk of incident asthma, but it may worsen asthma severity/control. Although the mechanisms linking obesity with asthma expression have not been completely elucidated, evidence suggests that increased frequency of acute respiratory infection (ARI) and decreased corticosteroid responsiveness may help to explain how obesity worsens asthma expression. In addition, obese individuals have low vitamin D status, and emerging evidence suggests vitamin D affects risk of ARI and corticosteroid responsiveness in individuals with asthma. In this review, we summarize the association between obesity and asthma severity/control in children and discuss ARI and corticosteroid responsiveness as potential mediators in the obesity-asthma pathway. We also discuss the potential role of vitamin D, including a brief summary of recent randomized controlled trials of vitamin D supplementation.

  5. [Cytokines and asthma].

    Science.gov (United States)

    Gani, F; Senna, G; Piglia, P; Grosso, B; Mezzelani, P; Pozzi, E

    1998-10-01

    Asthma is a chronic inflammatory lung disease in which eosinophils are one of the most important involved cells. These cells accumulate in the lung because of cytokines, which are able to regulate cellular responses. The role of cytokines is well known in allergic asthma: IL4, IL5, IL3, GMCSF are the principally cytokine involved. IL4 regulate IgE synthesis while IL5, (and IL3) cause the activation and accumulation of eosinophils. In non allergic asthma, whilst only IL5 seemed to be important recent data, shows that also IL4 plays an important role. Therefore nowadays no relevant difference seems to exist between allergic and non allergic asthma; instead the primer is different: the allergen in allergic asthma and often an unknown factor in the non allergic asthma. Recently other cytokines have been proved to play a role in the pathogenesis of asthma. IL8 is chemotactic not only for neutrophils but also for eosinophils and might cause chronic inflammation in severe asthma. IL13 works like IL4, while RANTES seems to be a more important chemotactic agent than IL5. Finally IL10, which immunoregulates T lymphocyte responses, may reduce asthma inflammation. In conclusion cytokine made us to learn more about the pathogenesis of asthma even if we do not yet know when and how asthma inflammation develops.

  6. Obesity and asthma.

    Science.gov (United States)

    Gibson, Peter G

    2013-12-01

    There is a global epidemic of asthma and obesity that is concentrated in Westernized and developed countries. A causal association in some people with asthma is suggested by observations that obesity precedes the onset of asthma and that bariatric surgery for morbid obesity can resolve asthma. The obese asthma phenotype features poor asthma control, limited response to corticosteroids, and an exaggeration of the physiological effects of obesity on lung function, which includes a reduction in expiratory reserve volume and airway closure occurring during tidal breathing. Obesity has important implications for asthma treatment. Increasing corticosteroid doses based on poor asthma control, as currently recommended in guidelines, may lead to overtreatment with corticosteroids in obese asthma. Enhanced bronchodilation, particularly of the small airways, may reduce the component of airway closure due to increased bronchomotor tone and suggests that greater emphasis should be placed on long-acting bronchodilators in obese asthma. The societal implications of this are important: with increasing obesity there will be increasing asthma from obesity, and the need to identify successful individual and societal weight-control strategies becomes a key goal.

  7. Diet and asthma: looking back, moving forward

    Directory of Open Access Journals (Sweden)

    Ellwood Philippa E

    2009-06-01

    Full Text Available Abstract Asthma is an increasing global health burden, especially in the western world. Public health interventions are sought to lessen its prevalence or severity, and diet and nutrition have been identified as potential factors. With rapid changes in diet being one of the hallmarks of westernization, nutrition may play a key role in affecting the complex genetics and developmental pathophysiology of asthma. The present review investigates hypotheses about hygiene, antioxidants, lipids and other nutrients, food types and dietary patterns, breastfeeding, probiotics and intestinal microbiota, vitamin D, maternal diet, and genetics. Early hypotheses analyzed population level trends and focused on major dietary factors such as antioxidants and lipids. More recently, larger dietary patterns beyond individual nutrients have been investigated such as obesity, fast foods, and the Mediterranean diet. Despite some promising hypotheses and findings, there has been no conclusive evidence about the role of specific nutrients, food types, or dietary patterns past early childhood on asthma prevalence. However, diet has been linked to the development of the fetus and child. Breastfeeding provides immunological protection when the infant's immune system is immature and a modest protective effect against wheeze in early childhood. Moreover, maternal diet may be a significant factor in the development of the fetal airway and immune system. As asthma is a complex disease of gene-environment interactions, maternal diet may play an epigenetic role in sensitizing fetal airways to respond abnormally to environmental insults. Recent hypotheses show promise in a biological approach in which the effects of dietary factors on individual physiology and immunology are analyzed before expansion into larger population studies. Thus, collaboration is required by various groups in studying this enigma from epidemiologists to geneticists to immunologists. It is now apparent that

  8. Epigenetics of asthma.

    Science.gov (United States)

    Durham, Andrew L; Wiegman, Coen; Adcock, Ian M

    2011-11-01

    Asthma is caused by both heritable and environmental factors. It has become clear that genetic studies do not adequately explain the heritability and susceptibility to asthma. The study of epigenetics, heritable non-coding changes to DNA may help to explain the heritable component of asthma. Additionally, epigenetic modifications can be influenced by the environment, including pollution and cigarette smoking, which are known asthma risk factors. These environmental trigger-induced epigenetic changes may be involved in skewing the immune system towards a Th2 phenotype following in utero exposure and thereby enhancing the risk of asthma. Alternatively, they may directly or indirectly modulate the immune and inflammatory processes in asthmatics via effects on treatment responsiveness. The study of epigenetics may therefore play an important role in our understanding and possible treatment of asthma and other allergic diseases. This article is part of a Special Issue entitled: Biochemistry of Asthma.

  9. Obesity and asthma

    DEFF Research Database (Denmark)

    Sivapalan, Pradeesh; Diamant, Zuzana; Ulrik, Charlotte Suppli

    2015-01-01

    PURPOSE OF REVIEW: Obesity has significant impact on asthma incidence and manifestations. The purpose of the review is to discuss recent observations regarding the association between obesity and asthma focusing on underlying mechanisms, clinical presentation, response to therapy and effect...... of weight reduction. RECENT FINDINGS: Clinical and epidemiological studies indicate that obese patients with asthma may represent a unique phenotype, which is more difficult to control, less responsive to asthma medications and by that may have higher healthcare utilization. A number of common comorbidities...... have been linked to both obesity and asthma, and may, therefore, contribute to the obese-asthma phenotype. Furthermore, recently published studies indicate that even a modest weight reduction can improve clinical manifestations and outcome of asthma. SUMMARY: Compared with normal-weight patients, obese...

  10. Interleukin 6 SNP rs1800797 associates with the risk of adult-onset asthma.

    Science.gov (United States)

    Lajunen, T K; Jaakkola, J J K; Jaakkola, M S

    2016-04-01

    Interleukin 6 (IL6) is an inflammatory cytokine that has been suggested to have an important role in the pathogenesis of asthma. IL6 single-nucleotide polymorphisms (SNPs) have been associated with levels of IL6, and with childhood and prevalent adult asthma. A recent study also suggested that IL6 SNPs associate especially with atopic asthma. However, association of IL6 SNPs with adult-onset asthma has not been studied. In a population-based study of 467 incident adult-onset asthma cases and 613 disease-free controls from South Finland, we analyzed association of 6 tagging SNPs of the IL6 locus with the risk of adult-onset asthma and with atopy. Asthma was clinically diagnosed, and atopy was defined based on Phadiatop test. IL6 SNP rs1800797 associated with the risk of adult-onset asthma in a log additive model, with adjusted odds ratio (aOR) 1.31 (95% confidence interval 1.09-1.57), and especially with the risk of atopic adult-onset asthma when compared with non-atopic controls, aOR 1.46 (95% CI 1.12-1.90). This is the first study to show an association of IL6 with adult-onset asthma, and especially with atopic adult-onset asthma.

  11. Global strategy for the diagnosis and management of asthma in children 5 years and younger.

    Science.gov (United States)

    Pedersen, Soren Erik; Hurd, Suzanne S; Lemanske, Robert F; Becker, Allan; Zar, Heather J; Sly, Peter D; Soto-Quiroz, Manuel; Wong, Gary; Bateman, Eric D

    2011-01-01

    Asthma is the most common chronic disease of childhood and the leading cause of childhood morbidity from chronic disease as measured by school absences, emergency department visits, and hospitalisation. During the past two decades, many scientific advances have improved our understanding of asthma and our ability to manage and control it effectively. However, in children 5 years and younger, the clinical symptoms of asthma are variable and non-specific. Furthermore, neither airflow limitation nor airway inflammation, the main pathologic hallmarks of the condition, can be assessed routinely in this age group. For this reason, to aid in the diagnosis of asthma in young children, a symptoms-only descriptive approach that includes the definition of various wheezing phenotypes has been recommended. In 1993, the Global Initiative for Asthma (GINA) was implemented to develop a network of individuals, organizations, and public health officials to disseminate information about the care of patients with asthma while at the same time assuring a mechanism to incorporate the results of scientific investigations into asthma care. Since then, GINA has developed and regularly revised a Global Strategy for Asthma Management and Prevention. Publications based on the Global Strategy for Asthma Management and Prevention have been translated into many different languages to promote international collaboration and dissemination of information. In this report, Global Strategy for Asthma Management and Prevention in Children 5 Years and Younger, an effort has been made to present the special challenges that must be taken into account in managing asthma in children during the first 5 years of life, including difficulties with diagnosis, the efficacy and safety of drugs and drug delivery systems, and the lack of data on new therapies. Approaches to these issues will vary among populations in the world based on socioeconomic conditions, genetic diversity, cultural beliefs, and differences in

  12. Spirometry use in children hospitalized with asthma.

    Science.gov (United States)

    Tan, Chee Chun; McDowell, Karen M; Fenchel, Matthew; Szczesniak, Rhonda; Kercsmar, Carolyn M

    2014-05-01

    Asthma is the most common chronic disorder of childhood and continues to be a leading cause of pediatric hospital admission. The National Asthma Education and Prevention Program (NAEPP) recommends that spirometry be obtained for asthma patients upon hospital admission, after bronchodilation during the acute phase of asthma symptoms, and at least one additional time before discharge from the hospital. The objectives of this study were to describe the use of spirometry in children hospitalized with asthma and to determine association of pulmonary function with future exacerbations. A retrospective cohort study design was utilized involving review of medical records of children ≥5 years old admitted with asthma to Cincinnati Children's Hospital Medical Center from September 1, 2009 to March 31, 2011. Hospitalization or emergency department (ED) visits were identified by the ICD-9-CM codes of having either a primary diagnosis of asthma (493) or a respiratory illness (460-496) plus a secondary diagnosis of asthma. Asthma re-exacerbation was defined as either having an ED visit or hospitalization for asthma that occurred within 3 months after the index hospitalization. All spirometries were performed in a pediatric pulmonary function laboratory. Among 1,037 admissions included in this study, 89 (8.6%) had spirometry that was recommended by a consulting asthma specialist and usually performed on the day of discharge. Spirometries for forty-five of these patients (54.9%) met all acceptability and repeatability criteria of the American Thoracic Society. Patients who performed acceptable spirometry were significantly older (12.4 ± 3.8 vs. 10.7 ± 3.0 years; P = 0.041). The average forced expiratory volume in the first second (FEV1 ) was 84.4 ± 19.7% predicted; forced vital capacity (FVC) was 98.1 ± 16.0% predicted; FEV1 /FVC was 74.6 ± 9.6%; forced expiratory flow at 25-75% (FEF25-75 ) was 61.2 ± 30.1% predicted. Ten patients (22%) who

  13. Characteristics and severity of asthma in children with and without atopic conditions : a cross-sectional study

    NARCIS (Netherlands)

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

    2015-01-01

    BACKGROUND: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children wi

  14. Nocturnal Dry Cough in the First 7 Years of Life is Associated With Asthma at School Age

    NARCIS (Netherlands)

    Boudewijn, Ilse M.; Savenije, Olga E. M.; Koppelman, Gerard H.; Wijga, Alet H.; Smit, Henriette A.; de Jongste, Johan C.; Gehring, Ulrike; Postma, Dirkje S.; Kerkhof, Marjan

    2015-01-01

    Background: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  15. Nocturnal dry cough in the first 7 years of life is associated with asthma at school age

    NARCIS (Netherlands)

    Boudewijn, Ilse M; Savenije, Olga E M; Koppelman, Gerard H; Wijga, Alet H; Smit, Henriëtte A; de Jongste, Johan C; Gehring, Ulrike; Postma, Dirkje S; Kerkhof, Marjan

    2015-01-01

    BACKGROUND: Childhood wheeze is an important, well-known risk factor for asthma, yet little is known about the contribution of nocturnal dry cough. We investigated the association of nocturnal dry cough at ages 1-7 years with doctor-diagnosed asthma at 8 years of age, both in the presence and absenc

  16. Characteristics and severity of asthma in children with and without atopic conditions: A cross-sectional study

    NARCIS (Netherlands)

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

    2015-01-01

    Background: Childhood allergic diseases have a major impact on a child's quality of life, as well as that of their parents. We studied the coexistence of reported allergies in children who use asthma medication. Additionally, we tested the hypothesis that asthma severity is greater among children wi

  17. Phenotyping asthma, rhinitis and eczema in MeDALL population-based birth cohorts : an allergic comorbidity cluster

    NARCIS (Netherlands)

    Garcia-Aymerich, J.; Benet, M.; Saeys, Y.; Pinart, M.; Basagana, X.; Smit, H. A.; Siroux, V.; Just, J.; Momas, I.; Ranciere, F.; Keil, T.; Hohmann, C.; Lau, S.; Wahn, U.; Heinrich, J.; Tischer, C. G.; Fantini, M. P.; Lenzi, J.; Porta, D.; Koppelman, G. H.; Postma, D. S.; Berdel, D.; Koletzko, S.; Kerkhof, M.; Gehring, U.; Wickman, M.; Melen, E.; Hallberg, J.; Bindslev-Jensen, C.; Eller, E.; Kull, I.; Carlsen, K. C. Lodrup; Carlsen, K. -H.; Lambrecht, B. N.; Kogevinas, M.; Sunyer, J.; Kauffmann, F.; Bousquet, J.; Anto, J. M.

    2015-01-01

    BackgroundAsthma, rhinitis and eczema often co-occur in children, but their interrelationships at the population level have been poorly addressed. We assessed co-occurrence of childhood asthma, rhinitis and eczema using unsupervised statistical techniques. MethodsWe included 17209 children at 4years

  18. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health Know How to Use Your Asthma ... 1 MB] ASL Asthma Film Asthma Clinical Guidelines Air Pollution & Respiratory Health File Formats Help: How do I ...

  19. Assesment of Quality of Life in Children with Asthma

    Directory of Open Access Journals (Sweden)

    Serhat Gümüş

    2012-04-01

    Full Text Available Aim: Bronchial asthma is among the most common chronic pediatric diseases that can result in variable restriction in the physical, emotional and social aspects of the patient%u2019s life. The aim of this study was to assess impairment on quality of life (QOL in asthmatic children. Material and Method: Ninety seven patients aged between 7 and 15 years which followed up at Pediatric Pulmonology Department of Dicle University Hospital were included into the study, during October 2009 %u2013 January 2010. To assess the quality of life Pediatric Asthma Quality of Life questionnaire%u2019s (PAQLQ self-applied Turkish version was used. In addition, the severity of asthma was measured using by Childhood Asthma Control Test (C-ACT. Results: The male to female ratio of asthmatic children was 2/1 and the mean age was 10.0 %uF0B1 2.5 years. Severity of asthma, history of steroid use and low family income were found as having negative effect on the PAQLQ scores (p < 0.001. Mother%u2019s education level also had statistically significant effect on the PAQLQ scores (P = 0.02. Father%u2019s education level; patient%u2019s age, gender, passive smoking exposure, family history of asthma or eczema and duration of disease did not have statistically significant effect on PAQLQ scores (p>0.05. Asthma control test score had a significant correlation with PAQLQ score (p

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

    Science.gov (United States)

    Fattore, Gisel Lorena; Santos, Carlos Antonio de Souza Teles; Barreto, Mauricio Lima

    2015-11-01

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

  1. Asthma in the Elderly

    Directory of Open Access Journals (Sweden)

    Domenico Lorenzo Urso

    2009-01-01

    Full Text Available Bronchial asthma is a common problem with enormous medical and economics impacts. It is an inflammatory disease of the airways associated with intermittent episodes of bronchospasm. Asthma is not uncommon in the elderly patients. Prevalence of asthma is similar in older and younger adults. Asthma in the elderly patient is underdiagnosed because of false perceptions by both patient and physician. The high incidence of comorbid conditions in the elderly patient makes the diagnosis and management more difficult. Correct diagnosis is demonstrated with spirometry. The goals of asthma treatment are to achieve and maintain control of symptoms and to prevent development of irreversible airflow limitation. Asthma drugs are preferably inhaled because this route minimizes systemic absorption and, thus, improves the ratio of the therapeutic benefit to the potential side-effects in elderly patients.

  2. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

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

  3. Asthma and obesity

    DEFF Research Database (Denmark)

    Ulrik, Charlotte S

    2016-01-01

    PURPOSE OF REVIEW: Obesity has significant negative impact on asthma control and risk of exacerbations. The purpose of this review is to discuss recent studies evaluating the effects of weight reduction on asthma control in obese adults. RECENT FINDINGS: Clinical studies have shown that weight...... reduction in obese patients is associated with improvements in symptoms, use of controller medication, and asthma-related quality of life together with a reduction in the risk for severe exacerbations. Furthermore, several studies have also revealed improvements in lung function and airway responsiveness...... reduction in obese adults with asthma leads to an overall improvement in asthma control, including airway hyperresponsiveness and inflammation. Weight reduction should be a cornerstone in the management of obese patients with asthma....

  4. Early life respiratory infections and asthma development: role in disease pathogenesis and potential targets for disease prevention

    Science.gov (United States)

    Beigelman, Avraham; Bacharier, Leonard B.

    2016-01-01

    Purpose of review To present recent findings and perspectives on the relationship between early life respiratory infections and asthma inception and to discuss emerging concepts on strategies that target these infectious agents for asthma prevention. Recent findings Cumulative evidence supports the role of early life viral infections, especially respiratory syncytial virus and human rhinovirus, as major antecedents of childhood asthma. These viruses may have different mechanistic roles in the pathogenesis of asthma. The airway microbiome and virus-bacteria interactions in early life have emerged as additional determinants of childhood asthma. Innovative strategies for the prevention of these early life infections, or for attenuation of acute infection severity, are being investigated and may identify effective strategies for the primary and secondary prevention of childhood asthma. Summary Early life infections are major determinants of asthma development. The pathway from early life infections to asthma is the result of complex interactions between the specific type of the virus, genetic and environmental factors. Novel intervention strategies that target these infectious agents have been investigated in proof-of-concepts trials, and further study is necessary to determine their capacity for asthma prevention. PMID:26854761

  5. Asthma among mink workers

    DEFF Research Database (Denmark)

    Grøntved, Berit; Carstensen, Ole; Petersen, Rolf

    2014-01-01

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

  6. Linking obesity and asthma.

    Science.gov (United States)

    Sutherland, E Rand

    2014-04-01

    A growing body of literature suggests that obesity has a significant impact on asthma risk, phenotype, and prognosis. Epidemiological studies have clearly demonstrated that asthma is more likely to occur in obese patients, and health status is impaired in obese individuals with asthma, with obese asthmatics experiencing more symptoms, worse quality of life, increased healthcare use, and increased asthma severity. However, obesity has well-described effects on lung function and mechanics that can lead to symptoms of dyspnea without causing the pathophysiologic changes of asthma. Adding to the challenges of evaluating this association, some studies have failed to demonstrate a robust relationship between obesity and traditional biomarkers of airway inflammation in adult asthmatics, leading to the conclusion that obesity does not necessarily worsen airway inflammation in asthma. In this regard, emerging data suggest that nonatopic mechanisms may be relevant in obese asthmatics, and that these mechanisms may have a direct impact on the response of obese asthmatics to asthma therapies, most notably inhaled glucocorticoids. This article will review selected aspects of the contributions of obesity-related airway and systemic inflammation to asthma, with a focus on the impact of obesity as a modifier of risk, prognosis, and therapeutic response in asthma.

  7. Pharmacogenomics of pediatric asthma

    Directory of Open Access Journals (Sweden)

    Gupta Sarika

    2010-01-01

    Full Text Available Context: Asthma is a complex disease with multiple genetic and environmental factors contributing to it. A component of this complexity is a highly variable response to pharmacological therapy. Pharmacogenomics is the study of the role of genetic determinants in the variable response to therapy. A number of examples of possible pharmacogenomic approaches that may prove of value in the management of asthma are discussed below. Evidence Acquisition: A search of PubMed, Google scholar, E-Medicine, BMJ and Mbase was done using the key words "pharmacogenomics of asthma", "pharmacogenomics of β-agonist, glucocorticoids, leukotriene modifiers, theophylline, muscarinic antagonists in asthma". Results: Presently, there are limited examples of gene polymorphism that can influence response to asthma therapy. Polymorphisms that alter response to asthma therapy include Arg16Gly, Gln27Glu, Thr164Ile for β-agonist receptor, polymorphism of glucocorticoid receptor gene, CRHR1 variants and polymorphism of LTC4S, ALOX5. Polymorphic variants of muscarinic receptors, PDE4 and CYP450 gene variants. Conclusion: It was concluded that genetic variation can improve the response to asthma therapy. However, no gene polymorphism has been associated with consistent results in different populations. Therefore, asthma pharmacogenomic studies in different populations with a large number of subjects are required to make possible tailoring the asthma therapy according to the genetic characteristic of individual patient.

  8. Asthma, sports, and death.

    Science.gov (United States)

    DiDario, A Geoffrey; Becker, Jack M

    2005-01-01

    The impact of asthma on the general population has been described in detail in medical literature. However, asthma also has a significant impact on the pediatric and adult athlete. This is rarely reported in either the lay press or the medical literature. In 2003, Becker and coworkers conducted a retrospective analysis of the incidence of asthma as a direct cause of death in competitive athletes across the United States between 1993 and 2000. They sought to raise awareness that severe asthma exacerbations and even death can occur during sports from asthma in athletes, while still supporting the concept of maximal participation in sporting activities. To their knowledge, this remains the only published study looking specifically at this issue. Fortunately, fatal asthma events are infrequent in either the adult or the pediatric populations. Those rare cases involving athletes are commonly highlighted in the lay press when they do occur, e.g., when the victim is a college football player such as Rashidi Wheeler. Wheeler died of a fatal asthma exacerbation on August 3, 2002, during a conditioning drill as a member of the Northwestern University football team. Although he was known to have chronic asthma with no obvious barriers to health care, he nevertheless succumbed to his condition. Here, we report a similar, although less well-known, case of an adolescent who died as a direct result of an asthma exacerbation during a high school physical education class. We also offer a brief review of the literature regarding morbidity and mortality in athletes.

  9. Association of the interactions between TGF-1 and ADAM33 gene with susceptibility and severity in childhood asthma%TGF-1和ADAM33基因交互作用与儿童哮喘易感性及严重程度相关性

    Institute of Scientific and Technical Information of China (English)

    李宏彬; 徐光翠; 桂立辉; 冯宪军; 赵兵; 席景砖

    2012-01-01

    Objective:To verify the association of transforming growth factor-pl and a disintegrin and metalloprotein as e domain 33 polymorphisms with childhood asthma susceptibility and severity in a sample of patients with moderate and severe asthma. Methods: total of 144 controls and 110 asthmatic patients were recruited for this hospital-based case-control study. Three polymorphic sites (T869C, V4,T2)were genotyped using the polymerase chain reaction-restriction fragment length polymorphism method. The gene-gene interactions were analyzed with the MDR software. Results:There were no significant differences for both allele and genotype frequencies of T869C of TGF-pl gene between the childhood asthma and control group (P > 0. 05) . The allele frequencies of two SNPs ( V4, T2) of ADAM33 in childhood asthma group was significantly higher than that in control group (P <0. 01) . The nonsignificant differences were observed for the genotype CC of V4 locus and the genotype GA of Tl locus between moderate asthmatic groups and controls (P =0. 129 and 0. 084, respectively) , the genotype AA of T2 locus was no statistical significance between severe asthma and controls (P =0. 063) . There were significant differences in the interaction model between TGF-pl and ADAM33 gene (including 2 and 3 loci best model) analyzed by MDR (P<0.05). Conclusion; The results highlight the role of ADAM33 as a susceptibility gene for children asthma, and the interactions among TGF-βl T869C and ADAM33 V4 and T2 also have associations with children asthma in Chinese Han people.%目的:探讨转化生长因子β1(TGF-β1)和解整合素金属蛋白酶33(ADAM33)基因单核苷酸多态性与儿童哮喘易感性及严重程度相关性.方法:采用以医院为基础的病例对照研究(110例哮喘患儿和144例对照)方法,三个多态性位点(V4、T2、T869C)用聚合酶链反应-限制性片段长度多态性分析(PCR-RFLP)技术进行基因分型,应用MDR软件分析基因各位点

  10. Trends in childhood disease.

    Science.gov (United States)

    Pallapies, Dirk

    2006-09-28

    Child mortality has declined remarkably during the last decades. While neonatal disorders, diarrhoea, pneumonia, and malaria as well as being underweight account for most of the child deaths worldwide, children's health discussions in Europe and the USA focus on other issues such as asthma, neurodevelopmental disorders, male genital malformations, and childhood cancer. There is clear evidence of increasing rates of asthma in various countries during the last decades, although rates in some countries may now have stabilised or even decline as recent UK data indicate. Although an increase in the frequency of neurodevelopmental disorders such as autism and attention deficit disorder has frequently been discussed, the limited data in this field does not justify such a conclusion. While geographic heterogeneity regarding reproductive outcomes is apparent, global trends have not been identified. Interpretation of the available information on asthma, neurodevelopmental disorders and reproductive outcomes is hampered by inconstant diagnostic criteria over place and time and the lack of good and comprehensive population-based surveillance data, which makes it impossible to ascertain trends in actual disease frequency. Data indicate that developed countries have a gradually increasing incidence in leukaemia with a corresponding drop in the incidence of lymphoma. Increases in brain tumour frequency may be related to the development and wide application of new diagnostic capabilities, rather than a true change in the incidence of malignant disease. With a better prognosis for childhood cancer survival, secondary cancers following chemotherapy appear to be increasing. A wide range of environmental factors is thought to have an impact on children's health. These factors include nutrition (protein, vitamins, antioxidants), lifestyle and behaviour choices such as tobacco and alcohol use, parental health, socio-economic status, choice of living environment (urban versus rural, etc

  11. Nutrition and Asthma

    Directory of Open Access Journals (Sweden)

    Gupta K

    2007-01-01

    Full Text Available Increase in the asthma prevalence in many countries over the recent decades, highlights the need for a greater understanding of the risk factors for asthma. Be-cause asthma is the result of interaction between genetic and environmental fac-tors, increasing prevalence is certainly the result of changes in environmental fac-tors because of process of wesernization. That is the reason for higher prevalence in countries where a traditional to a westernized lifestyle occurred earlier. This increasing prevalence has affected both rural and urban communities, suggesting that local environmental factors such as exposure to allergens or industrial air pol-lutions are not the sole cause. In the last few years, nutrition has represented an important conditioning factor of many cardiovascular, gastrointestinal and chronic pulmonary diseases. So it has been hypothesized that dietary constituents influence the immune system and thus, may also be actively involved in the onset of asthma and other allergic diseases. Dietary constituents can play beneficial as well as det-rimental role in asthma. The possible role of diet in the development of asthma can be described as follows: first, a food allergen can cause asthma. Second, there is role of breast-feeding for prevention of asthma later in life. Third, a low intake of antioxidative dietary constituents might be a risk factor for asthma. Moreover, role of cations such as sodium, potassium and magnesium has been described in development of asthma. Finally, intake of fatty acids specially the role of omega-3 and omega-6 fatty acids play important role in cause of asthma.

  12. Dysfunctional breathing in children with asthma: a rare but relevant comorbidity.

    Science.gov (United States)

    de Groot, Eric P; Duiverman, Eric J; Brand, Paul L P

    2013-05-01

    Hyperventilation and other clinical manifestations of dysfunctional breathing have been reported in childhood, but the prevalence is unknown. In adults, dysfunctional breathing may be a relevant comorbidity in asthma. We aimed to determine the prevalence of dysfunctional breathing in children with asthma and its impact on asthma control. We performed a cross-sectional survey in 203 asthmatic children (aged 5-18 years), using the Nijmegen Questionnaire and the paediatric Asthma Control Questionnaire. Dysfunctional breathing was found in 11 (5.3%) children; more females (eight (12.9%) out of 62) than males (three (2.1%) out 144, p=0.002). There was a dose-dependent relationship between increasing Nijmegen Questionnaire scores (increased risk of dysfunctional breathing) and poorer asthma control. Poor asthma control was more common in patients with dysfunctional breathing (10 (90.9%) out of 11 children) than in children without (65 (32.3%) out of 192 children; OR 19.3, 95% CI 3.14-430.70; pbreathing was higher (median (range) 2.00 (1.50-3.17)) than in children without (0.50 (0.17-1.17); pbreathing in children and adolescents referred to a hospital-based paediatric asthma clinic for severe or difficult-to-control asthma is 5%. The association between dysfunctional breathing and asthma control suggests that this may be a clinically relevant comorbidity in paediatric asthma.

  13. How Is Asthma Diagnosed?

    Science.gov (United States)

    ... 1.25 million of those individuals have severe asthma, a condition that can be difficult to control and treat. Learn more about his research by visiting the NHLBI Laboratory of Asthma and Lung Inflammation website: http://www.nhlbi.nih. ...

  14. Traveling and Asthma

    Science.gov (United States)

    ... Emergency Room? What Happens in the Operating Room? Traveling and Asthma KidsHealth > For Kids > Traveling and Asthma A A A What's in this ... t have to get in the way of travel fun. Let's find out how to be prepared ...

  15. Reflexology and bronchial asthma

    DEFF Research Database (Denmark)

    Brygge, T; Heinig, J H; Collins, P

    2001-01-01

    Many asthma patients seek alternative or adjunctive therapies. One such modality is reflexology, whereby finger pressure is applied to certain parts of the body. The aim of the study was to examine the popular claim that reflexology treatment benefits bronchial asthma. Ten weeks of active...

  16. [Occupational asthma in Hungary].

    Science.gov (United States)

    Endre, László

    2015-05-10

    Occupational asthma belongs to communicable diseases, which should be reported in Hungary. During a 24-year period between January 1990 and December 2013, 180 occupational asthma cases were reported in Hungary (52 cases between 1990 and 1995, 83 cases between 1996 and 2000, 40 cases between 2001 and 2006, and 5 cases between 2007 and 2013). These data are unusual, because according to the official report of the National Korányi Pulmonology Institute in Budapest, at least 14,000 new adult asthma cases were reported in every year between 2000 and 2012 in Hungary. Also, international data indicate that at least 2% of adult patients with asthma have occupational asthma and at least 50 out of 1 million employees develop occupational asthma in each year. In 2003, 631 new occupational asthma patients were reported in the United Kingdom, but only 7 cases in Hungary. Because it is unlikely that the occupational environment in Hungary is much better than anywhere else in the world, it seems that not all new occupational asthma cases are reported in Hungary. Of the 180 reported cases in Hungary, 55 were bakers or other workers in flour mills. There were 11 metal-workers, 10 health care assistants, 9 workers dealing with textiles (tailors, dressmakers, workers in textile industry) and 9 employees worked upon leather and animal fur. According to international data, the most unsafe profession is the animal keeper in scientific laboratories, but only 4 of them were reported as having occupational asthma during the studied 24 years in Hungary. Interestingly, 3 museologists with newly-diagnosed occupational asthma were reported in 2003, but not such cases occurred before or after that year. In this paper the Hungarian literature of occupational asthma is summarized, followed by a review on the classification, pathomechanism, clinical presentation, predisposing factors, diagnostics and therapeutic aspects of the disease. Epidemiological data of adult asthma in Hungary and data from

  17. [Distinguishing asthma from COPD].

    Science.gov (United States)

    Ohara, Kouhei; Samukawa, Takuya; Inoue, Hiromasa

    2016-05-01

    Asthma and chronic obstructive pulmonary disease (COPD) are major public health burdens. Asthma is characterized by airway inflammation, airway narrowing with reversibility, and hyperresponsiveness of airways. COPD has been associated with smoking and exposure to environmental fumes, which typically characterized by persistent airflow limitation and chronic inflammation of the airways. These differences are most apparent when young non-smoker with asthma and older smokers with COPD are compared. However, it would be difficult to differentiate asthma from COPD, especially in elderly who currently smoke or have a significant history of smoking. Furthermore, some patients exhibit characteristics of both diseases, this may represent a phenotype known as asthma-COPD overlap syndrome (ACOS). Therefore, the precise understanding of these diseases is important.

  18. Asthma control in children

    DEFF Research Database (Denmark)

    Pedersen, Søren

    2016-01-01

    The goal of asthma management is to achieve disease control. Poorly controlled asthma is associated with an increased number of days lost from school, exacerbations and days in hospital. Furthermore, children with uncontrolled asthma have more frequent contacts with the health-care system. Recent...... studies have added new information about the effects of poorly controlled asthma on a range of important, but less studied outcomes, including risk of obesity, daily physical activity, cardiovascular fitness, stress, concentration and focused attention, learning disabilities and risk of depression. From...... these studies it seems that poor asthma control may have a greater impact on the child than previously thought. This may have important long-term consequences for the child such as an increased risk of life-style associated diseases and poorer school performance. The level of control seems to be the most...

  19. Fertility outcomes in asthma

    DEFF Research Database (Denmark)

    Gade, Elisabeth Juul; Thomsen, Simon Francis; Lindenberg, Svend;

    2016-01-01

    Evidence is increasing of an association between asthma and aspects of female reproduction. However, current knowledge is limited and furthermore relies on questionnaire studies or small populations. In a prospective observational cohort study to investigate whether time to pregnancy, the number...... of fertility treatments, and the number of successful pregnancies differ significantly between women with unexplained infertility with and without asthma.245 women with unexplained infertility (aged 23-45 years) underwent questionnaires and asthma and allergy testing while undergoing fertility treatment. 96...... women entering the study had either a former doctor's diagnosis of asthma or were diagnosed with asthma when included. After inclusion they were followed for a minimum of 12 months in fertility treatment, until they had a successful pregnancy, stopped treatment, or the observation ended.The likelihood...

  20. Association between some factors in maternal pregnancy and childhood asthma with an onset before 3 years of age%婴幼儿期起病的儿童哮喘与母亲孕期相关因素分析

    Institute of Scientific and Technical Information of China (English)

    许慧洁; 袁雪晶

    2015-01-01

    Objective To study the association between some factors in maternal pregnancy and childhood asthma with an onset before 3 years of age, and to provide a basis for the prevention and treatment of childhood asthma and further research on its pathogenesis. Methods A retrospective clinical epidemiological study was carried out in 100 children with asthma (age of onset<3 years) and 100 children without allergic disease who were randomly selected as controls. The related information of children and mothers was investigated by questionnaire survey, including general information, medical history, personal and family allergic history, perinatal data, and mothers' health and lifestyle during their pregnancy such as diet, disease, and environmental exposure. The main survey indices were preliminarily analyzed, selected, and assigned, and then the data were subjected to univariate and multivariate logistic regression analyses. Results The univariate and multivariate logistic regression analyses showed that the fetal sex, history of atopic disease before pregnancy, history of respiratory infection in pregnancy, and the intake of ifsh, shrimp, crab, meat and spicy food in pregnancy were signiifcantly associated with childhood asthma with an onset before 3 years of age, with odds ratios of 2.868, 5.051, 4.640, 3.746, 2.971, 3.075, and 2.225, respectively. Conclusions Many factors in maternal pregnancy are associated with childhood asthma with an onset before 3 years of age, and the risk of which can be reduced by the prevention of respiratory infection and appropriate diet in pregnancy.%目的:探讨婴幼儿期起病的儿童哮喘与母亲孕期相关因素的关系,为今后儿童哮喘的防治工作及发病机制的深入研究提供依据。方法采用回顾性临床流行病学调查方法,选取3岁前起病的哮喘患儿100例,并随机选取无过敏性疾患的儿童100例作为对照,通过对患儿母亲问卷调查的形式,询问儿童一般情况

  1. Asthma control: Patient and environment

    NARCIS (Netherlands)

    Rijssenbeek-Nouwens, L.H.M.

    2015-01-01

    Control of asthma, the goal of asthma treatment, seems hard to obtain. However, it is largely unknown why control of asthma remains difficult in many patients in spite of available powerful medication. In this thesis we studied non-pharmacological factors influencing asthma control: patient related

  2. Factors associated with asthma control.

    NARCIS (Netherlands)

    Vries, M.P. de; Bemt, E.A.J.M. van den; Lince, S.; Muris, J.W.M.; Thoonen, B.P.A.; Schayck, C.P. van

    2005-01-01

    The aim of this study was to evaluate which factors are associated with asthma control experienced by asthma patients. In a cross-sectional study patients aged 16-60 years with mild to moderate asthma were selected. The influence of the following factors on asthma control was studied in a multivaria

  3. Advances in pediatric asthma in 2013: coordinating asthma care.

    Science.gov (United States)

    Szefler, Stanley J

    2014-03-01

    Last year's "Advances in pediatric asthma: moving toward asthma prevention" concluded that "We are well on our way to creating a pathway around wellness in asthma care and also to utilize new tools to predict the risk for asthma and take steps to not only prevent asthma exacerbations but also to prevent the early manifestations of the disease and thus prevent its evolution to severe asthma." This year's summary will focus on recent advances in pediatric asthma on prenatal and postnatal factors altering the natural history of asthma, assessment of asthma control, and new insights regarding potential therapeutic targets for altering the course of asthma in children, as indicated in Journal of Allergy and Clinical Immunology publications in 2013 and early 2014. Recent reports continue to shed light on methods to understand factors that influence the course of asthma, methods to assess and communicate levels of control, and new targets for intervention, as well as new immunomodulators. It will now be important to carefully assess risk factors for the development of asthma, as well as the risk for asthma exacerbations, and to improve the way we communicate this information in the health care system. This will allow parents, primary care physicians, specialists, and provider systems to more effectively intervene in altering the course of asthma and to further reduce asthma morbidity and mortality.

  4. The prevalence of asthma in schoolboys of travellers' families.

    LENUS (Irish Health Repository)

    Kearney, P M

    2012-02-03

    This study compared the prevalence of asthma in travelling schoolboys and settled controls to determine whether the travelling lifestyle may be a protective factor in the development of asthma. Information was collected by parental responses to the ISAAC (International Study of Asthma and Allergies in Childhood) questionnaire. The design was a cross-sectional study with descriptive and analytical components. The subjects were six to twelve year old schoolboys from all male travelling children in Cork and from a selection of settled schoolboys. In addition the study collected information on the predictor variables--age, passive smoking and number of siblings. The questionnaire was administered to 54 travelling boys and 129 controls. The parent reported prevalence of wheeze and related symptoms were all more common in controls compared with the travelling boys. The values were significant for wheeze in the last year (31.3% v 14.8%; OR-5.6, p = 0.025), and for doctor diagnosed asthma (25.6% v 11.1%; OR = 5.1, p = 0.04). Schoolboys from travelling families have less wheeze and doctor diagnosed asthma than controls. The experience of the travelling lifestyle maybe a protective factor in the development of asthma.

  5. Pre-natal exposure to paracetamol and risk of wheezing and asthma in children: A birth cohort study

    DEFF Research Database (Denmark)

    Rebordosa, Cristina; Kogevinas, Manolis; Sørensen, Henrik T

    2008-01-01

    BACKGROUND: Paracetamol use has been associated with increased prevalence of asthma in children and adults, and one study reported an association between pre-natal exposure to paracetamol and asthma in early childhood. METHODS: To examine if pre-natal exposure to paracetamol is associated...... with the risk of asthma or wheezing in early childhood, we selected 66 445 women from the Danish National Birth Cohort for whom we had information on paracetamol use during pregnancy and who participated in an interview when their children were 18-months-old and 12 733 women whose children had reached the age...... of 7 and estimated the prevalence of physician-diagnosed asthma and wheezing at the ages of 18 months and 7 years. We also linked our population to the Danish National Hospital Registry to record all hospitalizations due to asthma up to age of 18 months. RESULTS: Paracetamol use during any time...

  6. Childhood Schizophrenia

    Science.gov (United States)

    Childhood schizophrenia Overview By Mayo Clinic Staff Childhood schizophrenia is an uncommon but severe mental disorder in which children interpret reality abnormally. Schizophrenia involves a range of problems with thinking (cognitive), ...

  7. Exposure to secondhand smoke and asthma severity among children in Connecticut

    Science.gov (United States)

    Schifano, Elizabeth D.; Hammel, Christopher; Cloutier, Michelle M.

    2017-01-01

    Objective To determine whether secondhand smoke (SHS) exposure is associated with greater asthma severity in children with physician-diagnosed asthma living in CT, and to examine whether area of residence, race/ethnicity or poverty moderate the association. Methods A large childhood asthma database in CT (Easy Breathing) was linked by participant zip code to census data to classify participants by area of residence. Multinomial logistic regression models, adjusted for enrollment date, sex, age, race/ethnicity, area of residence, insurance type, family history of asthma, eczema, and exposure to dogs, cats, gas stove, rodents and cockroaches were used to examine the association between self-reported exposure to SHS and clinician-determined asthma severity (mild, moderate, and severe persistent vs. intermittent asthma). Results Of the 30,163 children with asthma enrolled in Easy Breathing, between 6 months and 18 years old, living in 161 different towns in CT, exposure to SHS was associated with greater asthma severity (adjusted relative risk ratio (aRRR): 1.07 [1.00, 1.15] and aRRR: 1.11 [1.02, 1.22] for mild and moderate persistent asthma, respectively). The odds of Black and Puerto Rican/Hispanic children with asthma being exposed to SHS were twice that of Caucasian children. Though the odds of SHS exposure for publicly insured children with asthma were three times greater than the odds for privately insured children (OR: 3.02 [2.84,3,21]), SHS exposure was associated with persistent asthma only among privately insured children (adjusted odds ratio (aOR): 1.23 [1.11,1.37]). Conclusion This is the first large-scale pragmatic study to demonstrate that children exposed to SHS in Connecticut have greater asthma severity, clinically determined using a systematic approach, and varies by insurance status. PMID:28362801

  8. Childhood obesity

    OpenAIRE

    Wilkinson, Justine; Howard, Simon

    2006-01-01

    Childhood obesity has important consequences for health and wellbeing both during childhood and also in later adult life. The rising prevalence of childhood obesity poses a major public health challenge in both developed and developing countries by increasing the burden of chronic non-communicable diseases. Despite the urgent need for effective preventative strategies, there remains disagreement over its definition due to a lack of evidence on the optimal cut-offs linking childhood BMI to dis...

  9. Early growth characteristics and the risk of reduced lung function and asthma

    DEFF Research Database (Denmark)

    den Dekker, Herman T; Sonnenschein-van der Voort, Agnes M M; de Jongste, Johan C;

    2016-01-01

    BACKGROUND: Children born preterm or with a small size for gestational age are at increased risk for childhood asthma. OBJECTIVE: We sought to assess the hypothesis that these associations are explained by reduced airway patency. METHODS: We used individual participant data of 24,938 children from...... 24 birth cohorts to examine and meta-analyze the associations of gestational age, size for gestational age, and infant weight gain with childhood lung function and asthma (age range, 3.9-19.1 years). Second, we explored whether these lung function outcomes mediated the associations of early growth...... characteristics with childhood asthma. RESULTS: Children born with a younger gestational age had a lower FEV1, FEV1/forced vital capacity (FVC) ratio, and forced expiratory volume after exhaling 75% of vital capacity (FEF75), whereas those born with a smaller size for gestational age at birth had a lower FEV1...

  10. Tobaksrygning og asthma

    DEFF Research Database (Denmark)

    Ulrik, Charlotte Suppli; Lange, Peter

    2002-01-01

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

  11. Eosinophilic Endotype of Asthma.

    Science.gov (United States)

    Aleman, Fernando; Lim, Hui Fang; Nair, Parameswaran

    2016-08-01

    Asthma is a heterogeneous disease that can be classified into different clinical endotypes, depending on the type of airway inflammation, clinical severity, and response to treatment. This article focuses on the eosinophilic endotype of asthma, which is defined by the central role that eosinophils play in the pathophysiology of the condition. It is characterized by elevated sputum and/or blood eosinophils on at least 2 occasions and by a significant response to treatments that suppress eosinophilia. Histopathologic demonstration of eosinophils in the airways provides the most direct diagnosis of eosinophilic asthma; but it is invasive, thus, impractical in clinical practice.

  12. Pediatric asthma disease management.

    Science.gov (United States)

    Myers, T R; Chatburn, R L

    2000-03-01

    The prevalence of asthma in children in the United States is estimated at more than 5% of the population, and it has risen more than 40% in the previous decade. Several guidelines for the management of acute and chronic asthma exist, and they all emphasize several basic components including state-of-the-art pharmacologic treatment, trigger avoidance, and patient self-management skills. This Article highlights the necessary components for pediatric asthma disease management to insure a smooth continuum of care across all disciplines and settings.

  13. The pool chlorine hypothesis and asthma among boys.

    LENUS (Irish Health Repository)

    Cotter, A

    2012-01-31

    Swimming pool sanitation has largely been concerned with the microbiological quality of pool water, which is normally treated using a number of chlorine products. Recent studies have pointed to the potential hazards of chlorine by-products to the respiratory epithelium, particularly in indoor, poorly ventilated, pools. The aim of our study was to elucidate whether chronic exposure to indoor chlorinated swimming pools was associated with an increased likelihood of the development of asthma in boys. METHODS: The subjects were boys aged between 6 and 12 years. Data was collected by means of parental responses to a standardized asthma questionnaire (ISAAC: International Study of Asthma and Allergies in Childhood), supplemented with additional questions regarding frequency of attendance, number of years attendance, whether the child is a swimming team member. The questionnaire return rate was 71\\/% (n = 121). 23 boys were excluded on the basis that they had asthma before they started swimming (n = 97). There was a significant association between number of years a boy had been swimming and the likelihood of wheezing in the last 12 months (p = 0.009; OR = 1.351; 95% CI = 1.077-1.693) and diagnosed asthma (p = 0.046; OR = 1.299; 95% CI = 1.004-1.506). The greater the number the number of years a boy had been attending an indoor, chlorinated pool, the greater the likelihood of wheezing in the last 12 months or "had asthma". Age, parental smoking habits and being a swimming team member had no association with any of the asthma variables examined. Swimming pool attendance may be a risk factor in asthma in boys.

  14. Long-acting β2-adrenergic receptor agonist in pediatric asthma

    Directory of Open Access Journals (Sweden)

    Shigemi Yoshihara

    2004-01-01

    Full Text Available Long-acting β2-adrenergic receptor agonists (LABA, a class of agents for the long-term management of childhood bronchial asthma, are recommended for use in combination with steroid inhalation for the treatment of the morning dip in severe childhood asthma. In the present review, salmeterol (SM, a LABA inhalant with a long-acting bronchodilator effect, was compared with the recently introduced tulobuterol patch (TBP in terms of safety and efficacy, based on their respective clinical effects on childhood asthma. From a clinical perspective, both drugs had a preventive effect by suppressing the morning dip and exercise-induced asthma when used concomitantly with an inhaled corticosteroid, and both agents were associated with a lower incidence of adverse effects on the cardiovascular system than oral β2-adrenergic receptor agonists. Based on these findings, both SM and TBP are concluded to be highly efficacious and safe bronchodilator agents that are appropriate for the long-term management of childhood asthma.

  15. Design and implementation of the asthma treat smart system in a pediatric institution

    Directory of Open Access Journals (Sweden)

    Judith W. Dexheimer

    2015-09-01

    Full Text Available Asthma is one of the most common chronic diseases of childhood, affecting an estimated 7 million children (9.4% in the United States. Asthma care is complex and dynamic requiring temporal, multi-faceted, and coordinated care. The purpose of the Asthma Treat Smart (ATS application was to help providers provide evidence-based, guideline-compliant care to patients presenting to the pulmonary clinic for treatment of asthma. The application guides the providers through collecting the necessary information to classify the patient’s severity and control and suggests appropriate medications according to the classification, age, and guidelines. The application helps to improve patient safety, healthcare provider training, and improves the quality of care patients receive by helping to align their chronic asthma care with national guidelines.

  16. Management of acute asthma in the pediatric patient: an evidence-based review.

    Science.gov (United States)

    Jones, Brittany Pardue; Paul, Audrey

    2013-05-01

    Asthma is the most common chronic disease of childhood, with asthma exacerbations and wheezing resulting in more than 2 million emergency department visits per year. Symptoms can vary from mild shortness of breath to fatal status asthmaticus. Given the high prevalence of asthma and its potential to progress from mild to moderate to life-threatening, it is vital for emergency clinicians to have a thorough understanding of acute asthma management. Current evidence clearly supports the use of inhaled bronchodilators and systemic steroids as first-line agents. However, in those who fail to respond to nitial therapies, a variety of adjunct therapies and interventions are available with varying degrees of evidence to support their use. This review focuses specifically on evaluation and treatment of pediatric asthma in the emergency department and reviews the current evidence for various modes of treatment.

  17. Stable admission rate for acute asthma in Danish children since 1977

    DEFF Research Database (Denmark)

    Sevelsted, Astrid; Pipper, Christian Bressen; Bisgaard, Hans

    2016-01-01

    Childhood asthma is consistently reported to have increased in recent decades in most westernized countries, but it is unknown if this increase is similar across severities. We aimed to study the time-trend of acute hospital admission and readmission for asthma of school-aged children in the recent...... 35 years in Denmark. We analyzed time-trends in the national incidence rate of hospitalization for acute severe asthma in children aged 5-15 in Denmark during the 35-year period 1977-2012 in the Danish national registry. Only in-patient admissions with a principal diagnosis of asthma (ICD-8: 493......** or ICD-10: J45** or J46**) were included. Among children with asthma hospitalizations, we investigated the risk of readmission beyond 1 month of first admission. Admissions were summarized as rates per thousand person years at risk. The overall time-trend is stable with a rate of one admission per year...

  18. Genetic associations with viral respiratory illnesses and asthma control in children

    DEFF Research Database (Denmark)

    Loisel, D A; Du, G; Ahluwalia, T S;

    2016-01-01

    BACKGROUND: Viral respiratory infections can cause acute wheezing illnesses in children and exacerbations of asthma. OBJECTIVE: We sought to identify variation in genes with known antiviral and pro-inflammatory functions to identify specific associations with more severe viral respiratory illnesses...... and the risk of virus-induced exacerbations during the peak fall season. METHODS: The associations between genetic variation at 326 SNPs in 63 candidate genes and 10 phenotypes related to viral respiratory infection and asthma control were examined in 226 children enrolled in the RhinoGen study. Replication...... of asthma control phenotypes was performed in 2128 children in the Copenhagen Prospective Study on Asthma in Childhood (COPSAC). Significant associations in RhinoGen were further validated using virus-induced wheezing illness and asthma phenotypes in an independent sample of 122 children enrolled...

  19. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Recommend on Facebook Tweet Share Compartir You can control your asthma and avoid an attack by taking ... people with asthma live healthier lives by gaining control over their asthma. Quick Links Asthma Action Plan ...

  20. TCM Differential Treatment of Cough Variant Asthma

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhong-de; DENG Yi-qi; ZHANG Yu; HAN Yun; LIN Lin; CHAO En-xiang

    2010-01-01

    @@ Cough variant asthma (CVA), also called latent asthma or cough asthma, is a special type of asthma. With gradually deepened understanding of CVA in recent years, good curative effect has been achieved in TCM treatment of CVA.

  1. What's an Asthma Flare-Up?

    Science.gov (United States)

    ... Your 1- to 2-Year-Old What's an Asthma Flare-Up? KidsHealth > For Parents > What's an Asthma ... of a straw that's being pinched. Causes of Asthma Flare-Ups People with asthma have airways that ...

  2. Know How to Use Your Asthma Inhaler

    Medline Plus

    Full Text Available ... Children with Current Asthma Overuse of quick-relief medication among persons with active asthma Use of long-term control medication among persons with active asthma Uncontrolled Asthma among ...

  3. Self-Esteem, Self-Focused Attention, and the Mediating Role of Fear of Negative Evaluation in College Students with and without Asthma

    Science.gov (United States)

    Junghans-Rutelonis, Ashley N.; Suorsa, Kristina I.; Tackett, Alayna P.; Burkley, Edward; Chaney, John M.; Mullins, Larry L.

    2015-01-01

    Objective: The current study investigated the mediating role of fear of negative evaluation on the relationship between self-focused attention and self-esteem among college students with and without asthma. Participants: Young adults with (n = 148) and without (n = 530) childhood-onset asthma were recruited from a college student population.…

  4. Asthma Triggers: Gain Control

    Science.gov (United States)

    Jump to main content US EPA United States Environmental Protection Agency Search Search Asthma Share Facebook Twitter Google+ ... remove an animal from the home, it is important to thoroughly clean the floors, walls, carpets and ...

  5. Asthma Medications and Pregnancy

    Science.gov (United States)

    ... correctly. Other Asthma Related Medication Treatment Annual influenza vaccine (flu shot) The annual flu shot is recommended for ... second or third trimester. Read more about the flu vaccine . Immunotherapy (allergy shots) Allergy shots should not be ...

  6. Asthma and Food Allergies

    Science.gov (United States)

    ... Pediatrician Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions Cleft & Craniofacial Developmental ... prepared food. Last Updated 11/21/2015 Source Nutrition: What Every Parent Needs to Know (Copyright © American ...

  7. Interleukin-16 in asthma

    Institute of Scientific and Technical Information of China (English)

    DENG Jing-min; SHI Huan-zhong

    2006-01-01

    @@ Bronchial asthma is a chronic inflammatory disease of the airways that is characterized by lymphocyte, eosinophil, and mast cell infiltration of the submucosa along with mucous gland hyperplasia and subepithelial fibrosis.

  8. Zoneterapi og asthma

    DEFF Research Database (Denmark)

    Brygge, Thor; Heinig, John Hilligsøe; Collins, Philippa;

    2002-01-01

    INTRODUCTION: Many patients with asthma seek alternative or adjunctive therapies. One such modality is reflexology. Our aim was to examine the popular claim that reflexology treatment benefits bronchial asthma. MATERIAL AND METHODS: Ten weeks of either active or simulated (placebo) reflexology were...... compared in an otherwise blind, controlled trial of 40 patients with asthma. RESULTS: Objective lung function tests did not change. Subjective scores and bronchial sensitivity to histamine improved on both regimens, but no differences were found in the groups receiving active or placebo reflexology....... However, a trend in favour of reflexology became significant when a supplementary analysis of symptom diaries was carried out. At the same time a significant pattern compatible with subconscious un-blinding was found. DISCUSSION: We found no evidence that reflexology has a specific effect on asthma beyond...

  9. Inhaled Asthma Medications

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  10. Asthma, Allergies and Pregnancy

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  11. Exercise and Asthma

    Science.gov (United States)

    ... Education Center Fellows-in-Training Grants & Awards Program Directors Practice Resources ASTHMA IQ Consultation and Referral Guidelines Practice Financial Survey Practice Tools Running a Practice Statements and Practice Parameters About AAAAI Advocacy Allergist / Immunologists: ...

  12. Precipitating factors of asthma.

    Science.gov (United States)

    Lee, T H

    1992-01-01

    Asthma is characterised by bronchial hyperresponsiveness. This feature of the asthmatic diathesis predisposes patients to wheezing in response to a number of different factors. These precipitating factors include specific allergen acting via sensitised mediator cells through an IgE-dependent mechanism. There are irritants which may work through a non-specific manner, or stimuli such as exercise and hyperventilation, which probably also act through mediator release via a non-IgE-dependent manner. The mechanism whereby physical stimuli such as exercise induce bronchoconstriction is of interest, because it increases the context in which the mast cell may participate in acute asthmatic bronchoconstriction. Respiratory infections also commonly provoke asthma, especially in infants and may, indeed, precipitate the asthmatic state itself. Finally, drugs can often trigger asthma attacks and the mechanisms of asthma precipitated by non-steroidal anti-inflammatory drugs such as aspirin have been the subject of recent research.

  13. Relvar Ellipta for asthma.

    Science.gov (United States)

    2014-08-01

    ▼Relvar Ellipta (GSK) is a dry powder inhaler that contains a corticosteroid (fluticasone furoate) and a long-acting beta2 agonist (vilanterol trifenatate). It is licensed for once-daily use as maintenance therapy for chronic obstructive pulmonary disease (COPD) and asthma. In a previous article we considered its use in the management of COPD.1 Here we review the evidence for Relvar Ellipta in the treatment of patients with asthma.

  14. Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: The Ahsmog study

    Energy Technology Data Exchange (ETDEWEB)

    McDonnell, W.F. [Environmental Protection Agency, Research Triangle Park, NC (United States). National Health and Environmental Effects Research Lab.; Abbey, D.E.; Nishino, N. [Loma Linda Univ., CA (United States). School of Public Health; Lebowitz, M.D. [Univ. of Arizona Coll. of Medicine, Tucson, AZ (United States).

    1999-02-01

    The authors conducted a prospective study of a cohort of 3091 nonsmokers, ages 27 to 87 years, to evaluate the association between long-term ambient ozone exposure and development of adult-onset asthma. Over a 15-year period, 3.2% of males and 4.3% of females reported new doctor diagnoses of asthma. For males, they observed a significant relationship between report of doctor diagnosis of asthma and 20-year mean 8-h average ambient ozone concentration. The authors observed no such relationship for females. Other variables significantly related to development of asthma were a history of ever-smoking for males, and for females, number of years worked with a smoker, age, and a history of childhood pneumonia or bronchitis. Addition of other pollutants to the models did not diminish the relationship between ozone and asthma for males. These data suggest that long-term exposure to ambient ozone is associated with development of asthma in adult males.

  15. FeNO and Bronchial Responsiveness are Associated and Continuous traits in Young Children Independent of Asthma

    DEFF Research Database (Denmark)

    Schoos, Ann-Marie Malby; Chawes, Bo Lund Krogsgaard; Bønnelykke, Klaus;

    2012-01-01

    ABSTRACT BACKGROUND Elevated fraction of exhaled nitric oxide (FeNO) and bronchial hyperresponsiveness are used as surrogate markers of asthma. These traits may be continuous in the population. OBJECTIVE To investigate whether FeNO and bronchial responsiveness are associated both in children...... with and in children without a history of asthma symptoms. METHODS 196 six-year-old children comprising asymptomatic children, children with intermittent asthmatic symptoms and children with persistent asthma were randomly included from the Copenhagen Prospective Study on Asthma in Childhood (COPSAC2000) high...... adjustment for gender, allergic rhinitis, current asthma, inhaled corticosteroid treatment and upper respiratory tract infections prior to testing. Stratified analyses showed similar associations in children with and without asthma. CONCLUSION FeNO and bronchial responsiveness are associated traits...

  16. [Asthma, obesity and diet].

    Science.gov (United States)

    Barranco, P; Delgado, J; Gallego, L T; Bobolea, I; Pedrosa, Ma; García de Lorenzo, A; Quirce, S

    2012-01-01

    Asthma and obesity have a considerable impact on public health and their prevalence has increased in recent years. Numerous studies have linked both disorders. Most prospective studies show that obesity is a risk factor for asthma and have found a positive correlation between baseline body mass index (BMI) and the subsequent development of asthma, although these results are not conclusive when studying the association between airway hyperresponsiveness with BMI. Furthermore, several studies suggest that whereas weight gain increases the risk of asthma, weight loss improves the course of the illness. Different factors could explain this association. Obesity is capable of reducing pulmonary compliance, lung volumes and the diameter of peripheral respiratory airways as well as affecting the volume of blood in the lungs and the ventilation-perfusion relationship. Furthermore, the increase in the normal functioning of adipose tissue in obese subjects leads to a systemic proinflammatory state, which produces a rise in the serum concentrations of several cytokines, the soluble fractions of their receptors and chemokines. Many of these mediators are synthesized and secreted by cells from adipose tissue and receive the generic name of adipokines, including IL-6, IL-10, eotaxin, TNF-α, TGF- 1, PCR, leptin y adiponectin. Finally, specific regions of the human genome which are related to both asthma and obesity have been identified. Most studies point out that obesity is capable of increasing the prevalence and incidence of asthma, although this effect appears to be modest. The treatment of obese asthmatics must include a weight control program.

  17. A survey of childhood asthma control situation and awareness of parents about the related knowledge in Xi'an%儿童哮喘控制现状及家长对疾病认知水平调查——西安地区单中心研究

    Institute of Scientific and Technical Information of China (English)

    侯伟; 刘海燕; 李静; 周戬平; 葛利吉; 叶高波; 赵娟

    2011-01-01

    目的 了解西安地区儿童哮喘控制现状及患儿家长对哮喘的认知水平,并分析其影响因素,为哮喘规范治疗和管理提供依据.方法 选取在西安交通大学医学院第二附属医院儿童哮喘门诊就诊且哮喘规范化治疗超过6个月的哮喘患儿,采用问卷调查方法,哮喘专科医生与患儿及其家长面对面沟通,可由父母共同参与完成,填写完成后由医生当场核查,并对数据进行统计分析.结果 收集的118例问卷显示:①患儿首次喘息发病年龄平均为5.1±3.7岁,首次喘息发作距确诊哮喘时间为2.3±1.6年;患儿中有55.1%合并过敏性鼻炎、50.0%有湿疹、28.8%有哮喘家族史;②患儿在三甲医院确诊哮喘占67.8%、二级及以下医院确诊占32.2%.89.0%的患儿在哮喘未发作时能够定期复诊,59.3%的患儿在过去12个月内有喘息发作,发作次数平均为4.2±2.5次.78.8%的患儿进行了肺功能检查,32.2%的患儿进行过敏原检测;③51.7%的患儿使用吸入激素与长效β2受体激动剂联合制剂,39.8%单独吸入激素,62.7%的家长选择喘息发作大于3次诊断为哮喘;④家长哮喘知识79.7%来自医生的讲解、44.9%为大众媒体宣传、29.7%为哮喘健康知识讲座.72.9%的家长最希望与医护人员一对一交流获得哮喘知识.结论 通过对儿童哮喘疾病的管理,可改善儿童哮喘的控制与家长对疾病的认知水平.%Objective To investigate the childhood asthma control situation and awareness of parents about the related knowledge in Xi' an. and to analyze the influencing factors so as to explore a new method of treatment and management of asthmatic children. Methods Questionnaires were distrihuted to the asthmatic children and their parents visiting the outpatients department of Second Hospital of Xi' an Jiaotong University. Asthma was diagnosed in the children and they were ohserved for more than 6 months. Results Asthma was diagnosed in children 2. 3 ± 1. 6

  18. Role of Asthma Education in the Management of Adult Asthma

    Directory of Open Access Journals (Sweden)

    Johanne Côté

    1995-01-01

    Full Text Available When a patient is newly diagnosed as having asthma, he or she is often prescribed new medication without getting much information on the disease and its treatment. This article emphasizes the need to educate asthmatics. Asthma treatment should begin with a proper adjustment of the medication, allowing asthmatics to lead a normal life. All asthmatics should be shown how to use their inhalation device properly. They should he knowledgeable about the basic aspects of asthma, airway inflammation and bronchoconstriction, use or medication and early symptoms heralding an asthma attack. Environmental factors that may trigger an asthma attack should be explained. Patients should be able to self-monitor asthma using either symptom severity or a peak flow meter. Because asthma is an unpredictable disease, patients should have a self-action plan to implement when their asthma deteriorates.

  19. The Significance of Asthma Follow-Up Consultations for Adherence to Asthma Medication, Asthma Medication Beliefs, and Asthma Control

    Directory of Open Access Journals (Sweden)

    Malin Axelsson

    2015-01-01

    Full Text Available Objective. The aim was to investigate adherence to asthma medication treatment, medication beliefs, and asthma control in relation to asthma follow-up consultations in asthmatics in the general population. A further aim was to describe associations between adherence, medication beliefs, and asthma control. Method. In the population-based West Sweden Asthma Study, data allowing calculation of adherence for 4.5 years based on pharmacy records were obtained from 165 adult asthmatics. Additional data were collected through questionnaires and structured interviews. Results. The mean adherence value for filled prescriptions for regular asthma medication was 68% (median 55.3% but varied over the year under study. Adherence to combination inhalers with corticosteroids and long-acting beta2 agonists was higher than adherence to single inhalers with corticosteroids only. More than one-third of participants reported not having seen an asthma nurse or physician for several years. Regular asthma follow-up consultations were associated with both higher adherence and the belief that asthma medication was necessary but were not associated with asthma control. Conclusions. Adherence to asthma medication treatment was low and varied over the year under study. The current study suggests that quality improvements in asthma care are needed if adherence to asthma medication is to be improved.

  20. Maternal use of folic acid supplements during pregnancy, and childhood respiratory health and atopy

    NARCIS (Netherlands)

    Bekkers, Marga B. M.; Elstgeest, Liset E. M.; Soholtens, Salome; Haveman-Nies, Annemien; de Jongste, Johan C.; Kerkhof, Marjan; Koppelman, Gerard H.; Gehring, Ulrike; Smit, Henriette A.; Wijga, Alet H.

    2012-01-01

    Previous studies have suggested possible adverse side-effects of maternal use of folic acid-containing supplements (FACSs) during pregnancy on wheeze and asthma in early childhood. We investigated the association between maternal use of FACSs and childhood respiratory health and atopy in the first 8

  1. Repeatability of Response to Asthma Medications

    Science.gov (United States)

    Wu, Ann; Tantisira, Kelan; Li, Lingling; Schuemann, Brooke; Weiss, Scott

    2010-01-01

    Background Pharmacogenetic studies of drug response in asthma assume that patients respond consistently to a treatment but that treatment response varies across patients, however, no formal studies have demonstrated this. Objective To determine the repeatability of commonly used outcomes for treatment response to asthma medications: bronchodilator response, forced expiratory volume in 1 second (FEV1), and provocative concentration of methacholine producing a 20% decline in FEV1 (PC20). Methods The Childhood Asthma Management Program (CAMP) was a multi-center clinical trial of children randomized to receiving budesonide, nedocromil, or placebo. We determined the intraclass correlation coefficient (ICC) for each outcome over repeated visits over four years in CAMP using mixed effects regression models. We adjusted for the covariates: age, race/ethnicity, height, family income, parental education, and symptom score. We incorporated each outcome for each child as repeated outcome measurements and stratified by treatment group. Results The ICC for bronchodilator response was 0.31 in the budesonide group, 0.35 in the nedocromil group, and 0.40 in the placebo group, after adjusting for covariates. The ICC for FEV1 was 0.71 in the budesonide group, 0.60 in the nedocromil group, and 0.69 in the placebo group, after adjusting for covariates. The ICC for PC20 was 0.67 in the budesonide and placebo groups and 0.73 in the nedocromil group, after adjusting for covariates. Conclusion The within treatment group repeatability of FEV1 and PC20 are high; thus these phenotypes are heritable. FEV1 and PC20 may be better phenotypes than bronchodilator response for studies of treatment response in asthma. PMID:19064281

  2. Genetics Home Reference: allergic asthma

    Science.gov (United States)

    ... 1 link) American Academy of Allergy Asthma and Immunology: Asthma Treatment and Management General Information from MedlinePlus (5 links) Diagnostic Tests Drug Therapy Genetic Counseling Palliative Care Surgery and Rehabilitation Related Information How are genetic conditions ...

  3. Allergy and Asthma Health Magazine

    Science.gov (United States)

    ... Of Age Older Adults Allergy and Asthma Health Magazine Women Infant, Children and Teenagers Living With Lung ... written by Respiratory Experts Like no other health magazine, Allergy & Asthma Health Magazine is published by people ...

  4. Smoking and Asthma (For Parents)

    Science.gov (United States)

    ... get absorbed into upholstery, clothing, and carpeting, leaving carcinogens that can't be washed away with soap ... asthma, let friends, relatives, and caregivers know that tobacco smoke may cause an asthma flare-up. To ...

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

    Directory of Open Access Journals (Sweden)

    Hartmut Vogt

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

  6. URECA: Efficient Resource Location Middleware for Ubiquitous Environment

    Institute of Scientific and Technical Information of China (English)

    Donggeon Noh; Heonshik Shin

    2008-01-01

    We describe an effective resource location framework for ubiquitous computing environments populated by a diverse set of networks, devices, services and computational entities. Our framework provides context adaptation with the aid of a middleware service to improve the quality of resource location. A resource location protocol suitable to each type of network locates resource effectively by means of dynamic reconfiguration to the current context. Our framework is also refined by support for interoperability between different types of resource location protocols occurring across a hybrid ubiquitous network. These characteristics also reduce the control overhead for resource location, saving resource, decreasing latency and permitting a considerable degree of scalability.

  7. Reduced work ability in middle-aged men with asthma from youth--a 20-year follow-up.

    Science.gov (United States)

    Lindström, Irmeli; Pallasaho, Paula; Luukkonen, Ritva; Suojalehto, Hille; Karjalainen, Jouko; Lauerma, Antti; Karjalainen, Antti

    2011-06-01

    We studied, whether asthma diagnosed in childhood or early adulthood affects work ability 20 years later. We used Finnish Defence Force registers, 1986-1990, to select: (1) conscripts with asthma to represent a mild/moderate asthma group (n=485), (2) asthmatics who were exempted from military service to represent a relatively severe asthma group (n=393) and (3) a control group (n 1500) without asthma. A questionnaire consisting of validated questions on asthma and work ability was sent out in 2009. A total of 54% of the men in the first study group, 44% of those in the second study group and 44% of the controls answered. The mean age of the participants was 41 (range 37-51). Self-assessed current work ability compared with lifetime best had decreased in 28.9% of the first asthma group, in 31.1% of the second asthma group, and in 19.7% of the controls (p = 0.0007). Current smoking (OR 2.5), only basic education (OR 2.6), being a manual worker (OR 2.7) and current severe asthma (OR 3.8) associated most strongly with decreased work ability among the asthmatics. Both mild and more severe asthma at the age of around 20 seems to be associated with reduced work ability in 40-year-old males.

  8. The Global Asthma Network rationale and methods for Phase I global surveillance: prevalence, severity, management and risk factors.

    Science.gov (United States)

    Ellwood, Philippa; Asher, M Innes; Billo, Nils E; Bissell, Karen; Chiang, Chen-Yuan; Ellwood, Eamon M; El-Sony, Asma; García-Marcos, Luis; Mallol, Javier; Marks, Guy B; Pearce, Neil E; Strachan, David P

    2017-01-01

    The Global Asthma Network (GAN), established in 2012, followed the International Study of Asthma and Allergies in Childhood (ISAAC). ISAAC Phase One involved over 700 000 adolescents and children from 156 centres in 56 countries; it found marked worldwide variation in symptom prevalence of asthma, rhinitis and eczema that was not explained by the current understanding of these diseases; ISAAC Phase Three involved over 1 187 496 adolescents and children (237 centres in 98 countries). It found that asthma symptom prevalence was increasing in many locations especially in low- and middle-income countries where severity was also high, and identified several environmental factors that required further investigation.GAN Phase I, described in this article, builds on the ISAAC findings by collecting further information on asthma, rhinitis and eczema prevalence, severity, diagnoses, asthma emergency room visits, hospital admissions, management and use of asthma essential medicines. The subjects will be the same age groups as ISAAC, and their parents. In this first global monitoring of asthma in children and adults since 2003, further evidence will be obtained to understand asthma, management practices and risk factors, leading to further recognition that asthma is an important non-communicable disease and to reduce its global burden.

  9. Polymorphisms and haplotypes of the chromosome locus 17q12-17q21.1 contribute to adult asthma susceptibility in Slovenian patients.

    Science.gov (United States)

    Žavbi, Mateja; Korošec, Peter; Fležar, Matjaž; Škrgat Kristan, Sabina; Marc Malovrh, Mateja; Rijavec, Matija

    2016-06-01

    One of the major asthma susceptibility loci is 17q12-17q21.1, but the relationship between this locus and adult asthma is unclear. Association analysis of 13 single nucleotide polymorphisms (SNPs) and haplotypes from 17q12-17q21.1 was performed in 418 adult patients with asthma and 288 controls from Slovenia. Single SNP analysis revealed only marginal associations with adult asthma for SNPs located in GSDMA, GSDMB, ORMDL3 and ZPBP2 genes, and rs7219080 was the most highly associated. Analyses of asthma phenotypes found no association with atopy or lung function, but rs2305480 and rs8066582 were associated with childhood asthma and rs9916279 was associated with asthma in smokers. Notably, haplotypes consisting of rs9916279, rs8066582, rs1042658, and rs2302777 harbouring PSMD3, CSF3 and MED24 genes were highly associated with asthma. The four most common haplotypes, TCCG, TTTA, CCCA and TTCA, were more frequent in patients with asthma, whereas TTCG, TCCA, TCTA and TTTG were more frequent in controls. Only 3% of asthma patients belonged to haplotypes TTCG, TCCA, TCTA and TTTG compared with nearly one-third (31%) of controls. Associations confirmed that the 17q12-17q21.1 locus harbours a genetic determinant for asthma risk in adults and suggest that in addition to the previously known ORMDL3-GSDM locus, CSF3-PSMD3-MED24 also plays a role in asthma pathogenesis.

  10. Agricultural exposure and asthma risk in the AGRICAN French cohort.

    Science.gov (United States)

    Baldi, Isabelle; Robert, Céline; Piantoni, Florence; Tual, Séverine; Bouvier, Ghislaine; Lebailly, Pierre; Raherison, Chantal

    2014-01-01

    Epidemiological studies have reported an increased risk of respiratory diseases in agricultural population, but a protective "farm-effect" has also been reported for asthma. In the AGRICAN cohort, self-reported doctor-diagnosed asthma was analyzed according to allergy, in relation with history of life-time exposure to 13 crops and 5 livestock, pesticide exposure and early life on a farm, taking into account sex, age, education and body mass index. Among the 1246 asthmatics (8.0%), 505 were allergic (3.3%) and 719 non-allergic (4.6%). In multivariate analysis, a significant excess was observed, only for allergic asthma, in vine-growing (OR=1.43, p=0.002), fruit-growing (OR=1.58, p=0.001), greenhouses (OR=1.66, p=0.02), grasslands (OR=1.35, p=0.009), beets (OR=1.52, p=0.003) and horses (OR=1.35, p=0.04). Pesticide use and history of pesticide poisoning were significantly associated with allergic asthma in grassland, vineyards and fruit-growing and with non-allergic asthma in beets. Living on a farm in the first year of life tended to be protective for childhood allergic asthma in farms with livestock (OR=0.72, p=0.07) but deleterious in farms with vineyards, fruit or vegetables (OR=1.44, p=0.07). In AGRICAN, an increased risk of allergic asthma was observed with crop exposure, pesticide use and early life on a farm, especially in vine-growing, grassland, beets, fruit and vegetable-growing.

  11. Perinatal Gene-Gene and Gene-Environment Interactions on IgE Production and Asthma Development

    Directory of Open Access Journals (Sweden)

    Jen-Chieh Chang

    2012-01-01

    Full Text Available Atopic asthma is a complex disease associated with IgE-mediated immune reactions. Numerous genome-wide studies identified more than 100 genes in 22 chromosomes associated with atopic asthma, and different genetic backgrounds in different environments could modulate susceptibility to atopic asthma. Current knowledge emphasizes the effect of tobacco smoke on the development of childhood asthma. This suggests that asthma, although heritable, is significantly affected by gene-gene and gene-environment interactions. Evidence has recently shown that molecular mechanism of a complex disease may be limited to not only DNA sequence differences, but also gene-environmental interactions for epigenetic difference. This paper reviews and summarizes how gene-gene and gene-environment interactions affect IgE production and the development of atopic asthma in prenatal and childhood stages. Based on the mechanisms responsible for perinatal gene-environment interactions on IgE production and development of asthma, we formulate several potential strategies to prevent the development of asthma in the perinatal stage.

  12. Japanese Guideline for Adult Asthma

    Directory of Open Access Journals (Sweden)

    Ken Ohta

    2011-01-01

    Full Text Available Adult bronchial asthma (hereinafter, asthma is characterized by chronic airway inflammation, reversible airway narrowing, and airway hyperresponsiveness. Long-standing asthma induces airway remodeling to cause an intractable asthma. The number of patients with asthma has increased, while the number of patients who die from asthma has decreased (1.7 per 100,000 patients in 2009. The aim of asthma treatment is to enable patients with asthma to lead a healthy life without any symptoms. A partnership between physicians and patients is indispensable for appropriate treatment. Long-term management with agents and elimination of causes and risk factors are fundamental to asthma treatment. Four steps in pharmacotherapy differentiate mild to intensive treatments; each step includes an appropriate daily dose of an inhaled corticosteroid (ICS, varying from low to high doses. Long-acting β2 agonists (LABA, leukotriene receptor antagonists, and theophylline sustained-release preparation are recommended as concomitant drugs, while anti-IgE antibody therapy is a new choice for the most severe and persistent asthma. Inhaled β2 agonists, aminophylline, corticosteroids, adrenaline, oxygen therapy, etc., are used as needed against acute exacerbations. Allergic rhinitis, chronic obstructive pulmonary disease (COPD, aspirin induced asthma, pregnancy, and cough variant asthma are also important factors that need to be considered.

  13. Genetics of onset of asthma

    NARCIS (Netherlands)

    Dijk, F. Nicole; de Jongste, Johan C.; Postma, Dirkje S.; Koppelman, Gerard H.

    2013-01-01

    Purpose of review Most asthma starts early in life. Defining phenotypes of asthma at this age is difficult as many preschool children have asthma-like respiratory symptoms. This review discusses progress in defining early wheezing phenotypes and describes genetic factors associated with the age of o

  14. Defining asthma in genetic studies

    NARCIS (Netherlands)

    Koppelman, GH; Postma, DS; Meijer, G.

    1999-01-01

    Genetic studies have been hampered by the lack of a gold standard to diagnose asthma. The complex nature of asthma makes it more difficult to identify asthma genes. Therefore, approaches to define phenotypes, which have been successful in other genetically complex diseases, may be applied to define

  15. How Do Asthma Medicines Work?

    Science.gov (United States)

    ... What Happens in the Operating Room? How Do Asthma Medicines Work? KidsHealth > For Kids > How Do Asthma Medicines Work? A A A en español ¿Cómo funcionan los medicamentos para el asma? People with asthma have what is called a chronic (say: KRAH- ...

  16. Rhinitis: a complication to asthma

    DEFF Research Database (Denmark)

    Hansen, J W; Thomsen, S F; Nolte, H;

    2010-01-01

    Asthma and rhinitis often co-occur, and this potentially increases the disease severity and impacts negatively on the quality of life. We studied disease severity, airway responsiveness, atopy, quality of life and treatment in subjects with both asthma and rhinitis compared to patients with asthma...

  17. Association between bronchial asthma in atopic children and their number of siblings

    Directory of Open Access Journals (Sweden)

    Johan El Hakim Siregar

    2014-09-01

    Full Text Available Background The prevalence of asthma in children has increased in many countries. Environmental factors are believed to play an important role and an inverse relationship between number of siblings and atopic disorders has been observed. Objective To assess for an association between bronchial asthma in atopic children and their number of siblings. Methods A cross-sectional study was conducted from June to November 2010 in three elementary schools in Medan, North Sumatera. Trace cards from the Allergy-Immunology Indonesian Pediatric Association (IDAI Working Group and questionnaires on the clinical history of atopy were used to screen children with the risk of atopy. The International Study of Asthma and Allergies in Childhood (ISAAC questionnaire to screen for bronchial asthma was distributed to children aged 7-10 years with a history of asthma, allergic rhinitis or atopic dermatitis. Subjects were divided into two groups, those with <3 siblings and those with ≥3 siblings. Chi-square test was used to analyze differences in bronchial asthma prevalence between the two groups. Results Ninety-six subjects enrolled in the study, with 48 subjects per group. The prevalence of bronchial asthma was significantly higher in atopic children who had <3 siblings than in children with ≥3 siblings (73.5% and 26.5%, respectively; P=0.04. Conclusion Bronchial asthma was significantly more frequent in children with less than 3 siblings compared to those with 3 or more siblings. [Paediatr Indones. 2014;54:289-93.].

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

    Science.gov (United States)

    Bønnelykke, Klaus; Ober, Carole

    2016-03-01

    Asthma is a heterogeneous clinical syndrome that includes subtypes of disease with different underlying causes and disease mechanisms. Asthma is caused by a complex interaction between genes and environmental exposures; early-life exposures in particular play an important role. Asthma is also heritable, and a number of susceptibility variants have been discovered in genome-wide association studies, although the known risk alleles explain only a small proportion of the heritability. In this review, we present evidence supporting the hypothesis that focusing on more specific asthma phenotypes, such as childhood asthma with severe exacerbations, and on relevant exposures that are involved in gene-environment interactions (GEIs), such as rhinovirus infections, will improve detection of asthma genes and our understanding of the underlying mechanisms. We will discuss the challenges of considering GEIs and the advantages of studying responses to asthma-associated exposures in clinical birth cohorts, as well as in cell models of GEIs, to dissect the context-specific nature of genotypic risks, to prioritize variants in genome-wide association studies, and to identify pathways involved in pathogenesis in subgroups of patients. We propose that such approaches, in spite of their many challenges, present great opportunities for better understanding of asthma pathogenesis and heterogeneity and, ultimately, for improving prevention and treatment of disease.

  19. Allergic Rhinitis in Childhood - Review

    Directory of Open Access Journals (Sweden)

    Arzu Babayiğit

    2010-12-01

    Full Text Available Allergic rhinitis, an immunoglobulin E mediated disease, is the most common chronic allergic childhood disease. The disease is characterized by nasal sneezing, rhinorrhea, palate and eye itchiness, and congestion and it can significantly impact children’s health. It causes uncomfortable symptoms, impairs quality of life and can predispose to the development of comorbidities such as asthma. Etiological diagnosis is based on cutaneous prick tests, which have a high sensitivity and specificity rate and which can be easily applied to young children. Treatment initially involves avoidance measures and, when necessary, pharmacotherapy or immunotherapy. Pharmacotherapy generally involves antihistamines and/or nasal corticosteroids, but leukotriene antagonists have also demonstrated effectiveness in treating allergic rhinitis symptoms. In this article, the symptoms, diagnosis and treatment of allergic rhinitis in childhood are discussed. (Journal of Current Pediatrics 2010; 8: 105-12

  20. Prevalence and socioeconomic associations of asthma and allergic rhinitis in northern [corrected] Africa.

    Science.gov (United States)

    Georgy, V; Fahim, H I; El-Gaafary, M; Walters, S

    2006-10-01

    The aims of the current study were to ascertain the prevalence of asthma and allergic rhinoconjunctivitis symptoms in Cairo, Egypt (northern Africa), and to elucidate the socioeconomic factors associated with symptom prevalence and severity. A translated and adapted version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire was distributed to a sample of 2,645 11-15-yr-olds in state and fee-paying schools in Cairo. The overall prevalences of wheeze ever, wheeze during the last year and physician-diagnosed asthma were 26.5% (697 out of 2,631), 14.7% (379 out of 2,570) and 9.4% (246 out of 2,609), respectively. The prevalence of rhinoconjunctivitis was 15.3% (399 out of 2,616). Asthma symptoms were independently associated with attendance at a state school, parental asthma, age, history of rhinitis and owning a pet cat. Rhinoconjunctivitis was independently associated with attendance at a state school, father's education, parental history of asthma, asthma symptoms and owning a pet cat. In spite of a higher prevalence of severe asthma symptoms in state schools prevalence of physician diagnosis of asthma was the same in both school types, suggesting inequalities in access to healthcare. In conclusion, the prevalence of physician-diagnosed asthma in Cairo was 9.4%, while the prevalence of rhinoconjunctivitis was 15.3%. There is a higher prevalence and increased severity of asthma symptoms in children of lower socioeconomic groups, as defined by state school attendance in Cairo.

  1. Population Health Considerations for Pediatric Asthma: Findings from the 2011-2012 California Health Interview Survey.

    Science.gov (United States)

    Shaikh, Ulfat; Byrd, Robert S

    2016-04-01

    Childhood asthma is a prevalent and costly chronic condition. Optimal management enables secondary and tertiary prevention. The goal was to identify population health considerations for pediatric asthma in California to inform the development of quality improvement interventions. California Health Interview Survey 2011-2012 is a random-digit dial telephone survey conducted in 5 languages. It includes 44,000 households from all 58 counties in California. This study assessed factors related to symptom control and health care use in children ages 2-11 years with asthma. An estimated 492,385 (9.6%) of children in California currently have asthma. Urban and rural residents face comparable asthma disease burdens. School-age male children as well as Asian and African American children are disproportionately affected. Asthma causes significant morbidity, with poorer health status, high utilization of emergency care, and the need for daily medication use. Only 38% of children with asthma have a recent asthma management plan. Half of all children with asthma did not receive influenza immunization in the past year, although this reflects the overall low rate of influenza vaccination. Parents of children with asthma frequently utilize the Internet for health information and communication with their child's health care provider. Children with asthma in California face several population-level challenges, including poor health status, low influenza vaccination rates, high use of emergency care, and suboptimal use of health literacy tools. Focusing on improved care coordination and preventive care for high-risk groups is especially urgent given the expansion of public health insurance and impending shortages in the primary care workforce. (Population Health Management 2016;19:145-151).

  2. What accounts for the association between late preterm births and risk of asthma?

    Science.gov (United States)

    Voge, Gretchen A.; Carey, William A.; Ryu, Euijung; King, Katherine S.; Wi, Chung-Il

    2017-01-01

    Background: Although results of many studies have indicated an increased risk of asthma in former late preterm (LPT) infants, most of these studies did not fully address covariate imbalance. Objective: To compare the cumulative frequency of asthma in a population-based cohort of former LPT infants to that of matched term infants in their early childhood, when accounting for covariate imbalance. Methods: From a population-based birth cohort of children born 2002–2006 in Olmsted County, Minnesota, we assessed a random sample of LPT (34 to 36 6/7 weeks) and frequency-matched term (37 to 40 6/7 weeks) infants. The subjects were followed-up through 2010 or censored based on the last date of contact, with the asthma status based on predetermined criteria. The Kaplan-Meier method was used to estimate the cumulative incidence of asthma during the study period. Cox models were used to estimate the hazard ratio and 95% confidence interval for the risk of asthma, when adjusting for potential confounders. Results: LPT infants (n = 282) had a higher cumulative frequency of asthma than did term infants (n = 297), 29.9 versus 19.5%, respectively; p = 0.01. After adjusting for covariates associated with the risk of asthma, an LPT birth was not associated with a risk of asthma, whereas maternal smoking during pregnancy was associated with a risk of asthma. Conclusion: LPT birth was not independently associated with a risk of asthma and other atopic conditions. Clinicians should make an effort to reduce exposure to smoking during pregnancy as a modifiable risk factor for asthma. PMID:28234052

  3. Preschool asthma in Italy: prevalence, risk factors and health resource utilization.

    Science.gov (United States)

    Peroni, Diego G; Piacentini, Giorgio L; Bodini, Alessandro; Boner, Attilio L

    2009-01-01

    Asthma in preschool children is greatly under-diagnosed worldwide. Aim was to investigate prevalence of wheezing, and asthma risk factors, doctor diagnosis, treatment and health resource utilization in preschool children. About 1402 children (3-5 years) attending local kindergartens participated in the study. The International Study of Asthma and Allergies in Childhood (ISAAC) written questionnaire (WQ) was used with additional questions on risk factors, asthma diagnosis, treatments, resource utilization. Allergic sensitisation was evaluated by skin prick tests for the common allergens. Prevalence of "wheezing in previous 12 months" and "doctor diagnosed asthma" were 12.1% and 8.6%, respectively. 4.7% of children have had both wheezing in the last 12 months and asthma diagnosis. Significant risk factors for wheezing were rhinitis, parental history of atopy and sensitivity to mites and grass pollens. 27.3% of children with asthma diagnosis, but only 4.9% of children without diagnosis, received regular treatment during the previous year (p<0.0001). Children with more than 4 episodes of wheezing a year received more frequently an asthma diagnosis, but 68.6% were not on regular treatment. Asthma diagnosis was associated with a significant increase in control visits for wheezing (p<0.0001). The prevalence of children requiring at least one hospital emergency visit in the previous year was not different among the two groups (83.3% vs. 82.5%). In preschool children the prevalence of wheezing and asthma is elevated. Preschool asthma seems to be under-treated with few cases receiving regular therapy. The social cost of the disease at this age seems to be elevated because of the high frequency of control and emergency visits.

  4. Diagnostic values of combination of free running asthma screening test and total serum allergen IgE level in children with asthma

    Institute of Scientific and Technical Information of China (English)

    Chen Xin; Li Yong; Zeng Meiying

    2014-01-01

    Background A free running asthma screening test is usually used for screening exercise-induced bronchoconstriction.The total serum allergen IgE level can reveal the patient's atopy characteristics.Our study is to evaluate the diagnostic values of the combination of the two tests in asthmatic children and compare this new diagnostic method with the Intemational Study of Asthma and Allergies in Childhood (ISSAC) questionnaires and the bronchial provocation test,which are popular diagnostic tool for pediatric asthma.Methods A total of 773 school children were recruited in this study.The children's asthma was diagnosed by means of a combination of the free running asthma screening test and total serum allergen IgE level.The new diagnostic method value was assessed using receiver operating characteristic (ROC) curves and compared with other diagnostic tools such as ISSAC questionnaires and the bronchial provocation test.Results The AUC of this new diagnostic method was higher than 0.9.When the cut-off value of total serum allergen IgE level was ≥47 KU/L,the sensitivity and the specificity were 71.4% and 85.1%,respectively,which were better than those of either the ISSAC questionnaires or bronchial provocation test.Conclusion The combination of the free running asthma screening test and total serum allergen IgE level may be an effective diagnostic tool for children's asthma.

  5. Air Pollutants, Climate, and the Prevalence of Pediatric Asthma in Urban Areas of China

    Science.gov (United States)

    Zhang, Juanjuan; Yan, Li; Fu, Wenlong; Yi, Jing; Chen, Yuzhi; Liu, Chuanhe; Xu, Dongqun; Wang, Qiang

    2016-01-01

    Background. Prevalence of childhood asthma varies significantly among regions, while its reasons are not clear yet with only a few studies reporting relevant causes for this variation. Objective. To investigate the potential role of city-average levels of air pollutants and climatic factors in order to distinguish differences in asthma prevalence in China and explain their reasons. Methods. Data pertaining to 10,777 asthmatic patients were obtained from the third nationwide survey of childhood asthma in China's urban areas. Annual mean concentrations of air pollutants and other climatic factors were obtained for the same period from several government departments. Data analysis was implemented with descriptive statistics, Pearson correlation coefficient, and multiple regression analysis. Results. Pearson correlation analysis showed that the situation of childhood asthma was strongly linked with SO2, relative humidity, and hours of sunshine (p air pollutants or climate, at least in terms of children, plays a major role in explaining regional differences in asthma prevalence in China. PMID:27556031

  6. Ion channels in asthma.

    Science.gov (United States)

    Valverde, Miguel A; Cantero-Recasens, Gerard; Garcia-Elias, Anna; Jung, Carole; Carreras-Sureda, Amado; Vicente, Rubén

    2011-09-23

    Ion channels are specialized transmembrane proteins that permit the passive flow of ions following their electrochemical gradients. In the airways, ion channels participate in the production of epithelium-based hydroelectrolytic secretions and in the control of intracellular Ca(2+) levels that will ultimately activate almost all lung cells, either resident or circulating. Thus, ion channels have been the center of many studies aiming to understand asthma pathophysiological mechanisms or to identify therapeutic targets for better control of the disease. In this minireview, we focus on molecular, genetic, and animal model studies associating ion channels with asthma.

  7. Childhood immunization and atopic disease into middle-age--a prospective cohort study.

    Science.gov (United States)

    Matheson, Melanie C; Haydn Walters, E; Burgess, John A; Jenkins, Mark A; Giles, Graham G; Hopper, John L; Abramson, Michael J; Dharmage, Shyamali C

    2010-03-01

    The association between childhood immunizations and risk of atopic diseases is unclear. No study has examined possible associations between childhood immunizations and such diseases in middle age. The Tasmanian Longitudinal Health Study (TAHS) is a population based cohort study of respiratory disease. The TAHS participants were followed from 7 to 44 yrs of age. Immunizations during childhood were examined for any association with asthma and atopic disease at age 44 yrs. Multivariable regression models were used to estimate relative risks while adjusting for confounders. Cox regression was used to estimate the association between childhood immunizations and asthma developing after the age of 7 yrs. We found no association between any childhood immunization (Diphtheria, Tetanus, Pertussis, Polio, Smallpox) and asthma (ORs ranged from 0.87 to 1.17 p > 0.05), eczema (ORs ranged from 0.99 to 1.07 p > 0.05), food allergy (ORs ranged from 0.97 to 1.11 p > 0.05), or hay fever (ORs ranged from 1.02 to 1.05 p > 0.05) at age 44. Nor did we find any association between childhood immunizations and an increased risk of incident asthma after the age of 7 yrs (Diphtheria HR = 1.06, 95% CI 0.82, 1.36; Tetanus HR = 1.13, 95% CI 0.88, 1.44; Pertussis HR = 1.03, 95% CI 0.81, 1.30; Polio HR = 1.15, 95% CI 0.86, 1.54; Smallpox HR = 1.21, 95% CI 0.99, 1.48; DTP HR = 1.05, 95% CI 0.85, 1.30). Our analysis does not support any association between common childhood immunizations and risk of asthma and atopic disease in middle-age. Our findings should provide reassurance that in terms of life time risk of asthma and atopic disease, childhood immunization is safe.

  8. Coeliac disease and asthma association in children: the role of antibiotic consumption.

    Science.gov (United States)

    Canova, Cristina; Pitter, Gisella; Ludvigsson, Jonas F; Romor, Pierantonio; Zanier, Loris; Zanotti, Renzo; Simonato, Lorenzo

    2015-07-01

    The relationship between coeliac disease and asthma has been scarcely investigated. Infant antibiotic exposure has been linked to both diseases. We evaluated the association between childhood coeliac disease and asthma and the role of antibiotics in the first year of life. We followed a cohort of children born in 1995-2011 in the Friuli-Venezia Giulia region (Italy). Prescriptions for antibiotics in the first year of life and subsequent treated asthma were retrieved from drug prescription records; coeliac disease incident cases were identified from pathology reports, hospital discharges and exemption from prescription charges for clinical tests. We estimated incidence rate ratios (IRRs) using multivariate Poisson regression models. Among the 143,144 children, we identified 717 coeliac children and 34,969 asthmatics. Children with asthma were at increased risk of coeliac disease (IRR 1.46, 95% CI 1.25-1.67). Restricting the analysis to asthma that occurred before the diagnosis of coeliac disease, the excess risk disappeared, except for coeliac disease diagnosed after 5 years of age (IRR 1.37, 95% CI 1.09-1.71). Antibiotics were not a confounding factor in these associations. Childhood treated asthma and coeliac disease are significantly associated. This association is not confounded by antibiotic exposure in the first year of life and may be explained by other shared risk factors.

  9. INFLUENCE OF A POSITIVE FAMILY HISTORY AND ASSOCIATED ALLERGIC DISEASES ON THE NATURAL COURSE OF ASTHMA

    NARCIS (Netherlands)

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

    1992-01-01

    The outcome of childhood asthma was studied in a cohort of 406 asthmatic children, with emphasis on the influence of family history for allergic disease, as well as the influence of associated allergic diseases on prognosis. Sixty-two per cent had a positive family history for atopy. In young adulth

  10. Maternal high-dose folic acid during pregnancy and asthma medication in the offspring

    NARCIS (Netherlands)

    Zetstra-van der Woude, Priscilla A.; De Walle, Hermien E. K.; Hoek, Annemieke; Bos, H. Jens; Boezen, H. Marike; Koppelman, Gerhard H.; de Jong-van den Berg, Lolkje T. W.; Scholtens, Salome

    2014-01-01

    Purpose Low-dose folic acid supplementation (0.5 mg) taken during pregnancy has been associated with an increased risk for childhood asthma. The effect of high-dose folic acid (5 mg) advised to women at risk for having a child with neural tube defect has not been assessed so far. Our aim was to inve

  11. Maternal smoking in pregnancy and asthma in preschool children: a pooled analysis of eight birth cohorts

    NARCIS (Netherlands)

    Neuman, A.; Hohmann, C.; Pershagen, G.; Eller, E.; Kjaer, H.F.; Gehring, U.; Granell, R.; Henderson, J.; Lau, S.; Nieuwenhuijsen, M.; Sunyer, J.; Tischer, C.; Torrent, M.; Wahn, U.; Wijga, A.H.; Wickman, M.; Keil, T.; Bergström, A.

    2012-01-01

    Rationale: Although epidemiological studies suggest that exposure to maternal smoking during fetal and early life increases the risk of childhood wheezing and asthma, previous studies were not able to differentiate the effects of prenatal from postnatal exposure. Objectives: To assess the effect of

  12. Dysfunctional breathing in children with asthma : a rare but relevant comorbidity

    NARCIS (Netherlands)

    de Groot, Eric P.; Duiverman, Eric J.; Brand, Paul L. P.

    2013-01-01

    Hyperventilation and other clinical manifestations of dysfunctional breathing have been reported in childhood, but the prevalence is unknown. In adults, dysfunctional breathing may be a relevant comorbidity in asthma. We aimed to determine the prevalence of dysfunctional breathing in children with a

  13. Fish Oil-Derived Fatty Acids in Pregnancy and Wheeze and Asthma in Offspring

    DEFF Research Database (Denmark)

    Bisgaard, Hans; Stokholm, Jakob; Chawes, Bo L.

    2016-01-01

    in their offspring. Methods: We randomly assigned 736 pregnant women at 24 weeks of gestation to receive 2.4 g of n-3 LCPUFA (fish oil) or placebo (olive oil) per day. Their children formed the Copenhagen Prospective Studies on Asthma in Childhood2010 (COPSAC2010) cohort and were followed prospectively...

  14. L-Carnitine Improves the Asthma Control in Children with Moderate Persistent Asthma

    Directory of Open Access Journals (Sweden)

    Mohammed Al-Biltagi

    2012-01-01

    Full Text Available The objective. was to investigate L-Carnitine level and the effects of its supplementation in children with moderate persistent Asthma. Methods. Free and total serum carnitine levels were measured in 50 children having moderate persistent asthma and 50 healthy control children. The patients group was randomly divided into two subgroups. Subgroup A was supplemented with L-carnitine for 6 months while subgroup B was used as a placebo controls. Both subgroups were assessed by pulmonary function tests (PFT and childhood-asthma control test (C-ACT before and 6 months after carnitine supplementation. Results. Total and free carnitine levels were significantly lower in patient group than in control group. PFT and C-ACT showed significant improvements in asthmatic children supplemented with L-carnitine than in those who were not supplemented. Conclusion. L-carnitine levels were initially lower in moderate persistent asthmatic children as compared to healthy control children. Asthmatic children who received L-carnitine supplementation showed statistically significant improvement of C-ACT and PFT.

  15. Food Consumption and Prevalence of Asthma & Allergies Symptoms in Children

    Directory of Open Access Journals (Sweden)

    M Karimi

    2011-03-01

    Full Text Available Introduction: The prevalence of asthma and allergy has increased significantly over the last 30 years. Genetic factors cannot explain this prevalence and a number of studies have been performed to determine the Environmental factors especially dietary factors which are effective in the incidence of these diseases. The aim of this study is to investigate the association between the food consumption and the subsequent development of asthma and other allergic disorder symptoms in 2003 of children in yazd. Methods: We performed a Descriptive cross-sectional study of selected children in primary and secondary schools in Yazd. Standardized questionnaire(ISAAC that was developed based on the International Study of Asthma and Allergies in Childhood were distributed to parents of 2768 children aged 6-7 years and 3201 children aged 13-14 years which randomly selected. The data was analyzed by Epi6.04 and SPSS softwares. Results: The prevalence of asthma, Allergic Rhinitis and Eczema symptoms in children 6-7 years old was 10.9%, 15.5% and 7.3% and in children 13-14 years old was 20.3 %, 42.7% and 14.8% respectively. High intake of butter-fat, chocolate, sweet and Sausage were associated with an increased risk of allergic rhinitis in children 6-7 years old. High intake of chocolate, Chips, egg were associated with an increased risk of wheeze and in children 13-14 years old. Conclusion: Dietary factors are associated with asthma and allergies symptoms. Fast foods, chocolates, junk foods & sausage may increase wheezing and allergic rhinitis & eczema symptoms in childhood

  16. Asthma and obesity in children: current evidence and potential systems biology approaches.

    Science.gov (United States)

    Frey, U; Latzin, P; Usemann, J; Maccora, J; Zumsteg, U; Kriemler, S

    2015-01-01

    Both obesity and asthma are highly prevalent, complex diseases modified by multiple factors. Genetic, developmental, lung mechanical, immunological and behavioural factors have all been suggested as playing a causal role between the two entities; however, their complex mechanistic interactions are still poorly understood and evidence of causality in children remains scant. Equally lacking is evidence of effective treatment strategies, despite the fact that imbalances at vulnerable phases in childhood can impact long-term health. This review is targeted at both clinicians frequently faced with the dilemma of how to investigate and treat the obese asthmatic child and researchers interested in the topic. Highlighting the breadth of the spectrum of factors involved, this review collates evidence regarding the investigation and treatment of asthma in obese children, particularly in comparison with current approaches in 'difficult-to-treat' childhood asthma. Finally, the authors propose hypotheses for future research from a systems-based perspective.

  17. Allergy, asthma and the environment; Allergie, Asthma und Umwelt

    Energy Technology Data Exchange (ETDEWEB)

    Ring, J. [Klinik und Poliklinik fuer Dermatologie und Allergologie am Biederstein, Technische Univ. Muenchen (Germany); Gfesser, M. [Klinik und Poliklinik fuer Dermatologie und Allergologie am Biederstein, Technische Univ. Muenchen (Germany)

    1996-10-11

    Asthma is a chronic inflammatory disease of the airways. Asthma and other allergic diseases have increased in prevalence during the last decades in many industrialized countries. Among other hypotheses, the possible role of environmental pollutants has received much public and scientific attention. Some pollutants may modulate the different phases of allergic reactions. Inflammation is a critical feature in the pathogenesis of asthma and therefore, beside allergen avoidance, anti-inflammatory treatment is the first line therapy of asthma. Cysteinyl-leukotrienes are lipid mediators which appear to play a major role in the pathophysiology of asthma. Based on current data, it appears that leukotrience receptor antagonists have bronchodilative and anti-inflammatory effects and may therefore enrich the pharmacotherapeutic spectrum within the therapeutic concept of patient management in asthma. (orig.) [Deutsch] Asthma bronchiale ist eine entzuendliche Erkrankung der Atemwege. Epidemiologische Studien konnten eine deutliche Zunahme der Erkrankung in den letzten zwei Jahrzehnten aufzeigen. In der Entstehung von Allergien und Asthma bronchiale spielen Umwelteinfluesse eine grosse Rolle. Luftschadstoffe scheinen mit verschiedenen Allergie-Parametern bei der Sensibilisierung, Symptombildung und Chronifizierung zu interferieren. Da beim Asthma bronchiale neben der Bronchokonstriktion die Entzuendung der Bronchialschleimhaut eine besondere Rolle spielt, wird heute neben Allergenkarenz und prophylaktischen Massnahmen eine fruehzeitige antientzuendliche Asthmatherapie angestrebt. Cysteinyl-Leukotriene gehoeren zu den wirksamsten Entzuendungsmediatoren beim Asthma bronchiale. Leukotrien-Rezeptorantagonisten scheinen sowohl bronchodilatatorische als auch antientzuendliche Wirkungen zu haben und koennten so innerhalb eines Gesamtkonzeptes von antiallergischer und antiasthmatischer Therapie das pharmakotherapeutische Spektrum bereichern. (orig.)

  18. 上海嘉定地区儿童过敏原调查及过敏原与支气管哮喘的相关性%Allergens and their relationships to childhood bronchial asthma in the Jiading District of Shanghai

    Institute of Scientific and Technical Information of China (English)

    董蔚; 盛军; 顾秀明; 严华杰; 曾春云; 徐慧婷; 钱丹; 黄秋兰; 邵洁

    2012-01-01

    Objective To study allergens and their relationship to the occurrence of childhood bronchial asthma in the Jiading District of Shanghai. Methods Three hundred and eighty-two 4 to 12-year-old children with asthma in the remission stage from Nanxiang Hospital in the Jiading District of Shanghai were used as a case group (asthma group), and 402 children from two primary schools and two kindergartens in Jiading were enrolled by cluster sampling and served as control group. Parents of the children completed a questionnaire on living conditions and allergy-related disease history. Skin prick test ( SPT) for 18 common allergens was carried out in both groups. In order to examine the effect of environment and living conditions on SPT results, children in the control group were further divided into two sub-groups according to birth place: migrant (219 cases) and resident (183 cases). Results SPT results revealed that the main allergens identified in the Jiading region were dermatophagoides farinae, house dust mites, shrimps, cockroaches, and dog hair. The SPT positive rate was 67.9% in the asthma group, and this was significantly higher than in the control group (31.8%) (P<0.01). The environment and living conditions in the migrant group were significantly different from the resident group (P <0.01), whereas the SPT positive rate for this group was significantly lower than in the resident group (P < 0. 01). Conclusions Allergens in the Jiading region mainly originate from dermatophagoides farinae, household dust mites, shrimps, cockroaches and dog hair. Children with asthma are more susceptible to allergens. Environment and living conditions may be relevant, to a certain extent, to an SPT positive rate.%目的 分析上海嘉定地区过敏原及其与支气管哮喘发生的相关性.方法 上海嘉定南翔医院382例4-12岁缓解期支气管哮喘患儿作为病例组(哮喘组),采用整群随机法抽取上海嘉定地区2所学校和2所幼儿园402例4~10岁儿

  19. Bronchial Thermoplasty in Asthma

    Directory of Open Access Journals (Sweden)

    Wayne Mitzner

    2006-01-01

    Full Text Available In this review we discuss the potential of a new procedure, termed Bronchial Thermoplasty to prevent serious consequences resulting from excessive airway narrowing. The most important factor in minimizing an asthmatic attack is limiting the degree of smooth muscle shortening. The premise that airway smooth muscle can be either inactivated or obliterated without any long-term alteration of other lung tissues, and that airway function will remain normal, albeit with reduced bronchoconstriction, has now been demonstrated in dogs, a subset of normal subjects, and mild asthmatics. Bronchial Thermoplasty may thus develop into a useful clinical procedure to effectively impair the ability for airway smooth muscle to reach the levels of pathologic narrowing that characterizes an asthma attack. It may also enable more successful treatment of asthma patients who are unresponsive to more conventional therapies. Whether this will remain stable for the lifetime of the patient still remains to be determined, but at the present time, there are no indications that the smooth muscle contractility will return. This successful preliminary experience showing that Bronchial Thermoplasty could be safely performed in patients with asthma has led to an ongoing clinical trial at a number of sites in Europe and North America designed to examine the effectiveness of this procedure in subjects with moderately severe asthma.

  20. Elastin in asthma

    NARCIS (Netherlands)

    Reddel, Caroline J; Weiss, Anthony S; Burgess, Janette K

    2012-01-01

    Extracellular matrix is generally increased in asthma, causing thickening of the airways which may either increase or decrease airway responsiveness, depending on the mechanical requirements of the deposited matrix. However, in vitro studies have shown that the altered extracellular matrix produced